Hospital Universitario San Rafael

Introduction: The clinical outcome of switching to levodopa-entacapone-carbidopa intestinal gel (LECIG) after failure of subcutaneous foslevodopa/foscarbidopa (fLD/fCD) is unknown. We analyze it in people with Parkinson's disease (PwP) treated in Spain. Methods: Retrospective analysis of PwP who had previously received fLD/fCD but dropped out for different reasons and started before this LECIG in Spain up to 30 November 2025. Non-parametric tests were applied to evaluate the changes between the pre- (Vpre) and post-treatment (Vpost) (LECIG) periods. Results: Data about 14 patients (57.1% males; 66.6 ± 8.6 years old) from 12 hospitals out of a total of 15 who were treated with LECIG were included. The mean time with fLD/fCD was 98.6 ± 92.3 days, with 92.9% and 57.1% experiencing side effects and lack of response, respectively. Specifically, significant subcutaneous nodules were reported in up to 64.3% of the patients. LECIG was a direct switch from fLD/fCD in 35.7% of the patients. LECIG was well tolerated, with only one dropout due to complications related to dementia. Adverse events were reported in 28.6% and 35.7% of the patients in the optimization and final follow-up evaluation (mean follow-up of 233.7 ± 157.4 days) phases, respectively. From Vpre to Vpost, "Off" time was reduced in 2.9 ± 1.9 h (p = 0.002) and motor symptoms burden improved significantly (p = 0.013), whereas a trend of significance was found for non-motor symptoms burden (p = 0.050) and quality of life (p = 0.126). Conclusions: LECIG could be an alternative therapeutic option in PwP who failed fLD/fCD.

Assessment tools for diagnosing aphasia in languages other than English are scarce, particularly for minority languages such as Catalan. The present study introduces the Catalan adaptation of the Comprehensive Aphasia Test (CAT-CAT), the first assessment tool of its kind in Catalan, which was developed with careful consideration of cultural and psycholinguistic factors. Additionally, the study provides normative data based on a sample of 110 Catalan-dominant speakers without language or speech disorders in order to establish the range of non-pathological performance and cut-off scores. We also examined the role of sociodemographic factors on language skills in multilingual speakers of a minority language, a topic often overlooked in the literature. Our findings show that subtests evaluating writing skills in Catalan-speaking individuals are less reliable than those assessing oral abilities, as many Catalan speakers have not received formal instruction in their mother tongue. This factor influences performance more than other variables, such as education level. Notably, language-mixing effects from Spanish were observed mainly in specific production subtests. These findings emphasize the need for language-specific adaptations and, therefore, the value of the CAT-CAT as a tool for both clinical and research purposes in aphasiology.

Abstract The Gelida Castle was mainly constructed between the 9th and 11th Century as a frontier castle between al-Andalus and the County of Barcelona. The base of the castle wall was constructed with a regularly cut yellowish-orange limestone of unknown origin, while the remaining parts of the walls were constructed with poorly cut local materials, mainly grey Triassic limestone. Finding the geological provenance of the materials used to build the base of the castle walls is the main objective of this study and helps to understand its historical origin. To achieve these aims, samples from the walls of Gelida Castle were compared with samples of outcrops and historical quarries of the nearby Prelitoral Catalan Depression with similar lithological features. These samples were studied from the viewpoint of their mineralogy (XRD and FTIR), palaeontology and petrology. The group of samples with the highest degree of similarity with the castle materials was found ca. 60 km west-southwest of the castle, not far from Tarragona. This together with the technique of rock cutting suggests that the ferruginous limestone materials from the Gelida Castle were most probably transported from this area after plundering the building blocks of an abandoned Roman construction. The historical background of these results suggests that the original castle of Gelida could have been an Andalusi castle. It would have been part of a network of fortifications housing military garrisons before the expansion of the County of Barcelona, which occurred in the first third of the 10th century.

Cardiosphere-derived cells (CDCs) and their extracellular vesicles (CDC-EVs) can rejuvenate and improve cardiac function, but their efficacy varies among donors. This study aimed to identify predictors of CDC-EV potency. CDCs from human donors were analyzed for phenotypical and biological properties. The anti-aging activity of CDC-EVs was tested using an in vitro matrix assay. Results showed that donor age did not determine potency, but CDC senescence correlated with most bioactive properties. However, senescence alone was insufficient to predict CDC-EV potency. CDC-EVs were classified as more potent (P-EVs) or less potent (NP-EVs) based on assay performance. In a rat model of premature cardiac aging, P-EVs reduced senescence-associated GLB1 gene expression and protected against hypertrophy and fibrosis, while NP-EVs had negative effects. The study concludes that CDC-EV anti-aging potency cannot be predicted by donor age or CDC senescence, proposing an in vitro potency assay for evaluating CDC-EVs before clinical use.

El feminismo es una pieza necesaria para alcanzar valores universales de igualdad, justicia y libertad. Para que realmente pueda ser considerado un elemento plural, muchos autores y autoras han reflexionado acerca de la necesidad de su integración en el ámbito educativo. Partiendo de que se trata de un elemento intrínseco al Trabajo Social, este estudio analiza el estado de la formación universitaria de los trabajadores y trabajadoras sociales en materia de feminismo y género. Para ello, se han revisado los planes de estudios de las 37 universidades españolas donde se imparte el Grado en Trabajo Social y los resultados indican una formación en cuestiones de género fundamentalmente desde las entidades públicas, con grandes desigualdades territoriales e impartida mediante asignaturas optativas.

ObjectivesTo investigate the correlation between laryngopharyngeal reflux (LPR) and psychological distress in a sample of adult Italian patients.MethodsLPR was assessed using the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and 24-hour impedance-pH monitoring. Psychological distress was evaluated with the following clinical tools: the Hospital Anxiety and Depression Scale (HADS), the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Impact of Event Scale-Revised (IES-R), the Insomnia Severity Index (ISI), and the Perceived Stress Scale-10 (PSS-10). Associations between RSI, RFS, and psychological scores were analyzed.ResultsA total of 45 patients with LPR (Study Group, SG) and 29 healthy volunteers (Control Group, CG) were included in the study. Psychological assessments revealed significant differences between the CG and SG, except for the ISI. The HAM-A score was 6.79 ± 6.5 in the CG versus 9.53 ± 5.8 in the SG (p = 0.025), with similar results for the HADS (p = 0.029). For the HAM-D, mean scores in both groups were below the threshold for mild depressive symptoms, though SG scores were just below the cut-off (CG: 4.86 ± 5.1; SG: 6.89 ± 4.1; p = 0.010). The PSS-10 indicated mild to moderate perceived stress, with significantly higher scores in the SG (CG: 13.90 ± 5.5; SG: 21.62 ± 8.1; p = 0.000). RSI scores were positively correlated with HAM-D, HADS, and HAM-A scores.ConclusionsPsychological distress is significantly higher in LPR patients compared to healthy controls. These preliminary findings suggest that psychological factors should be considered in the management of LPR.

Introducción: las enfermedades intestinales inflamatorias (EII) incluyen la enfermedad de Crohn (EC) y la colitis ulcerosa (CU), patologías que afectan principalmente al intestino y en algunos casos pueden generar complicaciones extraintestinales como la tromboembolia venosa (TEV), ya sea trombosis venosa profunda o embolia pulmonar. Caso clínico: es una mujer de 39 años que ingresó con un cuadro clínico de 12 horas de evolución consistente en dolor en zona torácica izquierda irradiado a la región escapular ipsilateral que se exacerba con la respiración y los cambios de posición, refirió un antecedente de trombosis venosa profunda en la pierna derecha. Los paraclínicos indicaron anemia microcítica hipocrómica y trombocitosis con imagen sugestiva de infarto pulmonar, angio-TAC con trombo a nivel del ramo segmentario lobar inferior derecho, derrame pleural derecho y atelectasia. Se indicó el estudio de anemia con colonoscopia, que reportó una pancolitis ulcerativa en fase aguda con escaso sangrado, y perfil inmunológico resultó negativo. Se inició el manejo con anticoagulante más mesalazina y metilprednisolona. Conclusiones: las complicaciones tromboembólicas tienen una prevalencia estimada de 1% a 8% en los pacientes que debutan con enfermedad de intestino irritable en fase activa y, por su parte, la embolia pulmonar incrementa la morbimortalidad. Los eventos fisiopatológicos posiblemente involucrados incluyen estado de hipercoagulabilidad, agregación plaquetaria, falla en la fibrinólisis inadecuada y condiciones genéticas. Es fundamental identificar los factores de riesgo e implementar medidas terapéuticas para prevenir futuros eventos tromboembólicos. La terapia tromboembólica profiláctica de elección es la heparina de bajo peso molecular y está recomendada en pacientes con alto riesgo que se encuentren hospitalizados en fase activa de la enfermedad.

Treatment options for amyotrophic lateral sclerosis (ALS) remain suboptimal. Results from a phase 2 study of reldesemtiv in ALS suggested that it may slow disease progression. To assess the effect of reldesemtiv vs placebo on functional outcomes in ALS. A Study to Evaluate the Efficacy and Safety of Reldesemtiv in Patients With Amyotrophic Lateral Sclerosis (COURAGE-ALS) was a double-blind, placebo-controlled phase 3 randomized clinical trial conducted at 83 ALS centers in 16 countries from August 2021 to July 2023. The first 24-week period was placebo controlled vs reldesemtiv. All participants received reldesemtiv during the second 24-week period with a 4-week follow-up. Two interim analyses were planned, the first for futility and the second for futility and possible resizing. This was a hybrid decentralized trial with approximately half the trial visits performed remotely and the remaining visits in the clinic. Eligible participants met criteria for definite, probable, or possible ALS with lower motor neuron signs by modified El Escorial Criteria, ALS symptoms for 24 months or less, ALS Functional Rating Scale-Revised (ALSFRS-R) total score of 44 or less, and forced vital capacity of greater than or equal to 65% of predicted. Oral reldesemtiv, 300 mg, or placebo twice daily. The primary end point was change in ALSFRS-R total score from baseline to week 24. Of the 696 participants screened, 207 were screen failures. A total of 486 participants (mean [SD] age, 59.4 [10.9] years; 309 male [63.6%]) were randomized to reldesemtiv (n = 325) or placebo (n = 161); 3 randomized patients were not dosed. The second interim analysis at 24 weeks after randomization included 256 participants. The data monitoring committee recommended that the trial should end due to futility, and the sponsor agreed. The mean (SE) group difference in the ALSFRS-R score from baseline to week 24 was -1.1 (0.53; 95% CI, -2.17 to -0.08; P = .04, favoring placebo). Given excess missing data from early termination, the combined assessment assumed greater importance; it, too, failed to show a benefit from treatment with reldesemtiv (win probability was 0.44 for reldesemtiv and 0.49 for placebo, with a win ratio of 0.91; 95% CI of win ratio, 0.77-1.10; P = .11). This randomized clinical trial failed to demonstrate efficacy for reldesemtiv in slowing functional decline in ALS. ClinicalTrials.gov Identifier: NCT04944784.

The Baltic Sea is a semi-enclosed shelf sea and characterized by its distinct geographical and oceanographic features. One of the Baltic’s most remarkable features is its surface salinity gradient that is horizontally decreasing from the saline North Sea to the near fresh Bothnian Sea in the north, and Gulf of Finland in the east. Additionally, a vertical gradient and strong stratification separate between less saline surface water and deep saline water. These salinity features are mainly driven by a combination of river runoff, net precipitation, wind conditions, and geographic features that lead to restricted and irregular inflow of saltwater into the Baltic and limited mixing. The overall positive freshwater balance causes the Baltic to be much fresher compared to fully marine ocean waters with a mean salinity of only about 7 g/kg. The Baltic Sea is particularly sensitive to climate change and global warming due to its shallowness,  small volume and limited exchange with the world oceans. Consequently, it is changing more rapidly than other regions. Recent changes in salinity are less clear due to a high variability but overall surface salinity seems to decrease with a simultaneous increase in the deeper water layers. Furthermore. the overall salinity distribution is indirectly linked to the general circulation of the Baltic Sea which consists mainly of cyclonic circulation cells comprising the main sub-basins of the Baltic Sea. Thus, improving the understanding of the salinity dynamics ultimately leads to a better understanding of the circulation in the Baltic Sea. Within the project 4DBALTDYN highly spatially resolved SMOS SSS (Sea Surface Salinity) satellite data will be combined with in situ observational data and numerical modeling to improve our understanding of the salinity dynamics of the Baltic Sea. SMOS SSS data (2011-2019) provide a continuous monitoring of the evolution of the surface salinity of the entire area of the Baltic Sea.