Hospital de Galdakao

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.

Bioresorbable nanopatterned scaffolds functionalized with polydopamine (PDA) and graphene oxide (GO) have been shown to promote the differentiation of murine neural stem cells (mNSCs) toward neural and glial lineages. Herein, we aim to evaluate the compatibility of these scaffolds for the culture and differentiation of both human embryonic (hESCs) and induced pluripotent (hiPSCs) stem cells. Our results indicate that PDA and GO scaffolds support the topographic alignment of hESCs and hiPSCs cultures, while preserving their pluripotency characteristics. Upon differentiation, PDA and GO scaffolds guide cell specification toward the neuroectoderm germ layer and the neural crest. This promotes enhanced differentiation into both neural and supportive glial cells of the central nervous system (CNS), as well as Schwann cells of the peripheral nervous system (PNS). Moreover, nanopatterned scaffolds also support the differentiation of hESCs and hiPSCs toward endothelial precursors. These findings establish a novel culture platform that enables combined differentiation pathways, potentially relevant for applications in personalized medicine and regenerative cell therapy.

Our study sought to determine the usefulness of biomarkers of systemic inflammation (C-reactive protein (CRP), procalcitonin (PCT) and proadrenomedullin (proADM)) on hospital admission, as compared to the CURB65 score, for predicting 30- and 90-day mortality in patients hospitalized for community acquired pneumonia (CAP). Observational, prospective study of adults admitted for CAP in four Spanish teaching hospitals. Disease severity was determined within the first 24 h of diagnosis, using the CURB65 score. CRP, PCT and proADM levels were assessed from samples obtained in the Emergency Department (ED). We compared the capacity of the different biomarkers and the CURB65 score to predict pneumonia-related 30- and 90-day mortality. A total of 956 patients hospitalized with CAP were included, 462 in the internal and 494 in the external sample. Of the biomarkers, proADM showed the greatest AUC for predicting 30- and 90-day mortality (0.80 and 0.76 respectively). Mortality at 30 and 90days increased as proADM levels rose. When proADM was used as a continuous variable, CURB65 showed a similar predictive capacity (AUC 0.80) to both crude and age-adjusted proADM (AUC 0.80 and 0.83 respectively) for 30-day mortality. The same was also true for 90-day mortality. However, proADM used as a categorical variable had a greater predictive capacity for 90-day mortality than the CURB65 score (<0.001). Amongst patients admitted for CAP, the use of proADM obtained in the ED may be useful for identifying patients at greatest risk of mortality, with a similar predictive capacity to the CURB65score.

Cytisinicline has proven to be an effective, efficient, and safe molecule in smoking cessation. However, the established 25-day regimen could be insufficient in a high percentage of smokers, so it is necessary to study maintained therapies of this drug. This study aims to compare the efficacy of the cytisinicline regimen used in routine clinical practice versus 2 maintained regimens of 50 and 75 days, respectively. In addition, the safety and economic impact of each regime will be determined. A prospective, multicenter, open-label, controlled, parallel, phase IV clinical trial of 402 smoker patients prepared to quit smoking. The study was conducted in 10 hospitals in Spain. A control group is compared to 2 intervention groups in which the duration of the drug is increased without increasing its dose, administering half and all, respectively, of an additional marketed container that includes 100 tablets. Thus, participants will be randomized to three groups in a 1:1:1 ratio to receive cytisinicline: (1) a control group treated with cytisinicline according to the usual clinical guidelines and product information (25 days); (2) a group with a 50-day cytisinicline regimen (an additional 25 days at a dose of 1.5 mg every 12 hours), seeking to increase its efficacy while minimally impacting adherence; and (3) a group with a 75-day regimen (an additional 50 days at a dose of 1.5 mg every 12 hours), attempting to increase its efficacy, although the longer duration of the drug may threaten adherence. Efficacy in the 3 arms will be analyzed through sustained abstinence at 6 and 12 months, point abstinence rate assessed every 7 days, and abstinence rate from Day 25 to Day 50 and from Day 25 to Day 75 in the 3 study arms. (1) The variation in withdrawal and craving symptoms in the 3 groups, (2) safety through the percentage of adverse events in the 3 treatment arms, and (3) economic impact by evaluating the cost-effectiveness and cost-utility ratios of the 2 prolonged regimens versus the usual clinical cytisinicline regimen. To calculate the differences between the 3 groups for each outcome variable, a univariate analysis will be performed. Statistically significant variables will be included in a multivariate model. Recruitment for the trial and patient enrollment were completed in November 2026. Follow-up of all participants will extend to December 2027. In conclusion, this study evaluates the optimization of cytisinicline in daily clinical practice, increasing the benefits of its pharmaceutical properties without affecting patient safety. All of this will improve the effectiveness of smoking cessation by reducing the number of smokers, which implies lower morbidity and mortality and lower costs associated with smoking. European Clinical Trials Register 2024-518936-36-00; https://euclinicaltrials.eu/ctis-public/view/2024-518936-36-00. PRR1-10.2196/76815.

Although patients with early-onset colorectal cancer (EOCRC) share characteristics with the general colorectal cancer population, they also exhibit distinct features. Parameters such as sarcopenia, myosteatosis, and overall body composition play a crucial role in disease progression. This study aimed to assess the impact of body composition on oncological prognosis. Patients were recruited from the Humanitas Research Hospital (Milan, Italy) and the Spanish Early-Onset Colorectal Cancer Consortium (SECOC) prospective multicenter study. Preoperative computed tomography scans were analyzed between January 2019 and December 2023. Skeletal muscle mass index, visceral adipose tissue cross-sectional area, and intermuscular and intramuscular adipose tissues at the level of the transverse processes of the third lumbar vertebra (L3) were measured. Sarcopenia, obesity, and myosteatosis were defined according to sex-specific and body mass index cutoff points. After analyzing 197 patients, the mean age at diagnosis was 42.16±6.1years. According to the colorectal tumor characteristics, 64% of the tumors were located in the colon (n =126). After analysis of radiological body characteristics, the prevalence of sarcopenia was 61.9% and myosteatosis was 40.1%. Overall and disease-free survival analysis identified, among other factors, psoas muscle index [hazard ratio (HR) 0.67, 95% CI 0.53-0.85], sarcopenia (HR 2.09, 95% CI 1.06-4.14), and myosteatosis (HR 2.29, 95% CI 1.25-4.19) as independent factors implicated in oncological prognosis. EOCRC patients showed a high prevalence of sarcopenia and myosteatosis, similar to that described in elderly cohorts. This deficiency in muscle quality and quantity was a risk factor for recurrence and mortality during the follow-up of their neoplasia.

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.

ABSTRACT Objective To demonstrate the association between hospital admissions, health-related quality of life (HRQoL), limitations in daily activities, mortality, and survival in relation to physical activity (PA) and functional capacity (FC), which were used together to classify a cohort of COPD patients. Methods Prospective study. Participants were consecutively recruited from six outpatient respiratory clinics of a single university hospital. Data were recorded on sociodemographic and clinical variables, dyspnea (Medical Research Council), HRQoL (Saint George’s Respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT)), and limitation of daily life (London Chest Activity of Daily Living scale (LCADL)). FC was evaluated with a 6-minute walk test. PA (average daily steps) was measured using an accelerometer. Participants were grouped into four “CanDo/DoDo” quadrants based on their PA and FC combinations. Results 401 patients were included. Compared to the “Can/Do” group, the “Can’t/Do” (Odds Ratio (OR): 3.34) and the “Can’t/Don’t” (OR: 27.3) groups had a higher risk of dying within one year, worse survival rates (Hazard Ratios: 2.37 and 2.87), and a higher risk of hospital admission (OR: 2.83 and 2.84) and additional admissions (Incidence Rate Ratios of 2.58 and 2.31) in the first year of follow-up. The “Can’t/Do” and the “Can’t/Don’t” groups had worse scores on the SGRQ (OR: 1.83 and 2.15), CAT (OR: 2.44 and 3.39), and LCADL (OR: 1.31 and 1.42) questionnaires conducted at the beginning of the study. Conclusion Using PA and FC quadrants to classify participants showed associations with robust outcomes, thus enabling strategies to be developed to improve those outcomes.

Abstract Background Mesalazine (msz) is commonly used alongside advanced therapies in ulcerative colitis (UC), but its precise effects on efficacy and safety are not fully defined. This meta-analysis indirectly evaluates the impact of concomitant msz use on clinical and endoscopic outcomes and safety profiles in adults with moderate-to-severe UC treated with approved biological agents and small molecules. Methods A meta-analysis of RCTs including approved biological agents (Adalimumab, Infliximab, Golimumab, Mirikizumab, Guselkumab, Ozanimod, Etrasimod, Ustekinumab) and small molecules (Tofacitinib, Upadacitinib) in UC patients reporting concomitant msz use was conducted through a search of four databases. Available data on clinical remission, endoscopic remission, mucosal healing and adverse events were extracted. Msz co-therapy prevalence was categorized using the median concomitant use across datasets as the baseline threshold. Studies were stratified into ‘High’ and ‘Low’ prevalence groups based on this median. Pooled proportions for each outcome and subgroup were estimated, with between-group differences tested by two-tailed z-tests. Separate analyses were performed for induction and maintenance phases, including only approved UC treatment doses. Meta-regression assessed correlations between concomitant mesalazine prevalence and treatment outcomes. Results 32 Phase II and III RCTs were included. No statistically significant differences were shown during the induction phase (Table1). In the maintenance phase, the subgroup with a higher prevalence of msz use showed significantly greater mucosal healing than the low-prevalence group (45.0%[95%CI,32.0%–58.0%] vs. 29.0%[95%CI,21.0%–39.0%]), with a borderline positive correlation in meta-regression (r = 0.503,p=0.067) (Figure1). Conversely, infection rates were significantly higher among patients with higher msz prevalence during maintenance therapy (23.0% [95%CI,0.9%–47.0%] vs. 0.1%[95%CI,0.0%–12.0%]), supported by a significant meta-regression correlation (r = 0.396,p=0.015). No difference was found in serious infection rates between the high and low prevalence groups (p &amp;gt; 0.05). No other efficacy nor safety outcomes showed significant differences between groups. Conclusion The concomitant use of msz and advanced therapies is associated with improved mucosal healing during maintenance therapy for UC, suggesting a potential synergistic effect in the long term. Future prospective studies incorporating histologic outcomes are warranted to elucidate the mechanistic contribution of msz in combination regimens. Conflict of interest: Rodríguez-Lago, Iago: Financial support for traveling and educational activities from or has served as an advisory board member for Abbvie, Adacyte, Alfasigma, Biogen, Chiesi, Faes Farma, Ferring, Fresenius Kabi, Galapagos, Johnson &amp; Johnson, Eli Lilly, Mirum Pharmaceuticals, Merck, Pfizer, Roche, Takeda, and Tillotts Pharma. Research support from AbbVie. Supported by a research grant from Gobierno Vasco-Eusko Jaurlaritza (Grant No 2020111061 and 2023222006). D’Amico, Ferdinando: Grant: ECCO fellowship grant 2020 ECCO grant 2021 Personal Fees: F D’Amico has served as a speaker for Abbvie, Alfasigma, Ferring, Lilly, Sandoz, Janssen, Fresenius Kabi, Galapagos, Giuliani, MSD, Pfizer, Takeda, Tillotts, and Omega Pharma he also served as an advisory board member for Abbvie, AnaptysBio, Ferring, Fresenius Kabi, Galapagos, Janssen, Lilly, MSD, Takeda, and Nestlè. Bamias, Giorgos: Grants: Grants from Takeda, AbbVie, Mylan/Viatris/Biocon, Genesis Pharma, Ferring, Vianex, and Aenorasis Consulting Fees and Speaker Honoraria: AbbVie, Adacyte Therapeutics, Amgen, Bristol Myers Squibb, Faran, Ferring, Galenica, Genesis Pharma, J&amp;ampJ, Lilly, MSD, Mylan/Viatris/Biocon, Pfizer, Shattuck Labs, Takeda, Vianex Mrs. Miranda Azpiazu, Patricia: Employed at Faes Farma S.A Barreiro-de Acosta, Manuel: MBA has been speaker, consultant and advisory member for or has received research funding from MSD, AbbVie, Janssen, Kern Pharma, Celltrion, Takeda, Alphasigma, Lilly, Pfizer, Sandoz, Biocon, Abivax, Fresenius, Faes Farma, Ferring, Tillots, Chiesi, Adacyte, Diasorin, Oncostellae and SunRock.