'Does it matter how old I feel?' The role of subjective age in a psychosocial intervention for improving depressive symptomatology among older adults in Brazil (PROACTIVE).

OBJECTIVES: Depression is a prevalent mental health condition that also often affects older adults. The PROACTIVE psychosocial intervention was developed to reduce depressive symptomatology among older adults within primary care settings in Brazil. An important psychological marker that affects individuals' aging experience relates to how old people feel. Known as subjective age, this marker has been shown to be a risk factor for experiencing greater depressive symptoms if individuals report feeling older than their (chronological) age. In this study, we perform secondary analyses of the PROACTIVE cluster-randomized controlled trial to examine the role of subjective age. METHOD: The sample included 715 Brazilian older adults (74% female, Mage 68.6, SD = 6.9, age range: 60-94 years) randomized to intervention (n = 360, 74% female, Mage 68.4, SD = 6.6, age range: 60-89 years) or control (n = 355, 74% female, Mage 68.9, SD = 7.2, age range: 60-94 years) arms. Here our primary outcome was depressive symptoms at the 8-month follow-up assessed with the 9-item Patient Health Questionnaire (PHQ-9) as a continuous variable. Our previous analyses demonstrated improved recovery from depression at follow-up in the intervention compared with the control arm. RESULTS: Relevant main effects and interactions in regression models for PHQ-9 presented here found that those reporting older subjective age had worse depressive symptoms at follow-up but that they benefitted more from the intervention when initial levels of depression were high. For participants who reported younger subjective ages the intervention showed positive effects that were independent of initial levels of depression. CONCLUSION: Our findings emphasize the importance of investigating possible underlying mechanisms that can help clarify the impact of mental health interventions.

Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study.

BACKGROUND: Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE: To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS: Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS: Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS: In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.

Selective Engagement in Preparations for Aging.

OBJECTIVES: Preparing for old age is an adaptive behavior with positive consequences on well-being. This study examined; (a) the degree to which the importance associated with positive outcomes within specific domains of everyday functioning (e.g., social relationships, health) varies across ages and cultures; (b) the impact of importance on preparing for old age; and (c) whether the effects of importance were greater in later life. METHODS: Using data from adults aged 30-85 years in Germany (n = 623), Hong Kong (n = 317), and the United States (n = 313) collected over 5 years, we examined variations in importance ratings across age, cultures, and behavioral domains, and the extent to which age and importance predicted preparations. RESULTS: Importance ratings were found to vary with age, time of test, domains, and culture, reflecting the expected contextual effects. Importance also was a positive predictor of preparations, with the strength of prediction being somewhat greater in old age. DISCUSSION: The results provide evidence that the perceived importance of functioning within domains is affected by a number of contextual factors, including the domain of everyday function and culture. Given that importance also predicts preparations, such variation may help explain differences in preparations across contexts. In line with selective engagement theory, some support was also obtained for the prediction that older adults are more selective in engaging resources in support of preparations. Such selectivity can be viewed as an adaptive response to diminishing personal resources in later life.

Age stereotypes: Dimensions, origins, and consequences.

We give an overview of what age stereotypes (AS) are, how they are acquired and change across the lifespan, and how they shape development in old age. AS reflect complex beliefs and expectations that vary on the following dimensions: They differ in content and valence, depending on the life-domain to which they are applied (context), they refer to different age-groups (reference), to older people or to oneself as an old person (direction of relevance), and they either describe how older people are or prescribe how they should be (modality). AS are acquired early, and later taint beliefs about one's own aging (internalization). Once they are part of the self-concept, AS act as self-fulfilling prophecies that shape the actual aging process (stereotype embodiment).

Do we all perceive experiences of age discrimination in the same way? Cross-cultural differences in perceived age discrimination and its association with life satisfaction.

Age discrimination is pervasive in most societies and bears far-reaching consequences for individuals' psychological well-being. Despite that, studies that examine cross-cultural differences in age discrimination are still lacking. Likewise, whether the detrimental association between age discrimination and psychological well-being varies across contexts remains an open question. In this study, therefore, we examined cross-cultural differences in perceived experiences of age discrimination and their detrimental association with a specific indicator of psychological well-being, which is life satisfaction. The sample was drawn from the Ageing as Future study and comprised 1653 older adults (60-90 years) from the Czech Republic, Germany, Hong Kong, Taiwan, and the USA. Participants self-reported their experiences of age discrimination and their life satisfaction. Findings indicated that participants from Hong Kong and Taiwan reported experiences of perceived age discrimination more often than participants from the Czech Republic, Germany, and the USA. Furthermore, experiences of age discrimination were negatively associated with life satisfaction. Cultural context moderated this relation: We found a smaller detrimental association between perceived experiences of age discrimination and life satisfaction in Eastern cultures, that is, in contexts where such experiences were perceived to be more prevalent. These findings highlight the importance of examining age discrimination across cultures. Experiences of age discrimination are clearly undesirable in that they negatively affect psychological well-being. Our results indicate that a higher self-reported prevalence of perceived age discrimination in the samples studied weakens this negative association. We discuss these findings in terms of adaptation (versus sensitization) in response to discrimination.

Willingness to Live Under Impairment: Factors Associated With Desired Longevity.

Background and Objectives: Longevity is a societal achievement. However, people might not wish to live long lives under all conditions. When deciding about their longevity desires, some individuals may focus on present-oriented, concrete aspects of their lives, like their current state of health, whereas others may weigh up more future-oriented, abstract aspects, such as how important it is to be healthy. We investigated what factors are associated with individuals' willingness to live with impairment. Research Design and Methods: Factors associated with willingness to live with impairment were examined in a sample of N = 790 German participants aged 39-90 years (Mage = 63.38, SD = 14.30, 51% female). To examine age-specific factors related to desired longevity under impairment conditions, chronological age was added as a moderator in the analyses. Results: Findings indicated that for middle-aged adults, fear of becoming a burden and higher importance of health were associated with lower willingness to live with impairment. For older adults, lower willingness to live with impairment was associated with higher levels of instrumental preparation for the end of life. Discussion and Implications: The obtained age differences can be understood as reflecting a shift in time perspective and personal experiences. Among middle-aged adults, willingness to live with impairment is more strongly influenced by distant events that pertain to the future (e.g., fear of becoming a burden). Older adults, however, place more importance on their current life situation (e.g., instrumental preparation), and their willingness to live with impairment seems to be more conditional on practical aspects in the present.

Manipulating prescriptive views of active aging and altruistic disengagement.

Older adults are faced with prescriptions to remain fit and socially engaged (active aging) or limit consumption of social resources (altruistic disengagement), and violations of these may result in backlash and marginalization. Despite such negative consequences that prescriptive views of aging (PVoA) may have for older adults, whether PVoA endorsement is modifiable is still to be examined. Thus, in our study, we investigated the malleability of PVoA endorsement. Further, we explored whether malleability of PVoA endorsement generalizes across specific age norms (active aging and altruistic disengagement), life domains (health and social), and targets (others and self). We conducted two preregistered experiments in which participants reflected on agreeing or disagreeing with PVoA. In Experiment 1, 536 adults (50-89 years) reflected on their personal agreement or disagreement with PVoA. In Experiment 2, 435 adults (50-87 years) reflected on agreement with PVoA in society. Reflecting on agreement changed endorsement of PVoA in both experiments: Participants who reflected on agreement reported higher endorsement of PVoA, whereas participants who reflected on disagreement reported lower endorsement. Our results indicated that the cognitive representation of PVoA is norm and domain specific: The endorsement effect did not transfer from active aging to altruistic disengagement (or vice versa) nor across health and social domains. Further, participants set the same prescriptions for their behavior as they set for others as shown by a transfer between endorsement of other- to self-related PVoA. Our findings attest to the complexity and specificity of PVoA and offer important insights for designing interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adjective position in the code-switched speech of Spanish and Papiamento heritage speakers in the Netherlands: Individual differences and methodological considerations.

Introduction: This study examines adjective-noun order in code-switched constructions by heritage speakers of Spanish and Papiamento in the Netherlands. Given that Dutch differs from Spanish and Papiamento regarding the default position of the adjective, word order in the nominal domain creates a so-called "conflict site" in code-switching. Most accounts of word order patterns in code-switching focus on structural constraints, such as the matrix language or the strength of the EPP feature in Agr. Thus far, studies comparing the two models have not found compelling evidence for either of them. Methods: The present study takes a more comprehensive approach and considers several linguistic (matrix language, adjective language, and type of insertion) as well as extra-linguistic variables (e.g., age, age of onset, and patterns of exposure and use). Moreover, we compare heritage speakers of two different heritage languages that are linguistically similar (both Spanish and Papiamento exhibit postnominal adjectives), and share the same dominant societal language, but are likely to differ from each other in terms of certain sociolinguistic properties. 21 Spanish and 15 Papiamento heritage speakers (aged 7-54) in the Netherlands carried out a Director-Matcher task, aimed at eliciting nominal constructions containing switches. Results: The results show that either the ML or the language of the adjective, or both, are important predictors for word order, although the data cannot disentangle these two factors. Moreover, the type of insertion was found to play a role: word order patterns for noun insertions differed from other types of insertions. In addition, the two groups did not behave similarly: Papiamento speakers were more categorical in their preference for noun-adjective order when inserting Dutch nouns into their heritage language than the Spanish speakers were. Finally, there was a great deal of individual variation, which seemed to be related mostly to the age of the participants: children and teen participants behaved differently from adults. Discussion: These findings demonstrate that both linguistic and extra-linguistic play a role in determining how heritage speakers deal with conflict sites in the nominal domain. Particularly, the findings suggest that, at least for some communities and in some code-switching modes, children may need more time, or more input, too converge on adult-like code-switching norms.

Contact With Older Adults Is Related to Positive Age Stereotypes and Self-Views of Aging: The Older You Are the More You Profit.

OBJECTIVES: Past studies showed that intergenerational contact is beneficial in improving attitudes toward older people. To date, however, research on the benefits of contact with older adults focused on younger adults (intergenerational contact), overlooking the effects for older adults (contact with same-age peers). In this study, we investigated the association between contact with older adults and views of the self in old age in a domain-specific way among younger and older adults. METHODS: The sample (n = 2,356) comprised younger (39-55 years) and older (65-90 years) adults who participated in the aging as future study and were from China (Hong Kong and Taiwan), the Czech Republic, Germany, and the United States. We used moderated mediation models for data analysis. RESULTS: Contact with older adults was related to more positive views of the self in old age and this effect was mediated by more positive stereotypes of older people. These relations were stronger for older adults. Beneficial effects of contact with older adults emerged mostly in the domains of friends and leisure, but less in the family domain. DISCUSSION: Having interactions with other older adults may help favorably shape how younger adults and particularly older adults view their own aging, especially in relation to friends and leisure activities. From the perspective of older adults, having regular contacts with other older adults may increase the heterogeneity of exposure to different aging experiences, thus encouraging the formation of more differentiated stereotypes of older people and of their views of themselves in old age.

Defining hereditary alpha-tryptasemia as a risk/modifying factor for anaphylaxis: are we there yet?

Summary: Hereditary α-tryptasemia (HαT) is a common autosomal dominant genetic trait with variable penetrance associated with increased serum baseline tryptase (SBT) levels. Clinical manifestations may range from an absence of symptoms to overtly severe and recurrent anaphylaxis. Symptoms have been claimed to result from excessive activation of EGF-like module-containing mucin-like hormone receptor-like 2 (EMR2) and protease-activated receptor 2 (PAR-2) receptors by α/ß-tryptase heterotetramers. Herein, we aimed to review the evidence on whether HαT can be considered a hereditary risk factor or a modifying factor for anaphylaxis.Increased SBT levels have been linked to an increased risk of anaphylaxis. Likewise, recent studies have shown that HαT might be associated with a higher risk of developing anaphylaxis and more severe anaphylaxis. The same has also been shown for patients with clonal mast cell disorders, in whom the co-existence of HαT might lead to a greater propensity for severe, potentially life-threatening anaphylaxis. However, studies leading to such conclusions are generally limited in sample size, while other studies have shown opposing results. As such, further studies investigating the potential association of HαT with anaphylaxis caused by different triggers, and different severity grades, in both patients with clonal mast cell activation syndromes and the general population are still needed.

What will you do with all that time? Changes in leisure activities after retirement are determined by age-related self-views and preparation.

Retirement is a normative life transition that liberates the individual from the external obligations of employment, being a catalyzer of leisure activity engagement. However, the individual's motivations to engage in leisure activities in the time that is gained after retirement may depend on their future self-views (i.e., views of their own ageing) as well as on their levels of preparation for age-related changes. In this study, therefore, we aim to examine longitudinal changes in levels of engagement in leisure activities that occur around the age of retirement as being influenced by views on ageing and preparation for old age. The sample consisted of 451 persons aged 50-65 years at baseline who participated in the Ageing as Future study at two time points 5 years apart. Participants were split in three age-matched groups: recently retired (in between baseline and follow-up), already retired (at baseline), and individuals who were still working (at follow-up). Findings indicated that changes in levels of leisure differed between groups. Compared to both already retired and still working participants, recently retired participants increased their levels of engagement in leisure activities. Positive views on ageing in the leisure domain (at baseline) predicted subsequent increases in activity levels but group and levels of preparation qualified this effect. A combination of positive views on ageing and preparation for age-related changes is needed for one to make use of the time that is gained with retirement, highlighting their role as determinants of behavior in response to normative life events in later life.

Selection of patients for percutaneous closure in nonlacunar cryptogenic stroke associated with patent foramen ovale. Data from the NORDICTUS cooperative registry.

INTRODUCTION: There is an extending use of percutaneous closure of patent foramen ovale (PFO) as therapy for PFO-associated cryptogenic strokes. The aim of our study was to investigate the clinical practice of percutaneous closure of PFO and to analyse the variables for decision-making on the selection of patients for this procedure. METHOD: A prospective observational multicentric survey was conducted using all the cases of cryptogenic stroke/transient ischaemic attack associated with PFO recorded in the NORDICTUS hospital registry during the period 2018-2021. Clinical data, radiological patterns, echocardiogram data and factors related to PFO-associated stroke (thromboembolic disease and paradoxical embolism criteria) were recorded. The indication for closure was analysed according to age (≤/> 60 years) and the characteristics of the PFO. RESULTS: In the group ≤ 60 years (n = 488), 143 patients (29.3%) underwent PFO closure. The most influential variables for this therapy were detection of a high-risk PFO (OR 4.11; IC 2.6-6.5, P < .001), criteria for paradoxical embolism (OR 2.61; IC 1.28-5.28; P = .008) and previous use of antithrombotics (OR 2.67; IC 1.38-5.18; P = .009). In the > 60 years group (n = 124), 24 patients had PFO closure (19%). The variables related to this option were history of pulmonary thromboembolism, predisposition to thromboembolic disease, paradoxical embolism criteria, and high-risk PFO. CONCLUSIONS: The detection of a high-risk PFO (large shunt, shunt with associated aneurysm) is the main criterion for a percutaneous closure-based therapy. Other conditions to consider in the eligibility of patients are the history of thromboembolic disease, paradoxical embolism criteria or the previous use of antithrombotics.

Saccharomyces cerevisiae Diversity in Arbutus unedo L. Fermentations in Association with the Volatile and Sensory Similarities of the Distillates.

The fermentation of Arbutus unedo L. fruit is traditionally carried out in the production of spirits. The present study followed the spontaneous fermentation of A. unedo fruit harvested in October and December 2019 by two producers from the central region of Portugal. The microbiota was studied, and although a great diversity of indigenous yeasts was found, S. cerevisiae isolates could still be grouped into eight clusters, and a good separation between producers was achieved. Based on the results of a multivariate analysis of the physical-chemical and volatile composition of the distillates, a distinction between the distillates from the two producers was determined. Moreover, these findings are corroborated by the similarities in flavor that were found. Along with the variability found in the distillates, S. cerevisiae isolates could be clustered and associated with each producer. On the other hand, the differentiation of the harvesting period was not so clear. The characterization of the indigenous yeasts associated with the fermentation process of Arbutus unedo L. fruit can serve as an important contribution to the preservation of the specific characteristics of its distillates.

Implementation and scalability of a digital intervention to reduce depressive symptoms in people with diabetes, hypertension or both in Brazil and Peru: a qualitative study of health system's stakeholders' perspectives.

Two randomized controlled trials (RCTs) in Brazil and Peru demonstrated the effectiveness of CONEMO, a digital intervention supported by trained nurses or nurse assistants (NAs), to reduce depressive symptoms in people with diabetes and/or hypertension. This paper extends the RCTs findings by reflecting on the conditions needed for its wider implementation in routine care services. A qualitative study using semi-structured interviews and content analysis was conducted with nurses/NAs, clinicians, healthcare administrators, and policymakers. Informants reported that CONEMO would be feasible to implement in their health services, but some conditions could be improved before its scale-up: reducing workloads of healthcare workers; raising mental health awareness among clinicians and administrators; being able to inform, deliver and accompany the intervention; assuring appropriate training and supervision of nurses/NAs; and supporting the use of technology in public health services and by patients, especially older ones. We discuss some suggestions on how to overcome these challenges.

Age Specificity in Explicit and Implicit Endorsement of Prescriptive Age Stereotypes.

In this study, we investigated explicit and implicit endorsement of prescriptive age stereotypes. To achieve that, we captured endorsement of a wide range of prescriptive expectations targeting both younger (younger adults are expected to be ambitious, eager to learn, unconventional, respectful) and older (older adults are expected to stay active, to be generous, dignified, and wise) people. Younger (n = 58, 50% female, M age = 26.07 years, SD = 3.01) and older adults (n = 75, 44% female, M age = 66.69 years, SD = 4.63) participated in the study. We assessed implicit endorsement of prescriptive age stereotypes with the Propositional Evaluation Paradigm (PEP) and used a direct measure to assess explicit endorsement. In general, we found strong support for age-specificity in both explicit and implicit endorsement of prescriptive age stereotypes: Sentences ascribing expectations for young/old to the respective age group (e.g., "young should be ambitious"; "old should be wise") were endorsed much more strongly than sentences in which expectations for young/old were ascribed to the other age group (e.g., "old should be ambitious"; "young should be wise"). Age group differences in the endorsement of prescriptive age stereotypes were found. Compared to younger participants, older participants showed stronger endorsement for prescriptive beliefs targeting both younger and older targets. Explicit and implicit endorsement of prescriptive age stereotypes did not correlate with one another, thus revealing they might assess independent belief systems with different predictive potential.

Antecedents and Consequences of Endorsing Prescriptive Views of Active Aging and Altruistic Disengagement.

In this study, we investigated endorsement of two types of prescriptive views of aging, namely active aging (e.g., prescriptions for older adults to stay fit and healthy and to maintain an active and productive lifestyle) and altruistic disengagement (e.g., prescriptions for older adults to behave altruistically toward the younger generation by granting young people access to positions and resources). The study comprised a large international sample of middle-aged and older adults (N = 2,900), covering the age range from 40 to 90 years. Participants rated their personal endorsement of prescriptive views of active aging and altruistic disengagement targeting older adults in general (i.e., "In my personal opinion, older adults should…"). Findings showed that endorsement was higher for prescriptions for active aging than for prescriptions for altruistic disengagement. Age groups in the sample differed regarding their endorsement of both prescriptive views of active aging and altruistic disengagement with older adults showing higher endorsement than middle-aged adults did. Prescriptive views of active aging and altruistic disengagement related positively to each other and to the superordinate social belief that older adults should not become a burden, which attests to their functional similarity. In contrast, prescriptive views of active aging and altruistic disengagement were associated with psychological adjustment in opposite ways, with endorsement of active aging (vs. altruistic disengagement) being related to better (vs. worse) adjustment outcomes such as life satisfaction and subjective health. Our findings highlight the internalization of prescriptive views of aging in older people and their implications for their development and well-being.

Growth and survival of the native oyster Crassostrea gasar cultured under different stocking densities in two grow-out systems in tropical climate / [Crescimento e sobrevivência da ostra nativa Crassostrea gasar cultivada em diferentes densidades em dois sistemas em clima tropical]

Survival and growth of the native oyster Crassostrea gasar along the juvenile and adult phases were evaluated in three different stocking densities [low (D), medium (2D) and high (3D)] and in two grow-out systems (fixed and floating system). The fixed system consisted of a rack made with PVC, fixed from the bottom with wood sticks. The floating system consisted of floating bags suspended by a rack made with PVC and maintained submerged from the seawater surface by eight floats. Survival and shell height of oysters cultured after 30, 60 and 90 days were registered in each phase and in each grow-out system. Results showed that the grow-out system did not affect survival and growth of C. gasar in the juvenile and adult phases. The tested densities affected the survival of oysters cultured over time in both phases but did not affect oyster growth. At times analyzed, it was observed positive growth in juvenile oysters grow after 90 days of culture. However, in the adult phase, no growth was observed after 90 days of culture. Oyster yield was higher in the density 3D, in both juvenile and adult phases. These findings contributed to the development of the oyster C. gasar culture.(AU)

A sobrevivência e o crescimento da ostra nativa Crassostrea gasar nas fases juvenil e adulta foram avaliados sob três diferentes densidades de estocagem [baixa (D), média (2D) e alta (3D)] e dois sistemas de engorda (fixo e flutuante). O sistema fixo consistiu em uma mesa de PVC, fixada na parte inferior com varas de madeira. O sistema flutuante consistiu em travesseiros flutuantes suspensos por uma mesa de PVC e mantidas submersas da superfície da água do mar por oito flutuadores. Registraram-se sobrevivência e altura da concha de ostras cultivadas após 30, 60 e 90 dias, em cada fase (juvenil e adulta) e em cada sistema (fixo e flutuante). Os resultados mostraram que o sistema de engorda não afetou a sobrevivência e o crescimento de C. gasar nas fases juvenil e adulta. As densidades testadas afetaram a sobrevivência das ostras ao longo do tempo, em ambas as fases, mas não afetaram o crescimento em altura. Nos tempos analisados, ostras juvenis apresentaram crescimento após 90 dias de cultivo. Porém, na fase adulta, não foi observado crescimento após 90 dias de cultivo. A produção de ostras, foi maior na densidade 3D, nas fases juvenil e adulta. Os presentes achados contribuíram para o desenvolvimento do cultivo da ostra C. gasar.(AU)

Clinical Characteristics, Treatment and Evolution of Splenic and Nodal Marginal Zone Lymphomas-Retrospective and Multicentric Analysis of Portuguese Centers.

INTRODUCTION: Treatment of Splenic (SMZL) and Nodal (NMZL) Marginal Zone Lymphoma is not consensual. Histologic transformation (HT) to aggressive lymphoma is a poorly understood event, with an unfavorable outcome. OBJECTIVES: Describe the clinical characteristics, treatment, outcomes and incidence of HT. METHODS: Characteristics of patients with SMZL and NMZL consecutively diagnosed in 8 Portuguese centers were retrospectively reviewed. Endpoints were overall survival (OS), time to first systemic treatment (TTFST), frequency of HT and time to transformation (TTT). RESULTS: This study included 122 SMZL and 68 NMZL, most of them received systemic treatment: 55.4% and 76.5%, respectively. Splenectomy was performed in 58.7% of patients with SMZL. Different treatment protocols were used. OS or TTFST did not differ significantly according to treatments. Given the small sample size, no conclusion can be made concerning the role of Rituximab in the treatment of NMZL and SMZL based in these results. HT was documented in 18 patients, mainly in SMZL, with a cumulative incidence at 5 years of 4.2%. We confirmed that age is a prognostic factor. CONCLUSION: Randomized prospective trials are needed to standardize treatment in MZL. Patients with HT did appear to have shorter OS in comparison with those who did not experience HT (OS 5 years of 68.4% vs. 80.4%), but the number of HT was too small to reach statistical significance.