Medicina Clinica最新文献

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Opportunistic Pneumocystis jirovecii infection in a COPD patient on anti-IL5 biologic treatment with benralizumab. A case report 使用贝纳利珠单抗抗il - 5生物治疗的COPD患者的机会性肺囊虫感染病例报告

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-02-01 Epub Date: 2026-01-14 DOI: 10.1016/j.medcli.2025.107319

Xavier Pomares, Daniella Yamunaque, Concepción Montón

引用次数: 0

Coral dermatitis 珊瑚皮炎

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-02-01 Epub Date: 2026-01-07 DOI: 10.1016/j.medcli.2025.107266

Pablo Balado-Simó, Lluís Corbella-Bagot

引用次数: 0

Coexistence of McArdle disease and hypokalemic periodic paralysis: A case report 麦卡德尔病与低钾血症性周期性麻痹共存1例。

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-02-01 Epub Date: 2026-01-20 DOI: 10.1016/j.medcli.2025.107336

Juyi Liu , Guang Ji , Xueqin Song

引用次数: 0

Clinical characteristics, disease course, and chronic organ damage in a real-world cohort of IgG4-related disease: Insights from an Interdisciplinary Unit igg4相关疾病的临床特征、病程和慢性器官损伤：来自跨学科单位的见解

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-02-01 Epub Date: 2026-01-20 DOI: 10.1016/j.medcli.2025.107317

Ernestina Angarola , Analia Pasqua , Matías Horacio Castro , Agustín Cáceres , Juan Carlos Spina , Paola Casciato , IgG4-RD Interdisciplinary Unit

Background and objective

IgG4-RD is a multisystemic disease, often underdiagnosed, with natural progression to chronic organ damage. We aim to describe clinical features, relapse and chronic organ damage.

Methods

Dynamic ambispective cohort including patients from the Institutional Registry of IgG4-RD at Hospital Italiano de Buenos Aires who met ACR/EULAR 2019 criteria. We analyzed clinical phenotypes, response to treatment, biomarkers and chronic organ damage.

Results

Sixty patients were included; 73% were male and median age at diagnosis was 61 years. Median time to diagnosis was 9 months (IQR 3–21), 10% had >10 years of delay. Multiorgan disease was present at diagnosis in 65% and the most common phenotype was pancreatohepatobiliary (40%). Corticosteroids were used at diagnosis in 77%; seven patients with totally resected disease required no further immunosuppression (median 59 months; IQR 31–144). Relapses occurred in 47%, predominantly in those with multiorgan involvement (89%). Kidneys and the biliary tract were most commonly affected in relapse. Relapsing predictive biomarkers were present in 63% at the onset; multiorgan involvement was associated with relapsing disease (p = 0.002). Chronic organ damage occurred in 71%, in 44% after surgical resection. The most frequent was exocrine pancreatic insufficiency (35%). Patients with baseline damage had a significantly longer diagnostic delay (p = 0.03). After a year of diagnosis, 85% of patients experienced damage.

Conclusion

Baseline organ damage was highly frequent, particularly with delayed diagnosis, while multiorgan involvement predicted relapse, underscoring the need for earlier and multidisciplinary management.

背景与目的：IgG4-RD是一种多系统疾病，常被漏诊，可自然发展为慢性器官损伤。我们的目的是描述临床特征，复发和慢性器官损伤。方法：动态双视角队列研究，包括来自布宜诺斯艾利斯意大利医院IgG4-RD机构登记处符合ACR/EULAR 2019标准的患者。我们分析了临床表型、对治疗的反应、生物标志物和慢性器官损伤。结果：纳入60例患者；73%为男性，诊断时的中位年龄为61岁。中位诊断时间为9个月（IQR 3-21）， 10%延迟10年。65%的诊断时存在多器官疾病，最常见的表型是胰肝胆道（40%）。诊断时使用皮质类固醇的占77%；7例完全切除的患者无需进一步免疫抑制（中位59个月；IQR 31-144）。复发发生率为47%，主要是多器官受累（89%）。复发时最常受肾脏和胆道的影响。63%的患者在发病时存在复发性预测性生物标志物；多器官受累与疾病复发相关（p=0.002）。慢性器官损害发生率为71%，手术切除后为44%。最常见的是外分泌性胰腺功能不全（35%）。基线损伤患者的诊断延迟明显延长（p=0.03）。经过一年的诊断，85%的患者出现了损伤。结论：基线器官损害非常频繁，特别是延迟诊断，而多器官累及预示复发，强调早期和多学科治疗的必要性。

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引用次数: 0

Pulmonary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue in a common variable immunodeficiency patient 一个常见的可变免疫缺陷患者的肺粘膜相关淋巴组织结外边缘区淋巴瘤

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-02-01 Epub Date: 2026-01-14 DOI: 10.1016/j.medcli.2025.107324

Luis Gorospe , Alberto Cabañero-Sánchez , Natalia Isabel Torres-Calcines

引用次数: 0

Valor pronóstico del índice PROFUND en pacientes con enfermedad pulmonar obstructiva crónica tras agudización 急性后慢性阻塞性肺病患者的深度指数预测值

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-02-01 Epub Date: 2026-01-17 DOI: 10.1016/j.medcli.2025.107314

Irene Casado López, Francisco Javier Teigell Muñoz, José Manuel Casas Rojo, María Mateos González, Alba Hernández Piriz, Pilar Cubo Romano

Objective

To evaluate the prognostic value of the PROFUND index for predicting all-cause mortality during hospitalization or within three months after discharge in patients hospitalized due to COPD exacerbation, as well as predicting readmissions within three months.

Method

An observational, retrospective, single-center study that included all patients hospitalized between January and December 2022 due to COPD exacerbation.

Results

The analysis included 172 patients. Half of the patients (50.6%) were multimorbid. These patients were older, had greater baseline dyspnea, a higher degree of obstruction, greater dependency for basic daily living activities, a higher PROFUND index, and were at higher risk of readmission within three months and in-hospital mortality (P<.05). There was a 35.98% readmission rate within three months, mostly due to a new COPD exacerbation (86%), an in-hospital mortality rate of 3.4%, and a three-month mortality rate of 5.2%. A high PROFUND index (≥7) was significantly associated with increased mortality during hospitalization or within the first 3 months after discharge (OR: 33; 95% CI: 3.9-273.4; P=.001) and a higher risk of hospital readmission for any cause (OR: 4.91; 95% CI: 1.99-12.13; P=.0003). The variables most influencing mortality were severe dyspnea, anemia, confusional syndrome, and functional impairment (Barthel index < 60).

Conclusion

The PROFUND index could be a good predictor of mortality and readmission risk in patients hospitalized due to a COPD exacerbation.

目的评价PROFUND指数对COPD加重住院患者住院期间及出院后3个月内全因死亡率的预测价值，以及对3个月内再入院的预测价值。方法一项观察性、回顾性、单中心研究，纳入2022年1月至12月因COPD恶化住院的所有患者。结果纳入172例患者。半数患者（50.6%）为多病。这些患者年龄较大，基线呼吸困难程度较高，梗阻程度较高，对基本日常生活活动的依赖程度较高，PROFUND指数较高，3个月内再入院和住院死亡率的风险较高（P< 0.05）。3个月内再入院率为35.98%，主要是由于新的COPD加重（86%），住院死亡率为3.4%，3个月死亡率为5.2%。高PROFUND指数（≥7）与住院期间或出院后前3个月内死亡率增加（or: 33; 95% CI: 3.9-273.4； P=.001）和因任何原因再入院的较高风险（or: 4.91; 95% CI: 1.99-12.13； P=.0003）显著相关。对死亡率影响最大的变量是严重呼吸困难、贫血、精神混乱综合征和功能障碍（Barthel指数60）。结论PROFUND指数可以很好地预测慢性阻塞性肺病加重患者的死亡率和再入院风险。

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引用次数: 0

Virus de la hepatitis E: un problema de salud pública emergente 乙型肝炎病毒：一个新出现的公共卫生问题

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-02-01 Epub Date: 2026-01-14 DOI: 10.1016/j.medcli.2025.107286

María Teresa Pérez-Gracia, Lara Martínez-Celdrán, Clara Más-Comes

Hepatitis E, caused by the hepatitis E virus (HEV), represents an emerging global public health problem, constituting one of the main causes of acute viral hepatitis. Since its first description, it has been considered a disease with an epidemiological pattern linked to the consumption of contaminated water and food, and with a higher prevalence in geographical areas with poor socio-sanitary conditions. According to WHO estimates, around 2 billion people, representing a quarter of the world's population, live in areas where HEV is endemic and are therefore at risk of infection. Improvements in diagnostic techniques have provided the data necessary to demonstrate that in developed countries, HEV infection is common, indigenous and has a different epidemiological pattern, associated with contact with domestic animals, especially pigs. Another interesting aspect is that HEV can cause chronic hepatitis in transplant and immunocompromised patients.

戊型肝炎由戊型肝炎病毒（HEV）引起，是一个新出现的全球公共卫生问题，是急性病毒性肝炎的主要病因之一。自首次对该病进行描述以来，该病一直被认为是一种与饮用受污染的水和食物有关的流行病，在社会卫生条件差的地理区域发病率较高。据世卫组织估计，约有20亿人（占世界人口的四分之一）生活在戊型肝炎流行地区，因此面临感染风险。诊断技术的改进提供了必要的数据，证明在发达国家，戊肝病毒感染是常见的、地方性的，具有不同的流行病学模式，与接触家畜，特别是猪有关。另一个有趣的方面是，HEV可在移植和免疫功能低下患者中引起慢性肝炎。

引用次数: 0

Monitorización terapéutica de golimumab en práctica de la vida real: hacia un tratamiento personalizado en la colitis ulcerosa (CU) 哥利姆单抗在现实生活中的治疗药物监测：溃疡性结肠炎（UC）的个性化管理。

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-02-01 Epub Date: 2026-01-20 DOI: 10.1016/j.medcli.2025.107330

Paulina Núñez , Francisca Carvajal , Rodrigo Quera , Fodda Chelech

引用次数: 0

Características de los ensayos clínicos no farmacológicos financiados por el Instituto de Salud Carlos III completados en 2009-2024 2009-2024年完成的由Salud Carlos III研究所资助的非药物临床试验的特点。

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-01-01 Epub Date: 2026-01-07 DOI: 10.1016/j.medcli.2025.107279

Rafael Dal-Ré , Elena García-Méndez , Ignacio Mahillo-Fernández

引用次数: 0

Uso racional de las inmunoglobulinas 合理使用免疫球蛋白。

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica

Pub Date : 2026-01-01 Epub Date: 2026-01-07 DOI: 10.1016/j.medcli.2025.107260

José Antonio García Erce , Ingrid Magnolia Parra Salinas

引用次数: 0

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