Usually associated with marine mammals, Mycobacterium pinnipedii infection in humans may occur, primarily among animal keepers. We describe a human tuberculosis case caused by M. pinnipedii in a veterinary scientist in Spain, secondary to a contact with an infected sea-lion. Surveillance of zoonotic tuberculosis is critical for informing global control strategies.
ABSTRACT:Accurate genomic stratification is essential for guiding therapeutic decisions in myelofibrosis (MF), particularly regarding allogeneic stem cell transplant. Conventional chromosome banding analysis (CBA), however, has limited resolution and provides an informative karyotype in only about half of patients with MF. In a prospective series of 107 patients with primary or secondary MF, we compared optical genome mapping (OGM) plus targeted next-generation sequencing with CBA. OGM generated interpretable cytogenetic data for every sample, whereas CBA succeeded in fewer than half. In addition, OGM revealed structurally complex alterations and copy-neutral loss of heterozygosity that conventional methods missed. Integration of OGM results into contemporary prognostic models, including DIPSS-plus, GIPSS, and MIPSS70-plus version 2.0 (MIPSS70v2), refined risk allocation across the cohort. The greatest impact was observed for the transplant-oriented MIPSS70v2: the proportion of patients assigned to high-risk or very-high-risk categories increased from 19% with CBA alone to 36% after incorporating OGM findings. Incorporation of OGM data enabled full risk stratification of all 57 individuals with nonevaluable CBA karyotypes; 16 were assigned directly to the high-risk or very high MIPSS70v2 risk categories, a reclassification with immediate implications for transplant referral and follow-up intensity. This study represents the largest prospective evaluation of OGM in MF, demonstrating that OGM overcomes the limitations of CBA, uncovers clinically relevant cryptic alterations, and refines prognostic stratification. These findings support integrating OGM with targeted sequencing as a step toward precision medicine in MF.
OBJECTIVES:To analyze the current situation of Healthcare Ethics Committees (HECs) in Spain, their composition and functions, as well as the implementation of Clinical Ethics Consultancy (CEC). Finally, to assess the involvement of internists in HECs. MATERIALS AND METHODS:A cross-sectional descriptive study conducted through a self-administered online survey distributed between February and May 2025 to all identified HECs in the country. RESULTS:A total of 112 HECs (47.66%) out of the 235 accredited nationwide participated. The average number of members per committee was 16 (range: 6-29). The most represented professional profiles were nursing and medicine. In 99.1% of the committees, at least one member had postgraduate training in Bioethics. The most frequent range of meetings per year was between 7 and 12 (46.8%). Most HECs (91.1%) were involved in educational activities, and 58% had produced ethical documents. The majority reviewed between 1 and 5 cases annually (69.6%). The CEC role was established in 40.2% of HECs and in the process of implementation in 18.8%. Internists were present in 54% of HECs. In 65% of cases, the internist is part of the CEC. CONCLUSIONS:HECs in Spain demonstrate significant involvement in educational activities and the development of ethical documents; however, they receive a relatively low number of annual consultations. Clinical Ethics Consultancy is gradually being integrated into the structure of HECs, which may enhance the management of ethical inquiries. Internists are members of more than half of the HECs and play a very active role in their operations.
BACKGROUND:In patients with transthyretin amyloid cardiomyopathy (ATTR-CM), amyloid can be deposited in the peripheral nerves, causing polyneuropathy (PN). We evaluated the rate of incident PN diagnosis among ATTR-CM patients. METHODS:This study utilized German claims data from January 2016-December 2023. We included adults newly diagnosed with ATTR-CM without a prior history of PN based upon International Classification of Diseases-Tenth Revision-German Modification (ICD-10-GM) diagnosis codes and coding for diagnostic testing. We identified incident PN using both a narrow (ATTR-PN-related) and broad (also including non-ATTR-specific polyneuropathies) set of ICD-10-GM codes. Incidence rates/100 person-years (PYs) with 95% confidence intervals (CIs) were calculated. RESULTS:We identified 309 newly diagnosed patients with ATTR-CM free of PN. During a median follow-up of 430 days (Q1 = 175, Q3 = 936) the rate of broadly defined incident PN was 10.8 cases/100PYs (7.9-14.3), declining to 2.4 cases/100PYs (1.2-4.1) when the narrow ATTR-related PN definition was used. CONCLUSIONS:In German routine care, the incidence of ATTR-related PN in patients with ATTR-CM was 2.4/100PYs, rising to 10.8/100PYs under a broad symptom-based definition. Although ATTR-related PN was infrequently identified in ATTR-CM, PN and ATTR-CM may coincide.
Alcohol consumption among older adults aged ≥ 80 years remains insufficiently characterised, despite increased susceptibility to alcohol-related harm. This study aimed to assess the prevalence of alcohol use and alcohol use disorder (AUD) and to examine associations with in-hospital complications in patients aged ≥ 80 years admitted to Internal Medicine. This multicentre prospective observational study was conducted from June 2022 to July 2023 across 19 hospitals. Consecutive patients aged ≥ 80 years admitted to Internal Medicine were included. Alcohol use was assessed through structured interviews and validated screening instruments, including the Alcohol Use Disorders Identification Test (AUDIT) and the CAGE questionnaire. Data on comorbidities, medication use, functional status, laboratory parameters, and in‐hospital complications were collected. Multivariable logistic regression was performed to identify independent predictors of in-hospital complications. A total of 916 patients (median age 86 years; 54
