Revista clinica espanola最新文献_第3页

Measles outbreak transmission in the ER waiting room: the role of vaccination. 麻疹疫情在急诊室候诊室的传播：疫苗接种的作用。

Revista clinica espanola Pub Date : 2024-10-03 DOI: 10.1016/j.rceng.2024.10.002

A Hernández-Aceituno, I Falcón García, E Marrero Marichal, D Sanabria Curbelo, Á Torres Lana, E Larumbe-Zabala

{"title":"Measles outbreak transmission in the ER waiting room: the role of vaccination.","authors":"A Hernández-Aceituno, I Falcón García, E Marrero Marichal, D Sanabria Curbelo, Á Torres Lana, E Larumbe-Zabala","doi":"10.1016/j.rceng.2024.10.002","DOIUrl":"10.1016/j.rceng.2024.10.002","url":null,"abstract":"<p><strong>Background: </strong>Measles is one of the most contagious infectious diseases. Spain was declared free of endemic measles transmission in 2017. However, less than half of EU/EEA countries have achieved vaccination coverage goals and measles outbreaks have been reported recently, some of them in healthcare facilities. The aim of this study was to present an outbreak in the pediatric emergency (ER) waiting room affecting a vaccinated healthcare worker.</p><p><strong>Methods: </strong>Descriptive study of an outbreak whose transmission occurred in the pediatric ER waiting room of a tertiary level hospital on the island of Tenerife (Canary Islands) in April 2024.</p><p><strong>Results: </strong>Between April 23 and May 12, 2024, four PCR-confirmed measles cases were identified, resulting in 407 contacts in healthcare center waiting rooms. One of the cases was a 26-year-old male nurse who had been correctly vaccinated with two doses of measles, mumps, and rubella vaccine during childhood. Between May 7 and 10, during his infective period, he took two two-and-a-half-hour flights and lived together with nine people during a trip. No evidence of infection has been identified among the individuals with whom he lived neither the passengers and crew of the two flights.</p><p><strong>Conclusions: </strong>In the emergency waiting room, an unvaccinated girl gave measles to two infants who were not yet old enough to be vaccinated and to a nurse who had been properly vaccinated as an infant. Despite generating more than 300 close contacts, the nurse did not infect anyone, suggesting that vaccination may help prevent both infection and transmission of measles.</p>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378773","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 consensus document on point-of-care ultrasound implementation: recommendations from the Clinical Ultrasound Working Groups of SEMI, SEDAR, SEGG, SEMERGEN, SEMES, SEMFYC, and SEMG. 护理点超声实施共识文件执行摘要：SEMI、SEDAR、SEGG、SEMERGEN、SEMES、SEMFYC 和 SEMG 的临床超声工作组的建议。

Revista clinica espanola Pub Date : 2024-10-03 DOI: 10.1016/j.rceng.2024.10.001

Y Tung-Chen

{"title":"Executive summary of the consensus document on point-of-care ultrasound implementation: recommendations from the Clinical Ultrasound Working Groups of SEMI, SEDAR, SEGG, SEMERGEN, SEMES, SEMFYC, and SEMG.","authors":"Y Tung-Chen","doi":"10.1016/j.rceng.2024.10.001","DOIUrl":"10.1016/j.rceng.2024.10.001","url":null,"abstract":"<p><p>Point-of-Care Ultrasound has significantly evolved, establishing itself as an essential tool in daily medical practice, especially in various clinical contexts. This consensus document, supported by several Spanish medical societies, proposes guidelines for the effective integration of ultrasound in healthcare, promoting its standardization and ensuring the quality and systematic application of this technique. The working groups, composed of experts from different specialties, conducted a comprehensive review of the literature in MEDLINE and extensively discussed recommendations to formulate a coherent and practical set of guidelines for different application areas: hospital and out-of-hospital emergencies and critical care, primary care, and outpatient hospital care, hospitalization. The methodology included virtual meetings and confidential voting to reach a consensus on the relevant recommendations. Ultrasound was highlighted as fundamental in the initial approach to various pathologies, such as abdominal, thoracic, and musculoskeletal issues, facilitating quick and accurate diagnoses, and reducing the need for unnecessary referrals. Furthermore, this technique has proven valuable in emergencies and critical care, guiding procedures and enhancing the safety and efficiency of clinical interventions. These guidelines not only serve as a framework for clinical practice, education, and research but also aim to ensure that professionals are adequately trained and that ultrasound evaluations are performed to a standard of excellence. The purpose of these recommendations is to standardize and facilitate the adoption of this clinical tool in the daily practice of healthcare, thus improving the quality of the services provided in its various possible applications.</p>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378772","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 predictive value of estimated pulse wave velocity (ePWV) combined with BMI for newly diagnosed diabetes 估计脉搏波速度（ePWV）与体重指数（BMI）相结合对新诊断糖尿病的预测价值。

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.07.001

{"title":"The predictive value of estimated pulse wave velocity (ePWV) combined with BMI for newly diagnosed diabetes","authors":"","doi":"10.1016/j.rceng.2024.07.001","DOIUrl":"10.1016/j.rceng.2024.07.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Estimated pulse wave velocity (ePWV) and body mass index (BMI) are significant predictors of new-onset diabetes. This study aims to evaluate the impact and predictive value of combining ePWV and BMI on the incidence of new-onset diabetes.</div></div><div><h3>Methods</h3><div>A secondary analysis was conducted on a cohort study by Rich Healthcare (China), involving 211,833 eligible participants. Logistic regression analysis identified factors influencing diabetes occurrence, while ROC curve analysis assessed the predictive value of ePWV, BMI, and their combination for new-onset diabetes.</div></div><div><h3>Results</h3><div>Over a mean follow-up period of 3.12 years, 3,000 men (1.41%) and 1,174 women (0.55%) were diagnosed with diabetes. Logistic regression revealed that BMI, triglycerides, alanine aminotransferase, blood urea nitrogen, creatinine clearance rate, ePWV, and family history of diabetes are high-risk factors for new-onset diabetes. The combination of ePWV and BMI provided a higher area under the ROC curve (0.822) compared to ePWV or BMI alone.</div></div><div><h3>Conclusion</h3><div>Elevated levels of ePWV and BMI are independent risk factors for new-onset diabetes. Combining these measures enhances predictive accuracy compared to using either indicator alone.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 503-509"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556435","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

Association between serum neurofilament light chains (sNfL) and neurologic disorders in a representative sample of US adults: a cross-sectional study 美国成年人代表性样本中血清神经丝蛋白轻链 (sNfL) 与神经系统疾病之间的关系：一项横断面研究。

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.07.002

{"title":"Association between serum neurofilament light chains (sNfL) and neurologic disorders in a representative sample of US adults: a cross-sectional study","authors":"","doi":"10.1016/j.rceng.2024.07.002","DOIUrl":"10.1016/j.rceng.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><div>While increased neurofilament light chain (NfL) in serum concentrations are linked to the progression of several neurological conditions, their distribution and implications within the general adult population remain largely unexplored. The current research aims to clarify the relationship between serum NfL levels and neurological disorders in a broad and representative population sample.</div></div><div><h3>Methods</h3><div>We utilized information gathered from 1751 adults involved in the 2013–2014 cycle of the National Health and Nutrition Examination Survey . Our analytical approach encompassed logistic regression, smoothed curve fitting, and subgroup analyses to identify potential correlations between serum NfL levels and neurological conditions, such as depression, severe hearing and visual impairments, stroke, subjective memory deficits, and sleep problems.</div></div><div><h3>Results</h3><div>After adjusting for all confounders, we found that higher serum NfL levels were significantly associated with increased risks of depression, stroke, subjective memory deficits, and longer sleep duration (<em>p</em> < 0.05). Subgroup analyses supported these findings. Additionally, BMI significantly influenced the relationship between serum NfL levels and long-term subjective memory decline.</div></div><div><h3>Conclusion</h3><div>Our research shows that higher serum NfL levels are strongly related to an elevated risk for several neurological disorders. These findings highlight the role of serum NfL serving as a critical marker for early detection and monitoring of neurological conditions, emphasizing its importance in both clinical and public health settings.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 510-521"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556434","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

Fear of illness in Kafka's Metamorphosis 特别文章：卡夫卡《变形记》中的疾病恐惧。

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.07.004

F. Tornero-Romero , M. Morante-Ruiz , L. Alberto Gonzales-Campos

引用次数: 0

The RICA-2 registry: design and baseline characteristics of the first 1,000 patients RICA-2 登记：首批 1,000 名患者的设计和基线特征。

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.07.008

J.C. Trullàs , M.C. Moreno-García , V. Mittelbrunn-Alquézar , A. Conde-Martel , L. Soler-Rangel , M. Montero-Pérez-Barquero , J. Casado , M. Sánchez-Marteles , J.C. Arévalo-Lorido , J. Pérez-Silvestre

{"title":"The RICA-2 registry: design and baseline characteristics of the first 1,000 patients","authors":"J.C. Trullàs , M.C. Moreno-García , V. Mittelbrunn-Alquézar , A. Conde-Martel , L. Soler-Rangel , M. Montero-Pérez-Barquero , J. Casado , M. Sánchez-Marteles , J.C. Arévalo-Lorido , J. Pérez-Silvestre","doi":"10.1016/j.rceng.2024.07.008","DOIUrl":"10.1016/j.rceng.2024.07.008","url":null,"abstract":"<div><h3>Background and objective</h3><div>Heart failure (HF) is a syndrome of epidemic proportions and one of the main reasons for hospital admission. Patient registries provide real-world clinical practice information which is complementary to clinical trials. RICA-2 is a registry of the Spanish Society of Internal Medicine. Its main goal is to know the clinical and epidemiological characteristics and prognostic factors of patients with HF treated in Internal Medicine Departments. The objective of this study is to present the design of the RICA-2, the baseline characteristics of the first 1000 patients included and their comparison with those of the historical cohort of the RICA registry.</div></div><div><h3>Methods</h3><div>Observational, multicentre and prospective study of patients with HF with the following inclusion criteria: age equal to or greater than 18 years old, diagnosis of HF according to the European Guidelines, indistinct inclusion in decompensation or stable phase, of patients with <em>de novo</em> HF or chronic HF, regardless of left ventricular ejection fraction, aetiology and comorbidities.</div></div><div><h3>Results</h3><div>RICA-2 patients have advanced age (83 years old) and 51% are women. The comorbidity burden is higher than in the RICA registry (5 points in the Charlson comorbidity index), with predominating chronic decompensated HF (74%), hypertensive aetiology (39%) and preserved ejection fraction (52%). Most patients are pre-frail or vulnerable and are at risk of malnutrition.</div></div><div><h3>Conclusion</h3><div>The RICA-2 represents a contemporary cohort of patients that will provide us with clinical, epidemiological and prognostic information on patients with acute and chronic HF treated in Internal Medicine.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 522-533"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763745","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

How does the risk of malnutrition evolve in elderly patients one year after hospital discharge? Results of a prospective cohort 老年患者出院一年后营养不良的风险如何演变？前瞻性队列研究结果。

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.07.003

A. Marne-Ortega , L. Corral-Gudino , P. Miramontes-González , M. Gabella-Martín

引用次数: 0

Risk factors for mortality in coronavirus disease 2019 patients with silent hypoxemia 2019年冠状病毒病无声低氧血症患者死亡的风险因素。

Revista clinica espanola Pub Date : 2024-10-01 DOI: 10.1016/j.rceng.2024.06.010

{"title":"Risk factors for mortality in coronavirus disease 2019 patients with silent hypoxemia","authors":"","doi":"10.1016/j.rceng.2024.06.010","DOIUrl":"10.1016/j.rceng.2024.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the predictors of mortality in hospitalized patients with severe acute respiratory syndrome<span> (SARS) due to COVID-19 presenting with silent hypoxemia.</span></div></div><div><h3>Material and methods</h3><div><span>Retrospective cohort study<span> of hospitalized patients with SARS due to COVID-19 and silent hypoxemia at admission, in Brazil, from January to June 2021. The primary outcome of interest was in-hospital death. Multivariable </span></span>logistic regression analysis was performed.</div></div><div><h3>Results</h3><div>Of 46,102 patients, the mean age was 59 ± 16 years, and 41.6% were female. During hospitalization, 13,149 patients died. Compared to survivors, non-survivors were older (mean age, 66 <em>vs.</em> 56 years; <em>P</em> < 0.001), less frequently female (43.6% <em>vs.</em> 40.9%; <em>P</em> < 0.001), and more likely to have comorbidities (74.3% <em>vs.</em> 56.8%; <em>P</em><span> < 0.001). Non-survivors had higher needs for invasive mechanical ventilation (42.4% </span><em>vs.</em> 6.6%; <em>P</em><span> < 0.001) and intensive care unit admission (56.9% </span><em>vs.</em> 20%; <em>P</em><span> < 0.001) compared to survivors. In the multivariable regression analysis, advanced age (OR 1.04; 95%CI 1.037–1.04), presence of comorbidities (OR 1.54; 95%CI 1.47–1.62), cough<span> (OR 0.74; 95%CI 0.71–0.79), respiratory distress (OR 1.32; 95%CI 1.26–1.38), and need for non-invasive respiratory support (OR 0.37; 95%CI 0.35–0.40) remained independently associated with death.</span></span></div></div><div><h3>Conclusions</h3><div>Advanced age, presence of comorbidities, and respiratory distress were independent risk factors for mortality, while cough and requirement for non-invasive respiratory support were independent protective factors against mortality in hospitalized patients due to SARS due to COVID-19 with silent hypoxemia at presentation.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 485-493"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474415","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

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