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Immune-checkpoint inhibitors (ICI) have revolutionized the therapeutic landscape of cancer. However, optimal patient selection is still an unmet need. One-hundred-forty-six patients with metastatic cancer candidates to ICI at the Hospital Clinic of Barcelona Clinical Trials Unit were prospectively recruited in this observational study. Blood samples were collected at different timepoints, baseline LIPI score calculated and pre-ICI archived tissues retrieved to evaluate PD-L1, tumor-infiltrating lymphocytes (TILs) and PD1 mRNA levels. Tumor assessments were centrally reviewed by RECIST 1.1 criteria. Associations with overall response rates (ORR), durable clinical benefit (DCB), progression-free survival (PFS) and overall survival (OS) were performed with univariable/multivariable logistic and Cox regressions, where appropriate. At a median follow-up of 26.9 months, median PFS and OS were 2.7 and 12.9 months. Response rates were 17.8% with duration of response (DOR) of 4.4 months. LIPI score was independently associated with PFS (p = 0.025) and OS (p p = 0.005). Time-to-best response (TTBR) and ORR (p p p = 0.028) and DCB (univariate p = 0.043). PD1 mRNA levels were strikingly associated to complete responses (p = 0.021). To resume, in our prospective observational pan-cancer study, baseline LIPI score, immunotherapy-naïve status, cancer type and RT before starting ICI were the most relevant clinical factors independently correlated with immunotherapy outcomes. Longer TTBR seemed to associate with better survival, while PD1 mRNA and PD-L1 protein levels might be tumor-agnostic predictive factors of response to ICI and should be furtherly explored.

Background: The choice of the imaging modality for diagnosis of pulmonary embolism (PE) could be influenced by provider, patient or hospital characteristics, or over time. However, little is known about the choice of the diagnostic modalities in practice. The aim of this study was to evaluate the variations in the use of imaging modalities for patients with acute PE. Methods: Using the data from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a prospective international registry of patients with venous thromboembolism (March 2001–January 2019), we explored the imaging modalities used in patients with acute PE. The imaging modalities included computed tomography pulmonary angiography, ventilation/perfusion scanning, pulmonary angiography, a combination of these tests, or PE signs and symptoms plus imaging-confirmed proximal deep vein thrombosis but no chest imaging. Results: Among 38 025 patients with confirmed PE (53.1% female, age: 67.3±17 years), computed tomography pulmonary angiography was the dominant modality of diagnosis in all RIETE enrollees (78.2% [99% CI, 77.6–78.7]); including pregnant patients (58.9% [99% CI, 47.7%–69.4%]) and patients with severe renal insufficiency (62.5% [99% CI, 59.9–65.0]). A greater proportion of patients underwent ventilation/perfusion scanning in larger hospitals compared with smaller hospitals (13.1% versus 7.3%, P P Conclusions: In a large multinational PE registry, variations were observed in the use of imaging modalities according to patient or institutional factors and over time. However, computed tomography pulmonary angiography was the dominant modality of diagnosis, even in pregnancy and severe renal insufficiency. The safety, costs, and downstream effects of these tests on PE-related and non-PE-related outcomes warrant further investigation.

INTRODUCCION: La Tempestad Electrica (TE) se refiere a un estado de inestabilidad electrica cardiaca caracterizada por multiples episodios de taquicardia ventricular dentro de un periodo relativamente corto de tiempo. La mayoria de las arritmias que se desarrollan durante una TE son la Taquicardia Ventricular (TV) del tipo de Torsades de Pointes (TdP), TV polimorfas y excepcionalmente Fibrilacion Ventricular. Debido a su muy rara presentacion y mas aun su registro, se presenta este caso. CASO CLINICO: Se presenta, a continuacion el primer caso documentado a nivel nacional de Tempestad Electrica sostenida por mas de 36 horas asociada a un sindrome de Q-T largo congenito en una paciente de 26 anos de edad. Se realizo manejo farmacologico concomitantemente con tratamiento extremo por medio de implante de marcapaso en vigencia de TE. CONCLUSION. La tempestad electrica es una emergencia medica, de rara presentacion que obliga a tomar decisiones rapidas y acertadas para evitar un potencial desenlace fatal.

INTRODUCCION: Las enfermedades cronicas no transmisibles constituyen a nivel mundial las causas mas frecuentes de comorbilidad en pacientes geriatricos. El objetivo del presente estudio fue determinar las principales causas de morbilidad en pacientes geriatricos atendidos ambulatoriamente. METODOS: El presente estudio de tipo observacional descriptivo, se realizo en el periodo Septiembre – Diciembre del ano 2013, de pacientes atendidos en su domicilio por el “Centro de atencion ambulatoria 302”. Se tomaron en cuenta variables como numero de pacientes, edad, genero, atencion por meses, comorbilidades mas frecuentes. RESULTADOS: Con un total de 433 pacientes el 63% de adultos mayores fue de genero femenino. El grupo de edad de mayor frecuencia se encontro alrededor de 80 – 84 anos. Durante el mes de Noviembre se atendieron ambulatoriamente 135 pacientes (31%), seguido del mes de Septiembre con 133 pacientes (31%). Las comorbilidades mas frecuentes de esta poblacion fueron la Hipertension Arterial con 139 pacientes (32%), trastorno depresivo con 57 pacientes (13%), Poliartrosis con 37 pacientes (9%), Diabetes Mellitus con 36 pacientes (8%). CONCLUSION: La Hipertension arterial, trastorno depresivo, poliartrosis y diabetes mellitus fueron las primeras causas de morbilidad en 433 pacientes geriatricos atendidos ambulatoriamente.