Revista clinica espanola最新文献

{"title":"Evaluation of the efficacy of N-acetylcysteine and bromhexine compared with standard care in preventing hospitalization of outpatients with COVID-19: a double blind randomized clinical trial","authors":"A. Eslami Ghayour M.D. ,&nbsp;S. Nazari M.D. ,&nbsp;F. Keramat ,&nbsp;F. Shahbazi Phd ,&nbsp;A. Eslami-Ghayour","doi":"10.1016/j.rceng.2023.12.011","DOIUrl":"10.1016/j.rceng.2023.12.011","url":null,"abstract":"<div><h3>Introduction and aim</h3><p>Since its emergence in December 2019, the coronavirus<span> disease caused by the severe acute respiratory syndrome coronavirus 2<span> has become a global emergency, spreading rapidly worldwide. In response to the early referral of these patients to outpatient health centers, we decided to seek more effective treatments in the early stages of their referral. This study aims to prevent both the progression and deterioration of the physical conditions of COVID-19 patients, reduce the rate of referrals, and mitigate the risks of hospitalization and death.</span></span></p></div><div><h3>Material and methods</h3><p><span><span>Conducted at Dibaj Therapeutic Center, Hamadan City, Iran, a double-blind randomized controlled trial encompassed 225 COVID-19 patients from April to September 2022. Ethical approval was obtained from Hamadan University of Medical Sciences (Approval No.: IR.UMSHA.REC.1400.957), with the protocol registered in the Iranian Registry of </span>Clinical Trials<span> (Registration No. : IRCT20220302054167N1). In this study, we included patients who tested positive for COVID-19- PCR and were symptomatic, excluding those who were pregnant or had received a COVID-19 vaccine. Patients with oxygen saturation above 92% were allocated to three groups: Group A received N-acetylcysteine, Group B received </span></span>Bromhexine, and Group C received standard care. Follow-ups on oxygen levels, symptoms, and hospitalization needs were conducted on days 7 and 14, with hospitalized patients monitored for one month post-hospitalization.</p></div><div><h3>Results</h3><p>The study found that both N-acetylcysteine and Bromhexine can effectively reduce hospitalization rates and mortality and shorten the duration of hospitalization. The third visit of patients who received N-acetylcysteine showed an increase of 1.33% in oxygen saturation compared to their first visit, and in patients who received Bromhexine, this increase was 1.19%. The mortality rate was 9.33% in the control group and zero in both groups of patients who received medication.</p></div><div><h3>Conclusion</h3><p>In conclusion, the results of this study indicate that NAC and bromhexine may be effective in the treatment of patients with positive COVID-19, with a lower hospitalization rate, shorter hospitalization, faster recovery time, and reduced mortality compared to the control group.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 2","pages":"Pages 86-95"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433240","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":"Disparities based on sex in clinical trials","authors":"Javier Ena","doi":"10.1016/j.rceng.2024.01.002","DOIUrl":"10.1016/j.rceng.2024.01.002","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 2","pages":"Pages 114-116"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479444","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":"Prevalence of chronic kidney disease in type 1 diabetes patients. A multicenter study in Castilla-La Mancha, Spain","authors":"M. Gallach Martínez ,&nbsp;M. Jara Vidal ,&nbsp;A. Ruiz de Assín Valverde ,&nbsp;P.J. Pinés Corrales","doi":"10.1016/j.rceng.2023.08.001","DOIUrl":"10.1016/j.rceng.2023.08.001","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 2","pages":"Pages 119-121"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433254","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 palliative care in advanced dementia","authors":"D.S. Marín-Medina ,&nbsp;H. Bautista-Mier ,&nbsp;D.M. Perilla-Orozco ,&nbsp;J.A. Sánchez-Duque","doi":"10.1016/j.rceng.2024.01.004","DOIUrl":"10.1016/j.rceng.2024.01.004","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 2","pages":"Pages 117-118"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479378","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":"Impact of malnutrition on the quality of life in older patients with advanced heart failure: a cohort study","authors":"J.-M. Verdu-Rotellar ,&nbsp;E. Calero ,&nbsp;J. Duran ,&nbsp;E. Navas ,&nbsp;S. Alonso ,&nbsp;N. Argemí ,&nbsp;M. Casademunt ,&nbsp;P. Furió ,&nbsp;E. Casajuana ,&nbsp;E. Vinyoles ,&nbsp;M.A. Muñoz ,&nbsp;on behalf of HADES study","doi":"10.1016/j.rceng.2024.01.005","DOIUrl":"10.1016/j.rceng.2024.01.005","url":null,"abstract":"<div><h3>Objectives</h3><p><span>The aim of this study was to assess the prevalence of malnutrition, the clinical characteristics associated with malnutrition and the impact of nutritional status on mortality, quality of life, self-care abilities, and </span>activities of daily living in the older patients with advanced heart failure.</p></div><div><h3>Methods</h3><p>A prospective multicentre cohort study including 260 community-dwelling elderly patients with advanced HF was conducted between June 2017 and December 2019.</p><p>The study was carried out in 22 primary healthcare centres, three university hospitals, one acute-care hospital, and one geriatric rehabilitation<span> unit in the city of Barcelona (Spain). Nutritional status was assessed at baseline using the Mini Nutritional Assessment questionnaire. Patient-reported outcome measures included quality of life (EQ-5D-3L), self-care behaviour (European Heart Failure Self-care Behaviour Scale) and impact on activities of daily living (Barthel Index).</span></p></div><div><h3>Results</h3><p>Using the MNA-SF, 126 (48.5%) patients were identified as being at risk of malnutrition and 33 (12.7%) patients as having confirmed malnutrition. Compared to HF patients with normal nutritional status, patients with confirmed malnutrition were significantly older, with a lower BMI, and with reduced haemoglobin levels. During follow-up (median 14.9 months, Interquartile Range; 4.9–26.9), 133 (51.2%) of the included participants died, and mortality was significantly higher among patients identified as having malnutrition (p &lt; 0.001).</p><p>Better Barthel index and quality of life scores were inversely related to the risk of malnutrition, [Odds Ratio (OR) 0.97 (95% Confidence interval 0.96; 0.98) and OR 0.98 (95% Confidence interval, 0.96; 0.99)], respectively. Higher scores in the European Heart Failure Self-care Behaviour Scale, which implies worse self care, were related to higher malnutrition risk, OR 1.05 (95% Confidence interval, 1.02; 1.09. Adjusted multivariate logistic model found that malnutrition was significantly associated with poor quality of life, and adverse impacts on daily activities and self-care.</p></div><div><h3>Conclusions</h3><p>In community-dwelling older patients with advanced HF, malnutrition was associated with worse patient reported outcome measures related to poor quality of life, and adverse impacts on self-care and daily activities. Nutritional status must be systematically addressed by primary care nurses and family doctors to improve survival rates in these patients. It would be helpful the incorporation of expert professionals in nutrition in the primary health care centres.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 2","pages":"Pages 105-113"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571771","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":"Predictive factors of osteoporotic hip fracture in octogenarians","authors":"A. Capdevila-Reniu ,&nbsp;M. Navarro-López ,&nbsp;V. Sapena ,&nbsp;AI. Jordan ,&nbsp;M. Arroyo-Huidobro ,&nbsp;A. López-Soto","doi":"10.1016/j.rceng.2024.01.001","DOIUrl":"10.1016/j.rceng.2024.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to identify the risk factors associated with osteoporotic hip fractures in octogenarians and seeks to refine primary prevention strategies for these fractures.</p></div><div><h3>Material and methods</h3><p><span>We conducted a case-control study involving individuals aged 79 years and older with hip fractures, comparing them to age- and sex-matched controls without a history of hip fractures. We collected epidemiological, clinical, anthropometric<span><span>, and analytical factors. We evaluated the presence of osteoporosis using bone </span>densitometry. We defined </span></span>sarcopenia according the European Working Group on Sarcopenia in Older People criteria (EWGSOP2).</p></div><div><h3>Results</h3><p><span><span>Ninety-five patients per group were analyzed, with a mean age of 82 years, of which 74% were women. The multivariate analysis included statistically significant factors found in the </span>univariate analysis (</span><em>p</em><span><span> &lt; 0.05). These factors included the Barthel Index<span>, nutritional assessment using the CONUT tool, </span></span>folic acid<span><span>, vitamin D deficiency, presence of previous fractures, loss of </span>visual acuity, bicipital circumference, sarcopenia, and osteoporosis (densitometry in the neck of the femur). The Nutritional state (OR: 0.08 [0.01–0.61]), the folic acid levels (OR 0.32 [0.1–1]), and a loss of visual acuity (OR 33.16 [2.91–377.87]) were the independent risk factors associated with hip fracture.</span></span></p></div><div><h3>Conclusions</h3><p>The assessment of nutritional status in elderly patients, coupled with a comprehensive geriatric assessment, represents easily reproducible and cost-effective tools. These tools can effectively aid in identifying individuals at risk of hip fractures, thereby contributing to more targeted and efficient preventive measures.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 2","pages":"Pages 77-85"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492951","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":"Polymorphisms of CCR5, IL-6, IFN-γ and IL-10 genes in Cuban HIV/AIDS patients","authors":"D. Hernández Requejo ,&nbsp;Y. de Armas ,&nbsp;E. Iglesias ,&nbsp;H.M. Díaz ,&nbsp;R. Gravier ,&nbsp;M.C. Godínez López ,&nbsp;L. Fonte ,&nbsp;M. Plascencia-Cruz ,&nbsp;K. Pacheco-Quijano ,&nbsp;J. Palomares ,&nbsp;H.R. Pérez-Gómez ,&nbsp;A. Plascencia-Hernández ,&nbsp;E.J. Calderón","doi":"10.1016/j.rceng.2023.12.012","DOIUrl":"10.1016/j.rceng.2023.12.012","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Genetic studies have shown associations of several single nucleotide polymorphisms (SNP) with different rates of progression and variation in susceptibility to </span>HIV infection<span>. This study aimed to estimate the frequency of ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A and IL-10-1082A/G polymorphisms in Cuban HIV-infected patients and a group of sero-discordant couples to assess their influence on risk and disease progression.</span></p></div><div><h3>Methods</h3><p><span>A cross-sectional study was carried out on 120 subjects registered at the Institute of Tropical Medicine «Pedro Kour» (IPK) and the Ameijeiras Hospital from June 2018 until December 2019. The amplification of fragments of the </span><em>ccr5</em>, <em>IL-6</em>, <em>IFN-γ</em> and <em>IL-10</em><span> genes was performed by polymerase chain reaction<span> followed by identification of polymorphisms using the restriction fragment length polymorphism analysis for IL-6 with the restriction enzymes Nla III. Amplification Refractory Mutation System was used for </span></span><em>IFN-γ</em> and <em>IL-10</em> genes.</p></div><div><h3>Results</h3><p>The allelic and genotypic distributions of the genes <em>ccr5</em>, <em>IL-6</em>, <em>IFN-γ</em> and <em>IL-10</em> did not differ significantly between the two groups. Cell counts and plasma viral load values did not differ significantly between genotypes of the <em>ccr5</em>, <em>IL-6</em>, <em>IFN-γ</em> and <em>IL-10</em> genes. Only the IL-6 GC genotype was associated with higher viral load values. The combination of alleles of the four considered SNPs showed a highly significant increase in the risk of HIV infection for one of them, but with a very low frequency (&lt;1%).</p></div><div><h3>Conclusion</h3><p>This study contributes to evaluating the frequency of these polymorphisms and their influence on biomarkers of the progression of HIV infection in the Cuban HIV-population.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 2","pages":"Pages 96-104"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521942","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":"Commentary on the article: “Cerebral venous thrombosis in adults: a case series of 35 patients from a tertiary hospital”","authors":"Aída Gil-Díaz","doi":"10.1016/j.rceng.2023.12.001","DOIUrl":"10.1016/j.rceng.2023.12.001","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Page 64"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138626303","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":"Smokers and risk of hospital death by COVID calculated with SAVANA’s natural language processing in the Castilla-La Mancha area","authors":"R. Godoy ,&nbsp;M. Benavent Núñez ,&nbsp;J. Cruz ,&nbsp;G. López Yepes ,&nbsp;A. Parralejo Jiménez ,&nbsp;F.J. Callejas ,&nbsp;J.L. Izquierdo","doi":"10.1016/j.rceng.2023.12.005","DOIUrl":"10.1016/j.rceng.2023.12.005","url":null,"abstract":"<div><h3>Introduction</h3><p>During the COVID pandemic<span>, it was speculated that patients with the virus<span> who were smoking-related might have a lower likelihood of disease exacerbation or death. To assess whether there is an association between smoking and risk of in-hospital mortality, SAVANA's big data and Natural Language Processing (NLP) technology is used.</span></span></p></div><div><h3>Method</h3><p><span><span>A retrospective, observational, non-interventional cohort study was conducted based on real-life data extracted from </span>medical records throughout Castilla La Mancha using Natural Language Processing and Artificial Intelligence techniques developed by SAVANA. The study covered the entire population of this region with </span>Electronic Medical Records in SESCAM presenting with a diagnosis of COVID from March 1, 2020 to February 28, 2021.</p></div><div><h3>Results</h3><p><span><span>Smokers had a significantly higher percentage of cardiovascular risk factors (hypertension, dyslipidemia and diabetes), </span>COPD<span>, asthma, IDP, IC, CVD<span>, PTE, cancer in general and lung cancer in particular, bronchiectasis, heart failure and a history of pneumonia (</span></span></span><em>p</em> &lt; 0.0001).Former smokers, current smokers and non-smokers have a significant age difference. As for in-hospital deaths, they were more frequent in the case of ex-smokers, followed by smokers and then non-smokers (<em>p</em> &lt; 0.0001).</p></div><div><h3>Conclusion</h3><p>There is an increased risk of dying in hospital in SARS-COV2-infected patients who are active smokers or have smoked in the past.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Pages 34-42"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139013449","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":"Executive summary on the optimization of the multidisciplinary and integrated approach to polymyalgia rheumatica and giant cell arteritis in Madrid region","authors":"A. González García ,&nbsp;C. del Arco ,&nbsp;D. Lucas Fernández ,&nbsp;M. Frías-Vargas ,&nbsp;M. Guillán ,&nbsp;M. Méndez-Bailón ,&nbsp;M. Ruiz Grinspan ,&nbsp;A.C. Aguado-Castaño ,&nbsp;J. Fraile Maya ,&nbsp;G. Latorre González ,&nbsp;S. Castañeda","doi":"10.1016/j.rceng.2023.12.009","DOIUrl":"10.1016/j.rceng.2023.12.009","url":null,"abstract":"<div><p>Polymyalgia rheumatica and giant cell arteritis can be a medical emergency in which a delay in correct diagnosis and therapeutic management can cause serious complications.</p><p>With the aim of improving the care of patients with these pathologies in the Community of Madrid, a study was designed to identify the causes and possible solutions to address the problems related to the diagnosis of these pathologies.</p><p>After the analysis, 11 areas of improvement related to four different aspects of the care process were identified: coordination and protocols, equipment, training and awareness of pathologies, and patient experience. Of all the areas identified, it was considered a priority to resolve those related to the generation of protocols for the comprehensive management of the pathologies, which include all the specialties and levels of care involved. Another crucial aspect is the increase in the degree of clinical suspicion of these pathologies.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 1","pages":"Pages 48-56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139026088","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}