Pub Date : 2025-10-01DOI: 10.1016/j.medcle.2025.107066
Iago Pinal-Fernández , José César Milisenda , Albert Selva-O’Callaghan
Eosinophilic fasciitis is a rare scleroderma-like syndrome of unknown cause. It is characterised by painful induration and progressive thickening of the muscular fascia and subcutaneous tissue of the limbs and trunk. The most common laboratory findings include peripheral eosinophilia, hypergammaglobulinemia, and an elevated erythrocyte sedimentation rate. The diagnosis is confirmed through a full-thickness wedge biopsy of the affected skin, revealing inflammation and thickening of the deep fascia.
The differential diagnosis includes scleroderma, morphea, myofasciitis in graft-versus-host disease, and epidemic fasciitis syndromes caused by toxins, such as eosinophilia-myalgia syndrome and toxic oil syndrome. Although the diagnosis is based on clinical, laboratory, and histological findings, no universal diagnostic criteria exist. Glucocorticoids are the standard treatment, although some patients may improve spontaneously.
{"title":"Eosinophilic fasciitis","authors":"Iago Pinal-Fernández , José César Milisenda , Albert Selva-O’Callaghan","doi":"10.1016/j.medcle.2025.107066","DOIUrl":"10.1016/j.medcle.2025.107066","url":null,"abstract":"<div><div>Eosinophilic fasciitis is a rare scleroderma-like syndrome of unknown cause. It is characterised by painful induration and progressive thickening of the muscular fascia and subcutaneous tissue of the limbs and trunk. The most common laboratory findings include peripheral eosinophilia, hypergammaglobulinemia, and an elevated erythrocyte sedimentation rate. The diagnosis is confirmed through a full-thickness wedge biopsy of the affected skin, revealing inflammation and thickening of the deep fascia.</div><div>The differential diagnosis includes scleroderma, morphea, myofasciitis in graft-versus-host disease, and epidemic fasciitis syndromes caused by toxins, such as eosinophilia-myalgia syndrome and toxic oil syndrome. Although the diagnosis is based on clinical, laboratory, and histological findings, no universal diagnostic criteria exist. Glucocorticoids are the standard treatment, although some patients may improve spontaneously.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 4","pages":"Article 107066"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290203","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 : 2025-10-01DOI: 10.1016/j.medcle.2025.107061
Zhibo Zhou , Shan Xiao , Xiaoyuan Guo , Yiling He , Shi Chen , Hongbo Yang , Hui Pan , Huijuan Zhu
Background and objective
Turner syndrome (TS), primarily characterized by premature ovarian insufficiency, is a disease resulting from a complete or partial absence of the second X chromosome. This study aims to describe the prevalence of metabolic comorbidities in TS patients of different ages and karyotypes.
Methods
The medical history, diagnosis, physical examination, laboratory examination and imaging examination data of 145 TS patients were obtained from the medical files.
Results
(1) In total, 4.1% of the TS patients in this cohort were diagnosed with hypertension, and elderly patients had higher blood pressure. (2) 6.9% of patients were diagnosed with diabetes, and monosomic TS had a lower TyG index. (3) The prevalence of dyslipidemia and fatty liver was 20.0% and 16.7% respectively. TS patients treated with recombinant human growth hormone (rhGH) had significantly higher LDL-C and Apo-A1 levels. (4) The prevalence of hyperuricemia was 27.6%, and higher uric acid levels were observed in young patients and those receiving rhGH treatment. A total of 17.2% of patients were diagnosed with liver dysfunction. (5) The prevalence of low bone mass, which was higher in elderly patients and those without rhGH treatment, was 53.8% in TS patients older than 19 years.
Conclusions
TS patients have a higher prevalence of metabolic comorbidities, including dyslipidemia, fatty liver, hyperuricemia, liver dysfunction and low bone mass. RhGH treatment in childhood had some positive effects on glucose, lipid and bone metabolism in young adulthood. Therefore, additional attention should be given to metabolic comorbidities in TS patients at high risk.
{"title":"Metabolic profiles of Turner syndrome: A real-world cohort study","authors":"Zhibo Zhou , Shan Xiao , Xiaoyuan Guo , Yiling He , Shi Chen , Hongbo Yang , Hui Pan , Huijuan Zhu","doi":"10.1016/j.medcle.2025.107061","DOIUrl":"10.1016/j.medcle.2025.107061","url":null,"abstract":"<div><h3>Background and objective</h3><div>Turner syndrome (TS), primarily characterized by premature ovarian insufficiency, is a disease resulting from a complete or partial absence of the second X chromosome. This study aims to describe the prevalence of metabolic comorbidities in TS patients of different ages and karyotypes.</div></div><div><h3>Methods</h3><div>The medical history, diagnosis, physical examination, laboratory examination and imaging examination data of 145 TS patients were obtained from the medical files.</div></div><div><h3>Results</h3><div>(1) In total, 4.1% of the TS patients in this cohort were diagnosed with hypertension, and elderly patients had higher blood pressure. (2) 6.9% of patients were diagnosed with diabetes, and monosomic TS had a lower TyG index. (3) The prevalence of dyslipidemia and fatty liver was 20.0% and 16.7% respectively. TS patients treated with recombinant human growth hormone (rhGH) had significantly higher LDL-C and Apo-A1 levels. (4) The prevalence of hyperuricemia was 27.6%, and higher uric acid levels were observed in young patients and those receiving rhGH treatment. A total of 17.2% of patients were diagnosed with liver dysfunction. (5) The prevalence of low bone mass, which was higher in elderly patients and those without rhGH treatment, was 53.8% in TS patients older than 19 years.</div></div><div><h3>Conclusions</h3><div>TS patients have a higher prevalence of metabolic comorbidities, including dyslipidemia, fatty liver, hyperuricemia, liver dysfunction and low bone mass. RhGH treatment in childhood had some positive effects on glucose, lipid and bone metabolism in young adulthood. Therefore, additional attention should be given to metabolic comorbidities in TS patients at high risk.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 4","pages":"Article 107061"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290194","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}
Acute pancreatitis can affect elderly people. Conflicting results have been published regarding the role of age in the course of this life-threatening disease.
Aim
To assess the clinical outcomes of acute pancreatitis in geriatric population compared to younger patients.
Patients and methods
retrospective observational study which includes patients admitted for acute pancreatitis to our Unit between 2014 and 2022. Two groups were created and compared, elderly patients (≥65 years) and young patients (<65 years). Clinical, demographic, analytical and radiological data were obtained from both cohorts. Primary endpoint was comparison of severity among both groups. Secondary endpoints included organ failure, local and systemic complications, length of hospital stay, intensive care unit admission, procedural interventions and mortality. Univariate and logistic regression were performed. A propensity score analysis was also used to minimize selection bias.
Results
We analysed 832 patients (546 ≥65 years and 286 patients <65 years). A higher mortality rate (4.95% vs. 1.05%, p = 0.004), organ failure (12.82% vs. 6.29%, p = 0.004) and systemic complications (21.25% vs. 14.34%, p = 0.016) were observed in the elderly group on univariate analysis; however, multivariate logistic regression analysis and propensity score matched analysis failed to detect any differences among both groups.
Conclusions
In our series patients ≥65 years-old did not suffered from more severe episodes of acute pancreatitis. In our study, age was not associated with worse clinical outcomes.
{"title":"The severity and outcomes in acute pancreatitis do not differ between the elderly and non-elderly patients: Experience in a clinical tertiary center","authors":"María-Lourdes Ruiz-Rebollo , María-Fe Muñoz-Moreno","doi":"10.1016/j.medcle.2025.107112","DOIUrl":"10.1016/j.medcle.2025.107112","url":null,"abstract":"<div><h3>Background</h3><div>Acute pancreatitis can affect elderly people. Conflicting results have been published regarding the role of age in the course of this life-threatening disease.</div></div><div><h3>Aim</h3><div>To assess the clinical outcomes of acute pancreatitis in geriatric population compared to younger patients.</div></div><div><h3>Patients and methods</h3><div>retrospective observational study which includes patients admitted for acute pancreatitis to our Unit between 2014 and 2022. Two groups were created and compared, elderly patients (≥65 years) and young patients (<65 years). Clinical, demographic, analytical and radiological data were obtained from both cohorts. Primary endpoint was comparison of severity among both groups. Secondary endpoints included organ failure, local and systemic complications, length of hospital stay, intensive care unit admission, procedural interventions and mortality. Univariate and logistic regression were performed. A propensity score analysis was also used to minimize selection bias.</div></div><div><h3>Results</h3><div>We analysed 832 patients (546 ≥65 years and 286 patients <65 years). A higher mortality rate (4.95% vs. 1.05%, <em>p</em> <!-->=<!--> <!-->0.004), organ failure (12.82% vs. 6.29%, <em>p</em> <!-->=<!--> <!-->0.004) and systemic complications (21.25% vs. 14.34%, <em>p</em> <!-->=<!--> <!-->0.016) were observed in the elderly group on univariate analysis; however, multivariate logistic regression analysis and propensity score matched analysis failed to detect any differences among both groups.</div></div><div><h3>Conclusions</h3><div>In our series patients ≥65 years-old did not suffered from more severe episodes of acute pancreatitis. In our study, age was not associated with worse clinical outcomes.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 4","pages":"Article 107112"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290197","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 : 2025-10-01DOI: 10.1016/j.medcle.2025.107046
Eusebio Campos , Eva Esther Tejerina Álvarez , José Ángel Lorente Balanza
Assessment of the pupillary reflex to light is essential in patients with acute brain injury, as pupillary abnormalities are associated with neurological impairment and elevated intracranial pressure. Manual assessment by headlamp is inaccurate, whereas quantitative pupillometry provides objective and accurate measurements of pupillary size and reactivity, anticipating severe neurological deterioration and allowing early intervention in life-threatening situations. The pupillary neurological index, a variable derived from automated pupillometry, correlates with intracranial pressure, allows monitoring of therapeutic response in trauma and status epilepticus, is associated with the severity of neurological damage and may serve as a predictor of unfavourable neurological prognosis. The aim of this review is to summarise the evidence on the clinical utility of monitoring by quantitative pupillometry in neurological emergencies.
{"title":"Clinical utility of quantitative pupillometric monitoring in patients with acute brain injury","authors":"Eusebio Campos , Eva Esther Tejerina Álvarez , José Ángel Lorente Balanza","doi":"10.1016/j.medcle.2025.107046","DOIUrl":"10.1016/j.medcle.2025.107046","url":null,"abstract":"<div><div>Assessment of the pupillary reflex to light is essential in patients with acute brain injury, as pupillary abnormalities are associated with neurological impairment and elevated intracranial pressure. Manual assessment by headlamp is inaccurate, whereas quantitative pupillometry provides objective and accurate measurements of pupillary size and reactivity, anticipating severe neurological deterioration and allowing early intervention in life-threatening situations. The pupillary neurological index, a variable derived from automated pupillometry, correlates with intracranial pressure, allows monitoring of therapeutic response in trauma and status epilepticus, is associated with the severity of neurological damage and may serve as a predictor of unfavourable neurological prognosis. The aim of this review is to summarise the evidence on the clinical utility of monitoring by quantitative pupillometry in neurological emergencies.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 4","pages":"Article 107046"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290202","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 : 2025-10-01DOI: 10.1016/j.medcle.2025.107062
Silvana Alejandra Nuñez , Pehuén Fernández , Walter Douthat , Javier de Arteaga , Emanuel José Saad , Jorge de la Fuente , Carlos Chiurchiu
Introduction
Acceptance criteria for kidney donors (KDs) have become more flexible over time, raising questions about their long-term consequences. The objective of this study was to evaluate changes in the baseline characteristics of accepted KDs and to analyze their evolution after donation.
Methods
A cohort study was conducted that included all KDs from our institution from 2010 to 2017. Baseline characteristics were compared by period and follow-up was carried out up to 10 years after donation.
Results
169 KDs aged 45.6 ± 12.2 years were included, mostly women (63.9%). The main comorbidity they presented was obesity (29.6%) and controlled arterial hypertension (10.7%). KDs showed significant differences in estimated glomerular filtration rate (eGFR) with lower values in the last study period (P = .002). Progression to chronic kidney disease (CKD) III-a was 31% (95% CI: 23.5-39.6) and III-b 3.9% (95% CI: 0.5-7.2). Related risk factors were age (HRa = 1.04; 95% CI: 1.01-1,07; P = .033) and pre-donation eGFR (HRa = 0,97; 95% CI: 0.95-0,99; P = .028). No patient progressed to CKD IV, V or died during follow-up.
Conclusion
There were subtle changes in the characteristics of the accepted KR. Age and baseline eGFR were independent predictors of progression to CKD III post-donation. The incidence of advanced CKD and mortality were null at 10 years of post-donation follow-up, so it seems to be a safe procedure in our environment in the long term.
{"title":"Renal donation: Acceptance criteria and their influence at 5 and 10 years after donation","authors":"Silvana Alejandra Nuñez , Pehuén Fernández , Walter Douthat , Javier de Arteaga , Emanuel José Saad , Jorge de la Fuente , Carlos Chiurchiu","doi":"10.1016/j.medcle.2025.107062","DOIUrl":"10.1016/j.medcle.2025.107062","url":null,"abstract":"<div><h3>Introduction</h3><div>Acceptance criteria for kidney donors (KDs) have become more flexible over time, raising questions about their long-term consequences. The objective of this study was to evaluate changes in the baseline characteristics of accepted KDs and to analyze their evolution after donation.</div></div><div><h3>Methods</h3><div>A cohort study was conducted that included all KDs from our institution from 2010 to 2017. Baseline characteristics were compared by period and follow-up was carried out up to 10 years after donation.</div></div><div><h3>Results</h3><div>169 KDs aged 45.6 ± 12.2 years were included, mostly women (63.9%). The main comorbidity they presented was obesity (29.6%) and controlled arterial hypertension (10.7%). KDs showed significant differences in estimated glomerular filtration rate (eGFR) with lower values in the last study period (<em>P</em> = .002). Progression to chronic kidney disease (CKD) III-a was 31% (95% CI: 23.5-39.6) and III-b 3.9% (95% CI: 0.5-7.2). Related risk factors were age (HRa = 1.04; 95% CI: 1.01-1,07; <em>P</em> = .033) and pre-donation eGFR (HRa = 0,97; 95% CI: 0.95-0,99; <em>P</em> = .028). No patient progressed to CKD IV, V or died during follow-up.</div></div><div><h3>Conclusion</h3><div>There were subtle changes in the characteristics of the accepted KR. Age and baseline eGFR were independent predictors of progression to CKD III post-donation. The incidence of advanced CKD and mortality were null at 10 years of post-donation follow-up, so it seems to be a safe procedure in our environment in the long term.</div></div>","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 4","pages":"Article 107062"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290195","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 : 2025-10-01DOI: 10.1016/j.medcle.2025.107126
Yuanyuan Shao , Chaomeng Wang , Rong Fu
{"title":"Wilson's disease with hemolysis and hyperandrogenism as the first symptom","authors":"Yuanyuan Shao , Chaomeng Wang , Rong Fu","doi":"10.1016/j.medcle.2025.107126","DOIUrl":"10.1016/j.medcle.2025.107126","url":null,"abstract":"","PeriodicalId":74154,"journal":{"name":"Medicina clinica (English ed.)","volume":"165 4","pages":"Article 107126"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145289970","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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