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WADD-SEPD Consensus on Psychological Treatment of Dual Disorders I: General Recommendations, Most Used Therapies, and Severe Mental Disorders
(MDPI, 2026-01-16) Benito, Ana; Jimenez Murcia, Susana; Tirado Munoz, Judit; Adan Puig, Ana
Background/Objectives: The treatment of dual disorders (DDs) must be comprehensive and multidisciplinary. There is evidence supporting the effectiveness of psychotherapy in their treatment. However, clinical guidelines, consensus statements, and reviews on the treatment of DDs typically devote considerably less space to psychological therapy than to pharmacological therapy. Therefore, this work aimed to synthesize the available evidence, recommendations, and clinical experience on the psychological treatment of DDs to reach a consensus. Methods: Two consensus methods were sequentially implemented: the nominal group technique and the Delphi method. Results: The first part of this consensus review encompassed a compilation of general recommendations for the psychological treatment of DDs, evidence on the efficacy of the most frequently used therapies, and recommendations for the psychological treatment of severe dual mental disorders. These disorders include schizophrenia and other psychotic disorders, bipolar disorders, depressive disorders, and obsessive compulsive disorders. Conclusions: (1) Psychological treatment is effective; (2) integrated psychological treatment is more effective; (3) motivational interviewing, cognitive behavioral therapy, and relapse prevention are the psychological interventions with the most supporting evidence; (4) the best alternative is multicomponent strategies; (5) the most frequently studied severe mental disorders are schizophrenia and depression; (6) for dual schizophrenia, motivational interviewing and integrated cognitive behavioral therapy combined with other components are recommended; (7) for dual depression, cognitive behavioral therapy with relapse prevention or motivational interviewing is recommended; (8) for dual bipolar disorder, group therapies with psychoeducation or relapse prevention and inclusion of the family, contingency management, and family intervention are recommended; (9) more empirical evidence is needed, especially for obsessive compulsive and schizoaffective disorders; and (10) more randomized clinical trials are needed to improve current methodological limitations.
Genome-wide interaction analysis of long-term trihalomethane exposure in drinking water and colorectal cancer risk in a Spanish Multicenter Case-Control Study (MCC-Spain)
(Elsevier Ltd., 2026-01-11) Moratalla Navarro, Ferran; Obón Santacana, Mireia; Rius Sansalvador, Blanca; Guinó, Elisabet; Moragas, Núria; Donat Vargas, Carolina; Fernández de Larrea-Baz, Nerea; Molina Barceló, Ana; Guevara, Marcela; Morón-Duran, Francisco D; Dierssen Sotos, Trinidad; Tardón, Adonina; Castaño-Vinyals, Gemma; Cabrera Castro, Natalia; Molina, Antonio J.; Aizpurua Atxega, Amaia; Morales Suárez Varela, María M.; Martín, Vicente; Fernández Navarro, Pablo; Villanueva, Cristina M.; Moreno Aguado, Víctor
We conducted a genome-wide interaction analysis between long-term exposure to trihalomethanes in drinking water and colorectal cancer (CRC) risk in a multicenter case-control study in Spain, including 1037 CRC cases and 2100 controls. Exposure categories were estimated based on sex-specific median and quartile values of total trihalomethanes (TTHM), chloroform (CHCl3), and brominated trihalomethanes (Br-THMs) among controls. In addition, TTHM exposure was assessed relative to the WHO guideline thresholds. Gene-environment interaction models were computed with the GxEScanR package. To explore biological plausibility, relevant results were inspected in search of expression quantitative trait loci (eQTLs) in two independent resources: BarcUVaSeq and the Genome Tissue Expression (GTEx) v8. Finally, we searched the Comparative Toxicogenomics Database to identify candidate genes previously linked to trihalomethane exposure, retrieved their eQTLs, and evaluated gene-environment interactions with TTHM levels. We found three variants that modulated CRC risk in relation to CHCl3 and TTHM exposure: rs77985109 near LRRC8B, chr15:28997737 near WHAMMP2, and rs7890183 near MAGEB2. Two additional variants were specifically found for women and one for rectal cancer. Functional assessment suggested a regulatory role of rs77985109 in LRRC8B expression. Moreover, eQTL analysis of candidate genes revealed an additional variant associated with CCL2 which could modulate CRC risk under different TTHM exposure levels. The present study identified novel loci potentially influencing CRC susceptibility under THM exposure, highlighting the importance of integrating environmental and genetic data to better understand environmental driven cancer risks. Further research is needed to confirm these results and clarify underlying mechanisms.
Nasal sublesional Bevacizumab injections as adjuvant treatment for diffuse sinonasal exophytic papillomas
(MDPI, 2026-01-15) Penella, Anna; Michavila, Adriana; Fulla, Marta; Leiva Badosa, Elisabet; Brunet, Aina; Foglia Fernández, Maria; Gonzalez Compta, Francesc Xavier
Background/Objectives: Diffuse sinonasal exophytic papillomas (DSNEPs) are rare entities, with similarities to recurrent respiratory papillomatosis (RRPs). DSNEP treatment is usually based on surgical excision, but the recurrence rate is high. Bevacizumab injections have been increasingly used as an adjuvant option for RRP, but their role in DSNEP treatment remains unknown. The current study describes the preliminary experience, safety profile, and exploratory outcomes of sublesional bevacizumab injections following surgical excision. Methods: We undertook a retrospective, single-centre study of a cohort of patients diagnosed with DSNEP between 2011 and 2018. All patients were treated with surgical excision and sublesional bevacizumab injections. The effect of bevacizumab was evaluated using a severity score developed to quantify lesion size and the extent of affected areas in each patient. Results: Seven patients diagnosed with DSNEP were treated. All patients were male, with a median age at diagnosis of 42 years [38–44.5]. Human papillomavirus (HPV) DNA was detected in all patients: HPV-11 in six cases (85.7%) and HPV-6 in one case (14.3%). Bevacizumab was injected into the submucosa of their surgical sites. The median follow-up was 55.5 months [40.85–82.73]. Most patients (85.72%) presented recurrence, with a median of 3 years [1.5–4]. A statistically significant reduction in the severity score was observed (p = 0.017), although this finding cannot be attributed solely to bevacizumab due to study design limitations. No relevant complications were reported. Conclusions: Nasal sublesional bevacizumab injections were well tolerated and feasible as an adjuvant approach to DSNEP. Larger prospective studies are needed to confirm its safety and assess its potential benefit.
Is the FIFA 11+ warm up effective fori nducing acute knee adaptations in recreational soccer players?
(MDPI, 2025-06-05) Caudet, Patricia; Baiget i Vidal, Ernest; Batalla Gavaldà, Abraham; Colomar Axup, Joshua; Crespo Celda, Miguel; Martínez Gallego, Rafael; Corbi Soler, Francisco
Objectives: Soccer is the most practiced sport around the world. The injury incidence has an estimated rate of up to 70 injuries per 1000 h of play. FIFA 11+ is a program designed to prevent injuries and optimize performance. The purpose of this study was to analyze the acute effects of this program as a warm-up on different functional, physiological, and mechanical properties of various knee tissues and whether there were differences between genders. Methods: The sample included 45 recreational soccer players. Several muscular and tendon mechanical properties, muscular oxygen saturation, electromyography, maximum voluntary contraction, and rate of force development were analyzed, before and after performing the FIFA 11+. Results: Only a moderate significant increase in muscle oxygen saturation in men from pre- to post-test was reported. No other parameters showed statistically significant differences between groups, suggesting that the intervention may lack clinical relevance. The reported effect sizes were mostly trivial, so differences are unlikely to have significant practical relevance. Statistical analyses were performed using a 2 × 2 factorial repeated measures factorial ANOVA with Bonferroni post hoc comparisons. Conclusions: FIFA 11+ warm-up does not provide a sufficient stimulus to elicit mechanical or metabolic responses in the per-knee structures. Other warm-up designs may be more appropriate for finding these effects.
Trait anxiety is associated with attentional brain networks
(Elsevier B.V., 2024) Peña Arteaga, Víctor de la; Chavarría-Elizondo, Pamela; Juaneda Seguí, Asier; Martínez Zalacaín, Ignacio; Morgado, Pedro; Menchón Magriñá, José Manuel; Picó Pérez, Maria; Fullana Rivas, Miguel Àngel; Soriano Mas, Carles
Trait anxiety is a well-established risk factor for anxiety and depressive disorders, yet its neural correlates are not clearly understood. In this study, we investigated the neural correlates of trait anxiety in a large sample (n = 179) of individuals who completed the trait and state versions of the State-Trait Anxiety Inventory and underwent resting-state functional magnetic resonance imaging. We used independent component analysis to characterize individual resting-state networks (RSNs), and multiple regression analyses to assess the relationship between trait anxiety and intrinsic connectivity. Trait anxiety was significantly associated with intrinsic connectivity in different regions of three RSNs (dorsal attention network, default mode network, and auditory network) when controlling for state anxiety. These RSNs primarily support attentional processes. Notably, when state anxiety was not controlled for, a different pattern of results emerged, highlighting the importance of considering this factor in assessing the neural correlates of trait anxiety. Our findings suggest that trait anxiety is uniquely associated with resting-state brain connectivity in networks mainly supporting attentional processes. Moreover, controlling for state anxiety is crucial when assessing the neural correlates of trait anxiety. These insights may help refine current neurobiological models of anxiety and identify potential targets for neurobiologically-based interventions.
Population-based national incidence of thyroid dysfunction in Spain
(Nature Publishing Group, 2025-12-20) Alonso, Silvia Patricia; Colomo, Natalia; Montanya Mias, Eduard; Lago Sampedro, Ana; Maldonado Araque, Cristina; García Fuentes, Eduardo
Thyroid dysfunction is a common health disorder. However, data on its incidence remain scarce and geographically limited. This study aimed to assess the incidence of thyroid dysfunction in the Spanish adult population and factors associated with its onset. A nationwide observational population‑based cohort study was conducted, including 1,629 euthyroid individuals (not receiving levothyroxine/thionamides, and TSH levels of 0.2-5.0mIU/mL) at baseline (2008–2010), who were re-evaluated in 2016–2017. Multivariable logistic regression analysis assessed the association between incident thyroid dysfunction and potential exposure factors. ROC analysis identified optimal TPOAb and TSH cut-offs for predicting incident hypothyroidism. The age- and sex-adjusted incidence of hypothyroidism was 13.38cases/1,000persons-year (CI95% 10.52–16.25) for TSH ≥ 5mIU/mL, and 6.78cases/1,000persons-year (CI95% 4.73–8.83) for TSH ≥ 10mIU/mL. The incidence of hyperthyroidism was 2.65cases/1,000persons-year (CI95% 1.46–3.83). Female sex, age between 30 and 40 and > 60 years, TPOAb > 20mIU/L and TSH > 2.8mIU/mL were independently associated with new cases of hypothyroidism. The presence of obesity, diabetes or urinary iodine levels were not associated with the incidence of thyroid disease. Baseline TPOAb and TSH cut-offs best predicting hypothyroidism were 9.1mIU/L (AUC 0.654; CI95% 0.583–0.725; p < 0.001), and 2.03mIU/mL (AUC 0.702; CI95% 0.639–0.766; p < 0.001) respectively. This study provides data on incidence rates and risk factors of thyroid dysfunction in the adult Spanish population.
GTX-11 attenuates lung fibrosis, inflammation and vascular remodeling in preclinical models of lung fibrotic disease
(Frontiers Media, 2026-01-27) Montes Worboys, Ana; Milara, Javier; Farrera, Consol; Fernández Asensio, Cristina; Sánchez Díez, Silvia; Mercadé, Jaume; Montero, Paula; Roger, Inés; Molina Molina, María; Ruiz Cánovas, Eugenia; Cortijo, Julio
Background: Fibrotic interstitial lung diseases (ILDs) are characterized by different degrees of inflammation and fibrosis of the lung parenchyma that are associated with progressive loss of breath, high morbidity and mortality. Current therapeutic options are limited, so there remains a significant need for effective and well-tolerated treatments. GTX-11 is an orally available small molecule in development for the treatment of fibrotic diseases. In this study, we aimed to assess the therapeutic potential of GTX-11 in different preclinical models of lung fibrotic disease.Methods: We assessed the activity of GTX-11 and its active metabolite, GTX-11m, in the bleomycin-induced pulmonary fibrosis model and in vitro in primary fibroblast cell cultures, including human normal lung fibroblasts (hNLFs) and ILD patient-derived fibroblasts.Results: In the murine model, GTX-11 treatment improved animal survival and significantly reduced lung fibrosis as measured by Ashcroft score and collagen deposition. GTX-11 also reduced the inflammatory cell count in bronchoalveolar lavage fluid and pro-inflammatory factors in lung tissue. Additionally, GTX-11 significantly improved lung vascular dysfunction and reduced pulmonary vascular remodeling. The preclinical anti-fibrotic effects of GTX-11 were comparable to, or in some cases exceeded, those of currently approved anti-fibrotic drugs used in clinical practice. In vitro, GTX-11m demonstrated anti-fibrotic and anti-inflammatory activity in hNLFs and ILD patient-derived fibroblasts. GTX-11m inhibited TGFβ-induced expression of key fibrotic markers and reduced fibroblast-to-myofibroblast transition and inflammatory cytokine production. The effects were consistent across the different tested ILD cultures and resulted from the prevention of SMAD2 and SMAD3 activation by TGFβ. The GTX‐11m anti-fibrotic and anti-inflammatory effects were comparable or better than nintedanib.Conclusion: Altogether, our studies reveal that GTX-11 is an effective antifibrotic both in vivo and in vitro, suggesting that GTX-11 has potential as a therapeutic option for fibrotic ILDs.
Impacto del ejercicio intenso en los niveles de interleucina-6 en futbolistas semi-profesionales: un estudio comparativo entre adultos y niños.
(Sociedad Chilena de Anatomía, 2025) Reverter Masia, Joaquin; Cirer Sastre, Rafel; Jové Deltell, Carme; Corbi, Francisco; López Laval, Isaac; Hernández González, Vicenç
El fútbol semi-profesional impone una gran demanda física, aumentando el riesgo de lesiones musculares debido a la acumulación de partidos y sesiones de entrenamiento con periodos de recuperación limitados. Este estudio evaluó los niveles de interleucina-6 (IL-6) en futbolistas semi-profesionales durante un partido de futbol siete, tanto en adultos como en niños. Se observó un notable aumento en los niveles de IL-6 tras un ejercicio de alta intensidad. La IL-6 no solo refleja una respuesta inflamatoria aguda, sino también una adaptación para mantener la homeostasis energética. Este incremento se asoció con una respuesta inflamatoria de fase aguda, evidenciada por el aumento de la intensidad del ejercicio. Aunque el ejercicio continuado mejora la eficiencia energética de los miocitos y podría reducir la liberación de IL-6, el ejercicio de alta intensidad en el fútbol semi-profesional parece superar estos efectos adaptativos. Esto subraya la necesidad de estrategias de recuperación adecuadas para mitigar el impacto del estrés físico acumulado y prevenir lesiones musculares. En conclusión, los niveles de IL-6 aumentan en respuesta al ejercicio intenso durante un partido de fútbol en jugadores semi-profesionales, tanto adultos como niños. Estos hallazgos destacan la importancia de monitorear IL-6 y otros marcadores inflamatorios para desarrollar estrategias efectivas de entrenamiento y recuperación. Futuros estudios deben investigar intervenciones que modulen la respuesta de IL-6 y optimicen la recuperación en atletas.
Mixed-model and transcriptome-wide association analyses identify transcription factors and genes associated with colorectal cancer susceptibility
(Nature Publishing Group, 2026-12-01) Chen, Zhishan; Song, Wenqiang; Moreno Aguado, Víctor; Moratalla Navarro, Ferran
Susceptibility transcription factors (TF) whose DNA bindings are altered by genetic variants regulating colorectal cancer (CRC) risk genes remain poorly defined. Using generalized linear mixed models, we analyze 218 TF ChIP-Seq datasets alongside GWAS data from 100,204 CRC cases and 154,587 controls of East Asian and European ancestries. We identify 51 TFs and TF-cofactor interactions, including VDR-cofactors, as key regulators of CRC risk. Integrating these TF insights with transcriptome-wide association studies (TWAS), we further evaluate associations between genetically predicted gene expression, alternative splicing, and alternative polyadenylation with CRC risk, using RNA-seq data from 364 Asian-ancestry and 707 European-ancestry individuals. Multi-ancestry TWAS identify 222 risk genes, including 95 novel genes and 48 potentially druggable targets. Single-cell analysis provides additional functional evidence supporting ~45% of these genes, and experimental validation confirms oncogenic roles for RHPN2, IRS2, and TXN. Our findings elucidate key TF–gene regulatory networks and uncover novel CRC risk genes.
Sentinel lymph node biopsy before and after neoadjuvant chemotherapy in cN0 breast cancer patients: impact on axillary morbidity and survival—a propensity score cohort study
(Springer Verlag, 2024-04-18) Fernandez Gonzalez, Sergi; Falo, Catalina; Pla Farnos, Maria Jesus; Campos Delgado, Míriam; Ortega-Exposito, Carlos; Ortega, Raul; Vicente, Maria; Petit, Anna; Bosch Schips, Jan; Bajén Lázaro, Ma. Teresa; Reyes, Gabriel; Martínez. Evelyn; González Viguera, Javier; Stradella, Agostina; Pernas, Sònia; Ponce, Jordi; Peñafiel, Judith; García Tejedor, María Amparo
Purpose In patients with clinically lymph node-negative (cN0) breast cancer, performing sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy (NACT) has been preferentially embraced in comparison to before NACT. However, survival outcomes associated with both strategies remain understudied. We aimed to compare the axillary lymphadenectomy (ALND) rate, disease-free survival (DFS), and overall survival (OS), between two strategies. Methods We included 310 patients in a retrospective observational study. SNLB was performed before NACT from December 2006 to April 2014 (107 cases) and after NACT from May 2014 to May 2020 (203 patients). An inverse probability of treatment weighting (IPTW) method was applied to homogenize both groups. Hazard ratios (HR) and odd ratios (OR) are reported with 95% confidence intervals (95%CI). Results The lymphadenectomy rate was 29.9% before NACT and 7.4% after NACT (p<0.001), with an OR of 5.35 95%CI (2.7–10.4); p=.002. After 4 years of follow-up, SLNB after NACT was associated with lower risk for DFS, HR 0.42 95%CI (0.17–1.06); p=0.066 and better OS, HR 0.21 CI 95% (0.07–0.67); p=0.009 than SLNB before NACT. After multivariate analysis, independent adverse prognostic factors for OS included SLNB before NACT, HR 3.095 95%CI (2.323–4.123), clinical nonresponse to NACT, HR 1.702 95% CI (1.012–2.861), and small tumors (cT1) with high proliferation index, HR 1.889 95% (1.195–2.985). Conclusion Performing SLNB before NACT results in more ALND and has no benefit for patient survival. These findings support discontinuing the practice of SLNB before NACT in patients with cN0 breast cancer.
White matter diffusion estimates in obsessive-compulsive disorder across 1653 individuals: machine learning findings from the ENIGMA OCD Working Group.
(Nature Publishing Group, 2024-02-07) Kim, Bo-Gyeom; Kim, Gakyung; Abe, Yoshinari; Alonso Ortega, María del Pino; Ameis, Stephanie H.; Anticevic, Alan; Arnold, Paul D.; Balachander, Srinivas; Banaj, Nerisa; Bargalló Alabart, Núria; Batistuzzo, Marcelo C.; Benedetti, Francesco; Bertolín Triquell, Sara; Beucke, Jan C.; Bollettini, Irene; Brem, Silvia; Brennan, Brian P.; Buitelaar, Jan K.; Calvo Escalona, Rosa; Castelo-Branco, Miguel; Cheng, Yuqi; Chhatkuli, Ritu Bhusal; Ciullo, Valentina; Coelho, Anna; Couto, Beatriz; Dallaspezia, Sara; Ely, Benjamin A.; Ferreira, Sónia; Fontaine, Martine; Fouche, Jean Paul; Grazioplene, Rachael G.; Gruner, Patricia; Hagen, Kristen; Hansen, Bjarne; Hanna, Gregory L.; Hirano, Yoshiyuki; Höxter, Marcelo Q.; Hough, Morgan; Hu, Hao; Huyser, Chaim; Ikuta, Toshikazu; Jahanshad, Neda; James, Anthony; Jaspers-Fayer, Fern; Kasprzak, Selina; Kathmann, Norbert; Kaufmann, Christian; Kim, Minah; Koch, Katharina; Kvale, Gerd; Kwon, Jun Soo; Lázaro García, Luisa; Lee, Junhee; Lochner, Christine; Lu, Jin; Rodriguez Manrique, Daniela; Martínez Zalacaín, Ignacio; Masuda, Yoshitada; Matsumoto, Koji; Maziero, Maria Paula; Menchón Magriñá, José Manuel; Minuzzi, Luciano; Moreira, Pedro Silva; Morgado, Pedro; Narayanaswamy, Janardhanan C.; Narumoto, Jin; Ortiz García, Ana Encarnación; Ota, Junko; Pariente, Jose Carlos; Perriello, Chris; Picó Pérez, Maria; Pittenger, Christopher; Poletti, Sara; Real, Eva; Reddy, Y. C. Janardhan; Rooij, Daan van; Sakai, Yuki; Sato, João R; Segalàs Cosi, Cinto; Shavitt, Roseli G.; Shen, Zonglin; Shimizu, Eiji; Shivakumar, Venkataram; Soriano Mas, Carles; Sousa, Nuno; Sousa, Mafalda Machado de; Spalletta, Gianfranco; Stern, Emily R.; Stewart, S. Evelyn; Szeszko, Philip R.; Thomas, Rajat; Thomopoulos, Sophia I.; Vecchio, Daniela; Venkatasubramanian, Ganesan; Vriend, Chris; Walitza, Susanne; Wang, Zhen; Watanabe, Anri; Wolters, Lidewij H.; Xu, Jian; Yamada, Kei; Yun, Je-Yeon; Zarei, Mojtaba; Zhao, Qin; Zhu, Xi; ENIGMA-OCD working group; Thompson, Paul M.; Bruin, Willem B.; Wingen, Guido van; Piras, Federica; Piras, Fabrizio; Stein, Dan J., 1962-; Heuvel, Odile A. van den; Simpson, Helen Blair; Marsh, Rachel; Cha, Jiook
White matter pathways, typically studied with diffusion tensor imaging (DTI), have been implicated in the neurobiology of obsessive-compulsive disorder (OCD). However, due to limited sample sizes and the predominance of single-site studies, the generalizability of OCD classification based on diffusion white matter estimates remains unclear. Here, we tested classification accuracy using the largest OCD DTI dataset to date, involving 1336 adult participants (690 OCD patients and 646 healthy controls) and 317 pediatric participants (175 OCD patients and 142 healthy controls) from 18 international sites within the ENIGMA OCD Working Group. We used an automatic machine learning pipeline (with feature engineering and selection, and model optimization) and examined the cross-site generalizability of the OCD classification models using leave-one-site-out cross-validation. Our models showed low-to-moderate accuracy in classifying (1) “OCD vs. healthy controls” (Adults, receiver operator characteristic-area under the curve = 57.19 ± 3.47 in the replication set; Children, 59.8 ± 7.39), (2) “unmedicated OCD vs. healthy controls” (Adults, 62.67 ± 3.84; Children, 48.51 ± 10.14), and (3) “medicated OCD vs. unmedicated OCD” (Adults, 76.72 ± 3.97; Children, 72.45 ± 8.87). There was significant site variability in model performance (cross-validated ROC AUC ranges 51.6–79.1 in adults; 35.9–63.2 in children). Machine learning interpretation showed that diffusivity measures of the corpus callosum, internal capsule, and posterior thalamic radiation contributed to the classification of OCD from HC. The classification performance appeared greater than the model trained on grey matter morphometry in the prior ENIGMA OCD study (our study includes subsamples from the morphometry study). Taken together, this study points to the meaningful multivariate patterns of white matter features relevant to the neurobiology of OCD, but with low-to-moderate classification accuracy. The OCD classification performance may be constrained by site variability and medication effects on the white matter integrity, indicating room for improvement for future research.
Endoresection in Choroidal Melanoma: Outcomes of Intentional Incomplete Tumor Removal
(MDPI, 2025-12-04) Anduaga Beramendi, Alexander; Caminal Caramés, Marta; Lorenzo Parra, Daniel; Cobos Martín, Estefanía; Mateos Olivares, Milagros; García Bru, Pere; Morwani, Rahul; Santamaría Álvarez, Juan Francisco; Garcia Garcia, Olga; Arias Barquet, Lluís; Caminal Mitjana, Josep Maria
To assess the outcomes of a modified surgical approach for the treatment of uveal melanoma involving endoresection with intentional residual tumor at the margins, combined with adjuvant ruthenium-106 brachytherapy. This technique aims to reduce surgical morbidity, while preserving visual function and maintaining effective local tumor control and survival. We conducted a retrospective observational study including 33 patients with choroidal melanoma treated between January 2017 and August 2024 at a single tertiary ocular oncology center in Spain. Patients underwent pars plana vitrectomy and endoresection leaving residual tumor followed by ruthenium-106 brachytherapy. Clinical, functional, and oncological outcomes were analyzed, including tumor recurrence, metastasis, visual acuity, complications, and cytogenetic findings. Kaplan-Meier analysis was used to estimate survival and recurrence rates. After a mean follow-up of 41.7 months, local tumor recurrence occurred in 2 patients (6.06%) and enucleation was performed in 1 patient (3.03%). Two patients (6.06%) developed metastases, with one disease-specific death, resulting in a 5-year survival rate of 97%. Visual acuity of 20/200 or better was preserved in 60.61% of patients. The most frequent complications were retinal detachment (36.36%) and macular edema (45.45%). Cytogenetic analysis showed a significant association between chromosome 1p loss and both recurrence and metastasis (p = 0.032). No cases of phthisis bulbi or severe hypotony were observed. This modified endoresection technique with intentional tumor residuals and adjuvant ruthenium-106 brachytherapy offers a safe and function-preserving option for selected patients with choroidal melanoma. It achieves good tumor control and visual outcomes, with a low rate of enucleation and metastasis. Further studies are required to validate its long-term efficacy.
Emotional dysregulation, obsessive-compulsive traits, and eating disorders: three constructs for one spectrum?
(Springer Nature, 2025-09-01) Tempia Valenta, Silvia; Beghelli, Valentina; Marcolini, Federica; Rosinska, Magda; Ronchi, Diana de; Fernández Aranda, Fernando; Atti, Anna Rita
Purpose: Dysfunctional eating behaviors are associated with emotional dysregulation and obsessive-compulsive symptoms. Traditionally, obsessiveness has been linked to anorexia nervosa (AN), while dysregulation has been associated with bulimia nervosa (BN) and binge eating disorder (BED). However, this dichotomous view fails to account for the frequent diagnostic crossover observed among individuals with eating disorders (EDs). This study aimed to identify specific clusters in individuals with EDs based on emotional dysregulation, obsessive-compulsive symptoms, eating symptoms, and body uneasiness. Methods: An observational cross-sectional study was conducted at the ED Unit of Clinical Psychiatry, Bologna, Italy. Participants (N = 360) completed the Difficulties in Emotion Regulation Scale (DERS), Obsessive Compulsive Inventory-Revised (OCI-R), Eating Disorders Examination Questionnaire (EDE-Q), and Body Uneasiness Test (BUT). Hierarchical and two-step cluster analyses were applied. Cluster differences were examined using Kruskal-Wallis tests and post-hoc comparisons. Results: The analysis identified three clusters with increasing levels of emotional dysregulation, obsessive-compulsive symptoms, eating symptoms, and body uneasiness (Cluster size ratio = 2.04; Silhouette = 0.30). Symptom severity ranged from more functional (Cluster 1) to moderate (Cluster 2) to more dysfunctional (Cluster 3). Conclusion: This study identified three clusters representing a progressive gradient in the symptoms assessed, challenging the traditional dichotomy linking obsessiveness solely to AN and dysregulation solely to BN/BED.
Shunt íleo-cava intraoperatorio transitorio en la resección de adenocarcinoma de cabeza de páncreas localmente avanzado: ¿rompiendo un techo?
(Elsevier España, 2026-02) Busquets Barenys, Juli; Peláez Serra, Nuria; Secanella Medayo, Lluis; Sorribas Grifell, María; Iborra Ortega, Elena
[spa] La reseccioń de adenocarcinoma de cabeza de páncreas localmente avanzado con oclusioń de la vena mesenterica ́ superior (VMS) y afectacioń del confluente esplenomesentericoportal ́ (EMP) obliga en ocasiones a un clampaje venoso prolongado con riesgo de isquemia intestinal. La utilizacioń de shunts venosos intraoperatorios ha sido publicado por grupos de referencia para permitir la reseccioń con exito. ́ En nuestro centro realizamos una duodenopancreatectomía total por adenocarcinoma de cabeza de páncreas localmente avanzado con oclusioń de VMS y confluente EMP. El uso de un shunt íleo-caval transitorio mediante un injerto venoso permitióla reseccioń del tumor sin repercusioń en el intestino. La cirugía finalizócon el cierre del shunt, anastomosis del injerto a la vena porta y reconstruccioń digestiva. El paciente presentó buena tolerancia a la cirugía, siendo dado de alta el 7 o día posoperatorio. El estudio anatomopatologico ́ describió adenocarcinoma pancreático ypT1N0(R0) grado regresioń GRT2/IIa, con 0/30 adenopatías afectas.
Association between arsenic levels in toenails and urine and prostate cancer risk: Findings from the MCC-Spain study
(Elsevier, 2026-03-15) Fernández Navarro, Pablo; Pollán, Marina; Pérez Gómez, Beatriz; García Esquinas, Esther; Varea-Jiménez, Elena; Pastor-Barriuso, Roberto; Sierra, Maria Angeles; Dierssen Sotos, Trinidad; Fernández Tardón, Guillermo; Aragonès Sanz, Núria; Gómez Acebo, Inés; Castaño-Vinyals, Gemma; Gómez Ariza, José Luis; Kogevinas, Manolis; Moreno Aguado, Víctor
Background: Arsenic (As) is a toxic metalloid widely distributed in the environment. Chronic exposure to As has been associated with the development of several types of cancer. However, its role in prostate cancer (PC) remains unclear. Objective: To evaluate the relationship between As exposure and the risk of PC, considering different clinical tumour classifications and genetic susceptibility, and to compare biomarkers that may reflect distinct exposure windows. Methods: We included 345 incident cases and 468 controls with available data on both urinary and toenail As concentrations within the MCC-Spain project. Toenail and urinary As levels were measured using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES), respectively. Genetic susceptibility was assessed using a polygenic risk score (PRS) based on SingleNucleotide Polymorphisms. Associations between As exposure and PC were examined using mixed-effects and multinomial logistic regression models. Results: Higher toenail As concentrations were associated with increased risk of PC [odds ratio (OR) comparing the fourth to first quartile: 1.94; 95 % confidence interval (CI):1.23–3.06]. Stratified analyses by tumor classification showed consistent risk increases for advanced and aggressive tumors [ISUP3-5 Relative risk ratio (RRR) quartile 4vs.1: 2.86 (1.16–7.06); AJCC IIB-IV RRR: 2.58 (1.48–4.50); cT2-cT4 RRR: 3.05 (1.55–5.99)]. No clear association was found with urinary As concentrations. Interaction analyses showed no evidence of effect modification by PRS.
Delays and detours during cancer diagnosis: a cross-sectional study on patient pathways and provider intervals in public healthcare networks of Chile, Colombia and Ecuador.
(BioMed Central, 2026-02) Vázquez, María Luisa; Eguiguren, Pamela; Mogollón Pérez, Amparo Susana; Peralta Chiriboga, Alejandro-Andrés; Borràs Andrés, Josep Maria; Azanar Lou, Ignacio; Jervelund, Signe Smith; Cardozo, Carol; Benthami Zarhouni, Samar; Dueñas Espín, Ivan; Garmendia, María Luisa; Dias, Sónia; Vargas Lorenzo, Ingrid
Background The longest delays in cancer diagnosis in Latin America occur between the first contact with health services and the confirmation of diagnosis (referred to as the provider interval), yet few studies have examined patient pathways to understand these delays. This study aims to analyze patient diagnostic pathways and their relationship to the provider interval in public healthcare networks of Chile, Colombia and Ecuador. Methods Cross-sectional study based on questionnaire survey to adult patients diagnosed with cancer in prior 12 months in the study networks (n=351 in Chile; 303 in Colombia; 365 in Ecuador). Study variables were diagnostic pathways (according to type and sequence of services) and provider intervals. Descriptive, bivariate and adjusted multivariate quantile regression analyses were conducted. Results Two pathway types were identified: a) public services use, frequent in Colombia (67.3%) and b) mixed public-private services use, predominant in Chile (76.9%) and Ecuador (59.2%). Under 20% of patients followed the public pathway starting in primary care followed by referral to secondary care for confirmation. In Colombia and Ecuador, it was common to start in emergency departments, and in Colombia, going back and forth between care levels. Median provider interval was 111 days (IQR:134) in Chile, 156 (IQR:275) in Colombia and 92 (IQR:173) in Ecuador. Public-private pathways, more frequent in symptomatic patients, were significantly longer than public-only pathways (Chile: 116 vs. 92 days; Colombia: 175 vs. 153 days; Ecuador: 92 vs. 75 days; all p<0.05). Emergency-initiated pathways were significantly shorter, whereas Colombia’s back-and-forth pathways were longer than those via primary care, although this difference was not statistically significant. Conclusion The results reveal fragmented diagnostic pathways with significant delays, particularly in Colombia. The results underscore the need for equity-oriented policies to improve access to care in public healthcare networks.
Impact of lung cancer screening eligibility criteria on participants characteristics and healthcare resources
(Wiley, 2025) Cabrera Godoy, Olivia; ten Haaf, Kevin; Borràs Andrés, Josep Maria; Font, Rebeca; Solà, Judit; Hubert, Juul; Ballesteros, Mónica; Espinàs Piñol, Josep Alfons
Selection criteria for lung cancer screening (LCS) are essential for implementing resource- and cost-efficient programs. However, different selection criteria may have similar resource requirements but select dissimilar individuals. This study explores the impact of inclusion criteria on participants' characteristics and health services in Spain. A cross-sectional study was conducted using data from 21,007 individuals from the 2012 Spanish National Health Survey. LCS eligibility was evaluated for four criteria: two from the 4-IN-THE-LUNG-RUN trial (4ITLR1: ages 60–79, 35 pack-years, current smokers or <10 years since cessation; 4ITLR2: ages 60–79, PLCOm2012noRace risk ≥2.6%), the United Kingdom's Targeted Lung Health Check (TLHC: ages 55–74, PLCOm2012noRace risk ≥1.51%), and the United States Preventive Services Task Force (USPSTF: ages 50–80, 20 pack-years, current smokers or <15 years since cessation). Under the most restrictive (4ITLR1) 5.6% of ages 50–80 were eligible, requiring 9.0% additional radiological capacity. Under the broadest (USPSTF) 21.6% of ages 50–80 were eligible, requiring 34.2% additional capacity. All criteria primarily selected men (68.1–82.2% of eligibles). Most criteria favored selecting former smokers (49.4–56.9%). However, eligible women were more often current smokers than men across all criteria (men: 38.5–46.8%, women: 52.7–66.5%). Former smokers smoked more cigarettes per day than current smokers (30 vs. 20) despite having shorter smoking durations, resulting in higher median pack-years across all criteria (range: 44–66). Overall, pack-year-based eligibility decreased with age, while risk-based eligibility was stable across age groups. Different LCS criteria yield populations with highly varied characteristics. Risk-based criteria may provide more equitable eligibility across age groups.
Women's experiences along the ovarian cancer diganostic pathway in Catalonia: A qualitative study
(John Wiley & Sons, 2023) Vela Vallespín, Carmen; Medina Perucha, Laura; Jacques Aviñó, Constanza; Codern Bové, Núria; Harris, Meggan; Borràs Andrés, Josep Maria; Marzo Castillejo, Mercè
Background Early detection of symptoms and prompt diagnosis of ovarian cancer are considered important avenues for improving patient experiences and outcomes. Methods This qualitative study used a phenomenological approach to perform patient interviews, collecting individual accounts of the prediagnostic phase in women diagnosed and treated for ovarian cancer in 2016–2017. Purposive sampling was used to obtain a diverse sample of 24 participants, while thematic content analysis was used to extract themes and subthemes from interview data. Results Three themes and nine subthemes were identified. The first theme was women's delay in recognizing symptoms and seeking care, with subthemes on the lack of knowledge about early signs of ovarian cancer, gender-related barriers and false reassurance from negative test results. A second theme was missed opportunities during healthcare encounters, due to misattribution of women's symptoms by their physicians, underestimation of symptom severity and need for mediation and inadequate tests and/or false negative results. Finally, interviews highlighted the use of resources and alternative healthcare pathways, including complementary/alternative medicines, access to private health care and women's capacity for action and decision-making (agency) about their health.
Consensus-based validation of key quality indicators in pancreatic cancer surgery in Catalonia: a modified Delphi study
(Elsevier España, 2026) Guarga, Laura; Esteban, Laura; Busquets Barenys, Juli; Ausania, Fabio; García-Domingo, M.; Borràs Andrés, Josep Maria; Manchon-Walsh, P.
ABSTRACT Introduction: Pancreatic cancer surgery is highly complex and associated with significantperioperative risk, high mortality and morbidity, low quality of life, and increased healthcarecosts. Establishing quality indicators to monitor these procedures may improve care qualityand outcomes. This study aims to define a set of quality indicators to evaluate pancreatic cancersurgery in Catalonia.Methods: A preliminary list of quality indicators was developed based on a literature review.Subsequently, a modified Delphi study was undertaken, involving 11 expert pancreaticsurgeons, one from each center where these complex surgeries are authorized in Catalonia, toachieve consensus on quality indicators for pancreatic cancer surgery.Results: The literature review yielded 21 potential quality indicators. After 4 rounds of voting,the expert panel accepted 17 indicators and rejected 4. The final set of quality indicatorsencompasses critical aspects including positive tumor resection margin, lymph nodes retrieved,Journal Pre-proof3 /21postoperative complications, hospital readmission, reoperation, 90-day mortality and one-yearsurvival.Conclusion: The outcome of this study is a set of agreed quality indicators to measure, describeand monitor the quality and outcomes of pancreatic cancer surgery. These quality indicatorscan be used as a foundation for benchmarking studies and systematic evaluations of quality ofcare and enhanced surgical performance in pancreatic cancer.
Online Gaming Disorder and Sports Betting Addiction: Convergences and Divergences
(Springer Verlag, 2024-12-01) Ayala Rojas, Rocío Elena; Granero, Roser; Fernández Aranda, Fernando; Gómez Peña, Mónica; Moragas, Laura; Perales, Iván; Jimenez Murcia, Susana
Worldwide estimates of the prevalence of online gaming disorder (OGD) and online sports betting addiction (OSBA) have become exceedingly high, particularly among young peo- ple. The objective of this study was to compare the sociodemographic and clinical pro- files of treatment-seeking patients for these mental health disorders. The sample included n = 495 patients (n = 108 OGD and n = 387 OSBA) recruited from a tertiary care unit spe- cialized in the treatment of behavioral addictions. Sociodemographic variables, psycho- pathologic state, impulsivity, emotion regulation, substances, and personality traits were assessed and compared between both these diagnostic subtypes. The prevalence for OGD was 3.82% and for OSBA was 13.01% among the whole sample of n = 3,036 patients. Compared with OGD, OSBA presented a profile characterized by a greater proportion of non-single men with higher levels of education, employed, and of higher socioeconomic status. OSBA was also characterized by older chronological age, later age of onset of the addictive behaviors, worse psychopathology state (greater likelihood of depression and anxiety), higher impulsivity, and higher substance use. The personality profile related to OSBA presented higher novelty seeking, reward dependence and persistence, and lower harm avoidance. Despite the similarities between OGD and OSBA, and even though both behaviors could be perceived by the general population as low-risk leisure activities (as opposed to other gambling types, such as casinos or slot machines), the differences in the clinical profiles should be considered in efforts to improve assessment tools and special- ized intervention plans.

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