Characteristics of human immunodeficiency virus-infected patients without antiretroviral treatment in Spain: PICNIT study

Domingo Pedrol, Pere; Viciana Fernández, Pompeyo; Castaño, Manuel; Ferrer Corbera, Elena

doi:10.1016/j.medcle.2014.01.003

array:24 ["pii" => "S2387020615000145" "issn" => "23870206" "doi" => "10.1016/j.medcle.2014.01.003" "estado" => "S300" "fechaPublicacion" => "2015-01-06" "aid" => "2880" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2013" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2015;144:43-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 135 "formatos" => array:2 [ "HTML" => 86 "PDF" => 49 ] ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S0025775314001109" "issn" => "00257753" "doi" => "10.1016/j.medcli.2014.01.018" "estado" => "S300" "fechaPublicacion" => "2015-01-06" "aid" => "2880" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "subdocumento" => "cor" "cita" => "Med Clin. 2015;144:43-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 161 "formatos" => array:2 [ "HTML" => 135 "PDF" => 26 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "Carta científica" "titulo" => "Características de los pacientes con infección por el virus de la inmunodeficiencia humana que no reciben tratamiento antirretroviral en España: estudio PICNIT" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "43" "paginaFinal" => "44" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Characteristics of human immunodeficiency virus-infected patients without antiretroviral treatment in Spain: PICNIT study" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pere Domingo Pedrol, Pompeyo Viciana Fernández, Manuel Castaño, Elena Ferrer Corbera" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Pere" "apellidos" => "Domingo Pedrol" ] 1 => array:2 [ "nombre" => "Pompeyo" "apellidos" => "Viciana Fernández" ] 2 => array:2 [ "nombre" => "Manuel" "apellidos" => "Castaño" ] 3 => array:2 [ "nombre" => "Elena" "apellidos" => "Ferrer Corbera" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020615000145" "doi" => "10.1016/j.medcle.2014.01.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615000145?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775314001109?idApp=UINPBA00004N" "url" => "/00257753/0000014400000001/v1_201412160101/S0025775314001109/v1_201412160101/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020615000091" "issn" => "23870206" "doi" => "10.1016/j.medcle.2014.03.001" "estado" => "S300" "fechaPublicacion" => "2015-01-06" "aid" => "2933" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2015;144:44-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 98 "formatos" => array:2 [ "HTML" => 44 "PDF" => 54 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Statin therapy does not influence in the form onset of differentiated thyroid carcinoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "44" "paginaFinal" => "45" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El tratamiento con estatinas no influye en la forma de presentación del carcinoma diferenciado de tiroides" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carles Zafon, Gabriel Obiols, Jordi Mesa" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Carles" "apellidos" => "Zafon" ] 1 => array:2 [ "nombre" => "Gabriel" "apellidos" => "Obiols" ] 2 => array:2 [ "nombre" => "Jordi" "apellidos" => "Mesa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S002577531400222X" "doi" => "10.1016/j.medcli.2014.03.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531400222X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615000091?idApp=UINPBA00004N" "url" => "/23870206/0000014400000001/v1_201509042040/S2387020615000091/v1_201509042040/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020615000157" "issn" => "23870206" "doi" => "10.1016/j.medcle.2014.01.004" "estado" => "S300" "fechaPublicacion" => "2015-01-06" "aid" => "2886" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2015;144:42-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 112 "formatos" => array:2 [ "HTML" => 96 "PDF" => 16 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Study of hidden hepatitis B in African immigrant people without data of liver disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "42" "paginaFinal" => "43" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio de hepatitis B oculta en población inmigrante africana sin datos de hepatopatía" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Ángel Cuenca-Gómez, M. Teresa Cabezas-Fernández, Manuel Jesús Soriano-Pérez, Joaquín Salas-Coronas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "José Ángel" "apellidos" => "Cuenca-Gómez" ] 1 => array:2 [ "nombre" => "M. Teresa" "apellidos" => "Cabezas-Fernández" ] 2 => array:2 [ "nombre" => "Manuel Jesús" "apellidos" => "Soriano-Pérez" ] 3 => array:2 [ "nombre" => "Joaquín" "apellidos" => "Salas-Coronas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S002577531400116X" "doi" => "10.1016/j.medcli.2014.01.023" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531400116X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615000157?idApp=UINPBA00004N" "url" => "/23870206/0000014400000001/v1_201509042040/S2387020615000157/v1_201509042040/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Characteristics of human immunodeficiency virus-infected patients without antiretroviral treatment in Spain: PICNIT study" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "43" "paginaFinal" => "44" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Pere Domingo Pedrol, Pompeyo Viciana Fernández, Manuel Castaño, Elena Ferrer Corbera" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Pere" "apellidos" => "Domingo Pedrol" "email" => array:1 [ 0 => "pere.domingo@uab.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Pompeyo" "apellidos" => "Viciana Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Manuel" "apellidos" => "Castaño" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Elena" "apellidos" => "Ferrer Corbera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Unidad de Enfermedades Infecciosas, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Enfermedades Infecciosas, Hospital Regional Carlos Haya, Málaga, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Unidad de VIH, Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Características de los pacientes con infección por el virus de la inmunodeficiencia humana que no reciben tratamiento antirretroviral en España: estudio PICNIT" ] ] "textoCompleto" => "The Hospital Survey on patients with HIV/AIDS, 2010,<a class="elsevierStyleCrossRef" href="#bib0035">1</a> that includes a representative sample of patients with HIV being followed up throughout the country, showed that 15% of those patients were not receiving antiretroviral therapy (ART) the day of the survey, because they had not started it yet or because they had interrupted it. The information on this group of patients is very limited. It is unknown if they do or do not have medical indications for treatment or the reasons why they are not receiving treatment.With the aim of describing the sociodemographic and clinical characteristics of these patients and of evaluating the possibility to start ART, we conducted a cross-sectional survey in 12 hospital units that did follow-ups on patients with HIV in Spain in 2009-2010. The patients included were receiving follow-up attention but no ART at the moment of the last visit. We gathered sociodemographic, clinical and epidemiological information, and potential indications to start treatment, according to the current Gesida/National AIDS Plan recommendations at the moment of the survey (2010).<a class="elsevierStyleCrossRef" href="#bib0040">2</a> The protocol was approved by the Medical Ethics Committee of the Santa Creu i Sant Pau Hospital (Barcelona), and followed the Declaration of Helsinki. The patients gave their informed consent to participate.The sample contained 1024 patients: From a total of 1024 patients, 865 (84%) were naïve and 159 (16%) had received ART before, but had suspended it. In the group of the naïve patients, the median age was 37 years (interquartile range [RIC]: 30–43 years), 83% were men and the median of time since HIV diagnosis was 2.3 years (RIC: 1–5 years). In the transmission category, 56% of the cases were unprotected sexual intercourse between men, 27% were unprotected heterosexual intercourse and 15% was drug use injection. In the group of naïve patients, 526 (61%) did not have indication to receive ART, according to the therapeutic guidelines of the moment; 111 (13%) had indication and were going to start ART in the following visit, and 228 (26%) had at least one indication, but were not programmed to initiate ART shortly. From the 228 of patients with indication for treatment but did not expect to start, the most frequent reasons of indication to start ART was the HIV/hepatitis C virus (HCV) co-infection, 48% of the cases; elevated viral load (>100,000copies/mL), 24% of the cases, and CD4 counts inferior to established limit at that moment (350 cells/μL), 18% of the cases. Of these 228 patients who had indication but were not programmed to begin treatment, in 199 (87%) of the cases the doctor did not consider the indication of treatment necessary, 21 (9%) of the cases adduced personal reasons and 8 patients (3%) were still in the phase of initial evaluation and deciding on the following steps. Of those 228 patients, 168 had only one indication for treatment; 47 patients had 2 indications and the last 13 had 3–5 indications of treatment (8 did not initiate by medical decision, 4 for personal reasons and 1 for other reasons).Indication to start ART in all HIV/HCV co-infected patients, regardless of their CD4 level, is based on the evidence that ART reduces progression to cirrhosis, fibrosis and death in the same levels as it does in HCV mono-infected patients. For this reason, it has been stated that early initiation of ART is the best way to reduce death caused by hepatic affectation of the population, even more than it is in the treatment for HCV.<a class="elsevierStyleCrossRef" href="#bib0045">3</a> On the other hand, there is countless evidence that late initiation of ART with low CD4 lymphocyte counts increases the risk of progression to AIDS and death,<a class="elsevierStyleCrossRefs" href="#bib0050">4,5</a> and that only keeping the level of that indicator high during prolonged periods will it be possible to bring life expectancy of HIV patients near to that of the general population.<a class="elsevierStyleCrossRef" href="#bib0060">6</a>In conclusion, almost one quarter of the patients being followed up, and who were not receiving ART, could benefit from this treatment depending on their clinical characteristics. Even though in some cases it is the patient themself who prefers not to receive medication, in most of the cases it is the doctor who considers that they do not have the indication to receive it yet.FundingGilead Sciences S. L. contributed to financing the study." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "xack185327" "titulo" => "Acknowledgements" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Domingo Pedrol P, Viciana Fernández P, Castaño M, Ferrer Corbera E. Características de los pacientes con infección por el virus de la inmunodeficiencia humana que no reciben tratamiento antirretroviral en España: estudio PICNIT. Med Clin (Barc). 2015;144:43–44." ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "The members of the PICNIT Study Group can be found in the Annex" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "Pere Domingo, Teaching Hospital Sant Pau, Barcelona; Piedad Arazo, Teaching Hospital Miguel Servet, Zaragoza; Jose Luis Casado, Teaching Hospital Ramon y Cajal, Madrid; Manuel Castaño, Teaching Hospital Carlos Haya, Malaga; Elena Ferrer, Teaching Hospital Bellvitge, Barcelona; Miguel Angel Goenaga, Teaching Hospital Donostia, San Sebastián; Rafael Granados, Teaching Hospital Dr. Negrín, Palmas de Gran Canaria; Federico Pulido, Teaching Hospital 12 de Octubre, Madrid; Jesus Rodriguez-Baños, Teaching Hospital Virgen Macarena, Seville; Rafael Rubio, Teaching Hospital 12 de Octubre, Madrid; Jose Sanz, Teaching Hospital Príncipe de Asturias, Alcala de Henares; Pompeyo Viciana, Teaching Hospital Virgen del Rocío, Seville." "etiqueta" => "Annex" "titulo" => "PICNIT Study Group" "identificador" => "sec0010" ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Centro Nacional de Epidemiología, Plan Nacional Sobre el Sida, Ministerio de Sanidad y Política Social. Encuesta Hospitalaria de pacientes de VIH/sida. Resultados 2010. Análisis de la evolución 2000–2010. Available from <a href="http://www.msssi.gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/vigilancia/InformeEncuestaHospitalaria2010.pdf">http://www.msssi.gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/vigilancia/InformeEncuestaHospitalaria2010.pdf</a> [accessed 10.01.14]." ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Documento de consenso de Gesida/Plan nacional sobre el Sida respecto al tratamiento antirretroviral en adultos infectados por el virus de la inmunodeficiencia humana (actualización enero 2010)" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Panel de Expertos de Gesida; Plan Nacional sobre el Sida" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eimc.2010.03.002" "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2010" "volumen" => "28" "paginaInicial" => "362" "paginaFinal" => "391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20554079" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early initiation of antiretroviral therapy: the current best way to reduce liver-related deaths in HIV/hepatitis C virus-coinfected patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.D. Shafran" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QAI.0b013e31803151c7" "Revista" => array:6 [ "tituloSerie" => "J Acquir Immune Defic Syndr" "fecha" => "2007" "volumen" => "44" "paginaInicial" => "551" "paginaFinal" => "556" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17224846" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of early versus deferred antiretroviral therapy for HIV on survival" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.M. Kitahata" 1 => "S.J. Gange" 2 => "A.G. Abraham" 3 => "B. Merriman" 4 => "M.S. Saag" 5 => "A.C. Justice" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa0807252" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2009" "volumen" => "360" "paginaInicial" => "1815" "paginaFinal" => "1826" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19339714" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. Sterne" 1 => "M. May" 2 => "D. Costagliola" 3 => "F. de Wolf" 4 => "A. Phillips" 5 => "R. Harris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(09)60612-7" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2009" "volumen" => "373" "paginaInicial" => "1352" "paginaFinal" => "1363" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19361855" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "HIV-infected adults with a CD4 cell count greater than 500cells/mm3 on long-term combination antiretroviral therapy reach same mortality rates as the general population" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Lewden" 1 => "G. Chene" 2 => "P. Morlat" 3 => "F. Raffi" 4 => "M. Dupon" 5 => "P. Dellamonica" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QAI.0b013e318134257a" "Revista" => array:6 [ "tituloSerie" => "J Acquir Immune Defic Syndr" "fecha" => "2007" "volumen" => "46" "paginaInicial" => "72" "paginaFinal" => "77" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17621240" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack185327" "titulo" => "Acknowledgements" "texto" => "We thank Ana Maria Caro-Murillo for revision of the manuscript and publishing assistance." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014400000001/v1_201509042040/S2387020615000145/v1_201509042040/en/main.assets" "Apartado" => array:4 [ "identificador" => "43311" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014400000001/v1_201509042040/S2387020615000145/v1_201509042040/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615000145?idApp=UINPBA00004N"]

ISSN: 2387-0206

Launched in 1943, Medicina Clínica is a fortnightly journal aimed at the promotion of clinical research and practice among internal medicine and other specialists. The key characteristics of Medicina Clínica are the scientific and methodological rigor of its manuscripts, the topicality of its contents, and, especially, its practical focus with highly useful information for clinical practice. Medicina Clínica is predominantly interested in publishing original research manuscripts, which are rigorously selected according to their quality, originality, and interest, and also in continued medical education-oriented manuscripts, which are commissioned by the journal to relevant authors (Editorials, Reviews, and Diagnosis and Treatment). These manuscripts contain updated topics with a major clinical or conceptual relevance in modern medicine. The journal adheres to the standards of academic research publications in all aspects including peer-review and ethical principles. Medicina Clínica is included in the General and Internal Medicine category of Thomson Reuters.

See more Open Access Option

Indexed in:

Current Contents/Clinical Medicine, Journal Citation Reports, SCI-Expanded, Index Medicus/Medline, Excerpta Medica/EMBASE, IBECS, IME, MEDES, PASCAL, SCOPUS, SciVerse ScienceDirect

Subscribe:

Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2023

2.6

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

3.1

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.371

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

0.511

View more metrics

Journal Information

Previous article | Next article

Vol. 144. Issue 1.

Pages 43-44 (January 2015)

Lee este artículo en Español

Export reference

Download PDF

Article

These are the options to access the full texts of the publication Medicina Clínica (English Edition)

Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”

Subscribe to

Medicina Clínica (English Edition)

More information

Purchase

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now

Contact

Phone for subscriptions and reporting of errors

From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.

Calls from Spain

932 415 960

Calls from outside Spain

+34 932 415 960

E-mail

atencionalcliente@elsevier.com

Publish in

Medicina Clínica

Tools

Free access articles

Early cortical atrophy in REM sleep behavior...

Med Clin. 2024;163:70-3

Disability degree assessment: A comprehensive approach...

Med Clin. 2024;163:e3-e7

Inappropriate hospitalization: Measurement...

Med Clin. 2024;163:91-7

Medicina Clínica (English Edition) follows the Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals

Indexed in:

Follow us:

Subscribe:

Article

Subscribe to our newsletter