Medicina clinica (English ed.)最新文献

{"title":"Skin and soft tissue infections in people migrating by sea to the Canary Islands, Spain","authors":"Pedro Laynez-Roldán ,&nbsp;María Pilar Gómez Álvarez ,&nbsp;Onán Pérez Hernández","doi":"10.1016/j.medcle.2024.11.008","DOIUrl":"10.1016/j.medcle.2024.11.008","url":null,"abstract":"<div><h3>Introduction</h3><div>People migrating to the Canary Islands by sea frequently suffer from potentially severe skin and soft tissue infections (SSTIs) for which optimal empirical antibiotic therapy is not well defined.</div></div><div><h3>Methods</h3><div>This descriptive retrospective observational study assess a case series of newly arrived maritime migrants to the Canary Islands who were diagnosed with clinical and microbiological SSTIs and admitted to the Nuestra Señora de La Candelaria Hospital in Tenerife between January 2020 and December 2023. Clinical data, bacterial species, resistance profiles, and choice of empirical treatments were analysed.</div></div><div><h3>Results</h3><div>A total of 23 patients with SSTIs were analysed, with 21 (91.3%) presenting lesions in the gluteal-sacral region. Thirty-seven community-acquired pathogenic microorganisms were isolated, including seven from blood cultures. The isolated bacteria included <em>Staphylococcus aureus</em> (<em>n</em> = 12/37, 32.4%), <em>Enterobacterales</em> (<em>n</em> = 9/37, 24.3%), marine bacteria (<em>n</em> = 7/37, 18.9%), non-fermenting gram-negative bacteria (<em>n</em> = 6/37, 16.2%), and other gram-positive cocci (<em>n</em> = 2/37, 5.4%). Treatment was inappropriate in 9 of 23 cases (39.1%), with amoxicillin/clavulanic acid being the most prescribed antibiotic (<em>n</em> = 11/23, 47.8%).</div></div><div><h3>Conclusions</h3><div>The study suggests that, in addition to the importance of bacteria such as S. aureus, consideration should be given to Enterobacterales, marine bacteria, and gram-negative non-fermenting bacteria (such as Pseudomonas aeruginosa) when choosing empirical antibiotic therapy for SSTIs in maritime migrants.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 369-373"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769075","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":"Varicella diaper rash","authors":"Sara Becerril Andrés ,&nbsp;Pablo Fernández Fernández ,&nbsp;Miguel Mansilla Polo ,&nbsp;Mónica Martins Lopes ,&nbsp;Marta González de Arriba","doi":"10.1016/j.medcle.2024.09.028","DOIUrl":"10.1016/j.medcle.2024.09.028","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 320-321"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696784","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":"Respiratory syncytial virus infections in adults","authors":"Catia Cilloniz ,&nbsp;Antoni Torres","doi":"10.1016/j.medcle.2024.11.007","DOIUrl":"10.1016/j.medcle.2024.11.007","url":null,"abstract":"<div><div>Respiratory syncytial virus (RSV) infections as an important cause of acute respiratory illness (ARI) and exacerbation of chronic lung disease in adults especially affect older adults, adults with immunosuppression, and adults with chronic disease, particularly pulmonary or cardiac disease, who may develop more severe complications. A more accurate determination of the burden of RSV infection in the adult population would improve the approach to infection, especially considering the growth of the older adult population in the world and, above all, that there are currently three approved vaccines aimed at the adult population that could have an effect on the prevention of RSV infection. This review article reviews the most relevant and novel scientific evidence on the epidemiology, diagnosis, treatment and prevention of RSV infection in the adult population.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 361-368"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769074","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":"Stress, microbiota, and the gut–brain axis in mental and digestive health","authors":"Javier Santos ,&nbsp;Patricia Laura Maran ,&nbsp;Amanda Rodríguez-Urrutia","doi":"10.1016/j.medcle.2024.11.006","DOIUrl":"10.1016/j.medcle.2024.11.006","url":null,"abstract":"<div><div>The prevailing mind-body dualism in contemporary medicine, rooted in reductionism and the fragmentation of knowledge, has impeded the development of a conceptual model that can adequately address the complexity of illnesses. Integrating biomedical data into a cohesive model that considers the mind–body–context interconnections is essential. This integration is not merely theoretical; rather, it has significant clinical implications. This is exemplified by chronic stress-related mental and digestive disorders. The onset and development of these disorders are intimately linked to chronic psychological stress via the brain–gut–microbiota axis. The present article examines the evidence and mechanisms indicating that stress is a primary factor and a potentiator of symptom severity in common mental health and digestive diseases, with a particular focus on human studies. However, due to space limitations, only a very general overview of preventive and therapeutic clinical strategies is provided. It is hoped that the recurring phrase, “Everything that happens to you is due to stress,” will become more comprehensible to the physician after reading this manuscript.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 295-304"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696724","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":"The attractiveness of the internal medicine specialty for the election of medical residence in Spain","authors":"Yoseba Cánovas Zaldúa ,&nbsp;Mónica Rodríguez Carballeria ,&nbsp;Aina Mas Tena ,&nbsp;Sara Rodoreda Noguerola","doi":"10.1016/j.medcle.2024.11.005","DOIUrl":"10.1016/j.medcle.2024.11.005","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 306-311"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696777","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":"Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population","authors":"Joan Pou Bordoy ,&nbsp;Alfonso Leiva ,&nbsp;Maria José Albendín Ariza ,&nbsp;Roberto Elosúa Llanos ,&nbsp;Fernando Rigo Carratalà ,&nbsp;Dora Romaguera ,&nbsp;Jordi Salas-Salvadó ,&nbsp;Nancy Babio ,&nbsp;Miguel Angel Martinez-González ,&nbsp;Estefanía Toledo ,&nbsp;Montserrat Fitó ,&nbsp;Fernando Aros ,&nbsp;Ramon Estruch ,&nbsp;Miquel Fiol Sala","doi":"10.1016/j.medcle.2024.10.011","DOIUrl":"10.1016/j.medcle.2024.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events.</div></div><div><h3>Objective</h3><div>To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO).</div></div><div><h3>Method</h3><div>1752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel’s C Indices, Nam d’Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated.</div></div><div><h3>Results</h3><div>At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51−58.03, <em>p</em> &lt; 0.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38−4.21, <em>p</em> = 0.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76−18.72, <em>p</em> = 0.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36−7.71, <em>p</em> &lt; 0.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed.</div></div><div><h3>Conclusions</h3><div>MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 277-286"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696787","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":"The internist as an expert in invasive ultrasound: Breaking barriers","authors":"José M. Porcel","doi":"10.1016/j.medcle.2024.12.002","DOIUrl":"10.1016/j.medcle.2024.12.002","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 292-294"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696723","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":"Adenocarcinoma of the renal pelvis and ureteral junction: A case report","authors":"Shuo Wu ,&nbsp;Meihong Ye ,&nbsp;Chaoming Wang","doi":"10.1016/j.medcle.2024.09.029","DOIUrl":"10.1016/j.medcle.2024.09.029","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 315-316"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696780","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":"Impact of belimumab on glucocorticoid intake in newly diagnosed systemic lupus erythematosus","authors":"Yin Zhao ,&nbsp;Fumin Qi ,&nbsp;Na Zhang ,&nbsp;Tong Yang ,&nbsp;Wenwen Sun ,&nbsp;Xin Li ,&nbsp;Yongjie Chen ,&nbsp;Wei Wei","doi":"10.1016/j.medcle.2024.09.032","DOIUrl":"10.1016/j.medcle.2024.09.032","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Systemic lupus erythematosus (SLE) is an autoimmune disease with unknown etiology. For newly diagnosed SLE, there are few studies analyzing whether the use of belimumab can reduce the dose of glucocorticoids while maintaining disease remission. To explore this, we conducted this single-center, real-world setting study, based on a prospective cohort.</div></div><div><h3>Methods</h3><div>Newly diagnosed SLE taking Belimumab and standard-of-care (SoC) treatment were consecutively enrolled from July 2021 to December 2023 in a prospective manner. Disease assessments (SLE Responder Index 4 (SRI-4) response (a composite indicator to evaluate the efficacy of belimumab in RCTs), SLEDAI-2K) were conducted regularly. Patients were followed up for at least 12 months. Matched patients with SoC alone were enrolled after propensity score matching. Difference examination and generalized estimated equations were conducted.</div></div><div><h3>Results</h3><div>A total of 31 patients were enrolled in Belimumab group. SRI-4 response rate was 87.10% at 12 months. Serological parameters (anti-dsDNA and C3/C4), SLEDAI-2K and daily prednisone intake were improved overall. Compared with SoC group, SRI-4 rate and the trends of complement C4, SLEDAI-2K during follow up was similar in two groups. Trends of complement C3 (13.16 (4.14–22.18), <em>P</em> <!-->=<!--> <!-->0.004), anti-dsDNA titer (−60.29 (−103.95 to −16.63), <em>P</em> <!-->=<!--> <!-->0.007) and prednisone intake (−18.59 (−26.88 to −10.30), <em>P</em> <!-->=<!--> <!-->0.000) were more significantly in Belimumab group. Belimumab group had significantly lower cumulative prednisone intake with overall well-tolerance.</div></div><div><h3>Conclusion</h3><div>Our data supported that prompt initiation of add-on Belimumab should be considered to control the disease and facilitate GC tapering/discontinuation, without prior failure to one or more conventional drugs.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 271-276"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696786","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":"Effect of pentoxifylline on hepcidin and iron profile in hemodialysis patients: A randomized, double-blind, placebo-controlled clinical trial","authors":"Hadeer Zakaria ,&nbsp;Noha Alaa Hamdy ,&nbsp;Nagy A.H. Sayed-Ahmed ,&nbsp;Ahmed El-Mallah","doi":"10.1016/j.medcle.2024.09.031","DOIUrl":"10.1016/j.medcle.2024.09.031","url":null,"abstract":"<div><h3>Background</h3><div>Hemodialysis (HD) patients often have elevated levels of hepcidin hormone, which is a key regulator of systemic iron homeostasis. While pentoxifylline (PTX) has been demonstrated to have anti-inflammatory properties, it is unclear if these effects would also have an inhibitory effect on hepcidin. This study aimed to examine the potential role of PTX on hepcidin and its consequent effects on iron profile and anemia in HD patients.</div></div><div><h3>Methods</h3><div>Eighty HD patients were randomly assigned 1:1 to the pentoxifylline group, receiving a daily dose of PTX (800<!--> <!-->mg), or the placebo group, receiving placebo capsules for 6-months. Different laboratory parameters, including hepcidin, hemoglobin (Hb), red blood cells (RBCs), hypoxia-inducible factor-2 alpha (HIF-2α), serum iron, total iron-binding capacity (TIBC), ferritin, transferrin saturation (TSAT), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs.CRP), were used for evaluation the patients’ response.</div></div><div><h3>Results</h3><div>In the PTX-treated patients, the hepcidin levels reduced significantly (<em>p</em> <!-->=<!--> <!-->0.001) from 628.03 (334.4–800.85)<!--> <!-->ng/ml to 235.25 (192.8–508.76)<!--> <!-->ng/ml, and this reduction was also statistically significant as compared to the placebo group (<em>p</em> <!-->&lt;<!--> <!-->0.001). Also, there were significant changes (<em>p</em> <!-->&lt;<!--> <!-->0.001) regarding other iron hemostasis parameters including Hb, RBCs, serum iron, TIBC, TSAT, and HIF-2α. Levels of IL-6 and hs.CRP, as a reflection of inflammatory status, decreased significantly (<em>p</em> <!-->=<!--> <!-->0.002 and <em>p</em> <!-->=<!--> <!-->0.003, respectively) in the pentoxifylline group, and the percent reduction in these parameters was also statistically significant compared to the placebo group (<em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>This study reveals that PTX reduces hepcidin levels and consequently provides an improvement in the iron profile and anemia in HD patients.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 263-270"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696785","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}