Articles publicats (Medicina i Cirurgia)

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    Open Access
    Validation of the virtual reality functional capacity assessment tool (VRFCAT) in a Spanish sample of individuals with psychosis and healthy controls
    (Cambridge University Press, 2025-11-17) González-Blanch, César; López-Carrilero, Raquel; Bobes-Bascarán, Teresa; Catalán, Ana; Aymerich, Claudia; Rodriguez-Jimenez, Roberto; Gutiérrez-Zotes, Alfonso; Díaz-Mandado, Olimpia; González-Pinto, Ana; Cano-Escalera, Guillermo; Zubia, Marta; Guinart, Daniel; Del-Castillo-Serrano, Manuel; Vilella, Elisabet; García-Álvarez, Leticia; Ochoa, Susana; Correa-Ghisays, Patricia; Balanzá-Martínez, Vicent; Sánchez-Ortí, Joan Vicent; Pousa, Esther; Miret, Salvador; Falip, Cristina; Reguera-Pozuelo, Pablo; Fernández-Martínez, Rafael; García-Cabeza, Ignacio; Campos-Rodriguez, Carlos; Crosas, Josep Maria; Cobo, Jesus; Pardina-Torner, Helena; Perona-Garcelán, Salvador; Muñoz-Caracuel, Manuel; Yorca-Ruiz, Ángel; Ortiz-García de la Foz, Víctor; Ayesa-Arriola, Rosa
    Background The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is a performance-based measure developed to assess functional capacity through simulations of daily activities. This study examined its psychometric properties in a Spanish sample, including individuals with first-episode psychosis (FEP), schizophrenia, and healthy controls. Methods A total of 370 participants (99 FEP, 116 schizophrenia, and 155 controls) completed the VRFCAT in a multicenter study. Internal consistency (McDonald’s omega), discriminative validity (group comparisons and ROC curves), and convergent validity via correlations with cognitive performance and clinical symptoms were examined. Reference percentiles were calculated from the healthy control sample using quantile regression, stratified by age and education. Results Item-level VRFCAT completion times showed acceptable to good internal consistency overall and in controls and schizophrenia samples, but poor in FEP. Differences in VRFCAT performance emerged (χ2 = 108.88, p < .001), with controls performing best, schizophrenia worst, and FEP in between. ROC analyses indicated good discriminative accuracy in distinguishing patients from controls (area under the curve [AUC] = 0.779, sensitivity = 80.0%, specificity = 64.2%); but limited discrimination between schizophrenia and FEP. Age and education, but not sex, significantly affected performance. VRFCAT showed small-to-moderate correlations with cognitive performance, and no significant associations with symptom severity. Conclusions The VRFCAT is a reliable and valid tool for assessing functional capacity in Spanish-speaking individuals with psychotic disorders. Its ecological validity, objectivity, psychometric properties, brief administration time, and ease of use support its potential use in clinical and research settings for evaluating functional recovery and treatment outcomes.
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    Open Access
    Economic burden of eosinophilic esophagitis in the first year after diagnosis in Spain: A direct medical cost analysis
    (Springer Nature, 2025-11-17) Rodriguez Alcolado, Leticia; Aranda Reneo, Isaac; Casabona, Sergio; Pérez Martínez, Isabel; Guagnozzi, Danila; Gutiérrez Junquera, Carolina; Amorena, Edurne; Guardiola Arévalo, Antonio; de la Peña Negro, Luisa; Jhon, Leonardo Blas; López García Dionisio, Sandra; Fernández Pacheco, Jennifer; Barrio, Jesús; Fernández Fernández, Sonia; Betoré, Elena; de la Riva, Susana; Teruel Sánchez-Vegazo, Carlos; Rodríguez Oballe, Juan Armando; Naves, Juan Enrique; Bisso Zein, Juan; Carrión, Silvia; Suárez, Adolfo; Llerena Castro, Ronald; García Díaz, Alejandro; Nantes Castillejo, Óscar; Granja Navacerrada, Alicia; Perelló, Antonia; Álvarez García, Marta; Santander, Cecilio; Laserna Mendieta, Emilio; Oliva Moreno, Juan; Lucendo, Alfredo
    Background: Despite its increasing prevalence, the economic impact of eosinophilic esophagitis (EoE) in Europe is understudied and direct economic costs remain unknown. Objective: To assess contemporaneous direct medical costs during the first year after EoE diagnosis in Spain to identify key cost determinants and assess variables that could affect these costs. Methods: Observational study of Spanish participants in the EUREOS EoE CONNECT registry with incident EoE in 2017-2018. We assessed average costs/year in Euros for endoscopic procedures, out-patient visits, medication, emergency room visits and hospitalizations, 2018 being our base year. Official regional tariffs were used to estimate direct costs from a healthcare provider perspective; official price lists were used for drug therapies. Cost differences and determinants were assessed with multivariate models. Results: The mean annual direct cost of EoE per person among 302 patients (76.5% male, 77.5% adults) was €1,842.07 (SD €795.69). Endoscopic procedures accounted for 68% of this, followed by outpatient visits (15.9%) and drug prescriptions (10.8%). Cost was higher for pediatric compared to adult patients (€2,101.51 vs. €1,784.29, p < 0.01), for those with higher EREFS score (€1,979.36 vs. €1,794.49; p < 0.01), and in high-volume hospitals (€1,941.48 vs. €1,723.92; p = 0.02). Early response to first-line treatment reduced annual costs by -€368.95 (p < 0.01), by avoiding further medical procedures. Conclusion: First year after EoE diagnosis produces significant direct costs in Spain, mainly due to endoscopic procedures, which are reduced in early responders to first-line therapy. Research for non-invasive methods for EoE assessment and identifying predictors of response are, therefore, key.
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    Combining Airway Clearance Techniques and Inhaled Antibiotics in Chronic Bronchial Infection: Real-World Evidence of Exacerbation Reduction (INBREATHING Study)
    (Elsevier, 2025-11) Monge, Aida; Martínez De Las Fuentes, Ane; Burgos, Javier; Pou, Cristina; Lakhani, Joel Suresh; Navarro, Annie; Castañon, Rosa Abril; García Urrestarazu, Eduardo; Sayés, Alicia; Alcaide, Ana Belén; Erro, Marta; Moreno, Beatriz Raboso; Sánchez Cucó, Anna; Santisteve, Sally; Benítez, Iván; Moncusí Moix, Anna; Gracia Lavedan, Esther; Manzano, Carlos; Morales, Arturo; Barbé Illa, Ferrán; Suarez Cuartín, Guillermo; de la Rosa Carrillo, David; de Torres, Juan; González Gutiérrez, Jessica
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    Have We Improved Pain Control in Cancer Patients? A Multicenter Study of Ambulatory and Hospitalized Cancer Patients
    (Mary Ann Liebert, Inc., 2015) Porta Sales, Josep; Nabal Vicuña, Maria; Vallano, Antonio; Espinosa, Jose; Planas Domingo, Josep; Verger Fransoy, Eugènia; Julià Torras, Joaquim; Serna, Judith; Pascual López, Antonio; Rodríguez, Dulce; Grimau, Isidre; Morlans, Germà; Sala Rovira, Carme; Calsina Berna, Agnes; Borras Andrés, Josep; Gomez Batiste, Xavier
    Background: Pain in cancer patients is recognised as a major health problem yet few studies of both inpatient and outpatient populations have been carried out. Objective: To assess the frequency, type, and characteristics of pain in adult cancer patients, including both inpatients and outpatients. Design and setting: Cross-sectional study of 1,064 adult cancer patients (437 outpatients and 627 inpatients) from 44 hospitals and/or long-term-care centres in Catalonia, Spain. Cancer patients suffering from pain of any aetiology for ≥ 2 weeks and/or under analgesic treatment ≥ 2 weeks were enrolled. Measurements: Demographic and pain data were collected. The Spanish version of the Brief Pain Inventory was used to assess pain. Results: Pain frequency was 55.3%.Pain was less frequent in outpatients than inpatients (41.6% vs. 64.7%; p < 0.001), although median pain duration was longer in outpatients (20 vs. 6 weeks; p < 0.001). Pain was assessable in 333 patients, and intensity was similar in both out- and in-patients ; however, outpatients reported less improvement, less pain interference with daily life, and less pain related to the cancer per se. In both groups, patients with multiple myeloma (73%), breast (65%), and lung cancer (61%) were most likely to report pain. Conclusions: Pain in cancer patients, both ambulatory and hospitalised, remains a challenge for health-care professionals, health administrators, and stakeholders. Our study reveals the high level of pain and distress that cancer patients continue to suffer, aproblem that is particularly notable in outpatients due to the intensity and duration of the pain.
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    Outcomes and predictors of mortality in patients with severe COVID-19 and COPD admitted to ICU: A multicenter study
    (Elsevier, 2025-09) Fernández Barat, Laia; Motos, Ana; Canseco Ribas, Joan; Gabarrús, Albert; López Aladid, Ruben; Alvaro Meca, Alejandro; Ceccato, Adrián; García, Nadia; Ferrer, Miquel; Battaglini, Denise; Ávarez Napagao, Sergio; García Gasulla, Dario; Ferrer, Ricard; de Gonzalo Calvo, David; Lorente, José Ángel; Menéndez, Rosario; Peñuelas, Oscar; Riera, Jordi; Rodríguez, Alejandro; Amaya Villar, Rosario; Añón, José; Balan Mariño, Ana; Barberà, Carme; Barberán, José; Blandino Ortiz, Aaron; Boado, Maria Victoria; Bofill, Neus; Bustamante Munguira, Elena; Caballero, Jesús; Cantón Bulnes, María Luisa; Carbajales Pérez, Cristina; Carbonell, Nieves; Catalán González, Mercedes; Del Carmen de la Torre, Maria; Díaz, Emili; Estella, Ángel; Figueras, Albert; de Frutos, Raul; Franco, Nieves; Galbán, Cristóbal; Gallego, Elena; García Garmendia, José Luis; González Gutiérrez, Jessica; Gómez, José; Gumucio Sanguino, Víctor; Huerta, Arturo; Jorge García, Ruth Noemí; Loza Vázquez, Ana; Marin Corral, Judith; Martin Delgado, María Cruz; Martínez de la Gándara, Amalia; Martínez Varela, Ignacio; Albaiceta, Guillermo; Nieto, Maite; Peñasco, Yhivian; Pérez Bastida, Leire; Pérez García, Felipe; Pozo Laderas, Juan Carlos; Ricart, Pilar; Sagredo, Víctor; Sánchez Miralles, Ángel; Sancho Chinesta, Susana; Socias, Lorenzo; Solé Violan, Jordi; Suarez Sipmann, Fernando; Tamayo Lomas, Luis; Trenado, José; Úbeda, Alejandro; Jorge Valdivia, Luis; Vidal, Pablo; Bermejo Martin, Jesús; Barbé Illa, Ferran; Torres, Antoni
    Background High mortality rates among patients with chronic obstructive pulmonary disease (COPD) admitted to intensive care units (ICUs) during the COVID-19 pandemic highlight the need for tailored clinical management strategies. Study Design and Methods Epidemiological, clinical, and laboratory data were collected in REDCap for 6512 patients hospitalized with COVID-19 across 55 Spanish ICUs. Patients were stratified into three groups: those with COPD, those with other chronic respiratory diseases (CRD), and those without respiratory comorbidities (No CRD). The primary outcome was to determine clinical predictors for 90-day mortality, focusing on the COPD group. A propensity score matching (PSM) method was applied to analyze the effects of respiratory support, biomarkers, and immunomarkers. Results Patients with COPD (n = 328) exhibited a 50% mortality rate compared to 33% of those with other chronic respiratory diseases (CRD, n = 547), and those without respiratory comorbidities (No CRD, n = 5124). Among COPD patients, 95% of whom had Acute Respiratory Distress Syndrome (ARDS) due to COVID-19, the use of a high-flow nasal cannula (HFNC) was associated with reduced 90-day mortality (hazard ratio: 0.54 (95% Confidence Interval [0.31–0.95]). At a molecular scale, lower IgG levels but higher viral load and TNF-alpha, Vascular Cell Adhesion Molecule-1 (VCAM-1), and Fas Cell Surface Death Receptor (Fas) were associated with mortality in the COPD group. Conclusions In COPD patients with ARDS due to COVID-19, the use of HFNC was associated with a better prognosis. The dysregulation in biomarkers and immunomarkers in COPD patients and its association with mortality highlight the need for further targeted therapeutic strategies.