Revista clinica espanola最新文献

Ketone elevation during SGLT2 inhibitor therapy is driven by acute illness rather than treatment indication. SGLT2抑制剂治疗期间酮体升高是由急性疾病而非治疗指征驱动的。

Revista clinica espanola Pub Date : 2026-05-05 DOI: 10.1016/j.rceng.2026.502565

M Constanti, V Liakopoulos, K Kotsa, T Koufakis

引用次数: 0

Community-acquired pneumonia: Assessment of therapeutic adequacy in patients admitted to a secondary-level hospital. 社区获得性肺炎：二级医院收治患者治疗充分性评估

Revista clinica espanola Pub Date : 2026-05-05 DOI: 10.1016/j.rceng.2026.502563

A Silva Asiain, M Arrondo Turrado, M A Domínguez Sepúlveda, P Bermejo Acevedo, R Barba Martín, J A Rueda Camino

{"title":"Community-acquired pneumonia: Assessment of therapeutic adequacy in patients admitted to a secondary-level hospital.","authors":"A Silva Asiain, M Arrondo Turrado, M A Domínguez Sepúlveda, P Bermejo Acevedo, R Barba Martín, J A Rueda Camino","doi":"10.1016/j.rceng.2026.502563","DOIUrl":"10.1016/j.rceng.2026.502563","url":null,"abstract":"<p><strong>Background: </strong>there is limited evidence regarding the appropriateness of therapeutic management for community-acquired pneumonia (CAP) in Spain. This study assessed treatment adequacy according to the 2019 IDSA guidelines.</p><p><strong>Materials and methods: </strong>retrospective cohort study involving adults hospitalized for CAP between January-December 2022, excluding nosocomial pneumonia and ICU admissions. Treatment was considered adequate if antibiotic type, duration, and dosage were appropriate. The primary outcome was the proportion of patients receiving adequate treatment. Secondary outcomes included length of stay and hospital costs.</p><p><strong>Results: </strong>382 patients (50% male, mean age 74.24 ± 16.62 years) were included; 17.8% (95% CI: 14.1%-22.0%) received adequate treatment. Patients with adequate treatment exhibited a significantly shorter hospital stay (-1 day, 95% CI: -1.7 to -0.3) and significantly lower hospital costs (-545€, 95% CI: -1081€ to -9€).</p><p><strong>Conclusion: </strong>therapeutic adequacy among hospitalized patients with CAP is low.</p>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":" ","pages":"502563"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848391","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}

引用次数: 0

Executive summary of the 2026 consensus document. Planning the future of Internal Medicine: A position statement of the International Forum of Internal Medicine (FIMI). 2026年共识文件执行摘要。规划内科的未来：国际内科论坛（FIMI）的立场声明。

Revista clinica espanola Pub Date : 2026-05-05 DOI: 10.1016/j.rceng.2026.502572

P Valdez, L Cámera, H L Puello Galarcio, D Manfellotto, A Fadhil Hlaihel, F Benmediouni, D Johnson, G Dalekos, E Casariego-Vales

{"title":"Executive summary of the 2026 consensus document. Planning the future of Internal Medicine: A position statement of the International Forum of Internal Medicine (FIMI).","authors":"P Valdez, L Cámera, H L Puello Galarcio, D Manfellotto, A Fadhil Hlaihel, F Benmediouni, D Johnson, G Dalekos, E Casariego-Vales","doi":"10.1016/j.rceng.2026.502572","DOIUrl":"10.1016/j.rceng.2026.502572","url":null,"abstract":"<p><p>The International Forum of Internal Medicine (FIMI) presents a position paper that analyzes the current state and projects the future of Internal Medicine in a global context marked by population aging, multimorbidity, fragmentation of health systems, and rapid technological transformation. The document emerged from a collaborative process involving 52 scientific societies from 43 countries, with representation from all five continents. Drawing on Ibero-American research and the consensus of international leaders, it describes the central role of the internist in comprehensive, longitudinal, and person-centered care for adults, particularly those with complex conditions. Key strengths are identified, including integrative clinical reasoning and interdisciplinary coordination, alongside persistent weaknesses such as heterogeneity in training, adverse working conditions, and professional burnout. The challenges and opportunities posed by telemedicine, point-of-care ultrasound, and artificial intelligence are also examined. Finally, a structured Improvement Plan is proposed, encompassing clinical care, education, research, management, and professional well-being.</p>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":" ","pages":"502572"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848422","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}

引用次数: 0

Understanding polymicrobial bloodstream infections: Clinical and microbiological insights from a Spanish University Hospital. 了解多微生物血流感染：来自西班牙大学医院的临床和微生物学见解。

Revista clinica espanola Pub Date : 2026-05-05 DOI: 10.1016/j.rceng.2026.502566

R Causa, M C García, G Santillana, Y Angulo, V Marín, L Grau, F Ríos, M Andrés

{"title":"Understanding polymicrobial bloodstream infections: Clinical and microbiological insights from a Spanish University Hospital.","authors":"R Causa, M C García, G Santillana, Y Angulo, V Marín, L Grau, F Ríos, M Andrés","doi":"10.1016/j.rceng.2026.502566","DOIUrl":"10.1016/j.rceng.2026.502566","url":null,"abstract":"<p><strong>Background and objectives: </strong>Evidence on polymicrobial bloodstream infections (PMB) in Spain remains limited. In this study, we aimed to describe its etiology, clinical features and outcomes in adult patients.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at a 350-bed hospital in Terrassa, Barcelona, from 2017 to 2024. Clinical and microbiological data were reviewed. Bivariate analyses and multivariate logistic regression were applied to identify predictors of 30-day mortality.</p><p><strong>Results: </strong>We identified 115 episodes. Intra-abdominal foci represented 50% of cases. Non-anaerobic Gram-negative bacilli predominated, either alone (31%) or combined with Gram-positive cocci (40%), while anaerobes appeared in 14%. Thirty-day mortality was 30%. In the multivariable analysis, three variables remained independently associated with mortality: baseline prognosis (McCabe-score), acute severity (Pitt bacteremia-score) and adequacy of empirical therapy.</p><p><strong>Conclusions: </strong>PMB is associated with high mortality. Prognosis is influenced by host vulnerability, infection severity and the initial empirical treatment. Early recognition and adequate empirical therapy are essential to improve outcomes.</p>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":" ","pages":"502566"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848465","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}

引用次数: 0

Medium-chain acyl-CoA dehydrogenase deficiency diagnosed in adulthood. 成人中链酰基辅酶a脱氢酶缺乏症。

Revista clinica espanola Pub Date : 2026-05-05 DOI: 10.1016/j.rceng.2026.502567

V Manzano-Gamero, A Rosales-Castillo

引用次数: 0

Clinical reliability of a wrist-worn oscillometric ambulatory blood pressure monitor: an independent agreement evaluation 腕戴式动态血压监测仪的临床可靠性：一项独立的一致性评估。

Revista clinica espanola Pub Date : 2026-05-01 Epub Date: 2026-03-23 DOI: 10.1016/j.rceng.2026.502523

Ó. Seoane-Casqueiro , N. Vázquez-Agra , A. Cruces-Sande , E. López-Prado , J.-E. López-Paz , M. Camafort , E. Casariego-Vales , Á. Hermida-Ameijeiras , A. Pose-Reino

{"title":"Clinical reliability of a wrist-worn oscillometric ambulatory blood pressure monitor: an independent agreement evaluation","authors":"Ó. Seoane-Casqueiro , N. Vázquez-Agra , A. Cruces-Sande , E. López-Prado , J.-E. López-Paz , M. Camafort , E. Casariego-Vales , Á. Hermida-Ameijeiras , A. Pose-Reino","doi":"10.1016/j.rceng.2026.502523","DOIUrl":"10.1016/j.rceng.2026.502523","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the concordance between a novel wrist-worn oscillometric device and a validated ambulatory blood pressure monitor (ABPM) for blood pressure (BP) and heart rate (HR) assessment under real 24-h ABPM conditions.</div></div><div><h3>Methods</h3><div>We conducted an observational concordance study in consecutive hypertensive outpatients requiring 24-h ABPM between May and October 2025. Participants simultaneously wore a validated reference device (SunTech Oscar 2) and the wrist-worn monitor (Huawei Watch D2). Mean BP and HR values for the 24-h, daytime, and nighttime periods were compared. Agreement was assessed using Bland–Altman analysis, intraclass correlation coefficients [ICC(A,1)], and the proportion of readings within ±5, ±10, and ±15 mmHg according to the AAMI/ESH/ISO criteria.</div></div><div><h3>Results</h3><div>Forty-one patients were included (63% women; median age: 47 years). The wrist-worn device systematically underestimated systolic BP (SBP) during the 24-h and daytime periods and exhibited reduced variability compared with the reference device. Bland–Altman analysis showed a mean bias of –6.8 mmHg for SBP with wide limits of agreement. ICC values indicated poor concordance for SBP (0.38) and moderate concordance for DBP (0.54), while HR agreement was excellent (ICC 0.87). Only 47% of systolic and 61% of DBP readings fell within ±10 mmHg of the reference values, below the AAMI/ESH/ISO acceptability threshold.</div></div><div><h3>Conclusions</h3><div>The wrist-worn device did not demonstrate sufficient concordance for ambulatory BP monitoring, although HR performance was reliable. These findings support the need for independent evaluations before considering such devices for clinical BP assessment.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"226 5","pages":"Article 502523"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518016","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}

引用次数: 0

The forgotten scurvy: association between long-term corticosteroid therapy and vitamin C metabolism 被遗忘的坏血病：长期皮质类固醇治疗与维生素C代谢之间的关系。

Revista clinica espanola Pub Date : 2026-05-01 Epub Date: 2026-03-27 DOI: 10.1016/j.rceng.2026.502537

E. López-Sanchez, D. Rico-Lopez, A. Ortiz-Parra

引用次数: 0

Benefits of a comprehensive care model in patients with heart failure and anemia: UMIPIC program 心力衰竭和贫血患者综合护理模式的益处：UMIPIC项目。

Revista clinica espanola Pub Date : 2026-05-01 Epub Date: 2026-03-27 DOI: 10.1016/j.rceng.2026.502538

J.M. Cerqueiro-González , Á.G. Franco , M.M. Bailón , P.L. Iborra , A.C. Martel , J. Pérez Silvestre , M.M. Pérez-Barquero , L.M. Espinosa

{"title":"Benefits of a comprehensive care model in patients with heart failure and anemia: UMIPIC program","authors":"J.M. Cerqueiro-González , Á.G. Franco , M.M. Bailón , P.L. Iborra , A.C. Martel , J. Pérez Silvestre , M.M. Pérez-Barquero , L.M. Espinosa","doi":"10.1016/j.rceng.2026.502538","DOIUrl":"10.1016/j.rceng.2026.502538","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the prognostic benefit of the UMIPIC care program in patients with heart failure (HF) and anemia.</div></div><div><h3>Methods</h3><div>Data from 3,152 patients with HF and anemia from the RICA registry were analyzed. They were divided into two groups and selected by matched match: one receiving UMIPIC follow-up (UMIPIC group, N: 621) and the other receiving conventional care (non-UMIPIC group, N: 524). Admissions and mortality were assessed during 12 months of follow-up.</div></div><div><h3>Results</h3><div>The UMIPIC group had a lower rate of admissions for HF (19.3% vs. 29.8%; p < 0.001) and a reduction in overall mortality (24.8% vs. 36.6%; p < 0.001). Patients in the UMIPIC group with associated iron deficiency (ID) also had a lower rate of admissions for HF (19.1% vs. 32.5%; p < 0.001).</div></div><div><h3>Conclusions</h3><div>Implementation of the UMIPIC program in patients with HF and anemia reduces admissions and overall mortality at one year. Additional studies are needed to explore the impact of specific ID treatment within these care program.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"226 5","pages":"Article 502538"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147577459","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}

引用次数: 0

Emotional distress and subjective well-being in adults with type 1 diabetes: a cross-sectional study using PAID-5 and WHO-5 成人1型糖尿病患者的情绪困扰和主观幸福感：一项使用PAID-5和WHO-5的横断面研究

Revista clinica espanola Pub Date : 2026-05-01 Epub Date: 2026-03-26 DOI: 10.1016/j.rceng.2026.502539

C. Delicado-Hernández , M. Gallach-Martínez , N. García-Corrales , P.J. Pinés-Corrales

引用次数: 0

Executive summary of the consensus document for recommendations on the diagnosis of venous thromboembolism in pregnancy. Recommendations from the Spanish Society of Internal Medicine, the Spanish Society of Medical Radiology, the Spanish Society of Vascular Interventional Radiology, and the Spanish Society of Gynecology and Obstetrics 2025 关于妊娠静脉血栓栓塞诊断建议的共识文件执行摘要：西班牙内科学会、西班牙医学放射学会、西班牙血管介入放射学会和西班牙妇产科学会2025年的建议。

Revista clinica espanola Pub Date : 2026-05-01 Epub Date: 2026-03-31 DOI: 10.1016/j.rceng.2026.502522

Sergio Moragón-Ledesma , María Ortiz-Rodríguez , M. Ángeles Fidalgo-Fernández , Sara Lojo-Lendoiro , Pablo Demelo-Rodriguez , Mikel Grau-García , Miguel Martín-Asenjo , Berta Serrano-Sánchez , Nuria Martínez-Sánchez , Olga Madridano-Cobo , Esther Gálvez-González , Francisco Galeano-Valle

{"title":"Executive summary of the consensus document for recommendations on the diagnosis of venous thromboembolism in pregnancy. Recommendations from the Spanish Society of Internal Medicine, the Spanish Society of Medical Radiology, the Spanish Society of Vascular Interventional Radiology, and the Spanish Society of Gynecology and Obstetrics 2025","authors":"Sergio Moragón-Ledesma , María Ortiz-Rodríguez , M. Ángeles Fidalgo-Fernández , Sara Lojo-Lendoiro , Pablo Demelo-Rodriguez , Mikel Grau-García , Miguel Martín-Asenjo , Berta Serrano-Sánchez , Nuria Martínez-Sánchez , Olga Madridano-Cobo , Esther Gálvez-González , Francisco Galeano-Valle","doi":"10.1016/j.rceng.2026.502522","DOIUrl":"10.1016/j.rceng.2026.502522","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnancy and the postpartum period increase the risk of venous thromboembolism (VTE). In pregnant women, diagnosing VTE is challenging due to the similarity between normal pregnancy symptoms and those of VTE, the physiological elevation of D-dimer levels, and the altered validity of diagnostic scoring systems. In 2019, Pregnancy-Adapted YEARS Algorithm for diagnosis of suspected pulmonary embolism was published, providing evidence on the safety and effectiveness of this diagnostic algorithm.</div></div><div><h3>Methods and Results</h3><div>This consensus document, developed by the Spanish Societies of Internal Medicine, Medical Radiology, Vascular and Interventional Radiology, and Obstetrics and Gynecology, presents a comprehensive review of the most recent evidence and updates the recommendations for the diagnosis of VTE in pregnancy.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"226 5","pages":"Article 502522"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617339","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}

引用次数: 0