Scientia, Dipòsit d’Informació Digital del Departament de Salut
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Tratamiento de la infección probable en un recién nacido expuesto a un caso de tuberculosis pulmonar
Get PDFNadons; Tuberculosi pulmonar; InfeccióBebés; Tuberculosis pulmonar; InfecciónInfants; Pulmonary tuberculosis; InfectionAquest article se centra en els nadons que han estat en contacte amb una persona amb tuberculosi activa. S’hi descriuen diverses situacions i errors vinculats a la continuïtat assistencial que evidencien la necessitat d’una millor coordinació entre tots els nivells assistencials per prevenir equivocacions en la medicació, especialment en programes d’atenció especialitzada.Este artículo se centra en los lactantes que han estado en contacto con una persona con tuberculosis activa. Se describen diversas situaciones y errores relacionados con la continuidad asistencial que evidencian la necesidad de una mejor coordinación entre todos los niveles asistenciales para prevenir equivocaciones en la medicación, especialmente en programas de atención especializada.This article focuses on infants who have been in contact with a person with active tuberculosis. It describes various situations and errors related to continuity of care, highlighting the need for better coordination across all levels of healthcare to prevent medication errors, especially in specialized care programs
Vacuna el teu infant contra la grip [cartell]
No full textVacunació; Grip; InfantsVacunación; Gripe; NiñosVaccination; Flu; ChildrenAquest cartell forma part de la campanya de vacunació de la tardor 2025-2026 i explica per què la vacunació és la millor eina per evitar la infecció i prevenir les possibles complicacions de la grip en els infants.Este cartel forma parte de la campaña de vacunación de otoño 2025-2026 y explica por qué la vacunación es la mejor herramienta para evitar la infección y prevenir las posibles complicaciones de la gripe en los niños.This poster is part of the 2025–2026 autumn vaccination campaign and explains why vaccination is the most effective tool to prevent infection and avoid possible flu-related complications in children
Efficacy and safety of a house dust mites allergoid in patients with allergic rhinitis-PROACAROS study: protocol for a randomized controlled trial
Get PDFDust mite allergy; Immunologic desensitization; VaccinesAl·lèrgia als àcars de la pols; Dessensibilització immunològica; VacunesAlergia a los ácaros del polvo; Desensibilización inmunológica; VacunasBackground
There is an important heterogeneity of the clinical research done to date for allergen immunotherapy (AIT). We plan to assess the safety and efficacy of a house dust mite (HDM) polymerized allergen extract mixture for allergic rhinoconjunctivitis (AR) according to both the EMA and European Academy of Allergy and Clinical Immunology (EAACI) guidelines for the clinical development of products for the treatment of AR.
Methods
We will perform a double-blind, placebo-controlled, randomized parallel group phase III clinical trial to assess the clinical efficacy and safety of a polymerized Dermatophagoides pteronyssinus and Dermatophagoides farinae allergen extract mixture (Beltavac®) to treat perennial AR in children and adults. Patients with moderate or severe rhinitis symptoms, either associated or not with asthma and confirmed HDM sensitization and without relevant concomitant conditions that may interfere with the planned evaluations test are eligible. Patients will be randomized in a 1:1 ratio to either the active AIT or placebo. The experimental group will receive 12 monthly AIT doses via subcutaneous route with a potency of 2 RC/ml per allergen. The expected sample size is 250 patients from 16 sites in Spain. The main efficacy outcome is the Combined Symptom and Medication Score (CSMS) for rhinitis. It will be patients’ self-assessed and collected through a phone App developed ad hoc for the study to improve the patient adherence and the quality of data. Main secondary outcomes include expanded CSMS for rhinoconjunctivitis symptoms, control of rhinitis, specific IgE and IgG4 values, quality of life, and the number of adverse reactions. Health-related direct and indirect costs will be also evaluated. Finally, several exploratory parameters will be used to assess the severity of asthma.
Discussion
This phase III clinical trial will be of interest to contribute to the scientific evidence about the efficacy and safety of AIT with allergoids. Our working hypothesis is that the investigational product in patients with AR associated or not with asthma is superior to placebo in providing a clinically significant improvement according to the standards defined by the EAACI. This trial will also supply valuable information about patients reported outcomes using health technology for rhinoconjunctivitis and asthma assessment.
Trial registration
EudraCT 2018–003427-11.
Date on which this record was first entered in the: 2021–06-14.This study is funded by Probelte Pharma S.L.U. with the support of the Spanish Department of Science and Innovation (CDTI Programme)
Surgical Technique: Viscodissection for Managing Funnel Retinal Detachments
Get PDFFunnel-shaped retinal detachment; Viscodissection; Vitreoretinal surgeryDesprendimiento de retina en embudo; Viscodisección; Cirugía vítreorretinianaDespreniment de retina en embut; Viscodissecció; Cirurgia vitreoretinalPurpose: To evaluate and describe the efficacy and safety of viscodissection in managing complex funnel-shaped retinal detachments, minimizing trauma and facilitating safer perfluorocarbon liquid (PFCL) application. Methods: A retrospective case series of five patients with funnel-shaped retinal detachments: three due to perforating trauma and two from recurrent detachments. Initial visual acuities ranged from light perception to hand motion. Viscodissection was used to separate adhered retinal tissues in the funnel-shaped retinal detachment in a controlled, minimally traumatic manner, allowing funnel opening and PFCL application. Data collected included demographics, visual acuities, surgical details, and complications. Results: Viscodissection enabled successful funnel opening and PFCL use in all cases, with one instance of subretinal migration of PFCL. No retinal detachment recurrences occurred, but three patients required reoperation for new premacular proliferative vitreoretinopathy (PVR). Postoperative visual acuities improved in four patients (up to 20/100), while one remained at hand motion. Conclusions: Viscodissection is a promising technique for complex funnel-shaped retinal detachments, allowing non-traumatic tissue separation and improving visualization and safety during PFCL application. This approach may enhance surgical outcomes and reduce complications
Neurological Manifestations of HEV Infection: A Rare Phenomenon or an Underrecognized Reality?
Get PDFHepatitis E virus; Neuralgic amyotrophy; Neurologic manifestationsVirus de la hepatitis E; Amiotrofia neurálgica; Manifestaciones neurológicasVirus de l'hepatitis E; Amiotròfia neuràlgica; Manifestacions neurològiquesAim: This study aimed to describe neurological manifestations secondary to hepatitis E virus (HEV) through the description of two clinical cases.
Methods: Two different cases of neuralgic amyotrophy and meningoradiculitis are evaluated in the emergency department of a tertiary referral hospital in 2024.
Results: Case 1: A 43-year-old male presented to the emergency department with proximal weakness and pain in the right upper extremity associated with acute onset of orthopnea. Laboratory tests revealed elevated AST/ALT levels (184/1164 IU/L) and positive HEV IgM and IgG, with detectable serum HEV viral load. Cerebrospinal fluid (CSF) was negative for HEV RNA. A significant decrease in forced vital capacity was observed on transition from the upright to the supine position. Electromyography showed severe bilateral phrenic nerve involvement. The diagnosis of neuralgic amyotrophy with diaphragmatic paralysis secondary to HEV was made. The patient was treated with intravenous immunoglobulins and noninvasive ventilation with partial improvement. Case 2: A 37-year-old male presented to the emergency department with paresthesias and weakness, initially affecting the distal upper and lower extremities and progressing proximally. Laboratory tests showed elevated AST/ALT levels (238/626 IU/L), positive HEV IgM and IgG, and a detectable HEV viral load in serum. HEV RNA was also detected in the CSF. Neurophysiological findings were normal. The patient was diagnosed with acute meningoradiculitis secondary to HEV. Treatment with intravenous immunoglobulins led to complete resolution of symptoms.
Conclusions: In cases of acute neurological symptoms and liver dysfunction, HEV should be considered as a potential causative agent
The routine use of a digital tool for the tumor cell fraction quantification in molecular pathology: an international validation of QuANTUM
Get PDFMolecular pathology; Non-small cell lung cancer; Tumor cell fractionPatología molecular; Cáncer de pulmón de células no pequeñas; Fracción de células tumoralesPatologia molecular; Càncer de pulmó de cèl·lules no petites; Fracció de cèl·lules tumoralsObjective: The absolute and relative quantification of tumor cell fraction (TCF) in tissue samples for molecular pathology testing is time-consuming and poorly reproducible.
Methods: Here we report the results of an international survey on non-small cell lung cancer (NSCLC), validating the Qupath Analysis of Nuclei from Tumor to Uniform Molecular tests (QuANTUM) automated computational pipeline for TCF quantification.
Results: The TCF obtained with QuANTUM is reliable, as demonstrated by the comparison with the manual counting of cells (ground truth, GT) in cell blocks, small biopsies and surgical specimens (overall correlation of 0.89). The visual evaluation of QuANTUM-processed images increased the pathologists' agreement with GT and QuANTUM of +0.16, +0.21, +0.09 and +0.17, +0.29, +0.21 across the three sample types, respectively. An overall increase in cases classified as containing ≥100 tumor cells for all sample types was noted after QuANTUM (from 75 cases, 63% to 96 cases, 80% among cell blocks, p = 0.003).
Conclusions: QuANTUM is an easy-to-use and reliable tool for the TCF assessment and its employment significantly modifies the visual estimation by pathologists, improving the assessment of NSCLC cases for molecular analysis.The work has been funded by the project in the Italian Ministry of the University MUR Dipartimenti di Eccellenza 2023-2027 (l. 232/2016, art. 1, commi 314-337). This work was partially funded by the National Plan for NRRP Complementary Investments (PNC, established with the decree-law 6 May 2021, n. 59, converted by law n. 101 of 2021) in the call for the funding of research initiatives for technologies and innovative trajectories in the health and care sectors (Directorial Decree n. 931 of 06-06-2022) - project n. PNC0000003 - AdvaNced Technologies for Human-centrEd Medicine (project acronym: ANTHEM)
Vigilància epidemiològica del VIH i la SIDA a Catalunya: informe anual - 2024
Get PDFSida; VIH; CatalunyaAids; HIV; CataloniaSida; VIH; CataluñaEl present informe té l’objectiu de descriure les característiques epidemiològiques de la infecció pel VIH i la SIDA, així com les tendències dels darrers anys.The present report aims to describe the epidemiological characteristics of HIV and AIDS infection, as well as trends in the last years.El presente informe tiene el objetivo de describir las características epidemiológicas de la infección por el VIH y el SIDA, así como las tendencias de los últimos años
The international, prospective CytOSorbⓇ treatMent Of critically ill patientS (COSMOS) registry: Interim results from the first 150 patients
Get PDFCytosorb; Hemoadsorption; HemoperfusionCitosorb; Hemoadsorció; HemoperfusióCitosorb; Hemoadsorción; HemoperfusiónBackground
The CytOSorbⓇ treatMent Of critically ill patientS (COSMOS) registry is an observational, prospective, multicenter, international real-world data collection platform executed in countries where the CytoSorbⓇ (CS) 300 mL device is approved and routinely used in everyday clinical practice. This study aims to investigate utilization patterns of the hemoadsorption device and associated outcomes in critical care.
Methods
Since July 2022, patients who were treated with CS as part of their intensive care treatment were enrolled from 16 sites in Germany, Italy, and Spain in the registry. After informed consent, real-world clinical data are systematically collected at multiple intervals, including 24 h before CS start, during CS treatment, and 24 h post-CS treatment, as well as at discharge from intensive care unit (ICU) and hospital discharge, and final follow-up on day 90. Vital status was assessed as ICU survival, 30-day survival, overall hospital survival, and 90-day survival. We compared details on the type of extracorporeal circuit used, device flow rate, anticoagulation regimen, vasopressor requirements, fluid balance, ratio of partial pressure of oxygen in arterial blood to the fraction of inspiratory oxygen concentration (P/F ratio), myoglobin in the rhabdomyolysis cohort and bilirubin in the liver failure cohort before and after CS treatment. Safety of the device was assessed by investigator-reported device-related adverse effects. Data were presented as either mean ± standard deviation or as median with interquartile range (IQR).
Results
A total of 150 patients were enrolled, 23 patients did not have any data entry by the time of the data readout for this interim analysis conducted and therefore had to be excluded from the analysis (33 % female, mean age [59±17] years). CS indications included septic shock (57.6 %), cardiogenic shock (12.9 %), and rhabdomyolysis (10.6 %). CS was mainly integrated with renal replacement therapy (82.8 %). Median Acute Physiology and Chronic Health Evaluation II score was 23 (IQR: 17–29), Sequential Organ Failure Assessment score 12 (IQR: 9–15), and ICU stay 20 (IQR: 11–33) days. Median interleukin-6 decreased significantly from 862.4 (IQR: 142–97,457) pg/mL in the 24 h before CS treatment to 202.8 (IQR: 42–3247) pg/mL in the 24 h post-CS treatment (P <0.0001). Post-CS, lactate and creatinine levels significantly decreased, fluid balance improved from 1386 (IQR: 220–3168) mL to 275 (IQR: -768–1846) mL (P <0.0001) and median P/F ratio increased from 132 (IQR: 68–208) mmHg to 189 (IQR: 115–260) mmHg (P <0.0001). Norepinephrine requirements reduced from 0.30 (IQR: 0.18–0.46) µg/(kg·min) to 0.19 (IQR: 0.10–0.33) µg/(kg·min) (P=0.0003). In rhabdomyolysis patients, myoglobin decreased from 18,976 (IQR: 1934–34,275) to 835 (IQR: 623–5925) µg/L (P=0.0273). Observed ICU mortality was 35 %, lower than predicted by baseline scores.
Conclusions
The COSMOS registry highlights CS-associated improvements in lactate, creatinine, norepinephrine needs, fluid balance, and oxygenation. Mortality was favorable compared with risk-based predictions.
Trial registration Clinicaltrials.gov Identifier: NCT05146336This study was supported by funds from CytoSorbents Corporation and CytoSorbents Medical Inc
A model based on artificial intelligence for the prediction, prevention and patient-centred approach for non-communicable diseases related to metabolic syndrome
Get PDFArtificial intelligence; Prevention; Metabolic syndromeInteligencia artificial; Prevención; Síndrome metabólicoIntel·ligència artificial; Prevenció; Síndrome metabòlicaMetabolic syndrome (MetS) is related to non-communicable diseases (NCDs) such as type 2 diabetes (T2D), metabolic-associated steatotic liver disease (MASLD), atherogenic dyslipidaemia (ATD), and chronic kidney disease (CKD). The absence of reliable tools for early diagnosis and risk stratification leads to delayed detection, preventable hospitalizations, and increased healthcare costs. This study evaluates the impact of Transformer-based artificial intelligence (AI) model in predicting and managing MetS-related NCDs compared to classical machine learning models. Electronical medical data registered in the MIMIC-IV v2.2database from 183 958 patients with at least two recorded medical visits were analysed. A two-stage AI approach was implemented: (1) pretraining on 60% of the dataset to capture disease progression patterns, and (2) fine-tuning on the remaining 40% for disease-specific predictions. Transformer-based models was compared with traditional machine learning approaches (Random Forest and Linear Support Vector Classifier [SVC]), evaluating predictive performance through AUC and F1-score. The Transformer-based model significantly outperformed classical models, achieving higher AUC values across all diseases. It also identified a substantial number of undiagnosed cases compared to documented diagnoses fold increase for CKD 2.58, T2D 0.78, dyslipidaemia 1.89, hypertension 3.33, MASLD 5.78, and obesity 4.07. Diagnosis delays ranged from 90 to 500 days, with 35% of missed intervention opportunities occurring within the first five appointments. These delays correlated with an 84% increase in hospitalizations and a 69% rise in medical procedures. This study demonstrates that Transformer-based AI models offer superior predictive accuracy over traditional methods by capturing complex temporal disease patterns. Their integration into clinical workflows and public health strategies could enable scalable, proactive MetS management, reducing undiagnosed cases, optimizing resource allocation, and improving population health outcomes
Oral glucocorticoid patterns use in moderate to severe active SLE: insights from the Spanish SPOCS data
Get PDFGlucocorticoids; Lupus erythematosus systemic; Patient reported outcome measuresGlucocorticoides; Lupus eritematós sistèmic; Mesures de resultats informades pels pacientsGlucocorticoides; Lupus eritematoso sistémico; Medidas de resultados informadas por los pacientesThis analysis has been funded by AstraZeneca Farmaceutica Spai