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Safety of Dupilumab Therapy for Atopic Dermatitis during Pregnancy: A Systematic Review and Meta-analysis

Fri, 03 Jul 2026 10:28:46 GMT

Título : Safety of Dupilumab Therapy for Atopic Dermatitis during Pregnancy: A Systematic Review and Meta-analysis Autor : Sánchez-García, Verónica; de Miguel Balsa, Eva; Ramos Rincón, José Manuel; Belinchón-Romero, Isabel Resumen : Atopic dermatitis (AD) is the most common skin condition among pregnant women. However, there is limited information on the safety of biologicals during pregnancy. A systematic review and meta-analysis was conducted following the PRISMA guidelines to evaluate the effects of exposure to biologicals during pregnancy and/or preconception in women with AD, and to estimate the pooled prevalence of spontaneous abortions and congenital malformations in their newborns. MEDLINE, Embase, Scopus, and Web of Science to 31 May 2024 were searched to identify randomized controlled trials and non-randomized studies. To test the robustness of our findings, sensitivity analyses were performed. Fifteen observational studies involving 115 pregnant women with a mean age of 33.46 years (standard deviation [SD] 3.02 were included). All studies evaluated dupilumab. The mean duration of exposure to dupilumab during pregnancy was 27.52 weeks (SD 11.16). The weighted prevalence of spontaneous abortions was 18.9% (95% confidence interval 5.3 to 38.2). There were no reports of congenital malformations. The sensitivity analyses showed no significant differences in weighted prevalences. In conclusion, the current scientific evidence suggests that dupilumab is probably safe during pregnancy and preconception in women with AD, with no significant increase in the risk of miscarriage or congenital malformations compared to the general population. However, the results of this review are inconclusive due to the limited number of large, well-designed clinical studies.

Comparative analysis of patient and family satisfaction in Spanish Intensive Care Units: A cross-sectional study of the impact of diagnosis

Fri, 03 Jul 2026 10:23:51 GMT

Título : Comparative analysis of patient and family satisfaction in Spanish Intensive Care Units: A cross-sectional study of the impact of diagnosis Autor : de Miguel Balsa, Eva; Rios-Albert, Esther; Quevedo-Sánchez, Beatriz; Jorda- Miñana, Angela; Portillo-Requena, Cristina; Perez-Quesada, Sonia; Alfaro-Garcia, Elena; Alcalá-López, Adoración Resumen : Analysing relatives and patients experiences and satisfaction can highlight areas for improving Intensive Care Units (ICUs) care. Patients and families may differ about satisfaction and experience, depending on the diagnosis and procedures. We aimed to compare the experience and satisfaction of patients according to diagnosis, severity, and the procedures received, and also between relatives and patients. Methods: Prospective analysis of voluntary responses to the FS (Family Satisfaction)- ICU 24 R questionnaire from surviving ICU patients and their relatives (January-April 2023) in four Spanish hospitals, according to diagnostic groups. Responses were scored on a Likert scale (0: worst score; 100: best score), and means and standard deviations were compared. Results: 185 responses were analysed, mostly acute cardiac pathology patients (91, 50.83%), followed by septic shock patients (22.9%). Patients rated the team performance higher than their relatives (98.79 5.37 vs 89.68 18.43; p < 0.0001), also symptom management such as pain (95.62 9.52 vs 89.64 17.24; p = 0.0001, and dyspnoea (94.23 12.27 vs 88.09 17.87; p = <0.001), the information process (91.50 13.43 vs 83.17 21.00; p < 0.001), and decision-making (80.38 13.60 vs 65.84 23.60; p < 0.001). Patients found visits to be scarce (43.75 20.79), although their families were satisfied with their involvement in care (85.49 19.64). Patients with sepsis and septic shock rated pain management the lowest compared to other diagnostic groups (sepsis/septic shock 89.58 12.5 vs 98.61 5.89; p < 0.001). Conclusions: Open visiting policies and enhancing the protocols for conscious sedation/analgesia in invasive procedures are opportunities to improve the satisfaction and experience of ICU patients and their families.

Screening for Human T-Cell Lymphotropic Virus (HTLV) in Pregnant Women in the Peruvian Amazon and Systematic Review with Meta-Analysis of HTLV Infection in Peru

Fri, 03 Jul 2026 10:22:33 GMT

Título : Screening for Human T-Cell Lymphotropic Virus (HTLV) in Pregnant Women in the Peruvian Amazon and Systematic Review with Meta-Analysis of HTLV Infection in Peru Autor : Ramos Rincón, José Manuel; Ortiz-Martínez, Sonia; Vásquez Chasnamote, María Esteyner; de Miguel Balsa, Eva; Gamboa-Paredes, Olga-Nohelia; Talledo, Michael ; López-Campana, Giovanni; Celis Salinas, Juan Carlos; Prieto-Pérez, Laura; Górgolas-Hernández, Miguel; Casapía-Morales, Martin Resumen : Human T-cell lymphotropic virus type 1 (HTLV-1) is responsible for tropical spastic paraparesis and HTLV-1-associated leukemia/lymphoma. The infection is endemic in some areas of Peru, but its prevalence in the Peruvian Amazon is not well established. We aimed to assess the seroprevalence of HTLV-1 infection in pregnant women in the Peruvian Amazon. Moreover, we performed a systematic literature review and meta-analysis of the seroprevalence of HTLV infection in Peru. (2)Methods. This is a prospective cross-sectional study involving pregnant women attending health centers in the city of Iquitos, Peru, in May and June 2019. The presence of antibodies against HTLV-1was assessed using ELISA(HTLV I + II ELISArecombinant v.4.0,Wiener lab, Rosario, Argentina). Positive caseswere confirmed byWestern Blot andHTLV-1 proviral load. (3)Results. The study included 300 pregnant women with a mean age of 26 years (standard deviation [SD] 6.4). Five patients were diagnosed with HTLV-1 infection (prevalence 1.7%, 95% confidence interval (CI) 0.7% to 3.8%). Pregnant women with HTLV-1 infection were discretely younger (mean age 22.6 [SD 22.6] vs. 26.8 [SD 6.3]; p = 0.128). None of the five women had been transfused, and all were asymptomatic. Two (40%) also had a positive serology for Strongyloides, but larvae were not detected in any of the parasitological stool studies. The systematic review component identified 40 studies, which showed that the prevalence of HTLV infection in the general population was 2.9% (95% CI 1.2% to 5.3%) and in women of childbearing age, 2.5% (95% CI 1.2% to 4.0%). (4) Conclusion. The prevalence of HTLV-1 in the Peruvian Amazon basin is about 1.7%, indicating an endemic presence. Screening for HTLV-1 in prenatal care is warranted.

Efectos de un programa de ejercicio de alta intensidad sobre la recuperación de peso y el perfil cardiometabólico después de 3 años de cirugía bariátrica: un ensayo aleatorizado.

Tue, 30 Jun 2026 06:59:51 GMT

Título : Efectos de un programa de ejercicio de alta intensidad sobre la recuperación de peso y el perfil cardiometabólico después de 3 años de cirugía bariátrica: un ensayo aleatorizado. Autor : Marc-Hernàndez, Artur; Aracil Marco, Adolfo; MOYA-RAMÓN, MANUEL Resumen : Weight regain is one of the most common problems in the long-term after bariatric surgery. It is unknown if high-intensity exercise programs applied in late phases of post-surgical follow-up could counteract this trend. After a 3-year follow-up, 21 patients underwent sleeve gastrectomy were randomized into an exercise group (EG, n = 11), that performed a 5-month supervised exercise program, and a control group (CG, n = 10), that followed the usual care. Body composition, cardiorespiratory fitness, glycaemia and blood cholesterol were evaluated before and after the intervention. Finally, the EG repeated the evaluations 2 months after the end of the exercise program. Both groups reached their maximum weight loss at the first year after surgery and showed significant weight regain by the end of the follow-up. After the exercise program, the EG showed reductions in fat mass (-2.5 ± 2.6 kg, P < 0.05), glycaemia (-13.4 ± 8.7 mg·dL-1, P < 0.01) and blood cholesterol (-24.6 ± 29.1 mg·dL-1, P < 0.05), whereas the CG during the same period showed increases in weight (1.5 ± 1.3 kg, P < 0.05) and fat mass (1.8 ± 0.9, P < 0.01). Two months after the end of the program, EG had increases in weight (1.1 ± 1.2 kg, P < 0.05), fat mass (2.6 ± 2.2 kg, P < 0.01), glycaemia (8.2 ± 11.6 mg·dL-1, P < 0.05) and blood cholesterol (20.0 ± 22.1 mg·dL-1, P < 0.05), when compared with the values after the exercise program. Therefore, in the medium-term after sleeve gastrectomy exercise may contribute to prevent weight regain and to reduce fat mass, glycaemia, and blood cholesterol.

Heart Rate Variability-Guided Training for Improving Mortality Predictors in Patients with Coronary Artery Disease.

Tue, 23 Jun 2026 11:35:49 GMT

Título : Heart Rate Variability-Guided Training for Improving Mortality Predictors in Patients with Coronary Artery Disease. Autor : Manresa Rocamora, Agustin; Sarabia, José M.; GUILLEN, SILVIA; Pérez-Berbel, Patricio; Miralles-Vicedo, Beatriz; Roche, Enrique; Vicente-Salar, Néstor; MOYA-RAMÓN, MANUEL Resumen : The objective of this research was to investigate whether heart rate variability (HRV)-guided training improves mortality predictors to a greater extent than predefined training in coronary artery disease patients. Twenty-one patients were randomly allocated to the HRV-guided training group (HRV-G) or the predefined training group (PRED-G). They measured their HRV at home daily and trained three times a week for six weeks. Resting heart rate, isolated vagal-related HRV indices (i.e., RMSSD, HF, and SD1), weekly averaged RMSSD, heart rate recovery, and maximum oxygen uptake were assessed before and after the training period. There was a statistically significant difference (p = 0.034) in the change in weekly averaged RMSSD in favor of the HRV-G, while no differences were found in the remaining analyzed variables (p > 0.050). Regardless of the training prescription method, exercise training decreased resting heart rate (p = 0.001; 􀀀4.10 [95% CI = 􀀀6.37–􀀀1.82] beats per minute (bpm)), and increased heart rate recovery at 2 min (p = 0.010; 4.33 [95% CI = 1.15–7.52] bpm) and maximum oxygen uptake (p < 0.001; 3.04 [95% CI = 1.70–4.37] mL kg􀀀1 min􀀀1). HRV-guided training is superior to predefined training in improving vagal-related HRV when methodological factors are accounted for.

Análisis del perfil de no adherencia a las estatinas en pacientes en prevención secundaria cardiovascular

Tue, 23 Jun 2026 11:35:11 GMT

Título : Análisis del perfil de no adherencia a las estatinas en pacientes en prevención secundaria cardiovascular Autor : Alcalá Belmonte, María; Quesada Rico, Jose Antonio; NOUNI GARCÍA, RAUF; Carbonell Soliva, Álvaro; Cordero Fort, Alberto; Arrarte Esteban, Vicente Ignacio; Guillén García, Silvia; González Llopis, Francisco; Pereira, Avelino; Cazorla-Morallon, Diego; Esquerdo Arroyo, Amanda; Carratalá Munuera, Concepción; Orozco-Beltrán, Domingo; López Pineda, Adriana Resumen : Introducción y objetivos: La falta de adherencia al medicamento implica mal control de la enfermedad, peor calidad de vida y posibles complicaciones y eventos. La adherencia es difícil de medir debido a su carácter multidimensional. En este estudio se midió la adherencia a las estatinas mediante un método directo y se describen los factores con mayor prevalencia entre los pacientes no adherentes. Métodos: Estudio transversal descriptivo que incluyó pacientes con cardiopatía isquémica en tratamiento con estatinas durante al menos un año. La adherencia se evaluó mediante la concentración plasmática de atorvastatina o rosuvastatina (y su metabolito en caso de atorvastatina) en sangre, definiendo la falta de adherencia como la ausencia de al menos dos dosis diarias. El punto de corte para rosuvastatina se estableció mediante curvas teóricas de farmacocinética, y el de atorvastatina a partir de valores propuestos en estudios experimentales previos. Se recogieron variables sociodemográficas, comorbilidades y tratamientos. Resultados: Se analizaron 309 pacientes de entre 30 y 92 años (media 66 años), siendo el 32,7% mujeres. Se estima que 49 pacientes (15,9%) eran no-adherentes, siendo en mayor medida pacientes sin estudios o solo estudios primarios (22,7%), separados/as o divorciados/as (25,7%), que tenían una renta neta del hogar inferior a 800 € (20%) o no la declararon (25%), que presentaban un SCA con elevación del ST (21,6%), alguna dificultad en actividades de la vida diaria (26,8%), mala o muy mala salud autopercibida (24%), fumadores actuales (22,9%), con fibrilación auricular (20%) o insuficiencia cardiaca (21,4%). Conclusiones: La falta de adherencia a las estatinas en prevención secundaria es moderada y se asocia a un perfil con menor nivel socioeconómico, peor calidad de vida y mayor carga de comorbilidades cardiovasculares. Son necesarias intervenciones para mejorar la adherencia en estos pacientes y optimizar el control lipídico para prevenir eventos en esta población de mayor riesgo cardiovascular.

Validez de los cuestionarios MMAS-8 y Haynes-Sackett como métodos de detección de la baja adherencia a estatinas en prevención secundaria cardiovascular: estudio transversal

Tue, 23 Jun 2026 11:29:41 GMT

Título : Validez de los cuestionarios MMAS-8 y Haynes-Sackett como métodos de detección de la baja adherencia a estatinas en prevención secundaria cardiovascular: estudio transversal Autor : Vidal Planelles, Inmaculada; NOUNI GARCÍA, RAUF; Carbonell Soliva, Álvaro; Quesada Rico, Jose A.; Esquerdo Arroyo, Amanda; Carratalá Munuera, Concepción; Orozco Beltrán, Domingo; López Pineda, Adriana; Cordero Fort, Alberto; Guillén García, Silvia; Arrarte Esteban, Vicente Ignacio; González Llopis, Francisco; Pereira, Avelino; Gil-Guillén, Vicente F Resumen : Introducción y objetivos: La falta de adherencia al tratamiento se asocia a un peor control clínico, menor calidad de vida y mayor riesgo de complicaciones y eventos cardiovasculares. Su medición resulta compleja debido a las variables latentes que la determinan. Este estudio evalúa la adherencia al tratamiento con estatinas mediante un método directo y la compara con la clasificación de los cuestionarios de adherencia MMAS-8 y Haynes-Sackett. Métodos: Estudio transversal descriptivo en pacientes en prevención secundaria con cardiopatía isquémica, en tratamiento diario con estatinas durante al menos un año. La adherencia se evaluó mediante análisis plasmático de concentración de atorvastatina y su metabolito o de rosuvastatina, definiéndose la falta de adherencia como la ausencia de al menos dos dosis según puntos de corte establecidos por curvas teóricas de farmacocinética (rosuvastatina) y estudios experimentales previos (atorvastatina). Se comparó con la clasificación de los cuestionarios mediante el cálculo de sensibilidad, especificidad y valores predictivos. Resultados: Se analizaron 309 pacientes de entre 30 y 92 años (media: 66 años), siendo el 32,7% mujeres. Se estimó que 49 pacientes (15,9%) no eran adherentes. El cuestionario MMAS-8 mostró una sensibilidad del 2% (IC95%: 0-5,9%) y especificidad del 95% (IC95%: 92,4-97,6%), con valores predictivos positivo (VPP) y negativo (VPN) de 7,1% y 83,7%, respectivamente. Estos indicadores fueron peores en mujeres. El cuestionario Haynes-Sackett presentó una sensibilidad del 18,4% (IC95%: 7,6-29,2%) y especificidad del 79,2% (IC95%: 74,3-84,1%), con VPP de 14,3% y VPN de 83,7%, sin diferencias relevantes por sexo. Conclusiones: El cuestionario MMAS-8 presenta una sensibilidad muy baja y alta especificidad, con peor rendimiento en mujeres, y no resulta válido como herramienta de cribado para detectar baja adherencia a las estatinas. Aunque el cuestionario Haynes-Sackett presenta indicadores ligeramente superiores, tampoco demuestra utilidad suficiente para identificar pacientes no adherentes al tratamiento con estatinas en prevención secundaria.

Sarcopenia en pacientes con insuficiencia cardíaca con fracción de eyección reducida. Prevalencia y propuesta de protocolo diagnóstico en consulta

Tue, 23 Jun 2026 10:57:01 GMT

Título : Sarcopenia en pacientes con insuficiencia cardíaca con fracción de eyección reducida. Prevalencia y propuesta de protocolo diagnóstico en consulta Autor : Bellot Beltrán, Ana; Guillén García, Silvia; Sánchez Aleixandre, Andrés; Niosi Mazzoni, María Laura; Berenguer Vila, Alicia; González Llopis, Francisco Ángel Resumen : Introducción: la sarcopenia es una enfermedad prevalente entre los adultos mayores, y especialmente en pacientes con insuficiencia cardíaca. Es un factor de riesgo independiente de hospitalizaciones y mortalidad. Existen diferentes herramientas de cribado, pero no existe consenso sobre cuál es más recomendada para la práctica clínica. Este estudio tiene como objetivo evaluar, en un entorno de práctica clínica, la prevalencia de la sarcopenia en pacientes con insuficiencia cardíaca con fracción de eyección reducida, mediante técnicas diagnósticas sencillas y reproducibles. Con los datos obtenidos, se pretende establecer un algoritmo diagnóstico viable en una consulta ambulatoria. Material y métodos: se realizó un estudio observacional descriptivo longitudinal en pacientes con disfunción ventricular sistólica izquierda (<40%) demostrada reciente mediante ecocardiograma o resonancia cardíaca. Se obtuvieron datos demográficos (género y edad), antropométricos (peso, talla) y por último se realizaron diversos métodos de detección de sarcopenia validados por las guías vigentes, incluyendo el cuestionario SARC-F, medición de la fuerza de agarre de la mano mediante dinamometría, test de levantarse de la silla, medición de la circunferencia del gastrocnemio y uso de bioimpedancia eléctrica para la obtención del índice de masa muscular esquelética. Resultados: se calcula una elevada prevalencia de sarcopenia en pacientes con insuficiencia cardíaca con fracción de eyección reducida (26%). Conclusiones: protocolos sencillos de cribado y alta sensibilidad deberían realizarse de forma sistemática en estos pacientes. Proponemos un nuevo algoritmo que mejora la capacidad diagnóstica de la sarcopenia en pacientes con insuficiencia cardíaca y fracción de eyección reducida.; Introduction: Sarcopenia is a prevalent condition among older adults, particularly in patients with heart failure. It is an independent risk factor for hospitalizations and mortality. Various screening tools exist, but there is no consensus on which is most recommended for clinical practice. This study aims to evaluate, in a clinical practice setting, the prevalence of sarcopenia in patients with heart failure with reduced ejection fraction, using simple and reproducible diagnostic techniques. Based on the data obtained, the goal is to establish a viable diagnostic algorithm for outpatient consultation. Material and Methods: A longitudinal descriptive observational study was conducted in patients with recently demonstrated left ventricular systolic dysfunction (< 40%) via echocardiogram or cardiac MRI. Demographic data (gender and age) and anthropometric data (weight and height) were collected. Various sarcopenia detection methods validated by current guidelines were applied, including the SARC-F questionnaire, handgrip strength measurement using dynamometry, chair stand test, calf circumference measurement, and bioelectrical impedance to obtain the skeletal muscle mass index. Results: A high prevalence of sarcopenia is estimated in patients with heart failure with reduced ejection fraction (26%). Conclusions: Simple, highly sensitive screening protocols should be systematically implemented in these patients. We propose a new algorithm that improves the diagnostic capacity. for sarcopenia in patients with heart failure and reduced ejection fraction.

Acute Increase in Blood αCGRP at Maximal Exercise and Its Association to Cardiorespiratory Fitness, Carbohydrate Oxidation and Work Performed: An Exploratory Study in Young Men

Tue, 23 Jun 2026 10:56:01 GMT

Título : Acute Increase in Blood αCGRP at Maximal Exercise and Its Association to Cardiorespiratory Fitness, Carbohydrate Oxidation and Work Performed: An Exploratory Study in Young Men Autor : Aracil Marco, Adolfo; Sarabia, José Manuel; Pastor, Diego; Guillén, Silvia; López-Grueso, Raúl; Gallar, Juana; Moya-Ramón, Manuel Resumen : This study aimed to explore if the acute variations in plasma concentration of α-calcitonin gene-related peptide (αCGRP) induced by a single maximal exercise bout may be associated to cardiorespiratory fitness and carbohydrate oxidation in humans. Twelve young adult Caucasian men (24.3 ± 0.9 years-old; 179.2 ± 1.9 cm of height; 23.9 ± 0.6 kg·m-2 body mass index) performed a graded exercise test. A venous catheter was placed before testing, and blood samples were taken at baseline, maximal effort and recovery. αCGRP was measured in plasma using a commercial double-sandwich enzyme-linked-immunoassay. A two-way repeated measurements ANOVA was used to compare the values obtained at baseline, maximal effort and recovery. In the whole sample, αCGRP increased at maximal effort and its concentration correlated directly, albeit non-significantly, with the muscle mass normalised VO2, VCO2, carbohydrate oxidation and relative power. Two thirds of the participants showed an increase in αCGRP concentration at maximal effort. Post hoc analysis showed that in these individuals, the muscle mass normalised VO2, VCO2, carbohydrate oxidation rate and relative power were higher than in the participants lacking this molecular response. Therefore, our data suggest that (a) a majority of young men respond to exercise with an increase in blood αCGRP concentration; and (b) individuals exhibiting this response also show a higher cardiorespiratory fitness, carbohydrate oxidation and work performed. These findings suggest that this neuropeptide could act as an exerkine with potential effects on physical performance.

Identifying Dimensions and Items for a Questionnaire to Assess Medication Adherence in Men and Women with Ischemic Heart Disease: Insights from the GENADHECAR Study

Tue, 23 Jun 2026 10:54:02 GMT

Título : Identifying Dimensions and Items for a Questionnaire to Assess Medication Adherence in Men and Women with Ischemic Heart Disease: Insights from the GENADHECAR Study Autor : Carbonell Soliva, Álvaro; NOUNI GARCÍA, RAUF; Quesada, Jose A.; González-Llopis, Francisco; Cordero, Alberto; Bertomeu-Gonzalez, Vicente; Orozco-Beltrán, Domingo; Verdú-Soriano, Jose; Nolasco, Andreu; Pérez-Jover, Virtudes; Mira, José Joaquín; López-Pineda, Adriana; Guillén-García, Silvia; Martínez Pérez, Pablo; Carratalá-Munuera, Concepción Resumen : Purpose: The objective of this study was to identify dimensions and items for a future questionnaire aimed at measuring medication nonadherence in people with ischemic heart disease, considering gender differences and incorporating the views of healthcare professionals, researchers, and patients. Patients and methods: We conducted a mixed-method cross-sectional study at San Juan de Alicante University Hospital and Miguel Hernández University (Spain). The methods used to identify dimensions included a consensus group of healthcare and scientific professionals, an open-response survey for community pharmacists, a closed-response patient survey, and patient focus groups. When drafting the item list, we followed international recommendations related to the number and wording of items. Our study also included a qualitative review of the item list and response scales by psychologists. Results: The resulting item list includes 41 potential items grouped into 26 dimensions and five domains: "patient", "treatment", "disease", "health professional-patient relationship" and "healthcare system". It covers aspects such as personal beliefs, mood, polypharmacy, disease symptoms, patient-healthcare professional interaction and healthcare system factors. Response options are presented on a 5-point Likert scale, including agreement-level responses and frequency-level responses. Conclusion: With the collaboration of patients, researchers, and healthcare providers, we potentially identified five domains, 26 dimensions, and 41 items with 5-point Likert scale response options. These will be considered in the subsequent development and validation of a questionnaire to measure medication adherence in patients with ischemic heart disease.