Revista clinica espanola最新文献

筛选
英文 中文
A prediction model for complications caused by portal hypertension or liver cancer in a Spanish cohort of chronic hepatitis B patients 西班牙慢性乙型肝炎患者门静脉高压或肝癌引起的并发症预测模型
Revista clinica espanola Pub Date : 2025-04-01 DOI: 10.1016/j.rceng.2024.11.009
P. Gavilán , J.-C. Gavilán , E. Clavijo , I. Viciana , J.-A. Gonzalez-Correa
{"title":"A prediction model for complications caused by portal hypertension or liver cancer in a Spanish cohort of chronic hepatitis B patients","authors":"P. Gavilán ,&nbsp;J.-C. Gavilán ,&nbsp;E. Clavijo ,&nbsp;I. Viciana ,&nbsp;J.-A. Gonzalez-Correa","doi":"10.1016/j.rceng.2024.11.009","DOIUrl":"10.1016/j.rceng.2024.11.009","url":null,"abstract":"<div><h3>Background aims</h3><div>To identify risk factors associated with liver complications in patients with chronic hepatitis B infection in an unselected cohort of hepatitis B patients in southern Spain.</div></div><div><h3>Methods</h3><div>A prospective open-cohort study was conducted on 437 patients with uncomplicated chronic hepatitis B infection in two hospitals in Málaga, southern Spain. The follow-up time ranged from 0.5 to 31.5 years (mean: 13.8<!--> <!-->±<!--> <!-->9.5 years; median: 11.4 years). The aim of this study was to evaluate the occurrence of the initial liver complication during follow-up, which is defined as the emergence of liver cancer or complications resulting from portal hypertension. Survival curves were obtained using a time-to-event method through Kaplan-Meier analysis. Multivariate Cox regression was conducted to estimate the hazard ratios of risk factors associated with complications after adjusting for multiple variables. The follow-up of the patients was carried out under conditions of usual clinical practice.</div><div>Based on the weighted adjustment of these factors, we developed a Hepatitis B Complication Score (HBCS) from which it was possible to identify patients with low and high risk of complications during follow-up.</div></div><div><h3>Results</h3><div>33 out of 437 patients (7.55%) experienced liver complications, 12 (36.3%) were secondary to portal hypertension, and 21 patients (63.7%) developed liver cancer. A Multivariate Cox regression identified the following independent risk factor: Age above 45 years: HR 7.10 (2.9–17.3); low platelet count: HR 4.88 (2.1–10.9); hepatitis C coinfection: HR 4.68 (2.0–10.9); Male gender: HR 4.64 (1.5–14.2); alkaline phosphatase above 147 UI/mL: HR 4.33 (2.0–8.9); and Child score above 5 points: HR 3.83 (1.7–8.4). The Risk of Complications Score (HBCS) was developed with a high predictive capacity AUROC 0.92 (0.87−0.97).</div></div><div><h3>Conclusion</h3><div>An HBCS score greater than 3.07 points identifies patients at high risk of developing complications and with an increased risk of liver and all-cause mortality.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 4","pages":"Pages 184-192"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384954","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
RECALMIN V. Evolution in the activity of internal medicine units of the National Health System (2007–2022) RECALMIN V.国家卫生系统内科单位活动的演变(2007-2022)。
Revista clinica espanola Pub Date : 2025-04-01 DOI: 10.1016/j.rceng.2025.02.007
J. Carretero Gómez , M.M. Chimeno Viñas , J.M. Porcel Pérez , M. Méndez Bailón , P. Pérez Martínez , M.T. Herranz Marín , N. del Prado , F.J. Elola Somoza
{"title":"RECALMIN V. Evolution in the activity of internal medicine units of the National Health System (2007–2022)","authors":"J. Carretero Gómez ,&nbsp;M.M. Chimeno Viñas ,&nbsp;J.M. Porcel Pérez ,&nbsp;M. Méndez Bailón ,&nbsp;P. Pérez Martínez ,&nbsp;M.T. Herranz Marín ,&nbsp;N. del Prado ,&nbsp;F.J. Elola Somoza","doi":"10.1016/j.rceng.2025.02.007","DOIUrl":"10.1016/j.rceng.2025.02.007","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyse the structure, activity and results of the Internal Medicine Units (IMUs) of the Spanish National Health System (SNHS). To compare the results of the RECALMIN 2023 survey with previous waves of surveys of the UMIs (2008, 2015, 2017, 2019. 2021) and to analyse trends in the structure, activity and results of the UMIs.</div></div><div><h3>Material and methods</h3><div>Two data sources: 1) survey on UMI structure and activity; and 2) Hospital discharges of UMIs from the Minimum and Basic Data Set (CMBD) of the SNHS. Cross-sectional descriptive study of the UMIs in acute hospitals of the SNHS with data referring to 2022, comparing them with previous studies.</div></div><div><h3>Results</h3><div>Over the period 2007–2022, the rate of internists per 100,000 inhabitants increased (IRR: 4.5%; p &lt; 0.001). Inpatient discharges per population and the number of discharges by UMI (IRR: 2.6%; p &lt; 0.005; IRR: 3.5%; p &lt; 0.001, respectively) also increased. The UMIs account for 20% of discharges from general hospitals in the NHS. The SEMI has a database of the CMBD_MIN 2007–2022 with 9,931,401 discharges given by the UMI. The crude in-hospital hospital mortality rate increased in the period 2007–2022 (p &lt; 0.001). From 2020 onwards (SARS-CoV-2 pandemic) overall risk-adjusted and process-adjusted mortality increased (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>UMIs have a central position in SNHS hospital care. The activity of the UMI has grown significantly in the period analysed. The RECALMIN project identifies strengths and opportunities to be strategically addressed by SEMI.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 4","pages":"Pages 211-222"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532028","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
Complexity based medicine 基于复杂性的医学。
Revista clinica espanola Pub Date : 2025-04-01 DOI: 10.1016/j.rceng.2025.02.004
A. Ruiz-Cantero
{"title":"Complexity based medicine","authors":"A. Ruiz-Cantero","doi":"10.1016/j.rceng.2025.02.004","DOIUrl":"10.1016/j.rceng.2025.02.004","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 4","pages":"Pages 181-183"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473398","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
Training in clinical ethics, a necessary tool for professional excellence of the internist 临床伦理学培训是内科医生提高专业水平的必要工具。
Revista clinica espanola Pub Date : 2025-04-01 DOI: 10.1016/j.rceng.2025.02.003
Carme Font , Paula Martínez de la Cruz , Benjamín Herreros
{"title":"Training in clinical ethics, a necessary tool for professional excellence of the internist","authors":"Carme Font ,&nbsp;Paula Martínez de la Cruz ,&nbsp;Benjamín Herreros","doi":"10.1016/j.rceng.2025.02.003","DOIUrl":"10.1016/j.rceng.2025.02.003","url":null,"abstract":"<div><div>Internists must respond to increasingly complex clinical scenarios in a context of progressively increasing life expectancy, techno-scientific development and accelerated demographic and sociocultural changes. Ethical reflection is a useful tool to resolve and prevent value conflicts, which are frequent in clinical practice. The ethical training of internists contributes to professional excellence and can be oriented at two complementary levels: 1) development of skills in all internists for the management of “clinical microethics”, which allow the integration of the techno-scientific aspects of medicine in a satisfactory clinical relationship at a human level; 2) specialization for internists who are experts in bioethics, to lead ethics committees (and other consulting models) in a more local setting and participate in bioethical debates and the development of normative ethics in a more general setting.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 4","pages":"Pages 244-249"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473400","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
Potential role of lung ultrasonography in outpatient follow-up of patients with COVID-19. A systematic review 肺部超声检查在COVID-19患者门诊随访中的潜在作用。系统回顾。
Revista clinica espanola Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.11.006
F. Navarro-Romero , J. Olalla-Sierra , M.D. Martín-Escalante
{"title":"Potential role of lung ultrasonography in outpatient follow-up of patients with COVID-19. A systematic review","authors":"F. Navarro-Romero ,&nbsp;J. Olalla-Sierra ,&nbsp;M.D. Martín-Escalante","doi":"10.1016/j.rceng.2024.11.006","DOIUrl":"10.1016/j.rceng.2024.11.006","url":null,"abstract":"<div><h3>Introduction and aim</h3><div>Currently, the usefulness of lung ultrasound in the follow-up of patients after hospital discharge for SARS-CoV-2 pneumonia is not well known. The main objective of this systematic review is to investigate the persistence of alterations in lung ultrasound of patients who have had COVID-19 pneumonia.</div></div><div><h3>Methods</h3><div>A systematic review has been carried out following the PRISMA regulations in the PubMed, EMBASE, Web of Science and Google Scholar database from January 2020 to May 2023 using the combination of MeSH terms: “lung ultrasound”, “ultrasonography”, “lung alterations”, “persistence”, “follow-up”, “consequences”, “hospital discharge”, “COVID”, “COVID-19”, “SARS-CoV-2”. Studies were selected that described alterations in the lung ultrasound of patients after having suffered from COVID-19 pneumonia. The JBI Critical Appraisal Tools were used to assess the risk of bias of the studies. No meta-analysis techniques were performed, the results being compared narratively.</div></div><div><h3>Results</h3><div>From two to six months after COVID-19 pneumonia, pulmonary ultrasound abnormalities appear frequently and are proportional to the intensity of the initial episode. The most frequent anomalies are irregularities in the pleural line, the presence of B lines and/or subpleural consolidations, predominantly in the basal regions of the thorax. These findings seem to correlate with those of the chest CT.</div></div><div><h3>Conclusions</h3><div>Lung ultrasound offers technical and economic advantages that should be considered for the study of patients after hospital discharge for COVID-19.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 2","pages":"Pages 101-110"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756080","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
Malnutrition in heart failure. The importance of assessing for congestion and sarcopenia 营养不良导致心力衰竭。充血和肌肉减少评估的重要性。
Revista clinica espanola Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.11.005
J. Carretero Gómez , T.F. Galeano Fernández , A.S. Vidal Ríos , S. Tolosa Álvarez , M. Sánchez Herrera , C. García Carrasco , F.J. Monreal Periañez , P. González González , J.C. Arévalo Lorido
{"title":"Malnutrition in heart failure. The importance of assessing for congestion and sarcopenia","authors":"J. Carretero Gómez ,&nbsp;T.F. Galeano Fernández ,&nbsp;A.S. Vidal Ríos ,&nbsp;S. Tolosa Álvarez ,&nbsp;M. Sánchez Herrera ,&nbsp;C. García Carrasco ,&nbsp;F.J. Monreal Periañez ,&nbsp;P. González González ,&nbsp;J.C. Arévalo Lorido","doi":"10.1016/j.rceng.2024.11.005","DOIUrl":"10.1016/j.rceng.2024.11.005","url":null,"abstract":"<div><h3>Aim</h3><div>This work aims to describe nutrition and sarcopenia in inpatients with heart failure (HF). It also aims to assess factors associated with in-hospital and short-term prognosis related to nutrition and sarcopenia.</div></div><div><h3>Methods</h3><div>We collected data on consecutive HF patients admitted to a single center’s internal medicine ward. Patients were recruited in May and October 2021. Malnutrition was determined by the Mini Nutritional Assessment-Short Form (MNA-SF) and sarcopenia by the screening test, SARC-F scale, and handgrip strength test.</div></div><div><h3>Results</h3><div>190 patients were analyzed, mean age 82.1 (±8.2), 54.2% women, median follow up 106 days. Patients were classified into three groups based on MNA-SF score: group 1 (12–14 points, no risk) included 50 patients, group 2 (8–12 points, high risk of malnutrition) included 81 patients, group 3 (0–7 points, malnourished) included 59 patients. Group 3 had significantly more inflammation (lower albumin and higher C-reactive Protein (CRP)) and congestion (measured by NT-ProBNP levels). In-hospital mortality was related to poor muscle function, CRP, and NT-ProBNP, but not to malnutrition. The poorest short-term outcomes were related to malnutrition and comorbidity. However, when the variable of muscle function was introduced, it could act as a poor prognostic factor related to CRP and NT-ProBNP, which were the main determinants of survival.</div></div><div><h3>Conclusion</h3><div>In malnourished patients with HF, inflammation and congestion were related to in-hospital mortality. Malnutrition along with comorbidity may play a role in decreasing short-term survival. Early identification through proactive nutritional and functional screenings should be a key element of assessing HF patients.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 2","pages":"Pages 92-100"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776102","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
Secondary adrenal insufficiency due to ipilimumab/nivolumab treatment for metastatic renal cancer 易匹单抗/纳武单抗治疗转移性肾癌导致继发性肾上腺功能不全。
Revista clinica espanola Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.12.003
D. Rico-López , A. Ortiz-Parra , F. Vázquez-Alonso , R. Roa-Chamorro
{"title":"Secondary adrenal insufficiency due to ipilimumab/nivolumab treatment for metastatic renal cancer","authors":"D. Rico-López ,&nbsp;A. Ortiz-Parra ,&nbsp;F. Vázquez-Alonso ,&nbsp;R. Roa-Chamorro","doi":"10.1016/j.rceng.2024.12.003","DOIUrl":"10.1016/j.rceng.2024.12.003","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 2","pages":"Pages 111-113"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857475","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
Failure of LDL-C goals achievement and underuse of lipid-lowering therapies in patients at high and very high cardiovascular risk: Spanish subset from the European SANTORINI study 来自欧洲SANTORINI研究的西班牙亚组:高和极高心血管风险患者LDL-C目标实现失败和降脂治疗使用不足
Revista clinica espanola Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.11.004
J.M. Mostaza , L. García-Ortiz , M.A. Suárez Tembra , P. Talavera Calle , J. Chimeno García , V. Escolar Pérez , J.L. Díaz-Díaz , L. Manzano-Espinosa , A.L. Catapano , K.K. Ray , G. Díaz Moya , J. Pedro-Botet Montoya , en representación del grupo de investigadores de SANTORINI España
{"title":"Failure of LDL-C goals achievement and underuse of lipid-lowering therapies in patients at high and very high cardiovascular risk: Spanish subset from the European SANTORINI study","authors":"J.M. Mostaza ,&nbsp;L. García-Ortiz ,&nbsp;M.A. Suárez Tembra ,&nbsp;P. Talavera Calle ,&nbsp;J. Chimeno García ,&nbsp;V. Escolar Pérez ,&nbsp;J.L. Díaz-Díaz ,&nbsp;L. Manzano-Espinosa ,&nbsp;A.L. Catapano ,&nbsp;K.K. Ray ,&nbsp;G. Díaz Moya ,&nbsp;J. Pedro-Botet Montoya ,&nbsp;en representación del grupo de investigadores de SANTORINI España","doi":"10.1016/j.rceng.2024.11.004","DOIUrl":"10.1016/j.rceng.2024.11.004","url":null,"abstract":"<div><h3>Introduction</h3><div>There are very few studies evaluating lipid-lowering treatments (LLTs) and low-density lipoprotein-cholesterol (LDL-C) goal attainment after the release of the 2019 guidelines of the European Societies of Cardiology (ESC) and Atherosclerosis (EAS). This manuscript shows baseline data of the Spanish subset from SANTORINI study (namely SANTORINI Spain) on LDL-C goal attainment and use of LLTs in patients at high and very high cardiovascular risk.</div></div><div><h3>Methods</h3><div>SANTORINI was a multinational, prospective, observational study involving patients at high and very high cardiovascular risk from 14 European countries in primary care and specialized healthcare settings. Sociodemographic data, blood lipid levels, and lipid treatments from the 1018 Spanish participants were separately analyzed and were put into perspective with the European cohort without Spanish participants.</div></div><div><h3>Results</h3><div>According to physicians, 295 (29.0%) subjects were classified as high, and 723 (71.0%) as very high cardiovascular risk. Overall, 26.5% attained risk-based LDL-C targets recommended by 2019 European guidelines, with 23.1% of patients at high cardiovascular risk and 27.9% at very high cardiovascular risk. High-intensity statin therapy in monotherapy was used in 21.8%, LLT combination therapy in 41.2%, and 10.7% were not receiving any LLT.</div></div><div><h3>Conclusions</h3><div>Baseline data from SANTORINI Spain population show that only about one-fourth of patients attain LDL-C targets recommended by the 2019 ESC/EAS guidelines in patients at high and very high risk. Despite their cardiovascular risk, patients appear to be not adequately treated, and high-intensity and combination LLT seem to be underused for cardiovascular disease prevention in the real-world setting. ClinicalTrials.gov Identifier: NCT04271280.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 2","pages":"Pages 78-84"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756079","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
Ethics education into Internal Medicine residency training: a survey by the Spanish Society of Internal Medicine Working Group in Bioethics 内科住院医师培训中的伦理教育:西班牙内科学会生物伦理工作组的调查。
Revista clinica espanola Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.12.002
P. Martínez de la Cruz , C. Font Puig , S. Ibáñez Barceló , A. Blanco Portillo
{"title":"Ethics education into Internal Medicine residency training: a survey by the Spanish Society of Internal Medicine Working Group in Bioethics","authors":"P. Martínez de la Cruz ,&nbsp;C. Font Puig ,&nbsp;S. Ibáñez Barceló ,&nbsp;A. Blanco Portillo","doi":"10.1016/j.rceng.2024.12.002","DOIUrl":"10.1016/j.rceng.2024.12.002","url":null,"abstract":"","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 2","pages":"Pages 114-116"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823028","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
Comparative study of the effectiveness of tolvaptan versus urea in patients with hyponatremia caused by SIADH 托伐普坦与尿素治疗SIADH所致低钠血症疗效的比较研究。
Revista clinica espanola Pub Date : 2025-02-01 DOI: 10.1016/j.rceng.2024.12.001
Á. Martínez González , M. González Nunes , P. Rodeiro Escobar , J. Llópiz Castedo , A. Cabaleiro Loureiro , R.P. Martínez Espinosa , R. Ruades Patiño , G. Lorenzo Canda , J. Aguayo Arjona , S. Rodríguez Zorrilla
{"title":"Comparative study of the effectiveness of tolvaptan versus urea in patients with hyponatremia caused by SIADH","authors":"Á. Martínez González ,&nbsp;M. González Nunes ,&nbsp;P. Rodeiro Escobar ,&nbsp;J. Llópiz Castedo ,&nbsp;A. Cabaleiro Loureiro ,&nbsp;R.P. Martínez Espinosa ,&nbsp;R. Ruades Patiño ,&nbsp;G. Lorenzo Canda ,&nbsp;J. Aguayo Arjona ,&nbsp;S. Rodríguez Zorrilla","doi":"10.1016/j.rceng.2024.12.001","DOIUrl":"10.1016/j.rceng.2024.12.001","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Hyponatraemia is common in elderly and hospitalised patients, often caused by the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This study evaluates the efficacy and safety of tolvaptan and urea in patients with hyponatraemia and SIADH.</div></div><div><h3>Materials and methods</h3><div>An observational cohort study was conducted on 198 patients with SIADH and hyponatraemia (Na+ &lt;135 mmol/L) at the Complejo Hospitalario Universitario de Pontevedra from January 2015 to May 2022. Of these, 86 were treated with tolvaptan (average dose of 7.5 mg) and 112 with urea (average dose of 15 g). The primary outcome was the normalization of sodium levels (Na ≥ 135 mmol/L).</div></div><div><h3>Results</h3><div>The tolvaptan group showed higher sodium concentrations at the end of therapy compared to the urea group (ME = 136, IQR = 135–137 vs. ME = 134, IQR = 132–137; <em>p</em> &lt; 0.001). The time to normalise sodium was shorter with tolvaptan (4 ± 3.4 days) compared to urea (6 ± 3.6 days; <em>p</em> = 0.03). A higher percentage of patients achieved sodium normalization with tolvaptan (83.72% vs. 59.82%; <em>p</em> = 0.005). Tolvaptan had more adverse effects, such as dry mouth, thirst, and sodium overcorrection, while urea caused dysgeusia, abdominal pain, and diarrhea. There were no significant differences in mortality between the groups.</div></div><div><h3>Conclusions</h3><div>Tolvaptan was more effective and quicker than urea in normalising sodium levels, though it showed a higher percentage of adverse effects, which did not require discontinuation of the drug.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 2","pages":"Pages 85-91"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788359","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
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信