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Criteris de no assistència de l’alumnat a l’escola o la llar d’infants durant un període de temps determinat a causa de malalties transmissibles
Full text linkAbsentismo escolar; Enfermedades infecciosas; Niños escolarizadosAbsentisme escolar; Malalties infeccioses; Nens escolaritzatsAbsenteeism from school; Infection diseases; SchoolchildrenRecomanacions per les quals l'alumnat de l'escola o de la llar d'infants hauria o no d'assistir a classe durant un període de temps a causa de diferents malalties transmissibles. Es resumeixen les malalties infeccioses més freqüents en nens en edat escolar agrupades per les seves manifestacions clíniques. S'explica la prevenció i el control que correspon a cada cas
Development and Validation of a Quantitative Score for the Criteria Clinical Control in Stable COPD Proposed in the Spanish COPD Guidelines (GesEPOC): Results of the EPOCONSUL Audit
Get PDFChronic obstructive pulmonary disease; Degree clinical control; Predicted probabilityMalaltia pulmonar obstructiva crònica; Grau de control clínic; Probabilitat previstaEnfermedad pulmonar obstructiva crónica; Grado de control clínico; Probabilidad previstaIntroduction/Objective: the concept of clinical control of COPD is a measure proposed in the Spanish COPD Guidelines (GesEPOC), which aims to help clinicians assess the clinical status in order to adapt the treatment plan at follow-up. However, studies that have evaluated clinical practice reveal that the degree of control of COPD is not always assessed, which underlines the need to promote its assessment through a scoring system. To develop a scoring system that quantitatively assesses the validated criteria defining the degree of COPD control. Methods: this study used data from the EPOCONSUL audit in respiratory clinics across Spain. We included in this analysis all patients with a COPD clinical control grade estimated and reported by the physician at the visit, who had registered the criteria necessary to define the degree of clinical control validated and established in GesEPOC. Patients were randomly assigned to either the development or validation cohorts. The development cohort included 485 patients and the validation cohort included 341 patients. Score modelling was conducted using a multivariate logistic regression model, and calibration of the model and score was assessed using the Hosmer-Lemeshow goodness-of-fit test and GiViTi Calibration belts. The model and generated score’s discrimination capacity were analyzed by calculating the Area Under the Curve (AUC). Results: the scoring system was developed using four criteria as predictors of poor clinical control of COPD reported by the treating physician:adjusted dyspnoea severity, use of rescue inhaler more than three times per week, walking less than 30 min per day, and COPD exacerbations in the last three months. The scoring system attributed scores from 0 to 8. Calibration was satisfactory in both development and validation cohorts, and the score’s discrimination power, as indicated by the AUC, was 0.892. Conclusions: this scoring system provides an easy-to-use quantitative assessment of clinical control of COPD that we believe will help to measure COPD control and its evolution during patient follow-up. Future research will be needed to prospectively evaluate this score as a predictor of outcome.This study has been promoted and sponsored by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR)
Extracellular Vesicles as Tools for Crossing the Blood–Brain Barrier to Treat Lysosomal Storage Diseases
Full text linkBlood–brain barrier; Extracellular vesicles; Lysosomal storage diseasesBarrera hematoencefàlica; Vesícules extracel·lulars; Malalties d'emmagatzematge lisosomaBarrera hematoencefálica; Vesículas extracelulares; Enfermedades de almacenamiento lisosomalExtracellular vesicles (EVs) are nanosized, membrane-bound structures that have emerged as promising tools for drug delivery, especially in the treatment of lysosomal storage disorders (LSDs) with central nervous system (CNS) involvement. This review highlights the unique properties of EVs, such as their biocompatibility, capacity to cross the blood-brain barrier (BBB), and potential for therapeutic cargo loading, including that of enzymes and genetic material. Current therapies for LSDs, like enzyme replacement therapy (ERT), often fail to address neurological symptoms due to their inability to cross the BBB. EVs offer a viable alternative, allowing for targeted delivery to the CNS and improving therapeutic outcomes. We discuss recent advancements in the engineering and modification of EVs to enhance targeting, circulation time and cargo stability, and provide a detailed overview of their application in LSDs, such as Gaucher and Fabry diseases, and Sanfilippo syndrome. Despite their potential, challenges remain in scaling production, ensuring isolation purity, and meeting regulatory requirements. Future developments will focus on overcoming these barriers, paving the way for the clinical translation of EV-based therapies in LSDs and other CNS disorders.This work was supported by the Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), which is financed by the Carlos III Health Institute (ISCiii) with assistance from the European Regional Development Fund (ERDF), as well as projects NEX-TRY (PI21/0936, ISCiii); EXPLORE-3 and PEGLyso-2 (CIBER-BBN); and Mimic-KEY (GA964386). We also appreciate the support from the Government of Catalonia (SGR 1173). M.M.-A. by the Catalan Government’s Strategic Plan for Research and Innovation in Health (PERIS, SLT017/20/000181)
Informed Consent
Full text linkConsentiment informat; Drets dels pacients; Documentació assistencialInformed consent; Patient rights; Healthcare documentationConsentimiento informado; Derechos de los pacientes; Documentación asistencialCartell adreçat a la ciutadania sobre el consentiment informat, que és un dret i garanteix la seguretat del pacient.Cartel dirigido a la ciudadanía sobre el consentimiento informado, que es un derecho y garantiza la seguridad del paciente.Poster aimed at citizens about informed consent, which is a right and guarantees patient safety
Resum de l’anàlisi de la mortalitat a Catalunya : avanç de resultats
No full textMortalitat; CatalunyaMortality; CataloniaMortalidad; CataluñaL’Estadística de mortalitat a Catalunya conté dades demogràfiques bàsiques i les causes de la mort corresponents a les defuncions anuals de persones residents a Catalunya esdevingudes en aquest territori.The Mortality Statistics in Catalonia contains basic demographic data and the causes of death corresponding to the annual deaths of people resident in Catalonia that have occurred in this territory.La Estadística de mortalidad en Cataluña contiene datos demográficos básicos y las causas de la muerte correspondientes a las defunciones anuales de personas residentes en Cataluña acaecidas en este territorio
Cohort Profile: The Girona Heart Registry
Full text linkCardiovascular disease; Population registry; Epidemiological cohortMalaltia cardiovascular; Registre poblacional; Cohort epidemiològicaEnfermedad cardiovascular; Registro poblacional; Cohorte epidemiológicaThe Girona Heart Registry (REGICOR) is a population-based study designed to analyse the magnitude of and factors related to
cardiovascular (CV) diseases in Southern Europe. The REGICOR cohort integrates the participants of four population-based surveys
conducted in 1995, 2000, 2005, and 2018 in the Girona province (North-Eastern Spain), with a current reference population of
approximately 790 000 inhabitants.
� The REGICOR cohort includes 11 631 individuals (1748 in 1995, 3030 in 2000, 6308 in 2005, and 545 in 2018). At inclusion, 52% of the
study population were females; their mean ages were 51, 50, 57, and 45, respectively.
� Two re-examinations were conducted for the participants recruited in 1995, 2000, and 2005.
� Follow-up data on CV events and cause-specific mortality are available for 11 518 participants since baseline, with a median follow-up
time of 18.6 years. Follow-up data on non-CV events have been available since 2008.
� During inclusion and re-examinations, we obtained blood samples and information on CV and other risk factors using validated
questionnaires, standardized tests, and imaging assessments. Genotyping was performed on the whole cohort. Circulating biomarkers,
DNA methylation, microRNAs, and proteomics have been measured in a cohort subset
Acute respiratory distress syndrome in patients with cancer: the YELENNA prospective multinational observational cohort study
Full text linkCancer; Leukemia; LymphomaCáncer; Leucemia; LinfomaCàncer; Leucèmia; LimfomaPurpose
Acute respiratory failure is the leading reason for intensive care unit (ICU) admission among critically ill patients with cancer. We aimed to describe the clinical characteristics, risk factors, and outcomes of patients with cancer and acute respiratory distress syndrome (ARDS) and to evaluate associations of venovenous extracorporeal membrane oxygenation (ECMO) with outcomes in the subgroup with severe ARDS.
Methods
We conducted a multinational, prospective, observational cohort study of patients with cancer and ARDS in 13 countries in Europe and North America. The primary endpoint was 90-day mortality.
Results
Among 715 included patients, 73.4% had hematologic malignancies and 26.6% solid tumors; 31.2% had undergone hematopoietic stem-cell transplantation (168 allogeneic). ICU, hospital, and 90-day mortality rates were 55.3%, 70.9%, and 73.2%, respectively. By multivariate analysis, independent predictors of higher 90-day mortality were older age, peripheral vascular disease, severe ARDS at inclusion, acute kidney injury, and ICU admission as a time-limited trial (vs. full code). Conversely, lymphoma was associated with lower 90-day mortality. Among the 322 patients (45.7%) with severe ARDS at inclusion, 90-day mortality was 82.2%; with no difference between patients who received ECMO (n = 58, 18%) and those who did not (82.6% vs. 80.7%, P = 0.89). This finding remained unchanged in a double-adjusted overlap- and propensity-weighted Cox mixed-effects model (adjusted hazard ratio, 1.12; 95% confidence interval 0.65–1.94; P = 0.69).
Conclusion
Patients with cancer and ARDS, particularly severe forms, experience high 90-day mortality, irrespective of ECMO use. These findings suggest a need for nuanced ICU goals-of-care discussions and raise concerns about the generalizability of ECMO guidelines to this population.Open access funding provided by Medical University of Vienna. This study was supported by a research grant of the European Society of Intensive Care Medicine (ESICM)
Consensus document for Severe Asthma. 2025 Update
Full text linkSevere asthma; Diagnosis; Follow-upAsma grave; Diagnóstico; SeguimientoAsma greu; Diagnòstic; SeguimentEl asma grave (AG) constituye un síndrome heterogéneo con diversas variantes clínicas y representa en muchas ocasiones, una enfermedad compleja con necesidad de un abordaje especializado y multidisciplinar, así como la utilización de múltiples fármacos. La prevalencia del AG varía de un país a otro, y se estima que el 50% de estos pacientes graves tienen un mal control de su enfermedad. Para el mejor manejo del paciente es necesario un correcto diagnóstico, un seguimiento adecuado y sin duda ofrecerle el mejor tratamiento disponible, incluyendo los tratamientos biológicos con anticuerpos monoclonales (mAb). Con este afán nació este proceso de consenso que se inició en su primera versión en el año 2018, cuya finalidad última es ofrecer al paciente el mejor manejo posible de su enfermedad para así minimizar su sintomatología. Para esta actualización del consenso 2025, se realizó por parte de los autores una revisión de la literatura, añadiéndose secciones sobre el tratamiento del asma en las comorbilidades y en pediatría, además de un apartado sobre el manejo del cambio de mAb. Posteriormente a través de un proceso interactivo tipo Delphi a dos rondas un panel amplio de expertos en asma de la Sociedad de Neumología y Cirugía Torácica (SEPAR) y las sociedades autonómicas de neumología propusieron las recomendaciones y conclusiones que se recogen en el documento.Severe asthma is a heterogeneous syndrome with several clinical variants and often represents a complex disease requiring a specialized and multidisciplinary approach, as well as the use of multiple drugs. The prevalence of severe asthma varies from one country to another, and it is estimated that 50% of these patients present a poor control of their disease. For the best management of the patient, it is necessary to have a correct diagnosis, an adequate follow-up and undoubtedly to offer the best available treatment, including biologic treatments with monoclonal antibodies. With this objective, this consensus process was born, which began in its first version in 2018, whose goal is to offer the patient the best possible management of their disease to minimize their symptomatology. For this 2025 consensus update, a literature review was conducted by the authors, and new sections of how to treat asthma comorbidities or pediatric asthma were added, as a paragraph about monoclonal antibody switch. Subsequently, through a two-round interactive Delphi process, a broad panel of asthma experts from SEPAR and the regional pulmonology societies proposed the recommendations and conclusions contained in this document.El desarrollo de este manuscrito ha sido financiado por fondos propios de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
The Associated Factors of Work Engagement, Work Overload, Work Satisfaction, and Emotional Exhaustion and Their Effect on Healthcare Workers: A Cross-Sectional Study
Full text linkWork engagement; Emotional exhaustion; Healthcare workers;Compromís laboral; Esgotament emocional; Satisfacció laboralCompromiso laboral; Agotamiento emocional; Satisfacción laboralIn today's fast-paced work environment, work engagement is crucial for both organizational success and individual well-being. Objective: Our aim is this study was to analyze the associated factors of work engagement, work overload, work satisfaction, and emotional exhaustion and describe their effect on nurses and physicians in the Central Catalonia Health Region during 2023. Methods: A multicenter cross-sectional study was conducted using an online questionnaire at the Territorial Management of Central Catalonia (Spain). The questionnaire was accessible from 28 November 2022 to 12 March 2023. The analysis was performed using the SPSS software. CHERRIES (Checklist for Reporting Results of Internet E-Surveys) guidelines were followed for communicating research results. Results: A total of 321 professionals answered the questionnaire, 60.7% of whom were nursing professionals and 39.3% of whom were medical professionals. Work overload, work satisfaction, and emotional exhaustion were associated with work engagement. Being a physician, permanent contracts, irregular work shifts, overtime, and salary were related to work overload and emotional exhaustion. Being a woman, salary, academic level, and irregular work shifts were related to work satisfaction. There was a gender inequality in work engagement among nursing professionals to the detriment of men. In terms of class inequality, there was a difference between occupational groups with respect to work overload and emotional exhaustion among women. Conclusions: Organizational practices need to be improved to promote greater engagement and work satisfaction, as well as to reduce emotional overload and exhaustion. This may include regulating unpaid overtime and promoting more stable working hours
Full informatiu del Sistema d’Informació per a la Vigilància d’Infeccions a Catalunya – 2025/01
Full text linkVigilància d'infeccions; Epidemiologia; Assistència sanitàriaInfection surveillance; Epidemiology; Health careVigilancia de infecciones; Epidemiología; Asistencia sanitariaL’objectiu de l’informe de la xarxa Sistema d’Informació per a la Vigilància d’Infeccions a Catalunya (SIVIC) és tenir un sistema de vigilància creat per seguir no només els casos més greus sinó també els casos comunitaris de diverses infeccions respiratòries, com són Covid-19, grip, virus sincitial respiratori i enterovirus, entre d’altres