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World Kidney Day: an opportunity to make kidney health and Nephrology visible
No full text20.500.12530/8785
Hospital Admissions for Eating Disorders in Children and Adolescents in Spain: A Population-Based Study.
No full text20.500.12530/87857Limited evidence exists regarding the impact of the COVID-19 pandemic on the onset and trajectory of eating disorders (EDs) among young in Spain. This study aims to analyze the characteristics and recent trends in hospital admissions for EDs within the pediatric population. A retrospective analysis was conducted on hospital admissions for EDs among patients aged 10-19 years between 2016 and 2022. The main outcomes examined included hospital rates (overall, stratified by ED type and age group), psychiatric comorbidities, and length of stay. A total of 8275 hospitalizations due to EDs were identified, constituting 1 in 6 hospital admissions for mental illness and behavioral disorders. Predominant characteristics of this population included female sex (93%), aged 15-19 years (58.3%), admission primarily for anorexia nervosa (71.6%), and psychiatric comorbidity (35.6%). Hospital admissions for EDs in the pediatric population showed an increasing trend, with an annual average increase of 11.1% (95% CI: 2.6, 22.6). This rise was led by children aged 10-14 years, with a yearly increase in EDs hospitalization rates of 28.4% (95% CI: 13.5, 56.3) since 2019. Each discharge related to EDs was associated with a median stay of 24 days (IQR: 10, 40). Efforts in community healthcare should prioritize early detection and intervention for symptoms indicative of EDs in the pediatric population, aiming to mitigate the severity of cases requiring hospitalization. These findings underscore the necessity for targeted health planning policies to address the growing burden of EDs among Spanish youth
Loneliness and Subjective Wellbeing During the Covid-19 Pandemic: A Systematic Review.
No full textTo prevent the transmission of COVID-19, unprecedented measures were implemented, such as community lockdowns. With limited social interactions, the problem of loneliness might have worsened. As loneliness is thought to have a detrimental effect on subjective wellbeing (SWB), the present systematic review aims to better investigate and summarize the existing evidence about the association of loneliness and SWB during the COVID-19 pandemic. A total of 18 articles were included. In all studies, independently of the component of wellbeing assessed or of the instrument used, a negative association between loneliness and SWB was found. The results show an increase in loneliness during times of restrictions on social contacts, with a subsequent association with lower SWB, and underscore the need for developing specific interventions to tackle loneliness and for promoting alternative forms of social interaction if further physical distancing measures are needed. However, the literature had several limitations, since most of the studies followed cross-sectional and descriptive methodologies
Linvoseltamab for Treatment of Relapsed/Refractory Multiple Myeloma.
No full textWe present a phase I/II first-in-human trial evaluating the safety and efficacy of 50 mg and 200 mg doses of linvoseltamab, a B-cell maturation antigen × CD3 bispecific antibody in relapsed/refractory multiple myeloma (RRMM). Phase II eligible patients had RRMM that either progressed on/after ≥three lines of therapy including a proteasome inhibitor (PI), an immunomodulatory drug (IMiD), and an anti-CD38 antibody or was triple-class (PI/IMiD/anti-CD38) refractory. Phase II treatment was once a week through week 14 and then once every 2 weeks. Phase II 200 mg patients who achieved a ≥very good partial response by week 24 received linvoseltamab once every 4 weeks. The primary end point in phase II was overall response rate (ORR). Among the 117 patients treated with 200 mg, the median age was 70 years, 39% had high-risk cytogenetics, and 28% had penta-refractory disease. At a median follow-up of 14.3 months, the ORR was 71%, with 50% achieving ≥complete response (CR). In 104 patients treated with 50 mg at a median follow-up of 7.4 months, the ORR was 48%, with 21% achieving ≥CR. The median duration of response (DOR) for 200 mg patients (n = 83) was 29.4 months (95% CI, 19.2 to not evaluable). Among 200 mg patients, the most common adverse events included cytokine release syndrome (35.0% Gr1, 10.3% Gr2, 0.9% Gr3), neutropenia (0.9% Gr2, 18.8% Gr3, 23.1% Gr4), and anemia (3.4% Gr1, 4.3% Gr2, 30.8% Gr3). Immune effector cell-associated neurotoxicity syndrome occurred in 7.7% of patients (2.6% each Gr1, Gr2, Gr3). Infections were reported in 74.4% of patients (33.3% Gr3, 2.6% Gr4); infection frequency and severity declined over time. Linvoseltamab 200 mg induced deep and durable responses, with a median DOR of 29.4 months, in patients with RRMM with an acceptable safety profile
Epstein-Barr Virus Infection Presenting With Acute Gastrointestinal Involvement. Report of Two Cases of Epstein-Barr Virus Colitis in Kidney-Transplant Recipients and Scoping Review of the Literature.
No full textEpstein-Barr virus (EBV) is a herpesvirus capable of establishing lifelong latent infections, leading to a wide spectrum of diseases. It can affect multiple organs, including the gastrointestinal tract, typically through lymphoproliferative syndromes or gastric cancer, while acute gastrointestinal disease is rare and poorly understood. Two cases of EBV-induced acute colitis in kidney transplant recipients were described. Additionally, a scoping review of the literature was conducted to identify all reported cases of EBV infection presenting with acute gastrointestinal involvement. A total of 11 174 articles from PubMed and Embase were analyzed, from which 30 articles were ultimately selected, encompassing 33 cases. Two distinct patient profiles emerged. Patients with gastric-limited disease were typically healthy women and exhibited a benign course, characterized by a more acute presentation and complete recovery in all cases. In contrast, patients with intestinal disease were often immunocompromised, presenting with deep colonic ulcers frequently associated with rectal bleeding, high rates of perforation, frequent need for surgical intervention, and significant mortality. Antiviral therapy and reduction of immunosuppression were commonly employed, although no specific treatment approach demonstrated a clear benefit in reducing mortality or complications. In conclusion, EBV-related gastrointestinal disease varies by patient immunocompetence and the site of involvement. Gastric-limited disease usually has a favorable prognosis, while intestinal involvement in immunocompromised patients is linked to severe complications and higher mortality. Individualized treatment strategies and vigilant long-term follow-up are needed due to the lack of standardized treatment protocols and the risk of relapse or development of EBV-associated lymphoproliferative disorders
Subtrochanteric Fractures of The Femur May a Short Nail Be a Reliable Option?
No full text20.500.12530/87853Objectives: Treatment of subtrochanteric fractures of the proximal femur mayAbe challenging due to their anatomical and biomechanical features. Intramedullary nails are the most frequently used devices, although there is no consensus concerning their optimal length. The aim of this study is to compare the functional and radiological outcomes of the fragility subtrochanteric fractures treated with short versus Methods: A retrospective cohort study was performed including all over-65-year-old patients that underwent surgery with a cephalomedullary nail between January 2013 to December 2020 due to a subtrochanteric fracture. The primary outcome was the presence of mechanical complications (cut out, cut in, varus consolidation, nonunion and nail breakage). Accuracy of the reduction, distance from the fractureAline to most proximal distal screw, operative time and Palmer Mobility score were also analyzed. Results: Ninety-five patients were included. There were not significant differences in complication rate, Parker mobility score nor quality of reduction between both cohorts. Patients with a good radiological reduction presented no complications, those with an acceptable reduction presented a complication rate of 35.5% and it raised to 53.3% in poorly reduced ones (P=0.002). The complication rate was higher in the 5cm distance group (22.64%) (P=0.014). Conclusion: Anatomical reduction mayAbe the key factor in the management of subtrochanteric fractures, in order to avoid complications. The chosen device working length should also beAtaken into account to treat these challenging injuries
Therapeutic strategies and treatment sequencing in patients with chronic lymphocytic leukemia: An international study of ERIC, the European Research Initiative on CLL.
No full text20.500.12530/8791
Reduced antiviral gene expression and elevated CXCL8 expression in peripheral blood are associated with severe hypoxemia in RSV-infected children.
No full text20.500.12530/87849The pathology of respiratory syncytial virus (RSV) infection remains unclear. An unbalanced immune response to RSV infection can lead to immunopathology, causing airway damage and impaired exchange of oxygen and carbon dioxide between the air and the bloodstream. We aimed to evaluate the association of the expression of inflammatory and antiviral genes in peripheral blood with severe hypoxemia in children with RSV infection seen in the hospital emergency room. We conducted a cross-sectional study on 121 RSV-infected children seen in hospital emergency rooms between 2015 and 2023. Total RNA was extracted from whole blood samples, and gene expression (IL-6, TNFα, CXCL8, ISG15, IFIT1, RIGI, IFNβ, CCL5, and CXCL10) was quantified using quantitative RT-PCR. The outcome variable was having severe hypoxemia (SpO2 ≤ 90%). The association analysis was performed using a volcano plot, adjusted logistic regression, and orthogonal partial least squares discriminant analysis (OPLS-DA). We found that 26 of 121 children had severe hypoxemia (SpO2 ≤ 90%). CXCL8 was overexpressed [fold changes (FC) > 2; q-value 2; q-valu
Appropriateness of behavioural scales in the monitoring of pain in the critically ill patient unable to self-report.
No full textAppropriateness is a dimension of quality that evaluates the effective use of technologies, resources or interventions in specific situations or populations, assessing whether our interventions do more benefit than harm. The evidence regarding pain monitoring in the critically ill patient points to the periodic assessment of pain using appropriate tools, with the aim of improving pain management and more efficient use of analgesics in the intensive care unit. The first step would be to assess the patient's ability to communicate or self-report and, based on this, to select the most appropriate pain assessment tool. In patients who are unable to self-report, behavioural pain assessment tools are recommended. When we talk about the suitability of behavioural scales for pain monitoring in critically ill patients unable to self-report, we refer to their use with a clear clinical benefit, i.e. using the right tool for pain assessment to be effective, efficient and consistent with bioethical principles. To our knowledge, there are no published data on the suitability of pain assessment tools in unable to self-report critically ill patients, so, in the framework of continuous quality improvement in pain care, new research should incorporate this approach by integrating the best scientific evidence with current clinical practice
Integrated management of stage III in nonsmall cell lung cancer: where do perioperative chemotherapy and immunotherapy fit?
No full text20.500.12530/87909Early-stage nonsmall cell lung cancer (NSCLC) accounts for 30% of the total NSCLC, being the stage III a heterogeneous disease that represents a challenge in the management of these patients. Multidisciplinary approach is essential for an adequate treatment strategy, with surgery being the only curative treatment. Neoadjuvant or adjuvant chemotherapy has been the standard of care for a long period, with modest results. Combination of chemotherapy and immunotherapy has revolutionized the neoadjuvant setting of resectable NSCLC, improving pathologic complete responses and survival outcomes in this scenario. Furthermore, perioperative treatment with immunotherapy has also recently shown promising results in several phase III trials. The landscape of early-stage resectable NSCLC has evolved in recent years, with an improvement in the survival of these patients since the incorporation of immunotherapy in this scenario