Scientia, Dipòsit d’Informació Digital del Departament de Salut
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Molecular predictive biomarker testing in advanced thyroid cancer – a European consensus
Full text linkBiomarkers; Molecular testing; Thyroid cancerBiomarcadores; Pruebas moleculares; Cáncer de tiroidesBiomarcadors; Proves moleculars; Càncer de tiroidesAs new precision oncology therapies become available in the thyroid cancer (TC) treatment landscape, appropriate and timely biomarker testing is crucial for treatment selection and requires a multidisciplinary approach. Recently published European guidelines on advanced/metastatic TC management include a special focus on biomarker testing. However, to date, there remains a need for comprehensive European guidance for standardized molecular testing strategies in TC that encompass a broad set of targetable or potentially targetable alterations, timing of testing, and patients to be tested. This expert opinion article outlines consensus testing algorithms for differentiated TC, medullary TC, and anaplastic TC from a team of endocrinologists, oncologists, molecular biologists, and pathologists to provide standardized recommendations for physicians involved in treating patients with advanced TC. In the differentiated TC algorithm, patients recommended for comprehensive testing by DNA and RNA next-generation sequencing (NGS) include those whose disease has progressed on or is resistant to radioactive iodine treatment. The medullary TC algorithm recommends RET germline testing for all patients at diagnosis. For patients exhibiting high-risk clinical or pathological features and those whose disease progresses, somatic RET testing with NGS should be discussed and conducted before considering systemic treatment. As anaplastic TC is a highly aggressive disease, molecular reflex testing for BRAF mutations is recommended for all patients at diagnosis, followed by DNA and RNA NGS for those who test BRAF negative. The article also provides consensus recommendations on the use of tumor tissue for testing and on centralization of molecular testing involving multidisciplinary tumor boards.Funding for the development of this manuscript was provided by Eli Lilly and Company
Peripheral memory B cell population maintenance and long-term survival after perioperative chemoimmunotherapy in NSCLC (NADIM trial)
Full text linkB lymphocytes; Chemoimmunotherapy; Flow cytometryLinfocitos B; Quimioinmunoterapia; Citometría de flujoLimfòcits B; Quimioimmunoteràpia; Citometria de fluxPerioperative chemoimmunotherapy has significantly improved survival rates for non-small cell lung cancer (NSCLC). However, current tissue biomarkers remain inadequate, underscoring the need for more sensitive and accessible alternatives to monitor relapse risk. Intratumoral B-cells are increasingly recognized for their role in enhancing immunotherapy outcomes, yet the contribution of peripheral B-cells to immune surveillance remains unexplored. Peripheral B-cell immunophenotypes were analyzed from blood samples (at diagnosis, post-neoadjuvant, and at 6- and 12-months of adjuvant treatment) in 41 stage IIIA NSCLC patients treated with perioperative nivolumab plus chemotherapy, included in the NADIM clinical trial (NCT03081689). Results were correlated with 5-year survival outcomes and validated through unsupervised clustering. An increase in the percentage of total B-cells (CD19+CD20+) and naïve B-cells (CD19+CD20+CD24+CD38+CD27-CD10-), along with a reduction in CD20 expression on total B-cells, a decrease in the proportion of memory B-cells (CD19+CD20+CD24+CD38-/lowCD27+) and transitional B-cells (CD19+CD20+CD24++CD38++CD10+), was observed during the time encompassed between the end of neoadjuvant treatment and the posterior 6 months of adjuvant treatment. Higher levels of CD20 expression on total B-cells, along with an increased percentage of memory B-cells, or activated B-cells (CD19+CD20+CD25+), at 6- and 12-months of adjuvant treatment, were associated with increased survival. Conversely, higher levels of a newly described circulating population of CD19+CD20lowCD25lowCD27low B-cells during adjuvant treatment were linked to disease progression. Perioperative nivolumab plus chemotherapy in resectable NSCLC patients induces significant changes in peripheral B-cells. The persistence of circulating memory B-cells during adjuvant treatment might play a crucial role in survival.Work in the authors’ laboratories was supported by “Instituto de Salud Carlos III” (ISCIII) PI19/01652 and PI22/01223 grants cofounded by European Regional Development Fund (ERDF), Bristol-Myers Squibb (BMS), Ministry of Science and Innovation RTC2017-6502-1 ‘INmunoSIGHT’, RTC2019-007359-1 ‘BLI-O’, CPP2022-009545 ‘STRAGEN-IO’, and European Union’s Horizon 2020 research and innovation programme, CLARIFY 875160 grant, to MP. AC-B is supported by a “Miguel Servet” contract CP23/00044 by ISCIII and received an ISCIII project grant PI23/01054 both cofounded by European Union. CM-T is supported by Comunidad de Madrid PIPF-2022/SAL-GL-25283 contract granted to MP. MM-A is supported by Ayuda Predoctoral Asociación Española Contra el Cáncer (AECC) Madrid 2023 contract granted to MP. AnG-G was supported by Comunidad de Madrid and European social fund PEJ-2023-AI/SAL-GL-27634 contract, and now is supported by FI24/00270 predoctoral contract from ISCIII granted to AC-B
Informe sobre consum problemàtic i conseqüències: Denúncies administratives i delictes penals relacionats amb el consum i tràfic de drogues; any 2023
Full text linkDenúncies administratives; Delictes penals; Consum de drogues; Tràfic de droguesAdministrative complaints; Criminal offences; Drug use; Drug traffickingDenuncias administrativas; Delitos penales; Consumo de drogas; Tráfico de drogasEn aquest informe es presenten dades facilitades per l’Àrea Central d’Anàlisi de la Criminalitat de la Policia de la Generalitat de Catalunya – Mossos d’Esquadra (PG - ME) sobre: 1) Denúncies per consum o tinença il·lícita de drogues. 2) Delictes penals relacionats amb el tràfic de drogues
Patient centric performance and interpretation of SPECT and SPECT/CT myocardial perfusion imaging: a clinical consensus statement of the European Association of Cardiovascular Imaging of the ESC
Full text linkMyocardial perfusion imaging; Clinical consensusImatges de perfusió miocardíaca; Consens clínicImágenes de perfusión miocárdica; Consenso clínicoThe non-invasive assessment of ischaemic heart disease with myocardial perfusion imaging remains an integral part of modern cardiology. This modality has been used for decades, but improving technology has maintained its relevance today. This document describes the fundamentals of single-photon emission computed tomography, including stress protocols, tracer pharmacodynamics, camera settings and capabilities, post-acquisition processing, and clinical translation in an easy to read and highly pictorial manner to be applicable to not only healthcare providers of all levels, but patients as well
COVID-19 Pandemic Waves and 2024-2025 Winter Season in Relation to Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Amantadine
Full text linkACE inhibitors; COVID-19; AmantadineOnades de COVID-19; Inhibidors de l’enzim convertidor d’angiotensina; AmantadinaOleadas de COVID-19; Inhibidores de la enzima convertidora de angiotensina; Amantadin
Incidence, kinetics, and clinical impact of thrombocytopenia in venovenous ECMO: insights from the multicenter observational PROTECMO study
Full text linkAnticoagulation; Bleeding; Intensive careAnticoagulación; Sangrado; Cuidados intensivosAnticoagulació; Sagnat; Cures intensivesBackground: Thrombocytopenia is a recognized risk factor for bleeding during extracorporeal membrane oxygenation (ECMO). This study determines the incidence, risk factors, and clinical relevance of thrombocytopenia and platelet transfusions during venovenous (VV) ECMO.
Methods: The multicenter, prospective observational PROTECMO study included 652 adult patients who received VV ECMO for respiratory failure. Thrombocytopenia was classified as mild (100-149·109/L), moderate (50-99·109/L), or severe (< 50·109/L). Bleeding events were evaluated using a modified Bleeding Academy Research Consortium score. Cox proportional hazards and logistic regression analyses were done to identify predictors, and quantify the association between platelet counts and bleeding risk.
Results: A total of 182 patients (27.9%) had thrombocytopenia at baseline (mild in 14.7%, moderate in 8.7%, and severe in 4.4%). Thrombocytopenia during ECMO, at least once in 80.2% of patients, was mild in 21.3% of cases, moderate in 32.2%, and severe in 26.7%. A 10·109/L decrease in platelet count was associated with a 3.7% (95% CI: 2.4-5.0%) increase in risk of bleeding. There was no strong evidence of nonlinear relationship within the platelet count range between 25,000 and 300,000. This relation remained consistent across all ECMO weeks. Mild thrombocytopenia increased the risk of experiencing a bleeding event by 61% (hazard ratio (HR) 1.611, 95% CI 1.230-2.109, p = 0.0005), while moderate and severe thrombocytopenia increased the risk by roughly 90% (moderate: HR 1.944 (CI 1.484-2.545), p < 0.0001; severe: HR 1.876 (CI 1.275-2.7680), p = 0.0014). The risk for thrombocytopenia < 100·109/L during ECMO significantly increased with ICU days prior to ECMO start, postoperative admission, immunocompromised state, renal replacement therapy, septic shock, low hemoglobin, and circuit exchange.
Conclusions: Thrombocytopenia is highly prevalent in VV ECMO, and associated with a significant increase in the risk of bleeding, and a reduction in 6-month survival, particularly at platelet counts below 100·109/L. Further research is needed to better define the outcomes associated with specific thresholds for transfusion of platelets.This study was supported by the Extracorporeal Life Support Organization (ELSO ) and by Italian Ministry of Health - Ricerca Corrente 2025
Structural covariance analysis for neurodegenerative and neuroinflammatory brain disorders
Full text linkGrey matter; Morphometric covariance networks; NeurodegenerationMateria gris; Redes de covarianza morfométrica; NeurodegeneraciónMatèria grisa; Xarxes de covariància morfomètrica; NeurodegeneracióStructural MRI can robustly assess brain tissue alterations related to neurological diseases and ageing. Traditional morphological MRI metrics, such as cortical volume and thickness, only partially relate to functional impairment and disease trajectories at the individual level. Emerging research has increasingly focused on reconstructing interregional meso- and macro-structural relationships in the brain by analysing covarying morphometric patterns. These patterns suggest that structural variations in specific brain regions tend to covary with deviations in other regions across individuals, a phenomenon termed structural covariance. This concept reflects the idea that physiological and pathological processes follow an anatomically defined spreading pattern. Advanced computational strategies, particularly those within the graph-theoretical framework, yield quantifiable properties at both the whole-brain and regional levels, which correlate more closely with the clinical state or cognitive performance than classical atrophy patterns.
This review highlights cutting-edge methods for evaluating morphometric covariance networks on an individual basis, with a focus on their utility in characterizing ageing, central nervous system inflammation and neurodegeneration. Specifically, these methods hold significant potential for quantifying structural alterations in patients with Alzheimer’s disease, Parkinson’s disease, frontotemporal dementia and multiple sclerosis. By capturing the distinctive morphometric organization of each individual’s brain, structural covariance network analyses allow the tracking and prediction of pathology progression and clinical outcomes, information that can be integrated into clinical decision-making and used as variables in clinical trials. Furthermore, by investigating distinct and cross-diagnostic patterns of structural covariance, these approaches offer insights into shared mechanistic processes critical to understanding severe neurological disorders and their therapeutic implications. Such advancements pave the way for more precise diagnostic tools and targeted therapeutic strategies
Informe VINCat
No full textInfeccions nosocomials; Hospitals; Vigilància epidemiològicaInfecciones nosocomiales; Hospitales; Vigilancia epidemiológicaNosocomial infections; Hospitals; Epidemiological surveillanceVINCat és un programa que estableix un sistema de vigilància unificat de les infeccions nosocomials als hospitals de Catalunya. La seva missió és contribuir a reduir les taxes d'aquestes infeccions mitjançant la vigilància epidemiològica activa i continuada. El programa es fonamenta en la tasca que porten a terme els professionals dels equips multidisciplinaris de control d'infecció dels hospitals catalans
Estandardització d'indicadors per a la Central de Resultats
Full text linkIndicadors de salut; Central de Resultats; Variabilitat territorialIndicadores de salud; Central de Resultados; Variabilidad territorialHealth indicators; Central Results; Territorial variabilityAquest document explica la necessitat d'estandarditzar els indicadors de salut a Catalunya a causa de la variabilitat territorial en la composició de la població (sexe, edat i nivell socioeconòmic) amb l'objectiu de fer comparacions i avaluacions justes, precises i rigoroses dels resultats en salut entre diferents territoris o centres.This document explains the need to standardize health indicators in Catalonia due to the territorial variability in the composition of the population (sex, age and socioeconomic level) with the aim of making fair, precise and rigorous comparisons and evaluations of health outcomes between different territories or centers.Este documento explica la necesidad de estandarizar los indicadores de salud en Cataluña debido a la variabilidad territorial en la composición de la población (sexo, edad y nivel socioeconómico) con el objetivo de realizar comparaciones y evaluaciones justas, precisas y rigurosas de los resultados en salud entre diferentes territorios o centros
Autologous stem cell transplantation for relapsed/refractory large B-cell lymphoma: a multicenter GETH-TC/GELTAMO study
Full text linkAutologous stem cell transplantation; Large B-cell lymphomaTrasplante autólogo de células madre; Linfoma de células B grandesTrasplantament autòleg de cèl·lules mare; Limfoma de cèl·lules B gransWe performed a retrospective multicenter study including 791 patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) who underwent autologous stem cell transplantation (ASCT). After a median follow-up of 74 months from infusion, 65% were alive and 84% free of disease. Progression-free survival (PFS) and overall survival (OS) at 6 years were 51% and 63%, respectively. Non-relapse mortality at 1 year was 9%. Age >60 years at ASCT (hazard ratio [HR], 1.31; 95% CI, 1.06-1.62; P = .011), ASCT as ≥3rd line (HR, 1.81; 95% CI, 1.42-2.31; P 60 years at ASCT (HR, 1.62; 95% CI, 1.24-2.12; P < .001), time period before 1 November 2012 (HR, 1.40; 95% CI, 1.07-1.83; P = .014), ASCT as ≥3rd line (HR, 1.77; 95% CI, 1.32-2.37; P < .001), PR vs CR (HR, 1.58; 95% CI, 1.22-2.05; P < .001), and stable disease vs CR pre-ASCT (HR, 3.41; 95% CI, 1.81-6.45; P < .001) were variables associated with worse OS. Refractory/early relapse did not significantly influence survival (6-year PFS and OS in patients with refractory, early, and late relapse were 54% and 64%, 46% and 62%, and 49% and 63%, respectively). To our knowledge, this is the largest series analyzing the efficacy of ASCT in patients with R/R LBCL after rituximab-containing frontline therapy. Our results indicate that ASCT is a curative option for patients with chemosensitive disease