Revista clinica espanola最新文献_第2页

El registro RICA-2: diseño y características basales de los primeros 1.000 pacientes RICA-2 登记：首批 1,000 名患者的设计和基线特征

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.010

J.C. Trullàs , M.C. Moreno-García , V. Mittelbrunn-Alquézar , A. Conde-Martel , L. Soler-Rangel , M. Montero-Pérez-Barquero , J. Casado , M. Sánchez-Marteles , J.C. Arévalo-Lorido , J. Pérez-Silvestre , en representación de los investigadores del registro RICA-2

Background and objective

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.

Methods

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 de novo HF or chronic HF, regardless of left ventricular ejection fraction, aetiology and comorbidities.

Results

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.

Conclusion

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.

背景和目的心力衰竭（HF）是一种流行性综合征，也是入院治疗的主要原因之一。患者登记提供了真实世界的临床实践信息，是临床试验的补充。RICA-2 是西班牙内科医学会的一个登记处。其主要目的是了解在内科接受治疗的高血压患者的临床和流行病学特征以及预后因素。本研究旨在介绍 RICA-2 的设计、首批纳入的 1000 名患者的基线特征及其与 RICA 登记历史队列的比较。方法对符合以下纳入标准的心房颤动患者进行观察性、多中心和前瞻性研究：年龄等于或大于18岁，根据欧洲指南诊断为心房颤动，未明确纳入失代偿期或稳定期，新发心房颤动或慢性心房颤动患者，无论左心室射血分数、病因和合并症如何。合并症负担高于 RICA 登记（夏尔森合并症指数为 5 分），以慢性失代偿性心房颤动（74%）、高血压病因（39%）和射血分数保留（52%）为主。结论：RICA-2 代表了一个当代患者群组，将为我们提供内科治疗的急慢性心房颤动患者的临床、流行病学和预后信息。

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引用次数: 0

Factores de riesgo de mortalidad en pacientes con enfermedad del coronavirus 2019 con hipoxemia silente 2019 年冠状病毒病无声低氧血症患者死亡的风险因素

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.004

B. Ximenes Braz , G. Cavalcante Meneses , G.B. da Silva Junior , A.M. Costa Martins , A.F. de S. Mourão Feitosa , G.C. Lima Chagas , E. De Francesco Daher

Objective

To describe the predictors of mortality in hospitalized patients with severe acute respiratory syndrome (SARS) due to COVID-19 presenting with silent hypoxemia.

Material and methods

Retrospective cohort study 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 logistic regression analysis was performed.

Results

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 vs. 56 years; P < 0.001), less frequently female (43.6% vs. 40.9%; P < 0.001), and more likely to have comorbidities (74.3% vs. 56.8%; P < 0.001). Non-survivors had higher needs for invasive mechanical ventilation (42.4% vs 6.6%; P < 0.001) and intensive care unit admission (56.9% vs 20%; P < 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 (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.

Conclusions

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 with SARS due to COVID-19 with silent hypoxemia at presentation.

材料和方法对 2021 年 1 月至 6 月期间巴西因 COVID-19 感染严重急性呼吸系统综合征（SARS）且入院时出现无声低氧血症的住院患者进行回顾性队列研究。主要研究结果为住院死亡。结果在 46 102 名患者中，平均年龄为 59 ± 16 岁，女性占 41.6%。住院期间，13149 名患者死亡。与幸存者相比，非幸存者年龄更大（平均年龄为 66 岁对 56 岁；P < 0.001），女性更少（43.6% 对 40.9%；P < 0.001），更有可能患有合并症（74.3% 对 56.8%；P < 0.001）。与存活者相比，非存活者对有创机械通气（42.4% 对 6.6%；P <；0.001）和入住重症监护室（56.9% 对 20%；P <；0.001）的需求更高。在多变量回归分析中，高龄（OR：1.04；95%CI：1.037-1.04）、合并症（OR：1.54；95%CI：1.47-1.62）、咳嗽（OR：0.74；95%CI：0.71-0.79）、呼吸困难（OR：1.32；95%CI：1.26-1.38）和需要无创呼吸支持（OR：0.37；95%CI：0.35-0.40）仍然与死亡独立相关。结论对于因COVID-19引起的SARS住院病人来说，高龄、合并症和呼吸窘迫是导致死亡的独立危险因素，而咳嗽和需要无创呼吸支持则是导致死亡的独立保护因素。

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引用次数: 0

Predicción eficaz de la diabetes de novo con velocidad estimada de onda de pulso (ePWV) e índice de masa corporal (IMC) 利用估计脉搏波速度 (ePWV) 和体重指数 (BMI) 有效预测新发糖尿病。

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.007

D. Dong , X. Qiao , C. Chen , W. Bao , C. Chen , X. Yuan , Y. Zhang

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

目的估计脉搏波速度（ePWV）和体重指数（BMI）是预测新发糖尿病的重要指标。本研究旨在评估结合 ePWV 和 BMI 对新发糖尿病发病率的影响和预测价值。方法对富康医疗（中国）的一项队列研究进行了二次分析，该研究涉及 211,833 名符合条件的参与者。结果在平均 3.12 年的随访期内，3000 名男性（1.41%）和 1174 名女性（0.55%）被诊断为糖尿病。逻辑回归显示，体重指数、甘油三酯、丙氨酸氨基转移酶、血尿素氮、肌酐清除率、ePWV 和糖尿病家族史是新发糖尿病的高危因素。与单独使用 ePWV 或 BMI 相比，ePWV 和 BMI 的组合提供了更高的 ROC 曲线下面积（0.822）。结论ePWV和BMI水平升高是新发糖尿病的独立风险因素，与单独使用其中一个指标相比，结合使用这些指标可提高预测准确性。

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引用次数: 0

¿Cómo evoluciona el riesgo de malnutrición en pacientes mayores al año del alta hospitalaria? Resultados de una cohorte prospectiva 老年患者出院一年后营养不良的风险如何变化？前瞻性队列研究结果

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.009

A. Marne Ortega , L. Corral-Gudino , P. Miramontes González , M. Gabella-Martín

引用次数: 0

Miedo a la enfermedad en La metamorfosis de Kafka 卡夫卡《变形记》中的疾病恐惧

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.003

F. Tornero-Romero , M. Morante-Ruiz , L.A. Gonzales-Campos

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, Metamorphosis.

今年是弗朗茨-卡夫卡逝世 100 周年。在全科医学，尤其是内科医学中，医生经常面临这样的情况，即他们将自己定位为病人与社会以及社会对疾病的看法之间的唯一保证人。很多时候，病人来就诊时并没有诊断结果，或者对诊断结果心存恐惧，有时还会遭到周围环境的排斥。这篇短文探讨了这一当前的话题，向这位杰出的作家及其最著名的作品《变形记》致敬。

引用次数: 0

Consumo de alcohol en las personas mayores. ¿Cuál es la magnitud real del problema? 老年人饮酒--问题的真实程度如何？

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.005

I. Fernández Castro , M. Marcos Martín , I. Novo Veleiro

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 to 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.

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.

关于饮酒的有害影响，在普通人群中已有大量研究，但对于 80 岁以上的老年人群，有关其相关性的信息却不多。据估计，这一人群中有 30% 至 40% 的人经常饮酒，约 10% 的人饮酒风险较高。此外，这种物质与该年龄段人群常服用的药物（如口服抗糖尿病药、抗凝血药和抗生素）之间的潜在相互作用可能会带来严重并发症的风险。从这个意义上说，本研究的目的是分析 80 岁以上老年人的饮酒量及其对健康的影响。我们对有关该主题的现有文献进行了叙述性回顾，结果表明，80 岁以上老年人饮酒在我们的环境中很常见，并且与多种并发症和不同病症的发生有关。正确量化高龄老人的饮酒量必须纳入医学，特别是内科学的日常临床实践中。

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引用次数: 0

Asociación entre las cadenas ligeras de neurofilamento en suero (sNfL) y los trastornos neurológicos en una muestra representativa de adultos en los Estados Unidos: un estudio transversal 美国代表性成人样本中血清神经丝蛋白轻链 (sNfL) 与神经系统疾病之间的关系：一项横断面研究。

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-10-01 DOI: 10.1016/j.rce.2024.06.008

Q. Xu , J. Wang , H. Li , Y. Gao

Background

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 among serum NfL levels and neurological disorders in a broad and representative population sample.

Methods

We utilized information gathered from 1,751 adults involved in the 2013-2014 cycle of the National Health and Nutrition Examination Survey (NHANES). Our analytical approach encompassed logistic regression, smoothed curve fitting, and subgroup analyses to identify potential correlations between serum NfL levels and neurological conditions, including depression, severe hearing and visual impairments, stroke, subjective memory deficits, and sleep problems.

Results

After adjusting for confounders, we found that higher serum NfL concentrations were significantly associated with increased risks of depression, stroke, subjective memory deficits, and longer sleep duration (P<.05). Subgroup analyses supported these findings. Additionally, BMI significantly influenced the relationship between serum NfL levels and subjective memory deficits.

Conclusion

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.

背景虽然血清中神经丝轻链（NfL）浓度的升高与多种神经系统疾病的进展有关，但其在普通成年人群中的分布和影响在很大程度上仍未得到探讨。目前的研究旨在通过广泛而具有代表性的人群样本，阐明血清中 NfL 水平与神经系统疾病之间的关系。方法我们利用了美国国家健康与营养调查（NHANES）2013-2014 年周期中收集的 1751 名成年人的信息。我们的分析方法包括逻辑回归、平滑曲线拟合和亚组分析，以确定血清 NfL 水平与神经系统疾病（包括抑郁症、严重听力和视力障碍、中风、主观记忆缺陷和睡眠问题）之间的潜在相关性。结果在对混杂因素进行调整后，我们发现血清 NfL 浓度越高，抑郁症、中风、主观记忆缺陷和睡眠时间越长的风险就越高（P< .05）。亚组分析支持这些发现。结论我们的研究表明，较高的血清 NfL 水平与多种神经系统疾病的风险升高密切相关。这些研究结果突显了血清 NfL 作为早期检测和监测神经系统疾病的重要标志物的作用，强调了其在临床和公共卫生环境中的重要性。

{"title":"Asociación entre las cadenas ligeras de neurofilamento en suero (sNfL) y los trastornos neurológicos en una muestra representativa de adultos en los Estados Unidos: un estudio transversal","authors":"Q. Xu , J. Wang , H. Li , Y. Gao","doi":"10.1016/j.rce.2024.06.008","DOIUrl":"10.1016/j.rce.2024.06.008","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 among 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 1,751 adults involved in the 2013-2014 cycle of the National Health and Nutrition Examination Survey (NHANES). Our analytical approach encompassed logistic regression, smoothed curve fitting, and subgroup analyses to identify potential correlations between serum NfL levels and neurological conditions, including depression, severe hearing and visual impairments, stroke, subjective memory deficits, and sleep problems.</div></div><div><h3>Results</h3><div>After adjusting for confounders, we found that higher serum NfL concentrations were significantly associated with increased risks of depression, stroke, subjective memory deficits, and longer sleep duration (<em>P</em><.05). Subgroup analyses supported these findings. Additionally, BMI significantly influenced the relationship between serum NfL levels and subjective memory deficits.</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":21223,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 510-521"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalencia y características de la anemia en personas con diabetes mellitus de 50 años o más en un área sanitaria de Cádiz (España) 加的斯（西班牙）一个健康地区 50 岁及以上糖尿病患者贫血症的患病率和特征。

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-08-01 DOI: 10.1016/j.rce.2024.05.007

A. Michán-Doña , E. Jiménez-Varo , M. Escribano-Cobalea , C. Casto-Jarillo , A. López-Ceres , E. Campos-Dávila , A. Hormigo-Pozo , C. Nieto-Ordoñez , M.Á. Rodríguez-Juliá , J. Escribano-Serrano

Background

Anemia is a common comorbidity in patients with diabetes mellitus (DM), particularly in older adults. However, there is a lack of data on the prevalence and the characteristics of anemia in this population in Spain.

Objective

To describe the prevalence and the characteristics of anemia in patients with DM aged 50 or older (PDM50) in a healthcare district in the province of Cádiz.

Methods

A retrospective cross-sectional study was conducted that included outpatient's laboratory tests (OLT) performed over 30 months at PDM50.

Results

The prevalence of anemia was 29.9% (95% CI: 28.7-31.1%), predominating in women (33.3% vs 26.7%; p< 0.01), in older people stratified by decades (61.7% in 9 th decade vs 12% in 5 th decade; p< 0.01), and in those with kidney disease (44.7% vs 28%; p< 0.01). Most cases were mild (68.3%), normocytic (78.7%), and hypochromic (52%). Similarly, moderate-to-severe anemia was more frequent in women (39% vs 23%), their prevalence increased with age (45% in the 9 th decade vs 24% in the 5 th decade), and with the progression of kidney damage, either measured by a decreased glomerular filtration rate (GFR) (49% in G4 vs 25% in G1), or the presence of albuminuria (p < 0.01). No association was found between DM control, based on glycated hemoglobin (HbA1c), and anemia in either sex (p = 0.887).

Conclusion

This study describes a high prevalence of anemia in PDM50, particularly in women, in the most advantageous people and in the presence of kidney disease, even in early stages, highlighting the clinical importance of this coexistence.

背景贫血是糖尿病（DM）患者，尤其是老年人常见的合并症。目的描述加的斯省一个医疗区 50 岁或以上 DM 患者（PDM50）的贫血患病率和特征。结果贫血患病率为 29.9% (95% CI: 28.7-31. 1%) ，以女性为主。1%），女性居多（33.3% 对 26.7%；p<；0.01），按年代分，老年人居多（61.7% 在第 9 个年代，12% 在第 5 个年代；p<；0.01），肾病患者居多（44.7% 对 28%；p<；0.01）。大多数病例为轻度（68.3%）、正常红细胞（78.7%）和低色素（52%）。同样，中重度贫血在女性中更为常见（39% 对 23%），其发病率随着年龄的增长而增加（45% 发生在第 9 个 10 年，24% 发生在第 5 个 10 年），并随着肾脏损害的进展而增加，肾脏损害是指肾小球滤过率（GFR）的下降（49% 发生在 G4，25% 发生在 G1）或白蛋白尿的出现（p< 0.01）。结论：本研究描述了 PDM50 中贫血的高发率，尤其是在女性、优势人群和存在肾脏疾病（即使是早期阶段）的人群中，强调了这种并存现象的临床重要性。

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引用次数: 0

Bronquiectasias, adenopatías relacionadas con la sobreexpresión del factor activador de los linfocitos B perteneciente a la familia del factor de necrosis tumoral y cistitis linfoplasmocítica como eventos adversos asociados al uso prolongado de rituximab en enfermedades reumáticas autoinmunes sistémicas 支气管扩张、与肿瘤坏死因子家族的 B 淋巴细胞活化因子（B 淋巴细胞活化因子）过度表达有关的腺病以及淋巴细胞性膀胱炎是全身性自身免疫性风湿病患者长期使用利妥昔单抗引起的不良反应。

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-08-01 DOI: 10.1016/j.rce.2024.04.015

C.A. Cañas , I. Posso-Osorio , V. Pérez-Uribe , V. Erazo-Martínez

Background

The long-term use of rituximab (RTX) has been gaining ground in the treatment of systemic autoimmune diseases. The adverse events (AEs) associated with its use different to infections are being reported.

Methods

A cohort of patients with SAIDs treated at a high-complexity center in Cali (southwestern Colombia) with follow-up from January 2008 to December 2022 were examined to search for potential AEs associated with prolonged use of RTX.

Results

From 178 patients with long-term use of RTX 3 (1.68%) had lymphadenopathies with lymphoid follicular hyperplasia related to BAFF overexpression, 4 (2.24%) with bronchiectasis, and 4 (2.24%) with lymphoplasmacytic cystitis.

Conclusion

Bronchiectasis, lymphoid follicular hyperplasia related to BAFF overexpression, and lymphoplasmacytic cystitis may be life-threatening long-term AEs in patients with prolonged use of RTX.

背景长期使用利妥昔单抗（RTX）治疗全身性自身免疫性疾病的趋势日益明显。方法对2008年1月至2022年12月期间在卡利（哥伦比亚西南部）一家高复杂性中心接受治疗的SAIDs患者进行队列研究，以寻找与长期使用RTX相关的潜在AEs。结论支气管扩张、与 BAFF 过度表达相关的淋巴滤泡增生和淋巴浆细胞性膀胱炎可能是长期使用 RTX 患者中危及生命的长期 AE。

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引用次数: 0

Espectro etiológico y desafíos diagnósticos de la fiebre de corta duración en Bengala Occidental (India): un estudio transversal en un centro de atención terciaria 印度西孟加拉邦短程发热的病原谱和诊断难题：在一家三级医疗中心进行的横断面研究。

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2024-08-01 DOI: 10.1016/j.rce.2024.06.002

U. Biswas , A. Bhattacharjee , S. Seth , R. Ghosh , A.K. Singh , A. Sohrab , J. Benito-León

Introduction

The scarcity of epidemiological data on acute febrile illnesses from South Asia impairs evidence-based clinical decision-making. Our study aimed to explore the etiological spectrum of short-duration fever in patients admitted to a tertiary care hospital in West Bengal, India.

Methods

We conducted a cross-sectional study from May 2021 to April 2022 involving 150 adult patients presenting with a fever lasting less than two weeks at Burdwan Medical College and Hospital (West Bengal, India). We performed comprehensive clinical assessments, including microbiological, serological, and other specific investigations, to identify the causes of the fever.

Results

The demographic profile predominantly included individuals aged 21-40 years, with a male-to-female ratio of 1.9:1; 60.7% of participants were from rural areas. The primary etiological agents identified were scrub typhus (25.3%), dengue (15.3%), and enteric fever (13.3%). Notably, 80% of patients presented with non-localizing symptoms, while 14.7% had respiratory symptoms. Blood cultures pinpointed Salmonella typhi and Staphylococcus aureus in a minority of cases (3.3%); malaria, primarily Plasmodium vivax, was diagnosed in 12% of the cases.

Conclusion

Our findings highlight the complexity of diagnosing short-duration fevers, dominated by a wide range of etiological agents, with a notable prevalence of scrub typhus. These results underscore the urgent need for enhanced diagnostic facilities, including the availability of scrub typhus testing at primary healthcare centers. We recommend empirical doxycycline therapy for suspected cases and emphasize the need for further research to develop management guidelines for acute febrile illnesses. This study also highlights the importance of raising both community and clinician awareness to prevent irrational antibiotic use.

导言南亚地区急性发热疾病的流行病学数据稀缺，影响了以证据为基础的临床决策。我们在 2021 年 5 月至 2022 年 4 月期间进行了一项横断面研究，涉及 150 名在 Burdwan 医学院和医院（印度西孟加拉邦）就诊的发热持续时间少于两周的成年患者。我们进行了全面的临床评估，包括微生物学、血清学和其他特殊检查，以确定发烧的原因。结果人口统计学特征主要包括 21-40 岁的人，男女比例为 1.9:1；60.7% 的参与者来自农村地区。主要病原体为恙虫病（25.3%）、登革热（15.3%）和肠热（13.3%）。值得注意的是，80%的患者出现非局部症状，14.7%的患者出现呼吸道症状。少数病例（3.3%）的血液培养结果为伤寒沙门氏菌和金黄色葡萄球菌；12%的病例被诊断为疟疾，主要是间日疟原虫。这些结果突出表明，迫切需要加强诊断设施，包括在初级医疗保健中心提供恙虫病检测。我们建议对疑似病例进行经验性强力霉素治疗，并强调有必要开展进一步研究，以制定急性发热性疾病的管理指南。这项研究还强调了提高社区和临床医生对防止不合理使用抗生素的认识的重要性。

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引用次数: 0