Feasibility of Double-Blind Clinical Trials with Oral Diacetylmorphine: A Randomized Controlled Phase II Study in an Inpatient Setting

The aim of this study was to evaluate the feasibility of conducting double-blind controlled randomized clinical trials using twice-a-day immediate-release oral diacetylmorphine (DAM) in heroin-dependent patients, by means of measuring the capacity of oral DAM to block opiate withdrawal and clinicians' ability to distinguish it from morphine and methadone. This was a randomized, phase II, double-blind, multicenter pilot study comparing immediate-release oral DAM, slow-release oral morphine and oral methadone administered twice a day during 10 days. Forty-five heroin-dependent patients were randomly assigned to these three treatment groups in an inpatient regime. Patients were stabilized with a mean of 350 mg (SD = 193) of immediate-release oral DAM, 108 mg (SD = 46.2) of slow-release oral morphine and 40 mg (SD = 17.9) of methadone. No statistically significant differences were found between any studied medication in clinical outcome. Neither patients nor clinicians were able to identify the administered medication. This study shows the feasibility of double-blind clinical trials using b.i.d. immediate-release oral DAM allowing further phase III clinical trials in the process of introducing oral DAM as a medication for heroin-dependent patients not responding to standard maintenance treatments

Recomanacions sobre el maneig de la infecció per COVID-19 en el pacient adult amb infecció pel VIH

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Pacient adult; VIH; Sida; Recomanacions mèdiquesCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Paciente adulto; VIH; Sida; Recomendaciones médicasCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Adult patient; HIV; AIDS; Medical recommendationsEl Grup PADEICS VIH i Malalties Associades, basant-se en l'escassa evidència que hi ha sobre el tema, ha redactat aquest document de recomanacions sobre el maneig de la COVID-19 dirigides al personal sanitari responsable del tractament de subjectes adults amb infecció per VIH

Prevalence of Fetal Alcohol Spectrum Disorders (FASD) among Children Adopted from Eastern European Countries: Russia and Ukraine

Fetal alcohol spectrum disorders; Adopted children; Cognitive disorderTrastornos del espectro alcohólico fetal; Niño adoptado; Trastorno cognitivoTrastorns de l'espectre alcohòlic fetal; Nens adoptats; Trastorn cognitiuFetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disorders. Children adopted internationally from countries where alcohol consumption during pregnancy is very high are at greater risk for FASD. Lack of expertise in diagnosing FASD and mixed neurodevelopmental and behavioral signs due to abandonment complicate a timely diagnosis. The aim of this study was to determine the prevalence of FASD in adopted children. Children between the ages of 8 and 24 adopted from Russia and Ukraine were evaluated for clinical and historical features of FASD. Of the 162 children evaluated, 81 (50%) met FASD diagnostic criteria. Thirty-three (20.4%) children had fetal alcohol syndrome (FAS), 28 (17.2%) had partial FAS, 2 (1.2%) had alcohol-related birth defects (ARBD) and 18 (11.1%) had alcohol-related neurodevelopmental disorder (ARND). Of the 81 children in which fetal alcohol exposure could not be confirmed, many had manifestations that would have established a diagnosis of FASD if a history of maternal alcohol consumption was confirmed. In a population of children with a high risk of prenatal alcohol exposure (adoptees from Eastern European countries), at least 50% showed manifestations associated with FASD. The reported prevalence in this study is in line with the results obtained in a previous study as well as in orphanages of origin

Recomanacions sobre el maneig de la infecció per COVID-19 en el pacient adult amb infecció pel VIH

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Pacient adult; VIH; Sida; Recomanacions mèdiquesCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Paciente adulto; VIH; Sida; Recomendaciones médicasCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Adult patient; HIV; AIDS; Medical recommendationsEl Grup PADEICS VIH i Malalties Associades, basant-se en l'escassa evidència que hi ha sobre el tema, ha redactat aquest document de recomanacions sobre el maneig de la COVID-19 dirigides al personal sanitari responsable del tractament de subjectes adults amb infecció per VIH

Prevalence of Fetal Alcohol Spectrum Disorders (FASD) among Children Adopted from Eastern European Countries: Russia and Ukraine

Fetal alcohol spectrum disorders; Adopted children; Cognitive disorderTrastornos del espectro alcohólico fetal; Niño adoptado; Trastorno cognitivoTrastorns de l'espectre alcohòlic fetal; Nens adoptats; Trastorn cognitiuFetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disorders. Children adopted internationally from countries where alcohol consumption during pregnancy is very high are at greater risk for FASD. Lack of expertise in diagnosing FASD and mixed neurodevelopmental and behavioral signs due to abandonment complicate a timely diagnosis. The aim of this study was to determine the prevalence of FASD in adopted children. Children between the ages of 8 and 24 adopted from Russia and Ukraine were evaluated for clinical and historical features of FASD. Of the 162 children evaluated, 81 (50%) met FASD diagnostic criteria. Thirty-three (20.4%) children had fetal alcohol syndrome (FAS), 28 (17.2%) had partial FAS, 2 (1.2%) had alcohol-related birth defects (ARBD) and 18 (11.1%) had alcohol-related neurodevelopmental disorder (ARND). Of the 81 children in which fetal alcohol exposure could not be confirmed, many had manifestations that would have established a diagnosis of FASD if a history of maternal alcohol consumption was confirmed. In a population of children with a high risk of prenatal alcohol exposure (adoptees from Eastern European countries), at least 50% showed manifestations associated with FASD. The reported prevalence in this study is in line with the results obtained in a previous study as well as in orphanages of origin

Prevalença del trastorn de l’espectre alcohòlic fetal (TEAF) en infants adoptats procedents de Rússia i Ucraïna a Catalunya

Trastorns de l'espectre alcohòlic fetal; Nens adoptats; Trastorn cognitiuTrastornos del espectro alcohólico fetal; Niño adoptado; Trastorno cognitivoFetal alcohol spectrum disorders; Adopted children; Cognitive disorderL’objectiu d’aquest document és conèixer la prevalença del TEAF en infants adoptats procedents de Rússia i Ucraïna i residents a Catalunya, coneixement essencial per elaborar protocols de diagnòstic, tractament i rehabilitació, així com per revisar i millorar els circuits i els procediments d’adopció internacional

Monitorización y evaluación del vih en Cataluña, cada vez más cerca de los objetivos 90-90-90

Background: Epidemiological surveillance of HIV infection allows monitoring its incidence as well as possible epidemiological changes, allowing specific interventions to be planned and their impact monitored. The objective of this article is to describe the results of the monitoring and evaluation of the response to the HIV epidemic in Catalonia, based on data included in the Integrated System of Epidemiological Surveillance of AIDS/HIV and Sexually Transmitted Infections of Catalonia (SIVES). Methods: A descriptive analysis of the data from the different sources of information of the SIVES was performed. The time period was defined based on the availability of data from each of the sources of information included in the analysis. The information was structured according to the conceptual representation of the cascade of HIV care, as described in the World Health Organization consolidated strategic information guidelines for HIV. Results: Of the total of 4,849 new diagnoses notified (2012- 2018), 86% were men, of these; the most frequently reported transmission group was men having sex with men with 65%. The trend in the number of new diagnoses decreased in all transmission groups. It is estimated that in 2018 there were 32,429 people living with HIV in Catalonia, of which 89% were diagnosed, of these, 83% were under follow-up in a specialized unit and 78% of them were under treatment. 73% of people in treatment had suppressed the viral load. Conclusions: SIVES as an integrated system of different sources of strategic information allows monitoring the HIV epidemic in Catalonia and evaluating the response to it, identifying key populations and determinants to acquire HIV, as well as the barriers to which people living with HIV they face to achieve viral suppression.Fundamentos: La vigilancia epidemiológica de la infección por el VIH permite monitorizar su incidencia así como eventuales cambios epidemiológicos, permitiendo planificar intervenciones específicas y monitorizar su impacto. El objetivo de este artículo fue describir los resultados de la monitorización y evaluación de la respuesta a la epidemia del VIH en Cataluña, a partir de los datos incluidos en el Sistema Integrado de Vigilancia Epidemiológica del Sida/VIH e Infecciones de transmisión sexual de Cataluña (SIVES). Métodos: Se realizó un análisis descriptivo de los datos de las diferentes fuentes de información del SIVES. El periodo de tiempo se definió a partir de la disponibilidad de los datos de cada una de las fuentes de información incluidas en el análisis. La información se estructuró de acuerdo a la representación conceptual de la cascada de diagnóstico y tratamiento de VIH, tal y como se describe en las directrices de información estratégica consolidada de la Organización Mundial de la Salud para el VIH. Resultados: Del total de 4.849 nuevos diagnósticos notificados (2012-2018), el 86% eran hombres. De estos, el grupo de transmisión informado más frecuente fueron los hombres que tiene sexo con hombres con un 65%. La tendencia del número de nuevos diagnósticos descendió en todos los grupos de transmisión. Se estima que en 2018 había 32.429 personas viviendo con el VIH en Cataluña, de las cuales el 89% estaban diagnosticadas. De estas, el 83% estaban en seguimiento en una unidad especializada, y el 78% de ellas estaban en tratamiento. El 73% de las personas en tratamiento tenían la carga viral suprimida. Conclusiones: El SIVES, como sistema integrado de diferentes fuentes de información estratégica, permite monitorizar la epidemia del VIH en Cataluña y evaluar la respuesta a la misma, identificando poblaciones claves y determinantes para adquirir el VIH, así como las barreras a las que se enfrentan las personas que viven con VIH para lograr a supresión viral