Medicina clinica (English ed.)最新文献

{"title":"Heart failure with reduced ejection fraction: Influence of gender on clinical characteristics, cardiac remodeling and neurohormonal response","authors":"Gloria Heredia-Campos ,&nbsp;Elena Rodríguez-Gómez Maria ,&nbsp;Jorge Perea-Armijo ,&nbsp;Rafael González-Manzanares ,&nbsp;Carlos Castillo-Domínguez Juan ,&nbsp;Mónica Delgado-Ortega ,&nbsp;Manuel Crespin-Crespin ,&nbsp;Martín Ruiz-Ortiz ,&nbsp;Dolores Mesa-Rubio ,&nbsp;Diana Ladera-Santos ,&nbsp;Rafael Iglesias-López ,&nbsp;Laura Calvo-Gutiérrez ,&nbsp;Laura Velarde-Morales ,&nbsp;Manuel Pan-Álvarez Osorio ,&nbsp;Manuel Anguita-Sánchez ,&nbsp;José López-Aguilera","doi":"10.1016/j.medcle.2025.106962","DOIUrl":"10.1016/j.medcle.2025.106962","url":null,"abstract":"<div><h3>Introduction</h3><div>It is estimated that 30−50% of patients with heart failure with reduced ejection fraction (HFrEF) are women. This population appears to differ in terms of clinical characteristics, aetiology and treatment optimisation compared to men. Our main objective was to analyse these considerations, the influence of female sex on cardiac remodelling and neurohormonal response, as well as their impact on medium- to long-term prognosis.</div></div><div><h3>Métodos</h3><div>Retrospective study of a cohort of HFrEF patients from real clinical practice. A comparative analysis was performed between male and female patients.</div></div><div><h3>Resultados</h3><div>409 patients were analysed, a total of 106 females (25.4%), with a higher mean age than males (71.4 ± 13.8 vs. 66 ± 11.9; p &lt; 0.001), higher prevalence of de novo HF (66.6% vs. 51.5%; p = 0.009), with a shorter HF evolution time (18.4 ± 42.6 vs. 42.8 ± 75.6 months; p = 0.001). Without significant differences in treatment optimisation, women had better cardiac remodelling at follow-up, as well as better neurohormonal response, with higher % reduction of NT-proBNP [−61,9% vs. −54,2%; p &lt; 0.01], and of CA125 [−63,4% vs. −50,9%; p &lt; 0.01]. With a median follow-up of 5 years, there were no differences in hospital readmissions or HF mortality in both sexes.</div></div><div><h3>Conclusiones</h3><div>Women with HFrEF have different clinical and aetiological characteristics compared to men. In evolution, they have better cardiac remodelling and neurohormonal response, although this has no impact on prognosis, readmission or mortality due to heart failure.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106962"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366925","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 of alirocumab and evolocumab (PCSK9i) for the treatment of hypercholesterolemia","authors":"Francisco José Fernández-Fernández ,&nbsp;Eugenia Ameneiros-Lago ,&nbsp;Alberto Muñiz-Gutiérrez","doi":"10.1016/j.medcle.2025.106924","DOIUrl":"10.1016/j.medcle.2025.106924","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106924"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366934","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":"Statin-related rhabdomyolysis in the context of drug interaction with tafamidis","authors":"Pablo Peláez-Ibáñez ,&nbsp;Núria Trullén-Malaret ,&nbsp;Marta Fanlo-Maresma","doi":"10.1016/j.medcle.2025.106947","DOIUrl":"10.1016/j.medcle.2025.106947","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106947"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366508","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":"Acute leukemia of ambiguous lineage: Diagnosis, prognosis and treatment","authors":"Anna Torrent ,&nbsp;Vitor Botafogo ,&nbsp;Josep Maria Ribera","doi":"10.1016/j.medcle.2025.106917","DOIUrl":"10.1016/j.medcle.2025.106917","url":null,"abstract":"<div><div>Acute leukemias of ambiguous lineage (ALAL) are an infrequent subtype of acute leukemias without clear evidence of differentiation to a one single cell lineage. Despite their rarity constitute a recognized subgroup in the recent international classifications, such as the WHO (World Health Organization) classification. Their diagnosis require highly specialized flow cytometry technology, and also cytogenetics and molecular techniques. The low frequency of the disease has made it difficult to find the best therapeutic strategy, due both to the lack of prospective studies and randomized trials, and to the heterogeneity of the published retrospective studies on follow-up and treatment. The group of ALAL has bad prognosis, and usually requires intensive strategies that include consolidation with allogeneic stem cell transplant as part of the treatment. The objective of this review was to analyze diagnosis, treatment and prognosis of this rare subtype of leukemias.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106917"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366928","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":"Is there new hope for rare diseases?","authors":"Álvaro Hermida Ameijeiras","doi":"10.1016/j.medcle.2025.106949","DOIUrl":"10.1016/j.medcle.2025.106949","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106949"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366927","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":"Geriatric assessment and results of transcatheter aortic valve implantation","authors":"Cristina de la Rubia-Molina ,&nbsp;Andrez Felipe Cubides-Novoa ,&nbsp;María Teresa Madrid-López ,&nbsp;Elisa Patín-González ,&nbsp;Verónica Merchán-Ordoñez ,&nbsp;Martín Negreira-Caamaño ,&nbsp;Javier Gil-Moreno ,&nbsp;Alfonso Freites ,&nbsp;Ignacio Sánchez-Pérez ,&nbsp;Virginia Mazoteras-Muñoz ,&nbsp;Jesús Piqueras-Flores","doi":"10.1016/j.medcle.2025.106936","DOIUrl":"10.1016/j.medcle.2025.106936","url":null,"abstract":"<div><h3>Introduction</h3><div>Comprehensive geriatric assessment (CGA) prior to transcatheter aortic valve replacement (TAVI) implantation for severe aortic stenosis (AS) may improve the selection of patients targeted for this strategy. Despite the fact that VGI includes multiple scales, comparative data among them are limited. Our aim was to evaluate the discriminative capacity of different scales used in CGA on the decision of suitability for TAVI implantation and the influence on prognosis after TAVI implantation.</div></div><div><h3>Methods</h3><div>Single-center prospective observational study including consecutive patients with severe AS referred for TAVI implantation. A CGA was performed in all patients including scales of functionality, frailty, cognitive impairment and comorbidities. The predictive capacity of each of the scales was evaluated. The development of major cardiovascular events (cardiovascular mortality, heart failure and stroke) was analyzed during follow-up.</div></div><div><h3>Results</h3><div>142 patients were selected as candidates for TAVI (80.2%), and 121 were finally implanted. The mean age was 83 ± 4.9 years. Patients who were candidates for TAVI had less valvular area, less atrial fibrillation (AF), less cognitive impairment, more autonomy and less frailty. The SPPB frailty and Barthel functional assessment scales were the main scales of the CGA for the TAVI candidacy decision.</div><div>After TAVI implantation, 21.5% presented a cardiovascular event, with an overall mortality of 19.8% (6.6% cardiovascular). Patients with a higher rate of events and mortality had more AF, HF, renal disease and malnutrition, as well as less family coverage.</div></div><div><h3>Conclusions</h3><div>In elderly patients with severe AS, the CGA is a determining factor in the selection of candidates for TAVI, with frailty and functional assessment being the most important aspects. Family support and nutritional status have a high impact on the prognosis of patients after TAVI.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106936"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366924","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":"Winds of change are blowing. The care role of internists in hospitals","authors":"Eduardo Montero Ruiz","doi":"10.1016/j.medcle.2025.106942","DOIUrl":"10.1016/j.medcle.2025.106942","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106942"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366930","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":"Intestinal obstruction secondary to distal ileitis caused by anisakiasis","authors":"Santiago Manuel de los Reyes Vázquez ,&nbsp;María del Carmen Palomar Muñoz ,&nbsp;Isabel Murciano Gómez","doi":"10.1016/j.medcle.2025.106946","DOIUrl":"10.1016/j.medcle.2025.106946","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106946"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366932","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":"Risk of venous thromboembolism in the transgender population on hormone therapy: A systematic review","authors":"Anabel Franco-Moreno ,&nbsp;Pablo Ryan ,&nbsp;Nuria Muñoz-Rivas ,&nbsp;Jorge Valencia ,&nbsp;Juan Torres-Macho ,&nbsp;Susana Bacete-Cebrián","doi":"10.1016/j.medcle.2025.106921","DOIUrl":"10.1016/j.medcle.2025.106921","url":null,"abstract":"<div><h3>Background and objective</h3><div>Hormone therapy is associated with an increased thrombotic risk. The objective of this systematic review is to assess the incidence of venous thromboembolism in the transgender population undergoing gender-affirming hormone therapy and compare it with that in cisgender individuals of the same sex assigned at birth.</div></div><div><h3>Materials and method</h3><div>A literature search was conducted in databases including PubMed, Cochrane Library, Scopus, and EMBASE, encompassing all studies that report data related to the incidence of venous thromboembolism in transgender individuals on hormone therapy.</div></div><div><h3>Results</h3><div>Twenty-one studies were included. Five studies assessed the incidence of thromboembolic events in both populations. The occurrence of thrombosis was higher in transgender women than cisgender men (OR 2.23; 95% CI: 1.93–2.57; <em>p</em> <!-->&lt;<!--> <!-->0.001). No differences between transgender men and cisgender women (OR 0.96; 95% CI: 0.87–2.31; <em>p</em> <!-->=<!--> <!-->0.60) were found.</div></div><div><h3>Conclusion</h3><div>Our systematic review suggests that hormone therapy in transgender women may increase the risk of venous thromboembolism.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106921"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366929","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":"Cutaneous nodules on tattoo as the first manifestation of pulmonary sarcoidosis with extrathoracic involvement","authors":"Miguel Antonio Lasheras-Pérez ,&nbsp;Judith González ,&nbsp;Sara Montesinos-González ,&nbsp;Antonio Sahuquillo-Torralba","doi":"10.1016/j.medcle.2025.106934","DOIUrl":"10.1016/j.medcle.2025.106934","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"164 12","pages":"Article 106934"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366935","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}