Artículos (Cirugía)

URI permanente para esta colecciónhttps://hdl.handle.net/11441/11000

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Grado de adhesión de la población pediátrica a las recomendaciones conductuales en relación con la miopía
(2026-07) Arias-Peso, Borja; Infante Cossio, Mónica; Monge Carmona, Raquel; Castaño Ariza, Lucía; Rodríguez de la Rúa Franch, Enrique; Cirugía; Instituto de Biomedicina de Sevilla (IBIS)
La miopía infantil ha aumentado exponencialmente a nivel global en los últimos años, elevando el riesgo de complicaciones oculares como glaucoma o el desprendimiento de retina. Las intervenciones para reducir la progresión de la miopía infantil pueden ser comportamentales, ópticas o médicas. Las primeras son recomendaciones en los hábitos de vida que han resultado efectivas para prevenir el inicio de la miopía o disminuir su progresión. Estos hábitos incluyen: pasar más tiempo al aire libre, evitar la realización de tareas de cerca con luz tenue o reducir el tiempo de uso de dispositivos digitales en visión cercana. Hasta el momento actual no existe en nuestro entorno ninguna herramienta que cuantifique de forma objetiva el cumplimiento de estas recomendaciones.
Perceived satisfaction in fetal therapy: proposal and pilot of a novel assessment tool (FETAL Surgery Global Satisfaction)
(Springer Nature, 2026-06-17) Domínguez-Moreno, Marta; Chimenea-Toscano, Ángel; Martín Hernández, José de; García-Díaz, Lutgardo; Antiñolo Gil, Guillermo; Cirugía; Instituto de Biomedicina de Sevilla (IBIS)
Background: The quality of healthcare services has drawn significant attention within the medical field, with patient-perceived satisfaction emerging as a crucial indicator. Analyzing patient satisfaction could uncover areas of weakness, suggesting the need for improvements in care. However, in the specialized field of Fetal Medicine and Therapy, there lacks a validated tool for assessing care quality from the patient´s perspective. This study aims to design and pilot an instrument for measuring patient-perceived satisfaction as a barometer of the quality of services provided. Methods: We developed a survey instrument to assess six key areas of healthcare (Follow-up care, environment, transparency, accessibility of care, link between physician and patient, and global satisfaction), through 20 multiple-choice questions. Every key area was rated from 1 to 5 and the overall score was calculated by dividing the total score by the number of areas, resulting in rates from 1 to 5, higher scoring represented a greater patient-perceived satisfaction. It was initially piloted on a sample of 34 pregnant women undergoing a specific fetal therapy (Ex Utero Intrapartum Treatment, EXIT) at our center between June 2007 and January 2024. Results: A total of 29 out of 34 patients agreed to participate. According to the proposed tool and the suggested scoring scale, we achieved an overall score of 4.67, indicating a very satisfactory rating. The highest mean score was for the “Global satisfaction” domain (4.76), revealing that participants where highly likely to recommend our department. It was followed by “Follow-up care” and “Environment” domains (4.69, each). Notably, “Transparency” and “Link between physician–patient” were the lowest rated domains (4.58 and 4.62, respectively), suggesting the timely provision of enhancement. Conclusions: We propose "FETAL Surgery Global Satisfaction Tool” as a potential valuable instrument to assess patient-perceived satisfaction. It could provide insights into the quality of services offered by Fetal Medicine and Therapy Units. By identifying key areas for improvement, this tool could support continuous quality enhancement across Fetal Therapy programs globally. Further studies are warranted to evaluate its validity and potential future reliability.
THRIVE. A Phase 3, Randomized, Double-Masked, Placebo-Controlled Study of Veligrotug for Active Thyroid Eye Disease
(Elsevier, 2026-09) Yen, Michael T.; Cockerham, Kimberly; Saeed, Peerooz; Leibowitz, Steven; Mudumbai, Raghu C.; Schittkowski, Michael P.; Garrido Hermosilla, Antonio Manuel; THRIVE Study Group; Cirugía
Purpose: Thyroid eye disease (TED) is a debilitating autoimmune disease with significant unmet needs. This study’s objective was to assess the efficacy and safety of veligrotug, a full antagonist monoclonal antibody to the insulin-like growth factor-1 receptor, in patients with active TED. Design: Veligrotug was assessed in THRIVE, a global, multicenter, randomized, double-masked, placebo-controlled phase 3 trial. Participants Adult patients with moderate-to-severe active TED (onset ≤ 15 months, proptosis ≥ 3 mm above normal, and clinical activity score [CAS] ≥ 3) received either veligrotug or placebo. Methods: Patients were randomized 2:1 to receive 10 mg/kg veligrotug or placebo administered every 3 weeks for a total of 5 IV infusions. Main Outcome Measures: The primary end point at week 15 was the proptosis responder rate (PRR; ≥ 2-mm reduction by Hertel exophthalmometry) or overall responder rate (ORR; PRR and ≥ 2-point reduction in CAS), depending on geographic region. Efficacy and safety were assessed through week 52. Results: A total of 113 patients received veligrotug (n = 75) or placebo (n = 38). Baseline characteristics were balanced between the 2 arms. Improvements were observed at week 3, with a significantly greater response at week 15 for veligrotug versus placebo (P < 0.001) across all primary and secondary end points including: PRR by Hertel, 70% versus 5%; PRR by magnetic resonance imaging (MRI) or computed tomography (CT), 71% versus 9%; ORR, 67% versus 5%; mean proptosis reduction, 2.90 mm versus 0.48 mm (Hertel) and 2.96 mm versus 0.58 mm (MRI/CT); diplopia improvement, 59% versus 20%; and diplopia resolution, 49% versus 12%. At week 52, 70% of initial responders maintained proptosis response. Veligrotug was generally well tolerated, with a 4% treatment discontinuation rate. Most adverse events were mild and resolved, with no serious treatment-related adverse events and no changes in the safety profile through week 52. Conclusions: A 5-infusion course of veligrotug administered over 12 weeks was generally well tolerated and led to rapid and significant improvements in diplopia, proptosis, and disease activity, with a durable response through week 52. Veligrotug may become a promising new treatment option for active TED.
Retención urinaria aguda como indicio clínico del himen imperforado en una adolescente
(Federación Mexicana de Colegios de Obstetricia y Ginecología A.C., 2021-04-01) Calderon-Cabrera, Ana María; Chimenea-Toscano, Ángel; Cirugía
ANTECEDENTES: La imperforación del himen es una anomalía congénita excepcional debida a una falla en la canalización del seno urogenital. Suele manifestarse después de la pubertad con amenorrea primaria, dolor cíclico y distensión abdominal; la retención aguda de orina es una forma infrecuente de indicio que puede derivar en falta de tratamiento adecuado, en complicaciones graves e, incluso, insuficiencia renal aguda. OBJETIVO: Reportar un caso de retención aguda de orina en una adolescente de 12 años originado por hematocolpos secundario a la imperforación de himen. CASO CLÍNICO: Paciente de 12 años, llevada a Urgencias debido a un dolor abdominal y molestias genitales acompañadas de anuria de al menos 12 horas de evolución. A la exploración se identificó un globo vesical palpable e himen imperforado, de aspecto azulado y abombado. En la ecografía se confirmó un hematocolpos de 130 x 89 mm y hematometra de 38 x 10 mm. Se efectuó un sondaje urinario y se procedió a la himenotomía en cruz, con desaparición completa del cuadro y restablecimiento de la función vesico-uretral. CONCLUSIÓN: El diagnóstico y tratamiento quirúrgico temprano de la imperforación himeneal permiten evitar complicaciones uroginecológicas a mediano y largo plazo. El hematocolpos obstructivo ha de tenerse en cuenta como una de las primeras posibilidades diagnósticas ante un cuadro de dolor abdominal cíclico y retención urinaria en adolescentes.
Letter Regarding: Quantum Molecular Resonance Effects on Patients with Dry Eye Disease
(2025-06) Ballesteros Sánchez, Antonio; Rocha de Lossada, Carlos; Sánchez González, José María; Borroni, Davide; Física de la Materia Condensada; Cirugía
A prospective descriptive cohort study of women aged ≥40 years conceiving through IVF at a tertiary care center
(Frontiers media SA, 2026-06-24) Domínguez-Moreno, Marta; Walsh, Blanca; De-Martin-Hernández, José; Chimenea-Toscano, Ángel; Antiñolo Gil, Guillermo; Cirugía
Objectives: To describe obstetric and perinatal outcomes of pregnant women with advanced maternal age (AMA) conceiving through in vitro fertilization (IVF) technology. Methods: A single-center prospective observational study was conducted between January and December 2024. All women aged 40 and older who conceived via IVF were included. Participants underwent regular prenatal follow-up in a maternal-fetal unit, including standardized maternal clinical assessment and fetal ultrasound evaluation. A subgroup analysis (40-44-year-old subgroup vs. ≥45-year-old subgroup) was also conducted to identify potential differences in obstetric and perinatal outcomes within our study population. Results: A total of 128 pregnant women were included. Nearly half were primigravid (n = 60, 46.88%) and 71 pregnancies resulted from oocyte donation (55.47%). Obstetric complications observed in this cohort included gestational diabetes mellitus (n = 3, 2.34%), hypertensive disorders (n = 6, 4.76%) preterm premature rupture of membranes (n = 11, 8.59%), preterm intrauterine growth restriction (n = 7, 5.56%) and preterm delivery (n = 15, 11.72%). It is noteworthy that these last three outcomes mentioned were observed significantly more frequently in the subgroup aged over 45 years. Cesarean delivery was performed in 62 cases (49.6%). Regarding neonatal outcomes, the median birth weight was 3,028 g and the median umbilical cord pH was 7.29. Eight newborns (6.45%) required admission to intensive care unit. Postnatal comorbidities were identified in 14 infants, with respiratory complications being the most frequent (12/14). Conclusions: In this cohort of women of AMA following IVF, several obstetric and neonatal complications were observed. Additionally, the subgroup analysis revealed that PPROM, preterm IUGR and preterm delivery, lower neonatal weight and respiratory complications were significantly more frequent among women aged 45 or older. These findings provide descriptive clinical data regarding pregnancies in this specific population, which remains relatively underrepresented in the literature. Given the single-center design of the study, further research, including studies with appropriate comparison groups and larger sample size conducted across multiple centers, are needed to better clarify the individual and combined contributions of AMA and IVF to these outcomes.
Characteristics of Electric Scooter-Related Maxillofacial Trauma, from 2017 to 2024: A Retrospective Study
(Multidisciplinary Digital Publishing Institute (MDPI), 2026-07) González Pérez, Luis Miguel; Wideberg, Johan; Álvarez-Delgado, Carlos; Ingeniería y Ciencia de los Materiales y del Transporte; Cirugía
Background/Objectives: The aims of this study were to investigate maxillofacial trauma resulting from electric scooter accidents and to identify risk factors associated with the location of injuries. Methods: An 8-year retrospective cohort study was conducted involving all patients presenting with electric scooter-related maxillofacial fractures at a tertiary care center from 2017 to 2024. Data recorded for each patient included gender, age, date and cause of injury, contributing factors, type of facial fractures, other injuries, helmet use, and length of hospital stay. Results: Maxillofacial fractures were diagnosed in 138 patients (18.5% of e-scooter accident presentations). The study included 93 male and 45 female patients (ratio 2:1), with a mean age of 25.8 ± 7.75 years (range 14–45 years). Patients aged 20–29 years formed the largest group (51%). Most patients (89%) sustained a single facial fracture, and the most affected facial area was the lower third, with 80 cases (58%), followed by the middle third (36%). The remaining patients were represented by a combination of the various facial thirds, with thirds I-II being the most representative (12%). The most recurrent patterns were multifocal mandibular fractures (55%), followed by fractures of the orbito-malar-zygomatic complex (33%). Dental injuries were also frequent and were recorded in 40 patients (29% of all cases). Concomitant injuries outside the facial region were documented in 32 patients (23%), among which orthopedic limb injuries were most common (44% of patients with concomitant injuries). Contributing factors were identifiable in 102 patients (74%). Self-reported helmet use was low, with 63% of patients reporting never wearing a helmet, and 27% reporting inconsistent or occasional use. Conclusions: Accidents involving personal mobility vehicles have become a primary cause of emergency room admissions in recent years. Although electric-scooter-related maxillofacial fractures are a new phenomenon, an awareness of their frequency, contributing factors, and anatomical distribution is important for emergency and trauma teams who assess these patients first. Early recognition and timely management are crucial because missed diagnoses or delayed treatment can lead to permanent facial deformities and functional disability. These findings can inform targeted public health strategies and injury-prevention programs. In the future, helmet designs should be modified to improve maxillofacial protection in scooter-related injuries.
A detailed exploration of the ex utero intrapartum treatment procedure with center-specific advancements
(MDPI, 2026-02-23) Domínguez-Moreno, Marta; Chimenea-Toscano, Ángel; Viegas-González, María Remedios; Morales-Muñoz, Clara; García Díaz, Lutgardo; Antiñolo Gil, Guillermo; Cirugía; Instituto de Biomedicina de Sevilla (IBIS)
The Ex Utero Intrapartum Treatment (EXIT) procedure has long been an invaluable tool in managing complex fetal conditions requiring airway interventions during the transition from intrauterine to extrauterine life. This technical note offers an in-depth examination of the EXIT procedure, emphasizing the refinements and innovations introduced at our center. The technique focuses on meticulous preoperative assessment and uses distinctive techniques and anesthetic methodologies. A multidisciplinary team assembles to plan the EXIT procedure, emphasizing patient communication and risk discussion. Our technique involves atraumatic access to the uterine cavity, achieved through the application of a uterine progressive distractor developed for this purpose. Following the use of this distractor, vascular clamps and a stapling device (Premium Poly Cs-57 Autosuture®, Medtronic) are employed. Our anesthetic approach employs general anesthesia with epidural catheter placement. Maternal operation involves low transverse laparotomy and intraoperative ultrasonography-guided hysterotomy. Fetal exposure includes gentle extraction or external version, ensuring airway access. After securing fetal airway access, umbilical cord clamping and maternal abdominal closure conclude the procedure. By revisiting the core principles of EXIT and incorporating center-specific advancements, we enhance our understanding and technical expertise. To our knowledge, this is the first time a detailed description of the technique has been published.
Transplacental treatment of fetal tachyarrhythmia: current trends and future perspectives
(MDPI, 2026-04-26) Chimenea-Toscano, Ángel; Vargas-Rodríguez, Carmen; García Díaz, Lutgardo; Antiñolo Gil, Guillermo; Cirugía
Fetal arrhythmias complicate 1% of pregnancies. Although most of them have a benign and intermittent course, sustained fetal tachyarrhythmias constitute an emerging situation, which is associated with high fetal morbidity and mortality. However, one of the major milestones in fetal therapy is the pharmacologic management of fetal arrhythmias by crossing the placental barrier. To date, there is no consensus on the first-line antiarrhythmic treatment for fetal tachyarrhythmias. The role of sotalol in therapeutic management, the use of flecainide versus digoxin as first line of treatment, the need for fetal intramuscular treatment administration, or the best treatment in case of fetal hydrops are situations whose application or management are controversial. The current paper is a scoping review of observational and experimental evidence, addressing the types of best management strategies for each type of tachyarrhythmia and the optimal pharmacological dose, considering precautions and safety elements. Finally, we will highlight new therapeutic perspectives and future diagnostic and therapeutic strategies.
Association of the neurokinin-1R/substance P pathway with intraoperative tumor cell mobilization and early postoperative metastasis in pancreatic cáncer
(Elsevier ; Lippincott williams & wilkins; Ovid Technologies (Wolters Kluwer Health), 2026-07-09) Padillo Ruiz, Francisco Javier; García Sánchez, Carlos Javier; Sánchez Valderrabanos, Elia; Escudero Severín, Carlos; Boul-Atarass, Iman Laga; Suárez Artacho, Gonzalo; Marín Gómez, Luis Miguel; Álamo Martínez, José María; Gómez Bravo, Miguel Ángel; Bernal Bellido, Carmen; Muñoz Sáez, Miguel; Cirugía; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía
Background: Pancreatic ductal adenocarcinoma (PDAC) patients often present with early metastases after surgery, probably due to the mobilization of intraoperative circulating tumor cells (CTCs) and clusters. This exploratory study aimed to assess the potential association between the expression of substance P (SP) and neurokinin-1 receptor (NK-1R) in PDAC cells with CTC and cluster spread during pancreatoduodenectomy. Secondly, the potential impact on metastasis development and overall survival (OS) was also assessed. Methods: Twenty-one PDAC patients undergoing pancreatoduodenectomy were evaluated to analyze SP/NK-1R intra-tumor expression. Intraoperative portal vein samples were collected to quantify CTCs and clusters. Metastatic disease-free survival (MDFS) and OS were assessed during the 3-year follow-up. Results: High cytoplasmic expression of NK-1R in PDAC cells was associated with CTCs and cluster mobilization during surgery, between the beginning of the intervention and the resection of the pancreatic tumor (P = 0.005 and P = 0.025, respectively). Cytoplasmic NK-1R expression in PDAC cells was also associated with lower MDFS 1 year after pancreatoduodenectomy (P = 0.042). Similarly, the higher the cytoplasmic SP expression, the lower the OS (P = 0.019). Conclusions: This exploratory study showed that higher NK-1R expression in PDAC cells’ cytoplasm was associated with higher intraoperative CTCs and cluster mobilization. A potential association between higher cytoplasmic expression of NK-1R and SP with lower MDFS and OS, respectively, was observed.
Papel de la cirugía en el tratamiento de la colitis pseudomembranosa
(Academia Mexicana de Cirugía, 2017-07) Tallón Aguilar, Luis; Herranz Guerrero, Pablo de la; López Ruiz, José Antonio; Sánchez Moreno, Laura; López Pérez, José; Padillo Ruiz, Francisco Javier; Cirugía; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía
Antecedentes: La colitis pseudomembranosa, producida por el Clostridium difficile, presenta una incidencia creciente en los últimos años, motivada principalmente por el uso indiscriminado de antibióticos. Aunque su tratamiento de inicio es médico, el papel de la cirugía de urgencias ha ido ganando terreno debido a una mortalidad elevada y a la aparición de cepas cada vez más virulentas. En nuestro medio su prevalencia aún es escasa, por lo que en ocasiones nuestra experiencia en su manejo es limitada. Objetivo: Analizar nuestra experiencia quirúrgica en el tratamiento de esta dolencia y recordar el rol de la cirugía, así como alguno de sus aspectos técnicos. Casos clínicos: Presentamos 2 casos clínicos de pacientes que han presentado un cuadro de colitis pseudomembranosa de presentación fulminante, sin respuesta al tratamiento médico inicial, por lo que se requiere una actuación quirúrgica urgente, con buena respuesta. Conclusiones: Es importante siempre tener en mente la posibilidad quirúrgica en el tratamiento de la colitis pseudomembranosa, sobre todo cuando se presenta de manera fulminante, existen complicaciones asociadas o falla de respuesta al tratamiento médico.
Lesión medular esternal avanzada en un paciente con mieloma múltiple
(Elsevier, 2016) Pardo Pardo, Carlos Andrés; Gutiérrez Carretero, Encarnación; González Calle, Antonio; Cirugía; CTS1134: Investigación Traslacional en la Fisiopatología Cardiovascular
Presentamos el caso de una mujer de 60 años de edad, diagnosticada hace 20 años de mieloma múltiple IgG kappa, ISS II, y con un Durie-Salmon estadio III; fue tratada durante estos años con radioterapia y 6 ciclos de quimioterapia con vincristina, adriamicina y dexametasona (VAD), y hace 2 años recibió un trasplante autógeno de progenitores hematopoyéticos. (extracto)
Fractura craneal deprimida congénita… ¿actitud a seguir?
(Doyma, 2016-04) Márquez-Rivas, Javier; Rivero Garvía, Mónica; Mayorga Buiza, María José; Aguayo Maldonado, Josefa; Cirugía; TEP203: Física Interdisciplinar Fundamentos y Aplicaciones
Los autores consideran que el tratamiento conservador, a pesar de que el caso que exponen fue intervenido, se está «imponiendo» en el manejo de esta afección. Sin embargo, nos gustaría puntualizar que el manejo conservador puede estar indicado en casos seleccionados como pequeñas depresiones en áreas estéticamente poco visibles, o no elocuentes, bien desapareciendo espontáneamente o con ayuda de sistemas de succión. Sin embargo, los grandes hundimientos, como el que presentan, no se resuelven espontáneamente y las medidas mecánicas externas son muchas veces insuficientes. De hecho, la literatura recoge estos casos como excepcionales y no como la norma. (extracto)
Descripción paso a paso de la técnica transaórtica para el tratamiento transcatéter de la estenosis aórtica severa
(Elsevier, 2016-06-20) Araji Tiliani, Omar; Gordillo, Alejandra; Fernández, Antonio; Barquero, José M.; Castro, Antonio; Cirugía
El tratamiento transcatéter de la estenosis aórtica severa se encuentra en continua evolución desde que se describió por Cribier por primera vez en 2002. Se han estandarizado la vía transfemoral retrógrada y la vía transapical, y con la mejora de los dispositivos, se está empleando cada vez con más frecuencia la vía transaórtica. Esta vía puede suponer muchas ventajas para el tratamiento de los pacientes con un alto riesgo quirúrgico y rechazados para los otros abordajes. Nuestro grupo comenzó a emplearla a finales del 2013 y se ha convertido en la vía preferida por delante de la transapical. En este artículo describimos nuestra técnica transaórtica paso a paso, sus ventajas e inconvenientes.
Documento de consenso sobre pautas de actuación y seguimiento del varón con síntomas del tracto urinario inferior secundarios a hiperplasia prostática benigna
(2016) Brenes Bermúdez, Francisco José; Brotons Muntó, Francisco; Castiñeiras Fernández, Jesús; Cózar Olmo, José Manuel; Fernández-Pro Ledesma, Antonio; Martín Jiménez, Juan Antonio; Martínez-Berganza Asensio, María Lourdes; Miñana López, Bernardino; Molero García, José María; Cirugía
La hiperplasia benigna de próstata (HBP) es una patología con una alta incidencia. Su diagnóstico y tratamiento son compartidos entre urólogos y médicos de atención primaria. Su manejo consume una enorme cantidad de recursos. La Sociedad Espanola ˜ de Médicos de Atención Primaria (SEMERGEN), la Sociedad Espanola ˜ de Médicos Generales y de Familia (SEMG), la Sociedad Espanola ˜ de Medicina de Familia y Comunitaria (semFYC) y la Asociación Espanola ˜ de Urología (AEU) han elaborado un documento sobre pautas de actuación y seguimiento de la HBP, presentado aquí de manera resumida, en el que se pretende actualizar las guías anteriormente publicadas, en base a las últimas evidencias. Estas nuevas recomendaciones tienen como objetivo principal sensibilizar al médico de atención primaria y ayudarle en la evaluación diagnóstica, el tratamiento y el seguimiento, además de aportar criterios unificados y consensuados de derivación al segundo nivel asistencial.
Evaluación de la calidad de vida de los supervivientes de cáncer de cabeza y cuello
(Arán Ediciones, 2026-07) Herce López, Javier; Rollón Mayordomo, Ángel; Infante Cossío, Pedro Antonio; Cirugía; CTS142: Patología Morfolog. y Func. del Territorio Oral y Maxilofacial
El tratamiento del cáncer de cabeza y cuello (CCC) puede tener un importante impacto en la calidad de vida (CV). Su evaluación a través de cuestionarios es cada vez más habitual y constituye un importante aspecto en la evaluación clínica y terapéutica de pacientes. Junto con la recurrencia y supervivencia, la medición de la CV ayuda a anticipar los resultados del tratamiento en beneficio de la salud del paciente. Existe un creciente interés en valorar la CV en pacientes tratados de CCC mediante cuestionarios estandarizados. El objetivo de este trabajo ha sido revisar los artículos indexados que evalúan la CV en pacientes tratados de CCC, los cuestionarios usados y sus resultados clínicos, con especial énfasis en pacientes con supervivencia superior a 5 años tras el tratamiento. Los factores más relacionados con la CV fueron aquellos derivados del paciente (edad, sexo, comorbilidad), del tumor (localización, tamaño tumoral) y del tratamiento (cirugía, radioterapia, reconstrucción quirúrgica, disección cervical). Si bien son necesarias nuevas investigaciones para incorporar los cuestionarios de CV a la práctica diaria, constituye un indicador para valorar la supervivencia de pacientes con CCC. La valoración de CV en pacientes oncológicos se ha convertido en un parámetro más para considerar en el cuidado y manejo de pacientes, entendimiento de los resultados de los tratamientos, supervivencia, morbilidad y años libres de enfermedad. Es necesario evaluar los resultados de CV a largo plazo, ya que los pacientes pueden necesitar mucho tiempo para recuperarse de la enfermedad y de los efectos adversos del tratamiento.
Evaluation of total alloplastic temporo-mandibular joint replacement with two different types of prostheses: A three-year prospective study
(Medicina Oral, S.L., 2016) González Pérez, Luis Miguel; Gonzalez Perez-Somarriba, Borja; Centeno Báez, Gabriel; Vallellano Martín, Carpóforo; Montes Carmona, Jose Francisco; Ingeniería Mecánica y Fabricación; Cirugía; TEP111: Ingeniería Mecánica
Background: Temporo-Mandibular Joint (TMJ) replacement has been used clinically for years. The objective of this study was to evaluate outcomes achieved in patients with two different categories of TMJ prostheses. Material and Methods: All patients who had a TMJ replacement (TMJR) implanted during the study period from 2006 through 2012 were included in this 3-year prospective study. All procedures were performed using the Biomet Microfixation TMJ Replacement System, and all involved replacing both the skull base component (glenoid fossa) and the mandibular condyle. Results: Fifty-seven patients (38 females and 19 males), involving 75 TMJs with severe disease requiring reconstruction (39 unilateral, 18 bilateral) were operated on consecutively, and 68 stock prostheses and 7 custom-made prostheses were implanted. The mean age at surgery was 52.6±11.5 years in the stock group and 51.8±11.7 years in the custom-made group. In the stock group, after three years of TMJR, results showed a reduction in pain intensity from 6.4±1.4 to 1.6±1.2 (p<0.001), and an improvement in jaw opening from 2.7±0.9 cm to 4.2±0.7 cm (p<0.001). In the custom-made group, after three years of TMJR, results showed a reduction in pain intensity from 6.0±1.6 to 2.2±0.4 (p<0.001), and an improvement in jaw opening from 1.5±0.5 cm to 4.3±0.6 cm (p<0.001). No statistically significant differences between two groups were detected. Conclusions: The results of this three-year prospective study support the surgical placement of TMJ prostheses (stock prosthetic, and custom-made systems), and show that the approach is efficacious and safe, reduces pain, and improves maximum mouth opening movement, with few complications. As such, TMJR represents a viable technique and a stable long-term solution for cranio-mandibular reconstruction in patients with irreversible endstage TMJ disease. Comparing stock and custom-made groups, no statistically significant differences were detected with respect to pain intensity reduction and maximum mouth opening improvement.
Fibrinogen-thrombin collagen patch reinforcement of high-risk colonic anastomoses in rats
(Baishideng Publishing Group Inc., 2016-09-27) Suárez Grau, Juan Manuel; Bernardos García, Carlos; Cepeda Franco, Carmen; Méndez García, Cristina; García Ruiz, Salud; Docobo Durántez, Fernando; Morales Conde, Salvador; Padillo Ruiz, Francisco Javier; Cirugía; CTS664: Cirugía Avanzada y Trasplantes. Terapia Celular y Bioingeniería Aplicada a la Cirugía
Aim: To evaluate the effectiveness of human fibrinogen-thrombin collagen patch (TachoSil®) in the reinforcement of high-risk colon anastomoses. Methods: A quasi-experimental study was conducted in Wistar rats (n = 56) that all underwent high-risk anastomoses (anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group (24 rats) and treatment group (24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil® (a piece of TachoSil® was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes. Results: Overall survival was 71.4% and 57.14% in the TachoSil® group and control group, respectively (P = 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage (P > 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups (P = 0.066). Conclusion: In our study, the use of TachoSil® was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil® has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions.
First Report of Acute Postoperative Endophthalmitis Caused by Rothia Mucilaginosa after Phacoemulsification
(MDPI, 2016-03) Álvarez Ramos, Pablo; Moral Ariza, Amparo del; Alonso Maroto, José M.; Mann Casanova, Pilar; Calandria Amigueti, José M.; Rodriguez Iglesias, Manuel; Rodríguez de la Rúa Franch, Enrique; Cirugía
We aimed at reporting the first case of rapidly progressive acute postoperative endophthalmitis after phacoemulsification cataract surgery in an immunocompetent patient caused by Rothia mucilaginosa. An immunocompetent patient manifested endophthalmitis signs 48 hours after an uncomplicated cataract surgery by phacoemulsification. A bacteria of the family Micrococcaceae was cultured in the vitreous biopsy, namely R. mucilaginosa. The patient did not show a favorable clinical response after vitrectomy and systemic, intravitreal, and topical fortified antibiotics. The patient’s eye was very painful, and consequently, it deemed necessary to perform an evisceration. R. mucilaginosa may be an aggressive etiologic agent for postoperative endophthalmitis. Although the isolated R. mucilaginosa was susceptible to empirical treatment, it was impossible to control the infection with standard treatment, probably due to its ability to create a biofilm around the intraocular lens.
Association between the use of prostaglandin analogues and ocular surface disease: a systematic review
(Springer Nature, 2024-10-08) Monge Carmona, Raquel; Caro Magdaleno, Manuel; Sánchez González, María del Carmen; Cirugía; Física de la Materia Condensada; Instituto de Salud Carlos III; Ministerio de Ciencia e Innovación (MICIN). España; European Union (UE)
Patients with glaucoma often experience chronic ocular surface diseases, potentially underestimated in frequency and severity. To provide updated estimates of ocular surface diseases linked to prostaglandin analogue antiglaucoma eye medication, a systematic review was conducted. Twenty-seven publications were selected from databases like PubMed, Scopus, and Web of Science, following a search strategy targeting glaucoma and prostaglandins while excluding certain medications ('(Glaucoma AND prostaglandins OR ‘prostaglandin analogues’)(‘eye drops’ OR ‘artificial tears’ OR ‘ocular surface’ OR ‘dry eye’ OR ‘dry eye syndrome’ OR ‘ocular surface disease’ OR ‘tear film’) NOT (‘beta blockers’ OR ‘alpha adrenergic agonists’ OR ‘carbonic anhydrase inhibitors’ OR ‘rho-quinase’)'. The review revealed a correlation between prostaglandin analogue use and ocular surface damage, assessing parameters such as tear break-up time, Schirmer test value, ocular surface staining, hyperaemia score, and meibomian gland characteristics. Some studies explored switching patients to alternative glaucoma medications, noting varied effects on ocular surface parameters. Comparisons suggested better tolerance and outcomes with preservative-free options over prostaglandins. Additionally, the impact of treatment duration and diquafosol on ocular health, including meibomian gland loss, was examined across different formulations. Although a link between prostaglandin analogues (with or without preservatives) and ocular surface damage was established, inconsistencies in methodologies and assessment across studies were noted. This comprehensive review, spanning a decade of glaucoma research, underscores the need for re-evaluation of treatment strategies in ophthalmology. It stresses the significance of informed decision-making for enhanced glaucoma care, taking into account the observed effects of various medications on eye health.

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