Medicina clinica (English ed.)最新文献

英文中文

Retina Stroke Code. A reality 视网膜卒中代码。现实

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.05.014

Susana Ruiz-Bilbao , Alejandro Bustamante

引用次数: 0

How certainty is certain enough? Challenges in the statistical methodology for forensic age assessment of living individuals 如何确定才算足够确定？活人法医年龄评估统计方法的挑战

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.07.007

Adam J. Streeter , Andreas Schmeling , André Karch

引用次数: 0

Genetic analysis of a family with hereditary hemorrhagic telangiectasia caused by a novel frameshift deletion mutation of the endoglin (ENG) gene 一个遗传性出血性毛细血管扩张症家族的遗传学分析，该家族的病因是内切酶蛋白（ENG）基因的一个新型缺失突变

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.05.016

Jiangtao Wu , Bin Liu , Zhou Zhou

引用次数: 0

Identification of patient-reported outcomes measures (PROMs) and patient-reported experiences measures (PREMs) in Gaucher disease in Spain 确定西班牙戈谢病患者报告的结果测量指标（PROM）和患者报告的体验测量指标（PREM

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.06.004

Pilar Giraldo , María Camprodón , Paloma Cerro Alcolea , Elena Gras-Colomer , Daiana Ibarretxe , Sunil Lakhwani , Elvira Mora , María Purificación Velasco Calderón , Montserrat Morales-Conejo

Background

Patient-reported outcome measures (PROMs) and patient-reported experiences measures (PREMs) are crucial for understanding the impact of GD on quality of life and patient's perceptions on care, but also to guide decision-making processes. Nevertheless, no specific PREMs in GD have been published, neither PROMs for Spanish GD patients have been developed.

Methods

Two project coordinators selected key-points to be included in a PROMs/PREMs questionnaire, and the scientific committee and a group of expert patients contributed to the initial draft. Then, 9 meetings with experts were held to discuss controversial points. After, a questionnaire with 103 items regarding symptomatology, aspects of daily life and care experience was developed. Finally, it was conducted a Delphi survey among a multidisciplinary group of experts in GD.

Results

Consensus was reached on 85 out of the 103 items. Recommendations on PROMs and PREMs regarding symptomatology, aspects of daily life and care experience were obtained. Consensus was reached on the importance of considering fatigue, concentration problems, and communication issues in GD patients using 5-step analog scales. Panelists recommended asking GD patients about the impact on social functioning and work/school performance. Finally, consensus was reached on considering care experiences, such as treatment satisfaction, treatment interruptions or transitions and healthcare professionals involved in patient's management to perceive patient's perceptions.

Conclusion

This expert consensus may help developing GD-specific PROMs/PREMs for improving GD management. Properly developed and validated PROMs/PREMs may help decision-making, establishing patient-tailored therapeutic and follow-up goals.

背景患者报告的结果测量（PROMs）和患者报告的体验测量（PREMs）对于了解 GD 对生活质量的影响和患者对护理的看法至关重要，同时也能指导决策过程。然而，目前还没有专门针对 GD 的 PREMs 出版，也没有针对西班牙 GD 患者的 PROMs。然后，与专家举行了 9 次会议，讨论有争议的问题。之后，制定了一份包含 103 个项目的调查问卷，内容涉及症状、日常生活和护理体验。结果在 103 个项目中，有 85 个项目达成了共识。就症状学、日常生活和护理体验方面的 PROM 和 PREM 提出了建议。就使用五级模拟量表考虑广东话患者疲劳、注意力不集中和沟通问题的重要性达成了共识。专家组成员建议向广东籍患者询问其对社会功能和工作/学业表现的影响。最后，专家们就考虑护理经验（如治疗满意度、治疗中断或过渡以及参与患者管理的医护人员）以感知患者的看法达成了共识。经适当开发和验证的 PROMs/PREMs 有助于决策、制定适合患者的治疗和随访目标。

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引用次数: 0

Medical-legal aspects in infectious diseases 传染病的医疗法律问题

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.06.005

Robert Güerri-Fernández , Josep Benet , César Vargas

This article reviews the medico-legal aspects associated with infectious diseases, highlighting their complexity and the challenges they pose. Infectious diseases cause not only an increase in morbidity and mortality in the healthcare setting but also involve complex legal issues. Healthcare-Associated Infections (HAIs) represent a growing risk with the increase in invasive procedures and can lead to patient complications and legal claims against healthcare professionals and institutions. The consequences of medical malpractice in this context are discussed, such as diagnostic delays, inappropriate use of treatments, and lack of adequate testing, which can have serious sequelae or even result in the patient's death.

The review focuses on highlighting the importance of prevention, considering that healthcare-associated infections can be difficult to avoid, posing complex legal challenges.

It concludes that managing infectious diseases and their legal consequences requires careful consideration of clinical practice guidelines, prevention and control strategies, and effective communication with patients. An integrated and evidence-based approach is advocated to address these challenges, emphasizing continuous education, the use of advanced diagnostic technologies, and interdisciplinary collaboration.

本文回顾了与传染病相关的医学法律问题，强调了传染病的复杂性及其带来的挑战。传染病不仅会增加医疗机构的发病率和死亡率，还会涉及复杂的法律问题。随着侵入性手术的增加，医疗相关感染（HAIs）的风险也越来越大，可能导致患者出现并发症，并引发针对医疗专业人员和医疗机构的法律索赔。综述重点强调了预防的重要性，认为医疗相关感染很难避免，会带来复杂的法律挑战。综述总结道，管理传染病及其法律后果需要仔细考虑临床实践指南、预防和控制策略以及与患者的有效沟通。报告提倡采用综合的循证方法来应对这些挑战，强调持续教育、使用先进的诊断技术和跨学科合作。

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引用次数: 0

Perineal leiomyoma: an infrecuent clinical entity 会阴部良性肌瘤：一种不常见的临床实体

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.04.030

Raquel Ruiz-Fernández , Daniel Fernández-Martínez , Iván Fernández-Vega

引用次数: 0

Listeria myelitis in immunocompetent adult patient with a favorable response to intrathecal gentamicin 免疫功能正常的成年患者患李斯特菌脊髓炎，但对鞘内庆大霉素反应良好

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.05.012

Eva González Martínez, Maite Misis del Campo, Fidel Nuñez Marín

引用次数: 0

Do we consider etanol consumption? 我们是否考虑过乙醇的消耗量？

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.04.028

Javier Velasco Montes , Silvia González Díez , Elena Rivas Cilleros

引用次数: 0

Catheter directed therapy in high-risk pulmonary embolism: Analysis of 9 cases 高危肺栓塞的导管引导治疗：9 个病例的分析

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.04.027

Sonia Pascual García , Ana Castell Herrera , Juan Julian Cuesta Pérez , Adriana Rodriguez Perojo , Araceli Abad Fernández , Maria Teresa Río Ramirez

Background

Mechanical thrombectomy is a useful technique in patients with high-risk pulmonary embolism. It is indicated as an alternative to systemic fibrinolysis when it is contraindicated or as an adjuvant therapy when it fails.

Objective

To describe clinical characteristics, evolution and survival of patients with high-risk pulmonary embolism who have undergone mechanical thrombectomy.

Method

Single-center retrospective descriptive study of consecutive patients who underwent mechanical thrombectomy. Demographic, clinical and survival variables were analyzed.

Results

9 patients were included (56% men, 44% women). All patients had pulmonary artery pressure assessed using a Swan-Ganz catheter before thrombectomy. The median pulmonary artery pressure before the procedure was 46 mmHg (51−38 mmHg). Systemic fibrinolysis was also performed in 5 cases, in 2 of them in the setting of cardiorespiratory arrest, without hemorrhagic complications. No patient died during hospitalization. Survival one month after the procedure was 100%.

Conclusions

In our series, mechanical thrombectomy is a useful technique as an alternative to systemic fibrinolysis or as an adjuvant therapy to it.

背景机械性血栓切除术是一种治疗高危肺栓塞患者的有效技术。方法对连续接受机械取栓术的患者进行单中心回顾性描述性研究，分析人口统计学、临床和生存变量。结果共纳入 9 名患者（男性占 56%，女性占 44%）。所有患者在血栓切除术前都使用斯旺-甘孜导管评估了肺动脉压力。术前肺动脉压力的中位数为 46 mmHg（51-38 mmHg）。5例患者还进行了全身纤维蛋白溶解术，其中2例在心肺功能骤停的情况下进行，未出现出血并发症。没有患者在住院期间死亡。结论在我们的系列研究中，机械血栓切除术是替代全身纤维蛋白溶解术或作为其辅助疗法的有效技术。

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引用次数: 0

Cutaneous myiasis in a pediatric patient: An ultrasound diagnostic approach 一名儿童患者的皮肤肌炎：超声诊断方法

Medicina clinica (English ed.)

Pub Date : 2024-11-15 DOI: 10.1016/j.medcle.2024.01.047

Maria Luísa Santos e Silva Caldeira Marques, Aida Menéndez Parrón, Marta Ivars Lleó

引用次数: 0

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