Ethanol consumption triggers oxidative stress by generating reactive oxygen species (ROS) through its metabolites. This process leads to steatosis and liver inflammation, which are critical for the development of alcoholic liver disease (ALD). Autophagy is a regulated dynamic process that sequesters damaged and excess cytoplasmic organelles for lysosomal degradation and may counteract the harmful effects of ROS-induced oxidative stress. These effects include hepatotoxicity, mitochondrial damage, steatosis, endoplasmic reticulum stress, inflammation, and iron overload. In liver diseases, particularly ALD, macroautophagy has been implicated as a protective mechanism in hepatocytes, although it does not appear to play the same role in stellate cells. Beyond the liver, autophagy may also mitigate the harmful effects of alcohol on other organs, thereby providing an additional layer of protection against ALD. This protective potential is further supported by studies showing that drugs that interact with autophagy, such as rapamycin, can prevent ALD development in animal models. This systematic review presents a comprehensive analysis of the literature, focusing on the role of autophagy in oxidative stress regulation, its involvement in organ–organ crosstalk relevant to ALD, and the potential of autophagy-targeting therapeutic strategies.
(1) Background: Aspergillus produces high morbidity and mortality, especially in at-risk populations. In Spain, the evolution of mortality in recent years due to this fungus is not well established. The aim of this study was to estimate the case fatality rate of aspergillosis in inpatients from 1997 to 2017 in Spain. (2) Methodology: A retrospective descriptive study was conducted with records of inpatients admitted to the National Health System with a diagnosis of aspergillosis. (3) Principal findings: Of 32,960 aspergillosis inpatients, 24.5% of deaths were registered, and 71% of the patients who died were men. The percentage of deaths increased progressively with age. The case fatality rate progressively decreased over the period, from 25.4 and 27.8% in 1997–1998 to values of 20.6 and 20.8% in 2016 and 2017. Influenza and pneumonia occurrence/association significantly increased case fatality rates in all cases. (4) Conclusions: Our study shows that lethality significantly decreased in the last two decades despite the increase in cases. This highlights the fact that patients with solid and/or hematological cancer do not have a much higher mortality rate than the group of patients with pneumonia or influenza alone, these two factors being the ones that cause the highest CFRs. We also need studies that analyze the causes of mortality to decrease it and studies that evaluate the impact of COVID-19.
28 August 2023 in Revista Española de Casos Clínicos en Medicina Interna
La dermatomiositis es una enfermedad rara caracterizada por una miopatía inflamatoria que cursa con debilidad muscular progresiva y disfagia en un elevado porcentaje de los pacientes. Asocia frecuentemente lesiones dermatológicas que pueden ayudar a orientar el diagnóstico. Presentamos el caso de un varón de 88 años que ingresó por debilidad muscular en extremidades inferiores, disfagia y lesiones eritematodescamativas en cuello y cara anterior de las extremidades. La importancia de este caso es la de sospechar causas cuyas características pueden solaparse con problemas de mayor prevalencia en el paciente anciano.
Adult-onset Still's disease (AOSD) is a rare systemic autoinflammatory disease. In our case, we present a 68-year-old patient whose main clinical symptom was a fever of unknown origin of a week of evolution at her admission, that did not respond to the administration of antibiotics but to corticosteroids. Guide sign that allowed us to stablish the diagnostic suspicion was an extreme hyperferritinemia, in which we must always consider two entities: hemophagocytic lynfohistiocytosis, and its variant related with AOSD, the macrophagic activation syndrome.
23 April 2026 in Revista Española de Casos Clínicos en Medicina Interna
Se presenta un caso de fibrosis retroperitoneal (FRP) probablemente relacionada con enfermedad por IgG4(IgG4-RD), asociada a positividad antifosfolípida no confirmatoria de síndrome antifosfolípido (SAF). Mujerde 57 años con antecedentes de cardiopatía isquémica, psoriasis e hipotiroidismo, que presentaba claudicaciónintermitente y dolor lumbar crónico con signos de arteriopatía periférica. La angio-TAC mostrótrombosis aórtica infrarrenal y periaortitis y PET-TC fue compatible con FRP activa. Además, el estudio deautoinmunidad mostró anticoagulante lúpico positivo y anticardiolipina IgM débilmente positiva. FRP activaprobablemente asociada a IgG4-RD y positividad antifosfolípida sugestiva de SAF. Recibió tratamiento concorticoides y rituximab con buena evolución. Este caso ilustra la complejidad diagnóstica de las enfermedadessistémicas y el riesgo vascular añadido de estas.