Revista clinica espanola最新文献_第7页

Clinical suspicion, diagnosis and management of cardiac amyloidosis: update document and executive summary 心脏淀粉样变性的临床怀疑、诊断和管理：更新文件和执行摘要。

Revista clinica espanola Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.009

S. Yun , J. Casado , J. Pérez-Silvestre , P. Salamanca , P. Llàcer , R. Quirós , R. Ruiz-Hueso , M. Méndez , L. Manzano , F. Formiga

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Impact of hypochloremia as a prognostic factor in patients with heart failure, a retrospective cohort study 低氯化物血症作为心力衰竭患者预后因素的影响，一项回顾性队列研究。

Revista clinica espanola Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.003

P. de Peralta García , M. Bolzoni , M. Yebra Yebra , M. Asenjo Martín , M. Arrondo Turrado , M.A. Domínguez Sepúlveda , J.A. Rueda Camino , R. Barba Martín

{"title":"Impact of hypochloremia as a prognostic factor in patients with heart failure, a retrospective cohort study","authors":"P. de Peralta García , M. Bolzoni , M. Yebra Yebra , M. Asenjo Martín , M. Arrondo Turrado , M.A. Domínguez Sepúlveda , J.A. Rueda Camino , R. Barba Martín","doi":"10.1016/j.rceng.2024.04.003","DOIUrl":"10.1016/j.rceng.2024.04.003","url":null,"abstract":"<div><h3>Background</h3><p>some studies suggest that hypochloremia is a risk factor in the prognosis of heart failure (HF) in patients with recent decompensation.</p></div><div><h3>Materials and methods</h3><p>retrospective cohort study of patients discharged due to HF decompensation who began follow-up in a specialized clinic. Two groups are defined: patients with hypochloremia (chloride < 98 mmol/L) and normochloremic patients (chloride > 98 mmol/L) in the initial assessment within the first month after discharge. The rate of intravenous diuretic rescue, emergency department visits, readmission for HF and cardiovascular (CV) death are compared using a Cox proportional hazards model.</p></div><div><h3>Results</h3><p>165 patients were included (59% women, mean age 85 years), with 60 (36%) having hypochloremia. Both groups were comparable in terms of baseline characteristics, except for female sex, presence of peripheral artery disease, moderate-to-severe liver disease (more prevalent in the hypochloremia group), PROFUND index, and baseline furosemide dose (higher in patients with hypochloremia). The incidence of the primary event was higher in subjects with hypochloremia than in normochloremic subjects (HR: 1.59, 95% CI 0.97–2.62), mainly due to the need for intravenous diuretic rescue (HR: 1.86, 95% CI 1.07−3.24).</p></div><div><h3>Conclusions</h3><p>hypochloremia following admission for HF decompensation is associated with a greater need for intravenous diuretic rescue therapy and probably worse overall prognosis across the spectrum of the disease, regardless of left ventricular ejection fraction (LVEF).</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 5","pages":"Pages 259-266"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790100","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}

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Analysis of the expression of the Serpina1 gene in SARS-CoV-2 infection: study of a new biomarker Serpina1基因在SARS-CoV-2感染中的表达分析：研究一种新的生物标志物

Revista clinica espanola Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.006

M. Pintanel-Raymundo , S. Menao-Guillén , J.J. Perales-Afán , A. García-Gutiérrez , I. Moreno-Gázquez , M. Julián-Ansón , M. Ramos-Álvarez , S. Olivera-González , I. Gutiérrez-Cía , M.A. Torralba-Cabeza

{"title":"Analysis of the expression of the Serpina1 gene in SARS-CoV-2 infection: study of a new biomarker","authors":"M. Pintanel-Raymundo , S. Menao-Guillén , J.J. Perales-Afán , A. García-Gutiérrez , I. Moreno-Gázquez , M. Julián-Ansón , M. Ramos-Álvarez , S. Olivera-González , I. Gutiérrez-Cía , M.A. Torralba-Cabeza","doi":"10.1016/j.rceng.2024.04.006","DOIUrl":"10.1016/j.rceng.2024.04.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The <em>SERPINA1</em> gene encodes the protein Alpha-1 Antitrypsin (AAT1). Possible imbalances between the concentrations of proteases and antiproteases (AAT1) can lead to the development of serious pulmonary and extrapulmonary pathologies. In this work we study the importance of this possible imbalance in patients with COVID-19.</p></div><div><h3>Objectives</h3><p>To correlate the severity of the symptoms of SARS-COV-2 infection with the AAT1 concentrations at diagnosis of the disease.</p></div><div><h3>Methods</h3><p>An observational, prospective, cross-sectional, non-interventional, analytical study was carried out where 181 cases with COVID-19 admitted to the “Lozano Blesa” University Clinical Hospital of Zaragoza were selected. The concentration of AAT1 was studied in all of them and this was correlated with the clinical aspects and biochemical parameters at hospital admission.</p></div><div><h3>Results</h3><p>141 cases corresponded to patients with severe COVID and 40 patients with mild COVID. AAT1 levels were positively correlated with the days of hospitalization, severity, C-Reactive Protein, ferritin, admission to Intensive Care, and death, and presented a negative correlation with the number of lymphocytes/mm3. AAT1 concentrations higher than 237.5 mg/dL allowed the patient to be classified as “severe” (S72%; E78%) and 311.5 mg/dL were associated with the risk of admission to Intensive Care or Exitus (S67%; E79%).</p></div><div><h3>Conclusions</h3><p>Levels of the SERPINA1 gene expression product, AAT1, correlate with the severity of COVID-19 patients at diagnosis of the disease, being useful as a prognostic biomarker.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 5","pages":"Pages 253-258"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756690","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}

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PICO questions and DELPHI methodology for improving the management of patients with acute hepatic porphyria 改善急性肝性卟啉症患者管理的 PICO 问题和 DELPHI 方法。

Revista clinica espanola Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.010

A. Riera-Mestre , J.S. García Morillo , J. Castelbón Fernández , M.E. Hernández-Contreras , P. Aguilera Peiró , J. Jacob , F. Martínez Valle , E. Guillén-Navarro , M. Morales-Conejo

{"title":"PICO questions and DELPHI methodology for improving the management of patients with acute hepatic porphyria","authors":"A. Riera-Mestre , J.S. García Morillo , J. Castelbón Fernández , M.E. Hernández-Contreras , P. Aguilera Peiró , J. Jacob , F. Martínez Valle , E. Guillén-Navarro , M. Morales-Conejo","doi":"10.1016/j.rceng.2024.04.010","DOIUrl":"10.1016/j.rceng.2024.04.010","url":null,"abstract":"<div><h3>Background</h3><p>Acute hepatic porphyrias (AHPs) are a group of rare diseases that encompasses acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, and 5-aminolaevulinic acid dehydratase deficiency porphyria. Symptoms of AHP are nonspecific which, together with its low prevalence, difficult the diagnosis and follow-up of these patients.</p></div><div><h3>Material and methods</h3><p>This project used DELPHI methodology to answer PICO questions related to management of patients with AHPs. The objective was to reach a consensus among multidisciplinary porhyria experts providing answers to those PICO questions for improving diagnosis and follow-up of patients with AHP.</p></div><div><h3>Results</h3><p>Ten PICO questions were defined and grouped in four domains: 1. Biochemical diagnosis of patients with AHP. 2. Molecular tests for patients with AHP. 3. Follow-up of patients with AHP. 4. Screening for long-term complications of patients with AHP.</p></div><div><h3>Conclusions</h3><p>PICO questions and DELPHI methodology have provided a consensus on relevant and controversial issues for improving the management of patients with AHP.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 5","pages":"Pages 272-280"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758081","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}

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DOI illusion DOI 幻想。

Revista clinica espanola Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.002

K. Moustafa

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Multidimensional frailty connection in older patients with diabetes mellitus 老年糖尿病患者的多维虚弱关系。

Revista clinica espanola Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.007

M. del Carmen Gamero-Sánchez , I. Barreto , J.C. Arévalo-Lorido , E. Vázquez-Jarén , J. Maese-Calvo , N. Mayoral-Testón , J. Carretero-Gómez , D. Fernández-Bergés

{"title":"Multidimensional frailty connection in older patients with diabetes mellitus","authors":"M. del Carmen Gamero-Sánchez , I. Barreto , J.C. Arévalo-Lorido , E. Vázquez-Jarén , J. Maese-Calvo , N. Mayoral-Testón , J. Carretero-Gómez , D. Fernández-Bergés","doi":"10.1016/j.rceng.2024.04.007","DOIUrl":"10.1016/j.rceng.2024.04.007","url":null,"abstract":"<div><h3>Background and objective</h3><p>Patients with diabetes mellitus (DM) experience accelerated aging and, thus, a high prevalence of frailty. Our aim is to outline the type of frailty and prefrailty from a multidimensional perspective and the interaction of these dimensions in this scenery.</p></div><div><h3>Material and methods</h3><p>Observational study of patients with DM over 60 years-old. Variables related to nutrition, cognitive and emotional status, physical and instrumental functional capacity and social resources were collected. They were divided into three groups (robust, prefrail and frail) according to the Fried scale. Each of the variables in the groups were compared and a correspondence analysis was carried out to see the influence of some dimensions with others in each stage of frailty.</p></div><div><h3>Results</h3><p>188 patients (mean age 72.6 <u>+</u> 7.5) were analysed. Of them, 105 patients had prefrailty and 66 were frail. With the exception of social resources, the rest of the variables had an increasing prevalence depending on the stage of frailty. However, in the correspondence analysis (with 22.9% of variation explained by two dimensions) it was only patients with frailty who were associated with worse functional capacity, cognitive and emotional situation and mild to moderate social incapacity.</p></div><div><h3>Conclusions</h3><p>In our sample there was a high prevalence of prefrailty, and frailty associated with an increase in the prevalence of other different dimensions except social resources. However, the interaction between these dimensions was only evident in the case of patients with frailty.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 5","pages":"Pages 281-287"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789909","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}

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Diagnosis and treatment of deep vein thrombosis of the lower and upper limbs. 2024 recommendations of the venous thromboembolism group of the Spanish Society of Internal Medicine 上下肢深静脉血栓的诊断与治疗。西班牙内科医学会血栓栓塞性疾病小组 2024 年建议。

Revista clinica espanola Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.004

A. Gil-Díaz , J. Martín Guerra , P. Parra Caballero , G. Puche Palao , N. Muñoz-Rivas , N. Ruiz-Giménez Arrieta

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Letter to the editor on «Bioethical challenges in clinical practice of the 20th century» 就 "20 世纪临床实践中的生物伦理挑战 "致编辑的信。

Revista clinica espanola Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.03.004

María Fernanda García Aguilera , Nayely García Méndez , Edgardo Álvarez Muñoz , J. Lagarda Cuevas

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Letter to the editor analysing a study about diabetes mellitus 致编辑的信，分析有关糖尿病的研究。

Revista clinica espanola Pub Date : 2024-04-01 DOI: 10.1016/j.rceng.2024.02.010

Elena Urízar Ursúa, Alicia Aldea, María Bayona, Patricia M. Oliván

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Successful desensitization to anakinra in a case with immediate cutaneous reaction in Still disease 成功脱敏安纳金拉（anakinra），治愈了一例立即出现皮肤反应的 Still 病例。

Revista clinica espanola Pub Date : 2024-04-01 DOI: 10.1016/j.rceng.2024.02.011

R. Pertusa Mataix , E. Menéndez Rivero , C. Hernández Quiles , J.S. García Morillo

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