Scientia, Dipòsit d’Informació Digital del Departament de Salut
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Sistema de detección automática de retinopatía diabética mediante inteligencia artificial (IA)
Get PDFRetinopatia diabètica; Diagnòstic; Intel·ligència artificialDiabetic retinopathy; Diagnosis; Artificial intelligenceRetinopatía diabética; Diagnóstico; Inteligencia artificialAquesta revisió sistemàtica té l'objectiu d'avaluar l'evidència disponible sobre el rendiment diagnòstic, seguretat clínica i tècnica, eficàcia i efectivitat clínica, com també el cost-efectivitat de la tecnologia LumineticsCore™ com a sistema de detecció automàtica de la retinopatia diabètica mitjançant la intel·ligència artificial (IA).Esta revisión sistemática tiene como objetivo evaluar la evidencia disponible sobre el rendimiento diagnóstico, la seguridad clínica y técnica, la eficacia y efectividad clínica, así como el coste-efectividad de la tecnología LumineticsCore™ como sistema de detección automática de la retinopatía diabética mediante inteligencia artificial (IA).This systematic review aims to assess the available evidence on the diagnostic performance, clinical and technical safety, efficacy and clinical effectiveness, as well as the cost-effectiveness of the LumineticsCore™ technology as an automated diabetic retinopathy detection system using artificial intelligence (AI)
Escàner ultrasònic portàtil per a mesurar el volum d'orina en la bufeta en pacients adults hospitalitzats amb sospita de retenció urinària
Get PDFEscàners; Ultrasons; Bufeta urinària; Retenció urinàriaEscáners; Ultrasonidos; Vejiga; Retención urinariaScanners; Ultrasound; Bladder; Urinary retentionSíntesi dels principals resultats de l'informe elaborat per avaluar l'evidència de l'escàner ultrasònic portàtil de bufeta amb marcatge CE en la valoració de la necessitat de sondatge vesical en pacients adults hospitalitzats amb sospita de retenció urinària.Síntesis de los principales resultados del informe elaborado para evaluar la evidencia del escáner ultrasónico portátil de vejiga con marcado CE en la valoración de la necesidad de sondeo vesical en pacientes adultos hospitalizados con sospecha de retención urinaria.Summary of the main results of the report prepared to evaluate the evidence of the CE-marked portable ultrasonic bladder scanner in assessing the need for bladder catheterization in hospitalized adult patients with suspected urinary retention
Vigilància de les infeccions relacionades amb l’atenció sanitària de Catalunya (VINCat): manual VINCat
No full textAtenció sanitària; Infeccions; Enquesta; MetodologiaAtención sanitaria; Infecciones; Encuesta; MetodologíaHealth care; Infections; Poll; MethodologyEl VINCat és un programa del Servei Català de la Salut que estableix un sistema de vigilància
unificat de les infeccions relacionat amb l’atenció sanitària (IRAS) als centres de salut de
Catalunya. La seva missió és contribuir a reduir les taxes d’aquestes infeccions mitjançant la
vigilància epidemiològica activa i continuada. El programa es fonamenta en la tasca que porten a
terme els professionals dels equips multidisciplinaris de control d’infecció dels centres de salut
catalan
Deep Learning Unravels Differences Between Kinematic and Kinetic Gait Cycle Time Series from Two Control Samples of Healthy Children Assessed in Two Different Gait Laboratories
Get PDFChildren; Deep learning; GaitNiños; Aprendizaje profundo; MarchaNens; Aprenentatge profund; MarxaWe investigate the application of deep learning in comparing gait cycle time series from two groups of healthy children, each assessed in different gait laboratories. Both laboratories used similar gait analysis protocols with minimal differences in data collection. Utilizing a ResNet-based deep learning model, we successfully identified the source laboratory of each dataset, achieving a high classification accuracy across multiple gait parameters. To address the inter-laboratory differences, we explored various pre-processing methods and time series properties that may have been detected by the algorithm. We found that the standardization of the time series values was a successful approach to decrease the ability of the model to distinguish between the two centers. Our findings also reveal that differences in the power spectra and autocorrelation structures of the datasets play a significant role in the model performance. Our study emphasizes the importance of standardized protocols and robust data pre-processing to enhance the transferability of machine learning models across clinical settings, particularly for deep learning approaches.This research was funded by Escuela Universitaria de Fisioterapia ONCE-UAM and TACTIC project—FORTALECE ISCIII grant no. FORT23/00034, Grant CNS2023-144775 funded by MICIU/AEI/10.13039/501100011033 by “European Union NextGenerationEU/PRTR”. This project has also received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant Agreement No. 851255). This work has been partially supported by the María de Maeztu project CEX2021-001164-M funded by the MCIN/AEI/10.13039/501100011033 and FEDER, EU. This research has been supported by a grant for an international stay from the Universidad Autonoma de Madrid travel grants Program for participation in International Research Conferences
Diagnostic and epidemiological landscape of anaerobic bacteria in Europe, 2020–2023 (ANAEuROBE)
Get PDFAnaerobes; Antimicrobial resistance; Blood cultureAnaerobios; Resistencia a los antimicrobianos; HemocultivoAnaerobis; Resistència als antimicrobians; HemocultiuIntroduction
Despite being implicated in a wide spectrum of community- and healthcare-acquired infections, anaerobes have not yet been incorporated into systematic surveillance programs in Europe.
Methods
We conducted a multicentre retrospective observational study analysing all anaerobic strains isolated from blood cultures in 44 European Hospital Centres over a 4-y period (2020–2023). Diagnostic approach, epidemiology, and antimicrobial susceptibility according to EUCAST v. 15.0 were investigated.
Results
Our study included 14,527 anaerobes, most of which were Gram-positive (45%) or Gram-negative (40%) bacilli. MALDI-TOF coupled to mass spectrometry was the most widely used tool for species identification (98%). Antimicrobial susceptibility testing was performed in the vast majority of centres, using mostly gradient diffusion strip (77%) and disk diffusion (45%) methods according to EUCAST guidelines. The most prevalent species were Cutibacterium acnes (18.7%), Bacteroides fragilis (16.3%), Clostridium perfringens (5.3%), Bacteroides thetaiotaomicron (4.2%), Fusobacterium nucleatum (3.5%), and Parvimonas micra (3.4%). C. acnes showed high resistance to benzylpenicillin (18%), clindamycin (39%), and imipenem (19% and 13% by MIC methods and disk diffusion, respectively). B. fragilis showed high resistance to amoxicillin/clavulanate (24%), piperacillin/tazobactam (22% and 14% by MIC methods and disk diffusion, respectively), clindamycin (22% by both MIC methods and disk diffusion), meropenem (13%), and metronidazole (10%, only by disk diffusion). A similar resistance pattern was observed in B. thetaiotaomicron, Bacteroides ovatus, and Parabacteroides distasonis. C. perfringens showed high resistance to clindamycin (69% and 45% by MIC methods and disk diffusion, respectively), while benzylpenicillin and metronidazole maintained over 90% activity. F. nucleatum showed high resistance to benzylpenicillin (11%), while Fusobacterium necrophorum showed alarming rates of resistance to clindamycin (12%), meropenem (16%) and metronidazole (11%).
Conclusions
This study presented an up-to-date analysis of the diagnostics and epidemiology of anaerobic bacteria in Europe, providing insights for future comparative analyses and the development of antimicrobial diagnostic and management strategies, as well as the optimization of current antibiotic treatments.This research was supported by EU funding within the MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases (Project no. PE00000007, INF-ACT)
Human papillomavirus infection and treatment
Get PDFVirus de papil·loma humà (VPH); Infeccions de transmissió sexual (ITS); TractamentVirus de papiloma humano (VPH); Infecciones de transmisión sexual (ITS); TratamientoHuman papillomavirus (HPV); Sexually transmitted infections (STIs); TreatmentRecomanació Essencial sobre la infecció pel virus de papil·loma humà i tractament segons la qual "en les persones amb un resultat positiu a la prova de detecció del virus de papil·loma humà (VPH), no existeix evidència suficient per recomanar la prescripció de prebiòtics, probiòtics o altres suplements, ni orals ni tòpics per a la prevenció del càncer ginecològic". Essencial és un projecte de l'Agència de Qualitat i Avaluació Sanitàries de Catalunya del Departament de Salut per reduir o evitar les pràctiques clíniques de poc valor.Recomendación Esssencial sobre la infección por el virus del papiloma humano y tratamiento según la cual "en las personas con un resultado positivo en la prueba de detección del virus del papiloma humano (VPH), no existe evidencia suficiente para recomendar la prescripción de prebióticos, probióticos u otros suplementos, ya sean orales o tópicos, para la prevención del cáncer ginecológico". Essencial es un proyecto de la Agencia de Calidad y Evaluación Sanitarias de Cataluña del Departamento de Salud para reducir o evitar las prácticas clínicas de poco valor.Essential Recommendation on human papillomavirus (HPV) infection and treatment stating that "in individuals with a positive result on the human papillomavirus (HPV) screening test, there is insufficient evidence to recommend the use of prebiotics, probiotics, or other supplements, whether oral or topical, for the prevention of gynecological cancer." Essencial is a project of the Catalan Agency for Health Quality and Assessment under the Department of Health aimed at reducing or avoiding low-value clinical practices
First-in-human study of FAZ053, an anti-programmed death-ligand 1 (anti-PD-L1) monoclonal antibody, alone and in combination with spartalizumab (anti-PD-1), in patients with advanced malignancies
Get PDFAdvanced alveolar soft part sarcoma; Chordoma; SpartalizumabSarcoma alveolar de partes blandas avanzado; Cordoma; EspartalizumabSarcoma alveolar de parts toves avançat; Cordoma; EspartalizumabBackground
FAZ053 triggers an antitumor response by targeting programmed death-ligand 1 (PD-L1), thereby activating effector T cells and negatively regulating T cells. This study assessed the safety, tolerability, and preliminary efficacy of FAZ053 monotherapy and in combination with spartalizumab (anti-PD-1) in patients with advanced solid tumors.
Methods
This phase I, multicenter, open-label study (NCT02936102) included dose escalation and dose expansion. The primary objectives were safety and tolerability; secondary objectives were pharmacokinetics, pharmacodynamics, and preliminary antitumor activity.
Results
Of the 154 patients treated, 49 (52.7%) patients receiving FAZ053 monotherapy experienced at least one treatment-related adverse event (TRAE), of whom 6 (6.5%) experienced grade ≥3 TRAEs; 35 patients (57.4%) receiving combination therapy experienced TRAEs, of whom 3 (4.9%) experienced grade ≥3 TRAEs. One patient who received FAZ053 1600 mg every 6 weeks (Q6W) and one who received FAZ053 20 mg every 3 weeks (Q3W) with spartalizumab 300 mg Q3W experienced dose-limiting toxicities of grade 4 creatinine increase and grade 3 liver function test increased, respectively. The median duration of exposure was 105 days for monotherapy and 85 days for combination therapy. During dose escalation, response was observed in 3 (5.1%) and 3 (4.9%) patients receiving FAZ053 monotherapy and combination therapy, respectively. In dose expansion, response was observed in 2 (50%) patients with advanced alveolar soft part sarcoma (ASPS) and 3 (30%) patients with advanced chordoma receiving FAZ053 monotherapy. FAZ053 demonstrated a dose-proportional pharmacokinetic profile with a terminal half-life of 20.6 days at 1200 mg Q3W. Biomarker analysis showed increased immune gene expression following FAZ053 treatment. The recommended dose for expansion was 1200 mg Q3W.
Conclusion
FAZ053 monotherapy was well tolerated and effective in maintaining disease control in various tumors including ASPS and chordoma. The anticipated synergistic effect of combined programmed cell death protein 1 (PD-1) and PD-L1 inhibition was not observed. These findings contribute to the growing evidence that rare, phenotypically ‘immune cold’ sarcomas, such as ASPS and chordoma, can become responsive to immune checkpoint inhibitors.This work was supported by Novartis Pharmaceuticals
Neoadjuvant nivolumab and chemotherapy in early estrogen receptor-positive breast cancer: a randomized phase 3 trial
Get PDFNeoadjuvant nivolumab; Breast cancer; Estrogen receptorNivolumab neoadyuvante; Cáncer de mama; Receptor de estrógenoNivolumab neoadjuvant; Càncer de mama; Receptors d'estrògenPatients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) primary breast cancer (BC) have low pathological complete response (pCR) rates with neoadjuvant chemotherapy. A subset of ER+/HER2− BC contains dense lymphocytic infiltration. We hypothesized that addition of an anti-programmed death 1 agent may increase pCR rates in this BC subtype. We conducted a randomized, multicenter, double-blind phase 3 trial to investigate the benefit of adding nivolumab to neoadjuvant chemotherapy in patients with newly diagnosed, high-risk, grade 3 or 2 (ER 1 to ≤10%) ER+/HER2− primary BC. In total, 510 patients were randomized to receive anthracycline and taxane-based chemotherapy with either intravenous nivolumab or placebo. The primary endpoint of pCR was significantly higher in the nivolumab arm compared with placebo (24.5% versus 13.8%; P = 0.0021), with greater benefit observed in patients with programmed death ligand 1-positive tumors (VENTANA SP142 ≥1%: 44.3% versus 20.2% respectively). There were no new safety signals identified. Of the five deaths that occurred in the nivolumab arm, two were related to study drug toxicity; no deaths occurred in the placebo arm. Adding nivolumab to neoadjuvant chemotherapy significantly increased pCR rates in high-risk, early-stage ER+/HER2− BC, particularly among patients with higher stromal tumor-infiltrating lymphocyte levels or programmed death ligand 1 expression, suggesting a new treatment paradigm that emphasizes the role of immunotherapy and T cell immunosurveillance in luminal disease. Clinical trials.gov identifier: NCT0410906
Association Between Accelerometer-Assessed Physical Activity and Cognitive Function in Older Adults: A Cross-Sectional Study
Get PDFAccelerometry; Cognitive function; Physical activityAcelerometría; Función cognitiva; Actividad físicaAccelerometria; Funció cognitiva; Activitat físicaObjective
Research suggests that physical activity (PA) improves cognitive function across various domains. However, the specific role of different PA measures, including step count, remains to be explored. Our aim was to assess the correlation between objectively measured PA and cognitive function.
Methods
We included 663 adults, aged ≥66 years, from the Swedish SNAC-K study (2016–2019). Global cognition and three cognitive domains (processing speed, executive function, and episodic memory) were assessed with validated tests. PA was measured through ActivPAL3 accelerometers. We applied age-stratified (<70 vs. ≥80 years), multi-adjusted, quantile regression to examine the cross-sectional associations between cognitive function and PA, considering steps/day and time spent in moderate-to-vigorous PA (MVPA).
Results
Each 1000-step increment (β = 0.04; 95% CI: 0.01, 0.07) and each additional hour of MVPA per day (β = 0.28; 95% CI: 0.02, 0.54) were correlated with better processing speed in the youngest-old, but not in the oldest-old. When further stratifying by MVPA (<60 min vs. ≥60 min/week), each 1000-step increment was associated with better processing speed in the youngest-old, regardless of their MVPA levels.
Conclusion
Our study links accelerometer-assessed PA (steps and MVPA) with better processing speed in the youngest-old adults. Step count correlated with processing speed regardless of intensity. Further research is needed to determine the directionality of these associations
La incapacitat temporal a Catalunya, 2024: informe 17
Get PDFIncapacitat temporal; Memòria; CatalunyaTemporary disability; Memory; CataloniaIncapacidad temporal; Memoria; CataluñaDocument que recull la situació de la incapacitat temporal a Catalunya a través de dades epidemiològiques