Medicina clinica (English ed.)最新文献

{"title":"Wilson disease presenting with isolated neurological manifestations","authors":"Jian Li, Qingle Chen, Xiequan Hu","doi":"10.1016/j.medcle.2026.107521","DOIUrl":"10.1016/j.medcle.2026.107521","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107521"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861640","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":"Artificial intelligence in retrospective observational studies in internal medicine: Methodological gaps and opportunities for improvement","authors":"Antoni Sicras Mainar","doi":"10.1016/j.medcle.2026.107483","DOIUrl":"10.1016/j.medcle.2026.107483","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107483"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862049","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":"Exchange transfusion as rescue therapy for severe methemoglobinemia in the absence of methylene blue","authors":"Enrique Santiago Lanas Mendoza, Andrés Sebastián Herdoíza Almeida, Alex Wladimir Guayta Valladares","doi":"10.1016/j.medcle.2026.107478","DOIUrl":"10.1016/j.medcle.2026.107478","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107478"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861667","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":"Current evidence on the use of potent P2Y12 inhibitors in elective percutaneous coronary intervention","authors":"Alberto Javier Vasquez Cadena, Paul Anthony Camacho Lopez, German Camilo Giraldo Gonzalez","doi":"10.1016/j.medcle.2026.107471","DOIUrl":"10.1016/j.medcle.2026.107471","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107471"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862040","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":"Three-year outcomes of elexacaftor/tezacaftor/ivacaftor in adults with cystic fibrosis: A real-world study","authors":"Ester Zamarrón de Lucas,&nbsp;Clara Crespo Catalán,&nbsp;Belén Romero Campos,&nbsp;Belén Sanz Sanjosé,&nbsp;María Longás Ouzzine,&nbsp;Cindy Stephania Aponte Guevara,&nbsp;Rodolfo Álvarez-Sala Walther,&nbsp;María Concepción Prados Sánchez","doi":"10.1016/j.medcle.2026.107448","DOIUrl":"10.1016/j.medcle.2026.107448","url":null,"abstract":"<div><h3>Introduction</h3><div>CFTR modulators have significantly changed the prognosis of cystic fibrosis (CF), although data on their long-term clinical and microbiological impact in adults in real-world practice remain limited.</div></div><div><h3>Objective</h3><div>To analyse the clinical, functional, and microbiological outcomes at 36 months in adults with CF treated with elexacaftor/tezacaftor/ivacaftor (ETI).</div></div><div><h3>Methods</h3><div>A longitudinal observational study was conducted in adults with CF. Lung function, number of exacerbations, weight, and sputum cultures were assessed at baseline and at 12, 24, and 36 months after initiation of ETI.</div></div><div><h3>Results</h3><div>A total of 55 patients were included (43.6% female; mean age 32 ± 13 years). FEV1 improved at 12 months and remained stable at 36 months. Exacerbations decreased, and weight increased progressively. The proportion of patients with potentially pathogenic microorganisms decreased from 93.1% at baseline to 36.2% at 36 months. Patients without microbiological isolation showed better lung function and fewer exacerbations.</div></div><div><h3>Conclusions</h3><div>In real-world clinical practice, ETI is associated with improvements in lung function, weight, and exacerbations, as well as a reduction in the isolation of potentially pathogenic microorganisms in sputum at 36 months.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107448"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861634","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":"Inflammatory myopathies with anti-TIF1γ antibodies and their association with neoplasms: A study of a series of 28 cases","authors":"Ana María Gutiérrez Baena,&nbsp;María Carlota Mir Castro,&nbsp;Guillem Verdaguer Faja,&nbsp;Leidy Johana Morales Osorio,&nbsp;Vanesa Garrigasait Vilaseca","doi":"10.1016/j.medcle.2026.107496","DOIUrl":"10.1016/j.medcle.2026.107496","url":null,"abstract":"<div><h3>Background and objective</h3><div>To describe the clinical, immunological, and evolutionary profile of patients with anti-TIF1γ-positive inflammatory myopathy and to analyze its association with neoplasms.</div></div><div><h3>Materials and methods</h3><div>Retrospective study of patients with inflammatory myopathy and positive anti-TIF1γ antibodies treated at a tertiary care hospital (2012–2024). Sociodemographic variables, clinical manifestations, immunological profile, presence and type of neoplasm, treatment, and evolution were collected.</div></div><div><h3>Results</h3><div>Twenty-eight patients were analyzed (mean age 63 years [31–88], 68% women). They were followed for a period of 5 years. Typical cutaneous manifestations predominated (61%), followed by proximal muscle weakness (61%) and dysphagia (32%), without significant pulmonary involvement. 54% presented with elevated CPK. ANA was positive in 71.4%. 57.1% presented myositis-associated antibodies and 25% other myositis-specific antibodies. Neoplasia was detected in 25%, mainly lung and ovary, with synchronous occurrence in more than half. The response to immunosuppressive treatment was favourable in 67.8%. Eight deaths were recorded, most within the first year.</div></div><div><h3>Conclusions</h3><div>Anti-TIF1γ positivity identifies an inflammatory myopathy with a high oncological risk that requires early screening and close follow-up, especially in the first three years after diagnosis.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107496"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861635","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":"Persistent isolated AST elevation due to macro-AST in a patient with suspected primary biliary cholangitis","authors":"Ana Tirado Escuder,&nbsp;Miriam Escalante-Reyes,&nbsp;María Rodriguez Soler","doi":"10.1016/j.medcle.2026.107484","DOIUrl":"10.1016/j.medcle.2026.107484","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107484"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861666","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":"Chronic refractory hiccups and a calcified subdiaphragmatic mass: Costal chondrosarcoma","authors":"Yuanxing Zhong,&nbsp;Qingle Chen,&nbsp;Xiequan Hu","doi":"10.1016/j.medcle.2026.107514","DOIUrl":"10.1016/j.medcle.2026.107514","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107514"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861712","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":"Supratentorial hemangioblastoma masquerading as meningioma","authors":"Zhaowei Wan,&nbsp;Qingle Chen","doi":"10.1016/j.medcle.2026.107503","DOIUrl":"10.1016/j.medcle.2026.107503","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107503"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861713","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":"Medical and economic impact of a regional Patient Blood Management program in Navarre, Spain (2016–2025)","authors":"José Antonio García Erce,&nbsp;Saioa Zalba Marcos,&nbsp;Gabriel Cerdán,&nbsp;Javier Ripollés-Melchor","doi":"10.1016/j.medcle.2026.107454","DOIUrl":"10.1016/j.medcle.2026.107454","url":null,"abstract":"<div><h3>Introduction</h3><div>Patient Blood Management (PBM) is a comprehensive ethical strategy that improves clinical outcomes, reduces transfusion requirements, and optimizes the use of resources, with proven benefits in terms of efficiency, safety, and healthcare costs.</div></div><div><h3>Methods</h3><div>We conducted a before–after observational study (2016–2025) from the perspective of the Blood Transfusion Center of the Chartered Community of Navarre. We analysed trends in blood donation, the annual supply of red blood cell, plasma and platelet concentrates to hospitals, the volume of plasma sent for industrial fractionation, and the yield of plasma-derived medicinal products (albumin, immunoglobulins, factor VIII). Direct economic impact, under a neutral scenario, was estimated by applying the official 2025 tariffs to the number of units “not supplied” compared with 2016; indirect impact was calculated from the difference between contract fractionation costs and ex-factory prices for returned plasma-derived products.</div></div><div><h3>Results</h3><div>With overall donations remaining stable, the supply of red blood cells and therapeutic plasma decreased steadily (by approximately 20–25% and &gt;50%, respectively), with an accumulated reduction of close to 50,000 units supplied. The estimated direct savings exceeded 5.5 million euros over the study period. In parallel, plasma sent for fractionation increased by around 40%, with &gt;40% increases in returned albumin and immunoglobulins, generating additional indirect savings of approximately 6.2 million euros through reduced dependence on commercial products.</div></div><div><h3>Conclusions</h3><div>The progressive implementation of a regional PBM program, led by the blood transfusion center, is associated with a marked reduction in whole blood donation and in the consumption of blood components, together with an increase in apheresis donation and greater self-sufficiency in plasma-derived medicinal products, resulting in a very substantial direct and indirect economic impact for the healthcare system.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"166 8","pages":"Article 107454"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862050","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}