Pub Date : 2024-09-24DOI: 10.1016/j.medcle.2024.01.030
{"title":"Ifosfamide-induced acute kidney injury and confusional syndrome in a patient with diffuse large B-cell lymphoma","authors":"","doi":"10.1016/j.medcle.2024.01.030","DOIUrl":"10.1016/j.medcle.2024.01.030","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1016/j.medcle.2024.03.030
{"title":"Familial aortic aneurysm: A case presentation","authors":"","doi":"10.1016/j.medcle.2024.03.030","DOIUrl":"10.1016/j.medcle.2024.03.030","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1016/j.medcle.2024.04.015
Background
Acquired critical illness weakness (AWCIP) is the most frequent neuromuscular disease in intensive care medicine departments. Its importance is given by the prolongation of hospital stay and the delayed recovery it causes to patients after hospitalization.
The main objective of this study was to investigate the association between neuromuscular blocking agents and the development of acquired weakness in critically ill patients.
Material and methods
We conducted a prospective study of 103 critically ill patients who were periodically monitored with electromyography.
Results
The development of AWCIP was observed in 63 patients. The group of patients who developed AWCIP had a significantly higher utilization of neuromuscular blocking agents than the group who did not develop AWCIP [79.4% vs 50%, OR:3.85 (1.63–9.39), p < 0.02]; likewise, this group of patients had a longer ICU stay [32 days vs 14 days, OR: 1.11 (1.06–1.17), p < 0.001] and a longer mechanical ventilation time [24 days vs 9 days, OR:1.2 (1.11–1.32), p < 0.001].
Conclusion
Neuromuscular blocking agents are a factor associated with the occurrence of AWCIP.
背景获得性危重病无力（AWCIP）是重症医学科最常见的神经肌肉疾病。本研究的主要目的是调查神经肌肉阻滞剂与危重病人获得性肌无力的发生之间的关系。材料和方法我们对 103 名定期接受肌电图监测的危重病人进行了前瞻性研究。发生 AWCIP 的一组患者使用神经肌肉阻滞剂的比例明显高于未发生 AWCIP 的一组患者[79.4% vs 50%，OR:3.85 (1.63-9.39)，p < 0.02]；同样，这组患者在重症监护室的住院时间也更长[32 天 vs 14 天，OR: 1.11 (1.06-1.17)，p <0.001]，机械通气时间更长[24 天 vs 9 天，OR:1.2 (1.11-1.32)，p <0.001]。
{"title":"Role of neuromuscular blocking agents in the development of polyneuropathy and myopathy in critically ill patients","authors":"","doi":"10.1016/j.medcle.2024.04.015","DOIUrl":"10.1016/j.medcle.2024.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Acquired critical illness weakness (AWCIP) is the most frequent neuromuscular disease in intensive care medicine departments. Its importance is given by the prolongation of hospital stay and the delayed recovery it causes to patients after hospitalization.</div><div>The main objective of this study was to investigate the association between neuromuscular blocking agents and the development of acquired weakness in critically ill patients.</div></div><div><h3>Material and methods</h3><div>We conducted a prospective study of 103 critically ill patients who were periodically monitored with electromyography.</div></div><div><h3>Results</h3><div>The development of AWCIP was observed in 63 patients. The group of patients who developed AWCIP had a significantly higher utilization of neuromuscular blocking agents than the group who did not develop AWCIP [79.4% vs 50%, OR:3.85 (1.63–9.39), p < 0.02]; likewise, this group of patients had a longer ICU stay [32 days vs 14 days, OR: 1.11 (1.06–1.17), p < 0.001] and a longer mechanical ventilation time [24 days vs 9 days, OR:1.2 (1.11–1.32), p < 0.001].</div></div><div><h3>Conclusion</h3><div>Neuromuscular blocking agents are a factor associated with the occurrence of AWCIP.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1016/j.medcle.2024.03.026
Background and objectives
Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of pulmonary embolism and a major cause of chronic pulmonary hypertension leading to right heart failure and death. While pulmonary endarterectomy is the treatment of choice, some patients might benefit from medical therapy or balloon pulmonary angioplasty. Sex differences in outcomes of these therapies are not well characterized.
Material and methods
We conducted a systematic review and meta-analysis to investigate sex differences in outcomes of various therapies for CTEPH. We searched MEDLINE, PubMed, Embase, CINAHL and the Cochrane Library databases between January 1, 2010 and April 30, 2021, published in English. We pooled incidence estimates using random-effects meta-analyses. We evaluated heterogeneity using the I2 statistic. We assessed publication bias using Begg's and Egger's tests. This study is registered in PROSPERO, CRD42021268504.
Results
A total of 19 studies met the eligibility criteria, but only 3 trials provided separate outcomes for women and men. Two studies evaluated the efficacy of BPA, and one study evaluated the efficacy of riociguat (129 patients). Overall, 57.3% of patients were women and 62.6% were in functional class III. Mean time of follow-up was 55.5 (SD 26.1) weeks. Women showed a significantly better response in cardiac index (mean difference [MD], 0.10 L/min/m2; 95% confidence interval [CI], 0.04–0.16; I2 = 0%; P = 0.001). Alternatively, the reduction of pulmonary vascular resistances was significantly higher for men than for women (MD, 161.17 dyn s cm−5; 95% CI, 67.99–254.35; I2 = 0%; P = 0.0007).
Conclusions
Women and men might show different hemodynamic responses to riociguat or BPA for CTEPH.
{"title":"Chronic thromboembolic pulmonary hypertension treatment and sex: Systematic review and meta-analysis","authors":"","doi":"10.1016/j.medcle.2024.03.026","DOIUrl":"10.1016/j.medcle.2024.03.026","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of pulmonary embolism and a major cause of chronic pulmonary hypertension leading to right heart failure and death. While pulmonary endarterectomy is the treatment of choice, some patients might benefit from medical therapy or balloon pulmonary angioplasty. Sex differences in outcomes of these therapies are not well characterized.</div></div><div><h3>Material and methods</h3><div>We conducted a systematic review and meta-analysis to investigate sex differences in outcomes of various therapies for CTEPH. We searched MEDLINE, PubMed, Embase, CINAHL and the Cochrane Library databases between January 1, 2010 and April 30, 2021, published in English. We pooled incidence estimates using random-effects meta-analyses. We evaluated heterogeneity using the <em>I</em><sup>2</sup> statistic. We assessed publication bias using Begg's and Egger's tests. This study is registered in PROSPERO, CRD42021268504.</div></div><div><h3>Results</h3><div>A total of 19 studies met the eligibility criteria, but only 3 trials provided separate outcomes for women and men. Two studies evaluated the efficacy of BPA, and one study evaluated the efficacy of riociguat (129 patients). Overall, 57.3% of patients were women and 62.6% were in functional class III. Mean time of follow-up was 55.5 (SD 26.1) weeks. Women showed a significantly better response in cardiac index (mean difference [MD], 0.10<!--> <!-->L/min/m<sup>2</sup>; 95% confidence interval [CI], 0.04–0.16; <em>I</em><sup>2</sup> <!-->=<!--> <!-->0%; <em>P</em> <!-->=<!--> <!-->0.001). Alternatively, the reduction of pulmonary vascular resistances was significantly higher for men than for women (MD, 161.17<!--> <!-->dyn<!--> <!-->s<!--> <!-->cm<sup>−5</sup>; 95% CI, 67.99–254.35; <em>I</em><sup>2</sup> <!-->=<!--> <!-->0%; <em>P</em> <!-->=<!--> <!-->0.0007).</div></div><div><h3>Conclusions</h3><div>Women and men might show different hemodynamic responses to riociguat or BPA for CTEPH.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1016/j.medcle.2024.03.028
{"title":"Membranous nephropathy and Crohn’s disease: Is it a cause and effect or just a coincidence?","authors":"","doi":"10.1016/j.medcle.2024.03.028","DOIUrl":"10.1016/j.medcle.2024.03.028","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1016/j.medcle.2024.03.029
{"title":"Mepolizumab as induction therapy in severe eosinophilic granulomatosis with polyangiitis","authors":"","doi":"10.1016/j.medcle.2024.03.029","DOIUrl":"10.1016/j.medcle.2024.03.029","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-14DOI: 10.1016/j.medcle.2024.03.022
{"title":"Refractorily to diuretics in volume overload: Report of a case treated with metolazone","authors":"","doi":"10.1016/j.medcle.2024.03.022","DOIUrl":"10.1016/j.medcle.2024.03.022","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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