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El uso de los perfiles analíticos pre-configurados (PAPs) en el contexto de la insuficiencia cardíaca (IC) podría ayudar a realizar un mejor manejo clínico y gestión eficiente del paciente. Los objetivos del estudio son entender el grado actual de implantación de los PAPs en el manejo de la IC en España y conocer la opinión de expertos sobre los mismos, prestando particular atención a los parámetros del metabolismo del hierro.

The use of specific test panels (STP) for heart failure (HF) could help improve the management of this condition. The purpose of this study is to gain an insight into the level of implementation of STPs in the management of HF in Spain and gather the opinions of experts, with a special focus on parameters related to iron metabolism.

Background: The assessment of serum neurofilament light chain (sNfL) is increasingly significant in the field of neurology. In multiple sclerosis (MS), it proves valuable as a marker for monitoring disease activity and treatment response. Objective: To compare the Simoa and Lumipulse platforms for measuring sNfL and to establish age‐specific reference ranges within a substantial cohort of individuals diagnosed with MS. Methods: Two hundred sixty‐one sNfL measurements from a cohort of 229 MS patients were analyzed with Simoa and Lumipulse. Reference ranges for sNfL were established for three age groups (18–39 years, 40–59 years, and > 60 years) selecting data from 166 patients with stable relapsing–remitting MS. Results: While sNfL levels correlated between assays, Lumipulse exhibited values higher than Simoa. Passing–Bablok's analysis confirmed linearity between the two datasets, and the Bland–Altman comparison further supported the agreement between the methods. Analyzing reference ranges for sNfL across three age groups in stable RRMS patients revealed significant differences between the groups on each of the platforms. Although the values followed the same trend, each technology utilized distinct reference ranges. Conclusion: Simoa and Lumipulse platforms proved equally effective in monitoring patients with MS. The enhanced accessibility of the Lumipulse platform facilitates the expansion of research on sNfL as a biomarker for monitoring MS, thus offering promising opportunities for broader accessibility and advancement in this field. [ABSTRACT FROM AUTHOR]

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Aim: The aim was to determine the accuracy of C‐reactive protein (CRP), procalcitonin and neutrophils in the early detection (fourth postoperative day) of anastomotic leakage (AL) after colorectal surgery. Methods: We conducted a multicentre, prospective study that included a consecutive series of patients who underwent colorectal resection with anastomosis without ostomy (September 2015 to December 2017). CRP, procalcitonin and neutrophil values on the fourth postoperative day after colorectal resection along with the postoperative outcome (60‐day AL, morbidity and mortality) were prospectively included in an online, anonymous database. Results: The analysis ultimately included 2501 cases. The overall morbidity and mortality was 30.1% and 1.6%, respectively, and the AL rate was 8.6%. The area under the receiver operating characteristic curve values (95% CI) for detecting AL were 0.84 (0.81–0.87), 0.75 (0.72–0.79) and 0.70 (0.66–0.74) for CRP, procalcitonin and neutrophils, respectively. The best cut‐off level for CRP was 119 mg/l, resulting in 70% sensitivity, 81% specificity and 97% negative predictive value. After laparoscopic resection, the accuracy for CRP and procalcitonin was increased, compared with open resection. The combination of two or three of these biomarkers did not significantly increase their accuracy. Conclusion: On the fourth postoperative day, CRP was the most reliable marker for excluding AL. Its high negative predictive value, especially after laparoscopic resection, allows for safe hospital discharge on the fourth postoperative day. The routine use of procalcitonin or neutrophil counts does not seem to increase the diagnostic accuracy. [ABSTRACT FROM AUTHOR]

• Elevated levels of the kappa free light chains index (FKLCi) have emerged as a predictor for therapeutic failure (TF), defined as the occurrence of a second relapse, two or more T2 lesions, or PIRA. • An FKLCi exceeding 130 was associated with TF in both univariate and multivariate analyses, adjusted for sex, age, presence of acute inflammatory activity, EDSS at the time of sampling, administered line of treatment, and time from CSF analysis to treatment initiation. • Initiating second-line disease-modifying therapies in patients with elevated FKLCi levels would be advisable, as they have shown to be a robust protective factor against TF. • Age emerged as a weak protective factor against TF. • In contrast to findings from other studies, oligoclonal IgM Bands, Chitinase-3 Like-1, and serum neurofilament (analyzed as either raw values or age-adjusted Z-scores) were not associated with worse disease outcomes. Background: Our objective was to explore various biomarkers for predicting suboptimal responses to disease-modifying treatments (DMTs) in patients with MS (pwMS). Methods: We conducted a longitudinal, bicentric study with pwMS stratified based on their DMTs responses. Treatment failure (TF) was defined as the onset of a second relapse, presence of two or more T2 new lesions, or disability progression independent of relapse during the follow-up period. We evaluated intrathecal synthesis (ITS) of IgG and IgM using OCB, linear indices, and Reibergrams. Free kappa light chains ITS was assessed using the linear index (FKLCi). NfL and GFAP in serum and CSF, and CHI3L1 in CSF were quantified. Quantitative variables were dichotomized based on the third quartile. Predictive efficacy was assessed through bivariate and multivariate analyses, adjusting for age, sex, EDSS, acute inflammatory activity (AI) -defined as the onset of a relapse or gadolinium-enhancing lesions within a 90-day window of lumbar puncture-, treatment modality, study center, and time from disease onset to treatment initiation. In case of collinearity, multiple models were generated or confounding variables were excluded if collinearity existed between them and the biomarker. The same methodology was used to investigate the predictive potential of various combinations of two biomarkers, based on whether any of them tested positive or exceeded the third quartile. Results: A total of 137 pwMS were included. FKLCi showed no differences based on AI, no correlation with EDSS and was significantly higher in pwMS with TF (p = 0.008). FKLCi>130 was associated with TF in bivariate analysis (Log-Rank p = 0.004). Due to collinearity between age and EDSS, two different models were generated with each of them and the rest of the confounding variables, in which FKLCi>130 showed a Hazard Ratio (HR) of 2.69 (CI: 1.35–5.4) and 2.67 (CI: 1.32–5.4), respectively. The combination of either FKLC or sNfL exceeding the third quartile was also significant in bivariate (Log-Rank p = 0.04) and multivariate (HR=3.1 (CI: 1.5–6.5)) analyses. However, when analyzed independently, sNfL did not show significance, and FKLCi mirrored the pattern obtained in the previous model (HR: 3.04; CI: 1.51–6.1). Treatment with highefficacy DMTs emerged as a protective factor in all models. Discussion: Our analysis and the fact that FKLCi is independent of EDSS and AI suggest that it might be a valuable parameter for discriminating aggressive phenotypes. We propose implementing high-efficacy drugs in pwMS with elevated FKLCi. [ABSTRACT FROM AUTHOR]

• The performance of Liaison in detecting acute Epstein-Barr infection is optimal in pediatric patients with compatible symptoms. • The optimal cutoff points obtained for the Liaison assay differed depending on the age range and symptomatic presentation. • Some autoantibodies such as ANCA or rheumatoid factor, and IgM against viruses like VHS or Cytomegalovirus, can cause cross-reactivity. • The use of Liaison is not recommended for protocol-driven manner in oncology patients and immunocompromised individuals. • Our data exclude the possibility of Epstein-Barr IgG antibodies causing cross-reactivity. The present investigation assessed the Liaison® diagnostic performance in detecting Epstein-Barr (EBV) IgM-VCA in a large patient cohort, considering age and symptomatology. VIDAS® were employed as a benchmark for acute EBV infection. The study also probed other coexisting conditions and potential cross-reactivity for error sources. A total of 1311 samples were analyzed, with notable associations found only among paediatric (kappa=0.75) and young adult (kappa=0.58) populations with compatible symptoms. ROC analysis revealed varying optimal cutoff values based on age and symptom categorizations. Logistic regression models identified age and patients from Oncology or Infectious Disease as significant factors for false positives. Potential interferences emerged with RF, ANCA, cytomegalovirus-IgM and VHS-IgM. Notably, Liaison® couldn´t distinguish EBV patients from Oncology, Haemathology or Internal Medicine. This study provides valuable insights, such as implementing ageand symptom-specific thresholds or reviewing test requests, for optimizing EBV serology in microbiology laboratories, leading to faster and more reliable responses. [ABSTRACT FROM AUTHOR]