Revista clinica espanola最新文献_第10页

Alcohol consumption in elderly people. What is the real magnitude of the problem? 老年人饮酒。问题的实际严重程度如何？

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.07.007

I. Fernández Castro , M. Marcos Martín , I. Novo Veleiro

{"title":"Alcohol consumption in elderly people. What is the real magnitude of the problem?","authors":"I. Fernández Castro , M. Marcos Martín , I. Novo Veleiro","doi":"10.1016/j.rceng.2024.07.007","DOIUrl":"10.1016/j.rceng.2024.07.007","url":null,"abstract":"<div><div>The harmful effects of alcohol consumption have been well studied in the general population, but in the group of people over 80 years of age there is not much information regarding its relevance. It is estimated than 30%–40% of this population consumes alcohol regularly and around 10% engage in high-risk consumption. Furthermore, potential interactions between this substance and commonly consumed drugs in this age group, like oral antidiabetics, anticoagulants and antibiotics, may pose a risk of serious complications.</div><div>In this sense, the aim of the present work was to analyze the magnitude of alcohol consumption within people over 80 years of age and the impact it has on their health. A narrative review of the available literature on the topic was carried out, which showed that alcohol consumption in people over 80 years of age is common in our environment and is associated with multiple complications and the development of different pathologies. The correct quantification of alcohol consumption in very elderly people must be integrated into the daily clinical practice of Medicine in general and Internal Medicine in particular.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 537-545"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750162","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

Cardiac amyloidosis worsens prognosis in patients with heart failure: findings from the PREVAMIC study 心脏淀粉样变性会加重心力衰竭患者的预后：PREVAMIC 研究的结果。

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.07.006

R. Ruiz Hueso , P. Salamanca Bautista , M.A. Quesada Simón , S. Yun , A. Conde Martel , J.L. Morales Rull , I. Fiteni Mera , D. Abad Pérez , I. Páez Rubio , Ó. Aramburu Bodas

{"title":"Cardiac amyloidosis worsens prognosis in patients with heart failure: findings from the PREVAMIC study","authors":"R. Ruiz Hueso , P. Salamanca Bautista , M.A. Quesada Simón , S. Yun , A. Conde Martel , J.L. Morales Rull , I. Fiteni Mera , D. Abad Pérez , I. Páez Rubio , Ó. Aramburu Bodas","doi":"10.1016/j.rceng.2024.07.006","DOIUrl":"10.1016/j.rceng.2024.07.006","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Cardiac amyloidosis (CA) is a common pathology in elderly patients that usually presents as heart failure (HF). However, it is not clear whether CA associated with HF has a worse prognosis compared with HF due to other etiologies.</div></div><div><h3>Material and methods</h3><div>Prospective, observational cohort study that recruited patients ≥65 years of age with HF in 30 Spanish centers. The cohort was divided according to whether the patients had AC or not. Patients were followed for 1 year.</div></div><div><h3>Results</h3><div>A total of 484 patients were included in the analysis. The population was elderly (median 86 years) and 49% were women CA was present in 23.8 % of the included patients. In the CA group, there was a lower prevalence of diabetes mellitus and valvular disease. At one year of follow-up, mortality was significantly more frequent in patients with CA compared to those without (33.0 vs.14.9%, p < 0.001). However, there were no differences between both groups in visits to the emergency room or readmissions. In the multivariate analysis, the variables that were shown to predict all-cause mortality at one year of follow-up were chronic kidney disease (HR 1.75 (1.01–3.05) p 0.045), NT-proBNP levels (HR 2.51 (1.46–4.30) p < 0.001), confusion (HR 2.05 (1.01–4.17), p 0.048), and the presence of CA (HR 1.77 (1.11–2.84), p 0.017).</div></div><div><h3>Conclusion</h3><div>The presence of CA in elderly patients with HF is related to a worse prognosis at one year of follow-up. Early diagnosis of the pathology and multidisciplinary management can help improve patient outcomes.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 494-502"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736312","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

Pneumocystis jirovecii in human disease: just pneumonia? 人类疾病中的肺孢子虫：仅仅是肺炎吗？

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.07.005

E.J. Calderón , V. Friaza

引用次数: 0

E-consults between primary care and internal medicine: implementation, accessibility, benefits, and implications 初级保健和内科之间的电子会诊：实施、可及性、益处和影响。

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rceng.2024.06.007

{"title":"E-consults between primary care and internal medicine: implementation, accessibility, benefits, and implications","authors":"","doi":"10.1016/j.rceng.2024.06.007","DOIUrl":"10.1016/j.rceng.2024.06.007","url":null,"abstract":"<div><h3>Aim</h3><p>This work aims to evaluate whether electronic consultations (e-consults) are a clinically useful, safe tool for assessing patients between primary care<span> and internal medicine.</span></p></div><div><h3>Methods</h3><p>This is a retrospective cohort study<span> of all e-consults ordered by the Primary Care Department to the Internal Medicine Department between September 2019 and December 2023. The results of initial consultations, emergency department visits and subsequent admissions, and survival were assessed and complaints and claims filed were reviewed.</span></p></div><div><h3>Results</h3><p>A total of 11,434 e-consults were recorded (55.4% women) with a mean age of 62.1 (SD19.4) years and a wide range (15–102 years). The mean response time was 2.55 (SD 1.6) days. As a result of the e-consults, 5645 patients (49.4%) were given an in-person appointment. For the remaining 5789 (50.6%), a written response was provided. Among those given appointments, the time between the response and in-person appointment was less than five days (95% of cases). Compared to those not given appointments, in-person appointments were older (<em>p</em> < 0.0001), visited the emergency department more times (one month: <em>p</em> = 0.04; three months: <em>p</em> = 0.001), were admitted to the hospital more times (one month: <em>p</em> = 0.0001; three months: <em>p</em> = 0.0001), and had higher mortality at one year (12.7% vs. 9.8% <em>p</em> = 0.0001). In the Cox analysis, only in-person appointments (RR = 1.11; <em>p</em> = 0.04)) and age (RR = 1.09; <em>p</em> < 0.01) were independent factors of mortality. No complaints or claims of any kind were registered.</p></div><div><h3>Conclusions</h3><p>These data suggest that e-consults are a clinically useful, safe tool for assessing patients referred from primary care to internal medicine departments.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 421-427"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319422","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

Counter reply in reference to “Prevalence of neutralizing antibodies against SARS-CoV-2 using a rapid serological test in health workers of a Spanish Department of Health in Alicante (Spain) before the booster dose of the vaccine” 就 "医护人员接种两剂 BNT162b2 疫苗（辉瑞生物科技公司）后产生的 SARS-CoV-2 中和抗体的流行情况 "致编辑的回信。

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rceng.2024.06.006

引用次数: 0

The utility of 18F-FDG-PET/CT in detecting extracranial large vessel vasculitis in rheumatic polymyalgia or giant cell arteritis. A systematic review and meta-analysis 18F-FDG-PET/CT在风湿性多肌痛或巨细胞动脉炎中检测颅外大血管炎的实用性：系统综述与荟萃分析。

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rceng.2024.06.005

{"title":"The utility of 18F-FDG-PET/CT in detecting extracranial large vessel vasculitis in rheumatic polymyalgia or giant cell arteritis. A systematic review and meta-analysis","authors":"","doi":"10.1016/j.rceng.2024.06.005","DOIUrl":"10.1016/j.rceng.2024.06.005","url":null,"abstract":"<div><h3>Objective</h3><p><span>Systematic review<span> of current evidence to analyze the prevalence of extracranial large vessel vasculitis (LVV) using </span></span><sup>18</sup><span><span>F-FDG PET/CT in patients with polymyalgia rheumatica (PMR) or </span>giant cell arteritis (GCA).</span></p></div><div><h3>Materials and methods</h3><p>PubMed and EMBASE were searched and the results were screened by two reviewers. Study quality was assessed using a modified version of the Newcastle-Ottawa scale. Heterogeneity between studies was assessed using the I<sup>2</sup> statistic and the Q test. Further subgroup analyses were performed by disease type, study quality, and <sup>18</sup><span>F-FDG PET/CT uptake criteria. Publication bias was assessed by funnel plot and Egger's test.</span></p></div><div><h3>Results</h3><p>268 publications were identified, of which 17 met the selection criteria and were included in the meta-analysis. The overall pooled prevalence of extracranial LVV by <sup>18</sup>F-FDG PET/CT was 54.5% [95% CI: 42.6%–66.1%]. In patients with GCA the prevalence was significantly higher than in patients with PMR (60.1% vs. 41.8%, <em>P</em> = 0.006). Likewise, studies with a lower risk of bias reported a higher prevalence of extracranial LVV (61.1% vs. 46.9%; <em>P</em> = 0.010). No publication bias was observed.</p></div><div><h3>Conclusions</h3><p>The <sup>18</sup>F-FDG PET/CT test may be useful in the detection of extracranial LVV, both in patients with PMR or GCA. Such involvement is more frequent in patients with GCA, and may vary depending on the quality of the studies.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 445-456"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297738","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

Letter to the Editor about “Prevalence of neutralizing antibodies against SARS-CoV-2 using a rapid serological test in health workers before the booster dose of the vaccine” 对 "医护人员接种两剂 BNT162b2 疫苗（辉瑞-生物技术公司）后产生的 SARS-CoV-2 中和抗体的流行率 "的答复

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rceng.2024.06.011

引用次数: 0

Bronchiectasis, lymphadenopathies related to BAFF overexpression and lymphoplasmacytic cystitis as adverse events associated with prolonged use of rituximab in systemic autoimmune rheumatic diseases 支气管扩张、与 BAFF 过度表达相关的淋巴腺病变和淋巴浆细胞性膀胱炎是全身性自身免疫性风湿病患者长期使用利妥昔单抗的不良反应。

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rceng.2024.06.001

{"title":"Bronchiectasis, lymphadenopathies related to BAFF overexpression and lymphoplasmacytic cystitis as adverse events associated with prolonged use of rituximab in systemic autoimmune rheumatic diseases","authors":"","doi":"10.1016/j.rceng.2024.06.001","DOIUrl":"10.1016/j.rceng.2024.06.001","url":null,"abstract":"<div><h3>Background</h3><p>The long-term use of rituximab<span><span> (RTX) has been gaining ground in the treatment of systemic autoimmune diseases. The </span>adverse events (AEs) associated with its use different to infections are being reported.</span></p></div><div><h3>Methods</h3><p>A cohort of patients with SAIDs treated at a high-complexity center in Cali (southwestern Colombia) with follow-up from January 2008 to December 2022 were examined to search for potential AEs associated with prolonged use of RTX.</p></div><div><h3>Results</h3><p><span>From 178 patients with long-term use of RTX 3 (1.68%) had lymphadenopathies with </span>lymphoid follicular hyperplasia<span><span> related to BAFF<span> overexpression, 4 (2.24%) with bronchiectasis, and 4 (2.24%) with lymphoplasmacytic </span></span>cystitis.</span></p></div><div><h3>Conclusion</h3><p><span><span>Bronchiectasis, lymphoid follicular hyperplasia related to </span>BAFF overexpression, and lymphoplasmacytic </span>cystitis may be life-threatening long-term AEs in patients with prolonged use of RTX.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 474-478"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289096","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

Oral anticoagulant treatment in atrial fibrillation: the AFIRMA real-world study using natural language processing and machine learning 心房颤动的口服抗凝治疗：使用自然语言处理和机器学习的 AFIRMA 真实世界研究。

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rceng.2024.06.002

{"title":"Oral anticoagulant treatment in atrial fibrillation: the AFIRMA real-world study using natural language processing and machine learning","authors":"","doi":"10.1016/j.rceng.2024.06.002","DOIUrl":"10.1016/j.rceng.2024.06.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Oral anticoagulation<span><span> (OAC) is key in atrial fibrillation (AF) </span>thromboprophylaxis, but Spain lacks substantial real-world evidence. We aimed to analyze the prevalence, clinical characteristics, and treatment patterns among patients with AF undertaking OAC, using natural language processing (NLP) and machine learning (ML).</span></p></div><div><h3>Materials and methods</h3><p>This retrospective study included AF patients on OAC from 15 Spanish hospitals (2014–2020). Using EHRead® (including NLP and ML), and SNOMED_CT, we extracted and analyzed patient demographics, comorbidities, and OAC treatment from electronic health records. AF prevalence was estimated, and a descriptive analysis was conducted.</p></div><div><h3>Results</h3><p>Among 4,664,224 patients in our cohort, AF prevalence ranged from 1.9% to 2.9%. A total of 57,190 patients on OAC therapy<span><span> were included, 80.7% receiving Vitamin K antagonists<span><span> (VKA) and 19.3% Direct-acting OAC (DOAC). The median age was 78 and 76 years respectively, with males constituting 53% of the cohort. Comorbidities like hypertension (76.3%), diabetes (48.0%), heart failure (42.2%), and renal disease (18.7%) were common, and more frequent in VKA users. Over 50% had a high CHA2DS2-VASc score. The most frequent treatment switch was from DOAC to </span>acenocoumarol (58.6% to 70.2%). In switches from VKA to DOAC, </span></span>apixaban was the most chosen (35.2%).</span></p></div><div><h3>Conclusions</h3><p>Utilizing NLP and ML to extract RWD, we established the most comprehensive Spanish cohort of AF patients with OAC to date. Analysis revealed a high AF prevalence, patient complexity, and a marked VKA preference over DOAC. Importantly, in VKA to DOAC transitions, apixaban was the favored option.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 428-436"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289097","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 value of multi-modal ultrasound in the assessment of sarcopenia in maintenance hemodialysis patients 多模态超声在评估维持性血液透析患者肌少症中的价值。

Revista clinica espanola Pub Date : 2024-08-01 DOI: 10.1016/j.rceng.2024.06.003

{"title":"The value of multi-modal ultrasound in the assessment of sarcopenia in maintenance hemodialysis patients","authors":"","doi":"10.1016/j.rceng.2024.06.003","DOIUrl":"10.1016/j.rceng.2024.06.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Sarcopenia is one of the common complications in maintenance hemodialysis (MHD) patients and is associated with poor prognosis. We aimed to study the validity and reliability of ultrasound in the assessment of sarcopenia in MHD patients.</p></div><div><h3>Methods</h3><p>MHD patients were categorized into the sarcopenia group and the non-sarcopenia group according to the diagnostic criteria of the Asian Working Group on Sarcopenia (AWGS) 2019. Ultrasonography of the left medial head of the gastrocnemius muscle was performed in MHD and healthy controls to obtain muscle thickness (MT), pinnation angle (PA), fascicle length (FL), cross-sectional area (CSA), echo intensity (EI), elastic modulus (E), shear wave velocity (SWV), and microvascular velocity (MV). Compare the differences in ultrasound parameters among different groups, and determine the cut-off values suitable for diagnosing sarcopenia in MHD patients.</p></div><div><h3>Results</h3><p>The MT, CSA, PA, and MV in the sarcopenia group were lower than those in the non-sarcopenia group and the control group; while the EI was higher, the FL of the sarcopenia group was lower than that of the non-sarcopenia group, while the E and SWV of the sarcopenia group were higher than those of the control group. Receiver operating characteristic curve analyses indicated that ultrasound combined index had a good diagnostic value, model <em>Y</em> = 13.511−0.121*MT-0.609*CSA-0.172*PA+0.011*EI-2.205*MV(<em>P</em> < 0.05), with a cut-off value of 0.69.</p></div><div><h3>Conclusions</h3><p>Multi-modal ultrasound is a safe, non-invasive, and real-time imaging examination method, and can provide information on muscle structure, stiffness, and perfusion, which is expected to be a promising potential tool for predicting sarcopenia in MHD patients.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 437-444"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2254887424000821/pdfft?md5=a0c3c97314799d9991c3f3ee011e5206&pid=1-s2.0-S2254887424000821-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0