Ileal Predominance in Crohn's Disease Is Associated With Increased Intestinal Surgery and Biological Therapy Use, With Lower Treatment Persistence.

Introduction: Crohn's disease (CD) varies by location, potentially affecting therapy efficacy and surgery risk, although research on this topic is conflicting. This study aims to investigate the independent association between CD location and therapeutic patterns.

Methods: We analyzed patients with CD diagnosed from January 2005 to May 2023 registered in the nationwide ENEIDA registry.

Anatomic vs. Ischemia-Driven Strategies for Percutaneous Coronary Revascularization in Chronic Coronary Syndrome: A Network Meta-Analysis.

Introduction: In patients with chronic coronary syndromes (CCS), the benefit of percutaneous coronary intervention (PCI) added to optimal medical therapy (OMT) remains unclear. The indication to PCI may be driven either by angiographic evaluation or ischemia assessment, thus depicting different potential strategies which have not yet been thoroughly compared.

Methods: Randomized controlled trials (RCTs) comparing OMT versus PCI angio-guided or versus PCI non-invasive or invasive ischemia guided were identified and compared via network meta-analysis.

Rationale and design of the beta-blockers in tako-tsubo syndrome study: a randomized clinical trial (β-Tako).

Unlabelled: Introduction y objectives: Tako-tsubo syndrome (TTS) is a cardiac condition that mimics acute coronary syndrome, characterized by transient left ventricular dysfunction in the absence of culprit coronary artery stenosis. Although its etiology remains unknown, reversible microvascular dysfunction secondary to an adrenergic surge is thought to play a role. Treatment is empirical, although most patients receive beta-blockers (BB) in clinical practice.

Cost analysis associated with intramuscular versus oral administration of antiretroviral therapy in the management of human immunodeficiency virus infection.

Objetive: To identify and analyze the resources and costs associated with the administration of intramuscular antiretroviral therapy (ART) cabotegravir+rilpivirine (CAB+RPV) compared to oral ART in the management of Human Immunodeficiency Virus Type 1 (HIV-1) infection in Spain.

Methods: An economic model was developed to identify resources and analyze costs from the perspective of the National Health System (NHS) and societal, associated with the administration of intramuscular ART (CAB+RPV) compared to oral ART over a two-year time horizon. Costs included treatment change monitoring, pharmaceutical dispensation, administration, management of adverse events to injection-site reactions (AEs-ISR), travel to the hospital, telepharmacy service, and lost work productivity.

Assessment and management of frailty in individuals living with dementia: expert recommendations for clinical practice.

Frailty complicates the care of individuals with dementia, increasing their vulnerability to adverse outcomes. This Personal View presents expert recommendations for managing frailty in individuals with dementia, aimed at health-care providers, particularly those in primary care. We conducted a rapid literature review followed by a consensus process involving 18 international experts on dementia and frailty.

Mapping two decades of research in rheumatology-specific journals: a topic modeling analysis with BERTopic.

Background: Rheumatology has experienced notable changes in the last decades. New drugs, including biologic agents and Janus kinase (JAK) inhibitors, have blossomed. Concepts such as window of opportunity, arthralgia suspicious for progression, or difficult-to-treat rheumatoid arthritis (RA) have appeared; and new management approaches and strategies such as treat-to-target have become popular.

Persistence, severity and reactivity thresholds in fish allergic patients sensitized to parvalbumin.

Background: Fish allergy affects children and adults worldwide and there are transient and persistent phenotypes.

Objective: We aimed to analyze persistence, severity and reactivity thresholds in challenge-confirmed fish allergic patients sensitized to parvalbumin.

Methods: Patients 12-65 years-old reporting immediate reactions to fish, with fish skin prick test ≥5 mm and IgE to cod and carp β-parvalbumins ≥0.

The Relationship Between Dietary Patterns and the Epidemiology of Food Allergy.

Food allergies are increasing globally, particularly in Asia; however, the etiologies of allergic diseases remain poorly understood despite comprehensive studies conducted across a variety of populations. Epidemiological research demonstrates that food allergy is more prevalent in Westernized or urbanized societies than in rural or developing ones. As such, comparing the distribution and patterns of food allergies as well as the environmental exposures between regions may provide insight into potential causal and protective factors of food allergy.

Early safety after TAVR according to VARC-3 criteria: incidence, predictors, and clinical impact.

Introduction And Objectives: The Valve Academic Research Consortium (VARC)-3 definition of the early safety (ES) composite endpoint after transcatheter aortic valve replacement (TAVR) lacks clinical validation. The aim of this study was to determine the incidence, predictors, and clinical impact of ES after TAVR as defined by VARC-3 criteria.

Methods: We performed a multicenter study including 10 078 patients with severe aortic stenosis undergoing transarterial TAVR.

Transcatheter aortic valve replacement in aortic stenosis patients with New York Heart Association functional class III or IV.

Background: Patients with symptomatic aortic stenosis are a vulnerable population with associated cardiac damage and a significant comorbidity burden. This study aimed to determine the rate, factors associated with, and prognostic value of poor functional status (NYHA class III-IV) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).

Methods: This multicenter study included 6,363 transarterial TAVR patients, classified according to baseline functional status (NYHA class I-II vs.

High-Power Short-Duration Radiofrequency Application for Faster and Safer Pulmonary Vein Isolation: The POWER-FAST III Trial.

Background: The optimal radiofrequency application (RFa) parameters for safe and durable pulmonary vein isolation (PVI) are debated. High-power short-duration (HPSD) has been used as an alternative to conventional power delivery (CPD).

Objectives: This study sought to compare HPSD 70 W/9-10 s (HPSD-70) with CPD 25-40 W in patients undergoing PVI.

De-escalating and discontinuing disease-modifying therapies in multiple sclerosis.

The development of disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS) has been highly successful in recent decades. It is now widely accepted that early initiation of DMTs after disease onset is associated with a better long-term prognosis. However, the question of when and how to de-escalate or discontinue DMTs remains open and critical.

Patient Blood Management: A conceptual and analytical vision from the leadership in Spain.

The evolution of blood saving programs to Patient Blood Management (PBM) represents a broader and more comprehensive approach to optimize the use of the patient's own blood, thus improving clinical outcomes and minimizing the risks associated with allogeneic blood transfusion with a holistic view of socio-economic sustainability. Implementing the strategies of the three PBM pillars in any hospital center involves a transversal change throughout the organization in which it can be very useful to apply the strategy defined by Kotter at the business level for change management. The support of renowned institutions such as the World Health Organization and the European Commission demonstrates the importance and urgency of implementing PBM programs, setting guidelines at an international level and supporting the adoption of effective strategies in the management of blood transfusion at a national and institutional level.

Randomized Study Comparing First-Line Dual Versus Single-Stent Retriever Technique: TWIN2WIN.

Background: The double-stent retriever (SR) technique has been described as an effective rescue technique when single-SR fails to induce recanalization. We aimed to assess the safety and efficacy of first-line double-SR in patients with stroke undergoing thrombectomy.

Methods: This was a multicenter, randomized, controlled, blinded adjudicated primary outcome study.

Intermittent Short Atrioventricular Delay in a Dual Chamber Pacemaker During Acute Pulmonary Edema.

We present the case of an 80-year-old female with acute pulmonary edema and a dual chamber pacemaker with intermittent short AV delays in the surface ECG after blocked premature atrial contractions (PACs). The behavior was consistent with the programmed Window of Atrial Rate Acceleration Detection (WARAD) and did not require further parameter modifications. As most cardiologists and emergency department physicians are not familiar with brand-specific algorithms, we believe that this case report will make these noncompetitive atrial pacing algorithms more accessible to non-cardiologists.

[Characterization of patients hospitalized by general practitioners for type 2 diabetes rebalancing : retrospective descriptive study of an internal medicine department in Strasbourg].

Unlabelled: Type 2 diabetes is a public health problem in which general practitioners are in the front line, acting on all fronts, from screening to management.

Methods: Single-centre, quantitative, retrospective and descriptive study aimed at characterising the profile of patients referred to hospital by general practitioners in an internal medicine department in Strasbourg for rebalancing of their type 2 diabetes during the period from 1 January 2020 to 31 December 2022.

Results: 167 files were analysed, resulting in the inclusion of 72 patients with an average age of 61.

Endovascular treatment of high-flow carotid-cavernous fistula secondary to rupture of a carotid-cavernous aneurysm post-flow diverter stent placement.

Carotid-cavernous aneurysms (CCAs) have the potential for growth, and their risk of rupture can lead to severe complications. Treatment is typically recommended to prevent these complications, with endovascular therapy being the preferred approach due to the challenging surgical access. This case presents a rare instance of rupture of a CCA that had been previously treated with a flow-diverting stent, which resulted in the development of a carotid-cavernous fistula, requiring venous access endovascular treatment.

Prospective validation of a prespecified algorithm for the management of conduction disturbances after transcatheter aortic valve replacement: The PROMOTE study.

Background: There is a large variability in the management of conduction disturbances (CDs) after transcatheter aortic valve replacement (TAVR).

Objective: This study aimed to validate a prespecified algorithm for managing CDs in patients undergoing TAVR.

Methods: This was a prospective multicenter study including consecutive patients without prior pacemaker undergoing TAVR.

Efficacy and Safety of Budesonide Orodispersible Tablets for Eosinophilic Esophagitis up to 3 Years: an Open-Label Extension Study.

Background And Aims: Budesonide orodispersible tablets (BOT) have been shown to be safe and effective in phase 3 double-blind trials of induction and 48-week maintenance therapy of eosinophilic esophagitis (EoE). We now analyzed the long-term efficacy and safety of BOT in a 96-week open-label extension (OLE) study.

Methods: All EoE patients in the 48-week double-blind maintenance study were eligible to receive BOT treatment for up to 96 weeks.

Association between lactate determined at emergency department arrival and the probability of inhospital mortality and intensive care admission in elderly patients.

Background And Importance: Elderly patients often have atypical clinical presentations. Lactate measurement on arrival at the Emergency Department (ED) could be useful to identify elderly patients with a bad prognosis.

Objective: The study aimed to investigate the relationship between serum lactate determined at ED arrival and the probability of inhospital mortality and intensive care (ICU) admission in elderly patients.

Meis transcription factors regulate cardiac conduction system development and adult function.

Aims: The Cardiac Conduction System (CCS) is progressively specified during development by interactions among a discrete number of Transcriptions Factors that ensure its proper patterning and the emergence of its functional properties. Meis genes encode homeodomain transcription factors (TFs) with multiple roles in mammalian development. In humans, Meis genes associate with congenital cardiac malformations and alterations of cardiac electrical activity, however the basis for these alterations has not been established.