ECLIM-SEHOP, a new platform to set up and develop international academic clinical trials for childhood cancer and blood disorders in Spain.

INTRODUCTION: Cancer and blood disorders in children are rare. The progressive improvement in survival over the last decades largely relies on the development of international academic clinical trials that gather the sufficient number of patients globally to elaborate solid conclusions and drive changes in clinical practice. The participation of Spain into large international academic trials has traditionally lagged behind of other European countries, mainly due to the burden of administrative tasks to open new studies, lack of financial support and limited research infrastructure in our hospitals. METHODS: The objective of ECLIM-SEHOP platform (Ensayos Clínicos Internacionales Multicéntricos-SEHOP) is to overcome these difficulties and position Spain among the European countries leading the advances in cancer and blood disorders, facilitate the access of our patients to novel diagnostic and therapeutic approaches and, most importantly, continue to improve survival and reducing long-term sequelae. ECLIM-SEHOP provides to the Spanish clinical investigators with the necessary infrastructural support to open and implement academic clinical trials and registries. RESULTS: In less than 3 years from its inception, the platform has provided support to 20 clinical trials and 8 observational studies, including 8 trials and 4 observational studies where the platform performs all trial-related tasks (integral support: trial setup, monitoring, etc.) with more than 150 patients recruited since 2017 to these studies. In this manuscript, we provide baseline metrics for academic clinical trial performance that permit future comparisons. CONCLUSIONS: ECLIM-SEHOP facilitates Spanish children and adolescents diagnosed with cancer and blood disorders to access state-of-the-art diagnostic and therapeutic strategies.

Comparison between one and three doses a week of recombinant erythropoietin in very low birth weight infants.

OBJECTIVE: To compare transfusion requirements and erythropoietic response in preterms between schedules of rEPO administration once or three times per week, using the same weekly dose. STUDY DESIGN: Prospective, randomized trial including infants weighing <1500 g at birth and/or were 32 weeks' gestation: Group 1 (60 infants) received subcutaneous rEPO at 250 units kg(-1) per dose, three times weekly for 6 weeks; Group 2 (59 infants), at 750 units kg(-1) per dose, once weekly for 6 weeks. Efficacy was evaluated based on the transfusion requirement, hemoglobin changes, reticulocyte counts, serum transferrin receptor (sTfR) and serum ferritin. The frequency of adverse effects was registered in both groups. RESULT: A total of 13 infants were transfused in each group (relative risk: 0.98; 95% confidence interval: 0.4 to 2.3). Phlebotomy loss and red blood cell transfusion volumes received were similar in both groups. Hemoglobin levels were lower at end of study in Group 2 (10.6±1.5 g dl(-1) versus 11.5±1.4 g dl(-1); P<0.003). At end of study, reticulocyte counts and sTfR values increased and serum ferritin values decreased, without significant differences between the two groups. Incidence of complications was similar in both groups. CONCLUSION: The once-weekly rEPO schedule for very low birth weight infants proved as effective as the three-times-weekly schedule, in relation to erythropoietic stimulus and transfusion requirement.

[Treatment of psoas abscess. Report of a case and review of the literature]. / Tratamiento del absceso de psoas. Aportación de un caso y revisión de la literatura.

Psoas abscess is an infrequent disease. We present a right psoas abscess diagnosed in a thirteen-year-old child. There wasn't a history of known trauma nor immunodeficiency. We didn't find another infection focus so the abscess was described as primary one. This is the most commonly presentation in children. Staphylococcus aureus was the bacteria identified in blood culture. The presenting symptoms were bottom and hip pain, limp and fever. The differential diagnosis was established with suppurative arthritis of the hip. Diagnosis was confirmed by Magnetic Resonance. In regard to treatment the patient was exclusively treated with systemic antibiotics, high spectrum of activity. The patient didn't require percutaneous-drainage. Though surgical drainage wasn't made, evolution was favourable and recurrence wasn't observed.

Tratamiento del absceso de psoas. Aportación de un caso y revisión de la literatura / Treatment of psoas abscess. Case report and review of the literature

El absceso de psoas es una enfermedad diagnosticada con poca frecuencia. Presentamos el caso de un niño de 13 años diagnosticado en nuestro centro de absceso de psoas derecho. El paciente no presentaba antecedentes traumáticos, ni de inmunodeficiencia y tampoco se encontró foco de infección, por lo que se calificó de absceso primario, que es la forma más frecuente en pediatría. El germen aislado en el hemocultivo fue el Staphylococcus aureus. En la clínica destacaba dolor en la zona glútea y cadera derecha que dificultaba la deambulación, así como fiebre elevada, lo que hizo plantearse en un principio el diagnóstico diferencial con una artritis séptica de cadera. El diagnóstico definitivo se realizó con resonancia magnética. En cuanto al tratamiento, hemos obtenido la total resolución del absceso con el empleo de antibióticos de amplio espectro por vía intravenosa, no precisando, como en la mayoría de los casos encontrados en la bibliografía, la realización de drenaje percutáneo. Pese a no haber sido realizado drenaje quirúrgico la evolución ha sido favorable y sin complicaciones, no observándose recidivas (AU)

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