Medicina clinica (English ed.)最新文献_第4页

Restrictive vs. liberal transfusion strategy in patients with chronic kidney disease: A retrospective cohort study 慢性肾病患者限制性与自由输血策略：一项回顾性队列研究

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-03-04 DOI: 10.1016/j.medcle.2026.107308

Mylena Benitez-Valderrama , Priscila Suárez-Puga , Jimmy Martin-Delgado , Fahd Beddar-Chaib , Manuel Méndez-Bailón , Jorge Carriel-Mancilla

{"title":"Restrictive vs. liberal transfusion strategy in patients with chronic kidney disease: A retrospective cohort study","authors":"Mylena Benitez-Valderrama , Priscila Suárez-Puga , Jimmy Martin-Delgado , Fahd Beddar-Chaib , Manuel Méndez-Bailón , Jorge Carriel-Mancilla","doi":"10.1016/j.medcle.2026.107308","DOIUrl":"10.1016/j.medcle.2026.107308","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD) is associated with anemia, a common complication that, in severe cases, requires red blood cell (RBC) transfusion. The optimal haemoglobin threshold for deciding when to transfuse remains a matter of debate. This study aimed to compare the effects of a restrictive transfusion strategy (Hemoglobin [Hb] ≤ 7 g/dL) versus a liberal strategy (Hb > 7 g/dL) in hospitalised patients with CKD.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort study was conducted between December 2022 and December 2023, including adult patients with CKD stages G3b, G4, and G5 who received RBC transfusions. Demographic data, comorbidities, clinical, laboratory, and prognostic variables were analyzed, including admission to the Intensive Care Unit (ICU), hospital length of stay, pulmonary complications, and transfusion-related adverse events.</div></div><div><h3>Results</h3><div>Of 934 patients evaluated, 682 met the inclusion criteria. The restrictive transfusion group (<em>n</em> = 341) showed a lower ICU admission rate (6.5% vs. 14.7%, <em>p</em> < 0.001) and fewer transfusion-related adverse events (<em>p</em> < 0.001). A prolonged hospital stay (>10 days) was more frequent in the liberal group (32% vs. 10.5%, <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>The restrictive strategy was associated with fewer complications and a shorter hospital stay, which appears to support a restrictive transfusion approach in patients with chronic kidney disease (CKD).</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 2","pages":"Article 107308"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147454174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Hepatitis E virus: An emerging public health problem 戊型肝炎病毒：一个新出现的公共卫生问题

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-02-20 DOI: 10.1016/j.medcle.2026.107286

María Teresa Pérez-Gracia, Lara Martínez-Celdrán, Clara Más-Comes

引用次数: 0

Acute macular neuroretinopathy in the context of autoimmune demyelinating disease of the central nervous system 中枢神经系统自身免疫性脱髓鞘疾病的急性黄斑神经视网膜病变

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-02-21 DOI: 10.1016/j.medcle.2026.107240

Julia López Martínez, Alberto García-Ortega, Javier Montañez Campos

引用次数: 0

Takayasu’s arteritis: normalization of FDG PET-CT after treatment with upadacitinib 高松动脉炎：upadacitinib治疗后FDG PET-CT恢复正常

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-03-04 DOI: 10.1016/j.medcle.2026.107350

Jose Luis Callejas Rubio , Maria Dolores Martinez-Valle Torres , Antonio Torres Gómez , Marta García Morales

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Fondaparinux-associated thrombocytopenia as a cause of bilateral pulmonary embolism fondaparinux相关的血小板减少症是双侧肺栓塞的一个原因

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-03-13 DOI: 10.1016/j.medcle.2026.107328

M. Acebo Castro, J.D. Álvarez Mavárez, C. Mañana Valdés

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Clinical implications of cardiac involvement in Q fever: Findings from a Spanish cohort Q热患者心脏受累的临床意义：来自西班牙队列的研究结果

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-03-13 DOI: 10.1016/j.medcle.2026.107311

Ester Mínguez de la Guía , Macarena López Vázquez , Jose Javier Blanch Sancho , Raúl Calvo Córdoba , Francisco Manuel Salmeron Martínez , Miguel Corbí Pascual

{"title":"Clinical implications of cardiac involvement in Q fever: Findings from a Spanish cohort","authors":"Ester Mínguez de la Guía , Macarena López Vázquez , Jose Javier Blanch Sancho , Raúl Calvo Córdoba , Francisco Manuel Salmeron Martínez , Miguel Corbí Pascual","doi":"10.1016/j.medcle.2026.107311","DOIUrl":"10.1016/j.medcle.2026.107311","url":null,"abstract":"<div><h3>Introduction</h3><div>Q fever is a zoonosis caused by <em>Coxiella burnetii</em>. Spain reports the highest incidence in Europe. Its chronic form may present as infective endocarditis, though other cardiac complications have also been described.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of patients admitted for Q fever at a tertiary hospital between 2000 and 2023. Only microbiologically confirmed cases were included. Clinical presentation was analyzed, focusing on patients with cardiac involvement.</div></div><div><h3>Results</h3><div>A total of 42 patients were included (66.6% male, mean age 49.7±20.6 years); 28 (66.7%) had acute Q fever and 14 (33.3%) chronic. Cardiac involvement was identified in 12 patients (28.5%): 7 with infective endocarditis (all chronic), 3 with myocarditis (2 progressed to dilated cardiomyopathy), and 2 with pericarditis. Overall mortality among patients with cardiac involvement was 25%.</div></div><div><h3>Conclusion</h3><div>Cardiac manifestations in Q fever may be underdiagnosed. In our cohort, cardiac involvement was frequent and associated with high mortality. Clinicians should maintain a high index of suspicion, especially in chronic Q fever or in patients with fever of unknown origin.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 2","pages":"Article 107311"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147453672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evidence-based guidelines on the use of prebiotics and probiotics in digestive diseases 在消化系统疾病中使用益生元和益生菌的循证指南

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-03-04 DOI: 10.1016/j.medcle.2026.107344

Mario Álvarez-Díez , María Varela , Adolfo Suárez , Sabino Riestra

引用次数: 0

Value of carbohydrate antigen 125 in pleural effusion from acute heart failure and its relationship with atrial fibrillation 急性心力衰竭胸腔积液碳水化合物抗原125的价值及其与房颤的关系

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-03-04 DOI: 10.1016/j.medcle.2026.107316

Esteban Pérez Pisón , Pau Llàcer , François Croset , Jorge Campos , Marina García Melero , Carlos Pérez , Alberto Pérez Nieva , Marina Vergara , Paul Cevallos , Cristina Fernández , Martín Fabregate , Luis Manzano

{"title":"Value of carbohydrate antigen 125 in pleural effusion from acute heart failure and its relationship with atrial fibrillation","authors":"Esteban Pérez Pisón , Pau Llàcer , François Croset , Jorge Campos , Marina García Melero , Carlos Pérez , Alberto Pérez Nieva , Marina Vergara , Paul Cevallos , Cristina Fernández , Martín Fabregate , Luis Manzano","doi":"10.1016/j.medcle.2026.107316","DOIUrl":"10.1016/j.medcle.2026.107316","url":null,"abstract":"<div><h3>Background</h3><div>Pleural effusion (PE) is a frequent complication in acute heart failure (AHF), driven by hydrostatic pressure, impaired lymphatic drainage, and systemic inflammation. This study aimed to evaluate the association between carbohydrate antigen 125 (CA125) and the presence of PE, stratified by atrial fibrillation (AF).</div></div><div><h3>Methods</h3><div>This retrospective observational study analyzed 506 patients hospitalized with AHF at Ramón y Cajal University Hospital. The presence of PE was assessed through bedside thoracic ultrasound or chest radiography. A multivariable logistic regression model was employed to identify independent predictors of PE. Interaction analyses were conducted to examine the combined effect of CA125 levels and AF on the likelihood of PE.</div></div><div><h3>Results</h3><div>The mean (SD) age was 85.1 years (7.8) and 66.0% were women. PE was identified in 43.7% of patients at admission, AF were present in 299 (59.1%) and median values CA125 were 58.8 U/mL (43.0–89.0). After multivariable adjustment, an interaction between CA125 and AF emerged as a significant predictor of PE (p for the interaction = 0.022). Each 10U/mL increase in CA125 was associated with an OR of 1.03, 95% CI: 1.01–1.06 for every 10 U/mL increase in CA125 levels.</div></div><div><h3>Conclusions</h3><div>In patients with acute heart failure, the predictive value of CA125 for pleural effusion is influenced by atrial fibrillation. Elevated CA125 levels were associated with PE only in the presence of AF. Conversely, in the absence of AF, high CA125 levels did not predict PE.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 2","pages":"Article 107316"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147454249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The utility of lung ultrasound and KL-6 values for the screening of rheumatoid arthritis-associated interstitial lung disease: An exploratory study 肺超声和KL-6值在类风湿关节炎相关间质性肺疾病筛查中的应用：一项探索性研究

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-03-13 DOI: 10.1016/j.medcle.2026.107340

Ivette Casafont-Solé , Irene Peralta-Garcia , Carmen Centeno , María Martínez-Bujidos , Paloma Millán-Billi , Susana Holgado , Pau Alcubilla , Ignasi Guasch , Karina Portillo

{"title":"The utility of lung ultrasound and KL-6 values for the screening of rheumatoid arthritis-associated interstitial lung disease: An exploratory study","authors":"Ivette Casafont-Solé , Irene Peralta-Garcia , Carmen Centeno , María Martínez-Bujidos , Paloma Millán-Billi , Susana Holgado , Pau Alcubilla , Ignasi Guasch , Karina Portillo","doi":"10.1016/j.medcle.2026.107340","DOIUrl":"10.1016/j.medcle.2026.107340","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the utility of lung ultrasound (LUS) and serum KL-6 levels as screening tools for interstitial lung disease (ILD) in seropositive rheumatoid arthritis (RA) patients, as well as their correlation with ILD extent on high-resolution computed tomography (HRCT).</div></div><div><h3>Methods</h3><div>A single-center exploratory study including 20 seropositive RA patients with recent HRCT scans (<2 years) was conducted. Clinical data and pulmonary function tests were recorded. Patients were classified as RA-ILD (<em>n</em>  =10). LUS assessed 14 intercostal spaces for B-lines and pleural abnormalities. Serum KL-6 was measured by chemiluminescence immunoassay. HRCT was evaluated by an expert radiologist to quantify ILD extent.</div></div><div><h3>Results</h3><div>KL-6 levels were higher in RA-ILD patients (<em>p</em>  =0.003), and 5–10 B-lines per field were suggestive of ILD (<em>p</em>  =0.035). Anterior lung fields were more specifically involved in RA-ILD. B-lines number correlated with ILD extent on HRCT (<em>p</em>  <!-->0.001).</div></div><div><h3>Conclusions</h3><div>KL-6 and LUS are useful non-invasive screening tools for ILD in seropositive RA patients. A simplified LUS focusing on anterior fields may offer a rapid, reproducible method. Larger prospective studies are needed to establish cut-off values and validate clinical use.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 2","pages":"Article 107340"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147454267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unlocking the potential of nailfold videocapillaroscopy in diagnosing and staging wild-type transthyretin amyloidosis: A preliminary approach 甲襞视频毛细血管镜检在野生型转甲状腺蛋白淀粉样变性诊断和分期中的潜力：初步方法

Medicina clinica (English ed.) Pub Date : 2026-02-01 Epub Date: 2026-03-13 DOI: 10.1016/j.medcle.2026.107283

Laura Pérez Abad , Miguel Ángel Aibar Arregui , Jimena Aramburu Llorente , Juan Ramón y Cajal Calvo , Alejandro Andrés Gracia , Pablo Revilla Martí , Saida Atienza Ayala , Carmen Lahuerta Pueyo , Amelia Campos Sáenz de Santamaría , Eduardo Ramos Ibañez , Borja del Carmelo Gracia Tello

{"title":"Unlocking the potential of nailfold videocapillaroscopy in diagnosing and staging wild-type transthyretin amyloidosis: A preliminary approach","authors":"Laura Pérez Abad , Miguel Ángel Aibar Arregui , Jimena Aramburu Llorente , Juan Ramón y Cajal Calvo , Alejandro Andrés Gracia , Pablo Revilla Martí , Saida Atienza Ayala , Carmen Lahuerta Pueyo , Amelia Campos Sáenz de Santamaría , Eduardo Ramos Ibañez , Borja del Carmelo Gracia Tello","doi":"10.1016/j.medcle.2026.107283","DOIUrl":"10.1016/j.medcle.2026.107283","url":null,"abstract":"<div><h3>Background</h3><div>Wild-type transthyretin amyloidosis (ATTRwt) is a serious condition. At early stages, symptoms resemble those of heart failure with preserved ejection fraction (HFpEF). Our aim was to perform software-supported nailfold videocapillaroscopy (NVC) analysis to identify hallmarks useful for diagnosis and build machine learning (ML)-based models to assess severity.</div></div><div><h3>Methods</h3><div>Thirty-two ATTRwt patients underwent NVC. Nineteen initiated TTR-stabilizing therapy and had a new NVC 12 months afterwards. Forty-one capillary-related variables were analyzed. Thirty NVCs were randomly chosen to train models to discriminate between poorer or less poor prognosis according to N-terminal pro-B-type natriuretic peptide (NT-proBNP) or Cheng score (cut-offs: 2000pg/mL and 4 points, respectively). The remaining 21 NVCs were used for validation purposes. A control population of 99 patients with heart failure with preserved ejection fraction (HFpEF) but without signs of amyloidosis was included.</div></div><div><h3>Results</h3><div>A profound disorganization in the nailfold capillary architecture was generally observed. The models achieved accuracies of 0.81 and 0.90, respectively, in predicting disease severity. An additional model designed to distinguish a profile suggestive of amyloidosis (vs. HFpEF controls) achieved an accuracy of 0.73.</div></div><div><h3>Conclusions</h3><div>NVC-based ML models may contribute to early diagnosis and staging of ATTRwt.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 2","pages":"Article 107283"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147454269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0