RECALMIN IV. Evolution in the activity of internal medicine units of the National Health System (2008-2021).

Aims: This work aims to analyze the structure, activity, and outcomes of internal medicine units and departments (IMU) of the Spanish National Health System (SNHS) and to analyze the challenges for the specialty and propose policies for improvement. It also aims to compare the results from the 2021 RECALMIN survey with IMU surveys from previous years (2008, 2015, 2017, 2019).

Methods: This work is a cross-sectional, descriptive study of IMUs in acute care general hospitals of the SNHS that compares data from 2020 with previous studies.

Impact of the iCODEX tool in routine clinical practice in Spain.

Introduction: The prognosis of COPD patients can be calculated using multidimensional indexes that improve the predictive capacity of the individual variables. The CODEX index can be calculated using iCODEX, a digital support tool available on the web and in an app. The aim of this study was to evaluate how the usefulness and applicability of iCODEX and its recommendations in routine clinical practice are perceived by specialists in internal medicine, pneumology, and primary care.

Management of the COPD Patient with Comorbidities: An Experts Recommendation Document.

Background: Chronic obstructive pulmonary disease (COPD) is associated with multiple comorbidities, which impact negatively on patients and are often underdiagnosed, thus lacking a proper management due to the absence of clear guidelines.

Purpose: To elaborate expert recommendations aimed to help healthcare professionals to provide the right care for treating COPD patients with comorbidities.

Methods: A modified RAND-UCLA appropriateness method consisting of nominal groups to draw up consensus recommendations (6 Spanish experts) and 2-Delphi rounds to validate them (23 Spanish experts) was performed.

A rare case of long-term paraesthesia diagnosed as a paraneoplastic syndrome by anti-SOX1 antibody determination.

Paraneoplastic syndromes (PS) are a rare presentation of cancer, most commonly associated with small cell lung cancer (SCLC), breast cancer and haematologic malignancies. The diagnosis of PS is challenging because it could affect multiple organ systems and it may present before the tumour is visible by imaging. We report a malignant tumour diagnosed in a male patient who referred long-term paraesthesia and proximal muscle strength loss.

A risk score to predict the absence of left ventricular reverse remodeling: Implications for the timing of ICD implantation in primary prevention.

Background: A prophylactic implantable cardioverter defibrillator (ICD) in patients with heart failure and reduced left ventricular ejection fraction (HFrEF) is only indicated when left ventricular ejection fraction (LVEF) reassessment remains ≤35% after 3-6 months on optimal pharmacological therapy. However, LVEF may not improve during this period and the patient may be exposed to an unnecessary risk of sudden cardiac death. This study aimed to determine the incidence and predictors of the absence of left ventricular reverse remodeling (LVRR) after pharmacological treatment optimization in patients with HFrEF to design a risk score of absence of LVRR.

Effectiveness of a simple intervention on management of acute exacerbations of chronic obstructive pulmonary disease and its cardiovascular comorbidities: COREPOC study.

Background And Objective: To determine the effectiveness of a simple educational intervention to improve the management of cardiovascular comorbidities in patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (COPD).

Material And Methods: Multicenter study participated in by 26 hospital centers. A panel of experts elaborated a set of recommendations about diagnostic and therapeutic management of acute exacerbation of COPD and cardiovascular comorbidities (coronary artery disease, atrial fibrillation, heart failure and diabetes).

[Complementary treatment of acute heart failure in patients with diabetes, chronic obstructive pulmonary disease or anemia].

Diabetes, chronic obstructive pulmonary disease (COPD) and anemia are comorbidities with a high prevalence and impact in heart failure (HF). The presence of these comorbidities considerably worsens the prognosis of HF. Diabetic patients have a higher likelihood of developing symptoms of HF and both the treatment of diabetes and that of acute HF are altered by the coexistence of both entities.

[Anemia in heart failure: its usefulness as prognosis or comorbidity marker: GESAIC-2 study].

Background And Objective: To assess the prognosis and etiology of anemia in heart failure (HF).

Patients And Methods: Prospective multicenter cohort of HF after one year of hospitalization.

Results: A total of 57 (27%) of the 211 patients died and 115 (67.

[Chronic obstructive pulmonary disease on inpatients with heart failure. GESAIC study results].

Background And Objective: The clinical relevance of Heart failure (HF) and chronic obstructive pulmonary disease (COPD) in the same patient is not well established. We decided to study the prevalence of COPD in patients admitted due to HF, to define their clinical profile and the relationship with adrenergic beta-blockers (BB) treatment.

Patients And Method: Prospective cohort of inpatients with HF admitted in 15 Internal Medicine Services from October 2005 to March 2006.

[A prospective study on patients with heart failure admitted to the internal medicine department].

Context: Heart failure (HF) is one of the most important causes of morbidity and mortality and represents one of the most frequent causes of rehospitalization.

Patients And Method: Prospective study on patients admitted because of HF. A data collection questionnaire was completed: cardiology history, HF etiology, reason for admission, previous treatment, treatment during and after the admission, hospital stay and complementary explorations carried out.

[Analysis of factors associated with anticoagulant treatment indication in chronic atrial fibrillation. Prospective study of 170 patients admitted at an internal medicine service].

Background: Anticoagulant therapy reduces the risk of stroke among patients with chronic atrial fibrillation. The objective of this study was to evaluate the use of anticoagulant therapy and to analyze the factors associated with the indication of anticoagulants in patients with chronic atrial fibrillation.

Patients And Methods: Prospective study of all patients with chronic atrial fibrillation admitted to our Department of Internal Medicine from February 1997 to September 1998.

[Varicella pneumonia in the adult. A review of 25 cases].

Objective: To study the clinical, therapeutic, and evolutive features in 25 patients with the diagnosis of varicella pneumonia (VP) in the last 15 years.

Patients And Methods: The diagnosis was established by clinical and radiologic criteria in the course of varicella infection. The antecedents of smoking habit, pregnancy, and underlying disease were evaluated.