Revista clinica espanola最新文献

{"title":"Incidence of pregnancy related pulmonary embolism in Spain 2016-2021: an observational population-based retrospective study","authors":"J.A. Rueda Camino PhD ,&nbsp;A. Azcoaga-Lorenzo PhD ,&nbsp;R. Noguero-Meseguer PhD ,&nbsp;D. Joya-Seijo ,&nbsp;M. Angelina-García ,&nbsp;D. Trujillo ,&nbsp;C. Miranda ,&nbsp;R. Barba-Martín","doi":"10.1016/j.rceng.2024.07.009","DOIUrl":"10.1016/j.rceng.2024.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to estimate the overall and annual age-standardized incidence of pregnancy-related pulmonary embolism (PE) in Spain from 2016 to 2021, explore the distribution of PE events during pregnancy and the postpartum period, identify potential risk factors, and estimate mortality rates during hospital admission.</div></div><div><h3>Methods</h3><div>In a retrospective, observational, population-based study, data from the Spanish National Hospital Discharge Database were analyzed to identify women with hospital episodes of pregnancy-related-PE. The primary outcome was the overall and annual age-standardized incidence of pregnancy-related-PE, with secondary aims including the distribution of events during pregnancy and postpartum and the calculation of age-standardized mortality rates during admission.</div></div><div><h3>Results</h3><div>Among 2,178,805 births from 2016 to 2021, 522 women were diagnosed with pregnancy-related PE, yielding an overall age-standardized incidence of 2.83 cases per 10,000 births. A non-significant increasing trend was observed from 2.43 to 4.18 cases per 10,000 births (p = 0.06). Comorbidities were low, with a notable association between PE and SARS-CoV-2 infection during the last two years. The mortality rate among women with pregnancy-related PE was 2.8%, with a higher incidence of PE reported during the postpartum period.</div></div><div><h3>Conclusion</h3><div>The incidence of pregnancy-related-PE in Spain exhibits a non-significant increasing trend, with a significant risk of mortality. The association with SARS-CoV-2 infection underscores the importance of vigilant monitoring and management of pregnant women, particularly during pandemics. This study contributes specific data on the incidence and characteristics of pregnancy-related-PE in Spain, emphasizing the need to consider PE in the differential diagnosis and management strategies for pregnant and postpartum women.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 9","pages":"Pages 553-559"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141880003","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":"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}

{"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> &lt; 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}

{"title":"Fear of illness in Kafka's Metamorphosis","authors":"F. Tornero-Romero ,&nbsp;M. Morante-Ruiz ,&nbsp;L. Alberto Gonzales-Campos","doi":"10.1016/j.rceng.2024.07.004","DOIUrl":"10.1016/j.rceng.2024.07.004","url":null,"abstract":"<div><div>This year marks 100 years since the death of Franz Kafka. Often in general medicine, and internal medicine in particular, doctors face situations in which they position themselves as the only guarantor of the patient in relation to society and how it conceives the disease. Many times, patients come to us without a diagnosis or with the fear of it; sometimes also rejected by their environment. This short text addresses this current topic, paying tribute to the brilliant writer and his best-known work, <em>Metamorphosis</em>.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 534-536"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141622093","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":"The RICA-2 registry: design and baseline characteristics of the first 1,000 patients","authors":"J.C. Trullàs ,&nbsp;M.C. Moreno-García ,&nbsp;V. Mittelbrunn-Alquézar ,&nbsp;A. Conde-Martel ,&nbsp;L. Soler-Rangel ,&nbsp;M. Montero-Pérez-Barquero ,&nbsp;J. Casado ,&nbsp;M. Sánchez-Marteles ,&nbsp;J.C. Arévalo-Lorido ,&nbsp;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}

{"title":"How does the risk of malnutrition evolve in elderly patients one year after hospital discharge? Results of a prospective cohort","authors":"A. Marne-Ortega ,&nbsp;L. Corral-Gudino ,&nbsp;P. Miramontes-González ,&nbsp;M. Gabella-Martín","doi":"10.1016/j.rceng.2024.07.003","DOIUrl":"10.1016/j.rceng.2024.07.003","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 549-551"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604738","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":"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> &lt; 0.001), less frequently female (43.6% <em>vs.</em> 40.9%; <em>P</em> &lt; 0.001), and more likely to have comorbidities (74.3% <em>vs.</em> 56.8%; <em>P</em><span> &lt; 0.001). Non-survivors had higher needs for invasive mechanical ventilation (42.4% </span><em>vs.</em> 6.6%; <em>P</em><span> &lt; 0.001) and intensive care unit admission (56.9% </span><em>vs.</em> 20%; <em>P</em><span> &lt; 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}

{"title":"Alcohol consumption in elderly people. What is the real magnitude of the problem?","authors":"I. Fernández Castro ,&nbsp;M. Marcos Martín ,&nbsp;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}

{"title":"Cardiac amyloidosis worsens prognosis in patients with heart failure: findings from the PREVAMIC study","authors":"R. Ruiz Hueso ,&nbsp;P. Salamanca Bautista ,&nbsp;M.A. Quesada Simón ,&nbsp;S. Yun ,&nbsp;A. Conde Martel ,&nbsp;J.L. Morales Rull ,&nbsp;I. Fiteni Mera ,&nbsp;D. Abad Pérez ,&nbsp;I. Páez Rubio ,&nbsp;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 &lt; 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 &lt; 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}

{"title":"Pneumocystis jirovecii in human disease: just pneumonia?","authors":"E.J. Calderón ,&nbsp;V. Friaza","doi":"10.1016/j.rceng.2024.07.005","DOIUrl":"10.1016/j.rceng.2024.07.005","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 546-548"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736313","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}