Prognostic performance of the two-step clinical care pathway in metabolic dysfunction-associated steatotic liver disease.

Background & Aims: Current guidelines recommend a 2-step approach for risk stratification in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) with Fibrosis-4 index (FIB-4) followed by liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) or similar second-line tests. This study aimed to examine to prognostic performance of this approach.

Methods: The VCTE-Prognosis Study was a longitudinal study of patients with MASLD who had undergone VCTE examinations at 16 centres from the US, Europe and Asia with subsequent follow-up for clinical events.

Leveraging Epigenetic Alterations in Pancreatic Ductal Adenocarcinoma for Clinical Applications.

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy characterized by late detection and poor prognosis. Recent research highlights the pivotal role of epigenetic alter- ations in driving PDAC development and progression. These changes, in conjunction with genetic mutations, contribute to the intricate molecular landscape of the disease.

Cohort study to evaluate the pattern of analgesic prescription in adult patients undergoing ambulatory surgery.

Introduction: Postoperative pain in ambulatory surgery (AS) continues to be a recurrent problem despite anesthetic and surgical advances. Analgesic prescription and follow-up by patients at home may be a determining factor. Our objective was to evaluate analgesic prescription and its impact on the intensity of postoperative pain at 24 h and 7 days in an AS unit.

Cardiopulmonary arrest in liver transplantation surgery: Perioperative beta-blockade implication in the cirrhotic patient.

Liver transplantation (LT) has an incidence of intraoperative cardiopulmonary arrest (CPA) of around 5%. Patients who experience CPA during this procedure have a reduced survival rate of approximately 50%. Most CPAs occur during the neohepatic phase due to reperfusion syndrome, but this is not always the underlying cause, and a broad differential diagnosis must be performed.

Prevalence of burnout syndrome in European and North American anesthesiologists: A systematic review and meta-analysis.

Aims: The prevalence of burnout syndrome dimensions in anesthesiologists show notable international differences. In this study, mean prevalences of European and North American anesthesiologists are compared.

Methods: Quantitative systematic review (meta-analysis) following the PRISMA and MOOSE criteria.

Mixed reality for preoperative planning and intraoperative assistance of surgical correction of complex congenital heart defects.

Objectives: Mixed reality (MixR) is an innovative visualization tool that presents virtual elements in a real-world environment, enabling real-time interaction between the user and the combined digital/physical reality. We aimed to explore the feasibility of MixR in enhancing preoperative planning and intraoperative guidance for the correction of various complex congenital heart defects (CHDs).

Methods: Patients underwent cardiac computed tomography or cardiac magnetic resonance and segmentation of digital imaging and communications in medicine (DICOM) images was performed.

Position statement on the use of point-of-care ultrasound in heart failure: Recommendations from the Heart Failure and Atrial Fibrillation, and Clinical Ultrasound Working Groups of the Spanish Society of Internal Medicine (SEMI).

This document provides a comprehensive analysis of the use of point-of-care ultrasound in heart failure (HF), offering detailed recommendations on echocardiography, lung ultrasound, and venous ultrasound. These advanced imaging techniques allow for an accurate, detailed, and non-invasive evaluation of heart failure, facilitating rapid and effective clinical decision-making. Echocardiography enables a rapid assessment of cardiac function at the point of care, enhancing traditional physical examination and being essential for the management of heart failure (HF).

Analysis of clinical features and prognosis in cardiac amyloidosis patients from Spanish hospitals (2016-2021).

Introduction And Objectives: Cardiac amyloidosis (CA) is a prevalent yet underdiagnosed heart condition characterized by the abnormal accumulation of amyloid fibres, frequently resulting in heart failure (HF), particularly in older people. Despite advancements in non-invasive diagnostic techniques and treatments, the epidemiology of CA patients remains inadequately understood. This nationwide retrospective observational study sought to comprehensively investigate CA patients' characteristics, mortality, and readmission patterns.

Diagnosis and treatment of pulmonary embolism. Recommendations of the Thromboembolic Disease Group of the Spanish Society of Internal Medicine 2024.

Pulmonary embolism (PE) is a disease with a rising incidence rate. This article presents the recommendations for the diagnosis and treatment of PE of the Thromboembolic Disease Group of the Spanish Society of Internal Medicine (SEMI). The main objective is to facilitate decision making to improve the diagnostic and therapeutic approach based on published evidence.

Hospital discharges (MBDS) for Takotsubo syndrome in Spain. Regional differences (2008-2021).

Background And Objectives: Takotsubo syndrome (TTS) is an infrequent cause of acute coronary syndrome much better diagnosed in recent years. This study sought to assess the clinical profile of patients admitted with TTS in Spain and to elucidate potential regional differences in admissions and in-hospital mortality between the years 2008 and 2021.

Methods: Retrospective observational study of patients admitted to acute general hospitals of the Spanish National Health System with a main or secondary diagnosis of STT, using the minimum basic data set.

Clinical presentation of pheochromocytoma and screening recommendations.

Pheochromocytomas are neuroendocrine tumors that derive from sympathetic adrenomedullary chromaffin tissue and produce catecholamines. Due to the excess release of catecholamines, they can produce arterial hypertension, tachycardia, sweating, headache and a large number of other clinical manifestations secondary to the stimulation of α and β adrenoreceptors. Screening for pheochromocytoma is recommended in patients with paroxysmal, resistant or early-onset arterial hypertension, in cases with symptoms suggestive of catecholamine hypersecretion, patients with hereditary syndromes associated with pheochromocytomas, diabetes mellitus of atypical presentation and in adrenal incidentalomas with radiological characteristics not typical of adenoma (with > 10 Hounsfield Units on non-contrast CT).

Tobramycin nanoformulation for chronic pulmonary infections: From drug product definition to scale-up for preclinical evaluation.

Cystic fibrosis (CF) is characterized by abnormal mucus hydration due to a defective CF Transmembrane Regulator (CFTR) protein, leading to the production of difficult-to-clear mucus. This causes airflow obstruction, recurrent infections, and respiratory complications. Chronic lung infections are the leading cause of death for CF patients and inhaled tobramycin is the first-in-line antibiotic treatment against these infections, mainly caused by Pseudomonas aeruginosa in adult patients.

Advancing medication compounding: Use of a pharmaceutical 3D printer to auto-fill minoxidil capsules for dispensing to patients in a community pharmacy.

Compounding medications in pharmacies is a common practice for patients with prescriptions that are not available commercially, but it is a laborious and error-prone task. The incorporation of emerging technologies to prepare personalised medication, such as 3D printing, has been delayed in smaller pharmacies due to concerns about potential workflow disruptions and learning curves associated with novel technologies. This study examines the use in a community pharmacy of a pharmaceutical 3D printer to auto-fill capsules and blisters using semisolid extrusion, incorporating an integrated quality control system.

Is the Coronal Plane Alignment of the Knee (CPAK) Classification Useful to Plan Individualized Total Knee Arthroplasty Surgery for the Spanish Population? A Critical Analysis of the CPAK Classification.

Introduction: The CPAK classification aims to categorize knee phenotypes. The original study was based on Australian and Belgian population, but significant variation in CPAK distribution exists between different geographic areas. The primary objective is to evaluate knee phenotypes of osteoarthritic Spanish population based on the CPAK system.

Atrial fibrillation versus. atrial myopathy in thrombogenesis: Two sides of the same coin?

Atrial fibrillation (AF) and atrial myopathy are recognized contributors to cardiovascular morbidity, particularly ischemic stroke. AF poses an elevated risk of thrombogenesis due to irregular heart rhythm leading to blood stasis and clot formation. Atrial myopathy, marked by structural and functional alterations in the atria, is emerging as a crucial factor influencing thromboembolic events, independently of AF.

RANDOMISED CLINICAL TRIAL TO COMPARE THE EFFICACY OF DENTAL WHITENING WITH 37.5% HYDROGEN PEROXIDE GEL AND 6% HYDROGEN PEROXIDE WHITENING STRIPS.: clinical study to compare the efficacy of dental whitening with 6% hydrogen peroxide whitening strips.

Objective: to evaluate the efficacy and chromatic stability after 4weeks, in all three thirds of the central incisor of two whitening treatments: in-office 37.5% hydrogen peroxide (HP) treatment alone, and 37.5% in-office HP followed by use of 6% HP whitening strips (WS).

Unique considerations in the assessment and management of traumatic brain injury in older adults.

The age-specific incidence of traumatic brain injury in older adults is rising in high-income countries, mainly due to an increase in the incidence of falls. The severity of traumatic brain injury in older adults can be underestimated because of a delay in the development of mass effect and symptoms of intracranial haemorrhage. Management and rehabilitation in older adults must consider comorbidities and frailty, the treatment of pre-existing disorders, the reduced potential for recovery, the likelihood of cognitive decline, and the avoidance of future falls.

Safety and efficacy of nipocalimab in adults with generalised myasthenia gravis (Vivacity-MG3): a phase 3, randomised, double-blind, placebo-controlled study.

Background: Given burdensome side-effects and long latency for efficacy with conventional agents, there is a continued need for generalised myasthenia gravis treatments that are safe and provide consistently sustained, long-term disease control. Nipocalimab, a neonatal Fc receptor blocker, was associated with dose-dependent reductions in total IgG and anti-acetylcholine receptor (AChR) antibodies and clinically meaningful improvements in the Myasthenia Gravis Activities of Daily Living (MG-ADL) scale in patients with generalised myasthenia gravis in a phase 2 study. We aimed to assess the safety and efficacy of nipocalimab in a phase 3 study.

A forward genetic screen identifies potassium channel essentiality in SHH medulloblastoma maintenance.

Distinguishing tumor maintenance genes from initiation, progression, and passenger genes is critical for developing effective therapies. We employed a functional genomic approach using the Lazy Piggy transposon to identify tumor maintenance genes in vivo and applied this to sonic hedgehog (SHH) medulloblastoma (MB). Combining Lazy Piggy screening in mice and transcriptomic profiling of human MB, we identified the voltage-gated potassium channel KCNB2 as a candidate maintenance driver.