Prevalence, management, health-care burden, and 90-day outcomes of prolonged mechanical ventilation in the paediatric intensive care unit (LongVentKids): an international, prospective, cross-sectional cohort study.

Background: The number of children requiring prolonged mechanical ventilation (PMV) has increased with the advancement of medical care. We aimed to estimate the prevalence of PMV worldwide, document demographic and clinical characteristics of children requiring PMV in paediatric intensive care units (PICUs), and to understand variation in clinical practice and health-care burden.

Methods: This international, multicentre, cross-sectional cohort study screened participating PICUs in 28 countries for children aged >37 postgestational weeks to 17 years who had been receiving mechanical ventilation (MV; invasive or non-invasive) for at least 14 consecutive days.

Incidence, Risk Factors, and Outcomes of BK Hemorrhagic Cystitis in Hematopoietic Stem Cell Transplantation From HLA-Matched and Haploidentical Donors With Post-Transplant Cyclophosphamide.

BK hemorrhagic cystitis (BK-HC) is a common complication following hematopoietic stem cell transplantation (HSCT), particularly when posttransplant cyclophosphamide (PTCy) is used as graft-versus-host disease (GVHD) prophylaxis. However, comparative studies of BK-HC incidence in matched sibling donors (MSD) and unrelated donors (MUD) often include small haploidentical (HAPLO) donor cohorts and usually lack detailed information on disease evolution, coinfections, management and impact on outcomes. This study aimed to evaluate the incidence, risk factors, and outcomes in patients with hematologic malignancies undergoing HSCT from MSD, MUD, HAPLO donors using PTCy as GVHD prophylaxis.

Recommendations for the management of cutaneous squamous cell carcinoma: a systematic multidisciplinary Delphi consensus approach.

Background: There are gaps and unanswered questions in clinical guidelines regarding several aspects of the management of patients with cutaneous squamous cell carcinoma (cSCC).

Methods: A scientific committee of ten cSCC specialists in Spain (dermatology, medical oncology, oral and maxillofacial surgery, plastic surgery, and radiotherapy) used ADAPTE methodology to develop recommendations by: (i) identifying clinical questions not fully answered by clinical practice guidelines; (ii) systematically reviewing the literature (published between November 2017 and July 2023 in PubMed and the Cochrane database) and grading the evidence (using Oxford levels); (iii) developing recommendations and assessing those with no consensus among the scientific committee or with evidence level 3-5 or strength of recommendation under C or D in a two-round Delphi method; and (iv) developing the final recommendations in the form of answers to key clinical questions, grading the strength of recommendation. An external group of 32 experts plus the members of the committee participated in both Delphi rounds, evaluating the appropriateness and need of the recommendations.

Petrous bone cholesteatoma (PBC): report of 94 cases of PBC with focus on intraoperative endoscopic assistance, and systematic review of the literature.

Purpose: The aim of this study is to assess the clinical characteristics, classification, surgical approaches, interventional strategies, and treatment outcomes of patients with petrous bone cholesteatoma (PBC).

Methods: Observational retrospective study of patients with PBC managed by the senior author of this paper between 1995 and 2024 in a tertiary referral center. A literature review was made, identifying 16 articles.

Position Paper on the Treatment of Eosinophilic Esophagitis With Dupilumab.

Eosinophilic esophagitis (EoE) is a chronic allergic condition affecting the esophagus and driven by food antigens. Many individuals diagnosed with EoE have other allergic conditions, such as food allergy, asthma, allergic rhinitis, and atopic dermatitis. The clinical goals of therapy in EoE include symptomatic, histologic, and endoscopic remission.

Triple Co-infection With Salmonella typhi, Leptospira, and Campylobacter coli in a Patient From Guayaquil, Ecuador: Clinical and Diagnostic Challenges.

This case report describes the unusual presentation of a 32-year-old male from Guayaquil, Ecuador, who was diagnosed with a rare triple infection caused by , , and . The patient presented with persistent high fever, severe gastrointestinal symptoms, abdominal pain, and jaundice, following the consumption of street food in a resource-limited area. Important clinical findings included hepatosplenomegaly and elevated liver enzymes, which initially complicated the differential diagnosis.

Morphological Description of the Embryonic to Fetal Development of the Menisco- Tibio-Popliteus-Fibular Complex and the Anterolateral Ligament.

Background: Little information is available on the embryology of the structures that connect the lateral meniscus to its nearby structures (proximal tibia, fibular head, and popliteus tendon), which restrict lateral meniscal extrusion.

Purpose: To describe the menisco-tibio-popliteus-fibular complex (MTPFC)-conformed by the lateral meniscotibial ligament (LMTL), popliteofibular ligament, meniscofibular ligament, and the 2 popliteomeniscal ligaments (superior and inferior)-and anterolateral ligament (ALL) of the knee in human embryos/fetuses from weeks 9 to 37 of gestation.

Study Design: Descriptive laboratory study.

Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI).

Purpose: Gastrointestinal (GI) dysfunction is common in critically ill patients and associated with poor outcomes. There is a lack of standardised methods for daily monitoring of GI function. COSMOGI aimed to develop a Core Outcome Set (COS) for daily monitoring of GI function to improve consistency and comparability in future studies in critically ill patients.

Protektem pikinini blong yu trial: protocol for a single arm field trial to assess the effectiveness of treating-all pregnant women with hepatitis B infection with tenofovir prophylaxis to prevent mother-to-child transmission in Vanuatu, 2024-2025.

Background: Hepatitis B infection is a major public health concern in Vanuatu, with approximately 9% of the general population estimated to be living with chronic hepatitis B. Most new infections are due to mother-to-child transmission (MTCT). Hepatitis B vaccination is available in Vanuatu, but coverage rates for first dose within 24 h of birth and third dose are suboptimal.

The spanish and catalan versions of the kidney patient reported experience measure (PREM) for chronic kidney disease (CKD): cultural adaptation and face validity.

Background: Chronic kidney disease (CKD) is a progressive condition affecting more than 800 million individuals worldwide. Patient Reported Experience Measures (PREMs) are questionnaires aimed at evaluating patients' experiences with healthcare received. Given that CKD management often involves continuous treatments, capturing patient experiences can guide improvements in care that align with patients' preferences, making PREMS a relevant tool in CKD management.

NeuroVoz: a Castillian Spanish corpus of parkinsonian speech.

The screening of Parkinson's Disease (PD) through speech is hindered by a notable lack of publicly available datasets in different languages. This fact limits the reproducibility and further exploration of existing research. To address this gap, this manuscript presents the NeuroVoz corpus consisting of 112 native Castilian-Spanish speakers, including 58 healthy controls and 54 individuals with PD, all recorded in ON state.

Fixed or weight-adjusted dose in immunotherapy?

Objective: To analyse the economic impact of the use of immune checkpoint inhibitors in fixed-dose regimens and to determine the potential economic savings of using weight-adjusted dosing, as well as to describe the current situation in Spanish hospitals.

Methods: Observational, descriptive, retrospective and multicentre study that included all patients treated with pembrolizumab, nivolumab, avelumab, durvalumab and cemiplimab in fixed-dose regimens from 2020 to 2022 in four hospitals in a Spanish province (Albacete). Clinical variables: drug, therapeutic indication, body weight, percentage of overdose and number of cycles received.

Metastatic conjunctival melanoma: a multicentre international study.

Background: To reveal clinical findings related to metastatic conjunctival melanoma.

Methods: 10 ophthalmic oncology centres (9 countries and 4 continents) shared data to create a large clinical case series. The main outcome measures were the incidence and cumulative risk of systemic metastasis, study mortality rates and Kaplan-Meier patient mortality after developing conjunctival melanoma metastasis.

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.

Abemaciclib Plus Fulvestrant in Advanced Breast Cancer Following Progression on CDK4/6 Inhibition: Results from the Phase III postMONARCH Trial.

Purpose: Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy (ET) are the standard first-line treatment for hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC); however, disease progression occurs in almost all patients and additional treatment options are needed. Herein we report outcomes of the postMONARCH trial investigating a switch in ET with/without CDK4/6 inhibition with abemaciclib after disease progression on CDK4/6i.

Methods: This double-blind, randomized Phase III study enrolled patients with disease progression on prior CDK4/6i plus aromatase inhibitor as initial therapy for advanced disease or recurrence on/after adjuvant CDK4/6i+ET.

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.

Sphenopalatine ganglion stimulation for the treatment of cerebrovascular ischemia.

Purpose: The parasympathetic effects of the sphenopalatine ganglion (SPG) on the cerebral vasculature provide a compelling rationale for its therapeutic application in cerebrovascular ischemia. In recent years, attempts have been made to stimulate the SPG to achieve beneficial effects on cerebral circulation.

Methods: This review synthesizes the available publications on SPG stimulation.

Diagnostic work-up of bile duct strictures: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

1: ESGE recommends the combination of endoscopic ultrasound-guided tissue acquisition (EUS-TA) and endoscopic retrograde cholangiopancreatography (ERCP)-based tissue acquisition as the preferred diagnostic approach for tissue acquisition in patients with jaundice and distal extrahepatic biliary stricture in the absence of a pancreatic mass. 2: ESGE suggests that brushing cytology should be completed along with fluoroscopy-guided biopsies, wherever technically feasible, in patients with perihilar biliary strictures. 3: ESGE suggests EUS-TA for perihilar strictures when ERCP-based modalities yield insufficient results, provided that curative resection is not feasible and/or when cross-sectional imaging has shown accessible extraluminal disease.

Analysis of high-molecular-weight proteins using MALDI-TOF MS and machine learning for the differentiation of clinically relevant Clostridioides difficile ribotypes.

Purpose: Clostridioides difficile is the main cause of antibiotic related diarrhea and some ribotypes (RT), such as RT027, RT181 or RT078, are considered high risk clones. A fast and reliable approach for C. difficile ribotyping is needed for a correct clinical approach.

Review: Efficacy of preventative interventions for children and adolescents at clinical high risk of psychosis - a systematic review and meta-analysis of intervention studies.

Background: Despite evidence suggesting that age moderates the response to preventative treatment for those at clinical high risk of psychosis (CHR-P), no meta-analysis has assessed the effectiveness of preventative interventions for CHR-P children and adolescents. Our aim was to synthesise evidence assessing preventative interventions on a wide range of mental health outcomes for CHR-P children and adolescents.

Method: A systematic search was conducted on Ovid MEDLINE, Pubmed, APA PsycInfo and Web of Science until June 2024 (PROSPERO: CRD42023406696).

[Strategies and Barriers to the Implementation of Continuing Education in Sentinel Hospitals for the Surveillance of COVID-19 Vaccine Safety in Honduras, 2022-2023Formação continuada: estratégias e barreiras de implementação em hospitais sentinela para a vigilância da segurança das vacinas contra a COVID-19 em Honduras, 2022-2023].

Objective: To describe the continuing education strategies implemented as part of the academic training of health workers; related barriers and facilitators; and the perceptions of health workers in sentinel hospitals in Honduras regarding changes in their knowledge.

Methods: The implemented continuing education strategies are described, as are the findings of a questionnaire given to assess health workers' perceptions of the effectiveness of these strategies in the acquisition of knowledge, skills, and competencies related to the surveillance of events supposedly attributable to vaccination, immunization, or adverse events of special interest. Barriers to participation in these strategies is also described.

Integrated 3D-Printed Hollow Microneedle Array and Lateral Flow Immunoassay for Point-of-Care Wound Healing Monitoring.

Chronic wound management requires continuous monitoring to assess healing and guide treatment. We developed a hollow microneedle array patch integrated with a lateral flow immunoassay strip to address the need for convenient, home-based diagnostics. This device extracts wound exudate directly from the wound matrix, overcoming the limitations of conventional swab sampling, which relies on surface exudate collection.

Comparative Study of Adalimumab, Infliximab and Certolizumab Pegol in the Treatment of Cystoid Macular Edema Due to Behçet's Disease.

The leading cause of blindness due to non-infectious uveitis is cystoid macular edema (CME). Behçet's disease (BD) is one of the most commonly conditions related to CME. To compare the effectiveness and safety of adalimumab (ADA), infliximab (IFX) and certolizumab (CZP) in refractory CME due to BD.