Revista clinica espanola最新文献_第4页

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

Therapeutic approach to acute crises of hepatic porphyrias. 肝卟啉症急性危象的治疗方法。

Revista clinica espanola Pub Date : 2024-09-21 DOI: 10.1016/j.rceng.2024.09.004

M Garrido Montes, R Pertusa Mataix, J S Garcia Morillo

引用次数: 0

Association between autoimmune diseases and Alzheimer's disease: analysis using big data tools. 自身免疫性疾病与阿尔茨海默病之间的关联：利用大数据工具进行分析。

Revista clinica espanola Pub Date : 2024-09-21 DOI: 10.1016/j.rceng.2024.09.003

A M Diezma-Martín, M I Morales-Casado, L Jiménez-Díaz, J D Navarro-López, B Mondéjar-Marín, J Parra-Serrano, A Vadillo-Bermejo, C Marsal-Alonso, P Beneyto-Martín

{"title":"Association between autoimmune diseases and Alzheimer's disease: analysis using big data tools.","authors":"A M Diezma-Martín, M I Morales-Casado, L Jiménez-Díaz, J D Navarro-López, B Mondéjar-Marín, J Parra-Serrano, A Vadillo-Bermejo, C Marsal-Alonso, P Beneyto-Martín","doi":"10.1016/j.rceng.2024.09.003","DOIUrl":"10.1016/j.rceng.2024.09.003","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to analyze the prevalence of Alzheimer's disease in patients with and without a diagnosis of different autoimmune diseases and the possible association between both pathologies.</p><p><strong>Patients and methods: </strong>A multicenter, retrospective, cohort study was conducted to study the prevalence of Alzheimer's disease among patients diagnosed with various autoimmune diseases compared to the general population. Data from electronic medical records from the Castilla-La Mancha healthcare system were analyzed using Natural Language Processing through the Savana Manager® artificial intelligence clinical platform. A total of 1,028,356 patients were analyzed, including 28,920 individuals with Alzheimer's disease and 999,436 control patients.</p><p><strong>Results: </strong>Out of the 12 autoimmune diseases analyzed, 5 showed a significant association with Alzheimer's disease with p < 0.05. Myasthenia gravis had an increased prevalence of AD with OR 1.49 (95% CI 1.11-2), systemic lupus erythematosus with OR 2.42 (95% CI 2.02-2.88), rheumatoid arthritis with OR 1.38 (95% CI 1.24-1.54), polymyalgia rheumatica with OR 2.01 (95% CI 1.08-2.23), and pernicious anemia with OR 2.06 (95% CI 1.59-2.66). The remaining autoimmune diseases analyzed did not show a higher prevalence of Alzheimer's disease compared to the general population.</p><p><strong>Conclusions: </strong>There may be an association between certain systemic autoimmune diseases and Alzheimer's disease. Further studies are needed to confirm our findings, establish causality, and explore the underlying mechanisms of this association.</p>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309572","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

Basic action protocol for the outpatient management of chronic heart failure of the Spanish Society of Internal Medicine. 西班牙内科医学会慢性心力衰竭门诊治疗基本行动方案。

Revista clinica espanola Pub Date : 2024-08-30 DOI: 10.1016/j.rceng.2024.08.004

J M Cerqueiro-González, A González-Franco, J M Fernández-Rodríguez, E Martínez-Litago, J Pérez-Silvestre, P Salamanca-Bautista, L Morales-Rull, A Conde-Martel, J Casado, O Aramburu-Bodas, L Manzano-Espinosa

{"title":"Basic action protocol for the outpatient management of chronic heart failure of the Spanish Society of Internal Medicine.","authors":"J M Cerqueiro-González, A González-Franco, J M Fernández-Rodríguez, E Martínez-Litago, J Pérez-Silvestre, P Salamanca-Bautista, L Morales-Rull, A Conde-Martel, J Casado, O Aramburu-Bodas, L Manzano-Espinosa","doi":"10.1016/j.rceng.2024.08.004","DOIUrl":"10.1016/j.rceng.2024.08.004","url":null,"abstract":"<p><p>Chronic heart failure (CHF) represents a challenge for the healthy system due to its high prevalence, high burden of morbidity and mortality, and high consumption of health resources. To address this problem, it is necessary to develop efficient management strategies that include both hospital care and outpatient care. The primary objective is to stabilize the patient and prevent decompensation, with the consequent improvement in quality of life, reduction in hospital admissions and emergency department care, and, consequently, reduction in healthcare costs. In this context, the heart failure and atrial fibrilation working group of the Spanish Society of Internal Medicine has developed a protocol for the management of outpatient CHF, that addresses, from the perspective of Internal medicine, all the problems suffered by the patient with CHF. This protocol aims to optimize pharmacological treatment, control cardiovascular risk factors and various comorbidities, educate the patient and their environment about the disease, promote adherence to treatment and stablish follow-up adapted to their condition.</p>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116801","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

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