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•Similar to clinical trial results, fostamatinib has demonstrated a high efficacy rate for ITP in daily clinical practice conditions.•Fostamatinib is a well-tolerated drug with a very low rate of thrombotic events associated with its use.

It has been argued that a schola medicorum(i.e. a headquarters of physicians) existed in ancient Rome. According to this, the evidence supporting the existence of the scholais the plinth of a statue engraved with the text translata de schola medicorum, the epitaph of a scriba medicorum, and a Greek inscription dedicated by a δεκαδάρχης ἰατρῶν, but these sources present some problems when they are subjected to a critical examination. Moreover, the silence of ancient authors about this place is striking, and subsequent doubts emerge when considering that the schola medicorumis first documented in a manuscript by Pirro Ligorio. The aim of this paper is to re-examine the documentary sources that allude to the schola medicorum, assessing also the use of this expression in scientific literature from the sixteenth century, and try to determine if the written sources support the existence of such a place in ancient Rome.

To study if the incidence of Candidainfection of diaper dermatitis (DD) and to assess if it is associated with clinical factors.

Peripheral T-cell lymphoma (PTCL) is a clinically aggressive disease, with a poor response to therapy and a low overall survival rate of approximately 30% after 5 years. We have analyzed a series of 105 cases with a diagnosis of PTCL using a customized NanoString platform (NanoString Technologies, Seattle, WA) that includes 208 genes associated with T-cell differentiation, oncogenes and tumor suppressor genes, deregulated pathways, and stromal cell subpopulations. A comparative analysis of the various histological types of PTCL (angioimmunoblastic T-cell lymphoma [AITL]; PTCL with T follicular helper [TFH] phenotype; PTCL not otherwise specified [NOS]) showed that specific sets of genes were associated with each of the diagnoses. These included TFH markers, cytotoxic markers, and genes whose expression was a surrogate for specific cellular subpopulations, including follicular dendritic cells, mast cells, and genes belonging to precise survival (NF-κB) and other pathways. Furthermore, the mutational profile was analyzed using a custom panel that targeted 62 genes in 76 cases distributed in AITL, PTCL-TFH, and PTCL-NOS. The main differences among the 3 nodal PTCL classes involved the RHOAG17V mutations (P < .0001), which were approximately twice as frequent in AITL (34.09%) as in PTCL-TFH (16.66%) cases but were not detected in PTCL-NOS. A multivariate analysis identified gene sets that allowed the series of cases to be stratified into different risk groups. This study supports and validates the current division of PTCL into these 3 categories, identifies sets of markers that can be used for a more precise diagnosis, and recognizes the expression of B-cell genes as an IPI-independent prognostic factor for AITL.

ABSTRACTImmunocompromised individuals, particularly autologous hematopoietic stem cell transplant (auHSCT) recipients, are at high risk for herpes zoster (HZ). We provide an in-depth description of humoral and cell-mediated immune (CMI) responses by age (protocol-defined) or underlying disease (post-hoc) as well as efficacy by underlying disease (post-hoc) of the adjuvanted recombinant zoster vaccine (RZV) in a randomized observer-blind phase III trial (ZOE-HSCT, NCT01610414). 1846 adult auHSCT recipients were randomized to receive a first dose of either RZV or placebo 50–70 days post-auHSCT, followed by the second dose at 1–2 months (M) later. In cohorts of 114–1721 participants, at 1 M post-second vaccine dose: Anti-gE antibody geometric mean concentrations (GMCs) and median gE-specific CD4[2+] T-cell frequencies (CD4 T cells expressing ≥2 of four assessed activation markers) were similar between 18–49 and ≥50-year-olds. Despite lower anti-gE antibody GMCs in non-Hodgkin B-cell lymphoma (NHBCL) patients, CD4[2+] T-cell frequencies were similar between NHBCL and other underlying diseases. The proportion of polyfunctional CD4 T cells increased over time, accounting for 79.6% of gE-specific CD4 T cells at 24 M post-dose two. Vaccine efficacy against HZ ranged between 42.5% and 82.5% across underlying diseases and was statistically significant in NHBCL and multiple myeloma patients. In conclusion, two RZV doses administered early post-auHSCT induced robust, persistent, and polyfunctional gE-specific immune responses. Efficacy against HZ was also high in NHBCL patients despite the lower humoral response.

Background/objectives: Obesity is associated with reduced neurocognitive performance. Individuals with obesity show decreased activation in the left dorsolateral prefrontal cortex (DLPFC), a key brain region relevant to the regulation of eating behavior. Transcranial direct current stimulation (tDCS) has emerged as a potential technique to correct these abnormalities. However, there is limited information to date, particularly in clinical settings and regarding long-term effects of tDCS. This study aimed to investigate the effects of DLPFC-targeted tDCS in young women with obesity. Subject/methods: Randomized, double-blind, sham-controlled parallel-design clinical trial conducted in 38 women, aged 20–40 years, with BMI 30–35 kg/m2. Study design: Phase I: target engagement(immediate effects of tDCS on working memory performance), Phase II: tDCS only(ten sessions, 2 weeks), Phase III: tDCS + hypocaloric diet(six sessions, 30% energy intake reduction, 2 weeks, inpatient), Phase IV: follow-up at 1, 3, and 6 months. Primary outcome: change in body weight. Secondary outcomes: change in eating behavior and appetite. Additional analyses: effect of Catechol-O-methyl transferase (COMT)gene variability. Data were analyzed as linear mixed models. Results: There was no group difference in change in body weight during the tDCS intervention. At follow-up, the active group lost less weight than the sham group. In addition, the active group regained weight at 6-month follow-up, compared with sham. Genetic analysis indicated that COMTMet noncarriers were the subgroup that accounted for this paradoxical response in the active group. Conclusion: Our results suggest that in young women with class I obesity, tDCS targeted to the DLPFC does not facilitate weight loss. Indeed, we found indications that tDCS could have a paradoxical effect in this population, possibly connected with individual differences in dopamine availability. Future studies are needed to confirm these findings.

Follicular helper T (TFH) cells are the providers of T-cell help to B-cells in the development of germinal centers and for the generation of most class-switched antibodies. The markers most commonly associated with TFHactivity are IL21, IL4, CD40L, BCL6, SAP, CXCR5/CXCL13, and ICOS. T-cell lymphoma genomic studies have shown that different T-cell lymphoma types express signatures typical for TFHcells, this including angioimmunoblastic T-cell lymphoma (AITL), a related condition termed peripheral T-cell lymphoma with TFHphenotype and primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder.

La talla baja es motivo de preocupación familiar y constituye una consulta frecuente en pediatría. Para su diagnóstico las gráficas de crecimiento son una herramienta imprescindible. El objetivo de este estudio es evaluar el impacto del cambio de gráficas de referencia en el diagnóstico de talla baja en nuestra área de salud.

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To investigate potential risk factors for the progression of myopia.

Background: Fostamatinib is a splenic tyrosine kinase (SYK) inhibitor that prevents antibody-mediated platelet destruction. This drug has demonstrated to be effective and safe in immune thrombocytopenia (ITP). However, clinical trials may not accurately reflect what happens in clinical practice. Here we evaluated the efficacy and safety of eltrombopag in ITP in a real-world setting.

Background

Free glutamate, a key substance underlying the umami taste of foods, fulfills a number of physiological functions related to energy balance. Previous experimental studies have shown that intake of a broth or soup supplemented with monosodium glutamate (MSG) prior to a meal can decrease appetite and food intake, particularly in women with propensity to overeat and gain weight. In this study, we examined potential neurocognitive mechanisms underlying this effect. We evaluated changes after intake of a chicken broth with or without MSG added (MSG+/MSG−) in a sample of healthy young women. Subjects were assessed with a food-modified computerized inhibitory control task, a buffet meal test with eye-tracking, and brain responses during a food choice paradigm evaluated with functional neuroimaging. We found evidence for improvement in key parameters related to inhibitory control following intake of the MSG+ broth, particularly in subjects with high levels of eating disinhibition, who also showed lower intake of saturated fat during the meal. Additionally, consumption of the MSG+ broth led to a reduction of the rate of fixation switches between plates at the meal, and increased engagement of a brain region in the left dorsolateral prefrontal cortex previously associated with successful self-control during dietary decisions. Altogether, these results, while preliminary, suggest potential facilitating effects of glutamate (MSG) on cognitive executive processes that are relevant for the support of healthy eating behaviors and food choice.

Regesmohs registry is a nationwide registry including patients evaluated for Mohs surgery in 17 Spanish centres since July 2013. Given that Mohs surgery is the therapy with best results for high risk basal cell carcinoma (BCC) and other skin tumours, we wanted to describe the reasons that lead to some patients being excluded from this therapy and the alternative treatments that they received. These data may be useful to avoid excluding patients for Mohs surgery use, to estimate the healthcare demand of these patients and the demand for Hedgehog inhibitors therapy in this group.

El registro Regesmohs es un registro de ámbito nacional, de pacientes evaluados y sometidos a una cirugía de Mohs, en 17 centros españoles, desde julio de 2013. Como la cirugía de Mohs es el tratamiento que mejores resultados da para el manejo del carcinoma de células basales (CCB) de alto riesgo y otros tumores de la piel, queríamos describir los motivos por los que algunos pacientes fueron considerados no aptos para ser sometidos a este tratamiento y qué tratamientos alternativos recibieron. Estos datos pueden ser útiles para evitar excluir a pacientes aptos para ser sometidos a una cirugía de Mohs, para calcular la demanda que estos pacientes generan a nivel sanitario, así como la demanda que hay de tratamientos de inhibidores de la vía de Hedgehog en dicho grupo de pacientes.

AbstractAn analysis of the bidirectionality of Spanish diasporic fluxes over the last twenty years is especially relevant for any approach to contemporary cultural fictions. In order to do so, this article analyses Flores de otro mundoand En tierra extraña, a fiction film and a documentary by Icíar Bollaín. Both texts form part of a new wave of continental cinema that questions the myth of multiculturalism in the European Union. Through them, Bollaín explores the intricacies of Spanish society before and after the economic crisis of the beginning of the twenty-first century. If Flores de otro mundorepresents Spain as a hostile ‘diaspora space’, En tierra extrañacentres on the subaltern experience of a young generation of Spaniards who are still looking for their place in the world. As this analysis will show, Bollaín’s works challenge national and ethnocentric traditions while approaching the drama of (im/e)migration in contemporary Europe.

The Spanish Mohs Surgery Registry is used to collect data on the use and outcomes of Mohs micrographic surgery (MMS) in Spain. The aim of this study was to describe perioperative and intraoperative data recorded for MMS procedures performed between July 2013 (when the registry started) and January 2016.

La apendicectomía laparoscópica por puerto único supone un avance en las técnicas mínimamente invasivas. El objetivo de este estudio es mostrar nuestra serie de 100 casos de apendicitis aguda, intervenidos mediante técnica de puerto único utilizando el sistema «glove port», exponiendo nuestra técnica, resultados y seguimiento de nuestros pacientes.

El Registro Español de Cirugía de Mohs recoge los datos de aplicación y resultados de esta técnica en España. Se describen los datos de las intervenciones realizadas desde el inicio del Registro en julio de 2013 a enero de 2016. Se analizan los datos de las cirugías tanto perioperatorios como intraoperatorios.

Inadequate cytotoxicity testing accepted by European Union (EU) and International Organization for Standardization (ISO) standards for perfluoro-octane used in intraocular surgery resulted in 117 cases of acute intraocular toxicity and severe loss of visual function. Clinical findings and an alternative method to determine cytotoxicity are described.

To analyze the age at which treatment with growth hormone (GH) is started in the different indications approved in our country, as well as to assess the response to it and detect points of improvement.

Analizar la edad de inicio de tratamiento con hormona de crecimiento (GH) en las distintas indicaciones aprobadas en nuestro país, valorar la respuesta y detectar puntos de mejora.

The main objective of oncologic dermatologic surgery is the complete excision of skin tumors. During reconstruction of the defect, we must attempt to preserve function and cosmetic appearance. At the labial commissure, fibers from the superior and inferior portions of the orbicularis oris muscle intersect and the vermillion inserts onto the modiolus, a complex, cone-shaped structure at the angle of the mouth. Surgical reconstruction of the labial commissure is challenging because of the need to preserve sphincter function and cosmetic symmetry. We present a number of cases of surgical defects at the labial commissure and describe the reconstruction techniques used. We also propose an algorithm to help determine the most suitable technique for different cases.

En julio de 2013 se inició la recogida de datos del registro español de cirugía micrográfica de Mohs, que describe la aplicación y los resultados de esta técnica en España. En este artículo se describen las características del paciente y de los tumores tratados.

The Spanish registry of Mohs micrographic surgery started collecting data in July 2013. The aim of the registry is to report on the use of this technique in Spain and the outcomes achieved. In the present article, we describe the characteristics of patients and the tumors treated.

With the rising prevalence of obesity, hedonic eating has become an important theme in obesity research. Hedonic eating is thought to be that driven by the reward of food consumption and not metabolic need, and this has focused attention on the brain reward system and how its dysregulation may cause overeating and obesity. Here, we begin by examining the brain reward system and the evidence for its dysregulation in human obesity. We then consider the issue of how individuals are able to control their hedonic eating in the present obesogenic environment and compare 2 contrasting perspectives on the control of hedonic eating, specifically, enhanced control of intake via higher cognitive control and loss of control over intake as captured by the food addiction model. We conclude by considering what these perspectives offer in terms of directions for future research and for potential interventions to improve control over food intake at the population and the individual levels.

Electromagnetic brain stimulation might have value to reduce motor deficits after stroke. Safety and behavioral effects of higher frequencies of repetitive transcranial magnetic stimulation (rTMS) require detailed assessment.

During precision grip, coherence between motor cortex and hand muscle EMG oscillatory activity in the 15‐30 Hz range covaries with the compliance of the manipulated object. The current study investigated whether short‐term synchrony and coherence between discharges of single motor units (SMUs) in the first dorsal interosseous (1DI) muscle were similarly modulated by object compliance during precision grip. Eight subjects used index finger and thumb to grip two levers that were under robotic control. Guided by visual feedback of the lever force levels, subjects held the levers against a steady force of 1.3 N for 8 s; they then linearly increased the force to 1.6 N over a 2 s period and held for a further 8 s before linearly decreasing the force back to the 1.3 N level over another 2 s period. Subjects performed the task at two different levels of compliance, each with identical grip force levels. Both surface EMG and SMU activity were recorded from the 1DI muscle. Short‐term synchrony between the discharges of pairs of SMUs was assessed in the time domain by cross‐correlation and in the frequency domain by coherence analysis. Coherence was seen in two frequency ranges: 6‐12 Hz and 15‐30 Hz. The compliance of the gripped object had a significant effect on both short‐term synchronisation and coherence in the 15‐30 Hz range between SMUs; both were greater for the more compliant condition. There was no change in the 6‐12 Hz coherence.

Introduction

Introduction: The bortezomib, lenalidomide, and dexamethasone (VRd) regimen is an acceptable standard of care (SoC) for both transplant-eligible and transplant-ineligible newly diagnosed multiple myeloma (TI NDMM). Ongoing development of novel therapies and combinations strive to improve survival outcomes beyond what is expected from SoC. Belantamab mafodotin (belamaf) is a B-cell maturation antigen-binding antibody-drug conjugate that eliminates myeloma cells by a multimodal mechanism and has demonstrated durable responses in patients with relapsed/refractory multiple myeloma (RRMM). Preclinical evidence of belamaf in combination with bortezomib or lenalidomide suggests enhanced anti-myeloma activity, providing rationale for this treatment combination. We report the preliminary findings of belamaf + VRd for TI NDMM patients.

Usmani: Pharmacyclics: Consultancy, Research Funding; Seattle Genetics: Consultancy, Research Funding; Takeda: Consultancy, Research Funding, Speakers Bureau; Merck: Consultancy, Research Funding; SkylineDX: Consultancy, Research Funding; Sanofi: Consultancy, Research Funding, Speakers Bureau; Janssen: Consultancy, Research Funding, Speakers Bureau; Janssen Oncology: Consultancy, Research Funding; Bristol-Myers Squibb: Research Funding; EdoPharma: Consultancy; GSK: Consultancy, Research Funding; Celgene/BMS: Consultancy, Research Funding, Speakers Bureau; Array BioPharma: Consultancy, Research Funding; Abbvie: Consultancy; Amgen: Consultancy, Research Funding, Speakers Bureau. Quach: Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Karyopharm: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; GlaxoSmithKline: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen/Cilag: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Sanofi: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Bristol Myers Squibb: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Antengene: Consultancy, Membership on an entity's Board of Directors or advisory committees; Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees; CSL: Consultancy, Membership on an entity's Board of Directors or advisory committees. Koh: Pfizer: Consultancy; Jassen: Honoraria; AstraZeneca: Honoraria; Novartis: Honoraria; GSK: Honoraria; Roche: Honoraria; Takeda: Honoraria. Guenther: Novartis: Consultancy; Celgene: Consultancy, Honoraria; Roche: Consultancy; Takeda: Consultancy, Honoraria; Amgen: Consultancy, Honoraria; AbbVie: Consultancy; Jazz Pharmaceuticals: Honoraria; Janssen Pharmaceuticals: Consultancy, Honoraria. Zhou: GlaxoSmithKline: Current Employment. Kaisermann: GlaxoSmithKline: Current Employment, Current equity holder in publicly-traded company. Mis: GlaxoSmithKline: Current Employment. Williams: GlaxoSmithKline: Current Employment. Yeakey: GlaxoSmithKline: Current Employment, Current equity holder in publicly-traded company. Ferron-Brady: GlaxoSmithKline: Current Employment, Current equity holder in publicly-traded company. Figueroa: GlaxoSmithKline: Current Employment. Kremer: GlaxoSmithKline: Current Employment. Gupta: Novartis: Current equity holder in publicly-traded company; GlaxoSmithKline: Current Employment, Current equity holder in publicly-traded company. Janowski: Celgene: Consultancy; AstraZeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees.

Martínez-López: Janssen, BMS, Novartis, Incyte, Roche, GSK, Pfizer: Consultancy; Roche, Novartis, Incyte, Astellas, BMS: Research Funding. Mateos: Oncopeptides: Honoraria, Membership on an entity's Board of Directors or advisory committees; Regeneron: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees; Adaptive Biotechnologies: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sea-Gen: Honoraria, Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene - Bristol Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bluebird bio: Honoraria; GSK: Honoraria; Oncopeptides: Honoraria. López-Muñoz: Amgen: Consultancy. Sureda: GSK: Consultancy, Honoraria, Speakers Bureau; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Roche: Other: Support for attending meetings and/or travel; Mundipharma: Consultancy; Bluebird: Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Kite, a Gilead Company: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; MSD: Consultancy, Honoraria, Speakers Bureau; BMS/Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Support for attending meetings and/or travel, Speakers Bureau; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Support for attending meetings and/or travel, Research Funding, Speakers Bureau. Rosinol: Janssen, Celgene, Amgen and Takeda: Honoraria. Lahuerta: Celgene, Takeda, Amgen, Janssen and Sanofi: Consultancy; Celgene: Other: Travel accomodations and expenses. San-Miguel: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, GlaxoSmithKline, Janssen, Karyopharm, Merck Sharpe & Dohme, Novartis, Regeneron, Roche, Sanofi, SecuraBio, Takeda: Consultancy, Other: Advisory board.

A new cognitive-motor, computer-administered instrument, the Random Rhythm Generation test (ARG), measured the schizophrenics' and control subjects' capacity of performing random (aleatory) rhythms. The interval frequencies between subjects' responses and chaotic dynamic attractor of the generated series, expressed in the phase space and correlation dimension, were analyzed. Results showed that schizophrenic patients (SG) generated more regular and rhythmic series than those of the control group (CG) when performing the ARG (correlation dimension in SG = 2.796 ± 0.47, in CG = 3.842 ± 0.51, p < 0.01). Therefore, the ARG may be usefull for the estimation and quantification of the cognitive-motor dysfunction in schizophrenic patients and possible definitions of treatments of cognitive and psychomotor dysfunctions. Our results also suggest that schizophrenic patients are characterized by more regular and rhythmic patterns than control subjects.

En un estudio prospectivoe fectuado en 33 niños con cardiopatía (edades comprendidas entre 5 días y 16 años) sometidos a cirugía extracorpórea, se realizó una valoracióndel comportamiento intra y postoperatorio de la glucemia en relación con la edad (el peso) de losniños y con la temperatura de perfusión intracirugía extracorpórea.