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To study how power is configured, this article analyzes the first and second seasons of the TV Series House of Cards. The behavior patterns of the main character, Frank Underwood, were tracked to analyze his foundations, the means used, the scope and the type of power he wields. The theoretical approaches of Dahl (1957) and French and Bertram (1959) were used for constructing a group of categories that served as a guide in the search for index units. Therefore, the methodology is based on units (Barthes, 1970) identified within the dialogues, the iconic composition, and the actions of the character. The results obtained reveal that in the first season argumentation as a means to exercise power predominates, and manipulation predominates in the second season. Also, the media repertoire is much broader in the first season when the main character builds the scenarios to achieve his goals. These findings contribute to the construction of a broader understanding of power and its exercise. En este artículo se analizan la primera y segunda temporadas de la serie televisiva House of Cards con el objetivo de evaluar cómo se configura la categoría de poder. Se realizó un seguimiento de las pautas de comportamiento del personaje principal, Frank Underwood, para analizar cuáles son sus bases, los medios utilizados, el alcance y el tipo de poder que ejerce. Este trabajo se basa en las aproximaciones teóricas de Dahl (1957) y de French y Bertram (1959) para orientar la construcción de un grupo de categorías que sirvieron como guía en la búsqueda de unidades indiciales. La metodología de análisis, por tanto, se sustenta en la identificación de indicios (Barthes, 1970), en los diálogos, composición icónica y acciones del personaje. Los resultados obtenidos revelan que en la primera temporada predomina el uso de la argumentación como medio para ejercer el poder, mientras que en la segunda predomina la manipulación. Asimismo, el repertorio de medios es mucho más amplio en la primera temporada, cuando el personaje principal construye los escenarios para el logro de sus objetivos. Estos hallazgos abonan la construcción de una comprensión más amplia del poder y de su ejercicio.

The diagnosis of adenocarcinomas located in the pancreas head, i.e., distal cholangiocarcinoma (dCCA) and pancreatic ductal adenocarcinoma (PDAC), constitutes a clinical challenge because they share many symptoms, are not easily distinguishable using imaging techniques and accurate biomarkers are not available. Searching for biomarkers with potential usefulness in the differential diagnosis of these tumors, we have determined serum metabolomic profiles in healthy controls and patients with dCCA, PDAC or benign pancreatic diseases (BPD). Ultra-high-performance liquid chromatography coupled to mass spectrometry (UHPLC-MS) analysis was performed in serum samples from dCCA (n = 34), PDAC (n = 38), BPD (n = 42) and control (n = 25) individuals, divided into discovery and validation cohorts. This approach permitted 484 metabolites to be determined, mainly lipids and amino acids. The analysis of the results led to the proposal of a logistic regression model able to discriminate patients with dCCA and PDAC (AUC value of 0.888) based on the combination of serum levels of nine metabolites (acylcarnitine AC(16:0), ceramide Cer(d18:1/24:0), phosphatidylcholines PC(20:0/0:0) and PC(O-16:0/20:3), lysophosphatidylcholines PC(20:0/0:0) and PC(0:0/20:0), lysophosphatidylethanolamine PE(P-18:2/0:0), and sphingomyelins SM(d18:2/22:0) and SM(d18:2/23:0)) and CA 19-9. In conclusion, we propose a novel specific panel of serum metabolites that can help in the differential diagnosis of dCCA and PDAC. Further validation of their clinical usefulness in prospective studies is required.

AIM: To evaluates the effectiveness and safety of the first generation, NS3/4A protease inhibitors (PIs) in clinical practice against chronic C virus, especially in patients with advanced fibrosis. METHODS: Prospective study and non-experimental analysis of a multicentre cohort of 38 Spanish hospitals that includes patients with chronic hepatitis C genotype 1, treatment-nai¨ve (TN) or treatment-experienced (TE), who underwent triple therapy with the first generation NS3/4A protease inhibitors, boceprevir (BOC) and telaprevir (TVR), in combination with pegylated interferon and ribavirin. The patients were treatment in routine practice settings. Data on the study population and on adverse clinical and virologic effects were compiled during the treatment period and during follow up. RESULTS: One thousand and fifty seven patients were included, 405 (38%) were treated with BOC and 652 (62%) with TVR. Of this total, 30% (n = 319) were TN and the remaining were TE: 28% (n = 298) relapsers, 12% (n = 123) partial responders (PR), 25% (n = 260) null-responders (NR) and for 5% (n = 57) with prior response unknown. The rate of sustained virologic response (SVR) by intention-to-treatment (ITT) was greater in those treated with TVR (65%) than in those treated with BOC (52%) (P < 0.0001), whereas by modified intention-to-treatment (mITT) no were found significant differences. By degree of fibrosis, 56% of patients were F4 and the highest SVR rates were recorded in the non-F4 patients, both TN and TE. In the analysis by groups, the TN patients treated with TVR by ITT showed a higher SVR (P = 0.005). However, by mITT there were no significant differences between BOC and TVR. In the multivariate analysis by mITT, the significant SVR factors were relapsers, IL28B CC and non-F4; the type of treatment (BOC or TVR) was not significant. The lowest SVR values were presented by the F4-NR patients, treated with BOC (46%) or with TVR (45%). 28% of the patients interrupted the treatment, mainly by non-viral response (51%): this outcome was more frequent in the TE than in the TN patients (57% vs 40%, P = 0.01). With respect to severe haematological disorders, neutropaenia was more likely to affect the patients treated with BOC (33% vs 20%, P = 0.0001), and thrombocytopaenia and anaemia, the F4 patients (P = 0.000, P = 0.025, respectively). CONCLUSION: In a real clinical practice setting with a high proportion of patients with advanced fibrosis, effectiveness of first-generation PIs was high except for NR patients, with similar SVR rates being achieved by BOC and TVR.