Scientia, Dipòsit d’Informació Digital del Departament de Salut
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La vacunació contra la grip i la COVID-19 en embarassades [cartell]
No full textEmbarassades; Vacunació; Grip; COVID-19Embarazadas; Vacunación; Gripe; COVID-19Pregnant; Vaccination; Flu; COVID-19Aquest cartell pertany a la campanya de vacunació de la tardor 2025-2026, s’adreça a dones embarassades i dona informació sobre la vacunació contra la grip i la COVID-19.Este cartel pertenece a la campaña de vacunación del otoño 2025-2026, se dirige a mujeres embarazadas y da información sobre la vacunación contra la gripe y la COVID-19.This poster belongs to the autumn 2025-2026 vaccination campaign, is aimed at pregnant women and gives information about vaccination against influenza and COVID-19
Recomanacions per a les cures de ferides quirúrgiques de cirurgia cardíaca
Get PDFInfecció quirúrgica; Prevenció; Cures infermeriaInfección quirúrgica; Prevención; Cuidados enfermeríaSurgical infection; Prevention; Nursing careL’objectiu és estandarditzar les cures de la ferida quirúrgica per tal de: Afavorir el procés de cicatrització. Detectar precoçment les possibles complicacions. Prevenir el risc d’infecció de localització quirúrgica o complicacions associades. Promoure la recuperació i el benestar del pacient. L’esterilitat en la cura de la feria quirúrgica i la col·locació d’apòsits postquirúrgics, ens ajuden en el procés de cicatrització sense interrupcions, disminuint el risc d’infecció.El objetivo es estandarizar los cuidados de la herida quirúrgica para: Favorecer el proceso de cicatrización. Detectar precozmente las posibles complicaciones. Prevenir el riesgo de infección de localización quirúrgica o complicaciones asociadas. Promover la recuperación y bienestar del paciente. La esterilidad en el cuidado de la feria quirúrgica y la colocación de apósitos postquirúrgicos, nos ayudan en el proceso de cicatrización sin interrupciones, disminuyendo el riesgo de infección.The objective is to standardize surgical wound care in order to: Promote the healing process. Detect possible complications early. Prevent the risk of infection of the surgical site or associated complications. Promote the patient's recovery and well-being. Sterility in the care of the surgical wound and the placement of post-surgical dressings help us in the healing process without interruptions, reducing the risk of infection
Natural variability of lung function in primary ciliary dyskinesia: longitudinal analysis from the PROVALF-PCD cohort
Get PDFLung function; Primary ciliary dyskinesiaFunción pulmonar; Discinesia ciliar primariaFunció pulmonar; Discinèsia ciliar primàriaBackground
The extent to which changes in lung function are due to natural variability in patients with primary ciliary dyskinesia (PCD) is unknown. We aimed to assess intra-individual variability in forced expiratory volume in 1 s (FEV1) derived from spirometry to define the extent to which the observed changes were due to test variability in clinically stable PCD patients.
Methods
PROVALF-PCD (Prospective Observational Multicentre Study on Variability of Lung Function in Stable PCD Patients) was a large international prospective cohort conducted in 2017–2019. We included patients aged ≥5 years who were clinically stable at two or more consecutive visits and provided spirometry-derived lung function measurements. To calculate the upper limit of normal (ULN), we fitted an unadjusted multilevel mixed-effect model, and to determine the absolute change in FEV1 z-scores, we calculated the coefficient of repeatability (CR). We performed sensitivity analyses by stratifying relative change by age (adults versus children), number of measurements (at least four), and time between measurements (<4 months apart).
Results
We included 252 participants from 12 countries with confirmed or highly likely PCD. We included 1028 FEV1 measurements from patients in stable state. The ULN for relative change between two measurements of FEV1 was 25%. Test variability remained high in all sensitivity analyses. The CR was 1.88 FEV1 z-score.
Conclusions
Changes in intra-individual FEV1 >25% between visits in stable PCD patients lie beyond the expected test variability and therefore could be considered physiologically relevant. These findings inform the selection of end-points for pulmonary intervention trials in PCD, as they suggest that FEV1 is not a sensitive test for monitoring lung health in PCD.K. Nielsen is supported by the Children's Lung Foundation. B. Rubbo is supported by the National Institute for Health and Care Research through the NIHR Southampton Biomedical Research Centre; and received funding from the NIHR Biomedical Research Centre Education, Training and Career development Fund, Southampton Academy of Research, to attend a course on multilevel modelling
Menú testimoni
Get PDFMenú testimoni; Normativa; Seguretat alimentàriaComida testigo; Normativa; Seguridad alimentariaFood sample; Regulations; Food safetyThis document aims to establish the necessary requirements that food sample must meet.Aquest document és la nota interpretativa 1/2021 aprovada en data 26/04/2021 que té com a objectiu establir els requisits necessaris que han de complir els menús testimoni.Este documento es la nota interpretativa 1/2021 aprobada en fecha 26/04/2021 y tiene como objetivo establecer los requisitos necesarios que deben cumplir las comidas testigo
Cefiderocol treatment for patients infected by Stenotrophomonas maltophilia, Burkholderia cepacia complex and Achromobacter spp.: subgroup analysis from the PERSEUS study
Get PDFAchromobacter spp; Burkholderia cepacia complex; Non-fermenting gram-negative bacteriaAchromobacter spp; Complejo Burkholderia cepacia; Bacterias gram-negativas no fermentadorasAchromobacter spp; Complex Burkholderia cepacia; Bacteris gramnegatius no fermentadorsPurpose: This subgroup analysis of the PERSEUS study aimed to describe the effectiveness of cefiderocol treatment in the early access programme in Spain in patients infected by Stenotrophomonas maltophilia, Burkholderia cepacia complex (Bcc) or Achromobacter species.
Methods: In the retrospective, observational, multicentre PERSEUS study in Spain, the effectiveness and safety of cefiderocol treatment administered for at least 72 h up to 28 days in patients infected by Gram-negative bacteria, except Acinetobacter spp., in the early access programme was investigated. Patient demographics and baseline clinical characteristics, cefiderocol use, clinical cure at end of treatment, all-cause mortality at Day 28 were the main outcomes.
Results: A total of 20 patients had S. maltophilia infections, and 14 patients had other rare glucose non-fermenters (Bcc 8, Achromobacter spp. 5, Ralstonia mannitolilytica 1). The median (interquartile range [IQR]) age was 60.5 (48.0-65.5) years and 49.5 (33.0-59.0) years for patients with S. maltophilia and other rare non-fermenters, respectively. The majority of patients had respiratory tract infections (S. maltophilia 55%; other rare non-fermenters 71.4%), and median (IQR) duration of cefiderocol treatment was 10.0 (6.5-13.5) days and 8.0 (6-14) days, respectively. Clinical cure rates were 70%, 62.5% and 80.0% for patients with S. maltophilia, Bcc and Achromobacter spp., respectively. Corresponding 28-day all-cause mortality rates were 30.0%, 37.5% and 40.0%, respectively. One patient with R. mannitolilytica had clinical cure and survived to Day 28.
Conclusions: Cefiderocol is an important addition to the limited treatment options for patients infected by these rare glucose non-fermenting Gram-negative bacteria.
Trial registration: ClinicalTrials.gov: NCT05789199 (Registration date: 16 February 2023).The study was funded by Shionogi & Co., Ltd., Osaka, Japan
Current status of adjuvant immunotherapy and relapse management in renal cell carcinoma: Insights from a European delphi study
Get PDFAdjuvant immunotherapy; Consensus; Renal cell carcinomaInmunoterapia adyuvante; Consenso; Carcinoma de células renalesImmunoteràpia adjuvant; Consens; Carcinoma de cèl·lules renalsIntroduction
Adjuvant immunotherapy has remarkably advanced the management of localized renal cell carcinoma (RCC) in patients at high risk of post-surgery recurrence. This Delphi study aimed to establish expert consensus on its use and subsequent management of relapse.
Methods
Fifteen RCC experts participated in a two-round Delphi process between July and November 2024. The study included 43 core survey items, divided into 67 components for comprehensive evaluation.
Results
Consensus, defined as ≥ 75 % agreement, was achieved for 39 of 67 items (58.2 %). Experts agreed on using the Leibovich score for selecting patients for adjuvant pembrolizumab (79 %), initiating therapy within 90 days post-surgery (86 %), and not restricting treatment to programmed death ligand-1 (PD-L1)-positive tumors (100 %). Plasma kidney injury molecule-1 (KIM-1) was considered by the experts as a potential useful recurrence risk biomarker (93 %). Immune checkpoint inhibitor (ICI)-refractory disease was defined as relapse within 6 months post-adjuvant therapy (80 %). Focal therapies for oligometastatic recurrence (80 %), and targeted therapies or clinical trial enrollment for ICI-refractory patients (87 %) were supported. Belzutifan was recommended for fourth-line or later use after ICI therapy and multiple tyrosine kinase inhibitors (93 %). By contrast, no consensus was reached on ICI salvage therapy in specific subgroups, including patients with clear-cell RCC (60 %), without bone/brain metastases (60 %), good performance status (60 %), low tumor burden (47 %), or papillary RCC (36 %).
Conclusions
This Delphi study provides insights into the evolving role of adjuvant immunotherapy in localized RCC and relapse management. A multidisciplinary approach and periodic review are essential to optimizing treatment strategies.The funding for this project was provided by Ipsen, which played no role in the design of the study or the collection, analysis, and interpretation of the data and therefore did not qualify for authorship. Ipsen provided organizational and logistical support for the scientific committee meetings. Ipsen also reviewed this manuscript for scientific accuracy but had no input into its content. The Delphi questionnaire received operational and editorial support from an independent medical publishing and communication agency (Kephren). Ipsen provided funding for medical writing support
Real-world evidence from the Global aHUS Registry confirms the safety and effectiveness of switching to ravulizumab from eculizumab in patients with aHUS: a plain language summary
Get PDFRegistry; Atypical hemolytic uremic syndrome; RavulizumabRegistre; Síndrome hemolític urèmic atípic; RavulizumabRegistro; Síndrome hemolítico urémico atípico; RavulizumabWhat is aHUS?
Atypical hemolytic uremic syndrome (aHUS) is a rare disease that is caused by tiny blood clots that can block small blood vessels in the body, especially in the kidneys. This happens when a part of the immune system, called the complement system, becomes overactive.
What are ravulizumab and eculizumab?
Ravulizumab and eculizumab are approved treatments that help to prevent overactivity of the complement system by blocking a protein called complement component C5. Ravulizumab is derived from eculizumab and works immediately to block C5. It also lasts longer than eculizumab so can be given less often (every 4–8 weeks compared with every 2 weeks with eculizumab).
What is the current gap in knowledge in aHUS?
There are limited data on how well ravulizumab works to treat aHUS based on real-life patient experiences.
What did this study look at?
This article describes a study on the real-world safety and effectiveness of ravulizumab in patients with aHUS who switched from eculizumab, using data from the Global aHUS Registry, which has been collecting information since April 2012.
Who was involved in the study?
The study included 60 patients (43 adults and 17 children) who switched to ravulizumab from eculizumab, including 15 who received a kidney transplant before starting ravulizumab treatment.
What were the safety results?
Overall, 13 patients experienced an unwanted reaction or side effect after ravulizumab treatment, but none of these were unexpected by their doctors. Three of these reactions (fatigue and headache in 1 patient and infusion reaction in another patient) were thought to be related to ravulizumab treatment. There were no cases of meningococcal infection (a serious bacterial infection that may be related to treatment with either ravulizumab, eculizumab or another treatment that affects the complement system) or deaths during treatment.
What were the effectiveness results?
A subset of patients (49 out of 60) was eligible for the effectiveness analyses. These were patients who were treated with ravulizumab long enough to assess how well it works and who had a short time gap between switching to ravulizumab from eculizumab. No patient required dialysis or kidney transplantation while receiving ravulizumab. Markers of disease measured by blood tests were stable after switching to ravulizumab from eculizumab.
What do the results mean?
The study provides real-world evidence that ravulizumab is safe and works in patients with aHUS after switching from eculizumab.The Global aHUS Registry is sponsored by Alexion, AstraZeneca Rare Disease. This plain language summary was sponsored by Alexion, AstraZeneca Rare Disease
VALIANT: Randomized, multicenter, double-blind, placebo-controlled, phase 3 trial of pegcetacoplan for patients with native or post-transplant recurrent C3G or primary (idiopathic) IC-MPGN
Get PDFPegcetacoplan; C3 glomerulopathy; Primary immune complex-membranoproliferative glomerulonephritisPegcetacoplan; Glomerulopatia per C3; Glomerulonefritis membranoproliferativa per complexos immunitaris primarisPegcetacoplan; Glomerulopatía por C3; Glomerulonefritis membranoproliferativa por complejos inmunitarios primariosAims
C3 glomerulopathy (C3G) and primary immune complex-membranoproliferative glomerulonephritis (IC-MPGN) are complement-mediated diseases driven by C3 dysregulation with excessive accumulation of C3 breakdown products in the kidney. Pegcetacoplan (PEG) a C3/C3b inhibitor, targets the central components of the complement pathway, directly inhibiting C3 overactivation and preventing further deposition of C3 breakdown products in the glomeruli. VALIANT (NCT05067127) is the first Phase 3 trial investigating PEG in a broad cohort, including adolescents (≥12 yrs) and adults with native or post-transplant recurrent C3G or primary IC-MPGN.
Methods:
VALIANT is a randomized, multicenter, double-blind, placebo (PBO)-controlled trial evaluating PEG efficacy and safety. 124 pts were randomized to PEG (n = 63) (twice weekly subcutaneous infusion) or PBO (n = 61) for 26 weeks (wks). The primary endpoint was log-transformed UPCR ratio at wk 26 vs baseline, assessing proteinuria reduction vs PBO. Key secondary endpoints at wk 26 were a composite renal endpoint (proportion of pts achieving ≥50% UPCR and ≤15% eGFR decline), proportion of patients achieving ≥50% UPCR reduction, C3G histologic index activity score change (adjusted LS mean change), reduced C3c renal biopsy staining of ≥2 OOM, eGFR change, (LS mean change), mL/min/1.73 m2. Safety was assessed by treatment-emergent adverse events (TEAE) frequency and severity.
Results:
The primary endpoint was met, with PEG demonstrating a 68.1% (95% CI: –76.2, –57.3) mean UPCR reduction vs. PBO at wk 26 (p < 0.0001). Results were consistent across disease type, age, and transplant status subgroups. PEG also led to robust reductions in C3c staining and clinically meaningful eGFR stabilization vs PBO. Treatment-emergent AE frequency and severity were similar between arms. None of the 4 serious infections (3 PEG; 1 PBO) were attributed to encapsulated bacteria.
Conclusion:
PEG is the first therapy to achieve significant and clinically meaningful reductions in proteinuria (68.1% vs. PBO), C3c staining and eGFR stabilization in pts ≥12 yrs with C3G or primary IC-MPGN. PEG was well tolerated with no new safety signals observed
DNA Damage Repair Pathway Alterations and Immune Landscape Differences in Pediatric/Adolescent, Young Adult (AYA) and Adult Sarcomas
Get PDFDNA damage response; Precision medicine; SarcomaResposta al dany de l'ADN; Medicina de precisió; SarcomaRespuesta al daño del ADN; Medicina de precisión; SarcomaBackground: DNA damage response (DDR) pathway alterations contribute to genomic instability and malignant progression in several cancers. Methods: We retrospectively reviewed molecular profiles from 5309 sarcoma patient samples, including 746 from pediatric/adolescent and young adults (ped/AYA), encompassing 38 histologic subtypes. The gene expression profiles were further analyzed for immunotherapy-related biomarker associations, including analysis of the T cell-inflamed score. Results: Pathogenic/likely pathogenic DDR alterations were detected in 15.9% (N = 842) of samples overall and 9.25% (N = 69) of Ped/AYA tumors, with mutations occurring most frequently in ATRX (10.1%). Shorter overall survival was observed for patients with DDR-alterations compared to those with DDR-wildtype tumors (Hazard Ratio = 1.172, 95% CI: 1.068-1.287; p < 0.001). In many subtypes, DDR-mutated tumors were found to have increased rates of immune markers, including PD-L1+, dMMR/MSI-high, and TMB. Conclusions: Our study of somatic DDR-pathway mutations provides a better understanding of the molecular associations across sarcoma subtypes that may aid in developing future prognostic and therapeutic options for these rare cancers.Funding César Serrano—ISCIII PI22-00720 and CRIS-excellence2023_44. AD, JC, AE, SB, GA, EJ, and DL are supported by the National Cancer Institute of the National Institutes of Health under Award Number P30CA240139. DL is supported in part by R01CA253986
Gendered interplay between socioeconomic position, urbanization and excess weight: a multilevel analysis in Spain
Get PDFGender; Socioeconomic position; Excess weightGénero; Posición socioeconómica; SobrepesoGènere; Posició socioeconòmica; SobrepèsIn a global context of increasingly urban populations, inequities, and obesity prevalence, the evidence about the joint influence of socioeconomic position (SEP), gender, and urbanization is crucial for defining effective and equitable actions. However, these relationships remain poorly understood in several countries, including Spain. We aim to evaluate the association between SEP and excess weight by gender and the interaction with the urbanization level of the place of residence among Spanish adults. This is a cross-sectional study with data on 20,331 individuals ≥ 18 years (52.1% women) from the third European Health Survey and the Living Conditions Survey for Spain (2020). SEP was proxied by individual education and household income, while urbanization was by the residential municipality size. We used gender-stratified Poisson mixed models to estimate Prevalence Rate Ratios of excess weight (Body Mass Index ≥ 25 kg/m2, based on self-reported weight and height) associated with individual SEP, including interactions with the urbanization level of the residential context. Low and medium educational levels are associated with higher prevalence of excess weight, stronger among women. Additionally, larger municipality size increases the individual SEP differences in excess weight among men: those of low education and income living in larger municipalities have higher prevalence of excess weight. Efforts to address excess weight should consider the interactions between SEP, gender, and urbanization, and include targeted interventions for more disadvantaged groups. Overall, our findings emphasize the need to develop more equity-oriented, context-specific, and gender-sensitive policy interventions to address the persistent epidemic of excess weight in Spain.This work was supported by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie [grant agreement N◦ 891025]