02.02. Área de Salud II Cartagena

Systemic Inflammation Aggravates Retinal Ganglion Cell Vulnerability to Optic Nerve Trauma in Adult Rats.

2026-02-03T00:00:00Z

Systemic Inflammation Aggravates Retinal Ganglion Cell Vulnerability to Optic Nerve Trauma in Adult Rats. Rovere, Giuseppe; Caja-Matas, Yolanda; Vidal-Villegas, Beatriz; Bernal-Garro, José-Manuel; Sobrado-Calvo, Paloma; Salinas-Navarro, Manuel; Nucci, Carlo; Villegas-Pérez, María-Paz; Vidal-Sanz, Manuel; Agudo-Barriuso, Marta; Nadal-Nicolás, Francisco-M Systemic inflammation is increasingly recognized as a modifier of neurodegenerative outcomes in the central nervous system; however, its impact on retinal ganglion cell (RGC) survival and retinal microglial responses following optic nerve (ON) injury in vivo remains incompletely understood. In this study, we investigated how systemic lipopolysaccharide (LPS)-induced inflammation influences retinal microglial activation and RGC vulnerability under physiological conditions and after traumatic ON damage. In adult female rats, systemic LPS administration by intraperitoneal injection induced rapid and robust microglial activation, characterized by process retraction and soma hypertrophy within hours and promoting microglial proliferation at later stages but without causing RGC loss in intact retinas. Following ON crush, systemic inflammation did not affect early RGC degeneration but significantly exacerbated neuronal loss during the late acute phase. This increased vulnerability was accompanied by a marked rise in microglial density and a pronounced redistribution of microglia toward the central retina and the ON head, a region of heightened anatomical and metabolic susceptibility. Together, these findings demonstrate that, in rats, systemic inflammation alone is insufficient to induce RGC degeneration but acts as a potent priming factor that amplifies neurodegeneration in the context of axonal injury. The temporal and spatial specificity of microglial responses underscores their context-dependent role in retinal pathology and identifies systemic inflammatory status as a critical determinant of retinal outcome after trauma. Targeted, time-dependent modulation of microglial activation may therefore represent a promising therapeutic strategy for optic neuropathies.

GPT-4o and OpenAI o1 Performance on the 2024 Spanish Competitive Medical Specialty Access Examination: Cross-Sectional Quantitative Evaluation Study

2026-01-12T00:00:00Z

GPT-4o and OpenAI o1 Performance on the 2024 Spanish Competitive Medical Specialty Access Examination: Cross-Sectional Quantitative Evaluation Study Benito, Pau; Isla-Jover, Mikel; González-Castro, Pablo; Fernández-Esparcia, Pedro-José; Carpio-Salmerón, Manuel; Blay-Simón, Iván; Gutiérrez-Bedia, Pablo; Lapastora, María-J; Carratalá, Beatriz; Carazo-Casas, Carlos BACKGROUND: In recent years, generative artificial intelligence and large language models (LLMs) have rapidly advanced, offering significant potential to transform medical education. Several studies have evaluated the performance of chatbots on multiple-choice medical examinations. OBJECTIVE: The study aims to assess the performance of two LLMs-GPT-4o and OpenAI o1-on the Médico Interno Residente (MIR) 2024 examination, the Spanish national medical test that determines eligibility for competitive medical specialist training positions. METHODS: A total of 176 questions from the MIR 2024 examination were analyzed. Each question was presented individually to the chatbots to ensure independence and prevent memory retention bias. No additional prompts were introduced to minimize potential bias. For each LLM, response consistency under verification prompting was assessed by systematically asking, "Are you sure?" after each response. Accuracy was defined as the percentage of correct responses compared to the official answers provided by the Spanish Ministry of Health. It was assessed for GPT-4o, OpenAI o1, and, as a benchmark, for a consensus of medical specialists and for the average MIR candidate. Subanalyses included performance across different medical subjects, question difficulty (quintiles based on the percentage of examinees correctly answering each question), and question types (clinical cases vs theoretical questions; positive vs negative questions). RESULTS: Overall accuracy was 89.8% (158/176) for GPT-4o and 90% (160/176) after verification prompting, 92.6% (163/176) for OpenAI o1 and 93.2% (164/176) after verification prompting, 94.3% (166/176) for the consensus of medical specialists, and 56.6% (100/176) for the average MIR candidate. Both LLMs and the consensus of medical specialists outperformed the average MIR candidate across all 20 medical subjects analyzed, with ?80% LLMs' accuracy in most domains. A performance gradient was observed: LLMs' accuracy gradually declined as question difficulty increased. Slightly higher accuracy was observed for clinical cases compared to theoretical questions, as well as for positive questions compared to negative ones. Both models demonstrated high response consistency, with near-perfect agreement between initial responses and those after the verification prompting. CONCLUSIONS: These findings highlight the excellent performance of GPT-4o and OpenAI o1 on the MIR 2024 examination, demonstrating consistent accuracy across medical subjects and question types. The integration of LLMs into medical education presents promising opportunities and is likely to reshape how students prepare for licensing examinations and change our understanding of medical education. Further research should explore how the wording, language, prompting techniques, and image-based questions can influence LLMs' accuracy, as well as evaluate the performance of emerging artificial intelligence models in similar assessments.

Quizartinib for Newly Diagnosed FLT3-Internal Tandem Duplication-Negative AML: The Randomized, Double-Blind, Placebo-Controlled, Phase II QUIWI Study

2026-01-01T00:00:00Z

Quizartinib for Newly Diagnosed FLT3-Internal Tandem Duplication-Negative AML: The Randomized, Double-Blind, Placebo-Controlled, Phase II QUIWI Study Montesinos, Pau; Rodríguez-Veiga, Rebeca; Bergua, Juan-Miguel; Algarra-Algarra, Jesús-Lorenzo; Botella, Carmen; Rodríguez-Arboli, Eduardo; Bernal, Teresa; Tormo, Mar; Calbacho, María; Salamero, Olga; Serrano, Josefina; Noriega, Victor; López-López, Juan-Antonio; Vives, Susana; López-Lorenzo, José-Luis; Colorado, Mercedes; Vidriales, María-Belén; García-Boyero, Raimundo; Olave, María-Teresa; Herrera-Puente, Pilar; Arce, Olga; Barrios, Manuel; José-Sayas, María; Polo, Marta; Gómez-Roncero, María-Isabel; Barragan, Eva; Ayala, Rosa; Chillon, Carmen; Calasanz, María-José; Paiva, Bruno; Boluda, Blanca; Casas-Aviles, Ignacio; Lloret-Madrid, Pilar; Sánchez, María-José; Rodríguez-Medina, Carlos; Cuevas, Laida; Raposo-Puglia, José-Ángel; Mateos, M-Carmen; Olivares, Matxalen; Martínez-Chamorro, Carmen; Alonso, Natalia; Suarez, Sandra; Sánchez-Vadillo, Irene; Sole-Rodríguez, María; González, Bernardo-Javier; Martínez-Francés, Antonio; Cuello, Rebeca; Fernández, Alfonso; Martínez-Cuadron, David; Labrador, Jorge PURPOSE Quizartinib, an oral, selective, second-generation, type-II FMS-like tyrosine kinase 3 (FLT3) inhibitor with high binding affinity to internal tandem duplication (ITD) and wild-type (WT) FLT3, has shown early clinical activity as monotherapy in patients with relapsed/refractory FLT3-ITD-negative AML. The phase III QuANTUM-First trial showed that quizartinib significantly prolonged survival versus placebo when added to standard chemotherapy, followed by single-agent maintenance, in patients with newly diagnosed (ND) FLT3-ITD-positive AML. We investigated the safety and efficacy of quizartinib in patients with ND FLT3-ITD-negative AML. METHODS The phase II, randomized, double-blind, placebo-controlled QUIWI trial enrolled patients age 18-70 years with ND FLT3-ITD-negative (mutant-to-WT allelic ratio <0.03) AML. Patients were randomly assigned 2:1 to receive standard induction and consolidation chemotherapy combined with either quizartinib 60 mg once daily or placebo, followed by single-agent maintenance with quizartinib or placebo. The primary end point was event-free survival (EFS). Secondary end points included overall survival (OS) and safety. RESULTS Overall, 273 patients were randomly assigned to quizartinib (n = 180) or placebo (n = 93). At data cutoff, median EFS was 20.4 months and 9.9 months in the quizartinib and placebo arms, respectively (P = .046). Median OS was not reached and 29.3 months in the quizartinib and placebo arms, respectively (P = .012); 3-year OS rates were 60.8% and 45.7%. The most frequently reported adverse events (any grade) were fever, rash, diarrhea, and mucositis. CONCLUSION The addition of quizartinib to standard chemotherapy was associated with significantly longer EFS and OS than placebo in patients with ND FLT3-ITD-negative AML.

Adolescents' experience of living with X-linked hypophosphataemia (XLH): a mixed-methods analysis of those who continued and discontinued burosumab treatment after end of skeletal growth

2026-02-03T00:00:00Z

Adolescents' experience of living with X-linked hypophosphataemia (XLH): a mixed-methods analysis of those who continued and discontinued burosumab treatment after end of skeletal growth Saraff, Vrinda; Arango-Sancho, Pedro; Bacchetta, Justine; Boot, Annemieke-M; Burren, Christine-P; Chinoy, Amish; Dharmaraj, Poonam; Gómez-Llorente, María-Amelia; González-Rodríguez, Juan-David; Gueorguieva, Iva; Hayes, Wesley; Schnabel, Dirk; Duro, Héctor-Ríos; Davies, Elin-Haf; Komarzynski, Sandra; Rylands, Ángela-J; Sandilands, Kerry; Ishii, Haruka; Williams, Ángela; Selveindran, Santhani; Barlassina, Adele; Bowden, Annabel; Linglart, Agnès