Medicina Clinica Practica最新文献

英文中文

Vesícula en porcelana: Cuando la vesícula biliar se convierte en una obra de arte patológica 瓷囊：胆囊成为病理艺术品

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-02-07 DOI: 10.1016/j.mcpsp.2024.100484

Alejandro del Caño Garrido , María Gómez Caballero

引用次数: 0

Eficacia y seguridad del tratamiento con la combinación fija a dosis bajas de cinarizina 20 mg y dimenhidrinato 40 mg en el vértigo de origen diverso en la práctica clínica en España. Resultados del estudio VERTINEL 在西班牙的临床实践中，不同来源的眩晕患者使用固定剂量的低剂量菊酯20mg和维地那酸40mg联合治疗的有效性和安全性。VERTINEL研究结果

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-02-05 DOI: 10.1016/j.mcpsp.2024.100489

Rafael Hijano-Esqué , Jesús Ignacio González Orodea , Javier Imaz Fandos , Natividad Pacheco Rubio , Gonzalo Daniel Alzuarte , Manuel Ruiz Cuetos , Amelia Rodríguez Mariblanca , Eva García Aguilar , En representación del grupo de investigación VERTINEL

Introduction

Vertigo is a condition affecting millions of people and significantly impacting their quality of life. Traditionally, vertigo management includes the use of antiemetics, vestibular sedatives, and betahistine, though these treatments have limitations and side effects. The aim of this study was to evaluate the efficacy and safety of a low-dose fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg in routine clinical practice.

Methods

An observational, multicenter study was conducted, comprising a primary retrospective cohort and a cross-sectional cohort as a control group, across 28 Primary Care centers and Otolaryngology specialist clinics nationwide in Spain. Adult patients with vertigo of various origins treated with the fixed low-dose combination of cinnarizine 20 mg and dimenhydrinate 40 mg were included, and compared with a control group without treatment. Efficacy was assessed using the Vertigo and Dizziness Symptom Questionnaire (VDI-SS), and quality of life was evaluated through the VDI-HRQoL. Additional outcomes such as speed of action, tolerability, and treatment satisfaction were also measured.

Results

A total of 181 patients were analyzed, showing significant improvement in vertigo symptoms and quality of life in those treated with the drug combination compared to both pre-treatment and control groups. The pre-post treatment difference was 28.41 points on the VDI-SS questionnaire, p < 0.0001. Additionally, the difference between the post-treatment group and the control group was 24.07 points in favor of the treated group; 20.26 (95% CI 18.8–21.7) vs. 44.33 (95% CI 42.6–46), p < 0.0001. In quality-of-life assessments, the mean difference was 14.56 points between pretreatment and post-treatment, p < 0.0001, with a similar result observed in comparison with the control group, p < 0.0001. Improvement was reported by 78.3% (65) of treated subjects within the first week, with 55.4% reporting benefits in the first few days of treatment, and reaching 89.1% by the second week. Tolerability was rated as very good or good in most cases, with no serious adverse events reported, and no extrapyramidal effects, drowsiness, or inhibition of vestibular compensation mechanisms were noted. Overall treatment satisfaction was high.

Discussion

The results confirm the efficacy and safety of the low-dose fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg in vertigo treatment. This therapeutic approach not only addresses specific vertigo symptoms but also improves patients' quality of life. Its rapid onset of action, along with high tolerability and satisfaction, supports the viability of this intervention in routine clinical practice, offering an effective and safe alternative for managing vertigo.

眩晕是一种影响数百万人的疾病，严重影响了他们的生活质量。传统上，眩晕治疗包括使用止吐药、前庭镇静剂和倍他司汀，尽管这些治疗有局限性和副作用。本研究的目的是评价低剂量固定联合肉桂利嗪20mg和苯海明40mg在常规临床实践中的疗效和安全性。方法进行了一项多中心观察性研究，包括主要回顾性队列和横断面队列作为对照组，涉及西班牙全国28个初级保健中心和耳鼻喉科 专科诊所。本研究纳入了采用肉桂利嗪20 mg和苯海明40 mg固定低剂量联合治疗的各种来源的眩晕的成年患者，并与未治疗的对照组进行比较。采用眩晕和头晕症状问卷（VDI-SS）评估疗效，通过VDI-HRQoL评估生活质量。其他结果如作用速度、耐受性和治疗满意度也被测量。结果共分析181例患者，与治疗前和对照组相比，联合用药组眩晕症状和生活质量均有显著改善。治疗前后VDI-SS量表差异为28.41分，p <；0.0001. 此外，治疗后组与对照组的差异为24.07分；20.26 (95% CI 18.8-21.7) vs. 44.33 (95% CI 42.6-46), p <；0.0001. 在生活质量评估中，治疗前后的平均差异为14.56分，p <；0.0001，与对照组比较的结果相似，p <；0.0001. 78.3%（65）的治疗对象在第一周内报告了改善，55.4%的人在治疗的前几天报告了改善，到第二周达到89.1%。在大多数情况下，耐受性被评为非常好或良好，没有严重的不良事件报告，没有锥体外系效应，嗜睡或前庭代偿机制的抑制。整体治疗满意度高。探讨小剂量固定联合肉桂利嗪20 mg与苯海明40 mg治疗眩晕的有效性和安全性。这种治疗方法不仅解决了特定的眩晕症状，而且提高了患者的生活质量。它的快速起效，以及高耐受性和满意度，支持了这种干预在常规临床实践中的可行性，为治疗眩晕提供了一种有效和安全的选择。

{"title":"Eficacia y seguridad del tratamiento con la combinación fija a dosis bajas de cinarizina 20 mg y dimenhidrinato 40 mg en el vértigo de origen diverso en la práctica clínica en España. Resultados del estudio VERTINEL","authors":"Rafael Hijano-Esqué , Jesús Ignacio González Orodea , Javier Imaz Fandos , Natividad Pacheco Rubio , Gonzalo Daniel Alzuarte , Manuel Ruiz Cuetos , Amelia Rodríguez Mariblanca , Eva García Aguilar , En representación del grupo de investigación VERTINEL","doi":"10.1016/j.mcpsp.2024.100489","DOIUrl":"10.1016/j.mcpsp.2024.100489","url":null,"abstract":"<div><h3>Introduction</h3><div>Vertigo is a condition affecting millions of people and significantly impacting their quality of life. Traditionally, vertigo management includes the use of antiemetics, vestibular sedatives, and betahistine, though these treatments have limitations and side effects. The aim of this study was to evaluate the efficacy and safety of a low-dose fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg in routine clinical practice.</div></div><div><h3>Methods</h3><div>An observational, multicenter study was conducted, comprising a primary retrospective cohort and a cross-sectional cohort as a control group, across 28 Primary Care centers and Otolaryngology specialist clinics nationwide in Spain. Adult patients with vertigo of various origins treated with the fixed low-dose combination of cinnarizine 20 mg and dimenhydrinate 40 mg were included, and compared with a control group without treatment. Efficacy was assessed using the Vertigo and Dizziness Symptom Questionnaire (VDI-SS), and quality of life was evaluated through the VDI-HRQoL. Additional outcomes such as speed of action, tolerability, and treatment satisfaction were also measured.</div></div><div><h3>Results</h3><div>A total of 181 patients were analyzed, showing significant improvement in vertigo symptoms and quality of life in those treated with the drug combination compared to both pre-treatment and control groups. The pre-post treatment difference was 28.41 points on the VDI-SS questionnaire, <em>p</em> < 0.0001. Additionally, the difference between the post-treatment group and the control group was 24.07 points in favor of the treated group; 20.26 (95% CI 18.8–21.7) vs. 44.33 (95% CI 42.6–46), <em>p</em> < 0.0001. In quality-of-life assessments, the mean difference was 14.56 points between pretreatment and post-treatment, <em>p</em> < 0.0001, with a similar result observed in comparison with the control group, <em>p</em> < 0.0001. Improvement was reported by 78.3% (65) of treated subjects within the first week, with 55.4% reporting benefits in the first few days of treatment, and reaching 89.1% by the second week. Tolerability was rated as very good or good in most cases, with no serious adverse events reported, and no extrapyramidal effects, drowsiness, or inhibition of vestibular compensation mechanisms were noted. Overall treatment satisfaction was high.</div></div><div><h3>Discussion</h3><div>The results confirm the efficacy and safety of the low-dose fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg in vertigo treatment. This therapeutic approach not only addresses specific vertigo symptoms but also improves patients' quality of life. Its rapid onset of action, along with high tolerability and satisfaction, supports the viability of this intervention in routine clinical practice, offering an effective and safe alternative for managing vertigo.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 2","pages":"Article 100489"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143327680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dermatomiositis clínicamente amiopática: primer signo de cáncer gástrico 临床肌肌炎：胃癌的第一个征兆

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-31 DOI: 10.1016/j.mcpsp.2024.100490

Nayi Xiomara Duque Alvarez , María del Mar Blanes Martínez , Jose M. Ramia Ángel , Silvia Carbonell-Morote

引用次数: 0

Severe mitral stenosis masquerading as malar rash 严重的二尖瓣狭窄伪装成颧疹

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-29 DOI: 10.1016/j.mcpsp.2025.100491

Ana Rita Teixeira, Luís Almeida Morais, Rui Cruz Ferreira

引用次数: 0

Infiltrado linfocítico de Jessner asociado a lupus eritematoso sistémico con lesiones cutáneas atípicas Jessner淋巴细胞浸润与系统性红斑狼疮和非典型皮肤病变相关

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-23 DOI: 10.1016/j.mcpsp.2024.100488

Hilayali Aguilar-Molina , Daniel Manzur-Sandoval

引用次数: 0

Neumonía por COVID-19 en urgencias: ecografía pulmonar. Implicaciones pronósticas 新型冠状病毒肺炎急诊：肺超声检查。pronósticas含义

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-23 DOI: 10.1016/j.mcpsp.2024.100486

Mónica Contreras-Moreira , Elpidio Calvo Manuel , Joaquín Antonio Álvarez Gregori

Introduction and objectives

In COVID-19 patients, the clinical picture allows estimating a certain pre-test probability of lung involvement; prediction that increases when associating lung ultrasound. This provides greater sensitivity than chest radiography in the detection of infiltrates, and makes it possible to predict the result of pathological pulmonary CT. The characteristic findings of SARS-CoV-2 pneumonia have been described, and the location of the lesions has been related to the prognosis. Few experiences have been published on the prognostic capacity of lung ultrasound, which do not include hospital-obtained laboratory parameters.

Material and methods

Through a prospective, multicenter, observational study with consecutive sampling, carried out between April and July 2020, 263 adult patients who attended the emergency department of Spanish hospitals due to symptoms compatible with respiratory infection were recruited. Six fields per lung were explored, and the presence or absence of focal B lines, global B lines, parenchymal consolidation, subpleural consolidation, and pleural effusion were described. The patients underwent a postero-anterior chest X-ray on the same day.

Results

Males predominated in the study population. The main comorbidity was neoplasms, followed by chronic kidney disease and ischemic heart disease. Patients with a positive result for SARS-CoV-2 RT-PCR and who required admission were more frequent, and 8% died. The pathological chest x-ray was positive in 75% of the patients, compared to 94.59% of the ultrasound scans. The most frequent findings were focal B lines in zones R6, R3, and L3. The specificity of bilateral consolidation or unilateral patchy infiltrate stands out, and in ultrasound the specificity of global B lines, consolidations, both pulmonary and subpleural, and left pleural effusion.

Conclusions

A regression model has been developed that incorporates the findings of the lung ultrasound and predicts the probability of admission in patients presenting to the emergency department, without using other hospital laboratory tests. A tool can be developed that allows the family physician to identify patients with a high probability of being hospitalized from those who will have an outpatient follow-up, to prioritize an early therapeutic approach or referral to the emergency room.

在COVID-19患者中，临床图像可以估计一定的检测前肺部受累概率；当结合肺部超声时，预测会增加。这提供了比胸片检查浸润更大的灵敏度，并使其有可能预测病理肺CT的结果。SARS-CoV-2肺炎的特征性表现已被描述，病变的位置与预后有关。很少有关于肺超声的预后能力的经验发表，其中不包括医院获得的实验室参数。材料和方法通过一项前瞻性、多中心、连续抽样的观察性研究，于2020年4月至7月进行，招募了263名因呼吸道感染症状而在西班牙医院急诊科就诊的成年患者。每个肺探查了6个病灶，并描述了局灶性B线、全局B线、实质实变、胸膜下实变和胸膜积液的存在或不存在。患者于同日接受胸部后前方x光检查。结果研究人群以男性为主。主要合并症为肿瘤，其次为慢性肾病和缺血性心脏病。SARS-CoV-2 RT-PCR阳性且需要入院的患者更为频繁，8%的患者死亡。病理胸片的阳性率为75%，而超声扫描的阳性率为94.59%。最常见的发现是病灶B线在R6， R3和L3区。双侧实变或单侧斑片状浸润的特异性突出，在超声中，全局B线、肺和胸膜下实变和左胸膜积液的特异性突出。结论建立了一个回归模型，该模型结合了肺部超声检查结果，并在不使用其他医院实验室检查的情况下预测到急诊科就诊的患者的入院概率。可以开发一种工具，使家庭医生能够从那些将进行门诊随访的患者中识别出高住院可能性的患者，从而优先考虑早期治疗方法或转介到急诊室。

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引用次数: 0

Are hospital workers' healthy habits adequeate? Influence of social determinants on health 医院工作人员的健康习惯是否足够？社会决定因素对健康的影响

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-17 DOI: 10.1016/j.mcpsp.2024.100487

Claudia Ruiz-Huerta , Gema Vega , Carmen Ferrer , Marcelle V. Canto , María de los Ángeles Díaz , Ana M. Palmar

Introduction/objectives

With regard to people who work in hospitals: Do they have better health habits than the general population? Or, do they have worse, despite most of them have the appropriate knowledge to follow a healthy lifestyle? This is a study to explore the habits of people working in a hospital, to compare them with the general population and to identify higher risk profiles on which to prioritize preventive interventions.

Methods

Cross-sectional study on health habits with workers from a hospital in Madrid (n = 399) using a questionnaire based on the National Health Survey. Descriptive and cluster analysis to classify homogeneous individuals according to health habits and identify risk patterns. Logistic regression was used to identify the independent risk factors that determine the unhealthy profile.

Results

The health habits of workers in a hospital are similar to those of the general population. Determinants of health influenced its distribution: The higher the spending capacity, the better the health habits; the older their age, more chronic disease is seen; women suffer worse mental health.

Conclusions

The results are superimposed onto those of the general population, where they would have been expected to be healthier. There are risk profiles in which to prioritize preventive interventions to promote health.

关于在医院工作的人：他们比一般人有更好的健康习惯吗？或者，他们是否有更糟糕的情况，尽管他们中的大多数人都有适当的知识来遵循健康的生活方式？这是一项探索医院工作人员习惯的研究，将他们与一般人群进行比较，并确定高风险人群，以便优先采取预防干预措施。方法采用全国健康调查问卷对马德里某医院职工的健康习惯进行横断面研究（n = 399）。描述性和聚类分析，根据健康习惯对同类个体进行分类，并确定风险模式。采用Logistic回归来确定决定不健康状况的独立危险因素。结果某医院职工的健康习惯与一般人群基本一致。健康决定因素影响其分布：消费能力越高，健康习惯越好；年龄越大，慢性病越多；妇女的心理健康状况更差。结论：这些结果是与一般人群的结果相叠加的，他们本来应该更健康。有风险概况，其中优先考虑预防性干预措施，以促进健康。

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Medicina Clinica Practica

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Medicina Clinica Practica

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Medicina Clinica Practica

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