Medicina clinica (English ed.)最新文献

{"title":"Cutaneous diphtheria","authors":"Irene Rivera-Ruiz , Carmen Mochón-Jiménez , Pedro Jesús Gómez-Arias","doi":"10.1016/j.medcle.2025.03.002","DOIUrl":"10.1016/j.medcle.2025.03.002","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 322-323"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697007","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":"Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia and small lymphocytic lymphoma from Chronic Lymphocytic Leukemia Spanish Group (GELLC)","authors":"Ángeles Medina , Ana Muntañola , Marta Crespo , Ángel Ramírez , José-Ángel Hernández-Rivas , Pau Abrisqueta , Miguel Alcoceba , Julio Delgado , Javier de la Serna , Blanca Espinet , Marcos González , Javier Loscertales , Alicia Serrano , María José Terol , Lucrecia Yáñez , Francesc Bosch , on behalf of the Grupo Español de Leucemia Linfocítica Crónica (GELLC)","doi":"10.1016/j.medcle.2024.10.012","DOIUrl":"10.1016/j.medcle.2024.10.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults in Western countries, with a median age at diagnosis of 72 years. This guide, developed by the Spanish Group for Chronic Lymphocytic leukemia (GELLC), addresses the most relevant aspects of CLL, with the objectives of facilitating and aiding the diagnostic process, establishing therapeutic recommendations for choosing the best treatment for each type of patient, as well as standardizing the management of CLL and ensuring equity across different hospitals in terms of the use of the various available treatment regimens.</div></div><div><h3>Methodology</h3><div>The references obtained were classified according to the level of evidence and following the criteria established by the Agency for Health Research and Quality, and the recommendations were classified according to the criteria of the National Comprehensive Cancer Network (NCCN).</div></div><div><h3>Diagnosis</h3><div>The diagnosis of CLL requires the presence of 5<!--> <!-->×<!--> <!-->10<sup>9</sup>/L clonal B lymphocytes with the characteristic phenotype (CD19, CD5, CD20, CD23, and kappa or lambda chain restriction) demonstrated by flow cytometry in peripheral blood and maintained for at least 3 months. The presence of cytopenia caused by a typical bone marrow infiltrate establishes the diagnosis of CLL, regardless of the number of circulating lymphocytes or existing lymph node involvement. CLL and small lymphocytic lymphoma (SLL) are the same disease with different presentations, so they should be treated the same way.</div><div>Current international guidelines recommend FISH with the 4 probes as a mandatory test in clinical practice to guide the prognosis of patients. They also recommend determining the mutational status of the immunoglobulin heavy chain variable region (<em>IGHV</em>) before the first treatment and detecting <em>TP53</em> mutations before the first and subsequent relapses.</div></div><div><h3>Treatment</h3><div>Treatment should be initiated in symptomatic patients with criteria for active disease according to iwCLL. The first aspect to highlight is the prioritization of targeted therapies over immunochemotherapy. In first-line treatment, for patients with del(17p) and/or <em>TP53</em> mutation, the best therapeutic option is a second-generation covalent Bruton’s tyrosine kinase inhibitor (BTKi) administered indefinitely, while in cases without del(17p) or <em>TP53</em> mutation with mutated IGHV, time-limited therapy with a combination including a BCL2 inhibitor (BCL2i) should be considered as the first therapeutic option. For patients with unmutated IGHV, both continuous BTKi and finite therapy with BCL2i are valid options that should be individually evaluated considering potential toxicities, drug interactions, patient preference, and logistical aspects. In very frail patients, supportive treatment should be considered. In relapse/refractory patients, prior t","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages e1-e18"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696725","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":"Panhypopituitarism and diabetes insipidus secondary to hypothalamic glioblastoma multiforme","authors":"Pablo Solís Sánchez, Sara Nieto Martínez, Javier Pardo Lledias","doi":"10.1016/j.medcle.2024.09.025","DOIUrl":"10.1016/j.medcle.2024.09.025","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 312-313"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696778","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":"Dronedarone pneumonitis: A case report","authors":"María Jesús Bruscas , Patricia Al-Cheikh , Gloria Abad","doi":"10.1016/j.medcle.2025.03.001","DOIUrl":"10.1016/j.medcle.2025.03.001","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 314-315"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696779","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":"Fecal occult blood is associated with an increased risk of cerebral small vessel disease in elderly patients","authors":"Cunsheng Wei,&nbsp;Xiaorong Yu,&nbsp;Yuan Chen,&nbsp;Junying Jiang,&nbsp;Meng Cao,&nbsp;Xuemei Chen","doi":"10.1016/j.medcle.2024.10.013","DOIUrl":"10.1016/j.medcle.2024.10.013","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Studies have shown that fecal occult blood is associated with an increased risk of ischemic stroke, but the relationship between fecal occult blood and cerebral small vessel disease (CSVD) remains largely unknown. This study aimed to identify predictors for CSVD, with fecal occult blood and its proxies as potential influencing factors in elderly patients.</div></div><div><h3>Method</h3><div>Patients aged 65 years or older with various chronic diseases were enrolled. The presence of CSVD was evaluated by brain MRI results. Fecal occult blood was measured by fecal immunochemical test. Logistic regression analysis was used for the association between the presence of fecal occult blood and the risk of CSVD.</div></div><div><h3>Results</h3><div>Logistic regression analysis indicated that a prevalence of positive fecal occult blood was related to CSVD (Model 1, adjusted OR<!--> <!-->=<!--> <!-->1.63, 95% CI: 1.15–2.29, <em>P</em> <!-->=<!--> <!-->0.006). We subsequently grouped all subjects as positive fecal occult blood (259, 16.48%) and negative fecal occult blood (1313, 83.52%), and logistic regression analysis indicated that a prevalence of CSVD was related to positive fecal occult blood (Model 2, adjusted OR<!--> <!-->=<!--> <!-->1.50, 95% CI: 1.08–2.08, <em>P</em> <!-->=<!--> <!-->0.015). In addition, the ratios of lacunes (67.18% vs. 53.85%, <em>P</em> <!-->&lt;<!--> <!-->0.001) and enlarged perivascular spaces (43.63% vs. 34.42%, <em>P</em> <!-->=<!--> <!-->0.005) were higher in patients with positive fecal occult blood than in controls.</div></div><div><h3>Conclusions</h3><div>The presence of fecal occult blood is probably related to the risk of CSVD in elderly patients and could be used as a screening tool for CSVD in elderly populations.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 287-291"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696722","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":"Institutional or personal e-mail address in manuscripts submitted to biomedical journals","authors":"Marta Pulido","doi":"10.1016/j.medcle.2024.09.027","DOIUrl":"10.1016/j.medcle.2024.09.027","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 6","pages":"Pages 318-319"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696783","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":"Association between cigarette smoking, genetic polymorphism and myelodysplasia: A multicentric case-control study","authors":"Natalia de las Heras Rodríguez ,&nbsp;Marta Megido Lahera ,&nbsp;José Ramón González Porras ,&nbsp;Sonia Sánchez Campos ,&nbsp;Raquel Díez Láiz ,&nbsp;Marta Fuertes Núñez ,&nbsp;Fernando Ramos Ortega","doi":"10.1016/j.medcle.2024.09.017","DOIUrl":"10.1016/j.medcle.2024.09.017","url":null,"abstract":"<div><h3>Background</h3><div>Both cigarette smoking (CGS), through its role as a benzene source, and some metabolic detoxyfiying enzymes (EDTOX) polymorphisms that hamper its inactivation, are considered as risk factors for the development of myelodysplastic neoplasms (MDS) and related disorders. This study aims to confirm such associations.</div></div><div><h3>Patients and methods</h3><div>We recruited 61 patients diagnosed with MDS following FAB Group criteria and 180 adults without peripheral blood cytopenia, and we analyzed: i) the crude odds-ratio (OR) for MDS between smokers and non-smokers, ii) the crude OR for MDS between homozygous individuals for the mutation NQO1⁶⁰⁹C—T, or harboring deletions in the genes codyfing for GSTM1 y GSTT1, and those who did not show such genotypes, and iii) the OR for MDS between smokers and non-smokers, adjusted for other potential risk factors.</div></div><div><h3>Results</h3><div>Our data confirm the association between MDS with a 28 pack-year or greater CGS history (OR 3.10; IC 95% 1.38–6.96). Conversely, we did not observe any association between MDS diagnosis and the EDTOX genotypes analyzed.</div></div><div><h3>Conclusions</h3><div>Cigarette smoking history is more relevant than EDTOX genotype in MDS etiopathogenesis.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 5","pages":"Pages 211-216"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609342","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":"Value of albumin administration in intensive care","authors":"Aurora Gil ,&nbsp;Ricard Ferrer","doi":"10.1016/j.medcle.2024.10.009","DOIUrl":"10.1016/j.medcle.2024.10.009","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 5","pages":"Pages 236-237"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609446","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":"Tumoral osteomalacia due to hemangiopericytoma","authors":"Julia Costas Eimil ,&nbsp;Antonia Rego Iraeta ,&nbsp;Lucía García Bernardo","doi":"10.1016/j.medcle.2024.08.016","DOIUrl":"10.1016/j.medcle.2024.08.016","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 5","pages":"Pages 251-252"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609339","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":"Ethics and challenges of artificial intelligence in healthcare","authors":"Aldo Medina Gamero","doi":"10.1016/j.medcle.2024.09.016","DOIUrl":"10.1016/j.medcle.2024.09.016","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 5","pages":"Page 254"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609449","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}