PublicationPredictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.(2022) Estella, Á; Garcia Garmendia, J L; de la Fuente, C; Machado Casas, J F; Yuste, M E; Amaya Villar, R; Estecha, M A; Yaguez Mateos, L; Cantón Bulnes, M L; Loza, A; Mora, J; Fernández Ruiz, L; Díez Del Corral Fernández, B; Rojas Amezcua, M; Rodriguez Higueras, M I; Díaz Torres, I; Recuerda Núñez, M; Zaheri Beryanaki, M; Rivera Espinar, F; Matallana Zapata, D F; Moreno Cano, S G; Gimenez Beltrán, B; Muñoz, N; Sainz de Baranda Piñero, A; Bustelo Bueno, P; Moreno Barriga, E; Rios Toro, J J; Pérez Ruiz, M; Gómez González, C; Breval Flores, A; de San José Bermejo Gómez, A; Ruiz Cabello Jimenez, M A; Guerrero Marín, M; Ortega Ordiales, A; Tejero-Aranguren, J; Rodriguez Mejías, C; Gomez de Oña, J; de la Hoz, C; Ocaña Fernández, D; Ibañez Cuadros, S; Garnacho Montero, J; Work Group of Infectious Disease (GTEI) de la Sociedad Andaluza de Medicina Intensiva y Unidades coronarias SAMIUCThe objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. Prospective descriptive multicenter cohort study. 26 Intensive care units (ICU) from Andalusian region in Spain. Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. None. Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission 6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission 470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor. PublicationAnterior Cruciate Ligament Revision Surgery Associated to Lateral Collateral and Anterolateral Ligaments Reconstruction With Single Achilles Tendon Allograft and Single Femoral Tunnel(Elsevier, 2022-10-20) Espejo-Reina, Alejandro; Josefa Espejo-Reina, Maria; Lombardo-Torre, Maximiano; Sevillano-Perez, Enrique; Llanos-Rodriguez, Alvaro; Espejo-Baena, Alejandro; [Espejo-Reina, Alejandro] Clin Espejo, Malaga, Spain; [Espejo-Baena, Alejandro] Clin Espejo, Malaga, Spain; [Espejo-Reina, Alejandro] Hosp Vithas Malaga, Malaga, Spain; [Lombardo-Torre, Maximiano] Hosp Vithas Malaga, Malaga, Spain; [Sevillano-Perez, Enrique] Hosp Vithas Malaga, Malaga, Spain; [Llanos-Rodriguez, Alvaro] Hosp Vithas Malaga, Malaga, Spain; [Espejo-Baena, Alejandro] Hosp Vithas Malaga, Malaga, Spain; [Josefa Espejo-Reina, Maria] Hosp San de Juan Dios Aljarafe, Seville, Spain; [Lombardo-Torre, Maximiano] Hosp Univ Virgen de la Victoria, Malaga, Spain; [Sevillano-Perez, Enrique] Hosp Reg Univo Malaga, Malaga, Spain; [Llanos-Rodriguez, Alvaro] Hosp Antequera, Malaga, SpainLateral collateral ligament (LC) injuries that go unnoticed when associated with an anterior cruciate ligament (ACL) tear can increase stress forces on the ACL graft causing its failure. Furthermore, it is a main stabilizer to varus stress and external rotation. On the other hand, the reinforcement of anterolateral structures during ACL reconstruction has regained popularity in recent years, because evidence has shown that it increases the control of rotational laxity and decreases ACL graft failures, especially in revision surgery. The present article shows a technique to perform an ACL reconstruction, associated with the reconstruction of the LCL and of the anterolateral ligament using a single Achilles tendon allograft, which is split after the fixation of the ACL graft into two fascicles. PublicationArthroscopic Superior Capsular Reconstruction with Achilles Tendon Allograft for Massive and Revision Rotator Cuff Tears.(2022-01-23) Llanos-Rodríguez, Álvaro; Escandón-Almazán, Pilar; Espejo-Reina, Alejandro; Nogales-Zafra, José; Espejo-Baena, AlejandroMassive irreparable rotator cuff tears (RCT) in younger and active patients remain a significant clinical challenge to orthopaedic surgeons. Superior capsular reconstruction (SCR) has been presented as a way to restore the restraining effect of the superior joint capsule and the balanced force couples necessary for dynamic shoulder function; furthermore, it does not exclude future treatment options. The purpose of this article is to show a technical modification of the SCR in massive and revision RCT using Achilles tendon allograft as an effective static restraint to prevent superior migration of the humeral head due to its thickness and robustness, and performing a side-to-side repair on the greater tuberosity between the graft and the residual infraspinatus tendon to completely restore the superior stability of the shoulder joint. PublicationThe Sound of Silence: Unspoken Meaning in the Discourse of Pregnant and Breastfeeding Women on Environmental Risks and Food Safety in Spain.(2022-01-29) Company-Morales, Miguel; Casadó, Lina; Zafra Aparici, Eva; Rubio Jiménez, María Filomena; Fontalba-Navas, Andrés(1) Background: In recent years, a growing number of qualitative health research studies have performed discourse analysis of data from participants' narratives. However, little attention has been paid to the gaps and silences within these narratives. The aim of the present study is to interpret the silences detected in the discourse of pregnant and breastfeeding women concerning environmental risks and food safety. (2) Methods: This descriptive, interpretive, observational study was conducted according to a qualitative research paradigm and from a phenomenological and ethnographic perspective. The study sample was composed of 88 intentionally selected women, among whom fifty interviews, three ethnographies and five focus groups were conducted. Data coding and analysis were performed using N-Vivo 12 software. (3) Results: The results obtained show that the women's discourse presented silences that reflected their minimisation of perceived environmental and food risks. However, these women were wary of food produced in the proximity of contaminated areas. Nevertheless, the participants believed they were powerless to overcome environmental pollution and the potential contamination of their own bodies. (4) Conclusions: The participants' minimisation of the environmental risks faced and their inaction in this respect are sustained by the biopolitical practices of public institutions, which have propelled these women into a situation of learned helplessness and social injustice. PublicationHigh-Risk Obesity Phenotypes: Target for Multimorbidity Prevention at the ROFEMI Study.(2022-08-09) Carretero-Gómez, Juana; Pérez-Martínez, Pablo; Seguí-Ripoll, José Miguel; Carrasco-Sánchez, Francisco Javier; Lois Martínez, Nagore; Fernández Pérez, Esther; Pérez Hernández, Onán; García Ordoñez, Miguel Ángel; Martín González, Candelaria; Vigueras-Pérez, Juan Francisco; Puchades, Francesc; Blasco Avaria, María Cristina; Pérez Soto, María Isabel; Ena, Javier; Arévalo-Lorido, José Carlos; On Behalf Of Diabetes Obesity And Nutrition Working Group Of Spanish Society Of Internal Medicine,Background: Describe the profile of patients with obesity in internal medicine to determine the role of adiposity and related inflammation on the metabolic risk profile and, identify various “high-risk obesity” phenotypes by means of a cluster analysis. This study aimed to identify different profiles of patients with high-risk obesity based on a cluster analysis. Methods: Cross-sectional, multicenter project that included outpatients attended to in internal medicine. A total of 536 patients were studied. The mean age was 62 years, 51% were women. Patients were recruited from internal medicine departments over two weeks in November and December 2021 and classified into four risk groups according to body mass index (BMI) and waist circumference (WC). High-risk obesity was defined as BMI > 35 Kg/m2 or BMI 30−34.9 Kg/m2 and a high WC (>102 cm for men and >88 cm for women). Hierarchical and partitioning clustering approaches were performed to identify profiles. Results: A total of 462 (86%) subjects were classified into the high-risk obesity group. After excluding 19 patients missing critical data, two profiles emerged: cluster 1 (n = 396) and cluster 2 (n = 47). Compared to cluster 1, cluster 2 had a worse profile, characterized by older age (77 ± 16 vs. 61 ± 21 years, p 35 Kg/m2 or BMI 30−34.9 Kg/m2 and a high WC (>102 cm for men and >88 cm for women). Hierarchical and partitioning clustering approaches were performed to identify profiles. Results: A total of 462 (86%) subjects were classified into the high-risk obesity group. After excluding 19 patients missing critical data, two profiles emerged: cluster 1 (n = 396) and cluster 2 (n = 47). Compared to cluster 1, cluster 2 had a worse profile, characterized by older age (77 ± 16 vs. 61 ± 21 years, p 102 cm for men and >88 cm for women). Hierarchical and partitioning clustering approaches were performed to identify profiles. Results: A total of 462 (86%) subjects were classified into the high-risk obesity group. After excluding 19 patients missing critical data, two profiles emerged: cluster 1 (n = 396) and cluster 2 (n = 47). Compared to cluster 1, cluster 2 had a worse profile, characterized by older age (77 ± 16 vs. 61 ± 21 years, p 88 cm for women). Hierarchical and partitioning clustering approaches were performed to identify profiles. Results: A total of 462 (86%) subjects were classified into the high-risk obesity group. After excluding 19 patients missing critical data, two profiles emerged: cluster 1 (n = 396) and cluster 2 (n = 47). Compared to cluster 1, cluster 2 had a worse profile, characterized by older age (77 ± 16 vs. 61 ± 21 years, p 3 (53% vs. 5%, p PublicationOpioids and Ocular Surface Pathology: A Literature Review of New Treatments Horizons.(2022-03-04) García-López, Celia; Gómez-Huertas, Carmen; Sánchez-González, José-María; Borroni, Davide; Rodríguez-Calvo-de-Mora, Marina; Romano, Vito; Rachwani-Anil, Rahul; Ramos-López, Juan-Francisco; Ortiz-Pérez, Santiago; Rocha-de-Lossada, CarlosThis review discusses the role of opioids in the corneal surface and the different pathways and therapeutic methods of management. A literature review was performed using PubMed database. For the database search, the main searching words "opioid" and "topical opioid treatment" were used with the descriptors "cornea", "ocular surface", "neuropathic corneal pain", "corneal sensitivity" and "naltrexone"; original scientific articles and reviews were included to achieve the purpose of the review. The endogenous opioid system has relevant functions in the organism, and in daily use, opioids are used as painkillers. However, these drugs may be employed for other indications as opioid pathways have a wide spectrum. The corneal surface for topical treatment is easily accessible, hence sparing the side effects of systemic opioids. Instillation of opioid antagonist substances, such as naltrexone, increases corneal healing rates and stimulates the division of corneal epithelium cells without deleterious effects. The natural modulation of endogenous opioids controls different forms of pain, including inflammatory and neuropathic pain, both in the ocular surface and in the central nervous system. There are diverse methods in controlling pain using opioids, especially in refractory forms. This review attempts to collect the literature about corneal surface and opioid pathways to provide an overview image and a possible direction of the news treatments. PublicationFacilitators and Barriers of Medication Adherence Based on Beliefs of Persons with Bipolar Disorder: A Qualitative Study.(2022-06-22) Alcalá, Jose Ángel; Fontalba-Navas, Andrés; Company-Morales, Miguel; Romero-Guillena, Samuel L; Gutiérrez-Higueras, Teófilo; Gutiérrez-Rojas, LuisOne of the big challenges in treating individuals with bipolar disorder (BD) is nonadherence to medication. This is the principal factor associated with a worse prognosis or outcome of the disease. This study aimed to explore and analyze the individual perceptions that people with BD have about the positive and negative aspects when taking medication. A descriptive and interpretative study was carried out using the qualitative research paradigm with the use of the analytical technique of discourse analysis, extracting the data through the completion of focus groups. Participants' speech was digitally audio-recorded in digital format. In order to complete the codification of the participants' speech content, we relied on the qualitative data analysis (using the QRS NVivo 10 computer software). Thirty-six participants diagnosed with bipolar disorder took part in our study. In the participants' speech concerning the main barriers to pharmacological treatment, three key topics were identified. Perceived facilitators were summarized in four factors. The main facilitators regarding the use of pharmacological treatment in individuals with BD were the ones related with the perceived need for treatment in the acute phase, the recognition of the illness, the shared clinical decision, and the causal biological attribution in the chronic phase. In terms of perceived barriers, social control was identified in both phases, adverse effects in the acute phase, and the absence of effective treatment in the chronic state. PublicationPseudopterygium: An Algorithm Approach Based on the Current Evidence.(2022-07-30) Urbinati, Facundo; Borroni, Davide; Rodríguez-Calvo-de-Mora, Marina; Sánchez-González, José-María; García-Lorente, María; Zamorano-Martín, Francisco; Rachwani-Anil, Rahul; Ortiz-Pérez, Santiago; Romano, Vito; Rocha-de-Lossada, CarlosPseudopterygium is a non-progressive conjunctival adhesion to the peripheral cornea secondary to a corneal-limbus damage. According to the literature, the main etiology is a previous eye trauma. Nevertheless, this could be biased by the existence of other underdiagnosed causes of pseudopterygium, some of which may have severe consequences for the integrity of the eye and patient's life. This comprehensive literature review was performed based on a search on the PubMed and Google Scholar databases of relevant pseudopterygium published papers according to our current knowledge and seeks to gather the existing evidence about its diverse etiologies and clinical features, as well as to propose a diagnostic algorithm to simplify its correct approach. PublicationEffectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.(2022-06-09) Del Cura-González, Isabel; López-Rodríguez, Juan A; Leiva-Fernández, Francisca; Gimeno-Feliu, Luis A; Pico-Soler, Victoria; Bujalance-Zafra, Mª Josefa; Domínguez-Santaella, Miguel; Polentinos-Castro, Elena; Poblador-Plou, Beatriz; Ara-Bardají, Paula; Aza-Pascual-Salcedo, Mercedes; Rogero-Blanco, Marisa; Castillo-Jiménez, Marcos; Lozano-Hernández, Cristina; Gimeno-Miguel, Antonio; González-Rubio, Francisca; Medina-García, Rodrigo; González-Hevilla, Alba; Gil-Conesa, Mario; Martín-Fernández, Jesús; Valderas, José M; Marengoni, Alessandra; Muth, Christiane; Prados-Torres, J Daniel; Prados-Torres, Alexandra; MULTIPAP PLUS GroupThe progressive ageing of the population is leading to an increase in multimorbidity and polypharmacy, which in turn may increase the risk of hospitalization and mortality. The enhancement of care with information and communications technology (ICT) can facilitate the use of prescription evaluation tools and support system for decision-making (DSS) with the potential of optimizing the healthcare delivery process. To assess the effectiveness and cost-effectiveness of the complex intervention MULTIPAP Plus, compared to usual care, in improving prescriptions for young-old patients (65-74 years old) with multimorbidity and polypharmacy in primary care. This is a pragmatic cluster-randomized clinical trial with a follow-up of 18 months in health centres of the Spanish National Health System. Unit of randomization: family physician. Unit of analysis: patient. Patients aged 65-74 years with multimorbidity (≥ 3 chronic diseases) and polypharmacy (≥ 5 drugs) during the previous 3 months were included. n = 1148 patients (574 per study arm). Complex intervention based on the ARIADNE principles with three components: (1) family physician (FP) training, (2) FP-patient interview, and (3) decision-making support system. The primary outcome is a composite endpoint of hospital admission or death during the observation period measured as a binary outcome, and the secondary outcomes are number of hospital admission, all-cause mortality, use of health services, quality of life (EQ-5D-5L), functionality (WHODAS), falls, hip fractures, prescriptions and adherence to treatment. Clinical and sociodemographic factors will be explanatory variables. The main result is the difference in percentages in the final composite endpoint variable at 18 months, with its corresponding 95% CI. Adjustments by the main confounding and prognostic factors will be performed through a multilevel analysis. All analyses will be carried out in accordance to the intention-to-treat principle. It is important to prevent the cascade of negative health and health care impacts attributable to the multimorbidity-polypharmacy binomial. ICT-enhanced routine clinical practice could improve the prescription process in patient care. ClinicalTrials.gov NCT04147130 . Registered on 22 October 2019. PublicationCross-cultural adaptation and psychometric validation of a Spanish version of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire.(2022-04-21) de Juan-Roldán, Jose Ignacio; Castillo-Jimena, Marcos; González-Hevilla, Alba; Sánchez-Sánchez, Clara; García-Ruiz, Antonio J; Gavilán-Moral, EnriqueSuccessful deprescribing depends largely on factors related to the patient. The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire was developed with the objective of evaluating the beliefs and attitudes of older adults and caregivers towards deprescribing. The present study was designed to validate a Spanish version of the rPATD questionnaire, both the versions for older adults and for caregivers, through a qualitative validation phase and the analysis of its psychometric properties. Cross-sectional validation study. Primary care settings in Málaga (Spain). A sample of 120 subjects (60 patients with polypharmacy and 60 caregivers of patients with polypharmacy) were enrolled in the study. In the qualitative validation stage, the rPATD questionnaire was translated/back-translated and subjected to a cross-cultural adaptation to evaluate its face validity and feasibility. Next, its psychometric properties were assessed. Confirmatory factor analysis was used to evaluate construct validity. Internal consistency was determined using Cronbach's alpha test. Criterion validity through pre-established hypotheses from the Beliefs about Medicines Questionnaire (BMQ) Specific-Concerns Scale, and test-retest reliability were analysed. Confirmatory factor analysis verified the four-factor structure of the original rPATD questionnaire, with items loading into four factors: involvement, burden, appropriateness and concerns about stopping. The Cronbach's alpha coefficient of the factors ranged from 0.683 to 0.879. The burden, appropriateness and concerns about stopping factors were significantly correlated with the BMQ Specific-Concerns Score, except for the concerns about stopping factor in the older adults' version. The consistency of the items between administration times (test-retest reliability) showed weighted Cohen's kappa values ranging from moderate (>0.4) to very good (>0.8). The Spanish version of the rPATD questionnaire is a feasible, valid and reliable instrument to evaluate attitudes towards deprescribing in Spanish-speaking patients and caregivers. PublicationPersons with first episode psychosis have distinct profiles of social cognition and metacognition (vol 9, 61, 2021)(Nature portfolio, 2022-02-24) Ferrer-Quintero, M.; Fernandez, D.; Lopez-Carrilero, R.; Birules, I.; Barajas, A.; Lorente-Rovira, E.; Diaz-Cutraro, L.; Verdaguer, M.; Garcia-Mieres, H.; Sevilla-Llewellyn-Jones, J.; Gutierrez-Zotes, A.; Grasa, E.; Pousa, E.; Huerta-Ramos, E.; Pelaez, T.; Barrigon, M. L.; Gonzalez-Higueras, F.; Ruiz-Delgado, I.; Cid, J.; Moritz, S.; Ochoa, S.; Spanish Metacognition Grp; Univ Politecn Cataluna, BarcelonaTech UPC, Dept Stat & Operat Res DEIO, Barcelona, SpainUPC BarcelonaTech IMTech, Inst Math, Barcelona, Spain PublicationPsychometrics properties of a questionnaire on the attitudes of general practitioners towards mental health (MAPSAM-14)(Univ murcia, 2018-05-01) Moreno Kustner, Berta; Bordallo Aragon, Antonio; Sepulveda Munoz, Jesus; [Moreno Kustner, Berta] Univ Malaga, Fac Psicol, Dept Personalidad & Tratamiento Psicol, Malaga, Spain; [Bordallo Aragon, Antonio] Hosp Reg Malaga, Unidad Gest Clin Salud Mental, Serv Andaluz Salud, Malaga, Spain; [Sepulveda Munoz, Jesus] Dist Sanitario Malaga Guadalhorce, Ctr Salud Alameda Perchel, Serv Andaluz Salud, Malaga, SpainBackground: The aim of this study is to adapt and analyze the psychometric properties of a questionnaire on the perceptions of general practitioners towards mental health. Method: This is a descriptive cross-sectional, observational study. A total of 145 general practitioners from the reference area of Malaga Regional Hospital answered this 25-item questionnaire; a factorial analysis was then conducted and its internal consistency reliability was tested. Results: The adequacy of sampling and sphericity were satisfactorily met. Three dimensions measured by 14 items were found in the factorial analysis explaining 55.1% of its variance: the MAPSAM-14 questionnaire. Conclusions: This questionnaire may be a proper tool with which to determine the satisfaction of general practitioners in relation to mental health services, their beliefs and stigma towards mental illness and their level of training in the field of schizophrenia and related disorders. PublicationOutpatient placement of perforated setons prior to treatment of sealants for perianal fistula: A Technical Note(Elsevier science bv, 2017-05-01) Perez Lara, F. J.; Ferrer Berges, A.; Oehling de los Reyes, H.; Oliva Munoz, H.; [Perez Lara, F. J.] Antequera Hosp, Serv Surg, Malaga, Spain; [Oehling de los Reyes, H.] Antequera Hosp, Serv Surg, Malaga, Spain; [Ferrer Berges, A.] Malaga Univ Hosp, Serv Plast Surg, Malaga, Spain; [Oliva Munoz, H.] Antequera Hosp, Surg Serv, Malaga, Spain PublicationApplying traction to fundoplication by means of a Penrose drain in gastro-oesophageal reflux surgery in difficult cases of hiatal hernia(Elsevier science bv, 2017-05-01) Perez Lara, F. J.; Ferrer Berges, A.; Oehling de los Reyes, H.; Oliva Munoz, H.; [Perez Lara, F. J.] Antequera Hosp, Serv Surg, Malaga, Spain; [Oehling de los Reyes, H.] Antequera Hosp, Serv Surg, Malaga, Spain; [Ferrer Berges, A.] Malaga Univ Hosp, Serv Plast Surg, Malaga, Spain PublicationPosterior Cruciate Ligament Reconstruction With Hamstring Tendons Using a Suspensory Device for Tibial Fixation and Interference Screw for Femoral Fixation(Elsevier science bv, 2017-02-01) Espejo-Baena, Alejandro; Espejo-Reina, Alejandro; Josefa Espejo-Reina, Maria; Lombardo-Torre, Maximiano; [Espejo-Baena, Alejandro] Hosp Univ Virgen Victoria, Malaga, Spain; [Espejo-Reina, Alejandro] Hosp Univ Virgen Victoria, Malaga, Spain; [Lombardo-Torre, Maximiano] Hosp Univ Virgen Victoria, Malaga, Spain; [Espejo-Baena, Alejandro] Hosp Vithas Parque San Antonio, Malaga, Spain; [Espejo-Reina, Alejandro] Hosp Vithas Parque San Antonio, Malaga, Spain; [Josefa Espejo-Reina, Maria] Hosp Comarcal Antequera, Antequera, SpainA technique for posterior cruciate ligament reconstruction is presented. Autologous hamstring tendons are selected as a graft. An interference screw is used for femoral fixation. A suspension device is used for tibial fixation to bring the fixation closer to the articular end of the tibial tunnel. Single diameter tunnels of the same diameter as the graft are created in an outside-in direction. PublicationCOVID-19 pandemic, as experienced in the surgical service of a district hospital in Spain.(2021) Pérez Lara, Francisco Javier; Jimenez Martinez, Maria Belen; Pozo Muñoz, Francisco; Fontalba Navas, Andres; Garcia Cisneros, Rogelio; Garcia Larrosa, Maria Jose; Garcia Delgado, Ignacio; Callejon Gil, Maria Del MarThe coronavirus disease 2019, which is caused by severe acute respiratory syndrome coronavirus 2, was first identified in December 2019 in Wuhan, China, and has since spread rapidly, evolving into a full-blown pandemic. We would like to report our experience after 1 year of this pandemic in the surgical service of a district hospital in Spain. There have been many changes (including new protocols) that our service and the hospital have undergone, to adapt to the new situation. We believe that this experience can be useful for other professionals who have lived and are living a similar situation. PublicationAnterior Capsular Reconstruction With Proximal Biceps Tendon for Large to Massive Rotator Cuff Tears.(2021-07-21) Llanos-Rodríguez, Álvaro; Escandón-Almazán, Pilar; Espejo-Reina, Alejandro; Nogales-Zafra, José; Egozgue-Folgueras, Ricardo; Espejo-Baena, AlejandroMassive rotator cuff tears (RCT) have traditionally been a challenging clinical problem for shoulder surgeons. A broad variety of treatment options have been proposed to address this problem, but outcomes have been as variable as the techniques themselves. Superior capsular reconstruction has been presented as a way to restore the restraining effect of the superior joint capsule and balanced force couples in massive tears of the superior rotator cuff. The purpose of this article is to propose a technical modification of the superior capsular reconstruction in large to massive RCT, and, especially in anterior L-shaped RCT, using the long head of the biceps tendon autograft to reinforce the weakest area of the anterior capsule, not as an augmentation of the rotator cuff, but as a static stabilizer of the humeral head, allowing the rotator cuff repair to heal without tension. PublicationMedial Patellofemoral Ligament Reconstruction: Use of All-Suture Anchors for Patellar Fixation and a Dynamic Femoral Attachment.(2021-04-26) Dalla-Rosa, Jaime; Nogales, José J; Verdejo, Miguel; Nogales, José IThe medial patellofemoral ligament is one of the most relevant structures preventing patellar dislocation. Numerous surgical techniques have been described to reconstruct this structure and patellar biomechanics. Complications after this procedure concern both patella and femur. This technique avoids tunneling the patella and the use of intraoperative radiographs by using the adductor magnus tendon insertion. PublicationPerception and Demands of Pregnant and Breastfeeding Women Regarding Their Role as Participants in Environmental Research Studies.(2021-04-14) Company-Morales, Miguel; Zafra Aparici, Eva; Casadó, Lina; Alarcón Montenegro, Cristina; Arrebola, Juan PedroA significant proportion of scientific studies consider pregnant and breastfeeding women as vulnerable subjects. The objective of this study was to analyse the perception of pregnant and breastfeeding women regarding their participation in environmental research studies. Our work is a descriptive and interpretative observational study that has been developed under the qualitative research paradigm following a phenomenological and ethnographic perspective. The study involved 173 women selected intentionally in two Spanish autonomous communities. To obtain the primary data, we relied upon 111 interviews, four focused ethnographies and eight focus groups. The data encoding and analysis was carried out with the help of NVivo 12 software (QSR International, Boston, MA, USA). We evidenced the need of pregnant and breastfeeding women for more detailed and accurate information on the risk of environmental pollutant exposure during their crucial life stage. In addition, these women claimed for a more participatory role in research studies. Pregnant and breastfeeding women in Spain ask for greater interaction with researchers and propose a dialogical relationship between valid partners. We conclude that our pregnant and breastfeeding women claim more research focused on their collective, as well as clearer, more accessible and structured information on the risks of exposure to environmental contaminants. In addition, they do not want to simply be informants; rather, they ask to be active and empowered members by providing their opinions and arguments throughout the research process. PublicationCitizen Consultation on Problematic Usage of the Internet: Ethical Considerations and Empirical Insights From Six Countries.(2021-04-01) Gjoneska, Biljana; Jones, Julia; Vella, Anna Maria; Bonanno, Philip; Flora, Katerina; Fontalba-Navas, Andrés; Hall, Natalie; Ignjatova, Liljana; Kirtava, Zviad; Moreno Sanjuán, Daniel; Vaz-Rebelo, Maria Piedade; Sales, Célia M DCitizens and scientists can work together to improve the collective well-being, if citizens are inspired to help the advancement of science, and researchers motivated to listen to the voices of citizens. The benefits of such collaboration are increasingly recognized by both citizens and scientists, as reflected in the growing number of related publications and initiatives. This is especially relevant for emerging areas of research, where early involvement of citizens could help to envision, prioritize, and plan prospective studies. The Problematic Usage of the Internet (PUI) is one such area, which is fast becoming a public mental health concern. However, there remains a lack of clarity regarding the practical guidelines and ethical requirements for citizen involvement at the earliest stages of PUI. In our paper, we propose a conceptual framework and a template for initial involvement of citizens in PUI. They are derived from our community case studies, conducted in six European countries (Georgia, Greece, Malta, North Macedonia, Portugal, and Spain) and consisting of consultation with diverse groups of interested citizens (students, parents, teachers, and health professionals). Informed by our consultation exercises, we also highlight four ethical aspects for citizen involvement in the research on PUI or novel disciplines in general. They follow simple guiding principles to ensure that scientists will: enable a long-term commitment and inclusive opportunities for citizens, challenge established power hierarchies, and support collaboration, co-production and co-authorship with citizens. We believe that the proposed practical guidelines and ethical considerations, provide a valuable foundation on which to advance our understanding and generate international strategies for citizen involvement in PUI.