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(1) Background: The aim of this study was (i) to analyze problems faced by informal caregivers in three areas of their life: health, work and finances, and family and social relationships, (ii) to investigate the main determinants of these problems, and (iii) to explore differences between men and women. (2) Methods: The study population consisted of people aged ≥18 years living in a family home who were providing unpaid care to a dependent person in the same or another home and who were registered as caregivers with the Primary Health Care District of Granada or the Provincial Council of Gipuzkoa. Several logistic regression models were built to analyze the likelihood of caregivers experiencing health, work-related, or social problems as a result of their caregiving responsibilities. (3) Results: Informal female caregivers were more likely to experience problems attributed to caregiving than their male counterparts, particularly in the areas of health and work. Additional factors associated with an increased likelihood of problems were low perceived social support, performance of ungratifying tasks, and fewer years as a caregiver. (4) Conclusions: Informal caregivers in Spain face significant problems as a result of their caregiving duties, and the impact on men and women is different. Policies and interventions to mitigate the negative effects of unpaid caregiving should incorporate differential strategies to meet the specific needs of male and female caregivers in different caregiving contexts.

Objective: Lung cancer (LC) is the leading cause of death from cancer worldwide. More than 27,000 LCs are diagnosed annually in Spain, and most are unresectable. Early detection and treatment reduce LC mortality. This study describes surgical outcomes in a longstanding LC screening cohort in Spain., Methods: We conducted a retrospective study of surgical outcomes in a LC screening (LCS) program using low dose computed tomography (LDCT) since the year 2000. A descriptive analysis of clinical and radiological parameters, presence or absence of a preoperative diagnosis, pathological staging, morbidity, mortality, and survival was performed., Results: Ninety-seven (2.5%) LC were diagnosed in 3825 screened. Twenty individuals with LC had no surgery due to advanced stage or small cell histology. Eighty-seven surgical procedures were carried out for suspected or biopsy proven LC, detected by LDCT. Most operated patients were male (57[85%]) aged 64±9.1 years. Nine patients underwent a second operation for a metachronous primary lung cancer. Mean tumor size was 15.2±7.6mm. Eight nodules were benign (9.2%). Lobectomy was performed in 56 cases (83.6%). Adenocarcinoma (n=39; 58.2%) was the most frequent histological type followed by squamous cell carcinoma (n=17; 25.4%). Fifty-nine (88%) tumors were in Stage I. Thirteen patients (15.4%) had 16 complications. The estimated survival rates at 5 and 10 years for stage I were 93% (95% CI: 79%-98%) and 83% (95% CI: 65%-92%), respectively., Conclusion: Lung cancer screening was associated with excellent surgical outcomes with 5 and 10-year survival rates exceeding 90 and 80%, respectively., (Copyright © 2020 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

In December 2019, an outbreak of severe acute respiratory syndrome associated to SARS-CoV2 was reported in Wuhan, China. To date, little is known on histopathological findings in patients infected with the new SARS-CoV2. Lung histopathology shows features of acute and organising diffuse alveolar damage. Subtle cellular inflammatory infiltrate has been found in line with the cytokine storm theory. Medium-size vessel thrombi were frequent, but capillary thrombi were not present. Despite the elevation of biochemical markers of cardiac injury, little histopathological damage could be confirmed. Viral RNA from paraffin sections was detected at least in one organ in 90% patients., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Each of the pathological stages (I-IIIa) of surgically resected non-small-cell lung cancer has hidden biological heterogeneity, manifested as heterogeneous outcomes within each stage. Thus, the finding of robust and precise molecular classifiers with which to assess individual patient risk is an unmet medical need. Here, we identified and validated the clinical utility of a new prognostic signature based on three proteins (BRCA1, QKI, and SLC2A1) to stratify early-stage lung adenocarcinoma patients according to their risk of recurrence or death. Patients were staged according to the new International Association for the Study of Lung Cancer (IASLC) staging criteria (8th edition, 2018). A test cohort (n = 239) was used to assess the value of this new prognostic index (PI) based on the three proteins. The prognostic signature was developed by Cox regression with the use of stringent statistical criteria (TRIPOD: Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis). The model resulted in a highly significant predictor of 5-year outcome for disease-free survival (p < 0.001) and overall survival (p < 0.001). The prognostic ability of the model was externally validated in an independent multi-institutional cohort of patients (n = 114, p = 0.021). We also demonstrated that this molecular classifier adds relevant information to the gold standard TNM-based pathological staging, with a highly significant improvement of the likelihood ratio. We subsequently developed a combined PI including both the molecular and the pathological data that improved the risk stratification in both cohorts (p ≤ 0.001). Moreover, the signature may help to select stage I-IIA patients who might benefit from adjuvant chemotherapy. In summary, this protein-based signature accurately identifies those patients with a high risk of recurrence and death, and adds further prognostic information to the TNM-based clinical staging, even when the new IASLC 8th edition staging criteria are applied. More importantly, it may be a valuable tool for selecting patients for adjuvant therapy. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd., (Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.)

Objective: To assess the management of suspected Alzheimer's disease (AD) patients at the first visit by Spanish specialist physicians., Materials & Methods: Epidemiological, cross-sectional and multicenter study. A total of 200 specialists (neurologists, psychiatrists and geriatricians) from hospitals and specialized centers across Spain included a total of 1851 patients of both sexes older than 18 years suspected to be suffering from AD. Data of clinical and demographic characteristics, methods of diagnosis, treatments and follow-up were collected in one visit., Results: The mean age of the population was 75.2 ± 7.9 years. The most frequent symptoms were difficulty in performing familiar tasks (76.7%), memory loss (76.0%) and misplacing items (72.7%). The assessment of suspected AD subjects included: neurological examination (walk apraxia [10.8%] and extrapyramidal signs [10.7%]), evaluation of cognition (mean of the Mini-Mental State Examination score was 19.9 ± 5.2 [mild AD]), function and behavior, and supplementary diagnostic tests (blood test [90%] and computerized axial tomography [66.8%]). In total, 69.5% of the patients were diagnosed with AD according to Spanish Society of Neurology criteria. Principal treatment was cholinesterase inhibitors (87.8%). The mean time for follow-up visit: 4 ± 2.4 months; with the same physician (95.5%), neurologist (68.2%), psychiatrist (19%) and geriatrician (11.7%)., Conclusions: Several possible areas are amenable to improvement by means of reducing the time to diagnosis, increasing the number of patients treated with nonpharmacological therapy, and providing more information on the benefits of treatment, care and providing the best therapeutic options available. In this study, almost half of the patients took 1-3 years to visit a physician after appearance of the first symptoms. Significant differences were observed between the medical specialty and treatments provided; nevertheless, the majority of physicians used cholinesterase inhibitors (87.8%) as the principal treatment.

The clinical characteristics and evolution of 15 patients with Diffuse Pulmonar Hemorrhage Syndrome are reviewed. According to etiology diseases are classified in three groups: 1) Basal Antimembrane Antibodies disease (66.6%), 2) Vasculitis-Granulomatosis (24.6%), and 3) Idiopathic (6.6%). Pulmonary Hemorrhage was the first manifestation of the primary disease in 80% of patients and was present in 100% of those patients with anemia and opacities in chest x-Ray and in 73% of those with renal insufficiency, nephritic sediment and respiratory insufficiency. To reach the etiological diagnosis, invasive techniques were needed in order to obtain samples for the pathology exam. Three patients died (20%) and 7 had a relapse (46.6%) during the first year. It is underlined the need of an empirical aggressive treatment with steroids and immune-suppress drugs before reaching the final etiological treatment.