García Erce JA, Zalba Marcos S, Cerdán G
… +1 more, Ripollés-Melchor J
Med Clin (Barc)
· 2026 May · PMID 42208139
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INTRODUCTION: Patient Blood Management (PBM) is a comprehensive ethical strategy that improves clinical outcomes, reduces transfusion requirements, and optimizes the use of resources, with proven benefits in terms of eff...INTRODUCTION: Patient Blood Management (PBM) is a comprehensive ethical strategy that improves clinical outcomes, reduces transfusion requirements, and optimizes the use of resources, with proven benefits in terms of efficiency, safety, and healthcare costs. METHODS: We conducted a before-after observational study (2016-2025) from the perspective of the Blood Transfusion Center of the Chartered Community of Navarre. We analyzed trends in blood donation, the annual supply of red blood cell, plasma and platelet concentrates to hospitals, the volume of plasma sent for industrial fractionation, and the yield of plasma-derived medicinal products (albumin, immunoglobulins, factor VIII). Direct economic impact, under a neutral scenario, was estimated by applying the official 2025 tariffs to the number of units "not supplied" compared with 2016; indirect impact was calculated from the difference between contract fractionation costs and ex-factory prices for returned plasma-derived products. RESULTS: With overall donations remaining stable, the supply of red blood cells and therapeutic plasma decreased steadily (by approximately 20-25% and >50%, respectively), with an accumulated reduction of close to 50,000 units supplied. The estimated direct savings exceeded 5.5 million euros over the study period. In parallel, plasma sent for fractionation increased by around 40%, with >40% increases in returned albumin and immunoglobulins, generating additional indirect savings of approximately 6.2 million euros through reduced dependence on commercial products. CONCLUSIONS: The progressive implementation of a regional PBM program, led by the blood transfusion center, is associated with a marked reduction in whole blood donation and in the consumption of blood components, together with an increase in apheresis donation and greater self-sufficiency in plasma-derived medicinal products, resulting in a very substantial direct and indirect economic impact for the healthcare system.
Zamarrón de Lucas E, Crespo Catalán C, Romero Campos B
… +5 more, Sanz Sanjosé B, Longás Ouzzine M, Aponte Guevara CS, Álvarez-Sala Walther R, Prados Sánchez MC
Med Clin (Barc)
· 2026 May · PMID 42202689
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INTRODUCTION: CFTR modulators have significantly changed the prognosis of cystic fibrosis (CF), although data on their long-term clinical and microbiological impact in adults in real-world practice remain limited. OBJECT...INTRODUCTION: CFTR modulators have significantly changed the prognosis of cystic fibrosis (CF), although data on their long-term clinical and microbiological impact in adults in real-world practice remain limited. OBJECTIVE: To analyze the clinical, functional, and microbiological outcomes at 36 months in adults with CF treated with elexacaftor/tezacaftor/ivacaftor (ETI). METHODS: A longitudinal observational study was conducted in adults with CF. Lung function, number of exacerbations, weight, and sputum cultures were assessed at baseline and at 12, 24, and 36 months after initiation of ETI. RESULTS: A total of 55 patients were included (43.6% female; mean age 32±13 years). FEV1 improved at 12 months and remained stable at 36 months. Exacerbations decreased, and weight increased progressively. The proportion of patients with potentially pathogenic microorganisms decreased from 93.1% at baseline to 36.2% at 36 months. Patients without microbiological isolation showed better lung function and fewer exacerbations. CONCLUSIONS: In real-world clinical practice, ETI is associated with improvements in lung function, weight, and exacerbations, as well as a reduction in the isolation of potentially pathogenic microorganisms in sputum at 36 months.
Moreno-Fernandez J, Martínez Montoro JI, Muñoz-Rodriguez JR
… +8 more, Herranz-Antolin S, Marco A, Pines P, Ruiz de Ancos M, González J, Maqueda E, Sastre J, Picón MJ
Med Clin (Barc)
· 2026 May · PMID 42202680
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AIM: Maturity onset diabetes of the young (MODY) is often misdiagnosed as type 1 diabetes (T1D). We proposed using continuous glucose monitoring (CGM) data as an additional tool to select patients in whom the fulfillment...AIM: Maturity onset diabetes of the young (MODY) is often misdiagnosed as type 1 diabetes (T1D). We proposed using continuous glucose monitoring (CGM) data as an additional tool to select patients in whom the fulfillment of classical MODY criteria should be reassessed, who may then be considered for genetic testing. METHOD: A multicentric cross-sectional and prospective study was designed to evaluate the clinical utility of CGM in the diagnosis of MODY among adult patients initially diagnosed as T1D with active CGM data. Pre-specified CGM criteria included: glucose management indicator <7%, time in range (70-180mg/dL [3.9-10.0mmol/L]) >70% and coefficient of variation <36%. Those meeting these requirements were assessed for classical clinical criteria and subsequently genetic testing. RESULTS: A total of 503 subjects with T1D out of 5571 fulfilled the pre-established glycometric requirements. After reviewing their medical records, 42 of them met the classic clinical criteria for MODY and genetic testing was performed in 34 patients. Finally, we found 5 new cases of MODY (3 patients with HNF1A-MODY3, 1 patient with HNF1B-MODY5 and 1 patient with ABCC8-MODY12) and detected 3 patients with heterozygous mutations associated with the development of diabetes. CONCLUSION: CGM added to classic clinical criteria for MODY may constitute an effective and easily implemented approach in routine clinical practice to identify patients with MODY who have been misdiagnosed as having T1D.
Grau García E, Leal Rodríguez S, Gómez-Lechón Quirós L
… +1 more, Román Ivorra JA
Med Clin (Barc)
· 2026 May · PMID 42202678
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OBJECTIVE: To investigate the association between serum TLR7 and TLR9 levels and previous viral infections, disease activity, and proinflammatory cytokine levels in SLE patients. METHODS: A cross-sectional observational...OBJECTIVE: To investigate the association between serum TLR7 and TLR9 levels and previous viral infections, disease activity, and proinflammatory cytokine levels in SLE patients. METHODS: A cross-sectional observational study was conducted in patients with SLE and healthy controls. Data on previous infections, disease activity, and clinical parameters were collected. Serum TLR7, TLR9, interleukin-10 (IL-10), and interferon-α (IFN-α) levels were measured by ELISA. RESULTS: TLR9 levels were significantly higher in SLE patients than in controls (P<0.001). TLR7 levels did not differ between groups but showed a positive association with age (P<0.001). No associations were found between TLR7 or TLR9 levels and CRP, ESR, anti-dsDNA, ENAs, antiphospholipid antibodies, disease activity, previous infections, or disease duration. Lower TLR7 levels were observed in patients with antiphospholipid syndrome (P=0.001). Elevated TLR9 levels were significantly associated with increased IL-10 and IFN-α (P<0.001). TLR7 was not associated with IFN-α, although a trend toward higher levels was observed with elevated IL-10. CONCLUSION: TLR9 is elevated in SLE and correlates with IL-10 and IFN-α, while TLR7 increases with age. .
Med Clin (Barc)
· 2026 May · PMID 42156199
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Artificial intelligence in healthcare represents a conceptual and cultural revolution. AI is transforming evidence-based medicine into data-driven medicine, enabling personalized and real-time clinical decisions. However...Artificial intelligence in healthcare represents a conceptual and cultural revolution. AI is transforming evidence-based medicine into data-driven medicine, enabling personalized and real-time clinical decisions. However, this progress requires prudence and ethical commitment, since healthcare is a complex domain due to the sensitivity of data and the need to safeguard patients' privacy, autonomy, and dignity. In addition, technical, ethical, and organizational challenges arise when implementing AI in healthcare systems. Robust infrastructures, professional training, and collaborative governance are needed to ensure equity and sustainability. Responsibility in the use of AI in healthcare must be shared among professionals, academic institutions, industry, public administration and obviously, the patients. Medical leadership is essential to guide technological development, and ensure that innovation benefits patients and society. The future of AI in healthcare depends on the ethical and social commitment, turning technology into an opportunity to strengthen healthcare system.