Artículos (Cirugía)

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Correction: Dasatinib, a Src inhibitor, sensitizes liver metastatic colorectal carcinoma to oxaliplatin in tumors with high levels of phospho-Src
(Impact Journals, 2016) Perez, Marco; Lucena Cacace, Antonio; Marín Gómez, Luis Miguel; Padillo Ruiz, Francisco Javier; Robles Frias, MJ; Saez, Carmen; García Carbonero, Rocío; Carnero Moya, Amancio; Cirugía; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía
Correct: The correct numbers are provided below. The authors sincerely apologize for this oversight
Técnica de artrodesis subastragalina mediante cirugía de mínima incisión
(Imaidea Interactiva, S.L., 2015) Carranza Bencano, Andrés; Fernández Torres, José Juan; Castillo Blanco, Gabriel del; Tejero García, Sergio; Alegrete-Blanco, A; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. CTS972: Análisis Biológico y Funcional del Ejercicio Físico
La indicación más frecuente de la artrodesis subastragalina aislada es artrosis dolorosa postraumática de esta articulación secundaria a fracturas de calcáneo o astrágalo. También está indicada en la artrosis subastragalina primaria, artritis postinfección, artrosis por desalineaciones, coaliciones tarsales, artritis inflamatorias y disfunciones neuromusculares. Muchos pacientes que requieren este tipo de cirugía presentan un elevado riesgo de complicaciones postoperatorias relacionadas con la cicatrización de las heridas debido a cirugías previas, la Diabetes Mellitus, artritis inflamatorias y otras alteraciones inmunológicas. Por esta razón es importante desarrollar una técnica quirúrgica mínimamente invasiva que se pueda realizar sin isquemia preventiva y que permita la corrección de las deformidades residuales.
Dolor crónico de tobillo después de un esguince. Lesiones nerviosas y distrofia simpaticorrefleja
(FondosScience : Scientific Knowledge Fund, 2016) Tejero García, Sergio; Prada-Chamorro, Estefanía; Fernández-Torres, José Juan; Carranza Bencano, Andrés; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. CTS972: Análisis Biológico y Funcional del Ejercicio Físico
Artrodesis subtalar y talonavicular mediante cirugía de mínima incisión en el pie plano del adulto estadio III
(Imaidea Interactiva, S.L., 2017-11-01) Carranza Bencano, Andrés; Tejero García, Sergio; Fernández Torres, J.J.; Carranza-Pérez-Tinao, Andrés; Fernández-Marín, Rocío; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. CTS972: Análisis Biológico y Funcional del Ejercicio Físico
Introducción: en los últimos años hay un incremento en el uso de técnicas mínimamente invasivas, tales como artroscopia, percutánea e incisiones mínimamente invasivas, en la cirugía del pie y tobillo. El propósito de este estudio fue analizar el resultado funcional y el grado de satisfacción del paciente después de doble artrodesis en el pie plano del adulto en estadio III usando una técnica original mínima mente invasiva (MIS) en una serie consecutiva de pacientes. Método: un total de 51 pies en 46 pacientes (5 bilaterales) fueron sometidos a doble artrodesis entre julio de 2007 y diciembre de 2014. Se llevó a cabo un protocolo de seguimiento mínimo de 12 meses. La indicación para la cirugía fue pie plano rígido o deformidad severa que no responde a un mínimo de 6 meses de tratamiento conservador, sin evidencia de degeneración de la articulación calcáneo-cuboidea. Resultados: se observó consolidación radiológica a las 12 semanas de la intervención en el 100% de la articulación subtalar (ST) y 2 casos (3,9%) presentaron retraso de consolidación de la articulación talonavicular (TN) sin repercusión clínica. La media preoperatoria del test AOFAS fue 29,82 y la media posquirúrgica 81,78. En la escala de satisfacción del paciente solo 1 (2,1%) se mostró insatisfecho y consideró que no se volvería a operar. Conclusión: este estudio demuestra que se puede conseguir la corrección de la deformidad del pie plano secundario del adulto debido a insuficiencia del tendón tibial posterior en grado III, mediante una técnica original de doble artrodesis por MIS, sin isquemia preventiva, consiguiendo la reducción mediante una maniobra multiplanar de rotación. Comparados con la literatura, los datos obtenidos en este estudio muestran una corrección radiográfica de la deformidad de forma equivalente a las series de triple o doble artrodesis estándar, con una tasa similar de fusión ósea y un semejante resultado funcional y grado de satisfacción de los pacientes. Todo ello, con menor índice de complicaciones, por lo que pueden beneficiarse los pacientes de alto riesgo quirúrgico.
Development and Validation in Porcine and Human Models of a Bioimpedance Spectroscopy System for the Objective Assessment of Kidney Graft Viability
(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Naranjo Hernández, David; Reina Tosina, Luis Javier; Roa Romero, Laura María; Barbarov-Rostán, Gerardo; Calvillo Arbizu, Jorge; Talaminos Barroso, Alejandro; Pérez Valdivia, Miguel Ángel; Medina López, Rafael; Universidad de Sevilla. Departamento de Teoría de la Señal y Comunicaciones; Universidad de Sevilla. Departamento de Ingeniería Telemática; Universidad de Sevilla. Departamento de Medicina; Universidad de Sevilla. Departamento de Cirugía; Fundación Mutua Madrileña; Junta de Andalucía
This work presents an innovative bioimpedance spectroscopy device, developed as a support tool for decision-making during the evaluation of kidney viability for renal transplantation. Given the increasing demand for organs and the need to optimize donation criteria, the precise and objective assessment of renal graft functionality has become crucial. The device, based on a modular design and adapted to the surgical environment, uses a novel Cole model with a frequency-dependent membrane capacitance, which improves measurement accuracy and repeatability compared to conventional models. Adapting the device for operating room usege involved overcoming significant challenges, such as the need for sterilization and a visual, tactile and acoustic user interface that facilitates device usability. Optimizing the sensing stage has minimized the influence of measurement artifacts, which is crucial for obtaining accurate and representative measurements of renal tissue bioelectrical properties. In addition, a rigorous electrode sterilization protocol was designed, ensuring asepsis during the procedure. The results of tests on porcine renal models demonstrated the device’s ability to monitor pathophysiological changes associated with renal ischemia, with a notable improvement against measurement repeatability.
Manejo de la artrosis en varo de tobillo
(Imaidea Interactiva, S.L., 2020) Alsayel, Faisal; Ávila, Jorge A; Tejero García, Sergio; Wiewiorski, Martin; Herrera‐Pérez, Mario; Valderrábano, Víctor; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. CTS972: Análisis Biológico y Funcional del Ejercicio Físico
Experience Using a New High-Density Polyethylene-Based Porous Orbital Implant: Explorative 1-Year Performance and Safety Results
(MDPI, 2024-11-27) Garrido Hermosilla, Antonio Manuel; Martínez-Alberquilla, Irene; Díaz-Ruiz, María Concepción; Monge-Carmona, Raquel; Méndez-Muros, Mariola; Sánchez Margalet, Víctor; Gutiérrez Sánchez, Estanislao; Relimpio-López, María Isabel; Rodríguez-de-la-Rúa-Franch, Enrique; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Bioquímica Médica y Biología Molecular e Inmunología; Universidad de Sevilla. CTS151: Bioquímica Medica
OBJECTIVES: To describe our experience with a new high-density porous polyethylene orbital implant post-enucleation and evisceration and comment on their performance and safety. METHODS: Patients with an indication of enucleation or evisceration with orbital implantation were included in a prospective study. All patients were implanted with OCULFIT orbital implants (AJL Ophthalmic S.A.) and followed up over 12 months. Anatomical and functional parameters, motility, and aesthetic appearance were evaluated. Patient satisfaction on a scale of 0 (very bad) to 5 (excellent), complications and success rates were reported. RESULTS: Overall, 16 enucleated and 17 eviscerated eyes were analyzed. Orbital implant motility was good for 93.8% and 100% of enucleated and eviscerated patients, respectively. No shortened fornixes were found after external prosthesis placement, and palpebral fissure, orbital volume, and lower eyelid laxity were symmetric with the contralateral eye for the vast majority. The aesthetic appearance was good for 87.5% and 100% of enucleated and eviscerated patients at the last visit with no differences between groups. Excellent satisfaction was reported for 100% and 94.1% of enucleated and eviscerated patients. Anatomical and functional success rates were 78.8% and 81.8%, respectively. No exposure, infection or complications related to surgery were reported during the follow-up. CONCLUSIONS: After 1 year of follow-up, OCULFIT orbital implants provide excellent patient satisfaction and performance in terms of motility and symmetry with the contralateral eye after external prosthesis placement with no complications related to the surgical procedure. No differences between enucleated and eviscerated eyes were found, and aesthetic results were remarkable for both groups. Conclusions should be interpreted with caution due to the small sample size.
Innovación y mentorización en medicina
(Universidad de Sevilla, 2023-05-10) López-Campos Bodineau, José Luis; Universidad de Sevilla. Departamento de Medicina
El Hospital simulado en la educación médica: retos económicos, beneficios docentes y claves para la sostenibilidad
(Universidad de Sevilla, 2025-03-19) Capitan-Morales, Luis-Cristobal; Capitán Pacheco, Amelia; Calderón Sandubete, Enrique José; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Medicina
Diversity and composition of ocular microbiota in contact lens wearers: Efficacy of liposomal ozonated oil
(Elsevier, 2025-06) Sánchez González, María del Carmen; Gallardo Real, Inmaculada; Gutiérrez Sánchez, Estanislao; Hita Cantalejo, María Concepción de; Capote Puente, Raúl; Sánchez González, José María; Universidad de Sevilla. Departamento de Física de la Materia Condensada; Universidad de Sevilla. Departamento de Cirugía
Purpose: To characterize the ocular surface microbiota in regular contact lens wearers with dry eyes and assess the effectiveness of reducing bacterial load using a liposomal ozonated oil solution. Methods: This prospective, longitudinal, controlled study randomized subjects into two groups. Group A (45 subjects) received hydroxypropylmethylcellulose (HPMC, Artific®), while Group B (41 subjects) received ozonated sunflower seed oil with soybean phospholipids (OSSO, Ozonest®). Microbial communities were analyzed via DNA metabarcoding of the 16S rRNA gene, and statistical analyses (alpha and beta diversity) were performed in R. Results: Both groups predominantly harbored Staphylococcus caprae, Streptococcus oralis, and Corynebacterium spp., with OSSO and HPMC users showing distinct bacterial profiles. Alpha diversity showed no significant differences, but beta diversity revealed differences in bacterial composition between the groups. Conclusions: The results seem to indicate that the use of ozonized oil reduces the bacterial load compared to the solution used as a control.
Efficacy of eyelid warming devices as first-step treatment in meibomian gland dysfunction: A systematic review with meta-analysis
(Elsevier, 2025-07) Ballesteros Sánchez, Antonio; Rocha de Lossada, Carlos; Sánchez González, José María; Universidad de Sevilla. Departamento de Física de la Materia Condensada; Universidad de Sevilla. Departamento de Cirugía
Purpose: To investigate the efficacy of eyelid warming devices as first-step treatment in patients with meibomian gland dysfunction (MGD). Methods: A systematic review with meta-analysis of RCTs, reporting the effects eyelid warming devices in 3 databases, PubMed, Scopus and Web of Science, was performed according to the PRISMA statement. Results: Seven studies including 367 patients, and 440 eyes were analysed. The overall efficacy did not significantly favor either group when comparing eyelid warming devices to the control groups or warm towel compresses, nor between moisture chamber devices and warm compress devices. However, the change in OSDI questionnaire (SMD 0.91; 95 % CI: 0.44 to 1.39; P = 0.0002) and NIBUT (SMD 1.10; 95 % CI: 0.61 to 1.59; P < 0.0001) were significantly favorable for eyelid warming devices compared to the control groups. Similar results were obtained for tear film stability (SMD 0.97; 95 % CI: 0.32 to 1.61; P = 0.003) when comparing eyelid warming devices to warm towel compresses. Specifically, the sensitivity analysis of these groups revealed that changes in OSDI questionnaire (MD 9.41; 95 % CI: 1.70 to 17.13; P = 0.02; I2 = 49 %) and NIBUT (MD 2.24; 95 % CI: 1.20 to 3.28; P < 0.0001; I2 = 71 %) were significantly favorable for eyelid warming devices. When comparing moisture chamber devices and warm compress devices, only the change in TBUT (SMD 0.75; 95 % CI: 0.23 to 1.28; P = 0.005; I2 = 30 %) were significantly favorable for moisture chamber goggles. Conclusions: Despite their limited overall efficacy, eyelid warming devices significantly reduce OSDI questionnaire and improve NIBUT compared to controls or warm towel compress groups. Evidence remains insufficient to confirm whether moisture chamber devices provide better outcomes than warm compress devices. Further well-designed RCTs are needed to confirm these findings.
Clinical Management of Non-alcoholic Steatohepatitis and the Role of the Cardiologist
(Radcliffe Cardiology, 2023-12-22) Millán-Rodríguez Carlos; Palacios Castelló Carlos; Caballero-Valderrama, María de Regla; Barón-Esquivias, Gonzalo; Universidad de Sevilla. Departamento de Cirugía; Instituto de Biomedicina de Sevilla (IBIS)
Non-alcoholic fatty liver disease (NAFLD) is a spectrum of fat-associated liver conditions that increase risk of cardiovascular disease and mortality. The diagnosis and clinical management of NAFLD remain a challenge for cardiologists. Our group performed a systematic review in PubMed of the relationship between NAFLD and cardiovascular disease, identifying 35 relevant articles. NAFLD is likely to be the liver’s expression of metabolic syndrome and increases the risk of several cardiovascular diseases, including coronary artery disease, stroke, heart failure and electrical disorders, and chronic kidney disease. Echocardiography is a useful tool to check early subclinical abnormalities in heart structure and function linked to NAFLD progression, such as cardiac diastolic impairment or epicardial fat thickness. Currently, NAFLD is predominantly managed by lifestyle changes with the aim of weight loss, based on the Mediterranean diet and intense exercise training. Despite the lack of approved drugs for NAFLD, new potential treatments, mainly glucagon-like peptide-1 agonists or sodium–glucose cotransporter 2 inhibitors, could change cardiologists’ approach to this pathology.
Long-Term Mental Health after High-Density Polyethylene-Based Porous Orbital Implant in Enucleated and Eviscerated Patients
(Mdpi, 2024-08-27) Garrido Hermosilla, Antonio Manuel; Martínez-Alberquilla, Irene; Díaz-Ruiz, María C; Monge-Carmona, Raquel; Méndez-Muros, Mariola; López Díaz, Álvaro; Sánchez Margalet, Víctor; Gutiérrez Sánchez, Estanislao; Relimpio-López, María Isabel; Rodríguez de la Rúa Franch, Enrique; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Psiquiatría; Universidad de Sevilla. Departamento de Bioquímica Médica y Biología Molecular e Inmunología; Universidad de Sevilla. CTS1086: Psiquiatría Traslacional; Universidad de Sevilla. CTS151: Bioquímica Medica
Objectives: To assess the overall mental health of enucleated or eviscerated patients after high-density porous polyethylene OCULFIT implantation and external prosthesis over a 1-year follow-up. Methods: Patients with an indication of enucleation or evisceration with OCULFIT implantation were included in a prospective study. The patients completed four questionnaires regarding mental health at three different visits (baseline, 3–6 months, and 9–12 months post-surgery). The questionnaires used were the following: SF-12 for multidimensional health-related quality of life (scale 0–100); Rosemberg self-esteem scale (scale 0–40); Patients Health Questionnaire-4 (PHQ-4) (scale 0–6); and a Lifetime Major Depression and Anhedonia questionnaire (categorised in groups with/without symptoms). Results: A total of 33 patients (16 enucleations and 17 eviscerations) were included in the study. The physical domain of the SF-12 questionnaire did not change between visits, but the mental domain significantly improved from the baseline to the last visit (41.71 ± 12.72 vs. 46.80 ± 10.68, p = 0.04). The number of patients with high, moderate, and low self-esteem (Rosemberg scale) was similar between the baseline and the last visit. The depression and anxiety scores of the PHQ-4 were not significantly different among visits. The number of patients with no symptoms (depression or anhedonia) improved from the baseline (42.2%) throughout the follow-up (66.7% at the last visit). Conclusions: OCULFIT orbital implant and external prosthesis placement maintained and/or improved the quality of life related to mental health in eviscerated and enucleated eyes. The number of patients with no symptoms improved from the baseline throughout the follow-up. The patients’ self-esteem was already high before implantation and remained stable over the follow-up.
Objective setup description and satisfaction assessment of spinal cord stimulation for treatment of chronic back and leg pain
(Med Crave: Step into the world of research, 2025-04-25) Castro Seoane, Fj; Pinta García, JC de la; Du Four, S; Elzinga, L.; López Millán, José Manuel; Smet, I.; Trinidad Martín, JM; Simonelli, C.; Hanbli, H.; Buschman, R.; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Objective: The aim of this survey was to collect user (patient and health care professional) satisfaction, therapy outcomes and device settings from patients who utilize a single spinal cord stimulation model for treatment of chronic pain in day-to-day clinical practice. Methods: The design was a clinical survey. The survey population were patients with chronic back and leg pain receiving spinal cord stimulation therapy, and the health care professionals who treat the patients and program the implantable neurostimulator. Patient data were collected once and at a time when spinal cord stimulation provided stable pain relief. Data was presented in aggregate form. Near 50 data-items were captured per patient, including demographics (e.g., age, gender, prior surgeries), technical data (e.g., implant details, stimulation parameters), patient reported outcomes (e.g., pain change, goal achievement, work) and satisfaction and health care professional satisfaction (e.g., satisfaction with neurostimulator size). Descriptive statistics were used to summarize the data. Continuous variables are summarized by computing mean and standard deviation. Results: Clinical staff from nine European sites independently collected data from 124 patients. Patients were on average 54.3 (±11.2) years old and had chronic pain for 9.9 (±6.0) years. The average time since spinal cord stimulation onset was 2.6 years. The indication for spinal cord stimulation was for overall pain (68.5%, 85/124), leg pain (22.6%, 28/124) and back pain (8.9%, 11/124). On average, patients reported an improvement in pain of 70.3% (± 17.1%) and pain medication was reduced for 82.3% (102/124) of patients. Thirtytwo patients (25.8%) returned to work of whom 16 (12.9%) returned to full time work. Functional goals measured on a VAS scale (0-100), were predefined by 110 patients, mostly for pain/medication reduction, improved quality of life, and mobility. On average, there was an improvement in the predefined goal, of 73.3% (±17.0%). Conclusions: The clinical survey provided an overview of the use of spinal cord stimulation for a specific device and indication in a day-to-day clinical setting.
Prevalencia, hábitos de consumo y complicaciones de los suplementos nutricionales proteicos en adolescentes
(Elsevier, 2023-09-15) Millán Jiménez, Antonio; Fernández Fontán, Isabel María; Sobrino Toro, Manuel; Fernández Torres, Bartolomé; Universidad de Sevilla. Departamento de Farmacología, Pediatría y Radiología; Universidad de Sevilla. Departamento de Cirugía
Introducción: El consumo de suplementos nutricionales y proteicos por adolescentes puede tener importantes repercusiones para su salud. Material y método: Estudio prospectivo observacional, basado en una encuesta, dirigido a los adolescentes de seis colegios, seleccionados aleatoriamente, de la ciudad de Sevilla. Nuestro objetivo principal es conocer el consumo real de suplementos alimentarios entre la población adolescente, cuantificando su contenido proteico. Resultados: Se obtuvieron 263 respuestas válidas, objetivando una prevalencia de consumo de 19,01% para todos los suplementos nutricionales, de ellos 56,0% tomaban suplementos de proteínas (10,64% del total), con una ingesta media de estas últimas de 0,26 ± 0,18 g/kg/día. El perfil del consumidor de cualquier tipo de suplementos se diferencia del de los que no los utilizan en la edad, el uso de medicación habitual y realizar dieta para perder peso o hiperproteica. Al comparar los adolescentes que ingerían productos proteicos con los no proteicos, la única variación significativa estuvo en el control del consumo. Aunque la mayoría no tiene control externo, en 25,92% de los que tomaban proteínas el seguimiento lo hacía un profesional, vs. 7,38% de los que ingerían suplementos no proteicos. De los consumidores de productos proteicos, 85,18% consiguió el objetivo buscado y 18,51% refirió algún efecto negativo. Conclusiones: La prevalencia de consumo de suplementos proteicos entre los adolescentes de nuestro medio es del 10,64%, en cantidades que suponen un 25% de las proteínas que deben ingerir diariamente. El perfil de consumidor de suplementos proteicos es muy similar al de aquel que toma productos no proteicos.
Idiopathic Neck Pain or Neck Pain of Gastric Origin? A Systematic Review of Rat Experimental Studies on Gastric Harm Pathophysiology and Therapy
(Wiley, 2025-05-22) Oliva Pascual-Vaca, Ángel; Navarro-Carmona, Ignacio; Oliva Pascual-Vaca, Jesús; Riquelme, Inmaculada; Luque Romero, Luis Gabriel; López Millán, José Manuel; Universidad de Sevilla. Departamento de Fisioterapia; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de Cirugía; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS1043: Salud, Fisioterapia y Actividad Física; Universidad de Sevilla. CTS1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Background: Most cases of neck pain are classified as nonspecific or idiopathic pain and show characteristics such as sensitization, hyperalgesia, limited range of motion, and muscle spasm. Visceral disorders can trigger all those features, and gastric disorders are related to neck pain. Furthermore, stress and anxiety are frequently somaticized as neck pain. However, its pathophysiological link has never been determined. Objectives: To identify the electromyographic and postural response to experimental gastric insult in rats. Methods: A systematic review was undertaken. Searches were conducted in the PubMed and Web of Science databases. The date of publication was not limited. References from included articles were assessed. The sample, experimental intervention, and the results were retrieved from each study. Results: Sixteen studies were included. Acromiotrapezius muscle showed the highest activity to gastric damage, being up to 8–10 times higher than abdominal muscles contraction. Also, a postural response compatible with neck muscles spasm was observed. The threshold for reaching cervical spasm was lowered by the addition of stress, gastritis, dyspepsia, ulcers, diabetes, or inflammation of the colon. Increased visceromotor response persisted even more than 60 days after gastric insult, despite no obvious injury was already visible in the stomach. Furthermore, prenatal or neonatal gastric injury also produced gastric hypersensitivity and increased trapezius spasm in adult rats. On the contrary, neck spasm was reduced by reversing diabetes or blocking the gastric receptors and its afferent pathways. Conclusions: Gastric harm triggers neck muscles spasm. Since many gastric conditions and hypersensitivity are common and tend to be chronic, this may contribute to explain the persistence of neck pain and sensitization in many patients. Prenatal and neonatal gastrointestinal suffering increases trapezius visceromotor response in adults. Furthermore, our findings might contribute to explain why stress is frequently somaticized as neck pain.
Usefulness of sonication in the microbiological diagnosis of cardiovascular implantable electronic device infections: systematic review, meta-analysis and meta-regression
(Biomed Central (BMC), 2024-11-05) Martín-Gutiérrez, Guillermo; Martín Pérez, Carlos; Ortiz de la Rosa, José Manuel; Gutiérrez Carretero, Encarnación; Alarcón, Arístides de; Lepe Jiménez, José Antonio; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Microbiología; Instituto de Salud Carlos III; Gobierno de España; Universidad de Sevilla. CTS1134: Investigación Traslacional en la Fisiopatología Cardiovascular; Universidad de Sevilla. CTS204: Biotecnología Aplicada al Estudio de Enfermedades Infecciosas
Background Multiple studies have demonstrated the utility of sonication to improve culture yield in patients with cardiovascular implantable electronic device (CIED) infections. Objective To analyze the usefulness of sonication in the microbiological diagnosis of CIED infections in comparison with traditional cultures. Methods Systematic database searches were performed to identify studies that provided enough data concerning both sensitivity and specificity of traditional (non-sonicated) and sonicated cultures from CIED samples. The diagnostic accuracy measures were obtained by three different statistical approaches: (i) The univariate model; (ii) The bivariate random; and (iii) The Bayesian bivariate hierarchical model. Heterogeneity was assessed using meta-regression. Findings Nine studies met the criteria for inclusion in the meta-analysis (1684 cultures). The summary estimates of sensitivity were higher for sonicated cultures (0.756) in comparison with non-sonicated cultures (0.446). On meta-regression, sonication of CIEDs significantly increased the sensitivity (p = 0.001) as well as the rates of false positive results (p = 0.003). The final model also showed that the studies that used a threshold for positivity were associated with lower rates of false positive results (p < 0.001).
Two year neurodevelopmental outcome after fetoscopic laser therapy for twin-twin transfusion syndrome: comparison with uncomplicated monochorionic diamniotic twins
(Mdpi Ag, 2023-07-20) Chimenea, Angel; García Díaz, Lutgardo; Antiñolo Gil, Guillermo; Universidad de Sevilla. Departamento de Cirugía
Background: Twin–twin Transfusion Syndrome (TTTS) represents a significant compli cation in monochorionic twin pregnancies, caused by an unbalanced shunting of blood through intertwin placental vascular anastomoses. Despite advances in fetoscopic laser surgery, TTTS is still associated with a high rate of cerebral injury. However, there are no studies comparing these pregnancies with uncomplicated monochorionic diamniotic (MCDA) twin pregnancies, establishing the baseline risk of neurodevelopmental impairment. The aim of this study is to evaluate the odds of neurodevelopmental impairment in MCDA twins who undergo fetoscopic laser surgery for twin twin transfusion syndrome, in comparison to a cohort of uncomplicated MCDA twin pregnancies. Study design: This is a retrospective cohort study of children born from MCDA twin pregnancies at a single center between 2008 and 2019. A routine, standardized follow-up assessment was conducted at a minimumof2years after delivery. The primary outcome of this was a 2 year neurodevelopmental impairment. Neurological, motor, and cognitive development was assessed by using the revised Brunet–Lézine scale. Results: 176 children met the enrolment criteria. Of these, 42 (24%; TTTS group) underwent fetoscopic laser surgery for TTTS during pregnancy, and 134 (76%; uncomplicated MCDA group) were uncomplicated MCDA pregnancies. The primary outcome was found in four children (9.52%) in the TTTS group and ten children (7.46%) in the uncomplicated MCDA group (p = 0.67, aOR2.82, 95% CI 0.49–16.23). Major neurologic impairment was found in 2.38% after fetoscopic laser surgery and 1.49% in uncomplicated MCDA twins (p = 0.70, aOR 0.97, 95% CI 0.22–4.24). The data were adjusted by birth order, birth weight, and gestational age at birth. Conclusions: The outcome in MCDAtwinswhounderwentfetoscopic laser surgery for TTTS is comparable to the outcome in uncomplicated MCDA twins. Our findings emphasize the need for long-term neurodevelopmental follow-ups in all children from monochorionic twin gestations.
Prenatal ultrasound, magnetic resonance imaging and therapeutic options for fetal thoracic anomalies: a pictorial essay
(Springer, 2023-05-11) Caro-Domínguez, Pablo; Victoria, Teresa; Ciet, Pierluigi; Torre, Estrella de la; Sáinz Bueno, José Antonio; Chimenea Toscano, Ángel; García Díaz, Lutgardo; Universidad de Sevilla. Departamento de Cirugía
Congenital thoracic anomalies are uncommon malformations that require a precise diagnosis to guide parental counseling and possible prenatal treatment. Prenatal ultrasound (US) is the gold standard imaging modality to first detect and characterize these abnormalities and the best modality for follow-up. Fetal magnetic resonance imaging (MRI) is a complementary tool that provides multiplanar assessment and tissue characterization and can help estimate prognosis. Prenatal treatment is increasingly being used in fetuses with signs of distress and to potentially decrease morbidity and mortality. In this essay, the authors illustrate side-by-side US, MRI and therapeutic options for congenital thoracic anomalies in cases that presented to a tertiary pediatric hospital during the 7-year period 2014–2021. Entities included are congenital diaphragmatic hernia, congenital pulmonary airway malformation, bronchopulmonary sequestration, hybrid lesions, foregut duplications cysts and congenital lobar overinflation. Treatment options include maternal steroids, thoraco-amniotic shunt and fetal endotracheal occlusion. Recognition of typical findings in congenital thoracic anomalies is helpful to establish diagnosis, predict prognosis and plan perinatal treatment.
Spanish consensus on managing pregnancy in women with Gaucher disease
(Biomed Central Ltd; Bmc (Biomed Central); Bmc, 2025-03-28) Calderón Sandubete, Enrique José; Rodríguez-Fernández, Alicia; Calderón-Baturone, Irene; Aporta-Rodríguez, Rafael; Castillo, Francisco J. del; García Díaz, Lutgardo; González-Meneses, Antonio; Hermosín-Ramos, María Lourdes; Yahyaoui, Raquel; Marín-León, Ignacio; Universidad de Sevilla. Departamento de Medicina; Universidad de Sevilla. Departamento de Cirugía
Gaucher disease can have effects on the development of pregnancy, childbirth, and lactation, with impact on health of both the mother and the newborn. Management of pregnancies in Gaucher patients is further complicated by using of enzyme replacement therapy. Unfortunately, the available scientific evidence is not conclusive because there are not proper clinical trials on this issue. The aim of this work was to establish a management guide to address the main clinical problems before, during and after pregnancy and to provide key information to healthcare professionals, patients, and families. GRADE methodology to evaluate the quality of scientific evidence and develop recommendations was incorporated to elaborate this guide. For final recommendations, a structured consensus 2-round process was carried out using the Delphi method with a Gaucher expert panel. After this process, nine recommendations were elaborated related to pre-pregnant status and genetic counseling and for management during pregnancy, seven related to childbirth, and eight focused on management after delivery and breastfeeding. Regarding the quality of the evidence, values and preferences of patients were also considered. A consensus guide to define and standardize pregnancy management in Gaucher disease considering the best available evidence, complemented by experts’ opinions, could be a relevant tool to help patients, nurses, midwives and physicians with little experience in Gaucher disease who do not have access to guidance from Gaucher disease treatment centers of excellence.

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