Medicina clinica (English ed.)最新文献

{"title":"Helicobacter pylori and gastric disease","authors":"Javier P. Gisbert","doi":"10.1016/j.medcle.2025.106974","DOIUrl":"10.1016/j.medcle.2025.106974","url":null,"abstract":"<div><div>The infection caused by <em>Helicobacter pylori</em> is the most common on the planet, affecting half of the global population. It is usually transmitted during childhood and persists for life if untreated. It is the primary cause of chronic gastritis, peptic ulcer, and gastric cancer. In young dyspeptic patients without alarm symptoms, the test-and-treat strategy (detection of <em>H. pylori</em> through a non-invasive test and subsequent eradication) is the preferred approach. The causal role of the infection in the development of gastric adenocarcinoma provides an opportunity to implement preventive strategies. The infection can be diagnosed through invasive methods (requiring endoscopy, such as the rapid urease test or histology) and non-invasive methods (such as the breath test or stool antigen test). The treatment for <em>H. pylori</em> combines a proton pump inhibitor with several antibiotics or bismuth salts.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106974"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686836","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":"Cardiac metastasis from myxoid liposarcoma","authors":"Óscar Porto Fuentes ,&nbsp;Adrián Muinelo Paul","doi":"10.1016/j.medcle.2025.106994","DOIUrl":"10.1016/j.medcle.2025.106994","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106994"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685932","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":"Neurologic symptoms as first manifestation of primary cardiac tumors","authors":"Yolanda Carrascal ,&nbsp;Bárbara Segura-Méndez ,&nbsp;Rocío Bernal ,&nbsp;Irene Velasco ,&nbsp;Ángel Luis Guerrero","doi":"10.1016/j.medcle.2025.106980","DOIUrl":"10.1016/j.medcle.2025.106980","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary cardiac tumors are very infrequent, usually benign, and occasionally present with neurological symptoms.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed a series of 107 patients diagnosed of primary cardiac tumors who underwent cardiac surgery between 1994 and 2024.</div></div><div><h3>Results</h3><div>Stroke was the debut form of tumor in 14 patients. Multiple ischemic lesions on neuroimaging were identified in fifty percent of patients, but no aneurysms or brain tumor metastases were observed at the time of diagnosis. Neurological symptoms were more frequent in patients with villous tumors (33.3 vs. 7.2%) (p: 0.001), regardless of tumor diameter. In the multivariate analysis, patients with neurological debut presented NYHA I functional class [RR: 11.9; 95% CI (2.3–60.5) (p: 0.003)] and villous tumor morphology [RR 6.78 95% CI (1.8–25.3) (p: 0.004)]. No patient underwent reperfusion treatment and surgical excision of the tumor was performed (median stroke-surgery: 19 days) without early postoperative or late neurological complications during follow-up.</div></div><div><h3>Conclusions</h3><div>Neurological symptoms can be the first manifestation of primary cardiac tumors in patients with good functional class and a history of multiple peripheral embolisms. Villous morphology favors neurological manifestations of embolic origin, despite tumor size. Late neurological complications, due to brain aneurysms or tumor metastases, are extremely rare and have not seen in our series.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106980"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686850","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":"Mortality trends of infective endocarditis in Spain (2003-2022)","authors":"Lucía Cayuela ,&nbsp;Aurelio Cayuela","doi":"10.1016/j.medcle.2025.106992","DOIUrl":"10.1016/j.medcle.2025.106992","url":null,"abstract":"<div><h3>Background</h3><div>Infective endocarditis (IE) is a life-threatening infection with high morbidity and mortality. Trends in IE-related mortality have been less extensively studied compared to incidence. This study aimed to examine IE mortality trends in Spain from 2003 to 2022.</div></div><div><h3>Methods</h3><div>This longitudinal ecological study analyzed data from the Spanish National Statistics Institute. Age-standardized mortality rates (ASMRs) were calculated, and joinpoint regression and age-period-cohort (APC) models were used to identify trends and underlying factors.</div></div><div><h3>Results</h3><div>A total of 25,327 deaths from IE occurred, with a higher number in women. Mortality was strongly age-related, with the vast majority in those over 65. Joinpoint analysis revealed increasing ASMRs in men for all ages and the 65+ age group, while rates remained stable in women. The 35–64 age group showed a decrease in rates for both sexes. A-P-C analysis confirmed age as a significant effect, with mortality rates increasing with age for both sexes. Cohort effects showed a decline in mortality risk in successive birth cohorts, particularly those born after the 1920s and 1930s. Period effects demonstrated a decline in IE mortality risk over the study period.</div></div><div><h3>Conclusion</h3><div>IE mortality trends in Spain are complex, with significant progress in reducing mortality rates, particularly among younger adults and women. However, challenges remain, especially for older men. These findings highlight the need for targeted interventions and further research to understand the factors driving mortality changes and improve outcomes for all affected by IE.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 1","pages":"Article 106992"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686849","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":"Piperacillin-induced encephalopathy","authors":"Pedro Parra-Caballero ,&nbsp;Ángela Sánchez-Juez ,&nbsp;Francisco Abad-Santos","doi":"10.1016/j.medcle.2025.106945","DOIUrl":"10.1016/j.medcle.2025.106945","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106945"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366933","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":"Effectiveness and immunogenicity of SARS-CoV-2 booster vaccine in immunosuppressed systemic autoimmune disease patients: A prospective study","authors":"Carolina Teles ,&nbsp;Ana Borges ,&nbsp;Ana Magalhães ,&nbsp;Cátia Barra ,&nbsp;Isabel Silva ,&nbsp;Patrícia Tomé ,&nbsp;Jorge Crespo ,&nbsp;Artur Paiva ,&nbsp;Lèlita Santos","doi":"10.1016/j.medcle.2025.106920","DOIUrl":"10.1016/j.medcle.2025.106920","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Patients with systemic autoimmune rheumatic disease (SARD) are a vulnerable population for severe COVID-19 and worse response to vaccination, prompting the need of a booster vaccine. Data regarding its response is limited and inconsistent. The aim of this study was to assess the effectiveness and immunogenicity of the third dose of the SARS-CoV-2 vaccine in immunosuppressed SARD patients.</div></div><div><h3>Materials and methods</h3><div>We conducted a prospective study in immunosuppressed SARD Portuguese patients, who received a SARS-CoV-2 booster vaccine, from October 2021 to August 2022. We evaluated COVID-19 incidence in the following 6 months, as well as vaccine immunogenicity through anti-Spike IgG titers and T-cell reactivity to the Spike protein.</div></div><div><h3>Results</h3><div>We included 131 patients with a mean age of 54.9<!--> <!-->±<!--> <!-->12.2 years. Almost 40% (<em>n</em> <!-->=<!--> <!-->52) developed COVID-19 within 6 months after the booster, but 51 (98.1%) were mild infections. Median post-booster antibody levels and antibody variation were 9540.7 (14,724) and 8937.9 (11,561.3)<!--> <!-->AU/mL, respectively, and 73.3% (<em>n</em> <!-->=<!--> <!-->96) of the patients showed post-booster T-cell reactivity. Antibody variation was significantly lower in the COVID group (<em>p</em> <!-->=<!--> <!-->0.015). Although post-booster antibody levels and T-cell reactivity were statistically significantly lower in the patients under biologic DMARD, there was not a significant increase in COVID-19 incidence.</div></div><div><h3>Conclusions</h3><div>This study shows that a booster vaccine elicits strong immunogenicity and reduces COVID-19 severity, highlighting its importance in immunosuppressed SARD patients. Larger and more homogeneous cohorts are needed to guide periodic booster administration in this susceptible population.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106920"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365105","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":"Tumor-related pulmonary thrombotic microangiopathy in a patient without known neoplasia","authors":"Jordi Ara i Bonet,&nbsp;Patricia Sigüenza Bonete,&nbsp;Yenny Paola Zuluaga Blanco","doi":"10.1016/j.medcle.2025.106948","DOIUrl":"10.1016/j.medcle.2025.106948","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106948"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366931","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":"Tuberous sclerosis complex","authors":"Qiang Tong ,&nbsp;Jianghong Zheng ,&nbsp;Sheng-Ming Dai","doi":"10.1016/j.medcle.2025.106929","DOIUrl":"10.1016/j.medcle.2025.106929","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106929"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366936","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":"Low vaccine coverage and absence of exacerbations after vaccination in a Myasthenia Gravis cohort: An observational retrospective series of 89 patients","authors":"Cristina Carbonero ,&nbsp;Lourdes Mozo ,&nbsp;Eva Fernández-Bretón ,&nbsp;Carolina Mulet ,&nbsp;María Fernández-Prada ,&nbsp;Germán Morís","doi":"10.1016/j.medcle.2025.106914","DOIUrl":"10.1016/j.medcle.2025.106914","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to collect data on the vaccination status of Myasthenia Gravis (MG) patients, assess the coverage of vaccines, and examine MG exacerbations.</div></div><div><h3>Methods</h3><div>We conducted a retrospectively observational study including patients diagnosed with MG between 2015 and 2023 with antibodies against acetylcholine receptors.</div></div><div><h3>Results</h3><div>Eighty-nine patients were analysed. Forty-one (46.1%) were women. The median age at onset was 68 years. The median follow-up was 3.9 years. Sixteen (17.9%) patients had early-onset MG and 32 (36.0%) had ocular MG. Fifty-four (60.7%) patients received pneumococcal vaccines. Seventy-five (84.3%) patients received one dose of the seasonal influenza vaccine. Ten patients (76.9%) received hepatitis A virus (HAV) vaccination, and 33 (64.7%) received four doses of the hepatitis B virus (HBV) vaccine. One and six patients were classified as non-responders for HAV and HBV vaccines, respectively. Two patients were vaccinated with the live attenuated varicella-zoster virus vaccine. No differences were found between vaccination in early versus late-onset MG. No MG exacerbations were observed following vaccination.</div></div><div><h3>Discussion</h3><div>It is mandatory to establish recommendations for vaccination to ensure timely and appropriate immunisation.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106914"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366926","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":"Tick-borne diseases in Spain","authors":"José A. Oteo,&nbsp;Sonia Santibáñez,&nbsp;Aránzazu Portillo","doi":"10.1016/j.medcle.2025.106989","DOIUrl":"10.1016/j.medcle.2025.106989","url":null,"abstract":"<div><div>Currently, tick-borne diseases are a threat to Public Health, as these arthropods are among the most effective infectious disease vectors in the industrialised world. In Spain there is a wide spectrum of tick-borne diseases with different forms of clinical presentation that sometimes pose a diagnostic challenge. This review analyses the difficulties we have in daily clinical practice for the diagnosis of tick-borne diseases in our environment and details the microbiological tests available for their etiological diagnosis.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106989"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365104","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}