Scientia, Dipòsit d’Informació Digital del Departament de Salut
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Covid persistente: ¿cómo afecta al desempeño laboral del personal sanitario?
Full text linkCovid persistent; Professionals de la salut; Rendiment laboralCovid persistente; Profesionales de la salud; Rendimiento laboralLong Covid; Health professionals; Work performanceAquest document és el primer d'una sèrie de tres infografies que presenten els resultats d'un projecte de recerca sobre l'impacte de la COVID persistent en l'acompliment laboral del personal sanitari procedent de diferents hospitals en el Sistema Nacional de Salut.
Aquesta infografia ofereix una síntesi dels objectius de l'estudi, les fases desenvolupades i les institucions participants.Este documento es el segundo de una serie de tres infografías que resumen un proyecto de investigación sobre el impacto de la COVID persistente en el desempeño laboral del personal sanitario procedente de varios hospitales del Sistema Nacional de Salud. La infografía presenta los principales resultados y conclusiones del informe: “Impacto de la COVID persistente en el rendimiento laboral del personal sanitario: revisión narrativa de informes técnicos, guías clínicas y protocolos de actuación”.This document is the second in a series of three infographics that summarize a research project on the impact of long COVID on the job performance of healthcare staff from several hospitals within the National Health System. The infographic presents the main results and conclusions of the report: ““Impacto de la COVID persistente en el rendimiento laboral del personal sanitario: revisión narrativa de informes técnicos, guías clínicas y protocolos de actuación”
Informe d’activitat assistencial: Centres d'atenció i seguiment a les drogodependències; any 2023
Full text linkCentres ambulatoris; Drogodependències; Centres d’atenció i seguiment a les drogodependènciesOutpatient centers; Drug addictions; Care and follow-up centers for drug addictionsCentros ambulatorios; Drogodependencias; Centros de atención y seguimiento en las drogodependenciasEls centres d’atenció i seguiment a les drogodependències (CAS) són centres ambulatoris públics especialitzats en el tractament de les addiccions. Actualment, a la Xarxa d’Atenció a les Drogodependències (XAD) de Catalunya, hi ha 61 centres ambulatoris distribuïts per tot el territori.
En aquests centres es fa el procés rehabilitador de les persones amb problemes d'addicció a substàncies amb potencial addictiu com l'alcohol, la cocaïna, l’heroïna, el cànnabis i d’altre addiccions, o amb problemes d’addiccions comportamentals, amb un suport sanitari, psicològic i social
Informe sobre consum problemàtic i conseqüències: Anàlisi de les aigües residuals
Full text linkAigües residuals; Monitoratge; Consum de droguesWaste water; Monitoring; Drug useAguas residuales; Monitorización; Consumo de drogasEn aquest informe es mostren els resultats obtinguts l’any 2022 en cadascuna de les dues EDAR i l’evolució entre 2011 i 2022 a l’EDAR del Baix Llobregat (de 2011 a 2015 només amb la mostra de primavera) i, entre 2016 i 2023, a l’EDAR de Lleida. Les drogues incloses en aquest informe no són totes les que s’analitzen, tan sols les més rellevants en el nostre context: alcohol, cocaïna (benzoilecgonina), amfetamínics (amfetamina, metamfetamina i èxtasi), al·lucinògens (ketamina), opioides (metabòlit de la metadona: EDDP, 2-etilè-1,5-dimetil-3,3-difenilpirrolodina) i cannabinoides (THC-COOH). El motiu principal pel qual no se’n mostren totes és que moltes de les drogues analitzades no assoleixen els llindars mínims de detecció
Structural brain changes in post-COVID condition and its relationship with cognitive impairment
Full text linkPost-COVID condition; Brain structure; Cognitive performanceCondició post-COVID; Estructura cerebral; Deteriorament cognitiuCondición post-COVID; Estructura cerebral; Deterioro cognitivoIt has been estimated that ∼4% of individuals infected with SARS-CoV-2 will be diagnosed with post-COVID condition. Previous studies have evidenced the presence of cognitive dysfunction and structural brain changes in infected individuals; however, the relationship between structural changes and cognitive alterations in post-COVID condition is still not clear. Consequently, the aim of this work is to study structural brain alterations in post-COVID condition patients after almost 2 years of infection and their likely relationship with patients' cognitive impairment. Additionally, the association with blood biomarkers and clinical variables was also explored. One hundred and twenty-eight individuals with post-COVID condition and 37 non-infected healthy controls from the Nautilus Project (ClinicalTrials.gov IDs: NCT05307549 and NCT05307575) underwent structural brain magnetic resonance imaging and a comprehensive neuropsychological assessment. A subsample of 66 post-COVID participants also underwent blood extraction to obtain levels of blood biomarkers. Cortical thickness and subcortical volumes were obtained and analysed using FreeSurfer (v7.1). FMRIB Software Library software (v6.0.4) was used to perform grey matter voxel-based analysis and to study microstructural white matter integrity. Patients with post-COVID performed significantly worse in working and verbal memory, processing speed, verbal fluency and executive functions, compared to healthy controls. Moreover, patients with post-COVID showed increased cortical thickness in the right superior frontal and the right rostral middle frontal gyri that negatively correlated with working memory performance. Diffusion tensor imaging data showed lower fractional anisotropy in patients in the right superior longitudinal fasciculus, the splenium and genu of the corpus callosum, the right uncinate fasciculus and the forceps major, that negatively correlated with subjective memory failures. No differences in blood biomarkers were found. Once patients were classified according to their cognitive status, post-COVID clinically cognitively altered presented increased cortical thickness compared to those classified as non-cognitively altered. In conclusion, our study showed that grey and white matter brain changes are relevant in this condition after almost 2 years of infection and partly explain long-term cognitive sequelae. These findings underscore the critical importance of monitoring this at-risk population over time.This work was sponsored by the Generalitat de Catalunya (SGR 2021SGR00801), Agency for Management of University and Research Grants (AGAUR) from the Generalitat de Catalunya (Pandemies, 202PANDE00053), Fundació la Marató de TV3 (202111-30-31-32), TED2021-130409BC51/MCIU/AEI/10.13039/501100011033 and TED2021- 130409A-C52/MCIU/AEI/10.13039/501100011033 by Ministerio de Ciencia, Innovación y Universidades (MCIU)/ Agencia Estatal de investigación (AEI) and NextGenerationEU/ Plan de Recuperación, Transformación y Resiliencia (PRTR) and supported by María de Maeztu Unit of Excellence (Institut de Neurociències, Universitat de Barcelona) (CEX2021-001159-M), Ministerio de Ciencia e Innovación. J.P. was supported by a fellowship from Ministerio de Economía y Competitividad (PRE2021-099674). J.O. was supported by a fellowship from Ministerio de Ciencia, Innovación y Universidades (PRE2018-086675). I.R. was supported by a fellowship from ‘la Caixa’ Foundation (LCF/BQ/ DR22/11950012)
From obscurity to opportunity: targeting Neuregulin 1 fusions in solid tumors
Full text linkNeuregulin 1 fusions; Solid tumorsFusiones de neuregulina; Tumores sólidosFusions de neuregulina; Tumors sòlidsS.L. is supported by AGAUR-FI Joan Oró fellowship (2024 FI-1 00399) from the Generalitat de Catalunya. A.L. is supported by grants from the Fundación AstraZeneca “Jóvenes Investigadores” program. T.V.T. is supported by grants from the Spanish Ministry of Science, Innovation and University (PID2023-146827OB-I00), “Ramon y Cajal” program (RYC2020-029098-I), FERO Foundation, Fundación AstraZeneca “Jóvenes Investigadores” program, and Cancer Core Europe TRYTRAC program
Development, implementation and evaluation of a digital treatment for adolescents with chronic pain: a protocol for a multi-phase study
Full text linkAdolescents; Chronic pain; Digital healthAdolescentes; Dolor crónico; Salud digitalAdolescents; Dolor crònic; Salut digitalChronic pain in adolescents is an increasing public health concern with a significant physical, psychological, and social impact. This study aims to develop, implement, and evaluate DigiDOL-Ad, a digital psychosocial treatment for adolescents with chronic pain, supplemented by dedicated websites for their parents and teachers. This multicenter study will be conducted in four phases: (1) Development of the intervention framework and foundational planning; (2) Focus groups with adolescents with chronic pain, their parents, teachers, healthcare professionals and health authorities to identify specific needs and tailor the psychosocial treatment and related components; (3) Iterative usability testing of the digital treatment, using an a hermeneutical circle methodology to refine the design based on participant feedback; and (4) Evaluation of DigiDOL-Ad through a pre-treatment, post-treatment, and 3-month follow-up assessment. DigiDOL-Ad has the potential to improve the quality of life for adolescents with chronic pain. By leveraging digital health technologies, this innovative approach could establish a new benchmark for treating adolescents with chronic pain, emphasizing interdisciplinary and stakeholder-driven care.This study is partially supported by a grant from the Spanish Ministry of Science and Innovation (ref. PID2022-142071OB-I00); and grants from the European Regional Development Fund (ERDF) and the Government of Catalonia (AGAUR; 2021SGR-730). JM's work is supported by ICREA-Acadèmia. RV's work is supported by the Spanish Ministry of Science and Innovation with a Ramon y Cajal contract (RYC2018-024722-I). The Chair in Pediatric Pain is supported by Fundación Grünenthal, ANUBIS, Cosmetic group, and ESTEVE
ESMO Precision Oncology Working Group recommendations on the structure and quality indicators for molecular tumour boards in clinical practice
Full text linkMolecular tumour boards; Precision medicine; Precision oncologyJuntas de tumores moleculares; Medicina de precisión; Oncología de precisiónJuntes de tumors moleculars; Medicina de precisió; Oncologia de precisióBackground
With an increased uptake of genomic profiling in clinical practice and the evolving complexity of diagnostic modalities, vast amounts of complex data need to be properly interpreted and integrated into an individualised care plan. To address these challenges, molecular tumour boards (MTBs) have been widely established. As of today, no international recommendations regulating the composition and workflows of MTBs have been defined.
Methods
ESMO’s Precision Oncology Working Group (POWG) established an international expert panel in precision oncology and defined core areas of interest. After several consultations and through an expert consensus process, the group reached a consensus level for each recommendation.
Results
The group defined five components in the MTB process that are critical to its function and clinical use: (i) the primary task of MTBs consists in providing genomic-informed clinical recommendations, particularly for cases exhibiting complex genomic alterations; (ii) to achieve this, MTBs should encompass interdisciplinary expertise, with key roles for oncologists with genomic expertise, pathologists with molecular training and clinical geneticists; (iii) MTBs’ recommendations should be documented in a structured report that includes genomic-informed treatment strategies, management plans for potential tumour-detected germline alterations and guidance for additional genomic testing; (iv) structured follow-up processes should be implemented for monitoring the clinical effectiveness of MTBs recommendations and (v) finally, the panel proposed quality indicators for operating MTBs, including turnaround times for cases discussion and the proportion of cases for which actionable recommendations and clinical trial enrolments were successfully implemented.
Conclusions
These ESMO’s POWG recommendations can serve as a guidance and help to define quality standards for MTBs to allow for harmonisation and to further expedite the integration of precision oncology into clinical practice.This project was funded by the European Society for Medical Oncology (no grant number)
Impacto de la COVID persistente en el rendimiento laboral del personal sanitario: revisión narrativa de la literatura de informes técnicos, guías clínicas y protocolos de actuación
Full text linkCOVID-19; COVID persistent; Professionals de la salut; Rendiment laboralCOVID-19 persistente; Rendimiento laboral; Personal sanitarioCOVID-19; Long COVID; Healthcare professionals; Work performanceAquest informe, basat en una revisió narrativa de l'evidència, inclou els impactes destacats de la COVID persistent en la vida diària del personal sanitari incloent l'àmbit laboral, les recomanacions i pràctiques referents per a la seva reincorporació al treball, així com per al seu maneig i seguiments clínics.Este informe, basado en una revisión narrativa de la evidencia, incluye los principales impactos de la COVID persistente en la vida diaria del personal sanitario, incluyendo el ámbito laboral, así como las recomendaciones y buenas prácticas referentes a su reincorporación al trabajo, manejo y seguimientoThis report, based on a narrative review of the evidence, includes the main impacts of long COVID on the daily life of healthcare staff, including the work environment, as well as recommendations and best practices regarding their return to work, management, and clinical follow-up
Atezolizumab and bevacizumab, with or without radiotherapy, versus docetaxel in patients with metastatic non-small cell lung cancer previously treated with a checkpoint inhibitor and chemotherapy: results from the randomized, phase Ib/II MORPHEUS-Lung study
Full text linkImmune checkpoint inhibitor; Lung cancer; Radiotherapy/radioimmunotherapyInhibidor del punt de control immunitari; Càncer de pulmó; Radioteràpia/radioimmunoteràpiaInhibidor del punto de control inmunitario; Cáncer de pulmón; Radioterapia/radioinmunoterapiaBackground Options remain limited for patients requiring later lines of therapy for metastatic non-small cell lung cancer (mNSCLC) due to poor prognosis and potential toxicities. Therefore, trials of novel combinations of existing therapeutic candidates are warranted. Here, we report robust interim analysis results from the MORPHEUS-Lung study in immune checkpoint inhibitor (CPI)-exposed patients with non-squamous mNSCLC and without targetable gene mutations.
Methods MORPHEUS-Lung enrolled patients with disease progression during or following treatment with a platinum-containing regimen and a PD-L1/PD-1 immune CPI, given in combination as one line or as two separate lines of therapy, regardless of PD-L1 expression. The primary efficacy endpoint was objective response rate (ORR). Secondary efficacy endpoints included progression-free survival, duration of response, disease control rate, overall survival, and safety; exploratory endpoints included biomarkers. Patients were randomized to the atezolizumab+bevacizumab+non-ablative stereotactic body radiotherapy (SBRT), atezolizumab+bevacizumab, or docetaxel (control) arms and included in this analysis.
Results At data cut-off (August 28, 2024), 121 patients were randomized and treated: atezolizumab+bevacizumab+SBRT (n=42), atezolizumab+bevacizumab (n=40), and docetaxel (n=39). Confirmed ORR was 16.7% (6/36), 20.0% (8/40), and 12.8% (5/39) in the atezolizumab+bevacizumab+SBRT, atezolizumab+bevacizumab, and docetaxel (control) arms, respectively; one patient (2.5%) in the atezolizumab+bevacizumab arm had a complete response. Grade≥3 adverse events (AEs) occurred in 47.6% (20/42) of patients receiving atezolizumab+bevacizumab+SBRT, 45.0% (18/40) receiving atezolizumab+bevacizumab, and 64.1% (25/39) receiving docetaxel. AEs leading to discontinuation of any treatment occurred in 14.3% of patients in the atezolizumab+bevacizumab+SBRT arm, 7.5% in the atezolizumab+bevacizumab arm, and 15.4% in the docetaxel (control) arm. There were no clear correlations of response or survival benefit with PD-L1 expression or immune phenotype.
Conclusions Results from this interim analysis suggest that atezolizumab+bevacizumab, with or without SBRT, showed evidence of numerically improved efficacy outcomes compared with docetaxel, with a trend toward a benefit in both the primary and secondary resistance settings. Safety was consistent with the known profiles of the individual drugs, with increased toxicity observed when SBRT was added to atezolizumab+bevacizumab
Severe Paediatric Asthma Collaborative in Europe: real-world data on children on biologics
Full text linkAsma pediátrica grave; Niños; Medicamentos biológicosAsma pediàtrica greu; Nens; Medicaments biològicsSevere paediatric asthma; Children; Biologics drugsIntroduction
Real-world data on children with severe asthma is scarce. We report characteristics of children with severe asthma already on biologics, enrolled in the Severe Paediatric Asthma Collaborative in Europe, a clinical research collaboration of the European Respiratory Society.
Methods
We describe patient's characteristics including asthma control assessed with Global Initiative for Asthma (GINA) criteria, composite asthma severity index (CASI), exacerbations, unscheduled medical attendances, lung function and quality of life in children on biologic treatment because of severe asthma. We also assessed previous biologics use. Forced expiratory volume in 1 s, CASI, GINA, Paediatric Asthma Quality of Life Questionnaire score, exacerbations, unscheduled medical attendance and hospital admission comparisons in patients treated with different biologics were adjusted by age, sex and biologic therapy duration.
Results
Among the 250 children (median age 13.2 years) recruited, 56.8% used omalizumab, 21.6% mepolizumab and 21.6% dupilumab. At enrolment, the dupilumab group was older (median 15.0 years), while the omalizumab group had been on biologic treatment the longest (median 622 days). Overall, 27% and 8% had partly controlled and uncontrolled asthma respectively, according to GINA. In the last 12 months, 52% and 29% had at least one and two exacerbations, respectively; airflow obstruction was found in 33%. 10% were admitted to hospital due to exacerbation. A previous switch from another biologic was recorded in 16%, predominantly due to nonresponse.
Conclusions
Most children on biologics obtained good symptom control, but many still experienced asthma attacks. Switching between biologics was substantial. There is still an unmet need in severe paediatric asthma