Medicina clinica (English ed.)最新文献

{"title":"Screening ECG for cardiovascular prevention","authors":"José Luis Hernández Hernández, Marta Martín Millán","doi":"10.1016/j.medcle.2025.01.004","DOIUrl":"10.1016/j.medcle.2025.01.004","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 358-360"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769073","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":"Association of smoking with the efficacy of continuous glucose monitoring in type 1 diabetes: A propensity score-matched cohort study","authors":"Fernando Sebastian-Valles ,&nbsp;Iñigo Hernando Alday ,&nbsp;Maria Sara Tapia-Sanchiz ,&nbsp;Juan José Raposo-López ,&nbsp;Jon Garai Hierro ,&nbsp;Victor Navas-Moreno ,&nbsp;Julia Martínez-Alfonso ,&nbsp;José Alfonso Arranz Martin ,&nbsp;Miguel Antonio Sampedro-Nuñez ,&nbsp;Mónica Marazuela","doi":"10.1016/j.medcle.2024.10.027","DOIUrl":"10.1016/j.medcle.2024.10.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Smoking affects glycemic control in individuals with type 1 diabetes (T1D); however, its impact in the era of continuous glucose monitoring (CGM) has not been thoroughly studied.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study was conducted at two centers, involving 405 T1D patients treated with multiple daily insulin injections and using CGM. The patients were matched using propensity scores based on sociodemographic and clinical characteristics. HbA1c levels were analysed before and after a 2.2-year follow-up period. The analysis was performed using mixed linear regression and multivariable conditional logistic models.</div></div><div><h3>Results</h3><div>The sample included 135 smokers and 270 non-smokers, with a mean age of 47.6 years, and 50.1% were women. Both groups had a similar baseline HbA1c of 8.0 (1.5%). After follow-up, non-smokers reduced their HbA1c to 7.3 (1.1%), while smokers only reduced it to 7.7 (1.3%), 95% CI [−0.57–0.10]). The proportion of non-smokers achieving HbA1c &lt;7% increased from 25% to 38.1%, 95% CI [0.14–0.36, whereas smokers showed no change (25.9%, 95% CI [−0.13–0.21]). Smoking was independently associated with a higher risk of not achieving HbA1c &lt;7%, despite CGM use (odds ratio 1.89, 95% CI [1.13–3.17].</div></div><div><h3>Conclusion</h3><div>Smoking limits the glycemic control benefits of CGM in individuals with T1D. It is crucial to include smokers in clinical trials and to develop strategies to discourage smoking in this population to maximise the benefits of diabetes technology.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 8","pages":"Pages 396-402"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860355","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":"Vascular Ehlers-Danlos syndrome, a therapeutic challenge","authors":"Antonio Padilla-Serrano,&nbsp;Alba Cebrián Cortés,&nbsp;Antonio Cárdenas Cruz","doi":"10.1016/j.medcle.2024.10.028","DOIUrl":"10.1016/j.medcle.2024.10.028","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 8","pages":"Pages 439-440"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860359","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":"Use of intravenous calcium in emergencies to treat patients with hyperkalemia and digoxin poisoning and its impact on short-term outcome","authors":"Pere Llorens ,&nbsp;María Mataix ,&nbsp;Matilde González Tejera ,&nbsp;Leticia Serrano ,&nbsp;Pablo Herrero-Puente ,&nbsp;María Luisa López-Grima ,&nbsp;Begoña Espinosa ,&nbsp;Francisco Javier Lucas-Imbernón ,&nbsp;María Pilar López-Díez ,&nbsp;Javier Millán ,&nbsp;Pilar Gallardo Rodríguez ,&nbsp;Pablo Chico-Sánchez ,&nbsp;Patricio Mas ,&nbsp;Paula Lafuente ,&nbsp;Cristina Calzón Blanco ,&nbsp;Òscar Miró","doi":"10.1016/j.medcle.2024.10.015","DOIUrl":"10.1016/j.medcle.2024.10.015","url":null,"abstract":"<div><h3>Objectives</h3><div>Patients with digitalis intoxication (DI) and hyperkalaemia are frequently encountered in the emergency department (ED). This alteration may require intravenous (iv) calcium, but its administration has been considered to increase cardiotoxicity and mortality in patients with DI. We studied the effect of iv calcium on mortality and 30-day readmission in patients with hyperkalaemia and DI.</div></div><div><h3>Methods</h3><div>A retrospective, multicentre, retrospective cohort study including all patients with DI and hyperkalaemia from 2004 to 2023 seen in 6 hospital emergency departments. Two cohorts were created according to iv calcium administration, and demographic, clinical, electrocardiographic and outcome variables (mortality, readmission and combined event at 30 days) were collected.</div></div><div><h3>Results</h3><div>117 patients with ID and hyperkalaemia were collected and 29% were administered iv calcium. Seventy-eight point six percent were women, with a median age of 82.8 years. Cardiological symptoms were present in 57.3%, 47% digestive and 37.6% neurological. Cardiac arrhythmia was present in 86.3%, the most frequent type being slow supraventricular arrhythmia in 76.1%. The presence of cardiological symptoms (76.5% vs 49.4, p = 0.007), arrhythmias (97.1% vs 81.9%, p = 0.037), and higher levels of creatinine (70.6% vs 42.2%, p = 0.005) and serum potassium (94.1% vs 31.3%, p &lt; 0.001) was more frequent in the group receiving iv calcium. An association was found between the administration of IV calcium. An association was found between calcium administration and the combined event at 30 days (ORa 3.11, 95% CI:1.02–9.53), but this increase was at the expense of more readmissions (ORa 3.58, 95% CI, 1.04–12,33), with no relationship found with mortality at 30 days (ORa 0,75, 95% CI: 0.18–3.09).</div></div><div><h3>Conclusion</h3><div>Calcium administration in hyperkalaemia and ID is not associated with short-term mortality.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 334-340"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768917","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":"Predictive factors of mortality in very old patients visited in Emergency Department and admitted for infection","authors":"Míriam Carbó Díez,&nbsp;Gina Osorio Quispe,&nbsp;Lourdes Artajona García,&nbsp;Marie Anette Arce Marañón,&nbsp;Natalia Miota Hernández,&nbsp;Dora Sempertegui Gutiérrez,&nbsp;Milagrosa Perea Gainza,&nbsp;María del Mar Ortega Romero","doi":"10.1016/j.medcle.2024.10.018","DOIUrl":"10.1016/j.medcle.2024.10.018","url":null,"abstract":"<div><h3>Objective</h3><div>To describe mortality predictive factors in patients 80 years or older with infection who were visited at the emergency department and were admitted to hospital.</div></div><div><h3>Methods</h3><div>Retrospective observational study. Patients ≥ 80 years old who visited the emergency department (January 1st to December 31st, 2022), whose main diagnosis was infection and required admission, were included. Factors associated with mortality at the end of the episode were determined.</div></div><div><h3>Results</h3><div>987 patients were included (mean age 87 years, 53% women). Mortality at the end of the episode was 13% (<em>n</em> = 127). Median survival of the series was 52 days (95% CI: 44–60). The independent factors related to mortality were: age (HR: 1.07; 95% CI: 1.03–1.11; <em>p</em> &lt; 0.001), frailty (Clinical Frailty Scale, CFS) (HR: 1.51; 95% CI: 1.15–1.97; <em>p</em> = 0.003), qSOFA (HR: 1.35; 95% CI: 1.07–1.70; <em>p</em> = 0.01), SOFA (HR: 1.23; 95% CI: 1.15–1.38; <em>p</em> &lt; 0.001), leukocyte count (HR: 1.04; 95% CI: 1.02–1.06; <em>p</em> &lt; 0.001) and criteria for sepsis and/or septic shock (HR: 2.52; 95% CI: 1.63–3.87; <em>p</em> &lt; 0.001). On the contrary, any type of microbiological isolation was associated with lower mortality (HR: 0.44; 95% CI: 0.29 – 0.64; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>qSOFA and SOFA scores, the sepsis and septic shock criteria, as well as frailty are predictive factors of poor prognosis in very elderly patients who come to the emergency room due to infection. Knowing frailty would allow us to adapt the treatment and therapeutic effort to the patient's characteristics.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 341-349"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769071","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":"Idiopathic inflammatory myopathy","authors":"Albert Selva-O’Callaghan ,&nbsp;Ernesto Trallero-Araguás ,&nbsp;Albert Gil-Vila","doi":"10.1016/j.medcle.2024.12.004","DOIUrl":"10.1016/j.medcle.2024.12.004","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 8","pages":"Pages 429-436"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860357","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":"Sudden hearing loss and vertigo following physical exercise","authors":"José M. Sala-Vivé Gallego ,&nbsp;Laura Acevedo Ortiz ,&nbsp;Xavier Galindo Ortegó","doi":"10.1016/j.medcle.2024.10.025","DOIUrl":"10.1016/j.medcle.2024.10.025","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 8","pages":"Pages 448-449"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860567","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":"Cardiovascular death in patients with acute heart failure in sinus rhythm: Results from the RICA registry","authors":"Alberto Elpidio Calvo-Elías ,&nbsp;Manuel Méndez-Bailón ,&nbsp;Francisco Javier Martín-Sánchez ,&nbsp;Rubén Ángel Martín-Sánchez ,&nbsp;Elpidio Calvo-Manuel ,&nbsp;Prado Salamanca-Bautista ,&nbsp;José Pérez-Silvestre ,&nbsp;Manuel Montero-Pérez-Baquero ,&nbsp;on behalf of the RICA registry researchers","doi":"10.1016/j.medcle.2024.10.026","DOIUrl":"10.1016/j.medcle.2024.10.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with heart failure in sinus rhythm may be at significant risk of major cardiovascular events, including cardiovascular death (CV death).</div></div><div><h3>Objective</h3><div>To assess CV mortality at a one-year follow up of those patients with heart failure and sinus rhythm, according to LVEF subgroups.</div></div><div><h3>Methods</h3><div>A prospective and multicentric study was conducted with patients in sinus rhythm included in the National Registry of Heart Failure. Firstly, a demographic, clinical and treatment analysis has been made comparing CV death. Secondly, a multivariate analysis of logistic regression was made including those CV death factors. Lastly, a Kaplan Meyer one year survival was made including LVEF.</div></div><div><h3>Results</h3><div>Of all 2040 patients included 14.8% presented CV death. The mortality predictors were Barthel index (OR 0.987 (0.982−0.992) [<em>p</em> &lt; 0.001]), LVEF &lt; 40% (OR 1.514 (1.144−2.003) [<em>p</em> 0.003]) and Charlson index (OR 1,069 (1.016−1.124) [<em>p</em> 0.01]).</div></div><div><h3>Conclusion</h3><div>According to our results CV death has been shown to be higher in those patients with reduced LVEF in sinus rhythm and worst score in Barthel index and Charlson scale.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 8","pages":"Pages 389-395"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860354","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":"Cystic adventitial disease of the popliteal artery","authors":"Bernat Morist-Beltrán,&nbsp;Vicente López-Pérez,&nbsp;Gloria Pedemonte-Parramón","doi":"10.1016/j.medcle.2024.09.034","DOIUrl":"10.1016/j.medcle.2024.09.034","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 376-377"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769077","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":"Contamination by Mycobacterium lentiflavum in the bronchoscope washing water","authors":"Concepción Prados-Sánchez,&nbsp;Alberto Mangas-Moro,&nbsp;Grupo de trabajo de Contaminación por M. lentiflavum","doi":"10.1016/j.medcle.2024.09.033","DOIUrl":"10.1016/j.medcle.2024.09.033","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 374-375"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769076","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}