Dipòsit Digital de la Universitat de Barcelona
El Dipòsit Digital de la Universitat de Barcelona és el repositori institucional que conté en format digital els materials derivats de l'activitat docent, investigadora i institucional de la comunitat universitària.
Enviaments recents
- ArticleFactores asociados a la no realización de colonoscopia tras prueba positiva en un programa de cribado poblacional de cáncer colorrectal(Elsevier, 2026-05-02) Pozo, Àngels; Serradesanferm, Anna; Rubio Rico, Maria Lourdes; Pellisé Urquiza, Maria; Grau Cano, J. (Jaume); Torà Rocamora, Isabel; Castells Garangou, AntoniResumen Objetivos Describir el perfil sociodemográfico y clínico de las personas que, habiendo obtenido un resultado positivo en la prueba de detección de sangre oculta en heces inmunoquímica (PDSOHi) en el Programa de detección precoz de cáncer de colon y recto (PDPCCR), rechazaron la colonoscopia de cribado en el centro de referencia y no se tuvo constancia de su realización posterior, e identificar los motivos del rechazo. Pacientes y métodos Estudio descriptivo, observacional, transversal, retrospectivo, que incluyó a 128 personas que, en 2022-2023, rechazaron la colonoscopia en el Hospital Clínic de Barcelona tras haber obtenido un resultado positivo de PDSOHi. Se describieron los datos obtenidos a través de la revisión de historias clínicas. Resultados Quienes rechazaron la colonoscopia tenían una edad media de 60,35 ± 5,25 años, nacionalidad española (90,63%) y el 85,16%, nivel socioeconómico alto. La mediana de participaciones en el PDPCCR fue 3. Mas de la mitad no presentaban historial de cáncer previo (64,06%), ni antecedentes familiares de cáncer colorrectal (64,84%), ni sintomatología sospechosa de cáncer colorrectal (71,09%). Los principales motivos del rechazo fueron: querer realizar la colonoscopia en centro externo al PDPCCR (21,09%) y multimorbilidad o enfermedad grave o enfermedad que precisaba de autorización de su médico para realizar la prueba (20,31%). Conclusiones Las personas que rechazaron la colonoscopia de cribado gozaban, en su mayoría, de nivel socioeconómico alto y una quinta parte preferían realizarla en un centro externo. Asimismo, una quinta parte de los sujetos presentaban comorbilidades graves que requerían una valoración individualizada del riesgo-beneficio de la prueba.
ArticleAdjunctive Intra-Arterial Alteplase After Successful Thrombectomy for Acute Ischemic Stroke: The CHOICE-2 Randomized Clinical Trial(American Medical Association (AMA), 2026-06-02) Renú, Arturo; Fernández Couto, Maria Dolores; Riva, Patricia de la; Delgado Mederos, Raquel; Herrera Isasi, Maria; Morales, Ana; Terceño, Mikel; López Hernández, Nicolás; Martínez Galdámez, Mario; Dorado, Laura; Vega, Pedro; Morales Caba, Lluis; González, Eva; Alonso, Maitane; Barredo Benítez, Pedro; Bermejo, Rebeca; Cabero Arnold, Andrea; Cabrera Maqueda, Jose Maria; Vargas, Martha; Calleja Bonilla, Ángel; Calleja, Sergio; Díaz Pérez, José; Rudilosso, Salvatore; Doncel Moriano, Antonio; Feal Painceiras, Maria J.; Gallego, José Ignacio; Hurtado, Paola; Laredo Gregorio, Carlos; Llull Estrany, Laura; Bartolomé Arenas, Inés; Martínez Calvo, Alberto; Ortega Sánchez, Álvaro; Rodríguez Vázquez, Alejandro; Rodríguez Caamaño, Isabel; Singla, Alba; Silva, Yolanda; Tarruella Hernández, Diana; Oleaga Zufiría, Laura; San Román, Luís; Serena, Joaquín; Freijo, Maria del Mar; Pérez de la Ossa, Natalia; Castellanos, Mar; Arenillas, Juan Francisco; Torres, Ferran; Leira, Enrique C.; Amaro Delgado, Sergio; Urra, Xabier; Chamorro, Ángel; CHOICE-2 InvestigatorsImportance Despite high recanalization rates with endovascular thrombectomy for acute ischemic stroke due to large vessel occlusion, functional outcomes remain suboptimal. The benefit of adjunctive intra-arterial thrombolysis after successful thrombectomy is uncertain. Objective To assess whether adjunctive intra-arterial alteplase after successful thrombectomy improves functional outcomes and cerebral reperfusion. Design, Setting, and Participants Randomized, open-label trial with blinded outcome assessment conducted at 14 stroke centers in Spain from December 11, 2023, through November 26, 2025. A total of 440 patients with acute ischemic stroke due to large vessel occlusion treated with thrombectomy within 24 hours and achieving an expanded Treatment in Cerebral Ischemia score of 2b50 to 3 were randomized. Interventions Thrombectomy plus intra-arterial alteplase (0.225 mg/kg; maximum dose, 20 mg) infused over 15 minutes (n = 221) or thrombectomy alone (n = 219). Main Outcomes and Measures The primary outcome was an excellent functional outcome at 90 days, which was defined as a modified Rankin Scale score of 0 or 1. There were 6 secondary outcomes, including residual hypoperfusion on follow-up computed tomography perfusion. The safety outcomes included symptomatic intracranial hemorrhage and death. Results Of 3786 patients treated with thrombectomy, 2776 (73%) fulfilled angiographic criteria and 440 (12%) were randomized. There were 433 patients who were treated as randomized (median age, 76 [IQR, 75-78] years; 51% female). At 90 days, 57.5% of patients (123/214) in the thrombectomy plus intra-arterial alteplase group had a modified Rankin Scale score of 0 or 1 vs 42.5% of patients (93/219) in the thrombectomy alone group (adjusted risk difference, 15.0% [95% CI, 5.7% to 24.3%]; P = .002). Of 6 secondary outcomes, 4 showed no significant between-group differences. Residual hypoperfusion occurred in 28.6% (55/192) of patients in the thrombectomy plus intra-arterial alteplase group vs 50.5% (96/190) of patients in the thrombectomy alone group (adjusted risk difference, –22.0% [95% CI, −31.5% to −12.4%]; P < .001) and symptomatic intracranial hemorrhage occurred in 1.4% (3/214) vs 0.5% (1/219), respectively (adjusted odds ratio, 3.10 [95% CI, 0.32 to 30.0]; P = .33). Mortality at 90 days was 12.1% (26/214) in the thrombectomy plus intra-arterial alteplase group vs 6.4% (14/219) in the thrombectomy alone group (adjusted risk difference, 5.9% [95% CI, 0.5% to 11.3%]; P = .03). Conclusions and Relevance Among patients with acute ischemic stroke and successful thrombectomy, adjunctive intra-arterial alteplase increased the proportion achieving excellent functional outcome at 90 days without a significant increase in symptomatic intracranial hemorrhage. Higher mortality in the thrombectomy plus intra-arterial alteplase group warrants further study.- ArticleSomatic mutations in cervicovaginal samples: assessing their role in ovarian cancer detection and prognosis(Elsevier, 2026-02-23) Pelegrina, Beatriz; Paytubi Casabona, Sònia; Benavente, Yolanda; Marín, Fátima; López-Querol Marta; Onieva, Irene; Frias Gomez, Jon; Pavon Diaz, Claudia; Martínez García, Jose Manuel; Fernandez Gonzalez, Sergi; Dorca Duch, Eduard; Vidal-Bel, August; Barahona, Marc; Pérez Escanilla, Yolanda; Brunet, Joan; Pineda, Marta; Pijuan, Lara; Ponce Sebastià, Jordi; Matias-Guiu, Xavier, 1958-; Alemany i Vilches, Laia; Costas, LauraBackground: Most patients with ovarian cancer are diagnosed at a late stage because of the lack of early stage symptoms or effective screening methods. To address this issue, we evaluated the presence of DNA somatic variants in cervicovaginal samples to aid the detection and prognosis of ovarian cancer. Methods: We employed next-generation sequencing (NGS) with molecular identifiers to analyze samples from a case-control study involving women diagnosed with ovarian cancer and age-matched controls. The study included Pap smear samples from 43 patients with ovarian cancer and 99 controls, 27 paired vaginal self-samples, 16 endometrial aspirates, and 13 tumor samples from cases, for a total of 198 samples. Results: Pathogenic and likely pathogenic variants were identified in 25.6 % (11/43, 95 % confidence interval -CI-:13.5–41.2) of Pap smear samples from patients with ovarian cancer. These variants were also found in 33.3 % of the control samples, leading to a specificity of 66.7 % (66/99, 95 %CI:56.5–75.8 %). Among the paired samples, we observed pathogenic and likely pathogenic variants in 14.3 % (2/14, 95 %CI:1.78–42.8) of the vaginal samples, 77.8 % (7/9, 95 %CI:40.0–97.2) of the endometrial aspirates, and 69.2 % (9/13, 95 %CI:39.6–90.9) of the tumor samples. In the age- and stage-adjusted survival models, women with variants detected in Pap smear samples had poorer overall survival than those without variants (hazard ratio -HR-=4.27, 95 %CI:1.06–17.23; P = 0.041). Conclusions: DNA somatic variants in cervicovaginal samples have limited diagnostic value for detecting ovarian cancer. However, their presence may have prognostic significance, warranting further investigation. Future research could explore multimodal strategies that integrate molecular markers with imaging or other approaches to improve early detection.
- ArticleUn asunto nada menor: análisis sistemático de la responsabilidad penal de las personas jurídicas ante las Audiencias Provinciales(UNED, 2025-07-01) Martín Muñoz, Jesús; Turienzo Fernández, Alejandro; Ortiz de Urbina Gimeno, ÍñigoEl trabajo presenta los resultados de un análisis cuantitativo de una muestra de 78 sentencias de las Audiencias Provinciales, dictadas en primera instancia y en apelación, en casos en los que hubo, al menos, una persona jurídica acusada. El objetivo del estudio es mostrar cómo estos órganos se han manejado con el sistema de responsabilidad penal de las personas jurídicas consagrado en los arts. 31 bis y ss. del Código Penal español. Para ello, se han estudiado diversas variables, como el número de personas jurídicas acusadas, condenadas y absueltas; los delitos por los que se siguieron los procesos; las penas a las que, en su caso, fueron condenadas, la responsabilidad civil exigida y la duración de cada proceso.
- ArticleCross-fertilization of knowledge and technologies in collaborative research projects(Emerald Publishing, 2021-03-22) González-Piñero, Manel; Páez Avilés, Cristina; Juanola, Esteve; Samitier i Martí, JosepThis paper aims to explore how the cross-fertilization of knowledge and technologies in EU-funded research projects, including serious games and gamification, is influenced by the following variables: multidisciplinarity, knowledge base and organizations (number and diversity). The interrelation of actors and projects form a network of innovation. The largest contribution to cross-fertilization comes from the multidisciplinary nature of projects and the previous knowledge and technology of actors. The analysis draws on the understanding of how consortia perform as an innovation network, what their outcomes are and what capabilities are needed to reap value.