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In autumn of 1942, Barcelona received the Exhibition of Modern German Architecture, directed by Albert Speer. The objective of this exhibition was to show to European allies the pharaonic projects of Germany, the Europa’s future new capital, the new constructions and the new urbanism of the Third Reich. The pro-Franco leaders of Barcelona and the “new” intellectual ones (architects of reference) admired the promises and the challenges that the Nazi power was projecting in a promise of an enormous remodeling of the continent. These leaders were completely fascinated by the German power, they admired their military deployment in the continent and they identified their ideas with the main part of the Nazy ideological program.

Despite its origin can be traced since ancient times, the Atrocity Propaganda became especially relevant as the pivotal theme of the discourses aimed to justify the extreme violence against the “other” during the major conflicts of the Twentieth Century. Few States were as skilled as the Nazi Regime to take advantage of the potential of Art to be the backbone of the process of violent socialization of its citizenship. The power of the image to show a degraded image of the enemy which, in turn, strengthened the validity of the addresser’s arguments is openly revealed at the exhibition Das Sowjetparadies held in Berlin in 1942. In this paper, we analyze the Exhibition contents and reflect on the importance of this type of actions to disseminate an anti-Communist and anti-Semitic discourse.

The 1929 Barcelona International Exposition became the driving force in the modernization of the city and at the same time, a propaganda tool for diffusion of a new image of progress and modernity. This paper deals the study of the transformation of Montjuïc Mountain, the site where the Exposition was located, as a new public space of leisure, entertainment and sport. Closely related to the previous point, sport became one of the three areas in which the event took place. This paper analyses the role of sport in the Exposition as a vehicle for improve the construction of new sports facilities and the spread of this practice between Catalans and Spanish working class.

Criticism of public opinion appears in all political systems, but the most important is its ability to respond to criticism and give them an answer. It is in this environment of control of all possible expressions of thought that flourish the political satire, which draws on reserves of imagination and ingenuity to the totalitarian system that denies its form of expression. The “seditious” opinions that came before the courts were related to anti-Nazi humor that was considered, in all its manifestations, as opposition propaganda. But to access to the “criminals”, the regime must have the cooperation of society. Satire adopted two main objectives: mocking the system, mocking their rules and institutions, and avoided the fear of the regime, by ridiculing aspects of daily life.

The mental health challenges faced by the migrant population in Spain are analyzed, emphasizing the gaps of our healthcare system to addresses their specific needs. Among these challenges are a high prevalence of mental disorders, increased exposure to mental health determinants, differences in the expression of distress, and behaviors related to access and demand for services. Proposals are presented to improve healthcare at multiple levels: 1) fostering of high-impact research, 2) providing rigorous culturally humility training for healthcare professionals and for the integration of community mental health agents, and 3) establishing reference care units as an organizational shift to enhance care and promote public health policies. In conclusion, urgent action through public health policies is necessary to ensure the best care for all., (Copyright © 2025 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Low-value practices are avoidable interventions that provide no health benefits. The objective of this study was to conduct a narrative review of the recommendations for practices of low value-care in vascular prevention., Methods: A narrative review of all low value-care recommendations for vascular prevention published in the main European and North American scientific societies for clinical practice guidelines between 2014 and 2024 was carried out., Results: A total of 38 clinical practice guidelines and consensus documents from international organizations in the United States, Canada, the United Kingdom, and Europe were reviewed, 28 of which included between 1 and 20 recommendations on practices of low value-care in vascular prevention. The total number of recommendations was 141. The American Heart Association is the society that offers the largest number of recommendations of low value-care, with 39 recommendations (27.7%) in 5 clinical practice guidelines (13.2% of the total guidelines with recommendations). The guideline for the management of arterial hypertension of the European Society of Hypertension is the guideline that concentrates the largest number of recommendations of low value-care in a single guideline, with 20 recommendations (14.2% of the total guidelines with recommendations)., Conclusions: There are more and more guidelines that explicitly describe diagnostic or pharmacological activities of low value-care or Do Not Do Class III or recommendation D. Some guidelines agree, but others show clear discrepancies, which can illustrate the uncertainty of the scientific evidence and the differences in its interpretation., (Copyright © 2025 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and Objective: Current upper tract urothelial carcinoma (UTUC) diagnosis and disease management rely on the combination of CT Urography (CTU), cytology and ureteroscopy (URS). The limited accuracy and complications associated with these tools have led to the search for non-invasive and reliable biomarkers. Our aim was to review and analyse the existing data on the use of Bladder EpiCheck® to assess its performance as a diagnostic tool for UTUC., Material and Methods: A literature search on the diagnostic value of Bladder EpiCheck® as a urinary biomarker in UTUC was conducted through PubMed, Web of Science and Scopus until February 2024. Pooled sensitivity (Se), specificity (Sp), negative predictive value (NPV) and positive predictive value (PPV) of the biomarker were calculated. Diagnostic performance was assessed through the area under the curve (AUC)., Results: Four studies, including 334 patients, were included in the quantitative analysis. Bladder EpiCheck® showed promising pooled diagnostic values with Se of 0.85 (95% CI 0.55-0.96), Sp of 0.93 (95% CI 0.56-0.99), PPV of 0.74 (95% CI 0.54-0.87) and NPV of 0.84 (95% CI 0.77-0.89). The exact AUC obtained was 0.912., Conclusions: Bladder EpiCheck® is an effective diagnostic tool in UTUC, showing a promising diagnostic accuracy, with a Se and NPV of 85% and 84%, respectively. Its use in UTUC diagnosis and follow-up could reduce or postpone the need for more invasive procedures, such as URS, thereby reducing the procedure-associated risks and improving patients' quality of life. Although further research and large prospective studies are needed, the current results indicate that Bladder EpiCheck® is a promising tool in UTUC diagnosis, treatment decision-making, and follow-up., Competing Interests: Declaration of competing interest None., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

FGFR3 mutations are among the most frequent genomic alterations in urothelial cancer (UC) being mainly associated with the luminal papillary (LumP) subtype. With the establishment of fibroblast growth factor receptor (FGFR) inhibitors, the treatment of UC is now shifting more and more towards personalized medicine. A systematic review using Medline and scientific meeting records was carried out according to the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines to assess the potential role of FGFR inhibitors in combination with additional therapies for the management of UC. Ongoing trials were identified via a systematic search on ClinicalTrials.gov. A total of eleven full-text papers, ten congress abstracts, and 5 trials on ClinicalTrials.gov were identified. Following the BLC2001 and THOR study, erdafitinib is the only approved FGFR1-4 inhibitor for metastatic UC with susceptible FGFR2/3 alterations following platinum-based chemotherapy. According to the THOR data of cohort 2, erdafitinib should not be recommended in patients who are eligible for and have not received prior immune checkpoint inhibitors (ICIs). One phase 3 trial is currently evaluating the intravesical device system (TAR210) in FGFR-altered intermediate non-muscle invasive bladder cancer (MoonRISe-1). Preclinical evidence suggests that combination-based approaches could be considered to improve the efficacy of FGFR inhibitors in patients with UC. Nine phase 1b/2 trials are focusing on the combination of FGFR inhibitors with ICIs, chemotherapy, or enfortumab vedotin. In metastatic disease, some preliminary analyses have reported promising results from these combinations (e.g. NORSE and FORT-2 trial). However, no phase 3 trial is terminated, so there is currently no level 1 evidence with long-term outcomes to support the combination of FGFR inhibitors with ICIs, chemotherapy, or targeted therapies. A better understanding of the different mechanisms of action to inhibit FGFR signaling pathways, optimal patient selection and treatment approaches is still needed., Competing Interests: Declaration of competing interest None., (Copyright © 2025 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Testicular cancer accounts for 5% of urological tumors, with an incidence of 5.6 cases per 100,000 men per year in Europe (1). Salvage retroperitoneal lymphadenectomy is the standard surgery for persistent retroperitoneal masses after chemotherapy. The advent of minimally invasive surgery is changing the therapeutic approach. The objective is to present our initial experience with the transmesocolic robotic approach for the surgical management of these masses., Methods: We report the perioperative and oncological outcomes of four patients affected by non-seminomatous germ cell tumors who were treated with transmesocolic robotic left para-aortic retroperitoneal lymphadenectomy., Results: The surgical time for the first case was 220 min, and the average surgical time for the remaining cases was 120 min (SD: 15). Estimated blood loss was 82.5 mL (SD: 79.3). No intraoperative or postoperative complications were observed. Pathological anatomy revealed post-pubertal teratoma (30%) and necrosis (70%) in case 1, necrosis with reactive adenitis in case 2, extensive fibrosis in case 3 and post-pubertal teratoma in case 4. Currently, all patients are disease-free., Conclusions: Robotic retroperitoneal lymphadenectomy is a safe and precise technique that offers favorable oncological and functional outcomes. The transmesocolic approach represents a feasible option in selected cases, ensuring rapid retroperitoneal access and reduced surgical time., Competing Interests: Declaration of competing interest None., (Copyright © 2025. Published by Elsevier España, S.L.U.)

Objectives: To evaluate the role of circulating tumor DNA (ctDNA) as a prognostic and predictive biomarker in the perioperative management of muscle-invasive bladder cancer (MIBC)., Methods: We conducted a systematic literature review using PubMed, MEDLINE, and Embase, following PRISMA guidelines. Studies from January 2013 to March 2024 were included if they examined ctDNA in MIBC patients undergoing radical cystectomy (RC) and perioperative chemotherapy or immunotherapy., Results: Eight studies were included. ctDNA detected before RC was associated with poor recurrence-free survival and higher risk of nodal and locally advanced disease. Postoperative ctDNA levels correlated with shorter disease-free survival and higher recurrence rates. ctDNA clearance during neoadjuvant chemotherapy was predictive of treatment response. ctDNA status post-neoadjuvant immunotherapy correlated with pathological outcomes and recurrence rates., Conclusions: ctDNA is a promising biomarker for predicting oncological outcomes in MIBC, with potential to guide perioperative treatment decisions. Further randomized controlled trials are needed to validate these findings., Competing Interests: Declaration of competing interest None., (Copyright © 2025. Published by Elsevier España, S.L.U.)

Introduction: Kidney transplant (KT) recipients are at an elevated risk of developing de novo cancers. However, penile (PeCa) and testis cancers have received limited attention in this setting., Objective: To summarize the epidemiology, treatment options, and oncological outcomes of penile and testis cancer in KT recipients., Evidence Acquisition: We conducted a systematic review of prospective, retrospective and national transplant registries studies published up to December 2023. Data on the incidence of penile and testis cancers among KT recipients, diagnostic protocols, screening recommendations, and therapeutic strategies tailored for KT recipients were collected. The risk of bias (RoB) of included studies was determined using the Newcastle and Ottawa scale., Evidence Synthesis: Overall, 21 studies involving 67924 KT male recipients were included. PeCa was diagnosed in 33 patients, yielding an incidence ranging from 0.04% to 0.3%. Additionally, 67 cases of testicular cancer were recorded, with an incidence ranging from 0.03% to 0.55%. Most tumors were localized, and histology variants were uncommon. While the surgical treatment of the primary tumor remains consistent with that of the general population, the use of radiotherapy and cytotoxic treatments are less frequently reported in this setting. These therapies should be considered on an individualized basis to minimize the risk of graft injury., Conclusions: Penile and testis cancers are relatively uncommon among KT recipients. General screening protocols and deviation from current treatment guidelines are not recommended in localized diseases. Given the risk of graft damage, any non-cytotoxic option should be preferred in locally advanced cases., Competing Interests: Declaration of competing interest None., (Copyright © 2025 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction and Objectives: Urothelial carcinoma is a challenging disease that requires a comprehensive approach. Multidisciplinary tumor committees are essential to bring specialists together, optimize treatment, ensure individualized care, and promote evidence-based decision making. This study aims to collect evidence and explore the impact of multidisciplinary tumor committees in the management of urothelial carcinoma., Materials and Methods: A systematic review was performed following PRISMA guidelines. We searched PubMed/Medline, Embase, Scopus and Cochrane databases for relevant studies on the role of multidisciplinary committees in the management of urothelial carcinoma, including bladder cancer, upper tract urothelial carcinoma and urethral carcinoma. Given the limited and heterogeneous evidence, a systematic review with narrative synthesis was performed., Results: Multidisciplinary tumor committees had a significant impact on the diagnosis and treatment of urothelial neoplasms, especially bladder cancer. Consistent findings showed that these committees produced substantial changes in treatment, improved adherence to clinical guidelines, and demonstrated a potential to improve patient outcomes. In addition, multidisciplinary committees increased the likelihood of curative treatments and were associated with reduced mortality rates, enhanced clinical decision making, and improved patient care, particularly in bladder and upper tract urothelial carcinoma., Conclusions: This review highlights the essential role of multidisciplinary tumor committees in improving the management of urothelial carcinoma of the bladder and upper urinary tract. However, further research using standardized approaches is needed. The absence of studies on urethral carcinoma underlines the urgent need to investigate the potential benefits of multidisciplinary tumor committees. Future studies should cover a wider range of tumor types and follow standardized methodologies to provide a more complete and generalizable picture., Competing Interests: Declaration of competing interest None., (Copyright © 2025. Published by Elsevier España, S.L.U.)

Objective: To evaluate outcomes of same sitting Bilateral Retrograde IntraRenal Surgery (SSB-RISRS) for kidney stone in patients aged ≥70 years., Methods: We retrospectively reviewed patients with bilateral kidney stones who underwent SSB-RISRS in 21 centers (January 2015-June 2022)., Inclusion Criteria: patients aged ≥70 years, bilateral kidney stones diagnosed due to either unilateral or bilateral symptomatic presentation. Patients were divided into 2 groups. Group 1: patients aged 70-74 years, Group 2: patients aged ≥75 years., Results: There were 86 patients in Group 1 and 60 patients in Group 2. There was no difference between the groups for gender, ASA score, BMI, comorbidities, presenting symptoms, and positive preoperative urine culture. Group 2 had a significantly higher proportion of recurrent stone formers (54.7% vs 35.0%, p = 0.03). A higher proportion of bilaterally pre-stented patients were present in group 2 (37.9% vs 18.6%). There was no difference in total operation time and rate of post-operative uni- and bilateral stent positioning. Surgery was discontinued in 15.1% and 18.3% of cases in groups 1 and 2, respectively (p = 0.773). Median length of postoperative stay was 2 days in both groups. The most frequent complication was fever requiring antibiotics and prolonged admission (10.5% in group 1 and 11.7% in group 2, p > 0.99). Sepsis rate was 2.3% patients in group 1 and none in group 2. 1.2% in group 1 required a blood transfusion due to hematuria. Bilateral SFR was similar (60.0% vs 47.7%, p = 0.194)., Conclusions: SSB-RISRS in elderly patients demonstrated an acceptable safety profile with good bilateral SFR., Competing Interests: Declaration of competing interest None., (Copyright © 2025 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Until recently there was no recommended adjuvant therapy for patients with lymph nodes metastasis (ypN+) following neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). The aim of the study was to describe the oncological outcomes of ypN+ patients following NAC and RC for MIBC., Methods: This collaborative retrospective study included 195 patients with ypN+ disease after NAC followed by RC and bilateral pelvic lymph node dissection for MIBC between 2000 and 2019 in seven centers. Patients' demographics, clinical and pathological features were collected. Survival analyses were carried out with Kaplan-Meier estimates and a Cox model was generated., Results: A total of 120 patients (62%) were pN1, 51 pN2 (26%) and 24 pN3 (12%). Adjuvant radiation therapy was performed in 18 (9%), adjuvant chemotherapy in 40 (21%) and the remaining 137 (70%) patients were observed. The median follow-up time was 51 months (95%CI 44-62). Median times for recurrence-free survival, cancer-specific survival and overall survival (OS) were 18 months (95%CI 16-21), 47 months (95%CI 31-70) and 28 months (95%CI 22-34) respectively. On multivariable analysis, female gender (HR = 1.5, 95%CI 1.002-2.21, p = 0.049) and positive surgical margins (HR = 1.6, 95%CI 1.06-2.38, p = 0.026) were the only independent predictor of OS. The type of adjuvant therapy did not impact OS (adjuvant chemotherapy, p = 0.44; adjuvant radiotherapy p = 0.40)., Conclusion: MIBC patients with residual node positive disease following NAC and RC have poor survival outcomes. Females and patients with positive margin status at RC carry a poorer prognosis. These results may be beneficial for clinical trial design., Competing Interests: Declaration of competing interest No conflict of interest for all authors., (Copyright © 2025. Published by Elsevier España, S.L.U.)

Background: Elevated night resting heart rate (HR) has been associated with increased depression severity, yet the underlying mechanisms remain elusive. This study aimed to investigate the mediating role of sleep disturbance and the influence of anxiety on the relationship between night resting HR and depression severity., Methods: This is a secondary data analysis of data collected in the Remote Assessment of Disease and Relapse (RADAR) Major Depressive Disorder (MDD) longitudinal mobile health study, encompassing 461 participants (1774 observations) across three national centers (Netherlands, Spain, and the UK). Depression severity, anxiety, and sleep disturbance were assessed every three months. Night resting HR parameters in the 2 weeks preceding assessments were measured using a wrist-worn Fitbit device. Linear mixed models and causal mediation analysis were employed to examine the impact of sleep disturbance and anxiety on night resting HR on depression severity. Covariates included age, sex, BMI, smoking, alcohol consumption, antidepressant use, and comorbidities with other medical conditions., Results: Higher night resting HR was linked to subsequent depressive severity, through the mediation of sleep disturbance. Anxiety contributed to an exacerbated level of sleep disturbance, subsequently intensifying depression severity. Anxiety exhibited no direct effect on night resting HR., Conclusions: Our findings underscore the mediating role of sleep disturbance in the effect of night resting HR on depression severity, and anxiety on depression severity. This insight has potential implications for early identification of indicators signalling worsening depression symptoms, enabling clinicians to initiate timely and responsive treatment measures., Competing Interests: Declaration of competing interest Vaibhav A Narayan is employee of Janssen Research and Development LLC. Peter Annas is employed by the pharmaceutical company H. Lundbeck A/S. Josep Maria Haro has received economic compensation for participating in advisory boards or giving educational lectures from Eli Lilly & Co, Sanofi, Lundbeck, and Otsuka. No other authors have competing interests to declare., (Copyright © 2025. Published by Elsevier B.V.)

Objective: Improving the management of metabolic dysfunction-associated steatotic liver disease (MASLD) in Primary Care requires a good knowledge of the disease. This study evaluated the knowledge of biomarkers and comorbidities associated with the disease among Primary Care Physicians (PCPs), the resources available for diagnosis, and the relationship with hepatologists., Materials and Methods: Cross-sectional study based on an anonymous email survey sent to PCPs actively practicing at the time of distribution. Retired professionals were excluded. The survey comprised 29 questions grouped into 3sections: 1. Sociodemographic characteristics, 2. Relationship with the gastroenterology department, 3. Diagnosis and management of MAFLD., Results: A total of 362 responses were received (10.23% participation). Of the respondents, 64.2% were women, and the most participative age group was 50-59 (29.4%). Cantabria, Catalonia, Andalusia, Castilla-León and Madrid were the regions with the highest response rates. 81.5% of PCPs did not have protocols for diagnosis and management, and while two-thirds were familiar with the Fib-4 marker, only half used it. Having protocols increased the use of Fib-4 (OR 4.41; 95%CI 1.68-11.53). A total of 81.5% recognized the importance of extrahepatic comorbidities, and 92% actively screened for cardiovascular risk factors. Elastography was considered useful by 58.7%, but only 11% had access to it. 72% of PCPs had no relationship with specialists, although 60% had access to a Hepatology Unit., Conclusions: It is necessary to improve knowledge of MAFLD, strengthen collaboration between care levels, and establish standardized management protocols., (Copyright © 2025 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Focal segmental glomerulosclerosis (FSGS) is a histological pattern of injury that derives from various pathological processes that affect podocytes, resulting in loss of selectivity of the glomerular filtration membrane, proteinuria and the development of renal failure that progresses to end-stage kidney disease in a significant number of patients. The classification proposed by the 2021 KDIGO guidelines divides FSGS into four categories: primary, secondary, genetic, and FSGS of undetermined cause, thus facilitating its diagnosis and management. Genetic causes of FSGS present significant clinical variability, complicating their identification. Genetic testing is crucial to identify FSGS of genetic cause. The prevalence of genetic FSGS is significant in children and considerable in adults, highlighting the importance of early diagnosis to avoid unnecessary treatments and facilitate genetic counselling. Massive sequencing techniques have revolutionized genetic diagnosis, allowing the identification of more than 60 genes responsible for podocyte damage. This document proposes clinical recommendations for carrying out genetic studies in adults with FSGS, highlighting the need for a correct classification for adequate therapeutic planning and improvement of results in clinical trials., Competing Interests: Declaration of competing interest Nothing declared., (Copyright © 2024 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: 11β-hydroxylase (11β-OH) deficiency is the second most frequent cause of classic congenital adrenal hyperplasia (CAH) (5%-8% of cases). Clinically, it is characterized by virilization and arterial hypertension. The objective of this study was to describe the clinical, biochemical and genetic characteristics classic 11β-OH deficiency in patients managed in our hospital and its outcomes., Patients and Methods: Retrospective longitudinal, observational and descriptive study., Inclusion Criteria: Patients with clinical features of virilization, high levels of 11-deoxycortisol and study of CYP11B1 gene with detection of pathogenic and likely pathogenic variants., Results: We identified 6 patients (1 male, 5 female) from 4 families. In the 4 index cases, the median age at diagnosis was 2.3 years. The 46,XX patients exhibited a variable degree of virilization at diagnosis, with a predominance of Prader stage V, and one case of male sex assignment at birth. All patients had elevated serum concentrations of 17-hydroxyprogesterone and testosterone. Fifty percent of the patients had developed arterial hypertension during the follow-up, with onset at a median age of 9.3 years. Three 46,XX patients reached a median final height of 154 cm. Six different variants of theCYP11B1 gene were identified, 5 of which were novel variants (c.595 G > A, c.710 T > C, c.1156delG, c.395 + 2dupT, c.1159dupA)., Conclusions: There is considerable heterogeneity in the clinical presentation of patients with CAH due to 11β-OH deficiency. Early diagnosis and treatment are important to prevent complications and improve long-term outcomes. We report 6 different variants of the CYP11B1 gene, including 5 novel variants., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

The Spanish enhanced recovery in adult surgery strategy, the "RICA pathway", was published in 2021 and includes 19 specific recommendations and more than 20 indirect recommendations for patient blood management (PBM). After reviewing these recommendations, and in the context of the new clinical evidence available, we propose the following updates: First: Detection and treatment of any preoperative anemia status in ALL patients who are candidates for major surgery with hematinic deficiencies. Second: Universal use of tranexamic acid in major surgery, bedside monitoring of intraoperative hemoglobin levels, restrictive transfusion criteria, and monitoring of patient well-being in terms of hydration, coagulability, normothermia and analgesia. Third: Restrictive transfusion criteria, single-unit blood transfusion and diagnosis/treatment of postoperative anemia. Real, universal implementation and integration of PBM in the RICA program is urgently needed., Competing Interests: Declaration of competing interest Dr García Erce is the representative of the Spanish Society of Hematology and Hemotherapy (SEHH) in the RICA pathway and member of the group that created RICA. Prof Manuel Muñoz was the representative of the Spanish Blood Transfusion Society in the RICA pathway. https://www.sanidad.gob.es/profesionales/excelencia/docs/via-clinica-cirugia-adulto-rica-2021.pdf. Dr Quintana Díaz was External Advisor for the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC). Dr Quintana Díaz is the Coordinator of the GESMA Working Group in the Community of Madrid. Dr Quintana Díaz is the President, Dr García Erce the Vice President and Dr Jericó Alba the Administrative Director of projects of the National Directive of the Ibero-American Society for Patient Blood Management https://siapbm.com. Drs Bueno Cabrera (SEHH), Jericó Alba (SEMI) and Páramo (SETH) collaborated in the review of the scientific literature as assessors of the RICA pathway., (Copyright © 2024. Published by Elsevier España, S.L.U.)

The recognition and treatment of intestinal bacterial overgrowth syndrome are matters of controversy. The symptoms that have guided the search for the disorder suffer from lack of specificity, especially in the absence of well-defined predisposing factors. The accuracy of diagnostic procedures has been questioned and the proposed therapies achieve generally low effectiveness figures, with large differences between available studies. It is also unknown whether the normalization of tests is really a guarantee of cure. Within this framework of uncertainty, and in order to contribute to the guidance and homogenization of medical practice, a group of experts from the AEG and ASENEM have formulated the key questions on the management of this pathology and have provided answers to them, in accordance with the available scientific evidence. In addition, they have drawn up statements based on the conclusions of the review and have voted on them individually to reflect the degree of consensus for each statement., (Copyright © 2024 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Patients with type 2 diabetes mellitus (T2DM) managed in both hospital and out-ofhospital settings usually have a high/very high cardiovascular risk, with a high burden of cardiovascular disease. All this justifies that the reduction of low-density lipoprotein cholesterol is the main therapeutic goal in T2DM. However, residual cardiovascular risk is very prevalent in T2DM, and is usually associated with atherogenic dyslipidemia and hyperlipoproteinemia(a); therefore, it is also necessary to reverse these lipoprotein abnormalities to achieve effective cardiovascular prevention. Given the considerable armamentarium of lipid-lowering drugs currently available, the Cardiovascular Disease Working Group of the Spanish Diabetes Society has considered it appropriate to carry out a narrative review and update of the effectiveness of these lipid-lowering drugs in the population with T2DM taking into account their effect on the lipoprotein profile and their potential impact on glycemic control., Competing Interests: Declaration of competing interest F. Arrieta, V. Sánchez-Margalet, J.A. Gimeno-Orna, J.I. Martínez-Montoro, E. Ortega-Martínez de Victoria, and J. Ribalta declared no conflicts of interest whatsoever. J. Pedro-Botet has received consultancy fees, expert testimony fees, speaking fees, and/or support for meetings from Almirall, Amarin, Amgen, Daiichi-Sankyo, Esteve, Ferrer, Novartis, Organon, Sanofi, and Viatris. M. Botana has received consultancy or speaking fees from Almirall, Amgen, Daiichi-Sankyo, Esteve, Ferrer, Novartis, Sanofi, and Viatris. A. Pérez-Pérez has been a consultant or received research grants, speaking fees, or conference attendance support from Sanofi Aventis, Almirall, Novo Nordisk, Eli Lilly, MSD, Abbott, Dexcom, Boehringer Ingelheim, Esteve, Gilead, Novartis, Amgen, Menarini, Amarin, Novartis, Bayer, Daiichi-Sankyo, and AstraZeneca., (Copyright © 2024 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Purpose: To systematically review and summarize the available literature on (1) postoperative healing rates, meniscal extrusion (ME) and clinical outcomes following lateral (LMPRR) versus medial (MMPRR) root repair and (2) potential correlations between residual ME and healing outcomes., Methods: A comprehensive literature search was conducted using the Scopus, PubMed and Embase databases. Clinical studies evaluating healing status on second-look arthroscopy and magnetic resonance imaging (MRI) after LMPRR and MMPRR were included. Study quality was assessed using the Methodological Index for Non-Randomized Studies criteria and the modified Coleman Methodology Score., Results: Twenty-three studies comprising 871 patients with LMPRR (n = 406) and MMPRR (n = 465) were included. Overall, 223 (54.9% of total) and 149 (32.04% of total) patients underwent second-look arthroscopy in the LMPRR and MMPRR groups, respectively. Complete root healing was observed in 190 (85.2%) patients in the LMPRR group versus 78 (52.3%) in the MMPRR group (p < 0.001). There were six (2.7%) failed repairs in the LMPRR group compared to 21 (14.09%) in the MMPRR group (p < 0.001). On postoperative MRI, 109 (75.7%) root repairs were healed in the LMPRR group compared to 192 (53.3%) in the MMPRR group (p < 0.001). Failure rates were lower after all-inside and transtibial pullout repairs in the LMPRR group but higher in the MMPRR group, with no significant mean difference between preoperative and postoperative ME in the MMPRR group (p = 0.95). Significantly better clinical outcomes were observed in the LMPRR group compared to the MMPRR group. A greater degree of postoperative ME was associated with lower healing rates (R = -0.78, p < 0.0005). Postoperative ME did not influence clinical outcomes (R = 0.28, p = 0.29)., Conclusions: Lateral meniscus posterior root repairs showed higher healing rates compared to MMPRR on both second-look arthroscopy and postoperative MRI. Meniscal extrusion decreased after LMPRR but not after MMPRR. Greater residual ME correlated inversely with healing rates, as more extrusion was associated with lower healing. Postoperative clinical improvement did not affect ME or healing status., Study Design: Systematic review of level III and IV studies., Level of Evidence: Level IV., (© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)

Children and adolescents with SGCE-myoclonus dystonia showed a progression of motor symptoms during a mean follow-up of 4 years. Patients developed a significant increase in the severity of axial and limb myoclonus, as well as dystonia during writing. Consequently, patients reported a marked decline in their speech, writing, and walking abilities. Up to 74% of patients had a psychiatric diagnosis, most commonly anxiety, obsessive-compulsive disorders, and attention-deficit/hyperactivity disorder., (© 2025 Mac Keith Press.)

Figurative language is a complex construct related to intelligence. Psychology and psycholinguistics are trying to understand it from an interdisciplinary perspective, but studies are still scarce, methodologies are heterogeneous, and results are difficult to integrate. Some studies suggest that understanding the cognitive processes underlying figurative language and its forms could provide a new approach to understanding intellectual differences, such as high intellectual ability (HIA), and new instruments to assess it. The language of HIA children develops earlier and includes the use of irony, which involves metalinguistic skills. In this context, the present study aims to offer an instrument, called the verbal irony questionnaire (or VIrQ), to test the comprehension of verbal irony in students with HIA. A convenience sample of n = 169 students with HIA, aged between 7 and 15 years, responded to the VIrQ. An exploratory factor analysis was conducted. The results revealed that 33 items were retained and categorized into four factors. F1, ironic dissociation (14 items); F2, ironic attitude (8 items); F3, ironic constructions (7 items); and F4, reinforced irony echo (4 items). All factors have adequate reliability indices above 0.70 and below 0.95. Finally, new perspectives are also discussed.

Background: Venous thromboembolism (VTE), whether pulmonary embolism (PE) or deep vein thrombosis (DVT), is common in patients with COVID-19. Recommendations on systematic screening in the intensive care unit (ICU) are lacking., Research Question: Is there any clinical benefit of systematic screening for DVT in critically ill patients with severe COVID-19?, Study Design and Methods: Single-center randomized clinical trial (RCT) of COVID-19 cases admitted to the ICU. Patients were randomized into two groups: a study group that underwent ultrasound (US) screening for DVT Mondays and Thursdays, and a control group that was treated according to the unit protocol. The primary outcome was the presence of DVT. Secondary outcomes were ICU total stay, death within 21-day follow-up and bleeding complications (minor or major). A composite outcome of poor prognosis variables was analyzed. We tested a superiority hypothesis with a confidence level of 95% and an equivalence limit of 20%., Results: 163 patients (84 screening group, 79 control group) were enrolled between April and July 2021. There were 90 men (55.2%) with a mean ± SD age of 49.8 ± 13.58 years. In screening group 16.7% developed DVT versus 3.8% in control group (p = .007), and 3.6% versus 5.1% developed PE, respectively (p = 0.7). Poor outcome variables were male sex, age, COVID-19 vaccination status, Fibrinogen, Urea, Creatinine and Interleukin 6 (IL6) levels; Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scales. The superiority comparison, with a power of 95%, showed no statistically significant differences for a composite endpoint (p = .123). After adjusting by group, the OR for poor outcome is 1.966 (0.761-5.081) p = 0.163., Interpretation: Among these patients, a strategy of systematic US screening for DVT was not associated with any significant improvements to clinical outcomes compared with usual care., Clinical Trial Registration: Clinicaltrials.org registration number: NCT05028244.

Objective: The effects of stimulation frequency on verbal fluency (VF) following subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) are not well understood. The present study examines the impact stimulation frequency has on VF following bilateral STN-DBS in PD., Methods: Prospective study of 38 consecutive patients with PD with low frequency STN-DBS (LFS) (n = 10) and high frequency STN-DBS (HFS) (n = 14), and a non-operated PD control group consisting of patients with fluctuating response to dopaminergic medication (n = 14) homogeneous in age, education, disease duration, and global cognitive function. Patients were evaluated on VF tasks (letter, semantic, action verbs, alternating). A one-way analysis of variance (ANOVA) was conducted to assess distinctions between groups. Pre- and post-surgical comparisons of fluencies were performed for operated groups. A mixed ANOVA was applied to the data to evaluate the interaction between treatment (HFS vs. LFS) and time (pre- vs. post-surgery). Strategy use (clustering and switching) was evaluated., Results: Semantic and letter fluency performance revealed significant differences between HFS and LFS groups. Pre- and post-surgical comparisons revealed HFS negatively affected letter, semantic, and action fluencies, but LFS had no effect on VF. No interaction effect or main effect of treatment was found. Main effect of time was significant for semantic and action fluencies indicating a decrease in postoperative fluency performance. Patients with LFS produced larger average cluster sizes than patients with HFS., Conclusion: LFS may be less detrimental to VF, but these findings suggest that VF decline following STN-DBS is not caused by stimulation frequency alone., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction and Objectives: In recent years, several cases of hereditary transthyretin amyloidosis (ATTRv) due to the p.Val142Ile variant have been described in patients without African ancestry. The aim of this study was to analyze the impact of ATTRv caused by p.Val142Ile in Spain, focusing on its phenotypic characteristics and its population frequency., Methods: Patients diagnosed with ATTRv caused by p.Val142Ile, as well as carriers irrespective of their phenotype, were recruited from 16 centers in Spain. Baseline characteristics and events during follow-up were retrieved. Population frequency was assessed using data from the Spanish National DNA Bank (N=3569) and the Catalan Health Databank (N=790)., Results: The cohort included 164 participants: 75 probands (45.7%) and 89 relatives (54.3%). Among the probands, the mean age was 73.9±8.5 years, and 47 (62.7%) were male. Sixty-seven probands (89.3%) reported European ancestry, while only 6 (8%) reported African ancestry. Cardiac symptoms were the most frequent reason for ATTRv diagnosis (n=64; 85.3%). The median follow-up was 2.6 years [Interquartile range, 1.5-4.1]. Overall penetrance at ages 65, 75, and 85 years was 12.8%, 44.3%, and 94.2%, respectively. Tafamidis was initiated during follow-up in 38 patients: after 1 year of treatment, 14 patients (38.9%) met the combined endpoint (12 experienced disease progression and 2 died from cardiovascular causes). Population frequency was estimated to range between 0.0% and 0.12%, based on data from the Spanish and Catalan databases, respectively., Conclusions: ATTRv caused by p.Val142Ile has a significant prevalence in Spain. Its phenotypic features are characterized by late onset, male predominance, and cardiac involvement., (Copyright © 2025 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Exacerbations of COPD decrease physical activity. Physical activity interventions after these events are desirable but have had mixed results. Understanding the barriers to and enablers of physical activity may help to improve the results of these interventions. We aimed to assess the barriers to and enablers of physical activity after COPD exacerbation and their association with daily steps., Methods: We carried out a cross-sectional analysis of patients with COPD enrolled during a hospitalisation for an exacerbation. Physical activity was measured with an accelerometer for 7 days after discharge. Patients completed an ad hoc 6-point Likert scale questionnaire about 13 barriers to and nine enablers of physical activity. We analysed the association between each item and patients' daily step counts., Results: 46 patients with a mean±sd forced expiratory volume in 1 s of 48.6±15.9% predicted completed the assessments. They were 65±10 years old, spent 8±2 days hospitalised and walked 5633±3314 steps·day -1 after discharge. The patients who reported "breathlessness" as a barrier (≥2 out of 6 points on the Likert scale) took statistically fewer daily steps (median (25th-75th centile) 3813 steps·day -1 (2664-5639 steps·day -1 ) versus 5549 steps·day -1 (3692-9984 steps·day -1 ), p=0.034). There was a similar finding for those who reported "low mood" as a barrier (≥2 out of 6 points) (3813 steps·day -1 (2456-5471 steps·day -1 ) versus 5426 steps·day -1 (3612-8942 steps·day -1 ), p=0.047). If they considered "physical activity as healthy" as an enabler, they walked statistically more (5085 steps·day -1 (3538-8703 steps·day -1 ) versus 2760 steps·day -1 (2271-5298 steps·day -1 ), p=0.031)., Conclusion: Some barriers to and enablers of physical activity reported by patients after a COPD exacerbation relate to daily steps. Assessing physical activity barriers and enablers could be useful to improve future physical activity interventions after these events., Competing Interests: Conflict of interest: None declared., (Copyright ©The authors 2025.)

Purpose: After 15 years of accumulated experience in the Descemet Membrane Endothelial Keratoplasty (DMEK) technique, this surgical method has demonstrated a high reproducibility and success rate. However, certain ocular conditions such as aphakia and previously vitrectomized eyes remain challenging. We describe a novel technique designed to improve surgical time and postoperative outcomes in these specific scenarios., Methods: Following delivery of the Descemet membrane graft into the anterior chamber (AC), a small air bubble was injected beneath the graft. One edge of the graft was grasped using the forceps. Subsequently, the external corneal surface was tapped, until the graft was unrolled., Results: In our experience, this technique has consistently led to a reduced surgical time and excellent anatomical outcomes, achieving complete membrane attachment., Conclusions: The technique developed and described herein provides a valuable surgical alternative for achieving successful DMEK outcomes in complex cases., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The AEP 2025 Vaccination and Immunization Schedule recommended for children, adolescents and pregnant women residing in Spain features the following novelties: Due to the increase in measles cases and outbreaks in recent years, we recommend advancing the second dose of measles, mumps and rubella (MMR) vaccine to 2 years of age. As a consequence of the above, since many autonomous communities (ACs) use the quadrivalent vaccine for the second dose of MMR and varicella vaccines, we recommend, for all ACs, advancing the second dose of varicella vaccine to 2 years of age. Due to the very significant increase in cases of pertussis since late 2023 and especially in 2024, we recommend advancing the dose of Tdap given in adolescence to 10-12 years of age. To complete protection against meningococcal disease in adolescence, we recommend vaccination against MenB at age 12 years. We believe that vaccination against seasonal influenza should be routine up to age 18 years, but given the disappointing coverage in children aged 6-59 months, we currently consider that improving this coverage should be prioritised, extending vaccination to children and adolescents aged 5-18 years once this objective has been achieved. Among other aspects, the routine immunization tables for healthy individuals and risk groups, the use of the new extended-valence conjugate vaccines against pneumococcal disease, routine vaccination at 4 months of age with MenACWY and vaccination against SARS-CoV-2 for individuals aged more than 6 months with risk factors remain unchanged with respect to the 2024 schedule., Competing Interests: Declaration of competing interest (Last five years) FJAG has collaborated in educational activities funded by Alter, AstraZeneca, GlaxoSmithKline, MSD, Pfizer and Sanofi and as a consultant in GlaxoSmithKline, MSD, Pfizer and Sanofi advisory boards. AIA has collaborated in educational activities funded by AstraZeneca and and as a consultant in GlaxoSmithKline and Pfizer advisory boards. He has also received funding from GlaxoSmithKline, MSD and Pfizer o attend domestic educational activities. JAA has collaborated in educational activities funded by AstraZeneca, GlaxoSmithKline, MSD, Pfizer, Sanofi and Seqirus, as a researcher in clinical trials for GlaxoSmithKline and Sanofi and as a consultant in AstraZeneca, GlaxoSmithKline, MSD, Pfizer and Sanofi advisory boards. EGL has received funding to attend domestic educational activities and has participated in educational activities funded by GlaxoSmithKline, MSD, Pfizer and Sanofi, as a researcher in clinical trials for GlaxoSmithKline and MSD and as an advisory board consultant for GlaxoSmithKline. LLG has collaborated in educational activities funded by AstraZeneca, GlaxoSmithKline, MSD, Moderna and Sanofi and as an advisory board consultant for MSD. She has also received funding from Pfizer and Sanofi to attend educational activities in Spain and abroad, and received grants sponsored by GlaxoSmithKline. MLNG has collaborated in educational activities funded by Gilead, GlaxoSmithKline, Janssen, MSD, Pfizer and ViiV, as a consultant in Abbott, AstraZeneca, Novartis and ViiV advisory boards and as a researcher in clinical trials sponsored by GlaxoSmithKline, Pfizer, Roche and Sanofi. VPS has received funding from MSD, Pfizer and Sanofi to attend educational activities in Spain and abroad, has collaborated in educational activities funded by AstraZeneca, GlaxoSmithKline, MSD, Pfizer and Sanofi and as a consultant in GlaxoSmithKline, Pfizer and Sanofi advisory boards. IRC has collaborated in educational activities funded by GlaxoSmithKline, MSD, Pfizer and Sanofi, as a researcher in vaccine clinical trials for Abbot, AstraZeneca, Enanta, Gilead, GlaxoSmithKline, HIPRA, Janssen, Medimmune, Merck, Moderna, MSD, Novavax, Pfizer, Reviral, Roche, Sanofi and Seqirus and as a consultant in GlaxoSmithKline, MSD, Pfizer and Sanofi advisory boards. JRC has collaborated in educational activities funded by GlaxoSmithKline, MSD, Pfizer and Sanofi and as a researcher in clinical trials for GlaxoSmithKline and Pfizer. ISC has collaborated in educational activities funded by GlaxoSmithKline, MSD, Moderna, Novavax, Pfizer, Sanofi and Seqirus, as a researcher in vaccine clinical trials for Ablynx, Abbot, Almirall, Allergan, Astra Zeneca, Biomedal, GlaxoSmithKline, Janssen, Lilly, Medimmune, Merck, MSD, Moderna, Nestlé, Novavax, Novartis, Nutricia, Pfizer, Roche, Regeneron, Sanofi, Seqirus and Wyeth and as a consultant in Astra Zeneca, GSK, MSD, Moderna, Novavax, Pfizer and Sanofi advisory boards. PSM has collaborated in educational activities as a researcher in vaccine clinical trials for Sanofi and as a consultant in GlaxoSmithKline and Sanofi. He has also received funding from GlaxoSmithKline, MSD and Pfizer to attend educational activities in Spain and abroad, and received grants sponsored by GlaxoSmithKline., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Triple-negative breast cancer (TNBC) is challenging to treat because of its lack of specific molecular targets. The IMMUNOPEG study aimed to evaluate a novel structured method for interpreting TNBC immunohistochemistry specimens processed with VENTANA PD-L1 (SP142) assay. The study involved 10 pathologists who evaluated 50 different immunohistochemistry specimens of TNBC with programmed death ligand 1 (PD-L1) expression considered challenging and that were previously evaluated by the scientific committee, using the NAVIFY Digital Pathology platform. Initially, the overall percent agreement (OPA) was 74%, with a negative percent agreement (NPA) of 68.2% for samples classified as negative, and a positive percent agreement (PPA) of 94.5% for positive samples. After training on the method, the OPA improved significantly to 81.6%, with the NPA increasing to 80.5% and the PPA decreasing to 85.5%. The mean percentage of the tumor area occupied by PD-L1-stained immune cells decreased from 2.5% to 1.6% post-training, approaching to the scientific committee's consensus of 1.029%. The study found that the pathologists' confidence in their assessments increased significantly when using the structured method, which was found to be easy to use by 9 out of 10 pathologists. All pathologists agreed that the structured method was useful for assessing PD-L1 expression. The study suggests that this method has potential value in interpreting challenging cases of PD-L1 immunohistochemistry (IHC) in TNBC. Further refinement and a training protocol may be necessary to enhance the method's efficiency. The potential for generalizing this structured method to other IHC procedures and pathologies warrants additional research., Competing Interests: V.P. has received fees as consultant, participated in advisory boards and/or received travel grants from Sysmex, Roche, MSD, AstraZeneca, Bayer, Exact Sciences, and Daiichi-Sankyo. M.A.M. has received travel grants and fees for having participated in scientific meetings from Roche and MSD. M.G.-R. has received fees as consultant, participated in advisory boards and/or received travel grants from Sysmex, Roche, MSD, and Hologic. D.H. has received fees as consultant, participated in advisory boards and/or received travel grants from Sysmex, AstraZeneca, and Daiichi-Sankyo. M.J.N. has received fees as consultant, participated in advisory boards, and/or received travel grants from Roche. M.L.S.-B. has received fees as travel grants from Sysmex and Roche. L.G. and I.R. have received honoraria from Roche Farma S.A. F.R. has received fees as consultant, participated in advisory boards, and/or received travel grants from Roche, MSD, BMS, AstraZeneca, Lilly, Astellas, Daiichi-Sankyo, AbbVie, GSK, Novartis, Merck, Agilent, Sophia Genetics, Menarini, Amgen, Janssen. The remaining authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Purpose: Patients with head and neck cancer (HNC) are particularly vulnerable to mental health concerns. Radiotherapy (RT) remains a key treatment modality for these malignancies, offering high chances of cure. However, the effects on mental health are not well defined. We aim to characterize longitudinally the prevalence and risk of depressive and anxiety symptoms over the course of RT in patients with HNC., Material and Methods: A literature search was performed from database inception until November 1st, 2024. PROSPERO/MOOSE-compliant and pre-registered (PROSPERO:CRD42023441432) systematic review identified studies longitudinally reporting in patients with HNC undergoing curative intent RT. Pooled prevalence and odds ratio of clinically significant anxiety and depressive symptoms between different treatment timepoints were estimated using random-effects meta-analysis., Results: 18 studies (total sample 1,920, mean age 59.9[SD = 3.17], 22.2 % female, 93.0 % white ethnicity) were included. Before RT, a pooled prevalence of depressive symptoms of 18.1 % (95 % confidence intervals [CI] = 13.1 %-24.4 %) was found. Short-term after completing RT (≤3 months), the prevalence of depressive symptoms peaked to 26.1 % (95 %CI = 18.9 %-35.0 %), decreasing in long-term (≥6 months) assessments to 16.4 % (95 %CI = 12.6 %-21.0 %). Anxiety symptoms continuously decreased from baseline (pooled prevalence 29.9 % [95 %CI = 27.3 %-32.7 %]) to 17.4 % (95 %CI = 12.1 %-24.5 %) in the long-term. Female and married patients showed higher prevalence of depressive symptoms. Those who underwent surgery showed a lower prevalence of anxiety symptoms., Conclusions: High prevalence of clinically significant depressive and anxiety symptoms were found in patients with HNC undergoing RT, from baseline to long-term follow-up. The weeks following completion of RT are key, as depressive symptoms increase in this period. Screening and interventions prior to, during, and especially immediately post-RT would be beneficial., Competing Interests: Declaration of competing interest PJ received personal fees or grants from Roche, Merck, MSD Merck Sharp & Dohme, and Novartis outside the current work. CA received personal fees or grants from Janssen Cilag and Neuraxpharm outside the current work and is supported by the Alicia Koplowitz Foundation. IB received personal fees from Merck sharp & Dohme, Sanofi, Achilles Therapeutics, eTheRNA Immunotherapies, Cancer Expert Now, Boehringer Ingelheim as a Speakers’ Bureau: Bristol Myers Squibb, Merck Serono, Roche, MSD. Lastly, as a research Funding: AstraZeneca (Inst), Bristol Myers Squibb (Inst), Celgene (Inst), Gliknik (Inst), GlaxoSmithKline (Inst), Janssen Oncology (Inst), Kura Oncology (Inst), Merck Sharp & Dohme (Inst), Novartis (Inst), Pfizer (Inst), Roche (Inst), Shattuck labs (Inst), Nanobiotix (Inst), Seattle Genetics (Inst), Immutep (Inst), Debiopharm Group (Inst), Regeneron (Inst), Boehringer Ingelheim (Inst), ISA Pharmaceuticals (Inst), Merck Serono (Inst), Seattle Genetics (Inst), Northern Biologics (Inst), VCN Biosciences (Inst), and for travel, accommodations and expenses: MSD Oncology. CN reports research funding paid to their institution from Cancer Research UK. KN received honoraria as a speaker's bureau from Eisai. KJH received honoraria from Arch Oncology (Inst), AstraZeneca (Inst), BMS (Inst), Boehringer Ingelheim (Inst), Merck Serono (Inst), MSD (Inst), Oncolys Biopharma (Inst), Pfizer (Inst), Replimune (Inst), Inzen Therapeutics (Inst) and Codiak Biosciences (Inst). Consulting or Advisory Role: Arch Oncology (Inst), AstraZeneca (Inst), BMS (Inst), Boehringer Ingelheim (Inst), Merck Serono (Inst), MSD (Inst), Oncolys BioPharma (Inst), Replimune (Inst), Inzen Therapeutics (Inst) Speakers’ Bureau: BMS (Inst), Merck Serono (Inst), MSD (Inst) Research Funding: AstraZeneca (Inst), Merck Sharp & Dohme (Inst), Replimune (Inst), Boehringer Ingelheim (Inst). AC received personal fees or grants from Janssen Cilag, ROVI, and Lundbeck outside the current work. All other authors have declared no conflicts of interest (AR, JC)., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Promoting incidental physical activity (IPA) can help reduce sedentary lifestyles and physical inactivity levels in the population. However, there is heterogeneity in the definition of IPA, and studies have yet to synthesize the empirical findings on this topic. This review aimed to (1) Synthesize the definitions of the IPA used in the scientific literature, (2) Identify the behaviors part of the IPA, and (3) Synthesize the main findings on IPA. The review followed PRISMA guidelines. A systematic search was performed in July 2023, and an update was made in February 2024 in the CINAHL databases by EBSCOhost, Cochrane Library, Pubmed, ScienceDirect, Scopus, and Web of Science. The search phrase was ("incidental physical activity" OR "incidental physical activity of daily living" OR "incidental movement" OR "vigorous intermittent lifestyle physical activity" OR "VILPA" OR "physical activity of daily living"). Fifty-five studies were included, with non-experimental (40), experimental (12), qualitative studies (2), and mixed design (1). Ten different terms for IPA were identified, and a conceptual definition was included in 33 articles. Behaviors measured as part of the IPA were reported in 41 articles. These definitions describe unstructured, unplanned, and unintentional physical activities of daily living that are performed as a by-product of an activity with a different primary purpose during free or occupational time and without specific fitness, sport, or recreation goals. Include light and vigorous intensities ranging from short sessions of < 1 min to prolonged ones. They include home activities, self-care, gardening, occupation, active transportation, and walking. Furthermore, evidence on IPA suggests an association with a lower risk of all-cause mortality. The findings of this review contribute to the updated study of IPA. Advances in data processing methods are needed to capture the diversity of behaviors and deepen the understanding of IPA., (© 2025 The Author(s). Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Objective: To evaluate the effectiveness of a virtual community of practice (vCoP) in improving the activation of individuals with ischemic heart disease (IHD)., Method: We conducted a randomized controlled trial. A total of 282 patients with IHD from Madrid, Catalonia, and the Canary Islands were randomly allocated to an intervention or a control group. Patients were anonymized and the statistician was blinded to group allocation. The intervention was a multicomponent-tailored vCoP built on the Web 2.0 concept and focused on skills toward patient empowerment. The primary outcome was the Patient Activation Measure score. Secondary outcomes were self-efficacy to manage the disease, adherence to the Mediterranean diet, level of physical activity, depression, anxiety, medication adherence, and health-related quality of life. A linear regression model of mixed effects was carried out to estimate the effect of participating in the vCoP., Results: Significant differences in adherence to the Mediterranean diet were found favoring the intervention at 6, 12, and 18 months, B = 0.86, 95% confidence interval (CI) [0.36, 1.35]. No significant changes among data collection points were found for the other variables., Conclusion: Our results suggest that vCoPs can be helpful for improving adherence to the Mediterranean diet in individuals with IHD, but not for improving their activation or quality of life. However, considerable uncertainty remains due to participants' high dropout rate. Further research is needed to identify the behavioral change mechanisms of such an intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Introduction: The use of the N category of the TNM staging system, lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) in predicting overall survival (OS) and disease-free survival (DFS) in patients with rectal cancer is still controversial., Material and Methods: A retrospective study of 445 patients with rectal cancer who underwent surgery between 2008 and 2017 in the University Complex Hospital of Vigo was performed. Patients were stratified according to number of lymph nodes examined (NLNE), N staging, LNR and LODDS. The analysis was performed using the log-rank test, Kaplan-Meier functions, Cox regression and ROC curves., Results: Five-year OS and DFS were 73.7% and 62.5%, respectively. No statistically significant differences were observed depending on NLNE. Increased LNR and LODDS were associated with shorter OS and DFS, independently of NLNE. Multivariate analysis showed that N stage, LNR and LODDS were independently associated with OS and DFS; however, the LODDS system obtained the best area under the curve, with greater predictive capacity for OS (AUC: 0.679) and DFS (AUC: 0.711)., Conclusion: LODDS and LNR give prognostic information that is not related to NLNE. LODDS provides better prognostic accuracy in patients with negative nodes than LNR and N stage., (Copyright © 2024. Published by Elsevier España, S.L.U.)

Objective: This retrospective single center study aims to describe changes in the severity and organ-specific distribution of GvHD, by comparing the outcomes of 3 distinct GvHD prophylaxis approaches., Methods: Between January 2012 and June 2022, 226 patients underwent allogeneic hematopoietic stem cell transplantation from HLA-matched or 1-allele mismatched related or unrelated donors. Fifty-eight (26%) received prophylaxis with calcineurin inhibitor in combination with mycophenolate mofetil or a short course of methotrexate (Cohort-1), 87 (38%) tacrolimus plus sirolimus (Cohort-2), and 81 (36%) post-transplant cyclophosphamide (PTCy) plus tacrolimus (Cohort-3)., Results: The incidence of grade II-IV aGvHD was 69% vs. 41.4% vs. 27.2%; p < .01. The most significant reduction with PTCy was observed in both stage 3-4 skin and lower gastrointestinal (GI) involvement (p < .01). The incidence of moderate-to-severe cGvHD at 12 months was 34.5% vs. 34.5% vs. 6.2%; p < .01. Moderate-to-severe skin and GI cGvHD was less common after PTCy (p < .01). The 1-year GvHD-free/relapse-free survival was higher with PTCy (p < .01)., Conclusions: Our study indicates that PTCy-based GvHD prophylaxis reduces the frequency and severity of both acute and chronic GvHD, with a notable decrease in severe GI and cutaneous manifestations. The higher GRFS may result in lower GvHD-related mortality, leading to an improved quality of life among survivors., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Certolizumab is an Fc-free PEGylated tumor necrosis factor-alpha (TNFα) inhibitor recently approved for the treatment of moderate-to-severe plaque psoriasis, although there is limited real-world evidence on the effectiveness and safety in patients with plaque psoriasis treated with certolizumab. The objective of this article is to determine the effectiveness, drug survival, and safety, including pregnancy, childbirth, and lactation, of certolizumab in moderate-to-severe plaque psoriasis under real-world conditions., Methods: This is a retrospective, multicenter, observational study performed in 15 hospitals in Spain. It evaluates the effectiveness and safety of certolizumab in plaque psoriasis in the clinical practice setting., Results: A total of 67 patients (73% female) were evaluated with a mean baseline Psoriasis Area Severity Index (PASI) of 8.9. At Week 12, the mean PASI was 2.3 (n = 67), 1.3 (n = 57) at Week 24 and 1.3 at Week 52 (n = 34). Absolute PASI < 3 was achieved in 69, 86, and 92% of patients at Weeks 12, 24, and 52, respectively, as observed. For its part, using the under-response imputation analysis, PASI < 3 at Weeks 12, 24, and 52 were achieved by 69, 73, and 49% of the patients, respectively. A total of 35 patients (52%) had concomitant psoriatic arthritis, and, in 24 of them, Disease Activity in Psoriatic Arthritis Score (DAPSA) was recorded at baseline, with a mean value of 17.9 which decreased to 8.2 at Week 12 (n = 22) and to 3.6 at Week 24 (n = 18). Certolizumab treatment was discontinued in 14 out of 67 patients (21%), due to lack/loss of cutaneous or articular effectiveness (n = 11) or patient decision (n = 2) or adverse event in only one patient who developed active tuberculosis. A lower baseline PASI [hazard ratio (HR): 1.12 (1.02-1.23); P = 0.023] and a more significant reduction in PASI at Week 12 [HR: 1.16 (1.07-1.27); P < 0.001] and Week 52 [HR: 1.47 (1.11-1.96); P = 0.007] was shown to be significantly related with better survival for the entire follow-up period. Fourteen patients were treated during pregnancy and/or lactation without reporting adverse events in either the patient or the newborn., Conclusions: Certolizumab consistently showed high effectiveness and drug survival rates in this real-life cohort. The safety demonstrated in clinical trials during pregnancy and lactation seems to be confirmed in clinical practice., (© 2024 the International Society of Dermatology.)

Introduction: Functional neurological disorder (FND) and autism spectrum disorder (ASD) are two complex neuropsychiatric conditions that have been historically classified within psychiatric domains, resulting in a lack of extensive research, insufficient clinical recognition, and persistent societal stigma. In recent years, there has been an increasing recognition among professionals and affected individuals of their possible overlap. This review explores the potential clinical and mechanistic overlap between FND and ASD, with particular attention to shared symptoms across sensory, motor, and psychiatric domains., Methods: We conducted a narrative analysis utilizing the PubMed, CINAHL, MEDLINE, and ScienceDirect databases from inception to June 2024. The search employed specific MeSH terms related to ASD and FND. Given the limited data availability, we included all relevant articles that explored the potential connections between FND and ASD, focusing on established findings and theoretical hypotheses areas., Results: Scientific evidence indicates that FND and ASD may co-occur more frequently than previously acknowledged and with notable overlaps in their clinical presentations and pathophysiology. Theoretical models that have been applied to FND and ASD, such as the Bayesian brain theory and the tripartite model of autism, may provide valuable insights into the intersection of these conditions. Although much of the current evidence remains speculative, it underscores the need for hypothesis-driven research to investigate these potential connections further., Conclusion: ASD and FND are heterogeneous conditions that appear to co-occur in a subset of individuals, with overlapping symptomatology and possibly shared underlying mechanisms. This hypothesis-generating review emphasizes the need for further research to better understand these links, ultimately aiming to improve clinical recognition and develop targeted interventions that enhance the quality of life for affected individuals., (© 2024 The Author(s). Brain and Behavior published by Wiley Periodicals LLC.)

Background: Failure to rescue (FTR) is defined as the inability to prevent death after the development of a complication. FTR is a parameter in evaluating multidisciplinary postoperative complication management. The aim of this study was to evaluate FTR rates after major liver resection for perihilar cholangiocarcinoma (pCCA) and analyze factors associated with FTR., Patients and Method: Patients who underwent major liver resection for pCCA at 27 centers were included. FTR was defined as the presence of a Dindo grade III or higher complication followed by death within 90 days after surgery. Liver failure ISGLS grade B/C were scored. Multivariable logistic analysis was performed to identify predictors of FTR and reported using odds ratio and 95% confidence intervals., Results: In the 2186 included patients, major morbidity rate was 49%, 90-day mortality rate 13%, and FTR occurred in 24% of patients with a grade III or higher complication. Across centers, major complication rate varied from 19 to 87%, 90-day mortality rate from 5 to 33%, and FTR ranged from 11 to 50% across hospitals. Age [1.04 (1.02-1.05) years], ASA 3 or 4 [1.40 (1.01-1.95)], jaundice at presentation [1.79 (1.16-2.76)], right-sided resection [1.45 (1.06-1.98)], and annual hospital volume < 6 [1.44 (1.07-1.94)] were positively associated with FTR. When liver failure is included, the odds ratio for FTR is 9.58 (6.76-13.68)., Conclusion: FTR occurred in 24% of patients after resection for pCCA. Liver failure was associated with a nine-fold increase of FTR and hospital volume below six was also associated with an increased risk of FTR., Competing Interests: Disclosures: Ulf Neumann presented for Astra Zeneca, Roche AG, Merck AG, and Dr Falk GMBH, BMS. No other conflicts of interest are present. Data available upon reasonable request., (© 2024. The Author(s).)

Objective: This non-interventional, prospective, single-center study aimed to develop a technique to measure ruxolitinib (RUX) concentrations and provide preliminary data on the distribution of plasma drug levels in patients with steroid refractory (SR) GvHD., Methods: Between April 2023 and May 2024, we analyzed 48 blood samples from 29 patients with SR-GvHD., Results: Median individual plasma concentrations varied across different RUX doses and largely overlapped: 39.2 ng/mL at 10 mg b.i.d (range: 0-73), 13.1 ng/mL at 10-5 mg (range, 6.1-35.6), and 31.6 ng/mL at 5 mg b.i.d (range: 0.7-99.9). Samples taken under non-optimal temperature conditions showed a lower median concentration of 0.77 ng/mL (range: 0-7.4 ng/mL). The four patients who did not respond at days +28 and +180 after RUX initiation (3 with lower gastrointestinal aGvHD, and 1 with ocular, hepatic, and pulmonary cGvHD) showed a median concentration of only (7.4 ng/mL (range, 0-29) ng/mL) with full dosing., Conclusions: The introduction and validation of a liquid chromatography-tandem mass spectrometry method for quantifying plasma RUX concentrations was feasible in our center. Administering predetermined and fixed doses of RUX in patients with SR-GvHD showed highly variable and overlapping plasma drug concentrations. This underscores the potential importance of RUX- pharmacokinetics (PK) monitoring., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)