Ana Piñar-Gutiérrez

Objectives: To describe a structured transition model for individuals with type 1 diabetes mellitus (T1DM) from pediatric to adult care in a tertiary hospital, and to explore demographic, clinical, and psychosocial factors associated with glycemic outcomes. Research Design and Methods: We conducted an observational, cross-sectional study including all patients with T1DM who transitioned from the Pediatric Endocrinology Clinic to the Adult Endocrinology and Nutrition Unit at Virgen del Rocío University Hospital between 2021 and 2024. Demographic, clinical, biochemical, glucometric, and socioeducational variables were collected at the first adult care visit. Statistical analyses included nonparametric tests and exploratory multivariate logistic regression models. Results: A total of 73 patients (45% female) were included, with a median age of 18 years and median diabetes duration of 9 years. The 46.6% of our cohort had an HbA1c > 7.5%. Overweight and obesity were present in 25% and 8% of patients, respectively, and 11% were active smokers. Eighteen percent were receiving mental health follow-up, mainly for anxiety–depressive disorders. Those using hybrid closed-loop insulin delivery and continuous glucose monitoring achieved significantly better glycemic control (TIR 67% vs. 48%; p < 0.01) and lower glycemic variability. In exploratory multivariable analyses, continuous glucose monitoring use > 90% of the time and higher maternal educational level were associated with a lower likelihood of HbA1c > 7.5%. Conclusions: In this cross-sectional transition cohort, intensive use of diabetes technology and higher maternal educational level were associated with better glycemic control at the time of transfer to adult care. These findings should be interpreted as exploratory and hypothesis-generating, and warrant confirmation in larger, prospective studies.

Background: Computed Tomography (CT) is considered a highly accurate tool for assessing body composition. The aim of this study is to assess the usefulness of chest CT for malnutrition diagnosis in people with cystic fibrosis (PwCF), compared with other body composition techniques, as well as to assess possible associations with nutritional and respiratory status. Methods: A cross-sectional study was carried out in clinically stable adult PwCF. Subjects who had undergone a CT including the twelfth thoracic vertebra (T12) during the 6 months prior to or after our assessment were included and body composition was assessed using FocusedON-BC. The results were compared with anthropometry, bioelectrical impedance analysis (BIA), muscle ultrasonography, and handgrip strength (HGS). Respiratory parameters were collected, and nutritional status was assessed using Global Leadership Initiative on Malnutrition (GLIM) criteria. Results: A total of 55 PwCF were included. Muscle area assessed by CT correlated significantly with fat-free mass determined by BIA (r = 0.725) and anthropometry (r = 0.645), muscle mass evaluated by ultrasonography (r = 0.657), HGS (r = 0.593), Bhalla score (r = 0.403), and FEV1 (r = 0.488). Differences were observed when comparing muscle area in CT based on the Bhalla score (94.6 ± 21.1 cm² in normal/mild involvement vs. 79.3 ± 20.9 cm² in moderate/severe involvement; p = 0.009) and on nutritional status (96.3 ± 17.9 cm² in normo-nourished vs. 75.9 ± 22.1 cm² in malnourished; p < 0.001). Conclusions: In adult PwCF, measurements obtained from CT image analysis correlate adequately with anthropometry, BIA, muscle ultrasound, and HGS. Muscle area in CT is related to nutritional and respiratory status.

Objectives: To describe the results of nutritional and morphofunctional assessment in a cohort of adults with cystic fibrosis; to evaluate differences in nutritional status between patients with and without exocrine and/or endocrine pancreatic involvement. Methods: Cross-sectional study: A cohort of adults with cystic fibrosis evaluated in a multidisciplinary unit was analyzed. Pancreatic status was examined, and malnutrition was diagnosed according to GLIM criteria. Morphofunctional assessment consisted of nutritional ultrasound, bioelectrical impedance, handgrip dynamometry, and anthropometry. Qualitative variables are expressed as n (%), quantitative variables as median (IQR). For group comparisons, Fisher’s exact test was used for qualitative variables and the non-parametric median comparison test for quantitative variables. Results: n = 101 participants were recruited, of whom 44 (43.6%) were women. Median age was 33 (25–40.5) years. A total of 64 participants (63.4%) had exocrine pancreatic insufficiency (EPI), 44 (43.6%) had endocrine pancreatic insufficiency, and 28 (27.7%) had cystic fibrosis-related diabetes (CFRD). Median BMI was 23.4 (20.1–24.89) kg/m². A total of 48 patients (47.5%) were malnourished. Males with EPI had a higher prevalence of undernourishment than those without (56.4% vs. 16.7%, p = 0.005), but not women. CFRD patients displayed no differences in morphofunctional assessment. Conclusions: Almost half the sample was undernourished using GLIM criteria. Males with exocrine pancreatic insufficiency had worse nutritional status. Endocrine pancreatic involvement did not affect nutritional status.

Incorrect Author NameIn the published article, an author name was incorrectly written as Juan Carlos Galofré -Ferrater. Thecorrect spelling is JC GalogréIn the published article, an author name was incorrectly written as Aida Orois-Añón. Thecorrect spelling is Aida OroisThe authors apologize for this error and state that this does not change the scientific conclusions of thearticle in any way. The original article has been updated.

Objective: This study describes the characteristics, survival and prognostic factors in a cohort of patients with bone metastases (BM) from differentiated thyroid carcinoma (DTC).Methods: This was a multicenter retrospective observational study conducted in Spain, including patients diagnosed with DTC and BM between 1980 and 2022. A Cox regression analysis was performed to examine prognostic factors for survival. Kaplan-Meier and log-rank tests were performed for survival analysis and comparison between groups.Results: A total of 133 patients were included with a median follow-up of 40 (17-70) months. Seventy patients (52.6%) had BM at the initial diagnosis. Fifty-two (39.1%) had follicular carcinoma. Sixty-six (49.6%) presented multiple BM. The most frequent location was the spine (63.2%). Other metastases were present at diagnosis in 88 (66.2%), mainly lung (60.9%). BM were treated with I131 in 91 (68.4%) patients, with BM uptake in 63 (47.4%). Fifty-six (42.1%) received treatment with multikinase inhibitors. Fifty-three (3.9%) had skeletal-related events. Seventy-two (54.1%) died. The 3-, 5- and 10-year survival was 53.5, 39.5% and 28.5%, respectively. Significant prognostic factors in the multivariate analysis were the presence of lymph node metastases (N1) HR 1.71 (95% CI 1.005-2.098; p=0.048), BM treatment with I131 HR 0.532 (95% CI 0.304-0.931; p=0.027) and age ≥67 years at BM diagnosis HR 1.991 (95% CI 1.142-3.47; p=0.015).Conclusions: Survival of DTC patients with BM treated in a Spanish cohort was 39.5% at 5 years and 28.5% at 10 years. Patients with BM treated with I131 appear to have a better outcome in terms of mortality and the presence of lymph node involvement and age over 67 years were associated with higher mortality.

Objectives: To compare complications associated with percutaneous gastrostomies performed using PUSH and PULL techniques, whether endoscopic (PEG) or radiological (PRG), in a tertiary-level hospital. Methods: This was a prospective observational study. Adult patients who underwent percutaneous PULL or PUSH gastrostomy using PEG or PRG techniques at the Virgen del Rocio University Hospital and subsequently followed up in the Nutrition Unit between 2009–2020 were included. X2 tests or Fisher’s test were used for the comparison of proportions when necessary. Univariate analysis was conducted to study risk factors for PRG-associated complications. Results: n = 423 (PULL = 181; PUSH = 242). The PULL technique was associated with a higher percentage of total complications (37.6% vs. 23.8%; p = 0.005), exudate (18.2% vs. 11.2%; p = 0.039), and irritation (3.3% vs. 0%; p = 0.006). In the total sample, there were 5 (1.1%) cases of peritonitis, 3 (0.7%) gastrocolic fistulas, and 1 (0.2%) death due to complications associated with gastrostomy. Gender, age, and different indications were not risk factors for a higher number of complications. The most common indications were neurological diseases (35.9%), head and neck cancer (29%), and amyotrophic lateral sclerosis (17.2%). Conclusions: The PULL technique was associated with more total complications than the PUSH technique, but both were shown to be safe techniques, as the majority of complications were minor.

Objective: The aim of this study is to describe the characteristics, survival and prognostic factors of a cohort of patients with bone metastases (BMs) from differentiated thyroid carcinoma (DTC). Methods: This was a multicenter retrospective observational study including patients diagnosed with BMs from DTC between 1980 and 2021. A Cox regression was performed to study prognostic factors for 5- and 10-year survival. Kaplan–Meier and log-rank tests were performed for the survival analysis and comparison between groups. Results: Sixty-three patients were evaluated. Median follow-up from BM diagnosis was 35 (15–68) months. About 30 (48.4%) patients presented with synchronous BMs. Regarding histology, 38 (60.3%) had the papillary variant. BMs were multiple in 32 (50.8%) patients. The most frequent location was the spine (60.3%). Other metastases were present in 77.8%, mainly pulmonary (69.8%). Concerning treatment, 54 (85.9%) patients received I131, with BM uptake in 31 (49.2%) and 25 (39.7%) received treatment with multikinase inhibitors. Regarding complications, 34 (54%) patients had skeletal-related events, 34 (54%) died and 5- and 10-year overall survival was 42.4% and 20.4%, respectively. Significant prognostic factors in the multivariate analysis were the presence of lymph node involvement (hazard ratio (HR): 2.916; 95% confidence interval (CI): 1.013–8.391; P = 0.047) and treatment with I131 (HR 0.214 (95% CI 0.069–0.665); P = 0.008) at 5 years, the presence of other metastases (HR 6.844. 95% CI 1.017–46.05; P = 0.048) and treatment with I131 (HR 0.23 (95% CI 0.058–0.913); P = 0.037) at 10 years. Conclusions: Our study reflects the management of patients with bone metastases from differentiated thyroid carcinoma in real clinical practice in several centers in southern Spain. Overall survival at 5 and 10 years was lower in patients who were not treated with I131, had nodal involvement and/or had other metastases.