The Marqués de Valdecilla University Hospital, mainly known as Valdecilla, is a general hospital located in the city of Santander, Cantabria, in Spain.
This review analyzes strategies to prevent or reduce the transmission of diseases caused by pathogenic variants in mitochondrial DNA (mtDNA). Among these, we will focus on prenatal screening, preimplantation genetic testing, gene-editing techniques, other molecular tools, and selected heterologous mitochondrial replacement techniques (MRTs), explaining their status and the uncertainties surrounding their clinical application. After this analysis and review, we recognise the limitations of the efficacy of prenatal and preimplantation genetic testing for mitochondrial DNA pathogenic variants, the legal constraints on gene editing, and the status of mitochondrial replacement techniques. MRTs are a safe and possibly more effective alternative for preventing diseases caused by mitochondrial DNA pathogenic variants.
Epithelial ovarian cancer (OC) is the second leading cause of death among gynecologic malignancies and exhibits marked histological and molecular heterogeneity. Advances in tumor biology and targeted therapies have increased the need for accurate biomarker characterization. This updated consensus by the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP) reviews key morphological and molecular features for diagnosis and providing recommendations for biomarker assessment across major OC subtypes. The document addresses classical serum biomarkers, prognostic tools, and genomic alterations with therapeutic implications, including homologous recombination deficiency (HRD), BRCA1 and BRCA2 mutations, mismatch repair status, as well as other established and emerging biomarkers. Emphasis is placed on optimal sample selection, validated techniques, and multidisciplinary integration is required to ensure diagnostic quality. These recommendations aim to optimize prognostic stratification and guide personalized treatment strategies, ultimately improving clinical outcomes in ovarian cancer.
Robot-assisted spine surgery (RASS) enhances procedural accuracy and reproducibility by ensuring full adherence to preoperative surgical plans. However, its widespread adoption remains limited by the need for a substantial upfront investment. In this study, the economic impact of spinal procedures performed under the guidance of the Mazor™ robotic system was compared with that of conventional techniques from an advanced Spanish hospital perspective. A 10-year budget impact analysis was conducted. The target population included all spinal surgeries potentially suitable for robot assistance, estimated from published data and expert input. Two scenarios were compared: a baseline scenario without Mazor™ and a progressive Mazor™ adoption scenario. Unit costs (€, 2025), obtained from Spanish sources, were applied to components of health care resource consumption. Model inputs and assumptions were validated by a panel of Spanish experts. A deterministic one-way sensitivity analysis (OWSA) was performed to assess the robustness of the results. The number of RASS-eligible patients increased from 213 to 330 annually over 10 years (2,673 total). The mean cost per patient was €10,093 for conventional surgery and €9,082 for RASS, generating average savings of €1,011 per patient. Savings were driven mainly by reductions in the length of hospital stay (€1,523), revision surgeries (€793), and complications (€261), outweighing the Mazor™ acquisition cost. Over the 10-year horizon, cumulative savings reached €2.54 million, achieving full capital investment recovery within 3.83 years. OWSA confirmed the robustness of these findings. From an advanced Spanish hospital perspective, the initial investment in RASS is recouped within four years, supporting its financial sustainability and long-term economic advantage over conventional spinal surgery.
Epidemiological data from Sapin are lacking, especially in a publication relating Spanish data and prevalence of programmed cell death ligand-1 (PD-L1) expression. This study aimed to evaluate the prevalence of PD-L1 expression by Combined Positive Score (CPS) ≥ 5 in patients with advanced esophagogastric adenocarcinoma (aEGAC) in Spain. This observational, retrospective, and multicenter study collected sociodemographic and clinical data from adult patients with locally advanced unresectable, recurrent, or metastatic EGAC across 21 centers in the AGAMENON-SEOM registry. CPS PD-L1 expression was centrally analyzed using the IHC 28–8 pharmDx. A total of 166 patients were included, with 144 valid and evaluable samples. The primary tumor locations were stomach (70.1
Atrial fibrillation (AF) is highly prevalent in internal medicine and often requires timely echocardiographic assessment. Limited availability of standard studies may delay management, particularly in acute or resource-limited settings. We conducted a multicenter, cross-sectional study across 35 Spanish hospitals, enrolling adults with new-onset or chronic AF without echocardiography in the previous 12 months, comparing internist-performed point-of-care ultrasound (POCUS) with blinded cardiologist-performed transthoracic or transesophageal echocardiography (TTE/TEE) as the reference standard. The primary outcome was diagnostic accuracy for structural abnormalities. Secondary outcomes included comparison with auscultation and the clinical impact of POCUS findings. Among 441 patients (mean age 80.4 ± 9.9 years; 51
