Scientia, Dipòsit d’Informació Digital del Departament de Salut
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Blood-borne virus testing in European emergency departments: current evidence and service considerations
Full text linkVirus; Blood; European emergency departmentsVirus; Sang; Serveis d'urgències europeusVirus; Sangre; Servicios de urgencias europeosInnovative testing approaches are needed to meet global targets for the blood-borne viruses (BBVs) HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). We conducted a systematic review of BBV testing in emergency departments (EDs) in Europe to evaluate prevalence, effectiveness of ED testing and linkage to care (LTC). We searched PubMed, Embase and Cochrane Library for articles on ED BBV testing published between January 2012 and July 2022. Studies conducted outside Europe or prior to 2012 were excluded owing to epidemiological and healthcare service variation, together with studies that did not report core parameters. Reference lists from included articles were manually searched. Seventeen original articles met the inclusion criteria. Seven studies reported on HIV testing only. ED prevalence: HIV Ab, 0.0%-1.1%; HBsAg, 0.2%-0.9%; and HCV RNA, 0.2%-3.9%. BBV testing uptake varied by policy and offer methodology: opt-out, provider-initiated: 9.7%-44.2%; electronic health record (EHR) modification: 52.1%-88.9%; and opt-in, provider-initiated: 3.9%-37.7%. LTC rates were 8.1%-100% and varied by BBV, generally highest for HIV and lowest for HCV. There was variable detail in outcome reporting and description of clinical LTC pathways. ED BBV testing in Europe is feasible and identifies high numbers of infections (including, where reported, new diagnoses and disengaged patients), often among marginalized populations who use open-access EDs for healthcare. Factors associated with higher levels of sustained testing uptake included opt-out testing (vs opt-in), EHR (vs provider-initiated) and integration of community services. We propose a toolkit of components necessary for a high-performing ED BBV testing programme.This work was supported by Medical Affairs, Gilead Sciences Europe
Immunització contra les infeccions pel virus respiratori sincicial (VRS) [cartell]
Full text linkVirus respiratori; Infecció; NadonsVirus respiratorio; Infección; BebésRespiratory virus; Infection; BabyAquest cartell conté informació sobre el virus respiratori sincicial (VRS) i per què cal immunitzar als nadons.Este cartel contiene información sobre el virus respiratorio sincicial (VRS) y por qué es necesario inmunizar a los bebés.This poster contains information about respiratory syncytial virus (RSV) and why babies should be immunized
Development of the mobile application Guide to medication reconciliation in the critically ill patient
No full textConciliación de la medicación; Unidad de cuidados intensivos; Aplicación móvilMedication reconciliation; Intensive care unit; Mobile health unitsConciliació de la medicació; Unitat de cures intensives; Aplicació mòbilObjetivo
la conciliación de la medicación es un proceso esencial en la atención de pacientes críticos, que garantiza que la medicación crónica de los pacientes sea adaptada a la situación clínica del paciente y administrada de forma segura durante su hospitalización. Dado el perfil del paciente ingresado en una unidad de críticos (UCI), adquiere una relevancia aún mayor. La conciliación minimiza posibles errores de medicación y efectos adversos, mejorando la seguridad en el paciente crítico. El objetivo es exponer el desarrollo de una app móvil de la Guía de conciliación farmacoterapéutica para su uso en la UCI, proporcionando a los profesionales sanitarios recomendaciones basadas en evidencia científica para la conciliación de la medicación en esta población.
Métodos
el proyecto, realizado entre 2021 y 2024, fue liderado por los grupos FarMIC (Farmacéuticos de medicina intensiva y pacientes críticos) y RedFaster (Atención farmacéutica en urgencias) de la Sociedad Española de Farmacia Hospitalaria (SEFH), e incluyó: la selección de los fármacos a analizar, la revisión de la bibliografía disponible y las guías de conciliación previas en ámbitos similares de aplicación, la elaboración de las fichas de medicamentos con las recomendaciones emitidas por el grupo de trabajo, la revisión de las mismas y el desarrollo del aplicativo móvil.
Resultados
en octubre de 2024 se lanzó la app Guía de conciliación en pacientes críticos®, disponible gratuitamente para iOS y Android. Ofrece un índice de medicamentos con información detallada sobre cronogramas de reintroducción de la medicación, vías de administración, monitorización y consideraciones específicas de cada fármaco. Además, la herramienta incluye información sobre los síndromes de retirada, las interacciones medicamentosas y los medicamentos peligrosos según la lista NIOSH.
Conclusiones
esta app facilita la conciliación farmacoterapéutica en la UCI, apoyando a los profesionales sanitarios en la toma de decisiones personalizadas. Su uso puede optimizar la seguridad del paciente, reducir los eventos adversos y mejorar la atención de los pacientes críticos. Finalmente, esta herramienta refuerza el papel del farmacéutico clínico en las UCI, que debe liderar este proceso en todas las transiciones asistenciales y adaptarlo a la situación clínica del paciente.Los autores declaran que el proyecto ha sido financiado con las Ayudas a Proyectos de Investigación y de Desarrollo Profesional o asistencial promovido por los Grupos de Trabajo de la Sociedad Española de Farmacia Hospitalaria convocado por la Fundación Española de Farmacia Hospitalaria en la convocatoria 2022–2023
A Phase II Study of Perioperative Avelumab plus Chemotherapy for Patients with Resectable Gastric Cancer or Gastroesophageal Junction Cancer - The MONEO Study
Full text linkPerioperative avelumab; Resectable gastric cancer; Gastroesophageal junction cancerAvelumab perioperatori; Càncer gàstric resecable; Càncer de la unió gastroesofàgicaAvelumab perioperatorio; Cáncer gástrico resecable; Cáncer de la unión gastroesofágicaPurpose: Immune checkpoint inhibitors combined with chemotherapy have provided successful results in patients with gastric and gastroesophageal junction (G/GEJ) cancers in the metastatic setting. Similar strategies have been explored in earlier stages. In this study, we present the final results of the phase II MONEO trial, which evaluated the addition of avelumab to neoadjuvant chemotherapy.
Patients and methods: Patients with untreated, resectable G/GEJ adenocarcinoma received neoadjuvant treatment with four cycles of avelumab plus the FLOT4 regimen, followed by surgery. Upon postoperative recovery, patients underwent four additional adjuvant cycles of the same combination, followed by avelumab monotherapy for up to 1 year. The primary endpoint was pathologic complete response rate. Sequential flow cytometry and cytokine determination were performed in peripheral blood, along with multiplex tissue immunofluorescence and RNA sequencing in tumor specimens.
Results: Forty patients were enrolled, achieving a pathologic complete response rate of 21.1% (95% confidence interval, 10.0-37.0). The major pathologic response rate was 28.9%, more pronounced in patients with tumors expressing PD-L1 before treatment as measured by the combined positive score (cutoff, 10; 33.3% vs. 21.1%). The results propose several potential biomarkers considering tumor immune infiltrate, circulating immune cells, and cytokines. Eighty percent of patients experienced treatment-related grade ≥3 adverse events.
Conclusions: The combination of avelumab plus the FLOT4 regimen showed relatively modest efficacy in resectable G/GEJ adenocarcinoma. Better results were observed in PD-L1 combined positive score ≥10% tumors. Exploratory biomarker analyses provide insights that may help to identify candidates most likely to benefit from chemoimmunotherapy as a neoadjuvant treatment.Avelumab was provided by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945). This study was financially supported by the healthcare business of Merck KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945). Vall d’Hebron Institute of Oncology would like to acknowledge the State Agency for Research (Agencia Estatal de Investigación) for the financial support as a Center of Excellence Severo Ochoa (CEX2020-001024-S/AEI/10.13039/501100011033), the Cellex Foundation for providing research facilities and equipment, and the CERCA Program from the Generalitat de Catalunya for their support on this research
Entitats d’assegurança sanitària lliure de Catalunya: memòria 2024
No full textEntitats d'assegurança sanitària lliure; Assistència sanitària privada; CatalunyaFree health insurance entities; Private healthcare; CataloniaEntidades de seguro sanitario libre; Asistencia sanitaria privada; CataluñaLes entitats d’assegurança lliure tenen com una de les seves finalitats oferir la cobertura del risc de malaltia als seus assegurats.
La memòria de les entitats d’assegurança lliure és una de les eines de què disposa el Departament de Salut per valorar l’evolució anual del sector, conèixer la població catalana que disposa d’una doble cobertura per al risc de malaltia i tenir una aproximació de l’activitat sanitària que realitzen les asseguradores.The free insurance entities have as one of their aims to offer the coverage of the risk of illness to their insured.
The memory of free insurance entities is one of the tools available to the Department of Health to assess the annual evolution of the sector, know the Catalan population that has a double coverage for the risk of illness and have an approximation of the health activity carried out by insurers.Las entidades de seguro libre tienen como una de sus finalidades ofrecer la cobertura del riesgo de enfermedad a sus asegurados.
La memoria de las entidades de seguro libre es una de las herramientas de que dispone el Departamento de Salud para valorar la evolución anual del sector, conocer la población catalana que dispone de una doble cobertura para el riesgo de enfermedad y tener una aproximación de la actividad sanitaria que realizan las aseguradoras
Selected Serious Adverse Events in a Cohort of Adult ICU Patients: Protocol for a Sub-Study of the PATIENCE Cohort
Full text linkAdverse events; Adult patients; ICUEsdeveniments adversos; Pacients adults; UCIEventos adversos; Pacientes adultos; UCIBackground
Serious adverse events (SAEs) are a relevant patient safety concern in critically ill patients, yet epidemiological data on their occurrence in the intensive care unit (ICU) remain limited. This sub-study of the PATIENCE cohort study aims to describe the occurrence of selected SAEs in adult ICU patients with and without prokinetic treatment.
Methods
This is a protocol and statistical analysis plan for a post hoc sub-study of the “Prokinetic agents in adult intensive care unit patients—An international inception cohort study (PATIENCE)” which has included 1440 acutely admitted adult ICU patients from 11 countries.
The primary outcome is the proportion of patients experiencing selected SAEs, assessed according to exposure to prokinetic treatment. Secondary outcomes include the proportion of patients experiencing each specific SAE, their distribution by treatment duration, and timing in relation to ICU admission and prokinetic use. Furthermore, patient characteristics for those with and without the SAEs will be described. Data will be presented descriptively.
Conclusion
This sub-study will use data from the international PATIENCE cohort study to provide epidemiological data on the occurrence of SAEs potentially related to prokinetic use in adult ICU patients
Projectes clau de millora organitzativa en els equips d’atenció primària: guia d’implementació; projectes desenvolupats en el marc del Pla d’enfortiment i transformació de l’atenció primària i comunitària (PEiTAPiC) per impulsar la transformació de l’atenció primària
Full text linkPla d’Enfortiment i Transformació de l’Atenció Primària i Comunitària; (PEiTAPiC) ; Millora organitzativaPlan de Fortalecimiento y Transformación de la Atención Primaria y Comunitaria; (PEiTAPiC) ; Mejora organizativaPlan for Strengthening and Transformation of Primary and Community Care; (PEiTAPiC); Organizational improvementEl PEITAPiC és un projecte que busca enfortir l’APiC per donar resposta als reptes actuals i futurs, tot adaptant-se a les necessitats de la població i potenciant el seu paper clau dins del sistema sanitari. Aquesta iniciativa posa èmfasi a millorar l’accessibilitat, la resolució assistencial i l’atenció integral a les persones amb malalties cròniques, així com a fomentar la coordinació entre dispositius assistencials. El seu objectiu és impulsar l’APiC per oferir una resposta més adequada, eficient i centrada en la ciutadania. El PEITAPiC vol posar en valor la importància d’aquest àmbit i reforçar-lo mitjançant tres grans línies: garantir l’accessibilitat en l’atenció, millorar la resolució dels processos assistencials i consolidar una atenció integral a les persones
How to eliminate hepatitis C between people who inject drugs in community services and prisons in Catalonia
Full text linkHepatitis C; People who inject drugs: Direct-acting antiviralsAntivirals d'acció directa; Hepatitis C; Persones que s'injecten droguesAntivirales de acción directa; Hepatitis C; Personas que se inyectan drogasThe Spanish National Health System, with devolved powers to autonomous communities such as Catalonia, faces significant challenges in controlling viral infections like hepatitis C (HCV) among vulnerable groups, particularly people who inject drugs (PWID), where prisons serve as crucial intervention sites. Catalonia's health authorities have implemented strategies to combat HCV, including direct-acting antiviral (DAA) treatments and harm reduction programmes within both community and penitentiary settings. However, substantial barriers persist in achieving full treatment uptake and clearance among PWID subpopulations.
This review aims to discuss the Catalonia's current HCV programmes and explores intervention proposals needed to achieve WHO elimination targets. Catalonia has implemented a comprehensive HCV plan, particularly targeting PWID, that has proven effective through enhanced screening, universal treatment access, and harm reduction, though structural and social barriers remain due to fragmented health and social systems.
Advancing towards HCV elimination requires strengthened inter-organisational coordination, integrated social and health services, simplified care pathways, enhanced screening, professional training, targeted research, measurable goals, culturally appropriate and participatory prevention strategies, and a comprehensive, people-centred approach. This is particularly important in prisons, where universal screening, adapted caring processes, harm reduction, and opioid substitution treatments (OST) are essential. Considering the social determinants of health perspective, it is essential that policies and programs are structured to reduce structural inequities and vulnerabilities, thereby promoting equity in both access to prevention, care, treatment, and health benefits across all population groups, particularly those most affected.Part of this study (translation) was supported by Gilead under Grant award: Free C, Hepatitis C treatment in prisons and consumption rooms (Gilead and Asociación Española para el Estudio del Hígado 2023)
Evaluation of the Safety, Pharmacokinetics, and Antitumor Activity of Tusamitamab Ravtansine in Patients With Nonsquamous NSCLC With High or Moderate Expression of Carcinoembryonic Antigen-Related Cell Adhesion Molecule 5
Full text linkAntibody-drug conjugate; Carcinoembryonic antigen-related cell adhesion molecule 5; Non-small cell lung cancerConjugat anticòs-fàrmac; Molècula d'adhesió cel·lular relacionada amb l'antigen carcinoembrionari 5; Càncer de pulmó de cèl·lules no petitesConjugado anticuerpo-fármaco; Molécula de adhesión celular relacionada con el antígeno carcinoembrionario 5; Cáncer de pulmón de células no pequeñasIntroduction
Tusamitamab ravtansine is an antibody-drug conjugate targeting cells expressing carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5) with a maytansinoid payload, DM4. This phase 1b dose-expansion study (NCT02187848) evaluated its safety, pharmacokinetics, and preliminary antitumor activity in patients with nonsquamous NSCLC (NSq NSCLC).
Methods
Patients aged above or equal to 18 years with advanced or metastatic NSq NSCLC, life expectancy more than or equal to 12 weeks, and high (≥2+ intensity in ≥50% of tumor cells) or moderate (≥2+ intensity in 1%–49% of tumor cells) CEACAM5 expression (assessed by immunohistochemistry) received intravenous tusamitamab ravtansine 100 mg/m2 every 2 weeks.
Results
A total of 64 patients with high and 28 with moderate CEACAM5 expression received a median of 8.0 (1–69) and 4.5 (1–38) treatment cycles, respectively. High expressors had 13 confirmed partial responses and 28 stable diseases (objective response rate, 20.3%; 95% confidence interval [CI]: 12.3%–31.7%, p < 0.0001); median duration of response was 6.7 months, and median time to progression was 3.7 months (95% CI: 2.7–5.1 mo). Moderate expressors had two confirmed partial responses (objective response rate, 7.1%; 95% CI: 2.0%–22.7%, p = 0.4117) and 15 stable diseases.
Treatment-emergent adverse events (AEs) occurred in 78.3% of patients (72/92), 37.0% (34/92) of patients required dose modifications, and 5.4% (5/92) discontinued treatment. The most common treatment-emergent AEs included asthenia (37.0%), keratitis (29.3%), and dyspnea (23.9%). Corneal AEs occurred in 38.0% (35/92), typically grade 1/2, reversible, and manageable by dose modifications.
Conclusions
Tusamitamab ravtansine demonstrated a favorable safety profile, objective responses, and antitumor activity in patients with high CEACAM5-expressing NSq NSCLC.This work was supported by Sanofi
Butll Farmacovigil Cat
No full textFarmacologia; Medicaments; Reaccions adversesFarmacología; Medicamentos; Reacciones adversasPharmacology; Drug; Adverse ReactionsIII Jornada de Farmacovigilància de Catalunya. Comunicacions sobre riscos a medicaments notificades per l’Agència Espanyola de Medicaments i Productes Sanitaris (AEMPS).III Jornada de Farmacovigilancia de Cataluña.
Comunicaciones sobre riesgos a medicamentos notificadas por la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)