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Integrating circulating microRNAs with epidemiological factors enhances breast cancer detection across subtypes: the MCC-Spain study
(Nature Publishing Group, 2026-03-07) Gómez Acebo, Inés; Valero Dominguez, Sara; Llorca Díaz, Javier; Alonso-Molero, Jéssica; Belmonte, Thalía; Castaño-Vinyals, Gemma; Moreno Aguado, Víctor; Romaguera, Aina; Amiano, Pilar; Alguacil, Juan; Martín, Vicente; Pérez Gómez, Beatriz; Burgui, Rosana; Molina Barceló, Ana; Rodríguez Cundín, Paz; Kogevinas, Manolis; Pollán, Marina; Dierssen Sotos, Trinidad
Circulating microRNAs (miRNAs) are promising non-invasive biomarkers for cancer detection; however, their diagnostic performance across breast cancer molecular subtypes and their incremental value beyond demographic and epidemiological variables remain incompletely characterized. We conducted a multicenter case–control study including 317 breast cancer cases and 127 population-based controls. Serum levels of 44 literature-derived miRNAs were quantified by RT-qPCR. Feature selection was performed using LASSO penalization, followed by multivariable logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Models were adjusted for demographic and epidemiological covariates. Predictive performance was assessed using repeated fivefold cross-validation and reported as area under the curve (AUC) with bootstrap bias-corrected 95% CIs. Incorporating demographic and epidemiological covariates enhanced discrimination overall (AUC = 0.908 vs. 0.802 unadjusted) and across subtypes. The most notable improvements were observed in Luminal A (0.896 vs. 0.751) and Luminal B (0.894 vs. 0.768), while HER2-positive and Basal-like tumors already showed high performance (AUC = 0.965 and 0.989, respectively). Among the 12 miRNAs selected by LASSO, miR-21-5p and miR-423-3p were consistently elevated in cases, particularly in HER2-positive and Basal-like tumors, whereas miR-101-3p, miR-146a-5p, and miR-29a-3p showed reproducibly lower levels across multiple subtypes, consistent with oncogenic and tumor-suppressive roles, respectively. Circulating miRNA signatures, especially when integrated with demographic and epidemiological information, demonstrate high discriminatory power for breast cancer detection across molecular subtypes. These results support subtype-aware, minimally invasive strategies for screening and risk stratification using miRNA-based models. Prospective validation in independent cohorts is warranted to confirm clinical utility.
Evaluation and Treatment of Compulsive Sexual Behavior Disorder and Co-Morbid Addictive Disorders: A Narrative Review
(Springer Nature Switzerland, 2026-03-26) Baenas, Isabel; Munguía, Lucero; Fernández Aranda, Fernando; Jimenez Murcia, Susana
Purpose of Review: This review aimed to synthesize recent literature on the comorbidity between compulsive sexual behavior disorder (CSBD) and addictive disorders, including substance use disorders (SUD) and behavioral addictions (BA). It sought to examine assessment practices, clinical profiles, treatment strategies, and transdiagnostic mechanisms to inform integrated interventions. Recent Findings: CSBD frequently co-occurs with SUD, though less research has emerged on the co-existence with BA. Compulsive sexual behavior often occurs as a maladaptive coping strategy for emotional distress and shared transdiagnostic factors—such as emotion regulation difficulties, impulsivity, and specific personality traits—underlie these comorbidities. Clinical assessments are heterogeneous and evidence for integrated treatment in dual diagnosis remains scarce, though interventions targeting emotion regulation and impulsivity emerged as useful strategies. Summary: The literature reveals substantial gaps in standardized assessment and integrated treatment for CSBD with comorbid addictive disorders. Findings underscore the need for multidisciplinary, transdiagnostic care frameworks and further research on shared mechanisms. Future studies should evaluate combined psychotherapeutic and pharmacological interventions to improve clinical outcomes and guide public mental health strategies.
Personalized medicine strategy for MPNSTs: using precision oncology on PDOX models to inform tumor boards
(BioMed Central, 2026-02-04) Ortega Bertran, Sara; Fernández Rodríguez, Juana; Magallón Lorenz, Miriam; Creus Bachiller, Edgar; Uriarte Arrazola, Itziar; Mazuelas, Helena; Garraus, Moira; Carrió, Meritxell; Gel Moreno, Bernat; Rovira, Carlota; Alvarez, Mariana; Villanueva Garatachea, Alberto; Castaneda, Alicia; Salvador, Héctor; Serra, Eduard; Lázaro García, Conxi
Background: Malignant peripheral nerve sheath tumors (MPNSTs) are a heterogeneous group of aggressive soft tissue sarcomas with poor prognosis. Currently there is a lack of effective treatments for MPNSTs. Here, we propose a personalized medicine approach that integrates a precision oncology strategy guided by MPNST genomic analysis, with a functional validation of treatment response in an orthotopic xenograft model (PDOX) derived from the same MPNST. Methods: Comprehensive whole genome sequencing analysis was performed in primary MPNSTs, relapses and (in one case) metastases, following disease progression in two independent individuals. Matched MPNST PDOX models were generated by orthotopically implanting tumor fragments near the sciatic nerve of immunodeficient mice. Candidate targeted combination therapies were prioritized based on genomic alterations and tested in vivo in the PDOX models. Results: The feasibility of the developed strategy is illustrated for two MPNST patients, one Neurofibromatosis type 1 (NF1) individual that developed two independent MPNSTs and another sporadic MPNST case with multiple metastatic relapses. Genomic analysis revealed a remarkable degree of genomic stability across primary MPNSTs and their successive relapses in each patient, and even metastases in one individual. While based on a small number of cases requiring additional analyses, this finding aligns with previous evidence suggesting a fair genomic conservation throughout tumor evolution. This stability supports the identification of consistent therapeutic vulnerabilities throughout disease progression. Among the therapies tested, co-treatment of MEK inhibitor (MEKi) plus bromodomain inhibitor (BETi) elicited the highest antitumor activity, resulting in approximately 60% tumor volume reduction in the sporadic MPNST PDX model, whose patient has been receiving this therapy for eight months with sustained remission. Conclusions: This study demonstrates the feasibility and clinical utility of integrating genomic-driven precision oncology with PDOX-based functional testing for MPNSTs. This strategy may support molecular tumor boards (MTBs) in their treatment decisions. The observed genomic stability supports the use of longitudinal tumor profiling to guide treatment, and the success of MEKi+BETi highlights its potential as a combination therapy for MPNSTs.
Exploring the strengths and limitations of AI-driven variant prioritization versus manual curation in inborn errors of immunity
(Frontiers Media, 2026-03-04) Moushib, Laith Ibrahim; Moreno-Ruiz, Nerea; Martin Nalda, Andrea; Rivière, Jacques G.; Urban, Blanca; Dieli Crimi, Romina; Perurena-Prieto, Janire; Aguiló Cucurull, Aina; Pérez Estévez, Elena; Solanich Moreno, Xavier; Soler-Palacín, Pere; Colobran, Roger; Batlle-Masó, Laura
Introduction: Next-generation sequencing (NGS) has transformed the genetic diagnosis of human diseases, yet many patients remain unsolved due to the complexity of variant interpretation. Manual curation of candidate variants is effective but time-consuming and requires specialized expertise. Artificial intelligence (AI)-driven platforms have emerged as scalable tools for variant prioritization, yet their performance compared with manual curation remains insufficiently evaluated. The aim of this study was to evaluate the performance of AI-driven platforms for variant prioritization in a cohort of patients with inborn errors of immunity (IEI) and to compare their strengths and limitations with manual curation. Methods: We analyzed 22 unsolved IEI cases that had previously undergone inconclusive NGS studies. Whole-genome sequencing was performed, and variant prioritization was carried out using two AI-driven platforms -AIMARRVEL and AION (Nostos Genomics)- and by manual curation. Selected variants were classified according to clinical relevance (very high, high, medium, or low), integrating both molecular and phenotypic evidence. Results: Across the cohort, AI platforms efficiently prioritized variants with clear pathogenic features, often reaching the same conclusions as manual curation but in a fraction of the time. One patient (5%) received a conclusive diagnosis (FAM111B), and four patients (18%) carried variants of high clinical relevance, including strong disease-causing candidates in CD247 and SH2B3. Additional medium-relevance variants were identified in 36% of cases, although evidence was insufficient for functional validation. Notably, concordance between AIMARRVEL and AION was limited, particularly for variants of uncertain significance (VUS), reflecting differences in algorithmic weighting of variant features versus clinical phenotype. Both platforms also highlighted potentially novel associations in RUNX1 and TRAF7, underscoring their capacity to extend beyond classical IEI genes. Discussion: Our results show that AI-driven tools are powerful for detecting clearly pathogenic variants and can markedly accelerate the diagnostic process. However, their strong reliance on curated databases, limited incorporation of phenotypic data, and challenges in handling VUS may reduce their effectiveness. Enhancing phenotype integration, expanding annotations (including non-coding regions), and incorporating up-to-date literature could improve their performance. Ultimately, AI tools should complement expert curation, with future models evolving toward integrative approaches that better capture the complexity of human disorders.
Association of germline variants with KRAS-mutation status in colorectal cancer
(Nature Publishing Group, 2026-02-13) Tjader, Nijole Pollock; Ramroop, Johnny; Gandhi, Tanish; Dauch, Cara; Meadows, Owen; Stevens, Patrick; Pearlman, Rachel; Hampel, Heather; Aglago, Elom K.; Berndt, Sonja I.; Bloomer, Amanda; Brenner, Hermann; Buchanan, Daniel D; Campbell, Peter T.; Cao, Yin; Chan, Andrew T.; Cheng, Iona; Dimou, Niki; Drew, David A.; French, Amy J.; Georgeson, Peter; Giannakis, Marios; Giles, Graham G.; Gomez, Maria; Gruber, Stephen B.; Hoffmeister, Michael; Huang, Wen-Yi; Hullar, Meredith Aj.; Huyghe, Jeroen R.; Loroña, Nicole; Moreno Aguado, Víctor; Newton, Christina C.; Nowak, Jonathan A.; Obón Santacana, Mireia; Ogino, Shuji; Pellatt, Andrew J.; Peoples, Anita R.; Permuth, Jennifer B.; Schmit, Stephanie L.; Schoen, Robert E.; Siegel, Erin M.; Steinfelder, Robert; Sun, Wei; Teer, Jamie K.; Thomas, Claire E.; Trinh, Quang M.; Tsilidis, Konstantinos K.; Ugai, Tomotaka; Um, Caroline Y.; Van Guelpen, Bethany; Zaidi, Syed H.; Figueiredo, Jane C.; Peters, Ulrike; Phipps, Amanda I.; McElroy, Joseph Paul; Toland, Amanda E.
Somatic mutations in KRAS are a common driver of colorectal cancer (CRC) and present at different frequencies by race, sex, tumor site, ethnicity, and genetic similarity. Inherited germline variants may influence tumor somatic mutation frequency by altering mutation or DNA repair processes or altering cellular, immunological and/or microenvironmental responses after a mutation. We hypothesized that the germline genetic background modifies somatic KRAS mutation frequency in CRC. To test this, we performed a genome-wide association study (GWAS) in 7071 individuals with CRC, using KRAS mutation status as the phenotype. Single-nucleotide variants were chosen for validation analyses based on P values from the discovery GWAS, predicted in silico functional effects, and proximity to genes with potential cancer relevance. A validation analysis of 101 SNVs of interest was performed in 2482 individuals. No SNVs were significantly associated with KRAS-mutant CRC (P value < 0.0005). One variant rs73067863-T showed a non-significant exploratory association with fewer KRAS-mutant tumors in the combined sample (P value = 9.7 × 10–7, OR = 0.75). Follow-up studies are needed to determine if these or other germline variants impact population differences in KRAS mutations in CRC.
The mitigating effect of social protection on undernourishment during economic downturns: A longitudinal study of 46 low- and middle-income countries over the last two decades
(Elsevier Ltd., 2024-11-01) Barreix Sibils, Gonzalo; Brachowicz Quintanilla, Nicolai; Silva, Natanael de Jesus; Landin, Elisa; Macicame, I.; Naidoo, M.; Morais, G. de Sampaio; Rasella, Davide
Background Low- and middle-income countries (LMICs) are particularly vulnerable to the adverse effects of economic downturns on the Prevalence of Undernourishment (PoU). Our study aimed to evaluate the impact of Social Protection and Labor Programs (SPL) on PoU in 46 LMICs from 2001 to 2019, and to estimate SPL mitigating effects during economic downturns. Methods This cohort study used a multi-country ecological design with two-ways fixed effects multivariable linear regression models, adjusted for relevant demographic, socioeconomic, and contextual variables. Interaction terms between economic downturns and SPL were used to evaluate SPL mitigating effects. Findings Our study cohort displayed an average 15.30% PoU and 34.34% SPL coverage in the initial year, contrasting with 8.58% PoU and 43.81% SPL coverage in the final year. A 10% SPL coverage was associated with a 0.51% PoU reduction (95%CI: 0.04–0.99) across all countries and 0.78% reduction within the poorest subgroup. SPL have been able to prevent an estimated 1.01 billion (95% UI: 0.16–1.86) cases of undernourishment over the study period in the 46 LMICs. Economic downturns were associated with a 4.55% PoU increase (95% CI: 1.28–7.81) in all countries, and a 6.06% PoU increase in the poorest subgroup. High SPL coverage during the downturns had significant mitigating effects, reducing an overall 1.17% PoU for every 10% SPL coverage in all countries, and 1.81% PoU in the poorest nations.
Chagas congénito, ¿es posible en España?
(Nexus medica, 2004) Cusnaider, Conrado M.; Gómez Roig, Ma. Dolores; Amat Tardiu, Lluís; Aguiló, Fernando; Hernández, Agustín; Lailla Vicens, José Ma. (José María), 1948-
La enfermedad de Chagas es una parasitosis endémica americana. Las embarazadas infectadas, pueden transmitir la enfermedad por vía de transmisión vertical o transplacentaria a su hijo; es la vía que nos interesa a los tocoginecólogos por dar lugar al Chagas congénito. Es la forma de Chagas que puede existir en zonas no endémicas como España. El recién nacido chagásico es sintomático en el 20% de casos y asintomático el 80% restante, pero siempre presenta examen de laboratorio positivo para Tripanosoma Cruzi. De todas las gestantes de áreas endémicas, un 3 a 17% son seropositivas para Chagas, de ese porcentaje el 0,7 al 10% de sus hijos presentará Chagas congénito. Es importante el diagnóstico y tratamiento precoz del Chagas congénito Si no se trata a tiempo, pasará de un fase aguda, a las fases indeterminada y crónica; por lo que convendría en España estudiar serología a las embarazadas de zonas endémicas, y si son seropositivas, corresponde solicitar estudios parasitológicos y luego serológico a sus hijos desde el nacimiento hasta el año de edad.
Impact of molecular point-of-care testing for respiratory pathogens on antibiotic use and clinical outcomes in acute respiratory tract infections: a systematic review and meta-analysis
(Elsevier, 2026-02-01) Li, Qinyuan; Zhou, Qi; Fan, Jiangbo; Feng, Xifeng; Lai, Honghao; Chen, Yaolong; Ye, Zhikang; Song, Fujian; Liu, Jiao; Chen, Dechang; Kang, Rui; Tang, Daolin; Teboul, Jean-Louis; Timsit, Jean-Francois; Torres Martí, Antoni; De Waele, Jan J.; Carratalà, Jordi; Jiang, Jianxin; Luo, Zhengxiu; Zeng, Ling
Background: Molecular point-of-care testing (mPOCT) offers rapid identification of respiratory pathogens, but its impact on antibiotic use and patient outcomes remains uncertain. We aimed to comprehensively evaluate the effects of mPOCT on antibiotic use and major clinical outcomes in patients presenting with acute respiratory tract infections (ARTIs). Methods: We searched MEDLINE, Embase, Web of Science, CENTRAL, CNKI, and Wanfang Data from inception to July 1, 2025, for randomised controlled trials (RCTs) evaluating mPOCT for patients presenting with ARTIs (PROSPERO CRD420251069333). The primary outcome was antibiotic use, assessed using pooled risk ratio (RR) with random-effects models. Risk of bias and certainty of evidence were assessed using the Risk Of Bias instrument for Use in SysTematic reviews-for Randomised Controlled Trials (ROBUST-RCT) and core Grading of Recommendations, Assessment, Development and Evaluation (GRADE), respectively. Findings: We included 25 RCTs involving 12,638 patients, of whom 61.0% were adults. Overall, mPOCT probably had little to no important effect on antibiotic use (RR 0.95, 95% CI 0.90–1.00; moderate certainty) or treatment duration (mean difference −0.44 days, 95% CI −0.98 to 0.09; moderate certainty). In adults, high-certainty evidence showed no effect on antibiotic use (RR 1.00, 95% CI 0.98–1.02), whereas in children, low-certainty evidence suggested a potential reduction (RR 0.79, 95% CI 0.65–0.97). Although mPOCT increased appropriate antibiotic prescribing (RR 2.07, 95% CI 1.55–2.77; moderate certainty), it did not affect 30-day mortality (RR 0.97, 95% CI 0.82–1.15; high certainty) and intensive care unit admission (RR 0.90, 95% CI 0.65–1.25; high certainty). Interpretation: Moderate to high certainty evidence suggests that mPOCT does not meaningfully reduce overall antibiotic use or improve patient outcomes, particularly in adults, despite enhancing prescribing appropriateness. Routine use of mPOCT for adults with ARTIs is therefore not supported. Funding: National Natural Science Foundation of China, the Postdoctoral Science Foundation, the Chongqing Municipality Joint Science and Health Major Medical Research Project, Outstanding Youth in Science and Technology, the Chongqing Youth Talent Fund, and the Research Foundation Flanders.
Epidemiological insights into Haemophilus influenzae and Pseudomonas aeruginosa persistent colonization in non-cystic fibrosis bronchiectasis patients: a longitudinal and multicenter study
(BioMed Central, 2026-02-16) Cadenas Jiménez, Irene; Camps Massa, Paula; Gonçalves Carvalho, Filipe; Benaali Bakkar, Yasmina; Quero Blanca, Sara; Rodríguez, Laura; Antuori, Adrián; Saiz Escobedo, Lucía; Calvo-Silveria, Sara; Oliver, Antonio; Domínguez Luzón, Ma. Ángeles (María Ángeles); Tubau, Fe; González-Díaz, Aaida; Ardanuy Tisaire, María Carmen; Santos Pérez, Salud; Marín, Alicia; Bronchiomics group; Martí Martí, Sara
Background: Bronchiectasis is a chronic respiratory disease characterized by recurrent exacerbations and persistent inflammation, often associated with bacterial pathogens such as Haemophilus influenzae and Pseudomonas aeruginosa. Phenotypic adaptations (e.g., antimicrobial resistance) complicate treatment and worsen a patient’s quality of life. Methods: Between 2019 and 2020, we isolated 52 H. influenzae and 48 P. aeruginosa strains from 62 non-CF bronchiectasis patients across three scheduled visits and during exacerbation episodes. Antimicrobial susceptibility (assessed by microdilution) and phenotyping assays (motility and hypermutability) were performed. Whole genome sequencing was applied for analyses of resistance determinants, virulence factors, and genetic diversity. Results: Of the 62 patients, 31 were colonized by H. influenzae, 28 by P. aeruginosa, and 3 were co-colonized. Severe disease was predominantly linked to P. aeruginosa (70.6%), while exacerbations were more common with H. influenzae (81.8%). Multilocus sequence typing (MLST) revealed high genetic diversity, with ST1025 and ST253 most common in H. influenzae and P. aeruginosa, respectively. Antimicrobial resistance was low, but H. influenzae showed the highest resistance to cotrimoxazole (40.4%), while P. aeruginosa showed high resistance to aminoglycosides (27.1%) and fluoroquinolones (25%). Virulence profiling of P. aeruginosa identified 22.9% of strains as hypermutable, 27.1% as mucoid, 31.3% harboring the exoU gene, and 41.7% with impaired twitching motility. Persistent colonization occurred in 16 patients (25.8%), with antimicrobial resistance emerging following previous antimicrobial treatment in one case. Conclusions: In this cohort, H. influenzae and P. aeruginosa showed similar prevalence, high genetic diversity, and rare co-colonization. P. aeruginosa was associated with more severe disease, higher antimicrobial resistance, and hypermutability, whereas H. influenzae was associated with acute exacerbations.
Functional and structural neuroretinal disorders in HIV Controllers. Prospective cohort study
(Wiley, 2024-11-01) Ruiz Bilbao, Susana; Videla Ces, Sebastià; Pascual Miralles, Esther; Soler, Marta; Puig Pla, Jordi; Grizolli, Stefano; Negredo, Eugènia; Castellvi Manent, Jordi
Objective: To estimate the prevalence and cumulative incidence of neuro-retinal-disorders (NRD) in HIV-controllers. Design: Prospective, single-centre, cohort study of people living with HIV (PLWH): elite-controllers, long-term-non-progressors and early diagnosed. Methods: The study compared “HIV-controllers” (including elite-controllers and long-term-non-progressors), who were not on antiretroviral therapy (ART), and “HIV-treatment” (HIV-infected subjects with a recent diagnosis and on ART). A matched cohort of “non-HIV subjects” was created. NRD was defined as at least one altered (not normal) ophthalmological parameter (functional or structural). Functional (visual acuity, contrast sensitivity, chromatic vision, visual field) and structural parameters (ganglion cells, macular nerve fibre layer, peripapillary nerve fibre layers, vascular calibre) as well as quality of life (Medical Outcomes Study-HIV Short Form-30) were assessed.
Implementation of the precision oncology program in catalonia's public health system: results, lessons learned, and future prospects
(Springer Verlag, 2026-03) Mur, Pilar; Pozuelo, Anna; Tabernero Caturla, Josep; Albanell Mestres, Joan; Bellosillo Paricio, Beatriz; Bosch Albareda, Francesc; Briones, Javier; Brunet, Joan; Colomer Pujol, Dolors; Domenech, Montserrat; Fontanet, Manel; Matias-Guiu, Xavier, 1958-; Salazar Soler, Ramón; Vivanco Hidalgo, Rosa Maria; Mollà, Meritxell; Moreno, Lucas; Prat Aparicio, Aleix; Ribera, Josep M.; Clèries Soler, Ramon; Guarga, Alex; Espinàs Piñol, Josep Alfons; Borràs Andrés, Josep Maria
Purpose: The Precision Oncology Program (POP) in Catalonia aims to provide equitable access to molecular testing for individuals with cancer, integrating Next-Generation Sequencing (NGS) into clinical practice to inform diagnosis, prognosis, and treatment decisions for both adult and pediatric patients with solid and hematologic malignancies, including somatic and germline alterations. This study evaluates the program's outcomes and impact. Methods: This evaluation covers the period from the program’s implementation in July 2021 through December 2023, with a more detailed analysis focusing on 2022–2023. The program involved 12 reference centers utilizing NGS technology for cancer genetic analysis, coordinated by CatSalut, the regional public health service payer. Data collected from each reference laboratory included the number of tests performed, types of tumor panels used, clinical indications, and associated outcomes. Results: Between July 2021 and December 2023, a total of 23,135 molecular tests were performed on 22,501 patients. The most frequently analyzed panels were for solid tumors (38.1%), hematologic cancers (17.3%), and germline mutations (42.2%). Pediatric patients accounted for 2.4% of the total. Notably, 24.7% of patients underwent a change in clinical management, contributing to more targeted treatment strategies, particularly in solid tumors (58.7%). Reports were delivered within an average of four weeks, meeting program benchmarks and facilitating timely decision-making. Sample submission compliance was high, reaching 98.5%. Conclusions: This POP successfully addressed operational, financial, and logistic challenges, ensuring equitable access to molecular testing. This program led to more efficient and personalized clinical management, with growing impact on cancer care and patient outcomes.
Eating disorder debut cases during COVID-19 lockdown in adults. Exploring differences in treatment outcome contrasting with pre-pandemic onset cases
(Wiley, 2024-10-23) Munguía, Lucero; Baenas, Isabel; Granero, Roser; Ohsako, Noriaki; Gaspar Pérez, Anahí; Perales, Iván; Rosinska, Magda; Sánchez, Isabel; Jimenez del Toro, Jessica; Sánchez González, Jéssica; Arcelus, Jon; Paslakis, Georgios; Jimenez Murcia, Susana; Fernández Aranda, Fernando
Despite an increase in eating disorder (ED) cases during the COVID-19 pandemic, there are limited longitudinal studies exploring treatment outcomes. The aims of the present study were: (1) to compare the clinical features of patients with EDs whose onset was during the COVID-19 lockdown (pandemic cohort) against patients with EDs whose onset was prior to the pandemic (pre-pandemic cohort) and, (2) to compare therapy responses between the cohorts.
Seizure prophylaxis in pneumococcal meningitis, cohort study
(John Wiley & Sons, 2024-12-01) Guillem Tió, Lluïsa; Hernández Pérez, Guillermo; Berbel, Dàmaris; Pelegrín Senent, Iván; Falip, Mercè; Cabellos Mínguez, Ma. Carmen
Our aim was to assess seizure development as a complication of pneumococcal meningitis and its possible prevention with antiseizure medication prophylaxis. Methods Antiseizure medication (ASM) prophylaxis has been practiced for a long time at our center. We assessed all cases of community-acquired pneumococcal meningitis admitted from January 2010 to April 2021 recorded in our prospective database and conducted further retrospective studies. Results Of the 86 cases recorded, 21 (24.4%) developed acute symptomatic seizures, more than half of which (11/21; 52.4%) before admission. Seizure development increased the need for orotracheal intubation and intensive care unit admission, while also lengthening hospital stays and suggesting more risk of death and disability at discharge [adjusted odds ratio (aOR), 3.13; 95% confidence interval (CI): 1–9.8]. Of the 74 patients eligible for ASM prophylaxis, 64 received it and 10 did not. ASM prophylaxis seemed effective in preventing seizure development, as only six seizure events were recorded in 64 patients with ASM prophylaxis (9.4%) compared with four in the 10 patients without prophylaxis (40%). Its preventive capacity was especially notable when administered within 4 h of admission. Differences in mortality did not reach statistical significance. Adverse effects were rare.
High-Sensitivity Cardiac Troponin T Release After the 20-m Shuttle Run Test in 733 Healthy Children and Adolescents
(John Wiley & Sons, 2026-03-06) Conesa Milian, Enric; Batalla Gavaldà, Abraham; Hernández González, Vicenç; López Laval, Isaac; Corbi, Francisco; Cirer Sastre, Rafel; Legaz Arrese, Alejandro; Reverter Masia, Joaquin
This study aimed to assess the effect of exercise on high-sensitivity cardiac troponin T (hs-cTnT) concentrations in children and adolescents and to examine whether sex, maturational status, anthropometric characteristics, cardiorespiratory fitness, and physical activity influence the hs-cTnT response. In this trial 733 participants completed the 20-m shuttle run test. Venous blood samples were collected at rest and 3 h postexercise to determine hs-cTnT concentrations. We included 296 girls and 437 boys (12.2 ± 1.7 years; 40% girls). At baseline, 61% of participants had hs-cTnT values below the limit of detection (LoD), and 2.5% exceeded the upper reference limit (URL). Postexercise, 36% remained below LoD, while 7.5% exceeded the URL. Overall, hs-cTnT increased from baseline to 3 h postexercise in 56.2% of participants. Linear mixed-effects models showed a significant main effect of time (β = -0.42, 95% CI 0.35-0.49; p < 0.01) and no main effect of sex (p = 0.85), although a small but significant time × sex interaction was observed (β = -0.11, 95% CI -0.20 to -0.02; p = 0.021), indicating a slightly greater exercise-induced increase in girls. Additional significant time × covariate interactions were identified for maturational, anthropometric, and fitness-related variables. However, these factors together explained only a small proportion of the overall variability in hs-cTnT response. Consequently, the 20-m shuttle run test induces a significant increase in hs-cTnT concentrations in children and adolescents. Exercise-induced hs-cTnT release is common but highly heterogeneous, and is only partly explained by sex, maturational, anthropometric, and fitness-related factors, suggesting an important contribution of individual-specific determinants not captured by conventional variables.
The Evaluation of a Nursing Care Model for Breast Cancer: What Are Women's Priorities?
(John Wiley & Sons, 2025-04-26) Rodriguez Ortega, Ana; Ferro, Tàrsila; Ochoa Arnedo, Cristian; Campos, Gloria; Valverde, Yolanda; Medina, Joan Carles; Borràs Andrés, Josep Maria
Aim: To assess patient satisfaction with the breast care nurse (BCN) model and its adequacy in meeting patients’ needs for information and support. Background: The BCN is a core multidisciplinary member of the breast cancer team. The evaluation of care models is necessary to detect gaps and improve the quality of care. Material and Methods: This cross-sectional descriptive study took place in a breast pathology unit and included patients with early breast cancer seen between 1 July 2016 and 30 June 2017 after finishing their treatment. Between July and December 2018, sociodemographic and clinical variables were collected from the clinical history, and satisfaction was measured using a questionnaire sent to the patients. Results: Of the 139 patients included, 99.3% reported that the BCN provided information correctly, 96.2% reported that she provided adequate information on self-care at home (96.2%), and 97.8% reported that the words of the BCN helped them feel better. However, some patients were unsure whether the BCN would have been willing to discuss alternative therapies (41%). Conclusions: Patients were satisfied with the BCN, including her role in meeting information and support needs. However, some issues needed to be sufficiently addressed. Comprehensive, continuous assessment is required to understand patient needs. Training and specific studies on topics that are of interest to patients can help respond to these needs. Implications for Nursing Management: BCN functions are being developed in some countries. BCN results make it easier for healthcare managers to commit to this role and for nurses to develop all their competencies. BCN models must respond to international guidelines but are also determined by organizational resources. The evaluation of these models is essential and must be considered by users. Advanced practice nursing roles, including the BCN, are well established in some countries but developing in others. BCN results make it easier for healthcare managers to commit to this role and for nurses to develop all their skills. BCN models must respond to the elements determined by organizations that work to improve the quality of care for patients with breast cancer. However, they are also determined by organizational resources. The evaluation of these models is essential to correct deficiencies and improve the quality of care. An important part of the evaluation must take into account the user who receives the care, in terms of satisfaction and the form of patient-reported outcome measures (PROMs).
Addressing Heterogeneity in Binge Eating Disorder: A Cluster Analysis Approach Based on Age of Onset, Clinical and Psychopathological Features
(J. Wiley, 2025-10-04) Camacho Barcia, Lucía; Sánchez-Salido, Lia-Tamar; Jiménez de Toro, Jessica; Granero, Roser; Sánchez, Isabel; Supit, Kim; Micali, Nadia; Giel, Katrin E.; Jimenez Murcia, Susana; Zipfel, Stephan; Fernández Aranda, Fernando
Objective: This study investigates clinical heterogeneity in patients with binge eating disorder (BED) and its association with treatment outcomes. Methods: A two-step cluster analysis was conducted on a clinical sample of 196 BED patients, using an agglomerative hierarchical procedure based on both categorical and quantitative measures—psychopathological symptoms, personality traits, emotional dysregulation, body composition, and food addiction. A subsequent comparison between clusters assessed therapy outcomes. Results: Two distinct clusters emerged: C1 (n = 77) and C2 (n = 119). C2 patients exhibited a more dysfunctional profile, marked by more frequent binge episodes, higher eating psychopathology, greater emotion regulation difficulties, higher impulsivity levels, worse psychopathological state, higher food addiction levels, and personality traits reflecting greater harm avoidance and lower self-directedness and cooperativeness. While clusters did not differ by age, C2 had earlier age of onset and longer duration of the disorder. In contrast, C1 showed a more functional profile, later age of onset, lower total body fat mass, and better treatment outcomes. Conclusion: These findings highlight heterogeneity in BED, particularly regarding age of onset and associated clinical features, which may influence treatment response. The results suggest the need for distinct treatment strategies and more personalised therapeutic approaches tailored to patient subtypes.
Cost during the first year after stroke by degree of functional disability: a societal perspective
(SAGE Publications, 2025-06-01) Ribó Jacobi, Marc; Abilleira, Sònia; Soler Font, Mercè; Ribera, Aida; Aznar Lou, Ignacio; Sánchez Viñas, Alba; Slof, John; Vela, Emili; Salvat Plana, Mercè; Villa García, Lorena; Serrano Blanco, Antoni; Pérez de la Osa, Natàlia
Introduction:The aim of this study was to estimate societal costs during the first year after stroke by degree of functional disability.Patients and methods:Descriptive study of the cumulative costs incurred during 1-year follow-up of a cohort of patients with stroke in Catalonia (Spain) participating in a multicentre, population-based, cluster-randomised trial (RACECAT). Patients were recruited between September 2017 and January 2019. Costs were collected for each patient from stroke onset to 1-year follow-up through hospital accounting records, electronic healthcare records and structured telephone-based interviews at 6 and 12-months follow-up. Disability was assessed using the 90-day modified Rankin Scale (mRS). Healthcare, community care, and patient/family costs were included. We used complete data from 567 eligible participants. Cost data were analysed using generalised linear models (GLMs) with gamma distributions and log link functions. For variables with >10% zero values, two-part models were applied. We performed sensitivity analyses modifying unit costs for patient/family costs.Results:Of the 567 patients included, 53% had ischaemic large vessel oclusion (LVO) stroke, 24% intracranial haemorrhage and 23% ischaemic non-LVO stroke. Mean cost per patient during the first year after stroke was €29,673 ± 28,632, and increased with degree of disability (mRS 0–2: €18,568 ± 12,244; mRS 3: €38,214 ± 28,172; mRS 4–5: €52,859 ± 36,383). Healthcare costs represented the highest proportion of total costs (63%; €18,724/patient) across all disability levels, with index hospitalisation being the highest (€12,319 ± 17,675); however, community care and patient/family costs represented over 40% of total cost in patients with higher disability levels.Discussion and conclusion:Our results are in line with other studies; the costs during the first year after stroke are high and increase with disability. These results are valuable for calculating the cost of severe stroke cases.
Impact of a Clinical Valve Coordinator on Hospital Length of Stay and Patient Outcomes: Results From the BENCHMARK Registry
(Elsevier Inc., 2026-01) Lauck, Sandra B.; Saia, Francesco; Durand, Eric; Kirk, Bettina Højberg; Kelly, Fiona; Muir, Douglas F.; McCalmont, Gemma; Spence, Mark S.; Vasa Nicotera, Mariuca; Wood, David; Urbano Carrillo, Cristóbal A.; Bouchayer, Damien; Iliescu, Vlad Anton; Etienne, Christophe Saint; Fauré, Nina; Hee, Céline; Leclercq, Florence; Auffret, Vincent; Asmarats, Lluís; Di Mario, Carlo; Veugeois, Aurelie; Maly, Jiri; Schober, Andreas; Nombela Franco, Luis; Werner, Nikos; Gómez Hospital, Joan Antoni; Mascherbauer, Julia; Musumeci, Giuseppe; Meneveau, Nicolas; Meurice, Thibaud; Mahfoud, Felix; De Marco, Federico; Seidler, Tim; Leuschner, Florian; Joly, Patrick; Collet, Jean Philippe; Vogt, Ferdinand; Di Lorenzo, Emilio; Kuhn, Elmar; Disdier, Vicente Peral; Rakova, Radka; Wesselink, Wilbert; Kurucova, Jana; Hachaturyan, Violetta; Lüske, Claudia M.; Zielinski, Marie; Bramlage, Peter; Frank, Derk
Background: Transcatheter aortic valve implantation (TAVI) treatment pathways can be supported by a dedicated clinical valve coordinator (CVC), enhancing their efficiency. We aimed to evaluate the impact of a CVC in managing the treatment pathway of patients undergoing TAVI across Europe before and after implementing 8 Benchmark best practices. Methods: The BENCHMARK registry (ClinicalTrials NCT04579445) was a multicenter international study of patients with severe symptomatic aortic stenosis undergoing TAVI with balloon-expandable valves across 28 European centers. Primary outcomes were hospital and intensive care length of stay (LoS). The secondary outcome was 30-day patient safety. Results: Of 2323 patients, 1262 were treated at centers without a pre-existing CVC and 1061 at centers with a pre-existing CVC; propensity matching resulted in 891 matched pairs. The total procedural time was significantly reduced in both groups (p < 0.001) after implementing Benchmark best practices. Hospital LoS was lower before Benchmark when a CVC was present and was significantly shorter in both groups following implementation (p < 0.001), as was the critical care LoS (p < 0.001). The presence of a CVC did not affect safety outcomes but was associated with a reduced risk of major vascular bleeding when combined with Benchmark best practices. Patient satisfaction was higher in centers with a pre-existing CVC (p < 0.001). Conclusions: The addition of a CVC to the multidisciplinary team and their sustained contributions to processes of care align with the implementation of Benchmark practices, significantly decrease the health service requirements of TAVI patients, and are associated with improved patient-reported experiences.
Empirical support for recognizing pathological buying/shopping as a mental disorder
(Elsevier B.V., 2026-02-19) Müller, Astrid; Brand, Matthias; Thomas, Tobias; Kessling, Annica; Schmid, Anna M.; Jimenez Murcia, Susana; Wegmann, Elisa; Müller, Silke M.; Steins-Loeber, Sabine
Objective: To address the question of whether pathological buying/shopping differs from both risky and non-problematic buying/shopping. Method: Post-hoc analysis of data collected within the Addiction Research Unit FOR2974. Three predefined groups, as determined by face-to-face diagnostic interviews, were compared: with pathological (pBSh, n = 62), risky (rBSh, n = 62), and non-problematic (control group, CG, n = 117) buying/shopping. Questionnaires were used to assess symptom severity (according to ICD-11 criteria for disorders due to addictive behaviors), functional impairment, craving, experience of gratification/compensation (all modified for buying/shopping), self-esteem, materialism, anxiety, depression, impulsiveness, and self-directedness. The laboratory testing included a cue reactivity paradigm and Go/No-Go affective shifting task with shopping-related cues, and standard tests for general cognitive functions (Stroop test, modified card sorting test, game of dice task, delay discounting task). Results: The pBSh group exhibited more pathological scores in the questionnaires assessing ICD-11 criteria/features for disorders due to addictive behaviors (including distress, harm, gratification/compensation), self-esteem, anxiety, depression and steeper delay discounting than the other groups. Moreover, the pBSh group scored higher on materialism and impulsiveness, showed higher craving, and poorer performance in the Go/No-Go task than the CG. Applying Bonferroni corrected p-values, the groups did not differ in the Stroop test, modified card sorting test and game of dice task. Conclusion: Pathological buying/shopping represents a distinct clinical syndrome that reflects underlying affective and cognitive dysfunctions and results in clinically significant distress and impairments. The findings provide further evidence of its classification as a disorder due to addictive behaviors.
Real-world experience with belimumab-based triple therapy in proliferative lupus nephritis: Data from the BEL-SPAIN Registry
(BMJ Publishing Group, 2026-01-27) Vidal Montal, Paola; Fabregat, Aina; Altabás González, Irene; Pego Reigosa, José María; Hernández Martínez, Andrea; Rúa Figueroa, Iñigo; Salman Monte, Tarek Carlos; Moriano, Clara; Tejera Segura, Beatriz; Vela, Paloma; Pareja Martínez, Anna; García Cirera, Silvia; García Villanueva, María Jesús; Garrote, Sandra; Heredia, Sergi; Riancho Zarrabeitia, Leyre; Manrique Arija, Sara; Bernárdez, Julia; Magallares, Berta; Torrente Segarra, Vicenç; Frade Sosa, Beatriz ; Gómez Puerta, José Alfredo; Martinez Barrio, Julia; Narváez, Javier
Objective: To evaluate the efficacy, safety and predictive factors of belimumab (BEL)-based triple therapy in proliferative lupus nephritis (LN) in real-world settings. Methods: We conducted a multicentre, retrospective study including patients with proliferative LN (new-onset or relapsing) who initiated BEL within 6 months of a renal flare, in combination with standard-of-care. Results: 49 patients were included (mean age 37 years; 85.7% female; 67.3% Caucasian). The median time from renal flare to BEL initiation was 1 month (IQR 0–3). By 12 months, 67.3% achieved complete renal response (CRR), 75.5% primary efficacy renal response (PERR) and 83.7% at least partial renal response. Median proteinuria declined from 2.7 g/day to 0.49 g/day, with parallel improvement in estimated glomerular filtration rate (71 to 78 mL/min/1.73 m²). Patients with baseline proteinuria <3 g/day achieved significantly higher CRR (78.1% vs 47.1%; p=0.027) and PERR (84.4% vs 58.8%; p=0.048) rates. The mean glucocorticoid (GC) dose decreased from 31.7 mg/day at baseline to 3.5 mg/day at 12 months, and 26.1% of patients achieved complete GC withdrawal. Extrarenal disease activity was present in 81.6% of patients at baseline, predominantly articular and mucocutaneous, with clinically meaningful improvement in 80% during follow-up. At 12 months, 40.8% met remission by Definition Of Remission In Systemic Lupus Erythematosus (DORIS) criteria and 46.9% attained Lupus Low Disease Activity State (LLDAS). Renal treatment failure occurred in 16.3% and renal relapse in 4.1%. Adverse events were mild, and no serious BEL-related events were observed. Conclusion BEL-based triple therapy is effective and safe in proliferative LN, achieving high renal and extrarenal response rates, substantial GC-sparing and treat-to-target outcomes in real-world practice.

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