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Publication Iodine deficiency disturbs the metabolic profile and elemental composition of human breast milk.(2021-10-05) Arias-Borrego, A; Velasco, I; Gómez-Ariza, J L; García-Barrera, THuman breast milk (HBM) has a beneficial impact on health programming, growth and neurodevelopment of newborns.Increase in iodine intake is recommended for pregnant women in order to produce enough thyroid hormones to meet foetal requirements.In this work, a combined analytical multiplatform based on gas chromatography coupled to mass spectrometry and ultra-high performance liquid chromatography coupled toquadrupole-time-of-flight mass spectrometryhas been appliedinthe first metabolomic study of HBM ofiodine-deficientwomen. In addition, the elemental composition of HBM has been determined by inductively coupled plasma triple quadrupole mass spectrometry. Remarkably,31 metaboliteswith important biological roles(e.g. glycerophospholipids for neurodevelopment)were seentobe alteredin the HBM of iodine-deficient women. The main metabolic pathwaysalteredinclude lipid metabolism, amino acid cycle, the tricarboxylic acid cycle and glycolysis.Additionally, the concentration of selenium, zinc and copperwere seento be significantlylowerin HBM of iodine-deficient women.Publication Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study.(2022-07-22) Lorido, José Carlos Arévalo; Gómez, Juana Carretero; Correa, Miriam Romero; Iglesias, Jesus Recio; Fernández, Teresa Choucino; Camajuncosa, Rosa Jordana; Izquierdo, Margarita Carrera; Guardiola, Carlos Jiménez; Pardo, Lucía Fuentes; Ruiz, Esther Piniella; Formiga, Francesc; Bautista, Prado SalamancaThis work aims to compare the characteristics of advanced heart failure (HF) in patients with and without type 2 diabetes mellitus (DM) and to determine the relevance of variables used to define advanced HF. This cross-sectional, multicenter study included patients hospitalized for HF. They were classified into four groups according to presence/absence of advanced HF, determined based on general and cardiac criteria, and presence/absence of DM. To analyze the importance of variables, we grew a random forest algorithm (RF) based on mortality at six months. A total of 3153 patients were included. The prevalence of advanced HF among patients with DM was 24% compared to 23% among those without DM (p=0.53). Patients with advanced HF and DM had more comorbidity related to cardiovascular and renal diseases; their prognosis was the poorest (log-rank <0.0001) though the adjusted hazard ratio by group in the Cox regression analysis was not significant. The variables that were significantly related to mortality were the number of comorbidities (p=0.005) and systolic blood pressure (p=0.024). The RF showed that general criteria were more important for defining advanced HF than cardiac criteria. Patients with advanced HF and DM were characterized by DM in progression with macro and microvascular complications. The outcomes among advanced HF patients were poor; patients with advanced HF and DM had the poorest outcomes. General criteria were the most important to establish accurately a definition of advanced HF, being decisive the evidence of disease progression in patients with DM.Publication Consensus of the ambulatory surgery commite section of the Spanish Association of Surgeons on the role of ambulatory surgery in the SARS-CoV-2 pandemic(Elsevier espana slu, 2022-03-01) Morales-Garcia, Dieter; Docobo-Durantez, Fernando; Capitan Vallvey, J. M.; Manuel Suarez-Grau, Juan; Eugenia Campo-Cimarras, Maria; Gonzalez-Vinagre, Salustiano; Antonio Hidalgo-Grau, Luis; Puigcercos-Fuste, J. M.; Zaragoza-Fernandez, Cristobal; Valera-Sanchez, Zoraida; Vega-Ruiz, Vicente; Grp Trabajo CIRUGIA-AEC-COVID-19; [Morales-Garcia, Dieter] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Docobo-Durantez, Fernando] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Capitan Vallvey, J. M.] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Manuel Suarez-Grau, Juan] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Eugenia Campo-Cimarras, Maria] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Gonzalez-Vinagre, Salustiano] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Antonio Hidalgo-Grau, Luis] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Puigcercos-Fuste, J. M.] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Zaragoza-Fernandez, Cristobal] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Valera-Sanchez, Zoraida] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Vega-Ruiz, Vicente] Asociac Espanola Cirujanos, Secc Cirugia Mayor Ambulatoria, Madrid, Spain; [Morales-Garcia, Dieter] Hosp Univ Marques de Valdecilla, Inst Invest IDIVAL, Santander, Spain; [Docobo-Durantez, Fernando] Asociac Andaluza de Cirujanos, Com Cient, Andalucia, Spain; [Capitan Vallvey, J. M.] Hosp Univ Jaen, Jaen, Spain; [Manuel Suarez-Grau, Juan] Hosp Riotinto, Huelva, Spain; [Eugenia Campo-Cimarras, Maria] Hosp Txagorritxu, Vitoria, Spain; [Gonzalez-Vinagre, Salustiano] Hosp Univ Santiago, Santiago De Compostela, Spain; [Antonio Hidalgo-Grau, Luis] Hosp Mataro, Barcelona, Spain; [Puigcercos-Fuste, J. M.] Hosp Dos de Mayo, Barcelona, Spain; [Zaragoza-Fernandez, Cristobal] Hosp Gen Univ Valencia, Valencia, Spain; [Valera-Sanchez, Zoraida] Hosp Univ Virgen Macarena, Seville, Spain; [Vega-Ruiz, Vicente] Hosp Univ Puerto Real, Cadiz, SpainThe current situation of the SARS-CoV-2 pandemic has paralyzed non-urgent and/or oncological surgery in many hospitals in our country with what it means for the health of citizens who are awaiting a surgical procedure. Outpatient Surgery can afford more than 85% of the surgical procedures that are performed in a surgical department and is presented as a feasible and safe alternative at the present time since it does not require admission and decreases clearly the risk of infection. In addition, it is the tool that should be generalized to solve the accumulation of patients on the waiting list that the pandemic is generating, so it seems appropriate that the Ambulatory Surgery section of the Spanish Association of Surgeons present a series of recommendations for the implementation of outpatient surgery in these exceptional circumstances that we have to live. (C) 2021 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.Publication [COVID-19 clinical features in primary care: COVIDPAP study].(2022-05-02) Carballal-Mariño, Marta; Balaguer-Martínez, Josep Vicent; García-Vera, César; Morillo-Gutierrez, Beatriz; Domínguez-Aurrecoechea, Begoña; Jimenez-Alés, Rafael; Gallego-Iborra, Ana; Cañavate-González, Cristina; Ciriza-Barea, EdurneIn Spain, the tools to diagnose COVID-19 were available in primary care from May 2020. Previously most studies described inpatients, and fever and cough were the most frequent symptoms. This study aims to define the clinical picture of the pediatric COVID-19 in the community. A descriptive and analytical observational study was performed including pediatric cases (0-14y) from 255 pediatricians, proportionally distributed to its population, from primary health centers in Spain, from 12th May 2020 to 30th April 2021. Diagnostics were made by PCR detection of viral RNA, rapid antigen detection test or positive IgG serology. There were 10,021 positive children included, 48.4% women, mean age 8,04 ± 4.17 years. Infection was detected due to contact tracing (70.9%), compatible symptoms (18.8%). Household was the main source of transmission (64.9%), followed by school setting (10%) or unknown (9.9%). We did not find any significant differences in the incidence between holidays and school terms. 43.2% of the children were asymptomatic. Most frequent symptoms are rhinorrhea in 9 y. An exhaustive description of objective and subjective symptoms by age is made. 18 patients were hospitalized, one with multisystem inflammatory syndrome in children. There were no deaths. Pediatric COVID-19 is a mild disease, with a large number of asymptomatic cases, with very few hospital admissions and deaths. The main setting for transmission is the household, and school closures should be a last resource measure during the COVID-19 pandemic. A specific clinical picture of pediatric COVID-19 was not found.Publication The EPICTER score: a bedside and easy tool to predict mortality at 6 months in acute heart failure(Wiley periodicals, inc, 2022-04-12) Romero-Correa, Miriam; Salamanca-Bautista, Prado; Bilbao-Gonzalez, Amaia; Quiros-Lopez, Raul; Dolores Nieto-Martin, Maria; Luisa Martin-Jimenez, Maria; Luis Morales-Rull, Jose; Quiles-Garcia, Dolores; Gomez-Gigirey, Adriana; Formiga, Francesc; Aramburu-Bodas, Oscar; Luis Arias-Jimenez, Jose; EPICTER Investigators Grp; [Romero-Correa, Miriam] Hosp Riotinto, Internal Med Dept, Huelva, Spain; [Salamanca-Bautista, Prado] Hosp Univ Virgen Macarena, Internal Med Dept, Seville, Spain; [Aramburu-Bodas, Oscar] Hosp Univ Virgen Macarena, Internal Med Dept, Seville, Spain; [Luis Arias-Jimenez, Jose] Hosp Univ Virgen Macarena, Internal Med Dept, Seville, Spain; [Salamanca-Bautista, Prado] Univ Seville, Seville, Spain; [Aramburu-Bodas, Oscar] Univ Seville, Seville, Spain; [Luis Arias-Jimenez, Jose] Univ Seville, Seville, Spain; [Bilbao-Gonzalez, Amaia] Basurto Univ Hosp, Osakidetza Basque Hlth Serv, Res Unit, Bilbao, Spain; [Bilbao-Gonzalez, Amaia] Hlth Serv Res Network Chron Dis REDISSEC, Baracaldo, Spain; [Bilbao-Gonzalez, Amaia] Kronikgune Inst Hlth Serv Res, Baracaldo, Spain; [Quiros-Lopez, Raul] Hosp Costa del Sol, Internal Med Dept, Marbella, Spain; [Dolores Nieto-Martin, Maria] Hosp Univ Virgen Rocio, Internal Med Dept, Seville, Spain; [Luisa Martin-Jimenez, Maria] Hosp Univ Puerto Hierro, Internal Med Dept, Madrid, Spain; [Luis Morales-Rull, Jose] Hosp Arnau Vilanova, Internal Med Dept, Lerida, Spain; [Quiles-Garcia, Dolores] Hosp Univ Gen Valencia, Internal Med Dept, Valencia, Spain; [Gomez-Gigirey, Adriana] Hosp Arquitecto Marcide, Internal Med Dept, La Coruna, Spain; [Formiga, Francesc] Hosp Univ Bellvitge, Internal Med Dept, Barcelona, SpainAims Estimating the prognosis in heart failure (HF) is important to decide when to refer to palliative care (PC). Our objective was to develop a tool to identify the probability of death within 6 months in patients admitted with acute HF.Methods and results A total of 2848 patients admitted with HF in 74 Spanish hospitals were prospectively included and followed for 6 months. Each factor independently associated with death in the derivation cohort (60% of the sample) was assigned a prognostic weight, and a risk score was calculated. The accuracy of the score was verified in the validation cohort. The characteristics of the population were as follows: advanced age (mean 78 years), equal representation of men and women, significant comorbidity, and predominance of HF with preserved ejection fraction. During follow-up, 753 patients (26%) died. Seven independent predictors of mortality were identified: age, chronic obstructive pulmonary disease, cognitive impairment, New York Heart Association class III-IV, chronic kidney disease, estimated survival of the patient less than 6 months, and acceptance of a palliative approach by the family or the patient. The area under the ROC curve for 6 month death was 0.74 for the derivation and 0.68 for the validation cohort. The model showed good calibration (Hosmer and Lemeshow test, P value 0.11). The 6 month death rates in the score groups ranged from 6% (low risk) to 54% (very high risk).Conclusions The EPICTER score, developed from a prospective and unselected cohort, is a bedside and easy-to-use tool that could help to identify high-risk patients requiring PC.Publication Chronic Obstructive Pulmonary Disease in Elderly Patients with Acute and Advanced Heart Failure: Palliative Care Needs-Analysis of the EPICTER Study.(2022-06-27) Méndez-Bailón, Manuel; Lorenzo-Villalba, Noel; Romero-Correa, Miriam; Josa-Laorden, Claudia; Inglada-Galiana, Luis; Menor-Campos, Eva; Gómez-Aguirre, Noelia; Clemente-Sarasa, Carolina; Salas-Campos, Rosario; García-Redecillas, Carmen; Asenjo-Martínez, María; Trullàs, Joan Carles; Cortés-Rodríguez, Begoña; de la Guerra-Acebal, Carla; Serrado Iglesias, Ana; Aparicio-Santos, Reyes; Formiga, Francesc; Andrès, Emmanuel; Aramburu-Bodas, Oscar; Salamanca-Bautista, Prado; On Behalf Of Epicter Study Group,Introduction: There are studies that evaluate the association between chronic obstructive pulmonary disease (COPD) and heart failure (HF) but there is little evidence regarding the prognosis of this comorbidity in older patients admitted for acute HF. In addition, little attention has been given to the extracardiac and extrapulmonary symptoms presented by patients with HF and COPD in more advanced stages. The aim of this study was to evaluate the prognostic impact of COPD on mortality in elderly patients with acute and advanced HF and the clinical manifestations and management from a palliative point of view. Methods: The EPICTER study (“Epidemiological survey of advanced heart failure”) is a cross-sectional, multicenter project that consecutively collected patients admitted for HF in 74 Spanish hospitals. Demographic, clinical, treatment, organ-dependent terminal criteria (NYHA III-IV, LVEFPublication Cancer Impacts Prognosis on Mortality in Patients with Acute Heart Failure: Analysis of the EPICTER Study.(2022-01-24) Méndez-Bailón, Manuel; Lorenzo-Villalba, Noel; Romero-Correa, Miriam; Guisado-Espartero, Esther; González-Soler, Juan; Rugeles-Niño, Jessica; Sebastián-Leza, Angel; Ceresuela-Eito, Luis; Romaní-Costa, Verónica; Quesada-Simón, Angustias; Soler-Rangel, Llanos; Herrero-Domingo, Almudena; Díez-García, Luis; Alcalá-Pedrajas, José; Villalonga-Comas, María; Andrès, Emmanuel; Gudiñ-Aguirre, Diego; Formiga, Francesc; Aramburu-Bodas, Oscar; Arias-Jiménez, Jose; Salamanca-Bautista, Prado; On Behalf Of Epicter Study Group,Heart failure (HF) and cancer are currently the leading causes of death worldwide, with an increasing incidence with age. Little is known about the treatment received and the prognosis of patients with acute HF and a prior cancer diagnosis. to determine the clinical characteristics, palliative treatment received, and prognostic impact of patients with acute HF and a history of solid tumor. The EPICTER study ("Epidemiological survey of advanced heart failure") is a cross-sectional, multicenter project that consecutively collected patients admitted for acute HF in 74 Spanish hospitals. Patients were classified into two groups according to whether they met criteria for acute HF with and without solid cancer, and the groups were subsequently compared. A multivariable logistic regression analysis was conducted, using the forward stepwise method. A Kaplan-Meier survival analysis was performed to evaluate the impact of solid tumor on prognosis in patients with acute HF. A total of 3127 patients were included, of which 394 patients (13%) had a prior diagnosis of some type of solid cancer. Patients with a history of cancer presented a greater frequency of weight loss at admission: 18% vs. 12% (p = 0.030). In the cancer group, functional impairment was noted more frequently: 43% vs. 35%, p = 0.039). Patients with a history of solid cancer more frequently presented with acute HF with preserved ejection fraction (65% vs. 58%, p = 0.048) than reduced or mildly reduced. In-hospital and 6-month follow-up mortality was 31% (110/357) in patients with solid cancer vs. 26% (637/2466), p = 0.046. Our investigation demonstrates that in-hospital mortality and mortality during 6-month follow-up in patients with acute HF were higher in those subjects with a history of concomitant solid tumor cancer diagnosis.Publication The influence of emotional burnout and resilience on the psychological distress of nursing students during the COVID-19 pandemic.(2022-08-08) Merino-Godoy, María Ángeles; Yot-Domínguez, Carmen; Conde-Jiménez, Jesús; Ramírez Martín, Patricia; Lunar-Valle, Piedad MaríaThe aim of this study was to measure and analyse the association of emotional burnout and resilience with the psychological distress of students who finished their nursing studies after the peak of the COVID-19 pandemic. The mental health of nursing students was affected during the pandemic, and resilience seems to counteract the negative effects. This is a cross-sectional study. The data (quantitative) were gathered at the beginning of the second term of the academic year 2020/2021. The study was carried out in the Spanish university context. Self-reported measures were gathered using three one-dimensional, valid, and reliable scales: the Psychological Distress Scale (K-10), the Emotional Burnout Scale (EBS), and the short version of the Connor-Davidson Resilience Scale (CD-RISC10). A total of 393 students of different Spanish universities participated in this study. A valid linear regression model was obtained, which allowed verifying that psychological distress is explained, with 37% variance, by emotional burnout and resilience. The total score in emotional burnout has more relevance than the total score in resilience, and the latter has a negative tendency. Facing the factors that generate emotional burnout in students in the academic scope and promoting resilience in them are fundamental aspects that contribute to their psychological well-being. The reflection should be extended to clinical practices. Universities are urged to think about last-year students, their experiences, perceptions, and feelings, to determine how their susceptibility to emotional burnout and psychological distress can be minimized in their future clinical practices. Strategies to promote their resilience should also be studied.Publication V-043 NEW CONCEPTS IN LIRA TECHNIQUE IN LAPAROSCOPIC VENTRAL HERNIA REPAIR. LIRA -LESS STEP BY STEP(Oxford univ press, 2022-10-13) Menchero, J. Gomez; Bohorquez, A. Gila; De la Herranz, P.; Guerrero, J. L.; Fernandez, Y. Lara; Luque, J. Bellido; Moreno, J. Garcia; Navarro, L.; Conde, S. Morales; [Menchero, J. Gomez] Hosp Riotinto, Surg, Riotinto, Spain; [Bohorquez, A. Gila] Hosp Riotinto, Surg, Riotinto, Spain; [De la Herranz, P.] Hosp Riotinto, Surg, Riotinto, Spain; [Guerrero, J. L.] Hosp Riotinto, Surg, Riotinto, Spain; [Fernandez, Y. Lara] Hosp Riotinto, Surg, Riotinto, Spain; [Moreno, J. Garcia] Hosp Riotinto, Surg, Riotinto, Spain; [Luque, J. Bellido] Hosp Univ Virgen Macarena, Surg, Seville, Spain; [Navarro, L.] Hosp Quiron Sevilla, Surg, Seville, Spain; [Conde, S. Morales] Hosp Univ Virgen Del Rocio, Surg, Seville, SpainPublication P-150 TRANSVERSUS ABDOMINIS RELEASE BY MINIMAL INVASIVE SURGERY. OUR EXPERIENCE IN A TERCIARY HOSPITAL(Oxford univ press, 2022-10-13) Menchero, J. Gomez; Lara Fernandez, Y.; Gila Bohorquez, A.; De La Herranz, P.; Guerrero, J. L.; Garcia Moreno, J.; Bellido Luque, J.; Morales Conde, S.; [Menchero, J. Gomez] Hosp Riotinto, Surg, Riotinto, Spain; [Lara Fernandez, Y.] Hosp Riotinto, Surg, Riotinto, Spain; [Gila Bohorquez, A.] Hosp Riotinto, Surg, Riotinto, Spain; [De La Herranz, P.] Hosp Riotinto, Surg, Riotinto, Spain; [Guerrero, J. L.] Hosp Riotinto, Surg, Riotinto, Spain; [Garcia Moreno, J.] Hosp Riotinto, Surg, Riotinto, Spain; [Bellido Luque, J.] Hosp Univ Virgen Macarena, Surg, Seville, Spain; [Morales Conde, S.] Hosp Univ Virgen del Rocio, Surg, Seville, SpainPublication OC-066 LIRA TECHNIQUE, A NEW PROCEDURE. WHERE ARE WE NOW?. OUR RESULTS IN A MEDIUM FOLLOW-UP(Oxford univ press, 2022-10-13) Gomez Menchero, J.; Guerrero, J. L.; Lara Fernandez, Y.; Navarro, L.; De La Herranz, P.; Gila Bohorquez, A.; Garcia Moreno, J.; Morales Conde, S.; [Gomez Menchero, J.] Hosp Riotinto, Surg, Riotinto, Spain; [Guerrero, J. L.] Hosp Riotinto, Surg, Riotinto, Spain; [Lara Fernandez, Y.] Hosp Riotinto, Surg, Riotinto, Spain; [De La Herranz, P.] Hosp Riotinto, Surg, Riotinto, Spain; [Gila Bohorquez, A.] Hosp Riotinto, Surg, Riotinto, Spain; [Garcia Moreno, J.] Hosp Riotinto, Surg, Riotinto, Spain; [Navarro, L.] Hosp Quiron, Surg, Seville, Spain; [Morales Conde, S.] Hosp Virgen Rocio, Surg, Seville, SpainPublication Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies(Bioscientifica ltd, 2018-01-01) Velasco, Ines; Taylor, Peter; [Velasco, Ines] Riotinto Hosp, Pediat Gynecol & Obstet Unit, Huelva, Spain; [Taylor, Peter] Cardiff Univ, Sch Med, Syst Immun Res Inst, Thyroid Res Grp, Cardiff, S Glam, WalesThyroid hormones are essential for an adequate growth and development of the fetus. In addition to the classical association between maternal hypothyroidism and neurological impairment in the progeny, other adverse reproductive events have been associated with maternal thyroid dysfunction including infertility, miscarriage and preterm delivery. Although all scientific societies endorse the treatment of overt hypothyroidism; the management and/or treatment of subclinical hypothyroidism, hypothyroxinemia or antithyroid antibody-positive women should be considered with caution. Important trials have found no clear benefit of treatment of subclinical hypothyroidism in terms of cognitive outcomes; however, other interventional studies appear to reduce some of the obstetric and perinatal complications. As a result, the dilemma between universal screening or selective screening of women at high risk of thyroid dysfunction during pregnancy remains unresolved. Despite this, levothyroxine is also now regularly prescribed by gynaecologists and centres for reproductive medicine. In this context, there is increasing concern regarding the risk of over diagnosis and subsequent potential overtreatment. Taken together, we need to reconsider how thyroid dysfunction should be identified in pregnant women and highlight the arguments for and against the use of levothyroxine in obstetric practices. Our main findings: the mismatch between the guidelines recommendations and the use of LT4 in clinical settings as well as the disparity of criteria between scientific societies from different medical specialties. In conclusion, it is essential to reach agreements between both endocrinologists and obstetricians.Publication Safety and effectiveness of self-adhesive mesh in laparoscopic ventral hernia repair using transabdominal preperitoneal route (vol 31, pg 1213, 2017)(Springer, 2017-12-01) Bellido Luque, Juan Antonio; Bellido Luque, Araceli; Gomez Menchero, Julio; Suarez Grau, Juan Manuel; Garcia Moreno, Joaquin; Tejada Gomez, Antonio; Guadalajara Jurado, Juan; [Bellido Luque, Juan Antonio] Riotinto Hosp, Minas De Riotinto, Huelva, Spain; [Gomez Menchero, Julio] Riotinto Hosp, Minas De Riotinto, Huelva, Spain; [Suarez Grau, Juan Manuel] Riotinto Hosp, Minas De Riotinto, Huelva, Spain; [Garcia Moreno, Joaquin] Riotinto Hosp, Minas De Riotinto, Huelva, Spain; [Guadalajara Jurado, Juan] Riotinto Hosp, Minas De Riotinto, Huelva, Spain; [Bellido Luque, Araceli] Quiron Sagrado Corazon Hosp, Seville, Spain; [Tejada Gomez, Antonio] Juan Ramon Jimenez Hosp, Huelva, SpainThe metadata listed the wrong given names and family names.Publication [Reactivation of neurocysticercosis in patient under study on suspicion of dengue].(2021-02-22) Ruíz Márquez, M J; Cabra Rodríguez, R; Ruíz Márquez, DPublication Metabolic and Functional Improvements in a Patient with Charcot-Marie-Tooth Disease Type 2 after EGCG Administration: A Case Report.(2021-01-24) Bustos, Antonio; Selvi Sabater, Pablo; Benlloch, María; Drehmer, Eraci; López-Rodríguez, María Mar; Platero, Felix; Platero, Jose Luis; Escribá-Alepuz, Jesús; de la Rubia Ortí, Jose EnriqueBackground and objectives: The aim of this study was to report a case of a patient with Charcot-Marie-Tooth disease type 2 (CMT2) treated with epigallocatechin gallate (EGCG) for 4 months in order to assess its therapeutic potential in CMT2. Materials and Methods: The study included a brother and a sister who have CMT2. The sister received 800 mg of EGCG for 4 months, while her brother received placebo for the same period of time. Both participants were assessed before and after daily administration by means of anthropometry; analysis of inflammatory and oxidation markers of interleukin-6 (IL-6) and paraoxonase 1 (PON1) in the blood sample; and motor tests: 2-min walk test (2MWT), 10-m walk test (10MWT), nine-hole peg test (9HPT) and handgrip strength measurement using a handheld Jamar dynamometer. Results: Regarding muscular and motor functions associated with higher inflammation and oxidation, improvements only observed in the woman in all analysed parameters (both biochemical and clinical associated with the metabolism and functionality) after 4 months of treatment with EGCG are noteworthy. Thus, this treatment is proposed as a good candidate to treat the disease.Publication Polypropylene and polyvinylidene fluoride transobturator slings for the treatment of female stress urinary incontinence: 1-Year outcomes from a multicentre randomized trial.(2020-12-01) Sabadell, Jordi; Pereda-Núñez, Anna; Ojeda-de-Los-Santos, Fernando; Urbaneja, Manuel; González-García, Carmen; Camps-Lloveras, Narcís; Pérez-Plantado, Àngela; Canet-Rodríguez, Judit; Pérez-Espejo, Maria Paz; Rodríguez-Mias, Nuria; Sarasa-Castelló, Núria; Palau, Marta; Montero-Armengol, Anabel; Salicrú, Sabina; Gil-Moreno, Antonio; Poza, Jose LTo compare the effectiveness and safety of polypropylene (PP) and polyvinylidene fluoride (PVDF) transobturator tapes (TOT) for the treatment of female stress urinary incontinence (SUI). This is a multicentre randomized trial. Women with SUI or stress-predominant mixed urinary incontinence and scheduled for a TOT procedure were randomized to PP or PVDF slings. The primary outcome was 1-year cure or improvement rate using composite criteria. Complications were also compared. Relationships with outcomes were analyzed using multivariable logistic regressions models. From April 2016 to January 2018 285 participants were randomized. PP and PVDF slings showed similar high cure or improvement rate (91.0% vs. 95.6%, p = .138). Improvement in validated questionnaires was also similar. PVDF slings were associated with a lower rate of de novo urgency incontinence (adjusted odds ratio = 0.35; 95% confidence interval = 0.15-0.80). We found no statistical differences in complications rates, although a higher incidence of long-term pain events were observed in the PP group. The study is underpowered to find differences in specific complications owing to the low number of events. PP and PVDF TOTs are equally effective, although PVDF is associated with fewer cases of de novo urgency incontinence. Further studies are needed to give robust conclusions on safety profiles.Publication Value-Based Healthcare in Ostomies.(2020-08-13) Montesinos Gálvez, Ana C; Jódar Sánchez, Francisco; Alcántara Moreno, Carmen; Pérez Fernández, Antonio J; Benítez García, Rosario; Coca López, Mercedes; Bienvenido Ramírez, María Paz; Cabrera López, Monserrat; Vázquez Burrero, Luisa; Jurado Berja, Pilar; Sánchez García, Raquel; Cebrián, Josefa Martín; Hervas García, María Luz; López Fernández, Remedios; Pérez Jiménez, Claudia; Reyes Vico, María Antonia; Vargas Villegas, Ana Belén; García-Agua Soler, Nuria; García Ruiz, Antonio JIn order to achieve significant improvements in quality, cost, and accessibility (the health "iron triangle"), innovation in organizational and service delivery models is necessary to increase the value of healthcare. The aim of this study is to evaluate the efficiency of a model of organizational innovation based on advanced practice nurse in the care of people with ostomies (APN-O) versus usual care. An observational, exploratory, analytical, prospective study with a six-month follow-up was carried out at 12 hospitals that implemented this model in Andalusia. A total of 75 patients who had undergone a digestive elimination ostomy and/or a urinary ostomy were followed for six months. Clinical outcomes, healthcare resources, health-related quality of life, and willingness to pay (WTP) were analyzed. The economic evaluation was conducted from a societal perspective, including healthcare costs and indirect costs. The cost difference between the two models was €136.99 and the quality-adjusted life year (QALY) gained was 0.05965 (€2297 per QALY gained). At six months, the mean of WTP was €69 per APN-O consultation. This model contributes to increasing the value-based healthcare in ostomies. Results of this study suggested that APN-O is an effective patient management model for improving their health status and is highly efficient.Publication [Necrotizing fasciitis pediatric debut].(2020-07-06) Cabra-Rodríguez, R; Ruíz-Márquez, M JPublication Towards the elimination of hepatitis C: implementation of reflex testing in Andalusia.(2020) Casas, María de la Paz; García, Fernando; Freyre-Carrillo, Carolina; Montiel, Natalia; de la Iglesia, Alberto; Viciana, Isabel; Domínguez, Ana; Guillot, Vicente; Muñoz, Aurora; Cantudo, Purificación; Franco-Álvarez, Francisco; Reguera, Juan Antonio; Romera, María Angustias; Cabezas, Teresa; Vargas, Julio; Ramírez-Arcos, Mercedes; Guerrero, Inmaculada; García-Navarrete, África; Pérez-Santos, María Jesús; Clavijo, Encarnación; Roldán, Carolina; Guzmán, Antonio; Palanca, Matilde; Torres, Eva; Serrano, María Del Carmen; Lozano, María Del Carmen; Becerril, Berta; Luzón, Pilar; Galán, María Ángeles; Alados, Juan Carlos; García, Federicoundiagnosed hepatitis C virus (HCV) infection and/or inadequate access to care are barriers to the elimination of HCV. Reflex testing has proven to facilitate referral to care, treatment and viral elimination. In this study, a reflex testing program was implemented in Andalusia and its impact on access to care was evaluated. an observational, retrospective and prospective study was performed across diagnostic laboratories responsible for HCV diagnosis in southern Spain. After surveying the barriers to performing reflex testing, the number of patients that were not referred for care in 2016 was retrospectively studied (pre-reflex cohort). Subsequently, several measures were proposed to overcome the identified barriers. Finally, reflex testing was implemented and its impact evaluated. the pre-reflex cohort included information from 1,053 patients. Slightly more than half of the patients (n = 580; 55%) visited a specialist for treatment evaluation during a median period of 71 days (interquartile range = 35-134) since the date of diagnosis. The post-reflex cohort (September 2017 to March 2018) included 623 patients. Only 17% (n = 106) of the patients had not been referred for care or evaluated for treatment in a median period of 52 days (interquartile range = 28-86). in 2016, nearly half of new HCV diagnoses in southern Spain were not referred for care. Barriers to the implementation of reflex testing were overcome in our study. Moreover, this strategy was effectively implemented in 2017. Reflex testing contributed to improving referral for care. This program will contribute to the micro-elimination of hepatitis C in Spain.Publication [Hemofagoctic sindrome by Leishmania in patient with poliglandular sindrome].(2020-03-11) Cabra Rodríguez, R; Ruíz Márquez, M J