Pub Date : 2025-01-01DOI: 10.1016/j.rce.2024.07.010
L. Lillo-Triguero , A. del Castillo-Rueda , J.M. Bellón , R. Peraita-Adrados
Background and objectives
Blood donation is suggested to increase the risk of restless legs syndrome (RLS). This study aims to assess the prevalence of RLS in Spanish blood donors and determined its potential correlation with iron metabolism parameters.
Materials and methods
Prospective cohort study of 129 blood donors (54.3% men, 39.44 years ± 11.0) that underwent a physical examination, blood analysis (hemoglobin, ferritin, transferrin saturation index and soluble transferrin receptor) and a RLS screening questionnaire followed by a prospective follow-up study including a clinical phone interview. A multivariate logistic regression model was performed to examine the association between RLS and other variables.
Results
Eighty-four (65.1%) participants were repeat blood donors (mean of 2.11 donations/year) at inclusion and 61 (47.4%) at follow-up (mean of 2.09 donations/year). Non-anemic iron deficiency (ferritin < 50 μg /L) was high in women P<0.001 and in repeat donors (P=0.003). The prevalence of RLS was 14.1% at inclusion increasing prospectively (19.5%; P=0.065). On multivariate analysis, gender was the only variable significantly associated with a RLS diagnosis, being higher in women (OR 5.1; 95% CI 1.71-15.3; P=0.003).
Conclusions
Despite the high prevalence of non-anemic iron deficiency there was no association between ferritin, soluble transferrin receptor concentration values and RLS diagnosis. Gender was associated with RLS diagnosis regardless of other variables.
{"title":"Estudio prospectivo del síndrome de piernas inquietas en una muestra de donantes de sangre","authors":"L. Lillo-Triguero , A. del Castillo-Rueda , J.M. Bellón , R. Peraita-Adrados","doi":"10.1016/j.rce.2024.07.010","DOIUrl":"10.1016/j.rce.2024.07.010","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Blood donation is suggested to increase the risk of restless legs syndrome (RLS). This study aims to assess the prevalence of RLS in Spanish blood donors and determined its potential correlation with iron metabolism parameters.</div></div><div><h3>Materials and methods</h3><div>Prospective cohort study of 129 blood donors (54.3% men, 39.44 years<!--> <!-->±<!--> <!-->11.0) that underwent a physical examination, blood analysis (hemoglobin, ferritin, transferrin saturation index and soluble transferrin receptor) and a RLS screening questionnaire followed by a prospective follow-up study including a clinical phone interview. A multivariate logistic regression model was performed to examine the association between RLS and other variables.</div></div><div><h3>Results</h3><div>Eighty-four (65.1%) participants were repeat blood donors (mean of 2.11 donations/year) at inclusion and 61 (47.4%) at follow-up (mean of 2.09 donations/year). Non-anemic iron deficiency (ferritin<!--> <!--><<!--> <!-->50<!--> <!-->μg /L) was high in women <em>P</em><0.001 and in repeat donors <em>(P</em>=0.003). The prevalence of RLS was 14.1% at inclusion increasing prospectively (19.5%; <em>P</em>=0.065). On multivariate analysis, gender was the only variable significantly associated with a RLS diagnosis, being higher in women (OR 5.1; 95% CI 1.71-15.3; <em>P</em>=0.003).</div></div><div><h3>Conclusions</h3><div>Despite the high prevalence of non-anemic iron deficiency there was no association between ferritin, soluble transferrin receptor concentration values and RLS diagnosis. Gender was associated with RLS diagnosis regardless of other variables.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 1","pages":"Pages 9-15"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143137095","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 : 2025-01-01DOI: 10.1016/j.rce.2024.09.003
A. Villalobos , R. Valle , J. Pagán-Escribano , M. Ortiz , P. Demelo-Rodríguez , C. Font
Venous thromboembolic disease (VTD) is a common complication associated to greater mortality in patients with cancer. Its etiology is multifactorial and depends on the characteristics and co-morbidities of the patient, the tumor type and extension, and the oncological treatment. The management of VTD is more complex in patients with cancer due to an increased risk of recurrence and major bleeding complications during anticoagulation compared to the general non-oncological population. The above differences have led to the development of specific clinical trials to assess the efficacy and safety of anticoagulant therapy in patients with cancer. The present clinical guidelines are intended to provide general recommendations on the management of cancer-associated VTD according to updated according to the most recent scientific evidence.
{"title":"Recomendaciones 2024 de la Sociedad Española de Medicina Interna (SEMI) para el manejo de la trombosis venosa asociada al cáncer","authors":"A. Villalobos , R. Valle , J. Pagán-Escribano , M. Ortiz , P. Demelo-Rodríguez , C. Font","doi":"10.1016/j.rce.2024.09.003","DOIUrl":"10.1016/j.rce.2024.09.003","url":null,"abstract":"<div><div>Venous thromboembolic disease (VTD) is a common complication associated to greater mortality in patients with cancer. Its etiology is multifactorial and depends on the characteristics and co-morbidities of the patient, the tumor type and extension, and the oncological treatment. The management of VTD is more complex in patients with cancer due to an increased risk of recurrence and major bleeding complications during anticoagulation compared to the general non-oncological population. The above differences have led to the development of specific clinical trials to assess the efficacy and safety of anticoagulant therapy in patients with cancer. The present clinical guidelines are intended to provide general recommendations on the management of cancer-associated VTD according to updated according to the most recent scientific evidence.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 1","pages":"Pages 35-44"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143137039","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 : 2025-01-01DOI: 10.1016/j.rce.2024.09.002
M. Méndez Bailón , Á. González-Franco , J.M. Cerqueiro , J. Pérez-Silvestre , C. Moreno García , A. Conde-Martel , J.C. Arévalo-Lorido , F. Formiga Pérez , L. Manzano-Espinosa , M. Montero-Pérez-Barquero
Background
Patients with heart failure (HF) and chronic obstructive pulmonary disease (COPD) have a high risk of hospital admission and mortality. This study evaluated the benefit of a care model, characterized by comprehensive and continuous care (UMIPIC program) in patients with HF and a history of COPD.
Methods
A total of 5644 patients were prospectively recruited, of which 1320 had a history of COPD between March 2008 and March 2020. They were divided into two follow-up groups at the time of discharge, one in follow-up in the UMIPIC program (435 patients) and another treated conventionally (885 patients). The baseline characteristics of each group were analyzed and patients in each group were selected by propensity score matching and admissions and mortality were evaluated during 12 months of follow-up, after an episode of hospitalization for HF.
Results
The UMIPIC group, compared to the conventional group in the matched cohort, had a lower rate of admissions for HF (21 vs. 30%, respectively; hazard ratio = 0.64; 95% CI: 0.54–0.84; p = 0.002) and mortality (28 vs. 36%, respectively; hazard ratio = 0.68; 95% CI: 0.51–0.90; p = 0.008). From a therapeutic point of view, patients with HF and a history of COPD who were followed in the UMIPIC program received a higher percentage of beta-blockers (63.9 vs. 54.2%; p < 0.05) and direct-acting anticoagulants (17 vs. 9%; p < 0.05) than those followed conventionally.
Conclusions
The implementation of the UMIPIC care program for patients with HF and a history of COPD, based on comprehensive and continuous care, reduces both admissions and mortality at one year of follow-up. The prescription of beta-blockers and direct-acting anticoagulants was also higher during follow-up in the UMIPIC program.
心衰（HF）和慢性阻塞性肺疾病（COPD）患者有较高的住院和死亡风险。本研究评估了一种护理模式的益处，其特点是对有慢性阻塞性肺病病史的心衰患者进行全面和持续的护理（UMIPIC计划）。方法前瞻性招募5644例患者，其中1320例在2008年3月至2020年3月有COPD病史。他们在出院时被分为两组，一组在UMIPIC项目中随访（435例患者），另一组接受常规治疗（885例患者）。分析每组的基线特征，通过倾向评分匹配选择每组患者，并在一次心衰住院后12个月的随访期间评估入院率和死亡率。结果：与匹配队列中的常规组相比，UMIPIC组的HF入院率较低(分别为21%和30%；风险比= 0.64；95% ci: 0.54-0.84；P = 0.002)和死亡率(分别为28%对36%；风险比= 0.68；95% ci: 0.51-0.90；p = 0.008)。从治疗角度来看，在UMIPIC项目中随访的HF和COPD病史患者接受了更高比例的β受体阻滞剂(63.9% vs. 54.2%；p & lt;0.05)和直接作用抗凝剂(17% vs. 9%；p & lt;0.05)。结论：对有慢性阻塞性肺病病史的HF患者实施UMIPIC护理方案，基于全面和持续的护理，可降低1年随访期间的住院率和死亡率。在UMIPIC项目的随访期间，β受体阻滞剂和直接作用抗凝剂的处方也较高。
{"title":"Beneficios de un modelo asistencial integral en pacientes con insuficiencia cardiaca y enfermedad pulmonar obstructiva crónica: programa UMIPIC","authors":"M. Méndez Bailón , Á. González-Franco , J.M. Cerqueiro , J. Pérez-Silvestre , C. Moreno García , A. Conde-Martel , J.C. Arévalo-Lorido , F. Formiga Pérez , L. Manzano-Espinosa , M. Montero-Pérez-Barquero","doi":"10.1016/j.rce.2024.09.002","DOIUrl":"10.1016/j.rce.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Patients with heart failure (HF) and chronic obstructive pulmonary disease (COPD) have a high risk of hospital admission and mortality. This study evaluated the benefit of a care model, characterized by comprehensive and continuous care (UMIPIC program) in patients with HF and a history of COPD.</div></div><div><h3>Methods</h3><div>A total of 5644 patients were prospectively recruited, of which 1320 had a history of COPD between March 2008 and March 2020. They were divided into two follow-up groups at the time of discharge, one in follow-up in the UMIPIC program (435 patients) and another treated conventionally (885 patients). The baseline characteristics of each group were analyzed and patients in each group were selected by propensity score matching and admissions and mortality were evaluated during 12 months of follow-up, after an episode of hospitalization for HF.</div></div><div><h3>Results</h3><div>The UMIPIC group, compared to the conventional group in the matched cohort, had a lower rate of admissions for HF (21 vs. 30%, respectively; hazard ratio<!--> <!-->=<!--> <!-->0.64; 95% CI: 0.54–0.84; <em>p</em> <!-->=<!--> <!-->0.002) and mortality (28 vs. 36%, respectively; hazard ratio<!--> <!-->=<!--> <!-->0.68; 95% CI: 0.51–0.90; <em>p</em> <!-->=<!--> <!-->0.008). From a therapeutic point of view, patients with HF and a history of COPD who were followed in the UMIPIC program received a higher percentage of beta-blockers (63.9 vs. 54.2%; <em>p</em> <!--><<!--> <!-->0.05) and direct-acting anticoagulants (17 vs. 9%; <em>p</em> <!--><<!--> <!-->0.05) than those followed conventionally.</div></div><div><h3>Conclusions</h3><div>The implementation of the UMIPIC care program for patients with HF and a history of COPD, based on comprehensive and continuous care, reduces both admissions and mortality at one year of follow-up. The prescription of beta-blockers and direct-acting anticoagulants was also higher during follow-up in the UMIPIC program.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 1","pages":"Pages 1-8"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143137145","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 : 2025-01-01DOI: 10.1016/j.rce.2024.08.003
C.-P. Fu , P.-K. Fu , M.-C. Lu , Y.-Y. Liao , J.-S. Wang
Backgroud and objectives
As patients with diabetes are at a significantly higher risk of cardiovascular diseases than those without diabetes, it is important to gain a clinical understanding of the differential effects of smoking cessation on several risk factors between patients with and without diabetes.
Materials and methods
Patients who participated in a smoking cessation program received an assessment of the outcomes of interest. The outcomes were changes in metabolic parameters and renal function from baseline to 6-month follow-up after the smoking cessation program.
Result
A total of 1,954 patients joined the smoking cessation program, and 1,381 patients were in the smoking cessation failure (SCF) group and 573 were in the smoking cessation success (SCS) group. The decrease in HbA1c after smoking cessation was only observed in patients with diabetes. Smoking cessation was also associated with a significant decrease in LDL cholesterol in patients with diabetes. In terms of renal function, smoking cessation was associated with an improvement in eGFR, and the trend was similar in patients with and without diabetes.
Conclusion
Successful smoking cessation was associated with improvement in renal function. Moreover, it was associated with improvements in HbA1c and LDL cholesterol in patients with diabetes, despite significant weight gain.
{"title":"Impacto del abandono del hábito de fumar sobre los parámetros metabólicos y la función renal en pacientes con y sin diabetes mellitus","authors":"C.-P. Fu , P.-K. Fu , M.-C. Lu , Y.-Y. Liao , J.-S. Wang","doi":"10.1016/j.rce.2024.08.003","DOIUrl":"10.1016/j.rce.2024.08.003","url":null,"abstract":"<div><h3>Backgroud and objectives</h3><div>As patients with diabetes are at a significantly higher risk of cardiovascular diseases than those without diabetes, it is important to gain a clinical understanding of the differential effects of smoking cessation on several risk factors between patients with and without diabetes.</div></div><div><h3>Materials and methods</h3><div>Patients who participated in a smoking cessation program received an assessment of the outcomes of interest. The outcomes were changes in metabolic parameters and renal function from baseline to 6-month follow-up after the smoking cessation program.</div></div><div><h3>Result</h3><div>A total of 1,954 patients joined the smoking cessation program, and 1,381 patients were in the smoking cessation failure (SCF) group and 573 were in the smoking cessation success (SCS) group. The decrease in HbA1c after smoking cessation was only observed in patients with diabetes. Smoking cessation was also associated with a significant decrease in LDL cholesterol in patients with diabetes. In terms of renal function, smoking cessation was associated with an improvement in eGFR, and the trend was similar in patients with and without diabetes.</div></div><div><h3>Conclusion</h3><div>Successful smoking cessation was associated with improvement in renal function. Moreover, it was associated with improvements in HbA1c and LDL cholesterol in patients with diabetes, despite significant weight gain.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 1","pages":"Pages 16-22"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143137172","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 : 2025-01-01DOI: 10.1016/j.rce.2024.08.002
J. Martínez de Victoria Carazo , D. Fernández Reyes , F.J. de la Hera Fernández , T. González Cejudo , N. Navarrete Navarrete , J.L. Callejas Rubio
Introduction
Anti-NOR90 antibodies were initially described in patients with autoimmune diseases based on staining of a nucleolar region known as the nucleolar organizer region (NOR). This study aims to explore the clinical aspects of anti-NOR90 antibodies in patients with systemic autoimmune diseases.
Methods
Observational study of patients with positive anti-NOR90 antibodies using the EUROLINE Systemic Sclerosis profile (IgG) kit (Euroimmun, Germany). Data on demographics, comorbidities, autoimmune diseases, treatment, and clinical manifestations were collected.
Results
Fifteen patients with positive anti-NOR90 antibodies were included. Majority were female (86.7%), with median age of 54 years. Most common clinical manifestations were Raynaud's phenomenon, dryness, and interstitial lung disease (ILD). Some patients had hematological or solid organ neoplasms. EPID was prevalent, with one case showing rapid progression requiring aggressive treatment.
Discussion and conclusions
This study highlights the association between anti-NOR90 antibodies and systemic autoimmune diseases, particularly SS and ES. EPID was a notable feature, suggesting its consideration in IPAF diagnosis for anti-NOR90 positive patients. Further multicenter studies are needed for better understanding and detection methods optimization.
{"title":"Anticuerpos anti-NOR90 y su significación clínica: experiencia multicéntrica en el sur de España","authors":"J. Martínez de Victoria Carazo , D. Fernández Reyes , F.J. de la Hera Fernández , T. González Cejudo , N. Navarrete Navarrete , J.L. Callejas Rubio","doi":"10.1016/j.rce.2024.08.002","DOIUrl":"10.1016/j.rce.2024.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Anti-NOR90 antibodies were initially described in patients with autoimmune diseases based on staining of a nucleolar region known as the nucleolar organizer region (NOR). This study aims to explore the clinical aspects of anti-NOR90 antibodies in patients with systemic autoimmune diseases.</div></div><div><h3>Methods</h3><div>Observational study of patients with positive anti-NOR90 antibodies using the EUROLINE Systemic Sclerosis profile (IgG) kit (Euroimmun, Germany). Data on demographics, comorbidities, autoimmune diseases, treatment, and clinical manifestations were collected.</div></div><div><h3>Results</h3><div>Fifteen patients with positive anti-NOR90 antibodies were included. Majority were female (86.7%), with median age of 54 years. Most common clinical manifestations were Raynaud's phenomenon, dryness, and interstitial lung disease (ILD). Some patients had hematological or solid organ neoplasms. EPID was prevalent, with one case showing rapid progression requiring aggressive treatment.</div></div><div><h3>Discussion and conclusions</h3><div>This study highlights the association between anti-NOR90 antibodies and systemic autoimmune diseases, particularly SS and ES. EPID was a notable feature, suggesting its consideration in IPAF diagnosis for anti-NOR90 positive patients. Further multicenter studies are needed for better understanding and detection methods optimization.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 1","pages":"Pages 51-55"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143137173","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 : 2024-12-01DOI: 10.1016/j.rce.2024.09.001
J. Ena
{"title":"Sarampión en la sala de urgencias: el enemigo sigue ahí","authors":"J. Ena","doi":"10.1016/j.rce.2024.09.001","DOIUrl":"10.1016/j.rce.2024.09.001","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 10","pages":"Pages 650-651"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757359","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 : 2024-12-01DOI: 10.1016/j.rce.2024.07.006
Y. Tung-Chen , J. Short Apellaniz , R. Alonso Roca , J.R. Alonso Viladot , I. Arnanz González , L. Beltrán Romero , A. Calvo Cebrián , R. Campo Linares , K.A. Foo Gil , I. García Suárez , A.D. González Delgado , A. Hernández Martínez , M.F. Marchese Ratti , O. Martínez Villén , J. Mercadal Mercadal , E. Minguela Puras , Maria Ester Montes Belloso , P.P. Reinoso Párraga , E. Rodríguez Urteaga , A. Romero Galán , Paola Pastora Reinoso Párraga
Point-of-Care Ultrasound has significantly evolved, establishing itself as an essential tool in daily medical practice, especially in various clinical contexts. This consensus document, supported by several Spanish medical societies, proposes guidelines for the effective integration of ultrasound in healthcare, promoting its standardization and ensuring the quality and systematic application of this technique. The working groups, composed of experts from different specialties, conducted a comprehensive review of the literature in MEDLINE and extensively discussed recommendations to formulate a coherent and practical set of guidelines for different application areas: hospital and out-of-hospital emergencies and critical care, primary care, and outpatient hospital care, hospitalization.
The methodology included virtual meetings and confidential voting to reach a consensus on the relevant recommendations. Ultrasound was highlighted as fundamental in the initial approach to various pathologies, such as abdominal, thoracic, and musculoskeletal issues, facilitating quick and accurate diagnoses, and reducing the need for unnecessary referrals. Furthermore, this technique has proven valuable in emergencies and critical care, guiding procedures and enhancing the safety and efficiency of clinical interventions.
These guidelines not only serve as a framework for clinical practice, education, and research but also aim to ensure that professionals are adequately trained and that ultrasound evaluations are performed to a standard of excellence. The purpose of these recommendations is to standardize and facilitate the adoption of this clinical tool in the daily practice of healthcare, thus improving the quality of the services provided in its various possible applications.
{"title":"Resumen ejecutivo del documento de consenso sobre la realización de la ecografía clínica: recomendaciones desde los Grupos de Trabajo de Ecografía Clínica de la SEMI, SEDAR, SEGG, SEMERGEN, SEMES, SEMFYC y SEMG","authors":"Y. Tung-Chen , J. Short Apellaniz , R. Alonso Roca , J.R. Alonso Viladot , I. Arnanz González , L. Beltrán Romero , A. Calvo Cebrián , R. Campo Linares , K.A. Foo Gil , I. García Suárez , A.D. González Delgado , A. Hernández Martínez , M.F. Marchese Ratti , O. Martínez Villén , J. Mercadal Mercadal , E. Minguela Puras , Maria Ester Montes Belloso , P.P. Reinoso Párraga , E. Rodríguez Urteaga , A. Romero Galán , Paola Pastora Reinoso Párraga","doi":"10.1016/j.rce.2024.07.006","DOIUrl":"10.1016/j.rce.2024.07.006","url":null,"abstract":"<div><div>Point-of-Care Ultrasound has significantly evolved, establishing itself as an essential tool in daily medical practice, especially in various clinical contexts. This consensus document, supported by several Spanish medical societies, proposes guidelines for the effective integration of ultrasound in healthcare, promoting its standardization and ensuring the quality and systematic application of this technique. The working groups, composed of experts from different specialties, conducted a comprehensive review of the literature in MEDLINE and extensively discussed recommendations to formulate a coherent and practical set of guidelines for different application areas: hospital and out-of-hospital emergencies and critical care, primary care, and outpatient hospital care, hospitalization.</div><div>The methodology included virtual meetings and confidential voting to reach a consensus on the relevant recommendations. Ultrasound was highlighted as fundamental in the initial approach to various pathologies, such as abdominal, thoracic, and musculoskeletal issues, facilitating quick and accurate diagnoses, and reducing the need for unnecessary referrals. Furthermore, this technique has proven valuable in emergencies and critical care, guiding procedures and enhancing the safety and efficiency of clinical interventions.</div><div>These guidelines not only serve as a framework for clinical practice, education, and research but also aim to ensure that professionals are adequately trained and that ultrasound evaluations are performed to a standard of excellence. The purpose of these recommendations is to standardize and facilitate the adoption of this clinical tool in the daily practice of healthcare, thus improving the quality of the services provided in its various possible applications.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 10","pages":"Pages 670-678"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757362","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 : 2024-12-01DOI: 10.1016/j.rce.2024.07.003
A.M. Diezma-Martín , M.I. Morales-Casado , L. Jiménez-Díaz , J.D. Navarro-López , B. Mondéjar-Marín , J. Parra-Serrano , A. Vadillo-Bermejo , C. Marsal-Alonso , P. Beneyto-Martín
Objective
The objective is to analyze the prevalence of Alzheimer's disease in patients with and without a diagnosis of different autoimmune diseases and the possible association between both pathologies.
Patients and methods
A multicenter, retrospective, cohort study was conducted to study the prevalence of Alzheimer's disease among patients diagnosed with various autoimmune diseases compared to the general population. Data from electronic medical records from the Castilla-La Mancha healthcare system were analyzed using Natural Language Processing through the Savana Manager® artificial intelligence clinical platform. A total of 1,028,356 patients were analyzed, including 28,920 individuals with Alzheimer's disease and 999,436 control patients.
Results
Out of the 12 autoimmune diseases analyzed, 5 showed a significant association with Alzheimer's disease with P .05. Myasthenia gravis had an increased prevalence of AD with OR 1.49 (95% CI 1.11 - 2), systemic lupus erythematosus with OR 2.42 (95% CI 2.02 – 2.88), rheumatoid arthritis with OR 1.38 (95% CI 1.24 – 1.54), polymyalgia rheumatica with OR 2.01 (95% CI 1.08 – 2.23), and pernicious anemia with OR 2.06 (95% CI 1.59 – 2.66). The remaining autoimmune diseases analyzed did not show a higher prevalence of Alzheimer's disease compared to the general population.
Conclusions
There may be an association between certain systemic autoimmune diseases and Alzheimer's disease. Further studies are needed to confirm our findings, establish causality, and explore the underlying mechanisms of this association.
目的分析阿尔茨海默病在患有和未诊断出不同自身免疫性疾病的患者中的患病率，以及两种疾病之间可能的联系。患者与方法本研究采用多中心、回顾性、队列研究的方法，对诊断为各种自身免疫性疾病的患者与普通人群的阿尔茨海默病患病率进行了研究。来自Castilla-La Mancha医疗保健系统的电子病历数据通过Savana Manager®人工智能临床平台使用自然语言处理进行分析。总共分析了1,028,356名患者，其中包括28,920名阿尔茨海默病患者和999,436名对照患者。结果12种自身免疫性疾病中，有5种与阿尔茨海默病有显著相关性（P < 0.05）。重症肌无力的AD患病率增加，OR为1.49 (95% CI 1.11 - 2)，系统性红斑狼疮的OR为2.42 (95% CI 2.02 - 2.88)，类风湿性关节炎的OR为1.38 (95% CI 1.24 - 1.54)，风湿性多肌痛的OR为2.01 (95% CI 1.08 - 2.23)，恶性贫血的OR为2.06 （95% CI 1.59 - 2.66）。其余的自身免疫性疾病分析并没有显示阿尔茨海默病的患病率高于一般人群。结论某些系统性自身免疫性疾病与阿尔茨海默病可能存在关联。需要进一步的研究来证实我们的发现，建立因果关系，并探索这种关联的潜在机制。
{"title":"Asociación entre enfermedades autoinmnues y enfermedad de Alzheimer: análisis a partir de herramientas de big data","authors":"A.M. Diezma-Martín , M.I. Morales-Casado , L. Jiménez-Díaz , J.D. Navarro-López , B. Mondéjar-Marín , J. Parra-Serrano , A. Vadillo-Bermejo , C. Marsal-Alonso , P. Beneyto-Martín","doi":"10.1016/j.rce.2024.07.003","DOIUrl":"10.1016/j.rce.2024.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>The objective is to analyze the prevalence of Alzheimer's disease in patients with and without a diagnosis of different autoimmune diseases and the possible association between both pathologies.</div></div><div><h3>Patients and methods</h3><div>A multicenter, retrospective, cohort study was conducted to study the prevalence of Alzheimer's disease among patients diagnosed with various autoimmune diseases compared to the general population. Data from electronic medical records from the Castilla-La Mancha healthcare system were analyzed using Natural Language Processing through the Savana Manager® artificial intelligence clinical platform. A total of 1,028,356 patients were analyzed, including 28,920 individuals with Alzheimer's disease and 999,436 control patients.</div></div><div><h3>Results</h3><div>Out of the 12 autoimmune diseases analyzed, 5 showed a significant association with Alzheimer's disease with <em>P</em> <!-->.05. Myasthenia gravis had an increased prevalence of AD with OR 1.49 (95% <span>C</span>I 1.11 - 2), systemic lupus erythematosus with OR 2.42 (95% CI 2.02 – 2.88), rheumatoid arthritis with OR 1.38 (95% CI 1.24 – 1.54), polymyalgia rheumatica with OR 2.01 (95% CI 1.08 – 2.23), and pernicious anemia with OR 2.06 (95% CI 1.59 – 2.66). The remaining autoimmune diseases analyzed did not show a higher prevalence of Alzheimer's disease compared to the general population.</div></div><div><h3>Conclusions</h3><div>There may be an association between certain systemic autoimmune diseases and Alzheimer's disease. Further studies are needed to confirm our findings, establish causality, and explore the underlying mechanisms of this association.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 10","pages":"Pages 627-633"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757414","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 : 2024-12-01DOI: 10.1016/j.rce.2024.07.007
M. Martín del Pozo , M. Martín Asenjo , A.I. Franco Moreno , E. Usandizaga de Antonio , F. Galeano Valle
Venous thromboembolim (VTE) is a highly prevalent condition that requires long-term monitoring and treatment. This monitoring includes: 1) completing the etiological study and determining the risk of VTE recurrence; 2) establishing the optimal duration of anticoagulant treatment, as well as the type of therapy and its dosage; 3) estimating the risk of bleeding, and 4) identifying the occurrence of chronic complications. This consensus document, prepared by the VTE Group of the Spanish Society of Internal Medicine (SEMI), aims to update and establish consensus recommendations on these aspects. The document focuses on four aspects of management: the first includes risk factors for VTE recurrence after an unprovoked VTE episode and describes the predictive scores of VTE recurrence; the second focuses on risk factors for bleeding; the third provides recommendations for long-term follow-up in VTE, addressing specific considerations for screening chronic thromboembolic pulmonary hypertension and post-thrombotic syndrome of the lower limbs; and the fourth provides guidance on the optimal duration of extended anticoagulant treatment, as well as the type of therapy and its dosage;. For each area, an exhaustive literature review was conducted, analyzing the updated VTE clinical guidelines and recent studies. This document is intended to be a guide in the long-term management of VTE based on the most current knowledge.
{"title":"Seguimiento y tratamiento de la enfermedad tromboembólica venosa a largo plazo: recomendaciones del Grupo de Enfermedad Tromboembólica de la Sociedad Española de Medicina Interna 2024","authors":"M. Martín del Pozo , M. Martín Asenjo , A.I. Franco Moreno , E. Usandizaga de Antonio , F. Galeano Valle","doi":"10.1016/j.rce.2024.07.007","DOIUrl":"10.1016/j.rce.2024.07.007","url":null,"abstract":"<div><div>Venous thromboembolim (VTE) is a highly prevalent condition that requires long-term monitoring and treatment. This monitoring includes: 1) completing the etiological study and determining the risk of VTE recurrence; 2) establishing the optimal duration of anticoagulant treatment, as well as the type of therapy and its dosage; 3) estimating the risk of bleeding, and 4) identifying the occurrence of chronic complications. This consensus document, prepared by the VTE Group of the Spanish Society of Internal Medicine (SEMI), aims to update and establish consensus recommendations on these aspects. The document focuses on four aspects of management: the first includes risk factors for VTE recurrence after an unprovoked VTE episode and describes the predictive scores of VTE recurrence; the second focuses on risk factors for bleeding; the third provides recommendations for long-term follow-up in VTE, addressing specific considerations for screening chronic thromboembolic pulmonary hypertension and post-thrombotic syndrome of the lower limbs; and the fourth provides guidance on the optimal duration of extended anticoagulant treatment, as well as the type of therapy and its dosage;. For each area, an exhaustive literature review was conducted, analyzing the updated VTE clinical guidelines and recent studies. This document is intended to be a guide in the long-term management of VTE based on the most current knowledge.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 10","pages":"Pages 652-663"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757360","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 : 2024-12-01DOI: 10.1016/j.rce.2024.06.015
J.M. Cerqueiro-González , A. González-Franco , J.M. Fernández-Rodríguez , E. Martínez-Litago , J. Pérez-Silvestre , P. Salamanca-Bautista , L. Morales-Rull , A. Conde-Martel , J. Casado , O. Aramburu-Bodas , L. Manzano-Espinosa , ET AL. la relación completa de colaboradores de este artículo se especifica dentro del texto
Chronic heart failure (CHF) represents a challenge for the healthy system due to its high prevalence, high burden of morbidity and mortality, and high consumption of health resources.
To address this problem, it is necessary to develop efficient management strategies that include both hospital care and outpatient care. The primary objective is to stabilize the patient and prevent decompensation, with the consequent improvement in quality of life, reduction in hospital admissions and emergency department care, and, consequently, reduction in healthcare costs.
In this context, the heart failure and atrial fibrilation working group of the Spanish Society of Internal Medicine has developed a protocol for the management of outpatient CHF, that addresses, from the perspective of Internal medicine, all the problems suffered by the patient with CHF.
This protocol aims to optimize pharmacological treatment, control cardiovascular risk factors and various comorbidities, educate the patient and their environment about the disease, promote adherence to treatment and stablish follow-up adapted to their condition.
{"title":"Protocolo de actuación básica para el manejo ambulatorio de la insuficiencia cardiaca crónica de la Sociedad Española de Medicina Interna","authors":"J.M. Cerqueiro-González , A. González-Franco , J.M. Fernández-Rodríguez , E. Martínez-Litago , J. Pérez-Silvestre , P. Salamanca-Bautista , L. Morales-Rull , A. Conde-Martel , J. Casado , O. Aramburu-Bodas , L. Manzano-Espinosa , ET AL. la relación completa de colaboradores de este artículo se especifica dentro del texto","doi":"10.1016/j.rce.2024.06.015","DOIUrl":"10.1016/j.rce.2024.06.015","url":null,"abstract":"<div><div>Chronic heart failure (CHF) represents a challenge for the healthy system due to its high prevalence, high burden of morbidity and mortality, and high consumption of health resources.</div><div>To address this problem, it is necessary to develop efficient management strategies that include both hospital care and outpatient care. The primary objective is to stabilize the patient and prevent decompensation, with the consequent improvement in quality of life, reduction in hospital admissions and emergency department care, and, consequently, reduction in healthcare costs.</div><div>In this context, the heart failure and atrial fibrilation working group of the Spanish Society of Internal Medicine has developed a protocol for the management of outpatient CHF, that addresses, from the perspective of Internal medicine, all the problems suffered by the patient with CHF.</div><div>This protocol aims to optimize pharmacological treatment, control cardiovascular risk factors and various comorbidities, educate the patient and their environment about the disease, promote adherence to treatment and stablish follow-up adapted to their condition.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"224 10","pages":"Pages 679-693"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757363","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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