{"title":"Patient and public involvement in registered non-pharmacological non-commercial Spanish trials completed in 2009–2024: A systematic review","authors":"Rafael Dal-Ré , Elena García-Méndez","doi":"10.1016/j.medcle.2025.106964","DOIUrl":"10.1016/j.medcle.2025.106964","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106964"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686838","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":"GLP-1 receptor agonists in obesity treatment: Effects on cardiometabolic variables and cardiovascular disease","authors":"Helena Sardà , Idoia Genua , Inka Miñambres","doi":"10.1016/j.medcle.2025.106951","DOIUrl":"10.1016/j.medcle.2025.106951","url":null,"abstract":"<div><div>Obesity is associated with an increased cardiovascular risk. Drugs with arGLP-1 action for overweight/obesity, such as liraglutide, semaglutide, and tirzepatide, have shown improvements in weight and body composition, as well as in parameters related to glucose metabSolism, hypertension, dyslipidemia (reduction of triglycerides and increase in HDL cholesterol), and metabolic dysfunction-associated steatotic liver disease. Additionally, semaglutide 2.4<!--> <!-->mg has shown a reduction in cardiovascular mortality, non-fatal myocardial infarction or stroke, and symptoms of heart failure, while tirzepatide has demonstrated a reduction in cardiovascular mortality and heart failure symptoms in patients with obesity and heart failure. The availability of these new drugs with arGLP-1 action represents a paradigm shift in the treatment of obesity, as they achieve greater weight loss and improvements in cardiometabolic comorbidities.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106951"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686847","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}
Xuan Qi , Xiaomeng Li , Yan Han , Lingyan Lei , Huifang Guo
{"title":"Diagnostic value of blood coagulation index in obstetric antiphospholipid syndrome and its subtypes","authors":"Xuan Qi , Xiaomeng Li , Yan Han , Lingyan Lei , Huifang Guo","doi":"10.1016/j.medcle.2025.106997","DOIUrl":"10.1016/j.medcle.2025.106997","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize blood coagulation index in obstetric antiphospholipid syndrome (OAPS) and its subtypes, analyzing correlations with immunological indices and diagnostic value.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on OAPS patients treated at the Department of Rheumatology and Immunology, Second Hospital of Hebei Medical University, from September 2023 to March 2024. Healthy women of the same age range were matched for comparison.</div></div><div><h3>Results</h3><div>A total of 102 OAPS patients and 80 matched healthy controls were included. OAPS patients exhibited significantly lower levels of complement factors C3 and C4, coagulation factors V and VII activities, and protein S activity (<em>p</em> <!--><<!--> <!-->0.05). Conversely, they had elevated levels of anti-β2 glycoprotein I antibodies, platelets, thrombin–antithrombin complex (TAT), thromboelastographic reaction time (R), maximum amplitude (MA), clot formation index (CI), von Willebrand factor activity, coagulation factor VIII activity, and activated partial thromboplastin time (APTT) (<em>p</em> <!--><<!--> <!-->0.05). Among OAPS patients, criteria OAPS cases showed significantly higher anti-β2-GPI antibodies and anticardiolipin antibody levels (<em>p</em> <!--><<!--> <!-->0.01), with more spontaneous abortions and fetal deaths in this group (<em>p</em> <!--><<!--> <!-->0.01).</div></div><div><h3>Conclusion</h3><div>Correlations were found between immunological indices (ANA, complement C3, anti-β2-GPI) and coagulation indices (TAT, APTT). ANA, complement C3, anti-β2-GPI antibodies, and TAT were identified as risk factors for predicting OAPS. Blood coagulation and immune indices correlate in OAPS. Detecting these indices may provide diagnostic value for OAPS and its subtypes.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106997"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687038","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":"GLP-1-based medications: Mechanisms involved in obesity treatment","authors":"Javier Salvador","doi":"10.1016/j.medcle.2025.107035","DOIUrl":"10.1016/j.medcle.2025.107035","url":null,"abstract":"<div><div>Thanks to biochemical engineering, the glucagon-like peptide-1 (GLP-1) molecule has emerged as an essential element in the development of diverse agonists and multiagonists, based in the GLP-1 structure for obesity treatment. These new antiobesity medications can reach up to 24% weight loss, which makes possible an effective management of obesity and its complications. GLP-1 agonists affect diverse obesity etiopathogenic processes such as abnormal food intake regulation, adipocyte dysfunction, insulin resistance, adipokine production, inflammation, endothelial dysfunction, lipid metabolism, and oxidative stress. All these factors are significantly involved in the pathophysiology of multiple obesity-related complications, including diabetes mellitus, metabolic dysfunction-associated steatotic liver disease, heart failure, and atherosclerosis, among others. Potentiation and complementation of GLP-1 effects by co-stimulation of GIP (glucose-dependent insulinotropic peptide), glucagon, or amylin and other receptors contribute to additional benefits, opening new horizons in the therapeutic individualization for persons living with obesity.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 107035"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687040","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}
Elena Colastra Ugena , Ana Peña Cabia , Ismael Calero Paniagua , Sonia Rodríguez Díaz , Begoña Rincón Ruiz , Juan Gómez de Oña
{"title":"Fabry disease: Importance of genetic counseling in the reclassification of variants of uncertain clinical significance","authors":"Elena Colastra Ugena , Ana Peña Cabia , Ismael Calero Paniagua , Sonia Rodríguez Díaz , Begoña Rincón Ruiz , Juan Gómez de Oña","doi":"10.1016/j.medcle.2025.106965","DOIUrl":"10.1016/j.medcle.2025.106965","url":null,"abstract":"<div><h3>Objective</h3><div>Fabry disease (FD) is an X-linked genetic disorder characterized by the deficiency or absence of the enzyme alpha-galactosidase. This leads to intracellular deposits of sphingolipids in vital organs, making it a multisystemic disease.</div><div>The aim ofthis study is to emphasize the importance of genetic diagnosis and multidisciplinary follow-up of patients with FD.</div></div><div><h3>Materials and methods</h3><div>This case presents two patients diagnosed with hypertrophic cardiomyopathy, both carrying the same variant of uncertain clinical significance (VUS) in the GLA gene, with no known relationship between them. Since the genetic counseling consultation, a family segregation study was performed, enabling the redirection of the diagnosis and detection of FD in several symptomatic and asymptomatic relatives.</div></div><div><h3>Results</h3><div>Genetic studies allowed the reclassification of the VUS as probably pathogenic, demonstrating its involvement in the pathology of these patients. Adequate clinical follow-up was provided for these patients, and reproductive genetic counseling was offered to family members.</div></div><div><h3>Discussion</h3><div>Early diagnosis of FD helps improve patient prognosis.</div></div><div><h3>Conclusion</h3><div>Genetic counseling enables early diagnosis and proper follow-up of FD.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106965"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686839","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}