Gros M, Gros-Bañeres B, Mesonero JE
… +1 more, Latorre E
Med Clin (Barc)
· 2026 May · PMID 41785841
·
Publisher ↗
BACKGROUND: Dietary habits are closely related to symptom modulation in irritable bowel syndrome (IBS), yet their characterization remains limited. Understanding habitual food intake in IBS patients may contribute to dia...BACKGROUND: Dietary habits are closely related to symptom modulation in irritable bowel syndrome (IBS), yet their characterization remains limited. Understanding habitual food intake in IBS patients may contribute to diagnosis and support personalized management. OBJECTIVES: To identify dietary patterns associated with IBS and to develop a diet-based score to aid in clinical stratification and nutritional guidance. METHODS: A case-control study was conducted including 109 participants (53 IBS patients and 56 healthy controls). Dietary intake was assessed using a validated short food frequency questionnaire. Multivariate logistic regression identified food items that best distinguished IBS patients from controls, which were then used to construct a composite dietary score. RESULTS: IBS patients exhibited distinct dietary patterns, characterized by higher intake of carbohydrates and lower consumption of dairy products, while fruit and vegetable intake were similar between groups. A score based on the intake of rice, bread, yoghurt, minced meat, and distilled beverages showed good discriminatory capacity (sensitivity: 85.7%, specificity: 81.1%). CONCLUSIONS: IBS patients present characteristic dietary profiles that may have diagnostic and therapeutic implications. The proposed dietary score could serve as a complementary tool to support clinical decision-making and guide personalized nutritional counseling. Further research is warranted to validate its applicability in routine clinical practice.
Távara-Vidalón P, Lloret-González JM, Alcalá-Cruz M
Med Clin (Barc)
· 2026 May · PMID 41780307
·
Publisher ↗
Chronic plantar fasciitis is a degenerative process that affects the plantar fascia of the foot. The aim of this literature review was to update knowledge on the diagnostic approach and to compare the therapeutic effecti...Chronic plantar fasciitis is a degenerative process that affects the plantar fascia of the foot. The aim of this literature review was to update knowledge on the diagnostic approach and to compare the therapeutic effectiveness of extracorporeal shockwave therapy and dextrose prolotherapy. A search was conducted in three databases, including articles published over the last 10-15years. There is sufficient scientific evidence supporting that shockwave therapy has become established as an effective, safe, and valid method for the treatment of chronic plantar fasciitis, providing good outcomes regardless of the type of wave and intensity level applied. In turn, dextrose prolotherapy has been shown to be effective in reducing pain in the short and medium term, proving superior to placebo or isolated conservative therapies, and emerging as a valid cost-effective alternative.
OBJECTIVES: Optimizing brain health is increasingly recommended for patients with multiple sclerosis (MS). We investigated associations between modifiable lifestyle and metabolic factors with physical and cognitive perfo...OBJECTIVES: Optimizing brain health is increasingly recommended for patients with multiple sclerosis (MS). We investigated associations between modifiable lifestyle and metabolic factors with physical and cognitive performance in 101 MS patients. METHODS: In this prospective, cross-sectional, exploratory study, we assessed smoking, alcohol consumption, body mass index (BMI), lipid profiles (high-density lipoprotein, HDL; low-density lipoprotein, LDL; triglycerides), and vitamin levels (vitamin D, vitamin B12, and folic acid). Associations with upper limb function (Nine-Hole Peg Test, 9HPT), lower limb function (10-meter walking test; balance board), cognitive performance (Symbol Digit Modalities Test, SDMT), and employment (weekly working hours) were examined. RESULTS: Many patients showed potential for metabolic improvement, with abnormal levels observed in LDL (57%), triglycerides (27%), vitamin D (14%), vitamin B12 (7%), and folic acid (19%). Elevated BMI was found in 41% and 24% reported smoking. Pack-years were negatively associated with performance in the 10-meter walking test (r=-0.59, 95% CI: -0.81 to -0.23, p=0.003), and a higher BMI was linked to poorer balance (r=0.21, 95% CI: 0.01-0.4, p=0.042), while higher HDL levels correlated with preserved upper limb function (r=-0.21, 95% CI: -0.39 to -0.01, p=0.04). No consistent correlations were observed regarding vitamins. Performance in the SDMT and the 10-meter walking test were associated with unemployment. CONCLUSIONS: Many MS patients exhibit dyslipidemia and obesity, highlighting the need for targeted interventions to enhance neurological resilience. Our cross-sectional analysis indicates that smoking, low HDL, and higher BMI may have adverse clinical effects in MS.
BACKGROUND AND OBJECTIVES: COPD is characterized by exacerbations that increase morbi-mortality. Maintenance pharmacological treatment is based on long-acting bronchodilators. This study assessed the effectiveness of dif...BACKGROUND AND OBJECTIVES: COPD is characterized by exacerbations that increase morbi-mortality. Maintenance pharmacological treatment is based on long-acting bronchodilators. This study assessed the effectiveness of different therapeutic strategies under real-world conditions. MATERIALS AND METHODS: Observational, longitudinal, retrospective cohort study using data from the Spanish BIFAP database (2010-2020) including patients with incident COPD. Patients were stratified by therapy: monotherapy, dual therapy (with/without inhaled glucocorticoids), and triple therapy. Multivariable mixed-effects Cox models adjusted for clinical factors and comorbidities were applied to estimate the risk of moderate-to-severe exacerbations. RESULTS: A total of 69.565 patients were included (mean age 63 years; 71% men). Age, female sex and diabetes were associated with a higher risk of moderate-to-severe exacerbations. Risk increased with treatment escalation: monotherapy (HR=4.14), dual therapy without inhaled glucocorticoids (HR=2.45), dual therapy with inhaled glucocorticoids (HR=7.11), and triple therapy (HR=5.31), reflecting indication bias. A higher risk was also observed with lack of treatment optimization, either by therapeutic regimen (HR=3.75) or number of devices (HR=1.31). Differences in risk were identified among specific active agents within the same therapeutic class. CONCLUSIONS: In real-world practice, the risk of moderate-to-severe exacerbations is influenced by baseline disease severity, particularly prior exacerbations, and by the therapeutic pattern. LAMA/LABA appears as the preferred option over dual therapy with inhaled glucocorticoids. Optimizing therapy and simplifying inhaler devices are associated with lower risk and should be prioritized in COPD management.
BACKGROUND: Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes of primary cutaneous lymphomas (PCLs). Despite increasing incidence, data on mortality trends specifically for MF and SS are scarce...BACKGROUND: Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes of primary cutaneous lymphomas (PCLs). Despite increasing incidence, data on mortality trends specifically for MF and SS are scarce. This study aimed to analyse mortality trends for these lymphomas in the Spanish population from 1983 to 2022. METHODS: An ecological study was conducted using data from the Spanish National Statistics Institute. Age-standardised mortality rates (ASMRs) were calculated based on the 2013 European standard population. Changes in mortality trends were identified by joinpoint regressions. Additionally, an age-period-cohort (A-P-C) model was performed to assess the independent effects of age, birth cohort and period of diagnosis on mortality. RESULTS: The study revealed a marked disparity in mortality rates between men and women. Male mortality was consistently higher, with a male-to-female ratio of approximately 2. The joinpoint analysis showed stable trends for both sexes throughout the study period. The A-P-C model confirmed a marked age effect, with mortality rates increasing with age for both sexes. However, the risk of dying from MF/SS remained stable across birth cohorts for both men and women. CONCLUSION: This study found stable mortality rates for MF/SS in Spain, with relevant differences in sex and age. The lack of variation across birth cohorts suggests that age and sex are the main determinants of mortality. Further research is needed to understand the underlying reasons for these trends and develop targeted interventions to improve patient outcomes.
INTRODUCTION: Obesity is a chronic adiposity-based disease with limited long-term response to lifestyle interventions. Oral semaglutide, currently approved for type 2 diabetes, may represent a therapeutic option for obes...INTRODUCTION: Obesity is a chronic adiposity-based disease with limited long-term response to lifestyle interventions. Oral semaglutide, currently approved for type 2 diabetes, may represent a therapeutic option for obesity, although real-world evidence is scarce. OBJECTIVE: To evaluate, in a real-world clinical setting, changes in body weight, body composition, and muscle strength after treatment with oral semaglutide in patients with obesity. Secondary objectives were to assess changes in metabolic and inflammatory parameters and depressive symptoms. METHODS: We conducted a multicenter, prospective, observational study including 70 adults with obesity without diabetes who initiated oral semaglutide as part of routine clinical care. RESULTS: After 4 months, mean body weight decreased by 5.4kg, mainly due to a reduction in fat mass, accompanied by decreases in waist circumference, and visceral fat. Lean mass showed a small reduction, while muscle strength remained unchanged. Clinically meaningful weight loss was achieved by 44.3% of patients. Improvements were also observed in metabolic parameters, inflammatory markers, and depressive symptoms. CONCLUSIONS: In real-world clinical practice, treatment with oral semaglutide at doses approved for type 2 diabetes was associated with short-term weight loss in patients with obesity, primarily driven by fat mass reduction, with preservation of muscle strength. These findings should be interpreted considering the observational design and lack of a comparator group.
Med Clin (Barc)
· 2026 Mar · PMID 41653587
·
Publisher ↗
Point-of-care ultrasound (POCUS) has become an essential diagnostic and procedural adjunct in infectious disease practice, providing real-time bedside evaluation that improves patient outcomes. Despite its clinical relev...Point-of-care ultrasound (POCUS) has become an essential diagnostic and procedural adjunct in infectious disease practice, providing real-time bedside evaluation that improves patient outcomes. Despite its clinical relevance, broad implementation faces educational challenges, including limited access to hands-on training, inconsistent curricular integration, and lack of standardized certification pathways across all stages of medical education. This review frames POCUS education as a longitudinal, progressive pathway starting with foundational exposure in undergraduate medical curricula and advancing through competency-based postgraduate training, continuing professional development, and formal credentialing. Key educational frameworks such as G.O.O.S.E. and I-AIM structure the acquisition of both technical imaging skills and clinical integration, fostering critical ultrasound competence. Various stakeholders contribute to this continuum: medical schools form the foundational base; private sector programs fill training gaps using innovative educational approaches including immersive workshops, simulation, blended learning, and small-group pathology-focused sessions; and scientific societies provide leadership by defining standards, supporting collaborative research, and advocating for formalized training and certification. These innovative training modalities enable flexible, practical skill acquisition tailored to evolving clinical needs and diverse practice environments, accelerating learners' progression toward competent, autonomous ultrasound use. Such approaches are especially valuable in resource-limited settings or where traditional academic resources are constrained. Sustained multisectoral collaboration among academic institutions, private educators, scientific societies, and regulatory bodies is vital to ensure accessible, effective, and equitable POCUS training worldwide. By outlining this comprehensive educational roadmap and recognizing ongoing innovations, this review aims to guide the integration of POCUS into infectious disease care, ultimately improving global patient outcomes.