Medicina Clinica最新文献

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A comprehensive approach to end-of-life care. Medical-legal, ethical, social, psychological and care aspects. 临终关怀的综合方法。医疗、法律、伦理、社会、心理和护理等方面。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-19 DOI: 10.1016/j.medcli.2024.10.001

Josep Arimany-Manso, Francesc Torralba, Ana Isabel Lima, María Die Trill

引用次数: 0

Increasing prevalence of psoriasis in Spain: A population-based study (2018-2022). 西班牙银屑病发病率不断上升：一项基于人口的研究（2018-2022 年）。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-18 DOI: 10.1016/j.medcli.2024.08.019

Lucía Cayuela, José-Juan Pereyra-Rodríguez, Juan-Carlos Hernández-Rodríguez, Lourdes Rodríguez Fernandez-Freire, Aurelio Cayuela

Objectives: This study aimed to investigate the prevalence of psoriasis in Spain from 2018 to 2022 and analyze trends by sex and age groups.

Methods: We used the Primary Care Clinical Database (BDCAP) to identify individuals coded with psoriasis (S91) during the study period. Population data for calculating rates was obtained from the Primary Care Information System (SIAP). Crude, age- and sex-specific, and standardized prevalence rates were calculated. Joinpoint analysis assessed annual percentage change (APC) in prevalence.

Results: The estimated psoriasis prevalence in Spain in 2022 was 1.9%. Psoriasis prevalence increased substantially by 43.3% (from 692,317 to 991,832 cases) over the study period. We observed a clear increase in both crude and standardized prevalence rates for men (7.2% annual increase) and women (8.3% annual increase) throughout the study period. Men consistently had slightly higher prevalence rates than women. Prevalence increased with age, reaching a peak in the 70-74 age group for men and 60-64 for women, before declining in older age groups.

Conclusions: This study revealed a concerning increase in psoriasis prevalence in Spain, independent of population aging. Increased disease awareness, improved diagnostics, and greater treatment seeking behavior are potential explanations. Further research is needed to explore the underlying causes of this rise and inform public health interventions.

研究目的本研究旨在调查2018年至2022年西班牙银屑病的患病率，并按性别和年龄组分析其发展趋势：我们使用初级医疗临床数据库（BDCAP）来识别研究期间编码为银屑病（S91）的个体。用于计算发病率的人口数据来自初级医疗信息系统（SIAP）。计算出了粗略患病率、年龄和性别患病率以及标准化患病率。连接点分析评估了患病率的年度百分比变化（APC）：结果：据估计，2022 年西班牙的银屑病患病率为 1.9%。在研究期间，银屑病患病率大幅增加了 43.3%（从 692,317 例增至 991,832 例）。我们观察到，在整个研究期间，男性（每年增长 7.2%）和女性（每年增长 8.3%）的粗略患病率和标准化患病率都有明显增长。男性的患病率一直略高于女性。患病率随着年龄的增长而增加，男性在 70-74 岁年龄组达到高峰，女性在 60-64 岁年龄组达到高峰，然后在老年组中有所下降：这项研究表明，西班牙银屑病发病率的增长令人担忧，这与人口老龄化无关。对疾病认识的提高、诊断方法的改进以及寻求治疗行为的增加都是可能的原因。需要开展进一步的研究，探索发病率上升的根本原因，并为公共卫生干预措施提供依据。

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引用次数: 0

Challenges of genetics in the diagnosis of sudden cardiac death. Interest of forensic and legal medicine. 遗传学在诊断心脏性猝死方面的挑战。法医和法律医学的兴趣。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-18 DOI: 10.1016/j.medcli.2024.10.002

Alejandro Blanco-Verea, Ángel Carracedo, María Brion

Sudden cardiac death is the leading cause of death in developed countries and a small but significant number of cases cannot be explained after a thorough autopsy process. Cases of sudden cardiac death in people under 40years of age are mainly due to structural heart disease or cardiomyopathies and arrhythmogenic diseases or channelopathies. In these cases, the search for associated genetic factors through molecular autopsy may help to find the cause of unexplained sudden cardiac death, through genetic diagnosis of previously undiagnosed channelopathies or cardiomyopathies. The finding of genetic variants classified as pathogenic associated with cardiac pathology would conclude the autopsy result and provide the possibility of genetic screening in other family members.

在发达国家，心脏性猝死是导致死亡的主要原因，其中有一小部分病例在彻底尸检后仍无法解释原因。40 岁以下人群的心脏性猝死病例主要由结构性心脏病或心肌病以及心律失常性疾病或通道病引起。在这些病例中，通过分子尸检寻找相关遗传因素可能有助于找到不明原因的心脏性猝死的原因，通过对以前未确诊的通道病或心肌病进行基因诊断。如果发现被归类为与心脏病理相关的致病基因变异，将对尸检结果做出结论，并为其他家庭成员的基因筛查提供可能。

引用次数: 0

¿Se tiene en cuenta la ingesta de etanol? 我们是否考虑过乙醇的消耗量？

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-15 DOI: 10.1016/j.medcli.2024.04.030

Javier Velasco Montes , Silvia González Díez , Elena Rivas Cilleros

引用次数: 0

Aspectos medicolegales en las enfermedades infecciosas 传染病的医疗法律问题。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-15 DOI: 10.1016/j.medcli.2024.06.003

Robert Güerri-Fernández , Josep Benet , César Vargas

This article reviews the medico-legal aspects associated with infectious diseases, highlighting their complexity and the challenges they pose. Infectious diseases cause not only an increase in morbidity and mortality in the healthcare setting but also involve complex legal issues. Healthcare-Associated Infections (HAIs) represent a growing risk with the increase in invasive procedures and can lead to patient complications and legal claims against healthcare professionals and institutions. The consequences of medical malpractice in this context are discussed, such as diagnostic delays, inappropriate use of treatments, and lack of adequate testing, which can have serious sequelae or even result in the patient's death.

The review focuses on highlighting the importance of prevention, considering that healthcare-associated infections can be difficult to avoid, posing complex legal challenges.

It concludes that managing infectious diseases and their legal consequences requires careful consideration of clinical practice guidelines, prevention and control strategies, and effective communication with patients. An integrated and evidence-based approach is advocated to address these challenges, emphasizing continuous education, the use of advanced diagnostic technologies, and interdisciplinary collaboration.

本文回顾了与传染病相关的医学法律问题，强调了传染病的复杂性及其带来的挑战。传染病不仅会增加医疗机构的发病率和死亡率，还会涉及复杂的法律问题。随着侵入性手术的增加，医疗保健相关感染（HAIs）的风险也越来越大，可能导致患者出现并发症，并引发针对医疗保健专业人员和机构的法律索赔。本综述讨论了在这种情况下医疗事故的后果，如诊断延误、治疗方法使用不当、缺乏足够的检测等，这些都可能造成严重的后遗症，甚至导致患者死亡。考虑到医疗相关感染难以避免，会带来复杂的法律挑战，本综述重点强调了预防的重要性。综述认为，管理传染病及其法律后果需要认真考虑临床实践指南、预防和控制策略以及与患者的有效沟通。报告提倡采用综合的循证方法来应对这些挑战，强调持续教育、使用先进的诊断技术和跨学科合作。

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引用次数: 0

Parkinsonism in liver diseases or dysfunction 肝脏疾病或功能障碍导致的帕金森症。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-15 DOI: 10.1016/j.medcli.2024.04.022

Sichen Li, Yuxia Zhua, Xi Liu

Parkinsonism in liver diseases or dysfunction, mainly including neurological manifestations in hereditary liver diseases and neurological complications of advanced liver diseases, occur in isolation or in combination with other movement disorders, and progress along disease course. Prominent akinetic-rigidity syndrome, various onset and progression, poor levodopa response and metabolism abnormalities reflected by serum biomarkers and neuroimaging, make this atypical parkinsonism recognizable and notable in clinical practice. Different susceptibility of brain areas, especially in basal ganglia, to manganese, iron, copper, ammonia overload, together with subsequent oxidative stress, neurotransmitter alterations, disturbed glia-neuron homeostasis and eventually neurotoxicity, contribute to parkinsonism under the circumstances of insufficient liver clearance ability. These mechanisms are interrelated and may interact collectively, adding to the complexity of clinical manifestations and treatment responses. This review summarizes shared clinical features of parkinsonism in liver diseases or dysfunction, depicts their underlying mechanisms and suggests practical flowchart for differential diagnosis.

肝病或肝功能异常引起的帕金森病，主要包括遗传性肝病的神经系统表现和晚期肝病的神经系统并发症，可单独发生，也可与其他运动障碍合并发生，并随病程进展。突出的运动-僵直综合征、不同的起病和进展、左旋多巴反应差以及血清生物标志物和神经影像学反映的代谢异常，使这种非典型帕金森病在临床实践中具有可识别性和显著性。在肝脏清除能力不足的情况下，脑区（尤其是基底神经节）对锰、铁、铜、氨超载的敏感性不同，再加上随后的氧化应激、神经递质改变、胶质神经元平衡紊乱以及最终的神经毒性，都会导致帕金森病。这些机制相互关联，可能共同作用，增加了临床表现和治疗反应的复杂性。本综述总结了肝脏疾病或功能障碍导致帕金森病的共同临床特征，描述了其潜在机制，并提出了实用的鉴别诊断流程图。

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引用次数: 0

Hipertensión arterial pulmonar asociada a lupus eritematoso sistémico: descripción de una serie de casos 与系统性红斑狼疮相关的肺动脉高压：一个病例系列。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-15 DOI: 10.1016/j.medcli.2024.05.009

Rossio Gardenia Ortuño Lobo, Marina Garcia Carrasco, Gustavo Medina

引用次数: 0

Mielitis por Listeria en adulto inmunocompetente con respuesta favorable a gentamicina intratecal 免疫功能正常的成年患者患李斯特菌脊髓炎，但对鞘内庆大霉素反应良好。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-15 DOI: 10.1016/j.medcli.2024.05.006

Eva González Martínez, Maite Misis del Campo, Fidel Nuñez Marín

引用次数: 0

Genetic analysis of a family with hereditary hemorrhagic telangiectasia caused by a novel frameshift deletion mutation of the endoglin (ENG) gene 一个遗传性出血性毛细血管扩张症家族的基因分析，该家族由内切酶蛋白（ENG）基因的新型缺失突变引起。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-15 DOI: 10.1016/j.medcli.2024.05.012

Jiangtao Wu , Bin Liu , Zhou Zhou

引用次数: 0

Inappropriate secretion of antidiuretic hormone as an initial clinical manifestation of neurocysticercosis. 抗利尿激素分泌失调是神经囊虫病的初期临床表现。

IF 2.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2024-11-15 DOI: 10.1016/j.medcli.2024.08.018

María José Abenza Abildúa, Patricia González-Ruano Pérez, Luis Moreno-Dominguez

引用次数: 0

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