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Comparison of the management of Helicobacter pylori infection between the older and younger European populations
No full textThe prevalence of Helicobacter pylori remains high in the older population. Specific age-related peculiarities may impact the outcomes of H. pylori treatment. The aim of the study was to evaluate the diagnostics and effectiveness of H. pylori eradication between the younger and older European populations. "European Registry on H. pylori Management (Hp-EuReg)" data from 2013 to 2022 were analyzed. Patients were divided into older (>= 60 years) and younger (18-59 years) groups. Modified intention-to-treat (mITT) and per-protocol (PP) analysis was performed. 49,461 patients included of which 14,467 (29%) were older-aged. Concomitant medications and penicillin allergy were more frequent among the older patients. Differences between younger and older populations were observed in treatment duration in first-line treatment and in proton pump inhibitors (PPIs) doses in second-line treatment. The overall incidence of adverse events was lower in the older adults group. The overall first-line treatment mITT effectiveness was 88% in younger and 90% in the older patients (p= 90%) was achieved by using bismuth and non-bismuth-based quadruple therapies. In conclusion, the approach to the diagnostics and treatment of H. pylori infection did not generally differ between younger and older patients. Main differences were reported in the concurrent medications, allergy to penicillin and adverse events both in first- and second-line treatment. Optimal effectiveness rates were mostly achieved by using bismuth and non-bismuth-based quadruple therapies. No clinically relevant differences in the effectiveness between the age groups were observed.This project was promoted and funded by the European Helicobacter and Microbiota Study Group (EHMSG) and received support from the Spanish Association of Gastroenterology (AEG) and the Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). Te Hp-EuReg was co-funded by the European Union programme HORIZON (grant agreement number 101095359) and supported by the UK Research and Innovation (grant agreement number 10058099). Views and opinions expressed are however those of the author(s) only and do not necessarily refect those of the European Union or the Health and Digitial Executive Agency (HaDEA). Neither the European Union nor the granting authority can be held responsible for them. Te Hp-EuReg was co-funded by the European Union programme EU4Health (grant agreement number 101101252). Tis study was funded by Diasorin; however, clinical data were not accessible and the company was not involved in any stage of the Hp-EuReg study (design, data collection, statistical analysis, or manuscript writing). We want to thank Diasorin for their support.Ye
Scoping review of the methodology of large health surveys conducted in Spain early on in the COVID-19 pandemic
No full textBackground: The use of health surveys has been key in the scientific community to promptly communicate results about the health impact of COVID-19. But what information was collected, where, when and how, and who was the study population?
Objective: To describe the methodological characteristics used in large health surveys conducted in Spain early on in the COVID-19 pandemic.
Methods: Scoping review. Inclusion criteria: observational studies published between January 2020 and December 2021, with sample sizes of over 2,000 persons resident in Spain. Databases consulted: PubMed, CINAHL, Literatura Latinoamericana y del Caribe en CC de la Salud, Scopus, PsycINFO, Embase, Sociological Abstracts, Dialnet and Web of Science Core Collection. We analyzed the characteristics of the literature references, methodologies and information gathered in the surveys selected. Fifty five studies were included.
Results: Sixty percentage of the studies included had mental health as their main topic and 75% were conducted on the general adult population. Thirteen percentage had a longitudinal design, 93% used the internet to gather information and the same percentage used non-probability sampling. Thirty percentage made some type of sampling correction to reduce coverage or non-response biases, but not selection biases. Sixty seven percentage did not state the availability of their data.
Conclusions: Consistent with the extensive use of non-probability sampling without any bias correction in the extraordinary setting created by COVID-19, quality population frameworks are required so that probability and representative samples can be extracted quickly to promptly address other health crises, as well as to reduce potential coverage, non-response and particularly selection biases by utilizing reweighting techniques. The low data accessibility despite the huge opportunity that COVID-19 provided for Open Science-based research is striking.Ye
Abordaje integral de víctimas de sumisión química y/o agresión por objeto punzante
No full textEste protocolo incluye todos los aspectos relevantes para una adecuada actuación sanitaria ante sospecha de Sumisión Química, y además informa de la necesaria relación del profesional sanitario con el resto de agentes implicados.Ye
Magnetization Transfer BOOST Noncontrast Angiography Improves Pulmonary Vein Imaging in Adults With Congenital Heart Disease.
No full textCardiac MRI plays an important role in the diagnosis and follow-up of patients with congenital heart disease (CHD). Gadolinium -based contrast agents are often needed to overcome flow-related and off-resonance artifacts that can impair the quality of conventional noncontrast 3D imaging. As serial imaging is often required in CHD, the development of robust noncontrast 3D MRI techniques is desirable.PurposeTo assess the clinical utility of noncontrast enhanced magnetization transfer and inversion recovery prepared 3D free- breathing sequence (MTC-BOOST) compared to conventional 3D whole heart imaging in patients with CHD.Study typeProspective, image quality.PopulationA total of 27 adult patients (44% female , mean age 30.9 ± 14.8 years) with CHD.Field Strength/SequenceA 1.5 T; free- breathing 3D MTC-BOOST sequence.AssessmentMTC-BOOST was compared to diaphragmatic navigator-gated, noncontrast T2 prepared 3D whole- heart imaging sequence (T2prep-3DWH) for comparison of vessel dimensions, lumen-to- myocardium contrast ratio (CR), and image quality (vessel wall sharpness and presence and type of artifacts ) assessed by two experienced cardiologists on a 5-point scale.Statistical TestsMann–Whitney test, paired Wilcoxon signed-rank test, Bland–Altman plots. P < 0.05 was considered statistically significant.ResultsMTC-BOOST significantly improved image quality and CR of the right-sided pulmonary veins (PV): (CR: right upper PV 1.06 ± 0.50 vs. 0.58 ± 0.74; right lower PV 1.32 ± 0.38 vs. 0.81 ± 0.73) compared to conventional T2prep-3DWH imaging where the PVs were not visualized in some cases due to off-resonance effects. MTC-BOOST demonstrated resistance to degradation of luminal signal (assessed by CR) secondary to accelerated or turbulent flow conditions. T2prep-3DWH had higher image quality scores than MTC-BOOST for the aorta and coronary arteries ; however, great vessel dimensions derived from MTC-BOOST showed excellent agreement with standard T2prep-3DWH imaging.Data ConclusionMTC-BOOST allows for improved contrast-free imaging of pulmonary veins and regions characterized by accelerated or turbulent blood flow compared to standard T2prep-3DWH imaging, with excellent agreement of great vessel dimensions.S
Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: ASCO Guideline Update
No full textTo conduct an update of the ASCO venous thromboembolism (VTE) guideline. After publication of potentially practice-changing clinical trials, identified through ASCO's signals approach to updating, an updated systematic review was performed for two guideline questions: perioperative thromboprophylaxis and treatment of VTE. PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) published between November 1, 2018, and June 6, 2022. Five RCTs provided information that contributed to changes to the 2019 recommendations. Two RCTs addressed direct factor Xa inhibitors (either rivaroxaban or apixaban) for extended thromboprophylaxis after surgery. Each of these postoperative trials had important limitations but suggested that these two oral anticoagulants are safe and effective in the settings studied. An additional three RCTs addressed apixaban in the setting of VTE treatment. Apixaban was effective in reducing the risk of recurrent VTE, with a low risk of major bleeding. Apixaban and rivaroxaban were added as options for extended pharmacologic thromboprophylaxis after cancer surgery, with a weak strength of recommendation. Apixaban was also added as an option for the treatment of VTE, with high quality of evidence and a strong recommendation.Additional information is available at www.asco.org/supportive-care-guidelines.Ye
SEOM-GOTEL clinical guidelines on diffuse large B cell lymphoma (2022).
No full textDiffuse large B-cell lymphoma is the most frequent histological subtype of NHL and the paradigm for the management of aggressive lymphoma. An excisional or incisional lymph node biopsy evaluated by an experienced hemopathologist is recommended to establish the diagnosis. Twenty years following its introduction, R-CHOP remains the standard first-line treatment. No modification of this scheme (increased chemotherapy dose intensity, new monoclonal antibodies, or the addition of immunomodulators or anti-target agents) has significatively improved the clinical outcomes, whereas therapy for recurrence or progression is evolving rapidly. The irruption of CART cells, polatuzumab vedotin, tafasitamab, and CD20/CD3 bispecific antibodies are changing the natural history of relapsed patients and will challenge R-CHOP as the benchmark for newly diagnosed patients.Ye
Vol. 28, nº 35. Chikungunya: relevancia como enfermedad importada y riesgo de brotes autóctonos
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 34/2023 y acumulado desde la semana 01/2023. Datos provisionales. Incluye además el artículo titulado “Chikungunya: relevancia como enfermedad importada y riesgo de brotes autóctonos”, de “Miguel Luque Rodríguez, Cristina Jiménez Biedma, Eric Duran Pla”.Ye
Circulating vitamin D levels and colorectal cancer risk: A meta-analysis and systematic review of case-control and prospective cohort studies.
No full textThe associations between circulating vitamin D concentrations and total and site-specific colorectal cancer (CRC) incidence have been examined in several epidemiological studies with overall inconclusive findings. The aim of this systematic review and meta-analysis of both case-control and prospective cohort studies was to evaluate the association between CRC and circulating levels of vitamin D. The main exposure and outcome were circulating total 25(OH)D and CRC, respectively, in the overall population (i.e., all subjects). Two reviewers, working independently, screened all the literature available to identify studies that met the inclusion criteria (e.g., case-control or prospective cohort studies, published in English, and excluding non-original papers). Data were pooled by the generic inverse variance method using a random or fixed effect model, as approriate. Heterogeneity was identified using the Cochran's Q-test and quantified by the I2 statistic. Results were stratified by study design, sex, and metabolite of vitamin D. Sensitivity and subgroup analyses were also performed. A total of 28 original studies were included for the quantitative meta-analysis. Meta-analyses comparing the highest vs lowest categories, showed a 39% lower risk between levels of total 25(OH)D and CRC risk (OR (95% CI): 0.61 (0.52; 0.71); 11 studies) in case-control studies; whereas a 20% reduced CRC risk in prospective cohort studies (HR (95% CI): 0.80 (0.66; 0.97); 6 studies). Results in women mirrored main results, whereas results in men were non-significant in both analyses. Our findings support an inverse association between circulating vitamin D levels and CRC risk.N
Relationship between insulin-biochemical resistance levels and the degree of depression and anxiety in patients from Honduras
No full textBackground/purpose Many studies suggest that insulin resistance in obese patients bridges mental illness. Our objective was to identify the association between levels of depression and anxiety with insulin resistance, and its relationship with obesity and abdominal obesity Methods A cross-sectional analytical study was carried out in Honduras. Sociodemographic variables, anthropometric parameters, HOMA index, and level of severity of anxiety and depression were collected, and a descriptive, bivariate, and multivariate were performed. Results In a sample of 381 adult patients, the bivariate analysis showed a statistic association of insulin resistance with all remaining variables. However, multivariate analysis showed a significative association of anxiety with BMI, depression, waist circumference, and insulinemia, while depression was associated with HOMA, anxiety, insulinemia, glycemia, and waist circumference. Conclusions Our results provide important evidence of a direct and growing association between HOMA-IR and the severity of depression, and indirectly with anxiety. Secondarily, also with anthropometric factors (BMI and WC), traditionally associated with cardiovascular risk. This finding has important implications both for the early diagnosis of these mental pathologies, taking into account HOMA-IR values, and for preventive interventions focused on maintaining blood insulin levels.S