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Human Papillomavirus (HPV) prophylactic vaccination has proven effective in preventing new infections, but it does not treat existing HPV infections or associated diseases. Hence, there is still an important reservoir of HPV in adults, as vaccination programs are mainly focused on young women. The primary objective of this non-randomized, open-label trial is to evaluate if a 3-dose regimen of Gardasil-9 in HPV16/18-positive women could reduce the infective capacity of their body fluids. We aim to assess if vaccine-induced antibodies could neutralize virions present in the mucosa, thus preventing the release of infective particles and HPV transmission to sexual partners. As our main endpoint, the E1^E4-HaCaT model will be used to assess the infectivity rate of cervical, anal and oral samples, obtained from women before and after vaccination. HPV DNA positivity, virion production, seroconversion, and the presence of antibodies in the exudates, will be evaluated to attribute infectivity reduction to vaccination. Our study will recruit two different cohorts (RIFT-HPV1 and RIFT-HPV2) of non-vaccinated adult women. RIFT-HPV1 will include subjects with an HPV16/18 positive cervical test and no apparent cervical lesions or cervical lesions eligible for conservative treatment. RIFT-HPV2 will include subjects with an HPV16/18 positive anal test and no apparent anal lesions or anal lesions eligible for conservative treatment, as well as women with an HPV16/18 positive cervical test and HPV-associated vulvar lesions. Subjects complying with inclusion criteria for both cohorts will be recruited to the main cohort, RIFT-HPV1. Three doses of Gardasil-9 will be administered intramuscularly at visit 1 (0 months), visit 2 (2 months) and visit 3 (6 months). Even though prophylactic HPV vaccines would not eliminate a pre-existing infection, our results will determine if HPV vaccination could be considered as a new complementary strategy to prevent HPV-associated diseases by reducing viral spread. Trial registration: https://clinicaltrials.gov/ct2/show/NCT05334706.

Objetivo Evaluar la eficacia de un protocolo de tratamiento en terapia de mano tras la reconstrucción artroscópica del ligamento escafosemilunar dorsal, siguiendo la técnica de Corella.

Abstract Background Cytoreductive surgery followed by systemic chemotherapy is the standard of treatment in advanced ovarian cancer where feasible. Neoadjuvant chemotherapy (NACT) followed by surgery is applicable where upfront cytoreductive surgery is not feasible because of few certain reasons. Nevertheless, surgical interventions and the chemotherapy itself may be associated with postoperative complications usually entailing slow postoperative recovery. Prehabilitation programs consist of the patient’s preparation before surgery to improve the patient’s functional capacity. The aim of this study was to evaluate the impact of a prehabilitation program during neoadjuvant treatment and interval cytoreductive surgery for ovarian cancer patients. Methods A retrospective observational pilot study of patients with advanced ovarian cancer treated with NACT and interval cytoreductive surgery was conducted. The prehabilitation group received a structured intervention based on physical exercise, nutritional counseling, and psychological support. Nutritional parameters were assessed preoperatively and postoperatively, and functional parameters and perioperative and postoperative complications were also recorded. Results A total of 29 patients were included in the study: 14 in the prehabilitation group and 15 in the control group. The patients in the prehabilitation program showed higher mean total protein levels in both preoperative (7.4 vs. 6.8, p = 0.004) and postoperative (4.9 vs. 4.3, p = 0.005) assessments. Up to 40% of controls showed intraoperative complications vs. 14.3% of patients in the prehabilitation group, and the requirement of intraoperative blood transfusion was significantly lower in the prehabilitation group (14.3% vs. 53.3%, p = 0.027). The day of the first ambulation, rate of postoperative complications, and length of hospital stay were similar between the groups. Finally, trends towards shorter time between diagnosis and interval cytoreductive surgery (p = 0.097) and earlier postoperative diet restart (p = 0.169) were observed in the prehabilitation group. Conclusion Prehabilitation during NACT in women with ovarian cancer candidates to interval cytoreductive surgery may improve nutritional parameters and thereby increase postoperative recovery. Nevertheless, the results of this pilot study are preliminary, and further studies are needed to determine the clinical impact of prehabilitation programs.

Resumen Esta investigación parte de la voluntad de detectar y caracterizar los lugares del conflicto urbano que han protagonizado las tres últimas décadas de desarrollo de la ciudad de Tarragona. Para ello, este ensayo parte de la observación sistematizada y crítica del relato mediático de la prensa escrita para identificar, acotar y examinar aquellos ámbitos geográficos donde colidan, con mayor o menor virulencia, las carencias, nostalgia, resistencia al cambio y expectativas de transformación. Son los lugares donde compiten múltiples intereses, a menudo contradictorios, por orientar el devenir urbano, espacios donde toman cuerpo los designios abstractos del mercado inmobiliario y las contestaciones, resistencias y fricciones derivadas. Son también los escenarios del error, el exceso, el infortunio o la obsolescencia y abandono. En todos ellos, el conflicto urbano puede actuar como motor del cambio y principio catalizador de transformación o, por el contrario, como condena a la parálisis eterna. El análisis sistemático de la hemeroteca local y la ponderación de variables como el momento, el grado de impacto, el sentimiento asociado a cada noticia o los ámbitos referentes emerge, pues, como estrategia innovadora para estructurar un hilo argumental de la biografía, geometría y geografía de los principales hechos urbanos de cualquier realidad metropolitana contemporánea. Abstract This research is based on the desire to detect and characterize the places of urban conflict that have played the leading roles of the last three decades of development in the city Tarragona. To do so, this essay starts from the systematized and critical observation of the media narrative of the written press to identify, delimit and examine those geographical areas where, with greater or lesser virulence, deficiencies, nostalgia, resistance to change and expectations of transformation collide. They are the places where multiple interests, often contradictory, compete to guide the urban future, spaces where the abstract designs of the real estate market and the resulting disputes, resistances and frictions take shape. They are also scenarios of error, excess, misfortune or obsolescence and abandonment. In all of them, the urban conflict can act as a motor and a catalyst for change or, on the contrary, as a sentence to eternal paralysis. Thus, the systematic analysis of the local newspaper archive and the weighting of variables such as the moment, the impact degree, the sentiment associated with each piece of news or the relevant areas emerges as an innovative strategy to structure a plot line of biography, geometry and geography of the main urban facts of any contemporary metropolitan reality.