Artículos (Instituto de Biomedicina de Sevilla (IBIS))

URI permanente para esta colecciónhttps://hdl.handle.net/11441/11095

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The burden of X-linked retinitis pigmentosa (XLRP) on patient experience and patient-reported outcomes (PROs): findings from the EXPLORE XLRP-2 study
(Springer Nature, 2025-01-07) Parmeggiani, Francesco; Weber, Michel; Bremond-Gignac, Dominique; Daly, Avril; Denee, Tom; Lahaye, Marjolein; Rodríguez de la Rúa Franch, Enrique; Pungor, Katalin; Cirugía
Background/aims: X-linked retinitis pigmentosa (XLRP) is considered one of the most severe forms of retinitis pigmentosa (RP), accounting for 5–15% of all RP cases and primarily affecting males. However, the real-world humanistic impacts of this disease on patients are poorly investigated, especially with respect to burdens faced by patients with varying disease severities. Methods: EXPLORE XLRP-2 was an exploratory, multicentre, non-interventional study. A retrospective chart review was conducted to collect clinical/demographic data, including XLRP clinical stage (mild, moderate or severe). Cross-sectional surveys were used to gather experiences directly from patients by validated and modified patient-reported outcomes. Results: 176 patients with XLRP caused by retinitis pigmentosa GTPase regulator (RPGR) gene mutation were enrolled, of whom 169 were included in analyses. 81% of patients were male, mean (SD) age was 39.3 (17.61) years, and 20 adolescents were included. Mean age (SD) at genetic confirmation was 33.4 years (17.98), and the mean duration (SD) from initial symptoms to genetic diagnosis was 16.4 (15.66) years. Compared with patients with mild disease, patients with severe XLRP are more likely to experience difficulties with functioning in low luminance, depression, unemployment, productivity issues, mobility and daily activities. Conclusion: This is the first real-world study to collect data directly from patients on the burden of XLRP and to correlate that burden with disease stage. As a result, several areas of significant burden, especially for patients with severe disease, have been identified that should provide focus for future public policies and therapeutic prospects.
The Spanish Polygenic Score reference distribution: a resource for personalized medicine
(Springer Nature, 2025-04-24) Carmona, Rosario; Roldán, Gema; Fernández Rueda, José L.; Navarro, Arcadi; Peña Chilet, María; Dopazo, Joaquín; López López, Daniel; CSVS Crowdsourcing Group; Borrego, Salud; Antiñolo Gil, Guillermo; Cirugía; Junta de Andalucía; European Commission. Fondo Social Europeo (FSO); Gobierno de España; Instituto de Salud Carlos III; European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER)
Here we present the Polygenic Score (PGS) distributions for 3124 common diseases and quantitative traits observed in the Spanish population. To achieve so, the genomes and exomes of 2190 unrelated individuals of Spanish ancestry were used. The analysis covered a wide range of diseases and traits, including both complex disorders, such as various types of cancer, and disorders associated with the digestive, cardiovascular, neuronal, and immune systems, as well as quantitative traits like hematological and anthropometric measurements. The resulting PGS distributions provide valuable insights into the genetic architecture of the Spanish population, offering a comprehensive framework for investigating disease susceptibility and potential risk factors in this specific population. The study has also explored potential relationships between diseases and traits based on PGS pairwise correlations, revealing significant correlations that warrant further investigation. These findings have contributed to increase our understanding of the genetic basis of human traits and have implications for personalized medicine and public health interventions in the Spanish population. In addition, for the sake of reproducibility, we provide a data processing pipeline, enabling the computation of PGS for external genomes and exomes. The pipeline, accessible on GitHub, supports parallel tasks on various computing platforms and contributes to the standardization of PGS comparisons globally. Lastly, a user-friendly web interface facilitates the exploration of PGS reference distributions, featuring a detailed table, distribution plots, and filtering options. This interface enhances accessibility for researchers and clinicians, fostering informed decision-making based on population-specific PGS distributions.
Tissue eosinophil level as a predictor of control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps
(Frontiers Media, 2025-04-25) Vizcarra Melgar, Julissa A.; Sánchez Gómez, Serafín; López González, Nuria; Moreno Luna, Ramón; González García, Jaime; Maza Solano, Juan Manuel; Cirugía
Introduction: The histopathologic study of nasal polyps establishes endotype features of chronic rhinosinusitis (CRS). A tissular eosinophil count greater than 10 per high power field (HPF) classifies this condition as type 2 inflammation. Blood and mucosal eosinophils are suggested as biomarkers of severity and control of CRS. Additionally, a tissular eosinophil count greater than 55 per HPF has been related to a high risk of recurrence in the Asian population. Our study aims to determine whether tissue eosinophil count is associated with the control, severity, and recurrence of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Methods: An observational study of patients with CRSwNP who underwent nasal mucosa biopsy was conducted between June 2021 and November 2023. Histopathologic features, asthma control, CRSwNP control and severity according to the POLINA consensus, quality of life parameters, recurrence of CRSwNP, and laboratory markers were recorded and compared with the tissular eosinophil count. Results: A total of 108 cases were included. The majority (70.4%) had concomitant asthma, with 31.5% of the cases having well-controlled disease. Most patients had uncontrolled (57.4%) and severe (62%) CRSwNP. Fifty-four cases underwent surgery and 43.5% experienced recurrence. More than half had a SNOT-22 score greater than 50 points. Eighty-one percent of patients had a tissular eosinophil count greater than 10 per HPF, and 60.2% had blood eosinophilia greater than 0.3×103. Blood eosinophilia was related to CRSwNP severity and control. No significant differences were found between tissue eosinophil count and the severity, control, and recurrence of CRSwNP. Conclusion: Tissue eosinophil levels were not a marker of control, severity, and recurrence of CRSwNP in our data. Blood eosinophil levels, however, were a marker of CRSwNP control and severity.
VEGF in Tears as a Biomarker for Exudative Age-Related Macular Degeneration: Molecular Dynamics in a Mouse Model and Human Samples
(MDPI, 2025-04-18) Moshtaghion, Seyed Mohamadmehdi; Locri, Filippo; Plaza Reyes, Álvaro; Plastino, Flavia; Kvanta, Anders; Morillo Sánchez, María José; Rodríguez de la Rúa Franch, Enrique; Gutiérrez Sánchez, Estanislao; Montero Sánchez, Adoración; Lucena Padrós, Helena; André, Helder; Díaz Corrales, Francisco Javier; Cirugía; European Union; European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER); Instituto de Salud Carlos III
Vascular endothelial growth factor (VEGF) is a key mediator of exudative age-related macular degeneration (eAMD), yet non-invasive biomarkers for disease monitoring remain limited. This study evaluates VEGF levels in human tear fluid as a potential biomarker for eAMD and investigates the molecular dynamics of VEGF in a laser-induced choroidal neovascularization (lCNV) mouse model. Tear VEGF levels were quantified using proximity qPCR immunoassays in eAMD patients (n = 29) and healthy controls (n = 21) and correlated with optical coherence tomography (OCT) findings. Molecular analyses, including immunohistochemistry, gene expression profiling, and phosphorylation assays, were conducted on choroid–retinal pigment epithelium (RPE) and lacrimal gland (LG) tissues from lCNV mice (n = 25). Tear VEGF levels were significantly elevated in eAMD patients, correlating with disease severity. Females exhibited higher VEGF levels, a pattern not replicated in the mouse model. In lCNV mice, VEGF overexpression originated from the choroid–RPE, driven by hypoxic and inflammatory signaling, with no significant LG contribution. Increased VEGF, IL-6, and vimentin expression, along with NF-κB and STAT3 activation, were observed. These findings suggest that tear VEGF is a promising non-invasive biomarker for eAMD, warranting further validation for clinical application in disease monitoring and treatment optimization.
Which risk factors are related to failure to rescue in left pancreatectomy? Mixed cohort study (ERPANDIS and SPANDISPAN projects)
(Elsevier, 2025-07) Ramia, Jose M.; Villodre, Celia; Vicente del Río, Juan; Blanco, Gerardo; Rotellar, Fernando; Sabater, Luis; Gómez Bravo, Miguel Ángel; Artigues, Enrique; Cirugía; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía
The morbidity and mortality rates associated with pancreatic surgery (PS) have improved in recent years. However, despite advancements in surgical techniques and perioperative care, these rates remain high. Morbidity and mortality can result from specific surgical complications related to PS or from severe medical events. (excert)
Bioinformatics Prediction for Network-Based Integrative Multi-Omics Expression Data Analysis in Hirschsprung Disease
(MDPI, 2024-01-27) Lucena Padrós, Helena; Bravo Gil, Nereida; Tous, Cristina; Rojano, Elena; Seoane Zonjic, Pedro; Fernández, Raquel María; Ranea, Juan A.G.; Antiñolo Gil, Guillermo; Borrego, Salud; Cirugía; Instituto de Salud Carlos III; Gobierno de España; Junta de Andalucía; European Union (UE)
Hirschsprung’s disease (HSCR) is a rare developmental disorder in which enteric ganglia are missing along a portion of the intestine. HSCR has a complex inheritance, with RET as the major disease-causing gene. However, the pathogenesis of HSCR is still not completely understood. Therefore, we applied a computational approach based on multi-omics network characterization and clustering analysis for HSCR-related gene/miRNA identification and biomarker discovery. Protein–protein interaction (PPI) and miRNA–target interaction (MTI) networks were analyzed by DPClusO and BiClusO, respectively, and finally, the biomarker potential of miRNAs was computationally screened by miRNA-BD. In this study, a total of 55 significant gene–disease modules were identified, allowing us to propose 178 new HSCR candidate genes and two biological pathways. Moreover, we identified 12 key miRNAs with biomarker potential among 137 predicted HSCR-associated miRNAs. Functional analysis of new candidates showed that enrichment terms related to gene ontology (GO) and pathways were associated with HSCR. In conclusion, this approach has allowed us to decipher new clues of the etiopathogenesis of HSCR, although molecular experiments are further needed for clinical validations.
Case series of secretory carcinoma in the parotid glands
(AME Publishing, 2024-11-26) Wang, Shuqin; Peng, Yixin; Jiang, Cailing; Lin, Zicong; Infante Cossío, Pedro Antonio; Li, Jun; Cirugía; CTS142: Patología Morfolog. y Func. del Territorio Oral y Maxilofacial
Background: Secretory carcinoma (SC) represents a relatively new and less recognized subtype of salivary gland cancer among clinicians. The objective of our study was to shed light on this rare entity by providing an in-depth analysis of the clinical presentation, pathological characteristics, and treatment outcomes of five patients diagnosed with SC. We also sought to contribute to the understanding of the diagnostic criteria and prognostic factors associated with SC. Case Description: The patients, treated at Guangdong Provincial People’s Hospital, were aged between 33 and 40 years, with an average age of 33 years. Notably, none of the patients reported pain or noticed a mass initially; however, the mass became progressively larger over time. Diagnostic imaging, such as magnetic resonance imaging (MRI), led to the classification of four cases as benign and one as a low-grade malignancy. We meticulously documented the diagnostic and treatment journey of these patients, including the clinical data, histopathological findings, and subsequent treatment responses. Conclusions: Our findings suggest that SC is associated with a favorable prognosis. Nevertheless, the clinical presentation of SC lacks distinct features, necessitating a comprehensive approach that includes immunohistochemistry (IHC) and genetic testing for an accurate diagnosis. This study underscores the importance of recognizing SC as a distinct pathological entity to ensure appropriate patient management and improve outcomes.
Closure of the Peritoneum in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair (TAPP) With Cyanoacrylate Glue in a Microdroplet Device: A Single Surgeon Prospective Comparison vs. Barbed Suture
(Frontiers Media, 2024-05-01) Suárez Grau, Juan Manuel; Navarro Morales, Laura; Tallón Aguilar, Luis; Morales Conde, Salvador; Padillo Ruiz, Francisco Javier; Cirugía; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía
Purpose: To describe and compare a peritoneal closure technique using cyanoacrylate glue (Glubran 2®, GEM, Cardiolink SL) with a microdroplet device (Glutack®, GEM, Cardiolink SL) in laparoscopic transabdominal preperitoneal repair (TAPP) of inguinal hernia with the routinely used barbed suture peritoneal closure (V-Lock 3.0, Covidien France). Materials and methods: From January to August 2022, 60 patients undergoing TAPP repair for uni- or bilateral inguinal hernia were randomized into one of two groups. One using as mesh fixation and peritoneal closure the Glutack® device with Glubran 2® cyanoacrylate glue (Glu-close group) and the other using mesh fixation with cyanoacrylate and peritoneal closure with V-lock 3.0 (Sut-close group), with a follow-up of 12 months. Demographic variables, operative time, peritoneal closure time, main surgical findings and main intra- and postoperative complications were analyzed prospectively. Results: 63 patients were included with no losses to follow-up. The mean operative time was 34 min (range 58.25) for the glu-close group and 40 (range 64.25) for the sut-close group, with no conversion (0%) for either group. The mean flap closure time was 1.18 min (SD 24 0.19) for the glu-close group and 3.24 min (SD 0.78) for the sut-close group, with statistically significant differences (p < 0.001). The intraoperative complication rate was 0 for the glu-close group and 0 for the sut-close group, with no significant difference. The median hospital stay was 0.8 days (range, 0–1) for both groups. The median duration of follow-up was 12 months and none had hernia recurrence. The postoperative VAS score at the first and second check-up at 1 month and 3 months was 2.83 (SD 1.341) and 0.60 (SD 0.621) in the sut-close group and 1.03 (0.984) and 0.24 (SD 0.435) in the glue-close group, with significant differences (p < 0.001 and p < 0.012). Conclusion: The data demonstrated by the study are that the glue can be used safely to close the peritoneum and that the method provides a small, statistically significant but not clinically relevant reduction in the time to close the peritoneal flap, as well as in postoperative pain after surgery in short and medium term.
Computational Analysis of Polymeric Biodegradable and Customizable Airway Stent Designs
(MDPI, 2024-06-14) Ayechu Abendaño, Ada; Pérez Jiménez, Aurora; Sánchez Matás, Carmen; López-Villalobos, José Luis; Díaz Jiménez, Cristina; Fernández Parra, Rocío; Malvè, Mauro; Cirugía; European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER); Gobierno de España
The placement of endotracheal prostheses is a procedure used to treat tracheal lesions when no other surgical options are available. Unfortunately, this technique remains controversial. Both silicon and metallic stents are used with unpredictable success rates, as they have advantages but also disadvantages. Typical side effects include restenosis due to epithelial hyperplasia, obstruction and granuloma formation. Repeat interventions are often required. Biodegradable stents are promising in the field of cardiovascular biomechanics but are not yet approved for use in the respiratory system. The aim of the present study is to summarize important information and to evaluate the role of different geometrical features for the fabrication of a new tracheo-bronchial prosthesis prototype, which should be biodegradable, adaptable to the patient’s lesion and producible by 3D printing. A parametric design and subsequent computational analysis using the finite element method is carried out. Two different stent designs are parameterized and analyzed. The biodegradable material chosen for simulations is polylactic acid. Experimental tests are conducted for assessing its mechanical properties. The role of the key design parameters on the radial force of the biodegradable prosthesis is investigated. The computational results allow us to elucidate the role of the pitch angle, the wire thickness and the number of cells or units, among other parameters, on the radial force. This work may be useful for the design of ad hoc airway stents according to the patient and type of lesion.
Consensus review on peri-implant femur fracture treatment: Peri-Implant Spanish Consensus (PISCO) investigators’ recommendations
(BioScientifica, 2024-01-09) Castillón, Pablo; Muñoz Vives, Josep María; Aguado, Hector José; Capel Agundez, Arantxa; Ortega Briones, Alina; Núñez, Jorge Hassan; PISCO Investigators; Giráldez Sánchez, Miguel Ángel; Cirugía
A peri-implant femoral fracture (PIFF) is defined as a femoral fracture in the presence of a pre-existing non-prosthetic implant. Classification systems, treatment guidelines and fixation strategies exist for peri-prosthetic fractures, but there is no standard of care regarding PIFFs. The aim of the Peri-Implant Spanish Consensus (aka PISCO) investigators is to reach an agreement regarding current practices for management of PIFFs and to propose four main principles to assess surgical treatment and prevention of these fractures. This consensus review was conducted according to the Delphi method. Twenty-two expert orthopaedic trauma surgeons performed the consensus and the definitive statements were approved unanimously. Biological fixation principles must be utilized in the surgical treatment of peri-implant femur fractures, which include closed or minimally invasive reduction techniques. The osteosynthesis must protect the entire bone. Gaps between two implants should be avoided. If implant overlap is not possible to achieve, then spanning inter-implant fixation systems must be used, especially in osteoporotic bone. Previous implants should be retained during surgical treatment of peri-implant femur fractures. Only those implants that would interfere with current fixation goals should be removed. If the previous implant is in the femoral neck region, then femoral neck protection must be maintained when treating the peri-implant fracture, even if the neck fracture has already healed.
Recomendaciones conjuntas sobre el manejo del paciente con osteoporosis y/o fracturas por fragilidad durante y después de la pandemia por COVID-19 de la SEIOMM, SEFRAOS, SER, SEMI, SEGG, SEMG, SEMERGEN y SEEN
(Sociedad Española de Investigaciones Óseas y Metabolismo Mineral, 2022-06) Naves Díaz, Manuel; Peris Bernal, Pilar; Montoya García, María José; Casado Burgos, Enrique; Caeiro Rey, José Ramón; Guañabens Gay, Núria; Rozas Moreno, Pedro; Medicina; Instituto de Biomedicina de Sevilla (IBIS); CTS211: Metabolismo Cálcico, Hipertensión y Arteriosclerosis
La pandemia por COVID-19 ha impactado en la asistencia sanitaria de los pacientes con osteoporosis y fracturas por fragilidad. Algunas estrategias dirigidas a la protección contra el contagio del virus, como el distanciamiento social, han provocado unos cambios en los modelos asistenciales que no han sido homogéneos en todas las áreas. La necesidad de limitar el acceso a los centros sanitarios y los contagios ha impuesto la telemedicina. Son muchas las ventajas que puede ofrecer a profesionales y usuarios, convirtiéndose en una herramienta asistencial clave para poder asegurar el distanciamiento social. Asimismo, la consulta telemática puede tener aplicaciones adicionales en la práctica clínica habitual, ya que permite atender a pacientes con problemas de desplazamiento y solucionar de forma eficaz dudas y/o problemas relacionados con el tratamiento, por lo que podría ser especialmente útil para controlar el cumplimiento terapéutico. Sin embargo, para poder avanzar en una atención telemática más efectiva y segura, procurando siempre la mayor agilidad en las respuestas, ésta debería estar protocolizada. A partir de las recomendaciones conjuntas de la American Society for Bone and Mineral Research (ASBMR), American Association of Clinical Endocrinologists (AACE), European Calcified Tissue Society (ECTS) and National Osteoporosis Foundation (NOF), un grupo multidisciplinar de expertos de SEIOMM, junto con los de otras sociedades científicas (SEFRAOS, SER, SEMI, SEGG, SEMG, SEMERGEN y SEEN), ha elaborado este documento con el objetivo de establecer una serie de recomendaciones en el diagnóstico, tratamiento y seguimiento de los pacientes con osteoporosis y/o fractura por fragilidad osteoporótica durante y después de la pandemia por COVID-19 en España.
Correction to: Differential effectiveness of tyrosine kinase inhibitors in 2D/3D culture according to cell differentiation, p53 status and mitochondrial respiration in liver cancer cells
(Springer Nature, 2024-08-20) Rodríguez Hernández, María A.; Chapresto Garzón, Raquel; Cadenas, Miryam; Navarro Villarán, Elena; Negrete, María; Gómez Bravo, Miguel Ángel; Victor, Victor M.; Padillo Ruiz, Francisco Javier; Muntané Relat, Jordi; Cirugía; Biología Celular; Fisiología Médica y Biofísica; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía; CTS1098: Mecanismos Moleculares del Hepatocarcinoma y Sus Estrategias Terapéuticas
In this article, the spheroid image obtained after 15 days of treatment of Hep3B with Cabozantinib was incorrectly duplicated from that obtained after 12 days. The new Fig. 1B shows the correct spheroid image at 15 days. The replacement does not change the results or conclusions of Fig. 1B. The authors apologize for the unexpected error in the preparation of Fig. 1B. (excerpt)
Economic analysis of the robotic approach to inguinal hernia versus laparoscopic: is it sustainable for the healthcare system?
(Springer, 2024-03-20) Hinojosa Ramírez, F.; Tallón Aguilar, Luis; Tinoco González, José; Sánchez Arteaga, A.; Aguilar del Castillo, F.; Alarcón del Agua, Isaías; Morales Conde, Salvador; Cirugía; Universidad de Sevilla
Introduction: There has been a rapid proliferation of the robotic approach to inguinal hernia, mainly in the United States, as it has shown similar outcomes to the laparoscopic approach but with a significant increase in associated costs. Our objective is to conduct a cost analysis in our setting (Spanish National Health System). Materials and methods: A retrospective single-center comparative study on inguinal hernia repair using a robotic approach versus laparoscopic approach. Results: A total of 98 patients who underwent either robotic or laparoscopic TAPP inguinal hernia repair between October 2021 and July 2023 were analyzed. Out of these 98 patients, 20 (20.4%) were treated with the robotic approach, while 78 (79.6%) underwent the laparoscopic approach. When comparing both approaches, no significant differences were found in terms of complications, recurrences, or readmissions. However, the robotic group exhibited a longer surgical time (86 ± 33.07 min vs. 40 ± 14.46 min, p < 0.001), an extended hospital stays (1.6 ± 0.503 days vs. 1.13 ± 0.727 days, p < 0.007), as well as higher procedural costs (2318.63 ± 205.15 € vs. 356.81 ± 110.14 €, p < 0.001) and total hospitalization costs (3272.48 ± 408.49 € vs. 1048.61 ± 460.06 €, p < 0.001). These results were consistent when performing subgroup analysis for unilateral and bilateral hernias. Conclusions: The benefits observed in terms of recurrence rates and post-surgical complications do not justify the additional costs incurred by the robotic approach to inguinal hernia within the national public healthcare system. Nevertheless, it represents a simpler way to initiate the robotic learning curve, justifying its use in a training context.
Effects of the superior mesenteric artery approach versus the no-touch approach during pancreatoduodenectomy on the mobilization of circulating tumour cells and clusters in pancreatic cancer (CETUPANC): randomized clinical trial
(Oxford University Press, 2024-11-01) Padillo Ruiz, Francisco Javier; Fresno, Cristóbal; Suárez Artacho, Gonzalo; Blanco, Gerardo; Muñoz Bellvis, Luis; Justo, Iago; Gómez Bravo, Miguel Ángel; Sabater, Luis; Cirugía; Instituto de Salud Carlos III; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía
Background Patients with pancreatic ductal adenocarcinoma present early postoperative systemic metastases, despite complete oncological resection. The aim of this study was to assess two pancreatoduodenectomy approaches with regard to intraoperative circulating tumour cells and cluster mobilization and their potential association with the development of distant metastasis. Methods Patients with periampullary tumours who underwent open pancreatoduodenectomy were randomly allocated to either the no-touch approach or the superior mesenteric artery approach. A total of four intraoperative portal vein samples (at the beginning of the intervention, after portal vein disconnection from the tumour, after tumour resection, and before abdominal closure) were collected to measure circulating tumour cells and cluster numbers. Primary outcomes were the intraoperative number of circulating tumour cells and cluster mobilization. Further, their potential impact on 3-year distant metastasis disease-free survival and overall survival was assessed. Results A total of 101 patients with periampullary tumours were randomized (51 in the superior mesenteric artery group and 50 in the no-touch group) and 63 patients with pancreatic ductal adenocarcinoma (34 in the superior mesenteric artery group and 29 in the no-touch group) were analysed. Circulating tumour cells and cluster mobilization were similar in both the no-touch group and the superior mesenteric artery group at all time points. There were no significant differences between surgical groups with regard to the median metastasis disease-free survival (12.4 (interquartile range 6.1–not reached) months in the superior mesenteric artery group and 18.1 (interquartile range 12.1–not reached) months in the no-touch group; P = 0.730). Patients with intraoperative cluster mobilization from the beginning to the end of surgery developed significantly more distant metastases within the first year after surgery (P = 0.023). Two intraoperative factors (the superior mesenteric artery approach (P = 0.025) and vein resection (P < 0.001)) were predictive factors for cluster mobilization. Conclusion Patients undergoing pancreatoduodenectomy using either the no-touch approach or the superior mesenteric artery approach had similar circulating tumour cells and cluster mobilization and similar overall survival and metastasis disease-free survival. A high intraoperative cluster dissemination during pancreatoduodenectomy was a predictive factor for early metastases in patients with pancreatic ductal adenocarcinoma.
How Context Shapes Person-Centred Fundamental Care Through Nurse–Patient Relationships: Validation of the FoC Intelligence Modelling Tool and Predictive Pathway Analysis
(John Wiley & Sons Ltd., 2025) Allande Cussó, Regina; Pinero de Plaza, Maria Alejandra; Kitson, Alison; Feo, Rebecca; Conroy, Tiffany; Porcel Gálvez, Ana María; Enfermería; Instituto de Biomedicina de Sevilla (IBIS); CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Background: The Fundamentals of Care (FoC) Framework emphasises that care quality depends not only on clinical tasks but also on interpersonal relationships and the organisational context in which care is delivered. Although patient-reported outcome and experience measures (PROMs and PREMs) have gained relevance in capturing these aspects, tools based on the FoC Framework remain limited in non-English-speaking settings. Objectives: To psychometrically validate the Spanish version of the FoC Intelligence Modelling Tool (FoC-IMT) and explore predictive relationships among the FoC dimensions: Context, Relationship and Integration of Care. Methods: A cross-sectional study was conducted with 1053 hospitalised patients in southern Spain. Exploratory and confirmatory factor analyses (EFA and CFA) were performed, alongside a mediation analysis using partial least squares structural equation modelling (PLS-SEM) to examine directional relationships among constructs. Results: EFA and CFA supported a two-factor model—Context and Integration of Care—with excellent internal consistency (Cronbach's α and McDonald's ω = 0.97). CFA showed a moderate correlation between these factors. However, PLS-SEM mediation analysis revealed a directional model in which Context influences Relationship (β = 0.39), which in turn predicts Integration of Care (β = 0.89). Although embedded within Integration under CFA, the Relationship showed independent predictive power in PLS-SEM, validating its conceptual importance. This aligns with the foundational assumption of the FoC Framework: that caregiving quality is shaped not only by tasks or procedures but by the broader environment and interpersonal relationships in which care occurs. Conclusions: The Spanish FoC-IMT Tool is a valid, reliable instrument for assessing person-centred care. The predictive model highlights the pivotal role of therapeutic relationships in delivering integrated, high-quality care.
Evaluation of the Wisconsin Gait Scale in Patients with Multiple Sclerosis and Spastic Hemiplegia
(International Scientific Information, Inc., 2025) Guzik, Agnieszka; Wolan-Nieroda, Andżelina; Kiper, Pawel; Cieślik, Błażej; Federico, Sara; Luque Moreno, Carlos; Drużbicki, Mariusz; Fisioterapia; Instituto de Biomedicina de Sevilla (IBIS); CTS1137: Neurophysius - Neurological Physiotherapy, Innovative Neurorehabilitation and Neurodevelopmental Disorders
BACKGROUND: Existing clinical tools do not comprehensively assess gait patterns in patients with multiple sclerosis (MS) across all planes or account for spatiotemporal and kinematic parameters. This study investigated the feasibility of the Wisconsin Gait Scale (WGS), originally designed to evaluate hemiparetic gait after stroke, in individuals with the spastic hemiplegic subtype of MS. MATERIAL AND METHODS: The study included 30 patients with the spastic hemiplegic subtype of MS. The WGS-based assessment of participants’ gait was performed twice, by 3 independent raters. The results of the 2 measurements reported by the 3 raters were compared to determine intra-rater and inter-rater reliability. The WGS scores were also compared with results of clinical tools: the 10-Meter Walk Test, the 2-Minute Walk Test, and the Timed Up and Go Test, to determine the concurrent criterion validity of the WGS. RESULTS: A comparison of the scores assigned by the same rater during measurement 1 and measurement 2 showed excellent agreement in each case, with intraclass correlation coefficients (ICCs) equal to or higher than 0.991. Likewise, there was excellent agreement between the scores awarded by the 3 raters, both in measurement 1 and measurement 2, with ICCs of 0.988 and 0.978, respectively. The analyses showed very strong and significant correlations (P<0.001) between the mean scores in the WGS and all the clinical tests applied in this study to assess gait. CONCLUSIONS: The findings show excellent intra-rater and inter-rater reliability and confirm the concurrent criterion validity of the WGS in patients with hemiplegic MS.
Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project)
(MDPI, 2024-04-26) Serradilla Martín, Mario; Villodre, Celia; Falgueras Verdaguer, Laia; Zambudio Carroll, Natalia; Castell Gómez, José Tomás; Blas Laina, Juan Luis; Gómez Bravo, Miguel Ángel; Ramia, José Manuel; Cirugía; Asociación Española de Cirujanos; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía
Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime. Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and ≥50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.
International consensus recommendations on face transplantation: A 2-step Delphi study
(Elsevier, 2023-09-01) Longo, Benedetto; Alberti, Fay Bound; Pomahac, Bohdan; Pribaz, Julian Joseph; Meningaud, Jean Paul; Lengelé, Benoît; Infante Cossío, Pedro Antonio; Cervelli, Valerio; Cirugía; CTS142: Patología Morfolog. y Func. del Territorio Oral y Maxilofacial
Face transplantation is a viable reconstructive approach for severe craniofacial defects. Despite the evolution witnessed in the field, ethical aspects, clinical and psychosocial implications, public perception, and economic sustainability remain the subject of debate and unanswered questions. Furthermore, poor data reporting and sharing, the absence of standardized metrics for outcome evaluation, and the lack of consensus definitions of success and failure have hampered the development of a “transplantation culture” on a global scale. We completed a 2-round online modified Delphi process with 35 international face transplant stakeholders, including surgeons, clinicians, psychologists, psychiatrists, ethicists, policymakers, and researchers, with a representation of 10 of the 19 face transplant teams that had already performed the procedure and 73% of face transplants. Themes addressed included patient assessment and selection, indications, social support networks, clinical framework, surgical considerations, data on patient progress and outcomes, definitions of success and failure, public image and perception, and financial sustainability. The presented recommendations are the product of a shared commitment of face transplant teams to foster the development of face transplantation and are aimed at providing a gold standard of practice and policy.
Long-read sequencing improves the genetic diagnosis of retinitis pigmentosa by identifying an Alu retrotransposon insertion in the EYS gene
(BioMed Central, 2024-05-04) Fernández Suárez, Elena; González del Pozo, María; Méndez Vidal, Cristina; Martín Sánchez, Marta; Mena, Marcela; Morena Barrio, Belén de la; Corral, Javier; Borrego, Salud; Antiñolo Gil, Guillermo; Cirugía; Instituto de Salud Carlos III; Gobierno de España; European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER); Junta de Andalucía; Fundación Isabel Gemio; Fundación Cajasol; CIBERER; MMS
Background: Biallelic variants in EYS are the major cause of autosomal recessive retinitis pigmentosa (arRP) in certain populations, a clinically and genetically heterogeneous disease that may lead to legal blindness. EYS is one of the largest genes (~ 2 Mb) expressed in the retina, in which structural variants (SVs) represent a common cause of disease. However, their identification using short-read sequencing (SRS) is not always feasible. Here, we conducted targeted long-read sequencing (T-LRS) using adaptive sampling of EYS on the MinION sequencing platform (Oxford Nanopore Technologies) to definitively diagnose an arRP family, whose affected individuals (n = 3) carried the heterozygous pathogenic deletion of exons 32–33 in the EYS gene. As this was a recurrent variant identified in three additional families in our cohort, we also aimed to characterize the known deletion at the nucleotide level to assess a possible founder effect. Results: T-LRS in family A unveiled a heterozygous AluYa5 insertion in the coding exon 43 of EYS (chr6(GRCh37):g.64430524_64430525ins352), which segregated with the disease in compound heterozygosity with the previously identified deletion. Visual inspection of previous SRS alignments using IGV revealed several reads containing soft-clipped bases, accompanied by a slight drop in coverage at the Alu insertion site. This prompted us to develop a simplified program using grep command to investigate the recurrence of this variant in our cohort from SRS data. Moreover, LRS also allowed the characterization of the CNV as a ~ 56.4kb deletion spanning exons 32–33 of EYS (chr6(GRCh37):g.64764235_64820592del). The results of further characterization by Sanger sequencing and linkage analysis in the four families were consistent with a founder variant. Conclusions: To our knowledge, this is the first report of a mobile element insertion into the coding sequence of EYS, as a likely cause of arRP in a family. Our study highlights the value of LRS technology in characterizing and identifying hidden pathogenic SVs, such as retrotransposon insertions, whose contribution to the etiopathogenesis of rare diseases may be underestimated.
Long-Term Clinical Outcomes in Patients with Chronic Rhinosinusitis with Nasal Polyps Associated with Expanded Types of Endoscopic Sinus Surgery
(MDPI, 2024-02-01) Martín Jiménez, Daniel; Moreno Luna, Ramón; Callejón Leblic, María Amparo; Cuvillo, Alfonso del; Ebert, Charles S. Jr.; Maza Solano, Juan Manuel; González García, Jaime; Infante Cossío, Pedro Antonio; Sánchez Gómez, Serafín; Cirugía; CTS142: Patología Morfolog. y Func. del Territorio Oral y Maxilofacial
Background: Surgical criteria for chronic rhinosinusitis with nasal polyps (CRSwNP) remain unresolved. This study addresses these discrepancies by comparing the clinical outcomes of expanded–functional endoscopic sinus surgeries (E–FESS) with more-limited FESS (L-FESS). Methods: A database was analyzed retrospectively to compare surgical outcomes in CRSwNP patients who underwent E-FESS versus those subjected to L-FESS. Quality of life, endoscopic and radiological outcomes were compared at the baseline and two years after surgery. The clinical status of the responder was defined when a minimal clinically important difference of 12 points in SNOT-22 change was achieved. Results: A total of 274 patients met the inclusion criteria and were analyzed; 111 underwent E-FESS and 163 were subjected to L-FESS. Both groups exhibited significant clinical improvements, although a greater magnitude of change in SNOT-22 (14.8 ± 4.8, p = 0.002) was shown after E-FESS. Higher significant improvements for endoscopic and radiological scores and lower surgical revision rates were also noted in the E-FESS group. Conclusions: E-FESS provides better clinical outcomes and reduced revision surgery rates when compared to L-FESS in CRSwNP patients two years after surgery, irrespective of any comorbidity. Further randomized prospective studies are needed to comprehensively contrast these results.

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