Revista clinica espanola最新文献

英文中文

Social determinants of health and their impact on internal medicine 健康的社会决定因素及其对内科医学的影响

Revista clinica espanola

Pub Date : 2024-06-01 DOI: 10.1016/j.rceng.2024.05.003

M. Montserrat Chimeno Viñas , P. Pérez-Martínez

引用次数: 0

Letter to the editor about the article “How to detect non-institutionalized older patients at risk of malnutrition during their hospitalization? Comparison of 8 screening tools for malnutrition or nutritional risk” 致编辑的信，内容涉及文章 "如何检测住院期间有营养不良风险的非住院老年患者？8种营养不良或营养风险筛查工具的比较"

Revista clinica espanola

Pub Date : 2024-06-01 DOI: 10.1016/j.rceng.2024.05.001

Teigell Muñoz F.J.

引用次数: 0

Time dedicated to physical activity among medical residents: are there differences based on gender or specialty type? 医学住院医师用于体育活动的时间：性别或专业类型是否存在差异？

Revista clinica espanola

Pub Date : 2024-06-01 DOI: 10.1016/j.rceng.2024.04.014

O. Pujol , L. Vila-Castillo , C. Álvaro , M. Aguilar , N. Joshi , J. Minguell

Introduction

Physical activity (PA) is associated with positive health outcomes such as prevention of chronic diseases, psychological well-being and improved work performance. Medical residents are subjected to sleep deprivation, extended work schedule and high burnout prevalence. These conditions may lead to the neglect of personal health and the restriction of time dedicated to PA. The objective of the present study was to analyze the time dedicated to PA of medical residents, comparing women vs men residents and surgical vs clinical residents.

Methods

It is a cross-sectional study performed in a Spanish third-level university hospital. All medical residents from our institution were invited to voluntarily participate in the study answering a web-based questionnaire on June 2022. Data regarding demographics, residency and PA practice was recorded.

Results

The response rate was 20.73% (114/550). The 32.5% of the residents considered themselves to be physically inactive and mean time dedicated to PA in a regular week was 3.62 ± 2.22 h. Men residents dedicated more time to PA than women residents (4.23 ± 2.42 h vs 3.14 ± 1.95 h, p = 0.012) and surgical residents dedicated more time than clinical residents (4.33 ± 2.36 h vs 3.23 ± 2.05 h, p = 0.01).

Conclusions

One third of the medical residents consider themself physically inactive. Women and clinical residents practice PA less time than men and surgical residents. Efforts should be made to encourage PA among residents, especially in women and non-surgeons.

导言：体力活动（PA）与积极的健康结果有关，如预防慢性疾病、心理健康和提高工作绩效。住院医师睡眠不足、工作时间长、职业倦怠率高。这些情况可能会导致住院医师忽视个人健康，并限制其用于体育锻炼的时间。本研究的目的是分析医学住院医师的个人防护时间，比较女性住院医师与男性住院医师、外科住院医师与临床住院医师的个人防护时间：这是一项在西班牙一所三级甲等大学医院进行的横断面研究。我院邀请所有住院医师自愿参与研究，并于 2022 年 6 月回答了一份网络问卷。研究记录了有关人口统计学、住院医师和PA实践的数据：答复率为 20.73%（114/550）。32.5%的住院医师认为自己不爱运动，每周用于运动疗法的平均时间为（3.62 ± 2.22）小时。男性住院医师比女性住院医师（4.23 ± 2.42 h vs 3.14 ± 1.95 h，p = 0.012）花费更多时间进行体育锻炼，外科住院医师比临床住院医师（4.33 ± 2.36 h vs 3.23 ± 2.05 h，p = 0.01）花费更多时间进行体育锻炼：结论：三分之一的医学住院医师认为自己缺乏运动。女性和临床住院医师的体育锻炼时间少于男性和外科住院医师。应努力鼓励住院医师（尤其是女性和非外科医生）进行体育锻炼。

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引用次数: 0

Letter to the editor about the article “Executive summary of the consensus document on the management of perioperative anemia in Spain” 致编辑的信，内容涉及 "西班牙围手术期贫血管理共识文件执行摘要 "一文。

Revista clinica espanola

Pub Date : 2024-06-01 DOI: 10.1016/j.rceng.2024.05.002

Teigell Muñoz F.J., Mateos-González M.

引用次数: 0

Association between serum α-Klotho levels and osteoarthritis prevalence among middle-aged and older adults: an analysis of the NHANES 2007–2016 血清 α-Klotho 水平与中老年人骨关节炎患病率之间的关系：对 2007-2016 年国家健康调查（NHANES）的分析

Revista clinica espanola

Pub Date : 2024-06-01 DOI: 10.1016/j.rceng.2024.04.012

Qi Xu , jiale Wang , Hanzhi Li , Yuwan Gao

Background

As individuals age, the prevalence of osteoarthritis tends to increase gradually. α-Klotho is a hormone renowned for its anti-aging properties. However, the precise role of serum α-Klotho in osteoarthritis is still not fully comprehended.

Methods

We conducted a cross-sectional study utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2016. Serum α-Klotho levels were measured using an enzyme-linked immunosorbent assay (ELISA). Osteoarthritis was assessed through self-reported questionnaires. Through univariate and multivariate logistic regression analyses, smooth curve fitting, threshold effect analysis, and subgroup analyses, we delved into the potential association between them.

Results

The study encompassed a cohort of 10,265 participants. In fully adjusted models of multivariate logistic regression analysis, we identified a negative correlation between serum ln α-Klotho and OA (OR = 0.77, 95% CI: 0.65−0.91, p = 0.003). When stratifying serum α-Klotho levels into tertiles, individuals in the highest tertile exhibited a 26% reduced risk of OA compared to those in the lowest tertile (OR = 0.84, 95% CI: 0.73−0.97, p = 0.014). Subsequent analyses indicated a linearly negative association. In subgroup analyses, we explored the relationship between serum ln α-Klotho and osteoarthritis across diverse populations, revealing the persistence of this association in the majority of subgroups.

Conclusion

Serum α-Klotho levels exhibit a significant negative linear correlation with the prevalence of osteoarthritis in middle-aged and elderly populations in the United States.

背景随着年龄的增长，骨关节炎的发病率呈逐渐上升趋势。然而，血清中的α-Klotho在骨关节炎中的确切作用仍未得到充分了解。方法我们利用美国国家健康与营养调查（NHANES）2007年至2016年的数据进行了一项横断面研究。使用酶联免疫吸附测定法（ELISA）测量血清中的α-Klotho水平。骨关节炎通过自我报告问卷进行评估。通过单变量和多变量逻辑回归分析、平滑曲线拟合、阈值效应分析和亚组分析，我们深入研究了它们之间的潜在关联。在多变量逻辑回归分析的完全调整模型中，我们发现血清 ln α-Klotho 与 OA 之间存在负相关（OR = 0.77，95% CI：0.65-0.91，p = 0.003）。将血清α-Klotho水平分为三等分时，与最低三等分的人相比，最高三等分的人患OA的风险降低了26%（OR = 0.84，95% CI：0.73-0.97，p = 0.014）。随后的分析表明两者呈线性负相关。在亚组分析中，我们探讨了不同人群中血清 ln α-Klotho 与骨关节炎之间的关系，结果表明这种关联在大多数亚组中持续存在。

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引用次数: 0

Comparative performance of vulvovaginal swab sampling versus endocervical sampling for the detection of Chlamydia, Gonorrhea, Mycoplasma genitalium, and Trichomoniasis: a cross-sectional study in Spain 外阴拭子取样与宫颈内膜取样在检测衣原体、淋病、生殖器支原体和滴虫病方面的性能比较：西班牙的一项横断面研究

Revista clinica espanola

Pub Date : 2024-06-01 DOI: 10.1016/j.rceng.2024.04.015

M. Linares , P. Galicia , A. Rojas , A. Miguel-Benito , J. Cuadros-González , J.M. Ramos-Rincón

Introduction

The global increase in sexual transmitted infections (STI) makes it necessary to seek public health strategies that facilitate rapid and minimally invasive diagnosis. The objective was to evaluate the concordance between vaginal and endocervical samples for STI diagnosis.

Materials and methods

A retrospective cross-sectional study was carried out on vaginal and endocervical samples from women attended in our reference area with symptoms suggestive of vulvovaginitis or for STI screening during the study period.

Results

A total of 130 paired samples were analyzed; fifty-seven and 59 samples were positive for vaginal and endocervical specimens (Kappa index of 0.969 (Standard error = 0.022). The sensitivity of the vaginal samples was 96.5% (IC95%: 87.2–99.4), with a specificity of 100% (IC95%: 93.0–100).

Discussion

The introduction of STI screening in vaginal samples in our environment can facilitate rapid and effective diagnosis and allow early treatment of STI. Additionally, it facilitates sample collection and diagnosis in the community setting, essential for optimal screening.

导言：随着全球性传播感染（STI）的增加，有必要寻求有利于快速和微创诊断的公共卫生策略。本研究旨在评估阴道和宫颈内膜样本在性传播感染诊断中的一致性：在研究期间，我们对参考区内出现外阴阴道炎症状或接受性传播感染筛查的妇女的阴道和宫颈内膜样本进行了回顾性横断面研究：共分析了 130 份配对样本；阴道和宫颈内膜样本中分别有 57 份和 59 份呈阳性（Kappa 指数为 0.969（标准误差 = 0.022））。阴道样本的敏感性为 96.5%（IC95%：87.2-99.4），特异性为 100%（IC95%：93.0-100）：讨论：在我们的环境中，对阴道样本进行性传播感染筛查可促进快速有效的诊断，并使性传播感染得到早期治疗。此外，它还有助于在社区环境中进行样本采集和诊断，这对优化筛查至关重要。

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引用次数: 0

External validation of the EFFECT mortality prediction scale in patients admitted for acute heart failure in Araba, Spain 对西班牙阿拉巴地区急性心力衰竭住院患者的 EFFECT 死亡率预测量表进行外部验证。

Revista clinica espanola

Pub Date : 2024-06-01 DOI: 10.1016/j.rceng.2024.05.004

S. Goya-Lirio , M. Hernando-Llorens , S. García de Garayo-Díaz , J. Regalado-de Los Cobos

Aim

To validate the EFFECT (Enhanced Feedback for Effective Cardiac Treatment) scales, which predict mortality at 1 month and 1 year after admission, in a defined cohort of patients admitted to the Araba University Hospital (HUA) with a diagnosis of acutely decompensated heart failure.

Method

External validation study of a predictive model, in a retrospective cohort of patients admitted between October 1, 2020 and September 30, 2021.

Results

A total of 550 patients were included. The two scales demonstrated good overall discriminatory ability in our series, with an area under ROC (0.755 y 0.756) and values in Brier score (0.094 y 0.194) similar to the original series. Calibration was assessed using the Hosmer-Lemeshow test and calibration plots and was also adequate. All this despite the fact that significant differences were observed in many clinical characteristics between our series and the original one.

Conclusions

The EFFECT scales showed good predictive ability and transportability. The one-month prediction scale was also useful for predicting mortality at one year. For both time periods, mortality was similar in the groups established in the original as low and very low risk.

目的：在阿拉巴大学医院（HUA）确诊为急性失代偿性心力衰竭的住院患者群体中验证EFFECT（有效心脏治疗强化反馈）量表，该量表可预测入院后1个月和1年的死亡率：方法：对2020年10月1日至2021年9月30日期间入院的患者进行回顾性队列研究，对预测模型进行外部验证：结果：共纳入 550 名患者。在我们的系列研究中，这两个量表表现出良好的整体判别能力，ROC下面积（0.755 y 0.756）和Brier评分值（0.094 y 0.194）与原始系列相似。使用 Hosmer-Lemeshow 检验和校准图对校准进行了评估，结果也是适当的。尽管在许多临床特征方面，我们的系列研究与原始系列研究之间存在着显著差异，但我们还是取得了上述成果：结论：EFFECT量表具有良好的预测能力和可移植性。结论：EFFECT量表显示出良好的预测能力和可移植性，一个月的预测量表对预测一年的死亡率也很有用。在这两个时间段内，在最初确定的低风险组和极低风险组中，死亡率相似。

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引用次数: 0

Determining factors of pulse oximetry accuracy: a literature review 脉搏氧饱和度准确性的决定因素：文献综述。

Revista clinica espanola

Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.005

D. León-Valladares , L.A. Barrio-Mateu , N. Cortés-Carmona , G. Fuentes-Lizana , A.M. Cabanas , K. Latorre-Progulakis , M. Fuentes-Guajardo , P. Martín-Escudero

Objective

Identify and reach consensus on the variables that affect the measurement of oxygen saturation using pulse oximetry.

Methods

We applied inclusion and exclusion criteria to select relevant studies in databases such as Ebsco and PubMed. The search strategies, carried out until December 2023, focused on publications that addressed the technology of pulse oximeters and variables that influence their accuracy. We assessed the risk of bias of the included studies and used standardized methods for synthesis of results.

Results

23 studies were included. The synthesis of the results highlighted that equipment with tetrapolar technology showed greater precision in oxygen saturation measurements. Increased skin pigmentation, hemoglobinopathies and high skin temperatures can lead to an overestimation of SpO₂, while factors such as low perfusion, cold skin temperature, nail polish or tattoos, hypoxemia, anemia and high altitude training, they may underestimate it. On the other hand, motion artifacts, light pollution, frequency >150 beats per minute, electromagnetic interference and location of the sensor can cause distortion of the photoplethymography signal.

Conclusions

The synthesis of the results highlighted that skin pigmentation and light interference can lead to an overestimation of SpO₂, while other factors such as low perfusion and altitude tend to underestimate it. The studies presented variability and heterogeneity in their designs, evidencing limitations in the consistency and precision of the evidence. Despite these limitations, the results underscore the importance of considering multiple variables when interpreting pulse oximetry measurements to ensure their reliability. The findings have significant implications for clinical practice and future research.

方法我们采用纳入和排除标准在 Ebsco 和 PubMed 等数据库中筛选相关研究。搜索策略一直持续到 2023 年 12 月，重点关注涉及脉搏血氧仪技术和影响其准确性的变量的出版物。我们对纳入研究的偏倚风险进行了评估，并采用标准化方法对结果进行了综合。结果综述强调，采用四极技术的设备在测量血氧饱和度时精度更高。皮肤色素沉着增加、血红蛋白病和皮肤温度过高会导致高估 SpO2，而低灌注、皮肤温度过低、指甲油或纹身、低氧血症、贫血和高海拔训练等因素则可能低估 SpO2。另一方面，运动伪影、光污染、每分钟 150 次的频率、电磁干扰和传感器的位置都会导致照相血氧饱和度成像信号失真。结论结果综合显示，皮肤色素沉着和光干扰会导致高估血氧饱和度，而低灌注和高海拔等其他因素往往会低估血氧饱和度。这些研究在设计上存在差异和异质性，证明了证据在一致性和精确性方面的局限性。尽管存在这些局限性，但研究结果强调了在解释脉搏血氧仪测量结果时考虑多种变量以确保其可靠性的重要性。研究结果对临床实践和未来研究具有重要意义。

{"title":"Determining factors of pulse oximetry accuracy: a literature review","authors":"D. León-Valladares , L.A. Barrio-Mateu , N. Cortés-Carmona , G. Fuentes-Lizana , A.M. Cabanas , K. Latorre-Progulakis , M. Fuentes-Guajardo , P. Martín-Escudero","doi":"10.1016/j.rceng.2024.04.005","DOIUrl":"10.1016/j.rceng.2024.04.005","url":null,"abstract":"<div><h3>Objective</h3><p>Identify and reach consensus on the variables that affect the measurement of oxygen saturation using pulse oximetry.</p></div><div><h3>Methods</h3><p>We applied inclusion and exclusion criteria to select relevant studies in databases such as Ebsco and PubMed. The search strategies, carried out until December 2023, focused on publications that addressed the technology of pulse oximeters and variables that influence their accuracy. We assessed the risk of bias of the included studies and used standardized methods for synthesis of results.</p></div><div><h3>Results</h3><p>23 studies were included. The synthesis of the results highlighted that equipment with tetrapolar technology showed greater precision in oxygen saturation measurements. Increased skin pigmentation, hemoglobinopathies and high skin temperatures can lead to an overestimation of SpO<sub>2</sub>, while factors such as low perfusion, cold skin temperature, nail polish or tattoos, hypoxemia, anemia and high altitude training, they may underestimate it. On the other hand, motion artifacts, light pollution, frequency >150 beats per minute, electromagnetic interference and location of the sensor can cause distortion of the photoplethymography signal.</p></div><div><h3>Conclusions</h3><p>The synthesis of the results highlighted that skin pigmentation and light interference can lead to an overestimation of SpO<sub>2</sub>, while other factors such as low perfusion and altitude tend to underestimate it. The studies presented variability and heterogeneity in their designs, evidencing limitations in the consistency and precision of the evidence. Despite these limitations, the results underscore the importance of considering multiple variables when interpreting pulse oximetry measurements to ensure their reliability. The findings have significant implications for clinical practice and future research.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 5","pages":"Pages 314-330"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779730","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}

引用次数: 0

Internal carotid artery bulb width: a novel potential parameter for the prediction of cerebral vascular diseases 颈内动脉球宽度：预测脑血管疾病的潜在新参数。

Revista clinica espanola

Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.008

İ. Ökçesiz , H. Dönmez , M.M. Etleç , A. Öztürk

Objective

To investigate the relationship between the width of the internal carotid artery (ICA) bulb and cerebral vascular diseases including stroke and intracranial aneurysms.

Material and methods

In total 300 patients who had supra-aortic computed tomography angiography (CTA) were enrolled in this study from 2015 to 2021. The study groups consisted of 100 ischemic stroke patients, 100 patients with intracranial aneurysms, and 100 control subjects. The intracranial aneurysm patient group was divided into two subgroups according to the presence of subarachnoid hemorrhage (SAH). The largest diameters of the ICA C1 (cervical) and C2 (petrous) segments in all individuals were measured bilaterally on CTA images. The ICA diameter ratios of the cases were measured using the formula $\frac{C 1 - C 2}{C 1}$ . The relationship between the age and ICA vessel analysis was evaluated as well.

Results

The mean ICA bulb width values in the ischemic stroke patient group and the intracranial aneurysm patient group were significantly higher than the control group (p < 0.001). The ICA C1 and C2 segment diameter values and ICA diameter ratio were smaller in the intracranial aneurysm patients with SAH than those who had not (p = 0.7). There was a statistically significant but weak relationship between the age and ICA diameter ratios in all study groups (R-squared value of 0.26, p = 0.03).

Conclusion

ICA bulb width is a parameter that can be easily evaluated with neuroimaging modalities and is a successful method that may be used for predicting the risk of ischemic stroke or the presence of an intracranial aneurysm.

摘要] 目的探讨颈内动脉（ICA）球的宽度与脑血管疾病（包括脑卒中和颅内动脉瘤）之间的关系。研究组包括 100 名缺血性脑卒中患者、100 名颅内动脉瘤患者和 100 名对照组。颅内动脉瘤患者组根据是否存在蛛网膜下腔出血（SAH）分为两个亚组。在 CTA 图像上测量了所有患者的 ICA C1（颈段）和 C2（枕段）双侧最大直径。用 C1-C2C1 公式测量了病例的 ICA 直径比。结果缺血性卒中患者组和颅内动脉瘤患者组的平均 ICA 球宽值明显高于对照组（p <0.001）。SAH 颅内动脉瘤患者的 ICA C1 和 C2 段直径值及 ICA 直径比均小于非 SAH 颅内动脉瘤患者（P = 0.7）。在所有研究组中，年龄与 ICA 直径比之间存在有统计学意义的微弱关系（R 平方值为 0.26，P = 0.03）。结论ICA 球部宽度是一个可以通过神经影像学模式轻松评估的参数，是一种可用于预测缺血性卒中风险或颅内动脉瘤存在的成功方法。

{"title":"Internal carotid artery bulb width: a novel potential parameter for the prediction of cerebral vascular diseases","authors":"İ. Ökçesiz , H. Dönmez , M.M. Etleç , A. Öztürk","doi":"10.1016/j.rceng.2024.04.008","DOIUrl":"10.1016/j.rceng.2024.04.008","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the relationship between the width of the internal carotid artery (ICA) bulb and cerebral vascular diseases including stroke and intracranial aneurysms.</p></div><div><h3>Material and methods</h3><p>In total 300 patients who had supra-aortic computed tomography angiography (CTA) were enrolled in this study from 2015 to 2021. The study groups consisted of 100 ischemic stroke patients, 100 patients with intracranial aneurysms, and 100 control subjects. The intracranial aneurysm patient group was divided into two subgroups according to the presence of subarachnoid hemorrhage (SAH). The largest diameters of the ICA C1 (cervical) and C2 (petrous) segments in all individuals were measured bilaterally on CTA images. The ICA diameter ratios of the cases were measured using the formula <span><math><mfrac><mrow><mi>C</mi><mn>1</mn><mo>-</mo><mi>C</mi><mn>2</mn></mrow><mrow><mtext>C</mtext><mn>1</mn></mrow></mfrac></math></span>. The relationship between the age and ICA vessel analysis was evaluated as well.</p></div><div><h3>Results</h3><p>The mean ICA bulb width values in the ischemic stroke patient group and the intracranial aneurysm patient group were significantly higher than the control group (<em>p</em> < 0.001). The ICA C1 and C2 segment diameter values and ICA diameter ratio were smaller in the intracranial aneurysm patients with SAH than those who had not (<em>p</em> = 0.7). There was a statistically significant but weak relationship between the age and ICA diameter ratios in all study groups (R-squared value of 0.26, <em>p</em> = 0.03).</p></div><div><h3>Conclusion</h3><p>ICA bulb width is a parameter that can be easily evaluated with neuroimaging modalities and is a successful method that may be used for predicting the risk of ischemic stroke or the presence of an intracranial aneurysm.</p></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"224 5","pages":"Pages 267-271"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765093","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}

引用次数: 0

Severe cardiovascular events among spectators of Spanish professional soccer league before and after COVID-19 onset 西班牙职业足球联赛观众在 COVID-19 启用前后发生的严重心血管事件。

Revista clinica espanola

Pub Date : 2024-05-01 DOI: 10.1016/j.rceng.2024.04.001

L. Consuegra-Sánchez , J.A. Martínez

引用次数: 0

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