A prospective multicenter study assessing effectiveness and safety of secukinumab in a real-life setting in 158 patients.

BACKGROUND: Secukinumab is a first-in-class interleukin 17A monoclonal antibody that has demonstrated an excellent safety and efficacy profile in phase 3 studies. OBJECTIVE: To evaluate the effectiveness of secukinumab in daily clinical practice and to understand the clinical and epidemiologic characteristics of patients treated with secukinumab in clinical settings. METHODS: In this multicenter prospective observational study, we recruited adult patients with moderate-to-severe plaque psoriasis from 12 hospitals in Spain during January-December 2016. These patients were treated with secukinumab and prospectively followed at 12-week intervals for 52 weeks. RESULTS: In total, 158 patients were recruited to the study. A Psoriasis Area and Severity Index (PASI) score improvement ≥75% over baseline (PASI-75) was achieved by 57%, 83.5%, 89%, and 78.5% of patients at weeks 4, 12, 24, and 52, respectively. PASI-90 was achieved in 27.8%, 62%, 64.6%, and 63.2% of patients at weeks 4, 12, 24, and 52, respectively; PASI-75 and PASI-90 responders were significantly more common among patients with a body mass index <30 kg/cm2 and patients without previous biologic therapy failures. LIMITATIONS: Observational study. Time from onset of psoriasis was not evaluated. CONCLUSION: Secukinumab is a safe treatment with effectiveness rates similar to those found in its phase 3 studies. These rates endure up to a year from start of treatment.

Usefulness of teledermatology in prisons. The experience in the Penitentiary Center Castellón II.

INTRODUCTION: Teledermatology is the application of new technologies for the care of skin diseases. Its application in prisons allows the diagnosis and treatment of prisoners without the need to transfer them to the hospital, avoiding the problems associated with travel. MATERIAL AND METHOD: The objective of this work is to analyze the usefulness of teledermatology in prisons, through a retrospective observational study in the Castellón II-Albocàsser penitentiary. RESULTS: The study sample consisted of 37 patients and 43 interconsultations. All the consultations corresponded to men, with a mean age of 42.43 years. 95.3% of the consultations were asynchronous and in 86% of them a diagnosis and a complete treatment plan were established. Only 18.6% of the consultations required a face-to-face consultation. DISCUSSION: It is concluded that teledermatology in prisons is effective in the care and resolution of dermatological problems.

[Castellón Field Hospital: comprehensive analysis of its use during the SARS-CoV-2 pandemic.] / Hospital de Campaña de Castellón: análisis integral de su uso durante la pandemia por SARS-CoV-2.

OBJECTIVE: Field hospitals, also known as alternative care sites, have been an important healthcare reinforcement during the SARS-CoV-2 pandemic worldwide. In the Valencian Community, three of these hospitals were opened, one for each province. Our study aimed to make a comprehensive analysis of this resource in Castellon. METHODS: A retrospective observational study was carried out with an analytical and statistical component of 3 aspects: infrastructure, satisfaction and clinical data from COVID-positive hospitalized patients. The sources of information were primary, institutional for the infrastructure and personal for the satisfaction surveys and clinical data. RESULTS: A set of 6x3 metres polyvalent tents was chosen, which joined formed a single-floor area of about 3.500 m2. Although hospital opened for approximately a year and a half with multiple uses, most in relation to the COVID pandemic (vaccination center, emergency room observation, hospital assistance, warehouse...), reception of positive patients for the virus began during the third wave of the pandemic, remaining active for eleven days. A total of thirty-one patients with a mean age of 56 years were admitted. 41.9% did not have any comorbidity and 54.8% needed treatment with oxygen therapy. Furthermore, the length of stay was three days, finding a significant relationship between this one, the oxygen flow required during admission and the age. Satisfaction was measured by a survey of seventeen questions where an average satisfaction of 8.33/10. CONCLUSIONS: This is one of the few studies in the literature in which a field hospital is analyzed from such different points of view. After this analysis, it is concluded that it is an extraordinary and temporary resource whose use is useful without reflecting an increase of morbidity/mortality among our patients and with a very favorable subjective assessment.

OBJETIVO: Los hospitales de campaña, también conocidos como alternative care sites, han supuesto un refuerzo sanitario importante durante la pandemia por SARS-CoV-2 a nivel mundial. En la Comunidad Valenciana se abrieron tres de estos hospitales, uno por cada provincia. Nuestro estudio pretendió hacer un análisis integral de dicho recurso en la provincia de Castellón. METODOS: Se realizó un estudio observacional retrospectivo con un componente analítico y estadístico de tres aspectos: la infraestructura, la satisfacción de los pacientes atendidos y los datos o características clínicas de los pacientes ingresados positivos por COVID. Las fuentes de información fueron primarias, institucionales para el apartado de la infraestructura y personales para las encuestas de satisfacción y los datos clínicos. RESULTADOS: El tipo de infraestructura que se eligió fue un conjunto de tiendas modulares polivalentes de 6x3 metros que unidas formaban una superficie de una sola planta de unos 3.500 m2. Aunque el hospital permaneció abierto durante aproximadamente año y medio con diversas funciones, la mayoría en relación con la pandemia por COVID (centro de vacunación, observación de Urgencias, asistencia hospitalaria, almacén…), inició su acogida de pacientes positivos debido al virus durante la tercera ola de la pandemia, ejerciendo este papel durante once días. En el hospital ingresaron un total de 31 pacientes con una edad media de 57 años, de los que un 41,9% no tenían ninguna comorbilidad y un 54,8% necesitaron oxigenoterapia. La estancia media hospitalaria fue de tres días, encontrándose una relación estadísticamente significativa entre ésta, el flujo de oxígeno requerido durante el ingreso y la edad. La satisfacción se midió mediante una encuesta de diecisiete preguntas donde se obtuvo una media de 8,33/10. CONCLUSIONES: Este es uno de los pocos estudios de la literatura en los que se abarca, desde puntos tan distintos, cómo funciona un hospital de campaña. Tras el análisis se concluye que se trata de un recurso extraordinario y temporal cuyo empleo es útil sin reflejar un aumento de la morbi/mortalidad de nuestros pacientes y con una valoración subjetiva del mismo muy favorable.