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Objective: The characterization of a sample of patients hospitalized with complications of the COVID-19 infection regarding potential prognostic factors, clinical evolution, and impact of rehabilitation treatment on functional, motor, and respiratory outcomes., Method: Descriptive, retrospective, longitudinal study of a cohort of patients under rehabilitation treatment admitted at Virgen de las Nieves University Hospital in Granada from March to June 2020, assessed upon admission, discharge and at 3 rd month using physical condition scales (IFIS) and functional assessment: general (Rankin, Barthel), respiratory (mMRC, BORG) and gait (FAC)., Results: 30 patients with a mean age of 62.8 (54-70) years were included, 80% with comorbidity: hypertension 66.7%, obesity 36.7%, diabetes 33.3%. The mean hospital stay was 45.4 days, with 86.7% requiring ICU (29.1 days) and 76.7% of them required mechanical ventilation. An 86.7% of the patients presented with complications, mostly with polyneuropathy-myopathy of the critical patient (83.3%). At discharge, 80% required walking assistance. The functionality index showed a "U"-evolution at admission, discharge and at 3 rd month (Barthel 93.8; 60.0; 91.6 respectively). A greater functional decline (Barthel < 60) was found in male patients, COPD, HT, obesity, and elevated protein C reactive at admission; and a more favourable evolution in those with elevated D-dimer and lymphocyte values upon admission. CONCLUSIóN: Hospital admission for COVID-19 patients involve complications at the functional, respiratory and gait levels that are mostly serious but partially reversible at 3 months with rehabilitation treatment. Potential prognostic factors are described and deserve prospective studies., (Copyright © 2021 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Early recognition and risk stratification are crucial in cardiogenic shock (CS). A lower adherence to recommendations has been described in women with cardiovascular diseases. Little information exists about disparities in clinical picture, management and performance of risk stratification tools according to gender in patients with CS., Methods: Data from the multicenter Red-Shock registry were used. All consecutive patients with CS were included. Both CardShock and IABP-SHOCK II risk scores were calculated. The primary end-point was in-hospital mortality. The discriminative ability of both scores according to gender was assessed by binary logistic regression, calculating Receiver operating characteristic (ROC) curves and the corresponding area under the curve (AUC)., Results: A total of 793 patients were included, of whom 222 (28%) were female. Women were significantly older and had a lower proportion of chronic obstructive pulmonary disease and prior myocardial infarction. CS was less often related to acute coronary syndromes (ACS) in women. The use of vasoactive drugs, renal replacement therapy, invasive ventilation, therapeutic hypothermia and mechanical circulatory support was similar between both groups. In-hospital mortality was 346/793 (43.6%). Mortality was not significantly different according to gender (p = 0.194). Cardshock risk score showed a good ability for predicting in-hospital mortality both in man (AUC 0.69) and women (AUC 0.735). Likewise, the IABP-II successfully predicted in-hospital mortality in both groups (man: AUC 0.693; women: AUC 0.722)., Conclusions: No significant differences were observed regarding management and in-hospital mortality according to gender. Both the CardShock and IABP-II risk scores depicted a good ability for predicting mortality also in women with CS.

Introduction: Phototype has been associated with an increased risk of prostate cancer, and it is yet unknown if it is related to other hormone-dependent cancers, such as breast cancer or whether this association could be considered causal., Methods: We examined the association between the phototype and breast and prostate cancers using a Mendelian randomization analysis. We studied 1,738 incident cases of breast cancer and another 817 cases of prostate cancer. To perform a Mendelian randomization analysis on the phototype-cancer relationship, a genetic pigmentation score was required that met the following criteria: (1) the genetic pigmentation score was associated with phototype in controls; (2) the genetic pigmentation score was not associated with confounders in the relationship between phototype and cancer, and (3) the genetic pigmentation score was associated with cancer only through its association with phototype. Once this genetic score is available, the association between genetic pigmentation score and cancer can be identified as the association between phototype and cancer., Results: The association between the genetic pigmentation score and phototype in controls showed that a higher genetic pigmentation score was associated with fair skin, blond hair, blue eyes and the presence of freckles. Applying the Mendelian randomization analysis, we verified that there was no association between the genetic pigmentation score and cancers of the breast and prostate., Conclusions: Phototype is not associated with breast or prostate cancer., Competing Interests: The authors have declared that no competing interests exist.

Background: Previous evidence suggests that 25-hydroxyvitamin D(3) [25(OH)D(3)] protects against several cancers. However, little is known regarding urothelial bladder cancer (UBC). We analyzed the association between plasma 25(OH)D(3) and overall risk of UBC, as well as according to stage and FGFR3 molecular subphenotypes., Methods: Plasma concentrations of 25(OH)D(3) in 1125 cases with UBC and 1028 control subjects were determined by a chemiluminescence immunoassay. FGFR3 mutational status and expression in tumor tissue were assessed. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by logistic regression adjusting for potential confounders. Analyses were further stratified by tumor invasiveness and grade, FGFR3 expression, and smoking status. Cell proliferation was measured in human UBC cell lines cultured with 1α,25-dihydroxyvitamin D(3)., Results: A statistically significantly increased risk of UBC was observed among subjects presenting the lowest concentrations of 25(OH)D(3) (OR(adj) = 1.83; 95% CI = 1.19 to 2.82; P = .006), showing a dose-response effect (P (trend) = .004). The association was stronger for patients with muscle-invasive tumors, especially among low-FGFR3 expressers (OR(adj) = 5.94; 95% CI = 1.72 to 20.45; P = .005). The biological plausibility of these associations is supported by the fact that, in vitro, 1α,25-dihydroxyvitamin D(3) upregulates FGFR3 expression in UBC cell lines with low levels of wild-type FGFR3., Conclusion: These findings support a role of vitamin D in the pathogenesis of UBC and show that 25(OH)D(3) levels are associated with FGFR3 expression in the tumor. Because FGFR3 mutation and overexpression are markers of better outcome, our findings suggest that individuals with low levels of plasma 25(OH)D(3) may be at high risk of more aggressive forms of UBC.

Objectives: The diagnosis of prostate cancer has changed significantly with the introduction of PSA in the clinical practice. Despite screening is under controversy the use of PSA has become widespread. The objective of this paper is to know the use of PSA in our health-care area and to analyze perceived risks and benefits., Methods: From the informatic archives we analyze PSA determinations performed in our health-care area (290.956 citizens) over 2000 and 2001. We also analyzed prostate biopsies generated and number of cancers detected., Results: 25.519 PSA determinations were performed. 59% came from general practitioners (GP), 34% from urologists and 7% from the rest of specialists. 39% are performed to men older than 70 years. PSA was normal in 78.7% of the patients and higher than 4 ng/ml in 21.2%. 488 prostatic biopsies were performed diagnosing 178 cancers (diagnostic yield 36.5%). Depending on the first PSA, diagnosis was started by a GP in 44% of the cases, a urologist in 46%, and the remaining 10% by other specialists. Mean time from first PSA to diagnosis was 5 months, without significant differences between GPs and specialities . The use of PSA by GPs is variable (between 8.1 and 45.8 determinations per 100 men over 50 years), without significant differences in prostate cancer detection by number of PSAs or differences in age. In comparison with the period 1982-1993 the incidence of prostate cancer goes from 30.76 to 52.8 new cases/100.000 inhabitants/year. There is a greater incidence and increase of cancer in the rural area (from 33.52 to 221.1 new cases/ 100.000 inhabitants/year)., Conclusions: We confirm the general use of this test and the trend to screening in the primary health-care level, which participates in an important manner in the diagnosis. PSA brings forward the diagnosis of prostate cancer 5 years in our area, and shoots its incidence rates. The high use of such marker in our population of advanced age may be considered inadequate.