The Hospital Universitario Insular de Gran Canaria (Insular University Hospital of Gran Canaria) is a teaching hospital of general scope in Gran Canaria (Canary Islands, Spain). Located in the city of Las Palmas de Gran Canaria, it was founded 13 February 1971 and consists in Februar 2021 of 503 beds. The first patient was hospitalized 20 September 1971.The hospital is managed by the Canarian Government via the Servicio Canario de Salud (Canary Health Service) and is geared to health care in the south and east of Gran Canaria (Telde, Valsequillo, Ingenio, Agüimes, Santa Lucía de Tirajana, San Bartolomé de Tirajana, Mogán and the south of Las Palmas de Gran Canaria). It is also the referral hospital of Fuerteventura and a referral hospital in some specialities of the Canary Islands.
BACKGROUND:Although mechanical thrombectomy (MT) is an effective treatment for large vessel occlusion (LVO) with a high successful recanalization rate, MT failure (MTF) occurs in 10-15% of cases and is associated with unfavorable outcomes. However, little is known about the clinical, technical, and radiological reasons for MTF. We investigated the technical factors associated with MTF. METHODS:We conducted a retrospective analysis of consecutive patients with anterior LVO prospectively included in the ongoing observational multicenter ROSSETTI registry. Patients were categorized according to the success (≥mTICI 2b) or failure (<mTICI 2b) of the MT procedure. Baseline clinical and demographic characteristics, endovascular MT techniques, and angiographic and clinical outcomes were compared. Multivariate analysis for prediction of MTF was performed. RESULTS:We analyzed 4135 patients, including 325 patients (7.9%) with MTF. Patients in the MTF group had a significantly lower Alberta Stroke Program Early CT Score (ASPECTS) at baseline (8 (7-10) vs 9 (8-10)), longer time since last time seen well (279 min vs 262 min), increased MT procedure time (76 min vs 31 min), higher rate of complications (23% vs 4%), higher symptomatic intracerebral hemorrhage (21% vs 7.9%), higher 24 hour National Institutes of Health Stroke Scale score (19 vs 6), worse functional outcome at 3 months (modified Rankin Scale score 0-2, 15.6% vs 53%), and higher mortality (45% vs 20%). Four or more passes were an independent predictor of MTF (OR 3.46, 95% CI 2.58 to 4.63; P<0.001). None of the endovascular techniques demonstrated a higher likelihood of MTF. CONCLUSION:In this study, MTF in anterior circulation LVO was associated with a high complication rate and worse outcomes.
Objective To evaluate the efficacy, safety and predictive factors of belimumab (BEL)-based triple therapy in proliferative lupus nephritis (LN) in real-world settings.Methods We conducted a multicentre, retrospective study including patients with proliferative LN (new-onset or relapsing) who initiated BEL within 6 months of a renal flare, in combination with standard-of-care.Results 49 patients were included (mean age 37 years; 85.7% female; 67.3% Caucasian). The median time from renal flare to BEL initiation was 1 month (IQR 0–3). By 12 months, 67.3% achieved complete renal response (CRR), 75.5% primary efficacy renal response (PERR) and 83.7% at least partial renal response. Median proteinuria declined from 2.7 g/day to 0.49 g/day, with parallel improvement in estimated glomerular filtration rate (71 to 78 mL/min/1.73 m²). Patients with baseline proteinuria <3 g/day achieved significantly higher CRR (78.1% vs 47.1%; p=0.027) and PERR (84.4% vs 58.8%; p=0.048) rates.The mean glucocorticoid (GC) dose decreased from 31.7 mg/day at baseline to 3.5 mg/day at 12 months, and 26.1% of patients achieved complete GC withdrawal. Extrarenal disease activity was present in 81.6% of patients at baseline, predominantly articular and mucocutaneous, with clinically meaningful improvement in 80% during follow-up. At 12 months, 40.8% met remission by Definition Of Remission In Systemic Lupus Erythematosus (DORIS) criteria and 46.9% attained Lupus Low Disease Activity State (LLDAS). Renal treatment failure occurred in 16.3% and renal relapse in 4.1%. Adverse events were mild, and no serious BEL-related events were observed.Conclusion BEL-based triple therapy is effective and safe in proliferative LN, achieving high renal and extrarenal response rates, substantial GC-sparing and treat-to-target outcomes in real-world practice.
BACKGROUND:Larotrectinib is a first-in-class, selective tropomyosin receptor kinase (TRK) inhibitor with proven activity across solid tumors. This study aimed to describe larotrectinib's effectiveness in patients with solid tumors in Spain. METHODS:SPAINTRK (NCT06837090) was a retrospective study including adult and pediatric patients with solid neoplasms treated with larotrectinib through compassionate use, between European Medicines Agency (EMA) approval and commercialization in Spain. TRK fusions were determined as part of standard care using next-generation sequencing (NGS), fluorescence in situ hybridization, or immunohistochemistry plus a confirmatory molecular test. The primary endpoint was duration of response (DoR). No formal sample size was calculated. RESULTS:From February to June 2025, 20 patients aged ten months to 81 years were included. Eight solid tumor types with TRK fusions were included involving NTRK1 gene in 8 patients (40 %), NTRK2 in 5 (25 %), and NTRK3 in 7 (35 %). NGS was used in 65 %. Median DoR was 24.5 months (95 % CI: 11.1- not reached) and objective response rate was 60 % (95 % CI: 36.1-80.9). At one year, 75 % of responses (9 out of 12) were ongoing, and 12 patients (60 %) remained progression-free. At data cutoff (median follow-up of 24.4 months (95 % CI: 13.2-35)), 41.7 % of the patients with a response were disease-free and/or remained on treatment. Treatment-related neutropenia and transaminitis were reported in 15 % of patients each. CONCLUSIONS:Larotrectinib evoked broad and durable antitumor activity in a plethora of solid tumors with NTRK fusions. Safety profile was consistent with that of clinical trials, even after long-term administration. While NGS use is increasing, broader access is needed.
Endothelial progenitor cells contribute to neurovascular repair after stroke. This study evaluated their temporal dynamics, prognostic value, and association with neuroimaging markers in stroke patients. We conducted a prospective cohort of 114 patients with ischemic strokes admitted to Hospital Universitario de Gran Canaria Doctor Negrín (Spain) between September 2023 and June 2024. EPC counts were measured at 48 h, 7 days, and 3 months and correlated with 3-month functional outcome (modified Rankin Scale, mRS). Neuroimaging included non-contrast CT (ASPECTS, established infarction) and, in a subgroup (n = 8), perfusion CT (ischemic core, hypoperfusion, Tmax > 10s, and related indices). The primary objective was to evaluate the association between EPC levels at 7 days and functional outcome at 3 months. Secondary objectives included characterization of EPC temporal dynamics and their association with neuroimaging markers, including non-contrast CT and exploratory CT perfusion parameters. EPC levels exhibited a non-linear temporal trajectory over time (ANOVA quadratic trend, p = 0.011; linear mixed model [LMM], p < 0.001), with LMM showing exploratory stroke subtype–specific dynamics (p = 0.006). Pairwise Wilcoxon analyses showed a significant decrease in EPC counts from 48 h to 7 days (p = 0.018), with no statistically significant differences between 7 days and 3 months or between 48 h and 3 months. EPC levels at 7 days demonstrated a modest but statistically significant discriminative ability for 3-month functional outcome (AUC = 0.623, p = 0.036). EPC counts were not associated with ASPECTS or established infarction. In exploratory perfusion analyses, EPC levels at 7 days were significantly correlated with absolute perfusion volumes, including ischemic core, hypoperfusion volume, and tissue with Tmax > 10 s, whereas relative perfusion indices showed no significant associations. EPC counts display a non-linear temporal evolution after ischemic stroke and show a modest association with functional outcome at 3 months. EPC mobilization appears more closely related to the absolute burden of ischemic injury than to relative perfusion indices. Although limited as standalone biomarkers, EPC measurements may contribute to multimodal prognostic assessment when integrated with clinical and imaging data.
BACKGROUND:Dyshidrotic eczema (DE), also termed acute and recurrent vesicular dermatitis, is a vesicular clinical pattern of hand eczema (HE) with heterogeneous aetiologies. OBJECTIVES:To characterise the clinical-allergological profile of patients with DE and to compare it with non-DE HE subtypes. METHODS:A multicentre, retrospective, observational study was conducted using data from the Spanish Contact Dermatitis Registry (2019-2024). RESULTS:Of 4378 patients with HE, 559 were diagnosed with DE. A longer median disease duration (24 vs. 14 months) and more frequent palmoplantar involvement (16% vs. 7%) were observed in DE compared with non-DE HE. At least one positive patch test was identified in 43% of DE versus 52% in non-DE HE. Although overall sensitisation patterns were largely comparable, DE showed lower sensitisation rates to 2-HEMA, carba mix and thiuram mix. Occupational factors were less frequently implicated in DE (9% vs. 29%) compared with non-DE HE. CONCLUSIONS:Despite a high overall frequency of contact allergen sensitisation, the pattern of findings suggests that the dyshidrotic phenotype may follow a clinical course less dependent on external or occupational triggers, pointing towards a relatively greater contribution of endogenous factors compared with other HE subtypes.
