Expert consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology on the determination of biomarkers in pancreatic and biliary tract cancer

Biliary tract cancer; Predictive value; Targeted therapiesCáncer de vías biliares; Valor predictivo; Terapias dirigidasCàncer de vies biliars; Valor predictiu; Teràpies dirigidesPancreatic cancer and biliary tract cancer have a poor prognosis. In recent years, the development of new diagnostic techniques has enabled the identification of the main genetic alterations involved in the development of these tumours. Multiple studies have assessed the ability of certain biomarkers, such as BRCA in pancreatic cancer, IDH1 or FGFR2 in biliary tract cancer and microsatellite instability or NTRK fusions in an agnostic tumour fashion, to predict response to treatment. In this consensus, a group of experts selected by the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP) reviewed the role played by these mutations in the process of carcinogenesis and their clinical implications. As a result, this article proposes a series of recommendations to optimize the determination of these biomarkers to help standardize the diagnosis and treatment of these tumours.SEOM and SEAP acknowledge the financial support for this project in the form of unrestricted collaboration in the logistics from AstraZeneca

Ocular penetration of fluorometholone-loaded PEG-PLGA nanoparticles functionalized with cell-penetrating peptides

Aim: Development of fluorometholone-loaded PEG-PLGA nanoparticles (NPs) functionalized with cellpenetrating peptides for the treatment of ocular inflammatory disorders. Materials & methods: Synthesized polymers and peptides were used for elaboration of functionalized NPs, which were characterized physicochemically. Cytotoxicity and ability to modulate the expression of proinflammatory cytokines were evaluated in vitro using human corneal epithelial cells (HCE-2). NP uptake was assayed in both in vitro and in vivo models. Results: NPs showed physicochemical characteristics suitable for ocular administration without evidence of cytotoxicity. TAT-NPs and G2-NPs were internalized and displayed anti-inflammatory activity in both HCE-2 cells and mouse eye. Conclusion: TAT-NPs and G2-NPs could be considered a novel strategy for the treatment of ocular inflammatory diseases of the anterior and posterior segment

Dehesilla Cave (Cádiz Mountains): returning to a key archaeological site for the Neolithic of the Southern Iberian Peninsula

La Cueva de la Dehesilla contó con dos excavaciones arqueológicas en 1977 y 1981. Desde entonces se conoce el potencial prehistórico del sitio, especialmente en relación con sus fases neolíticas, y se convirtió en uno de los enclaves fundamentales en el sur de la península ibérica. Este artículo presenta los datos procedentes de las recientes intervenciones arqueológicas retomadas cuatro décadas después. Concretamente se da a conocer la secuencia estratigráfica prehistórica de un sondeo efectuado en 2016, sus conjuntos cerámico y lítico, así como cuatro fechas radiocarbónicas. Entre los resultados, destaca la relativa antigüedad de las nuevas dataciones y la presencia de posible cerámica impresa, indicador material de las primeras poblaciones neolíticas en el Mediterráneo occidental. Los datos obtenidos implican diversos puntos de discusión sobre el origen y la evolución de las sociedades campesinas y ganaderas a niveles regional y peninsular.Dehesillako kobazuloan bi indusketa arkeologiko egin zituzten 1977an eta 1981ean. Ordutik, badakigu tokiak historiaurreko potentzial handia duela, bereziki bere fase neolitikoekin lotuta. Hori dela eta, Iberiar penintsulako hegoaldean oinarrizko gune bihurtu zen. Artikulu honek lau hamarkada geroago duela gutxi berriro hasi dituzten lan arkeologikoetatik jasotako datuak aurkezten ditu. Zehatzago esanda, 2016an egindako zundaketa baten historiaurreko segida estratigrafikoa, multzo zeramiko eta litikoa, eta lau data erradiokarboniko biltzen ditu. Emaitza horien artean, nabarmendu beharrekoa da datazio berriak nahiko zaharrak direla eta ceramica impressa delakoa topatu dutela ustez. Mendebaldeko Mediterraneoan lehen populazio neolitikoak zeudela erakusten duen adierazle materiala da hori. Lortutako datuek eskualde eta penintsula mailetako abeltzainen eta nekazarien gizarteek izandako bilakaerari eta jatorriari buruzko eztabaida sorrarazi dute.Two archaeological excavations were carried out at Dehesilla Cave in 1977 and 1981. The site gained a great scientific interest then, especially in relation to the Neolithic, and it became one of the key archaeological sites in the Southern Iberian Peninsula. This paper presents new data from the recent archaeological excavations resumed four decades later. Specifically, it provides the data on the Prehistoric stratigraphic sequence documented in 2016, along with the pottery and lithic assemblages, as well as four radiocarbon dates. Of particular interest is the relative antiquity of the new radiocarbon dates and the presence of possible ceramica impressa, a material proxy of the first Neolithic populations in the Western Mediterranean. These results raise several discussion key points on the origin and the evolution of farming and herding societies in the Southern Iberian Peninsula

Nivel de Depresion y Autocompasion en Adultors Mayores

Introducción. La autocompasión y la depresión son dos conceptos que a pesar de ser significativamente distintos, tienen gran cantidad de conexiones que influyen en la vida de una persona mayor. Objetivo. Valorar el nivel de depresión y de autocompasión en adultos mayores de la Unidad de Medicina Familiar del Instituto Mexicano del Seguro Social #14 el Pueblito, en el municipio de Corregidora, en Querétaro. Metodología. Estudio transversal, descriptivo, exploratorio. Muestreo por conveniencia. Se utilizaron el Inventario de Depresión de Beck (BDI) con dos dimensiones, Alfa de Cronbach 0.85 y la Escala de Autocompasión (SCS) de seis dimensiones, Alfa de Cronbach de 0.87. Se abordaron a adultos mayores, ambos géneros que aceptaran participar en el estudio. Para el análisis se utilizó estadística descriptiva. Los datos de las variables se procesaron usando el programa Excel. Se usaron medias, promedios y desviación estándar. Se considerarán los principios éticos para la investigación. Resultados. Se trabajó con 35 adultos mayores, 54% eran mujeres, la moda de edad fueron los 78 años. Con respecto al nivel de depresión, 17% estaban en grave; la mayoría (49%) estaban en nivel mínimo. Sobre la autocompasión, 20% se ubicó en nivel bajo; la mayoría (46%) estaba en nivel alto.  Conclusiones. Es importante valorar el nivel de depresión y autocompasión de esta población debido a la influencia en su vida diaria. La población mayor aumenta día con día, por lo que es relevante establecer programas que apoyen en el mantenimiento o mejora de la salud mental, entre otros.   Introduction. Self compassion and depression are very different but, with conexion and both have influence in an elderly people. Objective. To valorate level of depression and self compassion in elderly people from the Unidad de Medicina Familiar del Instituto Mexicano del Seguro Social #14, from „El Pueblito“, in Corregidora, in Queretaro. Metodology. Cross-sectional study, descriptive and exploratory. Convenience sample. It was used the Beck Depression Inventory (BDI) with two dimensions, Cronbach Alpha of 0.85 and Self Compassion Scale (SCS) with six dimenssions, Cronbach Alpha of 0.87. Elderly people, on both gender: male and female, were participants. Statistical analysis was used.  Data was procesed with Excel, using means, averages, and standard deviation. Ethic aspects were considered. Results. 35 elderly people participated in the study, 54% were female, the most common age was 78 years old. Related to depression levels, 17% were serious; more (49%) were on minimal level. About Self Compassion, 20% was on low level; most (46%) were on high level. Conclussion. It is important to valorate depression and self compassion levels with elderly people because both concepts, are related with their life. Elderly people are more day by day, and it is relevant to stablish manteining or improvement programs about mental health, and others

Nivel de Depresion y Autocompasion en Adultors Mayores

Introducción. La autocompasión y la depresión son dos conceptos que a pesar de ser significativamente distintos, tienen gran cantidad de conexiones que influyen en la vida de una persona mayor. Objetivo. Valorar el nivel de depresión y de autocompasión en adultos mayores de la Unidad de Medicina Familiar del Instituto Mexicano del Seguro Social #14 el Pueblito, en el municipio de Corregidora, en Querétaro. Metodología. Estudio transversal, descriptivo, exploratorio. Muestreo por conveniencia. Se utilizaron el Inventario de Depresión de Beck (BDI) con dos dimensiones, Alfa de Cronbach 0.85 y la Escala de Autocompasión (SCS) de seis dimensiones, Alfa de Cronbach de 0.87. Se abordaron a adultos mayores, ambos géneros que aceptaran participar en el estudio. Para el análisis se utilizó estadística descriptiva. Los datos de las variables se procesaron usando el programa Excel. Se usaron medias, promedios y desviación estándar. Se considerarán los principios éticos para la investigación. Resultados. Se trabajó con 35 adultos mayores, 54% eran mujeres, la moda de edad fueron los 78 años. Con respecto al nivel de depresión, 17% estaban en grave; la mayoría (49%) estaban en nivel mínimo. Sobre la autocompasión, 20% se ubicó en nivel bajo; la mayoría (46%) estaba en nivel alto.  Conclusiones. Es importante valorar el nivel de depresión y autocompasión de esta población debido a la influencia en su vida diaria. La población mayor aumenta día con día, por lo que es relevante establecer programas que apoyen en el mantenimiento o mejora de la salud mental, entre otros.   Introduction. Self compassion and depression are very different but, with conexion and both have influence in an elderly people. Objective. To valorate level of depression and self compassion in elderly people from the Unidad de Medicina Familiar del Instituto Mexicano del Seguro Social #14, from „El Pueblito“, in Corregidora, in Queretaro. Metodology. Cross-sectional study, descriptive and exploratory. Convenience sample. It was used the Beck Depression Inventory (BDI) with two dimensions, Cronbach Alpha of 0.85 and Self Compassion Scale (SCS) with six dimenssions, Cronbach Alpha of 0.87. Elderly people, on both gender: male and female, were participants. Statistical analysis was used.  Data was procesed with Excel, using means, averages, and standard deviation. Ethic aspects were considered. Results. 35 elderly people participated in the study, 54% were female, the most common age was 78 years old. Related to depression levels, 17% were serious; more (49%) were on minimal level. About Self Compassion, 20% was on low level; most (46%) were on high level. Conclussion. It is important to valorate depression and self compassion levels with elderly people because both concepts, are related with their life. Elderly people are more day by day, and it is relevant to stablish manteining or improvement programs about mental health, and others

Nivel de Depresion y Autocompasion en Adultos Mayores

Introducción; La autocompasión y la depresión son dos conceptos que a pesar de ser significativamente distintos, tienen gran cantidad de conexiones que influyen en la vida de una persona mayor. Objetivo: Valorar el nivel de depresión y autocompasión en adultos mayores de la Unidad de Medicina Familiar del Instituto Mexicano del Seguro Social #14 el Pueblito, en el municipio de Corregidora, en Querétaro. Metodología: Estudio transversal, descriptivo, exploratorio. Muestreo por conveniencia. Se utilizaron el Inventario de Depresión de Beck (BDI) con dos dimensiones, Alfa de Cronbach 0.85 y la Escala de Autocompasión (SCS) de seis dimensiones, Alfa de Cronbach de 0.87. Se abordaron a adultos mayores, ambos géneros que aceptaran participar en el estudio. Para el análisis se utilizó estadística descriptiva. Los datos de las variables se procesaron usando el programa Excel. Se manejaron medias, promedios y desviación estándar. Se consideron los principios éticos para la investigación. Resultados: Se trabajó con 35 personas, 54% eran mujeres, la moda de edad fueron los 78 años. Con respecto al nivel de depresión, 17% estaban en grave, la mayoría (49%) estaban en nivel mínimo. Sobre la autocompasión, 20% se ubicó en nivel bajo, la mayoría (46%) estaba en nivel alto.  Conclusiones: Es importante valorar el nivel de depresión y autocompasión de esta población debido a la influencia en su vida diaria. La población mayor aumenta día con día, por lo que es relevante establecer programas que apoyen en el mantenimiento o mejora de la salud mental, entre otros.   Introduction: Self-pity and depression are two concepts that, despite being significantly different, have a great deal of connections that influence the life of an elderly person. Objective: This paper focuses on assessing the level of depression and self-pity in older adults from the Family Medicine Unit of the Mexican Social Security Institute #14 in El Pueblito, in the municipality of Corregidora, Querétaro. Methodology: The study was cross-sectional, descriptive, and exploratory, employing convenience sampling. The Beck Depression Inventory (BDI), comprising two dimensions with a Cronbach's Alpha of 0.85, and the Self-Compassion Scale (SCS), comprising six dimensions with a Cronbach's Alpha of 0.87, were utilized. Older adults of both genders who consented to participate were engaged. Descriptive statistics were employed for analysis, and the variables' data were processed using the Excel program. Mean values, averages, and standard deviation were calculated, while ethical principles governing the research were also taken into account. Results: 35 elderly people participated in this study. 54% were women and the average age was 78 years. Regarding the level of depression, 17% were at severe levels, while the majority (49%) were at minimal levels. Regarding self-compassion, 20% were at a low level, while the majority (46%) were at a high level. Conclusion: It is important to assess the level of depression and self-pity of this population due to the influence on their daily life. Since the elderly population increases daily, it is relevant to establish programs that support the maintenance or improvement of mental health, among others

Moldando o corpo como uma prática de cuidado: el waltha-chumpi (criança envolvida) entre os imigrantes bolivianos

Objetivo: Describir el “chumpi”, una práctica de cuidados a niños de hasta un año de edad propia del ámbito cultural quechua. Método: Diseño cualitativo basado en el método etnográfico y teoría fundamentada. Muestra: 27 inmigrantes bolivianos. Las estrategias para recoger datos fueron las entrevistas en profundidad y la observación participante. Los datos se categorizaron y ordenaron en esquemas lógicos manualmente y a través del programa ATLAS-ti v.5. Resultados: El chumpi facilita el transporte de los recién nacidos y los protege del frío de la cordillera andina mientras la madre los transporta y trabaja, pero descubrimos que esta práctica se sigue desarrollando por inmigrantes bolivianos en el Sureste de España. Discusión y Conclusiones: Motivaciones relacionadas con la cosmovisión quechua llevan a las mujeres bolivianas a seguir practicando el chumpi en los países a los que emigran. El chumpi moldea el cuerpo y el carácter del lactante de forma que un niño envuelto fuerte será fuerte. El chumpi, una práctica de cuidados, se convierte en una práctica cultural identitaria que puede generar situaciones conflictivas en el ámbito sanitario.Objective: To analyze el chumpi, a Quechua baby body care cultural practice during the first year of life. Method: Qualitative study based on ethnography and grounded theory procedures. Muestra: 27 inmigrantes bolivianos. Las estrategias para recoger datos fueron las entrevistas en profundidad y la observación participante. Los datos se categorizaron y ordenaron en esquemas lógicos manualmente y a través del programa ATLAS-ti v.5. Results: El chumpi makes newborns transport easier and protects them from the cold of the Andean region while being carried by their working mothers. However, we found that this practice remains among Bolivian immigrants in southeast Spain. Conclusions: Quechua worldview motivations lead Bolivian women to continue practising el chumpi in destination countries. El chumpi molds the body and the character of the infant so that a strongly wrapped child will be strong. El chumpi, a practice of care, becomes a cultural identity sign. El chumpi generates controversial situations within the health sphere.Objetivo: Analisar o chumpi, uma prática cultural de cuidado corporal do bebê Quechua durante o primeiro ano de vida. Método: Estudo qualitativo baseado em procedimentos de etnografia e teoria fundamentada. Amostra: 27 imigrantes bolivianos. As estratégias para coletar os dados foram entrevistas em profundidade e observação participante. Os dados foram categorizados e ordenados em esquemas lógicos manualmente e através do programa ATLAS-ti v.5. Resultados: O chumpi facilita o transporte de recém-nascidos e protege-os do frio da região andina enquanto são transportados por suas mães trabalhadoras. No entanto, descobrimos que essa prática é mantida entre os imigrantes bolivianos no sudeste da Espanha. Conclusões: As motivações da visão de mundo quechua levam as mulheres bolivianas a continuar praticando o chumpi nos países de destino. O chumpi molda o corpo e o caráter do bebê, de modo que uma criança bem embrulhada é forte. O chumpi, uma prática de cuidado, torna-se um sinal de identidade cultural. O chumpi gera situações controversas dentro da esfera da saúde

A strategic reflection for the management and implementation of CAR-T therapy in Spain: an expert consensus paper

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process.This study was funded by Gilead Sciences, Inc.Peer reviewe

Omics approaches in pancreatic adenocarcinoma

Pancreatic ductal adenocarcinoma, which represents 80% of pancreatic cancers, is mainly diagnosed when treatment with curative intent is not possible. Consequently, the overall five-year survival rate is extremely dismal—around 5% to 7%. In addition, pancreatic cancer is expected to become the second leading cause of cancer-related death by 2030. Therefore, advances in screening, prevention and treatment are urgently needed. Fortunately, a wide range of approaches could help shed light in this area. Beyond the use of cytological or histological samples focusing in diagnosis, a plethora of new approaches are currently being used for a deeper characterization of pancreatic ductal adenocarcinoma, including genetic, epigenetic, and/or proteo-transcriptomic techniques. Accordingly, the development of new analytical technologies using body fluids (blood, bile, urine, etc.) to analyze tumor derived molecules has become a priority in pancreatic ductal adenocarcinoma due to the hard accessibility to tumor samples. These types of technologies will lead us to improve the outcome of pancreatic ductal adenocarcinoma patients