Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease : A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Incidence of retinal complications in a cohort of newly diagnosed diabetic patients.

PURPOSE: We aimed at estimating the incidence of diabetic retinopathy (DR) and maculopathy (DMP) among newly diagnosed type 1 (t1DM) and type 2 diabetic patients (t2DM) in the United Kingdom primary care system. The incidence of DMP among patients with DR was also estimated. METHOD: We conducted a cohort study using The Health Improvement Network database. The cohort included 64,983 incident diabetic patients (97.3% were t2DM) aged 1-84 years diagnosed between 2000 and 2007. This cohort was followed from the date of diabetes diagnosis until recording of DR or DMP in two separate follow-ups. Follow-up was censored at 85 years of age, death, or end of 2008. An additional follow-up was conducted from DR to DMP diagnosis using similar censoring reasons. DR and DMP cumulative incidences were calculated as well as incidence rates (IR; cases per 1,000 person-years) per calendar period (2000-2001 and 2006-2007). RESULTS: Follow-up for DR: 9 years after diabetes diagnosis, 28% of t2DM and 24% of t1DM patients had developed DR (7,899 incident DR cases). During the first 2 years with diabetes, the IR was almost 2 times higher in patients diagnosed with diabetes in 2006-2007 (47.7) than among those diagnosed in 2000-2001 (24.5). Follow-up for DMP: 9 years after diabetes diagnosis, 3.6% of t2DM and 4.4% of t2DM patients had developed DMP (912 incident DMP cases). During the first 2 years with diabetes, the IR was three times higher in patients diagnosed with diabetes in 2006-2007 (5.8) than among those diagnosed in 2000-2001 (1.8). Macular oedema occurred in 0.8% of patients. CONCLUSIONS: In a cohort of incident diabetes, 28% of patients developed retinopathy and 4% maculopathy within the first 9 years. The 2-year IRs of DR and DMP were higher in patients diagnosed with diabetes during the period 2006-2007 than in those diagnosed during the 2000-2001 period

Kaplan-Meier curves and table of annual cumulative incidence of diabetic retinopathy from the date of first diabetes diagnosis recorded.

<p>Kaplan-Meier curves and table of annual cumulative incidence of diabetic retinopathy from the date of first diabetes diagnosis recorded.</p

Flow of participants in cohort study of incidence of diabetic retinopathy (DR) and maculopathy (DMP) in patients with newly diagnosed type 1 and type 2 diabetes.

<p>Flow of participants in cohort study of incidence of diabetic retinopathy (DR) and maculopathy (DMP) in patients with newly diagnosed type 1 and type 2 diabetes.</p

Kaplan-Meier curves and table of annual cumulative incidence of diabetic maculopathy from the date of first diabetes diagnosis recorded.

<p>Kaplan-Meier curves and table of annual cumulative incidence of diabetic maculopathy from the date of first diabetes diagnosis recorded.</p

Management Accounting Innovation and Digitalisation in line with the Sustainable Development Goals: An imperative need?

El objetivo principal del proyecto ha sido digitalizar la asignatura para actualizar y adaptarse a los nuevos tiempos de semi-presencialidad docente universitaria, además de actualizar la docencia con los nuevos recursos didácticos tecnológicos. Este objetivo general se divide en varios objetivos específicos: 1) Mayor aprendizaje de los alumnos en la actualización de la Contabilidad de Gestión a las nuevas tendencias de concentración en la satisfacción del cliente en el análisis de la cadena de valor, nuevas tecnologías para el cálculo y análisis de los costes. 2) Mayor formación de los profesores en el diseño de nuevas metodologías docentes como clases invertidas, simulaciones o role-play para impartir la asignatura y formar a los profesores recién incorporados a la asignatura (suele haber un profesor nuevo asociado cada año) 3) Mayor motivación del profesorado a la adaptación de la asignatura a los nuevos recursos didácticos como gamificación concretada en escape-rooms, micro-videos, podcasts ..etc 4) Mayor internacionalización de la asignatura puesto que los contenidos y los recursos didácticos desarrollados serán en inglés y en español en paralelo. 5) Interrelación de la Contabilidad de Gestión con los Objetivos de Desarrollo Sostenible (ODS) definidos por la Agenda 2030 de Naciones Unidas para involucrar a nuestros jóvenes a vincularse a luchar por un mundo más justo, igualitario y pacífico. Es importante resaltar que el equipo de profesores ha sido el mayor activo del proyecto porque su trabajo en equipo ha hecho que el manual conste de un valor extraordinario. 1. Marie Anne Lorain: Profesora Contratada Doctor de la Universidad Complutense de Madrid 2. Alberto Martínez de Silva: Profesor Doctor Asociado de la Universidad Complutense de Madrid 3. Pilar López Sánchez: Profesora Doctora de la Universidad Francisco de Vitoria 4. Manuel Ángel Ferrer: Profesor colaborador de la Universidad Francisco Vitoria 5. Elisa Cano Montero: Profesora Contratada Doctor de la Universidad Castilla La Mancha 6. Julián Chamizo Gonzalez: Profesor Contratado Doctor de la Universidad Autónoma de Madrid 7. Mª José Rivero Menéndez Profesora Titular de CUNEF 8. Elena Urquía Grande: coordinadora del proyecto: Profesora Titular de la Universidad Complutense de Madrid Los objetivos alcanzados son una actualización de los contenidos de la asignatura de Contabilidad de Gestión a las nuevas tendencias. Como ejemplos de ello podemos destacar: centrar la toma de decisiones estratégicas en la satisfacción del cliente, el análisis de la cadena de valor, las nuevas tecnologías y los software que lo acompañan, para un mejor cálculo y análisis de los costes. Una mayor involucración de los profesores en el diseño de nuevas metodologías docentes como clases invertidas, simulaciones o role-play para impartir la asignatura. Mayor motivación del profesorado a la adaptación de la asignatura a las nuevas tendencias, los contenidos y los nuevos recursos didácticos como gamificación concretada en escape-room, micro-videos, podcasts ..etc Mayor internacionalización de la asignatura puesto que los contenidos y los recursos didácticos desarrollados serán en inglés y en español en paralelo. Finalmente, en línea con los Objetivos de Desarrollo Sostenible (ODS) definidos por la Agenda 2030 de Naciones Unidas para involucrar a nuestros jóvenes a vincularse a luchar por un mundo más justo, igualitario y pacífico, la Contabilidad de Gestión también intersecta con esta línea (Pérez et al., 2023).Depto. de Administración Financiera y ContabilidadFac. de Ciencias Económicas y EmpresarialesFALSEsubmitte

Characteristics of New Users of Aclidinium Bromide, Aclidinium/Formoterol, and Other COPD Medications in the United Kingdom, Denmark, and Germany

BACKGROUND AND OBJECTIVES: Aclidinium bromide was approved in the European Union for the treatment of chronic obstructive pulmonary disease (COPD) in adult patients in 2012 and in a fixed-dose combination with formoterol in 2014. We characterised new users of aclidinium, aclidinium/formoterol and other COPD medications and evaluated off-label prescribing of these medications in three European populations. METHODS: We described demographic characteristics, comorbidities, comedications, COPD severity and off-label prescribing of new users of aclidinium, aclidinium/formoterol and other COPD medications in patients with COPD aged ≥ 40 years in the Clinical Practice Research Datalink (CPRD, UK), Danish National Health Databases, and German Pharmacoepidemiological Research Database (GePaRD) between 2015 and 2017. RESULTS: We included 17,668 new users of aclidinium (CPRD, 4871; Denmark, 2836; GePaRD, 9961) and 14,808 new users of aclidinium/formoterol (CPRD, 2153; Denmark, 2586; GePaRD, 10,069). Study patients were of similar age, except in GePaRD, where users of long-acting beta2-agonists (LABA)/inhaled corticosteroids were younger. Patients had multiple comorbidities and used multiple comedications—most frequently hypertension (50–79%) and short-acting beta2-agonists (26–84%). Aclidinium users in CPRD and long-acting anticholinergics/LABA users in Denmark and GePaRD had the highest frequency of severe/very severe COPD. Off-label prescribing of aclidinium (5.0% [CPRD]–8.9% [Denmark]) and aclidinium/formoterol (2.6% [GePaRD]–3.2% [CPRD]) was low, and the main reason was asthma without a COPD diagnosis. CONCLUSIONS: Aclidinium and aclidinium/formoterol were mostly prescribed according to label, with preference given to older patients with more severe COPD and to patients with a high prevalence of comorbidities and comedication use