Revista clinica espanola最新文献

英文中文

Exploring the diversity of 1p36 microdeletion syndrome in patients diagnosed in adulthood 探讨1p36微缺失综合征在成年患者中的多样性。

Revista clinica espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.rceng.2025.502397

Á. García Tellado , M. García Castro , A. Sariego Jamardo , N. Puente Ruiz

引用次数: 0

Primary cutaneous anaplastic large cell lymphoma: diagnosis following the progression of chronic skin lesions 原发性皮肤间变性大细胞淋巴瘤：慢性皮肤病变进展后的诊断。

Revista clinica espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.rceng.2025.502395

A. Castillo Leonet , A.S. Collado Martín , I. Cabezón Estévanez

引用次数: 0

Impact of arterial hypertension on ocular vascular ischemia 高血压对眼血管缺血的影响。

Revista clinica espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.rceng.2025.502389

L. Castilla-Guerra , A.J. Gómez-Escobar , E. Gutiérrez-Sánchez , P. Luque-Linero , R. Dominguez Álvarez , M. Gandullo Moro , M.Á. Rico-Corral

Introduction

At the ocular level, hypertension causes retinal, choroidal and optic nerve lesions, and can be complicated by obstructive and ischaemic phenomena. We set out to assess the impact of hypertension on the different types of ocular vascular ischemia.

Patients and methods

Retrospective case-control study of patients seen in a vascular risk consultation. All patients underwent pulse wave velocity (PWV), ABI and carotid Doppler ultrasound.

Results

187 patients were included, 76 retinal venous occlusions (RVO), 21 retinal arterial occlusions (RAO), 28 non-arteritic ischaemic neuropathies (NAION) and 62 hypertensive controls without ocular ischaemia (CP). Mean age was 64 (±11), 68 (±10), 61 (±10) and 56 (±11) years in RVO, RAO, NAION, and PC respectively (P = 0.92). RVOs had a higher frequency of hypertension (71.4%), dyslipidaemia (55%) and diabetes (47.6%) (P = 0.001, P = 0.001 and P = 0.028 respectively) compared to the other groups. In relation to subclinical organ damage, patients with RVO had higher PWV 10.7 m/s (p = 0.004), pulse pressure 66 mmHg (p = 0.009), and vascular age 66.4 years (p = 0.005), with no differences in IMT, presence of carotid plaques or ITB. The occurrence of ocular ischaemia correlated with age (p = 0.009), DM2 (p = 0.027), dyslipidaemia (p = 0.047) and presence of plaques (p = 0.019).

Conclusions

Hypertension is a constant in vascular ocular ischaemic pathology, having a greater impact due to arterial stiffness in RVO. Age, diabetes, dyslipidaemia and the presence of plaques will increase the appearance of ocular ischemia.

在眼水平，高血压可引起视网膜、脉络膜和视神经病变，并可并发梗阻性和缺血性现象。我们开始评估高血压对不同类型的眼部血管缺血的影响。患者和方法：血管危险会诊患者的回顾性病例对照研究。所有患者均行脉搏波速度（PWV）、ABI及颈动脉多普勒超声检查。结果：纳入187例患者，其中视网膜静脉闭塞（RVO） 76例，视网膜动脉闭塞（RAO） 21例，非动脉缺血性神经病变（NAION） 28例，无眼缺血（CP）的高血压对照组62例。RVO、RAO、NAION、PC的平均年龄分别为64（±11）岁、68（±10）岁、61（±10）岁、56（±11）岁（P = 0.92）。RVOs组高血压（71.4%）、血脂异常（55%）和糖尿病（47.6%）发生率高于其他各组（P = 0.001、P = 0.001和P = 0.028）。与亚临床器官损害相关，RVO患者的PWV为10.7 m/s (p = 0.004)，脉压为66 mmHg (p = 0.009)，血管年龄为66.4岁（p = 0.005），而IMT、颈动脉斑块或ITB的存在无差异。眼部缺血的发生与年龄（p = 0.009）、DM2 （p = 0.027）、血脂异常（p = 0.047）、斑块存在（p = 0.019）相关。结论：高血压在血管性眼缺血病理中是一个常数，在RVO中由于动脉僵硬而有更大的影响。年龄、糖尿病、血脂异常和斑块的存在都会增加眼缺血的出现。

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引用次数: 0

Practical management of heart failure in hospital at home: recommendations from the Spanish Society of Internal Medicine and the Spanish Society of Hospital at Home 家庭医院心力衰竭的实际管理：来自西班牙内科学会和西班牙家庭医院学会的建议

Revista clinica espanola

Pub Date : 2025-12-01 DOI: 10.1016/j.rceng.2025.502399

Ruiz-Castellano M. , Aguiar D. , Aguilar-Rodríguez F. , Cubo P , Flox G. , Murcia J.M. , Coloma E. , Gracia V.M. , Vicente C. , Salamanca-Bautista P.

Heart failure (HF) is a major cause of morbidity, mortality, and hospital admissions worldwide. Home hospitalization (HaH) has emerged as an effective alternative, enhancing patient care and optimizing healthcare resources. This expert consensus document, endorsed by the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Home Hospitalization (SEHAD), provides practical recommendations for the management of HF in HaH settings. It outlines patient selection criteria, parameters for assessing congestion, and treatment protocols. The document emphasizes the use of telemonitoring and point-of-care ultrasound (POCUS). Therapeutic optimization, clinical follow-up, and patient education are fundamental. It also addresses comorbidity management and the integration of palliative care. Certification of HF care units and the strengthening of interdisciplinary collaboration are key to improving healthcare quality. HaH presents itself as an effective strategy for the comprehensive management of HF, reducing hospital-related complications and promoting patient-centered care.

心力衰竭（HF）是世界范围内发病率、死亡率和住院率的主要原因。家庭住院（HaH）已成为一种有效的替代方案，可加强患者护理并优化医疗保健资源。这份专家共识文件由西班牙内科学会（SEMI）和西班牙家庭住院学会（SEHAD）批准，为在医院环境中管理心衰提供了实用建议。它概述了患者的选择标准、评估充血的参数和治疗方案。该文件强调使用远程监测和即时超声（POCUS）。治疗优化、临床随访和患者教育是基础。它还涉及合并症管理和姑息治疗的整合。心衰护理单位的认证和加强跨学科合作是提高医疗保健质量的关键。体外循环是一种有效的心衰综合治疗策略，可减少与医院相关的并发症，促进以患者为中心的护理。

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引用次数: 0

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 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 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

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 DOI: 10.1016/j.rceng.2025.502378

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

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 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。

{"title":"Iron deficiency and iron deficiency anemia and their association with pulmonary embolism","authors":"N. Báez-Ferrer , J. Monllor-Méndez , D. Álvarez-Luis , L. Hernández-Chinea , A.W. Al-Hayani-Al-Hantoosh , A. Domínguez-Rodríguez","doi":"10.1016/j.rceng.2025.502382","DOIUrl":"10.1016/j.rceng.2025.502382","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Patients and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P</em>  =.05)).</div></div><div><h3>Conclusion</h3><div>ID may represent an increased risk of PE in the 12 months following its detection.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502382"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460986","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

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 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。

{"title":"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","authors":"Halbert Hernández-Negrin , Diana Paredes-Ruiz , Víctor Moreno-Torres , Ioana Ruiz-Arruza , Guillermo Ruiz-Irastorza","doi":"10.1016/j.rceng.2025.502384","DOIUrl":"10.1016/j.rceng.2025.502384","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":94354,"journal":{"name":"Revista clinica espanola","volume":"225 9","pages":"Article 502384"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369181","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

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 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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