Hospital General Mateu Orfila

<h3>Background and Importance</h3> Discrepancies between clinical remission and patients’ perceptions of their symptoms are common in psoriasis. While clinical scores such as PASI provide objective measures of disease activity, they may not fully capture the patient experience. Integrating patient-reported outcomes (PROs) is essential to complement clinical assessments and monitor treatment effectiveness. Adherence to biologic therapies is a key factor influencing long-term outcomes, yet its relationship with PROs remains underexplored in real-world settings. <h3>Aim and Objectives</h3> This study aimed to evaluate treatment adherence and explore its association with PROs in patients with moderate-to-severe psoriasis receiving guselkumab in routine clinical practice in Spain over a 12-month period. <h3>Material and Methods</h3> This was a prospective, observational, multicentre study including 269 adult patients across 39 Spanish dermatology centres. Baseline assessments included Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI). Adherence was measured using Medication Possession Ratio (MPR ≥90%) and the Morisky Medication Adherence Scale (MMAS-8 ≥6). PROs included the Treatment Satisfaction Questionnaire for Medication (TSQM), Hospital Anxiety and Depression Scale (HADS), and Psoriasis Signs and Symptoms Diary (PSSD). <h3>Results</h3> At baseline, mean age was 50.8 years, with a mean psoriasis duration of 16.5 years. Psoriatic arthritis was present in 35.3%, and 81.6% had prior biologic exposure. Mean PASI was 10.1, and DLQI was 9.8. At 12 months, 142 patients (52.8%) completed follow-up. Mean MPR was 96.7%, with 87.3% adherent by MPR and 96.5% by MMAS-8; 88.5% met both criteria. Concordance between MPR and MMAS-8 was low. At baseline, PROs were similar between adherent and non-adherent patients, except for HADS-anxiety (6.7 vs 10.4; p=0.007). At 12 months, trends favoured adherent patients in PSSD signs (21.1 vs 31.7; p=0.098) and HADS-anxiety (5.7 vs 7.9; p=0.076), though not statistically significant. <h3>Conclusion and Relevance</h3> High adherence to guselkumab was observed over 12 months. Preliminary findings suggest a potential association between adherence and improved patient-perceived outcomes, particularly anxiety and symptom burden. Combining objective and subjective adherence measures may enhance sensitivity in detecting these differences. These insights may inform strategies to optimise long-term psoriasis management. <h3>Conflict of Interest</h3> Corporate sponsored research or other substantive relationships: D. Martínez-López is an employee of Janssen-Cilag, the sponsor of this study. The remaining authors have no conflicts of interest to declare.

Background: Perinatal depression is a major public health problem, with an estimated prevalence of approximately 15&percnt; during the first postpartum year. Despite the high prevalence of postpartum depression, there is no consensus regarding assessment and treatment in the Spanish context. The General Council of Psychology of Spain convened a working group of experts in the field, including both academics and healthcare professionals, to review and propose recommendations based on evidence and best practices that could be applied in the Spanish context. Method: A literature search was completed in various databases (e.g., Medline, PsychInfo) including a combination of terms related to peripartum depression (PPD) assessment and diagnosis, prevention, treatment, and cost-effectiveness. A narrative synthesis of the literature has been conducted together with a critical overview of PPD with a special focus on the Spanish context. Results: In this consensus report, developing questions including prevalence and assessment tools, comparative effectiveness of preventive and treatment interventions, and cost-effectiveness of PPD management have been analyzed. Conclusions: The General Council of Psychology of Spain network advocates the establishment of compulsory screening protocols in all the autonomous regions. Also, it is necessary to promote the inclusion in maternal education of programs for the promotion of mental well-being and selective/indicated prevention carried out by a psychology professional with specialized training in the area. This consensus document also promotes the presence of a psychology professional with specialized training in the area.

Global thyroid cancer (TC) incidence is growing worldwide, but great heterogenicity exists among published studies, and thus, population-specific epidemiological studies are needed to adequate health resources and evaluate the impact of overdiagnosis. We conducted a Public Health System database retrospective review of TC incident cases from 2000 to 2020 in the Balearic Islands region and evaluated age-standardized incidence rate (ASIR), age at diagnosis, gender distribution, tumor size and histological subtype, mortality rate (MR), and cause of death. Estimated annual percent changes (EAPCs) were also evaluated and data from the 2000-2009 period were compared to the 2010-2020 period when neck ultrasound (US) was routinely performed by clinicians at Endocrinology Departments. A total of 1387 incident cases of TC were detected. Overall, ASIR (×105) was 5.01 with a 7.82% increment in EAPC. A significant increase in the 2010-2020 period was seen for ASIR (6.99 vs 2.82, P < 0.001) and age at diagnosis (52.11 vs 47.32, P < 0.001) compared to the 2000-2009 period. A reduction in tumor size (2.00 vs 2.78 cm, P < 0.001) and a 6.31% increase in micropapillary TC (P < 0.05) were also seen. Disease-specific MR remained stable at 0.21 (×105). The mean age at diagnosis for all mortality groups was older than survivors (P < 0.001). The incidence of TC has grown in the 2000-2020 period in the Balearic Islands, but MR has not changed. Beyond other factors, a significant contribution of overdiagnosis to this increased incidence is likely due to changes in the routine management of thyroid nodular disease and increased availability of neck US.

ABSTRACT Currently, the management of comorbidities and polypharmacy in HIV-infected patients requires a coordinated action, with special focus on gender differences. Observational, cross-sectional study was conducted to study the HIV population from Menorca (Illes Balears). Adult HIV-positive individuals on antiretroviral treatment attending the pharmacy service from Hospital Mateu Orfila (Menorca) were included. In a single visit, demographical and clinical characteristics, comorbidities and cotreatments were collected. Anticholinergic burden (Drug Burden Index, DBI), drug-to-drug interactions (BOT PLUS database) and symptoms associated with HIV treatment (HIV-SI index) were assessed. A total of 223 patients were included, 68.2% men, with a median age of 53.00 (44.50–58.00) years, median BMI of 24.07, 47.73% smokers and 9.90% drug consumers. Women had more advanced stages of the disease and significantly more symptoms (cough and anxiety) versus men (p = .033 and p = .048, respectively). Moreover higher exposures to anticholinergic drugs (DBI 0.51 vs. 0.27) were reported, together with more frequency of drug-to-drug interactions (57.7% vs. 37.5%; p = .005) that increased with age. Red interactions were more frequently reported in PI (2.69%), NNRTIs (1.92%) and booster drugs (1.92%). These results support the need to implement specific measures for the management of HIV-infected women and tools to assess polypharmacy and risk of drug-to-drug interactions.

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021.

En primer lugar quiero felicitar a la Sociedad Balear de Cirujanos (SOBACIR), al Colegio de Médicos de Baleares y a la Universitat de les Illes Balears por el convenio de colaboración para la edición de la revista Annals of Mediterranean Surgery.Es esta una revista necesaria, que permitirá unir científicamente a médicos y especialmente a cirujanos de países bañados por el Mar Mediterráneo, y a su vez potenciar, fomentar y divulgar los avances médicos y científicos para el resto de la comunidad médica, a través de Internet.Esta revista además supondrá un foro de debate, un intercambio de conocimientos, de experiencias y de bagaje quirúrgico, una fuente de aprendizaje, y en definitiva, un nexo entre los cirujanos de Baleares.En esta era de la comunicación inmediata, su formato digital favorecerá la difusión de los conocimientos científicos ligada inexcusablemente al inusitado protagonismo de las redes sociales.

ResumenObjetivo: Aplicar un protocolo que facilite la detección de malnutrición en los pacientes oncológicos durante su tratamiento de radioterapia o quimioterapia, seleccionando los que se podrían beneficiar de una intervención nutricional específica.Metodología: Se determinó la presencia de riesgo de desnutrición con el método de cribado Malnutrition Screening Tool (MST). A los sujetos con riesgo se les realizó una Valoración Global Subjetiva-Generada por el Paciente (VGS-GP) y a un subgrupo de la muestra estudiada también se midió la calidad de vida (CV) mediante el cuestionario EORTC QLQ-C30.Resultados: De un total de 222 pacientes se observó riesgo de desnutrición en 126 (56,7%). La VGS-GP muestra una prevalencia inicial de desnutrición del 69,2% (61,7% desnutrición moderada y 7,5% desnutrición severa) y una media de pérdida de peso de -10,27 kg. En la última valoración (+12 meses), el porcentaje de desnutrición o en riesgo se redujo de forma significativa a un 23,5% y la media de pérdida de peso disminuyó a -7,1kg. Durante el seguimiento mejoraron las puntuaciones del cuestionario EORTC QLQ-C30, en especial a los 3 meses la escala diarrea (p = 0,037), a los 6 meses la escala dolor (p = 0,009), y a los 12 meses las escalas dolor (p = 0,026), náusea y vómito (p = 0,002), disnea (p = 0,016), pérdida de apetito (p = 0,002) y estreñimiento (p = 0,0).Conclusión: El protocolo ha resultado eficaz mejorando la situación nutricional y la calidad de vida de los pacientes oncológicos con recuperación parcial del peso perdido.

To review the diagnostic accuracy of ultrasound-guided core-needle biopsy (CNB) in the diagnosis of salivary gland tumours (SGT). Retrospective, institutional review board approved, analysis of the CNB of SGT performed at our centre in 8 years. We used an automatic 18-G spring-loaded device. The final diagnosis was based on surgery in the cases that were operated on, and on clinical evolution and biopsy findings in the rest. Four hundred and nine biopsies were performed in 381 patients (ages, 2-97 years; mean, 55.9). There were two minor complications. Biopsy was diagnostic in 98.3%. There were eight false negatives. The diagnostic values for malignancy were: sensitivity 89.6%, specificity 100%, positive predictive value (PPV) 100% and negative predictive value (NPV) 98%. For the detection of neoplasms were: sensitivity 98.7%, specificity 99%, PPV 99.7% and VPN 96.1%. Accuracy of CNB in SGT is very high, with a very high sensitivity and an absolutely reliable diagnosis of malignancy. Complication rate is very low. It should be considered the technique of choice when a STG is detected. Normal tissue results warrant repeating biopsy. • Ultrasound-guided core-biopsy is the technique of choice in salivary glands nodules • Sensitivity, specificity for detecting neoplasms (which should be resected) are around 99% • Diagnosis of malignancy in core-biopsy is absolutely reliable • A CNB result of "normal tissue", however, warrants repeating the biopsy • Complication rate is very low.