Medicina clinica (English ed.)最新文献

英文中文

Experience with naldemedine in opioid-induced constipation in oncologic patients with chronic pain

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.06.010

Laura Fernández Madrigal, Laura Sánchez Escudero, Francisco Javier Jiménez Ruiz

引用次数: 0

Skeletal dysplasia

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.02.023

Alejandra Romano Medina , María José Bartolomé Albistegui , Margarita del Carmen Castro Rey , Andrea Patricia Espinoza Leiva

引用次数: 0

A cross-sectional study of Phase I Clinical Trials authorized in Spain: An analysis of characteristics and times of execution based on experience

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.06.009

Francesca Filippi-Arriaga , Pol Molina , Claudia Erika Delgado-Espinoza , Rosa Antonijoan

引用次数: 0

Nutritional intervention in chronic heart failure patients: A randomized controlled clinical trial

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.07.011

Carolina Ortiz Cortés , Purificación Rey-Sánchez , Jose Javier Gómez Barrado , Ramón Bover Freire , Emilio Paredes-Galán , Julián F. Calderón-García , Alberto Esteban-Fernández , Sergio Rico-Martín

Background and objectives

Malnutrition is common in patients with heart failure (HF) and is associated with poor prognosis. We evaluated the prognostic and clinical impact of a nutritional intervention in malnourished patients with chronic HF.

Methods

A randomized controlled clinical trial was carried out in patients with chronic HF who were malnourished or at risk. Participants were randomized to receive an individualized nutritional intervention or conventional management. The primary endpoint was a composite of all-cause mortality or time-to-first HF hospitalizations at the 12-month follow-up. The secondary endpoints were changes in nutritional status and functional capacity.

Results

We screened 225 patients, 86 of whom had some degree of malnutrition and were randomized. At 12 months, the primary outcome occurred in 10 patients (23.8%) in the intervention group and in 22 patients (50.0%) in the control group (HR = 0.39; 95% CI, 0.19–0.83). This effect was mainly related to a lower risk of hospitalization for HF in the intervention group: 8 patients (19.0%) versus 18 patients (40.9%) in the control group (HR = 0.39; 95% CI = 0.17–0.89). We observed an improvement in nutritional status and functional capacity in the intervention group versus the control group.

Conclusions

In patients with chronic HF and some degree of malnutrition, individualized nutritional intervention may reduce the risk of all-cause mortality or HF hospitalisations and improve nutritional status and functional capacity. These results underline the need for further randomized controlled trials with this approach to confirm the potential prognostic benefit.

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引用次数: 0

Drug-induced pancreatitis: Study of 38 patients

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.07.010

Adrià Domingo-Carnice , Dolores Rodríguez , Pilar Ordoñez , Roser Llop , Silvia Salord , Pilar Hereu

Introduction

Acute pancreatitis (AP) is an inflammatory disease with multiple etiologies, and the emergence of complications. Between 0.1%–5% of cases are attributed to drugs. The absence of specific characteristics complicates the diagnosis and treatment of drug-induced AP. Reviewing patients admitted with the diagnosis of drug-induced AP can provide information and improve its management.

Patients and methods

This is a descriptive, observational, and retrospective study. All patients admitted to the Hospital Universitari de Bellvitge (HUB) between June 2007 and March 2023 with suspected drug-induced AP were included. The data were obtained from the HUB pharmacovigilance program database.

Results

Thirty-eight patients with suspected drug-induced AP were identified, representing 0.62% of all adverse drug reactions (ADRs) (n = 6085). Of these, 65.8% (n = 25) had a single suspected drug. The median latency period for the onset of ADRs was 160.5 days (IQR 18–582 days), and the median hospital stay was 5 days (IQR 3–7 days). Fifty-nine suspected drugs were identified, involving 26 active principles. Azathioprine and atorvastatin were the most frequent, with 9 cases each (15.2%), followed by enalapril with 8 cases (13.6%). Drug etiology was assessed in 23 cases (60.5%), and the suspected drug was discontinued in all cases. There was 1 fatal case documented (2.63%).

Conclusion

This study can contribute to better understanding of drug-induced pancreatitis episodes. We propose the creation of a diagnostic algorithm that includes the assessment of the drug as a possible cause.

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引用次数: 0

Imaging tests in the diagnosis of dysimmune neuropathies: A study of three cases

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.10.004

María García García, Belén Salvador Saenz, Ana Pinel González

引用次数: 0

Differential features of Infective endocarditis caused by oral streptococci in the Reina Sofia University Hospital, Córdoba (Spain): 1987–2023 period

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.09.002

Paula Anguita Gámez , Juan C. Castillo Domínguez , José López Aguilera , Rafael González Manzanares , Manuel Pan Álvarez-Ossorio , Manuel Anguita Sánchez

Introduction and objectives

Infective endocarditis (IE) caused by oral streptococci is considered to be a ‘more benign’ IE than those caused by other microorganisms. Our aim is to analyse the changes in its incidence and its differential characteristics in our setting.

Methods

Observational, single-centre, prospective cohort study including all cases of IE diagnosed in our centre between 1987 and 2023. IE caused by oral streptococci were identified and their characteristicsand mortality were compared with those of other IE.

Results

Of 569 cases of IE, 104 (18.5%) were oral streptococcal IE, decreasing from 29.5% in 1987−1999 to 12.2% in 2000−2023 (p < 0.001). The incidence of serious complications was lower in oral IE (65.3 vs. 78.9%; p = 0.003), as was in-hospital mortality (14.4 vs. 29.9%; p = 0.001).

Conclusions

Oral streptococcal IE account for almost 20% of all cases of IE in our setting. They have a better prognostic clinical profile, with a lower incidence of severe complications, and their mortality is significantly lower than that of other IE. Their incidence seems to be decreasing in recent years.

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引用次数: 0

Squamous cell carcinoma in solid organ transplant recipients: Review of the literature

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.05.024

Inés Oteiza Rius, Ana Morelló Vicente, Leyre Aguado Gil

Solid organ transplant recipients (SOTRs) exhibit an elevated incidence and aggressiveness of squamous cell carcinomas (SCCs) due to their immunosuppression. These tumors are associated with a heightened risk of metastasis and increased mortality. Therefore, an appropriate management of these patients is essential to improve their prognosis. Given the scarcity of studies on non-melanoma skin cancers (NMSCs) in SOTRs, this article aims to summarize and analyze the evidence gathered to date regarding therapeutic approaches, personalized monitoring, and prevention strategies for SCCs in these patients. Additionally, recent advancements in understanding SCCs within this patient group are also documented.

引用次数: 0

Peritonitis secondary to liver abscesses in a peritoneal dialysis patient

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.06.011

Lide López Arsuaga, Maria Crucio López, Beatriz Millán Díaz

引用次数: 0

Effectiveness of brain magnetic resonance imaging in the early diagnosis and characterization of dementias: A systematic review

Medicina clinica (English ed.)

Pub Date : 2024-12-13 DOI: 10.1016/j.medcle.2024.05.025

Ana María Ruiz Tornero , Esther E. García Carpintero , Begoña Rodríguez Ortiz de Salazar

Introduction

Magnetic resonance imaging (MRI) is a frequently used test in the diagnosis of dementia. The objective was to evaluate its effectiveness for the early diagnosis of dementia in patients with mild cognitive impairment (MCI).

Material and methods

Original studies were selected from systematic reviews between 2011 and 2021, according to PRISMA 2020 criteria. QUADAS-2 and GRADE tools were used, and a meta-analysis was performed.

Results

Final selection of 23 articles. Patient selection and index test had a high probability of bias. The certainty of the evidence was very low. In the hippocampus, sensitivity was 0.62 (95%CI 0.48–0.79) and specificity 0.70 (95%CI 0.55–0.80). In the temporal lobe, sensitivity was 0.65 (range 0.45) and specificity 0.69 (range 0.32).

Conclusions

There is insufficient evidence to recommend routine brain MRI for the early diagnosis of dementia in patients with MCI.

引用次数: 0

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