Medicina clinica (English ed.)最新文献

{"title":"Association of anti-CarP levels with clinical activity and serological profile in rheumatoid arthritis","authors":"Pablo Martínez Calabuig ,&nbsp;Elena Grau García ,&nbsp;José Andrés Román Ivorra","doi":"10.1016/j.medcle.2025.107045","DOIUrl":"10.1016/j.medcle.2025.107045","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the association of anti-CarP levels with clinical activity, manifestations, and serological profile in rheumatoid arthritis (RA) patients.</div></div><div><h3>Methods</h3><div>Cross-sectional study including RA patients and healthy controls (HC). Clinical and analytical data were collected, and anti-CarP levels were measured by ELISA.</div></div><div><h3>Results</h3><div>A total of 101 patients (79% female, mean age 45), and 98 HC (67% female, mean age 55) were included. RA patients had significantly higher anti-CarP levels than HC (<em>p</em> <!-->&lt;<!--> <!-->0.001), increasing with age (<em>p</em> <!-->=<!--> <!-->0.004). Anti-CarP correlated with RF and ACPA positivity (<em>p</em> <!-->&lt;<!--> <!-->0.001). Those patients with RF/ACPA positive showed the highest anti-CarP levels compared to other groups (<em>p</em> <!-->&lt;<!--> <!-->0.001).</div><div>The threshold for elevated anti-CarP was set at 17.2<!--> <!-->ng/mL. Among 35 patients with elevated anti-CarP, 32 were RF/ACPA double-positive (<em>p</em> <!-->=<!--> <!-->0.006), and 3 were seronegative. Elevated anti-CarP levels were associated to clinical activity, tender joints (<em>p</em> <!-->=<!--> <!-->0.002), the presence of rheumatoid nodules and interstitial lung disease, but not with Sharp/van der Heijde score, joint damage progression or Sjögren syndrome.</div></div><div><h3>Conclusions</h3><div>RA patients exhibit higher anti-CarP levels, especially those with RF/ACPA double-positivity. Elevated levels correlate with higher disease activity and extra-articular involvement.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 3","pages":"Article 107045"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005286","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}

{"title":"Avoidable premature mortality and effectiveness of the health system to reduce it during the 21st century in Spain by region","authors":"Marta Donat ,&nbsp;Gregorio Barrio ,&nbsp;Juan Miguel Guerras ,&nbsp;Almudena Moreno ,&nbsp;Elena Ronda ,&nbsp;Julieta Politi ,&nbsp;María José Belza","doi":"10.1016/j.medcle.2025.107053","DOIUrl":"10.1016/j.medcle.2025.107053","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess inter-regional inequalities in avoidable mortality and in the effectiveness of the health system to reduce it during 2001−2022 in Spain.</div></div><div><h3>Materials and method</h3><div>An observational time trends study was performed, obtaining the following measures by region: age- and sex-standardized avoidable, preventable, treatable and non-avoidable mortality rates per 100,000 person-years, inter-annual rate differences (ARDs) in these mortalities, differences between the annual percentage changes (APCs) of avoidable and non-avoidable mortality (health system effectiveness against avoidable mortality), standard deviation and coefficient of variation (CV) of national mortality rates (absolute and relative inter-regional inequality, respectively), and difference between CVs in avoidable and non-avoidable mortality (health system contribution to inequality in avoidable mortality).</div></div><div><h3>Results</h3><div>In 2022, the highest avoidable mortality rates were observed in Asturias (218), the Canary Islands (208) and Andalusia (200), and the lowest in Madrid (142), Navarra (161) and La Rioja (165). During 2001−2022, avoidable mortality decreased in all communities, with the most unfavourable ARDs in Aragon (−2.8), Castile and Leon (−3.1), and Asturias (−3.2), and the lowest health system effectiveness in Castile-La Mancha, Madrid, Asturias and Aragon. The standard deviation of avoidable mortality also decreased (from 29.4 in 2001 to 20.2 in 2022), as well as the health system contribution to this inequality.</div></div><div><h3>Conclusions</h3><div>In Spain, important inter-regional inequalities in avoidable mortality persist, although during 2001−2022 its absolute inequality decreased. During this period, all regional health systems were effective in reducing avoidable mortality, and their contribution to inter-regional inequalities in such mortality decreased.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 3","pages":"Article 107053"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005442","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}

{"title":"Humoral immunogenicity after vaccination with the fourth dose of COVID-19 in patients with immunomediated inflammatory diseases","authors":"Yedra Usón-Rodríguez,&nbsp;Carlos Vázquez-Galeano,&nbsp;Julia Ulier-Bellmunt,&nbsp;Marta Medrano-San Ildefonso","doi":"10.1016/j.medcle.2025.106986","DOIUrl":"10.1016/j.medcle.2025.106986","url":null,"abstract":"<div><h3>Introduction</h3><div>On the whole, vaccines against COVID-19 have shown a good level of efficacy and safety, but in the subgroup of patients with immune-mediated inflammatory diseases there are contradictory data about the existence of an inadequate immune response after the administration of the vaccine. The objective of this study is to know and determine the immunogenicity generated after the administration of the vaccine against COVID-19 in patients with these diseases being treated with targeted therapies.</div></div><div><h3>Material and methods</h3><div>An analytical, observational and cross-sectional study was carried out at the Miguel Servet University Hospital in Zaragoza (Spain) of the Ab levels generated after the administration of the 4th dose of the COVID-19 vaccine in patients diagnosed with with immune-mediated inflammatory diseases and being treated with targeted therapies.</div></div><div><h3>Results</h3><div>A total of 243 patients were included. Only 3.3% of patients showed an inadequate post-vaccine immune response. It was observed that patients with seropositive rheumatoid arthritis showed a higher risk of presenting decreased post-vaccine antibodies IgG levels compared to other diseases such as spondyloarthritis B27 + (OR 0.039) or psoriatic arthritis (OR 0.023). Patients treated with tumour necrosis factor inhibitors drugs had a lower risk of generating decreased post-vaccine antibodies IgG levels compared to other targeted therapies such as abatacept (OR 20.03) or JAK inhibitors (OR 4.12).</div></div><div><h3>Conclusion</h3><div>The type of immune-mediated inflammatory diseases and the targeted therapy used influence the immune response generated after vaccination against COVID-19. The diagnosis of seropositive rheumatoid arthritis and the use of certain targeted therapies such as abatacept or JAK inhibitors influence negatively in the formation of antibodies IgG after vaccination.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106986"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686269","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}

{"title":"Local and extensive reactions due to Hymenoptera sting: Its relationship to systemic reactions","authors":"Alberto Palacios Cañas ,&nbsp;Miriam Clar Castelló ,&nbsp;Stephanie Bracamonte Odreman ,&nbsp;Esther Iniesta Tejera ,&nbsp;Alejandro Raúl Gratacós Gómez ,&nbsp;Elisa Gomez Torrijos","doi":"10.1016/j.medcle.2025.106982","DOIUrl":"10.1016/j.medcle.2025.106982","url":null,"abstract":"<div><h3>Introduction</h3><div>Hymenoptera stings (Hs) can cause allergic reactions to Hymenoptera venom (HV), both local and systemic. There is controversy regarding the risk of developing an HV-systemic reaction (HV-SR) after one or several previous extensive local allergic reactions (ELAR) due to HV.</div></div><div><h3>Objectives</h3><div>To evaluate the risk of HV-SR in patients who have suffered at least one previous ELAR due to HV, the relevance of sensitization to HV for suffering from SR-HV in the future, and the prevalence of sensitization to inhalants and foods.</div></div><div><h3>Methods</h3><div>A descriptive retrospective (first phase, years: 2000–2015) and prospective (second phase, years: 2016–2023) study were conducted with patients ELAR. We periodically reviewed the patients to detect HV-SR, sensitizations, and personal histories of ELAR.</div></div><div><h3>Results</h3><div>We examined 281 patients with ELAR to see if they had had HV-SR but detected only 2 patients with HV-SR. In the second phase, only 3 patients with HV-SR had a history of ELAR. HV-specific IgE was determined in 224 patients, of which 146 were sensitized to at least one HV. Using skin prick tests, we detected 54 patients sensitized to pollen and sensitized food to 8 patients.</div></div><div><h3>Conclusion</h3><div>Patients with ELAR due to an Hs have little chance of developing SR-HV, even though 2/3 of patients are sensitized to at least one HV. Atopic load is irrelevant for suffering a future HV-RS.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106982"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686833","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}

{"title":"Oropouche virus fever","authors":"Wilmer Silva-Caso,&nbsp;Juana del Valle-Mendoza","doi":"10.1016/j.medcle.2025.107010","DOIUrl":"10.1016/j.medcle.2025.107010","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 107010"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686834","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}

{"title":"Incorporation of the gender perspective in R + D + I projects in health. When and how","authors":"Isabel Ruiz-Perez ,&nbsp;Guadalupe Pastor-Moreno ,&nbsp;Clara Bermudez-Tamayo ,&nbsp;Vivian Benítez-Hidalgo ,&nbsp;Miguel Rodríguez-Barranco","doi":"10.1016/j.medcle.2025.106963","DOIUrl":"10.1016/j.medcle.2025.106963","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106963"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686837","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}

{"title":"Prevalence and evolution of post-COVID syndrome symptoms","authors":"Blanca Ayuso García ,&nbsp;Antía Pérez López ,&nbsp;Ramón Rabuñal Rey","doi":"10.1016/j.medcle.2025.106943","DOIUrl":"10.1016/j.medcle.2025.106943","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106943"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686842","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}

{"title":"Bilateral peripheral facial paralysis secondary to neuroborreliiosis","authors":"María Lalueza Cosculluela ,&nbsp;Laura Hernández Camacho ,&nbsp;Valentina Santacoloma Cardona","doi":"10.1016/j.medcle.2025.106961","DOIUrl":"10.1016/j.medcle.2025.106961","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106961"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686844","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}

{"title":"Hodgkin disease presenting as hemoptysis and mimicking lung cancer","authors":"Luis Gorospe ,&nbsp;Odile Ajuria-Illarramendi ,&nbsp;Rosa Mariela Mirambeaux-Villalona","doi":"10.1016/j.medcle.2025.106968","DOIUrl":"10.1016/j.medcle.2025.106968","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106968"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686402","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}

{"title":"Simpler modified Fried frailty scale: Translation and validation into Spanish","authors":"Celia Corral Tuesta ,&nbsp;Paula Sobrini Morillo ,&nbsp;Claudia Gabriela Álvarez Pinheiro ,&nbsp;Vicente Lavilla Gracia ,&nbsp;Susana Lippo ,&nbsp;Beatriz Montero Errasquín","doi":"10.1016/j.medcle.2025.106958","DOIUrl":"10.1016/j.medcle.2025.106958","url":null,"abstract":"<div><h3>Introduction</h3><div>The Fried phenotype is one of the most commonly used scales for assessing frailty, although its implementation in clinical practice can be complex. A simplified and modified version has been developed in Turkey, and the aim of this study is to translate and validate it into Spanish.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 100 participants. Internal consistency, inter-rater reliability, test-retest reliability, criterion validity (comparing the simplified and modified versions of Fried with the FRAIL scale), sensitivity, and specificity were evaluated.</div></div><div><h3>Results</h3><div>Inter-rater reliability and test-retest reliability were excellent (kappa indices of 0.83 and 0.86, respectively), while internal consistency was moderate (Cronbach's alpha of 0.67). Criterion validity was also moderate, with Cohen's kappa coefficients of 0.50 and 0.51 when compared to the modified version of Fried and FRAIL, achieving a sensitivity of 63% and a specificity of 89%.</div></div><div><h3>Conclusions</h3><div>The Spanish version shows excellent reliability but moderate internal consistency and validity, as well as low sensitivity. These limitations may hinder its utility in detecting frailty, potentially due to sample selection or cultural differences.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106958"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687039","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}