Pub Date : 2024-10-01DOI: 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.
{"title":"Predicción eficaz de la diabetes de novo con velocidad estimada de onda de pulso (ePWV) e índice de masa corporal (IMC)","authors":"D. Dong , X. Qiao , C. Chen , W. Bao , C. Chen , X. Yuan , Y. Zhang","doi":"10.1016/j.rce.2024.06.007","DOIUrl":"10.1016/j.rce.2024.06.007","url":null,"abstract":"<div><h3>Purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 503-509"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417144","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}
Pub Date : 2024-10-01DOI: 10.1016/j.rce.2024.06.009
A. Marne Ortega , L. Corral-Gudino , P. Miramontes González , M. Gabella-Martín
{"title":"¿Cómo evoluciona el riesgo de malnutrición en pacientes mayores al año del alta hospitalaria? Resultados de una cohorte prospectiva","authors":"A. Marne Ortega , L. Corral-Gudino , P. Miramontes González , M. Gabella-Martín","doi":"10.1016/j.rce.2024.06.009","DOIUrl":"10.1016/j.rce.2024.06.009","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 549-551"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417248","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}
Pub Date : 2024-10-01DOI: 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.
{"title":"Miedo a la enfermedad en La metamorfosis de Kafka","authors":"F. Tornero-Romero , M. Morante-Ruiz , L.A. Gonzales-Campos","doi":"10.1016/j.rce.2024.06.003","DOIUrl":"10.1016/j.rce.2024.06.003","url":null,"abstract":"<div><div>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, <em>Metamorphosis</em>.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 534-536"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839850","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}
Pub Date : 2024-10-01DOI: 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.
{"title":"Consumo de alcohol en las personas mayores. ¿Cuál es la magnitud real del problema?","authors":"I. Fernández Castro , M. Marcos Martín , I. Novo Veleiro","doi":"10.1016/j.rce.2024.06.005","DOIUrl":"10.1016/j.rce.2024.06.005","url":null,"abstract":"<div><div>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.</div><div>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.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 8","pages":"Pages 537-545"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417147","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}
Pub Date : 2024-10-01DOI: 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.
{"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}
Pub Date : 2024-08-01DOI: 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.
{"title":"Prevalencia y características de la anemia en personas con diabetes mellitus de 50 años o más en un área sanitaria de Cádiz (España)","authors":"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","doi":"10.1016/j.rce.2024.05.007","DOIUrl":"10.1016/j.rce.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Objective</h3><p>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.</p></div><div><h3>Methods</h3><p>A retrospective cross-sectional study was conducted that included outpatient's laboratory tests (OLT) performed over 30 months at PDM50.</p></div><div><h3>Results</h3><p>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).</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 457-465"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713732","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}
Pub Date : 2024-08-01DOI: 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.
{"title":"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","authors":"C.A. Cañas , I. Posso-Osorio , V. Pérez-Uribe , V. Erazo-Martínez","doi":"10.1016/j.rce.2024.04.015","DOIUrl":"10.1016/j.rce.2024.04.015","url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 474-478"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950829","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}
Pub Date : 2024-08-01DOI: 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.
{"title":"Espectro etiológico y desafíos diagnósticos de la fiebre de corta duración en Bengala Occidental (India): un estudio transversal en un centro de atención terciaria","authors":"U. Biswas , A. Bhattacharjee , S. Seth , R. Ghosh , A.K. Singh , A. Sohrab , J. Benito-León","doi":"10.1016/j.rce.2024.06.002","DOIUrl":"10.1016/j.rce.2024.06.002","url":null,"abstract":"<div><h3>Introduction</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 <em>Salmonella typhi</em> and <em>Staphylococcus aureus</em> in a minority of cases (3.3%); malaria, primarily <em>Plasmodium vivax</em>, was diagnosed in 12% of the cases.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 466-473"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691898","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}
Pub Date : 2024-08-01DOI: 10.1016/j.rce.2024.06.001
A.C. Montagud , J. Llenas-García , R. Moragues , A. Pérez-Bernabeu , M.J. Alcocer Pertegal , F.J. García Gómez , A.M. Gamayo Serna , H. García Morante , P. Caballero , J. Tuells
{"title":"Respuesta a la carta al Director sobre «Prevalencia de anticuerpos neutralizantes frente al SARS-CoV-2 inducidos tras 2 dosis de vacuna BNT162b2 (Pfizer–BioNTech) en trabajadores sanitarios»","authors":"A.C. Montagud , J. Llenas-García , R. Moragues , A. Pérez-Bernabeu , M.J. Alcocer Pertegal , F.J. García Gómez , A.M. Gamayo Serna , H. García Morante , P. Caballero , J. Tuells","doi":"10.1016/j.rce.2024.06.001","DOIUrl":"10.1016/j.rce.2024.06.001","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Pages 482-483"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695274","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}
Pub Date : 2024-08-01DOI: 10.1016/j.rce.2024.05.006
H. Daungsupawong , V. Wiwanitkit
{"title":"Carta réplica a «Prevalencia de anticuerpos neutralizantes frente al SARS-CoV-2 inducidos tras 2 dosis de vacuna BNT162b2 (Pfizer–BioNTech) en trabajadores sanitarios»","authors":"H. Daungsupawong , V. Wiwanitkit","doi":"10.1016/j.rce.2024.05.006","DOIUrl":"10.1016/j.rce.2024.05.006","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 7","pages":"Page 481"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950827","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}
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