Artículos (Cirugía)

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Esplenosis tras esplenectomías postraumáticas, comparación del estado inmunológico celular y humoral versus esplenectomizados
(Aran ediciones, S A, 1989) Ortega-Beviá, José María; Cantillana-Martinez, Jose; Naranjo Capitán, M.; Capitan-Morales, Luis-Cristobal; Vaquero-Pérez, M. M.; Segura-Ramos, R; Universidad de Sevilla. Departamento de Cirugía
Partiendo del concepto asimilable de que la esplenosis (presencia de tejido esplénico intracavitario postesplenectomía) no es más que un autotrasplante esplénico de carácter involuntario, hemos intentado establecer las características inmunológicas celulares y humorales de estos pacientes, definiéndolos en este punto, y hallar las diferencias que en este punto presentasen con pacientes esplenectomizados que no presentasen tejido esplénico residual. Para ello, hemos seleccionado seis pacientes portadores de esplenosis postesplenectomía postraumática y los hemos comparado con 10 pacientes esplenectomizados. Hemos determinado en ellos IgA, IgG, IgM, C-3, C-4, estimulación de cultivos linfocitarios con fitohemaglutinina, concanavalina y pokeed mitogen (PWIM), junto a estudio de la incidencia de infecciones intercurrentes postoperatorias. El resultado de nuestro estudio define que ambos grupos tienen un comportamiento inmunológico similar estadísticamente tratados sus resultados.
Innovaciones en Educación Médica. Un enfoque integral
(Universidad de Sevilla, 2023-12-01) Capitan-Morales, Luis-Cristobal ; Universidad de Sevilla. Departamento de Cirugía
Una oportunidad de Innovación
(Universidad de Sevilla, 2023-05-10) Capitan-Morales, Luis-Cristobal; Universidad de Sevilla. Departamento de Cirugía
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
Decreased number of myeloid-derived suppressor cells in the placental trophoblast of gestational diabetes mellitus. Possible role of leptin
(Elsevier, 2025-03-25) Tami, Malika; Hontecillas-Prieto, Lourdes; García-Domínguez, Daniel J.; Flores-Campos, Rocío; Vilariño-García, Teresa; Sanchez Jimenez , Flora; Guadix, Pilar; Dueñas Díez, José Luis; Jimenez Cortegana, Carlos; Cruz Merino, Luis de la; Pérez Pérez, Antonio; Sánchez Margalet, Víctor; Universidad de Sevilla. Departamento de Bioquímica Médica y Biología Molecular e Inmunología; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Medicina; Instituto de Biomedicina de Sevilla (IBIS); FEDER Funds; Instituto de Salud Carlos III (ISCIII); Universidad de Sevilla. CTS607: Salud Reproductiva de la Mujer; Universidad de Sevilla. CTS151: Bioquímica Medica
Gestational diabetes mellitus (GDM) is the most common complication of pregnancy and significantly increases both maternal and fetal morbidity and mortality. Inflammation is a hallmark of GDM, and placental inflammation may play a key role in the pathophysiology of the disease. Myeloid-derived suppressor cells (MDSCs), which are innate immunosuppressive, are thought to contribute to feto-maternal tolerance. In normal pregnancies, elevated levels of MDSCs have been observed in both peripheral and umbilical cord blood. Our hypothesis postulates that trophoblasts from placentas belonging to women with GDM may have lower levels of MDSCs compared to trophoblasts from placentas originating from healthy pregnancies. Furthermore, since leptin is overexpressed in the placenta of GDM patients, we hypothesized that leptin might contribute to the reduction of MDSCs. To test this, we investigated the in vitro effects of leptin on MDSC levels in isolated peripheral blood leukocytes after 24 h of incubation. Our findings indicate that trophoblasts from placentas from women with GDM contain a lower percentage of MDSCs compared to trophoblasts from healthy pregnancies. In addition, in vitro studies demonstrated that leptin reduces the number of MDSCs in peripheral blood leukocytes. In conclusion, MDSCs are decreased in placentas from pregnancies with GDM, and leptin appears to reduce the number of MDSCs in leukocytes isolated in vitro. Increased leptin expression in trophoblasts from placentas of women with GDM may contribute to the lower levels of MDSCs, potentially playing a role in placental inflammation. However, further investigations are required to fully elucidate this mechanism.
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.
Giant Chronic Gastric Trichobezoar: Total Gastrectomy
(SciRes Literature LLC., 2025-05-23) Domínguez-Adame Lanuza, Eduardo; Hurtado, Cristina; Domínguez, Marta; Universidad de Sevilla. Departamento de Cirugía
Factores determinantes en la indicación de la prótesis invertida de hombro
(Editorial Ciencias Médicas, 2017) Giráldez Sánchez, Miguel Ángel; Molina Linde, Juan Máximo; Baños Álvarez, Elena; Beltrán Calvo, Carmen; Romero Tabares, Antonio; Lacalle Remigio, Juan Ramón; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria
Objetivo: Desarrollar criterios para determinar las indicaciones apropiadas de la prótesis invertida de hombro en artropatías por lesión del manguito rotador y las variables determinantes de este proceso. Método: Se utilizó un panel de expertos mediante metodología RAND/UCLA con 9 expertos en Traumatología, 2 en Rehabilitación y 1 en Reumatología, que evaluaron 192 casos hipotéticos. Cada experto puntuó mediante una escala del 1 (extremadamente inadecuado) al 9 (extremadamente apropiado). Resultados: 22 casos hipotéticos fueron considerados adecuados. El dolor, limitación funcional, necesidad funcional, defecto glenoideo, edad, artrosis y posibilidad de reparación del manguito rotador son variables determinantes para indicar la implantación de una prótesis invertida de hombro. Conclusiones: El método RAND/UCLA es útil para el estudio de las indicaciones de procedimientos como la prótesis invertida de hombro, y proporciona una lista de las indicaciones adecuadas. Las variables requieren ser validadas mediante estudios prospectivos o revisión de historias clínicas.
Assessment of pre and postoperative anxiety in patients undergoing ambulatory oral surgery in primary care
(Sociedad Española de Medicina Oral, 2017-10) Reyes Gilabert, Eva; Luque Romero, Luis Gabriel; Bejarano Ávila, Gracia; Garcia Palma, Alfonso; Rollón Mayordomo, Ángel; Infante Cossío, Pedro Antonio; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. CTS142: Patología Morfolog. y Func. del Territorio Oral y Maxilofacial; Universidad de Sevilla. CTS410: Epidemiología del Cáncer
Background To analyze the pre- and postoperative anxiety level in patients undergoing ambulatory oral surgery (AOS) in a primary healthcare center (PHC). Material and Methods Prospective and descriptive clinical study on 45 patients who underwent AOS procedures in the dental clinic of a public PHC of Spain between April and September 2015. Anxiety analysis was carried out with pre- and postoperative anxiety-state (STAI-S), anxiety-trait (STAI-T) and dental anxiety (MDAS) questionnaires. A descriptive, inferential and binary logistic regression analysis were performed for the variables age, sex, educational level, previous experience of oral treatment, type of oral surgery, degree of third molar impaction, surgical time, intraoperative complications, postoperative complications, and pain score with a visual analogue scale (VAS). Results The majority were female (57.8%) with a mean age of 33.5+9.6 years. The most frequent procedure was the lower third molar removal (82.2%). The mean pain score on the VAS was 1.6+1.8. The incidence of complications was low (7.8%). There was a statistically significant association between post- and preoperative anxiety (r=0.56, p<0.001) and a correlation between pain score and postoperative anxiety (Rho= -0.35, p=0.02). The likelihood of postoperative anxiety was related to preoperative anxiety (OR=1.3, p=0.03). Conclusions AOS in a HPC is safe and should be more encouraged in the public primary care. The emotional impact on users was relatively low, highlighting that the preoperative anxiety levels were higher than the postoperative ones. Psychological factors related to pre- and postoperative anxiety should be considered in the AOS carried out in PC.
Ultrasound Diagnosis of Pelvic Organ Prolapse Using Artificial Intelligence
(MDPI, 2025-05-22) García Mejido, José Antonio; Galán Páez, Juan; Solís Martín, David; Fernández Palacín, Fernando; Fernández Palacín, Ana; Sáinz Bueno, José Antonio; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Ciencias de la Computación e Inteligencia Artificial; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Fondo Europeo de Desarrollo Regional (FEDER); Universidad de Sevilla. TIC137: Lógica, Computación e Ingeniería del Conocimiento; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria
Background/Objectives: The aim of this study was to design a fully automated hybrid AI-based method, combining a convolutional neural network (CNN) and a tree-based model (XGBoost), which was capable of diagnosing different pelvic organ prolapses (POPs) in a dynamic two-dimensional ultrasound study from the midsagittal plane. Methods: This was a prospective observational study with 188 patients (99 with POP and 89 without POP). Transperineal pelvic floor ultrasound videos were performed, and normality or POP was defined. These videos were subsequently labeled, and an algorithm was designed to detect POP based on three phases: 1. Segmentation—a CNN was used to locate and identify the visible pelvic organs in each frame of the ultrasound video. The output had a very high dimensionality. 2. Feature engineering and dataset construction—new features related to the position and shape of the organs detected using the CNN were generated. 3. The POP predictive model—this was created from the dataset generated in the feature engineering phase. To evaluate diagnostic performance, accuracy, precision, recall, and F1-score were considered, along with the degree of agreement with the expert examiner. Results: The best agreements were observed in the diagnosis of cystocele and uterine prolapse (88.1%) and enterocoele (81.4%). The proposed methodology showed an accuracy of 96.43%, an overall accuracy of 98.31%, a recall of 100%, and an F1-score of 98.18% in detecting the presence of POP. However, when differentiating between the various types of POP, we observed that the precision, accuracy, recall, and F1-score were higher when detecting cystocele and uterine prolapse. Conclusions: We have developed the first predictive model capable of diagnosing POP in a dynamic, bi-dimensional ultrasound study from the midsagittal plane using deep learning and machine learning techniques.
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).
Ultrasound, echocardiography, mri, and genetic analysis of a fetus with congenital diaphragmatic hernia and partial 11q trisomy
(Hindawi, 2017-03-02) Fernández-Perea, Yolanda; García Díaz, Lutgardo; Sánchez, Javier; Antiñolo Gil, Guillermo; Borrego, Salud; Universidad de Sevilla. Departamento de Cirugía
Congenital diaphragmatic hernia (CDH) is a serious birth defect with a significant mortality and morbidity. The current and constant progress in ultrasound techniques has led to the improvement of the prenatal diagnosis of this malformation. CDH is a developmental defect whose etiology is heterogeneous and takes place when the pleuroperitoneal folds and septum transversum fail to converge and fuse. Survival depends on the extent of pulmonary hypoplasia and the disease may be potentially worsened by the presence of added congenital defects. 40% of CDH cases are associated with at least one additional anomaly. The ultrasound diagnosis is established with essential signs: loss of uniform echogenicity of lungs and marked mediastinal shift. We report the case of a fetus with isolated CDH diagnosed at 21 weeks of gestation by ultrasound and confirmed by RMI, whose genetic analysis of amniotic fluid cells identified a de novo partial trisomy of the long arm of chromosome 11. Different genetic causes have been associated with CDH. Moreover, it is expectable that the use of new techniques for prenatal diagnosis will reveal novel CNVs associated with CDH and will help us to estimate the recurrence risk for this defect as well as for other associated anomalies.
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.

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