Persistence and effectiveness of guselkumab treatment in patients with moderate-to-severe plaque psoriasis in a non-interventional real-world setting: The SPRING study.

BACKGROUND: Guselkumab is a monoclonal antibody that blocks the IL-23 pathway with proven efficacy and tolerability in the treatment of moderate-to-severe plaque psoriasis. OBJECTIVES: To assess the persistence, effectiveness and safety of guselkumab in patients with moderate-to-severe psoriasis in real clinical practice in Spain. METHODS: SPRING was a Phase IV, retrospective and non-interventional study analysing patients with moderate-to-severe plaque psoriasis who had initiated guselkumab under clinical practice conditions at least 12 months before inclusion in the study. The primary endpoint was persistence (non-persistence: discontinuation or interruption ≥90 days). Effectiveness was assessed using the Psoriasis Area Severity Index (PASI) and Investigator Global Assessment (IGA). Dermatology Life Quality Index (DLQI) and safety were also evaluated. RESULTS: A total of 284 patients were included between September 2020 and June 2021. The 1-year probability of persistence was 89.6% (86.1%-93.3%). The 1-year probability of persistence was also calculated according to prior biologic treatment, being 90.3% for biologic-naïve patients and 89.5% for patients who received one or more biologic therapies before guselkumab. Additionally, patients were also classified based on the frequency of the administration of guselkumab treatment; the 1-year probability of persistence was 91.9% in patients receiving guselkumab according to the Summary of Product Characteristics and 89.3% in patients with lengthened intervals of administration. After 1 year, PASI 90 was achieved by 56.4% of patients, IGA 0/1 response and BSA <3% were achieved by 65.5% and 77.8% of patients, respectively, and 65.8% achieved a minimal clinically significant difference (>4-point reduction) in the DLQI score at 1 year. Twenty-six adverse reactions (4 of them serious) were reported in 16 patients. CONCLUSIONS: This study suggests that guselkumab has high persistence in real clinical practice in Spain, independently of the previous biologic treatments and changes in the frequency of treatment. Effectiveness and safety are consistent with previously published data.

Fístula arteriovenosa posterior a trombosis venosa profunda persistente en ilíaca pimitiva posparto / Early postpartum arteriovenous fistula after persistent iliac deep vein thrombosis

La trombosis venosa profunda es 5 veces más frecuente en mujeres gestantes o puérperas, pero con las mismas complicaciones a largo plazo. Aquí ilustramos un caso de una trombosis venosa ilíaca izquierda durante el posparto inmediato, persistente, con desarrollo de abundante circulación colateral compensatoria (Palmaz), y con hallazgo de fístula arteriovenosa en femoral común, posteriormente diagnosticada por ecografía, y confirmado por angio-TC, sin empeoramiento del síndrome postrombótico de la paciente. Se trata de un caso, en el cual casi no hay referencias bibliográficas, con etiopatogenia atribuible a la cascada de moléculas proinflamatorias y proangiogénicas derivadas de la remodelación, recanalización del trombo venoso y desarrollo de circulación colateral, afectando dichas moléculas a los vasa vasorum y los vasos de alrededor, dando lugar a fístulas arteriovenosas, hecho poco frecuente, y generalmente poco sintomáticas

Deep vein thrombosis is five times more common in pregnant women or new mothers, but with the same long-term complications. We present a case of early postpartum persistent left iliac vein thrombosis with abundant development of compensatory collateral circulation (Palmaz) and common femoral arteriovenous fistula subsequently diagnosed by ultrasound and confirmed by CT angiography, with no deterioration of the patient's post-thrombotic syndrome. This is a case with very few references in the scientific literature, with pathogenesis attributable to the cascade of pro-inflammatory and pro-angiogenic molecules derived from remodelling, recanalisation of the venous thrombus and development of collateral circulation. These molecules invade the vasa vasorum and surrounding vessels, which can, on rare occasions, lead to generally asymptomatic arteriovenous fistulas

[Analysis of the nutritional status and body composition of persons with intellectual disability]. / Analisis del estado nutricional y composicion corporal de personas con discapacidad intelectual.

INTRODUCTION: Intellectual disability refers to substantial limitations in intellectual functioning, affecting 0.7-1.5% of the population. People with intellectual disability have higher rates of obesity, since caloric values and nutritional status, are deficient. AIMS: To determine the nutritional habits, analyze the effectiveness of nutritional education and evaluate the possible effect of improvement introducing exercise and nutrition workshops, in a group of people with intellectual disability. PATIENTS AND METHODS: Clinical, nutritional and anthropometric (weight, height, body mass index, body fat, waist circumference) assessment was conducted in 47 patients. An ad hoc survey was designed in which exercise habits, medical and dietary history, record of 72 hours (including 2 weekdays and 1 weekend) and the adherence to Mediterranean diet data were collected. The workshops of exercise and nutrition counted with a structure of theoretical-practical explanation and games. RESULTS: 76.1% presented weight excess at baseline. After the intervention values of total body fat (-0.94 ± 4.4%) and visceral fat (-0.86 ± 2%), weight (-0.4 ± 3.3 kg) and body mass index (-0.2 ± 1.6 kg/m2) decreased, more in women than in men. 60.5% of subjects did not meet a high adherence to the Mediterranean diet. After nutritional intervention, a significant difference (p <= 0,001) was observed in the KidMed score. The workshop of physical activity had positive effects on the anthropometry of subjects. CONCLUSIONS: Both the intake and the prevalence of obesity in this group of people are inadequate. Nutritional education and physical exercise workshops are useful for working with this group, achieving significant changes to prevent obesity and improve their health.

TITLE: Analisis del estado nutricional y composicion corporal de personas con discapacidad intelectual.Introduccion. La discapacidad intelectual, definida como limitaciones sustanciales en el funcionamiento intelectual, afecta al 0,7-1,5% de la poblacion. Estas personas presentan mayores tasas de obesidad, y sus valores caloricos y estado nutricional son deficientes. Objetivos. Conocer los habitos nutricionales, analizar la eficacia de la educacion nutricional y evaluar la posible mejora, introduciendo talleres de ejercicio fisico y nutricion, en la discapacidad intelectual. Pacientes y metodos. Se realizo una valoracion clinica, nutricional y antropometrica (peso, talla, indice de masa corporal, grasa corporal, perimetro de la cintura) a 47 sujetos con discapacidad intelectual. Se registraron los habitos deportivos, la historia clinica y la historia dietetica mediante un registro alimentario y un cuestionario de adhesion a la dieta mediterranea (KidMed). Los talleres de nutricion y ejercicio fisico contaron con una estructura de explicacion teorica, practica y juegos. Resultados. El 76,1% presentaba exceso ponderal en el inicio del estudio. Tras la intervencion, los valores de grasa corporal (­0,94 ± 4,4%) y grasa visceral (­0,86 ± 2%), asi como el peso (­0,4 ± 3,3 kg) y el indice de masa corporal (­0,2 ± 1,6 kg/m2), disminuyeron, mas en las mujeres que en los hombres. El 60,5% no cumplia con una alta adhesion a la dieta mediterranea. Tras la intervencion, se observo una diferencia significativa (p <= 0,001) en la puntuacion del KidMed. El taller de actividad fisica tuvo efectos positivos sobre la antropometria. Conclusiones. La alimentacion fue inadecuada en la mayoria de los individuos. La prevalencia de obesidad fue elevada. Los talleres de educacion nutricional y de ejercicio son una herramienta util para trabajar con este colectivo, y consiguen cambios significativos para prevenir la obesidad y mejorar su salud.

Predictors of cardiovascular risk in a population of diabetic adults of Gypsy origin, in Granada.

AIMS: The aim of this work is to identify cardiovascular risk factors in a population of ethnic Gypsy diagnosed with type 2 diabetes mellitus (T2DM) and to compare this population with a control group of non-Gypsy patients also diagnosed with T2DM and with a similar sociological background. DESIGN: Observational descriptive cross-cutting study. METHODS: Using a systematic random sampling, we selected a sample of 220 Gypsy patients diagnosed with T2DM and another sample of 230 non-Gypsy patients, also diagnosed with T2DM. Both samples were composed of patients registered at the Almanjáyar and Cartuja health centres, in Granada (Spain). The data were collected between October 2010 and October 2011. RESULTS: There were statistically significant differences between the Gypsy and non-Gypsy patients in the following variables concerning the control of cardiovascular risk: systolic blood pressure, diastolic blood pressure, HDL cholesterol, triglycerides and cardiovascular risk. CONCLUSIONS: The factors of cardiovascular risk presented by Gypsy patients diagnosed with T2DM were more acute than those of non-Gypsy patients (Tab. 7, Ref. 26).

Effectiveness of early intervention in hydrotherapy

Objetivo Valorar la eficacia de la hidroterapia en atención temprana. Estrategia de búsqueda Revisión sistemática en bases de datos PEDro, PubMed, Enfispo, Dialnet, IME (índice médico español), Science Direct e Isi Web Of Knowledge mediante términos Mesh y el operador lógico AND, así como una búsqueda bibliográfica manual. Selección de estudios y datos Fueron seleccionados 5 artículos que cumplían los criterios de inclusión y exclusión establecidos. Resultados Todos los estudios cuantificaron una mejora tras la intervención, ya fuese en variables fisiológicas, en el comportamiento o en la movilidad funcional; sin embargo, la calidad metodológica era escasa, siendo dos de ellos estudios de un solo caso, otros dos presentaban un tamaño muestral superior pero sin grupo control y un quinto estudio carecía de muestra aleatoria. Conclusiones Son necesarios estudios de mayor calidad metodológica que permitan evidenciar los efectos reales producidos por la hidroterapia en este ámbito (AU)

Objective To evaluate the efficacy of hydrotherapy in early intervention. Search strategy A systematic review was made in the PEDro database, PubMed, Enfispo, Dialnet, IME (Spanish Medical Index), Science Direct and ISI Web of Knowledge using Mesh terms and the logical AND as well as a manual literature search. Study selection and data We selected five articles that met the inclusion and exclusion criteria established. Results All studies quantified improvement after surgery, either in physiological variables, in behavior or functional mobility. However, the methodological quality was poor, two of them being study of only one cases, and two others had a larger sample size but with no control group. A fifth study lacked a random sample. Conclusions More studies having better methodological quality are needed to make it possible to see the real effects produced by hydrotherapy in this setting (AU)

Sulfonamida: el grupo mágico / Sulfonamide: the magic group

En este trabajo se establece el papel protagonista que el grupo sulfonamida ha tenido en el diseño de nuevos fármacos a lo largo de la historia. La sulfonamida es un grupo funcional que contiene el radical –SO2NH2. Así, la sulfonamida puede ser considerada como un derivado de un ácido sulfónico, donde el grupo hidroxilo se ha sustituido por una amina. La aplicación de las sulfamidas en el tratamiento de enfermedades infecciosas ha sido el primer fruto de la combinación de la observación inteligente con la «serendipity»; sólo así se puede entender el descubrimiento de esta serie de fármacos, que surge a partir de la extracción de la anilina del alquitrán de la hulla, que realizó Runge, y que daría lugar posteriormente a la potente industria de los colorantes azoicos. En la actualidad existen numerosos medicamentos donde está presente este grupo mágico, entre los que se encuentran antibióticos, antimaláricos, antimicrobianos, diuréticos, hipoglucemiantes, antiinflamatorios, antihipertensivos, etc., poniendo de manifiesto el amplio espectro terapéutico de las sulfonamidas, como grupo funcional de interés terapéutico

The significant role of sulfonamide in the development of new drugs is shown in this article, through an overview of its history. Sulfonamide is an organic sulfur compound containing the radical –SO2NH2. Then, any sulfonamide can be considered as derived from a sulfonic acid by replacing a hydroxyl group with an amine group. The treatment of infectious diseases with sulfamides has been the result of a combination of intelligent research and «serendipity»; this is the only way to explain the development of this drugs, starting from the aniline extraction by Runge and its evolution to give the azoic dyes manufacturing. Nowadays, this magic group is present in many drugs as antibiotics, antimalaric drugs, antimicrobial agents, diuretics, hypoglycemics, anti-inflammatory drugs, antihypertensive drugs, etc. showing the broad therapeutic field of sulfonamides as therapeutic function