Scientia, Dipòsit d’Informació Digital del Departament de Salut
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Denúncies administratives i delictes penals relacionats amb el consum i tràfic de drogues: informe sobre consum problemàtic i conseqüències - 2024
No full textDenúncies administratives; Delictes penals; Consum de drogues; Tràfic de droguesAdministrative complaints; Criminal offences; Drug use; Drug traffickingDenuncias administrativas; Delitos penales; Consumo de drogas; Tráfico de drogasEn aquest informe es presenten dades facilitades per l’Àrea Central d’Anàlisi de la Criminalitat de la Policia de la Generalitat de Catalunya – Mossos d’Esquadra (PG - ME) sobre: 1) Denúncies per consum o tinença il·lícita de drogues. 2) Delictes penals relacionats amb el tràfic de drogues
Prevalence and risk factors of dependence-related skin lesions in neonatal units: A multicentre study across Spanish hospitals
Get PDFNewborn; Pressure injuries; Risk factorsNounat; Lesions per pressió; Factors de riscNeonato; Úlceras por presión; Factores de riesgoAim
This study aimed to obtain updated epidemiological indicators of dependence-related skin lesions (DRSLs) in neonatal units of Spanish hospitals and to analyze preventive interventions and risk factors associated with DRSL development.
Materials and methods
A multicentre, observational, cross-sectional prevalence study was conducted across three data collection phases in 12 Spanish hospitals with neonatal units, and included 398 hospitalised neonates. Data collection was based on direct observation, clinical record review, and caregiver interviews. The Neonatal Skin Risk Assessment Scale (e-NSRAS) was used to assess DRSL risk. Demographic variables, risk factors, and preventive measures were also analyzed.
Results
DRSL prevalence was 29.4 %. Moisture-related lesions (18.6 %) were the most common, especially in intermediate care, followed by pressure injuries (13.07 %), more prevalent in intensive care, and friction-related lesions (3.02 %). Non-invasive mechanical ventilation and urinary catheterisation were significantly associated with DRSL occurrence. Additionally, 34 % of neonates were classified as at risk of pressure injuries.
Discussion
A high DRSL prevalence was observed among hospitalised neonates, exceeding rates reported in other national and international studies. The e-NSRAS appears unsuitable for assessing all DRSL types. The use of multiple medical devices was associated with higher DRSL rates, and preventive measures were often applied late or inadequately. Study limitations include those typical of cross-sectional studies, such as representativeness, confounding factors, and sample size.
Conclusion
DRSLs are a prevalent issue in Spanish neonatal units. The development and implementation of targeted preventive measures, along with the adaptation of assessment tools, are critical for enhancing the quality of neonatal care.The translation and publication of this article were funded by the Spanish Society of Neonatal Nursing (SEEN)
Tractament del càncer de mama metastàtic HER2 positiu
Get PDFCàncer de mama metastàtic; Her2 positiu; Pacients adultsCáncer de mama metastático; Her2 positivo; Pacientes adultosMetastatic breast cancer; Her2 positive; Adult patientsL’objectiu d’aquest informe és analitzar l’ús del tractament per a càncer de mama metastàtic HER2 positiu en pacients adults en termes poblacionals, d’adequació als criteris clínics establerts pel PHF1-4, de la seva efectivitat i la despesa en l’àmbit del sistema sanitari integral d’utilització pública de Catalunya (SISCAT)
Per una resposta global enfront al VIH [cartell]
No full textVIH; Conscienciació; Dia MundialHIV; Awareness; World DayVIH; Concienciación; Día MundialCartell per al Dia Mundial de la Sida de l'any 2025
Efficacy results from a 12-month double-blind randomized trial of arimoclomol for treatment of Niemann-Pick disease type C (NPC): Presenting a rescored 4-domain NPC Clinical Severity Scale
Get PDFArimoclomol; NPC clinical severity scale; Niemann-Pick disease type CArimoclomol; Escala de gravetat clínica de la NPC; Malaltia de Niemann-Pick tipus CArimoclomol; Escala de gravedad clínica de la NPC; Enfermedad de Niemann-Pick tipo CBackground
In the 12-month, randomized, double-blind, placebo-controlled Phase 2/3 NPC-002 study (NCT02612129), arimoclomol significantly reduced annual disease progression versus placebo, measured by the 5-domain NPC Clinical Severity Scale (5DNPCCSS). Arimoclomol has been approved in the US for treatment of Niemann-Pick disease type C (NPC) in combination with miglustat. This paper introduces the rescored 4-domain NPCCSS (R4DNPCCSS) as a post-hoc primary endpoint in NPC-002, discusses its validation, and presents the results of the post-hoc primary analysis.
Methods
To more accurately assess changes in disease course over a 12-month time period in a heterogeneous group of patients, the Cognition domain was removed from the 5DNPCCSS and the Swallow domain was rescored to reflect linearity in disease progression. Rescoring of the Swallow domain was based on input from clinical NPC and swallow experts from a qualitative interview-based study (N = 12), resulting in the R4DNPCCSS. To supplement prior validation analyses, data supporting the overall validity and reliability of the R4DNPCCSS was gathered through additional analyses of construct and convergent validity. The NPC-002 prespecified primary efficacy endpoint analysis based on the 5DNPCCSS score change from baseline to 12 months was repeated with R4DNPCCSS.
Results
Construct validity analysis demonstrated high agreement between the R4DNPCCSS domain scores and the Clinical Global Impression Scale of Severity (CGI-S) and NPC Clinical Database (NPC-cdb) scores. Convergent validity was confirmed by strong correlations between the R4DNPCCSS domains and corresponding items on the Scale for Assessment and Rating of Ataxia (SARA), 9-hole peg test (9-HPT), and Video Fluoroscopic Swallowing Study (VFSS) performance tests. The NPC-002 post-hoc primary analysis showed a mean standard error (SE) change in R4DNPCCSS score of 0.35 (0.40) with arimoclomol (N = 34) versus 2.05 (0.54) with placebo (N = 16), and a treatment effect in favor of arimoclomol over placebo of −1.70 (p = 0.0155). In the miglustat subgroup analysis, mean (SE) change in R4DNPCCSS score was −0.23 (1.02) with arimoclomol (N = 22) versus 1.92 (3.37) with placebo (N = 12), representing a treatment effect of −2.21 (p = 0.0077).
Conclusion
The R4DNPCCSS is a valid and reliable measure of disease progression demonstrating consistent outcomes with the prespecified 5DNPCCSS endpoint. Arimoclomol significantly slowed disease progression through 12 months as measured by the R4DNPCCSS versus placebo.The research was funded by Zevra Therapeutics Inc
Patient and Caregiver Perceptions of Health-Related Quality of Life in Children and Adolescents After Allogeneic Hematopoietic Stem Cell Transplantation
Get PDFHealth-related quality of life; Caregiver; Allogeneic hematopoietic stem cell transplantationQualitat de vida relacionada amb la salut; Cuidadors; Trasplantament al·logènic de cèl·lules mare hematopoètiquesCalidad de vida relacionada con la salud; Cuidadores; Trasplante alogénico de células madre hematopoyéticasPurpose
The purpose of this study was to analyze the patients’ and caregivers’ perceptions of health-related quality of life (HRQOL) of pediatric allogeneic hematopoietic stem cell transplant (HSCT) recipients. The perceptions in HRQOL of patients and their caregivers were studied using PROMS (patient-reported outcome measures) questionnaires.
Methods
Retrospective analysis of data from children and adolescents who underwent HSCT at our hospital between 2017 and 2022. The self-report and parent-proxy report versions of the Pediatric Quality of Life Inventory 4.0 generic core scales (PedsQL 4.0) were used to assess HRQOL in four areas (physical, emotional, social, and school functioning) as reported by patients aged ≥ 2 to < 18 years and their caregivers and evaluated 1 and 2 years after hospital discharge allogeneic HSCT.
Results
We collected data on the HRQOL of 36 patients and their caregivers through self- and proxy-reports. More than 70% of children and their caregivers perceived good HRQOL in all areas both 1 and 2 years after allogeneic HSCT. Patients and caregivers largely agreed in their assessments, although caregivers gave slightly higher HRQOL ratings. Children aged < 10 years had higher HRQOL scores than adolescents at both time points. Patients with an HLA-mismatched donor were at greater risk of impaired HRQOL than those with an HLA-matched donor, particularly in terms of physical functioning.
Conclusions
More than 70% of patients and caregivers perceived good overall HRQOL (total PedsQL score) 2 years after hospital discharge from the HSCT unit.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature
Metabolic adaptation and fragility in healthy 3D in vitro skeletal muscle tissues exposed to chronic fatigue syndrome and Long COVID-19 sera
Get PDFLong Covid-19; Chronic fatigue syndrome; Metabolic adaptationCovid-19 prolongada; Síndrome de fatiga crònica; Adaptació metabòlicaCovid-19 prolongado; Síndrome de fatiga crónica; Adaptación metabólicaMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long Covid-19 (LC-19) are complex conditions with no diagnostic markers or consensus on disease progression. Despite extensive research, noin vitromodel exists to study skeletal muscle wasting, peripheral weakness, or potential therapies. We developed 3Din vitroskeletal muscle tissues to map muscle adaptations to patient sera over time. Short exposures (48 H) to patient sera led to a significant reduction in muscle contractile strength. Transcriptomic analysis revealed the upregulation of protein translation, glycolytic enzymes, disturbances in calcium homeostasis, hypertrophy, and mitochondrial hyperfusion. Structural analyses confirmed myotube hypertrophy and elevated mitochondrial oxygen consumption In ME/CFS. While muscles initially adapted by increasing glycolysis, prolonged exposure (96-144 H) caused muscle fragility and weakness, with mitochondria fragmenting into a toroidal conformation. We propose that skeletal muscle tissue in ME/CFS and LC-19 progresses through a hypermetabolic state, leading to severe muscular and mitochondrial deterioration. This is the first study to suggest such transient metabolic adaptation.This work received financial support from the Ministerio de Ciencia e Innovación (Spain; grant PID2022-136833OB-C22 to J.R.-A.). S.M. was supported by the FPI predoctoral fellowship from Ministerio de Economía y Competitividad (PRE2020-092676, ayudas para contratos predoctorales para la formación de doctores). Open Access funding provided by Institute for Bioengineering of Catalonia. The Spanish Ministry of Science, Innovation and Universities through the ‘Severo Ochoa’ Program for Centres of Excellence in R&D (CEX2023-001282-S), the CERCA Programme/Generalitat de Catalunya (2021-SGR-01495). Institutional support to CNAG was provided by the Spanish Ministry of Science and Innovation through the Instituto de Salud Carlos III, and by the Generalitat de Catalunya through the Departament de Salut and the Departament de Recerca i Universitats
An Overview of Actinic Keratoses: Understanding Etiology, Diagnosis, and Treatment Approaches
Get PDFQueratosis actínica; Tratamiento; DiagnósticoActinic keratosis; Treatment; DiagnosisQueratosi actínica; Tractament; DiagnòsticLas queratosis actínicas (QA) son lesiones cutáneas frecuentes que surgen en la piel crónicamente expuesta a los rayos ultravioleta y que potencialmente pueden progresar a un carcinoma epidermoide cutáneo (CEC) infiltrante. Debido a que no se puede predecir qué lesiones progresarán a CEC ni cuándo, generalmente se recomienda el tratamiento de todas las QA. Existe un amplio abanico de tratamientos disponibles para la QA a los que se les han unido nuevas aprobaciones en los últimos años. Estos cambios en los tratamientos disponibles para la QA hacen necesaria la revisión de la evidencia científica y del estado actual del diagnóstico y manejo de la QA en España.Actinic keratoses (AK) are common cutaneous lesions located in skin areas chronically exposed to UV radiation, with the potential of progressing into invasive squamous cell carcinoma (SCC). Since it is not possible to predict which AK lesions will become SCC or when will that happen, treating all AK is generally recommended. There is a wide range of therapies available for AK and new drug approvals have joined the therapeutic armamentarium in recent years. These changes in the available treatments for AK require a review of the scientific evidence available and the current status of AK diagnosis and management in Spain
Efficacy and Safety of a Balanced Gelatine Solution for Fluid Resuscitation in Sepsis: A Prospective, Randomised, Controlled, Double-Blind Trial-GENIUS Trial
Get PDFCrystalloid; Fluid balance; Fluid resuscitationCristaloide; Balanç de fluids; Reanimació amb fluidsCristaloide; Balance de líquidos; Reanimación con líquidosBackground/Objective: Sepsis is a leading cause of death in noncoronary intensive care units (ICUs). Fluids for intravascular resuscitation include crystalloids and colloids. There is extensive clinical evidence on colloid use, but large trials comparing gelatine with crystalloid regimens in ICU and septic patients are lacking. This study aimed to determine whether early, protocol-driven volume resuscitation using a gelatine-based regimen achieves hemodynamic stability (HDS) more rapidly than a crystalloid-based regimen in septic patients. Methods: This prospective, controlled, randomised, double-blind, multinational phase IV study compared two parallel groups of septic patients receiving a gelatine-based regimen (Gelaspan® 4% and Sterofundin® ISO, B. Braun Melsungen AG each, at a 1:1 ratio) or a crystalloid regimen (Sterofundin® ISO). Primary endpoint was time to first HDS within 48 h after randomisation. Secondary endpoints included fluid overload, fluid balance, and patient outcomes. Results: 167 patients were randomised. HDS was achieved after 4.7 h in the gelatine group and after 5.8 h in the crystalloid group (p = 0.3716). The gelatine group had a more favourable fluid balance at 24 h (medians: 3463.00 mL vs. 4164.00 mL; p = 0.0395) and less fluid overload (medians: 4296.05 vs. 5218.75%; p = 0.0217). No differences were observed in serious adverse events or mortality. Conclusions: The study provided clinical evidence of balanced gelatine solution for volume resuscitation in septic patients, although it was terminated prematurely. The early and protocol-based administration of gelatine was safe and effective in the enrolled patient population. Time to HDS was not different between groups but the gelatine-based regimen led to better fluid balance and less fluid overload.In this clinical study, B. Braun Melsungen AG, Carl-Braun Str. 1, D-34212 Melsungen acts as the sponsor, funder, and data holder of this study. B. Braun Melsungen AG organised protocol development and contracted a contract research organisation (CRO) for clinical trial application, monitoring, and collection/analysis of study data. Investigational tests and reference products were produced and delivered by B. Braun Melsungen AG to all participating sites
Long-Term Follow-Up of Prophylactic Mesh and Methodological Considerations
Get PDFMesh complications; Methodology; Prophylactic meshComplicaciones de la malla; Metodología; Malla profilácticaComplicacions de la malla; Metodologia; Malla profilàctic