Hospital General de Granollers - HG

Similarities and differences between systemic juvenile idiopathic arthritis and adult-onset Still's disease: a multicenter Spanish study

Wed, 15 Apr 2026 08:41:12 GMT

Similarities and differences between systemic juvenile idiopathic arthritis and adult-onset Still's disease: a multicenter Spanish study Mosquera Angarita, Juan Manuel; Iglesias , Estíbaliz; Zacarias Crovato, Andrea; Olivé, Alejandro; ORTIZ-SANTAMARIA, VERA; Anton, Jordi; Calzada-Hernández, Joan Adult-onset still’s disease; Epidemiology; Juvenile arthritis;; Enfermedad de Still de inicio en la edad adulta; Epidemiología; Artritis juvenil; Malaltia de Still d'aparició en adults; Epidemiologia; Artritis juvenil; To describe the characteristics of systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still's disease (AOSD), compare their presentation and evolution, and analyse possible complication predictors. Multicenter study. Data were retrieved from a hospital-based study of patients with a diagnosis or suspected diagnosis of sJIA or AOSD according to the responsible physician and followed-up for at least one year. Descriptive variables (classification criteria, clinical manifestations, complications, family, and personal history) were collected at disease onset and during follow-up. We present the clinical characteristics of 326 patients, 67% of whom had a diagnosis of sJIA and 33% of AOSD. Clinical manifestation frequencies were similar between the two groups, except for odynophagia, which was significantly more frequent in AOSD than in sJIA (78.4% vs. 25.5%; p < 0.0001). Among the complications, macrophage activation syndrome (MAS) was significantly more common in sJIA than in AOSD (24.4% vs. 9.5%; p = 0.002), to the extent that an sJIA diagnosis significantly increased the risk of MAS, together with serositis presence, and the need for biological therapy. Patients with sJIA and AOSD showed similar characteristics, supporting the idea that they are both part of Still's disease, but are expressed at different ages. Differences in manifestations and complications might be due to different management between diseases and immune response maturity.

The FLARE Score and Circulating Neutrophils in Patients with Cancer and COVID-19 Disease

Wed, 15 Apr 2026 09:04:27 GMT

The FLARE Score and Circulating Neutrophils in Patients with Cancer and COVID-19 Disease Torres Canizales, Juan; Casadevall, David; Peiro Carmona, Sara; Urbano, Cristina; Seguí, Elia; Auclin, Edouard; Aguilar-Company, Juan COVID-19; Neoplasms; Neutrophils; COVID-19; Neoplàsies; Neutròfils; COVID-19; Neoplasias; Neutrófilos; Purpose: Inflammation and neutrophils play a central role in both COVID-19 disease and cancer. We aimed to assess the impact of pre-existing tumor-related inflammation on COVID-19 outcomes in patients with cancer and to elucidate the role of circulating neutrophil subpopulations. Methods: We conducted a multicenter retrospective analysis of 524 patients with cancer and SARS-CoV-2 infection, assessing the relationship between clinical outcomes and circulating inflammatory biomarkers collected before and during COVID-19 infection. Additionally, a single-center prospective cohort study provided data for an exploratory analysis, assessing the immunophenotype of circulating neutrophils and inflammatory cytokines. The primary endpoints were 30-day mortality and the severity of COVID-19 disease. Results: Prior to COVID-19, 25% of patients with cancer exhibited elevated dNLR, which increased to 55% at the time of COVID-19 diagnosis. We developed the FLARE score, incorporating both tumor- and infection-induced inflammation, which categorized patients into four prognostic groups. The poor prognostic group had a 30-day mortality rate of 68%, significantly higher than the 23% in the favorable group (p < 0.0001). This score proved to be an independent predictor of early mortality. This prospective analysis revealed a shift towards immature forms of neutrophils and higher IL-6 levels in patients with cancer and severe COVID-19 infection. Conclusions: A pre-existing tumor-induced pro-inflammatory state significantly impacts COVID-19 outcomes in patients with cancer. The FLARE score, derived from circulating inflammatory markers, emerges as an easy-to-use, globally accessible, effective tool for clinicians to identify patients with cancer at heightened risk of severe COVID-19 complications and early mortality who might benefit most from immediate and intensive treatment strategies. Furthermore, our findings underscore the significance of immature neutrophils in the progression of COVID-19 in patients with cancer, advocating for further investigation into how these cells contribute to both cancer and COVID-19 disease.

Real-World Experience of Imipenem-Relebactam Treatment as Salvage Therapy in Difficult-to-Treat Pseudomonas aeruginosa Infections (IMRECOR Study)

Wed, 15 Apr 2026 08:30:09 GMT

Real-World Experience of Imipenem-Relebactam Treatment as Salvage Therapy in Difficult-to-Treat Pseudomonas aeruginosa Infections (IMRECOR Study) MACHUCA, ISABEL; Dominguez, Arantxa; Amaya, Rosario; Arjona-Torres, Cristina; Gracia-Ahufinger, Irene; Carralon, Maravillas; Iglesias, Rayden Pseudomonas aeruginosa; Imipenem; Relebactam; Pseudomonas aeruginosa; Imipenem; Relebactam; Pseudomones aeruginosa; Imipenem; Relebactam; Introduction: Difficult-to-treat-resistant (DTR) infections caused by Pseudomonas aeruginosa represent a global public health threat, prioritizing the search and development of new antibiotics for this microorganism. Methods: We present the real-life experience of the compassionate use of imipenem/cilastatin/relebactam in a descriptive study involving 14 patients with DTR-P. aeruginosa infection and limited treatment options. Results: The primary source of infection was skin and soft tissue infection, 57.1% (8/14), followed by respiratory infection-pneumonia, 28.6% (4/14). At the onset of infection, 71.4% (10/14) of patients were in the intensive care unit (ICU). All our patients had a Charlson Score of ≥ 3. Septic shock was observed in 64.3% (9/14) of patients. The median treatment duration was 15 days, and no patient experienced an adverse event that required treatment interruption. All-cause 30-day mortality was observed in 42.9% of cases (6/14), while clinical efficacy and microbiological success were observed in 64.3% (9/14). Conclusions: Imipenem/cilastatin/relebactam may represent a treatment option for patients with DTR-P. aeruginosa infections, which should be validated in prospective clinical trials.

Resumen ejecutivo de las Guías Españolas de Diagnóstico y Manejo de Enfermedades Febriles Importadas de la Sociedad Española de Medicina Tropical y Salud Internacional (SEMTSI)l, el Grupo de Patoogía Importada de la Sociedad Española de Enfermedades Infecciosas y microbiología clínica (GEPI-SEIMC), la Sociedad Española de Medicina de Familia y Comunitaria (SEMFYC), la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) y la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES)

Wed, 15 Apr 2026 09:04:24 GMT

Resumen ejecutivo de las Guías Españolas de Diagnóstico y Manejo de Enfermedades Febriles Importadas de la Sociedad Española de Medicina Tropical y Salud Internacional (SEMTSI)l, el Grupo de Patoogía Importada de la Sociedad Española de Enfermedades Infecciosas y microbiología clínica (GEPI-SEIMC), la Sociedad Española de Medicina de Familia y Comunitaria (SEMFYC), la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) y la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES); Executive Summary of the Spanish Guidelines for the Diagnosis and Management of Imported Febrile Illnesses from the Spanish Society of Tropical Medicine and International Health (SEMTSI), the Imported Pathology Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEPI-SEIMC), the Spanish Society of Family and Community Medicine (SEMFYC), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Emergency Medicine (SEMES) Camprubí, Daniel; Azkune Galparsoro, Harkaitz; Belhassen-Garcia, Moncef; Cuadros-González, Juan; Diaz Menendez, Marta; Crespillo-Andújar, Clara; Alegria Coll, Iñaki Imported febrile illnesses; Arbovirus; Travel medicine; Enfermedades febriles importadas; Arbovirus; Medicina del viajero; Malalties febrils importades; Arbovirus; Medicina del viatger; The Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Emergency Medicine (SEMES), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Family and Community Medicine (SEMFYC) have prepared a consensus statement on the diagnosis and management of patients with imported febrile illnesses. Twenty authors with different backgrounds and representing different healthcare perspectives (ambulatory primary care, travel and tropical medicine specialists, emergency medicine, hospital care, microbiology and parasitology and public health), identified 39 relevant questions, which were organised in 7 thematic blocks. After a systematic review of the literature and a thoughtful discussion, the authors prepared 125 recommendations, as well as several tables and figures to be used as a consulting tool. The present executive summary shows a selection of some of the most relevant questions and recommendations included in the guidelines.; La Sociedad Española de Medicina Tropical y Salud Internacional (SEMTSI), la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES), la Sociedad Española de Médicos de Atención Primaria (SEMERGEN) y la Sociedad Española de Medicina Familiar y Comunitaria (SEMFYC) han elaborado un documento de consenso sobre el diagnóstico y manejo de pacientes con enfermedades febriles importadas. Veinte autores que representaban diferentes perspectivas de la atención médica (atención primaria ambulatoria, especialistas en medicina tropical y del viajero, urgencias, atención hospitalaria, microbiología y parasitología y salud pública), identificaron 39 preguntas clínicamente relevantes, que se organizaron en 7 bloques temáticos. Tras una revisión sistemática de la literatura, los autores elaboraron 125 recomendaciones, así como varias tablas e imágenes para ser utilizadas como herramientas de consulta. Este resumen ejecutivo muestra una selección de las preguntas y recomendaciones más relevantes incluidas en las presentes guías.