Stress, microbiota, and the gut-brain axis in mental and digestive health
The prevailing mind-body dualism in contemporary medicine, rooted in reductionism and the fragmentation of knowledge, has impeded the development of a conceptual model that can adequately address the complexity of illnesses. Integrating biomedical data into a cohesive model that considers the mind-body-context interconnections is essential. This integration is not merely theoretical; rather, it has significant clinical implications. This is exemplified by chronic stress-related mental and digestive disorders. The onset and development of these disorders are intimately linked to chronic psychological stress via the brain-gut-microbiota axis. The present article examines the evidence and mechanisms indicating that stress is a primary factor and a potentiator of symptom severity in common mental health and digestive diseases, with a particular focus on human studies. However, due to space limitations, only a very general overview of preventive and therapeutic clinical strategies is provided. It is hoped that the recurring phrase, "Everything that happens to you is due to stress," will become more comprehensible to the physician after reading this manuscript.
Crescents and CKD progression in diabetic nephropathy
Crescents play important roles in the pathophysiology of patients with biopsy-proven diabetic nephropathy (DN). However, their relationship to disease severity and progression has not been fully clarified.
Superficial vein thrombosis: A complex entity with understimated risk
Role of lenvatinib as neoadjuvant therapy in advanced thyroid cancer
Skin and soft tissue infections in people migrating by sea to the Canary Islands, Spain
People migrating to the Canary Islands by sea frequently suffer from potentially severe skin and soft tissue infections (SSTIs) for which optimal empirical antibiotic therapy is not well defined.
Cognitive dysfunction in systemic lupus erythematosus: Its relationship with intracerebral volumes and antiphospholipid antibody profile. Case series
The incidence of cognitive compromise in systemic lupus erythematosus is variable; it presents early and is usually asymptomatic. Our study evaluated the frequency of cognitive impairment in patients without a previous diagnosis of neuropsychiatric lupus and compared the differences in intracerebral size in subgroups with cognitive alterations and positive autoantibodies.
The internist as an expert in invasive ultrasound: Breaking barriers
Acute coronary syndrome due to coronary aneurysm thrombosis as a late complication of Kawasaki disease
Monitoring of adverse effects and quality of life during chemotherapy treatment through the EMMA Salud mobile App in patients with colorectal cancer
One third of patients with colorectal cancer (CRC) undergoing chemotherapy develop serious adverse effects. The aim was to monitor toxicities, evaluate quality of life and the usefulness of the EMMA Salud mobile App in these patients.
Cardiovascular profile of systemic lupus erythematosus patients hospitalized for COVID-19 in Spain: Analysis of the SEMI-COVID-19 Registry
Despite advancements in understanding the interplay between systemic lupus erythematosus (SLE), cardiovascular disease and COVID-19, challenges and knowledge gaps persist. This study aimed to characterize the cardiovascular profiles of SLE patients hospitalized with COVID-19 and to evaluate the influence of SLE on the development of cardiovascular complications.
Pyoderma gangrenosum, acne and hidradenitis suppurativa (PASH syndrome) treated with dapsone monotherapy
Thyroid cancer
In recent decades, the diagnosis of thyroid cancer, especially the papillary type, has increased significantly due to the use of imaging techniques such as ultrasound. For this reason, it is essential to rationalize diagnosis and treatment, since the behavior of thyroid cancer varies from slow-progressing tumors to highly aggressive ones. The application of risk assessment systems for ultrasound images and the optimization of cytology incorporating molecular studies allows cases to be stratified in order to select therapy on an individual basis. Currently, attempts are being made to avoid overtreatment in low-risk tumors, with active surveillance or minimally invasive techniques. The administration of radioiodine is indicated according to risk, with lower doses, and in advanced cases, oncospecific systemic treatments are being incorporated. The management of thyroid cancer requires a multidisciplinary team and population studies and quality clinical trials are necessary to update treatment guidelines.