Our Work

BACKGROUND Cardiac resynchronization therapy (CRT) is a guideline-recommended therapy in patients with heart failure with mildly reduced ejection fraction (HFmrEF, 36%-50%) and left bundle branch bloc…

BACKGROUND Cardiac resynchronization therapy (CRT) is a guideline-recommended therapy in patients with heart failure with mildly reduced ejection fraction (HFmrEF, 36%-50%) and left bundle branch block or indication for ventricular pacing. Conduction system pacing (CSP) using left bundle branch area pacing or His bundle pacing has been shown to be a safe and physiologic alternative to biventricular pacing (BVP). OBJECTIVE The aim of this study was to compare the clinical outcomes between BVP and CSP for patients with HFmrEF undergoing CRT. METHODS Consecutive patients who underwent BVP or CSP with HFmrEF between January 2018 and June 2023 at 16 international centers were included. The primary outcome was the composite end point of time to death or heart failure hospitalization (HFH). Secondary end points included change in left ventricular ejection fraction (LVEF) and individual end points of death and HFH. RESULTS A total of 1004 patients met inclusion criteria: BVP, 178; CSP, 826 (His bundle pacing, 154; left bundle branch area pacing, 672). Mean age was 73 +/- 13 years; female, 34%; and LVEF, 42% +/- 5%. Paced QRS duration in CSP was significantly narrower compared with BVP (129 +/- 21 ms vs 144 +/- 19 ms; P < .001). LVEF improved during follow-up in both groups (49% +/- 10% vs 48% +/- 10%; P = .32). CSP was independently associated with significant reduction in the primary end point of time to death or HFH compared with BVP (22% vs 34%; hazard ratio, 0.64; 95% confidence interval, 0.43-0.94; P = .025). CONCLUSION CSP was associated with improved clinical outcomes compared with BVP in this large cohort of patients with HFmrEF undergoing CRT. Randomized controlled trials comparing CSP with BVP will be necessary to confirm these results.

OBJECTIVE: To describe, analyse, and compare the situation of pharmaceutical care consultations for outpatients with immune-mediated inflammatory diseases of the Pharmacy Services of Spain at 2 differ…

OBJECTIVE: To describe, analyse, and compare the situation of pharmaceutical care consultations for outpatients with immune-mediated inflammatory diseases of the Pharmacy Services of Spain at 2 different times. METHOD: Longitudinal, multicentre, and unidisciplinary descriptive observational study, carried out by the Immune-mediated Inflammatory Diseases Working Group of the Spanish Society of Hospital Pharmacy through a virtual survey in 2019 and 2021. Variables were collected regarding coordination, resources, biosimilars, unmet needs, and telepharmacy. Numerical results were presented in absolute value and percentage and free-text responses were grouped by topic areas. To compare the results between the 2 collection times, the Chi-Square test was used with a significance level of P < .05. RESULTS: The level of participation was 70 pharmacists in 2019 and 53 in 2021. The main significant findings obtained were an increase in participation in asthma biologic committees (P = .044) and care coordination in dermatology (P = .003) and digestive system (P = .022). The wide use of biosimilar biological medicines stood out, with a 15% increase in the exchange of the reference biological to the biosimilar. The lack of research in the field and insufficient human resources, among other unmet needs, were revealed. In the outpatient units, the use of the stratification model of the MAPEX project was a minority and an increase in the use of information and communication technologies was promoted. Motivated by the pandemic derived from COVID-19, telepharmacy was established for the first time in 85% of the centres, maintaining the service at 66% at the time of the second survey. CONCLUSIONS: Outpatient units are undergoing constant change to adapt to new times, for which institutional support is needed to invest more resources to promote the development of strategies to reduce unmet needs. We must continue working to achieve a pharmaceutical practice that provides efficiency, safety, quality of life, and access to innovative drugs in patients with immune-mediated inflammatory diseases. Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.

AIM: Cone beam CT pulmonary angiography (CBCT-PA) has proven to be a valuable technique during balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH) in establis…

AIM: Cone beam CT pulmonary angiography (CBCT-PA) has proven to be a valuable technique during balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH) in established centres. This study aimed to demonstrate the safety and efficacy of CBCT-PA-guided BPA for CTEPH during the initial period of a BPA program. CBCT-PA improves procedural accuracy by visualising distal thromboembolic lesions and providing real-time guidance, which is critical during program initiation. MATERIALS AND METHODS: This single-centre, single-arm study prospectively evaluated patients with CTEPH undergoing BPA from 2017 to 2022. Outcomes of interest included pre-BPA and post-BPA 6-minute walking distance, New York Heart Association Functional Classification (NYHA-FC), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), N-terminal pro B-type natriuretic peptide (NT-proBNP), and BPA-related adverse events (AEs). Statistical analysis compared pre-BPA and post-BPA results. CBCT-PA was used for three-dimensional (3D) vascular mapping and precise lesion targeting. RESULTS: Ninety BPA sessions were performed on 19 patients under CBCT-PA guidance. Significant improvements were observed in mPAP (37.0 mmHg [interquartile range (IQR): 28.0-46.0] vs 25.5 [IQR: 22.8-31.5]; P<0.001), PVR (5.5 Wood units [IQR: 3.4-8.5] vs 3.3 [IQR: 2.7-4.6]; P < 0.001), NYHA-FC I-II rate (8 [42%] vs 18 [94%]; P = 0.04), and NT-proBNP (165 pg/mL [IQR: 82-1146] vs 127.0 [IQR: 57-216]; P = 0.014). Overall AE rate was 14.4%, and major AE rate was 7.7% (all Cardiovascular and Interventional Radiology Society of Europe [CIRSE] grade 3). The haemoptysis rate was 4.4%. No periprocedural deaths were reported. CONCLUSION: BPA performed under CBCT-PA guidance appeared to be an effective and safe approach in the program's initial period, helping achieving similar results as established centres. Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.

This repository contains detailed methodological information, baseline participant characteristics, and de-identified source data supporting the study. The source data include frequencies of total ILC…

This repository contains detailed methodological information, baseline participant characteristics, and de-identified source data supporting the study. The source data include frequencies of total ILC2s, ICOS⁺ ILC2s, and FHL2⁺ ILC2s in nasal tissue and peripheral blood from control, eCRSwNP, and non-eCRSwNP groups.

Introduction: Transurethral resection of the prostate has been considered the gold standard for surgical management of benign prostatic enlargement. Despite its high success rate, a percentage of pati…

Introduction: Transurethral resection of the prostate has been considered the gold standard for surgical management of benign prostatic enlargement. Despite its high success rate, a percentage of patients (20%-40%) do not improve afterward. Our purpose is to determine the underlying lower urinary tract dysfunction of patients with persistent symptoms after transurethral resection of the prostate (TURP). Material and methods: We queried our prospectively maintained database to identify male patients with lack of symptoms improvement after TURP for benign condition. Patients with neurological condition and prostate cancer were excluded. Evaluation included symptoms assessment, prostate volume, uroflowmetry, maximum cystometric capacity, bladder compliance, detrusor overactivity and urodynamic stress urinary incontinence. We considered obstruction if Bladder Outlet Obstruction Index (BOOI) >= 40, no obstruction if BOOI < 20. We considered detrusor underactivity if Bladder Contractility Index (BCI) < 100. Results: 219 patients had complete urodynamic study. Complete data were obtained from 107 patients, the mean (SD) age was 65.6 (8.2) years. Median (IQR) prostatic volume was 40 (31)cc. After surgery, storage symptoms were the most prevalent (73.8% of the patients). Urodynamic findings were: detrusor underactivity in 75 of 107 patients (70.1%), detrusor overactivity in 54 (50.5%), obstruction in 26 (24.3%). The only correlation found was between the pre-surgery voided volume in uroflowmetry and detrusor overactivity in the urodynamic study (rho: -0.28, p = 0.033). No difference regarding Qmax before and after TURP was observed in the detrusor underactivity group (p = 0.481). Unfavorable outcome after previous prostate surgery might be explained by detrusor underactivity rather than obstruction. Conclusions: The most common persistent symptoms after TURP are storage, and the most common urodynamic finding is detrusor underactivity. In this scenario urodynamic study is advisable.

After more than 50 years of experience, newborn screening programs represent one of the most significant advancements in public health, particularly in pediatric and neonatal care, benefiting almost 3…

After more than 50 years of experience, newborn screening programs represent one of the most significant advancements in public health, particularly in pediatric and neonatal care, benefiting almost 350 000 children annually in Espana. Following the inclusion of congenital hearing loss screening in 2003 and screening for 7 congenital diseases by newborn blood spot test in 2014 as part of the population-wide neonatal screening program of the National Health System, significant advances have been achieved in recent years. This progress is evident in the implementation of screening for critical congenital heart diseases, approved in January 2024 by the National Public Health Commission of the Interterritorial Council of the National Health System, as well as screening for congenital diseases through the newborn blood spot test, with the incorporation of new conditions enabled by advances in second-tier testing and emerging scientific evidence. Neonatologists and pediatricians must keep abreast of these developments and where the field is heading, as even more rapid progress may take place with the advent of genomic newborn screening. (c) 2025 Asociacion Espanola de Pediatr & imath;a. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).

Heart transplantation from donors after the circulatory determination of death is expanding worldwide. Thoraco-abdominal normothermic regional perfusion (TA-NRP) allows the validation and recovery of …

Heart transplantation from donors after the circulatory determination of death is expanding worldwide. Thoraco-abdominal normothermic regional perfusion (TA-NRP) allows the validation and recovery of the donation after the circulatory determination of death (DCDD) heart, but there is limited evidence on the results of heart transplants performed with this approach. This multicenter, nationwide, prospective study describes the short-term outcomes of adult patients receiving a DCDD heart transplant obtained via TA-NRP followed by static cold storage in Spain. Recipients of hearts from donors after the neurologic determination of death were used as controls. The primary outcome was a composite of 1-year all-cause death or severe primary graft failure. During 2020-2023, 98 adult DCDD and 347 donations after the neurologic determination of death (DNDD) heart transplants were performed across 11 centers. The primary outcome was met by 21 (21.4%) and 77 (22.2%) patients, respectively (P = .87). Thirty-day and 1-year survival were 94.9% and 88.8% in the DCDD vs 93.7% and 87.3% in the DNDD group (P = .70), respectively. Severe primary graft failure was observed in 13 (13.3%) vs 52 (15.0%) patients (P = .67). By inverse probability weighting, the DCDD heart was not associated with the primary outcome (hazard ratio, 0.97; 95% confidence interval, 0.58-1.62; P = .91). In conclusion, adult DCDD heart transplantation based on TA-NRP and static cold storage provides similar short-term outcomes than DNDD heart transplants. Copyright © 2025. Published by Elsevier Inc.

We created and validated the Neuro-Score, a specific scale to detect and monitor cognitive impairment, including mild stages, in kidney or liver transplant recipients. A qualitative study was conducte…

We created and validated the Neuro-Score, a specific scale to detect and monitor cognitive impairment, including mild stages, in kidney or liver transplant recipients. A qualitative study was conducted to define a preliminary set of 62 items. Item reduction was performed using exploratory factor analysis. Confirmatory factor analysis assessed the adequacy of the factorial solution. The total scores of the Neuro-Score and mini-mental state examination were compared. Responsiveness to change was evaluated from visit 1 (baseline) to 2A (18 months later) and temporal stability from visit 2A to 2B (1-2 weeks later). Factor analysis showed 11 factors with an eigenvalue of >1. Confirmatory factor analysis yielded a logical solution with 1 factor and 11 items that explained 27.9% of the variance. The final model showed satisfactory internal consistency (Cronbach a = 0.82). A weak negative correlation was found between Neuro-Score and mini-mental state examination total scores (Pearson r = -0.12; P = .0095). The Neuro-Score responsiveness to change was demonstrated (P = .022). No significant differences in the total score were observed between visits 2A and 2B, supporting the Neuro-Score temporal stability. The Neuro-Score scale is a simple, reliable, self-administered, easy-to-interpret, and consistent 11-item scale to detect and monitor cognitive impairment in kidney and liver transplant recipients. Copyright © 2025. Published by Elsevier Inc.

The objective of this article is to collect and describe the most relevant BIOBADADERM findings since its beginning in 2008. BIOBADADERM is a prospective cohort registry whose main aim is to analyze t…

The objective of this article is to collect and describe the most relevant BIOBADADERM findings since its beginning in 2008. BIOBADADERM is a prospective cohort registry whose main aim is to analyze the safety profile of the new systemic therapy for the management of psoriasis. Data included in the registry allowed the publication of numerous articles over the past 15 years (2008-2023). Data from the registry join those obtained from clinical trials regarding safety and efficacy profile. Additionally, it has expanded our knowledge of population groups excluded from clinical trials and in less frequent settings. Collaboration with other registries has given us a few fact-checking answers in smaller groups. Copyright © 2025 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Ewing sarcoma is a small round-cell sarcoma characterized by gene fusion involving EWSR1 (or another TET family protein like FUS) and an ETS family transcription factor. The estimated incidence of thi…

Ewing sarcoma is a small round-cell sarcoma characterized by gene fusion involving EWSR1 (or another TET family protein like FUS) and an ETS family transcription factor. The estimated incidence of this rare bone tumor, which occurs most frequently in adolescents and young adults, is 0.3 per 100,000/year. Although only 25% of patients with Ewing sarcoma are diagnosed with metastatic disease, historical series show that this is a systemic disease. Patient management requires multimodal therapies-including intensive chemotherapy-in addition to local treatments (surgery and/or radiotherapy). In the recurrent/refractory disease setting, different approaches involving systemic treatments and local therapies are also recommended as well as patient inclusion in clinical trials whenever possible. Because of the complexity of Ewing sarcoma diagnosis and treatment, it should be carried out in specialized centers and treatment plans should be designed upfront by a multidisciplinary tumor board. These guidelines provide recommendations for diagnosis, staging, and multimodal treatment of Ewing sarcoma. © 2024. The Author(s).