Revista clinica espanola最新文献

英文中文

Epidemiology of rhinovirus/enterovirus infection in hospitalized patients 住院患者鼻病毒/肠病毒感染的流行病学研究。

Revista clinica espanola

Pub Date : 2025-12-01 Epub Date: 2025-11-06 DOI: 10.1016/j.rceng.2025.502391

B. Lopez-Villalba , L. Tejedor-Cantero , M. Toquero-Asensio , V. Fernández-Espinilla , C. Hernán-García , S. Rojo-Rello , C. Prada-García , J.M. Eiros-Bouza , J. Castrodeza-Sanz

Background and Objective

Rhinovirus/enterovirus (RV/EV), commonly known for causing mild colds, has emerged as a significant cause of hospitalization. The objective of the study is to analyze the characteristics of patients hospitalized for viral respiratory infections, with an emphasis on RV/EV.

Methodology

This retrospective study was conducted between 2019 and 2022 at the University Clinical Hospital of Valladolid. Data from 1,528 cases were analyzed, sourced from medical records and microbiological tests (Biofire Respiratory y NxTAG respiratory panel).

Results

RV/EV was the most common respiratory virus (42.6%). There was a slight predominance of cases in males. 44.6% had a hospital stay of 2–7 days. The average hospitalization incidence was 3 per 1,000 adults per year. Children aged 0–15 years are at higher risk of RV/EV infection, with a 1.5 times higher probability in single infections (OR 1.496; 95% CI 1.147−1.952; p = 0.003), 7 times in coinfections with other respiratory viruses (OR 6.887; 95% CI 3.928–12.045; p < 0.01), and 8 times in coinfections with RSV (OR 8.580; 95% CI 3.866−19.041; p < 0.01). RV/EV is associated with a higher risk of asthma exacerbation (OR 2.545; 95% CI 1.336−4.851; p = 0.005) and COPD exacerbation (OR 1.781; 95% CI 1.022−3.103; p = 0.042), but a lower probability of bronchiolitis (OR 0.236; 95% CI 0.117−0.474; p < 0.01).

Conclusion

This study identifies RV/EV as the main respiratory virus in hospitalized patients, with a greater impact on those under 15 years and over 60 years. Seasonality and the coexistence of multiple viruses complicate its behaviour. These findings underscore the importance of preventive strategies and the need for continued research on its health impact.

背景和目的：鼻病毒/肠道病毒（RV/EV）通常以引起轻度感冒而闻名，现已成为住院治疗的重要原因。本研究的目的是分析病毒性呼吸道感染住院患者的特征，重点是RV/EV。方法：这项回顾性研究于2019年至2022年在巴利亚多利德大学临床医院进行。分析了1,528例病例的数据，这些数据来自医疗记录和微生物测试（Biofire Respiratory y NxTAG呼吸面板）。结果：RV/EV是最常见的呼吸道病毒（42.6%）。病例中男性略占优势。44.6%住院时间为2 ~ 7天。每年平均住院率为千分之三。0 ~ 15岁儿童感染RV/EV的风险较高，单次感染的概率为1.5倍（OR为1.496；95% CI为1.147 ~ 1.952;p = 0.003），合并其他呼吸道病毒感染的概率为7倍(OR为6.887；95% CI为3.928 ~ 12.045；p结论：本研究确定RV/EV为住院患者呼吸道病毒的主要感染类型，15岁以下和60岁以上患者的影响更大。季节性和多种病毒的共存使其行为复杂化。这些发现强调了预防战略的重要性以及继续研究其对健康影响的必要性。

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引用次数: 0

Assessment of body fat distribution by ultrasound as a risk factor for mortality and readmission in patients admitted for sepsis 超声评估体脂分布作为败血症患者死亡率和再入院的危险因素。

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-16 DOI: 10.1016/j.rceng.2025.502369

J.T. Algado-Rabasa , I. Ribes-Mengual , E. Ronda-Perez , N. Algado-Selles

Background

Sepsis is a serious condition with high mortality. Body fat can influence the production of inflammatory cytokines at the systemic level, leading to adverse outcomes; therefore, the distribution of body fat may have prognostic value. The objective is to evaluate whether there is a relationship between the distribution of body fat measured by ultrasound and prognosis in patients admitted with sepsis.

Methods

A prospective cohort study was conducted in patients admitted for sepsis at a Spanish hospital between September 2023 and June 2024. The risk of mortality and readmission at 30 and 90 days was calculated based on the ratio of ultrasound measurements of subcutaneous fat (SAT) and visceral fat (VAT). The hazard ratio (HR) and 95% confidence interval for mortality and readmission were estimated based on the VAT/SAT ratio.

Results

62 patients were included. The median age was 77 years. The risk of mortality at 30 and 90 days post-admission was: for patients with VAT/SAT > 5.85, 18% and 35% respectively, and for patients with VAT/SAT < 5.85, 3% and 6.1%. The adjusted HR for mortality was 6.6 (95% CI: 1.4–30.6; p = 0.016). The risk of readmission at 30 and 90 days in patients with VAT/SAT > 8.03 was 46% and 80%, respectively, and in patients with VAT/SAT < 8.03, 23% and 30%. The HR for readmission was 3.1 (95% CI: 1.1–8.5; p = 0.026).

Conclusions

An increase in the VAT/SAT ratio, measured by ultrasound, is a risk factor for mortality and readmission in patients admitted for sepsis.

背景：脓毒症是一种严重的疾病，死亡率高。体脂可以在全身水平上影响炎症细胞因子的产生，导致不良后果；因此，体脂分布可能具有预测价值。目的是评估脓毒症住院患者超声测量体脂分布与预后之间是否存在关系。方法：对2023年9月至2024年6月在西班牙一家医院因败血症入院的患者进行前瞻性队列研究。根据超声测量皮下脂肪（SAT）和内脏脂肪（VAT）的比例计算30天和90天的死亡率和再入院风险。根据VAT/SAT比值估计死亡率和再入院的风险比（HR）和95%置信区间。结果：纳入62例患者。中位年龄为77岁。入院后30天和90天的死亡风险分别为：VAT/SAT为5.85、18%和35%，VAT/SAT为8.03的患者分别为46%和80%。结论：超声测量的VAT/SAT比值升高是脓毒症患者死亡和再入院的危险因素。

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引用次数: 0

Iron deficiency and iron deficiency anemia and their association with pulmonary embolism 缺铁和缺铁性贫血及其与肺栓塞的关系。

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-25 DOI: 10.1016/j.rceng.2025.502382

N. Báez-Ferrer , J. Monllor-Méndez , D. Álvarez-Luis , L. Hernández-Chinea , A.W. Al-Hayani-Al-Hantoosh , A. Domínguez-Rodríguez

Introduction

Iron deficiency (ID) has not been associated with pulmonary embolism (PE). The aim was to assess whether ID is associated with an increased likelihood of developing PE within the subsequent 12 months.

Patients and methods

Retrospective observational study. Patients with PE during follow-up were selected as cases, and those without the event as controls. Patients with chronic diseases, cancer, fractures, or recent hospital admissions were excluded.

Results

A total of 43 cases and 199 controls were enrolled. The mean age was 61 ± 21 years. ID increased the risk of PE at 12 months with an odds ratio of 2.15 (95% confidence interval (CI95%): 1.01–4.58; P = .046). Survival analysis showed more than a two-fold increase in the risk of developing PE in the presence of prior ID (hazard ratio: 2.37 (CI95%: 1.30–4.31; P = .05)).

Conclusion

ID may represent an increased risk of PE in the 12 months following its detection.

铁缺乏（ID）与肺栓塞（PE）无关。目的是评估ID是否与随后12个月内发生PE的可能性增加有关。患者和方法：回顾性观察研究。随访期间发生PE的患者作为病例，未发生PE的患者作为对照。患有慢性疾病、癌症、骨折或近期住院的患者被排除在外。结果：共纳入病例43例，对照组199例。平均年龄61岁 ± 21岁。ID增加了12个月时PE的风险，比值比为2.15(95%可信区间（CI95%）： 1.01-4.58；P = .046)。生存分析显示，先前存在ID的患者发生PE的风险增加了两倍以上（风险比：2.37 (CI95%: 1.30-4.31; P = .05)）。结论：ID可能在其检测后的12个月内增加PE的风险。

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引用次数: 0

Medium-sized vessel uptake on PET/CT as a clue to extracranial giant cell arteritis PET/CT中等血管摄取作为颅外巨细胞动脉炎的线索。

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-24 DOI: 10.1016/j.rceng.2025.502378

Á. García Tellado , B. Lucas-Velázquez , J. Pardo Lledías

引用次数: 0

No association between socioeconomic deprivation and cardiovascular risk or damage in systemic lupus erythematosus within a universal healthcare system: a cohort study from the Basque Country 巴斯克地区的一项队列研究：在全民医疗保健系统中，社会经济剥夺与系统性红斑狼疮心血管风险或损害之间没有关联。

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-22 DOI: 10.1016/j.rceng.2025.502384

Halbert Hernández-Negrin , Diana Paredes-Ruiz , Víctor Moreno-Torres , Ioana Ruiz-Arruza , Guillermo Ruiz-Irastorza

Background

Socioeconomic deprivation is a well-recognized determinant of cardiovascular health. We evaluated its influence on cardiovascular risk and damage in patients with systemic lupus erythematosus (SLE) in the Basque Country, where universal healthcare coverage is guaranteed.

Methods

Observational cohort study including 293 SLE patients with a 5-year follow-up. The association between the Basque Country’s Socioeconomic Deprivation Index and cardiovascular risk factors and damage (SLICC index) was analyzed using multilevel generalized linear mixed models.

Results

No significant associations were found between deprivation levels and the number of cardiovascular risk factors at diagnosis or at 5 years, nor with cardiovascular damage. Age at diagnosis and disease activity were the main predictors of cardiovascular outcomes.

Conclusion

In a universal healthcare setting, socioeconomic deprivation was not associated with worse cardiovascular risk or damage in SLE patients. These findings do not establish causality but are consistent with the hypothesis that universal healthcare may mitigate socioeconomic gradients in SLE cardiovascular outcomes.

背景：社会经济剥夺是心血管健康的一个公认的决定因素。我们评估了它对巴斯克地区系统性红斑狼疮（SLE）患者心血管风险和损害的影响，那里有全民医疗保险保障。方法：观察性队列研究，纳入293例SLE患者，随访5年。采用多水平广义线性混合模型分析巴斯克地区社会经济剥夺指数与心血管危险因素和损伤（SLICC指数）之间的关系。结果：在诊断时或5年时，剥夺水平与心血管危险因素数量之间没有发现显著关联，也与心血管损伤无关。诊断年龄和疾病活动度是心血管预后的主要预测因素。结论：在全民医疗环境中，社会经济剥夺与SLE患者更严重的心血管风险或损害无关。这些发现没有建立因果关系，但与普遍医疗保健可能减轻SLE心血管结局的社会经济梯度的假设一致。

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引用次数: 0

Executive summary of the 2025 consensus on the diagnosis and treatment of hypertension of the International Forum on Internal Medicine 国际内科论坛《2025年高血压诊治共识》执行摘要

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-05 DOI: 10.1016/j.rceng.2025.502368

R. Sabio , P. Valdez , E. Casariego Vales , L. Cámera , H.L. Puello Galarcio , M. Camafort , en nombre del Grupo de Trabajo Hipertensión arterial-FIMI

The diagnosis and treatment of hypertension is a challenge for any healthcare system. Given the difficulties, limitations, and differences among Spanish- and Portuguese-speaking countries, the International Forum of Internal Medicine (FIMI) has promoted this Consensus, which includes 23 scientific societies from 21 countries in Europe and the Americas. The objective was to develop a proposal capable of establishing an updated, robust, and common framework for the diagnosis and treatment of hypertension, aimed at internists and hospitalists and useful in Latin America, Spain, and Portugal. The document we present includes the executive summary of FIMI recommendations that, for the various aspects of the disease, aim to guarantee effective, safe, efficient, sustainable, and proportionate healthcare interventions based on the best available scientific evidence. The authors consider that this document should be updated within a maximum of two years.

高血压的诊断和治疗对任何医疗保健系统都是一个挑战。鉴于西班牙语和葡萄牙语国家之间的困难、限制和差异，国际内科论坛（FIMI）促进了这一共识，其中包括来自欧洲和美洲21个国家的23个科学学会。目的是制定一项提案，为高血压的诊断和治疗建立一个更新、健全和共同的框架，针对内科医生和医院医生，并在拉丁美洲、西班牙和葡萄牙有用。我们提交的文件包括FIMI建议的执行摘要，这些建议针对该疾病的各个方面，旨在根据现有的最佳科学证据保证有效、安全、高效、可持续和相称的医疗保健干预措施。作者认为，本文件最多应在两年内更新。

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引用次数: 0

Impact of SARS-CoV-2 infection on perioperative mortality SARS-CoV-2感染对围手术期死亡率的影响

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-25 DOI: 10.1016/j.rceng.2025.502379

B. Ayuso-García , Á. Marchán-López , H.J. Castro Pousada , E. Romay Lema , M.J. García-Pais , J. Corredoira Sánchez , P. Peinó Camba , Y. Chantres Legaspi , R. Monte-Secades , R. Rabuñal Rey

Introduction

perioperatively acquired COVID-19 may increase mortality. The aim of this study was to assess the influence of SARS-CoV-2 infection on the length of stay and mortality among surgical patients.

Methods

retrospective study of surgical interventions performed between 1st March 2020 and 31st December 2022 after exclusion of minor procedures. Clinical, administrative, and epidemiological data were collected. Multivariate Cox regression analysis was conducted.

Results

19,152 interventions were included. Patients had median age of 66 years (53–77), 53.8% were male, and the median number of conditions was 1 (0–3). Six hundred and twenty-two (3.2%) interventions were performed in COVID-19 patients, who were older (70 (57–80) vs 67 (55–77) years; p = 0.003) and more comorbid (2 (1–3) vs 1 (0–3); p < 0.001). COVID-19 patients had longer stays (11 (4–28) vs 6 (3–12) days; p < 0.001), and higher mortality rates (incidence rate ratio 2.28 (1.70–3.00), p < 0.001). The adjusted hazard ratio was 1.54 (1.15–2.05), p = 0.001. Age, number of conditions, and incomplete vaccination, and surgeries conducted in 2022 (as compared to 2020 and 2021) were related to higher mortality. Mortality was higher during the first week of the infection, but not after that (HR 2.09 (1.04–4.21), p = 0.037), and the risk window narrowed after 2020.

Conclusions

perioperative COVID-19 increases mortality, especially during the first week of the infection. Age, comorbidity, and vaccine status should also be considered when scheduling interventions.

围手术期获得性COVID-19可能增加死亡率。本研究的目的是评估SARS-CoV-2感染对外科患者住院时间和死亡率的影响。方法：回顾性研究2020年3月1日至2022年12月31日期间排除小手术后进行的手术干预。收集临床、行政和流行病学资料。进行多因素Cox回归分析。结果：共纳入19152项干预措施。患者中位年龄66岁（53 ~ 77岁），男性53.8%，中位病例数1例（0 ~ 3例）。对年龄较大的COVID-19患者(70 （57-80)vs 67（55-77）岁）进行了622例（3.2%）干预；P = 0.003)和更多的合并症(2 (1-3)vs 1 (0-3)；p 结论：围手术期COVID-19增加了死亡率，特别是在感染的第一周。在安排干预措施时，还应考虑年龄、合并症和疫苗状况。

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引用次数: 0

About the study of geriatric syndromes: the definition matters 关于老年综合征的研究：定义很重要。

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-25 DOI: 10.1016/j.rceng.2025.502383

L. Artajona, M. Carbó, A. García-Martínez

引用次数: 0

Counterreply to the letter “About the study of geriatric syndromes: the definition matters” 对“关于老年综合征的研究：定义很重要”信函的答复。

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-28 DOI: 10.1016/j.rceng.2025.502385

M.C. Montes , J.A. Rueda-Camino , N. Rallón , S. Nistal-Juncos , R. Barba-Martín

引用次数: 0

Evolution of angiogenic and inflammatory biomarkers in patients with hereditary hemorrhagic telangiectasia during treatment with bevacizumab: study protocol 贝伐单抗治疗期间遗传性出血性毛细血管扩张患者血管生成和炎症生物标志物的演变：研究方案

Revista clinica espanola

Pub Date : 2025-11-01 Epub Date: 2025-10-05 DOI: 10.1016/j.rceng.2025.502370

B. Villanueva , A. Figueras , R. Torres-Iglesias , M. Muñoz , S. Moreno-Lopes , N. Trullén-Malaret , A. Martínez , F. Viñals , A. Riera-Mestre

Background

Hereditary haemorrhagic telangiectasia (HHT) is a rare disease characterized by mucocutaneous telangiectasia and visceral vascular malformations. Treatment with bevacizumab is recommended in patients with liver involvement and high output heart failure (HOHF) or those with severe gastrointestinal (GI) involvement. However, there is no evidence on how to monitor such treatment using biomarkers.

Material and methods

This is an exploratory, observational, prospective, single-centre study carried out in an HHT referral unit. The inclusion period for the start of bevacizumab was from January 2022 to May 2023. Patients with an indication for starting bevacizumab were selected and underwent blood tests at baseline and during the induction (36 weeks) and maintenance phases to analyse 21 biomarkers related to angiogenesis and inflammation. In addition, control HHT patients without indication for bevacizumab and healthy controls matched 1:1:1 by age, sex, and genetic subtype (for HHT patients) underwent a baseline biomarker study. The main objective was to analyse the evolution of these biomarkers in patients with HHT treated with bevacizumab. As secondary objectives, baseline differences in the concentration of these biomarkers between the three groups and correlation with the haemoglobin levels were analysed.

Groups description

During the study period, nine patients with an indication for bevacizumab were included, seven due to anaemia of GI origin and two due to liver involvement with HOHF, with an overall mean age of 70 ± 8.4 years. Subsequently, the respective nine patients with HHT without bevacizumab and nine controls without HHT were selected.

Conclusions

The results of this exploratory study will provide new knowledge regarding potential biomarkers for monitoring the response to treatment with bevacizumab. Furthermore, it could generate new hypotheses about the role of certain biomarkers at the pathophysiological, diagnostic, and therapeutic levels.

背景：遗传性出血性毛细血管扩张症（HHT）是一种以皮肤粘膜毛细血管扩张和内脏血管畸形为特征的罕见疾病。贝伐单抗推荐用于肝脏受累和高输出心力衰竭（HOHF）或严重胃肠道（GI）受累的患者。然而，没有证据表明如何使用生物标志物来监测这种治疗。材料和方法：这是在HHT转诊单位进行的一项探索性、观察性、前瞻性、单中心研究。贝伐单抗开始的纳入期为2022年1月至2023年5月。选择有起始贝伐单抗适应症的患者，在基线、诱导（36周）和维持阶段进行血液检查，分析与血管生成和炎症相关的21种生物标志物。此外，无贝伐单抗适应症的对照组HHT患者和健康对照者按年龄、性别和遗传亚型（HHT患者）匹配1:1:1进行了基线生物标志物研究。主要目的是分析这些生物标志物在接受贝伐单抗治疗的HHT患者中的演变。作为次要目标，分析了三组之间这些生物标志物浓度的基线差异及其与血红蛋白水平的相关性。组描述：在研究期间，纳入了9例有贝伐单抗适应症的患者，其中7例因胃肠道贫血，2例因HOHF累及肝脏，总体平均年龄为70±8.4岁。随后，分别选择9例未使用贝伐单抗的HHT患者和9例未使用HHT的对照组。结论：这项探索性研究的结果将为监测贝伐单抗治疗反应的潜在生物标志物提供新的知识。此外，它可以产生关于某些生物标志物在病理生理、诊断和治疗水平上的作用的新假设。

{"title":"Evolution of angiogenic and inflammatory biomarkers in patients with hereditary hemorrhagic telangiectasia during treatment with bevacizumab: study protocol","authors":"B. Villanueva , A. Figueras , R. Torres-Iglesias , M. Muñoz , S. Moreno-Lopes , N. Trullén-Malaret , A. Martínez , F. Viñals , A. Riera-Mestre","doi":"10.1016/j.rceng.2025.502370","DOIUrl":"10.1016/j.rceng.2025.502370","url":null,"abstract":"<div><h3>Background</h3><div>Hereditary haemorrhagic telangiectasia (HHT) is a rare disease characterized by mucocutaneous telangiectasia and visceral vascular malformations. Treatment with bevacizumab is recommended in patients with liver involvement and high output heart failure (HOHF) or those with severe gastrointestinal (GI) involvement. However, there is no evidence on how to monitor such treatment using biomarkers.</div></div><div><h3>Material and methods</h3><div>This is an exploratory, observational, prospective, single-centre study carried out in an HHT referral unit. The inclusion period for the start of bevacizumab was from January 2022 to May 2023. Patients with an indication for starting bevacizumab were selected and underwent blood tests at baseline and during the induction (36 weeks) and maintenance phases to analyse 21 biomarkers related to angiogenesis and inflammation. In addition, control HHT patients without indication for bevacizumab and healthy controls matched 1:1:1 by age, sex, and genetic subtype (for HHT patients) underwent a baseline biomarker study. The main objective was to analyse the evolution of these biomarkers in patients with HHT treated with bevacizumab. As secondary objectives, baseline differences in the concentration of these biomarkers between the three groups and correlation with the haemoglobin levels were analysed.</div></div><div><h3>Groups description</h3><div>During the study period, nine patients with an indication for bevacizumab were included, seven due to anaemia of GI origin and two due to liver involvement with HOHF, with an overall mean age of 70 ± 8.4 years. Subsequently, the respective nine patients with HHT without bevacizumab and nine controls without HHT were selected.</div></div><div><h3>Conclusions</h3><div>The results of this exploratory study will provide new knowledge regarding potential biomarkers for monitoring the response to treatment with bevacizumab. Furthermore, it could generate new hypotheses about the role of certain biomarkers at the pathophysiological, diagnostic, and therapeutic levels.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502370"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245932","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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