Medicina clinica
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Clostridioides difficile is the main cause of healthcare-associated diarrhoea in adults. The incidence of C.difficile infection (CDI) has increased in recent years. The risk of recurrence of CDI is 15%-25% in a first episode and this risk is increased in subsequent episodes. ⋯ These are laborious and slow techniques and therefore they have been replaced in clinical practice by the application of a multi-step algorithm that includes the detection of glutamate dehydrogenase (GDH), toxins and molecular techniques. The treatment of choice for CDI is Vancomycin. In recent years, new drugs and new treatment strategies have appeared that are especially useful in the treatment of relapses of CDI.
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There are multiple frailty detection tools, but they have not been specifically developed for the institutionalised population. The aim of this study is to ascertain at 3-year follow-up which tool predicts functional impairment and mortality most precisely. ⋯ The Imputed Fried and FRAIL-NH tools showed a higher predictive capability for functional and cognitive decline, but only the Imputed Fried Frailty Criteria found a significant relationship between frailty and mortality.
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Treatment of rheumatoid arthritis with rituximab (RTX) requires repeated cycles, but there is no well-established retreatment regimen in dose and frequency. The objective was to analyse the persistence of RTX treatment and factors that influence in terms of routine clinical practice. ⋯ The persistence of RTX in clinical practice is higher in seropositive patients and in those who are treated with RTX associated with a csDMARD. Dose per cycle and retreatment frequency do not have a decisive role in rituximab persistence.