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Vol. 30, nº 21. Brotes y casos de sarampión 2025: AGS este de Málaga Axarquía. Coordinación con Salud Responde.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 22/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Brotes y casos de sarampión 2025: AGS este de Málaga Axarquía. Coordinación con Salud Responde.”, de “Loreto Barceló López, Gema Mata Ruiz”.Ye
Gender Differences in Clinical Practice Regarding Coronary Heart Disease: A Systematic Review.
No full textA systematic review was performed with the aim of analysing potential sex differences in the overall treatment of coronary heart disease (CHD). : Studies published between January 2011 and November 2023 that conducted a sex-based analysis of the provision of any type of therapeutic measure to treat CHD were included. A search was performed of the Web of Science database in November 2023, resulting in 9070 articles. Study quality was examined using the Newcastle-Ottawa scale. A worksheet was produced to extract data pertaining to the title, year of publication, sample, context, study design, dependent variables, time-frame, treatment type, and outcomes reported by each article. This systematic review followed PRISMA guidelines, and the research protocol was submitted to PROSPERO (CRD42022330238). : A total of 80 articles presenting data representing 560.070,624 individual datapoints were selected to comprise the final sample. The main findings revealed that the majority of studies highlighted inequalities that disadvantaged females in all analysed treatment categories (pharmacological treatment, invasive interventions, rehabilitation programmes, and other treatment types). : Despite the abundance of evidence on the need to improve healthcare provision to females with CHD, few studies examined the reasons or mechanisms underlying the inequalities identified.Ye
Clinical remission in subjects with rheumatoid arthritis treated with subcutaneous tocilizumab as monotherapy or in combination with methotrexate or other synthetic dmards: a realworld clinical trial (tospace)
No full textBackground: Subcutaneous tocilizumab (TCZ-SC) has demonstrated noninferiority to TCZ-IV and superiority to placebo. Objectives: The primary objective of this study was to assess the 24-week efficacy and safety of subcutaneous (SC) tocilizumab (TCZ) 162 mg weekly (qw) as monotherapy or in combination with methotrexate (MTX) or other synthetic (s) DMARDs in patients with active rheumatoid arthritis (RA) in the real world setting. Methods: This multinational (Spain, Ireland, Portugal), multicenter, phase IIIb study. Subjects ≥18 years of age with active RA (DAS 28-ESR >3.2) who have had inadequate response or intolerance to sDMARDs or to a first anti-TNF drug. The study comprised a phase 1 with open-label design in which patients received TCZ-SC 162 mg qw (+/- oral/SC MTX or other sDMARDs) for 24 weeks and the main outcome was the percentage of patients achieving sustained clinical remission (DAS 28-ESR <2.6) at Week 20 and Week 24 (primary outcome of the study); and a phase 2 where patients achieving sustained clinical remission during the phase 1 were randomized to receive TCZ-SC 162 mg qw or TCZ-SC 162 mg q2w (+/- oral/SC MTX or other sDMARDs) for an additional 24 weeks; the main outcome of the phase 2 was the percentage of patients who maintained the remission at Week 48 (i.e. DAS 28-ESR <2.6).S
Vol. 30, nº 13. Sarampión en Andalucía: año 2024.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 12/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Sarampión en Andalucía: año 2024”, del “Servicio de Vigilancia y Salud Laboral”.Ye
Sistema de alertas: informe de alertas epidemiológicas del año 2023.
No full textEl propósito de este monográfico es realizar un estudio descriptivo sobre las alertas declaradas en RedAlerta durante los años 2022 y 2023. Se estudiaron las tendencias en cuanto a número de alertas declaradas, tipo de alerta, medidas implementadas, resultado de la investigación de la alerta, resultado de la intervención, etc. Estos datos fueron posteriormente desagregados según provincia y distrito sanitario.N
Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses).
No full textThe CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18-84, 54% female, 96% born in Spain, 20% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (~ 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.The CORDELIA Study variable harmonization and GWAS were funded by Instituto de Salud Carlos III and co-funded by the European Union (Proyecto de Investigación de Medicina Personalizada de Precisión PMP22/00033, and projects PI21/00040 and PI21/00163). A detailed description of the funding sources of the individual cohorts is available in Appendix II.Ye
Nutritional profile of the diet according to circadian clock genes in the European Prospective Investigation into Cancer and Nutrition (EPIC) chronodiet study.
No full textBackground & aims: Circadian rhythms seem to impact both dietary intake and metabolism, depending on the individual's chronotype. We aimed to explore whether the nutritional composition of meals throughout the day is influenced by genetics linked to the circadian clock and chronotype within the "European Prospective Investigation into Cancer and Nutrition (EPIC) chronodiet" study.
Methods: The study population comprised 3,183 subjects with information on diet and twelve genetic variants of six genes (PER1, PER2, PER3, CRY1, NR1D1, CLOCK). The associations between the variants with chrononutrition variables (macronutrients and serving sizes of each meal) were evaluated using linear regression, considering an additive genetic model, and adjusting for sex, age and center, among others. The β coefficients, 95 % confidence intervals (CI), and p-values corrected for multiple comparisons were estimated. A genetic risk score (GRS) that was associated to the evening/late chronotype as well as overweight/obesity in a previous study, the chronotype-GRS, was tested for its association with chrononutrition variables.
Results: The nutritional profile of the diet differed according to the individual's chronotype, with evening/late chronotypes exhibiting an unbalanced intake during breakfast and dinner compared to the intermediate and early chronotypes (e.g., percentage of fats consumed at breakfast relative to the total fat intake: 13 % and 9 %, respectively). However, significant differences were not encountered by the chronotype-GRS. In multivariate analyses, individual associations between the genetic variants and the nutrients revealed some nominal associations (e.g., rs1801260 and rs2070062 with carbohydrates at breakfast: β = -0.06 to 0.08). Higher scorings of the chronotype-GRS were inversely associated with the intake of proteins and carbohydrates (β = -0.46 and -0.41; nominal p-value<0.006; corrected = 0.25) during breakfast. Also, there was an inverse association between the chronotype-GRS and the breakfast's portion size (β = -0.3; nominal p-value = 0.03; corrected = 0.1).
Conclusions: Genetic susceptibility to an evening-like chronotype prone to overweight/obesity seems to be associated with a smaller serving size during breakfast, with lower protein and carbohydrate content.Ye
Vol. 30, nº 19. Cambios en la epidemiología del sarampión en poniente de Almería 2024-2025 en el contexto de salud global.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 20/2025 y acumulado desde la semana 01/2025. Datos provisionales. Incluye además el artículo titulado “Cambios en la epidemiología del sarampión en poniente de Almería 2024-2025 en el contexto de salud global”, de “Silvia Vallejo Godoy, Reyes Álvarez-Ossorio, Estefanía Manzano Galdeano, Arancha Viruega Navarro, Senay Rueda Nieto, Leticia Romero García, Vanesa Fernández Humanes, Mónica Archilla Castillo, Pilar Luzón García”.N
Tachycardia-induced cardiomyopathy in de novo heart failure: prevalence, short-term outcomes, and the role of guideline-directed therapy in ejection fraction improvement
No full textHeart failure (HF) secondary to tachycardia-induced cardiomyopathy (TIC) is often underdiagnosed due to inconsistent definitions and perceived reversibility. The treatment focuses on early arrhythmia control, but the impact of guideline-directed medical therapy (GDMT) on left ventricular ejection fraction (LVEF) improvement has not been fully explored. This multicentric prospective registry study included patients with newly onset HF and reduced ejection fraction (HFrEF). Data were collected on clinical characteristics, echocardiographic and laboratory parameters, pharmacological treatment, and follow-up events. The statistical analyses focused on TIC patients, analyzing the event rates and the influence of GDMT on LVEF improvement according to sinus rhythm (SR) restoration. Among 808 patients, 174 (21.5%) were diagnosed with TIC, with an age of 67.2 (SD: 9.4) years. After a median follow-up of 3.5 months [IQR: 2.6-4.3], SR was restored in 56.8% of patients, and LVEF improved from 29.6 to 49%. The increase was more pronounced in patients who restored SR compared to those remaining in atrial fibrillation (AF) (22.4% vs. 15.1%; p < 0.05). The natriuretic peptides significantly decreased in the SR group (- 1883.7 pg/mL) but did not in the AF group. The overall readmission rate was 25.1% and the overall mortality rate was 3.6%, with no significant differences between patients who achieved SR and those with persistent AF at the end of up-titration. HF readmission was infrequent (4%) despite AF persistence. Early GDMT was initiated in TIC patients, regardless of SR recovery and significantly improved LVEF, especially in AF patients [RR = 4.24 (95% CI: 1.44-12.45)] compared to SR patients [(RR = 1.41 95% CI: 1.02-1.92)]. TIC represents a significant proportion of HFrEF patients, with early restoration of SR leading to greater LVEF improvement. Despite AF persistence, HF readmissions were rare, highlighting the efficacy of early quadruple therapy. Enhanced adherence to GDMT should be prioritized, particularly in patients with persistent AF.Ye
TOCILIZUMAB IN LARGE-VESSEL GIANT CELL ARTERITIS AND TAKAYASU ARTERITIS: MULTICENTRIC OBSERVATIONAL COMPARATIVE STUDY
No full textBackground: Tocilizumab (TCZ) has shown to be effective for large vessel vasculitis including giant cell arteritis (GCA) and Takayasu arteritis (TAK) (1-5). However, LVV-GCA and TAK show different demographic and clinical features that may influence on TCZ therapeutic response. Objectives: To compare the effectiveness of TCZ in patients with LVV-GCA and patients with TAK. Methods: Observational multicenter study of patients with LVV-GCA and TAK who received TCZ. Outcome variables were: a) proportion of patients who achieved complete clinical improvement along with normalization of laboratory markers (CRP ≤0.5mg/dL and/or ESR ≤ 20 mm/1st hour) at 12 months b) complete improvement in imaging techniques. A comparative study between patients with LVV-GCA and TAK was performed.S