Medicina clinica (English ed.)最新文献

Invasive aspergillosis (IA) is a severe fungal infection caused by Aspergillus species, particularly Aspergillus fumigatus, although new species, sometimes resistant to antifungals are becoming more common. IA predominantly affects immunocompromised patients, such as those with haematological malignancies, solid organ transplant recipients, and critically ill patients. However, new at-risk populations have emerged in recent years, such as IA associated with severe viral infections. Advanced diagnostic methods are crucial, especially considering the rising concern of antifungal resistance. Early detection is critical for successful treatment, typically involving antifungal medications like voriconazole or amphotericin B, but new antifungals are arriving to complete the therapeutic strategies. Despite advancements, mortality rates remain high, underscoring the importance of timely interventions and ongoing research. Healthcare providers should maintain a high index of suspicion, especially in immunocompromised patients and other new risk factors that are arising, to promptly diagnose and manage invasive aspergillosis.

Introduction

Peripheral arterial disease is a marker of vascular damage that is diagnosed by measuring the ankle-brachial index. The aim of this study was to determine the validity and agreement of the MESI ABPI-MD and Microlife WatchBP Office-ABI oscillometric devices with respect to the gold standard arterial Doppler.

Materials and methods

Observational, cross-sectional, descriptive study of inpatients who underwent ABI measurement with the three devices. Values are considered normal between 1–1.4, indeterminate between 0.91–0.99 and pathological ≤0.9 and >1.4.

Results

A total of 187 patients (54.4% male) with a mean age of 66 years were included. The Doppler results were inferior to those of the oscillometric devices (median [IQR] 1.1 [0.2] vs. 1.2 [0.2], p < 0.05), with no significant differences between the automated devices (p = 0.29 for the right lower limb and p = 0.342 for the left lower limb). Both devices had high specificity (96.5–99.2%) and low sensitivity (29.5–45.4%). The evaluation of the results was good-moderate for MESI and moderate for Microlife. The agreement between the two was acceptable-moderate.

Conclusion

Automated oscillometric devices could be useful in asymptomatic patients as an alternative to arterial Doppler.

Objectives

This study aims to assess the current state of childhood overweight and obesity in Spain, and its relationship with socioeconomic status and health-related behaviors.

Methods

Population-based cross-sectional observational study, based on the 2017 National Health Survey in minors in Spain. This study included all children surveyed who were aged 1–14 years. Childhood obesity was estimated from the z-score of the body mass index.

Results

The study included 4882 children aged 1–14 years (mean 7.5). The prevalence of obesity was 18.6% (95% confidence interval [CI] 18.5–18.7), while 13.5% (95% CI 13.4–13.6) were overweight. These figures represent over a million children in Spain who are obese and nearly 750,000 who are overweight. A north–south geographic gradient was apparent, with higher prevalence of unhealthy body weight in southern Spain. Factors associated with childhood obesity were low socioeconomic status, poor diet and sedentarism, among others.

Conclusions

Childhood overweight in Spain is strongly associated with socioeconomic status and other factors such as diet and sedentarism. Multidisciplinary public health interventions are needed to reduce this serious health problem in children.