Nicolau J, Sanchís P, Nadal A
… +6 more, Isabel Tamayo M, Sfondrini G, Grimalt M, García P, Nadal C, Masmiquel L
Med Clin (Barc)
· 2026 May · PMID 41832804
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BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis strongly associated with obesity and metabolic dysfunction. GLP-1 receptor agonists (GLP-1 RAs), such as semaglutide, promote weight loss and...BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis strongly associated with obesity and metabolic dysfunction. GLP-1 receptor agonists (GLP-1 RAs), such as semaglutide, promote weight loss and exhibit anti-inflammatory properties, but evidence regarding their effects in HS remains limited. OBJECTIVE: To evaluate the effects of 6 months of semaglutide treatment at doses >1mg/week on anthropometric, dermatologic, metabolic, inflammatory, and quality-of-life outcomes in patients with HS and obesity. METHODS: We conducted a prospective, open-label cohort study including 20 adults with HS and obesity. Anthropometric, morphofunctional, dermatologic (Hurley stage, DLQI, pain VAS), psychological (BDI), metabolic, and inflammatory parameters were assessed at baseline and after 6 months. RESULTS: After 6 months, body weight (-21.4kg), BMI, waist circumference, blood pressure, and preperitoneal and subcutaneous fat were significantly reduced (all p<0.05). Dermatologic outcomes improved markedly: Hurley stage decreased in all patients, DLQI improved (-8.8), pain VAS decreased (-4.1), and BDI improved (-12.9; all p<0.001). Metabolic and inflammatory markers also improved. After adjustment for weight change, improvements in DLQI, pain, depressive symptoms, Hurley stage, vitamin D, CRP, and cortisol remained significant. CONCLUSIONS: Semaglutide treatment in patients with HS and obesity improved weight, body composition, metabolic and inflammatory profiles, and dermatologic and psychological status. Several clinical and inflammatory benefits persisted after adjustment for weight loss.
Escalante-Reyes M, Tejera-Muñoz A, González-Hermoso I
… +3 more, Sirera-Sirera P, Alfayate-Guerra R, Llorens P
Med Clin (Barc)
· 2026 May · PMID 41832802
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BACKGROUND AND OBJECTIVE: The diagnosis of intracranial injury (ICI) after mild traumatic brain injury (TBI) is made using cranial computed tomography (CT), a technique that involves radiation and waiting times in the em...BACKGROUND AND OBJECTIVE: The diagnosis of intracranial injury (ICI) after mild traumatic brain injury (TBI) is made using cranial computed tomography (CT), a technique that involves radiation and waiting times in the emergency department. Serum biomarkers, such as S100β, GFAP, and UCH-L1, could be rapid and efficient alternatives for ruling out ICI. MATERIALS AND METHODS: This was a cross-sectional observational study evaluating diagnostic tests in adult patients treated in the emergency department between 2023 and 2024 for mild TBI, who underwent cranial CT and serum determination of these biomarkers. RESULTS: A total of 329 patients with a mean age of 77 years were included, 59.3% of whom were women. 8.4% showed ICI on cranial CT. Sensitivity was 92.9% and negative predictive value was 96.3% in TBI test (GFAP+UCH-L1), higher than that of S100β. Patients with ICI had higher GFAP concentrations. CONCLUSIONS: TBI test, and more specifically GFAP, showed greater diagnostic performance, supporting its use as a tool to optimize the indication for cranial CT in the emergency department after mild TBI.
Echeverría Gorriti A, Gorricho Mendívil J, Etxegia Apezetxea J
… +11 more, Tamayo Rodríguez I, Librero López J, Rodríguez Esquíroz A, Celaya Lecea MC, Garjón Parra J, Sanz Álvarez L, Marín Marín M, García González P, Fernández González J, Irisarri Garde R, Campillo Arregui A
Med Clin (Barc)
· 2026 May · PMID 41832801
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BACKGROUND AND OBJECTIVE: In 2017, 2018, and 2022, a population-based strategy was implemented to deprescribe proton pump inhibitors (PPIs) in patients who did not meet clinical indications for treatment. This study eval...BACKGROUND AND OBJECTIVE: In 2017, 2018, and 2022, a population-based strategy was implemented to deprescribe proton pump inhibitors (PPIs) in patients who did not meet clinical indications for treatment. This study evaluates health outcomes related to the safety of deprescribing and the adverse effects associated with PPI consumption in these patients. PATIENTS AND METHODS: A nested case-control study within a cohort was conducted, with follow-up through December 31, 2024. The primary endpoint was a composite of mortality or urgent hospital admission. Secondary endpoints included upper gastrointestinal bleeding, other gastrointestinal events (ulcers, gastritis, or esophagitis), hypomagnesemia, cyanocobalamin deficiency, hypocalcemia, iron deficiency, pneumonia, Clostridioides difficile infection, and bone fractures. Adjustments were made for sex, age, Charlson Comorbidity Index, prior urgent hospital admissions, number of primary care visits in the preceding year, and number of prescribed medications. Additionally, a process mining analysis was performed to describe patient trajectories. RESULTS: A total of 28,161 patients were included. PPI deprescribing proved to be safe regarding mortality and hospitalization (OR=0.78; 95% CI: 0.70-0.88). A higher incidence of gastric adverse events was observed, but not of gastrointestinal bleeding. Furthermore, a lower incidence of micronutrient deficiencies, fractures, and pneumonia was found among patients who underwent PPI deprescribing. In the sex-stratified analysis, deprescribing was associated with fewer admissions or hospitalizations in both groups. CONCLUSIONS: The PPI deprescribing strategy in patients without risk factors for gastrointestinal bleeding seems to be safe in terms of mortality and hospital admissions.
Riveiro V, Ferreiro L, Abelleira R
… +6 more, Rodríguez-Núñez N, Toubes ME, Ricoy J, García-Sobrino T, Valdés L, Zamarrón C
Med Clin (Barc)
· 2026 May · PMID 41819726
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INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a progressive and heterogeneous neurodegenerative disease that manifests itself in different phenotypes depending on the anatomical region affected. PATIENTS AND METHO...INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a progressive and heterogeneous neurodegenerative disease that manifests itself in different phenotypes depending on the anatomical region affected. PATIENTS AND METHODS: Retrospective observational study of patients diagnosed with ALS in our healthcare area, classified by phenotypes to assess their relationship with functional respiratory variables, gas exchange, and sleep-related breathing disorders. The search period was from 2014 to 2024. RESULTS: Data from 201 patients were analyzed. The overall mean incidence of ALS was 3.8 cases (95%CI: 3.3-4.3)/100,000 inhabitants/year, while the prevalence was 9.4 cases (95%CI: 7.8-11.1)/100,000 inhabitants. The results indicated that the spinal phenotype is the most common (49.3%), while the bulbar phenotype presented greater respiratory involvement, with a lower forced vital capacity (FVC) (86% [IQR: 66.5-98]) and greater nocturnal desaturation CT90 8% (IQR: 2.3-32.5%). Likewise, a prevalence of respiratory disorders during sleep was observed, with approximately 50% mild obstructive sleep apnea (OSA), 30% moderate, and 15% severe. Severe OSA was recorded in 8% of patients with spinal ALS, 14% of patients with bulbar ALS, and 17% with other forms of ALS. CONCLUSIONS: The disease significantly affects respiratory function, especially in the bulbar phenotype, and respiratory disturbances during sleep are common. The heterogeneity of ALS highlights the importance of a personalized approach to patient management.
Ezquerra-Durán A, Guillen-Del-Castillo A, Felix Tellez FA
… +6 more, Argibay-Filgueira A, Marí-Alfonso B, Freire M, Alcalá-González LG, Simeón-Aznar CP, e investigadores del registro REMSCLE de la Sociedad Española Multidisciplinar de Enfermedades Autoinmunes (SEMAIS)
INTRODUCTION: Gastrointestinal (GI) involvement is the most frequent visceral manifestation of systemic sclerosis (SSc) and is associated with increased morbidity and mortality. To date, its characterization using specif...INTRODUCTION: Gastrointestinal (GI) involvement is the most frequent visceral manifestation of systemic sclerosis (SSc) and is associated with increased morbidity and mortality. To date, its characterization using specific diagnostic tests has been poorly described in the Spanish population. METHODS: A cross-sectional study was conducted including patients with SSc enrolled in the Spanish Multidisciplinary Scleroderma Registry (REMSCLE) up to April 2024 who had undergone at least one GI diagnostic test. Objective GI involvement was defined as the presence of pathological findings in any of these tests. Clinical, immunological, and functional characteristics were compared between patients with and without objective GI involvement. RESULTS: A total of 816 patients were included, of whom 492 (60.3%) presented objective GI involvement, with esophageal dysmotility being the most frequent finding (77.3%). GI involvement was associated with an earlier disease onset (46.2 vs. 50.7 years; P=.002), a higher prevalence of the diffuse subtype (23.2% vs. 14.8%; P=.003), and more vascular manifestations, including digital ulcers (42.8% vs. 34.7%; P=.021), telangiectasias (72.0% vs. 63.0%; P=.008), and non-inflammatory myopathy (11.3% vs. 4.4%; P=.015). Patients with GI involvement also showed a higher prevalence of interstitial lung disease (51.4% vs. 39.2%; P=.001) and cardiac involvement (41.3% vs. 28.0%; P<.001). In addition to a distinct immunological profile, a lower frequency of anti-centromere antibodies (43.0% vs. 53.7%; P=.004) and a higher prevalence of anti-U1RNP antibodies (6.5% vs. 3.1%; P=.043) were observed. CONCLUSION: Objective GI involvement in the REMSCLE cohort is highly prevalent and is associated with more severe clinical phenotypes, multiorgan involvement, and specific serological profiles, underscoring the need for systematic and early evaluation of GI tract involvement in patients with SSc.
BACKGROUND: Phenylketonuria (PKU), the inherited metabolic autosomal recessive disorder, is a prevalent disorder in Arabic countries (1 in 6000 babies are affected by this disorder) due to the high prevalence of consangu...BACKGROUND: Phenylketonuria (PKU), the inherited metabolic autosomal recessive disorder, is a prevalent disorder in Arabic countries (1 in 6000 babies are affected by this disorder) due to the high prevalence of consanguinity. In children with PKU, excess body weight and its associated complications - such as non-alcoholic fatty liver disease (NAFLD) - are highly reported due to the sedentary lifestyle, low physical activity, and restriction of the consumption of most important natural dietary proteins that can pose a potential risk of overconsumption of carbohydrates, sugars, and fats to meet children's energy needs. Investigating the effect of an 8-week walking exercise program on liver enzymes in children with PKU and NAFLD was the aim of this randomized controlled trial. METHODS: This PKU trial is a randomized controlled trial in children. Forty overweight/obese children with PKU and NAFLD who were aged 9-12 years old were included. Children were randomly assigned into an exercise group (n=20) that received an 8-week free walking program or control group (waitlist group, n=20). Serum alanine transaminase (ALT), body mass index (BMI), serum gamma-glutamyl transferase (GGT), serum triglycerides (TG), serum alkaline phosphatase (ALP), and serum aspartate transaminase (AST) were assessed in both groups. RESULTS: A significant enhancement (improvement) in BMI, ALT, GGT, ALP, AST, and TG was reported in the exercise group only. CONCLUSION: Participation in an 8-week free walking program significantly improves BMI, AST, ALP, ALT, GGT, and TG in children with NAFLD and PKU.