Pub Date : 2025-11-01Epub Date: 2025-10-31DOI: 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 : 2025-11-01Epub Date: 2025-10-27DOI: 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.
{"title":"Resumen ejecutivo de consenso 2025 en el diagnóstico y tratamiento de la hipertensión arterial del Foro Internacional de Medicina Interna","authors":"R. Sabio , P. Valdez , E. Casariego Vales , L. Cámera , H.L. Puello Galarcio , M. Camafort , en nombre del Grupo de trabajo hipertensión arterial-FIMI","doi":"10.1016/j.rce.2025.502368","DOIUrl":"10.1016/j.rce.2025.502368","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502368"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532614","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.2025.502378
Á. García Tellado , B. Lucas-Velázquez , J. Pardo Lledías
{"title":"Captación en vasos de mediano calibre en PET/TC como indicio de arteritis de células gigantes extracraneal","authors":"Á. García Tellado , B. Lucas-Velázquez , J. Pardo Lledías","doi":"10.1016/j.rce.2025.502378","DOIUrl":"10.1016/j.rce.2025.502378","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502378"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532617","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 : 2025-11-01Epub Date: 2025-10-31DOI: 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}
Pub Date : 2025-11-01Epub Date: 2025-11-11DOI: 10.1016/j.rce.2025.502380
F.M. Escandell Rico , L. Pérez Fernández
Objective
To evaluate the vaccination coverage against seasonal influenza in Spain between 2019 and 2023, analyzing trends by population groups, autonomous communities and factors associated with temporal and contextual variations.
Method
Retrospective longitudinal study using data from the Vaccine Information System (SIVAMIN). Coverage was analyzed in the following groups: children (6-59 months), adults (60-64, 65-74, > 74 years), pregnant women and health personnel. Coverage was calculated as the percentage of vaccinated patients with respect to the susceptible population and a descriptive and regression analysis was performed to evaluate temporal trends.
Results
Between 2019 and 2023, those over 74 years of age maintained high coverage (> 73%), with slight decreases. In the 65-74 age group, coverage was good but uneven across regions. In adults aged 60-64 years and pregnant women, a post-pandemic decline was observed. Coverage in health professionals fell markedly (from 66 to 44%). In children aged 6-59 months, incorporated in 2023, coverage was 36%, with marked regional disparities.
Conclusions
Vaccination coverage shows persistent progress and challenges, with significant inequalities by autonomous communities. Those over 74 years of age and pregnant women have maintained relatively high rates, reflecting campaigns aimed at these vulnerable groups. The pandemic boosted occasional coverage, but the trend was not sustained. Sustainable strategies are required to improve equity and maintain confidence in vaccination, especially in key groups such as children, health care providers, and by autonomous communities with less access.
{"title":"Cobertura vacunal contra la gripe: avances, desafíos y desigualdades por comunidades autónomas en España (2019-2023)","authors":"F.M. Escandell Rico , L. Pérez Fernández","doi":"10.1016/j.rce.2025.502380","DOIUrl":"10.1016/j.rce.2025.502380","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the vaccination coverage against seasonal influenza in Spain between 2019 and 2023, analyzing trends by population groups, autonomous communities and factors associated with temporal and contextual variations.</div></div><div><h3>Method</h3><div>Retrospective longitudinal study using data from the Vaccine Information System (SIVAMIN). Coverage was analyzed in the following groups: children (6-59 months), adults (60-64, 65-74, ><!--> <!-->74 years), pregnant women and health personnel. Coverage was calculated as the percentage of vaccinated patients with respect to the susceptible population and a descriptive and regression analysis was performed to evaluate temporal trends.</div></div><div><h3>Results</h3><div>Between 2019 and 2023, those over 74 years of age maintained high coverage (><!--> <!-->73%), with slight decreases. In the 65-74 age group, coverage was good but uneven across regions. In adults aged 60-64 years and pregnant women, a post-pandemic decline was observed. Coverage in health professionals fell markedly (from 66 to 44%). In children aged 6-59 months, incorporated in 2023, coverage was 36%, with marked regional disparities.</div></div><div><h3>Conclusions</h3><div>Vaccination coverage shows persistent progress and challenges, with significant inequalities by autonomous communities. Those over 74 years of age and pregnant women have maintained relatively high rates, reflecting campaigns aimed at these vulnerable groups. The pandemic boosted occasional coverage, but the trend was not sustained. Sustainable strategies are required to improve equity and maintain confidence in vaccination, especially in key groups such as children, health care providers, and by autonomous communities with less access.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502380"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532613","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 : 2025-11-01Epub Date: 2025-11-06DOI: 10.1016/j.rce.2025.502379
B. Ayuso García , Á. Marchán-López , H.J. Castro Pousada , E. Romay Lema , M.J. García-Pais , J. Corredoira Sánchez , P. Peinó Camba , Y. Chantres Legaspi , R. Monte Secades , R. Rabuñal Rey
Introduction
Perioperatively acquired COVID-19 may increase mortality. The aim of this study was to assess the influence of SARS-CoV-2 infection on the length of stay and mortality among surgical patients.
Methods
Retrospective study of surgical interventions performed between 1st March 2020 and 31st December 2022 after exclusion of minor procedures. Clinical, administrative, and epidemiological data were collected. Multivariate Cox regression analysis was conducted.
Results
19152 interventions were included. Patients had median age of 66 years (53-77), 53.8% were male, and the median number of conditions was 1 (0-3). Six hundred and twenty-two (3.2%) interventions were performed in COVID-19 patients, who were older (70 (57-80) vs. 67 (55-77) years; p = 0.003) and more comorbid (2 (1-3) vs. 1 (0-3); p < 0.001). COVID-19 patients had longer stays (11 (4-28) vs. 6 (3-12) days; p < 0.001), and higher mortality rates (incidence rate ratio 2.28 (1.70-3.00), p < 0.001). The adjusted hazard ratio was 1.54 (1.15-2.05), p = 0.001. Age, number of conditions, and incomplete vaccination, and surgeries conducted in 2022 (as compared to 2020 and 2021) were related to higher mortality. Mortality was higher during the first week of the infection, but not after that (HR 2.09 (1.04-4.21), p = 0.037), and the risk window narrowed after 2020.
Conclusions
Perioperative COVID-19 increases mortality, especially during the first week of the infection. Age, comorbidity, and vaccine status should also be considered when scheduling interventions.
{"title":"Impacto de la infección por SARS-CoV-2 sobre la mortalidad durante el periodo perioperatorio","authors":"B. Ayuso García , Á. Marchán-López , H.J. Castro Pousada , E. Romay Lema , M.J. García-Pais , J. Corredoira Sánchez , P. Peinó Camba , Y. Chantres Legaspi , R. Monte Secades , R. Rabuñal Rey","doi":"10.1016/j.rce.2025.502379","DOIUrl":"10.1016/j.rce.2025.502379","url":null,"abstract":"<div><h3>Introduction</h3><div>Perioperatively acquired COVID-19 may increase mortality. The aim of this study was to assess the influence of SARS-CoV-2 infection on the length of stay and mortality among surgical patients.</div></div><div><h3>Methods</h3><div>Retrospective study of surgical interventions performed between 1<sup>st</sup> March 2020 and 31<sup>st</sup> December 2022 after exclusion of minor procedures. Clinical, administrative, and epidemiological data were collected. Multivariate Cox regression analysis was conducted.</div></div><div><h3>Results</h3><div>19152 interventions were included. Patients had median age of 66 years (53-77), 53.8% were male, and the median number of conditions was 1 (0-3). Six hundred and twenty-two (3.2%) interventions were performed in COVID-19 patients, who were older (70 (57-80) vs. 67 (55-77) years; p<!--> <!-->=<!--> <!-->0.003) and more comorbid (2 (1-3) vs. 1 (0-3); p <<!--> <!-->0.001). COVID-19 patients had longer stays (11 (4-28) vs. 6 (3-12) days; p <<!--> <!-->0.001), and higher mortality rates (incidence rate ratio 2.28 (1.70-3.00), p <<!--> <!-->0.001). The adjusted hazard ratio was 1.54 (1.15-2.05), p<!--> <!-->=<!--> <!-->0.001. Age, number of conditions, and incomplete vaccination, and surgeries conducted in 2022 (as compared to 2020 and 2021) were related to higher mortality. Mortality was higher during the first week of the infection, but not after that (HR 2.09 (1.04-4.21), p<!--> <!-->=<!--> <!-->0.037), and the risk window narrowed after 2020.</div></div><div><h3>Conclusions</h3><div>Perioperative COVID-19 increases mortality, especially during the first week of the infection. Age, comorbidity, and vaccine status should also be considered when scheduling interventions.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502379"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532612","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 : 2025-11-01Epub Date: 2025-11-05DOI: 10.1016/j.rce.2025.502381
R. Hurtado García, M. Lorente García, P. Cámara Cases
{"title":"Golpe a la arteria radial: el precio del tambor","authors":"R. Hurtado García, M. Lorente García, P. Cámara Cases","doi":"10.1016/j.rce.2025.502381","DOIUrl":"10.1016/j.rce.2025.502381","url":null,"abstract":"","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502381"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532616","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 : 2025-10-01Epub Date: 2025-09-19DOI: 10.1016/j.rce.2025.502356
M.A. Martínez Olmos , E. Venegas Moreno , M. Morales Conejo , L. Ceberio Hualde , B. Pérez , M. de Tallo Forga , F.J. Pérez-Sádaba , P. Correcher Medina
Objectives
To describe the sociodemographic and clinical characteristics and management of patients with phenylketonuria (PKU) followed in centres, services, and reference units (CSUR) or clinical excellence units specialised in inborn errors of metabolism (IEM). Additionally, to determine patients’ health-related quality of life (HRQoL).
Methods
Observational, cross-sectional, descriptive study conducted with Spanish PKU patients attending CSUR centres or clinical excellence units specialised in IEM during the study period.
Results
The study included 55 patients (54 adults and one teenager) with different PKU phenotypes. The mean (SD) age was 32.1 (9.7) years, with 69.1% women. The most frequent phenotype at diagnosis was classical PKU (67.3%). Mean (SD) plasma Phe levels at diagnosis were 901.9 (606.1) μmol/L and 422.8 (288.9) μmol/L in the last year. Neurological symptoms were present in 23.6% of patients, the most frequent being intellectual disability (21.8%). Psychological symptoms were present in 34.5% of patients, the most frequent being anxiety (14.5%) and depression (12.7%). Of the patients, 85.5% responded to the EQ-5D-5L questionnaire. Of these, 44.7% of patients reported no anxiety or depression, while 34.0% had mild anxiety or depression. The mean (SD) EQ-VAS value was 80.9 (15.2). Forty-one (74.5%) patients responded to the PKU-QoL questionnaire. The results indicated that PKU patients perceived the impact of their disease to be moderate across all domains included in the questionnaire.
Conclusions
Adults with PKU may experience neurological or psychological symptoms including intellectual disability, anxiety, and depression. However, their HRQoL was found to be good and comparable to that of the general population.
{"title":"Características clínicas y manejo de los pacientes españoles adultos con fenilcetonuria","authors":"M.A. Martínez Olmos , E. Venegas Moreno , M. Morales Conejo , L. Ceberio Hualde , B. Pérez , M. de Tallo Forga , F.J. Pérez-Sádaba , P. Correcher Medina","doi":"10.1016/j.rce.2025.502356","DOIUrl":"10.1016/j.rce.2025.502356","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the sociodemographic and clinical characteristics and management of patients with phenylketonuria (PKU) followed in centres, services, and reference units (CSUR) or clinical excellence units specialised in inborn errors of metabolism (IEM). Additionally, to determine patients’ health-related quality of life (HRQoL).</div></div><div><h3>Methods</h3><div>Observational, cross-sectional, descriptive study conducted with Spanish PKU patients attending CSUR centres or clinical excellence units specialised in IEM during the study period.</div></div><div><h3>Results</h3><div>The study included 55 patients (54 adults and one teenager) with different PKU phenotypes. The mean (SD) age was 32.1 (9.7) years, with 69.1% women. The most frequent phenotype at diagnosis was classical PKU (67.3%). Mean (SD) plasma Phe levels at diagnosis were 901.9 (606.1) μmol/L and 422.8 (288.9) μmol/L in the last year. Neurological symptoms were present in 23.6% of patients, the most frequent being intellectual disability (21.8%). Psychological symptoms were present in 34.5% of patients, the most frequent being anxiety (14.5%) and depression (12.7%). Of the patients, 85.5% responded to the EQ-5D-5L questionnaire. Of these, 44.7% of patients reported no anxiety or depression, while 34.0% had mild anxiety or depression. The mean (SD) EQ-VAS value was 80.9 (15.2). Forty-one (74.5%) patients responded to the PKU-QoL questionnaire. The results indicated that PKU patients perceived the impact of their disease to be moderate across all domains included in the questionnaire.</div></div><div><h3>Conclusions</h3><div>Adults with PKU may experience neurological or psychological symptoms including intellectual disability, anxiety, and depression. However, their HRQoL was found to be good and comparable to that of the general population.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502356"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189773","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 : 2025-10-01Epub Date: 2025-09-17DOI: 10.1016/j.rce.2025.502352
J. Carretero Gómez , J.M. Fernández Rodríguez , A. Michan Doña , J.P. Miramontes González , J.J. González Soler , M.I. Pérez Soto , F.J. Carrasco Sánchez , F. Gómez Delgado , J.C. Arévalo Lorido , P. Pérez Martínez , en representación del grupo de trabajo de Diabetes, Obesidad y Nutrición de la Sociedad Española de Medicina Interna (SEMI)
Obesity is currently recognized as a chronic, progressive, and relapsing disease, and constitutes a major global public health challenge. This document, promoted by the Spanish Society of Internal Medicine through its Working Group on Diabetes, Obesity, and Nutrition, outlines a comprehensive, multidisciplinary approach to care, with a specific focus on obesity-related comorbidities. Excess adipose tissue is conceptualized as a systemic pathogenic agent that actively contributes to the pathophysiology of numerous complications, including cardiovascular disease, heart failure, chronic kidney disease, osteoarthritis, obstructive sleep apnea, and metabolic dysfunction-associated steatotic liver disease (MASLD). Furthermore, the document reviews the current evidence base regarding pharmacological interventions for obesity, addressing both their overall efficacy in weight management and their specific therapeutic impact in the context of the distinct obesity-associated comorbidities for which clinical benefit has been demonstrated.
The document endorses the implementation of the Edmonton Obesity Staging System (EOSS) as a pivotal framework for the clinical stratification of risk in individuals with obesity, facilitating a more nuanced and personalized therapeutic approach that prioritizes the functional, metabolic, and prognostic dimensions of the disease. In this context, the document proposes a paradigm shift in the therapeutic objectives for obesity management, moving beyond a sole reliance on anthropometric metrics, such as body mass index (BMI) or absolute weight reduction. Instead, it emphasizes a pathophysiological and patient-centered approach focused on the prevention of obesity-related complications, the early detection and management of its comorbid conditions, and the sustained improvement of both quality-adjusted and overall life expectancy, while simultaneously promoting the elimination of stigma and discrimination.
{"title":"Desde la obesidad a las comorbilidades: una propuesta de atención integral para ganar en salud de la Sociedad Española de Medicina Interna","authors":"J. Carretero Gómez , J.M. Fernández Rodríguez , A. Michan Doña , J.P. Miramontes González , J.J. González Soler , M.I. Pérez Soto , F.J. Carrasco Sánchez , F. Gómez Delgado , J.C. Arévalo Lorido , P. Pérez Martínez , en representación del grupo de trabajo de Diabetes, Obesidad y Nutrición de la Sociedad Española de Medicina Interna (SEMI)","doi":"10.1016/j.rce.2025.502352","DOIUrl":"10.1016/j.rce.2025.502352","url":null,"abstract":"<div><div>Obesity is currently recognized as a chronic, progressive, and relapsing disease, and constitutes a major global public health challenge. This document, promoted by the Spanish Society of Internal Medicine through its Working Group on Diabetes, Obesity, and Nutrition, outlines a comprehensive, multidisciplinary approach to care, with a specific focus on obesity-related comorbidities. Excess adipose tissue is conceptualized as a systemic pathogenic agent that actively contributes to the pathophysiology of numerous complications, including cardiovascular disease, heart failure, chronic kidney disease, osteoarthritis, obstructive sleep apnea, and metabolic dysfunction-associated steatotic liver disease (MASLD). Furthermore, the document reviews the current evidence base regarding pharmacological interventions for obesity, addressing both their overall efficacy in weight management and their specific therapeutic impact in the context of the distinct obesity-associated comorbidities for which clinical benefit has been demonstrated.</div><div>The document endorses the implementation of the Edmonton Obesity Staging System (EOSS) as a pivotal framework for the clinical stratification of risk in individuals with obesity, facilitating a more nuanced and personalized therapeutic approach that prioritizes the functional, metabolic, and prognostic dimensions of the disease. In this context, the document proposes a paradigm shift in the therapeutic objectives for obesity management, moving beyond a sole reliance on anthropometric metrics, such as body mass index (BMI) or absolute weight reduction. Instead, it emphasizes a pathophysiological and patient-centered approach focused on the prevention of obesity-related complications, the early detection and management of its comorbid conditions, and the sustained improvement of both quality-adjusted and overall life expectancy, while simultaneously promoting the elimination of stigma and discrimination.</div></div>","PeriodicalId":21223,"journal":{"name":"Revista clinica espanola","volume":"225 8","pages":"Article 502352"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189783","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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