The end of the roman empire in northwestern iberia: Recent research at the site of O Castelo, in Valencia Do Sil (Ourense)

[ES] En este trabajo se presentan los resultados de dos intervenciones arqueológicas realizadas en 2019 en en el yacimiento de O Castelo, en Valencia do Sil (Ourense), así como una síntesis analítica de toda la información disponible sobre el sitio. Se trata de un asentamiento fortificado que, gracias al análisis estratigráfico y las dataciones radiocarbónicas, podemos situar en los momentos finales del imperio romano en el noroeste peninsular. Así, se interpreta el enclave como un espacio de control del territorio en un momento de gran transformación política y económica. Las diferentes excavaciones llevadas a cabo en el sitio han permitido documentar dos entornos domésticos que ofrecen una importante información sobre la organización social de sus habitantes. El trabajo concluye con unas reflexiones interpretativas sobre el contexto histórico en el que se insertan este tipo de asentamientos en el norte peninsular.[EN] In this paper, we present the results of two recent archaeological interventions carried out at the site of O Castelo, in Valencia do Sil (Ourense), together with an analytic synthesis of all prior available data. This is a fortified settlement which, thanks to stratigraphic analyses and radiocarbon analysis, it can be dated within the final moments of the Roman Empire in northwestern Iberia. Therefore, we interpret the site as a territorial control nucleus in a period of great political and economic changes. Different excavations have uncovered two large domestic areas which offer quite important information on the social organization of its inhabitants. This paper concludes with some interpretative thoughts on the historic context in which this type of sites are inserted in northwestern Iberia.SIEste trabajo ha sido realizado en el marco del Proyecto «Agencia campesina y complejidad sociopolítica en el noroeste de la Península Ibérica en época medieval» (Ministerio de Economía, Industria y Competitividad, AEI/FEDER UE HUM2016-76094-C4-2-R), del Grupo de Investigación en Arqueología Medieval, Patrimonialización y Paisajes Culturales / ErdiArokoArkeologia, Ondaregintza eta KulturPaisaiakIkerketaTaldea(Gobierno Vasco, IT1193-19) y del Grupo de Estudios Rurales (Unidad Asociada UPV/EHU-CSIC)

Bendamustine in combination with ofatumumab as first line treatment for elderly patients with mantle cell lymphoma: a phase II risk-adapted design

This study evaluated ofatumumab (Ofa), an anti-CD20 monoclonal antibody, alone or with bendamustine (Benda), in transplant-ineligible patients with mantle cell lymphoma. Low-risk patients received Ofa monotherapy. Non-responders received subsequent treatment with Benda-Ofa. Six patients received Ofa monotherapy and 3 patients crossed over to Bend-Ofa. Twenty-four high-risk patients were initially treated with Benda-Ofa. The overall response rate for patients treated with Ofa monotherapy was 1/6 (17%) and 23/25 (92%) for patients treated with Benda-Ofa. With a median follow-up of 8.6 years, all Ofa patients progressed with a median progression-free survival (PFS) of 0.6 years (95% CI 0.31-NR) and remain alive. With a median follow-up of 6.3 years, Bend-Ofa treated patients had median PFS 2.5 years (95% CI 1.8-NR) and a median overall survival of 7.4 years (95% CI 5.8-NR). Benda-Ofa had a favorable adverse event profile and efficacy similar, but not clearly superior, to those reported for Benda-Rituximab

The end of the Roman Empire in Northwestern Iberia: Recent research at the site of O Castelo, in Valencia do Sil (Ourense)

En este trabajo se presentan los resultados de dos intervenciones arqueológicas realizadas en 2019 en el yacimiento de O Castelo, en Valencia do Sil (Ourense), así como una síntesis analítica de toda la información disponible sobre el sitio. Se trata de un asentamiento fortificado que, gracias al análisis estratigráfico y las dataciones radiocarbónicas, podemos situar en los momentos finales del imperio romano en el noroeste peninsular. Así, se interpreta el enclave como un espacio de control del territorio en un momento de gran transformación política y económica. Las diferentes excavaciones llevadas a cabo en el sitio han permitido documentar dos entornos domésticos que ofrecen una importante información sobre la organización social de sus habitantes. El trabajo concluye con unas reflexiones interpretativas sobre el contexto histórico en el que se insertan este tipo de asentamientos en el norte peninsular.In this paper, we present the results of two recent archaeological interventions carried out at the site of O Castelo, in Valencia do Sil (Ourense), together with an analytic synthesis of all prior available data. This is a fortified settlement which, thanks to stratigraphic analyses and radiocarbon analysis, it can be dated within the final moments of the Roman Empire in northwestern Iberia. Therefore, we interpret the site as a territorial control nucleus in a period of great political and economic changes. Different excavations have uncovered two large domestic areas which offer quite important information on the social organization of its inhabitants. This paper concludes with some interpretative thoughts on the historic context in which this type of sites are inserted in northwestern Iberia.Este trabajo ha sido realizado en el marco del Proyecto «Agencia campesina y complejidad sociopolítica en el noroeste de la Península Ibérica en época medieval» (Ministerio de Economía, Industria y Competitividad, AEI/FEDER UE HUM2016-76094-C4-2-R), del Grupo de Investigación en Arqueología Medieval, Patrimonialización y Paisajes Culturales / ErdiArokoArkeologia, Ondaregintza eta KulturPaisaiakIkerketaTaldea(Gobierno Vasco, IT1193-19) y del Grupo de Estudios Rurales (Unidad Asociada UPV/EHU-CSIC)

ESHRE guideline: endometriosis

Main results and the role of chance: This guideline aims to help clinicians to apply best care for women with endometriosis. Although studies mostly focus on women of reproductive age, the guideline also addresses endometriosis in adolescents and postmenopausal women. The guideline outlines the diagnostic process for endometriosis, which challenges laparoscopy and histology as gold standard diagnostic tests. The options for treatment of endometriosis-associated pain symptoms include analgesics, medical treatments and surgery. Non-pharmacological treatments are also discussed. For management of endometriosis-associated infertility, surgical treatment and/or medically assisted reproduction are feasible. While most of the more recent studies confirm previous ESHRE recommendations, there are five topics in which significant changes to recommendations were required and changes in clinical practice are to be expected. Limitations reasons for caution: The guideline describes different management options but, based on existing evidence, no firm recommendations could be formulated on the most appropriate treatments. Also, for specific clinical issues, such as asymptomatic endometriosis or extrapelvic endometriosis, the evidence is too scarce to make evidence-based recommendations. Wider implications of the findings: The guideline provides clinicians with clear advice on best practice in endometriosis care, based on the best evidence currently available. In addition, a list of research recommendations is provided to stimulate further studies in endometriosis.Study question: How should endometriosis be diagnosed and managed based on the best available evidence from published literature? Summary answer: The current guideline provides 109 recommendations on diagnosis, treatments for pain and infertility, management of disease recurrence, asymptomatic or extrapelvic disease, endometriosis in adolescents and postmenopausal women, prevention and the association with cancer. What is known already: Endometriosis is a chronic condition with a plethora of presentations in terms of not only the occurrence of lesions, but also the presence of signs and symptoms. The most important symptoms include pain and infertility. Study design size duration: The guideline was developed according to the structured methodology for development of ESHRE guidelines. After formulation of key questions by a group of experts, literature searches and assessments were performed. Papers published up to 1 December 2020 and written in English were included in the literature review. Participants/materials setting methods: Based on the collected evidence, recommendations were formulated and discussed within specialist subgroups and then presented to the core guideline development group (GDG) until consensus was reached. A stakeholder review was organized after finalization of the draft. The final version was approved by the GDG and the ESHRE Executive Committee. Summary answer: The current guideline provides 109 recommendations on diagnosis, treatments for pain and infertility, management of disease recurrence, asymptomatic or extrapelvic disease, endometriosis in adolescents and postmenopausal women, prevention and the association with cancer. What is known already: Endometriosis is a chronic condition with a plethora of presentations in terms of not only the occurrence of lesions, but also the presence of signs and symptoms. The most important symptoms include pain and infertility. Study design size duration: The guideline was developed according to the structured methodology for development of ESHRE guidelines. After formulation of key questions by a group of experts, literature searches and assessments were performed. Papers published up to 1 December 2020 and written in English were included in the literature review. Participants/materials setting methods: Based on the collected evidence, recommendations were formulated and discussed within specialist subgroups and then presented to the core guideline development group (GDG) until consensus was reached. A stakeholder review was organized after finalization of the draft. The final version was approved by the GDG and the ESHRE Executive Committee. Main results and the role of chance: This guideline aims to help clinicians to apply best care for women with endometriosis. Although studies mostly focus on women of reproductive age, the guideline also addresses endometriosis in adolescents and postmenopausal women. The guideline outlines the diagnostic process for endometriosis, which challenges laparoscopy and histology as gold standard diagnostic tests. The options for treatment of endometriosis-associated pain symptoms include analgesics, medical treatments and surgery. Non-pharmacological treatments are also discussed. For management of endometriosis-associated infertility, surgical treatment and/or medically assisted reproduction are feasible. While most of the more recent studies confirm previous ESHRE recommendations, there are five topics in which significant changes to recommendations were required and changes in clinical practice are to be expected. Limitations reasons for caution: The guideline describes different management options but, based on existing evidence, no firm recommendations could be formulated on the most appropriate treatments. Also, for specific clinical issues, such as asymptomatic endometriosis or extrapelvic endometriosis, the evidence is too scarce to make evidence-based recommendations. Wider implications of the findings: The guideline provides clinicians with clear advice on best practice in endometriosis care, based on the best evidence currently available. In addition, a list of research recommendations is provided to stimulate further studies in endometriosis. Study funding/competing interests: The guideline was developed and funded by ESHRE, covering expenses associated with the guideline meetings, with the literature searches and with the dissemination of the guideline. The guideline group members did not receive payments. C.M.B. reports grants from Bayer Healthcare and the European Commission; Participation on a Data Safety Monitoring Board or Advisory Board with ObsEva (Data Safety Monitoring Group) and Myovant (Scientific Advisory Group). A.B. reports grants from FEMaLE executive board member and European Commission Horizon 2020 grant; consulting fees from Ethicon Endo Surgery, Medtronic; honoraria for lectures from Ethicon; and support for meeting attendance from Gedeon Richter; A.H. reports grants from MRC, NIHR, CSO, Roche Diagnostics, Astra Zeneca, Ferring; Consulting fees from Roche Diagnostics, Nordic Pharma, Chugai and Benevolent Al Bio Limited all paid to the institution; a pending patent on Serum endometriosis biomarker; he is also Chair of TSC for STOP-OHSS and CERM trials. O.H. reports consulting fees and speaker's fees from Gedeon Richter and Bayer AG; support for attending meetings from Gedeon-Richter, and leadership roles at the Finnish Society for Obstetrics and Gynecology and the Nordic federation of the societies of obstetrics and gynecology. L.K. reports consulting fees from Gedeon Richter, AstraZeneca, Novartis, Dr KADE/Besins, Palleos Healthcare, Roche, Mithra; honoraria for lectures from Gedeon Richter, AstraZeneca, Novartis, Dr KADE/Besins, Palleos Healthcare, Roche, Mithra; support for attending meetings from Gedeon Richter, AstraZeneca, Novartis, Dr KADE/Besins, Palleos Healthcare, Roche, Mithra; he also has a leadership role in the German Society of Gynecological Endocrinology (DGGEF). M.K. reports grants from French Foundation for Medical Research (FRM), Australian Ministry of Health, Medical Research Future Fund and French National Cancer Institute; support for meeting attendance from European Society for Gynaecological Endoscopy (ESGE), European Congress on Endometriosis (EEC) and ESHRE; She is an advisory Board Member, FEMaLe Project (Finding Endometriosis Using Machine Learning), Scientific Committee Chair for the French Foundation for Research on Endometriosis and Scientific Committee Chair for the ComPaRe-Endometriosis cohort. A.N. reports grants from Merck SA and Ferring; speaker fees from Merck SA and Ferring; support for meeting attendance from Merck SA; Participation on a Data Safety Monitoring Board or Advisory Board with Nordic Pharma and Merck SA; she also is a board member of medical advisory board, Endometriosis Society, the Netherlands (patients advocacy group) and an executive board member of the World Endometriosis Society. E.S. reports grants from National Institute for Health Research UK, Rosetrees Trust, Barts and the London Charity; Royalties from De Gruyter (book editor); consulting fees from Hologic; speakers fees from Hologic, Johnson & Johnson, Medtronic, Intuitive, Olympus and Karl Storz; Participation in the Medicines for Women's Health Expert Advisory Group with Medicines and Healthcare Products Regulatory Agency (MHRA); he is also Ambassador for the World Endometriosis Society. C.T. reports grants from Merck SA; Consulting fees from Gedeon Richter, Nordic Pharma and Merck SA; speaker fees from Merck SA, all paid to the institution; and support for meeting attendance from Ferring, Gedeon Richter and Merck SA. The other authors have no conflicts of interest to declar