Hospital Universitario Son Espases

Tandem lesions (TLs) are a subtype of acute ischemic stroke, which involve an extracranial carotid lesion (ie, severe carotid stenosis ≥70%) with large vessel occlusion. While large vessel occlusion has a standard approach with mechanical thrombectomy (MT), the best practice for intervention of the carotid lesion is not well-established. Utilizing data from the ASSIST registry, we investigated the differences in clinical and procedural outcomes between acute versus nonacute stenting. The ASSIST registry (an international acute ischemic stroke MT prospective study) was utilized to identify the subgroup of patients with acute ischemic stroke secondary to TL who received MT. The TLs were grouped by MT+acute carotid stenting (CAS) versus MT+acute carotid nonstenting. The demographics and clinical outcomes (90-day modified Rankin Scale score) were compared between TL and non-TL groups, and between MT+CAS and MT+acute carotid nonstenting. Multivariable analyses were performed to determine independent predictors of clinical outcomes. A total of 183 of 1270 (14.4%) TLs were identified in the ASSIST registry. MT+CAS was performed in 83 of 183 (45.4%) subjects, and 100 of 183 (54.6%) received MT+acute carotid nonstenting. There are no significant differences at baseline between the 2 groups in the National Institutes of Health Stroke Scale score, Alberta Stroke Program Early Computed Tomography Score, or target vessel. Achieving a modified Rankin Scale score of 0 to 2 at 90 days was 70.9% in the MT+CAS group versus 48.9% in the MT+acute carotid nonstenting group (P=0.001), with a modified Rankin Scale score of 0 to 2 being significantly associated with the MT+CAS group in multivariable analysis (odds ratio, 2.14 [95% CI, 1.01-4.51]). There was no significant difference in mortality or symptomatic intracerebral hemorrhage between the groups. In acute ischemic stroke, secondary to TLs treatment with thrombectomy and acute carotid stenting is associated with improved 90-day functional outcome without an increase in symptomatic intracerebral hemorrhage compared with no acute stenting approach. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03845491.

Introduction: The clinical outcome of switching to levodopa-entacapone-carbidopa intestinal gel (LECIG) after failure of subcutaneous foslevodopa/foscarbidopa (fLD/fCD) is unknown. We analyze it in people with Parkinson's disease (PwP) treated in Spain. Methods: Retrospective analysis of PwP who had previously received fLD/fCD but dropped out for different reasons and started before this LECIG in Spain up to 30 November 2025. Non-parametric tests were applied to evaluate the changes between the pre- (Vpre) and post-treatment (Vpost) (LECIG) periods. Results: Data about 14 patients (57.1% males; 66.6 ± 8.6 years old) from 12 hospitals out of a total of 15 who were treated with LECIG were included. The mean time with fLD/fCD was 98.6 ± 92.3 days, with 92.9% and 57.1% experiencing side effects and lack of response, respectively. Specifically, significant subcutaneous nodules were reported in up to 64.3% of the patients. LECIG was a direct switch from fLD/fCD in 35.7% of the patients. LECIG was well tolerated, with only one dropout due to complications related to dementia. Adverse events were reported in 28.6% and 35.7% of the patients in the optimization and final follow-up evaluation (mean follow-up of 233.7 ± 157.4 days) phases, respectively. From Vpre to Vpost, "Off" time was reduced in 2.9 ± 1.9 h (p = 0.002) and motor symptoms burden improved significantly (p = 0.013), whereas a trend of significance was found for non-motor symptoms burden (p = 0.050) and quality of life (p = 0.126). Conclusions: LECIG could be an alternative therapeutic option in PwP who failed fLD/fCD.

<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.

Abstract Functional capacity, muscle strength, and patient-reported outcome measures are important indicators of health. In chronic obstructive pulmonary disease (COPD), these traits are often impaired beyond normal age-related decline. Substantial variability exists in both COPD and healthy populations, the biological basis of which remains poorly understood. Given the known contribution of genetics to complex traits, genetic factors may partly explain this variability. This study aimed to identify genetic variants associated with measures used to characterise extrapulmonary traits in COPD. Genome-wide association studies were conducted on the Lab3R-ESSUA cohort for the 6-minute walk test (6MWT), the 1-minute sit-to-stand test (1-min STS), the quadriceps maximal voluntary contraction (QMVC), the handgrip muscle strength, and the chronic airways assessment test (CAAT), adjusting for age, sex, body mass index, pack-years and ancestry. Variants with P&lt;1E -05 were selected for replication in the EARLYCOPD cohort, and effects compared between COPD and healthy populations (two-way ANOVA). A total of 639 participants (364 people with COPD, 275 healthy; 75% male, median age 67 years; BMI of 27 Kg/m 2 ; 10 pack-years) were included. Significant variants were identified for the 6MWT (rs1108983:G, β=-186.5m, P=4.8E -08 ), the 1-min STS (rs5889103:GTT, β=4.2reps, P=4.8E -08 ), the Handgrip (rs67352743:A, β=-4.4Kg, P=2.8E -08 ), and for the CAAT (rs11747040:C, β=4.4points, P=4.0E -09 ; rs11041680:A, β=-2.6points, P=2.5E -08 ). Effects were independent of COPD diagnosis. Replication in EARLYCOPD (n=282) confirmed one SNP for 6MWT and three for CAAT. These findings highlight genetic contributions to functional capacity, muscle strength, and disease burden. COPD-related impairments appear to build on pre-existing genetic predisposition, contributing to disease heterogeneity.