Hospital Virgen de los Lirios

Migrant populations face a disproportionate risk of undiagnosed HIV and viral hepatitis, posing a major challenge to elimination goals. The HEPINMIGRA study evaluated the acceptability, feasibility, and effectiveness of an integrated community-based screening program for migrants in Alicante, Spain. Between March 2024 and February 2025, nine outreach campaigns were conducted in community settings with the support of intercultural mediators. Screening was performed using finger-prick dried blood spots. Among 535 attendees, 529 migrants were screened (acceptance rate 98.9%). Participants had a median age of 39 years, 56.1% were male, and 77.9% were of African origin. Seroprevalence was 1.1% for HIV (95% CI: 0.4-2.3%), 0.6% for HCV (95% CI: 0.1-1.6%), and 4.5% for HBsAg (95% CI: 2.9-6.6%). Although most individuals with positive results were successfully contacted and linked to care, treatment initiation rates were low. Community-based DBS screening was highly feasible and effective for case detection, but major gaps were identified in linkage to care and treatment initiation.

Atopic dermatitis (AD) involving special areas such as the hands, head and neck, and genital region poses important therapeutic challenges owing to distinct barrier fragility, environmental exposure, and mixed Th1/Th2/Th17 activation. These sites often drive treatment escalation despite limited overall body surface involvement. Evidence on the real-world effectiveness of upadacitinib in these anatomical locations remains limited. A retrospective, observational multicenter study was conducted across five Spanish dermatology departments (November 2024 to November 2025). Adults and adolescents with moderate-to-severe AD and involvement of at least one special area treated with upadacitinib (15 or 30 mg) for ≥ 16 weeks were included. Disease severity was assessed using the Eczema Area and Severity Index (EASI), body surface area (BSA), pruritus numeric rating scale (NRS), Dermatology Life Quality Index (DLQI), Investigator's Global Assessment (IGA), and local 0-4 Physician Global Assessment (PGA). Minimal disease activity (MDA) was defined as EASI ≤ 3 plus pruritus-NRS 0-1. Descriptive statistics were applied. Distribution-shift plots were used to analyze categorical changes in special areas. Overall, 57 patients were included (mean age 47.9 ± 17.6 years, 59.6% women). Facial/neck, hand, and genital involvement were present in 73.7%, 61.4%, and 21.1% of patients, respectively; 31.9% had ≥ 2 special areas affected. Upadacitinib induced rapid improvement, with EASI decreasing from 18.9 to 2.7 at week 16 and 2.4 at week 52. MDA was reached by 61% at week 16 and 69% at week 52. Special-area PGA improved markedly across all sites. Upadacitinib provided rapid, sustained, and clinically meaningful improvement in AD involving special areas, supporting its use in anatomically sensitive areas.

ABSTRACTIntroductionA strong nurse–patient therapeutic relationship is crucial in acute mental health care yet remains challenging, potentially affecting outcomes and perceived quality of care. Interventions that foster structured, person‐centred encounters may address these challenges effectively.AimTo evaluate the effects of the ‘Reserved Therapeutic Space’ intervention in terms of its impact on the improvement of the nurse–patient therapeutic relationship, the quality of care, perceived coercion and humiliation and length of stay.MethodsA multicentre quasi‐experimental trial design in twelve acute mental health units compared the Reserved Therapeutic Space to standard care. Participants completed validated instruments assessing the therapeutic relationship, perceived quality of care and coercion. Mixed‐effects models and survival analyses evaluated intervention effects.ResultsParticipants receiving the Reserved Therapeutic Space reported stronger nurse–patient relationships, higher quality of care ratings and lower coercion scores compared to those receiving standard care. Survival analysis indicated significantly shorter hospitalizations in the intervention group.ImplicationsFindings suggest that dedicating structured time for nurse–patient engagement enhances therapeutic relationships, reduces negative experiences and potentially improves both satisfaction and resource use. Providing structured therapeutic encounters can advance person‐centred, collaborative mental health nursing practices in acute settings. Future research should explore long‐term outcomes of this intervention.

Gram-negative diplobacilli Moraxella, commonly found on skin and mucous membranes, rarely cause ocular infections, except for Moraxella nonliquefaciens , associated with severe endophthalmitis. We present the case of a patient with common variable immunodeficiency (CVID) who developed bilateral ulcers due to M. nonliquefaciens without local predisposing factors. This case underscores the relevance of considering M. nonliquefaciens as an important ocular pathogen, even in the absence of local predisposition. This case presents a 42-year-old woman with a history of viral conjunctivitis and common variable immunodeficiency presented with pain and blurred vision in her left eye. She was diagnosed with infectious keratitis caused by M. nonliquefaciens , treated with fortified antibiotic eye drops and cycloplegics. Subsequently, she developed similar symptoms in her right eye, also caused by the same microorganism. After several weeks of treatment, both eyes showed improvement, allowing for continued treatment with topical corticosteroids and antibiotics. Two months later, her visual acuity significantly improved, with clear corneas and paracentral leukomas in both eyes. In conclusion, patients with CVID undergoing intravenous immunoglobulin (IVIG) therapy may develop severe ocular infections, even by uncommon microorganisms such as M. nonliquefaciens . Although IVIG therapy is essential for managing CVID, susceptibility to ocular infections may persist due to deficiencies in local immune response, especially in the tear film. It is crucial to consider this risk when treating patients with CVID for proper management and prevention of ocular complications.

ABSTRACTAimTo examine the association between perceived quality of care and the level of coercion experienced by individuals hospitalised in acute mental health units.DesignNational cross‐sectional study.MethodsData were collected from 255 patients admitted to 12 acute mental health units across Spain. Standardised instruments assessed perceived quality of care and levels of coercion, humiliation and fear at discharge. Multiple linear regression analyses were used to explore associations between care quality dimensions and patients' experiences.ResultsPerceived quality of care was significantly associated with lower levels of perceived coercion and humiliation. All dimensions of care quality showed inverse associations, with the “secluded” dimension showing the strongest association. The association between care quality and perceived fear was less consistent. These findings are particularly relevant for mental health nurses, who play a central role in delivering relational care and ensuring patients' emotional safety.ConclusionHigher perceived quality of care is associated with lower levels of coercion, humiliation, and fear during hospitalisation in acute mental health settings.Implications for the Profession and/or Patient CareFor mental health nursing, these results underscore the critical role of nurses in creating therapeutic environments that reduce coercive experiences. By fostering trust, promoting patient autonomy, and ensuring emotional and physical safety, nurses can significantly influence the quality of care and patient outcomes.ImpactThe study addresses the lack of evidence on how perceived quality of care influences experiences of coercion in acute mental health settings. Better perceived care quality is linked to reduced feelings of coercion, humiliation and fear. The research has direct implications for mental health nurses, clinical educators and healthcare managers aiming to improve patient experiences and reduce coercive practices in psychiatric care.Reporting MethodSTROBE reporting guideline.Patient or Public ContributionNo patient or public contribution.

Introduction: The maximum residual tumour size after surgery is the most important prognostic factor related to survival in advanced ovarian cancer. This parameter can be subjectively determined by the surgeon at the end of the operation and by a radiologist with a postoperative CT scan. CT scans after optimal cytoreduction can reveal residual/progressive disease in a significant percentage of patients, ranging from 21% to 49%. The aim of this study was to validate the PCI scale for the systematic reading of postoperative CT scans in patients with advanced ovarian cancer and to establish it as a new prognostic marker. Material and Methods: Patients with advanced ovarian cancer (FIGO II-IV), diagnosed between 2007 and 2019 in Hospital La Fe Valencia, in whom cytoreductive surgery was performed (achieving R0 or R1), and in whom a postoperative CT scan was performed between the third and eighth week post-surgery and prior to the start of chemotherapy, were included. Two different radiologists who specialised in gynaecological malignancy performed a blind analysis of the CT scans. They then read the images using the Peritoneal Carcinomatosis Index (PCI) scale, which divides the abdominopelvic cavity into 12 quadrants. Using the Qualitative Assessment (QA) scale, they established the presence or lack of tumour disease in each of these regions, with QA 1–2 being definitely/probably normal, QA 3 indeterminate and QA 4–5 probably/definitely metastatic. Results: This study included a cohort of 117 patients. The radiological study found measurable tumour disease in up to 49% of patients after optimal primary cytoreduction (R0 or R1). There was “substantial agreement” between the results of the two radiologists according to the Kappa analysis (0.624). Both radiologists’ (A and B) findings were related to a significant reduction in both disease-free survival (DFS) and overall survival (OS) in patients with residual disease in the CT scan (QA 4–5) versus those without macroscopic disease (QA 1–3) (p < 0.05). Conclusions: The finding of radiological tumour disease on a standardised and systematised postsurgical CT scan prior to the initiation of adjuvant chemotherapy is associated with the prognosis of patients with advanced ovarian cancer.