Medicina clinica (English ed.)最新文献

{"title":"Unveiling spatial clusters of systemic sclerosis mortality in Spain: A comprehensive geographical analysis","authors":"Lucia Cayuela ,&nbsp;José-Juan Pereyra-Rodríguez ,&nbsp;Paz Collado Ramos ,&nbsp;Nuria Garvín Grande ,&nbsp;Aurelio Cayuela","doi":"10.1016/j.medcle.2024.10.029","DOIUrl":"10.1016/j.medcle.2024.10.029","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examined the spatial patterns of systemic sclerosis mortality in Spain from 2003 to 2022, identifying provincial-level clusters and sex-specific differences to explore potential underlying factors.</div></div><div><h3>Methods</h3><div>Mortality and population data (2003–2022) were sourced from the National Institute of Statistics. Age-standardized mortality rates were calculated, and spatial patterns were analyzed using standardized mortality ratios and smoothed relative risks via the Besag, York, and Mollié model, with statistical inference performed using the Integrated Nested Laplace Approximation (INLA) technique. Spatial clustering was assessed using Tango's and Kulldorff's tests.</div></div><div><h3>Results</h3><div>A total of 2016 SSc deaths were recorded, revealing a marked gender disparity. SSc mortality rates showed a consistent annual increase of 2.1% for both sexes, with women experiencing rates approximately 3.4 times higher than men. Age-specific analysis demonstrated higher mortality rates among women across all age groups, with an average sex ratio of 2.9, and rates increased with age for both sexes. Spatial analysis identified significant clusters of elevated SSc mortality in northwestern Spain, primarily in León and Asturias, with additional clusters extending to nearby provinces. These regions, characterized by silica mining and related industries, exhibited notable variations between men and women in the specific provinces affected.</div></div><div><h3>Conclusions</h3><div>This study identifies significant geographic and sex-based disparities in SSc mortality across Spain, with prominent clusters in the north. The results highlight the potential impact of environmental and occupational exposures on disease outcomes, emphasizing the need for targeted public health interventions in high-risk areas.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 8","pages":"Pages 403-409"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860356","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":"Patera syndrome in African migrants. An emerging clinical entity","authors":"Elena Pisos-Álamo ,&nbsp;José-Luis Pérez-Arellano","doi":"10.1016/j.medcle.2025.01.005","DOIUrl":"10.1016/j.medcle.2025.01.005","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 8","pages":"Pages 418-420"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859226","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":"In-hospital linagliptin for management simplification and hypoglycemia reduction in very old patients with type 2 diabetes","authors":"Miguel A. Pérez-Velasco ,&nbsp;Julio Osuna-Sánchez ,&nbsp;Mercedes Millán-Gómez ,&nbsp;Michele Ricci ,&nbsp;Almudena López-Sampalo ,&nbsp;María-Rosa Bernal-López ,&nbsp;Ricardo Gómez-Huelgas ,&nbsp;Luis M. Pérez-Belmonte","doi":"10.1016/j.medcle.2024.10.023","DOIUrl":"10.1016/j.medcle.2024.10.023","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The role of in-hospital dipeptidyl peptidase-4 inhibitors in very old patients has not been widely described. This work analyzes the simplification of in-hospital antihyperglycemic management (less insulin use) and reductions in hypoglycemia events using linagliptin in patients aged<!--> <!-->≥<!--> <!-->80 years with type 2 diabetes.</div></div><div><h3>Patients and methods</h3><div>This real-world observational study included hospitalized patients<!--> <!-->≥<!--> <!-->80 years with type 2 diabetes treated with an antihyperglycemic protocol of either basal-bolus insulin or linagliptin between January 2016 and December 2023. A 1:1 propensity score matching analysis was performed.</div></div><div><h3>Results</h3><div>Post-matching, 944 patients were included in each group. The total and basal insulin doses and number of daily injections were significantly lower in the linagliptin group than the basal-bolus insulin group with no differences in glycemic efficacy. Regarding safety, patients on the basal-bolus insulin regimen had more hypoglycemic events. The use of basal-bolus insulin regimen (odds ratio: 4.22; 95% confidence interval: 2.14–6.28; <em>p</em> <!-->&lt;<!--> <!-->0.001), a higher total insulin dose (odds ratio: 3.55; 95% confidence interval: 2.02–5.36; <em>p</em> <!-->&lt;<!--> <!-->0.001) and the number of insulin injections (odds ratio: 2.86; 95% confidence interval: 1.50–4.12; <em>p</em> <!-->=<!--> <!-->0.002) were associated with a greater risk of hypoglycemia. Other hypoglycemia risk factors were older age, moderate–severe functional dependence, moderate–severe dementia, polypharmacy, and complex health status.</div></div><div><h3>Conclusions</h3><div>The linagliptin regimen simplified in-hospital antihyperglycemic management and reduced hypoglycemia events compared to basal-bolus insulin regimen in patients with type 2 diabetes aged<!--> <!-->≥<!--> <!-->80 years. Basal-bolus insulin use and clinical factors were associated with hypoglycemia. The linagliptin regimen could be considered as standard of care for older adult type 2 diabetes patients in the hospital setting.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 350-357"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769072","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":"Black hairy tongue","authors":"Julio C. Salas-Alanís ,&nbsp;Mauricio Salas-Garza ,&nbsp;María G. Moreno-Treviño ,&nbsp;Ma. G. Treviño-Alanís ,&nbsp;Gerardo Rivera-Silvac","doi":"10.1016/j.medcle.2024.10.021","DOIUrl":"10.1016/j.medcle.2024.10.021","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 386-387"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769134","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":"Which patients need thromboprophylaxis for venous thromboembolism prevention after hospitalization due to COVID-19? A sub-analysis from the CV COVID-19 registry","authors":"Andrea Ruberti ,&nbsp;Luis Ortega-Paz ,&nbsp;Salvatore Brugaletta ,&nbsp;on behalf of the CV COVID-19 Registry Investigators","doi":"10.1016/j.medcle.2024.10.022","DOIUrl":"10.1016/j.medcle.2024.10.022","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 380-381"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769080","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":"Carotid Plaque-Burden scale and outcomes: A real-life study","authors":"Carmen Sánchez-Bacaicoa ,&nbsp;Sergio Rico-Martin ,&nbsp;Clara Costo-Muriel ,&nbsp;Eduardo Ortega-Collazos ,&nbsp;Marta Sánchez-Lozano ,&nbsp;Marisol Sánchez-Bacaicoa ,&nbsp;Javier Galán-González ,&nbsp;Julián F. Calderón-García ,&nbsp;Juan Francisco Sánchez Muñoz-Torrero","doi":"10.1016/j.medcle.2024.10.020","DOIUrl":"10.1016/j.medcle.2024.10.020","url":null,"abstract":"<div><h3>Background</h3><div>The value of carotid ultrasound in real-world practice remains controversial. We investigated the outcomes of people with vascular risk factors according to an easy carotid-plaque burden scale (CPB-scale). Predictive yield of the addition CPB-scale to ESC-SCORE2 (CPB-SCORE2 table) was assessed.</div></div><div><h3>Methods</h3><div>A cohort of participants without preexisting cardiovascular disease (CVD) was evaluated for clinical outcomes according to the number of plaques by segment. The usefulness of the CPB-SCORE2 table was investigated.</div></div><div><h3>Results</h3><div>A total of 1004 patients were followed for a mean of 12.5 years for major adverse cardiovascular events (MACEs) and death. The CPB-scale was independently associated with MACEs; compared to those in the low-risk group, the corresponding adjusted hazard ratios (95% confidence intervals) for MACEs among the intermediate and high-risk groups were 13.1 (4.87–35.5) and 19.4 (7.27–51.9), respectively. Similarly, the risk of death was greater for participants stratified as high-risk than for those in the low-risk group (adjusted HR 3.36 [1.58–7.15]). According to our CPB-SCORE2 table, 149 of 178 (84%) CV events were detected in the high-risk group and exhibited greater sensitivity than did the SCORE2 Table, 84%; vs. 62%; but slightly less specificity, 62%; vs. 68%. Our table shows the improved performance of SCORE2; <em>c</em>-statistics: 0.74 vs. 0.68; <em>p</em> <!-->&lt;<!--> <!-->0.001 for net reclassification index and integrated discrimination index.</div></div><div><h3>Conclusions</h3><div>A simple prognostic CPB-scale was strongly associated with the long-term risk of developing a first MACE and all-cause death. Adding the CPB-scale to the SCORE2 may improve risk prediction with easy applicability in clinical practice.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 7","pages":"Pages 325-333"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768969","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":"Decisions at the end of life in health professionals","authors":"Yanira Aranda Rubio ,&nbsp;Beatriz Corrales González","doi":"10.1016/j.medcle.2024.11.013","DOIUrl":"10.1016/j.medcle.2024.11.013","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 9","pages":"Pages 504-505"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900212","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":"Pyoderma gangrenosum, acne and hidradenitis suppurativa (PASH syndrome) treated with dapsone monotherapy","authors":"Juan Pablo Velasco-Amador,&nbsp;David Moyano-Bueno,&nbsp;Ricardo Ruiz-Villaverde","doi":"10.1016/j.medcle.2024.11.014","DOIUrl":"10.1016/j.medcle.2024.11.014","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 9","pages":"Pages 508-509"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900213","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":"Carpal tunnel syndrome: Ulcerative-mutilating variant","authors":"Antonio Bustos-Merlo,&nbsp;María Martín-Armada","doi":"10.1016/j.medcle.2024.11.016","DOIUrl":"10.1016/j.medcle.2024.11.016","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 9","pages":"Pages 510-511"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900308","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":"Harm reduction of tobacco: Mith or reality?","authors":"Rodrigo Córdoba ,&nbsp;Vidal Barchilón ,&nbsp;Francisco Pascual ,&nbsp;Joan B. Soriano","doi":"10.1016/j.medcle.2024.12.006","DOIUrl":"10.1016/j.medcle.2024.12.006","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 9","pages":"Pages 499-503"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143900175","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}