BackgroundLong COVID-19 is a medical condition associated with persistent physical, cognitive, and emotional symptoms. Despite its significant impact, there are still few psychological interventions-especially with transdiagnostic approaches- that have been rigorously tested in this population. The aim of the present protocol is to describe a randomized controlled trial to examine the effectiveness and acceptability of the online, group-delivered Unified Protocol (UP) for improving emotional, and cognitive outcomes in adults with long COVID-19. We expect greater improvements in emotional and cognitive outcomes for the UP group compared to controls. Additionally, exploratory analyses will assess changes in neurocognitive performance and hair cortisol/cortisone levels as potential correlates of treatment response.Methods90 individuals diagnosed with long COVID-19 will be randomized to an experimental group or a waiting-list control group (1:1 ratio). Participants in the experimental group will receive the UP across 12 online group sessions. Longitudinal assessments (pre-treatment, post-treatment and 3, 6 and 12 months follow-ups) will include psychological (e.g., anxiety and depressive symptoms) and cognitive outcomes (e.g., memory failures). Participants in the experimental group will also complete neuropsychological tests and will provide hair samples for the assessment of cortisol/cortisone levels.Data analysesBaseline characteristics will be described using descriptive statistics, and linear mixed-effects models will evaluate the effects of time, group, and their interaction on psychological and cognitive outcomes. Neuropsychological performance and hair cortisol levels will be analyzed over time in the experimental group. Associations between cortisol and psychological or cognitive measures will be explored through correlational analyses.ConclusionsWe expect positive outcomes after the intervention in acceptability and in emotional symptoms and cognitive complaints in individuals living with long COVID-19, the maintenance of the benefits in all follow-ups, and statistically significant changes in favor of the UP condition in comparison with the waiting-list control group. If effective, the UP could provide an accessible and evidence-based psychological treatment for this population, improving the quality of healthcare to individuals with long COVID-19.Trial registrationclinicatrials.gov (registration identifier: NCT06928480; May 22, 2025).
BACKGROUND AND AIMS:Post-operative recurrence (POR) of colonic Crohn's Disease (CD) after segmental (SC) or subtotal colectomy (STC) is scarcely described. Therefore, we aimed to report the rates and predictors of POR in this setting. METHODS:Multicentre, nationwide, retrospective study including colonic CD patients undergoing SC or STC. Clinical, endoscopic, radiologic and surgical POR were assessed and POR-free survival was compared between procedures. Cox regression determined predictors of post-colectomy POR. Inverse probability of treatment weighting (IPTW) was carried out for sensitivity analyses. RESULTS:A total of 224 patients were included (157 SC, 67 STC). Clinical POR occurred less frequently after SC than after STC (38% vs 63%, p = 0.001), as did endoscopic POR (50% vs 71%, p = 0.012); whereas radiologic and surgical POR rates were similar (p = 0.1 and p = 0.992, respectively). Clinical POR-free survival at 1 and 5 years was higher after SC than after STC (82% and 64.8% vs 67.6% and 39%, log-rank p = 0.001). Endoscopic POR-free survival followed a similar pattern (log-rank p < 0.001). In multivariable Cox regression, SC remained protective against clinical (HR 0.54 [0.36-0.81]) and early endoscopic POR (HR 0.54 [0.35-0.82]). After IPTW, SC was still associated with a significantly lower risk of clinical and endoscopic POR. CONCLUSION:Clinical and endoscopic POR rates are significantly lower following SC compared with STC in colonic CD, while radiologic and surgical recurrence rates were similar. SC shows a protective effect regarding clinical and early endoscopic POR. These data support segmental resection of colonic CD when feasible.
La enfermedad de Still del adulto (ESA) es una entidad autoinflamatoria sistémica infrecuente. Presentamosel caso de un varón de 30 años que debutó con miopericarditis aguda con disfunción biventricular graveacompañada de elevación generalizada de marcadores proinflamatorios, hiperferritinemia extrema y rashcutáneo atípico. Tras descartar etiología infecciosa y autoinmune, se le diagnosticó de un brote de ESA, iniciándose tratamiento con corticoides e inmunomoduladores, con pronta mejoría. Este caso impresiona por el debut de la enfermedad, dada la rareza de la afectación miocárdica como manifestación inicial y refuerza la importancia de una correcta interpretación de los marcadores inflamatorios dentro del contexto clínicoy evolutivo.
