Revista clinica espanola最新文献

英文中文

Impacto de la hipertensión arterial en la isquemia vascular ocular 高血压对眼部血管性缺血的影响

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-12-01 Epub Date: 2025-11-20 DOI: 10.1016/j.rce.2025.502389

L. Castilla-Guerra , A.J. Gómez-Escobar , E. Gutiérrez-Sánchez , P. Luque-Linero , R. Dominguez Álvarez , M. Gandullo Moro , M.Á. Rico-Corral

Introduction

At the ocular level, hypertension causes retinal, choroidal and optic nerve lesions, and can be complicated by obstructive and ischaemic phenomena. We set out to assess the impact of hypertension on the different types of ocular vascular ischemia.

Patients and methods

Retrospective case-control study of patients seen in a vascular risk consultation. All patients underwent pulse wave velocity (PWV), ABI and carotid Doppler ultrasound.

Results

One hundred eighty-seven patients were included, 76 retinal venous occlusions (RVO), 21 retinal arterial occlusions (RAO), 28 non-arteritic ischaemic neuropathies (NAION) and 62 hypertensive controls without ocular ischaemia (CP). Mean age was 64 (±11), 68 (±10), 61 (±10) and 56 (±11) years in RVO, RAO, NAION, and PC respectively (P=.92). RVOs had a higher frequency of hypertension (71.4%), dyslipidaemia (55%) and diabetes (47.6%) (P=.001, P=.001 and P=.028 respectively) compared to the other groups. In relation to subclinical organ damage, patients with RVO had higher PWV 10.7 m/s (P=.004), pulse pressure 66 mmHg (P=.009), and vascular age 66.4 years (P=.005), with no differences in IMT, presence of carotid plaques or ITB. The occurrence of ocular ischaemia correlated with age (P=.009), DM2 (P=.027), dyslipidaemia (P=.047) and presence of plaques (P=.019).

Conclusions

Hypertension is a constant in vascular ocular ischaemic pathology, having a greater impact due to arterial stiffness in RVO. Age, diabetes, dyslipidaemia and the presence of plaques will increase the appearance of ocular ischemia.

在眼水平，高血压可引起视网膜、脉络膜和视神经病变，并可并发阻塞性和缺血性现象。我们开始评估高血压对不同类型的眼部血管缺血的影响。患者与方法血管危险会诊患者的回顾性病例对照研究。所有患者均行脉搏波速度（PWV）、ABI及颈动脉多普勒超声检查。结果共纳入187例患者，其中视网膜静脉闭塞（RVO） 76例，视网膜动脉闭塞（RAO） 21例，非动脉性缺血性神经病（NAION） 28例，无眼缺血（CP）的高血压对照组62例。RVO、RAO、NAION、PC的平均年龄分别为64（±11）岁、68（±10）岁、61（±10）岁、56（±11）岁（P= 0.92）。RVOs组高血压（71.4%）、血脂异常（55%）和糖尿病（47.6%）的发生率分别高于对照组（P= 0.001、P= 0.001和P= 0.028）。与亚临床器官损害相关，RVO患者的PWV为10.7 m/s (P= 0.004)，脉压为66 mmHg (P= 0.009)，血管年龄为66.4岁（P= 0.005），而IMT、颈动脉斑块或ITB的存在无差异。眼部缺血的发生与年龄（P= 0.009）、DM2 （P= 0.027）、血脂异常（P= 0.047）、斑块存在（P= 0.019）相关。结论高血压是血管性眼缺血病理的常见病，在RVO中动脉硬化对其影响较大。年龄、糖尿病、血脂异常和斑块的存在都会增加眼缺血的出现。

{"title":"Impacto de la hipertensión arterial en la isquemia vascular ocular","authors":"L. Castilla-Guerra , A.J. Gómez-Escobar , E. Gutiérrez-Sánchez , P. Luque-Linero , R. Dominguez Álvarez , M. Gandullo Moro , M.Á. Rico-Corral","doi":"10.1016/j.rce.2025.502389","DOIUrl":"10.1016/j.rce.2025.502389","url":null,"abstract":"<div><h3>Introduction</h3><div>At the ocular level, hypertension causes retinal, choroidal and optic nerve lesions, and can be complicated by obstructive and ischaemic phenomena. We set out to assess the impact of hypertension on the different types of ocular vascular ischemia.</div></div><div><h3>Patients and methods</h3><div>Retrospective case-control study of patients seen in a vascular risk consultation. All patients underwent pulse wave velocity (PWV), ABI and carotid Doppler ultrasound.</div></div><div><h3>Results</h3><div>One hundred eighty-seven patients were included, 76 retinal venous occlusions (RVO), 21 retinal arterial occlusions (RAO), 28 non-arteritic ischaemic neuropathies (NAION) and 62 hypertensive controls without ocular ischaemia (CP). Mean age was 64 (±11), 68 (±10), 61 (±10) and 56 (±11) years in RVO, RAO, NAION, and PC respectively (<em>P</em>=.92). RVOs had a higher frequency of hypertension (71.4%), dyslipidaemia (55%) and diabetes (47.6%) (<em>P</em>=.001, <em>P</em>=.001 and <em>P</em>=.028 respectively) compared to the other groups. In relation to subclinical organ damage, patients with RVO had higher PWV 10.7 m/s (<em>P</em>=.004), pulse pressure 66mmHg (<em>P</em>=.009), and vascular age 66.4 years (<em>P</em>=.005), with no differences in IMT, presence of carotid plaques or ITB. The occurrence of ocular ischaemia correlated with age (<em>P</em>=.009), DM2 (<em>P</em>=.027), dyslipidaemia (<em>P</em>=.047) and presence of plaques (<em>P</em>=.019).</div></div><div><h3>Conclusions</h3><div>Hypertension is a constant in vascular ocular ischaemic pathology, having a greater impact due to arterial stiffness in RVO. Age, diabetes, dyslipidaemia and the presence of plaques will increase the appearance of ocular ischemia.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 10","pages":"Article 502389"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalencia y toma de decisiones en demencia avanzada 晚期痴呆的患病率和决策

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-12-01 Epub Date: 2025-11-20 DOI: 10.1016/j.rce.2025.502388

A. Castellano Candalija , L. Díez Porres , H. Notario Leo , A. Roca Martiartu , N. Mayoral Canalejas , A. Alonso Babarro

Introduction

Dementia is a chronic neurodegenerative disease with a high prevalence and economic cost. Our objective was to evaluate the prevalence of advanced dementia (AD) in patients hospitalized in the Internal Medicine service; to analyze the therapeutic and diagnostic measures implemented, the degree of adequacy of the therapeutic effort and the information of the family.

Methodology

Descriptive study that included a retrospective analysis of medical records and a telephone interview with family. Patients with GDS 6-7 dementia admitted to Internal Medicine were included, for 3 weeks in 3 different months.

Results

194 (22%) patients with dementia were included. The prevalence of admissions with AD was 11%. The median age was 87.5 years (QR 81.75-93), 65% women. 45% came from residence for the elderly. The most frequent etiology was Alzheimer's (48%). The most frequent cause of admission was infection (72%). 37% died. Regarding the measures implemented: 100% were treatment intravenous; 89% received anticoagulation; 26% received artificial nutrition; 81% received pharmacological restraint and 63% physical restraint; and 48% underwent invasive diagnostic tests. Regarding adequacy: lipid-lowering treatment was withdrawn in 19%, antidementia drugs in 23%, anticoagulation in 21%; cardiopulmonary resuscitation was not performed in 30%, adequacy of care in 34%, and 13% were assessed by Palliative Care. A telephone interview was conducted with 55 patients. 42% were not aware of any complications. Care planning was carried out in 2 patients.

Conclusions

The prevalence of admission to AD is high, and almost half of the patients come from residence for the elderly. Associated mortality is high and therapeutic adequacy and planning are very scarce.

痴呆是一种慢性神经退行性疾病，发病率高，经济成本高。我们的目的是评估内科住院患者中晚期痴呆（AD）的患病率；分析实施的治疗和诊断措施、治疗努力的充分程度和家庭信息。方法：描述性研究，包括对医疗记录的回顾性分析和对家属的电话访谈。纳入了在3个不同月份住院的GDS 6-7痴呆患者，为期3周。结果纳入194例（22%）痴呆患者。阿尔茨海默病入院率为11%。中位年龄87.5岁（QR 81.75-93）， 65%为女性。45%来自养老院。最常见的病因是阿尔茨海默病（48%）。最常见的入院原因是感染（72%）。37%死亡。实施措施方面：100%为静脉治疗；89%接受抗凝治疗；26%接受人工营养；81%接受药物约束，63%接受物理约束；48%的人接受了侵入性诊断测试。关于充分性：19%的降脂治疗停药，23%停药，21%停药；30%的患者没有进行心肺复苏，34%的患者护理充足，13%的患者通过姑息治疗进行评估。对55例患者进行了电话访谈。42%的患者未意识到任何并发症。对2例患者进行护理计划。结论阿尔茨海默病住院率高，近半数患者来自老年住院者。相关的死亡率很高，治疗的适当性和计划非常缺乏。

{"title":"Prevalencia y toma de decisiones en demencia avanzada","authors":"A. Castellano Candalija , L. Díez Porres , H. Notario Leo , A. Roca Martiartu , N. Mayoral Canalejas , A. Alonso Babarro","doi":"10.1016/j.rce.2025.502388","DOIUrl":"10.1016/j.rce.2025.502388","url":null,"abstract":"<div><h3>Introduction</h3><div>Dementia is a chronic neurodegenerative disease with a high prevalence and economic cost. Our objective was to evaluate the prevalence of advanced dementia (AD) in patients hospitalized in the Internal Medicine service; to analyze the therapeutic and diagnostic measures implemented, the degree of adequacy of the therapeutic effort and the information of the family.</div></div><div><h3>Methodology</h3><div>Descriptive study that included a retrospective analysis of medical records and a telephone interview with family. Patients with GDS 6-7 dementia admitted to Internal Medicine were included, for 3 weeks in 3 different months.</div></div><div><h3>Results</h3><div>194 (22%) patients with dementia were included. The prevalence of admissions with AD was 11%. The median age was 87.5 years (QR 81.75-93), 65% women. 45% came from residence for the elderly. The most frequent etiology was Alzheimer's (48%). The most frequent cause of admission was infection (72%). 37% died. Regarding the measures implemented: 100% were treatment intravenous; 89% received anticoagulation; 26% received artificial nutrition; 81% received pharmacological restraint and 63% physical restraint; and 48% underwent invasive diagnostic tests. Regarding adequacy: lipid-lowering treatment was withdrawn in 19%, antidementia drugs in 23%, anticoagulation in 21%; cardiopulmonary resuscitation was not performed in 30%, adequacy of care in 34%, and 13% were assessed by Palliative Care. A telephone interview was conducted with 55 patients. 42% were not aware of any complications. Care planning was carried out in 2 patients.</div></div><div><h3>Conclusions</h3><div>The prevalence of admission to AD is high, and almost half of the patients come from residence for the elderly. Associated mortality is high and therapeutic adequacy and planning are very scarce.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 10","pages":"Article 502388"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impacto de la insuficiencia cardiaca en la mortalidad intrahospitalaria durante el ingreso por otras patologías 心脏衰竭对其他疾病住院期间医院内死亡率的影响

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-12-01 Epub Date: 2025-11-20 DOI: 10.1016/j.rce.2025.502387

J.M. García Vallejo , C. Martel Vera , S. González Sosa , A. Santana García , S. Blanco Tajes , M.N. Sánchez Vadillo , A. Conde Martel

Background and objective

Acute heart failure (AHF) is a frequent cause of hospitalization and has been extensively studied. However, its characteristics when it appears secondarily during admission for other pathologies are less well defined. The aim of this study was to analyze the clinical characteristics, prognostic factors and evolution of AHF in patients hospitalized for other causes, diagnosed by interconsultation to Internal Medicine (IM).

Materials and methods

Observational study that included patients diagnosed with AHF after consultation with IM (2020-2022). Demographic and clinical characteristics, admission reasons, type of heart disease, triggering factors, in-hospital mortality and associated factors were collected.

Results

Of 1583 consultations, 347 patients (21.9%) were diagnosed with AHF. The mean age was 79.9 (±10.3 years) and 184 (53%) were female. 76% came from surgical services. The most frequent comorbidities were hypertension, dyslipidemia and atrial fibrillation. Most patients had hypertensive etiology and preserved ejection fraction (68.6%). The main triggers were infections, anemia and fluid overload. In 50% of the cases, AHF was the debut of HF. In-hospital mortality was 20.5%, 26.4% at one-year follow up, and 39.7% were readmitted. In-hospital mortality was associated with older age (p = 0.031), elevated NT-proBNP (p = 0.048) and lower hemoglobin (p = 0.004) and albumin (p = 0.006) levels.

Conclusions

Patients who develop AHF during admission for other pathologies present advanced age, multiple comorbidities and high mortality. Early detection of triggering factors and identification of prognostic factors could help to optimize their management and improve their outcome.

背景与目的急性心力衰竭（acute heart failure， AHF）是一种常见的住院原因，已被广泛研究。然而，当它在其他病理入院时次要出现时，其特征就不那么明确了。本研究的目的是分析AHF的临床特点，预后因素和演变的其他原因住院的患者，诊断内科（IM）会诊。材料和方法一项观察性研究，纳入与IM会诊后诊断为AHF的患者（2020-2022）。收集患者的人口学和临床特征、入院原因、心脏病类型、诱发因素、住院死亡率及相关因素。结果1583例就诊中，347例（21.9%）诊断为AHF。平均年龄79.9（±10.3岁），女性184例（53%）。76%来自外科服务。最常见的合并症是高血压、血脂异常和心房颤动。大多数患者有高血压病因，并保留了射血分数（68.6%）。主要的诱因是感染、贫血和体液过量。在50%的病例中，AHF是HF的首次发病。住院死亡率为20.5%，1年随访时为26.4%，再入院率为39.7%。住院死亡率与年龄较大（p = 0.031）、NT-proBNP升高（p = 0.048）、血红蛋白（p = 0.004）和白蛋白（p = 0.006）水平降低有关。结论住院时因其他病理发生AHF的患者年龄大、合并症多、病死率高。早期发现诱发因素和确定预后因素有助于优化其管理和改善其预后。

{"title":"Impacto de la insuficiencia cardiaca en la mortalidad intrahospitalaria durante el ingreso por otras patologías","authors":"J.M. García Vallejo , C. Martel Vera , S. González Sosa , A. Santana García , S. Blanco Tajes , M.N. Sánchez Vadillo , A. Conde Martel","doi":"10.1016/j.rce.2025.502387","DOIUrl":"10.1016/j.rce.2025.502387","url":null,"abstract":"<div><h3>Background and objective</h3><div>Acute heart failure (AHF) is a frequent cause of hospitalization and has been extensively studied. However, its characteristics when it appears secondarily during admission for other pathologies are less well defined. The aim of this study was to analyze the clinical characteristics, prognostic factors and evolution of AHF in patients hospitalized for other causes, diagnosed by interconsultation to Internal Medicine (IM).</div></div><div><h3>Materials and methods</h3><div>Observational study that included patients diagnosed with AHF after consultation with IM (2020-2022). Demographic and clinical characteristics, admission reasons, type of heart disease, triggering factors, in-hospital mortality and associated factors were collected.</div></div><div><h3>Results</h3><div>Of 1583 consultations, 347 patients (21.9%) were diagnosed with AHF. The mean age was 79.9 (±10.3 years) and 184 (53%) were female. 76% came from surgical services. The most frequent comorbidities were hypertension, dyslipidemia and atrial fibrillation. Most patients had hypertensive etiology and preserved ejection fraction (68.6%). The main triggers were infections, anemia and fluid overload. In 50% of the cases, AHF was the debut of HF. In-hospital mortality was 20.5%, 26.4% at one-year follow up, and 39.7% were readmitted. In-hospital mortality was associated with older age (p=0.031), elevated NT-proBNP (p=0.048) and lower hemoglobin (p=0.004) and albumin (p=0.006) levels.</div></div><div><h3>Conclusions</h3><div>Patients who develop AHF during admission for other pathologies present advanced age, multiple comorbidities and high mortality. Early detection of triggering factors and identification of prognostic factors could help to optimize their management and improve their outcome.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 10","pages":"Article 502387"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Carta al editor «La controversia en torno al hierro sucrosomado» 给编辑的信《蔗糖铁的争议》

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-12-01 Epub Date: 2025-11-21 DOI: 10.1016/j.rce.2025.502396

F.J. Teigell Muñoz, M. Mateos González

引用次数: 0

Ecografía clínica en una Unidad de Hospitalización a Domicilio: utilidad y limitaciones 家庭医院单位的临床超声：用途和局限性

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-12-01 Epub Date: 2025-11-20 DOI: 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.

前言和目的在过去的几年中，点护理超声的使用在内科单位得到了广泛的应用。然而，关于其在家庭医院（HaH）使用的文献是不足的。该研究的目的是量化和评估点护理超声在HaH中的使用。材料与方法本研究为描述性观察性研究。记录2022年7月至12月期间在HaH单位进行的即时超声检查。结果72例患者共行85次超声检查。最常见的超声检查类型是多器官检查（71.8%），最常见的超声检查原因是对心力衰竭患者的监测（68%）。在72.8%的情况下避免了医院流离失所。结论超声点检是医院的一种有效工具，它可以优化患者的随访，改善临床决策，甚至避免患者转移到医院。

{"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}

引用次数: 0

Explorando la diversidad del síndrome de microdeleción 1p36 en pacientes diagnosticados en la edad adulta 探索成年患者中1p36微缺失综合征的多样性

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-12-01 Epub Date: 2025-11-21 DOI: 10.1016/j.rce.2025.502397

A. García Tellado , M. García Castro , A. Sariego Jamardo , N. Puente Ruiz

引用次数: 0

Tendencias regionales en la incidencia de embolia pulmonar en España (2016-2022): un análisis de las diferencias entre comunidades autónomas 西班牙肺栓塞发病率的区域趋势（2016-2022年）：自治区间差异分析

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-31 DOI: 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>  =.04; 14.3%, <em>P</em>  =.003), and less so in Galicia, La Rioja, and Extremadura (APC 4.1%, <em>P</em>  =.003; 5.7%, <em>P</em>    <!-->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}

引用次数: 0

Déficit de hierro y anemia ferropénica y su asociación con la embolia pulmonar 缺铁和缺铁性贫血及其与肺栓塞的关联

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-11-07 DOI: 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 12months.</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 12months with an odds ratio of 2.15 (95% confidence interval [CI95%]: 1.01-4.58; <em>P</em>   =.05]).</div></div><div><h3>Conclusion</h3><div>ID may represent an increased risk of PE in the 12months 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}

引用次数: 0

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 在全民医疗体系中，社会经济剥夺与系统性红斑狼疮的心血管损伤风险之间无关联：巴斯克地区的一项队列研究

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-11-07 DOI: 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.

社会经济贫困是心血管健康的一个公认的决定因素。我们评估了它对巴斯克地区系统性红斑狼疮（SLE）患者心血管风险和损害的影响，那里有全民医疗保险保障。方法采用观察性队列研究，对293例SLE患者进行5年随访。采用多水平广义线性混合模型分析巴斯克地区社会经济剥夺指数与心血管危险因素和损伤（SLICC指数）之间的关系。结果在诊断时或5年时，剥夺水平与心血管危险因素数量之间没有显著相关性，与心血管损害也没有显著相关性。诊断年龄和疾病活动度是心血管预后的主要预测因素。结论：在普遍的医疗保健环境中，社会经济剥夺与SLE患者更严重的心血管风险或损害无关。这些发现没有建立因果关系，但与普遍医疗保健可能减轻SLE心血管结局的社会经济梯度的假设一致。

{"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}

引用次数: 0

Contrarréplica a la carta «Sobre el estudio de síndromes geriátricos: la definición importa» 对“关于老年综合症的研究：定义很重要”这封信的答复

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-11-07 DOI: 10.1016/j.rce.2025.502385

M.C. Montes , J.A. Rueda-Camino , N. Rallón , S. Nistal-Juncos , R. Barba Martín

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Revista clinica espanola

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀