Updated document on the management of functional dyspepsia by the Asociación Española de Neurogastroenterologia y Motilidad (ASENEM) and Sociedad Española de Medicina Familiar y Comunitaria (semFYC).

Functional dyspepsia (FD) is a gut-brain axis disorder characterized by postprandial fullness, early satiety, bloating and/or epigastric pain, which are presumed to originate in the gastroduodenal tract. While the international recommendations in the Rome IV consensus require endoscopy to rule out an organic condition before establishing a diagnosis of FD, international guidelines recommend that, in the absence of risk factors, patient management be initiated at the primary care level by establishing Helicobacter pylori infection status, with eradication when positive, followed by empiric therapy with proton pump inhibitors and/or prokinetics, and that endoscopy be reserved for patients refractory to said measures. Second-line therapy includes neuromodulating agents, among which tricyclic antidepressants and atypical antipsychotics such as levosulpiride stand out.

Vitamin D Controversies in the Laboratory Medicine: A Review of Clinical Guidelines and Recommendations.

A narrative review of the main guidelines and recommendations published from 2011 up to date about the status of vitamin D deficiency has been carried out. The objective of this review is to discuss the origin of the controversy about the status of this entity, as well as the evolution of the methodological aspects and clinical situations that require vitamin D screening. The results obtained indicate that the criteria defining vitamin D status, according to two studies published in 2011, the Institute of Medicine (IOM) recommendations and the Endocrine Society (ES) guidelines, regardless the affected population.

Prenatal Exercise Decreases Urinary Incontinence in Late Pregnancy and Three Months Postpartum: A Randomized Controlled Trial.

Purpose: This study aimed to evaluate the impact of a supervised exercise program, including Pelvic Floor Muscle Training (PFMT), throughout pregnancy on Urinary Incontinence (UI).

Methods: A randomized clinical trial (NCT04563065) was conducted. Initially, 600 pregnant women were screened for eligibility, with data from 356 participants eventually analyzed.

Unveiling the interplay between soluble guanylate cyclase activation and redox signalling in stroke pathophysiology and treatment.

Soluble guanylate cyclase (sGC) stands as a pivotal regulatory element in intracellular signalling pathways, mediating the formation of cyclic guanosine monophosphate (cGMP) and impacting diverse physiological processes across tissues. Increased formation of reactive oxygen species (ROS) is widely recognized to modulate cGMP signalling. Indeed, oxidatively damaged, and therefore inactive sGC, contributes to poor vascular reactivity and more severe neurological damage upon stroke.

Epidemiologic and clinical characteristics and course of acute heart failure and cardiogenic shock diagnosed in emergency departments.

Objective: To describe the characteristics of patients diagnosed with acute heart failure (AHF) in emergency departments (EDs) who develop cardiogenic shock (CS) not associated with ST-segment elevation acute coronary syndrome (STACS).

Methods: Information for patients diagnosed with AHF in 23 Spanish EDs and registered between 2009 and 2019 were included for analysis if the patients developed symptoms consistent with CS. We described baseline clinical characteristics related to cardiac decompensation and CS, as well as 30-day mortality.

Second-Line Treatment Options for Patients with Metastatic Triple-Negative Breast Cancer: A Review of the Clinical Evidence.

Metastatic triple-negative breast cancer has a poor prognosis and poses significant therapeutic challenges. Until recently, limited therapeutic options have been available for patients with advanced disease after failure of first-line chemotherapy. The aim of this review is to assess the current evidence supporting second-line treatment options in patients with metastatic triple-negative breast cancer.

Sex Differences in Aortic Valve Inflammation and Remodeling in Chronic Severe Aortic Regurgitation.

Aortic regurgitation (AR) is more prevalent in male, although cellular and molecular mechanisms underlying the sex differences in prevalence and pathophysiology are unknown. This study evaluates the impact of sex on aortic valve (AV) inflammation and remodeling as well as the cellular differences in valvular interstitial cells (VICs) and valvular endothelial cells (VECs) in patients with AR. A total of 144 patients (27.

Allergic Reactivity and Memory Occur Independently of Sequential Switching Through IgG1.

Allergic reactions to foods are primarily driven by allergen-binding immunoglobulin (Ig)E antibodies. IgE-expressing cells can be generated through direct switching from IgM to IgE or a sequential class switching pathway where activated B cells first switch to an intermediary isotype, most frequently IgG1, and then to IgE. It has been proposed that sequential class switch recombination is involved in augmenting the severity of allergic reactions, generating high affinity IgE, differentiation of IgE plasma cells, and in holding the memory of IgE responses.

Distal Access Catheter Improves Balloon Guide and Stent Retriever Thrombectomy Outcomes in Nonagenarians.

Background And Purpose: The safety and effectiveness of endovascular techniques in elderly patients with large vessel occlusion (LVO) remain controversial. We investigated the angiographic and clinical outcomes of nonagenarians treated with different endovascular techniques using a balloon guide catheter (BGC), distal aspiration catheter (DAC), and/or stent retriever (SR).

Methods: We analyzed the data from the Registry of Combined versus Single Thrombectomy Techniques (ROSSETTI) of consecutive nonagenarian patients with anterior circulation LVO and compared the outcomes of those treated with BGC+noDAC+SR (101-group), BGC+DAC+SR (111-group), and noBGC+DAC+SR (011-group).

Brief communication: gaps and opportunities in HIV research in Venezuela.

Over the past decade, Venezuela has experienced a political and economic crisis that has affected the country's scientific research development. Currently, the state of HIV research in Venezuela remains unknown. We conducted a systematic review identifying 683 articles over the last 20 years of which only 101 met our inclusion criteria.

Transition to competent oral feeding in preterm infants: Analyzing timing and determinants.

Introduction: The achievement of oral feeding competence (OFC) is a challenge in preterm infants and can be affected by several factors.

Objective: The aim of our study was to determine the time elapsed to development of OFC in very low birth weight (VLBW, weight <1500g) preterm infants and to identify factors associated with greater difficulty in achieving this skill.

Population And Methods: Observational, longitudinal and prospective study in VLBW infants over a period of 7 years (2016-2022).

Prospective association of changes in (poly)phenol intake, body weight and physical activity with inflammatory profile.

Backgrounds And Aim: To prospectively evaluate the associations between changes in (poly)phenol intake, body weight(BW), and physical activity(PA) with changes in an inflammatory score after 1-year.

Methods And Results: This is a prospective observational analysis involving 484 participants from the PREDIMED-Plus with available inflammatory measurements. (Poly)phenol intake was estimated using a validated semi-quantitative food frequency questionnaire and the Phenol-Explorer database.

Intrarater and interrater reliability of the Clinical Frailty Scale-Es and FRAIL-Es in critically ill patients.

Objective: To evaluate the intrarater and interrater reliability of the Clinical Frailty Scale-Spain (CFS-España) and FRAIL-España and the internal consistency of the FRAIL-España when implemented in critically ill patients by intensive care nurses and physicians.

Design: Descriptive, observational and metric study.

Setting: intensive care unit (ICU) of Spain.

Secondary hyperoxaluria: Cause and consequence of chronic kidney disease.

Secondary hyperoxaluria is a metabolic disorder characterized by an increase in urinary oxalate excretion. The etiology may arise from an increase in the intake of oxalate or its precursors, decreased elimination at the digestive level, or heightened renal excretion. Recently, the role of the SLC26A6 transporter in the etiopathogenesis of this disease has been identified.

Evolution of arterial stiffness and association with cardiovascular risk factors in the Spanish population. Follow-up EVA.

Introduction And Objectives: To analyse the increase of arterial stiffness over a five-year period and its relationship with cardiovascular risk factors and sex-based differences in a Spanish population without cardiovascular disease.

Methods: Longitudinal study. Analysis of the increase in arterial stiffness measures evaluated with SphygmoCor and Vasera of 480 subjects followed for 5 years of the 501 subjects included in the baseline evaluation, selected through random sampling stratified by age and sex, mean age of 55.

[Small intestine bacterial overgrowth: Myths and realities].

The small intestine bacterial overgrowth (SIBO) is a clinical disorder resulting from colonization of the small intestine by an excessive number of microorganisms or by unusual microorganisms. When they are methane producers it is called intestinal methanogen overgroth (IMO). Known risk factors are congenital or acquired anatomical alterations, motility alterations, some systemic and autoimmune diseases, those that cause alterations in biliopancreatic secretions, hypochlorhydria and some drugs.

Some thoughts about the "Consensus statement on smoking and vascular risk" from the Spanish Autonomous Societies of Hypertension and Vascular Risk.

Smoking is a known preventable risk factor for vascular diseases. However, it is one of the most forgotten risks when we talk about its relationship with kidney disease. Following the publication of the "Consensus statement on smoking and vascular risk" promoted by the autonomous societies of hypertension and vascular risk of Spain, we consider that the nephrology community should be alerted about the deleterious effects of exposure to tobacco smoke and its consequences on renal damage.