Medicina clinica
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Review
Paradigm shift in monogenic autoinflammatory diseases and systemic vasculitis: The VEXAS syndrome.
VEXAS syndrome was described by the end of 2020 as an autoinflammatory disease caused by post-zygotic variants in the UBA1 gene. VEXAS syndrome occurs in adult males with recurrent fever, arthralgia/arthritis, ear/nose chondritis, neutrophilic dermatosis, lung inflammation, venous thrombosis, and different types of vasculitis. Common laboratory changes include raised acute phase reactants and macrocytic anemia. ⋯ Azacitidine has been associated with a good response, especially in patients with accompanying myelodysplastic syndrome. Allogeneic hematopoietic stem cell transplantation appears to be the only curative therapy by now. VEXAS syndrome has become a paradigm shift in the diagnosis and treatment of autoinflammatory diseases and systemic vasculitis.
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Multicenter Study
Mortality risk factors in patients with SARS-CoV-2 infection and atrial fibrillation: Data from the SEMI-COVID-19 registry.
Atrial fibrillation and associated comorbidities pose a risk factor for mortality, morbidity and development of complications in patients admitted for COVID-19. ⋯ Previous treatment with DOACs and DOACs treatment during admission seem to have a protective role in patients with atrial fibrillation, although this fact should be verified in prospective studies.
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Randomized Controlled Trial
Physical training program for people at risk of cardiovascular disorders in the primary care setting: A randomized clinical trial.
The impact of a physical training program on moderate-vigorous physical activity is still poorly known in primary cardiovascular prevention. Our objective was to determine the efficacy of a physical training program to promote moderate-vigorous physical activity and exercise in individuals at risk of suffering a cardiovascular event. ⋯ A short-duration physical training program performed in the primary care setting is efficacious and safe in promoting moderate-vigorous physical activity and exercise in the short-term, in a population at risk of suffering a cardiovascular event.
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Diagnosing pulmonary thromboembolism (PTE) is difficult. Clinical probability scales (CPS) can help. The aim is to find out which one is the best. ⋯ The YEARS scale is shown to be better than the others due to its potential greater number of imaging tests avoided and the degree of application of the CPS could be improved.