Pub Date : 2025-12-01DOI: 10.1016/j.rce.2025.502393
I. Martínez de Narvajas Urra, S. Arnedo Hernández, D. Aguiar Cano, M. Ruiz Castellano, J. Oteiza Olaso
Introduction and objectives
In the last few years, the use of point-of-care ultrasound has become widespread on the Internal Medicine Units. However, the literature on its use in Hospital-at-Home (HaH) is insufficient. The objective of the research is to quantify and evaluate the use of point-of-care ultrasound in HaH.
Materials and methods
It is a descriptive observational study. Point-of-care ultrasound performed in a HaH Unit between July and December 2022 were recorded.
Results
85 ultrasounds were performed on 72 patients. The type of ultrasound most frequently performed was multi-organ 71.8% and the most common reason for performing it was the monitoring of patients admitted for heart failure 68%. Hospital displacement was avoided in 72.8% of the situations.
Conclusions
Point-of-care ultrasound is a useful tool in the HaH Unit considering it allows optimizing patient's follow-up, improving clinical decision making and even avoiding the displacement of patients to the hospital.
{"title":"Ecografía clínica en una Unidad de Hospitalización a Domicilio: utilidad y limitaciones","authors":"I. Martínez de Narvajas Urra, S. Arnedo Hernández, D. Aguiar Cano, M. Ruiz Castellano, J. Oteiza Olaso","doi":"10.1016/j.rce.2025.502393","DOIUrl":"10.1016/j.rce.2025.502393","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In the last few years, the use of point-of-care ultrasound has become widespread on the Internal Medicine Units. However, the literature on its use in Hospital-at-Home (HaH) is insufficient. The objective of the research is to quantify and evaluate the use of point-of-care ultrasound in HaH.</div></div><div><h3>Materials and methods</h3><div>It is a descriptive observational study. Point-of-care ultrasound performed in a HaH Unit between July and December 2022 were recorded.</div></div><div><h3>Results</h3><div>85 ultrasounds were performed on 72 patients. The type of ultrasound most frequently performed was multi-organ 71.8% and the most common reason for performing it was the monitoring of patients admitted for heart failure 68%. Hospital displacement was avoided in 72.8% of the situations.</div></div><div><h3>Conclusions</h3><div>Point-of-care ultrasound is a useful tool in the HaH Unit considering it allows optimizing patient's follow-up, improving clinical decision making and even avoiding the displacement of patients to the hospital.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 10","pages":"Article 502393"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693248","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 : 2025-12-01DOI: 10.1016/j.rce.2025.502397
A. García Tellado , M. García Castro , A. Sariego Jamardo , N. Puente Ruiz
{"title":"Explorando la diversidad del síndrome de microdeleción 1p36 en pacientes diagnosticados en la edad adulta","authors":"A. García Tellado , M. García Castro , A. Sariego Jamardo , N. Puente Ruiz","doi":"10.1016/j.rce.2025.502397","DOIUrl":"10.1016/j.rce.2025.502397","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 10","pages":"Article 502397"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693249","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 : 2025-11-01DOI: 10.1016/j.rce.2025.502377
F.J. Gimena-Rodríguez , R. Barba-Martín , M. Angelina-García , D. Trujillo-Luque , M.D. Joya-Seijo , J.A. Rueda-Camino
Background and objective
The regional distribution of pulmonary embolism (PE) incidence within Spain is unknown. This study aims to describe the temporal and regional distribution of PE in Spain during the period 2016-2022.
Materials and methods
All PE episodes during the study period were identified using the Minimum Basic Data Set. Age-standardized annual incidence rates were calculated for each autonomous cities and communities. Temporal trends were evaluated using joinpoint regression. For each community, the incidence rate ratio (IRR) relative to all others was estimated using a negative binomial regression model, adjusted for sex and age.
Results
A total of 229,728 episodes were identified (49.5% women, mean age 70.3 ± 15.7 years). Nationwide, the incidence increased from 53.16 to 78.49 cases per 100,000 inhabitants (annual percentage change [APC], 9.2%, P = .007). The increase was most pronounced in the Balearic Islands, Murcia, and Andalusia (APC 14.4%, P = .04; 14.3%, P = .001; 13.4%, P = .003), and less so in Galicia, La Rioja, and Extremadura (APC 4.1%, P = .021; 5.4%, P = .003; 5.7%, P = .008). The change was not significant in Asturias, Madrid, Melilla, and Ceuta. The highest sex- and age-adjusted incidence rate for the period was observed in Madrid (IRR 1.29; 95% CI: 1.26-1.32) and the lowest in Ceuta (IRR 0.59; 95% CI: 0.5-0.69).
Conclusions
The incidence of PE in Spain increased during the period 2016-2022, with this increase being more pronounced in the southern and eastern regions of the Iberian Peninsula. The results of this study may contribute to maintain an adequate level of awareness in concerned professionals.
背景与目的在西班牙，肺栓塞（PE）发病率的区域分布尚不清楚。本研究旨在描述2016-2022年期间西班牙PE的时间和区域分布。材料和方法研究期间的所有PE事件使用最小基本数据集进行识别。计算各自治市和社区年龄标准化年发病率。使用连接点回归评估时间趋势。对于每个社区，使用负二项回归模型估计相对于所有其他社区的发病率比（IRR），并根据性别和年龄进行调整。结果共发现229,728例，其中女性49.5%，平均年龄70.3±15.7岁。在全国范围内，发病率从每10万居民53.16例上升到78.49例（年变化百分比[APC]， 9.2%, P = .007）。增幅在巴利阿里群岛、穆尔西亚和安达卢西亚最为明显（APC 14.4%, P = 0.04; 14.3%, P = 0.001; 13.4%, P = 0.003），加利西亚、拉里奥哈和埃斯特雷马杜拉的增幅较小（APC 4.1%, P = 0.021; 5.4%, P = 0.003; 5.7%, P = 0.008）。在阿斯图里亚斯、马德里、梅利利亚和休达，这种变化并不显著。该期间性别和年龄调整后的发病率最高的是马德里（IRR 1.29, 95% CI: 1.26-1.32），最低的是休达（IRR 0.59, 95% CI: 0.5-0.69）。结论2016-2022年期间，西班牙PE发病率有所上升，伊比利亚半岛南部和东部地区的增加更为明显。本研究的结果可能有助于在相关专业人员中保持足够的意识水平。
{"title":"Tendencias regionales en la incidencia de embolia pulmonar en España (2016-2022): un análisis de las diferencias entre comunidades autónomas","authors":"F.J. Gimena-Rodríguez , R. Barba-Martín , M. Angelina-García , D. Trujillo-Luque , M.D. Joya-Seijo , J.A. Rueda-Camino","doi":"10.1016/j.rce.2025.502377","DOIUrl":"10.1016/j.rce.2025.502377","url":null,"abstract":"<div><h3>Background and objective</h3><div>The regional distribution of pulmonary embolism (PE) incidence within Spain is unknown. This study aims to describe the temporal and regional distribution of PE in Spain during the period 2016-2022.</div></div><div><h3>Materials and methods</h3><div>All PE episodes during the study period were identified using the Minimum Basic Data Set. Age-standardized annual incidence rates were calculated for each autonomous cities and communities. Temporal trends were evaluated using joinpoint regression. For each community, the incidence rate ratio (IRR) relative to all others was estimated using a negative binomial regression model, adjusted for sex and age.</div></div><div><h3>Results</h3><div>A total of 229,728 episodes were identified (49.5% women, mean age 70.3<!--> <!-->±<!--> <!-->15.7 years). Nationwide, the incidence increased from 53.16 to 78.49 cases per 100,000 inhabitants (annual percentage change [APC], 9.2%, <em>P</em> <!-->=<!--> <!-->.007). The increase was most pronounced in the Balearic Islands, Murcia, and Andalusia (APC 14.4%, <em>P</em> <!-->=<!--> <!-->.04; 14.3%, <em>P</em> <!-->=<!--> <!-->.001; 13.4%, <em>P</em> <!-->=<!--> <!-->.003), and less so in Galicia, La Rioja, and Extremadura (APC 4.1%, <em>P</em> <!-->=<!--> <!-->.021; 5.4%, <em>P</em> <!-->=<!--> <!-->.003; 5.7%, <em>P</em> <!-->=<!--> <!-->.008). The change was not significant in Asturias, Madrid, Melilla, and Ceuta. The highest sex- and age-adjusted incidence rate for the period was observed in Madrid (IRR 1.29; 95%<!--> <!-->CI: 1.26-1.32) and the lowest in Ceuta (IRR 0.59; 95%<!--> <!-->CI: 0.5-0.69).</div></div><div><h3>Conclusions</h3><div>The incidence of PE in Spain increased during the period 2016-2022, with this increase being more pronounced in the southern and eastern regions of the Iberian Peninsula. The results of this study may contribute to maintain an adequate level of awareness in concerned professionals.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502377"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532611","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 : 2025-11-01DOI: 10.1016/j.rce.2025.502382
N. Báez-Ferrer , J. Monllor-Méndez , D. Álvarez-Luis , L. Hernández-Chinea , A.W. Al-Hayani-Al-Hantoosh , A. Domínguez-Rodríguez
Introduction
Iron deficiency (ID) has not been associated with pulmonary embolism (PE). The aim was to assess whether ID is associated with an increased likelihood of developing PE within the subsequent 12 months.
Patients and methods
Retrospective observational study. Patients with PE during follow-up were selected as cases, and those without the event as controls. Patients with chronic diseases, cancer, fractures, or recent hospital admissions were excluded.
Results
A total of 43 cases and 199 controls were enrolled. The mean age was 61 ± 21 years. ID increased the risk of PE at 12 months with an odds ratio of 2.15 (95% confidence interval [CI 95%]: 1.01-4.58; P = .046). Survival analysis showed more than a two-fold increase in the risk of developing PE in the presence of prior ID (hazard ratio: 2.37 [CI 95%: 1.30-4.31; P = .05]).
Conclusion
ID may represent an increased risk of PE in the 12 months following its detection.
铁缺乏（ID）与肺栓塞（PE）无关。目的是评估ID是否与随后12个月内发生PE的可能性增加有关。患者和方法回顾性观察研究。随访期间发生PE的患者作为病例，未发生PE的患者作为对照。患有慢性疾病、癌症、骨折或近期住院的患者被排除在外。结果共纳入病例43例，对照组199例。平均年龄61±21岁。ID增加了12个月时PE的风险，比值比为2.15（95%可信区间[CI 95%]: 1.01-4.58; P = 0.046）。生存分析显示，先前存在ID的患者发生PE的风险增加了两倍以上（风险比：2.37 [CI 95%: 1.30-4.31; P = 0.05]）。结论id可能在检测后的12个月内增加PE的风险。
{"title":"Déficit de hierro y anemia ferropénica y su asociación con la embolia pulmonar","authors":"N. Báez-Ferrer , J. Monllor-Méndez , D. Álvarez-Luis , L. Hernández-Chinea , A.W. Al-Hayani-Al-Hantoosh , A. Domínguez-Rodríguez","doi":"10.1016/j.rce.2025.502382","DOIUrl":"10.1016/j.rce.2025.502382","url":null,"abstract":"<div><h3>Introduction</h3><div>Iron deficiency (ID) has not been associated with pulmonary embolism (PE). The aim was to assess whether ID is associated with an increased likelihood of developing PE within the subsequent 12<!--> <!-->months.</div></div><div><h3>Patients and methods</h3><div>Retrospective observational study. Patients with PE during follow-up were selected as cases, and those without the event as controls. Patients with chronic diseases, cancer, fractures, or recent hospital admissions were excluded.</div></div><div><h3>Results</h3><div>A total of 43 cases and 199 controls were enrolled. The mean age was 61<!--> <!-->±<!--> <!-->21 years. ID increased the risk of PE at 12<!--> <!-->months with an odds ratio of 2.15 (95% confidence interval [CI<!--> <!-->95%]: 1.01-4.58; <em>P</em> <!-->=<!--> <!-->.046). Survival analysis showed more than a two-fold increase in the risk of developing PE in the presence of prior ID (hazard ratio: 2.37 [CI<!--> <!-->95%: 1.30-4.31; <em>P</em> <!-->=<!--> <!-->.05]).</div></div><div><h3>Conclusion</h3><div>ID may represent an increased risk of PE in the 12<!--> <!-->months following its detection.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502382"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532396","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 : 2025-11-01DOI: 10.1016/j.rce.2025.502384
H. Hernández-Negrin , D. Paredes-Ruiz , V. Moreno-Torres , I. Ruiz-Arruza , G. Ruiz-Irastorza
Background
Socioeconomic deprivation is a well-recognized determinant of cardiovascular health. We evaluated its influence on cardiovascular risk and damage in patients with systemic lupus erythematosus (SLE) in the Basque Country, where universal healthcare coverage is guaranteed.
Methods
Observational cohort study including 293 SLE patients with a 5-year follow-up. The association between the Basque Country's Socioeconomic Deprivation Index and cardiovascular risk factors and damage (SLICC index) was analyzed using multilevel generalized linear mixed models.
Results
No significant associations were found between deprivation levels and the number of cardiovascular risk factors at diagnosis or at 5 years, nor with cardiovascular damage. Age at diagnosis and disease activity were the main predictors of cardiovascular outcomes.
Conclusion
In a universal healthcare setting, socioeconomic deprivation was not associated with worse cardiovascular risk or damage in SLE patients. These findings do not establish causality but are consistent with the hypothesis that universal healthcare may mitigate socioeconomic gradients in SLE cardiovascular outcomes.
{"title":"No hay asociación entre la privación socioeconómica y el riesgo de daño cardiovascular en el lupus eritematoso sistémico dentro de un sistema de salud universal: un estudio de cohorte del País Vasco","authors":"H. Hernández-Negrin , D. Paredes-Ruiz , V. Moreno-Torres , I. Ruiz-Arruza , G. Ruiz-Irastorza","doi":"10.1016/j.rce.2025.502384","DOIUrl":"10.1016/j.rce.2025.502384","url":null,"abstract":"<div><h3>Background</h3><div>Socioeconomic deprivation is a well-recognized determinant of cardiovascular health. We evaluated its influence on cardiovascular risk and damage in patients with systemic lupus erythematosus (SLE) in the Basque Country, where universal healthcare coverage is guaranteed.</div></div><div><h3>Methods</h3><div>Observational cohort study including 293 SLE patients with a 5-year follow-up. The association between the Basque Country's Socioeconomic Deprivation Index and cardiovascular risk factors and damage (SLICC index) was analyzed using multilevel generalized linear mixed models.</div></div><div><h3>Results</h3><div>No significant associations were found between deprivation levels and the number of cardiovascular risk factors at diagnosis or at 5 years, nor with cardiovascular damage. Age at diagnosis and disease activity were the main predictors of cardiovascular outcomes.</div></div><div><h3>Conclusion</h3><div>In a universal healthcare setting, socioeconomic deprivation was not associated with worse cardiovascular risk or damage in SLE patients. These findings do not establish causality but are consistent with the hypothesis that universal healthcare may mitigate socioeconomic gradients in SLE cardiovascular outcomes.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502384"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532615","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 : 2025-11-01DOI: 10.1016/j.rce.2025.502385
M.C. Montes , J.A. Rueda-Camino , N. Rallón , S. Nistal-Juncos , R. Barba Martín
{"title":"Contrarréplica a la carta «Sobre el estudio de síndromes geriátricos: la definición importa»","authors":"M.C. Montes , J.A. Rueda-Camino , N. Rallón , S. Nistal-Juncos , R. Barba Martín","doi":"10.1016/j.rce.2025.502385","DOIUrl":"10.1016/j.rce.2025.502385","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502385"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532619","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 : 2025-11-01DOI: 10.1016/j.rce.2025.502369
J.T. Algado-Rabasa , I. Ribes-Mengual , E. Ronda-Perez , N. Algado-Selles
Background
Sepsis is a serious condition with high mortality. Body fat can influence the production of inflammatory cytokines at the systemic level, leading to adverse outcomes; therefore, the distribution of body fat may have prognostic value. The objective is to evaluate whether there is a relationship between the distribution of body fat measured by ultrasound and prognosis in patients admitted with sepsis.
Methods
A prospective cohort study was conducted in patients admitted for sepsis at a Spanish hospital between September 2023 and June 2024. The risk of mortality and readmission at 30 and 90 days was calculated based on the ratio of ultrasound measurements of subcutaneous fat (SAT) and visceral fat (VAT). The hazard ratio (HR) and 95% confidence interval (95% CI) for mortality and readmission were estimated based on the VAT/SAT ratio.
Results
Sixty-two patients were included. The median age was 77 years. The risk of mortality at 30 and 90 days post-admission was: for patients with VAT/SAT > 5.85, 18 and 35% respectively, and for patients with VAT/SAT ≤ 5.85, 3 and 6%. The adjusted HR for mortality was 6.6 (95% CI: 1.4 to 30.6; p = 0.016). The risk of readmission at 30 and 90 days in patients with VAT/SAT > 8.03 was 46 and 80%, respectively, and in patients with VAT/SAT ≤ 8.03, 23 and 30%. The HR for readmission was 3.1 (95% CI: 1.1 to 8.5; p = 0.026).
Conclusions
An increase in the VAT/SAT ratio, measured by ultrasound, is a risk factor for mortality and readmission in patients admitted for sepsis.
脓毒症是一种死亡率很高的严重疾病。体脂可以在全身水平上影响炎症细胞因子的产生，导致不良后果；因此，体脂分布可能具有预测价值。目的是评估脓毒症住院患者超声测量体脂分布与预后之间是否存在关系。方法对2023年9月至2024年6月在西班牙一家医院因败血症入院的患者进行前瞻性队列研究。根据超声测量皮下脂肪（SAT）和内脏脂肪（VAT）的比例计算30天和90天的死亡率和再入院风险。死亡率和再入院的风险比（HR）和95%置信区间（95% CI）是根据VAT/SAT比值估计的。结果共纳入62例患者。中位年龄为77岁。入院后30天和90天的死亡风险分别为：VAT/SAT≤5.85、18%和35%，VAT/SAT≤5.85、3%和6%。校正后死亡率为6.6 （95% CI: 1.4 ~ 30.6; p = 0.016）。VAT/SAT≤8.03的患者30天和90天再入院风险分别为46%和80%，VAT/SAT≤8.03的患者为23%和30%。再入院的HR为3.1 （95% CI: 1.1 ~ 8.5; p = 0.026）。结论超声测量VAT/SAT比值升高是脓毒症患者死亡和再入院的危险因素。
{"title":"Valoración de la distribución de la grasa corporal mediante ecografía como factor de riesgo de mortalidad y reingreso en pacientes hospitalizados por sepsis","authors":"J.T. Algado-Rabasa , I. Ribes-Mengual , E. Ronda-Perez , N. Algado-Selles","doi":"10.1016/j.rce.2025.502369","DOIUrl":"10.1016/j.rce.2025.502369","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is a serious condition with high mortality. Body fat can influence the production of inflammatory cytokines at the systemic level, leading to adverse outcomes; therefore, the distribution of body fat may have prognostic value. The objective is to evaluate whether there is a relationship between the distribution of body fat measured by ultrasound and prognosis in patients admitted with sepsis.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted in patients admitted for sepsis at a Spanish hospital between September 2023 and June 2024. The risk of mortality and readmission at 30 and 90 days was calculated based on the ratio of ultrasound measurements of subcutaneous fat (SAT) and visceral fat (VAT). The hazard ratio (HR) and 95% confidence interval (95% CI) for mortality and readmission were estimated based on the VAT/SAT ratio.</div></div><div><h3>Results</h3><div>Sixty-two patients were included. The median age was 77 years. The risk of mortality at 30 and 90 days post-admission was: for patients with VAT/SAT<!--> <!-->><!--> <!-->5.85, 18 and 35% respectively, and for patients with VAT/SAT<!--> <!-->≤<!--> <!-->5.85, 3 and 6%. The adjusted HR for mortality was 6.6 (95% <span>C</span>I: 1.4 to 30.6; p<!--> <!-->=<!--> <!-->0.016). The risk of readmission at 30 and 90 days in patients with VAT/SAT<!--> <!-->><!--> <!-->8.03 was 46 and 80%, respectively, and in patients with VAT/SAT<!--> <!-->≤<!--> <!-->8.03, 23 and 30%. The HR for readmission was 3.1 (95% CI: 1.1 to 8.5; p<!--> <!-->=<!--> <!-->0.026).</div></div><div><h3>Conclusions</h3><div>An increase in the VAT/SAT ratio, measured by ultrasound, is a risk factor for mortality and readmission in patients admitted for sepsis.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502369"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532620","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 : 2025-11-01DOI: 10.1016/j.rce.2025.502368
R. Sabio , P. Valdez , E. Casariego Vales , L. Cámera , H.L. Puello Galarcio , M. Camafort , en nombre del Grupo de trabajo hipertensión arterial-FIMI
The diagnosis and treatment of hypertension is a challenge for any healthcare system. Given the difficulties, limitations, and differences among Spanish- and Portuguese-speaking countries, the International Forum of Internal Medicine (FIMI) has promoted this Consensus, which includes 23 scientific societies from 21 countries in Europe and the Americas. The objective was to develop a proposal capable of establishing an updated, robust, and common framework for the diagnosis and treatment of hypertension, aimed at internists and hospitalists and useful in Latin America, Spain, and Portugal. The document we present includes the executive summary of FIMI recommendations that, for the various aspects of the disease, aim to guarantee effective, safe, efficient, sustainable, and proportionate healthcare interventions based on the best available scientific evidence. The authors consider that this document should be updated within a maximum of two years.
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Pub Date : 2025-11-01DOI: 10.1016/j.rce.2025.502370
B. Villanueva , A. Figueras , R. Torres-Iglesias , M. Muñoz , S. Moreno-Lopes , N. Trullén-Malaret , A. Martínez , F. Viñals , A. Riera-Mestre
Background
Hereditary hemorrhagic telangiectasia (HHT) is a rare disease characterized by mucocutaneous telangiectasia and visceral vascular malformations. Treatment with bevacizumab is recommended in patients with liver involvement and high output cardiac failure (HOCF) or those with severe gastrointestinal (GI) involvement. However, there is no evidence on how to monitor such treatment using biomarkers.
Material and methods
This is an exploratory, observational, prospective, single-center study carried out in an HHT referral unit. The inclusion period for the start of bevacizumab was from January 2022 to May 2023. Patients with an indication for starting bevacizumab were selected and underwent blood tests at baseline and during the induction (36 weeks) and maintenance phase in order to analyze 21 biomarkers related to angiogenesis and inflammation. In addition, control HHT patients without indication for bevacizumab and healthy controls matched 1:1:1 by age, sex, and genetic subtype (for HHT patients) underwent a baseline biomarker study. The main objective is to analyze the evolution of these biomarkers in patients with HHT treated with bevacizumab. As secondary objectives, baseline differences in the concentration of these biomarkers between the three groups and correlation with the hemoglobin levels will be analyzed.
Groups description
During the study period, nine patients with an indication for bevacizumab were included, seven due to anemia of GI origin and two due to liver involvement with HOCF, with an overall mean age of 70 ± 8.4 years, and subsequently the respective nine patients with HHT without bevacizumab and nine controls without HHT were selected.
Conclusions
The results of this exploratory study will provide new knowledge regarding potential biomarkers for monitoring the response to treatment with bevacizumab. Furthermore, it could generate new hypotheses about the role of certain biomarkers at the pathophysiological, diagnostic, and therapeutic levels.
{"title":"Evolución de biomarcadores de angiogénesis e inflamación en pacientes con telangiectasia hemorrágica hereditaria durante el tratamiento con bevacizumab: protocolo de estudio","authors":"B. Villanueva , A. Figueras , R. Torres-Iglesias , M. Muñoz , S. Moreno-Lopes , N. Trullén-Malaret , A. Martínez , F. Viñals , A. Riera-Mestre","doi":"10.1016/j.rce.2025.502370","DOIUrl":"10.1016/j.rce.2025.502370","url":null,"abstract":"<div><h3>Background</h3><div>Hereditary hemorrhagic telangiectasia (HHT) is a rare disease characterized by mucocutaneous telangiectasia and visceral vascular malformations. Treatment with bevacizumab is recommended in patients with liver involvement and high output cardiac failure (HOCF) or those with severe gastrointestinal (GI) involvement. However, there is no evidence on how to monitor such treatment using biomarkers.</div></div><div><h3>Material and methods</h3><div>This is an exploratory, observational, prospective, single-center study carried out in an HHT referral unit. The inclusion period for the start of bevacizumab was from January 2022 to May 2023. Patients with an indication for starting bevacizumab were selected and underwent blood tests at baseline and during the induction (36 weeks) and maintenance phase in order to analyze 21 biomarkers related to angiogenesis and inflammation. In addition, control HHT patients without indication for bevacizumab and healthy controls matched 1:1:1 by age, sex, and genetic subtype (for HHT patients) underwent a baseline biomarker study. The main objective is to analyze the evolution of these biomarkers in patients with HHT treated with bevacizumab. As secondary objectives, baseline differences in the concentration of these biomarkers between the three groups and correlation with the hemoglobin levels will be analyzed.</div></div><div><h3>Groups description</h3><div>During the study period, nine patients with an indication for bevacizumab were included, seven due to anemia of GI origin and two due to liver involvement with HOCF, with an overall mean age of 70<!--> <!-->±<!--> <!-->8.4 years, and subsequently the respective nine patients with HHT without bevacizumab and nine controls without HHT were selected.</div></div><div><h3>Conclusions</h3><div>The results of this exploratory study will provide new knowledge regarding potential biomarkers for monitoring the response to treatment with bevacizumab. Furthermore, it could generate new hypotheses about the role of certain biomarkers at the pathophysiological, diagnostic, and therapeutic levels.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502370"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532609","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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