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Protocol d’actuació davant la malaltia meningocòccica invasiva
Get PDFMalaltia meningocòccica invasiva; Protocol; ActuacióEnfermedad meningocócica invasiva; Protocolo; ActuaciónInvasive meningococcal disease; Protocol; ActionAquest protocol estableix les mesures de salut pública per a la detecció, notificació, prevenció i control de la malaltia meningocòccica invasiva, que afecta especialment infants i joves. En el marc de l’actual situació epidemiològica, es detallen les estratègies de prevenció, incloent la vacunació sistemàtica i selectiva contra els serogrups A, B, C, W i Y, així com les pautes de quimioprofilaxi. S’hi remarca la necessitat de notificació urgent i d’una resposta sanitària immediata. El document també defineix els circuits de comunicació amb la Xarxa de Vigilància Epidemiològica i els criteris clínics i microbiològics per a la classificació dels casos i la gestió de brots.Este protocolo establece las medidas de salud pública para la detección, notificación, prevención y control de la enfermedad meningocócica invasiva, que afecta especialmente a niños y jóvenes. En el contexto epidemiológico actual, se detallan las estrategias de prevención, incluyendo la vacunación sistemática y selectiva contra los serogrupos A, B, C, W e Y, así como las pautas de quimioprofilaxis. Se remarca la necesidad de una notificación urgente y de una respuesta sanitaria inmediata. El documento también define los circuitos de comunicación con la Red de Vigilancia Epidemiológica y los criterios clínicos y microbiológicos para la clasificación de los casos y la gestión de brotes.This protocol sets out the public health measures for the detection, notification, prevention, and control of invasive meningococcal disease, which mainly affects children and young people. In the current epidemiological context, it outlines prevention strategies, including systematic and targeted vaccination against serogroups A, B, C, W, and Y, as well as chemoprophylaxis guidelines. It emphasizes the need for urgent notification and immediate healthcare response. The document also defines communication pathways with the Epidemiological Surveillance Network and the clinical and microbiological criteria for case classification and outbreak management
Strategies for organizing research and care in mental health for migrant populations
Get PDFMigrantes; Salud mental; Política de saludMigrants; Mental health; Health policyMigrants; Salut mental; Política de salutSe analizan los desafíos de salud mental que enfrenta la población inmigrante en España, destacando la falta de una asistencia coordinada que responda a sus necesidades específicas. Se encuentran una elevada prevalencia de trastornos mentales, una mayor exposición a los determinantes de salud mental, y diferencias en la expresión del malestar mental y en las conductas relacionadas con el acceso y la demanda de servicios. Se presentan propuestas en varios niveles para mejorar la atención sanitaria: 1) fomentar la investigación de alto impacto, 2) ofrecer una formación rigurosa a los profesionales en humildad cultural y para la integración de agentes comunitarios de salud mental, y 3) crear centros de referencia como un cambio organizativo para mejorar la asistencia y promover políticas públicas. En conclusión, se destaca la urgencia de realizar acciones, a través de políticas públicas de salud específicas, que garanticen la atención a la salud mental de calidad y equitativa para toda la población, que cada vez es más diversa.The mental health challenges faced by the migrant population in Spain are analyzed, emphasizing the gaps of our healthcare system to addresses their specific needs. Among these challenges are a high prevalence of mental disorders, increased exposure to mental health determinants, differences in the expression of distress, and behaviors related to access and demand for services. Proposals are presented to improve healthcare at multiple levels: 1) fostering of high-impact research, 2) providing rigorous culturally humility training for healthcare professionals and for the integration of community mental health agents, and 3) establishing reference care units as an organizational shift to enhance care and promote public health policies. In conclusion, urgent action through public health policies is necessary to ensure the best care for all
Safety of ceftobiprole in patients with impaired renal, hepatic or immune function: A multinational retrospective hospital chart review (RETRACE study)
Get PDFComorbidity; Liver toxicity; SafetyComorbilitat; Toxicitat hepàtica; SeguretatComorbilidad; Toxicidad hepática; SeguridadBackground and Aim
Ceftobiprole, an advanced-generation cephalosporin with broad bactericidal activity, is approved for community-acquired and hospital-acquired pneumonia (excluding ventilator-associated pneumonia). We aimed to evaluate, in a real-world setting, the safety profile of ceftobiprole in patients with risk conditions (severe renal impairment, hepatic impairment, and immunocompromised status), groups excluded from clinical trials.
Methods
In this retrospective study (NCT04170309), 396 consecutive charts of patients treated with ceftobiprole during 2016–2022 in 15 centres in France, Italy, and Spain were analysed: 62 had severe renal impairment, 51 had a hepatic impairment, 120 were immunocompromised, and 203 had no predefined risk condition (controls).
Results
Ceftobiprole was used for off-label indications in 110/396 (27.8%) patients; 46/396 (11.6%) patients received a higher-than-recommended dose. Treatment-emergent adverse events (TEAEs) considered as ceftobiprole-related occurred in 44 patients, more frequently in the risk groups compared to controls (severe renal impairment: 8/62 [12.9%]; hepatic impairment: 7/51 [13.7%]; immunocompromised: 19/120 [15.8%]; controls: 15/203, [7.4%]); in 7/44 patients, these events were serious. Compared to controls, liver-related AEs occurred more frequently in the impaired hepatic function (17/51 [33.3%] vs. 22/203 [10.8%], odds ratio [OR:]: 4.11; 95% confidence interval [CI]: 1.98–8.55) and immunocompromised (30/120 [25.0%] vs. 22/203 [10.8%], OR: 2.74; 95% CI: 1.50–5.02) groups. Hyponatremia was also more frequent in immunocompromised patients than controls (14/120 [11.7%] vs. 9/203 [4.4%], OR: 2.85; 95% CI: 1.19–6.80). Underlying disease, concomitant medications and the poor health status of the patients likely affected these imbalances.
Conclusion
Overall, no new safety concerns related to ceftobiprole use in real-world patients with severe renal impairment, hepatic impairment or immunocompromised status were identified.This study was sponsored by ADVANZ PHARMA Switzerland SARL, a company of the ADVANZ PHARMA group, previously known as Correvio International. The content of this article is solely the responsibility of the authors. No honoraria or payments were made for authorship
La transición desde un piso con soporte de salud mental a un piso comunitario: En los últimos escalones de la rehabilitación psicosocial
Get PDFRecuperació en salut mental; Psicosi; AutonomiaRecuperación en salud mental; Psicosis; AutonomíaMental health recovery; Psychotic disorders; AutonomyAquesta investigació va consistir en un estudi sobre l'efectivitat d'un programa de pis amb suport per a persones diagnosticades amb trastorn de l'espectre psicòtic que té com a objectiu la transició a un habitatge a la comunitat d'acord amb el model de recuperació i rehabilitació psicosocial. 26 persones distribuïdes en dos grups. El primer, grup experimental, comptava amb 15 participants que havien passat pel programa i el segon, el grup control, comptava amb 11 persones que no van participar-hi. va utilitzar un model lineal generalitzat (GLMM), els resultats del qual van indicar una millora significativa en pràcticament la totalitat dels indicadors en el grup experimental en comparació del grup control. Amb això, s'evidencia que l'enfocament rehabilitador i comunitari són efectius i contribueixen de forma essencial a la recuperació.La presente investigación consistió en un estudio sobre la efectividad de un programa de piso con soporte para personas diagnosticadas con trastorno del espectro psicótico cuyo objetivo es la transición a una vivienda en la comunidad de acuerdo con el modelo de recuperación y rehabilitación psicosocial. Este se ha desarrollado en la red de salud mental de la Selva Interior (Girona), realizando un análisis descriptivo y explicativo del tal proceso, así como un análisis experimental de una muestra de 26 personas distri-buidas en dos grupos. El primero, grupo experimental, contaba con 15 participantes que habían pasado por el programa y el segundo, el grupo control, contaba con 11 personas que no participaron. Se seleccionaron los siguientes indicadores de análisis: datos socio-demográficos, número de ingresos hospitalarios, estado funcional evaluado con la escala BELS y perfil de calidad de vida evaluado con la escala de Calidad de Vida de Lancashire (LQoLP). Se utilizó un modelo lineal generalizado (GLMM), cuyos resultados indicaron una mejora significativa en prácticamente la totalidad de los indicadores en el grupo ex-perimental en comparación con el grupo control. Con ello, se evidencia que el enfoque re-habilitador y comunitario son efectivos y contribuyen de forma esencial a la recuperación.This research study investigates the effectiveness of a "housing with support" program for subjects diagnosed with a psychotic spectrum disorder with the aim of transitio-ning to a community house according to the model of psychological rehabilitation. The study was performed in the Mental Health network of "La Selva Interior" (Girona, Spain). We per-formed a descriptive and an explicative analysis in a cohort of 26 subjects divided into two groups. The experimental group included 15 subjects that participated in the program and the control group included 11 subjects that did not. The following indicators were selected for the analysis: sociodemographic data, number of hospitalizations, functional status eva-luated using the BELS scale, and the quality of life profile evaluated by the Lancashire Scale of Quality of Life (LQoLP). We used a generalized linear model (GLMM). Results showed a significant improvement in virtually all of the indicators in the experimental group compared to the control group. These results indicate that the rehabilitation and community approa-ches are effective and essential for the recovery and improvement of the quality of life of subjects with a psychotic spectrum disorder
Informe anual de l’Observatori Català d’Addiccions: any 2024
Get PDFAddiccions comportamentals; Consum; Drogues; AddiccionsBehavioral addictions; Consumption; Drugs; AddictionsAdicciones comportamentales; Consumo; Drogas; AdiccionesL’objectiu principal de l’Observatori Català d’Addiccions (OCA) és conèixer la prevalença i la tendència del consum de drogues i de determinats comportaments, així com de les addiccions que generen, els seus determinants i l’impacte en la càrrega de malaltia atribuïble i els costos socioeconòmics associats. Tot això contribueix a mesurar l’impacte de les polítiques de salut i socials per facilitar la presa de decisions tant en l’àmbit polític com en el de gestió, decisions que han de comptar amb l’evidència científica.This report analyses data on drug use and behavioural addictions in Catalonia, based on various sources and epidemiological indicators, both internal and external, with data from 2024 and previous years, such as the 2022 EDADES household survey, which is carried out biennially. The results allow us to identify trends and the socio-economic impact of addictions, contributing to the key objective of the OCDA (Catalan Observatory on Drugs and Addictions): to disseminate this knowledge to citizens and professionals to improve decision-making and health policies.Este informe analiza los datos sobre el consumo de drogas y adicciones comportamentales en Cataluña, basándose en diversas fuentes e indicadores epidemiológicos, tanto propios como externos, con datos de 2023 y años anteriores, como la encuesta domiciliaria EDADES de 2022, que se realiza bienalmente. Los resultados permiten identificar tendencias y el impacto socioeconómico de las adicciones, contribuyendo al objetivo clave de la OCDA (Observatorio Catalán de Drogas y Adicciones): difundir este conocimiento a la ciudadanía ya los profesionales para mejorar la toma de decisiones y las políticas de salud
Saps com utilitzar la teva mascareta correctament? [cartell]
No full textMascaretes; Ús correcte; Mesures de proteccióMascarillas; Uso correcto; Medidas de protecciónMasks; Correct use; Protective measuresInformació adreçada a la població sobre la utilització correcta de la mascareta com a mesura de prevenció i control d'infeccions respiratòries
Long-Term Outcomes of Topical 5% Imiquimod Treatment for Lentigo Maligna: A Systematic Review
Get PDFImiquimod; Lentigo maligna; Mortality; Recurrence; SurvivalImiquimod; Lentigo maligno; Mortalidad; Recurrencia; SupervivenciaImiquimod; Lentigen maligne; Mortalitat; Recurrència; SupervivènciaLentigo maligna (LM) is a melanoma in situ frequently located on sun-exposed areas. While surgery is the standard of care, topical 5% imiquimod has emerged as a non-invasive alternative for patients unsuitable for surgery. However, existing literature often lacks long-term follow-up. This systematic review aims to assess the long-term effectiveness and safety of imiquimod in LM, focusing on studies with ≥ 48 months of follow-up.
A comprehensive search was conducted in MEDLINE (PubMed) and the Cochrane Library up to July 2025. Inclusion criteria comprised original studies reporting on LM treated with 5% imiquimod with ≥ 48 months of follow-up.
Six studies (422 patients) met the inclusion criteria: one prospective and five retrospective studies. Median follow-up ranged from 49 to 205 months. Clinical clearance rates varied between 63.6% and 97.1%, with recurrence rates ranging from 0% to 20.7%. Histological clearance was inconsistently confirmed. Progression to lentigo maligna melanoma (LMM) was infrequent (9/422). One retrospective study (n = 111) reported melanoma-specific survival at 10 years as 100% (95% CI 90.5-100%). The presence of a robust local inflammatory response was consistently associated with improved outcomes. Adverse effects were mostly mild and self-limiting. Overall evidence certainty was moderate to low.
This review provides evidence that 5% imiquimod may offer durable responses for LM, particularly in patients who develop a marked inflammatory reaction. Nevertheless, recurrence and occasional progression to LMM underscore the need for long-term monitoring, ideally combining clinical, dermoscopic and histological assessment. Lack of standardized treatment protocols and heterogeneous definitions of response limit comparability between studies.
Topical 5% imiquimod may be a viable long-term treatment option for selected patients with LM, although the evidence is scarce and mostly of low quality. A strong local inflammatory response appears predictive of clinical success. Given the potential for late recurrence and risk of progression to LMM, long-term structured follow-up is essential. Future prospective studies with uniform protocols are warranted.No funding or sponsorship was received for this study or publication of this articl
CD40 agonist mitazalimab with mFOLFIRINOX in untreated metastatic pancreatic cancer: Biomarkers associated with outcomes from OPTIMIZE-1
Get PDFCD40 agonist; Biomarker; ChemotherapyAgonista CD40; Biomarcador; QuimioterapiaAgonista CD40; Biomarcador; QuimioteràpiaResponse determinants to immunotherapy in metastatic pancreatic ductal adenocarcinoma (mPDAC) remain unclear, limiting treatment advancements. We report a single-arm phase 1b/2 study (OPTIMIZE-1) evaluating the safety and efficacy of the cluster of differentiation 40 (CD40) agonist mitazalimab combined with modified FOLFIRINOX (mFOLFIRINOX), in chemotherapy-naive patients with mPDAC. Patients receive an initial dose of mitazalimab one week before starting biweekly cycles of mFOLFIRINOX plus mitazalimab. The study meets its pre-specified primary endpoint, achieving a confirmed objective response rate (ORR) of 42.1%. Median duration of response, progression-free survival, and overall survival was 12.6 months, 7.7 months, and 14.9 months, respectively. Multi-omic analyses of tumor and blood specimens identify a baseline tumor-intrinsic gene signature related to fibrosis associated with improved survival. Additionally, mitazalimab-induced increases in activated circulating myeloid, B cell, and T cell frequencies correlate with better outcomes. These results may inform future patient stratification strategies supporting a planned randomized confirmatory trial of mitazalimab with mFOLFIRINOX in mPDAC. This study was registered at ClinicalTrials.gov (NCT04888312).This study and publication were funded by Alligator Bioscience AB
Mental Health-Related Work Disabilities During the COVID-19 Lockdown in Spain: A Retrospective Analysis
Get PDFConfinament per la COVID-19; Ansietat relacionada amb la pandèmia; Salut mentalConfinamiento por la COVID-19; Ansiedad relacionada con la pandemia; Salud mentalCOVID-19 lockdown; Pandemic-related anxiety; Mental healthThe COVID-19 lockdown posed unprecedented psychological challenges worldwide. In Spain, Mutual Collaborators with Social Security manage work-related disabilities, including mental health cases. Objectives: To describe and analyze work-related disabilities with mental health diagnoses during the COVID-19 lockdown in Spain from the perspective of a Mutual Collaborator with Social Security in the Spanish healthcare system. Methods: Descriptive, retrospective, and cross-sectional study of a sample of 5135 patients. Descriptive statistics reported mean values and standard deviation by sex and age. Inferential analyses were conducted using the Mann-Whitney U-test and correlation analysis. Results: The study population included 5135 patients managed by a Mutual Collaborator with Social Security during the COVID-19 lockdown, 63.5% of whom were women. Cantabria reported the highest average sick leave duration (62.80 days), while La Rioja had the lowest (39.19 days). Generalized anxiety disorder was the most prevalent diagnosis (69.17%), followed by adaptive disorders and mild depression. Women had a slightly higher prevalence of anxiety, while men showed higher rates of adaptive disorders. Conclusions: The findings underscore the psychological impact of the COVID-19 lockdown, revealing significant sex and regional differences in mental health diagnoses and sick leave duration. Generalized anxiety disorder was the predominant diagnosis, highlighting the need for targeted mental health interventions during crises
A Pilot Study: The Effect of CPAP Intervention on Sleep Architecture and Cognition in Alzheimer’s Disease Patients with Obstructive Sleep Apnea
Get PDFAlzheimer’s disease; Cognitive decline; Mild cognitive impairmentEnfermedad de Alzheimer; Deterioro cognitivo; Deterioro cognitivo leveMalaltia d'Alzheimer; Deteriorament cognitiu; Deteriorament cognitiu lleuBackground: Obstructive sleep apnea (OSA) is highly prevalent in the early stages of Alzheimer's disease (AD), and its hallmark, sleep fragmentation, may accelerate cognitive decline. Continuous positive airway pressure (CPAP) improves OSA-related hypoxia during slow-wave sleep, but its cognitive benefits in AD remain unclear.
Methods: We performed a 12-month sub-analysis of a prospective, longitudinal pilot study that enrolled 21 adults (median age = 77 yr; 71% women) with Mild Cognitive Impairment (MCI) with AD confirmed biomarkers and polysomnography-diagnosed OSA. All participants underwent baseline overnight polysomnography (PSG) and neuropsychological testing (Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)) that were repeated after 12 months. Twelve participants were CPAP-compliant (moderate/severe OSA) and nine were non-users (mild OSA/intolerance). Cognitive change scores (Δ = 12 months -baseline) were compared with Generalized Linear Models (GLM) adjusted for baseline cognition and Apnea-Hypopnea Index (AHI); associations between baseline sleep parameters and cognitive trajectories were examined. And the association of sleep variables with the use of CPAP was also evaluated.
Results: Compared with non-users, CPAP users showed significantly slower global decline (Δ MMSE: p = 0.016) and improvements in overall cognition (Δ RBANS Total: p = 0.028) and RBANS sub-domains (Δ RBANS FC: p = 0.010; Δ RBANS SF: p = 0.045). Longer baseline non-rapid eye movement (NREM) stage 3 and rapid eye movement (REM) sleep, greater total sleep time and sleep efficiency, and right-side sleeping were each linked to better cognitive outcomes, whereas extended NREM stage 2, wakefulness, and supine sleeping were associated with poorer trajectories.
Conclusions: Twelve months of CPAP use was associated with attenuated cognitive decline and domain-specific gains in AD-related MCI with OSA. Sleep architecture and body position during sleep predicted cognitive outcomes, underscoring the therapeutic relevance of optimizing breathing and sleep quality. Larger, longer-term trials are warranted to confirm CPAP's disease-modifying potential and to clarify the mechanistic role of sleep in AD progression.This research was funded by COCKPI-Takeda Funding Research Grant (RKE-21-0591). The role of sleep–wake patterns on the glymphatic system function and their causal link to the development of Alzheimer’s disease