Knowledges and attitudes of dentistry students towards mental health care
Authorship
M.P.B.H.
Bachelor of Odontology
M.P.B.H.
Bachelor of Odontology
Defense date
09.05.2024 09:30
09.05.2024 09:30
Summary
Introduction: Dental students during their clinical practices have cared for patients and among the skills and knowledge they need to care for their patients are the knowledge and skills for mental health care. However, the role of the dentist in mental health care is not defined. Objective: to identify the knowledge and attitudes of dental students in relation to mental health care, identify the barriers/difficulties they face in caring for the mental health of patients during clinical practices and how they influence mental background in dental care. Method: The chosen method is through focus groups of dental students who have had clinical practices with patients. Two focus groups were held in which 9 dentistry degree students who have had clinical practices participated. The qualitative data analysis was carried out using Braun and Clarke's thematic analysis. Results: The participants considered that they did not have adequate knowledge to properly care for patients with mental health problems. The lack of patient collaboration and knowledge being the main barriers identified for the management of patients with mental health problems. On the other hand, they highlighted the importance of the role of the dentist and the lack of determination of this role. Conclusion: This study concludes the areas of improvement regarding mental health care by dental students. Above all, in determining the role of the dentist when faced with a patient with mental health problems. More research and consensus is required to determine it.
Introduction: Dental students during their clinical practices have cared for patients and among the skills and knowledge they need to care for their patients are the knowledge and skills for mental health care. However, the role of the dentist in mental health care is not defined. Objective: to identify the knowledge and attitudes of dental students in relation to mental health care, identify the barriers/difficulties they face in caring for the mental health of patients during clinical practices and how they influence mental background in dental care. Method: The chosen method is through focus groups of dental students who have had clinical practices with patients. Two focus groups were held in which 9 dentistry degree students who have had clinical practices participated. The qualitative data analysis was carried out using Braun and Clarke's thematic analysis. Results: The participants considered that they did not have adequate knowledge to properly care for patients with mental health problems. The lack of patient collaboration and knowledge being the main barriers identified for the management of patients with mental health problems. On the other hand, they highlighted the importance of the role of the dentist and the lack of determination of this role. Conclusion: This study concludes the areas of improvement regarding mental health care by dental students. Above all, in determining the role of the dentist when faced with a patient with mental health problems. More research and consensus is required to determine it.
Direction
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Tutorships)
MULERO DE CASO, MARTA (Co-tutorships)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Tutorships)
MULERO DE CASO, MARTA (Co-tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
Pose Rodríguez, José Manuel (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
Pose Rodríguez, José Manuel (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
Progesterone use in the prevention of preterm birth.
Authorship
L.C.M.
Bachelor of Medicine
L.C.M.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Preterm birth occurs between 20+0 and 36+6 weeks of gestation. Approximately 70-80% are spontaneous, often resulting from premature rupture of membranes or, less frequently, cervical insufficiency. The remaining 20-30% are medically indicated due to various maternal-fetal pathologies. There are multiple risk factors and metabolic pathways whose disruption can lead to preterm birth. Various treatments aimed at reducing its incidence focus on identifying these situations and intervening to prevent it. However, few therapeutic measures have proven effective in prolonging pregnancy.
Preterm birth occurs between 20+0 and 36+6 weeks of gestation. Approximately 70-80% are spontaneous, often resulting from premature rupture of membranes or, less frequently, cervical insufficiency. The remaining 20-30% are medically indicated due to various maternal-fetal pathologies. There are multiple risk factors and metabolic pathways whose disruption can lead to preterm birth. Various treatments aimed at reducing its incidence focus on identifying these situations and intervening to prevent it. However, few therapeutic measures have proven effective in prolonging pregnancy.
Direction
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Suicidal behavior in adolescents in Spain. The role of drug intoxication
Authorship
N.C.G.
Bachelor of Medicine
N.C.G.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Suicidal behaviors represent a serious and increasing public health problem, especially among adolescents. In Spain, the Suicide Observatory reported a historic increase in suicides among young people aged 15-29 years in 2022, surpassing deaths from traffic accidents and tumors. Objective: To investigate and analyze the current situation of suicide attempt with drug intoxication among adolescents in Spain. Material and methods: Bibliographic review using the databases PubMed, SciELO, Dialnet and Google Scholar, in addition to consulting the websites of official bodies such as the WHO, INE and ANAR. Results and discussion: In recent years, suicidal behaviors have increased in adolescents in Spain, being the most common methods hanging, jumping from high places, confronting moving objects and drugs ingestion. Risk factors include previous attempts, mental health and sleep disorders, and bullying, while family support, resilience and access to professional help act as protective factors. Medication poisoning is mainly caused by benzodiazepines, antidepressants and paracetamol, although it usually has a favorable outcome. Conclusions: Drug intoxication is an important method of suicide among adolescents. It is more frequent in females, with benzodiazepines, antidepressants and paracetamol being the most commonly used substances. These data highlight the importance of implementing prevention strategies and mental health care.
Introduction: Suicidal behaviors represent a serious and increasing public health problem, especially among adolescents. In Spain, the Suicide Observatory reported a historic increase in suicides among young people aged 15-29 years in 2022, surpassing deaths from traffic accidents and tumors. Objective: To investigate and analyze the current situation of suicide attempt with drug intoxication among adolescents in Spain. Material and methods: Bibliographic review using the databases PubMed, SciELO, Dialnet and Google Scholar, in addition to consulting the websites of official bodies such as the WHO, INE and ANAR. Results and discussion: In recent years, suicidal behaviors have increased in adolescents in Spain, being the most common methods hanging, jumping from high places, confronting moving objects and drugs ingestion. Risk factors include previous attempts, mental health and sleep disorders, and bullying, while family support, resilience and access to professional help act as protective factors. Medication poisoning is mainly caused by benzodiazepines, antidepressants and paracetamol, although it usually has a favorable outcome. Conclusions: Drug intoxication is an important method of suicide among adolescents. It is more frequent in females, with benzodiazepines, antidepressants and paracetamol being the most commonly used substances. These data highlight the importance of implementing prevention strategies and mental health care.
Direction
CRUZ LANDEIRA, ANGELINES (Tutorships)
CRUZ LANDEIRA, ANGELINES (Tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Neuromuscular Diseases: the importance of its diagnosis
Authorship
A.C.D.C.M.
Bachelor of Medicine
A.C.D.C.M.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Neuromuscular diseases (NMD) are chronic conditions affecting the muscle and nervous system, causing varying degrees of disability. This systematic review evaluates the benefits and effectiveness of molecular genetic diagnostic techniques, particularly next-generation sequencing (NGS), in the early diagnosis of NMDs. A systematic review was conducted on 17 articles published between 2012 and 2024 in databases such as Elsevier, Scielo, Dialnet, and Pubmed. The selection was based on relevant studies on NMDs and molecular diagnostic techniques. Advances in NGS have improved diagnostic accuracy, although 50% of rare neurological diseases remain genetically unresolved. Whole exome sequencing (WES) and gene panels are effective but have limitations. Biomarkers and multi-omic approaches are essential for diagnosis and monitoring. Early intervention, especially through neonatal screening, shows significant benefits in conditions like spinal muscular atrophy (SMA). Despite advances in the genetic diagnosis of NMDs, technological and interpretative challenges persist. Future improvements should focus on more cost-effective diagnostic techniques, better therapeutic options, and expanded screening programs. These advances will improve patient outcomes and reduce the diagnostic odyssey.
Neuromuscular diseases (NMD) are chronic conditions affecting the muscle and nervous system, causing varying degrees of disability. This systematic review evaluates the benefits and effectiveness of molecular genetic diagnostic techniques, particularly next-generation sequencing (NGS), in the early diagnosis of NMDs. A systematic review was conducted on 17 articles published between 2012 and 2024 in databases such as Elsevier, Scielo, Dialnet, and Pubmed. The selection was based on relevant studies on NMDs and molecular diagnostic techniques. Advances in NGS have improved diagnostic accuracy, although 50% of rare neurological diseases remain genetically unresolved. Whole exome sequencing (WES) and gene panels are effective but have limitations. Biomarkers and multi-omic approaches are essential for diagnosis and monitoring. Early intervention, especially through neonatal screening, shows significant benefits in conditions like spinal muscular atrophy (SMA). Despite advances in the genetic diagnosis of NMDs, technological and interpretative challenges persist. Future improvements should focus on more cost-effective diagnostic techniques, better therapeutic options, and expanded screening programs. These advances will improve patient outcomes and reduce the diagnostic odyssey.
Direction
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Barbosa Sousa Gouveia, Sofia Isabel (Co-tutorships)
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Barbosa Sousa Gouveia, Sofia Isabel (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Relationship between Oral Lichen Planus and autoimmunity
Authorship
M.D.S.A.
Bachelor of Medicine
M.D.S.A.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Oral lichen planus (OLP) is a chronic inflammatory disease that affects the oral mucosa and is characterized by a subepithelial lymphocytic infiltrate and degeneration of basal keratinocytes. Its etiology is unknown, but it has been proposed that it has an autoimmune origin, mediated by CD8+ T lymphocytes that recognize self or foreign antigens on epithelial cells. OLP can cause pain, burning, pruritus, ulceration and altered taste, affecting patients' quality of life. In addition, it has been associated with an increased risk of developing oral cancer, which is why it is considered a potentially malignant lesion.
Oral lichen planus (OLP) is a chronic inflammatory disease that affects the oral mucosa and is characterized by a subepithelial lymphocytic infiltrate and degeneration of basal keratinocytes. Its etiology is unknown, but it has been proposed that it has an autoimmune origin, mediated by CD8+ T lymphocytes that recognize self or foreign antigens on epithelial cells. OLP can cause pain, burning, pruritus, ulceration and altered taste, affecting patients' quality of life. In addition, it has been associated with an increased risk of developing oral cancer, which is why it is considered a potentially malignant lesion.
Direction
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Direct-acting oral anticoagulants versus vitamin K antagonists in patients with non-valvular atrial fibrillation. Literature Review.
Authorship
Y.Y.D.L.
Bachelor of Medicine
Y.Y.D.L.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Abstract Introduction: This literature review aims to thoroughly examine the available evidence on the efficacy, safety, and other relevant aspects of both types of anticoagulants (direct-acting oral anticoagulants, DOACs, and vitamin K antagonists, VKAs). Objective: To review the available evidence on the effectiveness and safety of treatment with vitamin K antagonists compared to direct-acting oral anticoagulants in patients with non-valvular atrial fibrillation. YALE YALO DONG LIU 2 Methodology: A review of the current literature is conducted with the support of the BiblioSaúde platform of the Galician Health Service, which provided access to various resources of evidence and information from international organizations such as the WHO, CDC, Spanish Society of Cardiology, PubMed, Health Evidence, etc. Results: A total of 352 articles were retrieved in the searches, and after screening and critical evaluation tools, 6 articles were finally selected for analysis. Conclusions: In summary, this review supports the preferential use of DOACs over VKAs in the prevention of thromboembolic events in patients with non-valvular atrial fibrillation, providing updated guidance for therapeutic decision-making.
Abstract Introduction: This literature review aims to thoroughly examine the available evidence on the efficacy, safety, and other relevant aspects of both types of anticoagulants (direct-acting oral anticoagulants, DOACs, and vitamin K antagonists, VKAs). Objective: To review the available evidence on the effectiveness and safety of treatment with vitamin K antagonists compared to direct-acting oral anticoagulants in patients with non-valvular atrial fibrillation. YALE YALO DONG LIU 2 Methodology: A review of the current literature is conducted with the support of the BiblioSaúde platform of the Galician Health Service, which provided access to various resources of evidence and information from international organizations such as the WHO, CDC, Spanish Society of Cardiology, PubMed, Health Evidence, etc. Results: A total of 352 articles were retrieved in the searches, and after screening and critical evaluation tools, 6 articles were finally selected for analysis. Conclusions: In summary, this review supports the preferential use of DOACs over VKAs in the prevention of thromboembolic events in patients with non-valvular atrial fibrillation, providing updated guidance for therapeutic decision-making.
Direction
RIVERA GALLEGO, ALBERTO JOSE (Tutorships)
RIVERA GALLEGO, ALBERTO JOSE (Tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Anogenital warts in pediatric population
Authorship
B.F.F.
Bachelor of Medicine
B.F.F.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Anogenital warts (AGW) in the pediatric population are a clinical manifestation of the human papillomavirus (HPV). The relevance of these lesions lies in their possible association with child sexual abuse, although they can also be transmitted through non-sexual routes. This bibliographic review seeks to explore the relationship between anogenital warts in children and sexual abuse, as well as current management strategies. Objectives: To evaluate the prevalence of AGW in children, identify the most common methods of transmission, and the association between anogenital warts and child sexual abuse. Methods: Bibliographic review of the available scientific literature on AGW in children between 0 months and 12 years, their transmission, epidemiology, diagnosis, management, and treatment, conducted through the PUBMED bibliographic search engine and following PRISMA guidelines. Original articles published in English, Spanish, and Portuguese between 2000 and 2024 were included. Results: Findings suggest that AGW in childhood can originate through different forms of contagion. This includes transmission from mother to child during birth and direct exposure to contaminated objects or virus carriers. The possibility of sexual transmission, especially in children over four years of age, should be taken into account. The utility of genetic analysis to identify specific types of HPV in determining sexual abuse is a topic of debate and there is no consensus in the medical community. Conclusions: Evidence shows that in cases of AGW in children under four years of age, non-sexual transmission should be seriously considered if there is no presence of other sexually transmitted infections (STIs), signs of abuse, or a coherent account of sexual abuse. The likelihood of an association between HPV and sexual abuse increases with age, particularly after four years. During the investigation, it is crucial to obtain a complete medical history and perform a thorough physical examination of both the child and their caregivers. A multidisciplinary approach is required to treat AGW in children, taking into account the different forms of transmission and the possibility of sexual abuse. Collaboration among professionals is crucial to ensure a comprehensive evaluation and care for the child’s well-being. The results highlight the importance of having defined management protocols and carefully evaluating the possibility of sexual abuse in children with anogenital warts.
Introduction: Anogenital warts (AGW) in the pediatric population are a clinical manifestation of the human papillomavirus (HPV). The relevance of these lesions lies in their possible association with child sexual abuse, although they can also be transmitted through non-sexual routes. This bibliographic review seeks to explore the relationship between anogenital warts in children and sexual abuse, as well as current management strategies. Objectives: To evaluate the prevalence of AGW in children, identify the most common methods of transmission, and the association between anogenital warts and child sexual abuse. Methods: Bibliographic review of the available scientific literature on AGW in children between 0 months and 12 years, their transmission, epidemiology, diagnosis, management, and treatment, conducted through the PUBMED bibliographic search engine and following PRISMA guidelines. Original articles published in English, Spanish, and Portuguese between 2000 and 2024 were included. Results: Findings suggest that AGW in childhood can originate through different forms of contagion. This includes transmission from mother to child during birth and direct exposure to contaminated objects or virus carriers. The possibility of sexual transmission, especially in children over four years of age, should be taken into account. The utility of genetic analysis to identify specific types of HPV in determining sexual abuse is a topic of debate and there is no consensus in the medical community. Conclusions: Evidence shows that in cases of AGW in children under four years of age, non-sexual transmission should be seriously considered if there is no presence of other sexually transmitted infections (STIs), signs of abuse, or a coherent account of sexual abuse. The likelihood of an association between HPV and sexual abuse increases with age, particularly after four years. During the investigation, it is crucial to obtain a complete medical history and perform a thorough physical examination of both the child and their caregivers. A multidisciplinary approach is required to treat AGW in children, taking into account the different forms of transmission and the possibility of sexual abuse. Collaboration among professionals is crucial to ensure a comprehensive evaluation and care for the child’s well-being. The results highlight the importance of having defined management protocols and carefully evaluating the possibility of sexual abuse in children with anogenital warts.
Direction
COUCE PICO, MARIA DE LA LUZ (Tutorships)
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Impact of oncological pathology on quality of life in a Galician population sample
Authorship
M.F.T.
Bachelor of Medicine
M.F.T.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Cancer is a disease that leads to negative consequences for oncology patients. Changes in the lifestyle of patients are a fundamental factor in the diagnosis, follow-up and treatment of these patients. Therefore, measuring health-related quality of life allows us to correctly face the challenges of cancer, knowing the factors that affect patients and improving the evolution of the disease. Material and methods: In this study, sociodemographic data and lifestyle habits were collected from a sample of 1512 adults in the municipality of A Estrada (Pontevedra), including 71 cancer patients. The SF-36, an instrument that measures health-related quality of life that assesses 9 dimensions, such as physical function, physical role, mental health and social function, was used. Participants were recruited by random sampling between December 2012 and March 2015, organized into 7 age groups. Sociodemographic variables, lifestyle habits, and SF-36 scores were compared between healthy subjects and those diagnosed with cancer using statistical tests such as Mann-Whitney U. Generalized additive regression models were fitted by age and sex for each SF-36 scale. Objective: To assess the impact of oncologic pathology on HRQOL in a general sample of a Galician population. Results: Statistically significant differences were found between the groups with and without cancer in several variables such as age, BMI, smoking, marital status, educational level, current work situation, physical function, physical role, general health and health perception with respect to the previous year. Conclusion: Cancer is a chronic disease that has important consequences on the quality of life of cancer patients. The results allow us to observe a general worsening of the HRQOL of cancer patients in most of the domains studied with the SF-36 if we compare the values with the healthy population. A clear correlation can be established between oncologic pathology and an integral organic repercussion that affects the biopsychosocial development of patients.
Introduction: Cancer is a disease that leads to negative consequences for oncology patients. Changes in the lifestyle of patients are a fundamental factor in the diagnosis, follow-up and treatment of these patients. Therefore, measuring health-related quality of life allows us to correctly face the challenges of cancer, knowing the factors that affect patients and improving the evolution of the disease. Material and methods: In this study, sociodemographic data and lifestyle habits were collected from a sample of 1512 adults in the municipality of A Estrada (Pontevedra), including 71 cancer patients. The SF-36, an instrument that measures health-related quality of life that assesses 9 dimensions, such as physical function, physical role, mental health and social function, was used. Participants were recruited by random sampling between December 2012 and March 2015, organized into 7 age groups. Sociodemographic variables, lifestyle habits, and SF-36 scores were compared between healthy subjects and those diagnosed with cancer using statistical tests such as Mann-Whitney U. Generalized additive regression models were fitted by age and sex for each SF-36 scale. Objective: To assess the impact of oncologic pathology on HRQOL in a general sample of a Galician population. Results: Statistically significant differences were found between the groups with and without cancer in several variables such as age, BMI, smoking, marital status, educational level, current work situation, physical function, physical role, general health and health perception with respect to the previous year. Conclusion: Cancer is a chronic disease that has important consequences on the quality of life of cancer patients. The results allow us to observe a general worsening of the HRQOL of cancer patients in most of the domains studied with the SF-36 if we compare the values with the healthy population. A clear correlation can be established between oncologic pathology and an integral organic repercussion that affects the biopsychosocial development of patients.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Fernández Domínguez, M. José (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Fernández Domínguez, M. José (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Analysis of the role of sedentary lifestyle as a factor related to the prevalence and control of cardiovascular risk factors in a sample of Galician patients attended in Primary Care. IBERICAN study.
Authorship
T.S.M.
Bachelor of Medicine
T.S.M.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Objective: To analyse the association between sedentary lifestyle and other CVRF and CVD in the autonomous community of Galicia in the context of the IBERICAN study. Material and methods: The samples for our work were obtained from the IBERICAN study, which is an epidemiological, multicentre, observational study that includes a total of 8,066 patients aged between 18 and 65 years, seen in primary care consultations in Spain and followed annually for 10 years. The main objective of this study is to analyse the prevalence, incidence and geographical distribution of CVRF and/or CVD in the Spanish adult population treated in the Spanish NHS. For the present TFG we analysed the variables recorded at the inclusion visit of patients recruited in Galicia (n=608). A prevalence ratio analysis was performed for each group of variables, adjusted for the rest and, finally, a multivariate analysis was performed to analyse the neutral effect of each variable. The odds ratio (OR) and the 95% confidence interval [95%CI95] are shown for each analysis. Results: In a sample of 608 patients, 153 were sedentary. Sedentary lifestyle was more frequent with age (61.8 [14.5] vs 58.2 [15.1], p=0.012), in patients living in rural areas (2.59 [1.68-3.99]), unemployed (4.59 [2.10-10.01]), retired (3.67 [2.09-6.43]) or engaged in housework (2.65 [1.41-6.43]), retired (3.67 [2.09-6.43]) or engaged in housework (2.65 [1.41-4.98]), with lower income (1.73 [1.16-2.57]) and lower educational level (24.19 [7.71-75.85]). In terms of cardiovascular risk factors, we observed a strong association between sedentary lifestyle and HTN (2.22 [1.41-3.51]), its degree of control (47.3% vs 63.1%, p=0.013), as well as DM (43.3% vs 70.7%, p=0.01), and smoking (1.85 [1.03-3.31]). Although no association with any form of CVD was observed, a higher cardiovascular risk was estimated by SCORE in sedentary patients (39.2% were at very high risk vs. 31.1% of non-sedentary patients, p=0.033). Conclusions: Sedentary patients have a higher prevalence of CVRFs such as HT and smoking. They also have poorer control of HT and DM and a higher level of cardiovascular risk estimated by SCORE.
Objective: To analyse the association between sedentary lifestyle and other CVRF and CVD in the autonomous community of Galicia in the context of the IBERICAN study. Material and methods: The samples for our work were obtained from the IBERICAN study, which is an epidemiological, multicentre, observational study that includes a total of 8,066 patients aged between 18 and 65 years, seen in primary care consultations in Spain and followed annually for 10 years. The main objective of this study is to analyse the prevalence, incidence and geographical distribution of CVRF and/or CVD in the Spanish adult population treated in the Spanish NHS. For the present TFG we analysed the variables recorded at the inclusion visit of patients recruited in Galicia (n=608). A prevalence ratio analysis was performed for each group of variables, adjusted for the rest and, finally, a multivariate analysis was performed to analyse the neutral effect of each variable. The odds ratio (OR) and the 95% confidence interval [95%CI95] are shown for each analysis. Results: In a sample of 608 patients, 153 were sedentary. Sedentary lifestyle was more frequent with age (61.8 [14.5] vs 58.2 [15.1], p=0.012), in patients living in rural areas (2.59 [1.68-3.99]), unemployed (4.59 [2.10-10.01]), retired (3.67 [2.09-6.43]) or engaged in housework (2.65 [1.41-6.43]), retired (3.67 [2.09-6.43]) or engaged in housework (2.65 [1.41-4.98]), with lower income (1.73 [1.16-2.57]) and lower educational level (24.19 [7.71-75.85]). In terms of cardiovascular risk factors, we observed a strong association between sedentary lifestyle and HTN (2.22 [1.41-3.51]), its degree of control (47.3% vs 63.1%, p=0.013), as well as DM (43.3% vs 70.7%, p=0.01), and smoking (1.85 [1.03-3.31]). Although no association with any form of CVD was observed, a higher cardiovascular risk was estimated by SCORE in sedentary patients (39.2% were at very high risk vs. 31.1% of non-sedentary patients, p=0.033). Conclusions: Sedentary patients have a higher prevalence of CVRFs such as HT and smoking. They also have poorer control of HT and DM and a higher level of cardiovascular risk estimated by SCORE.
Direction
PORTELA ROMERO, MANUEL (Tutorships)
Cinza Sanjurjo, Sergio (Co-tutorships)
PORTELA ROMERO, MANUEL (Tutorships)
Cinza Sanjurjo, Sergio (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Meditation as part of heart failure management. Systematic bibliographic review.
Authorship
S.V.M.
Bachelor of Medicine
S.V.M.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Background: Meditation has emerged as a complementary practice in the treatment of heart failure (HF), aiming to improve both the psychological and physical symptoms of patients. This systematic review synthesizes the current scientific evidence on various meditation interventions and their impact on the quality of life, cardiovascular health, and mental health of individuals with HF. Objectives: To review and synthesize the evidence of meditation strategies in the treatment of patients with HF. To analyze the different meditation interventions and evaluate their impact. Methods: The systematic review was conducted following PRISMA guidelines. Randomized controlled trials, non-randomized controlled trials, and quasi-experimental studies published from 2000 to 2024 that investigated meditation techniques in patients diagnosed with HF were included. The search included the PubMed, PsycInfo, and Embase databases. Additionally, a manual search of bibliographic citations was performed. The descriptors to be investigated were meditation, mindfulness, and heart failure. Results: Out of an initial selection of 83 articles, 10 studies were finally eligible, meeting the predefined inclusion and exclusion criteria. A total of 456 patients were evaluated. There are notable differences in study design, the meditation technique used, and follow-up. More than 30 research objectives were identified. Some studies observed significant improvements in various parameters such as quality of life, depressive symptoms, perceived stress, functional capacity, and some biomarkers in the groups that received the meditation intervention. Conclusions: The results of this systematic review suggest that meditation could play a beneficial role in the comprehensive management of patients with HF, improving psychological, psychosocial and physical aspects. These findings support the need for additional studies, especially randomized controlled trials with more standardized protocols, larger sample sizes, and longer follow-up periods, to confirm and expand these preliminary results.
Background: Meditation has emerged as a complementary practice in the treatment of heart failure (HF), aiming to improve both the psychological and physical symptoms of patients. This systematic review synthesizes the current scientific evidence on various meditation interventions and their impact on the quality of life, cardiovascular health, and mental health of individuals with HF. Objectives: To review and synthesize the evidence of meditation strategies in the treatment of patients with HF. To analyze the different meditation interventions and evaluate their impact. Methods: The systematic review was conducted following PRISMA guidelines. Randomized controlled trials, non-randomized controlled trials, and quasi-experimental studies published from 2000 to 2024 that investigated meditation techniques in patients diagnosed with HF were included. The search included the PubMed, PsycInfo, and Embase databases. Additionally, a manual search of bibliographic citations was performed. The descriptors to be investigated were meditation, mindfulness, and heart failure. Results: Out of an initial selection of 83 articles, 10 studies were finally eligible, meeting the predefined inclusion and exclusion criteria. A total of 456 patients were evaluated. There are notable differences in study design, the meditation technique used, and follow-up. More than 30 research objectives were identified. Some studies observed significant improvements in various parameters such as quality of life, depressive symptoms, perceived stress, functional capacity, and some biomarkers in the groups that received the meditation intervention. Conclusions: The results of this systematic review suggest that meditation could play a beneficial role in the comprehensive management of patients with HF, improving psychological, psychosocial and physical aspects. These findings support the need for additional studies, especially randomized controlled trials with more standardized protocols, larger sample sizes, and longer follow-up periods, to confirm and expand these preliminary results.
Direction
Barge Caballero, Eduardo (Tutorships)
Piñeiro Portela, Miriam (Co-tutorships)
Barge Caballero, Eduardo (Tutorships)
Piñeiro Portela, Miriam (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Reassessment of response to sapropterin in adults with phenylketonuria
Authorship
M.A.G.
Bachelor of Medicine
M.A.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Phenylketonuria is an autosomal recessive disease caused by a deficiency of the enzyme phenylalanine hydroxylase, which is responsible for the conversion of phenylalanine to tyrosine. Inactivation of this enzyme results in increased levels of phenylalanine in the blood, which is manifested by neurocognitive developmental deficits. Sapropterin is the only drug marketed for its treatment, however, to be eligible for treatment, there must be at least a 30% reduction in pre-test baseline phenylalanine levels. The aim of this study is to re-evaluate the response to Sapropterin in those adult patients who, at the time of diagnosis, were not tested for Sapropterin overload or did not demonstrate a response above the arbitrary cut-off, in case they could currently benefit from it. Material and methods: Descriptive study of a series of 5 cases following adult patients diagnosed with PKU and who did not exceed the required 30% response to Sapropterin at the time of diagnosis. Re-evaluation through blood Phe measurements before and after drug administration. Results: Seventy-five per cent of adult patients whose response to Sapropterin was re-evaluated had a greater than or equal to 30% reduction and were considered responders. Three of them had previously undergone a BH4 tolerance protocol with unfavourable response, however, in all cases, their molecular study revealed a residual in vitro PAH function of 44% in one of its allelic variants. Of the five patients in the study, four of them are on drug treatment with Sapropterin, and the reduction in blood Phe levels two years after initiation is 38.44%. These patients also experienced an increase in natural protein tolerance. Conclusion: Reassessment of response is recommended in patients with potentially responsive allelic variants, and who have not previously shown a greater than or equal to 30% reduction in blood phenylalanine levels following oral BH4 overload testing. Consideration should always be given to factors such as the duration of the test, the percentage of reduction and the various causes that can lead to significant fluctuations in phenylalanine concentrations.
Introduction: Phenylketonuria is an autosomal recessive disease caused by a deficiency of the enzyme phenylalanine hydroxylase, which is responsible for the conversion of phenylalanine to tyrosine. Inactivation of this enzyme results in increased levels of phenylalanine in the blood, which is manifested by neurocognitive developmental deficits. Sapropterin is the only drug marketed for its treatment, however, to be eligible for treatment, there must be at least a 30% reduction in pre-test baseline phenylalanine levels. The aim of this study is to re-evaluate the response to Sapropterin in those adult patients who, at the time of diagnosis, were not tested for Sapropterin overload or did not demonstrate a response above the arbitrary cut-off, in case they could currently benefit from it. Material and methods: Descriptive study of a series of 5 cases following adult patients diagnosed with PKU and who did not exceed the required 30% response to Sapropterin at the time of diagnosis. Re-evaluation through blood Phe measurements before and after drug administration. Results: Seventy-five per cent of adult patients whose response to Sapropterin was re-evaluated had a greater than or equal to 30% reduction and were considered responders. Three of them had previously undergone a BH4 tolerance protocol with unfavourable response, however, in all cases, their molecular study revealed a residual in vitro PAH function of 44% in one of its allelic variants. Of the five patients in the study, four of them are on drug treatment with Sapropterin, and the reduction in blood Phe levels two years after initiation is 38.44%. These patients also experienced an increase in natural protein tolerance. Conclusion: Reassessment of response is recommended in patients with potentially responsive allelic variants, and who have not previously shown a greater than or equal to 30% reduction in blood phenylalanine levels following oral BH4 overload testing. Consideration should always be given to factors such as the duration of the test, the percentage of reduction and the various causes that can lead to significant fluctuations in phenylalanine concentrations.
Direction
Hermida Ameijeiras, Álvaro (Tutorships)
Hermida Ameijeiras, Álvaro (Tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Development of a community care process for the elderly in a health center.
Authorship
L.A.V.
Bachelor of Medicine
L.A.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Community action is defined as the dynamization of cooperative social relations between people in a given area or space of coexistence. Thanks to it, it is possible to improve people's living conditions, strengthen ties without excluding anyone, seeking equity and promoting individual and collective action. In order to carry out a community action, we must carry out a community cycle that allows us to explore the community and evaluate its needs. Objetive: Define the development of a community action cycle. Material and methods: The information comes from two sources, developed and written by the Spanish Ministry of Health was used: La Guía de Acción Comunitaria para ganar salud and La Guía de Orientaciones Didácticas para la acción comunitaria. The mapping carried out in the Beiramar Health Center was used to find out the main problem of the elderly population, loneliness. After this, three qualitative participatory action research techniques were carried out: narrative interview, nominal group and mapping of emotions. Results: After carrying out the different participatory action research techniques, two problems were detected. Firstly, the lack of knowledge of the different assets and resources of the neighborhood and, secondly, the lack of interest in participating. Conclusion: Get to know the needs of our elders is essential to improve their health. For this, it is important to carry out techniques that allow us to detect both the problems and the positive aspects of their daily life and their environment.
Introduction: Community action is defined as the dynamization of cooperative social relations between people in a given area or space of coexistence. Thanks to it, it is possible to improve people's living conditions, strengthen ties without excluding anyone, seeking equity and promoting individual and collective action. In order to carry out a community action, we must carry out a community cycle that allows us to explore the community and evaluate its needs. Objetive: Define the development of a community action cycle. Material and methods: The information comes from two sources, developed and written by the Spanish Ministry of Health was used: La Guía de Acción Comunitaria para ganar salud and La Guía de Orientaciones Didácticas para la acción comunitaria. The mapping carried out in the Beiramar Health Center was used to find out the main problem of the elderly population, loneliness. After this, three qualitative participatory action research techniques were carried out: narrative interview, nominal group and mapping of emotions. Results: After carrying out the different participatory action research techniques, two problems were detected. Firstly, the lack of knowledge of the different assets and resources of the neighborhood and, secondly, the lack of interest in participating. Conclusion: Get to know the needs of our elders is essential to improve their health. For this, it is important to carry out techniques that allow us to detect both the problems and the positive aspects of their daily life and their environment.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Aldecoa Landesa, Susana (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Aldecoa Landesa, Susana (Co-tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Autoimmune inner ear disease: diagnostic and therapeutic strategy
Authorship
T.F.A.F.
Bachelor of Medicine
T.F.A.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Autoimmune inner ear disease (AIED) is defined as a rapidly progressive (3 to 90 days), bilateral, sensorineural hearing loss that may be fluctuating and corticosteroid-responsive. It results from direct immune system damage to inner ear structures or from a systemic autoimmune disease. Up to 50% of patients with this disease may have vestibular symptoms, tinnitus and ear fullness. AIED is a rare but serious condition that can cause permanent hearing loss if not treated on time. The incidence of autoimmune inner ear disease is difficult to determine. It is probably a rare entity, accounting for less than 1% of all cases of hearing disorders or dizziness, however, the diagnosis of AIED may be overlooked due to the lack of specific tests and well-established diagnostic criteria. The diagnostic suspicion of AIED is based on the clinic, with evidence of progressive sensorineural hearing loss in serial audiograms of at least one ear and with improvement after corticosteroid administration. It is important to perform laboratory, serological and radiological tests and rule out other causes of hearing loss. Elevated HSP70 levels and a decrease in CD4+CD45RA+ T cells with an increase in CD4+CD45RO+ T cells may be two suggestive findings of this entity. There is no cure for AIED, but treatment can help to control the disease and improve hearing. The therapeutic gold standard remains high doses of corticosteroids, but biological agents and immunosuppressants (mainly methotrexate) are increasingly important as adjuvant therapy to save corticosteroids and as an alternative treatment for patients who are intolerant to corticotherapy or do not respond to it. The cochlear implant may be a good alternative for patients with severe hearing loss that does not respond to any medical treatment.
Autoimmune inner ear disease (AIED) is defined as a rapidly progressive (3 to 90 days), bilateral, sensorineural hearing loss that may be fluctuating and corticosteroid-responsive. It results from direct immune system damage to inner ear structures or from a systemic autoimmune disease. Up to 50% of patients with this disease may have vestibular symptoms, tinnitus and ear fullness. AIED is a rare but serious condition that can cause permanent hearing loss if not treated on time. The incidence of autoimmune inner ear disease is difficult to determine. It is probably a rare entity, accounting for less than 1% of all cases of hearing disorders or dizziness, however, the diagnosis of AIED may be overlooked due to the lack of specific tests and well-established diagnostic criteria. The diagnostic suspicion of AIED is based on the clinic, with evidence of progressive sensorineural hearing loss in serial audiograms of at least one ear and with improvement after corticosteroid administration. It is important to perform laboratory, serological and radiological tests and rule out other causes of hearing loss. Elevated HSP70 levels and a decrease in CD4+CD45RA+ T cells with an increase in CD4+CD45RO+ T cells may be two suggestive findings of this entity. There is no cure for AIED, but treatment can help to control the disease and improve hearing. The therapeutic gold standard remains high doses of corticosteroids, but biological agents and immunosuppressants (mainly methotrexate) are increasingly important as adjuvant therapy to save corticosteroids and as an alternative treatment for patients who are intolerant to corticotherapy or do not respond to it. The cochlear implant may be a good alternative for patients with severe hearing loss that does not respond to any medical treatment.
Direction
PALLAS PALLAS, ESTRELLA (Tutorships)
Pérez-Carro Ríos, Adela (Co-tutorships)
PALLAS PALLAS, ESTRELLA (Tutorships)
Pérez-Carro Ríos, Adela (Co-tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Real-world safety analysis of SGLT2 inhibitor use in the elderly population diagnosed with heart failure. Experience from a specialized clinic.
Authorship
D.A.G.
Bachelor of Medicine
D.A.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Objectives: The treatment with sodium-glucose cotransporter type two inhibitors is fundamental in the pharmacological management of patients with chronic heart failure across different ranges of left ventricular ejection fraction. Its safety and efficacy in improving quality of life and reducing major adverse cardiovascular events has been demonstrated in development studies, although the elderly and frail population was underrepresented in these studies. To date, there is limited real-world data for this patient profile, which could significantly benefit from these drugs. Subjects and Methods: A retrospective study was conducted on patients followed in a specialized heart failure clinic within Internal Medicine. Patients aged eighty-five and older who were being treated with sodium-glucose cotransporter type two inhibitors were analyzed. Demographic data, cardiac disease data, comorbidities, sociodemographic data, adverse events, and mortality were collected. Results: Two hundred twenty-nine patients aged eighty-five and older were followed in a heart failure clinic between January 2020 and December 2023. Of these, thirty-six were not receiving treatment with sodium-glucose cotransporter type two inhibitors at the time of analysis for various reasons, including one case of suspension due to adverse events. Patients receiving treatment were educated on potential adverse events, with an average follow-up of nine months. The overall mortality during the three-year study period was thirty-point-six percent, higher in men (forty percent) than in women (twenty-one percent). The average age at death was ninety years. Fifty-three patients (twenty-three percent) were over ninety years old and did not present major adverse events. Baseline characteristics included an average age of eighty-eight years, with a majority of women (fifty-one percent). Most had three or more comorbidities, primarily hypertension, atrial fibrillation, dyslipidemia, and chronic kidney disease. The predominant cardiac condition was valvular, with most patients in New York Heart Association functional class two. Three percent experienced adverse events related to the treatment, mainly urinary infections, renal deterioration, and dizziness. Mortality was significantly associated with worse New York Heart Association functional class, ischemic heart disease, cerebrovascular disease, chronic renal failure, smoking, and dependency. Conclusions: The use of sodium-glucose cotransporter type two inhibitors in an elderly population with heart failure is shown to be safe and apparently effective. No major adverse events related to their use were observed, and mortality was lower than expected for the studied age group.
Objectives: The treatment with sodium-glucose cotransporter type two inhibitors is fundamental in the pharmacological management of patients with chronic heart failure across different ranges of left ventricular ejection fraction. Its safety and efficacy in improving quality of life and reducing major adverse cardiovascular events has been demonstrated in development studies, although the elderly and frail population was underrepresented in these studies. To date, there is limited real-world data for this patient profile, which could significantly benefit from these drugs. Subjects and Methods: A retrospective study was conducted on patients followed in a specialized heart failure clinic within Internal Medicine. Patients aged eighty-five and older who were being treated with sodium-glucose cotransporter type two inhibitors were analyzed. Demographic data, cardiac disease data, comorbidities, sociodemographic data, adverse events, and mortality were collected. Results: Two hundred twenty-nine patients aged eighty-five and older were followed in a heart failure clinic between January 2020 and December 2023. Of these, thirty-six were not receiving treatment with sodium-glucose cotransporter type two inhibitors at the time of analysis for various reasons, including one case of suspension due to adverse events. Patients receiving treatment were educated on potential adverse events, with an average follow-up of nine months. The overall mortality during the three-year study period was thirty-point-six percent, higher in men (forty percent) than in women (twenty-one percent). The average age at death was ninety years. Fifty-three patients (twenty-three percent) were over ninety years old and did not present major adverse events. Baseline characteristics included an average age of eighty-eight years, with a majority of women (fifty-one percent). Most had three or more comorbidities, primarily hypertension, atrial fibrillation, dyslipidemia, and chronic kidney disease. The predominant cardiac condition was valvular, with most patients in New York Heart Association functional class two. Three percent experienced adverse events related to the treatment, mainly urinary infections, renal deterioration, and dizziness. Mortality was significantly associated with worse New York Heart Association functional class, ischemic heart disease, cerebrovascular disease, chronic renal failure, smoking, and dependency. Conclusions: The use of sodium-glucose cotransporter type two inhibitors in an elderly population with heart failure is shown to be safe and apparently effective. No major adverse events related to their use were observed, and mortality was lower than expected for the studied age group.
Direction
de la Iglesia Martínez, Fernando Antonio (Tutorships)
Rodríguez Osorio, Iria (Co-tutorships)
Seoane González, Beatriz Alicia (Co-tutorships)
de la Iglesia Martínez, Fernando Antonio (Tutorships)
Rodríguez Osorio, Iria (Co-tutorships)
Seoane González, Beatriz Alicia (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Role of immunotherapy as complement to surgery in early stage non-small cell lung cancer: a systematic review.
Authorship
P.A.A.
Bachelor of Medicine
P.A.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Although a significant percentage of non-small cell lung carcinoma (NSCLC) cases are resectable at diagnosis, many of them suffer recurrence after surgery, worsening survival. Immunotherapy with checkpoint inhibitors may improve the prognosis of these patients, as it already does in those with metastatic disease. Objectives: to summarize the available evidence on the use of immunotherapy in resectable NSCLC in adjuvant, neoadjuvant or perioperative settings. Methods: Successive searches were made in PubMed to identify randomized controlled clinical trials that met the previously specified inclusion criteria. Results: 8 studies were identified that met the pre-established criteria, of which 2 evaluated immunotherapy in adjuvant setting, 5 in perioperative scheme and one as neoadjuvant treatment. In neoadjuvant or perioperative studies, immunotherapy led to an improvement in the pathologic complete response rate (pCR) and event-free survival (EFS), while in the adjuvant trials it led to an improvement in disease-free survival (DFS). Conclusions: the use of immunotherapy with checkpoint inhibitors improves the prognosis of patients with resectable non-small cell lung cancer, which should be translated into routine clinical practice.However, further studies are required to determine the most appropriate treatment regime and its duration, as well as a better selection of which patients benefit most from this treatment.
Introduction: Although a significant percentage of non-small cell lung carcinoma (NSCLC) cases are resectable at diagnosis, many of them suffer recurrence after surgery, worsening survival. Immunotherapy with checkpoint inhibitors may improve the prognosis of these patients, as it already does in those with metastatic disease. Objectives: to summarize the available evidence on the use of immunotherapy in resectable NSCLC in adjuvant, neoadjuvant or perioperative settings. Methods: Successive searches were made in PubMed to identify randomized controlled clinical trials that met the previously specified inclusion criteria. Results: 8 studies were identified that met the pre-established criteria, of which 2 evaluated immunotherapy in adjuvant setting, 5 in perioperative scheme and one as neoadjuvant treatment. In neoadjuvant or perioperative studies, immunotherapy led to an improvement in the pathologic complete response rate (pCR) and event-free survival (EFS), while in the adjuvant trials it led to an improvement in disease-free survival (DFS). Conclusions: the use of immunotherapy with checkpoint inhibitors improves the prognosis of patients with resectable non-small cell lung cancer, which should be translated into routine clinical practice.However, further studies are required to determine the most appropriate treatment regime and its duration, as well as a better selection of which patients benefit most from this treatment.
Direction
VARELA PONTE, RAFAEL (Tutorships)
Areses Manrique, María Carmen (Co-tutorships)
VARELA PONTE, RAFAEL (Tutorships)
Areses Manrique, María Carmen (Co-tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Pharmacocinetic and pharmacogenetic study of palmitate of paliperidone in severe mental disorder and its secondary effects
Authorship
V.A.E.
Bachelor of Medicine
V.A.E.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Paliperidone palmitate, an active metabolite of risperidone, is a medication used in injectable format in patients with severe mental disorders, due to its ability to mantain continuity of treatment, as well as the reduction of relapses and risk of hospitalization. This research studies the connection between life standarts and secondary effects with the concentration in plasma of paliperidone, a long-acting injectable antipsychotic Methodology: a prospective, open-label, uncontrolled study of 62 patients with severe mental disorder treated with paliperidone palmitate was conducted. The CGI, GASS and PANSS were used to asses both, patients and their side effects. Main results: The patients present secondary effects in relation to the type of metabolizer. There is a good tolerance to Paliperidone Palmitate independently of the concentration in plasma and its aplication decreases drug abuse, emergencies and hospitalizations. As for general satisfaction, it is negative in the majority of subjects.
Paliperidone palmitate, an active metabolite of risperidone, is a medication used in injectable format in patients with severe mental disorders, due to its ability to mantain continuity of treatment, as well as the reduction of relapses and risk of hospitalization. This research studies the connection between life standarts and secondary effects with the concentration in plasma of paliperidone, a long-acting injectable antipsychotic Methodology: a prospective, open-label, uncontrolled study of 62 patients with severe mental disorder treated with paliperidone palmitate was conducted. The CGI, GASS and PANSS were used to asses both, patients and their side effects. Main results: The patients present secondary effects in relation to the type of metabolizer. There is a good tolerance to Paliperidone Palmitate independently of the concentration in plasma and its aplication decreases drug abuse, emergencies and hospitalizations. As for general satisfaction, it is negative in the majority of subjects.
Direction
VIDAL MILLARES, MARIA (Tutorships)
Mondelo García, Cristina (Co-tutorships)
VIDAL MILLARES, MARIA (Tutorships)
Mondelo García, Cristina (Co-tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Hypertrophic cardiomyopathy in Noonan spectrum rasopathies. Systematic review.
Authorship
A.D.M.
Bachelor of Medicine
A.D.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: RASopathies are a group of disorders caused by different mutations in the RAS/MAPK pathway. This review focuses on Noonan-type RASopathies characterized by presenting a common phenotype, including hypertrophic cardiomyopathy in some cases. These disorders are rare, which hinders the conduct of studies on hypertrophic cardiomyopathy in patients with RASopathy. Objectives: The objectives of this review are to deepen the phenotype-genotype correlation of hypertrophic cardiomyopathy and RASopathy, establish possible predictors of mortality, determine the safety of rhGH treatment in patients with short stature and RASopathy, and investigate the feasibility of new therapeutic targets. Method: For this purpose, a search was conducted in PubMed, including a total of 20 articles. Discussion: The results obtained in this review could simplify decision-making regarding managing patients with hypertrophic cardiomyopathy and RASopathy. HCM is more prevalent in patients with certain mutations and syndromes within the RASopathies group. Specific predictors of mortality have been described, which could be of great utility for professionals who follow up on these patients. On the other hand, rhGH treatment appears to be safe in these patients, and new therapeutic targets pose promising scenarios. However, the heterogeneity and low prevalence of these disorders make it necessary to conduct further research and both clinical and preclinical trials that consolidate the current evidence regarding all the discussed issues.
Introduction: RASopathies are a group of disorders caused by different mutations in the RAS/MAPK pathway. This review focuses on Noonan-type RASopathies characterized by presenting a common phenotype, including hypertrophic cardiomyopathy in some cases. These disorders are rare, which hinders the conduct of studies on hypertrophic cardiomyopathy in patients with RASopathy. Objectives: The objectives of this review are to deepen the phenotype-genotype correlation of hypertrophic cardiomyopathy and RASopathy, establish possible predictors of mortality, determine the safety of rhGH treatment in patients with short stature and RASopathy, and investigate the feasibility of new therapeutic targets. Method: For this purpose, a search was conducted in PubMed, including a total of 20 articles. Discussion: The results obtained in this review could simplify decision-making regarding managing patients with hypertrophic cardiomyopathy and RASopathy. HCM is more prevalent in patients with certain mutations and syndromes within the RASopathies group. Specific predictors of mortality have been described, which could be of great utility for professionals who follow up on these patients. On the other hand, rhGH treatment appears to be safe in these patients, and new therapeutic targets pose promising scenarios. However, the heterogeneity and low prevalence of these disorders make it necessary to conduct further research and both clinical and preclinical trials that consolidate the current evidence regarding all the discussed issues.
Direction
CABANAS RODRIGUEZ, PALOMA (Tutorships)
CABANAS RODRIGUEZ, PALOMA (Tutorships)
Use of PARP inhibitors for the treatment of ovarian cancer: a systematic review
Authorship
M.D.M.
Bachelor of Medicine
M.D.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Purpose: To review the bibliography regarding the use of PARP inhibitors in ovarian cancer. Methods: A systematic review on the use of PARP inhibitors in advanced ovarian cancer was conducted during the last trimester of 2023 using PubMed and Web of Science, essentially. The studies included in the analysis were found with the following search terms: ovarian cancer AND maintenance therapy OR maintenance treatment, narrowing down the results to the titles or abstracts. Results: The systematic literature review yielded a significant number of studies on the use of PARP inhibitors in the treatment of recurrent ovarian cancer, of which 5 were considered relevant for the review. These studies cover various aspects, including the efficacy and safety of PARP inhibitors as maintenance therapy, their impact on progression-free survival, as well as their role in different subtypes of ovarian cancer and in combination with other treatments. Consistent evidence was found supporting the benefit of PARP inhibitors in maintenance therapy for patients with recurrent ovarian cancer. The studies establish that the use of PARP inhibitors significantly prolongs progression-free survival compared to placebo or observation without treatment. Additionally, it was observed that PARP inhibitors are effective in different subtypes of ovarian cancer, including tumors with mutations in BRCA and those with deficiencies in DNA repair (HDR). Conclusion: PARP inhibitors represent an effective and promising therapeutic option in the treatment of recurrent ovarian cancer. Their use as maintenance therapy has been shown to significantly improve progression-free survival in various studies. However, it is crucial to continue researching to better understand their long-term efficacy, as well as their impact on overall survival and the quality of life of patients. The proper identification of biomarkers will remain fundamental for the accurate selection of patients and to maximize the benefits of this therapy.
Purpose: To review the bibliography regarding the use of PARP inhibitors in ovarian cancer. Methods: A systematic review on the use of PARP inhibitors in advanced ovarian cancer was conducted during the last trimester of 2023 using PubMed and Web of Science, essentially. The studies included in the analysis were found with the following search terms: ovarian cancer AND maintenance therapy OR maintenance treatment, narrowing down the results to the titles or abstracts. Results: The systematic literature review yielded a significant number of studies on the use of PARP inhibitors in the treatment of recurrent ovarian cancer, of which 5 were considered relevant for the review. These studies cover various aspects, including the efficacy and safety of PARP inhibitors as maintenance therapy, their impact on progression-free survival, as well as their role in different subtypes of ovarian cancer and in combination with other treatments. Consistent evidence was found supporting the benefit of PARP inhibitors in maintenance therapy for patients with recurrent ovarian cancer. The studies establish that the use of PARP inhibitors significantly prolongs progression-free survival compared to placebo or observation without treatment. Additionally, it was observed that PARP inhibitors are effective in different subtypes of ovarian cancer, including tumors with mutations in BRCA and those with deficiencies in DNA repair (HDR). Conclusion: PARP inhibitors represent an effective and promising therapeutic option in the treatment of recurrent ovarian cancer. Their use as maintenance therapy has been shown to significantly improve progression-free survival in various studies. However, it is crucial to continue researching to better understand their long-term efficacy, as well as their impact on overall survival and the quality of life of patients. The proper identification of biomarkers will remain fundamental for the accurate selection of patients and to maximize the benefits of this therapy.
Direction
VARELA PONTE, RAFAEL (Tutorships)
Arias Ron, David (Co-tutorships)
VARELA PONTE, RAFAEL (Tutorships)
Arias Ron, David (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Advantages and disadvantages of robotic surgery in myomectomies
Authorship
A.R.D.M.
Bachelor of Medicine
A.R.D.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Robotic surgery has emerged as a revolutionary tool for precise and less invasive surgical procedures. Uterine leiomyomas are the most common pelvic tumor in women. They are benign, well-defined and non-invasive neoformations that usually appear during reproductive age and when symptomatic they typically manifest as abnormal uterine bleeding and/or pelvic pain or pressure. Additionally, these fibroids can affect reproductive health, causing problems such as infertility or pregnancy complications. Objectives: The main objective of this bibliographic review is to review the current scientific evidence on the application of robotic surgery in myomectomies. The aim is to identify the benefits and limitations of this surgical approach compared to conventional methods (laparotomy and laparoscopy), with the aim of contributing to an expanded understanding of the role of robotic surgery in this gynecological pathology. Material and methods: Bibliographic review of the available scientific literature on the benefits and limitations of robotic surgery compared to conventional laparoscopic surgery and open surgery, carried out using the PUBMED bibliographic search engine and following the PRISMA guidelines. Original articles published in English between 2019 and 2024 were included. Results: Data from 7 articles were analyzed. The speed of the learning curve, which can be attributed to an improvement in the visualization of the surgical field and an ergonomically favorable environment, is one of the advantages of robotic surgery, allowing the surgeon greater precision manipulation, flexibility and control of instruments. The use of the robot compared to conventional laparoscopy has comparable results, however, this new approach is superior to laparotomy. The parameters in which it can be considered inferior to traditional laparoscopy and open surgery are surgical time and costs. Conclusions: The use of the robot in myomectomies is a safe and effective option with results similar to conventional laparoscopy, but superior to laparotomy. It is proven that the disadvantages it presents can be minimized by increasing the surgeon's experience and applying it in a greater number of surgeries in order to offset the costs.
Introduction: Robotic surgery has emerged as a revolutionary tool for precise and less invasive surgical procedures. Uterine leiomyomas are the most common pelvic tumor in women. They are benign, well-defined and non-invasive neoformations that usually appear during reproductive age and when symptomatic they typically manifest as abnormal uterine bleeding and/or pelvic pain or pressure. Additionally, these fibroids can affect reproductive health, causing problems such as infertility or pregnancy complications. Objectives: The main objective of this bibliographic review is to review the current scientific evidence on the application of robotic surgery in myomectomies. The aim is to identify the benefits and limitations of this surgical approach compared to conventional methods (laparotomy and laparoscopy), with the aim of contributing to an expanded understanding of the role of robotic surgery in this gynecological pathology. Material and methods: Bibliographic review of the available scientific literature on the benefits and limitations of robotic surgery compared to conventional laparoscopic surgery and open surgery, carried out using the PUBMED bibliographic search engine and following the PRISMA guidelines. Original articles published in English between 2019 and 2024 were included. Results: Data from 7 articles were analyzed. The speed of the learning curve, which can be attributed to an improvement in the visualization of the surgical field and an ergonomically favorable environment, is one of the advantages of robotic surgery, allowing the surgeon greater precision manipulation, flexibility and control of instruments. The use of the robot compared to conventional laparoscopy has comparable results, however, this new approach is superior to laparotomy. The parameters in which it can be considered inferior to traditional laparoscopy and open surgery are surgical time and costs. Conclusions: The use of the robot in myomectomies is a safe and effective option with results similar to conventional laparoscopy, but superior to laparotomy. It is proven that the disadvantages it presents can be minimized by increasing the surgeon's experience and applying it in a greater number of surgeries in order to offset the costs.
Direction
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Cordeiro Vidal, Gloria (Co-tutorships)
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Cordeiro Vidal, Gloria (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Association between the response to anti-TNF treatment and the HLA-DQA1*05 haplotype in patients with ulcerative colitis and its prevalence in our region. Prospective observational study
Authorship
F.J.D.C.
Bachelor of Medicine
F.J.D.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Ulcerative colitis (UC) is a chronic inflammatory disease whose management constitutes a medical challenge. The arrival of biological treatment represents a therapeutic revolution. However, one of its limitations is the inability to predict the efficacy and safety of these drugs. Outcomes: To know the prevalence of the HLA-DQA1*05 mutation in patients with UC in our region. Determine the role of the HLA-DQA1*05 haplotype in the response to anti-TNF treatment, evaluating its efficacy, persistence and safety. Methods: Prospective analytical observational study includind a cohort of patients with UC who started anti-TNF treatment (adalimumab, infliximab) between January-2021 and October-2023. At 12 weeks, 6 months and 12 months, the clinical and biological response, adverse effects and antibody formation were evaluated. The HLA-DQA1*05 haplotype was determined in saliva samples. Results: We included 54 patients and 61 cycles of anti-TNF treatments with a median follow-up of 10.5 months. Eighteen patients (33.3%) presented the HLA-DQA1*05 haplotype. No association was found between HLA-DQA1*05 and UC phenotype (age, gender, location, history of surgery, perianal or extraintestinal disease). Seven treatment cycles had a primary failure (11.5%). After 6 months we found a reduction in fecal calprotectin (p= 0.039). During follow-up, 26 cycles (42.6%) were suspended, mainly due to the presence of adverse events (16.4%), mostly infusion reactions. The use of infliximab is associated with a higher rate of adverse events compared to adalimumab (p=0.005). There were no differences in treatment persistence between HLA-DQA1*05 carriers and non-carriers. The presence of antibodies was not related to HLA-DQA1*05, adverse effects or persistence of anti-TNF treatment. Conclusions: In patients with UC, the HLA-DQA1*05 mutation was not associated with the efficacy, safety or persistence of anti-TNF treatment or the development of antibodies. Thus, the role of this haplotype as a guide in the choice of biological treatment seems questionable.
Introduction: Ulcerative colitis (UC) is a chronic inflammatory disease whose management constitutes a medical challenge. The arrival of biological treatment represents a therapeutic revolution. However, one of its limitations is the inability to predict the efficacy and safety of these drugs. Outcomes: To know the prevalence of the HLA-DQA1*05 mutation in patients with UC in our region. Determine the role of the HLA-DQA1*05 haplotype in the response to anti-TNF treatment, evaluating its efficacy, persistence and safety. Methods: Prospective analytical observational study includind a cohort of patients with UC who started anti-TNF treatment (adalimumab, infliximab) between January-2021 and October-2023. At 12 weeks, 6 months and 12 months, the clinical and biological response, adverse effects and antibody formation were evaluated. The HLA-DQA1*05 haplotype was determined in saliva samples. Results: We included 54 patients and 61 cycles of anti-TNF treatments with a median follow-up of 10.5 months. Eighteen patients (33.3%) presented the HLA-DQA1*05 haplotype. No association was found between HLA-DQA1*05 and UC phenotype (age, gender, location, history of surgery, perianal or extraintestinal disease). Seven treatment cycles had a primary failure (11.5%). After 6 months we found a reduction in fecal calprotectin (p= 0.039). During follow-up, 26 cycles (42.6%) were suspended, mainly due to the presence of adverse events (16.4%), mostly infusion reactions. The use of infliximab is associated with a higher rate of adverse events compared to adalimumab (p=0.005). There were no differences in treatment persistence between HLA-DQA1*05 carriers and non-carriers. The presence of antibodies was not related to HLA-DQA1*05, adverse effects or persistence of anti-TNF treatment. Conclusions: In patients with UC, the HLA-DQA1*05 mutation was not associated with the efficacy, safety or persistence of anti-TNF treatment or the development of antibodies. Thus, the role of this haplotype as a guide in the choice of biological treatment seems questionable.
Direction
DE CASTRO PARGA, MARIA LUISA (Tutorships)
García Morales, Natalia (Co-tutorships)
DE CASTRO PARGA, MARIA LUISA (Tutorships)
García Morales, Natalia (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Risk Factors for Anterior Cruciate Ligament Rupture and prevention in female athletes
Authorship
J.D.G.
Bachelor of Medicine
J.D.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Anterior cruciate ligament (ACL) injuries are common in the sports field, being 4 to 6 times more frequent in female athletes than in males. With a particular incidence in football, basketball, and lacrosse, most of them occur, however, in non-contact injuries. Additionally, after ACL reconstruction, women are more likely to rupture the contralateral ACL than men. Various intrinsic factors such as increased Q-angle, posterior tibial slope, and narrow intercondylar notch, among others; as well as extrinsic neuromuscular and sports-related factors, may predispose women to a higher incidence of ACL injury. The aim of this study is to evaluate, through a systematic review of the scientific literature, the relevance of these and other risk factors (anatomical, biomechanical, hormonal, etc.) in the development of ACL injuries in female athletes, as well as to analyze if any type of neuromuscular or proprioceptive training would be effective in their prevention.
Anterior cruciate ligament (ACL) injuries are common in the sports field, being 4 to 6 times more frequent in female athletes than in males. With a particular incidence in football, basketball, and lacrosse, most of them occur, however, in non-contact injuries. Additionally, after ACL reconstruction, women are more likely to rupture the contralateral ACL than men. Various intrinsic factors such as increased Q-angle, posterior tibial slope, and narrow intercondylar notch, among others; as well as extrinsic neuromuscular and sports-related factors, may predispose women to a higher incidence of ACL injury. The aim of this study is to evaluate, through a systematic review of the scientific literature, the relevance of these and other risk factors (anatomical, biomechanical, hormonal, etc.) in the development of ACL injuries in female athletes, as well as to analyze if any type of neuromuscular or proprioceptive training would be effective in their prevention.
Direction
CAEIRO REY, JOSE RAMON (Tutorships)
Sola Mallo, Xacobe (Co-tutorships)
CAEIRO REY, JOSE RAMON (Tutorships)
Sola Mallo, Xacobe (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Emerging infections in a changing world. A literature review.
Authorship
C.D.P.
Bachelor of Medicine
C.D.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
A few years ago it seemed unthinkable to imagine that in the 21st century, when the most advances are being made in medicine, a pandemic could paralyze the world´s population and decimate the health systems of the most developed countries. After suffering the consequences of COVID-19, we have learned not to underestimate new pathogens. This work will address the latest epidemics that caused social alarm, from the first coronaviruses to the recent outbreak of avian flu that is of concern today, relating its appearance to human activities and climate change.
A few years ago it seemed unthinkable to imagine that in the 21st century, when the most advances are being made in medicine, a pandemic could paralyze the world´s population and decimate the health systems of the most developed countries. After suffering the consequences of COVID-19, we have learned not to underestimate new pathogens. This work will address the latest epidemics that caused social alarm, from the first coronaviruses to the recent outbreak of avian flu that is of concern today, relating its appearance to human activities and climate change.
Direction
Antela López, Antonio Rafael (Tutorships)
Antela López, Antonio Rafael (Tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Microbiology of removed vascular grafts: aggregated data analysis in a tertiary hospital in the last five years.
Authorship
E.D.R.
Bachelor of Medicine
E.D.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The aim of this study is to evaluate the microbiology of vascular graft infections based on positive cultures from the explanted grafts in our center. Methods: Descriptive analysis of vascular graft samples sent to the Microbiology laboratory (2019-2023). Supracoronary tubes and hemodialysis fistulas were excluded. The study protocol was sonication and inoculation of sonicated fluid into blood culture bottles. Results: Overall, 118 samples from 76 patients (mean age: 70 years; male sex: 87%) were analyzed. The location was: 7 (6%) aortic, 32 (27%) aorto-femoral, 65 (55%) lower limb and 14 (12%) axillo-femoral. The most common material was Dacron (73%) and 6 (5%) endografts were removed. The most serious complications that led to graft excision were thrombosis (18%), rupture (16%) and aorto-enteric fistula (11%). Microorganisms (n=134) were classified into Gram-positive bacteria (67%), Gram-negative bacteria (22%), anaerobes (5%) and fungi (6%). The culture was negative in 24%. Polymicrobial samples, 24%. In order of frequency, 41 CoNS (33 oxa-R), 25 S. aureus (1 MRSA), 14 P. aeruginosa (6 multidrug-resistant) and 10 enterococci (9 E. faecium) were identified. No S. aureus or P. aeruginosa were found in intracavitary samples. In contrast, E. faecium (21% vs. 3%; p less than 0.01) and anaerobes (14% vs. 3%; p=0.02) were significantly more frequent in this location. S. aureus was the most prevalent microorganism in blood cultures (37% vs. 13%; p= 0.03) and enterococci were associated with the presence of aorto-enteric fistula (56% vs. 9%; p less than 0.01). Conclusion: - Microbiology varies depending on the location. Although the prevalence of MRSA is low, the presence of resistant microorganisms such as E. faecium and MDR P. aeruginosa is significant. - The isolation of S. aureus was related to the presence of bacteremia and enterococci with aorto-enteric fistula.
Introduction: The aim of this study is to evaluate the microbiology of vascular graft infections based on positive cultures from the explanted grafts in our center. Methods: Descriptive analysis of vascular graft samples sent to the Microbiology laboratory (2019-2023). Supracoronary tubes and hemodialysis fistulas were excluded. The study protocol was sonication and inoculation of sonicated fluid into blood culture bottles. Results: Overall, 118 samples from 76 patients (mean age: 70 years; male sex: 87%) were analyzed. The location was: 7 (6%) aortic, 32 (27%) aorto-femoral, 65 (55%) lower limb and 14 (12%) axillo-femoral. The most common material was Dacron (73%) and 6 (5%) endografts were removed. The most serious complications that led to graft excision were thrombosis (18%), rupture (16%) and aorto-enteric fistula (11%). Microorganisms (n=134) were classified into Gram-positive bacteria (67%), Gram-negative bacteria (22%), anaerobes (5%) and fungi (6%). The culture was negative in 24%. Polymicrobial samples, 24%. In order of frequency, 41 CoNS (33 oxa-R), 25 S. aureus (1 MRSA), 14 P. aeruginosa (6 multidrug-resistant) and 10 enterococci (9 E. faecium) were identified. No S. aureus or P. aeruginosa were found in intracavitary samples. In contrast, E. faecium (21% vs. 3%; p less than 0.01) and anaerobes (14% vs. 3%; p=0.02) were significantly more frequent in this location. S. aureus was the most prevalent microorganism in blood cultures (37% vs. 13%; p= 0.03) and enterococci were associated with the presence of aorto-enteric fistula (56% vs. 9%; p less than 0.01). Conclusion: - Microbiology varies depending on the location. Although the prevalence of MRSA is low, the presence of resistant microorganisms such as E. faecium and MDR P. aeruginosa is significant. - The isolation of S. aureus was related to the presence of bacteremia and enterococci with aorto-enteric fistula.
Direction
Sousa Regueiro, María Dolores (Tutorships)
Sousa Regueiro, María Dolores (Tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Monitoring and reversal of neuromuscular blockade in clinical practice
Authorship
M.H.P.
Bachelor of Medicine
M.H.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Neuromuscular blocking agents are highly used drugs in surgical clinical practice to paralyze skeletal muscle, thus facilitating the orotracheal intubation and extubation, allowing good ventilation, and facilitating the surgical act per se. To know the level of muscle relaxation, some devices are used to measure and monitor the neuromuscular block depth.
Neuromuscular blocking agents are highly used drugs in surgical clinical practice to paralyze skeletal muscle, thus facilitating the orotracheal intubation and extubation, allowing good ventilation, and facilitating the surgical act per se. To know the level of muscle relaxation, some devices are used to measure and monitor the neuromuscular block depth.
Direction
VEIRAS DEL RIO, SONIA (Tutorships)
López Pérez, Rosa María (Co-tutorships)
VEIRAS DEL RIO, SONIA (Tutorships)
López Pérez, Rosa María (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
New lines of treatment in alopecia areata
Authorship
C.I.I.
Bachelor of Medicine
C.I.I.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Alopecia areata is one of the main causes of hair loss and can affect up to 2% of the population and is classified as a non-scarring alopecia. Its pathophysiology has not been fully clarified, but it points to a T-lymphocyte-mediated autoimmune disease which, combined with genetics and the environment, affects the hair follicle in the anagen phase and produces clinical phenotypes of varying severity. The classic lesion is a round or oval alopecic area with a clear boundary and may present as single or multiple patches. The scalp is the most frequently affected site, with patterns such as patchy, diffuse, ophthalmic and syphotic. There are other more extensive forms, affecting the eyebrows, eyelashes and beard in alopecia areata totalis and the rest of the body in alopecia areata universalis. Its course is variable and depends on the severity. Some patients experience spontaneous hair regeneration, but most patients recur and require dermatological therapy, including principally: contact immunotherapy, classical immunosuppressants, phototherapy and JAK-STAT pathway inhibitors. Although some patients respond favourably to the available treatments, the success rate in more severe forms remains low. The aim of this paper is to review the literature on advances in the treatment of alopecia areata, a pathology that can have a negative impact on quality of life, with unmet needs at present and for which advances have been made in the knowledge of the aetiopathogenesis and, in parallel, in its treatment.
Alopecia areata is one of the main causes of hair loss and can affect up to 2% of the population and is classified as a non-scarring alopecia. Its pathophysiology has not been fully clarified, but it points to a T-lymphocyte-mediated autoimmune disease which, combined with genetics and the environment, affects the hair follicle in the anagen phase and produces clinical phenotypes of varying severity. The classic lesion is a round or oval alopecic area with a clear boundary and may present as single or multiple patches. The scalp is the most frequently affected site, with patterns such as patchy, diffuse, ophthalmic and syphotic. There are other more extensive forms, affecting the eyebrows, eyelashes and beard in alopecia areata totalis and the rest of the body in alopecia areata universalis. Its course is variable and depends on the severity. Some patients experience spontaneous hair regeneration, but most patients recur and require dermatological therapy, including principally: contact immunotherapy, classical immunosuppressants, phototherapy and JAK-STAT pathway inhibitors. Although some patients respond favourably to the available treatments, the success rate in more severe forms remains low. The aim of this paper is to review the literature on advances in the treatment of alopecia areata, a pathology that can have a negative impact on quality of life, with unmet needs at present and for which advances have been made in the knowledge of the aetiopathogenesis and, in parallel, in its treatment.
Direction
PEREIRO FERREIROS, MANUEL (Tutorships)
Flórez Menéndez, María Ángeles (Co-tutorships)
PEREIRO FERREIROS, MANUEL (Tutorships)
Flórez Menéndez, María Ángeles (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Effectiveness and safety of Electroconvulsive Therapy in the adolescent population: a systematic review.
Authorship
S.I.C.
Bachelor of Medicine
S.I.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Electroconvulsive therapy (ECT) is a psychiatric treatment with a controversial history and a particularly stigmatized and little-known procedure. Its effectiveness and safety in the adult population has been widely demonstrated in different disorders. Objectives: Review the effectiveness and safety of ECT in psychiatric disorders in the adolescent population (13-18 years). Materials and methods: The methodology used includes a bibliographic search in the PubMed database of articles published in the last decade, with the terms “electroconvulsive therapy” AND “adolescent”. The initial search reported 223 studies, of which once analyzed, 204 studies were discarded. Finally, 19 studies were included in the review. Results: The results indicate that this technique is effective in the adolescent population and especially in severe cases refractory to other treatments, with improvement in depressive, catatonic and psychotic symptoms. ECT was also shown to be effective in preventing relapses and the most frequent side effects such as headache, short-term memory loss or nausea were similar to those found in the adult population. Conclusions: Although more studies are needed, the use of electroconvulsive therapy in adolescents seems to be an effective and safe option.
Introduction: Electroconvulsive therapy (ECT) is a psychiatric treatment with a controversial history and a particularly stigmatized and little-known procedure. Its effectiveness and safety in the adult population has been widely demonstrated in different disorders. Objectives: Review the effectiveness and safety of ECT in psychiatric disorders in the adolescent population (13-18 years). Materials and methods: The methodology used includes a bibliographic search in the PubMed database of articles published in the last decade, with the terms “electroconvulsive therapy” AND “adolescent”. The initial search reported 223 studies, of which once analyzed, 204 studies were discarded. Finally, 19 studies were included in the review. Results: The results indicate that this technique is effective in the adolescent population and especially in severe cases refractory to other treatments, with improvement in depressive, catatonic and psychotic symptoms. ECT was also shown to be effective in preventing relapses and the most frequent side effects such as headache, short-term memory loss or nausea were similar to those found in the adult population. Conclusions: Although more studies are needed, the use of electroconvulsive therapy in adolescents seems to be an effective and safe option.
Direction
BRAÑAS GONZALEZ, ANTIA (Tutorships)
BRAÑAS GONZALEZ, ANTIA (Tutorships)
Usefulness of vestibular rehabilitation in bilateral vestibulopathy. Systematic review.
Authorship
A.J.D.
Bachelor of Medicine
A.J.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction Álvaro Juiz Díaz. Trabajo de Fin de Grado. Universidad Santiago de Compostela. Bilateral vestibulopathy (BVP) is a pathology with dysfunction of both vestibular organs. He maintains a latent clinic with great complications for daily life. Vestibular rehabilitation aims to strengthen the capabilities of each patient's balance system, improving instability and thus quality of life. Scientific studies provide information on the advances in results of these techniques, some of them novel, in order to advance in this pathology. Objectives A search is carried out in the literature in order to group and expose the effectiveness of different rehabilitation therapies, in the improvement, habituation and adaptability to the symptoms, in order to obtain a higher quality of life. Methods Different clinical trials and meta-analyses are reviewed in three different databases (Iacobus, Cochrane Library and Pubmed). The PRISMA flowchart is used for the selection of articles. Results Eight studies pass the selection criteria and are analyzed to obtain data on rehabilitation therapies (galvanic stimulation, electrotactile and vibrotactile feedback, as well as modifications of conventional therapy), obtaining different results that allow us to make a comparison. Conclusion BVP is a pathology with a complex definition, and with symptoms that are difficult to control. This disease improves thanks to vestibular rehabilitation, which is why new advances allow this treatment to be more efficient in clinical practice. Galvanic stimulation, devices such as the Vertiguard or Brainport, or different ways and approaches of performing conventional therapy can improve postural control, balance and quality of life.
Introduction Álvaro Juiz Díaz. Trabajo de Fin de Grado. Universidad Santiago de Compostela. Bilateral vestibulopathy (BVP) is a pathology with dysfunction of both vestibular organs. He maintains a latent clinic with great complications for daily life. Vestibular rehabilitation aims to strengthen the capabilities of each patient's balance system, improving instability and thus quality of life. Scientific studies provide information on the advances in results of these techniques, some of them novel, in order to advance in this pathology. Objectives A search is carried out in the literature in order to group and expose the effectiveness of different rehabilitation therapies, in the improvement, habituation and adaptability to the symptoms, in order to obtain a higher quality of life. Methods Different clinical trials and meta-analyses are reviewed in three different databases (Iacobus, Cochrane Library and Pubmed). The PRISMA flowchart is used for the selection of articles. Results Eight studies pass the selection criteria and are analyzed to obtain data on rehabilitation therapies (galvanic stimulation, electrotactile and vibrotactile feedback, as well as modifications of conventional therapy), obtaining different results that allow us to make a comparison. Conclusion BVP is a pathology with a complex definition, and with symptoms that are difficult to control. This disease improves thanks to vestibular rehabilitation, which is why new advances allow this treatment to be more efficient in clinical practice. Galvanic stimulation, devices such as the Vertiguard or Brainport, or different ways and approaches of performing conventional therapy can improve postural control, balance and quality of life.
Direction
SANTOS PEREZ, SOFIA MARIA SOLEDAD (Tutorships)
Rossi Izquierdo, Marcos (Co-tutorships)
SANTOS PEREZ, SOFIA MARIA SOLEDAD (Tutorships)
Rossi Izquierdo, Marcos (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Benefits of cannabidiol treatment in pediatric patients with autism spectrum disorder: systematic review.
Authorship
L.L.P.
Bachelor of Medicine
L.L.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Treatment with cannabidiol is a reality in neuropediatric pathologies, in autism spectrum disorder, cannabidiol or CBD could represent a treatment alternative that could be initiated from the diagnosis and enhance other first-line treatments. The objective of this systematic review is to analyze the available evidence on the effectiveness of CBD or cannabidiol in treating cardinal symptoms such as social or disruptive behavior in pediatric patients with autism spectrum disorder. In order to carry out this research, a systematic search was done in the Medline, Cochrane, Scopus, Scielo and Dialnet databases with the aim to identify studies published in the last 10 years on CBD treatment in children with autism spectrum disorder. The risk of biases and the design of the 8 results obtained were evaluated, two of those studies were randomized clinical trials with a control group; but only one had exclusive pediatric population. The other 6 studies were open trials or observational studies, most of them with mixed population, so the risk of bias was important. In the included studies, only specific improvements were observed in terms of social symptoms in those patients treated with CBD or cannabis plant extract compared to those treated with placebo. Regarding disruptive behavior, the results were even more modest. The differences were significant between the groups treated with associated purified cannabinoids and those treated with plant extract, supporting the influence that the association of THC with CBD may have on these results. After the review, we cannot conclude that there is sufficient evidence to support CBD treatment for the control of autism core symptoms. Currently, there are still many challenges in the treatment of ASD and more well-designed clinical trials are needed, which study the effectiveness of cannabidiol without association of THC, evaluating risks and individualizing doses.
Treatment with cannabidiol is a reality in neuropediatric pathologies, in autism spectrum disorder, cannabidiol or CBD could represent a treatment alternative that could be initiated from the diagnosis and enhance other first-line treatments. The objective of this systematic review is to analyze the available evidence on the effectiveness of CBD or cannabidiol in treating cardinal symptoms such as social or disruptive behavior in pediatric patients with autism spectrum disorder. In order to carry out this research, a systematic search was done in the Medline, Cochrane, Scopus, Scielo and Dialnet databases with the aim to identify studies published in the last 10 years on CBD treatment in children with autism spectrum disorder. The risk of biases and the design of the 8 results obtained were evaluated, two of those studies were randomized clinical trials with a control group; but only one had exclusive pediatric population. The other 6 studies were open trials or observational studies, most of them with mixed population, so the risk of bias was important. In the included studies, only specific improvements were observed in terms of social symptoms in those patients treated with CBD or cannabis plant extract compared to those treated with placebo. Regarding disruptive behavior, the results were even more modest. The differences were significant between the groups treated with associated purified cannabinoids and those treated with plant extract, supporting the influence that the association of THC with CBD may have on these results. After the review, we cannot conclude that there is sufficient evidence to support CBD treatment for the control of autism core symptoms. Currently, there are still many challenges in the treatment of ASD and more well-designed clinical trials are needed, which study the effectiveness of cannabidiol without association of THC, evaluating risks and individualizing doses.
Direction
Moreno Álvarez, Ana (Tutorships)
Varela Pájaro, Celia (Co-tutorships)
Moreno Álvarez, Ana (Tutorships)
Varela Pájaro, Celia (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Use of smart insuline pens in the treatment of type 1 Diabetes Mellitus. Impact on glucose variability and metabolic control.
Authorship
I.L.P.
Bachelor of Medicine
I.L.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Smart insulin pens are rechargeable devices that have an electronic memory in which they record the administered doses. Objectives: Evaluate the real-life impact of smart insulin pens on glycemic control in patients with T1D, by analyzing glucometric parameters obtained from continuous glucose monitoring. Methods: Retrospective observational study in 23 patients with T1D who started using Novo-Pen 6 and NovoPen Echo Plus smart insulin pens. Data obtained from continuous glucose monitoring, available on LibreView, were analyzed 14 days before starting treatment with smart pens and 14 days before the 3-month follow-up visit. Changes in CV, TIR, TBR, TAR and GMI were analyzed. Results: No statistically differences were detected in CV from baseline to follow-up visit (p=0.57). TIR increased significantly (54% initial, 57% final) (p=0.028), but there were no significant differences in the other parameters analyzed. In patients with poor metabolic control at baseline, TIR increased, and both TAR and GMI decreased. In contrast, a significant increase in CV and TBR was observed. In well-controlled patients there were no significant changes in any of the analyzed parameters. Conclusions: The use of smart insulin pens did not result in a significant change in the CV of the sample. However, time in the target glucose range increased. Previous glycemic control influenced the results obtained, with those having poorer prior glycemic control benefiting the most.
Introduction: Smart insulin pens are rechargeable devices that have an electronic memory in which they record the administered doses. Objectives: Evaluate the real-life impact of smart insulin pens on glycemic control in patients with T1D, by analyzing glucometric parameters obtained from continuous glucose monitoring. Methods: Retrospective observational study in 23 patients with T1D who started using Novo-Pen 6 and NovoPen Echo Plus smart insulin pens. Data obtained from continuous glucose monitoring, available on LibreView, were analyzed 14 days before starting treatment with smart pens and 14 days before the 3-month follow-up visit. Changes in CV, TIR, TBR, TAR and GMI were analyzed. Results: No statistically differences were detected in CV from baseline to follow-up visit (p=0.57). TIR increased significantly (54% initial, 57% final) (p=0.028), but there were no significant differences in the other parameters analyzed. In patients with poor metabolic control at baseline, TIR increased, and both TAR and GMI decreased. In contrast, a significant increase in CV and TBR was observed. In well-controlled patients there were no significant changes in any of the analyzed parameters. Conclusions: The use of smart insulin pens did not result in a significant change in the CV of the sample. However, time in the target glucose range increased. Previous glycemic control influenced the results obtained, with those having poorer prior glycemic control benefiting the most.
Direction
Fernández Rodríguez, Eva (Tutorships)
Seoane Cruz, Inés (Co-tutorships)
Fernández Rodríguez, Eva (Tutorships)
Seoane Cruz, Inés (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Tumour resection margins and post-surgical complications study in patients with limbs soft tissues musculoskeletal malignant mesenchymal tumours treated with neoadjuvant therapy.
Authorship
V.V.L.
Bachelor of Medicine
V.V.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Objective: to characterize tumour resection margins in patients who received neoadjuvant therapy for the treatment of limbs soft tissues musculoskeletal malignant mesenchymal tumours. In addition, the influence of neoadjuvant therapy on post-surgical complications was evaluated. Materials and methods: a prospective case-control study was designed, including patients diagnosed, treated and clinically followed by the Mesenchymal Tumours Unit of the Integrated Management Department of Santiago de Compostela and Barbanza (XXIS). By taking the patients’ medical histories and managing them through the IANUS system, the necessary clinical parameters were determined. Consent for this study was obtained from the Research Ethics Committee of Santiago de Compostela-Lugo. Results: 81 patients, 40 men and 41 women, were studied. The average age among the cases was 60.5 years and their hospital stay was 18.73 days. In total, 22 received neoadjuvant chemotherapy (CT), 28 neoadjuvant radiotherapy (RT) and 20 neoadjuvant CT+RT. Different histological tumour types were studied; the most common were undifferentiated pleomorphic sarcoma, liposarcoma and myxofibrosarcoma. In 49 patients the location of the tumor was the lower extremity. Surgical wound infection, dehiscence, seroma, hematoma, and necrosis were considered as postsurgical complications. No statistically significant association was observed between the development of postsurgical complications and the two neoadjuvant protocols described (trend in QT+RT). Conclusions: we observed that coverage by the Plastic Surgery Service is associated with a lower rate of complications. There is also a higher proportion of reintervention due to post-surgical complications in patients who received neoadjuvant CT+RT; as well as some patients whose tumour location was the lower extremity. We found a statistically significant association between patients who received CT+RT and neoadjuvant CT and coverage by the Plastic Surgery Service with a lower rate of complications. Lastly, we observed that those patients who received neoadjuvant CT and CT+RT were younger. This may be due to the development of more aggressive tumors, as well as the refusal to administer such an aggressive treatments to older patients; considering their side effects.
Objective: to characterize tumour resection margins in patients who received neoadjuvant therapy for the treatment of limbs soft tissues musculoskeletal malignant mesenchymal tumours. In addition, the influence of neoadjuvant therapy on post-surgical complications was evaluated. Materials and methods: a prospective case-control study was designed, including patients diagnosed, treated and clinically followed by the Mesenchymal Tumours Unit of the Integrated Management Department of Santiago de Compostela and Barbanza (XXIS). By taking the patients’ medical histories and managing them through the IANUS system, the necessary clinical parameters were determined. Consent for this study was obtained from the Research Ethics Committee of Santiago de Compostela-Lugo. Results: 81 patients, 40 men and 41 women, were studied. The average age among the cases was 60.5 years and their hospital stay was 18.73 days. In total, 22 received neoadjuvant chemotherapy (CT), 28 neoadjuvant radiotherapy (RT) and 20 neoadjuvant CT+RT. Different histological tumour types were studied; the most common were undifferentiated pleomorphic sarcoma, liposarcoma and myxofibrosarcoma. In 49 patients the location of the tumor was the lower extremity. Surgical wound infection, dehiscence, seroma, hematoma, and necrosis were considered as postsurgical complications. No statistically significant association was observed between the development of postsurgical complications and the two neoadjuvant protocols described (trend in QT+RT). Conclusions: we observed that coverage by the Plastic Surgery Service is associated with a lower rate of complications. There is also a higher proportion of reintervention due to post-surgical complications in patients who received neoadjuvant CT+RT; as well as some patients whose tumour location was the lower extremity. We found a statistically significant association between patients who received CT+RT and neoadjuvant CT and coverage by the Plastic Surgery Service with a lower rate of complications. Lastly, we observed that those patients who received neoadjuvant CT and CT+RT were younger. This may be due to the development of more aggressive tumors, as well as the refusal to administer such an aggressive treatments to older patients; considering their side effects.
Direction
TABOADA SUAREZ, ANTONIO (Tutorships)
Couto González, Iván (Co-tutorships)
TABOADA SUAREZ, ANTONIO (Tutorships)
Couto González, Iván (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Mental health and Roma in Spain: a scoping review.
Authorship
L.P.R.
Bachelor of Medicine
L.P.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Several known risk factors for mental health intersect in the Roma population in Spain, and there are indicators in the national and international literature of a worse state of mental health for this population. However, the availability and quality of this information are unclear. Because of this, an exploratory systematic review (scoping review) was carried out, with the main objective of analysing the mental health status of the Roma population in Spain through the existing literature. Secondary objectives include understanding the degree of development of this field of research in Spain, reviewing the characteristics of the selected studies, recognizing the specific mental health problems detected, and discussing future research and intervention lines. A systematic search was carried out in Medline, PsycInfo, Google Scholar and Dialnet databases, covering the period of the last 30 years. We included the studies focused on the Roma population in Spain, regardless of whether they belonged to a specific subgroup, that explored the state of mental health in both its psychiatric and psychological dimensions. Systematic reviews and/or meta-analyses, experimental or quasi-experimental studies and observational studies were considered, whether they were analytical, descriptive, quantitative or qualitative: clinical trials (randomized or not), cohort studies, case-control studies, cross-sectional studies, case series... From the included works, data regarding participants, instruments/comparisons, main results and design were extracted. The results were analysed from a descriptive perspective due to the lack of standardization of their instruments and methodologies. It is concluded that the state of mental health in the Roma population in Spain is a poorly developed and unspecific field of research. Gypsy people in Spain have higher rates of depression and anxiety and drug, alcohol and tobacco consumption. The study of psychopathology is limited and incomplete: no data were found on most of the psychiatric pathology in this population. On the other hand, protective factors were found, such as ethnic identity and community self-esteem, social organization based on the extended family, or an intense relationship with the transcendental. Regarding the quality of the research, we highlight its heterogeneity in approach, sampling and methodology, with a significant lack of experimental studies regarding possible intervention strategies, no study using instruments or tests validated in the Roma population, the majority of studies using non-probabilistic and local sampling methods, and with a great shortage of studies arising directly from the Roma population and/or integrate Roma professionals.
Several known risk factors for mental health intersect in the Roma population in Spain, and there are indicators in the national and international literature of a worse state of mental health for this population. However, the availability and quality of this information are unclear. Because of this, an exploratory systematic review (scoping review) was carried out, with the main objective of analysing the mental health status of the Roma population in Spain through the existing literature. Secondary objectives include understanding the degree of development of this field of research in Spain, reviewing the characteristics of the selected studies, recognizing the specific mental health problems detected, and discussing future research and intervention lines. A systematic search was carried out in Medline, PsycInfo, Google Scholar and Dialnet databases, covering the period of the last 30 years. We included the studies focused on the Roma population in Spain, regardless of whether they belonged to a specific subgroup, that explored the state of mental health in both its psychiatric and psychological dimensions. Systematic reviews and/or meta-analyses, experimental or quasi-experimental studies and observational studies were considered, whether they were analytical, descriptive, quantitative or qualitative: clinical trials (randomized or not), cohort studies, case-control studies, cross-sectional studies, case series... From the included works, data regarding participants, instruments/comparisons, main results and design were extracted. The results were analysed from a descriptive perspective due to the lack of standardization of their instruments and methodologies. It is concluded that the state of mental health in the Roma population in Spain is a poorly developed and unspecific field of research. Gypsy people in Spain have higher rates of depression and anxiety and drug, alcohol and tobacco consumption. The study of psychopathology is limited and incomplete: no data were found on most of the psychiatric pathology in this population. On the other hand, protective factors were found, such as ethnic identity and community self-esteem, social organization based on the extended family, or an intense relationship with the transcendental. Regarding the quality of the research, we highlight its heterogeneity in approach, sampling and methodology, with a significant lack of experimental studies regarding possible intervention strategies, no study using instruments or tests validated in the Roma population, the majority of studies using non-probabilistic and local sampling methods, and with a great shortage of studies arising directly from the Roma population and/or integrate Roma professionals.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
DEL RIO CASANOVA, LUCIA (Co-tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
DEL RIO CASANOVA, LUCIA (Co-tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
10 year evaluation of the “APLD” program for severe mental disorders in the Drug Addiction Care Unit of Coruña.
Authorship
M.P.L.
Bachelor of Medicine
M.P.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Dual pathology can be defined as the association between substance use disorders and other mental disorders in parallel, sequential or throughout life. This study is part of the project called Evaluation of patients for treatment in addiction care networks in Galicia and northern Portugal with long-term injectable antipsichotics (APS-ILD), whose main objective is to investigate the quality of care provided to patients belonging to these care networks. In this TFG I will focus on the evaluation over a ten-year period of the clinical characteristics, efficacy, efficiency, safety and costs of treatment with LAIs (long-acting injectable antipsychotics) throughout the analysis of the APLD program for severe mental disorders in Coruña, developed at ACLAD.
Dual pathology can be defined as the association between substance use disorders and other mental disorders in parallel, sequential or throughout life. This study is part of the project called Evaluation of patients for treatment in addiction care networks in Galicia and northern Portugal with long-term injectable antipsichotics (APS-ILD), whose main objective is to investigate the quality of care provided to patients belonging to these care networks. In this TFG I will focus on the evaluation over a ten-year period of the clinical characteristics, efficacy, efficiency, safety and costs of treatment with LAIs (long-acting injectable antipsychotics) throughout the analysis of the APLD program for severe mental disorders in Coruña, developed at ACLAD.
Direction
VIDAL MILLARES, MARIA (Tutorships)
GAGO AGEITOS, ANA MARIA (Co-tutorships)
VIDAL MILLARES, MARIA (Tutorships)
GAGO AGEITOS, ANA MARIA (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Benefits of the new injectable treatment for HIV control compared to oral antiretroviral treatment
Authorship
A.P.S.
Bachelor of Medicine
A.P.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Recent advances in antiretroviral therapies have achieved significant success in transforming HIV-1 infection from a disease with a very poor prognosis to a treatable condition. These advances have led to significant improvements in immune system function and an overall reduction in morbidity and mortality. Current therapies are highly effective in controlling the infection and preventing transmission. Despite this, HIV infection remains a chronic and incurable condition that requires lifelong daily treatment. This can lead to dissatisfaction and increased stigma among people living with HIV, potentially resulting in poor therapeutic adherence; and directly, in a failure to control the virus, the emergence of drug resistance, and disease progression. Consequently, one of the research objectives in this field is to consider therapies with less frequent dosing to facilitate therapeutic adherence and reduce the awareness of the disease among these individuals. Objectives: The main objective of this work is to assess the benefits of injectable cabotegravir and rilpivirine treatment compared to traditional oral antiretroviral therapies. Materials and Methods: A literature review was conducted using various bibliographic sources, primarily the Medline database. To evaluate the quality of the evidence for the recommendations, the main pivotal studies prior to the commercialization of the injectable treatment were selected, reviewing their effectiveness, safety, tolerability, and adverse effects. For the main objective of the work, PROs (patient-reported outcomes) were chosen to determine the degree of personal satisfaction reported by the participants themselves. The selection of pivotal studies focused on those prior to the commercialization of the treatment. Study protocols and online supplements of each article were consulted. Results: The injectable Cabotegravir-Rilpivirine treatment demonstrated non-inferiority compared to oral treatment in individuals with previously undetectable viral load, as well as in naïve individuals without prior antiretroviral treatment. The injectable treatment administered every 4 weeks was shown to be non-inferior to the therapy administered every 8 weeks. Adverse effects were common, mostly related to the method of drug administration in the form of local reactions. Severe adverse effects were infrequent. Despite the frequency of adverse effects, treatment discontinuations for this reason were not frequent. The level of satisfaction was higher in individuals on injectable therapy, with the difference increasing over the weeks of follow-up. Similarly, long-acting therapy was preferred by respondents when asked directly. Conclusion: The injectable Cabotegravir-Rilpivirine therapy is a treatment option for people living with HIV with an undetectable viral load, offering high efficacy, not inferior to current oral treatments, and a good safety profile. The new therapy achieved high satisfaction rates and was the preferred option for the majority of respondents.
Introduction: Recent advances in antiretroviral therapies have achieved significant success in transforming HIV-1 infection from a disease with a very poor prognosis to a treatable condition. These advances have led to significant improvements in immune system function and an overall reduction in morbidity and mortality. Current therapies are highly effective in controlling the infection and preventing transmission. Despite this, HIV infection remains a chronic and incurable condition that requires lifelong daily treatment. This can lead to dissatisfaction and increased stigma among people living with HIV, potentially resulting in poor therapeutic adherence; and directly, in a failure to control the virus, the emergence of drug resistance, and disease progression. Consequently, one of the research objectives in this field is to consider therapies with less frequent dosing to facilitate therapeutic adherence and reduce the awareness of the disease among these individuals. Objectives: The main objective of this work is to assess the benefits of injectable cabotegravir and rilpivirine treatment compared to traditional oral antiretroviral therapies. Materials and Methods: A literature review was conducted using various bibliographic sources, primarily the Medline database. To evaluate the quality of the evidence for the recommendations, the main pivotal studies prior to the commercialization of the injectable treatment were selected, reviewing their effectiveness, safety, tolerability, and adverse effects. For the main objective of the work, PROs (patient-reported outcomes) were chosen to determine the degree of personal satisfaction reported by the participants themselves. The selection of pivotal studies focused on those prior to the commercialization of the treatment. Study protocols and online supplements of each article were consulted. Results: The injectable Cabotegravir-Rilpivirine treatment demonstrated non-inferiority compared to oral treatment in individuals with previously undetectable viral load, as well as in naïve individuals without prior antiretroviral treatment. The injectable treatment administered every 4 weeks was shown to be non-inferior to the therapy administered every 8 weeks. Adverse effects were common, mostly related to the method of drug administration in the form of local reactions. Severe adverse effects were infrequent. Despite the frequency of adverse effects, treatment discontinuations for this reason were not frequent. The level of satisfaction was higher in individuals on injectable therapy, with the difference increasing over the weeks of follow-up. Similarly, long-acting therapy was preferred by respondents when asked directly. Conclusion: The injectable Cabotegravir-Rilpivirine therapy is a treatment option for people living with HIV with an undetectable viral load, offering high efficacy, not inferior to current oral treatments, and a good safety profile. The new therapy achieved high satisfaction rates and was the preferred option for the majority of respondents.
Direction
Anibarro García, Luís (Tutorships)
Pernas Pardavila, Hadrián (Co-tutorships)
Anibarro García, Luís (Tutorships)
Pernas Pardavila, Hadrián (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Sex impact on clinical presentation and prognosis in Transthyretin Cardiac Amyloidosis.
Authorship
M.P.S.
Bachelor of Medicine
M.P.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
In recent years important progress has been made related to the diagnosis and treatment of tranthyretin cardiac amyloidosis. Nonetheless, it remains an underdiagnosed entity linked to a poor vital prognosis. Information obtained from different patient records diagnosed with AC-ATTR has allowed us to know that it predominantly affects men more tan women. Furthermore, new research suggest the existence of notable differences in both sexes regarding its clinical presentation and its prognosis. Given these facts, it is valuable to analize the impact of sex in patients diagnosed with AC-ATTR in our community with 2 leading objectives: 1. Compare clinical characteristics and complementary test results (laboratory, electrocardiogram and transthoracic echocardiogram) at the time of diagnosis between both sexes. 2. Compare the incidence of several clinical events and mortality between men and women diagnosed with AC-ATTR.
In recent years important progress has been made related to the diagnosis and treatment of tranthyretin cardiac amyloidosis. Nonetheless, it remains an underdiagnosed entity linked to a poor vital prognosis. Information obtained from different patient records diagnosed with AC-ATTR has allowed us to know that it predominantly affects men more tan women. Furthermore, new research suggest the existence of notable differences in both sexes regarding its clinical presentation and its prognosis. Given these facts, it is valuable to analize the impact of sex in patients diagnosed with AC-ATTR in our community with 2 leading objectives: 1. Compare clinical characteristics and complementary test results (laboratory, electrocardiogram and transthoracic echocardiogram) at the time of diagnosis between both sexes. 2. Compare the incidence of several clinical events and mortality between men and women diagnosed with AC-ATTR.
Direction
Barge Caballero, Eduardo (Tutorships)
Barge Caballero, Gonzalo (Co-tutorships)
Barge Caballero, Eduardo (Tutorships)
Barge Caballero, Gonzalo (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Efficacy and safety of JAK inhibitors in Juvenile Idiopathic Arthritis
Authorship
A.P.G.
Bachelor of Medicine
A.P.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Juvenile Idiopathic Arthritis (JIA) is a chronic disease that affects children and adolescents, characterized by chronic inflammation of the joints. It is classified into several subtypes based on clinical criteria, with refractory JIA posing a therapeutic challenge. Conventional treatments may not be effective in all cases, leading to research into new therapeutic options such as JAK inhibitors. These drugs have demonstrated efficacy in disease control in previous studies, generating interest in their use in pediatric patients with refractory JIA. Objectives: The main objective of the study is to evaluate the efficacy and safety of treatment with JAK inhibitors in patients diagnosed with juvenile idiopathic arthritis who do not respond favorably to other implemented therapies. Materials and Methods: A systematic literature review was conducted using databases such as PubMed, Cochrane, WOS, and Embase. Selection criteria were applied to identify relevant studies comparing the efficacy and safety of JAK inhibitors in patients with JIA. Results: Following the analysis of selected studies, JAK inhibitors were found to be effective in treating JIA, showing significant improvements in symptoms and patients' quality of life. Additionally, an overall acceptable safety profile was observed. Conclusions: The results support the use of JAK inhibitors as an effective and safe therapeutic option for the treatment of JIA in children and adolescents. The importance of further research in this field is emphasized to further improve the care and prognosis of patients with this disease.
Background: Juvenile Idiopathic Arthritis (JIA) is a chronic disease that affects children and adolescents, characterized by chronic inflammation of the joints. It is classified into several subtypes based on clinical criteria, with refractory JIA posing a therapeutic challenge. Conventional treatments may not be effective in all cases, leading to research into new therapeutic options such as JAK inhibitors. These drugs have demonstrated efficacy in disease control in previous studies, generating interest in their use in pediatric patients with refractory JIA. Objectives: The main objective of the study is to evaluate the efficacy and safety of treatment with JAK inhibitors in patients diagnosed with juvenile idiopathic arthritis who do not respond favorably to other implemented therapies. Materials and Methods: A systematic literature review was conducted using databases such as PubMed, Cochrane, WOS, and Embase. Selection criteria were applied to identify relevant studies comparing the efficacy and safety of JAK inhibitors in patients with JIA. Results: Following the analysis of selected studies, JAK inhibitors were found to be effective in treating JIA, showing significant improvements in symptoms and patients' quality of life. Additionally, an overall acceptable safety profile was observed. Conclusions: The results support the use of JAK inhibitors as an effective and safe therapeutic option for the treatment of JIA in children and adolescents. The importance of further research in this field is emphasized to further improve the care and prognosis of patients with this disease.
Direction
MERA VARELA, ANTONIO JOSE (Tutorships)
MANEIRO FERNANDEZ, JOSE RAMON (Co-tutorships)
MERA VARELA, ANTONIO JOSE (Tutorships)
MANEIRO FERNANDEZ, JOSE RAMON (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Total hip arthroplasty in adults, evolution and current status of its application in the patient. A bibliographic review.
Authorship
H.Q.P.
Bachelor of Medicine
H.Q.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Currently in our country, more than 30,000 total hip prostheses are implanted per year. The increase in the indication for arthroplasties, especially in young patients, and a longer life expectancy, lead to a similar increase in complications and failures. The objective of the following final degree project will be focused on the different types of prostheses, their indications, complications, influence of new techniques and other variables that exist in our country. The existing literature was reviewed using databases and specific inclusion and exclusion criteria. Methods: An initial search was conducted in PubMed and a complementary search in other electronic databases, including scientific articles published between 2000 and 2023, in English or Spanish, that include total hip arthroplasty data. Results: Several studies that meet our objectives were analyzed. Conclusion: Total hip arthroplasty is a safe and reliable alternative to treat patients with hip involvement due to chronic arthritis with osteoarthritis. There are prosthesis models with a duration between 10-30 years already tested and clinically tested. The purpose of surgical revisions is due to a multitude of factors, without being able to justify one against the other, assuming the multifactoriality of this complication as an impediment to its study through a simple approach. The greater the skill and experience of the surgeon, the better the results will be obtained and, for this, practice with life-size 3D printed models will play a crucial role to train the best professionals by individualizing each intervention.
Introduction: Currently in our country, more than 30,000 total hip prostheses are implanted per year. The increase in the indication for arthroplasties, especially in young patients, and a longer life expectancy, lead to a similar increase in complications and failures. The objective of the following final degree project will be focused on the different types of prostheses, their indications, complications, influence of new techniques and other variables that exist in our country. The existing literature was reviewed using databases and specific inclusion and exclusion criteria. Methods: An initial search was conducted in PubMed and a complementary search in other electronic databases, including scientific articles published between 2000 and 2023, in English or Spanish, that include total hip arthroplasty data. Results: Several studies that meet our objectives were analyzed. Conclusion: Total hip arthroplasty is a safe and reliable alternative to treat patients with hip involvement due to chronic arthritis with osteoarthritis. There are prosthesis models with a duration between 10-30 years already tested and clinically tested. The purpose of surgical revisions is due to a multitude of factors, without being able to justify one against the other, assuming the multifactoriality of this complication as an impediment to its study through a simple approach. The greater the skill and experience of the surgeon, the better the results will be obtained and, for this, practice with life-size 3D printed models will play a crucial role to train the best professionals by individualizing each intervention.
Direction
MEAÑOS MELON, ENRIQUE RAMON (Tutorships)
MEAÑOS MELON, ENRIQUE RAMON (Tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Anaphylaxis with type 2 Kounis syndrome secondary to hazelnut ingestion in an adult without previous atopic disease due to cross-reactivity with panallergen PR10 protein.
Authorship
I.R.C.
Bachelor of Medicine
I.R.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Food allergy is an allergic reaction by which our body recognizes as harmful a certain antigen that is harmless to the rest of the population. Different immunological mechanisms are involved in allergy. In the case of IgE-mediated food allergy, immunoglobulin E (IgE) is responsible for mediating these reactions, encompassing type 1 hypersensitivity, with an immediate onset of symptoms, from minutes to approximately 1 hour after ingestion. of the food These symptoms can vary from a slight itching in the mouth, known as oral allergy syndrome, to a mild systemic reaction such as acute urticaria or cause an episode of anaphylaxis where different organs and systems are compromised, putting the health of the body at risk patient life. Nuts are very energetic foods, rich in fat and protein, as well as trace elements. Depending on the type of nut, they can also provide good amounts of vitamins (especially group B) or omega 3 fatty acids. Hence, they are foods widely used throughout the world population. We present the case of a 72-year-old male patient, without previous atopic disease, who presented with severe anaphylaxis that required admission to the ICU, associated with type 2 Kounis syndrome after ingesting a mixture of dried fruits.
Food allergy is an allergic reaction by which our body recognizes as harmful a certain antigen that is harmless to the rest of the population. Different immunological mechanisms are involved in allergy. In the case of IgE-mediated food allergy, immunoglobulin E (IgE) is responsible for mediating these reactions, encompassing type 1 hypersensitivity, with an immediate onset of symptoms, from minutes to approximately 1 hour after ingestion. of the food These symptoms can vary from a slight itching in the mouth, known as oral allergy syndrome, to a mild systemic reaction such as acute urticaria or cause an episode of anaphylaxis where different organs and systems are compromised, putting the health of the body at risk patient life. Nuts are very energetic foods, rich in fat and protein, as well as trace elements. Depending on the type of nut, they can also provide good amounts of vitamins (especially group B) or omega 3 fatty acids. Hence, they are foods widely used throughout the world population. We present the case of a 72-year-old male patient, without previous atopic disease, who presented with severe anaphylaxis that required admission to the ICU, associated with type 2 Kounis syndrome after ingesting a mixture of dried fruits.
Direction
VIDAL PAN, Mª DEL CARMEN (Tutorships)
García Paz, Vanesa (Co-tutorships)
VIDAL PAN, Mª DEL CARMEN (Tutorships)
García Paz, Vanesa (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Nasal effects of mepolizumab in patients with chronic rhinosinusitis and nasal polyps.
Authorship
M.R.R.
Bachelor of Medicine
M.R.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNS) is a disease with a considerable prevalence, with a negative impact on the quality of life of patients as well as a great economic burden for the healthcare system. In recent years, a new line of treatment for CRSwPN, monoclonal antibodies, has emerged. These monoclonal drugs act on different pathways thus decreasing the inflammatory process. Mepolizumab is the only monoclonal drug with indication and reimbursement price in the NHS. Background: The present study aims to summarize in a meta-analysis all the available evidence on the nasosinusal effects of mepolizumab in patients with CRSwPN from actual published observational studies. Methodology: Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were searched in duplicated. Results: 13 studies (426 patients) met the inclusion criteria. 12 studies (422 patients) evaluating the SNOT-22 were assembled in a metaanalysis finding a decrease of -26.76 points, in contrast to the MUSCA clinical trial which only reported a decrease of -13.7. On the other hand, 6 studies (207 patients) evaluating nasal polyp score were included in the metaanalysis, finding a mean decrease of -1.77 points. Conclusions: Real-life studies exclusively on patients with severe CRSwNP receiving mepolizumab are currently not available. In view of this limitation, the results of our metaanalysis cannot be compared to the synapse clinical trial, but to the MUSCA clinical trial showing this comparison a better clinical response with statistically significant results with regard to SNOT-22 and NPS (compared to Synapse).
Introduction: Chronic rhinosinusitis with nasal polyps (CRSwNS) is a disease with a considerable prevalence, with a negative impact on the quality of life of patients as well as a great economic burden for the healthcare system. In recent years, a new line of treatment for CRSwPN, monoclonal antibodies, has emerged. These monoclonal drugs act on different pathways thus decreasing the inflammatory process. Mepolizumab is the only monoclonal drug with indication and reimbursement price in the NHS. Background: The present study aims to summarize in a meta-analysis all the available evidence on the nasosinusal effects of mepolizumab in patients with CRSwPN from actual published observational studies. Methodology: Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were searched in duplicated. Results: 13 studies (426 patients) met the inclusion criteria. 12 studies (422 patients) evaluating the SNOT-22 were assembled in a metaanalysis finding a decrease of -26.76 points, in contrast to the MUSCA clinical trial which only reported a decrease of -13.7. On the other hand, 6 studies (207 patients) evaluating nasal polyp score were included in the metaanalysis, finding a mean decrease of -1.77 points. Conclusions: Real-life studies exclusively on patients with severe CRSwNP receiving mepolizumab are currently not available. In view of this limitation, the results of our metaanalysis cannot be compared to the synapse clinical trial, but to the MUSCA clinical trial showing this comparison a better clinical response with statistically significant results with regard to SNOT-22 and NPS (compared to Synapse).
Direction
Martín Martín, Carlos Santiago (Tutorships)
Calvo Henríquez, Christian Ezequiel (Co-tutorships)
Martín Martín, Carlos Santiago (Tutorships)
Calvo Henríquez, Christian Ezequiel (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Exploring Neuroplastic Changes Induced by Ketamine and Its Role in Depression
Authorship
E.T.G.
Bachelor of Medicine
E.T.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The mechanism of action underlying the rapid antidepressant effects of ketamine in patients with major depressive disorder (MDD), including treatment-resistant depression (TRD), remains unclear. Of the various pathways of action contemplated for ketamine, restoration of neuroplasticity deficits may be the most plausible mechanism, both in human patients and in preclinical models of depression. Objetives: To synthesize the scientific evidence on the role of ketamine in restoring synaptic plasticity to induce its rapid antidepressant effect. To identify cellular and molecular events relevant to neuroplasticity observed after ketamine administration that correlate with rapid improvements in mood in humans and antidepressant effects in animals. To explore how deficits or alterations in molecular neuroplasticity may constitute pathological markers of depression. Methodology: Search conducted through PubMed, Scopus and Cochrane database. Selection of experimental studies, with a maximum of 10 years since publication, related to the neuroplastic effect of ketamine and its relation to clinical improvement in major depressive disorder. Analysis of the most relevant trials, according to the inclusion and exclusion criteria. Results: 22 trials on the use of ketamine in animal, human and in vitro models were selected, showing a clear correlation between its administration and antidepressant effects, as well as its administration and neuroplasticity. On the other hand, more understanding is required on the antidepressant mechanism of ketamine and its direct relationship with neuroplasticity. Conclusions: We found evidence supporting that ketamine induces an increase in molecules involved in modulating neuroplasticity, and that these changes are paired with rapid antidepressant effects. The molecules or complexes of major interest include glutamate, AMPA receptors (AMPAR), mTOR AND BDNF/TrkB. These studies suggest a strong relationship between improvements in mood and ketamine- induced increases in molecular neuroplasticity, particularly with regard to intracellular signaling molecules.
Introduction: The mechanism of action underlying the rapid antidepressant effects of ketamine in patients with major depressive disorder (MDD), including treatment-resistant depression (TRD), remains unclear. Of the various pathways of action contemplated for ketamine, restoration of neuroplasticity deficits may be the most plausible mechanism, both in human patients and in preclinical models of depression. Objetives: To synthesize the scientific evidence on the role of ketamine in restoring synaptic plasticity to induce its rapid antidepressant effect. To identify cellular and molecular events relevant to neuroplasticity observed after ketamine administration that correlate with rapid improvements in mood in humans and antidepressant effects in animals. To explore how deficits or alterations in molecular neuroplasticity may constitute pathological markers of depression. Methodology: Search conducted through PubMed, Scopus and Cochrane database. Selection of experimental studies, with a maximum of 10 years since publication, related to the neuroplastic effect of ketamine and its relation to clinical improvement in major depressive disorder. Analysis of the most relevant trials, according to the inclusion and exclusion criteria. Results: 22 trials on the use of ketamine in animal, human and in vitro models were selected, showing a clear correlation between its administration and antidepressant effects, as well as its administration and neuroplasticity. On the other hand, more understanding is required on the antidepressant mechanism of ketamine and its direct relationship with neuroplasticity. Conclusions: We found evidence supporting that ketamine induces an increase in molecules involved in modulating neuroplasticity, and that these changes are paired with rapid antidepressant effects. The molecules or complexes of major interest include glutamate, AMPA receptors (AMPAR), mTOR AND BDNF/TrkB. These studies suggest a strong relationship between improvements in mood and ketamine- induced increases in molecular neuroplasticity, particularly with regard to intracellular signaling molecules.
Direction
ALVAREZ ARIZA, MARÍA (Tutorships)
ALVAREZ ARIZA, MARÍA (Tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Associated factors to pressotherapy use for burn injury treatment.
Authorship
E.T.O.
Bachelor of Medicine
E.T.O.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction and objectives: Burns are injuries that affect the skin and other tissues due to agents that produce protein denaturation. They can be classified according to the causing agent, the depth or the extent. The most severe and extensive ones present a hight morbidity and mortality rate. A frequent complication is hypertrophic scarring, characterized by an excessive collagen deposit, resulting in both functional and esthetical consequences. Pressotherapy is one of the main treatments for this kind of scars, involving the use of compressive garments. This study aims to determine which factors are associated with pressotherapy use. Material and methods: A retrospective observational and analytical study was conducted using data from patients hospitalized in the Burn Unit of the University Hospital Complex of A Coruña during 2022. Several study variables were described and analysed using a simple logistic regression analysis, followed by a multiple logistic regression model in order to analyse those ones that were statistically significant. Results: In the descriptive analysis, sample sizes, means and standard deviations, medians, interquartile ranges and ranges of the quantitative variables were presented, as well as sample sizes and percentages of each category of the qualitative variables. Meanwhile, in the statistical analysis, after applying the simple model, six statistically significant variables were obtained, which were reduced to four after using the multiple model. Conclusions: Four factors that increase the risk of pressure therapy use were identified: feminine gender, upper limb involvement, surgery and Nexobrid (Mediwound, Germany) use. The remaining variables did not show any significant association, even though three of them could not be analysed due to the lack of data. The need for additional and more exhaustive studies to better understand these associations must be considered.
Introduction and objectives: Burns are injuries that affect the skin and other tissues due to agents that produce protein denaturation. They can be classified according to the causing agent, the depth or the extent. The most severe and extensive ones present a hight morbidity and mortality rate. A frequent complication is hypertrophic scarring, characterized by an excessive collagen deposit, resulting in both functional and esthetical consequences. Pressotherapy is one of the main treatments for this kind of scars, involving the use of compressive garments. This study aims to determine which factors are associated with pressotherapy use. Material and methods: A retrospective observational and analytical study was conducted using data from patients hospitalized in the Burn Unit of the University Hospital Complex of A Coruña during 2022. Several study variables were described and analysed using a simple logistic regression analysis, followed by a multiple logistic regression model in order to analyse those ones that were statistically significant. Results: In the descriptive analysis, sample sizes, means and standard deviations, medians, interquartile ranges and ranges of the quantitative variables were presented, as well as sample sizes and percentages of each category of the qualitative variables. Meanwhile, in the statistical analysis, after applying the simple model, six statistically significant variables were obtained, which were reduced to four after using the multiple model. Conclusions: Four factors that increase the risk of pressure therapy use were identified: feminine gender, upper limb involvement, surgery and Nexobrid (Mediwound, Germany) use. The remaining variables did not show any significant association, even though three of them could not be analysed due to the lack of data. The need for additional and more exhaustive studies to better understand these associations must be considered.
Direction
BREA GARCIA, BEATRIZ (Tutorships)
Fernández Quinto, Alejandro (Co-tutorships)
BREA GARCIA, BEATRIZ (Tutorships)
Fernández Quinto, Alejandro (Co-tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Evolution of nutritional status in children with celiac disease on a gluten free diet
Authorship
M.T.V.
Bachelor of Medicine
M.T.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Coeliac disease (CD) is a prevalent systemic disease (1% of the population), triggered by gluten consumption in genetically predisposed people. It produces atrophy of the intestinal villi, which causes malabsorption. The gluten-free diet (GFD) is the only treatment available, progressively improving intestinal absorption and symptoms. Factors such as early diagnosis or the GSD itself influence the nutritional status of the child, both at the initial moment and during follow-up. Objective: Analyse the evolution of the nutritional status of children newly diagnosed with CD in a Pediatric Gastroenterology clinic of a tertiary hospital after the start of a GFD. Methods: Retrospective and descriptive observational study, including patients between 1 and 15 years old diagnosed with CD from January 2011 to July 2018. Demographic variables, anthropometric measurements and analytical determinations were evaluated at diagnosis, at 2 and at 5 years. of the start of the GFD. Results: 221 pediatric patients (57,5% girls) with a mean age at diagnosis of 4.4 years were examined. 94% were symptomatic. At diagnosis, 7% were malnourished and 15% were overweight or obese. 40% had iron deficiency, 80% had vitamin D deficiency and 6% had hypocalcemia. After the start of GFD, the BMI of the sample increased progressively, iron deficiency improved significantly and vitamin D remained low. The prevalence of malnutrition temporarily decreased after 2 years. Five years after diagnosis, the prevalence of overweight/obesity increased to 23,5%. Conclusions: An increase in the prevalence of overweight and obesity is observed in celiac children after several years of GFD, which underlines the importance of continuous and personalized nutritional monitoring for patients with CD.
Background: Coeliac disease (CD) is a prevalent systemic disease (1% of the population), triggered by gluten consumption in genetically predisposed people. It produces atrophy of the intestinal villi, which causes malabsorption. The gluten-free diet (GFD) is the only treatment available, progressively improving intestinal absorption and symptoms. Factors such as early diagnosis or the GSD itself influence the nutritional status of the child, both at the initial moment and during follow-up. Objective: Analyse the evolution of the nutritional status of children newly diagnosed with CD in a Pediatric Gastroenterology clinic of a tertiary hospital after the start of a GFD. Methods: Retrospective and descriptive observational study, including patients between 1 and 15 years old diagnosed with CD from January 2011 to July 2018. Demographic variables, anthropometric measurements and analytical determinations were evaluated at diagnosis, at 2 and at 5 years. of the start of the GFD. Results: 221 pediatric patients (57,5% girls) with a mean age at diagnosis of 4.4 years were examined. 94% were symptomatic. At diagnosis, 7% were malnourished and 15% were overweight or obese. 40% had iron deficiency, 80% had vitamin D deficiency and 6% had hypocalcemia. After the start of GFD, the BMI of the sample increased progressively, iron deficiency improved significantly and vitamin D remained low. The prevalence of malnutrition temporarily decreased after 2 years. Five years after diagnosis, the prevalence of overweight/obesity increased to 23,5%. Conclusions: An increase in the prevalence of overweight and obesity is observed in celiac children after several years of GFD, which underlines the importance of continuous and personalized nutritional monitoring for patients with CD.
Direction
Martinón Torres, Nazareth (Tutorships)
Martinón Torres, Nazareth (Tutorships)
Efficacy of Ustekinumab in the treatment of Ulcerative colitis: Experience from one center. Study of a series of cases
Authorship
P.U.M.
Bachelor of Medicine
P.U.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Inflammatory Bowel Diseases, and more specifically Ulcerative Colitis, are immune-mediated pathologies. Ustekinumab has demonstrated its efficacy in Phase III Clinical Trials, being incorporated to the current lines of treatment. However, there is limited data on its effectiveness in real life. Objectives: The main objective is to measure the efficacy of Ustekinumab in real life by assessing clinical remission without corticosteroids after induction, maintenance, and persistence of Ustekinumab. Patients and methods: Single-center retrospective descriptive study of patients diagnosed with UC who received treatment with Ustekinumab. Demographic, therapeutic and clinical variables were examined. Clinical and biological disease activity, contaminating corticosteroid use, and discontinuation of USTK at defined periods (weeks 1 and 16 after induction and every 6 months) were analyzed. Results: Eighteen patients were studied. Two did not receive previous advanced therapy (naïve). Ten patients did not respond to 2 or more advanced therapies. The mean follow-up was 52 weeks (IQR 24-70). At week 16, nine patients (50%) had clinical remission, and six (33.3%) had corticosteroid-free remission. Only two patients obtained biological remission. Overall efficacy, with clinical remission, was recorded in 9 patients (50%). Five were in clinical remission free of corticosteroids. Six patients discontinued treatment due to non-response. The estimated ustekinumab treatment persistence rate was 88.5% (95% confidence interval, 61-97% ) at week 52. No serious adverse effects were observed. Conclusion: This real-life study supports that USTK is an effective therapeutic option in patients refractory to previous advanced treatments. Less persistence was observed in patients with more severe disease. Ustkekinumab has a good safety profile, with few side effects. These are more related to the degree of disease activity than to the drug.
Introduction: Inflammatory Bowel Diseases, and more specifically Ulcerative Colitis, are immune-mediated pathologies. Ustekinumab has demonstrated its efficacy in Phase III Clinical Trials, being incorporated to the current lines of treatment. However, there is limited data on its effectiveness in real life. Objectives: The main objective is to measure the efficacy of Ustekinumab in real life by assessing clinical remission without corticosteroids after induction, maintenance, and persistence of Ustekinumab. Patients and methods: Single-center retrospective descriptive study of patients diagnosed with UC who received treatment with Ustekinumab. Demographic, therapeutic and clinical variables were examined. Clinical and biological disease activity, contaminating corticosteroid use, and discontinuation of USTK at defined periods (weeks 1 and 16 after induction and every 6 months) were analyzed. Results: Eighteen patients were studied. Two did not receive previous advanced therapy (naïve). Ten patients did not respond to 2 or more advanced therapies. The mean follow-up was 52 weeks (IQR 24-70). At week 16, nine patients (50%) had clinical remission, and six (33.3%) had corticosteroid-free remission. Only two patients obtained biological remission. Overall efficacy, with clinical remission, was recorded in 9 patients (50%). Five were in clinical remission free of corticosteroids. Six patients discontinued treatment due to non-response. The estimated ustekinumab treatment persistence rate was 88.5% (95% confidence interval, 61-97% ) at week 52. No serious adverse effects were observed. Conclusion: This real-life study supports that USTK is an effective therapeutic option in patients refractory to previous advanced treatments. Less persistence was observed in patients with more severe disease. Ustkekinumab has a good safety profile, with few side effects. These are more related to the degree of disease activity than to the drug.
Direction
DELGADO BLANCO, MANUEL BENJAMIN (Tutorships)
Diz-Lois Palomares, María Teresa (Co-tutorships)
DELGADO BLANCO, MANUEL BENJAMIN (Tutorships)
Diz-Lois Palomares, María Teresa (Co-tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Impact of enzymatic debridement with bromelain in the treatment of burn patients
Authorship
A.V.L.
Bachelor of Medicine
A.V.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introdución: As queimaduras son lesións que poden resultar devastadoras, a miúdo causando unha morbilidade significativa, afectando negativamente ó benestar emocional e na calidade de vida. A nivel mundial, son a cuarta causa máis común de traumatismos, despois dos accidentes de tráfico, as caídas e a violencia interpersoal. No tratamento das queimaduras, coñécese que a eliminación temperá da escara reduce as complicacións e a estancia hospitalaria. Tradicionalmente, este tipo de queimaduras tratábase con desbridamento tanxencial cirúrxico. Con todo, na actualidade disponse do desbridamento enzimático con bromelaína (NexoBrid, Mediwound), que elimina de forma selectiva o tecido danado por calor, optimizando o desbridamento e preservando o tecido san. Obxectivo: Coñecer o impacto na actividade asistencial e evolución dos pacientes ingresados na Unidade de Queimados CHUAC tras o desbridamento encimático con bromelaína no ano 2022. Metodoloxía: Realizouse un estudo retrospectivo observacional analítico, onde foron analizados un total de 111 pacientes que foron ingresados por queimaduras térmicas na Unidade de Queimados do CHUAC entre o 1 de xaneiro do 2022 e o 31 de decembro do 2022, que cumprían os criterios de inclusión e exclusión do estudo. Resultados: A maioría das queimaduras foron de segundo grao (75,7%) e afectaron unha superficie corporal total media (SCQ) do 9,5%. O principal axente causal foi a chama (51,4%). 35 pacientes foron sometidos a desbridamento encimático. A aplicación de NexoBrid relacionouse de forma estatísticamente significativa con: o grao máximo da queimadura, MMSS queimado, necesidade de cirurxía urxente, % SCQ, días de estancia hospitalaria, número de intervencións cirúrxicas e días ata a cirurxía. Tras realizar regresión loxística múltiple, relacionouse de forma estatísticamente significativa con: %SCQ e días ata a cirurxía. Conclusións: No noso estudo relacionouse o uso de Nexobrid con queimaduras dunha maior extensión e cunha espera maior á cirurxía, así como unha localización destas no membro superior e a presenza de queimaduras profundas.
Introdución: As queimaduras son lesións que poden resultar devastadoras, a miúdo causando unha morbilidade significativa, afectando negativamente ó benestar emocional e na calidade de vida. A nivel mundial, son a cuarta causa máis común de traumatismos, despois dos accidentes de tráfico, as caídas e a violencia interpersoal. No tratamento das queimaduras, coñécese que a eliminación temperá da escara reduce as complicacións e a estancia hospitalaria. Tradicionalmente, este tipo de queimaduras tratábase con desbridamento tanxencial cirúrxico. Con todo, na actualidade disponse do desbridamento enzimático con bromelaína (NexoBrid, Mediwound), que elimina de forma selectiva o tecido danado por calor, optimizando o desbridamento e preservando o tecido san. Obxectivo: Coñecer o impacto na actividade asistencial e evolución dos pacientes ingresados na Unidade de Queimados CHUAC tras o desbridamento encimático con bromelaína no ano 2022. Metodoloxía: Realizouse un estudo retrospectivo observacional analítico, onde foron analizados un total de 111 pacientes que foron ingresados por queimaduras térmicas na Unidade de Queimados do CHUAC entre o 1 de xaneiro do 2022 e o 31 de decembro do 2022, que cumprían os criterios de inclusión e exclusión do estudo. Resultados: A maioría das queimaduras foron de segundo grao (75,7%) e afectaron unha superficie corporal total media (SCQ) do 9,5%. O principal axente causal foi a chama (51,4%). 35 pacientes foron sometidos a desbridamento encimático. A aplicación de NexoBrid relacionouse de forma estatísticamente significativa con: o grao máximo da queimadura, MMSS queimado, necesidade de cirurxía urxente, % SCQ, días de estancia hospitalaria, número de intervencións cirúrxicas e días ata a cirurxía. Tras realizar regresión loxística múltiple, relacionouse de forma estatísticamente significativa con: %SCQ e días ata a cirurxía. Conclusións: No noso estudo relacionouse o uso de Nexobrid con queimaduras dunha maior extensión e cunha espera maior á cirurxía, así como unha localización destas no membro superior e a presenza de queimaduras profundas.
Direction
BREA GARCIA, BEATRIZ (Tutorships)
Fernández Quinto, Alejandro (Co-tutorships)
BREA GARCIA, BEATRIZ (Tutorships)
Fernández Quinto, Alejandro (Co-tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Intestinal intussusception in pediatric patients: case review and clinical management.
Authorship
J.V.P.
Bachelor of Medicine
J.V.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Acute intestinal intussusception is defined as the introduction of the proximal segment of an intestinal loop into the distal segment. The most common type is ileocolic intussusception, which requires early treatment. The most frequent etiology of this condition is idiopathic, often associated with a viral infection context. The diagnosis is primarily based on clinical presentation, commonly characterized by abdominal pain accompanied by episodes of lethargy combined with intense crying and irritability, as well as vomiting and rectal bleeding. To confirm the diagnostic suspicion, ultrasound is the reference technique, also useful for ruling out a secondary cause, which is more frequent in older children. Intestinal intussusception is predominantly observed during the first year of life, being the main cause of occlusive syndrome in children under 2 years of age. Treatment is usually radiological, using an air, hydrostatic, or ultrasound-guided enema, all of which have a high success rate provided there are no signs of severity. In cases of radiological treatment failure or the presence of a pathological point, surgical intervention is required, which can be performed via laparotomy or laparoscopy.
Acute intestinal intussusception is defined as the introduction of the proximal segment of an intestinal loop into the distal segment. The most common type is ileocolic intussusception, which requires early treatment. The most frequent etiology of this condition is idiopathic, often associated with a viral infection context. The diagnosis is primarily based on clinical presentation, commonly characterized by abdominal pain accompanied by episodes of lethargy combined with intense crying and irritability, as well as vomiting and rectal bleeding. To confirm the diagnostic suspicion, ultrasound is the reference technique, also useful for ruling out a secondary cause, which is more frequent in older children. Intestinal intussusception is predominantly observed during the first year of life, being the main cause of occlusive syndrome in children under 2 years of age. Treatment is usually radiological, using an air, hydrostatic, or ultrasound-guided enema, all of which have a high success rate provided there are no signs of severity. In cases of radiological treatment failure or the presence of a pathological point, surgical intervention is required, which can be performed via laparotomy or laparoscopy.
Direction
Méndez Gallart, Roberto (Tutorships)
Méndez Gallart, Roberto (Tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Utility of intraoperative optical coherence tomography in anterior segment surgery
Authorship
B.V.T.
Bachelor of Medicine
B.V.T.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Intraoperative optical coherence tomography (iOCT) is a non-contact and non-invasive diagnostic imaging method that has experienced extraordinary development in recent years, as it allows obtaining in vivo histological images of ocular structures without interrupting the surgical procedure, facilitating a dynamic real-time view of surgery. The main objective of our review was to evaluate the utility of iOCT in anterior segment surgery. Literature was searched based on querying the Medline database (via PubMed), including 37 studies. We classify their results according to their respective fields, including the use of iOCT in different anterior segment procedures. The findings suggest the usefulness of iOCT in lamellar corneal transplantation as relevant, especially in Descemet membrane transplantation (DMEK), cataract surgery and phakic lens implant surgery. No studies have been found that meet the inclusion criteria on amniotic membrane surgery, glaucoma, penetrating keratoplasty, intracorneal segments and keratoprosthesis surgery, so no conclusions can be provided about their usefulness in these procedures. The authors perceive the implementation of iOCT as a step forward in most anterior segment procedures, constituting a key technology in the future of ophthalmic surgery. iOCT significantly affects surgical decision making and has the necessary potential to improve surgical results and avoid complications, increasing the safety of the procedures. However, there are still limitations to its adoption due to its high cost, the lack of automatic image analysis, the need to implant compatible surgical instruments, and the heterogeneity of the published studies.
Intraoperative optical coherence tomography (iOCT) is a non-contact and non-invasive diagnostic imaging method that has experienced extraordinary development in recent years, as it allows obtaining in vivo histological images of ocular structures without interrupting the surgical procedure, facilitating a dynamic real-time view of surgery. The main objective of our review was to evaluate the utility of iOCT in anterior segment surgery. Literature was searched based on querying the Medline database (via PubMed), including 37 studies. We classify their results according to their respective fields, including the use of iOCT in different anterior segment procedures. The findings suggest the usefulness of iOCT in lamellar corneal transplantation as relevant, especially in Descemet membrane transplantation (DMEK), cataract surgery and phakic lens implant surgery. No studies have been found that meet the inclusion criteria on amniotic membrane surgery, glaucoma, penetrating keratoplasty, intracorneal segments and keratoprosthesis surgery, so no conclusions can be provided about their usefulness in these procedures. The authors perceive the implementation of iOCT as a step forward in most anterior segment procedures, constituting a key technology in the future of ophthalmic surgery. iOCT significantly affects surgical decision making and has the necessary potential to improve surgical results and avoid complications, increasing the safety of the procedures. However, there are still limitations to its adoption due to its high cost, the lack of automatic image analysis, the need to implant compatible surgical instruments, and the heterogeneity of the published studies.
Direction
DE ROJAS SILVA, MARIA VICTORIA (Tutorships)
DE ROJAS SILVA, MARIA VICTORIA (Tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Observational study of two prophylactic regimens with oral fosfomycin tromethanol in transrectal prostate biopsy
Authorship
M.A.L.
Bachelor of Medicine
M.A.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction. Transrectal prostate biopsy (BPTR) is one of the most common procedures in urological clinical practice. This is an invasive procedure so it requires antibiotic prophylaxis with oral fosfomycin trometamol (FMT) as it is one of the drugs recommended by clinical guidelines. The evidence of the presence of two prophylactic guidelines in the care provided to patients during BPTR at CHUVI, duly supported, led us to evaluate whether there are differences in the result. Objective. Patients undergoing BPTR with a dose of 3 g oral FMT and a second group receiving two doses, one before and one after, were compared. The incidence of urinary tract infection (BPTR-UTI) and a series of variables that could be associated with the appearance of the complication were studied. Methodology. An observational, retrospective, cohort study was carried out on consecutive cases from a single center. 1052 BPTR were studied, carried out by CHUVI urologists, mainly during the year 2023. Finally, two cohorts were analysed, one of prophylaxis with one dose, 340 BPTR and another of two doses of 670 techniques. Authorization was obtained from CEIm-G, registration code 2023/538. Results. The total incidence of BPTR-UTI was 6.7%, without finding a significant difference between the prophylactic regimens. Nor was a significant association obtained with the rest of the variables studied, except age. Conclusion. We conclude that both guidelines offered similar protection and that the only variable that could recommend a concern for the possible infectious complication is age.
Introduction. Transrectal prostate biopsy (BPTR) is one of the most common procedures in urological clinical practice. This is an invasive procedure so it requires antibiotic prophylaxis with oral fosfomycin trometamol (FMT) as it is one of the drugs recommended by clinical guidelines. The evidence of the presence of two prophylactic guidelines in the care provided to patients during BPTR at CHUVI, duly supported, led us to evaluate whether there are differences in the result. Objective. Patients undergoing BPTR with a dose of 3 g oral FMT and a second group receiving two doses, one before and one after, were compared. The incidence of urinary tract infection (BPTR-UTI) and a series of variables that could be associated with the appearance of the complication were studied. Methodology. An observational, retrospective, cohort study was carried out on consecutive cases from a single center. 1052 BPTR were studied, carried out by CHUVI urologists, mainly during the year 2023. Finally, two cohorts were analysed, one of prophylaxis with one dose, 340 BPTR and another of two doses of 670 techniques. Authorization was obtained from CEIm-G, registration code 2023/538. Results. The total incidence of BPTR-UTI was 6.7%, without finding a significant difference between the prophylactic regimens. Nor was a significant association obtained with the rest of the variables studied, except age. Conclusion. We conclude that both guidelines offered similar protection and that the only variable that could recommend a concern for the possible infectious complication is age.
Direction
BLANCO PARRA, MIGUEL ANGEL (Tutorships)
Castro Iglesias, Ángel Maximino (Co-tutorships)
BLANCO PARRA, MIGUEL ANGEL (Tutorships)
Castro Iglesias, Ángel Maximino (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Evaluation of the efficacy and safety of treatment with anti-beta-amyloid monoclonal antibodies in Alzheimer’s disease. Systematic review.
Authorship
G.A.L.
Bachelor of Medicine
G.A.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Alzheimer’s disease (AD) is the most frequent primary neurodegenerative disease and the first cause of dementia. It is characterized by a progressive and selective degeneration of neuronal populations and histologically there are amyloid plaques and neurofobrilar degeneration, which are the hallmark of the disease. The main drugs currently available are acetylcholinesterase inhibitors, such as donepezil, galantamine and rivastigmine, and memantine, a non-competitive NMDA receptor antagonist. It is a symptomatic treatment that has shown little effectiveness. Hypothesis and objectives: In recent years, research has focused on the development of anti-beta-amyloid monoclonal antibodies, a protein involved in the pathophysiology of the disease and the main component of amyloid plaques. The review carried out aims to answer the question: Are anti-beta-amyloid monoclonal antibodies safe and effective in the treatment of Alzheimer’s disease? The objective is to synthesize the available evidence to determine whether these new drugs constitute an effective and safe alternative to modify the course of AD. Material and methods: A review of the scientific articles obtained after a systematic search in PubMed is carried out. The search is limited to publications of the last 5 years (2019 to 2024). It is also limited by type of article (randomized controlled clinical trial (RCT)) and by language (English and Spanish). The review process consists of the analysis of efficacy and safety variables, with emphasis on modifications of basic neuropsychological test (CDR-SB, MMSE and ADAS-Cog) and biomarkers (CSF beta-amyloid, amyloid PET and MRI). Results and discussion: It includes a total of 8 articles, published between 2022 and 2023, all in English and open access. They have 10 phase III RCTs that include a total of 11,426 patients and test five anti-beta-amyloid monoclonal antibodies. Most of the studies analyzed do not reach statistical significance, except Lecanemab and Donanemab, which show promising results, but without clinical relevance and at the expense of a significant association with ARIA events and a slightly higher incidence of any adverse effect. Regarding biomarkers, the available findings are not significant, but point to a significant decrease in amyloid burden in PET and a generalized increase in Abeta1-42 levels. Conclusion: The risk/benefit ratio of these drugs is unfavorable. Although Lecanemab and Donanemab present the most positive results, with frank statistical significance and, at least, a slight modification of the course of the disease with respect to the reduction of the Abeta burden, do not demonstrate a clinically relevant impact that exceeds the risks of side effects, which are clearly associated with these drugs.
Introduction: Alzheimer’s disease (AD) is the most frequent primary neurodegenerative disease and the first cause of dementia. It is characterized by a progressive and selective degeneration of neuronal populations and histologically there are amyloid plaques and neurofobrilar degeneration, which are the hallmark of the disease. The main drugs currently available are acetylcholinesterase inhibitors, such as donepezil, galantamine and rivastigmine, and memantine, a non-competitive NMDA receptor antagonist. It is a symptomatic treatment that has shown little effectiveness. Hypothesis and objectives: In recent years, research has focused on the development of anti-beta-amyloid monoclonal antibodies, a protein involved in the pathophysiology of the disease and the main component of amyloid plaques. The review carried out aims to answer the question: Are anti-beta-amyloid monoclonal antibodies safe and effective in the treatment of Alzheimer’s disease? The objective is to synthesize the available evidence to determine whether these new drugs constitute an effective and safe alternative to modify the course of AD. Material and methods: A review of the scientific articles obtained after a systematic search in PubMed is carried out. The search is limited to publications of the last 5 years (2019 to 2024). It is also limited by type of article (randomized controlled clinical trial (RCT)) and by language (English and Spanish). The review process consists of the analysis of efficacy and safety variables, with emphasis on modifications of basic neuropsychological test (CDR-SB, MMSE and ADAS-Cog) and biomarkers (CSF beta-amyloid, amyloid PET and MRI). Results and discussion: It includes a total of 8 articles, published between 2022 and 2023, all in English and open access. They have 10 phase III RCTs that include a total of 11,426 patients and test five anti-beta-amyloid monoclonal antibodies. Most of the studies analyzed do not reach statistical significance, except Lecanemab and Donanemab, which show promising results, but without clinical relevance and at the expense of a significant association with ARIA events and a slightly higher incidence of any adverse effect. Regarding biomarkers, the available findings are not significant, but point to a significant decrease in amyloid burden in PET and a generalized increase in Abeta1-42 levels. Conclusion: The risk/benefit ratio of these drugs is unfavorable. Although Lecanemab and Donanemab present the most positive results, with frank statistical significance and, at least, a slight modification of the course of the disease with respect to the reduction of the Abeta burden, do not demonstrate a clinically relevant impact that exceeds the risks of side effects, which are clearly associated with these drugs.
Direction
LEIRA MUIÑO, ROGELIO MANUEL (Tutorships)
Aldrey Vázquez, José Manuel (Co-tutorships)
LEIRA MUIÑO, ROGELIO MANUEL (Tutorships)
Aldrey Vázquez, José Manuel (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Comparison between holmium laser enucleation and transurethral resection in the treatment of benign prostatic hyperplasia: a retrospective study.
Authorship
M.A.A.S.
Bachelor of Medicine
M.A.A.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: benign prostatic hyperplasia is a disease that affects millions of men and greatly reduces their quality of life. Different therapeutic options are available, including two surgical techniques that are the subject of this study: transurethral resection of the prostate (TURP) and holmium laser prostatic enucleation (HoLEP). Objective: to compare the effectiveness of TURP and HoLEP in the treatment of prostatic hyperplasia, in terms of maximum urinary flow rate, voided volume, postvoid residual urine, impact on PSA levels, enucleated/resected tissue and duration of surgery, hospitalization and catheterization, as well as the presence of associated complications. Methods: a retrospective study was carried out on a pseudonymized database of a series of 96 cases operated on at the CHUAC: 41 TURP and 55 HoLEP, between January 2022 and October 2023. Preoperative, intraoperative, and postoperative variables were collected, and the statistical analysis was performed in the SPSS 29 platform. Results: statistically significant differences were found in terms of difference in maximum flow rate (p-value less than 0.001, in favor of HoLEP), duration of surgery (p-value less than 0.001, in favor of TURP), PSA reduction and enucleated tissue (both p-value less than0.001 and in favor of HoLEP) and decrease in hemoglobin (p-value 0.030 in favor of TURP). For the rest of objectives, no significant differences were found. Conclusions: with HoLEP, significantly greater increases in postoperative maximum flow and the amount of enucleated prostate tissue were achieved, as well as a greater decreases in PSA levels. In the TURP group, the duration of surgeries was shorter and the decrease in hemoglobin was lower. No significant differences were found in terms of voiding volume, postvoid residual rate, duration of hospitalization and catheterization, or in terms of complications.
Introduction: benign prostatic hyperplasia is a disease that affects millions of men and greatly reduces their quality of life. Different therapeutic options are available, including two surgical techniques that are the subject of this study: transurethral resection of the prostate (TURP) and holmium laser prostatic enucleation (HoLEP). Objective: to compare the effectiveness of TURP and HoLEP in the treatment of prostatic hyperplasia, in terms of maximum urinary flow rate, voided volume, postvoid residual urine, impact on PSA levels, enucleated/resected tissue and duration of surgery, hospitalization and catheterization, as well as the presence of associated complications. Methods: a retrospective study was carried out on a pseudonymized database of a series of 96 cases operated on at the CHUAC: 41 TURP and 55 HoLEP, between January 2022 and October 2023. Preoperative, intraoperative, and postoperative variables were collected, and the statistical analysis was performed in the SPSS 29 platform. Results: statistically significant differences were found in terms of difference in maximum flow rate (p-value less than 0.001, in favor of HoLEP), duration of surgery (p-value less than 0.001, in favor of TURP), PSA reduction and enucleated tissue (both p-value less than0.001 and in favor of HoLEP) and decrease in hemoglobin (p-value 0.030 in favor of TURP). For the rest of objectives, no significant differences were found. Conclusions: with HoLEP, significantly greater increases in postoperative maximum flow and the amount of enucleated prostate tissue were achieved, as well as a greater decreases in PSA levels. In the TURP group, the duration of surgeries was shorter and the decrease in hemoglobin was lower. No significant differences were found in terms of voiding volume, postvoid residual rate, duration of hospitalization and catheterization, or in terms of complications.
Direction
BLANCO PARRA, MIGUEL ANGEL (Tutorships)
Vázquez-Martul Pazos, Darío (Co-tutorships)
BLANCO PARRA, MIGUEL ANGEL (Tutorships)
Vázquez-Martul Pazos, Darío (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Efficacy of probiotics in Rheumatoid Arthritis: systematic review and meta-analysis.
Authorship
L.A.C.
Bachelor of Medicine
L.A.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. Despite recent advances, there is still a need to find additional therapeutic approaches. Increasing evidence suggests a link between the gut microbiota and the cells involved in RA pathogenesis. Probiotics may represent an effective way to slow disease progression by balancing the intestinal microbiota. Objectives: To analyze the effectiveness of probiotics in reducing signs and symptoms when administered as a complementary therapy in the treatment of patients with RA. Methods: A systematic search was conducted through the databases Medline, Embase, the Cochrane Library, and Web of Science for articles published in English and Spanish. Articles were selected if they included patients diagnosed with RA, had disease evaluation recorded, and if patients in the experimental group had received some probiotic preparation. Results: The systematic review included 11 studies. A meta-analysis of 6 RCT was carried out: Probiotics were found to be a protective factor of EULAR non-response in patients with RA (95% CI 0.094, 0.306; p=0.000), a moderate EULAR response in patients with moderate DAS28 (95% CI 2.084, 8.596; p=0.000), a significant decrease in HAQ (95% CI -0.746, -0.220; p=0.000) and in the number of swollen joints (95% CI -0.503, -0.039; p=0.022). Conclusions: Probiotic supplementation may improve the response of patients with RA, especially those with moderate to high disease activity, but more clinical trials with a larger number of patients are needed to evaluate the effectiveness of different strains, doses of probiotics, and necessary administration time.
Introduction: Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. Despite recent advances, there is still a need to find additional therapeutic approaches. Increasing evidence suggests a link between the gut microbiota and the cells involved in RA pathogenesis. Probiotics may represent an effective way to slow disease progression by balancing the intestinal microbiota. Objectives: To analyze the effectiveness of probiotics in reducing signs and symptoms when administered as a complementary therapy in the treatment of patients with RA. Methods: A systematic search was conducted through the databases Medline, Embase, the Cochrane Library, and Web of Science for articles published in English and Spanish. Articles were selected if they included patients diagnosed with RA, had disease evaluation recorded, and if patients in the experimental group had received some probiotic preparation. Results: The systematic review included 11 studies. A meta-analysis of 6 RCT was carried out: Probiotics were found to be a protective factor of EULAR non-response in patients with RA (95% CI 0.094, 0.306; p=0.000), a moderate EULAR response in patients with moderate DAS28 (95% CI 2.084, 8.596; p=0.000), a significant decrease in HAQ (95% CI -0.746, -0.220; p=0.000) and in the number of swollen joints (95% CI -0.503, -0.039; p=0.022). Conclusions: Probiotic supplementation may improve the response of patients with RA, especially those with moderate to high disease activity, but more clinical trials with a larger number of patients are needed to evaluate the effectiveness of different strains, doses of probiotics, and necessary administration time.
Direction
PEREZ PAMPIN, EVA MARIA (Tutorships)
Dos Santos Sobrín, Raquel (Co-tutorships)
PEREZ PAMPIN, EVA MARIA (Tutorships)
Dos Santos Sobrín, Raquel (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Impact of dry eye disease on the quality of life of patients with diabetic macular edema undergoing antiangiogenic treatment
Authorship
J.A.S.
Bachelor of Medicine
J.A.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Objectives: intravitreal treatment with Anti-VEGF received by patients with diabetic macular edema (DME) has been associated with ocular surface damage. Scientific evidence indicates that these treatments can improve vision. However, this beneficial effect may be compromised by the underdiagnosis of dry eye disease (DED), whose symptoms can significantly affect quality of life. Additionally, concern about the risks associated with injections and the anxiety generated by the procedure may lead some patients to refuse to follow the treatment as regularly recommended. The objective of this study is to investigate the prevalence of DED in patients with DME undergoing antiangiogenic intravitreal treatment and to estimate its impact on quality of life. Patients and Methods: a case-control study was conducted with 52 participants: 26 patients with DME undergoing intravitreal injections and 26 control patients. Demographic data, ocular, and systemic history were collected. DED symptoms were assessed with the SANDE questionnaire and a preference analysis (utilities) was performed with the TTO questionnaire. The following tests were also conducted: tear breakup time (TBUT), fluorescein staining, lissamine green staining, and the Schirmer test. Results: the SANDE questionnaire revealed symptoms in 7.69% of the DME group. In the tests performed to evaluate signs of dry eye (TBUT, fluorescein staining, lissamine green staining, and the Schirmer test), no statistically significant differences were observed between the control group and the DME group. The questionnaire results showed that none of the DME patients were willing to trade years of life to avoid dry eye symptoms. Conclusions: intravitreal injections in DME patients do not increase the prevalence of DED symptoms and signs, nor do they negatively impact their quality of life. DME patients value other aspects of their health more highly.
Objectives: intravitreal treatment with Anti-VEGF received by patients with diabetic macular edema (DME) has been associated with ocular surface damage. Scientific evidence indicates that these treatments can improve vision. However, this beneficial effect may be compromised by the underdiagnosis of dry eye disease (DED), whose symptoms can significantly affect quality of life. Additionally, concern about the risks associated with injections and the anxiety generated by the procedure may lead some patients to refuse to follow the treatment as regularly recommended. The objective of this study is to investigate the prevalence of DED in patients with DME undergoing antiangiogenic intravitreal treatment and to estimate its impact on quality of life. Patients and Methods: a case-control study was conducted with 52 participants: 26 patients with DME undergoing intravitreal injections and 26 control patients. Demographic data, ocular, and systemic history were collected. DED symptoms were assessed with the SANDE questionnaire and a preference analysis (utilities) was performed with the TTO questionnaire. The following tests were also conducted: tear breakup time (TBUT), fluorescein staining, lissamine green staining, and the Schirmer test. Results: the SANDE questionnaire revealed symptoms in 7.69% of the DME group. In the tests performed to evaluate signs of dry eye (TBUT, fluorescein staining, lissamine green staining, and the Schirmer test), no statistically significant differences were observed between the control group and the DME group. The questionnaire results showed that none of the DME patients were willing to trade years of life to avoid dry eye symptoms. Conclusions: intravitreal injections in DME patients do not increase the prevalence of DED symptoms and signs, nor do they negatively impact their quality of life. DME patients value other aspects of their health more highly.
Direction
RODRIGUEZ ARES, MARIA TERESA (Tutorships)
Viso Outeiriño, Eloy Fernando (Co-tutorships)
RODRIGUEZ ARES, MARIA TERESA (Tutorships)
Viso Outeiriño, Eloy Fernando (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Compression:ventilation ratio in cardiopulmonary resuscitation of the newborn out of the delivery room: a systematic review.
Authorship
C.A.C.
Bachelor of Medicine
C.A.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Two different cardiopulmonary resuscitation algorithms coexist in the pediatric age group, one intended for the newborn in the delivery room (neonatal CPR) and the other for the rest of the pediatric population (pediatric CPR), differing from each other in various aspects, such as the compression: ventilation ratio they employ. Although the neonatal CPR algorithm has been specifically designed for newborns in the delivery room, the fact that pediatric CPR includes such a large and heterogeneous group gives rise to numerous discrepancies as to which is the best to use in patients of smaller age and size, so that aspects of one or the other protocol are frequently applied to newborns outside the delivery room. One of these controversies is in the compression: ventilation ratio. The aim of this study was to determine which of the two compressions: ventilation ratios, 3:1 or 15:2, is more effective in neonatal patients out of the delivery room. Methods: A systematic literature review of studies comparing both ratios in the neonatal population and including some measure of outcome success was designed. Results: Six studies were included in this systematic review. These studies correspond to clinical trials in neonatal pigs and dummies, published in the last 20 years. Four of the six included studies favour a 3:1 compression: ventilation ratio based on return of spontaneous circulation, mechanical ventilation, and resuscitator quality and fatigue. One of the studies found no significant difference based on cerebral inflammatory response between the two ratios and another study favored the 15:2 ratio as causing less fatigue when a single rescuer is involved. Conclusions: Although studies comparing compression: ventilation ratios are scarce and limited to experimental designs, there appears to be some data in favour of the 3:1 ratio. However, it is not possible to draw firm recommendations and more studies are needed.
Introduction: Two different cardiopulmonary resuscitation algorithms coexist in the pediatric age group, one intended for the newborn in the delivery room (neonatal CPR) and the other for the rest of the pediatric population (pediatric CPR), differing from each other in various aspects, such as the compression: ventilation ratio they employ. Although the neonatal CPR algorithm has been specifically designed for newborns in the delivery room, the fact that pediatric CPR includes such a large and heterogeneous group gives rise to numerous discrepancies as to which is the best to use in patients of smaller age and size, so that aspects of one or the other protocol are frequently applied to newborns outside the delivery room. One of these controversies is in the compression: ventilation ratio. The aim of this study was to determine which of the two compressions: ventilation ratios, 3:1 or 15:2, is more effective in neonatal patients out of the delivery room. Methods: A systematic literature review of studies comparing both ratios in the neonatal population and including some measure of outcome success was designed. Results: Six studies were included in this systematic review. These studies correspond to clinical trials in neonatal pigs and dummies, published in the last 20 years. Four of the six included studies favour a 3:1 compression: ventilation ratio based on return of spontaneous circulation, mechanical ventilation, and resuscitator quality and fatigue. One of the studies found no significant difference based on cerebral inflammatory response between the two ratios and another study favored the 15:2 ratio as causing less fatigue when a single rescuer is involved. Conclusions: Although studies comparing compression: ventilation ratios are scarce and limited to experimental designs, there appears to be some data in favour of the 3:1 ratio. However, it is not possible to draw firm recommendations and more studies are needed.
Direction
Ávila Álvarez, Alejandro (Tutorships)
Ávila Álvarez, Alejandro (Tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Use of 445-nm laser in larynx pathology treatment: A systematic review.
Authorship
S.A.G.
Bachelor of Medicine
S.A.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: The larynx, an essential structure in vocal production and swallowing, is often affected by various pathologies (cancer, nodules, polyps, granulomas, papillomas, etc.) that can significantly impact patients' quality of life. The 445 nm laser, also known as the blue laser, is a novel therapeutic tool that is gaining interest in the medical community for treating conditions in the otorhinolaryngology area. OBJECTIVE: To examine the utility of the blue laser in the treatment of laryngeal pathologies in minimally invasive procedures. MATERIALS AND METHODS: Independent searches were conducted by three authors in the following indexed databases: PubMed/MEDLINE, the Cochrane Library, and ScienceDirect. Inclusion, exclusion, and diagnostic criteria were analyzed, as well as the evaluation of the clinical outcomes of the included studies using PRISMA criteria. Bias analysis was evaluated using the NICE Public Health Guidance tool. RESULTS: A total of 151 articles were identified. After excluding duplicates and unrelated articles, 24 articles were selected. Their full texts were evaluated according to the proposed methodology, after which 9 manuscripts were excluded, resulting in a final inclusion of 15 articles. The blue laser is a recent tool indicated for the treatment of various laryngeal pathologies. Studies show excellent procedural tolerance and satisfactory results related to lesion regression and scales evaluating vocal quality. CONCLUSION: Based on the existing studies to date, the 445 nm laser is an effective and safe therapeutic modality for the treatment of laryngeal pathology. However, further research in representative population samples is needed.
INTRODUCTION: The larynx, an essential structure in vocal production and swallowing, is often affected by various pathologies (cancer, nodules, polyps, granulomas, papillomas, etc.) that can significantly impact patients' quality of life. The 445 nm laser, also known as the blue laser, is a novel therapeutic tool that is gaining interest in the medical community for treating conditions in the otorhinolaryngology area. OBJECTIVE: To examine the utility of the blue laser in the treatment of laryngeal pathologies in minimally invasive procedures. MATERIALS AND METHODS: Independent searches were conducted by three authors in the following indexed databases: PubMed/MEDLINE, the Cochrane Library, and ScienceDirect. Inclusion, exclusion, and diagnostic criteria were analyzed, as well as the evaluation of the clinical outcomes of the included studies using PRISMA criteria. Bias analysis was evaluated using the NICE Public Health Guidance tool. RESULTS: A total of 151 articles were identified. After excluding duplicates and unrelated articles, 24 articles were selected. Their full texts were evaluated according to the proposed methodology, after which 9 manuscripts were excluded, resulting in a final inclusion of 15 articles. The blue laser is a recent tool indicated for the treatment of various laryngeal pathologies. Studies show excellent procedural tolerance and satisfactory results related to lesion regression and scales evaluating vocal quality. CONCLUSION: Based on the existing studies to date, the 445 nm laser is an effective and safe therapeutic modality for the treatment of laryngeal pathology. However, further research in representative population samples is needed.
Direction
Parente Arias, Pablo Luis (Tutorships)
Mayo Yañez, Miguel (Co-tutorships)
Parente Arias, Pablo Luis (Tutorships)
Mayo Yañez, Miguel (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Characterization of the plasma proteome in Fabry disease.
Authorship
C.S.A.R.
Bachelor of Medicine
C.S.A.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Fabry disease (FD) is a lysosomal storage disease, which results from an inborn error of glycosphingolipid catabolism. It is a rare disease, with X-linked inheritance, due to mutations in the GLA gene that encodes the enzyme alpha-galactosidase A (alfa-Gal A). These mutations lead to the absence or decrease in the activity of this enzyme, which generates the progressive accumulation of globotriaosylceramide (GL3) and other glycosphingolipids in lysosomes, especially in endothelial, neuronal, cardiac, renal and integumentary system cells. Early diagnosis of FD and clinical follow-up by a multidisciplinary team are essential. Therefore, it is necessary to find reliable biomarkers for diagnosis and monitoring of the disease, which is the main objective of this study. Material and method: A cross-sectional study was performed on 50 patients with FD and 50 healthy controls for proteome analysis. Data on demographic variables (gender, age, age at diagnosis, and disease duration) were collected from each FD patient, as well as pertinent information from each healthy control subject, including age, gender, lyso-GL3 levels, and enzymatic activity of alfa-Gal A. In total, 50 patients with FD and 50 healthy controls were studied, who were matched through the use of DDA and SWATH-MS analysis to ensure comparability between groups. This study was designed to deepen the understanding of Fabry disease (FD), examining not only the demographic aspects of affected patients but also comparing them with healthy individuals on key biochemical variables. The use of advanced technologies such as DDA and SWATH-MS allowed detailed and precise analysis of the proteins and metabolites involved, thus providing a clearer view of the fundamental biochemical differences between patients and controls. This meticulous approach helps unravel the underlying mechanisms of FD and could open new avenues for the development of more effective therapeutic strategies. Results: The more than 30 proteins that were differentially expressed between the 2 groups included proteins involved in processes such as inflammation, heme and hemoglobin metabolism, oxidative stress, coagulation, the complement cascade, glucose metabolism, and lipids and glycocalyx formation. Stratification by sex revealed that certain proteins were differentially expressed in a sex-dependent manner. Apolipoprotein A-IV was increased in FD patients with complications, especially in those with chronic kidney disease, and apolipoprotein C-III and fetuin-A were identified as possible markers of FD with left ventricular hypertrophy. All of these proteins had a greater capacity to identify the presence of complications in patients with FD than lyso-GL3, with apolipo-protein A-IV standing out as being more sensitive and effective in differentiating the presence and absence of chronic kidney disease in patients with FD. EF than renal markers such as creatinine, glomerular filtration rate and microalbuminuria. Conclusiones: Current work has identified a series of proteins that could serve as potential biomarkers to help improve our understanding of the pathophysiological processes underlying the heterogeneous clinical manifestations associated with FD.
Introduction: Fabry disease (FD) is a lysosomal storage disease, which results from an inborn error of glycosphingolipid catabolism. It is a rare disease, with X-linked inheritance, due to mutations in the GLA gene that encodes the enzyme alpha-galactosidase A (alfa-Gal A). These mutations lead to the absence or decrease in the activity of this enzyme, which generates the progressive accumulation of globotriaosylceramide (GL3) and other glycosphingolipids in lysosomes, especially in endothelial, neuronal, cardiac, renal and integumentary system cells. Early diagnosis of FD and clinical follow-up by a multidisciplinary team are essential. Therefore, it is necessary to find reliable biomarkers for diagnosis and monitoring of the disease, which is the main objective of this study. Material and method: A cross-sectional study was performed on 50 patients with FD and 50 healthy controls for proteome analysis. Data on demographic variables (gender, age, age at diagnosis, and disease duration) were collected from each FD patient, as well as pertinent information from each healthy control subject, including age, gender, lyso-GL3 levels, and enzymatic activity of alfa-Gal A. In total, 50 patients with FD and 50 healthy controls were studied, who were matched through the use of DDA and SWATH-MS analysis to ensure comparability between groups. This study was designed to deepen the understanding of Fabry disease (FD), examining not only the demographic aspects of affected patients but also comparing them with healthy individuals on key biochemical variables. The use of advanced technologies such as DDA and SWATH-MS allowed detailed and precise analysis of the proteins and metabolites involved, thus providing a clearer view of the fundamental biochemical differences between patients and controls. This meticulous approach helps unravel the underlying mechanisms of FD and could open new avenues for the development of more effective therapeutic strategies. Results: The more than 30 proteins that were differentially expressed between the 2 groups included proteins involved in processes such as inflammation, heme and hemoglobin metabolism, oxidative stress, coagulation, the complement cascade, glucose metabolism, and lipids and glycocalyx formation. Stratification by sex revealed that certain proteins were differentially expressed in a sex-dependent manner. Apolipoprotein A-IV was increased in FD patients with complications, especially in those with chronic kidney disease, and apolipoprotein C-III and fetuin-A were identified as possible markers of FD with left ventricular hypertrophy. All of these proteins had a greater capacity to identify the presence of complications in patients with FD than lyso-GL3, with apolipo-protein A-IV standing out as being more sensitive and effective in differentiating the presence and absence of chronic kidney disease in patients with FD. EF than renal markers such as creatinine, glomerular filtration rate and microalbuminuria. Conclusiones: Current work has identified a series of proteins that could serve as potential biomarkers to help improve our understanding of the pathophysiological processes underlying the heterogeneous clinical manifestations associated with FD.
Direction
Hermida Ameijeiras, Álvaro (Tutorships)
Ortolano -, Saida (Co-tutorships)
Hermida Ameijeiras, Álvaro (Tutorships)
Ortolano -, Saida (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Alzheimer's Disease and Periodontal Disease: a possible causal relationship
Authorship
S.L.E.
Bachelor of Odontology
S.L.E.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
The hypothesis of an infectious connection from the oral cavity to the brain underlines the interest in analyzing the link between periodontal disease and Alzheimer's disease. The objective of this systemic review is to evaluate the involvement of periodontal disease in the development of Alzheimer's disease. After analyzing the databases (PubMed, Cochrane and Scopus) for relevant references in the last five years, the studies were selected and the data extracted. Four studies were included in this work. The results of these studies described a significant increase in the number of pathogenic bacteria in the oral microbiome and a higher concentration of cytokines in the patient's blood in Alzheimer's patients compared to healthy patients. Specifically, an increase in P. gingivalis, F. nucleatum and P. intermedia (p-0.05) was evident in the EA group compared to the control 2 group, as well as concentrations of IL-1 and IL-6 (p - 0.05). .05), and TNF-alfa (p -0.001). It was also observed that the total score of decayed, missing and filled teeth (CAOD) (p = 0.001) and the levels of serum Tau protein (p = 0.043), hsCRP (p = 0.004) and anti-P.gingivalis LPS ( p=0.046) of the subjects with AD was significantly higher than in the controls. The current review suggests an association between periodontal disease and Alzheimer's disease. Although more studies are required to clarify the role of periodontitis as a risk factor for AD, treatment of periodontal disease could be a way to explore the prevention of Alzheimer's disease.
The hypothesis of an infectious connection from the oral cavity to the brain underlines the interest in analyzing the link between periodontal disease and Alzheimer's disease. The objective of this systemic review is to evaluate the involvement of periodontal disease in the development of Alzheimer's disease. After analyzing the databases (PubMed, Cochrane and Scopus) for relevant references in the last five years, the studies were selected and the data extracted. Four studies were included in this work. The results of these studies described a significant increase in the number of pathogenic bacteria in the oral microbiome and a higher concentration of cytokines in the patient's blood in Alzheimer's patients compared to healthy patients. Specifically, an increase in P. gingivalis, F. nucleatum and P. intermedia (p-0.05) was evident in the EA group compared to the control 2 group, as well as concentrations of IL-1 and IL-6 (p - 0.05). .05), and TNF-alfa (p -0.001). It was also observed that the total score of decayed, missing and filled teeth (CAOD) (p = 0.001) and the levels of serum Tau protein (p = 0.043), hsCRP (p = 0.004) and anti-P.gingivalis LPS ( p=0.046) of the subjects with AD was significantly higher than in the controls. The current review suggests an association between periodontal disease and Alzheimer's disease. Although more studies are required to clarify the role of periodontitis as a risk factor for AD, treatment of periodontal disease could be a way to explore the prevention of Alzheimer's disease.
Direction
Santana Mora, Urbano Alejandro (Tutorships)
Santana Mora, Urbano Alejandro (Tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
BORRAJO GARCIA, MARIA ISABEL (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
BORRAJO GARCIA, MARIA ISABEL (Member)
Characterization of the oral microbiome in health across different oral niches: a multi batch analysis
Authorship
R.F.M.
Bachelor of Odontology
R.F.M.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Aim: To analyse the supragingival plaque, subgingival plaque, and salivary microbiomes of periodontally healthy patients at the amplicon sequence variant (ASV) level in terms of alpha diversity, community structure, and differential abundance. This was done under a compositional data analysis approach and after removing batch effects. Materials and methods: Searches were performed in several databases to identify Illumina V3,V4 sequencing studies on the supragingival plaque, subgingival plaque, and/or salivary microbiome in periodontal health. Investigations that met the criteria for metadata and sequences were included in our analysis, reaching 848 samples. The sequences were processed under the same bioinformatics protocol, including classification at the ASV level and the use of an oral specific database for taxonomic assignment. Statistical analysis was performed with RBioconductor. Results: Supragingival plaque was richer than subgingival plaque and saliva (ASVs612.00 vs. 479.00 and 445.00; 95%coverage 224.00 vs. 171.00 and 172.00; pless0.05). However, sub plaque had a more even distribution (Pielou0.65 vs. 0.62; pless0.01), and saliva had a greater diversity and evenness (Shannon4.11 vs. 4.07; Pielou0.65 vs. 0.62; pless0.05) than supra plaque. The PCA revealed a clustering of healthy samples according to the niche to which they belonged (pless0.0001). Finally, 121 ASVs (1.14% of the total detected), of which 10 (0.09%) had large effect sizes, showed differential abundance between plaques. Comparing the two plaques vs. saliva, these numbers were 212 (2.00%) and 107 (1.01%) for supra, and 160 (1.51%) and 95 (0.90%) for sub. Conclusion: In states of oral health, supragingival plaque is richer than subgingival plaque and saliva. Conversely, the subgingival plaque is more even, and saliva is more diverse and even than the supragingival plaque. The microbial community structure is different in the three studied niches. In terms of differential abundance, the supragingival and subgingival plaques are more similar to each other than to saliva.
Aim: To analyse the supragingival plaque, subgingival plaque, and salivary microbiomes of periodontally healthy patients at the amplicon sequence variant (ASV) level in terms of alpha diversity, community structure, and differential abundance. This was done under a compositional data analysis approach and after removing batch effects. Materials and methods: Searches were performed in several databases to identify Illumina V3,V4 sequencing studies on the supragingival plaque, subgingival plaque, and/or salivary microbiome in periodontal health. Investigations that met the criteria for metadata and sequences were included in our analysis, reaching 848 samples. The sequences were processed under the same bioinformatics protocol, including classification at the ASV level and the use of an oral specific database for taxonomic assignment. Statistical analysis was performed with RBioconductor. Results: Supragingival plaque was richer than subgingival plaque and saliva (ASVs612.00 vs. 479.00 and 445.00; 95%coverage 224.00 vs. 171.00 and 172.00; pless0.05). However, sub plaque had a more even distribution (Pielou0.65 vs. 0.62; pless0.01), and saliva had a greater diversity and evenness (Shannon4.11 vs. 4.07; Pielou0.65 vs. 0.62; pless0.05) than supra plaque. The PCA revealed a clustering of healthy samples according to the niche to which they belonged (pless0.0001). Finally, 121 ASVs (1.14% of the total detected), of which 10 (0.09%) had large effect sizes, showed differential abundance between plaques. Comparing the two plaques vs. saliva, these numbers were 212 (2.00%) and 107 (1.01%) for supra, and 160 (1.51%) and 95 (0.90%) for sub. Conclusion: In states of oral health, supragingival plaque is richer than subgingival plaque and saliva. Conversely, the subgingival plaque is more even, and saliva is more diverse and even than the supragingival plaque. The microbial community structure is different in the three studied niches. In terms of differential abundance, the supragingival and subgingival plaques are more similar to each other than to saliva.
Direction
TOMAS CARMONA, INMACULADA (Tutorships)
Regueira Iglesias, Alba (Co-tutorships)
TOMAS CARMONA, INMACULADA (Tutorships)
Regueira Iglesias, Alba (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
¿AED fordummies? Competencies in the use of an Automated External Defibrillator among Pregraduate Dental Students
Authorship
M.G.A.
Bachelor of Odontology
M.G.A.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Background: Early defibrillation using a Semi-Automatic External Defibrillator (AED) improves the survival of patients with heart failure in out-of-hospital settings. Its use represents a fundamental competence for dentists in the context of medical emergencies. It has not yet been conclusively demonstrated whether potential AED users are prepared to deal with its use adequately. Objective: Analyze the knowledge and skills of the students of the last year of the Dental Degree in the management of AED. Methodology: A cross-sectional descriptive observational study was designed, in which 42 fifth-year students of the Dental Degree at the University of Santiago de Compostela (Spain) participated. All of them faced a simulated scenario of cardiac arrest in an adult. To do this, an AED (Phillips HeartStart FRx) was used and its performance was evaluated with the defibrillator on a resuscitation dummy (Little Anne QCPR). The evaluation was carried out by applying a 10-item survey distributed in 3 blocks: Preparation (4 items), Placement and Discharge (4 items), and Post-discharge (2 items). The time elapsed from the start of the simulation to the moment of discharge was determined. The activity was directed by a monitor with specific training who acted as a second rescuer. Results: Less than 10% of the participants adequately completed 8 of the 10 items evaluated. No students checked the AED battery status and only 4.8% turned on the AED. The average time elapsed until the shock was carried out was 2 minutes and 23 seconds (range: 1 minute 15 seconds to 3 minutes 53 seconds). Conclusion: The skills on the management of AED among the students of the last year of the Dental Degree are very poor. It is necessary to implement specific training on the management of AED in the Degree curriculum.
Background: Early defibrillation using a Semi-Automatic External Defibrillator (AED) improves the survival of patients with heart failure in out-of-hospital settings. Its use represents a fundamental competence for dentists in the context of medical emergencies. It has not yet been conclusively demonstrated whether potential AED users are prepared to deal with its use adequately. Objective: Analyze the knowledge and skills of the students of the last year of the Dental Degree in the management of AED. Methodology: A cross-sectional descriptive observational study was designed, in which 42 fifth-year students of the Dental Degree at the University of Santiago de Compostela (Spain) participated. All of them faced a simulated scenario of cardiac arrest in an adult. To do this, an AED (Phillips HeartStart FRx) was used and its performance was evaluated with the defibrillator on a resuscitation dummy (Little Anne QCPR). The evaluation was carried out by applying a 10-item survey distributed in 3 blocks: Preparation (4 items), Placement and Discharge (4 items), and Post-discharge (2 items). The time elapsed from the start of the simulation to the moment of discharge was determined. The activity was directed by a monitor with specific training who acted as a second rescuer. Results: Less than 10% of the participants adequately completed 8 of the 10 items evaluated. No students checked the AED battery status and only 4.8% turned on the AED. The average time elapsed until the shock was carried out was 2 minutes and 23 seconds (range: 1 minute 15 seconds to 3 minutes 53 seconds). Conclusion: The skills on the management of AED among the students of the last year of the Dental Degree are very poor. It is necessary to implement specific training on the management of AED in the Degree curriculum.
Direction
Diniz Freitas, Márcio (Tutorships)
Diniz Freitas, Márcio (Tutorships)
Role of Forensic Odontology in Mass Disasters
Authorship
I.G.M.
Bachelor of Odontology
I.G.M.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Introduction: In recent decades, major catastrophes or mass disasters have become more frequent due to changes in society (technological advancements, large constructions, terrorist attacks…). In these situations, the international reference guide is the Interpol protocol for Disaster Victim Identification (DVI). The role of Forensic Dentistry in this procedure is of great importance, since it offers fast, reliable and affordable techniques. Objectives: To determine the role that Forensic Dentistry has played identification of corpses in mass disasters in the last 20 years. Material and Methods: Bibliographic review by searching for articles in PubMed, Dialnet, Scielo, and Google Scholar in the time range from 2004 to 2024. Results: 36 articles were selected for this study, of which 16 referred to disasters that occurred in the last 20 years. The Interpol DVI Guide provides details of all phases of the identification process and the role of individual professionals, including forensic odontologists. In the last 20 years, of the 16 mass disasters from which information has been obtained, forensic odontology has contributed to DVI in 14 of them (87,5%), being the main method in 4 (25%). Conclusions: Forensic Odontology is necessary and continues to be effective for the identification of corpses in mass disasters.
Introduction: In recent decades, major catastrophes or mass disasters have become more frequent due to changes in society (technological advancements, large constructions, terrorist attacks…). In these situations, the international reference guide is the Interpol protocol for Disaster Victim Identification (DVI). The role of Forensic Dentistry in this procedure is of great importance, since it offers fast, reliable and affordable techniques. Objectives: To determine the role that Forensic Dentistry has played identification of corpses in mass disasters in the last 20 years. Material and Methods: Bibliographic review by searching for articles in PubMed, Dialnet, Scielo, and Google Scholar in the time range from 2004 to 2024. Results: 36 articles were selected for this study, of which 16 referred to disasters that occurred in the last 20 years. The Interpol DVI Guide provides details of all phases of the identification process and the role of individual professionals, including forensic odontologists. In the last 20 years, of the 16 mass disasters from which information has been obtained, forensic odontology has contributed to DVI in 14 of them (87,5%), being the main method in 4 (25%). Conclusions: Forensic Odontology is necessary and continues to be effective for the identification of corpses in mass disasters.
Direction
CRUZ LANDEIRA, ANGELINES (Tutorships)
CRUZ LANDEIRA, ANGELINES (Tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
Service-Learning in Oral Mucosa Disease, a scoping review. SL-OMD
Authorship
L.G.P.
Bachelor of Odontology
L.G.P.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Service-Learning (SL) is a pedagogical proposal that involves voluntary works by students in community service projects that allow them to consolidate their knowledge. For this reason, research has been carried out into its implementation in dental schools, so that students can learn about the reality of the communities they will be dealing with and enhance their academic experience. In this literature review, a search was made in 2 databases in order to find evidence based on the evaluation of these projects to determine the effectiveness of the methodology in dental students, focusing on the promotion of oral health. In general terms, positive impact and good ratings of the projects have been observed. However, as its arrival at Galician universities is so recent, there is still a lot of work to be done to reach a consensus on terms between institutions and to achieve an optimal experience for the participants.
Service-Learning (SL) is a pedagogical proposal that involves voluntary works by students in community service projects that allow them to consolidate their knowledge. For this reason, research has been carried out into its implementation in dental schools, so that students can learn about the reality of the communities they will be dealing with and enhance their academic experience. In this literature review, a search was made in 2 databases in order to find evidence based on the evaluation of these projects to determine the effectiveness of the methodology in dental students, focusing on the promotion of oral health. In general terms, positive impact and good ratings of the projects have been observed. However, as its arrival at Galician universities is so recent, there is still a lot of work to be done to reach a consensus on terms between institutions and to achieve an optimal experience for the participants.
Direction
GANDARA VILA, PILAR (Tutorships)
Sanmartín Barragáns, Valeria (Co-tutorships)
GANDARA VILA, PILAR (Tutorships)
Sanmartín Barragáns, Valeria (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
Anterior open bite correction in adults: Utilization of aligners and/or TADs for molar intrusion
Authorship
M.P.C.P.
Bachelor of Odontology
M.P.C.P.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Introducion Anterior open bite is a multifactorial pathology that prevents various aesthetic and functional repercussions. Proper diagnosis and management considering the severity and cause are essential to solve this malocclusion. Nevertheless, nowadays, there is a priority in many cases to perform less invasive treatments that provide greater comfort and aesthetics to the patient, hence treatments such as invisible aligners and Temporary Anchorage Devices (TADs) are introduced. Objectives To update the treatment of anterior open bite by evaluating molar intrusion and overbite obtained in adults through the exclusive use of aligners or TADs with aligners or conventional orthodontics. Material and methods In the treatment of anterior open bite using aligners, we initially collected 198 articles, wich were reduced to 13. On the other hand, 236 articles were found about miniscrews initially, wich were reduced to 12 after applying inclusion and explusion criteria. Conclusion It is evident that both aligners and the use of skeletal anchorage are effective options for solving anterior open bite. Aligners achieved a molar intrusion of approximately 0.6 mm, wich can increase up to 2.20 mm with TADs. These treatments also improve overbite in all cases, providing aesthetic benefits. Further studies are needed to compare these treatments with conventional orthodontics and evaluate their long-term stability.
Introducion Anterior open bite is a multifactorial pathology that prevents various aesthetic and functional repercussions. Proper diagnosis and management considering the severity and cause are essential to solve this malocclusion. Nevertheless, nowadays, there is a priority in many cases to perform less invasive treatments that provide greater comfort and aesthetics to the patient, hence treatments such as invisible aligners and Temporary Anchorage Devices (TADs) are introduced. Objectives To update the treatment of anterior open bite by evaluating molar intrusion and overbite obtained in adults through the exclusive use of aligners or TADs with aligners or conventional orthodontics. Material and methods In the treatment of anterior open bite using aligners, we initially collected 198 articles, wich were reduced to 13. On the other hand, 236 articles were found about miniscrews initially, wich were reduced to 12 after applying inclusion and explusion criteria. Conclusion It is evident that both aligners and the use of skeletal anchorage are effective options for solving anterior open bite. Aligners achieved a molar intrusion of approximately 0.6 mm, wich can increase up to 2.20 mm with TADs. These treatments also improve overbite in all cases, providing aesthetic benefits. Further studies are needed to compare these treatments with conventional orthodontics and evaluate their long-term stability.
Direction
PEREZ VARELA, JUAN CARLOS (Tutorships)
López Vila, Miriam (Co-tutorships)
PEREZ VARELA, JUAN CARLOS (Tutorships)
López Vila, Miriam (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
Radiotherapy's effectiveness in oral cancer: survival and control rates.
Authorship
M.N.G.R.
Bachelor of Odontology
M.N.G.R.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Oral cancer is a pathology that affects thousands of people every year, altering their lives at every level. As each patient is different, their treatment must be individualized, and between the principal therapeutic methods, there’s radiotherapy, either as primary treatment or coadjuvant. Objectives: we want to determine if radiotherapy improves the survival, locorregional control and distant control in patients with oral cancer; check which factors can affect the outcomes of patients treated with radiotherapy and which type of radiotherapy shows better data on survival and control. Material and methods: we make a literature review by making a search in the Pubmed database using the terms (radiotherapy) AND (oral cancer) AND (survival). Results: 532 articles are retrieved; 24 are selected. Conclusions: coadjuvant radiotherapy could improve survival and control regarding primary surgery; primary radiotherapy and chemoradiotherapy show worse outcomes than surgery, but better than immunotherapy; however, non-surgical treatment could be used in case of unresectable tumors. Patients’ age, tumor stage, malnutrition, presence of HPV-16, time and inflamatory cells’ ratio could affect survival. Control and survival ratios improve when irradiation of the whole neck takes place, as well as when doses over 60Gy are used. Descalation could be applied in SCC stage I-II without it gravely affecting survival, as well as proton radiotherapy to reduce doses applied to organs at risk in oral cancer, without reducing the received dose by the tumor.
Oral cancer is a pathology that affects thousands of people every year, altering their lives at every level. As each patient is different, their treatment must be individualized, and between the principal therapeutic methods, there’s radiotherapy, either as primary treatment or coadjuvant. Objectives: we want to determine if radiotherapy improves the survival, locorregional control and distant control in patients with oral cancer; check which factors can affect the outcomes of patients treated with radiotherapy and which type of radiotherapy shows better data on survival and control. Material and methods: we make a literature review by making a search in the Pubmed database using the terms (radiotherapy) AND (oral cancer) AND (survival). Results: 532 articles are retrieved; 24 are selected. Conclusions: coadjuvant radiotherapy could improve survival and control regarding primary surgery; primary radiotherapy and chemoradiotherapy show worse outcomes than surgery, but better than immunotherapy; however, non-surgical treatment could be used in case of unresectable tumors. Patients’ age, tumor stage, malnutrition, presence of HPV-16, time and inflamatory cells’ ratio could affect survival. Control and survival ratios improve when irradiation of the whole neck takes place, as well as when doses over 60Gy are used. Descalation could be applied in SCC stage I-II without it gravely affecting survival, as well as proton radiotherapy to reduce doses applied to organs at risk in oral cancer, without reducing the received dose by the tumor.
Direction
GARCIA GARCIA, ABEL (Tutorships)
GARCIA GARCIA, ABEL (Tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
Batalla Vázquez, María Pilar (Member)
Civil incapacity in Galicia as a result of a mental disorder
Authorship
S.L.R.D.C.
Bachelor of Medicine
S.L.R.D.C.
Bachelor of Medicine
Defense date
02.09.2024 09:00
02.09.2024 09:00
Summary
This study describes the characteristics and circumstances related to the civil incapacity acquired by people that have been judged as legally vulnerable due to a mental disorder. To this end, 38 court rulings, from various types of courts, were selected and analyzed. The concession or denial of the petitions was decided based on the Law on Civil Procedure 1/2000. 33 of them took place before its modification with the law 8/2021 and 5 of them were declared after said change. The main focus of this study lies on the court rulings before this reform. From these first 33 court rulings, 27 accepted the petition and the other 6 denied it. The most relevant frequency patterns drawn from the study of the court rulings accepting a petition of civil incapacity due to a mental disorder were laid out.
This study describes the characteristics and circumstances related to the civil incapacity acquired by people that have been judged as legally vulnerable due to a mental disorder. To this end, 38 court rulings, from various types of courts, were selected and analyzed. The concession or denial of the petitions was decided based on the Law on Civil Procedure 1/2000. 33 of them took place before its modification with the law 8/2021 and 5 of them were declared after said change. The main focus of this study lies on the court rulings before this reform. From these first 33 court rulings, 27 accepted the petition and the other 6 denied it. The most relevant frequency patterns drawn from the study of the court rulings accepting a petition of civil incapacity due to a mental disorder were laid out.
Direction
MATEOS ALVAREZ, RAIMUNDO (Tutorships)
MATEOS ALVAREZ, RAIMUNDO (Tutorships)
Evaluation of Virtual Teaching Tools in the Study of Anatomy.
Authorship
F.A.M.L.
Bachelor of Medicine
F.A.M.L.
Bachelor of Medicine
Defense date
02.09.2024 09:00
02.09.2024 09:00
Summary
Introduction: anatomical medical education is one of the most important knowledge bases for professional clinical practice. The arrival of new technologies and the advances that have arisen along with them have modified the learning and teaching methodology in medical universities. The appearance of 3D applications, in which students can observe three- dimensional anatomical structures, rotate, modify the size, have a better relationship of space with respect to other structures, has marked a change in the traditional teaching paradigm. Objective: to evaluate the use of new virtual learning tools, 3D applications, in comparison with audiovisual models and resin mock-ups, in anatomical teaching. Material and methods: it is carried out by searching and analyzing the information obtained from a survey of first year students of the Faculty of Medicine of the University of Santiago de Compostela, regarding the use of new teaching tools (3D applications, such as Complete Anatomy, Youtube tutorial videos), in relation to more traditional methods (resin models). Results: A large percentage of the students surveyed prefer the use of virtual tools as the main study method for anatomical structures (46.95%), due to a better understanding and assimilation of the concepts, compared to students who prefer the traditional study by observing resin models (31.3%) or the use of tutorial videos on YouTube (21.7%). However, the combined use of new 3D techniques along with visualization on resin models in anatomy laboratories continues to have importance and relevance as a teaching method (53.71%), in relation to students who prefer dual teaching with the use of “YouTube” tutorials in combination with mockups (13.91%). Conclusions: technological progress, the arrival of new virtual tools in medicine, specifically in medical practice, has modified the teaching and learning methodology for students and teachers. Adapting to this new change, and integrating these new technologies in the transmission of anatomical concepts and structures, is one of the challenges facing universities and their professors in order not to be left behind in the technological race that we are living today, where updating is constant, fast and continuous.
Introduction: anatomical medical education is one of the most important knowledge bases for professional clinical practice. The arrival of new technologies and the advances that have arisen along with them have modified the learning and teaching methodology in medical universities. The appearance of 3D applications, in which students can observe three- dimensional anatomical structures, rotate, modify the size, have a better relationship of space with respect to other structures, has marked a change in the traditional teaching paradigm. Objective: to evaluate the use of new virtual learning tools, 3D applications, in comparison with audiovisual models and resin mock-ups, in anatomical teaching. Material and methods: it is carried out by searching and analyzing the information obtained from a survey of first year students of the Faculty of Medicine of the University of Santiago de Compostela, regarding the use of new teaching tools (3D applications, such as Complete Anatomy, Youtube tutorial videos), in relation to more traditional methods (resin models). Results: A large percentage of the students surveyed prefer the use of virtual tools as the main study method for anatomical structures (46.95%), due to a better understanding and assimilation of the concepts, compared to students who prefer the traditional study by observing resin models (31.3%) or the use of tutorial videos on YouTube (21.7%). However, the combined use of new 3D techniques along with visualization on resin models in anatomy laboratories continues to have importance and relevance as a teaching method (53.71%), in relation to students who prefer dual teaching with the use of “YouTube” tutorials in combination with mockups (13.91%). Conclusions: technological progress, the arrival of new virtual tools in medicine, specifically in medical practice, has modified the teaching and learning methodology for students and teachers. Adapting to this new change, and integrating these new technologies in the transmission of anatomical concepts and structures, is one of the challenges facing universities and their professors in order not to be left behind in the technological race that we are living today, where updating is constant, fast and continuous.
Direction
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
Souto Bayarri, José Miguel (Co-tutorships)
Sánchez Varela, Nerea (Co-tutorships)
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
Souto Bayarri, José Miguel (Co-tutorships)
Sánchez Varela, Nerea (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Differential extraction and its alternative methodologies in forensic genetics
Authorship
L.M.L.
Bachelor of Medicine
L.M.L.
Bachelor of Medicine
Defense date
02.09.2024 09:00
02.09.2024 09:00
Summary
Sexual assaults are traumatic and a violation of victims' rights, as well as a public health problem. In order to imprison the aggressor, we need clear scientific evidence, with DNA evidence that incriminates them. Samples from a sexual assault are mostly composed of many epithelial cells from the victim with few sperm from the aggressor, so if this samples were analyzed, a female genetic profile would be obtained. To avoid this, the differential extraction technique was created, this method allows the separation of epithelial cells from spermatozoa, in order to obtain only male DNA. However, this method has some limitations and a high workload due to the increase in samples to be analyzed in laboratories. As a result, other alternative methods to differential extraction have emerged with their own peculiarities. In this paper we will describe differential extraction technique and the most innovative alternative methodologies. In addition, we will conduct a bibliographic review to identify the latest trends in differential extraction research and alternative methodologies.
Sexual assaults are traumatic and a violation of victims' rights, as well as a public health problem. In order to imprison the aggressor, we need clear scientific evidence, with DNA evidence that incriminates them. Samples from a sexual assault are mostly composed of many epithelial cells from the victim with few sperm from the aggressor, so if this samples were analyzed, a female genetic profile would be obtained. To avoid this, the differential extraction technique was created, this method allows the separation of epithelial cells from spermatozoa, in order to obtain only male DNA. However, this method has some limitations and a high workload due to the increase in samples to be analyzed in laboratories. As a result, other alternative methods to differential extraction have emerged with their own peculiarities. In this paper we will describe differential extraction technique and the most innovative alternative methodologies. In addition, we will conduct a bibliographic review to identify the latest trends in differential extraction research and alternative methodologies.
Direction
PUENTE VILA, MARIA DEL CARMEN DE LA (Tutorships)
PUENTE VILA, MARIA DEL CARMEN DE LA (Tutorships)
Relationship of genetic risk factors with the presence of prodromal and clinical symptoms in patients with Parkinson's Disease.
Authorship
E.L.T.O.
Bachelor of Medicine
E.L.T.O.
Bachelor of Medicine
Defense date
02.09.2024 09:00
02.09.2024 09:00
Summary
Introduction: Parkinson's disease is considered a motor syndrome characterized by bradykinesia, resting tremor, and musculoskeletal rigidity. Additionally, it is associated with a variety of non-motor symptoms. In recent years, the discovery of genetic risk factors for Parkinson's disease has highlighted their importance in the development and progression of this disease. Objective: To relate genetic risk factors to the presence of prodromal and clinical symptoms in patients with Parkinson's Disease. Materials and methods: A systematic review was conducted in the PubMed database using the following keywords: “Parkinson's disease” and “genetic risk factors”, “prodromic symptoms”, “clinical symptoms”, “genetic mutations”. A total of 25 articles were selected based on inclusion and exclusion criteria. Results: A total of 25 articles were selected, including a total of N=255 patients. Depression/anxiety was the most frequent prodromal symptom, reported in 25 patients from 8 articles; followed by cognitive deficit, which was recorded in 22 patients in 6 articles, and urinary urgency, for 18 patients from 5 articles. Mutations in the PRKN gene were the most identified (102 patients), followed by mutations in the GBA gene (40 patients). However, the genetic risk factors with the most studies included were SNCA and SYNJ, with 5 articles each. Conclusions: There is a relationship between genetic risk factors for Parkinson's disease and prodromal symptoms, given by three groups of genes: the first with patients who commonly manifested prodromal symptoms with a high variety of presentation (GBA, SNCA, and CHCHD2), the second with patients with a low frequency of prodromal symptoms and intermediate variety (RIC3, VPS35, PRKN, and FBXO7), and the third group with patients who did not present any prodromal symptom (DNAJC13, GIGYF2, TMEM230, SYNJ1, and DNAJC6).
Introduction: Parkinson's disease is considered a motor syndrome characterized by bradykinesia, resting tremor, and musculoskeletal rigidity. Additionally, it is associated with a variety of non-motor symptoms. In recent years, the discovery of genetic risk factors for Parkinson's disease has highlighted their importance in the development and progression of this disease. Objective: To relate genetic risk factors to the presence of prodromal and clinical symptoms in patients with Parkinson's Disease. Materials and methods: A systematic review was conducted in the PubMed database using the following keywords: “Parkinson's disease” and “genetic risk factors”, “prodromic symptoms”, “clinical symptoms”, “genetic mutations”. A total of 25 articles were selected based on inclusion and exclusion criteria. Results: A total of 25 articles were selected, including a total of N=255 patients. Depression/anxiety was the most frequent prodromal symptom, reported in 25 patients from 8 articles; followed by cognitive deficit, which was recorded in 22 patients in 6 articles, and urinary urgency, for 18 patients from 5 articles. Mutations in the PRKN gene were the most identified (102 patients), followed by mutations in the GBA gene (40 patients). However, the genetic risk factors with the most studies included were SNCA and SYNJ, with 5 articles each. Conclusions: There is a relationship between genetic risk factors for Parkinson's disease and prodromal symptoms, given by three groups of genes: the first with patients who commonly manifested prodromal symptoms with a high variety of presentation (GBA, SNCA, and CHCHD2), the second with patients with a low frequency of prodromal symptoms and intermediate variety (RIC3, VPS35, PRKN, and FBXO7), and the third group with patients who did not present any prodromal symptom (DNAJC13, GIGYF2, TMEM230, SYNJ1, and DNAJC6).
Direction
DIAZ RUIZ, MARIA DEL CARMEN (Tutorships)
DIAZ RUIZ, MARIA DEL CARMEN (Tutorships)
Primary Care Interventions for asthma management in the older adult.
Authorship
M.R.B.C.
Bachelor of Medicine
M.R.B.C.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Asthma is a highly prevalent chronic respiratory disease across all age groups. However, the management of this condition in older patients has received limited attention, likely due to its complexity. The pathophysiology of asthma in the elderly includes physiological and immunological changes specifically associated with aging. Developing effective strategies to address asthma in this population is crucial, as they are at higher risk for exacerbations and therapeutic non-compliance. In this context, primary care plays a fundamental role due to its proximity and understanding of the patient. Implementing management strategies based on health education can improve asthma control in this population and should be systematically integrated into primary care services. To delve into this topic, this study aims to synthesize current evidence on various management strategies for older asthma patients and identify the most relevant interventions to enhance disease control in this age group. To this end, a scoping review of available literature was conducted using the bibliographic databases PubMed and WOS, following PRISMA guidelines. This study included systematic reviews, randomized controlled trials, and meta-analyses, examining a total of 7 articles. The studies using ACQ and ACT questionnaires demonstrate improvements in asthma control among intervention groups, although results vary. Some interventions show improved medication adherence, while reductions in exacerbations are significant in several studies. Inhalation technique education, particularly through active education methods, proves effective in enhancing inhaler competence. Overall, educational strategies show promise in optimizing asthma management in older adults, emphasizing the need for tailored approaches in primary care settings.
Asthma is a highly prevalent chronic respiratory disease across all age groups. However, the management of this condition in older patients has received limited attention, likely due to its complexity. The pathophysiology of asthma in the elderly includes physiological and immunological changes specifically associated with aging. Developing effective strategies to address asthma in this population is crucial, as they are at higher risk for exacerbations and therapeutic non-compliance. In this context, primary care plays a fundamental role due to its proximity and understanding of the patient. Implementing management strategies based on health education can improve asthma control in this population and should be systematically integrated into primary care services. To delve into this topic, this study aims to synthesize current evidence on various management strategies for older asthma patients and identify the most relevant interventions to enhance disease control in this age group. To this end, a scoping review of available literature was conducted using the bibliographic databases PubMed and WOS, following PRISMA guidelines. This study included systematic reviews, randomized controlled trials, and meta-analyses, examining a total of 7 articles. The studies using ACQ and ACT questionnaires demonstrate improvements in asthma control among intervention groups, although results vary. Some interventions show improved medication adherence, while reductions in exacerbations are significant in several studies. Inhalation technique education, particularly through active education methods, proves effective in enhancing inhaler competence. Overall, educational strategies show promise in optimizing asthma management in older adults, emphasizing the need for tailored approaches in primary care settings.
Direction
Mosquera Nogueira, Jacinto José (Tutorships)
Fernández Villar, José Alberto (Co-tutorships)
Mosquera Nogueira, Jacinto José (Tutorships)
Fernández Villar, José Alberto (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Antibody- drug conjugates, the magic bullet against cancer: role in breast cancer. Systematic review.
Authorship
A.C.L.
Bachelor of Medicine
A.C.L.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Breast cancer is one of the most prevalent neoplasms worldwide, being the most diagnosed tumor in women in our region and representing the leading cause of cancer death in women in developed countries. These tumors are highly heterogeneous from a biological perspective, the molecular classification, based on the overexpression of molecules on the surface of tumor cells, has revolutionized the treatment of this disease thanks to the development of new drugs targeted at these molecules. In this review, we focus on the role played by antibody-drug conjugates, these drugs consist of a monoclonal antibody capable of specifically recognizing the overexpressed molecules on the tumor surface; it is attached via a stable or cleavable link to a cytotoxic substance that, upon reaching the target cells, induces their death as well as the death of neighboring cells in the tumor microenvironment. Antibody-drug conjugates have improved the prognosis for women with neoplasms that previously had very limited treatment options with traditional therapies, improving survival and reducing toxicity, establishing them as one of the main lines of treatment in breast cancer.
Breast cancer is one of the most prevalent neoplasms worldwide, being the most diagnosed tumor in women in our region and representing the leading cause of cancer death in women in developed countries. These tumors are highly heterogeneous from a biological perspective, the molecular classification, based on the overexpression of molecules on the surface of tumor cells, has revolutionized the treatment of this disease thanks to the development of new drugs targeted at these molecules. In this review, we focus on the role played by antibody-drug conjugates, these drugs consist of a monoclonal antibody capable of specifically recognizing the overexpressed molecules on the tumor surface; it is attached via a stable or cleavable link to a cytotoxic substance that, upon reaching the target cells, induces their death as well as the death of neighboring cells in the tumor microenvironment. Antibody-drug conjugates have improved the prognosis for women with neoplasms that previously had very limited treatment options with traditional therapies, improving survival and reducing toxicity, establishing them as one of the main lines of treatment in breast cancer.
Direction
VARELA PONTE, RAFAEL (Tutorships)
García Mata, Jesús (Co-tutorships)
Guedella López, Ana (Co-tutorships)
VARELA PONTE, RAFAEL (Tutorships)
García Mata, Jesús (Co-tutorships)
Guedella López, Ana (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Tracheoesophageal fistulas as a method of post-laryngectomy vocal rehabilitation. Complications.
Authorship
P.C.F.
Bachelor of Medicine
P.C.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: In the treatment of laryngeal cancer, the main objective is to ensure complete tumour removal. In advanced stages, total laryngectomy is the only effective therapeutic measure. This aggressive intervention results in the total loss of normal phonation. For this reason, the search for methods that allow the recovery of phonatory capacity has been a primary objective. There are currently three vocal rehabilitation options available for these patients: the erigmophonic voice, the electrolarynx and the tracheoesophageal fistula with the insertion of a prosthesis in the tracheoesophageal fistula. The latter is the post-laryngectomy vocal rehabilitation method with a phonatory quality closest to the physiological one. Despite this, they are not free of complications and even have a higher complication rate than the other two rehabilitation methods. Aim and methods: The main objective of the present literature review is to understand the methods of vocal rehabilitation in laryngectomised patients, as well as the more specific complications of tracheoesophageal fistulas and the duration of the different prostheses implanted in the fistula. It has been carried out through a review of 19 articles in the literature. Outcomes: Endoprosthetic and periprosthetic leaks are complications that have a higher rate of appearance. In addition, most studies also collected data on complications due to fungal colonization, tracheostoma stenosis, prosthetic fall or extrusion, appearance of granulation, use of prosthetic prosthetics with inadequate size or lack of use. The rate of occurrence of complications is conditioned by other factors such as the type of tumor, or tumor stage, or type of surgical intervention, or radiotherapeutic treatment, or type of valve inset. In addition, this determines the average useful life of the prosthesis and therefore the number of prosthetic replacements that the patient needs. Conclusions: The choice of the post-laryngectomy rehabilitation method must be individualised, considering the complication rate of prostheses and, at the same time, their phonatory superiority over other methods
Introduction: In the treatment of laryngeal cancer, the main objective is to ensure complete tumour removal. In advanced stages, total laryngectomy is the only effective therapeutic measure. This aggressive intervention results in the total loss of normal phonation. For this reason, the search for methods that allow the recovery of phonatory capacity has been a primary objective. There are currently three vocal rehabilitation options available for these patients: the erigmophonic voice, the electrolarynx and the tracheoesophageal fistula with the insertion of a prosthesis in the tracheoesophageal fistula. The latter is the post-laryngectomy vocal rehabilitation method with a phonatory quality closest to the physiological one. Despite this, they are not free of complications and even have a higher complication rate than the other two rehabilitation methods. Aim and methods: The main objective of the present literature review is to understand the methods of vocal rehabilitation in laryngectomised patients, as well as the more specific complications of tracheoesophageal fistulas and the duration of the different prostheses implanted in the fistula. It has been carried out through a review of 19 articles in the literature. Outcomes: Endoprosthetic and periprosthetic leaks are complications that have a higher rate of appearance. In addition, most studies also collected data on complications due to fungal colonization, tracheostoma stenosis, prosthetic fall or extrusion, appearance of granulation, use of prosthetic prosthetics with inadequate size or lack of use. The rate of occurrence of complications is conditioned by other factors such as the type of tumor, or tumor stage, or type of surgical intervention, or radiotherapeutic treatment, or type of valve inset. In addition, this determines the average useful life of the prosthesis and therefore the number of prosthetic replacements that the patient needs. Conclusions: The choice of the post-laryngectomy rehabilitation method must be individualised, considering the complication rate of prostheses and, at the same time, their phonatory superiority over other methods
Direction
Martín Martín, Carlos Santiago (Tutorships)
Vázquez Barro, Juan Carlos (Co-tutorships)
Martín Martín, Carlos Santiago (Tutorships)
Vázquez Barro, Juan Carlos (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Emerging Therapies in familial Amyotrophic Lateral Sclerosis.
Authorship
S.C.L.
Bachelor of Medicine
S.C.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects motor neurons, causing weakness, progressive muscular atrophy and a noticeable decrease in patients’ survival. 90-95% of cases are sporadic, but 5-10% are hereditary and have been most frequently associated with mutations in the C9ORF72, SOD1, TARDBP and FUS genes, although more than 40 genes are implicated. Objectives: Carry out a systematic review of the studies about emerging treatments for familial ALS with the purpose of determine if the emergence of new therapies would represent a change in the diagnostic and therapeutic paradigm of the disease. Material and methods: The information was searched in the databases PubMed, Scopus and Cochrane, as well as in the clinical trial registries ClinicalTrials.gov and Clinicaltrialsregister.eu. Worldwide clinical trials that analyzed new treatments for familial amyotrophic lateral sclerosis were included. Outcomes: Most of the available studies are of Phase I and II and only exist Phase III studies for the treatment with antisense oligonucleotides (Tofersen) in SOD1 mutations and with RNA-silencing oligonucleotides (Jacifusen) in FUS mutations. There are only published results from a Phase III study with Tofersen, that has already been approved by the FDA in 2023. Conclusions: The results of the treatment with an intrathecal administration of an antisense oligonucleotide (Tofersen) certified its use in ALS-SOD1 patients. Due to this therapeutic alternative, it should be appropriate to run a genetic study to all ALS patients regardless of their family history.
Introduction: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that affects motor neurons, causing weakness, progressive muscular atrophy and a noticeable decrease in patients’ survival. 90-95% of cases are sporadic, but 5-10% are hereditary and have been most frequently associated with mutations in the C9ORF72, SOD1, TARDBP and FUS genes, although more than 40 genes are implicated. Objectives: Carry out a systematic review of the studies about emerging treatments for familial ALS with the purpose of determine if the emergence of new therapies would represent a change in the diagnostic and therapeutic paradigm of the disease. Material and methods: The information was searched in the databases PubMed, Scopus and Cochrane, as well as in the clinical trial registries ClinicalTrials.gov and Clinicaltrialsregister.eu. Worldwide clinical trials that analyzed new treatments for familial amyotrophic lateral sclerosis were included. Outcomes: Most of the available studies are of Phase I and II and only exist Phase III studies for the treatment with antisense oligonucleotides (Tofersen) in SOD1 mutations and with RNA-silencing oligonucleotides (Jacifusen) in FUS mutations. There are only published results from a Phase III study with Tofersen, that has already been approved by the FDA in 2023. Conclusions: The results of the treatment with an intrathecal administration of an antisense oligonucleotide (Tofersen) certified its use in ALS-SOD1 patients. Due to this therapeutic alternative, it should be appropriate to run a genetic study to all ALS patients regardless of their family history.
Direction
Pardo Fernández, Julio (Tutorships)
Pardo Fernández, Julio (Tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
HIV pre-exposure prophylaxis program experience in Lugo
Authorship
S.C.R.
Bachelor of Medicine
S.C.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Pre-exposure prophylaxis (PrEP) is an intervention to prevent, through the use of anti-retroviral drugs, the acquisition of human immunodeficiency virus (HIV) infection in HIV-seronegative high-risk individuals. In November 2019, the Spanish Ministry of Health approved the funding of daily tenofovir-disoproxil-fumarate/emtricitabine (FTC/TDF) as PrEP regime. OBJECTIVES: To describe the sociodemographic, clinical and behavioural characteristics of the PrEP users, as well as to assess the effectiveness, safety, treatment adherence and sexually transmitted infections (STI) dynamics. METHOD: A retrospective cohort study was undertaken in the Lucus Augusti University Hospital that included PrEP users from November 2020 to February 2024. The sociodemographic, clinical and behavioural characteristics of the participants, the effectiveness and side effects of the medication, the therapeutic adherence and STI dynamics were assessed. RESULTS: 35 participants were included, 33 men and two trans women. The PrEP user profile is a 39-year-old man who has sex with men (MSM), born in Spain, that requests to be included in the program. There was often history of STI (60%) and, despite systematic referral to Preventive Medicine for vaccination, there was lack of immunization against hepatitis A virus and hepatitis B in around half of the cases (54.3% and 45.7%, respectively). Only a small percentage of subjects reported using always condom (2.9%), the median of sexual partners per month was 3.5 and one of the users reported engaging chemsex. PrEP was abandoned by 14.3% of the subjects, the main reason being the appearance of digestive side effects (8,6%) and one third of the participants (28.6%) developed some STI during follow-up (gonorrhea, Chlamydia trachomatis and syphilis, in order of frequency). CONCLUSIONS: PrEP was shown as an effective and safe measure with high levels of adherence.
INTRODUCTION: Pre-exposure prophylaxis (PrEP) is an intervention to prevent, through the use of anti-retroviral drugs, the acquisition of human immunodeficiency virus (HIV) infection in HIV-seronegative high-risk individuals. In November 2019, the Spanish Ministry of Health approved the funding of daily tenofovir-disoproxil-fumarate/emtricitabine (FTC/TDF) as PrEP regime. OBJECTIVES: To describe the sociodemographic, clinical and behavioural characteristics of the PrEP users, as well as to assess the effectiveness, safety, treatment adherence and sexually transmitted infections (STI) dynamics. METHOD: A retrospective cohort study was undertaken in the Lucus Augusti University Hospital that included PrEP users from November 2020 to February 2024. The sociodemographic, clinical and behavioural characteristics of the participants, the effectiveness and side effects of the medication, the therapeutic adherence and STI dynamics were assessed. RESULTS: 35 participants were included, 33 men and two trans women. The PrEP user profile is a 39-year-old man who has sex with men (MSM), born in Spain, that requests to be included in the program. There was often history of STI (60%) and, despite systematic referral to Preventive Medicine for vaccination, there was lack of immunization against hepatitis A virus and hepatitis B in around half of the cases (54.3% and 45.7%, respectively). Only a small percentage of subjects reported using always condom (2.9%), the median of sexual partners per month was 3.5 and one of the users reported engaging chemsex. PrEP was abandoned by 14.3% of the subjects, the main reason being the appearance of digestive side effects (8,6%) and one third of the participants (28.6%) developed some STI during follow-up (gonorrhea, Chlamydia trachomatis and syphilis, in order of frequency). CONCLUSIONS: PrEP was shown as an effective and safe measure with high levels of adherence.
Direction
Gonzalez Quintela, Arturo (Tutorships)
Rabuñal Rey, Ramón (Co-tutorships)
Gonzalez Quintela, Arturo (Tutorships)
Rabuñal Rey, Ramón (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
The relationship between illness anxiety disorder and medical students: a review
Authorship
M.L.D.C.S.N.
Bachelor of Medicine
M.L.D.C.S.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Health anxiety disorder (formerly hypochondriasis) belongs to the category of somatic symptom disorders and is defined by an excessive conviction and preoccupation with a serious illness, based on the misinterpretation of physiological signals from the body. There is a widespread belief that medical students, being more aware of the functioning and respective pathologies of the human body, may be particularly susceptible to developing this syndrome, leading to negative consequences either in academic performance or in their future professional lives. Objective: This study aims to synthesize the current evidence on the relationship between health anxiety disorder and medical students, seeking to provide an updated overview of the state of the art in this field and to propose areas for future research. Methods: This is a scope review of the available literature on the above-mentioned subject, conducted using the bibliographic search engines PubMed and Ovid and following the PRISMA guidelines. The inclusion criteria selected original articles, free access, with publication language in English or Spanish, published between 2019 and 2023 and whose title contains one of the keywords. Systematic reviews, observational cross-sectional and cohort studies were included. Results: Data from a total of eight articles were analyzed. The results were unclear regarding the prevalence of health anxiety in medical students. Only one study related the increase in pathology to the population studied. Certain factors (such as gender, academic year and/or sample size) could have influenced the studies. Conclusion: Symptomatology suggestive of illness anxiety disorder was not significantly more frequent in medical students compared to other academic degrees.
Introduction: Health anxiety disorder (formerly hypochondriasis) belongs to the category of somatic symptom disorders and is defined by an excessive conviction and preoccupation with a serious illness, based on the misinterpretation of physiological signals from the body. There is a widespread belief that medical students, being more aware of the functioning and respective pathologies of the human body, may be particularly susceptible to developing this syndrome, leading to negative consequences either in academic performance or in their future professional lives. Objective: This study aims to synthesize the current evidence on the relationship between health anxiety disorder and medical students, seeking to provide an updated overview of the state of the art in this field and to propose areas for future research. Methods: This is a scope review of the available literature on the above-mentioned subject, conducted using the bibliographic search engines PubMed and Ovid and following the PRISMA guidelines. The inclusion criteria selected original articles, free access, with publication language in English or Spanish, published between 2019 and 2023 and whose title contains one of the keywords. Systematic reviews, observational cross-sectional and cohort studies were included. Results: Data from a total of eight articles were analyzed. The results were unclear regarding the prevalence of health anxiety in medical students. Only one study related the increase in pathology to the population studied. Certain factors (such as gender, academic year and/or sample size) could have influenced the studies. Conclusion: Symptomatology suggestive of illness anxiety disorder was not significantly more frequent in medical students compared to other academic degrees.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Study and comparative of variables in patients with different metabolizing phenotypes treated with long-acting injectable aripiprazole for a personalized medicine
Authorship
A.C.C.
Bachelor of Medicine
A.C.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The atypical antipsychotic aripiprazole is mainly metabolised in the liver by cytochrome P450, specifically by CYP2D6 and CYP3A4, until it is converted into dehydroaripiprazole, its main active metabolite. These enzymes have a high allelic variability that gives them different abilities for drug metabolism. This results in plasma concentrations of antipsychotic drugs outside the established therapeutic ranges, especially in cases of poor and ultra-rapid metabolisers. This inter-individual variability argues for a personalised treatment for each patient depending on their metabolising phenotype, in order to obtain a personalised medicine, achieving plasma concentrations in therapeutic ranges and improving the effectiveness, safety and quality of life of patients. Objectives: Study the response to antipsychotic treatment with aripiprazole in terms of safety and effectiveness based on plasma values of aripiprazole/dehydroaripiprazole and the characterisation of metabolising phenotypes for CYP2D6 and CYP3A4. Material and methods: Prospective, open, uncontrolled study of 22 outpatients treated with long-acting injectable aripiprazole in Area Sanitaria de Santiago de Compostela e Barbanza. Results: All patients have minimal or none side effects except one patient who has moderate adverse effects. The CYP3A4 phenotype was connected to the side effects akathisia, malaise and urinary retention and the CYP2D6 phenotype was directly related to the two pathological prolactins. Side effects measured with GASS in relation to injection site were the ones injected in the deltoid, resulting in grogginess and drowsiness, and also the ones in the gluteus, succeeding in tremors. Regarding quality of life, it has been good except in two patients with a very poor one. Positive and negative symptoms are minimal, depressive symptoms normal-moderate and cognitive symptoms normal-medium (except for one patient with more severe cognitive symptoms). A wide range of aripiprazole+dehydroaripiprazole concentrations have been determined, with 5 patients in under-therapeutic ranges and a higher aripiprazole/dehydroariprazole ratio in CYP2D6 and CYP3A4 poor metabolisers. Conclusions: Treatment with aripiprazole depot is safe with few side effects, patients have a good life quality and it is generally a well-tolerated drug. The CYP3A4 phenotype is associated with some side effects and CYP2D6 with hyperprolactinaemia. Both injection sites are safe sites and do not influence the plasma concentration of antipsychotic. These concentrations are highly variable depending on the metabolising phenotype with the consequences of increased side effects or lack of effectiveness. Therefore, it is important to know the phenotype of each patient to attain a personalised medicine approach.
Introduction: The atypical antipsychotic aripiprazole is mainly metabolised in the liver by cytochrome P450, specifically by CYP2D6 and CYP3A4, until it is converted into dehydroaripiprazole, its main active metabolite. These enzymes have a high allelic variability that gives them different abilities for drug metabolism. This results in plasma concentrations of antipsychotic drugs outside the established therapeutic ranges, especially in cases of poor and ultra-rapid metabolisers. This inter-individual variability argues for a personalised treatment for each patient depending on their metabolising phenotype, in order to obtain a personalised medicine, achieving plasma concentrations in therapeutic ranges and improving the effectiveness, safety and quality of life of patients. Objectives: Study the response to antipsychotic treatment with aripiprazole in terms of safety and effectiveness based on plasma values of aripiprazole/dehydroaripiprazole and the characterisation of metabolising phenotypes for CYP2D6 and CYP3A4. Material and methods: Prospective, open, uncontrolled study of 22 outpatients treated with long-acting injectable aripiprazole in Area Sanitaria de Santiago de Compostela e Barbanza. Results: All patients have minimal or none side effects except one patient who has moderate adverse effects. The CYP3A4 phenotype was connected to the side effects akathisia, malaise and urinary retention and the CYP2D6 phenotype was directly related to the two pathological prolactins. Side effects measured with GASS in relation to injection site were the ones injected in the deltoid, resulting in grogginess and drowsiness, and also the ones in the gluteus, succeeding in tremors. Regarding quality of life, it has been good except in two patients with a very poor one. Positive and negative symptoms are minimal, depressive symptoms normal-moderate and cognitive symptoms normal-medium (except for one patient with more severe cognitive symptoms). A wide range of aripiprazole+dehydroaripiprazole concentrations have been determined, with 5 patients in under-therapeutic ranges and a higher aripiprazole/dehydroariprazole ratio in CYP2D6 and CYP3A4 poor metabolisers. Conclusions: Treatment with aripiprazole depot is safe with few side effects, patients have a good life quality and it is generally a well-tolerated drug. The CYP3A4 phenotype is associated with some side effects and CYP2D6 with hyperprolactinaemia. Both injection sites are safe sites and do not influence the plasma concentration of antipsychotic. These concentrations are highly variable depending on the metabolising phenotype with the consequences of increased side effects or lack of effectiveness. Therefore, it is important to know the phenotype of each patient to attain a personalised medicine approach.
Direction
VIDAL MILLARES, MARIA (Tutorships)
Mondelo García, Cristina (Co-tutorships)
VIDAL MILLARES, MARIA (Tutorships)
Mondelo García, Cristina (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Maternal pregestational weight, weight gain and physical exercise during pregnancy, and breastfeeding as risk factors for childhood obesity. A systematic review.
Authorship
P.C.D.
Bachelor of Medicine
P.C.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Justification: The first 1000 days of life are a window of opportunity for the prevention of pediatric obesity. Intervention strategies for women of fertile and pregnant age and infants could be essential. Objectives: The main objective is to evaluate the association between pregestational weight, weight gain and physical exercise during pregnancy and breastfeeding and childhood overweight and obesity. In addition to identifying interactions between these and their possible combined effect. Material and Methods: A systematic review is carried out according to PRISMA in the PubMed database, using the formula (((((((Pediatric Obesity/prevention and control[Mesh]) OR Overweight/prevention and control[Mesh]) AND Risk Factors[Mesh]) AND Obesity, Maternal[Mesh]) OR Gestational Weight Gain[Mesh]) OR Breast Feeding[Mesh]) OR Exercise[Mesh]) AND Pregnancy[Mesh ] OR First 1000 day*. Scopus and Web of Science are also explored. Biases are analyzed using ROBINS-E and ROBINS-I. Results: 169 studies were obtained after searching the databases, of which 13 were included. Higher maternal pregestational weight and excessive weight gain during pregnancy were shown to be risk factors for childhood obesity. Moderate intensity physical exercise during pregnancy and an adequate duration of breastfeeding were protective factors for its development. Furthermore, the addition of risk factors represents an increase in risk. Conclusions: The risk factors studied turn out to be critical factors that influence the risk of childhood overweight and obesity. Understanding and properly managing these factors plays a significant role in preventing obesity from the first years of life.
Justification: The first 1000 days of life are a window of opportunity for the prevention of pediatric obesity. Intervention strategies for women of fertile and pregnant age and infants could be essential. Objectives: The main objective is to evaluate the association between pregestational weight, weight gain and physical exercise during pregnancy and breastfeeding and childhood overweight and obesity. In addition to identifying interactions between these and their possible combined effect. Material and Methods: A systematic review is carried out according to PRISMA in the PubMed database, using the formula (((((((Pediatric Obesity/prevention and control[Mesh]) OR Overweight/prevention and control[Mesh]) AND Risk Factors[Mesh]) AND Obesity, Maternal[Mesh]) OR Gestational Weight Gain[Mesh]) OR Breast Feeding[Mesh]) OR Exercise[Mesh]) AND Pregnancy[Mesh ] OR First 1000 day*. Scopus and Web of Science are also explored. Biases are analyzed using ROBINS-E and ROBINS-I. Results: 169 studies were obtained after searching the databases, of which 13 were included. Higher maternal pregestational weight and excessive weight gain during pregnancy were shown to be risk factors for childhood obesity. Moderate intensity physical exercise during pregnancy and an adequate duration of breastfeeding were protective factors for its development. Furthermore, the addition of risk factors represents an increase in risk. Conclusions: The risk factors studied turn out to be critical factors that influence the risk of childhood overweight and obesity. Understanding and properly managing these factors plays a significant role in preventing obesity from the first years of life.
Direction
Leis Trabazo, María Rosaura (Tutorships)
García García, Eva María (Co-tutorships)
Leis Trabazo, María Rosaura (Tutorships)
García García, Eva María (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Return to sport in handball players surgically operated due to glenohumeral instability: A systematic review.
Authorship
M.C.L.
Bachelor of Medicine
M.C.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Handball is a high-intensity sport that involves contact and throwing, which can lead to glenohumeral instability due to micro or macrotraumatic events. To treat it, there are countless techniques, with the most common being Bankart repair (B, with/without remplissage) and Bristow-Latarjet (L). Hypothesis: It is possible for a high percentage of cases to return to competition at the same level. OBJECTIVES: Description of the most common techniques for these patients. Compare the results of returning to competition in handball players with glenohumeral instability treated with B or L in terms of return to competition (yes/no and at pre-injury level), time needed for it, and recurrence rate. MATERIAL AND METHODS: Systematic review in Medline (via Pubmed) and Embase searching (from 2000 to present). Inclusion criteria: case series of handball players operated on using one of the 2 techniques (B vs. L), with a minimum follow-up of 2 years. RESULTS: Return to competition: 89% (B 88% vs. L 93%). Same level: 67% of the total (B 64% vs. L 80%). Average return time: 7.6 months (B 8.7 vs. L 6.5). Recurrences: 6% (B 7% vs L 5%; long-term B increases). CONCLUSIONS: 1. It is possible for a high percentage of players (89%) to return to competition. 2. There is no single technique of choice, so it is very important to classify the injury. 3. The indications for B and L are different, initially. But a progressive convergence between them is observed, with L achieving better results with fewer complications. 4. Therefore, L is likely to become the standard technique in the coming years. 5. The use of remplissage is controversial in handball, unlike in other contexts, due to the stiffness it causes. 6. More studies are needed to draw firmer conclusions.
Handball is a high-intensity sport that involves contact and throwing, which can lead to glenohumeral instability due to micro or macrotraumatic events. To treat it, there are countless techniques, with the most common being Bankart repair (B, with/without remplissage) and Bristow-Latarjet (L). Hypothesis: It is possible for a high percentage of cases to return to competition at the same level. OBJECTIVES: Description of the most common techniques for these patients. Compare the results of returning to competition in handball players with glenohumeral instability treated with B or L in terms of return to competition (yes/no and at pre-injury level), time needed for it, and recurrence rate. MATERIAL AND METHODS: Systematic review in Medline (via Pubmed) and Embase searching (from 2000 to present). Inclusion criteria: case series of handball players operated on using one of the 2 techniques (B vs. L), with a minimum follow-up of 2 years. RESULTS: Return to competition: 89% (B 88% vs. L 93%). Same level: 67% of the total (B 64% vs. L 80%). Average return time: 7.6 months (B 8.7 vs. L 6.5). Recurrences: 6% (B 7% vs L 5%; long-term B increases). CONCLUSIONS: 1. It is possible for a high percentage of players (89%) to return to competition. 2. There is no single technique of choice, so it is very important to classify the injury. 3. The indications for B and L are different, initially. But a progressive convergence between them is observed, with L achieving better results with fewer complications. 4. Therefore, L is likely to become the standard technique in the coming years. 5. The use of remplissage is controversial in handball, unlike in other contexts, due to the stiffness it causes. 6. More studies are needed to draw firmer conclusions.
Direction
DIEZ ULLOA, MAXIMO ALBERTO (Tutorships)
Quinteiro Moreno, José Manuel (Co-tutorships)
DIEZ ULLOA, MAXIMO ALBERTO (Tutorships)
Quinteiro Moreno, José Manuel (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Efficacy of Deep Brain Stimulation on Obsessive-Compulsive Disorder: Systematic Review.
Authorship
M.P.C.S.
Bachelor of Medicine
M.P.C.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
At least 10% of patients with obsessive-compulsive disorder (OCD) do not respond to conventional treatments, especially the more severe forms of the disease. In these cases, deep brain stimulation (DBS) is a viable option to improve the well-being and quality of life of these people. This technique stimulates different areas and brain circuits involved in this pathology, such as the subthalamic nucleus or the ventral capsule. The aim of this work is to carry out a systematic review of the articles published in English and Spanish in PubMed on this subject.
At least 10% of patients with obsessive-compulsive disorder (OCD) do not respond to conventional treatments, especially the more severe forms of the disease. In these cases, deep brain stimulation (DBS) is a viable option to improve the well-being and quality of life of these people. This technique stimulates different areas and brain circuits involved in this pathology, such as the subthalamic nucleus or the ventral capsule. The aim of this work is to carry out a systematic review of the articles published in English and Spanish in PubMed on this subject.
Direction
ARROJO ROMERO, MANUEL (Tutorships)
Gascón González, Marta (Co-tutorships)
ARROJO ROMERO, MANUEL (Tutorships)
Gascón González, Marta (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Clinical and functional differences in patients with alpha-1 antitrypsin genotypes PI*ZZ and PI*SZ included in the EARCO registry by the Álvaro Cunqueiro Hospital.
Authorship
C.G.G.
Bachelor of Medicine
C.G.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
BACKGROUND: alpha-1antitrypsin deficiency (AATD) is an inherited disorder that predisposes to the development of COPD, emphysema, and liver disease. The protein is encoded by the SERPINA1 gene, which is transmitted by autosomal codominant Mendelian inheritance. The Pi*ZZ genotype, which is associated with very low concentrations of AT protein in plasma, predisposes patients to the development of emphysema and liver disease. The Pi*SZ genotype is related with these manifestations but in a lower way than the Pi*ZZ and usually in combination with other risk factors. The registries of patients are useful tools to improve the knowledge about rare diseases, like AATD. OBJECTIVES AND METHOD: to analyze the patients with AATD included by the Álvaro Cunqueiro Hospital in the international registry of AATD, EARCO, from February 28, 2020, to June 30, 2023. To describe the demographic, social, clinical and functional characteristics of the patients, and to compare the Pi*ZZ and Pi*SZ genotypes using the statistical package SPSS 21. RESULTS: the study included 197 patients: Pi*SZ (64,9%), Pi*ZZ (23,7%) Pi*SS (4,6%), and others (6,7%). The percentage of males was 52.6% and the mean age was 51,6+-16,2 years. The comparative analysis between both genotypes found significant differences in the mean age, the prevalence of respiratory and liver diseases, and in lung function. There were no significant differences in tobacco exposure, age at diagnosis of AATD and age at onset of symptoms. CONCLUSIONS: the prevalence of Pi*SZ patients in Vigo and its surrounding area is high. This means a potential advantage in the investigation of this genotype. The individuals with Pi*ZZ genotype have more clinical and functional alterations.
BACKGROUND: alpha-1antitrypsin deficiency (AATD) is an inherited disorder that predisposes to the development of COPD, emphysema, and liver disease. The protein is encoded by the SERPINA1 gene, which is transmitted by autosomal codominant Mendelian inheritance. The Pi*ZZ genotype, which is associated with very low concentrations of AT protein in plasma, predisposes patients to the development of emphysema and liver disease. The Pi*SZ genotype is related with these manifestations but in a lower way than the Pi*ZZ and usually in combination with other risk factors. The registries of patients are useful tools to improve the knowledge about rare diseases, like AATD. OBJECTIVES AND METHOD: to analyze the patients with AATD included by the Álvaro Cunqueiro Hospital in the international registry of AATD, EARCO, from February 28, 2020, to June 30, 2023. To describe the demographic, social, clinical and functional characteristics of the patients, and to compare the Pi*ZZ and Pi*SZ genotypes using the statistical package SPSS 21. RESULTS: the study included 197 patients: Pi*SZ (64,9%), Pi*ZZ (23,7%) Pi*SS (4,6%), and others (6,7%). The percentage of males was 52.6% and the mean age was 51,6+-16,2 years. The comparative analysis between both genotypes found significant differences in the mean age, the prevalence of respiratory and liver diseases, and in lung function. There were no significant differences in tobacco exposure, age at diagnosis of AATD and age at onset of symptoms. CONCLUSIONS: the prevalence of Pi*SZ patients in Vigo and its surrounding area is high. This means a potential advantage in the investigation of this genotype. The individuals with Pi*ZZ genotype have more clinical and functional alterations.
Direction
REPRESAS REPRESAS, CRISTINA (Tutorships)
Torres Durán, María Luisa (Co-tutorships)
REPRESAS REPRESAS, CRISTINA (Tutorships)
Torres Durán, María Luisa (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Predictors of outcome of talc slurry pleurodesis in malignant pleural effusion. Experience in a tertiary referral hospital and systematic review of the literature
Authorship
M.A.G.G.
Bachelor of Medicine
M.A.G.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
More than half of the malignant pleural effusions (MPE) relapse a few weeks after a thoracocentesis. In these cases, pleural procedures like chemical pleurodesis or the insertion of an indwelling pleural catheter are recommended. Talc is the most effective sclerosant pleurodesis agent. Nonetheless, pleurodesis will fail if the preparation of the pleural space is inadequate and lung re-expansion is not achieved. Until recently, a controversial point was if talc slurry pleurodesis was as effective as other chemical pleurodesis modalities. Different studies have shown that talc pleurodesis involves a successful procedure for the control of MPE. Nevertheless, differences regarding success comparing talc slurry pleurodesis with another techniques, such as talc poudrage, remain unclear. The primary end point of this study is to analyse the effectiveness and safety of talc slurry pleurodesis to treat the MPE. We have performed a systematic review of 7 articles released in the last ten years. The results obtained have been compared with those carried out by the “Unidad de Técnicas Broncopleurales del Hospital Álvaro Cunqueiro”.
More than half of the malignant pleural effusions (MPE) relapse a few weeks after a thoracocentesis. In these cases, pleural procedures like chemical pleurodesis or the insertion of an indwelling pleural catheter are recommended. Talc is the most effective sclerosant pleurodesis agent. Nonetheless, pleurodesis will fail if the preparation of the pleural space is inadequate and lung re-expansion is not achieved. Until recently, a controversial point was if talc slurry pleurodesis was as effective as other chemical pleurodesis modalities. Different studies have shown that talc pleurodesis involves a successful procedure for the control of MPE. Nevertheless, differences regarding success comparing talc slurry pleurodesis with another techniques, such as talc poudrage, remain unclear. The primary end point of this study is to analyse the effectiveness and safety of talc slurry pleurodesis to treat the MPE. We have performed a systematic review of 7 articles released in the last ten years. The results obtained have been compared with those carried out by the “Unidad de Técnicas Broncopleurales del Hospital Álvaro Cunqueiro”.
Direction
REPRESAS REPRESAS, CRISTINA (Tutorships)
Botana Rial, María Isabel (Co-tutorships)
REPRESAS REPRESAS, CRISTINA (Tutorships)
Botana Rial, María Isabel (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Osgood - Schlatter Disease: Literature review and creation of a clinical guide
Authorship
R.G.G.
Bachelor of Medicine
R.G.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Osgood Schlatter disease is one of the most frequent injuries due to overuse of the leg extensor apparatus in athletic children and adolescents during growth. It affects 1 in 10 adolescent athletes in the form of insidious pain in the anterior part of the knee, becoming more pronounced with the advancement of time and sporting activity and is generally a self-limiting condition. Numerous factors coexist in its pathogenesis, but it is thought to be closely related to the overuse of the extensor muscles during growth. The diagnosis is mainly clinical, and the treatment is mostly based on conservative management, along with physiotherapy and physical rehabilitation exercises. JUSTIFICATION AND OBJECTIVES: OSD is a highly prevalent disease that causes significant physical limitation and knee pain in adolescents who suffer from it, causing a significant health demand. The primary objective of this TFG is to carry out a complete and updated bibliographic review on this pathology. As a secondary objective, to make a clinical guide with standardized procedures that will help the families and teachers of young people who suffer from this pathology. MATERIALS AND METHODS: the criteria of the PRISMA 2020 methodology were used and the search strategy was formulated following the PICO structure. The search was carried out in Pubmed, and after applying the inclusion and exclusion criteria of interest, 18 articles were selected for this work. RESULTS: The main results show that the genesis of OSD is related to the overuse of the leg extensor muscles and the traction exerted by the patellar tendon and the tension of the quadriceps tendon and muscle on the anterior tibial tuberosity during growth. Regarding treatment, benefits are observed with early treatment based on conservative management, together with physiotherapy and physical rehabilitation. In subsequent lines of treatment, PRP infiltration and in chronic cases arthroscopic surgery become important. CONCLUSIONS: further research on the pathology and its treatment is necessary. The theory of muscle overuse along with other predisposing factors is one of the most accepted. Conservative management based on early physiotherapy and physical rehabilitation seems to be the first-line treatment of choice, keeping in mind PRP infiltrations in patients with maintenance of symptoms despite correct conservative management.
INTRODUCTION: Osgood Schlatter disease is one of the most frequent injuries due to overuse of the leg extensor apparatus in athletic children and adolescents during growth. It affects 1 in 10 adolescent athletes in the form of insidious pain in the anterior part of the knee, becoming more pronounced with the advancement of time and sporting activity and is generally a self-limiting condition. Numerous factors coexist in its pathogenesis, but it is thought to be closely related to the overuse of the extensor muscles during growth. The diagnosis is mainly clinical, and the treatment is mostly based on conservative management, along with physiotherapy and physical rehabilitation exercises. JUSTIFICATION AND OBJECTIVES: OSD is a highly prevalent disease that causes significant physical limitation and knee pain in adolescents who suffer from it, causing a significant health demand. The primary objective of this TFG is to carry out a complete and updated bibliographic review on this pathology. As a secondary objective, to make a clinical guide with standardized procedures that will help the families and teachers of young people who suffer from this pathology. MATERIALS AND METHODS: the criteria of the PRISMA 2020 methodology were used and the search strategy was formulated following the PICO structure. The search was carried out in Pubmed, and after applying the inclusion and exclusion criteria of interest, 18 articles were selected for this work. RESULTS: The main results show that the genesis of OSD is related to the overuse of the leg extensor muscles and the traction exerted by the patellar tendon and the tension of the quadriceps tendon and muscle on the anterior tibial tuberosity during growth. Regarding treatment, benefits are observed with early treatment based on conservative management, together with physiotherapy and physical rehabilitation. In subsequent lines of treatment, PRP infiltration and in chronic cases arthroscopic surgery become important. CONCLUSIONS: further research on the pathology and its treatment is necessary. The theory of muscle overuse along with other predisposing factors is one of the most accepted. Conservative management based on early physiotherapy and physical rehabilitation seems to be the first-line treatment of choice, keeping in mind PRP infiltrations in patients with maintenance of symptoms despite correct conservative management.
Direction
PINO MINGUEZ, JESUS (Tutorships)
Neira Boga, Miguel (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
Neira Boga, Miguel (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Current situation of liver biopsy: techniques, indications and complications. Systematic review
Authorship
R.G.R.
Bachelor of Medicine
R.G.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: liver biopsy (BH) is an invasive technique for diagnosing diseases of the liver parenchyma and space-occupying lesions. BH allows the histological and anatomopathological study of the extracted material, reaching a diagnosis when laboratory tests and imaging techniques have a limited role. In addition to offering a diagnosis, this invasive technique provides information about the prognosis, the possibility of success with different treatments, the response to these and determinesthe severity of the disease or the grade of the tumor. There are different types of approaches for performing the biopsy: the percutaneous approach, which can be performed direct or coaxial, the endoscopic approach and the transvenous or transiugular approach, each of them with their advantages and drawbacks. Like any invasive diagnostic test, BH is not free of complications, which can be divided into: minor complications, those that can be resolved with analgesia, being pain the most frequent complication, and major complications, those that require surgical intervention or the transfusion of blood products. Objectives: The main objective of this systematic review is to recognize and compare the different liver biopsy techniques, their indications, as well as the complications that exist when carrying out the procedure. The results regarding effectiveness, risk factors, advantages and disadvantages of each technique described in the academic literature will also be presented, focusing mainly on the percutaneous technique and focal liver lesions. Material and methods: PubMed was used as a search engine, in which a systematized search was carried out in three steps. Articles from the last 20 years that met the inclusion criteria and not the exclusion criteria were included. Results: In this work, a total of 14 articles were analyzed that met the inclusion criteria and did not have any exclusion criteria. The different liver biopsy techniques, the effectiveness of each one, their strengths and weaknesses were analyzed, focusing mainly on percutaneous biopsy. All the examined techniques show success rates close to 100%, with high sensibilities and specificities. The most frequent complications were minor ones, mainly pain. The existence of complications was related to predictors and bleeding risk factors, which were mainly those associated with the patient's coagulation status. The use of ultrasound has not been shown to reduce complications, however it is recommended as a guide whenever possible. Conclusions: There is no superiority between liver biopsy techniques, but there are circumstances that make us go for one of them; it is essential to approach it in an individualized and multidisciplinary manner. It has been shown that liver biopsy is useful and effective for the diagnosis of parenchymal diseases and LOEs, not without risks, minor complications are the most usual, pain is the most common. There is no clear evidence that ultrasound guidance reduces the risk of hematomas, however it is systematically advised.
Introduction: liver biopsy (BH) is an invasive technique for diagnosing diseases of the liver parenchyma and space-occupying lesions. BH allows the histological and anatomopathological study of the extracted material, reaching a diagnosis when laboratory tests and imaging techniques have a limited role. In addition to offering a diagnosis, this invasive technique provides information about the prognosis, the possibility of success with different treatments, the response to these and determinesthe severity of the disease or the grade of the tumor. There are different types of approaches for performing the biopsy: the percutaneous approach, which can be performed direct or coaxial, the endoscopic approach and the transvenous or transiugular approach, each of them with their advantages and drawbacks. Like any invasive diagnostic test, BH is not free of complications, which can be divided into: minor complications, those that can be resolved with analgesia, being pain the most frequent complication, and major complications, those that require surgical intervention or the transfusion of blood products. Objectives: The main objective of this systematic review is to recognize and compare the different liver biopsy techniques, their indications, as well as the complications that exist when carrying out the procedure. The results regarding effectiveness, risk factors, advantages and disadvantages of each technique described in the academic literature will also be presented, focusing mainly on the percutaneous technique and focal liver lesions. Material and methods: PubMed was used as a search engine, in which a systematized search was carried out in three steps. Articles from the last 20 years that met the inclusion criteria and not the exclusion criteria were included. Results: In this work, a total of 14 articles were analyzed that met the inclusion criteria and did not have any exclusion criteria. The different liver biopsy techniques, the effectiveness of each one, their strengths and weaknesses were analyzed, focusing mainly on percutaneous biopsy. All the examined techniques show success rates close to 100%, with high sensibilities and specificities. The most frequent complications were minor ones, mainly pain. The existence of complications was related to predictors and bleeding risk factors, which were mainly those associated with the patient's coagulation status. The use of ultrasound has not been shown to reduce complications, however it is recommended as a guide whenever possible. Conclusions: There is no superiority between liver biopsy techniques, but there are circumstances that make us go for one of them; it is essential to approach it in an individualized and multidisciplinary manner. It has been shown that liver biopsy is useful and effective for the diagnosis of parenchymal diseases and LOEs, not without risks, minor complications are the most usual, pain is the most common. There is no clear evidence that ultrasound guidance reduces the risk of hematomas, however it is systematically advised.
Direction
VARELA PONTE, RAFAEL (Tutorships)
Martínez Lago, Nieves Purificación (Co-tutorships)
VARELA PONTE, RAFAEL (Tutorships)
Martínez Lago, Nieves Purificación (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Bibliographic review of hyperhidrosis as a paraneoplastic syndrome
Authorship
B.G.S.
Bachelor of Medicine
B.G.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Hyperhidrosis is characterized by excessive sweating in response to heat or emotional stimuli, surpassing physiological needs to regulate body temperature. Eccrine, apocrine, and apoecrine sweat glands play various roles in sweat production, and regulation by the sympathetic nervous system is crucial in this process. It is classified as primary or secondary depending on its cause, and as focal or generalized depending on its localization. Multiple factors can trigger secondary hyperhidrosis, such as medications, infections, neoplasms, endocrine, and neurological diseases. OBJECTIVES: To determine, based on available evidence, whether hyperhidrosis as a paraneoplastic syndrome is more common in benign or malignant neoplasms, if there is any cytological type of neoplasm in which hyperhidrosis is more frequently a guiding symptom, if there is any tumor histological origin in which hyperhidrosis is a more common guiding symptom, if hyperhidrosis as a paraneoplastic syndrome is more common in its generalized or localized form, how much time passes from the onset of hyperhidrosis until the diagnosis of the neoplasm, if hyperhidrosis as a paraneoplastic syndrome is more common in males or females, at what ages hyperhidrosis as a paraneoplastic syndrome is more frequent, if hyperhidrosis as a paraneoplastic syndrome is associated with weight loss, and if hyperhidrosis as a paraneoplastic syndrome resolves with the treatment of it. MATERIALS AND METHODS: Literature review between December 2023 and January 2024 of clinical cases published from 1946 to 2024 in the PubMed database. RESULTS: The search identified 209 articles. After the selection process, 35 articles were included. CONCLUSIONS: Hyperhidrosis as a paraneoplastic syndrome is more common in benign neoplasms. Angiomatous hamartomas are the most associated with hyperhidrosis, although fibrous hamartomas are also common. Neoplasms with vascular and parenchymal origin are the main causes of hyperhidrosis, followed by tumors of the nervous, glandular, and epithelial systems. The tumor's location may correlate with the presence of hyperhidrosis, being mostly localized. Hyperhidrosis related to neoplasms tends to persist for more than a year in most cases. Mostly, hyperhidrosis as a paraneoplastic syndrome occurs in males. Most patients with hyperhidrosis as a guiding symptom of a paraneoplastic syndrome are under 25 years old. Weight loss is not usually associated with neoplasms that induce hyperhidrosis. Treating the underlying neoplasm improves hyperhidrosis in most cases, emphasizing the importance of timely diagnosis and treatment.
INTRODUCTION: Hyperhidrosis is characterized by excessive sweating in response to heat or emotional stimuli, surpassing physiological needs to regulate body temperature. Eccrine, apocrine, and apoecrine sweat glands play various roles in sweat production, and regulation by the sympathetic nervous system is crucial in this process. It is classified as primary or secondary depending on its cause, and as focal or generalized depending on its localization. Multiple factors can trigger secondary hyperhidrosis, such as medications, infections, neoplasms, endocrine, and neurological diseases. OBJECTIVES: To determine, based on available evidence, whether hyperhidrosis as a paraneoplastic syndrome is more common in benign or malignant neoplasms, if there is any cytological type of neoplasm in which hyperhidrosis is more frequently a guiding symptom, if there is any tumor histological origin in which hyperhidrosis is a more common guiding symptom, if hyperhidrosis as a paraneoplastic syndrome is more common in its generalized or localized form, how much time passes from the onset of hyperhidrosis until the diagnosis of the neoplasm, if hyperhidrosis as a paraneoplastic syndrome is more common in males or females, at what ages hyperhidrosis as a paraneoplastic syndrome is more frequent, if hyperhidrosis as a paraneoplastic syndrome is associated with weight loss, and if hyperhidrosis as a paraneoplastic syndrome resolves with the treatment of it. MATERIALS AND METHODS: Literature review between December 2023 and January 2024 of clinical cases published from 1946 to 2024 in the PubMed database. RESULTS: The search identified 209 articles. After the selection process, 35 articles were included. CONCLUSIONS: Hyperhidrosis as a paraneoplastic syndrome is more common in benign neoplasms. Angiomatous hamartomas are the most associated with hyperhidrosis, although fibrous hamartomas are also common. Neoplasms with vascular and parenchymal origin are the main causes of hyperhidrosis, followed by tumors of the nervous, glandular, and epithelial systems. The tumor's location may correlate with the presence of hyperhidrosis, being mostly localized. Hyperhidrosis related to neoplasms tends to persist for more than a year in most cases. Mostly, hyperhidrosis as a paraneoplastic syndrome occurs in males. Most patients with hyperhidrosis as a guiding symptom of a paraneoplastic syndrome are under 25 years old. Weight loss is not usually associated with neoplasms that induce hyperhidrosis. Treating the underlying neoplasm improves hyperhidrosis in most cases, emphasizing the importance of timely diagnosis and treatment.
Direction
Anibarro García, Luís (Tutorships)
Cancela Nieto, María Gumersinda (Co-tutorships)
Anibarro García, Luís (Tutorships)
Cancela Nieto, María Gumersinda (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Variation on white blood cells and clozapine plasmatic levels after Covid-19 vaccination.
Authorship
A.G.V.
Bachelor of Medicine
A.G.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Patients with Severe Mental Illness are a susceptible group to SARS-Cov2 infection not only due to their poor self-care and associated comorbidities, but also because of those psychotropic drugs that may compromise their immune response. Clozapine, a potent antipsychotic and focus of this systematic review, has a narrow therapeutic range and agranulocytosis as idiosyncratic adverse effect. Therefore, concerns appear around whether vaccination against this new coronavirus is a safe and convenient practice for these patients. Objectives: This Systematic reviewis carried out with the main objective of analyzing the safety profile of Covid-19 vaccination in psychiatric patients undergoing clozapine treatment. As secondary objectives, we aim to classify the elevation of C-reactive protein as an early marker of clozapine intoxication and to analyze whether the benefit outranks the risk in patients with higher prescribed clozapine doses. Methods: A systematic search is conducted in scientific databases: PubMed and Cochrane Library, from inception to March 15, 2024. Results: Seven studies, including one observational cohort, one cross-sectional study, and five reported cases met the inclusion criteria. The studies demonstrated positive results, all cytopenias were transient and C-reactive protein (CRP) proved to be a good indicator of the risk of clozapine intoxication. The importance of therapeutic drug monitoring is recognized. Conclusions: This systematic review concludes that Covid-19 vaccination in patients undergoing CLZ treatment is indeed a safe intervention, at least in the short term. There was no demonstrated higher incidence of agranulocytosis in these patients. However, several limitations hinder the establishment of contrasted conclusions so further studies in this matter are needed.
Introduction: Patients with Severe Mental Illness are a susceptible group to SARS-Cov2 infection not only due to their poor self-care and associated comorbidities, but also because of those psychotropic drugs that may compromise their immune response. Clozapine, a potent antipsychotic and focus of this systematic review, has a narrow therapeutic range and agranulocytosis as idiosyncratic adverse effect. Therefore, concerns appear around whether vaccination against this new coronavirus is a safe and convenient practice for these patients. Objectives: This Systematic reviewis carried out with the main objective of analyzing the safety profile of Covid-19 vaccination in psychiatric patients undergoing clozapine treatment. As secondary objectives, we aim to classify the elevation of C-reactive protein as an early marker of clozapine intoxication and to analyze whether the benefit outranks the risk in patients with higher prescribed clozapine doses. Methods: A systematic search is conducted in scientific databases: PubMed and Cochrane Library, from inception to March 15, 2024. Results: Seven studies, including one observational cohort, one cross-sectional study, and five reported cases met the inclusion criteria. The studies demonstrated positive results, all cytopenias were transient and C-reactive protein (CRP) proved to be a good indicator of the risk of clozapine intoxication. The importance of therapeutic drug monitoring is recognized. Conclusions: This systematic review concludes that Covid-19 vaccination in patients undergoing CLZ treatment is indeed a safe intervention, at least in the short term. There was no demonstrated higher incidence of agranulocytosis in these patients. However, several limitations hinder the establishment of contrasted conclusions so further studies in this matter are needed.
Direction
ARROJO ROMERO, MANUEL (Tutorships)
MAROÑAS AMIGO, OLALLA (Co-tutorships)
Fernández Monterroso, Álvaro (Co-tutorships)
ARROJO ROMERO, MANUEL (Tutorships)
MAROÑAS AMIGO, OLALLA (Co-tutorships)
Fernández Monterroso, Álvaro (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Narrative review on the effects of the ketogenic diet on athletic performance
Authorship
C.G.N.
Bachelor of Medicine
C.G.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The ketogenic diet (KD) is a normocaloric diet composed of high-fat, low-carbohydrate, and adequate protein that induces fasting-like effects and results in the production of ketone bodies. Objectives: The objective of this TFG is to conduct a systematic review of the most recent scientific literature to evaluate the impact of the ketogenic diet on athletic performance according to current scientific evidence. Materials and Methods: Narrative review of the scientific literature available in PubMed. Results: Of those found articles, 13 were selected, including metaanalysis, sistematic reviews and clinical trials, which analyzed changes in body composition, performance in endurance and strength exercises, and biochemical and molecular changes. Conclusions: This diet has the potential to increase endurance, recovery capacity, and improve athletes' body composition. However, the effects vary depending on the type of exercise, individual adaptation, and the duration of the diet. Further research is needed to fully understand the underlying mechanisms and optimize its application in different sports disciplines, as well as to individualize a
Introduction: The ketogenic diet (KD) is a normocaloric diet composed of high-fat, low-carbohydrate, and adequate protein that induces fasting-like effects and results in the production of ketone bodies. Objectives: The objective of this TFG is to conduct a systematic review of the most recent scientific literature to evaluate the impact of the ketogenic diet on athletic performance according to current scientific evidence. Materials and Methods: Narrative review of the scientific literature available in PubMed. Results: Of those found articles, 13 were selected, including metaanalysis, sistematic reviews and clinical trials, which analyzed changes in body composition, performance in endurance and strength exercises, and biochemical and molecular changes. Conclusions: This diet has the potential to increase endurance, recovery capacity, and improve athletes' body composition. However, the effects vary depending on the type of exercise, individual adaptation, and the duration of the diet. Further research is needed to fully understand the underlying mechanisms and optimize its application in different sports disciplines, as well as to individualize a
Direction
ARAUJO VILAR, DAVID (Tutorships)
Vidal Casariego, Alfonso José (Co-tutorships)
ARAUJO VILAR, DAVID (Tutorships)
Vidal Casariego, Alfonso José (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Impact of comorbidity in major non-cardiac surgery
Authorship
F.G.N.
Bachelor of Medicine
F.G.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Surgery has quantifiable risks with an indisputable impact on the prognosis of patients. Events occurring during surgery and the postoperative period are difficult to predict, unlike comorbidity, which is a more constant factor. To this end, different risk scales have been designed, such as the Charlson index, the SRS and the ASA-PS. Our aim is to assess the usefulness of the first two in particular, as well as to identify parameters included in them that are of little value. Material and methods: After signing the informed consent, demographic data, surgery data, personal history, mortality, hospital stay, ICU stay and data necessary for the calculation of the above-mentioned indices were collected from 50 patients undergoing abdominal surgery. We excluded patients with a very high risk of decease irrespective of the surgical procedure, patients younger than 18 or older than 85 years and patients whose surgical procedure could not be completed. Results and discussion: The median age of the patients was 63 years. There was a higher percentage of women than men in the sample. The median operative time was 269 minutes. Seventy- eight percent were oncological patients and 70% had metastases at the time of surgery. The ICC showed a median value of 8.00, while the SRS was 10. Mortality was 0% at 90 days, 2% at 6 months and 16% at 1 year follow-up. Patients with a longer ICU stay than 10 days had a longer ICU stay and patients with a longer hospital stay had a higher SRS score value. Patients with an ICU stay longer than 1 day had a higher BMI and hospital stay, as well as higher values for all comorbidity indices (Charlson) and risk of surgical intervention (SRS). The small sample size meant that many of the data analysed did not reach statistical significance. Conclusions: In our sample, the SRS was shown to be superior to the Charlson index in predicting hospital and ICU stay. We propose the elimination of oncohaematological pathology and AIDS as parameters when classifying comorbidities in surgical patients, due to the infrequency of surgery in patients in the former group and the excellent pharmacological control that can be achieved today in the latter, and therefore of little use.
Introduction: Surgery has quantifiable risks with an indisputable impact on the prognosis of patients. Events occurring during surgery and the postoperative period are difficult to predict, unlike comorbidity, which is a more constant factor. To this end, different risk scales have been designed, such as the Charlson index, the SRS and the ASA-PS. Our aim is to assess the usefulness of the first two in particular, as well as to identify parameters included in them that are of little value. Material and methods: After signing the informed consent, demographic data, surgery data, personal history, mortality, hospital stay, ICU stay and data necessary for the calculation of the above-mentioned indices were collected from 50 patients undergoing abdominal surgery. We excluded patients with a very high risk of decease irrespective of the surgical procedure, patients younger than 18 or older than 85 years and patients whose surgical procedure could not be completed. Results and discussion: The median age of the patients was 63 years. There was a higher percentage of women than men in the sample. The median operative time was 269 minutes. Seventy- eight percent were oncological patients and 70% had metastases at the time of surgery. The ICC showed a median value of 8.00, while the SRS was 10. Mortality was 0% at 90 days, 2% at 6 months and 16% at 1 year follow-up. Patients with a longer ICU stay than 10 days had a longer ICU stay and patients with a longer hospital stay had a higher SRS score value. Patients with an ICU stay longer than 1 day had a higher BMI and hospital stay, as well as higher values for all comorbidity indices (Charlson) and risk of surgical intervention (SRS). The small sample size meant that many of the data analysed did not reach statistical significance. Conclusions: In our sample, the SRS was shown to be superior to the Charlson index in predicting hospital and ICU stay. We propose the elimination of oncohaematological pathology and AIDS as parameters when classifying comorbidities in surgical patients, due to the infrequency of surgery in patients in the former group and the excellent pharmacological control that can be achieved today in the latter, and therefore of little use.
Direction
Álvarez Escudero, Julián (Tutorships)
dos Santos Carregal, Laura (Co-tutorships)
González Nogueiras, Mariana (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
dos Santos Carregal, Laura (Co-tutorships)
González Nogueiras, Mariana (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Role of Artificial Intelligence in Assisted Reproductive Technologies
Authorship
P.M.R.
Bachelor of Medicine
P.M.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Infertility is a serious public health problem that has a significant impact on couples and society. That is why, during the last decades, the field of assisted reproduction techniques has rapidly flourished to try to address this issue. Manual evaluation and selection procedures of embryos are carried out in in vitro fertilization (IVF) laboratories, with the aim of selecting those of higher quality. However, this traditional method of visual morphological evaluation is subject to variability among observers, resulting in lower success rates than desired. Currently, promising techniques based on artificial intelligence are emerging, which possess mathematical tools that aim to be more objective, faster, and more accurate to improve the results of IVF, as well as reduce the workload of laboratory personnel. Objective and method: The main objective of this review is to understand the new techniques based on artificial intelligence and analyze their utility in the field of assisted reproduction, through a review of the literature published to the current date. Results: We performed an analysis of 13 studies that met the established inclusion criteria. All the studies demonstrated the potential of Artificial Intelligence (AI) in the field of assisted reproduction, highlighting its usefulness in embryo selection. AI proved to be more accurate and reliable than trained embryologists, with the added benefit of reducing and even eliminating inter-observer variability, which is a significant limitation in traditional morphological assessment. Additionally, its effectiveness was highlighted in the morphological analysis of spermatozoa and oocytes, as well as in the prediction of implantation and the final success of pregnancy. Conclusion: AI is proposed as a promising tool in the field of assisted reproduction, improving the precision and efficiency of procedures in the In Vitro Fertilization (IVF) laboratory, while reducing the workload of staff. Additionally, AI could support clinical decision-making, benefiting patients and professionals, and contributing to an improvement in healthcare quality. However, further research is needed to determine the feasibility of its implementation in real clinical practice.
Introduction: Infertility is a serious public health problem that has a significant impact on couples and society. That is why, during the last decades, the field of assisted reproduction techniques has rapidly flourished to try to address this issue. Manual evaluation and selection procedures of embryos are carried out in in vitro fertilization (IVF) laboratories, with the aim of selecting those of higher quality. However, this traditional method of visual morphological evaluation is subject to variability among observers, resulting in lower success rates than desired. Currently, promising techniques based on artificial intelligence are emerging, which possess mathematical tools that aim to be more objective, faster, and more accurate to improve the results of IVF, as well as reduce the workload of laboratory personnel. Objective and method: The main objective of this review is to understand the new techniques based on artificial intelligence and analyze their utility in the field of assisted reproduction, through a review of the literature published to the current date. Results: We performed an analysis of 13 studies that met the established inclusion criteria. All the studies demonstrated the potential of Artificial Intelligence (AI) in the field of assisted reproduction, highlighting its usefulness in embryo selection. AI proved to be more accurate and reliable than trained embryologists, with the added benefit of reducing and even eliminating inter-observer variability, which is a significant limitation in traditional morphological assessment. Additionally, its effectiveness was highlighted in the morphological analysis of spermatozoa and oocytes, as well as in the prediction of implantation and the final success of pregnancy. Conclusion: AI is proposed as a promising tool in the field of assisted reproduction, improving the precision and efficiency of procedures in the In Vitro Fertilization (IVF) laboratory, while reducing the workload of staff. Additionally, AI could support clinical decision-making, benefiting patients and professionals, and contributing to an improvement in healthcare quality. However, further research is needed to determine the feasibility of its implementation in real clinical practice.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Beira Salvador , Pedro Manuel (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Beira Salvador , Pedro Manuel (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Anaphylaxis secondary to viper vite, review of the literature regarding a case
Authorship
C.M.M.
Bachelor of Medicine
C.M.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
We present the case of a 56-year-old woman who was bitten by a snake while walking on Doniños beach (Ferrol, A Coruña), presenting severe anaphylaxis that required admission to the ICU and orotracheal intubation. The Seoane viper (Vipera seoanei) is a species endemic to Spain whose location is distributed along the entire Cantabrian coast, the north of Portugal and bordering areas of both territories. It is a small reptile, with a flattened snout, triangular head and oval pupils. The venom of this species is composed of a series of proteolytic enzymes that are responsible for the symptoms. Most bites produce only a local reaction (pain, edema, macules and vesicles), exceptionally, the venom of the seonae viper can cause anaphylaxis and shock.
We present the case of a 56-year-old woman who was bitten by a snake while walking on Doniños beach (Ferrol, A Coruña), presenting severe anaphylaxis that required admission to the ICU and orotracheal intubation. The Seoane viper (Vipera seoanei) is a species endemic to Spain whose location is distributed along the entire Cantabrian coast, the north of Portugal and bordering areas of both territories. It is a small reptile, with a flattened snout, triangular head and oval pupils. The venom of this species is composed of a series of proteolytic enzymes that are responsible for the symptoms. Most bites produce only a local reaction (pain, edema, macules and vesicles), exceptionally, the venom of the seonae viper can cause anaphylaxis and shock.
Direction
VIDAL PAN, Mª DEL CARMEN (Tutorships)
García Paz, Vanesa (Co-tutorships)
VIDAL PAN, Mª DEL CARMEN (Tutorships)
García Paz, Vanesa (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Obstetric outcomes after transcervical radiofrequency ablation of uterine fibroids
Authorship
M.D.C.M.R.
Bachelor of Medicine
M.D.C.M.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: uterine fibroids are benign tumors found in approximately 70% of women. While most are asymptomatic, around 25% of affected women experience symptoms such as uterine bleeding, which is the most common, as well as pressure and/or pelvic pain. Some women face reproductive issues due to the location of fibroids in the uterus, particularly submucosal or intramural fibroids. Radiofrequency ablation (RFA) is a minimally invasive technique used to treat symptomatic uterine fibroids through an electrode guided by an ultrasound probe. The electromagnetic waves induce necrosis of the fibroid tissue, sparing the surrounding healthy uterine tissue from damage. This technique presents lower risk and a much faster recovery compared to conventional methods, such as hysterectomy for patients not wishing to preserve fertility, or myomectomy, the current technique of choice for fertility preservation. Objective: to evaluate obstetric outcomes following the procedure in women of reproductive age. Methods and Study Design: a systematic search was conducted in databases such as Medline (PubMed), Google Scholar, and Cochrane Library using keywords Uterine fibroids, pregnancy, radiofrequency. The results of 10 studies were finally reviewed. Results: out of a total of 563 patients, 61 pregnancies occurred post-procedure. There were 26 cesarean sections, 15 vaginal deliveries, 11 spontaneous abortions, 3 therapeutic abortions, and 1 ectopic pregnancy. Reported obstetric complications included one case of partially accreta placenta and one postpartum hemorrhage. Discussion and Conclusion: transvaginal radiofrequency ablation is a treatment option for women wishing to preserve their fertility. The reviewed studies provide positive data regarding the efficacy and safety of the technique, although more evidence is needed to confirm these findings.
Introduction: uterine fibroids are benign tumors found in approximately 70% of women. While most are asymptomatic, around 25% of affected women experience symptoms such as uterine bleeding, which is the most common, as well as pressure and/or pelvic pain. Some women face reproductive issues due to the location of fibroids in the uterus, particularly submucosal or intramural fibroids. Radiofrequency ablation (RFA) is a minimally invasive technique used to treat symptomatic uterine fibroids through an electrode guided by an ultrasound probe. The electromagnetic waves induce necrosis of the fibroid tissue, sparing the surrounding healthy uterine tissue from damage. This technique presents lower risk and a much faster recovery compared to conventional methods, such as hysterectomy for patients not wishing to preserve fertility, or myomectomy, the current technique of choice for fertility preservation. Objective: to evaluate obstetric outcomes following the procedure in women of reproductive age. Methods and Study Design: a systematic search was conducted in databases such as Medline (PubMed), Google Scholar, and Cochrane Library using keywords Uterine fibroids, pregnancy, radiofrequency. The results of 10 studies were finally reviewed. Results: out of a total of 563 patients, 61 pregnancies occurred post-procedure. There were 26 cesarean sections, 15 vaginal deliveries, 11 spontaneous abortions, 3 therapeutic abortions, and 1 ectopic pregnancy. Reported obstetric complications included one case of partially accreta placenta and one postpartum hemorrhage. Discussion and Conclusion: transvaginal radiofrequency ablation is a treatment option for women wishing to preserve their fertility. The reviewed studies provide positive data regarding the efficacy and safety of the technique, although more evidence is needed to confirm these findings.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Turrado Sánchez, Elena María (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Turrado Sánchez, Elena María (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Neurosurgical treatment for trigeminal neuralgia
Authorship
M.M.M.
Bachelor of Medicine
M.M.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: trigeminal neuralgia (TN) is a neuropathic disorder characterized by brief recurrent episodes of pain that affect the territory of the V cranial nerve. This systematic review exposes the different neurosurgical approaches to this pathology, which will have to be resorted to when pharmacological treatment is not enough to control the pain. Methods: the present systematic review has been structured in according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Three main databases have been used for the bibliographic search of this work; namely, Pubmed/Medline, Web of Science and Cochrane. Results: a total of 10 studies were analyzed. Different techniques were compared: vascular microdecompression (MVD), gamma-knife radiosurgery (GKR), radiofrequency thermocoagulation (RFTC), percutaneous balloon compression (PBC) and glycerol rhizotomy. MVD constitutes the procedure with the highest rates of pain remission in the different studies, obtaining results of 92.3%, 86.76% and 96.97%. PBC has a similar efficacy; however, they had a higher rate of pain recurrence than those patients who had undergone MVD (OR = 3.50, 95% CI: 2.25-5.44; P less than 0.00001), in addition to experience more adverse reactions. There are currently no high-quality controlled trials to evaluate the independent efficacy of MVD and RFTC. GKR should be reserved as secondary treatment for recurrent cases. Injections of glycerol may be useful in patients with multiple sclerosis. Conclusions: the heterogeneity of the techniques and the variability of the quality of the studies make it necessary to continue the research in this field, being essencial the individualized and multidisciplinary evaluation when deciding the treatment that suits best each patient.
Background: trigeminal neuralgia (TN) is a neuropathic disorder characterized by brief recurrent episodes of pain that affect the territory of the V cranial nerve. This systematic review exposes the different neurosurgical approaches to this pathology, which will have to be resorted to when pharmacological treatment is not enough to control the pain. Methods: the present systematic review has been structured in according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Three main databases have been used for the bibliographic search of this work; namely, Pubmed/Medline, Web of Science and Cochrane. Results: a total of 10 studies were analyzed. Different techniques were compared: vascular microdecompression (MVD), gamma-knife radiosurgery (GKR), radiofrequency thermocoagulation (RFTC), percutaneous balloon compression (PBC) and glycerol rhizotomy. MVD constitutes the procedure with the highest rates of pain remission in the different studies, obtaining results of 92.3%, 86.76% and 96.97%. PBC has a similar efficacy; however, they had a higher rate of pain recurrence than those patients who had undergone MVD (OR = 3.50, 95% CI: 2.25-5.44; P less than 0.00001), in addition to experience more adverse reactions. There are currently no high-quality controlled trials to evaluate the independent efficacy of MVD and RFTC. GKR should be reserved as secondary treatment for recurrent cases. Injections of glycerol may be useful in patients with multiple sclerosis. Conclusions: the heterogeneity of the techniques and the variability of the quality of the studies make it necessary to continue the research in this field, being essencial the individualized and multidisciplinary evaluation when deciding the treatment that suits best each patient.
Direction
MARTINEZ ROLAN, ROSA MARIA (Tutorships)
MARTINEZ ROLAN, ROSA MARIA (Tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
The influence of corticosteroid use in the late preterm infants
Authorship
A.P.N.M.
Bachelor of Medicine
A.P.N.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction Prenatal corticosteroids are the standard of care for preterm births before 34 weeks of gestation based on consistent evidence that the use of corticosteroids in the prenatal period in pregnant women at risk of premature birth reduces neonatal morbidity and mortality. The use of corticosteroids beyond 34 weeks, and therefore, in the late preterm period, is more controversial due to potential short- and long-term (neurological) adverse effects on neonates. Objectives To review the existing evidence to date on the influence on mortality and respiratory comorbidity in late preterm infants exposed to prenatal corticosteroids, as well as their long-term effects on neurological development, such as neurological, behavioral alterations, and other types of psychiatric comorbidities. Methodology Systematic review of available scientific literature on the effects or prenatal corticosteroid therapy in late preterm infants, conducted through the PUBMED bibliographic search and following PRISMA guidelines. The inclusion criteria used were studies available in English, Spanish and Portuguese, publication dates between january 2005- april 2024 (a broad range, as long-term studies were analyzed), randomized controlled clinical trials, retrospective cohort studies, studies conducted in humans, studies applied to live neonates with late preterm birth, between 34/0-36-6 weeks of gestation. Results Data from a total of 8 articles were analyzed. The results, regarding both objectives of the review, varied across different studies. Some results suggest a reduction in death and respiratory comorbidities with prenatal corticosteroid therapy in late preterm infants. The same was observed regarding the influence on long-term neurological disabilities. Conclusions The studies analyzed have contradictory results regarding the effect of prenatal corticosteroid therapy in late preterm infants. Further long-term studies are needed to assess the influence of this therapy within this range of prematurity.
Introduction Prenatal corticosteroids are the standard of care for preterm births before 34 weeks of gestation based on consistent evidence that the use of corticosteroids in the prenatal period in pregnant women at risk of premature birth reduces neonatal morbidity and mortality. The use of corticosteroids beyond 34 weeks, and therefore, in the late preterm period, is more controversial due to potential short- and long-term (neurological) adverse effects on neonates. Objectives To review the existing evidence to date on the influence on mortality and respiratory comorbidity in late preterm infants exposed to prenatal corticosteroids, as well as their long-term effects on neurological development, such as neurological, behavioral alterations, and other types of psychiatric comorbidities. Methodology Systematic review of available scientific literature on the effects or prenatal corticosteroid therapy in late preterm infants, conducted through the PUBMED bibliographic search and following PRISMA guidelines. The inclusion criteria used were studies available in English, Spanish and Portuguese, publication dates between january 2005- april 2024 (a broad range, as long-term studies were analyzed), randomized controlled clinical trials, retrospective cohort studies, studies conducted in humans, studies applied to live neonates with late preterm birth, between 34/0-36-6 weeks of gestation. Results Data from a total of 8 articles were analyzed. The results, regarding both objectives of the review, varied across different studies. Some results suggest a reduction in death and respiratory comorbidities with prenatal corticosteroid therapy in late preterm infants. The same was observed regarding the influence on long-term neurological disabilities. Conclusions The studies analyzed have contradictory results regarding the effect of prenatal corticosteroid therapy in late preterm infants. Further long-term studies are needed to assess the influence of this therapy within this range of prematurity.
Direction
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Durán Fernández-Feijóo, Cristina (Co-tutorships)
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Durán Fernández-Feijóo, Cristina (Co-tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
The effectiveness of nonpharmacological interventions to reduce chronic pelvic pain in women with endometriosis
Authorship
M.P.N.V.
Bachelor of Medicine
M.P.N.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Endometriosis is a complex and common pathology that manifests through chronic pelvic pain and infertility. The condition is defined by the presence of ectopic endometrial tissue, causing a chronic inflammatory response. It predominantly affects women of reproductive age and is characterized by significant variability in clinical manifestations, significantly impacting the quality of life of patients. Objectives: The primary objective of this study is to review the effectiveness of nonpharmacological interventions in managing chronic pelvic pain associated with endometriosis. Additionally, it seeks to explore how these interventions can influence the improvement of the quality of life of affected patients. Methods: A literature review was conducted in PubMed following PRISMA guidelines to identify relevant studies published in the last 10 years. Selected studies were those that investigated the efficacy of non-pharmacological interventions in women diagnosed with endometriosis, excluding studies not focused on the treatment of chronic pelvic pain. Results: Out of a total of 2016 identified studies, 31 passed the inclusion and exclusion criteria. After a detailed evaluation, 13 studies were included in the final review. These studies demonstrated that non-pharmacological interventions can significantly reduce chronic pelvic pain and improve the quality of life of patients, although results varied depending on the type of intervention and the severity of the disease in the studied patients. Conclusion: Non-pharmacological interventions represent a promising and complementary alternative to medical treatments for managing pelvic pain associated with endometriosis. These methods, ranging from physical therapies to psychological techniques, offer significant benefits in pain relief and quality of life improvement, emphasizing the importance of an individualized and multidisciplinary approach in treating this complex condition.
Introduction: Endometriosis is a complex and common pathology that manifests through chronic pelvic pain and infertility. The condition is defined by the presence of ectopic endometrial tissue, causing a chronic inflammatory response. It predominantly affects women of reproductive age and is characterized by significant variability in clinical manifestations, significantly impacting the quality of life of patients. Objectives: The primary objective of this study is to review the effectiveness of nonpharmacological interventions in managing chronic pelvic pain associated with endometriosis. Additionally, it seeks to explore how these interventions can influence the improvement of the quality of life of affected patients. Methods: A literature review was conducted in PubMed following PRISMA guidelines to identify relevant studies published in the last 10 years. Selected studies were those that investigated the efficacy of non-pharmacological interventions in women diagnosed with endometriosis, excluding studies not focused on the treatment of chronic pelvic pain. Results: Out of a total of 2016 identified studies, 31 passed the inclusion and exclusion criteria. After a detailed evaluation, 13 studies were included in the final review. These studies demonstrated that non-pharmacological interventions can significantly reduce chronic pelvic pain and improve the quality of life of patients, although results varied depending on the type of intervention and the severity of the disease in the studied patients. Conclusion: Non-pharmacological interventions represent a promising and complementary alternative to medical treatments for managing pelvic pain associated with endometriosis. These methods, ranging from physical therapies to psychological techniques, offer significant benefits in pain relief and quality of life improvement, emphasizing the importance of an individualized and multidisciplinary approach in treating this complex condition.
Direction
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Vieitez Villaverde, María Dolores (Co-tutorships)
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Vieitez Villaverde, María Dolores (Co-tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
Femoral agenesis and its treatment: a case report.
Authorship
M.L.D.L.O.S.
Bachelor of Medicine
M.L.D.L.O.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Femoral agenesis is an extraordinarily complex congenital condition involving the total or partial absence of the femoral bone, one of the fundamental components of the lower extremity. This malformation, which originates in the early stages of fetal development, leads to considerable variability in clinical presentation. It can manifest as a complete absence of the femoral bone or as a severe deformity and underdevelopment of this essential anatomical structure. In the context of this study, we highlight a specific clinical case of a patient from the University Hospital of Santiago de Compostela, who was diagnosed with femoral agenesis prenatally. Throughout her life, the patient has undergone multiple surgical interventions designed to address the complexities associated with femoral agenesis. These interventions have sought not only to correct the anatomic abnormalities, but also to improve the functionality of the affected limb. In the discussion of this study, the correlation between each surgical procedure and the associated risks has been thoroughly explored. It has been examined in detail how each step, from osteotomy to the application of various types of external fixators, can carry a range of potential complications, ranging from bone consolidation problems to neurologic, vascular, and implant deformity complications. This analysis of the relationships between procedures and potential complications has proven essential to understanding the patient's treatment trajectory and to making informed decisions about the most appropriate management strategies at each stage of the process. The fundamental objective of the paper is to provide a comprehensive view of femoral agenesis through a specific clinical case, evidencing the importance of prenatal diagnosis and surgical management strategies and possible complications
Femoral agenesis is an extraordinarily complex congenital condition involving the total or partial absence of the femoral bone, one of the fundamental components of the lower extremity. This malformation, which originates in the early stages of fetal development, leads to considerable variability in clinical presentation. It can manifest as a complete absence of the femoral bone or as a severe deformity and underdevelopment of this essential anatomical structure. In the context of this study, we highlight a specific clinical case of a patient from the University Hospital of Santiago de Compostela, who was diagnosed with femoral agenesis prenatally. Throughout her life, the patient has undergone multiple surgical interventions designed to address the complexities associated with femoral agenesis. These interventions have sought not only to correct the anatomic abnormalities, but also to improve the functionality of the affected limb. In the discussion of this study, the correlation between each surgical procedure and the associated risks has been thoroughly explored. It has been examined in detail how each step, from osteotomy to the application of various types of external fixators, can carry a range of potential complications, ranging from bone consolidation problems to neurologic, vascular, and implant deformity complications. This analysis of the relationships between procedures and potential complications has proven essential to understanding the patient's treatment trajectory and to making informed decisions about the most appropriate management strategies at each stage of the process. The fundamental objective of the paper is to provide a comprehensive view of femoral agenesis through a specific clinical case, evidencing the importance of prenatal diagnosis and surgical management strategies and possible complications
Direction
PINO MINGUEZ, JESUS (Tutorships)
Noya Álvarez, Felipe (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
Noya Álvarez, Felipe (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Efficacy of minimally invasive minor salivary gland biopsy in Sjögren’s Syndrome. Experience in a Systemic Diseases Unit and Systematic Literature Review.
Authorship
S.N.R.
Bachelor of Medicine
S.N.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION Salivary gland biopsy (SGB) is important in the diagnosis of certain systemic diseases, particularly Sjögren's syndrome (SS). The minimally invasive technique is notable for its speed and simplicity, although currently, few groups have reported their experience, so its diagnostic yield and related complications are not fully established. OBJECTIVES To conduct a systematic review of the literature on the accumulated experience with various types of minimally invasive techniques in SGB, their complications, and their diagnostic yield. PATIENTS AND METHODS Systematic search with the PICO question: Is minor salivary gland biopsy performed using a minimally invasive technique a cost-effective, sensitive, and safe technique? in three databases, selecting case series. The methodological quality of the studies was assessed according to the Oxford Centre for Evidence-Based Medicine 2009 system. Additionally, five of our own patients were selected as illustrative examples of the usefulness of this technique. All signed a specific consent form. RESULTS Twenty studies were selected, most with a recommendation grade B, including 2801 patients. The diagnostic sensitivity of the technique varied according to the evaluated disease, from 7.7% in neurosarcoidosis, 54.2% in non-Hodgkin lymphoma in SS, 55%-61.1% in amyloidosis, 72% in SS, and 100% in neuroamyloidosis. Regarding the obtaining of adequate or representative samples, most reported high success rates (89%-100%), higher than the 78.6% reported by surgical technique in the only included comparative study. Complications were few and mild, with the most frequent being immediate (minor bleeding 1.69-7.5%; vagal response 1.39- 4.24%; hematomas 2.7-4%; pain 1%, need to extend the incision 2.54-2.78%), followed by intermediate (pain 1.61-7.32%, inflammation 3.66-8.92%, numbness 1.79-3.06%, granuloma 0.5-1.22%, suture failure 7.14%, keloid 1.79%) and lastly, late complications, which were very rare (numbness 0.1%). Groups that did not use sutures to close the wound reported fewer complications. CONCLUSIONS This study confirms the safety and effectiveness of SGB performed using a minimally invasive technique in the diagnosis of certain systemic diseases.
INTRODUCTION Salivary gland biopsy (SGB) is important in the diagnosis of certain systemic diseases, particularly Sjögren's syndrome (SS). The minimally invasive technique is notable for its speed and simplicity, although currently, few groups have reported their experience, so its diagnostic yield and related complications are not fully established. OBJECTIVES To conduct a systematic review of the literature on the accumulated experience with various types of minimally invasive techniques in SGB, their complications, and their diagnostic yield. PATIENTS AND METHODS Systematic search with the PICO question: Is minor salivary gland biopsy performed using a minimally invasive technique a cost-effective, sensitive, and safe technique? in three databases, selecting case series. The methodological quality of the studies was assessed according to the Oxford Centre for Evidence-Based Medicine 2009 system. Additionally, five of our own patients were selected as illustrative examples of the usefulness of this technique. All signed a specific consent form. RESULTS Twenty studies were selected, most with a recommendation grade B, including 2801 patients. The diagnostic sensitivity of the technique varied according to the evaluated disease, from 7.7% in neurosarcoidosis, 54.2% in non-Hodgkin lymphoma in SS, 55%-61.1% in amyloidosis, 72% in SS, and 100% in neuroamyloidosis. Regarding the obtaining of adequate or representative samples, most reported high success rates (89%-100%), higher than the 78.6% reported by surgical technique in the only included comparative study. Complications were few and mild, with the most frequent being immediate (minor bleeding 1.69-7.5%; vagal response 1.39- 4.24%; hematomas 2.7-4%; pain 1%, need to extend the incision 2.54-2.78%), followed by intermediate (pain 1.61-7.32%, inflammation 3.66-8.92%, numbness 1.79-3.06%, granuloma 0.5-1.22%, suture failure 7.14%, keloid 1.79%) and lastly, late complications, which were very rare (numbness 0.1%). Groups that did not use sutures to close the wound reported fewer complications. CONCLUSIONS This study confirms the safety and effectiveness of SGB performed using a minimally invasive technique in the diagnosis of certain systemic diseases.
Direction
SOPEÑA PEREZ-ARGÜELLES, BERNARDO (Tutorships)
SOPEÑA PEREZ-ARGÜELLES, BERNARDO (Tutorships)
Therapeutic use of esketamine in patients with Major Depression: A systematic review.
Authorship
I.S.C.
Bachelor of Medicine
I.S.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Major Depression is a pathology with a prevalence in Spain of around 5.4% and with a great social impact due to its effects on the people who suffer from it.. One third of patients with depression are resistant to treatment, so they often have to resort to second-line treatments. S-ketamine is a racemic variant of ketamine that the FDA approved in 2019 for the treatment of TRD. This S-ketamine is administered intranasally and is marketed under the trade name Spravato. In order to evaluate the efficacy, safety and benefits of esketamine treatment, this literature review is carried out following PRISMA guidelines. For this purpose, a systematic search was carried out in PubMed and Google Scholar. Ten articles published since 2019 were analyzed, obtaining as results an apparent short-term efficacy achieving a decrease in depressive symptoms, even reaching a statistically significant complete remission of depressive symptoms among the included patients, but these benefits could not be demonstrated in the long term. Most of the side effects observed were self-limited. Therefore, esketamine seems to be a drug that may have an important role in the future treatment of depression, but there are a number of limitations: the lack of studies with a large sample size and that include patients with psychiatric comorbidity, the lack of comparative studies with techniques such as ECT or its use in monotherapy, and its high cost, make it necessary to continue investigating alternatives for the treatment of resistant depression.
Major Depression is a pathology with a prevalence in Spain of around 5.4% and with a great social impact due to its effects on the people who suffer from it.. One third of patients with depression are resistant to treatment, so they often have to resort to second-line treatments. S-ketamine is a racemic variant of ketamine that the FDA approved in 2019 for the treatment of TRD. This S-ketamine is administered intranasally and is marketed under the trade name Spravato. In order to evaluate the efficacy, safety and benefits of esketamine treatment, this literature review is carried out following PRISMA guidelines. For this purpose, a systematic search was carried out in PubMed and Google Scholar. Ten articles published since 2019 were analyzed, obtaining as results an apparent short-term efficacy achieving a decrease in depressive symptoms, even reaching a statistically significant complete remission of depressive symptoms among the included patients, but these benefits could not be demonstrated in the long term. Most of the side effects observed were self-limited. Therefore, esketamine seems to be a drug that may have an important role in the future treatment of depression, but there are a number of limitations: the lack of studies with a large sample size and that include patients with psychiatric comorbidity, the lack of comparative studies with techniques such as ECT or its use in monotherapy, and its high cost, make it necessary to continue investigating alternatives for the treatment of resistant depression.
Direction
ARROJO ROMERO, MANUEL (Tutorships)
Núñez Sande, Carmen (Co-tutorships)
ARROJO ROMERO, MANUEL (Tutorships)
Núñez Sande, Carmen (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Robotic nipple-sparing mastectomy: comparison between the different available techniques. A systematic review.
Authorship
P.M.S.B.
Bachelor of Medicine
P.M.S.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The increase in survival in breast cancer due to medical advances in its treatment has led to a change in the approaches of surgical resection techniques, promoting interest in using increasingly less invasive approaches that preserve the body integrity, as is the case of robotic nipple-sparing mastectomy (R-NSM). However, this technique has not yet received approval for use in the treatment of breast cancer. Objectives: To compare R-NSM with the endoscopic and conventional techniques in the treatment of breast cancer by reviewing the scientific literature published on the matter. Material and methods: An exhaustive bibliographic search was conducted in different databases (MEDLINE-Pubmed, Web of Science, Embase, Tripdatabase, Scopus and Cochrane Library) and in gray literature. The quality level of the selected studies was analyzed using the Qualsyst tool (range 0.00 - 1.00). Results: Nine articles were selected for analysis. The following parameters were compared: surgical times, learning curve, costs, complications, oncological results, length of hospital stay, postoperative pain, aesthetic results and general satisfaction. The R-NSM manages to achieve better aesthetic results and greater patient satisfaction in exchange for longer operation time and higher costs. However, there are no significant differences between complications rate, short and medium term oncological results and postoperative pain that influence the preference of one approach over another. Conclusions: R-NSM is a safe and non-inferior technique to conventional and endoscopic approaches in the treatment of breast cancer. Given the novelty of the technique, more research is required to consolidate its position as the gold standard in the treatment of breast cancer, especially regarding long-term oncological safety.
Introduction: The increase in survival in breast cancer due to medical advances in its treatment has led to a change in the approaches of surgical resection techniques, promoting interest in using increasingly less invasive approaches that preserve the body integrity, as is the case of robotic nipple-sparing mastectomy (R-NSM). However, this technique has not yet received approval for use in the treatment of breast cancer. Objectives: To compare R-NSM with the endoscopic and conventional techniques in the treatment of breast cancer by reviewing the scientific literature published on the matter. Material and methods: An exhaustive bibliographic search was conducted in different databases (MEDLINE-Pubmed, Web of Science, Embase, Tripdatabase, Scopus and Cochrane Library) and in gray literature. The quality level of the selected studies was analyzed using the Qualsyst tool (range 0.00 - 1.00). Results: Nine articles were selected for analysis. The following parameters were compared: surgical times, learning curve, costs, complications, oncological results, length of hospital stay, postoperative pain, aesthetic results and general satisfaction. The R-NSM manages to achieve better aesthetic results and greater patient satisfaction in exchange for longer operation time and higher costs. However, there are no significant differences between complications rate, short and medium term oncological results and postoperative pain that influence the preference of one approach over another. Conclusions: R-NSM is a safe and non-inferior technique to conventional and endoscopic approaches in the treatment of breast cancer. Given the novelty of the technique, more research is required to consolidate its position as the gold standard in the treatment of breast cancer, especially regarding long-term oncological safety.
Direction
GARCIA GARCIA, MANUEL (Tutorships)
Maes Carballo, Marta (Co-tutorships)
GARCIA GARCIA, MANUEL (Tutorships)
Maes Carballo, Marta (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Analysis of the role of the socioeconomic level of Galician patients seen in primary care, as a factor related to the prevalence and control of cardiovascular risk factors. IBERICAN study.
Authorship
M.S.B.
Bachelor of Medicine
M.S.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Objective: To analyse the association of socioeconomic status with other CVRFs and CVD in the autonomous community of Galicia in the context of the IBERICAN study. Material and methods: The samples for our work were obtained from the IBERICAN study, which is an epidemiological, multicentre, observational study that includes a total of 8,066 patients aged between 18 and 65 years, seen in primary care consultations in Spain and followed up annually for a minimum period of 10 years. The main objective of this study is to analyse the prevalence, incidence and geographical distribution of CVRFs and/or CVD in the Spanish adult population treated in the Spanish NHS. Results: In a sample of 608 patients, 283 had an income of less than €18,000/year. Low income was associated with being female (55.1% vs 50.8% p=0.283), living in rural areas (38.2% vs 18.2% p=0.001), having no education (18% vs 3.4% p=0.001) or primary education (71% vs 59.4% p=0.001) and being unemployed (7.5% vs 3.4% p=0.001) or retired (54.3% vs 31.1% p=0.001). The CVRFs in order of highest to lowest prevalence in patients with lower income levels are sedentary lifestyle (1.87 [1.69-2.07]), smoking (1.38 [1.22-1.57]), DM (1.22 [1.08-1.38]), dyslipidaemia (1.08 [0.97-1.20]), and HBP (1.06 [0.95-1.19]). Conversely, being male (0.71 [0.65 - 0.78]) and being active at work (0.34 [0.30-0.38]) were associated with a higher level of income. Conclusions: Patients with an income of less than €18,000/year have a higher prevalence of CVRFs such as sedentary lifestyle, smoking and DM. Likewise, a low income level is socially associated with women, rural habitat and a lower level of education.
Objective: To analyse the association of socioeconomic status with other CVRFs and CVD in the autonomous community of Galicia in the context of the IBERICAN study. Material and methods: The samples for our work were obtained from the IBERICAN study, which is an epidemiological, multicentre, observational study that includes a total of 8,066 patients aged between 18 and 65 years, seen in primary care consultations in Spain and followed up annually for a minimum period of 10 years. The main objective of this study is to analyse the prevalence, incidence and geographical distribution of CVRFs and/or CVD in the Spanish adult population treated in the Spanish NHS. Results: In a sample of 608 patients, 283 had an income of less than €18,000/year. Low income was associated with being female (55.1% vs 50.8% p=0.283), living in rural areas (38.2% vs 18.2% p=0.001), having no education (18% vs 3.4% p=0.001) or primary education (71% vs 59.4% p=0.001) and being unemployed (7.5% vs 3.4% p=0.001) or retired (54.3% vs 31.1% p=0.001). The CVRFs in order of highest to lowest prevalence in patients with lower income levels are sedentary lifestyle (1.87 [1.69-2.07]), smoking (1.38 [1.22-1.57]), DM (1.22 [1.08-1.38]), dyslipidaemia (1.08 [0.97-1.20]), and HBP (1.06 [0.95-1.19]). Conversely, being male (0.71 [0.65 - 0.78]) and being active at work (0.34 [0.30-0.38]) were associated with a higher level of income. Conclusions: Patients with an income of less than €18,000/year have a higher prevalence of CVRFs such as sedentary lifestyle, smoking and DM. Likewise, a low income level is socially associated with women, rural habitat and a lower level of education.
Direction
PORTELA ROMERO, MANUEL (Tutorships)
Cinza Sanjurjo, Sergio (Co-tutorships)
PORTELA ROMERO, MANUEL (Tutorships)
Cinza Sanjurjo, Sergio (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Systematic review on antibody-drug conjugates for the treatment of gynecological cancers.
Authorship
E.S.A.
Bachelor of Medicine
E.S.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Antibody-drug conjugates represent a new therapeutic approach in cancer, allowing drug release against a specific antigen in tumor cells. After designing a protocol, this systematic review will address the efficacy and safety of treatment in gynecological cancer (endometrium, cervix, and ovary), as well as its outcomes through an electronic search of research articles.
Antibody-drug conjugates represent a new therapeutic approach in cancer, allowing drug release against a specific antigen in tumor cells. After designing a protocol, this systematic review will address the efficacy and safety of treatment in gynecological cancer (endometrium, cervix, and ovary), as well as its outcomes through an electronic search of research articles.
Direction
Gonzalez Quintela, Arturo (Tutorships)
VILLANUEVA SILVA, MARIA JOSE (Co-tutorships)
Gonzalez Quintela, Arturo (Tutorships)
VILLANUEVA SILVA, MARIA JOSE (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
Comprehensive approach to Borderline Personality Disorder (BPD): Has one treatment proven more effective than another in BPD?
Authorship
E.S.B.
Bachelor of Medicine
E.S.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Borderline Personality Disorder (BPD) is characterized by an intense emotional dysregulation and impulsivity. People with BPD, mostly young adults, engage in self-destructive and dangerous behaviours and have a high rate of suicide attempts. Psychotherapy is the first line of treatment and specific drugs are not yet available. Due to the high morbidity and suffering associated with this disorder it is advisable to optimize the therapeutic strategy and make a comparison of treatments to see which is the best option. Objectives: review the different psychotherapeutic and pharmacological treatments available for people with Borderline PD, analysing the improvement of quality of life, clinical remission and reduction of symptoms, emotional dysregulation and self-destructive behaviours. Material and methods: systematic review of the scientific literature following the PRISMA model. The bibliographic search was performed in the PubMed database without including articles from other databases due to the similarity of the results. Of a total of 6148 articles, 11 were finally selected. Results and discussion: psychotherapies with better results and greater symptomatology reduction were DBT, especially of six months duration which was not inferior to that of twelve months; adventure therapy which showed improvement in both symptomatology and quality of life; and the combined treatment of group therapies in Day Hospital followed by individual outpatient treatment. Drugs such as Lamotrigine or Citalopram did not show significant improvement while the atypical antipsychotics Asenapine and Olanzapine did reduce affective instability and paranoid ideas among others. The combination of Valproic Acid and PUFAs significantly improved drug effectiveness and intranasal Oxytocin administration improved affective empathy. rTMS and glabellar injection of botulinum toxin are promising ideas but require further research as no significant results have been obtained to demonstrate their efficacy in the treatment of BPD. Conclusions: psychotherapy continues to be the gold standard in the treatment of Borderline PD, with Dialectical Behavioural Therapy (DBT) and new therapies such as Adventure Therapy standing out. Some mood stabilizing or antipsychotic drugs such as Asenapine and combinations of Valproic Acid with PUFAs are good concomitant treatments. Transcranial stimulation techniques or intranasal injections of oxytocin should be further investigated.
Introduction: Borderline Personality Disorder (BPD) is characterized by an intense emotional dysregulation and impulsivity. People with BPD, mostly young adults, engage in self-destructive and dangerous behaviours and have a high rate of suicide attempts. Psychotherapy is the first line of treatment and specific drugs are not yet available. Due to the high morbidity and suffering associated with this disorder it is advisable to optimize the therapeutic strategy and make a comparison of treatments to see which is the best option. Objectives: review the different psychotherapeutic and pharmacological treatments available for people with Borderline PD, analysing the improvement of quality of life, clinical remission and reduction of symptoms, emotional dysregulation and self-destructive behaviours. Material and methods: systematic review of the scientific literature following the PRISMA model. The bibliographic search was performed in the PubMed database without including articles from other databases due to the similarity of the results. Of a total of 6148 articles, 11 were finally selected. Results and discussion: psychotherapies with better results and greater symptomatology reduction were DBT, especially of six months duration which was not inferior to that of twelve months; adventure therapy which showed improvement in both symptomatology and quality of life; and the combined treatment of group therapies in Day Hospital followed by individual outpatient treatment. Drugs such as Lamotrigine or Citalopram did not show significant improvement while the atypical antipsychotics Asenapine and Olanzapine did reduce affective instability and paranoid ideas among others. The combination of Valproic Acid and PUFAs significantly improved drug effectiveness and intranasal Oxytocin administration improved affective empathy. rTMS and glabellar injection of botulinum toxin are promising ideas but require further research as no significant results have been obtained to demonstrate their efficacy in the treatment of BPD. Conclusions: psychotherapy continues to be the gold standard in the treatment of Borderline PD, with Dialectical Behavioural Therapy (DBT) and new therapies such as Adventure Therapy standing out. Some mood stabilizing or antipsychotic drugs such as Asenapine and combinations of Valproic Acid with PUFAs are good concomitant treatments. Transcranial stimulation techniques or intranasal injections of oxytocin should be further investigated.
Direction
TORRES IGLESIAS, ANGELA JUANA (Tutorships)
NUÑEZ ARIAS, DANIEL (Co-tutorships)
TORRES IGLESIAS, ANGELA JUANA (Tutorships)
NUÑEZ ARIAS, DANIEL (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
HER2-low and Trastuzumab-deruxtecan Treatment in Metastatic Breast Cancer
Authorship
A.R.D.S.N.
Bachelor of Medicine
A.R.D.S.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Breast cancer is the most common malignant tumour in women (1 in 8 will suffer from it in the long term of their life). Breast carcinomas are classified by immunohistochemistry into 5 biological subtypes: Luminal A, Luminal B1 (Luminal B/HER2 negative), Luminal B2 (Luminal B/HER2 positive), HER2, and Triple negative. Expression of the HER2 membrane receptor gives tumor cells great division capacity and tendency to invasion and metastasis. These tumors progressed very poorly until the introduction of the monoclonal antibody trastuzumab in 1998, which radically improved the prognosis of patients with HER2-positive tumors. Early 2023, the EMA approved the use of a new antibody (trastuzumab-deruxtecan) in metastatic breast cancer, with which results were obtained in the Destiny Breast04 trial. The aim of this study is to conduct a literature review of the clinical trials of trastuzumab-deruxtecan in metastatic breast cancer, and to analyze the existing studies on the determination of the immunohistochemistry of HER2-low using different antibodies and platforms.
Breast cancer is the most common malignant tumour in women (1 in 8 will suffer from it in the long term of their life). Breast carcinomas are classified by immunohistochemistry into 5 biological subtypes: Luminal A, Luminal B1 (Luminal B/HER2 negative), Luminal B2 (Luminal B/HER2 positive), HER2, and Triple negative. Expression of the HER2 membrane receptor gives tumor cells great division capacity and tendency to invasion and metastasis. These tumors progressed very poorly until the introduction of the monoclonal antibody trastuzumab in 1998, which radically improved the prognosis of patients with HER2-positive tumors. Early 2023, the EMA approved the use of a new antibody (trastuzumab-deruxtecan) in metastatic breast cancer, with which results were obtained in the Destiny Breast04 trial. The aim of this study is to conduct a literature review of the clinical trials of trastuzumab-deruxtecan in metastatic breast cancer, and to analyze the existing studies on the determination of the immunohistochemistry of HER2-low using different antibodies and platforms.
Direction
GARCIA-CABALLERO PARADA, TOMAS M. M. (Tutorships)
GARCIA-CABALLERO PEREZ, LUCIA (Co-tutorships)
Fernández Rodríguez, Beatriz (Co-tutorships)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Tutorships)
GARCIA-CABALLERO PEREZ, LUCIA (Co-tutorships)
Fernández Rodríguez, Beatriz (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
Effects on mental health from the use and abuse of new technologies in young people: a systematic review
Authorship
M.S.S.
Bachelor of Medicine
M.S.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
New technologies, or Information and Communication Technologies (ICT), have changed the way we communicate, entertain ourselves and even work; and their use has increased notably since the COVID-19 pandemic. The World Health Organization (WHO) has recognized that their excessive usage is a global problem that leads to an inability to manage time, energy and attention, which can favor the onset of insomnia, emotional distress, anxiety, depression, amnesic disturbances, eating disorders, withdrawal and social isolation, and in extreme cases, increase the risk of suicide. From a gender perspective, different profiles are also recognized, as men tend to make use of video games more, while women make greater use of social networks. The main objective of this study is to analyze and synthesize the available scientific evidence on the relationship between ICT abuse from an early age and the mental health disorders that can result from it, both neurobiologically and clinically. The secondary objectives are the description of risk and protective factors involved in these disorders, prevention strategies and the scientific evidence that supports them.
New technologies, or Information and Communication Technologies (ICT), have changed the way we communicate, entertain ourselves and even work; and their use has increased notably since the COVID-19 pandemic. The World Health Organization (WHO) has recognized that their excessive usage is a global problem that leads to an inability to manage time, energy and attention, which can favor the onset of insomnia, emotional distress, anxiety, depression, amnesic disturbances, eating disorders, withdrawal and social isolation, and in extreme cases, increase the risk of suicide. From a gender perspective, different profiles are also recognized, as men tend to make use of video games more, while women make greater use of social networks. The main objective of this study is to analyze and synthesize the available scientific evidence on the relationship between ICT abuse from an early age and the mental health disorders that can result from it, both neurobiologically and clinically. The secondary objectives are the description of risk and protective factors involved in these disorders, prevention strategies and the scientific evidence that supports them.
Direction
OLIVARES DIEZ, JOSE MANUEL (Tutorships)
OLIVARES DIEZ, JOSE MANUEL (Tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
Women breastfeeding with HIV under antiretroviral therapy: analysis and comparison of 2 high-income national scope guidelines: The US and the Swiss
Authorship
H.S.
Bachelor of Medicine
H.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Context: The treatment for HIV is more and more efficient and the benefice of breastfeeding are well-established. Therefore breastfeeding with HIV in countries with milk formula available has been questioned. Method: We analyzed the basis of the guidelines of breastfeeding with HIV under anti-HIV treatment of the USA and Switzerland (high-income settings). Transmission rate of less than 1 % has been found in the main worldwide studies. Findings: Transmission rate cannot be considered as an isolated value. Perfect adherence at large scale population has not been achieved. Perfect adherence doesn’t insure always undetectable viral load. The frequency of testing viral load in studies could be a limitation. Lost-to-follow-up are probably problematic and should be avoided. Conclusion: In high-income settings case studies should be carefully continued. Mothers with strong wish to breastfeed should be supported but the risk of transmission is not 0.
Context: The treatment for HIV is more and more efficient and the benefice of breastfeeding are well-established. Therefore breastfeeding with HIV in countries with milk formula available has been questioned. Method: We analyzed the basis of the guidelines of breastfeeding with HIV under anti-HIV treatment of the USA and Switzerland (high-income settings). Transmission rate of less than 1 % has been found in the main worldwide studies. Findings: Transmission rate cannot be considered as an isolated value. Perfect adherence at large scale population has not been achieved. Perfect adherence doesn’t insure always undetectable viral load. The frequency of testing viral load in studies could be a limitation. Lost-to-follow-up are probably problematic and should be avoided. Conclusion: In high-income settings case studies should be carefully continued. Mothers with strong wish to breastfeed should be supported but the risk of transmission is not 0.
Direction
Leis Trabazo, María Rosaura (Tutorships)
Couceiro Gianzo, José Antonio (Co-tutorships)
Leis Trabazo, María Rosaura (Tutorships)
Couceiro Gianzo, José Antonio (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
Graphic medicine applied to delirium prevention: development of healthcare personnel survey and graphic material.
Authorship
P.G.M.
Bachelor of Medicine
P.G.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Delirium, also known as acute confusional syndrome, is a disorder that affects 20% to 30% of hospitalized patients, more frequently as the patient's age increases. About half of the cases could be prevented applying small changes in the hospital environment, and health education of family members is crucial when identifying and solving the problem. With the idea of proposing alternative communication methods, a movement graphic medicine has recently been developed, which can be an useful tool for health professionals, patients and their relatives, as it allows information to be transmitted, improving the understanding and visibility of diseases and humanizing the patient. Objectives: Development of informative graphic medicine material regarding delirium, with patients at risk, their relatives, and students in medical fields as its target audience. Through a survey aimed at medical personnel and a short bibliographic review, find out the most relevant aspects about the disease as well as possible preventive strategies. Use the retrieved data as a basis for the development of the graphic material. Materials and methods: Creative project in comic format, from its theoric inception (plot/writing) to its final development. Survey aimed at medical personnel, selected through opportunistic sampling, and delivered among the different departments of a second level hospital. Results and conclusion: Risk factors for delirium that are most frequently seen in the environment are advanced age, presence of neuropsychiatric history, polypharmacy and intercurrent diseases. As prevention strategies, the most chosen included modifications in the hospital environment and family accompaniment. Given the importance of prevention and health education in this pathology, we designed graphic material in order to illustrate and improve the understanding of delirium, especially in relation to these elements.
Background: Delirium, also known as acute confusional syndrome, is a disorder that affects 20% to 30% of hospitalized patients, more frequently as the patient's age increases. About half of the cases could be prevented applying small changes in the hospital environment, and health education of family members is crucial when identifying and solving the problem. With the idea of proposing alternative communication methods, a movement graphic medicine has recently been developed, which can be an useful tool for health professionals, patients and their relatives, as it allows information to be transmitted, improving the understanding and visibility of diseases and humanizing the patient. Objectives: Development of informative graphic medicine material regarding delirium, with patients at risk, their relatives, and students in medical fields as its target audience. Through a survey aimed at medical personnel and a short bibliographic review, find out the most relevant aspects about the disease as well as possible preventive strategies. Use the retrieved data as a basis for the development of the graphic material. Materials and methods: Creative project in comic format, from its theoric inception (plot/writing) to its final development. Survey aimed at medical personnel, selected through opportunistic sampling, and delivered among the different departments of a second level hospital. Results and conclusion: Risk factors for delirium that are most frequently seen in the environment are advanced age, presence of neuropsychiatric history, polypharmacy and intercurrent diseases. As prevention strategies, the most chosen included modifications in the hospital environment and family accompaniment. Given the importance of prevention and health education in this pathology, we designed graphic material in order to illustrate and improve the understanding of delirium, especially in relation to these elements.
Direction
Gonzalez Quintela, Arturo (Tutorships)
López Mato, Pablo (Co-tutorships)
Gonzalez Quintela, Arturo (Tutorships)
López Mato, Pablo (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Anaesthetic management of obstetric haemorrhage: approach and preventive use of tranexamic acid.
Authorship
A.G.L.
Bachelor of Medicine
A.G.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Obstetric haemorrhage, especially postpartum haemorrhage (PPH), represents a significant cause of maternal morbidity and mortality globally. Although recommendations have been established for its prevention and treatment, the efficacy of tranexamic acid (TXA) as a preventive measure still lacks a clear definition in the medical literature. This work aims to review the available scientific evidence on the use of TXA in the prevention of PPH, in order to understand its impact on blood loss quantity. Additionally, it seeks to define the profile of patients who could benefit from its administration, determine the optimal timing for its use, and evaluate the possible side effects and associated complications. An investigation was conducted on PubMed using combinations of key terms related to obstetric haemorrhage prevention and tranexamic acid. Seven articles were included, all randomized clinical trials, which evaluated the preventive use of TXA. The results obtained in these studies were analysed to draw meaningful conclusions. It was found that six out of seven studies showed promising results regarding the preventive use of TXA to reduce obstetric haemorrhage and the need for transfusions, especially in women undergoing caesarean section. However, one study showed inconsistent results, questioning the efficacy of TXA in reducing maternal mortality and other important outcomes. TXA presents as a drug with potential for PPH prophylaxis due to its demonstrated efficacy in other clinical situations. However, its inclusion in clinical guidelines requires additional studies, especially multicentre randomized controlled trials with a larger sample size and adequate statistical power. These steps are crucial to determine with certainty its role in preventing obstetric haemorrhage and its safety in the obstetric context.
Obstetric haemorrhage, especially postpartum haemorrhage (PPH), represents a significant cause of maternal morbidity and mortality globally. Although recommendations have been established for its prevention and treatment, the efficacy of tranexamic acid (TXA) as a preventive measure still lacks a clear definition in the medical literature. This work aims to review the available scientific evidence on the use of TXA in the prevention of PPH, in order to understand its impact on blood loss quantity. Additionally, it seeks to define the profile of patients who could benefit from its administration, determine the optimal timing for its use, and evaluate the possible side effects and associated complications. An investigation was conducted on PubMed using combinations of key terms related to obstetric haemorrhage prevention and tranexamic acid. Seven articles were included, all randomized clinical trials, which evaluated the preventive use of TXA. The results obtained in these studies were analysed to draw meaningful conclusions. It was found that six out of seven studies showed promising results regarding the preventive use of TXA to reduce obstetric haemorrhage and the need for transfusions, especially in women undergoing caesarean section. However, one study showed inconsistent results, questioning the efficacy of TXA in reducing maternal mortality and other important outcomes. TXA presents as a drug with potential for PPH prophylaxis due to its demonstrated efficacy in other clinical situations. However, its inclusion in clinical guidelines requires additional studies, especially multicentre randomized controlled trials with a larger sample size and adequate statistical power. These steps are crucial to determine with certainty its role in preventing obstetric haemorrhage and its safety in the obstetric context.
Direction
Varela Durán, Marina (Tutorships)
Varela Durán, Marina (Tutorships)
Treatment of refractory recurrent pericarditis with Anakinra (interleukin-1 receptor antagonist).
Authorship
L.F.P.L.
Bachelor of Medicine
L.F.P.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Refractory recurrent pericarditis (RRP) is a serious health problem due to the functional disability it causes, repeated admissions, side effects and tissue damage resulting from corticosteroid therapy. Some studies have suggested that Anakinra may be very effective in these patients. However, clinical experience on its use is scarce and we have not found any study carried out in our country. OBJECTIVES: To evaluate the clinical efficacy, safety and tolerability of RRP treatment with Anakinra. PATIENTS AND METHODS: Prospective observational study of all patients with RRP treated with Anakinra in a specific Internal Medicine consultation from 1/1/2016 to 31/12/2023. Patient history before starting the drug is detailed: number of relapses, emergency department frequentation, hospital admissions and corticosteroid doses. The data collected were included in an anonymized database for subsequent analysis. RESULTS: 92 patients with recurrent pericarditis were attended. 6 of them (6.5%) met criteria for RRP and corticosteroid dependence, who were treated with Anakinra. The average age at diagnosis was 43.17 years (range: 16-76). The mean number of relapses with colchicine before Anakinra was 5.2 per patient (range 4-6), mean emergency department attendance was 2.5 (range 1-6) and 3.67 hospital admissions (range 2-5). The mean follow-up of the patients was 23 months (range 5-32). After the introduction of treatment, complete reduction of corticoids and relapses was achieved in all cases except one patient, who had Anakinra suspended early due to skin lesions. One other patient also presented this effect (33%), which was self-limiting. There were no serious or frequent infections during follow-up. CONCLUSIONS: Treatment of RRP with Anakinra allowed discontinuation of corticosteroids, as well as avoiding recurrences, the need for medical care and improving the quality of life of these patients.
INTRODUCTION: Refractory recurrent pericarditis (RRP) is a serious health problem due to the functional disability it causes, repeated admissions, side effects and tissue damage resulting from corticosteroid therapy. Some studies have suggested that Anakinra may be very effective in these patients. However, clinical experience on its use is scarce and we have not found any study carried out in our country. OBJECTIVES: To evaluate the clinical efficacy, safety and tolerability of RRP treatment with Anakinra. PATIENTS AND METHODS: Prospective observational study of all patients with RRP treated with Anakinra in a specific Internal Medicine consultation from 1/1/2016 to 31/12/2023. Patient history before starting the drug is detailed: number of relapses, emergency department frequentation, hospital admissions and corticosteroid doses. The data collected were included in an anonymized database for subsequent analysis. RESULTS: 92 patients with recurrent pericarditis were attended. 6 of them (6.5%) met criteria for RRP and corticosteroid dependence, who were treated with Anakinra. The average age at diagnosis was 43.17 years (range: 16-76). The mean number of relapses with colchicine before Anakinra was 5.2 per patient (range 4-6), mean emergency department attendance was 2.5 (range 1-6) and 3.67 hospital admissions (range 2-5). The mean follow-up of the patients was 23 months (range 5-32). After the introduction of treatment, complete reduction of corticoids and relapses was achieved in all cases except one patient, who had Anakinra suspended early due to skin lesions. One other patient also presented this effect (33%), which was self-limiting. There were no serious or frequent infections during follow-up. CONCLUSIONS: Treatment of RRP with Anakinra allowed discontinuation of corticosteroids, as well as avoiding recurrences, the need for medical care and improving the quality of life of these patients.
Direction
SOPEÑA PEREZ-ARGÜELLES, BERNARDO (Tutorships)
FREIRE DAPENA, MARIA DEL CARMEN (Co-tutorships)
SOPEÑA PEREZ-ARGÜELLES, BERNARDO (Tutorships)
FREIRE DAPENA, MARIA DEL CARMEN (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Efficacy of phototherapy for treating hyperbilirubinemia in term and preterm infants and long-term side effects: systematic review.
Authorship
B.P.F.
Bachelor of Medicine
B.P.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Jaundice due to indirect hyperbilirubinemia affects more than 50% of newborns, being mostly benign and reversible. The main treatment for neonatal jaundice is phototherapy, with the aim of preventing the most feared toxic effect of bilirubin, kernicterus. Although phototherapy is generally considered to be safe, some studies have shown possible harmful effects both in the short and long term.
Jaundice due to indirect hyperbilirubinemia affects more than 50% of newborns, being mostly benign and reversible. The main treatment for neonatal jaundice is phototherapy, with the aim of preventing the most feared toxic effect of bilirubin, kernicterus. Although phototherapy is generally considered to be safe, some studies have shown possible harmful effects both in the short and long term.
Direction
Concheiro Guisán, Ana (Tutorships)
Arias Novas, María Begoña (Co-tutorships)
Concheiro Guisán, Ana (Tutorships)
Arias Novas, María Begoña (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Targeted therapy for RET fusión-possitive non-small cell lung cancer. Systematic re-view.
Authorship
H.P.G.
Bachelor of Medicine
H.P.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Targeted drugs are increasingly playing a role in the treatment of different tu-mors. One of these targets is the RET gene, which can be altered in patients with non-small cell lung cancer (NSCLC). This gene encodes a receptor tyrosine kinase involved in several intra-cellular signaling pathways which are important for cell proliferation, growth, and survival. Re-cently, some treatments capable of acting against this RET fusion-positive cells have been de-veloped. These therapies have been shown as alternatives to the classic chemotherapy treatment. Objectives: The objective of this work is to carry out a review of the main drugs used in NSCLC in patients with RET alteration, analyzing which of them may have the most promising efficacy, as well as some of their most frequent side effects. Methods: The scientific literature research was carried out in the Medline and Web of Science databases. Publications that analyzed the efficacy and/or safety of selpercatinib and/or pralset-inib, that are “selective” inhibitors against RET, were selected. Results: After the research, 62 articles were obtained, of which 27 were duplicated. Following a first screening, 26 more articles were eliminated. Subsequently, after a full reading of the re-maining articles, 5 more were excluded. Finally 4 articles were included in the review. The main efficacy measures analyzed were ORR, MDR, PFS, and the quality of life perceived by patients during treatment. The degree of adverse effects of each drug was also evaluated. Conclusions: Serlpercatinib and pralsetinib are effective treatments in advanced NSCLC and RET alteration, also showing benefit in the control of intracranial disease. Both treatments are considered safe, although they differ in some of their adverse effects. Selpercatinib is presented as the main therapeutic strategy in metastatic disease, showing superior results to chemotherapy and pralsetinib.
Introduction: Targeted drugs are increasingly playing a role in the treatment of different tu-mors. One of these targets is the RET gene, which can be altered in patients with non-small cell lung cancer (NSCLC). This gene encodes a receptor tyrosine kinase involved in several intra-cellular signaling pathways which are important for cell proliferation, growth, and survival. Re-cently, some treatments capable of acting against this RET fusion-positive cells have been de-veloped. These therapies have been shown as alternatives to the classic chemotherapy treatment. Objectives: The objective of this work is to carry out a review of the main drugs used in NSCLC in patients with RET alteration, analyzing which of them may have the most promising efficacy, as well as some of their most frequent side effects. Methods: The scientific literature research was carried out in the Medline and Web of Science databases. Publications that analyzed the efficacy and/or safety of selpercatinib and/or pralset-inib, that are “selective” inhibitors against RET, were selected. Results: After the research, 62 articles were obtained, of which 27 were duplicated. Following a first screening, 26 more articles were eliminated. Subsequently, after a full reading of the re-maining articles, 5 more were excluded. Finally 4 articles were included in the review. The main efficacy measures analyzed were ORR, MDR, PFS, and the quality of life perceived by patients during treatment. The degree of adverse effects of each drug was also evaluated. Conclusions: Serlpercatinib and pralsetinib are effective treatments in advanced NSCLC and RET alteration, also showing benefit in the control of intracranial disease. Both treatments are considered safe, although they differ in some of their adverse effects. Selpercatinib is presented as the main therapeutic strategy in metastatic disease, showing superior results to chemotherapy and pralsetinib.
Direction
LEON MATEOS, LUIS ANGEL (Tutorships)
Lázaro Quintela, Martín Emilio (Co-tutorships)
LEON MATEOS, LUIS ANGEL (Tutorships)
Lázaro Quintela, Martín Emilio (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Genetic therapy in infants with early diagnosis of spinal muscular atrophy (sma)
Authorship
M.P.B.
Bachelor of Medicine
M.P.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: the spinal muscular atrophy (SMA) is one of the most commonly found neurodegenerative illnesses in the paediatric age group. It has an autosomal recessive inheritance and an incidence of 1 in 10.000 births, with high morbimortality rates which may lead to decease if not treated. These patients have a low concentration of SMN, an essential protein, due to a failure in the nerve conduction of the motor neurons. They exhibit muscular atrophy and weakness in the muscles at the axial, respiratory and bulbar levels disfunction, as well as in the limbs. Currently, it is mainly diagnosed through premature neonatal screening. There are some medications approved by the FDA and the EMA for the treatment of this disease, but no curative drug. We find the Onasmenogene abeparvovec, recently approved, which modifies the genome of the patients, and so presents gene therapy as the definitive treatment. Justification and objectives: the aim of this study is to conduct a systematic review of the studies that gather the clinical evolution of the patients, with an early screening and subsequent diagnosis of the disease, which have undergone gene therapy in monotherapy with the Onasemnogene abeparvovec. It also intends to revise the possible side effects of the drug, with the intention of assessing the impact that this new diagnostic approach and therapeutic may entail for the patients affected by SMA. This backs the enormous advance that is disclosed in the clinical approach of this disease, counting with the example of the recent introduction of the gene therapy with Onasemnogene abeparvovec in the autonomous community of Galicia for patients with early diagnosis in the neonatal screening. The objective of this work is to make known the Spinal Muscular Atrophy, whose treatments have always been palliative, but with high hopes in a definitive treatment thanks to gene therapy with Onasemnogene abeparvovec. Resources and methods: a bibliographical review on the treatment of SMA has been conducted, selecting the relevant articles obtained through the databases MEDLINE (PubMed) and Clarivate (Web of Science). Results and discussion: 7 articles were selected, in which it is studied the benefits and potential adverse effects in the natural evolution of the disease once Onasemnogene is administered, as well as the importance of the symptoms before the treatment starts and the precocity in the administration of the genetic therapy, looking for the best of the benefits. Conclusions: A clear motor improvement is observed in patients once they are treated with Onasemnogene. It is still necessary to further monitor the patients as to observe if is indeed a curative, long-term treatment, supporting the results of the clinical trials published up to this moment.
Introduction: the spinal muscular atrophy (SMA) is one of the most commonly found neurodegenerative illnesses in the paediatric age group. It has an autosomal recessive inheritance and an incidence of 1 in 10.000 births, with high morbimortality rates which may lead to decease if not treated. These patients have a low concentration of SMN, an essential protein, due to a failure in the nerve conduction of the motor neurons. They exhibit muscular atrophy and weakness in the muscles at the axial, respiratory and bulbar levels disfunction, as well as in the limbs. Currently, it is mainly diagnosed through premature neonatal screening. There are some medications approved by the FDA and the EMA for the treatment of this disease, but no curative drug. We find the Onasmenogene abeparvovec, recently approved, which modifies the genome of the patients, and so presents gene therapy as the definitive treatment. Justification and objectives: the aim of this study is to conduct a systematic review of the studies that gather the clinical evolution of the patients, with an early screening and subsequent diagnosis of the disease, which have undergone gene therapy in monotherapy with the Onasemnogene abeparvovec. It also intends to revise the possible side effects of the drug, with the intention of assessing the impact that this new diagnostic approach and therapeutic may entail for the patients affected by SMA. This backs the enormous advance that is disclosed in the clinical approach of this disease, counting with the example of the recent introduction of the gene therapy with Onasemnogene abeparvovec in the autonomous community of Galicia for patients with early diagnosis in the neonatal screening. The objective of this work is to make known the Spinal Muscular Atrophy, whose treatments have always been palliative, but with high hopes in a definitive treatment thanks to gene therapy with Onasemnogene abeparvovec. Resources and methods: a bibliographical review on the treatment of SMA has been conducted, selecting the relevant articles obtained through the databases MEDLINE (PubMed) and Clarivate (Web of Science). Results and discussion: 7 articles were selected, in which it is studied the benefits and potential adverse effects in the natural evolution of the disease once Onasemnogene is administered, as well as the importance of the symptoms before the treatment starts and the precocity in the administration of the genetic therapy, looking for the best of the benefits. Conclusions: A clear motor improvement is observed in patients once they are treated with Onasemnogene. It is still necessary to further monitor the patients as to observe if is indeed a curative, long-term treatment, supporting the results of the clinical trials published up to this moment.
Direction
BLANCO BARCA, MANUEL OSCAR (Tutorships)
Escolar Martín, José María (Co-tutorships)
BLANCO BARCA, MANUEL OSCAR (Tutorships)
Escolar Martín, José María (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Clinical efficacy assessment of vaccines in the treatment of Glioblastoma Multiforme.
Authorship
M.P.C.
Bachelor of Medicine
M.P.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Glioblastoma multiforme (GBM) is one of the most aggressive neoplasms and the most common primary malignant brain tumor, accounting for 14,5% of all central nervous system (CNS) tumors and 48,6% of malignant brain tumors. The overall median survival of patients with GBM is poor, averaging around 15 months from the time of diagnosis, with a 5-year survival rate between 5-10%, highlighting the need to develop innovative therapies to achieve a curative treatment or at least significantly prolong the life expectancy of patients with this condition. Objectives: The aim of this work is to analyze the effectiveness of vaccines as a potential treatment for both newly diagnosed glioblastoma multiforme and recurrent glioblastoma multiforme. Materials and methods: A systematic review of scientific articles has been carried out. To do this, the PubMed database was consulted, applying a series of restrictions based on the type of study, date of publication and species (humans). Results: After conducting a systematic review of the literature found, the complete reading of 19 articles was carried out which met the established inclusion criteria and whose content provided answers to the questions posed, out of a total of 109 articles identified in the search. Finally, 11 of these articles were selected for analysis and extraction of the most relevant data for the purpose of this study. Conclusions: After reviewing the studies, we conclude that vaccines are a relevant tool in the treatment of Glioblastoma Multiforme, especially dendritic cell vaccines. They are safe, with mainly mild adverse effects. When combined with standard treatment, a significant increase in progression-free survival and overall survival is observed. This comprehensive approach addresses multiple aspects of the disease, from direct tumor cell elimination to immune system activation. Further clinical trials are needed to evaluate long-term efficacy and explore therapeutic combinations, as well as to identify predictive biomarkers and improve patient selection.
Introduction: Glioblastoma multiforme (GBM) is one of the most aggressive neoplasms and the most common primary malignant brain tumor, accounting for 14,5% of all central nervous system (CNS) tumors and 48,6% of malignant brain tumors. The overall median survival of patients with GBM is poor, averaging around 15 months from the time of diagnosis, with a 5-year survival rate between 5-10%, highlighting the need to develop innovative therapies to achieve a curative treatment or at least significantly prolong the life expectancy of patients with this condition. Objectives: The aim of this work is to analyze the effectiveness of vaccines as a potential treatment for both newly diagnosed glioblastoma multiforme and recurrent glioblastoma multiforme. Materials and methods: A systematic review of scientific articles has been carried out. To do this, the PubMed database was consulted, applying a series of restrictions based on the type of study, date of publication and species (humans). Results: After conducting a systematic review of the literature found, the complete reading of 19 articles was carried out which met the established inclusion criteria and whose content provided answers to the questions posed, out of a total of 109 articles identified in the search. Finally, 11 of these articles were selected for analysis and extraction of the most relevant data for the purpose of this study. Conclusions: After reviewing the studies, we conclude that vaccines are a relevant tool in the treatment of Glioblastoma Multiforme, especially dendritic cell vaccines. They are safe, with mainly mild adverse effects. When combined with standard treatment, a significant increase in progression-free survival and overall survival is observed. This comprehensive approach addresses multiple aspects of the disease, from direct tumor cell elimination to immune system activation. Further clinical trials are needed to evaluate long-term efficacy and explore therapeutic combinations, as well as to identify predictive biomarkers and improve patient selection.
Direction
LEON MATEOS, LUIS ANGEL (Tutorships)
Bernárdez Ferrán, Beatriz (Co-tutorships)
LEON MATEOS, LUIS ANGEL (Tutorships)
Bernárdez Ferrán, Beatriz (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Relationship of the microbiota and its impact on the diagnosis and prognosis of Colorectal Cancer: Systematic review of the literature
Authorship
B.A.J.
Bachelor of Medicine
B.A.J.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Colorectal cancer (CRC) is one of the most common cancers and represents a significant burden on global health. Its etiology has been linked to the composition of the gut microbiota. Objective: To study the relationship between the microbiota and its impact on the diagnosis and prognosis of colorectal cancer. Methodology: A systematic review was conducted in accordance with the guidelines established in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Prospective observational studies, cross-sectional cohort studies, or randomized clinical trials conducted in humans were included. Congress abstracts, non-indexed works, or studies published in a language other than English or Spanish were excluded. The databases PUBMED, Scielo, Web of Science, and Google Scholar were consulted. Results: The search and selection process resulted in 25 studies that met the inclusion and exclusion criteria, covering various aspects of the relationship between gut microbiota and colorectal cancer. The results indicated that the gut microbiota of CRC patients differs from that of healthy individuals, presenting a dysbiotic profile that promotes oncogenesis. Additionally, the studies showed that combining routine diagnostic techniques for CRC with sequencing techniques to determine microbiota profiles and metabolome analysis has been building much more sensitive and specific diagnostic platforms. Certain bacteria, such as Clostridium symbiosum and Fusobacterium nucleatum, could serve as markers of tumor progression in CRC. The use of probiotics benefits patients pre- and post-surgery due to their inhibitory effects on mechanisms contributing to tumor development. Conclusion: The results of the analyzed studies confirm that the composition of the gut microbiota influences the etiology and development of colorectal cancer. Advances in molecular biology techniques currently allow for the identification of bacterial species that are key in the development of this pathology and that could serve as prognostic and monitoring markers.
Introduction: Colorectal cancer (CRC) is one of the most common cancers and represents a significant burden on global health. Its etiology has been linked to the composition of the gut microbiota. Objective: To study the relationship between the microbiota and its impact on the diagnosis and prognosis of colorectal cancer. Methodology: A systematic review was conducted in accordance with the guidelines established in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Prospective observational studies, cross-sectional cohort studies, or randomized clinical trials conducted in humans were included. Congress abstracts, non-indexed works, or studies published in a language other than English or Spanish were excluded. The databases PUBMED, Scielo, Web of Science, and Google Scholar were consulted. Results: The search and selection process resulted in 25 studies that met the inclusion and exclusion criteria, covering various aspects of the relationship between gut microbiota and colorectal cancer. The results indicated that the gut microbiota of CRC patients differs from that of healthy individuals, presenting a dysbiotic profile that promotes oncogenesis. Additionally, the studies showed that combining routine diagnostic techniques for CRC with sequencing techniques to determine microbiota profiles and metabolome analysis has been building much more sensitive and specific diagnostic platforms. Certain bacteria, such as Clostridium symbiosum and Fusobacterium nucleatum, could serve as markers of tumor progression in CRC. The use of probiotics benefits patients pre- and post-surgery due to their inhibitory effects on mechanisms contributing to tumor development. Conclusion: The results of the analyzed studies confirm that the composition of the gut microbiota influences the etiology and development of colorectal cancer. Advances in molecular biology techniques currently allow for the identification of bacterial species that are key in the development of this pathology and that could serve as prognostic and monitoring markers.
Direction
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Early detection of preeclampsia with cell-free RNA
Authorship
E.B.S.
Bachelor of Medicine
E.B.S.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Type of study: Systematic review. Justification: Preeclampsia is a hypertensive disorder of pregnancy with a significant prevalence which can lead to serious complications. It is essential to detect women at risk of developing preeclampsia before the onset of symptoms. Therefore, it is necessary to find an effective screening method to select at-risk patients who can benefit from preventive actions aimed at avoiding the onset of maternal-fetal complications. Objective: The objective of this review is to evaluate whether the measurement of cell-free RNA (cf-RNA) in maternal blood is useful for predicting preeclampsia. Methods: A search of the available literature on the prediction of preeclampsia in pregnant women using cf-RNA (PICO question) was performed in the Medline database (via Pubmed) and Web of Science. Results: Of 147 initial articles, 7 studies were selected that met the criteria for this review. Case-control and cohort studies were selected. In the first study selected, amniotic fluid samples were used, while in the rest of the studies blood samples were used. In all articles, genes related to the pathophysiology of preeclampsia were found to be differentially expressed in pregnant women who developed or already had preeclampsia. Conclusions: With the results obtained we can determine that cf-RNA analysis can be used to predict preeclampsia in pregnant women effectively. Further studies are still needed to determine the optimal timing for sample extraction and the gene panel to be used, but the results of the latest studies are promising and, in the future, it is possible that a liquid biopsy test can be developed for preeclampsia screening. Key words: preeclampsia and cell free RNA.
Type of study: Systematic review. Justification: Preeclampsia is a hypertensive disorder of pregnancy with a significant prevalence which can lead to serious complications. It is essential to detect women at risk of developing preeclampsia before the onset of symptoms. Therefore, it is necessary to find an effective screening method to select at-risk patients who can benefit from preventive actions aimed at avoiding the onset of maternal-fetal complications. Objective: The objective of this review is to evaluate whether the measurement of cell-free RNA (cf-RNA) in maternal blood is useful for predicting preeclampsia. Methods: A search of the available literature on the prediction of preeclampsia in pregnant women using cf-RNA (PICO question) was performed in the Medline database (via Pubmed) and Web of Science. Results: Of 147 initial articles, 7 studies were selected that met the criteria for this review. Case-control and cohort studies were selected. In the first study selected, amniotic fluid samples were used, while in the rest of the studies blood samples were used. In all articles, genes related to the pathophysiology of preeclampsia were found to be differentially expressed in pregnant women who developed or already had preeclampsia. Conclusions: With the results obtained we can determine that cf-RNA analysis can be used to predict preeclampsia in pregnant women effectively. Further studies are still needed to determine the optimal timing for sample extraction and the gene panel to be used, but the results of the latest studies are promising and, in the future, it is possible that a liquid biopsy test can be developed for preeclampsia screening. Key words: preeclampsia and cell free RNA.
Direction
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
COUCEIRO NAVEIRA, EMILIO (Co-tutorships)
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
COUCEIRO NAVEIRA, EMILIO (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Vaccines development against substance of abuse. Current status
Authorship
C.A.B.C.
Bachelor of Medicine
C.A.B.C.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Substance use disorders are a relevant health and social problem, affecting a significant percentage of the population, and for which there is no effective treatment. In the last two decades, much research focused on the development of vaccines against these substances. Objective: The objective of this work was to collect information on the current state of development of vaccines against substance of abuse. Material and Methods: A narrative bibliographic review was carried out from information retrieved from PubMed, using keywords related to the topic. Results: Drugs of abuse are small molecules that behave like haptens, so they must be conjugated with any kind of transport protein in order to be immunogenic. Vaccines act by generating antibodies, which bind to the drug in blood and prevent its access to the CNS. The main indication for this treatment would be the immunization of addicts highly motivated to stop drug use. Other kind of indications (preventive use, use by legal imposition…) have many ethical considerations. Currently vaccines against opioids, methamphetamine, nicotine and cocaine are being developed. Results from animal tests are promising, although the clinical trials carried out to date do not confirm these results. Conclusion: The latest vaccines developed have proven to be effective in preclinical essays, but there is still much more to investigate to achieve the same results in humans.
Introduction: Substance use disorders are a relevant health and social problem, affecting a significant percentage of the population, and for which there is no effective treatment. In the last two decades, much research focused on the development of vaccines against these substances. Objective: The objective of this work was to collect information on the current state of development of vaccines against substance of abuse. Material and Methods: A narrative bibliographic review was carried out from information retrieved from PubMed, using keywords related to the topic. Results: Drugs of abuse are small molecules that behave like haptens, so they must be conjugated with any kind of transport protein in order to be immunogenic. Vaccines act by generating antibodies, which bind to the drug in blood and prevent its access to the CNS. The main indication for this treatment would be the immunization of addicts highly motivated to stop drug use. Other kind of indications (preventive use, use by legal imposition…) have many ethical considerations. Currently vaccines against opioids, methamphetamine, nicotine and cocaine are being developed. Results from animal tests are promising, although the clinical trials carried out to date do not confirm these results. Conclusion: The latest vaccines developed have proven to be effective in preclinical essays, but there is still much more to investigate to achieve the same results in humans.
Direction
DE CASTRO RIOS, ANA (Tutorships)
LOPEZ-RIVADULLA LAMAS, MANUEL (Co-tutorships)
DE CASTRO RIOS, ANA (Tutorships)
LOPEZ-RIVADULLA LAMAS, MANUEL (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Dietary Patterns and Cardiovascular Risk: A Systematic Review
Authorship
M.C.P.
Bachelor of Medicine
M.C.P.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Cardiovascular diseases (CVDs) have become the leading cause of morbidity and mortal- ity worldwide, replacing infectious diseases due to unhealthy lifestyles such as smoking, alco- hol abuse, physical inactivity, and poor diets. Atherosclerosis, the common pathophysiology of CVDs, is exacerbated by thrombosis, the main cause of fatal cardiovascular events. The proposed systematic review investigates the relationship between dietary patterns and the pre- vention of CVDs. Patterns such as the Mediterranean diet, DASH, and plant-based diets have shown positive effects in reducing risk factors and cardiovascular events. This review aims to evaluate the efficacy of these dietary patterns in the primary and secondary prevention of CVDs in patients aged 19 to 64, measuring mortality, incidence of cardiovascular events, and cardi- ometabolic parameters such as weight, lipid profile, and blood glucose levels.
Cardiovascular diseases (CVDs) have become the leading cause of morbidity and mortal- ity worldwide, replacing infectious diseases due to unhealthy lifestyles such as smoking, alco- hol abuse, physical inactivity, and poor diets. Atherosclerosis, the common pathophysiology of CVDs, is exacerbated by thrombosis, the main cause of fatal cardiovascular events. The proposed systematic review investigates the relationship between dietary patterns and the pre- vention of CVDs. Patterns such as the Mediterranean diet, DASH, and plant-based diets have shown positive effects in reducing risk factors and cardiovascular events. This review aims to evaluate the efficacy of these dietary patterns in the primary and secondary prevention of CVDs in patients aged 19 to 64, measuring mortality, incidence of cardiovascular events, and cardi- ometabolic parameters such as weight, lipid profile, and blood glucose levels.
Direction
Mosquera Nogueira, Jacinto José (Tutorships)
Mosquera Nogueira, Jacinto José (Tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Efficacy and safety of live attenuated vaccines in patients with multiple sclerosis
Authorship
D.C.C.
Bachelor of Medicine
D.C.C.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction. Immunization of patients with multiple sclerosis (MS) is a topic of interest because of the infectious risk associated with new disease-modifying therapies. Although live vaccines are contraindicated in immunocompromised patients, their role in multiple sclerosis is controversial. Objective. The objectives of this review are to study the risks and benefits of live vaccines, as well as their indications and contraindications in patients with MS. Methods. A systematic review has been carried out following PRISMA guidelines of empirical studies found in Pubmed, Scopus and Neurology, finally including 8 studies. Results. The results indicate high seroconversion rates, variable according to the number of doses and treatment received. One study found a significant increase in the relapse rate after yellow fever vaccination, not supported by two subsequent studies. Conclusions. Varicella and MMR vaccines generate an adequate serologic response in patients with untreated multiple sclerosis or with low efficacy DMT, although humoral immunity may be impaired by anti CD20 or S1RP modulators. These vaccines are safe in patients without immunosuppressive treatment, but there is insufficient evidence to affirm the same safety of yellow fever vaccine.
Introduction. Immunization of patients with multiple sclerosis (MS) is a topic of interest because of the infectious risk associated with new disease-modifying therapies. Although live vaccines are contraindicated in immunocompromised patients, their role in multiple sclerosis is controversial. Objective. The objectives of this review are to study the risks and benefits of live vaccines, as well as their indications and contraindications in patients with MS. Methods. A systematic review has been carried out following PRISMA guidelines of empirical studies found in Pubmed, Scopus and Neurology, finally including 8 studies. Results. The results indicate high seroconversion rates, variable according to the number of doses and treatment received. One study found a significant increase in the relapse rate after yellow fever vaccination, not supported by two subsequent studies. Conclusions. Varicella and MMR vaccines generate an adequate serologic response in patients with untreated multiple sclerosis or with low efficacy DMT, although humoral immunity may be impaired by anti CD20 or S1RP modulators. These vaccines are safe in patients without immunosuppressive treatment, but there is insufficient evidence to affirm the same safety of yellow fever vaccine.
Direction
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Antibiotic resistance to Helicobacter pylori.
Authorship
E.L.A.R.
Bachelor of Medicine
E.L.A.R.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans and may be associated with a variety of gastrointestinal diseases, including peptic ulcers and gastric cancer. However, the prevalence of this infection and the resistance to antibiotics used in its treatment vary according to the geographic region and other factors. In this study, we aim to understand the current situation of H. pylori prevalence and antibiotic resistance in different countries, as well as to evaluate the effectiveness of available treatments. Objectives: 1. To analyze the prevalence of H. pylori and antibiotic resistance in different countries. 2. To evaluate the effectiveness of available treatments for eradicating H. pylori. 3. To investigate the molecular methods used to detect clarithromycin resistance in H. pylori. 4. To identify factors associated with antibiotic resistance in patients infected with H. pylori. Patients and Methods: a comprehensive review of the scientific literature was conducted using electronic databases. Studies reporting on the prevalence of H. pylori and antibiotic resistance in different countries were included, as well as clinical trials evaluating the effectiveness of treatments for H. pylori infection eradication. Data on molecular methods used to detect clarithromycin resistance in H. pylori were collected, and factors associated with antibiotic resistance were analyzed. Results: the results show a continuous prevalence of H. pylori in certain areas, with variability in antibiotic resistance among different countries. High resistance to antibiotics such as clarithromycin, metronidazole, and levofloxacin is observed in most countries, while resistance to amoxicillin and tetracycline is relatively low. Several molecular methods for detecting clarithromycin resistance in H. pylori are identified, including PCR-RFLP, PCROLA, and real-time DNA sequencing. Conclusions: 1. The prevalence of H. pylori remains significant in some areas despite the overall decreasing trend. 2. Resistance to clarithromycin, metronidazole, and levofloxacin is common in most countries, highlighting the need for alternative therapeutic strategies. 3. Susceptibility testing is required before initiating treatment to select the most appropriate regimen. 4. Molecular methods provide a precise tool for detecting clarithromycin resistance in H. pylori. 5. Continuous research is needed to develop more effective treatments and understand the mechanisms of antibiotic resistance.
Introduction: Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans and may be associated with a variety of gastrointestinal diseases, including peptic ulcers and gastric cancer. However, the prevalence of this infection and the resistance to antibiotics used in its treatment vary according to the geographic region and other factors. In this study, we aim to understand the current situation of H. pylori prevalence and antibiotic resistance in different countries, as well as to evaluate the effectiveness of available treatments. Objectives: 1. To analyze the prevalence of H. pylori and antibiotic resistance in different countries. 2. To evaluate the effectiveness of available treatments for eradicating H. pylori. 3. To investigate the molecular methods used to detect clarithromycin resistance in H. pylori. 4. To identify factors associated with antibiotic resistance in patients infected with H. pylori. Patients and Methods: a comprehensive review of the scientific literature was conducted using electronic databases. Studies reporting on the prevalence of H. pylori and antibiotic resistance in different countries were included, as well as clinical trials evaluating the effectiveness of treatments for H. pylori infection eradication. Data on molecular methods used to detect clarithromycin resistance in H. pylori were collected, and factors associated with antibiotic resistance were analyzed. Results: the results show a continuous prevalence of H. pylori in certain areas, with variability in antibiotic resistance among different countries. High resistance to antibiotics such as clarithromycin, metronidazole, and levofloxacin is observed in most countries, while resistance to amoxicillin and tetracycline is relatively low. Several molecular methods for detecting clarithromycin resistance in H. pylori are identified, including PCR-RFLP, PCROLA, and real-time DNA sequencing. Conclusions: 1. The prevalence of H. pylori remains significant in some areas despite the overall decreasing trend. 2. Resistance to clarithromycin, metronidazole, and levofloxacin is common in most countries, highlighting the need for alternative therapeutic strategies. 3. Susceptibility testing is required before initiating treatment to select the most appropriate regimen. 4. Molecular methods provide a precise tool for detecting clarithromycin resistance in H. pylori. 5. Continuous research is needed to develop more effective treatments and understand the mechanisms of antibiotic resistance.
Direction
GARCIA RIESTRA, CARLOS (Tutorships)
GARCIA RIESTRA, CARLOS (Tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Therapeutic efficacy of GnRH antagonists on quality of life in patients with endometriosis.
Authorship
N.C.S.
Bachelor of Medicine
N.C.S.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Objectives: Synthesis of available scientific evidence on the therapeutic efficacy of GnRH antagonists (Elagolix, Relugolix and Linzagolix) in improving quality of life in women diagnosed with endometriosis and associated pelvic pain. Methods: Systematic review of randomised clinical trials (n=16) in premenopausal women with a surgical diagnosis of endometriosis and associated pelvic pain under treatment with GnRH antagonists (Elagolix, Relugolix and Linzagolix) and assessment of therapeutic efficacy on quality of life using the Endometriosis Health Profile EHP-30 and EHP-5. Results: Improvement in quality of life with highest significance in the pain subscale, followed by the control and impotence domain of the EHP-30 and EHP-5 profiles. A dose-dependent therapeutic response defined under a time frame is outlined, proportional to the improvement in the patients' quality of life. Likewise, the comparable therapeutic efficacy of agonists and antagonists in the management of pain of endometriotic origin and the improvement in the indices of well-being are consolidated. Conclusion: The systematic review supports the therapeutic efficacy of GnRH antagonists (Elagolix, Relugolix and Linzagolix) in improving quality of life in patients with endometriosis.
Objectives: Synthesis of available scientific evidence on the therapeutic efficacy of GnRH antagonists (Elagolix, Relugolix and Linzagolix) in improving quality of life in women diagnosed with endometriosis and associated pelvic pain. Methods: Systematic review of randomised clinical trials (n=16) in premenopausal women with a surgical diagnosis of endometriosis and associated pelvic pain under treatment with GnRH antagonists (Elagolix, Relugolix and Linzagolix) and assessment of therapeutic efficacy on quality of life using the Endometriosis Health Profile EHP-30 and EHP-5. Results: Improvement in quality of life with highest significance in the pain subscale, followed by the control and impotence domain of the EHP-30 and EHP-5 profiles. A dose-dependent therapeutic response defined under a time frame is outlined, proportional to the improvement in the patients' quality of life. Likewise, the comparable therapeutic efficacy of agonists and antagonists in the management of pain of endometriotic origin and the improvement in the indices of well-being are consolidated. Conclusion: The systematic review supports the therapeutic efficacy of GnRH antagonists (Elagolix, Relugolix and Linzagolix) in improving quality of life in patients with endometriosis.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Santa María Ortiz, Johana Karin (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Santa María Ortiz, Johana Karin (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Non-Cystic Fibrosis Bronchiectasis
Authorship
I.D.C.P.
Bachelor of Medicine
I.D.C.P.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Bronchiectasis is defined as an abnormal and persistent dilation of the peripheral bronchi caused by chronic inflammation and infection of the airways, leading to characteristic symptoms such as persistent or recurrent chronic wet cough and repeated respiratory infections. The most common cause of bronchiectasis in children is cystic fibrosis. However, in recent decades there has been an increase in the prevalence of non-cystic fibrosis bronchiectasis in children, despite it being an uncommon and underdiagnosed condition, partly due to the lack of suspicion. Several studies have highlighted the importance of early identification of this condition, delving into its etiology and establishing appropriate treatment to prevent disease progression or even reverse the changes caused by underlying infection or inflammation in most cases, thereby reducing the associated high morbidity. The objective of this work is to conduct a bibliographic review of the most recent scientific literature on this condition and to describe, through a retrospective study, the clinical, epidemiological, diagnostic, therapeutic, and prognostic characteristics of pediatric patients with non-cystic fibrosis bronchiectasis followed up in the Pediatric Pulmonology clinic at the Maternal and Child Hospital of A Coruña between the years 2013-2023.
Bronchiectasis is defined as an abnormal and persistent dilation of the peripheral bronchi caused by chronic inflammation and infection of the airways, leading to characteristic symptoms such as persistent or recurrent chronic wet cough and repeated respiratory infections. The most common cause of bronchiectasis in children is cystic fibrosis. However, in recent decades there has been an increase in the prevalence of non-cystic fibrosis bronchiectasis in children, despite it being an uncommon and underdiagnosed condition, partly due to the lack of suspicion. Several studies have highlighted the importance of early identification of this condition, delving into its etiology and establishing appropriate treatment to prevent disease progression or even reverse the changes caused by underlying infection or inflammation in most cases, thereby reducing the associated high morbidity. The objective of this work is to conduct a bibliographic review of the most recent scientific literature on this condition and to describe, through a retrospective study, the clinical, epidemiological, diagnostic, therapeutic, and prognostic characteristics of pediatric patients with non-cystic fibrosis bronchiectasis followed up in the Pediatric Pulmonology clinic at the Maternal and Child Hospital of A Coruña between the years 2013-2023.
Direction
Moreno Álvarez, Ana (Tutorships)
González Torres, Ana Lucía (Co-tutorships)
Moreno Álvarez, Ana (Tutorships)
González Torres, Ana Lucía (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
MERA VARELA, ANTONIO JOSE (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Cocaine Use and Suicide in Young People and Adults in Spain
Authorship
A.F.E.N.
Bachelor of Medicine
A.F.E.N.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Introduction Suicide is due to a multifactorial cause. Suicidal behavior occurs in men and women of all ages, races, creeds, sexual orientations, and educational levels. According to the World Health Organization (WHO), it is estimated that approximately 800,000 people commit suicide every year, which is equivalent to one death every 40 seconds. Worldwide, suicide is the second cause of violent death in people between 15 and 29 years old and the fifth cause of death in people between 30 and 49 years old. This makes it a major public health problem. On the other hand, several studies have shown that alcohol consumption and/or substance abuse are strongly associated with suicidal ideation. It is known that people with a substance use disorder have a risk of suicide more than 4 times higher than the general population after adjustments for sociodemographic differences and comorbidities. Objectives The present study aims to summarize the current evidence on the relationship between cocaine use and completed suicide in young people and adults in Spain to offer an updated perspective on this topic. Through this updated perspective, we aim to examine the possible impact and relationship of acute and/or chronic cocaine use with a potential increase in the risk of completed suicide in young people and adults in Spain. Methodology This study consists of a scope review of the available scientific literature on the aforementioned topic, elaborated through different databases such as PubMed and Google Scholar. Following the inclusion criteria, several original articles were selected, with free access, with publication language in English or Spanish and whose title contains some of the keywords. This study was based on the PRISMA guidelines. Results Seven articles were analyzed: the results indicate that there is a relationship between cocaine use and increased suicide rates among young people and adults in Spain, with four studies with significantly relevant data highlighting this link. Conclusion The risk of suicide is higher in cocaine users, showing an increased suicide rate among young and adult cocaine users in Spain.
Introduction Suicide is due to a multifactorial cause. Suicidal behavior occurs in men and women of all ages, races, creeds, sexual orientations, and educational levels. According to the World Health Organization (WHO), it is estimated that approximately 800,000 people commit suicide every year, which is equivalent to one death every 40 seconds. Worldwide, suicide is the second cause of violent death in people between 15 and 29 years old and the fifth cause of death in people between 30 and 49 years old. This makes it a major public health problem. On the other hand, several studies have shown that alcohol consumption and/or substance abuse are strongly associated with suicidal ideation. It is known that people with a substance use disorder have a risk of suicide more than 4 times higher than the general population after adjustments for sociodemographic differences and comorbidities. Objectives The present study aims to summarize the current evidence on the relationship between cocaine use and completed suicide in young people and adults in Spain to offer an updated perspective on this topic. Through this updated perspective, we aim to examine the possible impact and relationship of acute and/or chronic cocaine use with a potential increase in the risk of completed suicide in young people and adults in Spain. Methodology This study consists of a scope review of the available scientific literature on the aforementioned topic, elaborated through different databases such as PubMed and Google Scholar. Following the inclusion criteria, several original articles were selected, with free access, with publication language in English or Spanish and whose title contains some of the keywords. This study was based on the PRISMA guidelines. Results Seven articles were analyzed: the results indicate that there is a relationship between cocaine use and increased suicide rates among young people and adults in Spain, with four studies with significantly relevant data highlighting this link. Conclusion The risk of suicide is higher in cocaine users, showing an increased suicide rate among young and adult cocaine users in Spain.
Direction
TABERNERO DUQUE, MARIA JESÚS (Tutorships)
TABERNERO DUQUE, MARIA JESÚS (Tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
GLP-1 in metabolism: implications in diabetes and obesity
Authorship
P.G.A.
Bachelor of Medicine
P.G.A.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Incretins are a group of hormones produced in the gastrointestinal tract that play an important role in regulating glucose homeostasis, primarily by increasing pancreatic insulin secretion. These are mostly secreted following the oral intake of nutrients, especially carbohydrates and fats. However, their actions are not limited to the regulation of glucose levels; they also play a significant role in regulating intake, weight loss, gastric emptying, the formation or destruction of fat tissue, and various functions not related to glucose metabolism, such as their cardioprotective or neuroprotective effects, among many others. The objective of this narrative review is to synthesize the available information about the therapeutic applications of treatments related to incretins, focusing specifically on Diabetes Mellitus and obesity, including the latest information on mono-, dual- and triple-agonist molecules, their potential, and a critique of the possible evolution of this field of research in the future. To achieve this, a bibliographic search was conducted in the PubMed (MEDLINE) digital library using various MeSH terms in combination with Boolean operators, followed by a selection of studies that, in the opinion of the author, could most effectively present the current landscape of GLP-1 related therapies. In the preparation of this paper, the original articles that collect the results of clinical trials in humans have always been consulted and cited, as well as those that describe the potential molecular mechanisms involved in preclinical models. The multiple effects of incretins sparked interest in the development of synthetic analogues capable of resisting the rapid degradation these hormones undergo due to the action of the enzyme DPP-4. After the serendipitous isolation of the peptide exendin-4 from the saliva of the Gila Monster lizard and the discovery that it was homologous to human GLP-1, its synthetic form, exenatide, was quickly commercialized and administered subcutaneously twice a day. Following this, various formulations were developed, including weekly injection forms or oral administration, among others. Moreover, upon observing generalized weight loss in diabetic patients treated with GLP-1RAs, their potential applications in the treatment of obesity began to be studied, with the first GLP-1RA approved for this indication in 2014. Nowadays, there are several lines of research open regarding treatments related to incretins, especially those related to the multiple agonism/antagonism of several receptors simultaneously, in order to improve their efficacy in the treatment of diabetes and obesity.
Incretins are a group of hormones produced in the gastrointestinal tract that play an important role in regulating glucose homeostasis, primarily by increasing pancreatic insulin secretion. These are mostly secreted following the oral intake of nutrients, especially carbohydrates and fats. However, their actions are not limited to the regulation of glucose levels; they also play a significant role in regulating intake, weight loss, gastric emptying, the formation or destruction of fat tissue, and various functions not related to glucose metabolism, such as their cardioprotective or neuroprotective effects, among many others. The objective of this narrative review is to synthesize the available information about the therapeutic applications of treatments related to incretins, focusing specifically on Diabetes Mellitus and obesity, including the latest information on mono-, dual- and triple-agonist molecules, their potential, and a critique of the possible evolution of this field of research in the future. To achieve this, a bibliographic search was conducted in the PubMed (MEDLINE) digital library using various MeSH terms in combination with Boolean operators, followed by a selection of studies that, in the opinion of the author, could most effectively present the current landscape of GLP-1 related therapies. In the preparation of this paper, the original articles that collect the results of clinical trials in humans have always been consulted and cited, as well as those that describe the potential molecular mechanisms involved in preclinical models. The multiple effects of incretins sparked interest in the development of synthetic analogues capable of resisting the rapid degradation these hormones undergo due to the action of the enzyme DPP-4. After the serendipitous isolation of the peptide exendin-4 from the saliva of the Gila Monster lizard and the discovery that it was homologous to human GLP-1, its synthetic form, exenatide, was quickly commercialized and administered subcutaneously twice a day. Following this, various formulations were developed, including weekly injection forms or oral administration, among others. Moreover, upon observing generalized weight loss in diabetic patients treated with GLP-1RAs, their potential applications in the treatment of obesity began to be studied, with the first GLP-1RA approved for this indication in 2014. Nowadays, there are several lines of research open regarding treatments related to incretins, especially those related to the multiple agonism/antagonism of several receptors simultaneously, in order to improve their efficacy in the treatment of diabetes and obesity.
Direction
Dieguez Gonzalez, Carlos (Tutorships)
González Rellán, María Jesús (Co-tutorships)
Dieguez Gonzalez, Carlos (Tutorships)
González Rellán, María Jesús (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Smoke and mirrors: a review of moyamoya disease and its treatment.
Authorship
A.G.L.
Bachelor of Medicine
A.G.L.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Moyamoya disease is a cerebrovascular pathology characterized by chronic and progressive stenosis of the internal carotid artery and its main branches, inducing a state of chronic ischemia leading to vessel neoformation as compensatory mechanism. It is a rare entity still surrounded by many unknowns yet to be solved, one of them being the treatment of choice. The objective is to review recent scientific literature to gain an overview of moyamoya disease and compare treatment options in reducing unfavourable clinical outcomes (stroke, transient ischemic attacks, rebleeding, cognitive impairment and death).
Moyamoya disease is a cerebrovascular pathology characterized by chronic and progressive stenosis of the internal carotid artery and its main branches, inducing a state of chronic ischemia leading to vessel neoformation as compensatory mechanism. It is a rare entity still surrounded by many unknowns yet to be solved, one of them being the treatment of choice. The objective is to review recent scientific literature to gain an overview of moyamoya disease and compare treatment options in reducing unfavourable clinical outcomes (stroke, transient ischemic attacks, rebleeding, cognitive impairment and death).
Direction
Fernández Rodríguez, Eva (Tutorships)
Pérez Lorenzo, Gema (Co-tutorships)
Fernández Rodríguez, Eva (Tutorships)
Pérez Lorenzo, Gema (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Treatment of the hypertrophy of the muscle masseter with the application of Botulin Toxin Type A
Authorship
M.M.J.L.
Bachelor of Medicine
M.M.J.L.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
The etiology of this clinical condition is multifactorial and may be related to numerous processes such as bruxism, specific pathology of the temporomandibular joint, occlusion alterations, emotional disorders, chronic stress, absence of REM sleep, as well as a specific alteration in the modulation of acetylcholine and dopamine in the nociceptors and muscle neuroreceptors of one or both masseter muscles. The initial clinical manifestations are very variable, most of them are asymptomatic and are usually diagnosed after the patient perceives a variable bulge in the proximities of the mandibular angle. This anatomical modification and disfigurement can be perceived by the patient with greater or lesser intensity, depending on the variations in weight that he/she may experience during a short period of time. It should also be noted that not in all unilateral or bilateral masseter hypertrophies the application of botulinum toxin is indicated, and that in some cases, it can lead to the undesirable circumstance of overtreatment, with the consequent masking of other pathologies that should have been diagnosed by the professional through the prior prescription of other complementary diagnostic tests. A 40-year-old female patient came to the Oral Surgery Teaching Unit of the University of Santiago de Compostela, referred by her dentist, who had previously treated her for bruxism and TMJ joint dysfunction with an anterior joint repositioning splint. The patient has been reporting for two years the existence of a progressive, bilateral and sometimes painful muscular bulging in the area of the masseter muscles. Although a clear differential diagnosis with other pathologies could be established by inspection and clinical history, we indicated conventional imaging tests, magnetic resonance imaging and ultrasound of both parotid spaces and the area of both masseter muscles.
The etiology of this clinical condition is multifactorial and may be related to numerous processes such as bruxism, specific pathology of the temporomandibular joint, occlusion alterations, emotional disorders, chronic stress, absence of REM sleep, as well as a specific alteration in the modulation of acetylcholine and dopamine in the nociceptors and muscle neuroreceptors of one or both masseter muscles. The initial clinical manifestations are very variable, most of them are asymptomatic and are usually diagnosed after the patient perceives a variable bulge in the proximities of the mandibular angle. This anatomical modification and disfigurement can be perceived by the patient with greater or lesser intensity, depending on the variations in weight that he/she may experience during a short period of time. It should also be noted that not in all unilateral or bilateral masseter hypertrophies the application of botulinum toxin is indicated, and that in some cases, it can lead to the undesirable circumstance of overtreatment, with the consequent masking of other pathologies that should have been diagnosed by the professional through the prior prescription of other complementary diagnostic tests. A 40-year-old female patient came to the Oral Surgery Teaching Unit of the University of Santiago de Compostela, referred by her dentist, who had previously treated her for bruxism and TMJ joint dysfunction with an anterior joint repositioning splint. The patient has been reporting for two years the existence of a progressive, bilateral and sometimes painful muscular bulging in the area of the masseter muscles. Although a clear differential diagnosis with other pathologies could be established by inspection and clinical history, we indicated conventional imaging tests, magnetic resonance imaging and ultrasound of both parotid spaces and the area of both masseter muscles.
Direction
SUAREZ QUINTANILLA, JOSE MARIA (Tutorships)
SUAREZ QUINTANILLA, JOSE MARIA (Tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Approach in Spain between immigrant population and mental health: Measures to improve acceptance of diagnosis and treatment
Authorship
L.M.L.Z.
Bachelor of Medicine
L.M.L.Z.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Immigration does not constitute a pathogenic factor for mental disorder itself, but it can be pointed as a risk factor for mental health, especially in adverse circumstances. The migration process includes the loss of family, social and cultural bonds, and the adaptation to a new reality with all the problems and difficulties that come with it, such as integration in a new society, the language, job insecurity, among other elements that cause migratory stress that can end up in an extreme migratory grief. This paper is focused on migratory grief, what difficulties immigrants face and how this cultural diversity affects the access to health care and the possible approach strategies that could be implemented to better the health care provided to this group.
Immigration does not constitute a pathogenic factor for mental disorder itself, but it can be pointed as a risk factor for mental health, especially in adverse circumstances. The migration process includes the loss of family, social and cultural bonds, and the adaptation to a new reality with all the problems and difficulties that come with it, such as integration in a new society, the language, job insecurity, among other elements that cause migratory stress that can end up in an extreme migratory grief. This paper is focused on migratory grief, what difficulties immigrants face and how this cultural diversity affects the access to health care and the possible approach strategies that could be implemented to better the health care provided to this group.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Neddylation: a post-translational modification with a role in human metabolism
Authorship
J.A.L.F.
Bachelor of Medicine
J.A.L.F.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
The term “post-translational modifications” refers to any biochemical process that a protein goes through after its biosynthesis. These alterations of a protein’s native structure, usually comprising either proteolysis or the attachment of a modifier group, allow for a change in functionality and characteristics, thus being a fundamental molecular mechanism to understand in order to understand a protein’s biology as a whole. By advancing our knowledge of post-translational modifications in health and disease, we might open new therapeutic options aiming to modify or prevent their effects entirely. While some post-translational modifications, such as phosphorylation or ubiquitination, have already been described and studied extensively and are known both in terms of their implications and effects, there are some others, however, that are still in the process of being properly understood. Neddylation is one of the latter, and recent preclinical findings have shown its strong involvement in energy metabolism, especially when it comes to obesity, hepatic steatosis, insulin resistance and diabetes. This paper aims to define the potential role of neddylation within energy metabolism through a systematic review of related literature.
The term “post-translational modifications” refers to any biochemical process that a protein goes through after its biosynthesis. These alterations of a protein’s native structure, usually comprising either proteolysis or the attachment of a modifier group, allow for a change in functionality and characteristics, thus being a fundamental molecular mechanism to understand in order to understand a protein’s biology as a whole. By advancing our knowledge of post-translational modifications in health and disease, we might open new therapeutic options aiming to modify or prevent their effects entirely. While some post-translational modifications, such as phosphorylation or ubiquitination, have already been described and studied extensively and are known both in terms of their implications and effects, there are some others, however, that are still in the process of being properly understood. Neddylation is one of the latter, and recent preclinical findings have shown its strong involvement in energy metabolism, especially when it comes to obesity, hepatic steatosis, insulin resistance and diabetes. This paper aims to define the potential role of neddylation within energy metabolism through a systematic review of related literature.
Direction
Dieguez Gonzalez, Carlos (Tutorships)
González Rellán, María Jesús (Co-tutorships)
Dieguez Gonzalez, Carlos (Tutorships)
González Rellán, María Jesús (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Comparison between endoscopic and open approach in carpal tunnel syndrome: systematic review.
Authorship
M.M.P.
Bachelor of Medicine
M.M.P.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
INTRODUCTION: Carpal Tunnel Syndrome (CTS) is the clinical condition caused by compression of the median nerve during its journey through the carpal canal. It is a highly prevalent pathology, affecting between 0.1% and 10% of the population. More common in women with a higher incidence in the fourth and fifth decades of life. It presents sensory, motor and trophic symptoms. Its etiology encompasses structural, genetic, biological, environmental, and occupational aspects, although it is frequently idiopathic. AIM: Conduct a systematic bibliographic review of the literature that provides data to compare the effectiveness, profitability, safety and possible benefits of the less common endoscopic treatment compared to the classic open treatment and evaluate it as an option in the treatment of CTS. METHODOLOGY: Search in the MEDLINE/Pubmed database, selecting randomized clinical trials, systematic reviews and meta-analyses carried out in humans, published between 2014 and 2024, in English and Spanish and with free access to reading their full text. RESULTS: 9 articles were obtained comparing both strategies. The main complications of endoscopic treatment were an ineffective release of the transverse carpal ligament that requires reintervention, and a greater frequency of transient nerve injuries of the median nerve. The main advantages were an earlier recovery with faster return to work. The endoscopic technique was more expensive, although profitable due to its good results in symptomatic relief and functional aspects of the hand. CONCLUSION: The endoscopic technique in CTS represents an evolution in its surgical treatment. Its minimally invasive approach appears to reduce some complications (infections, surgical wound) and allow early recovery. Its functional results seem equivalent to those of open surgery. However, it is more expensive, and its complications could be more serious. It is necessary to continue carrying out quality studies that allow its possible advantages to be adequately assessed.
INTRODUCTION: Carpal Tunnel Syndrome (CTS) is the clinical condition caused by compression of the median nerve during its journey through the carpal canal. It is a highly prevalent pathology, affecting between 0.1% and 10% of the population. More common in women with a higher incidence in the fourth and fifth decades of life. It presents sensory, motor and trophic symptoms. Its etiology encompasses structural, genetic, biological, environmental, and occupational aspects, although it is frequently idiopathic. AIM: Conduct a systematic bibliographic review of the literature that provides data to compare the effectiveness, profitability, safety and possible benefits of the less common endoscopic treatment compared to the classic open treatment and evaluate it as an option in the treatment of CTS. METHODOLOGY: Search in the MEDLINE/Pubmed database, selecting randomized clinical trials, systematic reviews and meta-analyses carried out in humans, published between 2014 and 2024, in English and Spanish and with free access to reading their full text. RESULTS: 9 articles were obtained comparing both strategies. The main complications of endoscopic treatment were an ineffective release of the transverse carpal ligament that requires reintervention, and a greater frequency of transient nerve injuries of the median nerve. The main advantages were an earlier recovery with faster return to work. The endoscopic technique was more expensive, although profitable due to its good results in symptomatic relief and functional aspects of the hand. CONCLUSION: The endoscopic technique in CTS represents an evolution in its surgical treatment. Its minimally invasive approach appears to reduce some complications (infections, surgical wound) and allow early recovery. Its functional results seem equivalent to those of open surgery. However, it is more expensive, and its complications could be more serious. It is necessary to continue carrying out quality studies that allow its possible advantages to be adequately assessed.
Direction
Concheiro Guisán, Ana (Tutorships)
Quinteiro Antolín, Tomás Luis (Co-tutorships)
Concheiro Guisán, Ana (Tutorships)
Quinteiro Antolín, Tomás Luis (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Results of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy as a Treatment for Peritoneal Carcinomatosis of Colorectal and Appendiceal Origin: a Retrospective Observational Study
Authorship
C.N.R.P.
Bachelor of Medicine
C.N.R.P.
Bachelor of Medicine
Defense date
09.05.2024 09:00
09.05.2024 09:00
Summary
Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved overall survival (OS) in selected patients with peritoneal carcinomatosis (PC) of colorectal (CRC) and appendiceal origin, previously a pathology with very poor prognosis. Objectives: To determine OS, disease-free survival (DFS), postoperative morbimortality, the correlation between intraoperative and anatomopathological PC index (PCI), and possible prognostic factors for lower OS and higher morbimortality. Material and Methods: This is a single-center retrospective observational study on 25 patients treated with CRS/HIPEC for PC of colorectal (21 patients, 84%) and appendiceal (4 patients, 16%) origin. Findings: The incidence of complications and mortality at 30 days was 28% and 8%, respectively, with the male sex being identified as a risk factor for complications (p0.020). The correlation between intraoperative and anatomopathological PCI was very strong (0.814). The OS rate at 1, 3, and 5 years was 87.5%, 79.1%, and 66.6%, respectively, with left CRC being associated with lower OS (log-rank p0.04). The incidence of recurrences was 47.83%, resulting in a DFS rate at 1, 3 and 5 years of 58.3%, 50% and 45.8%, respectively. Conclusion: CRS/HIPEC offers an increase in OS, and an improvement in DFS and morbimortality is expected, thanks to the incorporation of new prognostic factors for patient selection, together with the gaining of experience of surgeons and centers and advances in systemic chemotherapy, immunotherapy and HIPEC.
Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved overall survival (OS) in selected patients with peritoneal carcinomatosis (PC) of colorectal (CRC) and appendiceal origin, previously a pathology with very poor prognosis. Objectives: To determine OS, disease-free survival (DFS), postoperative morbimortality, the correlation between intraoperative and anatomopathological PC index (PCI), and possible prognostic factors for lower OS and higher morbimortality. Material and Methods: This is a single-center retrospective observational study on 25 patients treated with CRS/HIPEC for PC of colorectal (21 patients, 84%) and appendiceal (4 patients, 16%) origin. Findings: The incidence of complications and mortality at 30 days was 28% and 8%, respectively, with the male sex being identified as a risk factor for complications (p0.020). The correlation between intraoperative and anatomopathological PCI was very strong (0.814). The OS rate at 1, 3, and 5 years was 87.5%, 79.1%, and 66.6%, respectively, with left CRC being associated with lower OS (log-rank p0.04). The incidence of recurrences was 47.83%, resulting in a DFS rate at 1, 3 and 5 years of 58.3%, 50% and 45.8%, respectively. Conclusion: CRS/HIPEC offers an increase in OS, and an improvement in DFS and morbimortality is expected, thanks to the incorporation of new prognostic factors for patient selection, together with the gaining of experience of surgeons and centers and advances in systemic chemotherapy, immunotherapy and HIPEC.
Direction
Fernández Pérez, José Aquilino (Tutorships)
Conde Rodríguez, María (Co-tutorships)
Fernández Pérez, José Aquilino (Tutorships)
Conde Rodríguez, María (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Probiotics and lactational mastitis: a systematic review
Authorship
E.C.F.
Bachelor of Medicine
E.C.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Lactational mastitis, defined as the inflammation of the mammary tissue, constitutes a significant public health problem as it is one of the main causes of early and unwanted weaning, depriving the mother and infant of the multiple benefits of breastfeeding. The World Health Organization (WHO) promotes the practice of exclusive breastfeeding until 6 months of age, followed by a gradual introduction of complementary foods, while maintaining breastfeeding for a minimum period of two years. However, compliance with these recommendations in our environment is hindered by various factors, such as working conditions, insufficient information, and limited support for breastfeeding practices, to which the problem of mastitis is sometimes added. The majority of mastitis cases occur within the first twelve weeks postpartum, with an incidence ranging from 10 to 33% of lactating women. Currently, there is no clear consensus on its etiology, but it has been suggested that its origin is likely related to the alteration of the mammary microbiota. One of the most common treatment strategies for mastitis is antibiotic therapy, although it is not always effective and can cause other undesirable side effects. Given the relationship between antibiotic use and the growing problem of antimicrobial resistance, there is great interest in the search for other therapeutic alternatives. In this work, we propose to analyze the available results on the use of probiotics for the prevention or treatment of lactational mastitis, one of the most promising strategies to reduce the use of antibiotics and, therefore, the resistance to these drugs, as well as to minimize the interruption of breastfeeding.
Lactational mastitis, defined as the inflammation of the mammary tissue, constitutes a significant public health problem as it is one of the main causes of early and unwanted weaning, depriving the mother and infant of the multiple benefits of breastfeeding. The World Health Organization (WHO) promotes the practice of exclusive breastfeeding until 6 months of age, followed by a gradual introduction of complementary foods, while maintaining breastfeeding for a minimum period of two years. However, compliance with these recommendations in our environment is hindered by various factors, such as working conditions, insufficient information, and limited support for breastfeeding practices, to which the problem of mastitis is sometimes added. The majority of mastitis cases occur within the first twelve weeks postpartum, with an incidence ranging from 10 to 33% of lactating women. Currently, there is no clear consensus on its etiology, but it has been suggested that its origin is likely related to the alteration of the mammary microbiota. One of the most common treatment strategies for mastitis is antibiotic therapy, although it is not always effective and can cause other undesirable side effects. Given the relationship between antibiotic use and the growing problem of antimicrobial resistance, there is great interest in the search for other therapeutic alternatives. In this work, we propose to analyze the available results on the use of probiotics for the prevention or treatment of lactational mastitis, one of the most promising strategies to reduce the use of antibiotics and, therefore, the resistance to these drugs, as well as to minimize the interruption of breastfeeding.
Direction
Leis Trabazo, María Rosaura (Tutorships)
Vázquez Rodríguez, Marta (Co-tutorships)
Leis Trabazo, María Rosaura (Tutorships)
Vázquez Rodríguez, Marta (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Towards a consensus guideline for the management of Duchenne muscular dystrophy: A comparative evaluation of deflazacort and prednisone
Authorship
D.C.M.
Bachelor of Medicine
D.C.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Duchenne muscular dystrophy (DMD) is the most severe and common of the dystrophinopathies. It is a genetic disorder in the dystrophin gene, which is inherited in an X-linked recessive manner. It is characterized by progressive deterioration of motor function, beginning in childhood and continuing into adolescence and early adulthood, culminating in premature death from respiratory and cardiac complications. There is currently no cure, but thanks to treatment with corticosteroids, quality of life of patients has improved greatly. Justification: Corticosteroid therapy is, and possibly will be, a cornerstone of DMD treatment. However, there is currently no definitive body of information to define an optimal corticosteroid regimen. Objectives: To compare the two most commonly used corticosteroid treatments for DMD, prednisone and deflazacort, and to present the unwanted side effects associated with this treatment. Material and Methods: A systematic review was conducted using the PubMed biomedical database of primary studies comparing the use of both corticosteroids in patients with DMD. A clinical case of deflazacort treatment is presented. Results: Five studies were included, with notable differences in terms of population and outcome assessment, making comparison difficult. Clinical improvement and the appearance of some side effects are the most notable aspects of the presented clinical case. Conclusions: It cannot be definitively stated that deflazacort is superior to prednisone in DMD treatment, although it does provide better clinical outcomes and is better tolerated. Intermittent regimens are not as effective as daily regimens, but may be an option if there is poor treatment tolerance.
Introduction: Duchenne muscular dystrophy (DMD) is the most severe and common of the dystrophinopathies. It is a genetic disorder in the dystrophin gene, which is inherited in an X-linked recessive manner. It is characterized by progressive deterioration of motor function, beginning in childhood and continuing into adolescence and early adulthood, culminating in premature death from respiratory and cardiac complications. There is currently no cure, but thanks to treatment with corticosteroids, quality of life of patients has improved greatly. Justification: Corticosteroid therapy is, and possibly will be, a cornerstone of DMD treatment. However, there is currently no definitive body of information to define an optimal corticosteroid regimen. Objectives: To compare the two most commonly used corticosteroid treatments for DMD, prednisone and deflazacort, and to present the unwanted side effects associated with this treatment. Material and Methods: A systematic review was conducted using the PubMed biomedical database of primary studies comparing the use of both corticosteroids in patients with DMD. A clinical case of deflazacort treatment is presented. Results: Five studies were included, with notable differences in terms of population and outcome assessment, making comparison difficult. Clinical improvement and the appearance of some side effects are the most notable aspects of the presented clinical case. Conclusions: It cannot be definitively stated that deflazacort is superior to prednisone in DMD treatment, although it does provide better clinical outcomes and is better tolerated. Intermittent regimens are not as effective as daily regimens, but may be an option if there is poor treatment tolerance.
Direction
Hermida Ameijeiras, Álvaro (Tutorships)
Guijarro del Amo, Mónica (Co-tutorships)
Hermida Ameijeiras, Álvaro (Tutorships)
Guijarro del Amo, Mónica (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
GWAS studies of response to the antipsychotic clozapine: A systematic review.
Authorship
M.E.C.O.
Bachelor of Medicine
M.E.C.O.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia, although it is sometimes underused, in part because of rare but serious side effects such as agranulocytosis and myocarditis. Interindividual variability in drug response and side effects can be expected to have a genetic and environmental basis. GWAS studies are presented as a useful strategy to increase the knowledge of the genetic factors involved in the interindividual variability of clozapine concentrations and to know a possible predisposition to the occurrence of side effects. In this paper, a systematic review of the relevant scientific literature on GWAS studies on clozapine has been carried out in which 9 studies have been analyzed in their totality. These studies identified different polymorphisms that may affect the variability of concentrations such as genetic variants in UGT2B10 that influence norclozapine plasma levels or in CYP1A1/CYP1A2 and in NFIB, both associated with a reduction in clozapine plasma concentrations. All studies that investigated neutropenia/agranulocytosis found some genetic variant of relevance in HLA-B. Risk SNPs were also found in HLA-DQB1 and a regulatory variant in ACKR1 (Duffy-null genotype) that showed an increased predisposition to develop neutropenia. Moreover, the results suggested that genetic variants in SLCO1B3 and SLCO1B1 increase the risk of neutropenia. The studies have provided evidence for the existence of a genetic contribution to the variation in clozapine concentrations and adverse effects. However, it is necessary to continue expanding the sample size of the GWAS that study the variability in the response to clozapine, both in terms of efficacy and side effects.
Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia, although it is sometimes underused, in part because of rare but serious side effects such as agranulocytosis and myocarditis. Interindividual variability in drug response and side effects can be expected to have a genetic and environmental basis. GWAS studies are presented as a useful strategy to increase the knowledge of the genetic factors involved in the interindividual variability of clozapine concentrations and to know a possible predisposition to the occurrence of side effects. In this paper, a systematic review of the relevant scientific literature on GWAS studies on clozapine has been carried out in which 9 studies have been analyzed in their totality. These studies identified different polymorphisms that may affect the variability of concentrations such as genetic variants in UGT2B10 that influence norclozapine plasma levels or in CYP1A1/CYP1A2 and in NFIB, both associated with a reduction in clozapine plasma concentrations. All studies that investigated neutropenia/agranulocytosis found some genetic variant of relevance in HLA-B. Risk SNPs were also found in HLA-DQB1 and a regulatory variant in ACKR1 (Duffy-null genotype) that showed an increased predisposition to develop neutropenia. Moreover, the results suggested that genetic variants in SLCO1B3 and SLCO1B1 increase the risk of neutropenia. The studies have provided evidence for the existence of a genetic contribution to the variation in clozapine concentrations and adverse effects. However, it is necessary to continue expanding the sample size of the GWAS that study the variability in the response to clozapine, both in terms of efficacy and side effects.
Direction
ARROJO ROMERO, MANUEL (Tutorships)
Costas Costas, Javier (Co-tutorships)
Facal Molina, Fernando (Co-tutorships)
ARROJO ROMERO, MANUEL (Tutorships)
Costas Costas, Javier (Co-tutorships)
Facal Molina, Fernando (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Analgesic electrotherapy in musculoskeletal pain narrative revisión
Authorship
D.D.S.L.
Bachelor of Medicine
D.D.S.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
The employ of electric energy in different modalities has broadly used for a long time for many uses. One of these is its medical treatment in diverse areas, as the muscle skeletal pain. Its theoretical benefits are based on exogenic stimulation in cells with different types and forms of electricity to modify their membrane potential and to achieve therapeutic cellular activity levels. There are numerous techniques, each one has a different effect depending on the tissue. For example, ultrasounds are mainly absorbed by tissues with high density of collagen as cartilage, tendons, or fascia. On the other hand, Transcutaneous Electrical Nerve Stimulation (TENS) and Short Wave (OC) are especially useful in tissues with high component of water, edemas and hematomas. The previous ones, among them the magnetotheraphy, have been and are still being frequently employed around the world. However, the therapeutic evidence shown has always been limited. This project aims to make a narrative revision about the actual evidence of quality (metanalysis, systematic revisions and rabdomized clinical trials) to realize recommendations of to do or “not to do” applied in the habitual clinical practice.
The employ of electric energy in different modalities has broadly used for a long time for many uses. One of these is its medical treatment in diverse areas, as the muscle skeletal pain. Its theoretical benefits are based on exogenic stimulation in cells with different types and forms of electricity to modify their membrane potential and to achieve therapeutic cellular activity levels. There are numerous techniques, each one has a different effect depending on the tissue. For example, ultrasounds are mainly absorbed by tissues with high density of collagen as cartilage, tendons, or fascia. On the other hand, Transcutaneous Electrical Nerve Stimulation (TENS) and Short Wave (OC) are especially useful in tissues with high component of water, edemas and hematomas. The previous ones, among them the magnetotheraphy, have been and are still being frequently employed around the world. However, the therapeutic evidence shown has always been limited. This project aims to make a narrative revision about the actual evidence of quality (metanalysis, systematic revisions and rabdomized clinical trials) to realize recommendations of to do or “not to do” applied in the habitual clinical practice.
Direction
FIGUEROA RODRIGUEZ, JESUS (Tutorships)
Formigo Couceiro, Jacobo (Co-tutorships)
FIGUEROA RODRIGUEZ, JESUS (Tutorships)
Formigo Couceiro, Jacobo (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Predictors of hospitalization in children diagnosed with Community-acquired pneumonia: bibliographic review and case series
Authorship
A.D.M.
Bachelor of Medicine
A.D.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Objective: Recognize predictive markers for hospital admission in children with community-acquired pneumonia to manage this type of patients early and effectively according to the literature and compare them with the cases studied. Method: Literature review in the PubMed, Medline, Cochrane and UptoDate databases with the terms: Child, Bronchial Hyperreactivity, Pneumonia, Pneumonia, Bacterial, Hospitalization. Case series with 6 patients aged 2 to 14 years who attended between February 2024 and March 2024 to the pediatric emergency service of the Teresa Herrera Maternal and Child Hospital in A Coruña, diagnosed with community-acquired pneumonia and who required observation with /without subsequent hospitalization. Results and conclusions: The severity of community-acquired pneumonia is directly associated with the level of lobar involvement, the previous days of symptoms and fever, and the use of antibiotics, history of bronchial hyperreactivity or pneumonia, which corresponds to the patients who required admission in our series
Objective: Recognize predictive markers for hospital admission in children with community-acquired pneumonia to manage this type of patients early and effectively according to the literature and compare them with the cases studied. Method: Literature review in the PubMed, Medline, Cochrane and UptoDate databases with the terms: Child, Bronchial Hyperreactivity, Pneumonia, Pneumonia, Bacterial, Hospitalization. Case series with 6 patients aged 2 to 14 years who attended between February 2024 and March 2024 to the pediatric emergency service of the Teresa Herrera Maternal and Child Hospital in A Coruña, diagnosed with community-acquired pneumonia and who required observation with /without subsequent hospitalization. Results and conclusions: The severity of community-acquired pneumonia is directly associated with the level of lobar involvement, the previous days of symptoms and fever, and the use of antibiotics, history of bronchial hyperreactivity or pneumonia, which corresponds to the patients who required admission in our series
Direction
Ávila Álvarez, Alejandro (Tutorships)
Yáñez Mesía, Sandra (Co-tutorships)
Ávila Álvarez, Alejandro (Tutorships)
Yáñez Mesía, Sandra (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Effect of preoperative prehabilitation on the 6-minute walking test on pre-surgical adult patients: a systematic review and meta-analysis.
Authorship
P.D.V.
Bachelor of Medicine
P.D.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: One of the main factors associated with the increase in perioperative complications is cardiorespiratory fitness (CRF). Hence, preoperative prehabilitation programs have been implemented to improve patients’ CRF before facing surgery and recovery. Objectives: The primary objective is to evaluate the effect of surgical prehabilitation programs, based on exercise, on pre and postoperative CRF, measured through the six-minute walk test (6MWT). Secondarily, we aimed to analyze factors that could influence the 6MWT, as well as perioperative complications, measured by hospital stay and mortality. The study protocol was registered in OSF (DOI: osf.io/upyqv). Methods: We conducted a systematic review and metaanalysis, including studies that carried out physical prehabilitation in adults for any type of elective surgery, and used the 6MWT. We followed the PRISMA methodology, searching in PUBMED and WOS, using ROB to analyze the risk of bias, through a random effects model, with RevMan and Meta-Essentials software. Results: Twenty-seven studies with 2163 patients were included. Prehabilitation was associated with a significant improvement in preoperative CRF, with a mean difference of 29 m compared to the control group (95%CI 17; 42, p under 0.001). The prehabilitation group exceeded the minimum detectable and the clinically relevant distance [OR 2.77 (95%CI 1.77; 4.35) and OR 2.66 (95%CI 1.76; 4.00), both p under 0.001] more than the control group. During the postoperative period, the improvement in CRF remained higher in the prehabilitation group (p=0.005). Subjects with lower baseline CRF achieved greater improvement [mean difference 47 m (95%CI 11; 83), p=0.01]. The type of surgery or exercise was not associated with differences in the 6MWT, nor were found improvements in hospital stay or perioperative mortality. Discussion: Prehabilitation with physical exercise was associated with a clinically relevant improvement in preoperative CRF (moderate quality of evidence). This was maintained during the postoperative period (low quality of evidence), with the most notable improvements showing in the group with lower CRF (moderate quality of evidence). No differences were found according to the type of exercise or surgery, nor was there influence on perioperative complications (low quality of evidence). The high level of heterogeneity found caused a reduction in the quality of evidence. New studies, providing better evidence on exercise protocols and their individual adaptation, are needed to optimize clinical outcomes.
Introduction: One of the main factors associated with the increase in perioperative complications is cardiorespiratory fitness (CRF). Hence, preoperative prehabilitation programs have been implemented to improve patients’ CRF before facing surgery and recovery. Objectives: The primary objective is to evaluate the effect of surgical prehabilitation programs, based on exercise, on pre and postoperative CRF, measured through the six-minute walk test (6MWT). Secondarily, we aimed to analyze factors that could influence the 6MWT, as well as perioperative complications, measured by hospital stay and mortality. The study protocol was registered in OSF (DOI: osf.io/upyqv). Methods: We conducted a systematic review and metaanalysis, including studies that carried out physical prehabilitation in adults for any type of elective surgery, and used the 6MWT. We followed the PRISMA methodology, searching in PUBMED and WOS, using ROB to analyze the risk of bias, through a random effects model, with RevMan and Meta-Essentials software. Results: Twenty-seven studies with 2163 patients were included. Prehabilitation was associated with a significant improvement in preoperative CRF, with a mean difference of 29 m compared to the control group (95%CI 17; 42, p under 0.001). The prehabilitation group exceeded the minimum detectable and the clinically relevant distance [OR 2.77 (95%CI 1.77; 4.35) and OR 2.66 (95%CI 1.76; 4.00), both p under 0.001] more than the control group. During the postoperative period, the improvement in CRF remained higher in the prehabilitation group (p=0.005). Subjects with lower baseline CRF achieved greater improvement [mean difference 47 m (95%CI 11; 83), p=0.01]. The type of surgery or exercise was not associated with differences in the 6MWT, nor were found improvements in hospital stay or perioperative mortality. Discussion: Prehabilitation with physical exercise was associated with a clinically relevant improvement in preoperative CRF (moderate quality of evidence). This was maintained during the postoperative period (low quality of evidence), with the most notable improvements showing in the group with lower CRF (moderate quality of evidence). No differences were found according to the type of exercise or surgery, nor was there influence on perioperative complications (low quality of evidence). The high level of heterogeneity found caused a reduction in the quality of evidence. New studies, providing better evidence on exercise protocols and their individual adaptation, are needed to optimize clinical outcomes.
Direction
Álvarez Escudero, Julián (Tutorships)
DIZ GOMEZ, JOSE CARLOS (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
DIZ GOMEZ, JOSE CARLOS (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Titanium impregnation in patients treated with growing rods for Early Onset Scoliosis: Magnetic Growth Rods
Authorship
E.D.S.
Bachelor of Medicine
E.D.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
CONTEXT: The volumetric development of the thoracic cage depends on the longitudinal growth of the spine. Therefore, definitive spinal fusion must be avoided until the thoracic cage is fully developed, using casts, braces, or growth rods (GR, magnetic -MCGR-, or traditional -TGR-). Titanium from these implants is released through friction, causing a local tissue reaction (metallosis). HYPOTHESIS: MCGR generates more metallosis than TGR. OBJECTIVES: Detection of the problem of metallosis in the GR literature, with reference to the type of implant: MCGR vs. TGR. Titanium levels in soft tissues adjacent to the rods, blood, and other distant tissues (hair, nails, etc.). SOURCES OF INFORMATION: Systematic review in MEDLINE (via PubMed), indirect citations from screened articles, and consultation with EOS experts. RESULTS: The literature detects the problem of metallosis: chronic inflammatory pseudomembrane adjacent to the MCGR. Elevated Ti values were also found in this pseudomembrane (0.62-54.4 g/Kg), in blood (0.8-28.2 micrograms/L), hair (3.09 mg/Kg), and nails (less than 0.05 mg/Kg) in the analyzed studies. CONCLUSIONS: 1. We emphasize that EOS treatment should allow the full development of the thorax. 2. There is titanium-induced metallosis in MCGR users. 3. It is higher in patients with MCGR than in patients with TGR. 4. There are elevated serum and distant tissue Ti levels in patients with MCGR. 5. No deleterious health effects of Ti have been demonstrated. 6. We highlight the importance of long-term follow-up for these patients. 7. More studies are needed on this topic, such as the one we are developing.
CONTEXT: The volumetric development of the thoracic cage depends on the longitudinal growth of the spine. Therefore, definitive spinal fusion must be avoided until the thoracic cage is fully developed, using casts, braces, or growth rods (GR, magnetic -MCGR-, or traditional -TGR-). Titanium from these implants is released through friction, causing a local tissue reaction (metallosis). HYPOTHESIS: MCGR generates more metallosis than TGR. OBJECTIVES: Detection of the problem of metallosis in the GR literature, with reference to the type of implant: MCGR vs. TGR. Titanium levels in soft tissues adjacent to the rods, blood, and other distant tissues (hair, nails, etc.). SOURCES OF INFORMATION: Systematic review in MEDLINE (via PubMed), indirect citations from screened articles, and consultation with EOS experts. RESULTS: The literature detects the problem of metallosis: chronic inflammatory pseudomembrane adjacent to the MCGR. Elevated Ti values were also found in this pseudomembrane (0.62-54.4 g/Kg), in blood (0.8-28.2 micrograms/L), hair (3.09 mg/Kg), and nails (less than 0.05 mg/Kg) in the analyzed studies. CONCLUSIONS: 1. We emphasize that EOS treatment should allow the full development of the thorax. 2. There is titanium-induced metallosis in MCGR users. 3. It is higher in patients with MCGR than in patients with TGR. 4. There are elevated serum and distant tissue Ti levels in patients with MCGR. 5. No deleterious health effects of Ti have been demonstrated. 6. We highlight the importance of long-term follow-up for these patients. 7. More studies are needed on this topic, such as the one we are developing.
Direction
GELABERT GONZALEZ, MIGUEL (Tutorships)
HERBELLO HERMELO, PALOMA (Co-tutorships)
GELABERT GONZALEZ, MIGUEL (Tutorships)
HERBELLO HERMELO, PALOMA (Co-tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Effect of Implementation of ERAS Protocols on Perioperative Outcomes in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis
Authorship
E.D.F.
Bachelor of Medicine
E.D.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Postoperative recovery in cardiac surgery is associated with a high number of complications. Hence, Enhanced Recovery After Surgery (ERAS) protocols have emerged as a strategy to attempt to reduce morbidity and mortality. Objectives: The primary objectives were to assess the effect on hospital stay and mortality when implementing an ERAS protocol in cardiac surgery. Secondarily, the quality of life and incidence of post-surgical complications were analyzed. Methods: We conducted a systematic review and meta-analysis, including studies with ERAS protocols implemented in adult patients undergoing elective cardiac surgery. The PRISMA methodology was followed, searching PUBMED and WOS, using ROB and NOS to analyze the risk of bias, through a random effects model, with RevMan and Meta-Essentials software. The protocol was registered on OSF. Results: Twenty articles with 5362 patients were analyzed. ERAS was associated with a reduction in hospital stay of 1.24 days (95% CI 0.82; 1.67, p under 0.05) and in ICU stay of 11.67 hours (95% CI 4.13; 19.22, p under 0.05). There was no significant difference in mortality or risk of atrial fibrillation. Quality of life could not be analyzed as it was not assessed in any of the studies. In post hoc analysis, ERAS was associated with reductions in the risk of acute renal failure, infections, opioid use, intubation time, and reintubation risk. There was no association with variation in the risk of stroke, ICU or hospital readmission, or reintervention. Discussion: ERAS protocols were associated with a reduction in hospital stay and ICU stay (both with very low-quality evidence). However, they were not associated with a variation in mortality risk (very low-quality evidence) or atrial fibrillation risk (very low-quality evidence). The association of ERAS protocols with quality of life could not be studied. The high heterogeneity found and the use of observational studies led to a decrease in the quality of evidence. New studies providing better evidence on quality of life and patient-centered recovery criteria are needed.
Introduction: Postoperative recovery in cardiac surgery is associated with a high number of complications. Hence, Enhanced Recovery After Surgery (ERAS) protocols have emerged as a strategy to attempt to reduce morbidity and mortality. Objectives: The primary objectives were to assess the effect on hospital stay and mortality when implementing an ERAS protocol in cardiac surgery. Secondarily, the quality of life and incidence of post-surgical complications were analyzed. Methods: We conducted a systematic review and meta-analysis, including studies with ERAS protocols implemented in adult patients undergoing elective cardiac surgery. The PRISMA methodology was followed, searching PUBMED and WOS, using ROB and NOS to analyze the risk of bias, through a random effects model, with RevMan and Meta-Essentials software. The protocol was registered on OSF. Results: Twenty articles with 5362 patients were analyzed. ERAS was associated with a reduction in hospital stay of 1.24 days (95% CI 0.82; 1.67, p under 0.05) and in ICU stay of 11.67 hours (95% CI 4.13; 19.22, p under 0.05). There was no significant difference in mortality or risk of atrial fibrillation. Quality of life could not be analyzed as it was not assessed in any of the studies. In post hoc analysis, ERAS was associated with reductions in the risk of acute renal failure, infections, opioid use, intubation time, and reintubation risk. There was no association with variation in the risk of stroke, ICU or hospital readmission, or reintervention. Discussion: ERAS protocols were associated with a reduction in hospital stay and ICU stay (both with very low-quality evidence). However, they were not associated with a variation in mortality risk (very low-quality evidence) or atrial fibrillation risk (very low-quality evidence). The association of ERAS protocols with quality of life could not be studied. The high heterogeneity found and the use of observational studies led to a decrease in the quality of evidence. New studies providing better evidence on quality of life and patient-centered recovery criteria are needed.
Direction
Álvarez Escudero, Julián (Tutorships)
Álvarez Escudero, Julián (Tutorships)
Court
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
CRUZ LANDEIRA, ANGELINES (Chairman)
ANTUNEZ LOPEZ, JOSE RAMON (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Sensitization profile and drivers of immunotherapy's prescription in patients with respiratory allergy in Latin America
Authorship
N.G.P.
Bachelor of Medicine
N.G.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Allergen-specific immunotherapy (AIT) is the only available treatment capable of modifying respiratory allergic disease and inducing tolerance against the allergen. Objectives: The main objective of this study was to identify the clinical drivers of AIT prescription in clinical practice in Latin America in patients with allergic respiratory pathology. Secondary objectives were to identify the clinical characteristics and sensitization profiles of included patients and to identify the type of AIT preferred in this region. Materials and methods: Data collection for the CHOICE-Global study was conducted using the online PQ questionnaire (Patients' questionnaire), which had to be completed by AIT-prescribing doctors and consists of 27 questions about patient sociodemographic data, allergic disease, sensitization profile, and characteristics of prescribed AIT. Patients of any age with respiratory allergy who had initiated AIT against pollen, dust mites, molds, or animal epithelia were included. Participation was voluntary and unpaid. Results: The study included a total of 1865 patients from 10 Latin American countries. The most frequent clinical presentation is rhinitis (64.8%), followed by the combination of rhinitis and asthma (31.8%). 94.4% of patients are sensitized to dust mites. 43% of patients are polysensitized. Prick tests are performed in 94.4% of patients, and only 21.1% undergo in vitro diagnosis of IgE against complete extracts. Rhinitis is persistent and of moderate/severe characteristics in 70.7% of patients. The subcutaneous route is selected for AIT in 77.7% of cases. The most used extract type (47.5%) is depot allergoid. Main conclusion: The main drivers of AIT prescription in allergic respiratory pathology in Latin America are the severity of the patient's allergic pathology, treatment safety, treatment efficacy after discontinuation, and biological quantification of extract activity.
Introduction: Allergen-specific immunotherapy (AIT) is the only available treatment capable of modifying respiratory allergic disease and inducing tolerance against the allergen. Objectives: The main objective of this study was to identify the clinical drivers of AIT prescription in clinical practice in Latin America in patients with allergic respiratory pathology. Secondary objectives were to identify the clinical characteristics and sensitization profiles of included patients and to identify the type of AIT preferred in this region. Materials and methods: Data collection for the CHOICE-Global study was conducted using the online PQ questionnaire (Patients' questionnaire), which had to be completed by AIT-prescribing doctors and consists of 27 questions about patient sociodemographic data, allergic disease, sensitization profile, and characteristics of prescribed AIT. Patients of any age with respiratory allergy who had initiated AIT against pollen, dust mites, molds, or animal epithelia were included. Participation was voluntary and unpaid. Results: The study included a total of 1865 patients from 10 Latin American countries. The most frequent clinical presentation is rhinitis (64.8%), followed by the combination of rhinitis and asthma (31.8%). 94.4% of patients are sensitized to dust mites. 43% of patients are polysensitized. Prick tests are performed in 94.4% of patients, and only 21.1% undergo in vitro diagnosis of IgE against complete extracts. Rhinitis is persistent and of moderate/severe characteristics in 70.7% of patients. The subcutaneous route is selected for AIT in 77.7% of cases. The most used extract type (47.5%) is depot allergoid. Main conclusion: The main drivers of AIT prescription in allergic respiratory pathology in Latin America are the severity of the patient's allergic pathology, treatment safety, treatment efficacy after discontinuation, and biological quantification of extract activity.
Direction
VIDAL PAN, Mª DEL CARMEN (Tutorships)
VIDAL PAN, Mª DEL CARMEN (Tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Study about the genetic basis of parkinsonisms: Do they meet the criteria for Parkinson's disease?
Authorship
T.G.R.
Bachelor of Medicine
T.G.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: The etiopathogenesis of Parkinson’s disease (PD) remains unknow in most case, but in 5-10% of cases it has a monogenic basis. In the late 1990s, the first two genes responsible for PD were identified, named with abbreviation PARK followed by the corresponding ordinal number. The PARK forms group together levodopa-responsive parkinsonisms secondary to a mutation with mendelian inheritance, however, in recent years this classification has been the subject of debate as not all forms meet the criteria for PD. Objectives: The purpose of this systematic review is to determine which mendelian genetic forms meet the criteria for PD. In addition, the role of genetic studies in routine clinical practice will be discussed, as well as when it is indicated to request them and whether genetic testing should be incorporated into the presurgical assessment protocol for patients who are candidates for deep brain stimulation. Methods: For the analysis of the clinical characteristics of PARK forms, a systematic search of the literature was performed in OMIM and Medline (via PubMed) databases. On the other hand, Medline (via PubMed) and Cochrane databases were used for the selection of articles about genetic studies. Case series, reviews and meta-analysis were included. Results: A total of 49 articles concerning rare PARK forms were selected and a detailed description of the clinical characteristics of each of the affected families was carried out. For the frequent PARK forms (PARK2 and PARK8), 2 systematic reviews and 6 case series were selected. Subsequently, the role of genetic studies in routine clinical practice and the role of genetics in predicting response to deep brain stimulation were analysed with a total of 22 articles out of the initial 244. Conclusions: Most of the PARK forms meet the criteria for PD. However, in the case of PARK9, PARK19A and PARK23, parkinsonism is part of a broader disorder. PARK2 lacks the main histopathological marker of PD, Lewy bodies, and the same happens in some forms of PARK8, so we should not speak of PD in these cases. Given the growing importance of the genotype-phenotype relationship, genetic studies will become more important in routine clinical practice in the future. Patients with monogenic parkinsonian syndrome are good candidates for deep brain stimulation, but more studies are needed before genetic screening can be recommended as part of the presurgical assessment protocol.
Background: The etiopathogenesis of Parkinson’s disease (PD) remains unknow in most case, but in 5-10% of cases it has a monogenic basis. In the late 1990s, the first two genes responsible for PD were identified, named with abbreviation PARK followed by the corresponding ordinal number. The PARK forms group together levodopa-responsive parkinsonisms secondary to a mutation with mendelian inheritance, however, in recent years this classification has been the subject of debate as not all forms meet the criteria for PD. Objectives: The purpose of this systematic review is to determine which mendelian genetic forms meet the criteria for PD. In addition, the role of genetic studies in routine clinical practice will be discussed, as well as when it is indicated to request them and whether genetic testing should be incorporated into the presurgical assessment protocol for patients who are candidates for deep brain stimulation. Methods: For the analysis of the clinical characteristics of PARK forms, a systematic search of the literature was performed in OMIM and Medline (via PubMed) databases. On the other hand, Medline (via PubMed) and Cochrane databases were used for the selection of articles about genetic studies. Case series, reviews and meta-analysis were included. Results: A total of 49 articles concerning rare PARK forms were selected and a detailed description of the clinical characteristics of each of the affected families was carried out. For the frequent PARK forms (PARK2 and PARK8), 2 systematic reviews and 6 case series were selected. Subsequently, the role of genetic studies in routine clinical practice and the role of genetics in predicting response to deep brain stimulation were analysed with a total of 22 articles out of the initial 244. Conclusions: Most of the PARK forms meet the criteria for PD. However, in the case of PARK9, PARK19A and PARK23, parkinsonism is part of a broader disorder. PARK2 lacks the main histopathological marker of PD, Lewy bodies, and the same happens in some forms of PARK8, so we should not speak of PD in these cases. Given the growing importance of the genotype-phenotype relationship, genetic studies will become more important in routine clinical practice in the future. Patients with monogenic parkinsonian syndrome are good candidates for deep brain stimulation, but more studies are needed before genetic screening can be recommended as part of the presurgical assessment protocol.
Direction
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
Sesar Ignacio, Ángel (Co-tutorships)
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
Sesar Ignacio, Ángel (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Aging in HIV patients: study of a cohort over 65 years old
Authorship
M.G.S.
Bachelor of Medicine
M.G.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Type of study: Cohort study Justification: Nowadays, older people living with HIV enjoy a life expectancy comparable to the general population. This increase in longevity leads to the appearance of new age-related comorbidities, which leads to the necessity to adapt to new circumstances and individualize the care and attention of older people living with HIV. Aim: To describe and analyze the characteristics of older people living with HIV and how they are related to the different comorbidities and polypharmacy that they currently present. Methods: Cross-sectional analysis of patients with HIV who are being monitored in the Infectious Diseases Unit of the University Clinical Hospital of Santiago de Compostela. Their clinical data, as well as comorbidities and polypharmacy will be analyzed in a sample of 85 patients. Results: A total of 85 people over 65 years old living with HIV have been studied, with an average age of 69 years and a median duration of living with HIV of 17 years. 41% were diagnosed with AIDS-defining criteria. The most frequent comorbidities are arterial hypertension 55% and dyslipidemia 52%. In the field of polypharmacy, at least 40% of our patients living with HIV take 5 or more medications. 35% of patients have received more than 5 lines of antiretroviral treatment. At the time of the study, all people had an undetectable viral load. A weak correlation has been found between age, the number of antiretroviral treatments received throughout their lives and the number of comorbidities that older people living with HIV present. Conclusions: From this analysis we highlight the different comorbidities and the burden of polypharmacy experienced by older people living with HIV. In order to understand the variables that influence the development of comorbidities and improve the care provided, more studies are required.
Type of study: Cohort study Justification: Nowadays, older people living with HIV enjoy a life expectancy comparable to the general population. This increase in longevity leads to the appearance of new age-related comorbidities, which leads to the necessity to adapt to new circumstances and individualize the care and attention of older people living with HIV. Aim: To describe and analyze the characteristics of older people living with HIV and how they are related to the different comorbidities and polypharmacy that they currently present. Methods: Cross-sectional analysis of patients with HIV who are being monitored in the Infectious Diseases Unit of the University Clinical Hospital of Santiago de Compostela. Their clinical data, as well as comorbidities and polypharmacy will be analyzed in a sample of 85 patients. Results: A total of 85 people over 65 years old living with HIV have been studied, with an average age of 69 years and a median duration of living with HIV of 17 years. 41% were diagnosed with AIDS-defining criteria. The most frequent comorbidities are arterial hypertension 55% and dyslipidemia 52%. In the field of polypharmacy, at least 40% of our patients living with HIV take 5 or more medications. 35% of patients have received more than 5 lines of antiretroviral treatment. At the time of the study, all people had an undetectable viral load. A weak correlation has been found between age, the number of antiretroviral treatments received throughout their lives and the number of comorbidities that older people living with HIV present. Conclusions: From this analysis we highlight the different comorbidities and the burden of polypharmacy experienced by older people living with HIV. In order to understand the variables that influence the development of comorbidities and improve the care provided, more studies are required.
Direction
Antela López, Antonio Rafael (Tutorships)
Antela López, Antonio Rafael (Tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Quality of life (SF-36) in patients with chronic respiratory disease
Authorship
I.G.S.
Bachelor of Medicine
I.G.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background. Chronic Respiratory Diseases (CRD) are a group of pathologies with lung and/or airway involvement with a slow progression and without definitive curative treatment. Their control aims to reduce the occurrence of exacerbations, prevent their progression and reduce the influence on cognitive, emotional, physical, family and social development. Among the most frequent CRD we highlight chronic obstructive pulmonary disease (COPD), asthma and obstructive sleep apnea (OSA). Objective. To analyze health-related quality of life in patients diagnosed with COPD, asthma and OSA. Material and methods. Study based on the AEGIS study database with a randomized and stratified sampling by age (over 18 years) of a population of the municipality of A Estrada (n=1516). Socio-demographic variables, alcohol, tobacco and physical activity were collected, and the SF-36 quality of life was completed. Results. A total of 678 (45%) men and 838 (55%) women participated. The prevalence of chronic respiratory disease was 9.7% (147). The proportion of men with CRD was statistically higher than that of the group without CRD. No statistically significant differences were found with respect to age, body mass index, physical activity, smoking or alcohol consumption in individuals with CRD vs those without CRD. No significant differences were found in marital status or educational level between the two groups, while the proportion of retired people, students and people on sick leave was higher in the group of individuals with CRD than in the group without CRD. Health-related quality of life is worse in individuals with CRD. In the regression analysis, significant differences were found in physical function, physical role, vitality and general health, worse in CRD. Adjusting for age and sex, a statistically significant association was found between age and physical function, physical role, vitality, bodily pain, general health and health transition, with men scoring higher overall on all SF-36 items except health transition. Conclusions. Men suffer more from CRD. Quality of life is better in men than in women and is worse in patients with CRD. There is a statistically significant association between CRD and the components physical function, physical role, vitality, general health and health transition. The same occurs with age but in a non-linear way.
Background. Chronic Respiratory Diseases (CRD) are a group of pathologies with lung and/or airway involvement with a slow progression and without definitive curative treatment. Their control aims to reduce the occurrence of exacerbations, prevent their progression and reduce the influence on cognitive, emotional, physical, family and social development. Among the most frequent CRD we highlight chronic obstructive pulmonary disease (COPD), asthma and obstructive sleep apnea (OSA). Objective. To analyze health-related quality of life in patients diagnosed with COPD, asthma and OSA. Material and methods. Study based on the AEGIS study database with a randomized and stratified sampling by age (over 18 years) of a population of the municipality of A Estrada (n=1516). Socio-demographic variables, alcohol, tobacco and physical activity were collected, and the SF-36 quality of life was completed. Results. A total of 678 (45%) men and 838 (55%) women participated. The prevalence of chronic respiratory disease was 9.7% (147). The proportion of men with CRD was statistically higher than that of the group without CRD. No statistically significant differences were found with respect to age, body mass index, physical activity, smoking or alcohol consumption in individuals with CRD vs those without CRD. No significant differences were found in marital status or educational level between the two groups, while the proportion of retired people, students and people on sick leave was higher in the group of individuals with CRD than in the group without CRD. Health-related quality of life is worse in individuals with CRD. In the regression analysis, significant differences were found in physical function, physical role, vitality and general health, worse in CRD. Adjusting for age and sex, a statistically significant association was found between age and physical function, physical role, vitality, bodily pain, general health and health transition, with men scoring higher overall on all SF-36 items except health transition. Conclusions. Men suffer more from CRD. Quality of life is better in men than in women and is worse in patients with CRD. There is a statistically significant association between CRD and the components physical function, physical role, vitality, general health and health transition. The same occurs with age but in a non-linear way.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Castaño Carou, Ana Isabel (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Castaño Carou, Ana Isabel (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Phage Therapy in Gastrointestinal and Liver Diseases: A Scoping Review
Authorship
L.G.T.
Bachelor of Medicine
L.G.T.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: In recent years, a greater understanding of the role of the gut microbiome in the pathophysiology of multiple gastrointestinal and liver diseases has been achieved. However, its conception as a therapeutic target is very recent and is currently under development. One of the proposed strategies is phage therapy, based on viruses capable of editing the gut microbiota with high precision and, possibly, modifying the course of many of these pathologies. Objective: Analyse the latest scientific evidence on the safety and efficacy of phage therapy in non-communicable gut and liver diseases, as well as to determine its potential role in future clinical practice. Methods: A scoping review was conducted using the PRISMA-ScR methodology. To this end, a search was carried out for primary articles published in the last 5 years (2018-2023) in the main databases (Pubmed, Embase, Scopus, Cochrane, Web of Science, Dimensions and Google Scholar). Then, using the Zotero bibliographic manager and the Rayyan QCRI application, the papers that answered the research question were selected according to the inclusion/exclusion criteria. Afterwards, the full text was critically read with the support of the FLC 3.0 tool and, finally, the quality of the clinical trials was evaluated with that same platform and with the GRADE system. Results: A total of 1798 publications were retrieved, of which only 14 (3 clinical trials and 11 preclinical studies) were finally selected. Diseases addressed included gastrointestinal distress, Inflammatory Bowel Disease, Colorectal cancer, Primary Sclerosing Cholangitis, Alcoholic Liver Disease and Metabolic Dysfunction-Associated Steatotic Liver Disease. The heterogeneity of the studies, the preliminary nature of the clinical trials and the predominance and limitations of preclinical research limited the assessment of quality and prevented the correct comparison of the results obtained. However, the evidence analysed seems to confirm the safety of phage therapy in the treatment of gastrointestinal and liver diseases, despite not being able to replicate its preclinical efficacy in human studies. Conclusions: Current evidence establishes phage therapy as a potential therapeutic option in non-communicable gastrointestinal and liver diseases. However, in order to advance in its development and be able to apply it in clinical practice in the future, more quality clinical trials will be needed, which will allow the obtention of consistent and robust efficacy data.
Background: In recent years, a greater understanding of the role of the gut microbiome in the pathophysiology of multiple gastrointestinal and liver diseases has been achieved. However, its conception as a therapeutic target is very recent and is currently under development. One of the proposed strategies is phage therapy, based on viruses capable of editing the gut microbiota with high precision and, possibly, modifying the course of many of these pathologies. Objective: Analyse the latest scientific evidence on the safety and efficacy of phage therapy in non-communicable gut and liver diseases, as well as to determine its potential role in future clinical practice. Methods: A scoping review was conducted using the PRISMA-ScR methodology. To this end, a search was carried out for primary articles published in the last 5 years (2018-2023) in the main databases (Pubmed, Embase, Scopus, Cochrane, Web of Science, Dimensions and Google Scholar). Then, using the Zotero bibliographic manager and the Rayyan QCRI application, the papers that answered the research question were selected according to the inclusion/exclusion criteria. Afterwards, the full text was critically read with the support of the FLC 3.0 tool and, finally, the quality of the clinical trials was evaluated with that same platform and with the GRADE system. Results: A total of 1798 publications were retrieved, of which only 14 (3 clinical trials and 11 preclinical studies) were finally selected. Diseases addressed included gastrointestinal distress, Inflammatory Bowel Disease, Colorectal cancer, Primary Sclerosing Cholangitis, Alcoholic Liver Disease and Metabolic Dysfunction-Associated Steatotic Liver Disease. The heterogeneity of the studies, the preliminary nature of the clinical trials and the predominance and limitations of preclinical research limited the assessment of quality and prevented the correct comparison of the results obtained. However, the evidence analysed seems to confirm the safety of phage therapy in the treatment of gastrointestinal and liver diseases, despite not being able to replicate its preclinical efficacy in human studies. Conclusions: Current evidence establishes phage therapy as a potential therapeutic option in non-communicable gastrointestinal and liver diseases. However, in order to advance in its development and be able to apply it in clinical practice in the future, more quality clinical trials will be needed, which will allow the obtention of consistent and robust efficacy data.
Direction
Dieguez Gonzalez, Carlos (Tutorships)
Fernández Fondevila, Marcos (Co-tutorships)
Dieguez Gonzalez, Carlos (Tutorships)
Fernández Fondevila, Marcos (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Neurological monitoring methods in intracerebral hemorrhage: a systematic review
Authorship
P.G.O.
Bachelor of Medicine
P.G.O.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Intraparenchymal hemorrhage (IPH) is a severe form of stroke characterized by bleeding within the brain parenchyma. Neurological monitoring plays a crucial role in the management and prognosis of patients with IPH, allowing for early detection of complications and optimization of treatment. Objectives: This work aims to review and compare different methods of neurological monitoring used in IPH, focusing on their efficacy, clinical applicability, and limitations. This search will attempt to compile a list of various monitoring methods and compare them to try to select the optimal one in each case to improve patient prognosis, reducing the morbidity and mortality associated with this condition. Results and discussion: Among the results obtained are traditional methods such as the Glasgow Coma Scale and intracranial pressure monitoring, as well as emerging technologies. Subsequently, the results are compared with the 2022 AHA guidelines. Conclusion: After selecting 12 articles addressing a wide variety of methods, it is concluded that it is necessary to establish a monitoring model tailored to the needs of each patient, thus further research in this field is needed.
Introduction: Intraparenchymal hemorrhage (IPH) is a severe form of stroke characterized by bleeding within the brain parenchyma. Neurological monitoring plays a crucial role in the management and prognosis of patients with IPH, allowing for early detection of complications and optimization of treatment. Objectives: This work aims to review and compare different methods of neurological monitoring used in IPH, focusing on their efficacy, clinical applicability, and limitations. This search will attempt to compile a list of various monitoring methods and compare them to try to select the optimal one in each case to improve patient prognosis, reducing the morbidity and mortality associated with this condition. Results and discussion: Among the results obtained are traditional methods such as the Glasgow Coma Scale and intracranial pressure monitoring, as well as emerging technologies. Subsequently, the results are compared with the 2022 AHA guidelines. Conclusion: After selecting 12 articles addressing a wide variety of methods, it is concluded that it is necessary to establish a monitoring model tailored to the needs of each patient, thus further research in this field is needed.
Direction
Anibarro García, Luís (Tutorships)
Touceda Bravo, Alberto (Co-tutorships)
Anibarro García, Luís (Tutorships)
Touceda Bravo, Alberto (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Management of Wernicke’s encefalopathy. Bibliografic review regarding a series of cases.
Authorship
E.E.G.C.
Bachelor of Medicine
E.E.G.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Wernicke encephalopathy (WE) is an acute and potentially reversible neurological disorder characterized by a clinical triad of altered mental state, oculomotor disturbances, and gait alteration or ataxia. It is caused by thiamine deficiency, which is more common in patients with alcohol use disorder. Diagnosis is primarily clinical and can be made using Caine’s criteria. The cornerstone of WE treatment is the early administration of thiamine via the parenteral route. OBJECTIVE: The objective of this work is to synthesize the scientific literature and compare the extracted data with those corresponding to a case series, all with the aim of clarifying the appropriate approach to WE. METHODS: A review was conducted in the PubMed database of relevant articles showing data on patients diagnosed with WE. Additionally, data from a case series of patients diagnosed with WE in the area of Santiago de Compostela and Barbanza were used. RESULTS: A detailed description of the results obtained in the different articles and the case series was carried out regarding patients’ personal characteristics and backgrounds, clinical manifestations, treatment characteristics, and recovery experienced. DISCUSION AND CONCLUSIONS: Most patients do not simultaneously present the three signs of the classic triad. This nonspecificity in clinical presentation leads to a significant underdiagnosis of WE. There is considerable variability in the dosage and administration routes used in treatment. The main issue is the lack of consensus on the optimal dose and administration route, and the absence of clear clinical guidelines establishing the protocol to follow in the management of WE.
INTRODUCTION: Wernicke encephalopathy (WE) is an acute and potentially reversible neurological disorder characterized by a clinical triad of altered mental state, oculomotor disturbances, and gait alteration or ataxia. It is caused by thiamine deficiency, which is more common in patients with alcohol use disorder. Diagnosis is primarily clinical and can be made using Caine’s criteria. The cornerstone of WE treatment is the early administration of thiamine via the parenteral route. OBJECTIVE: The objective of this work is to synthesize the scientific literature and compare the extracted data with those corresponding to a case series, all with the aim of clarifying the appropriate approach to WE. METHODS: A review was conducted in the PubMed database of relevant articles showing data on patients diagnosed with WE. Additionally, data from a case series of patients diagnosed with WE in the area of Santiago de Compostela and Barbanza were used. RESULTS: A detailed description of the results obtained in the different articles and the case series was carried out regarding patients’ personal characteristics and backgrounds, clinical manifestations, treatment characteristics, and recovery experienced. DISCUSION AND CONCLUSIONS: Most patients do not simultaneously present the three signs of the classic triad. This nonspecificity in clinical presentation leads to a significant underdiagnosis of WE. There is considerable variability in the dosage and administration routes used in treatment. The main issue is the lack of consensus on the optimal dose and administration route, and the absence of clear clinical guidelines establishing the protocol to follow in the management of WE.
Direction
NOVO VELEIRO, IGNACIO (Tutorships)
López Rodríguez, María (Co-tutorships)
NOVO VELEIRO, IGNACIO (Tutorships)
López Rodríguez, María (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Impact of periodontitis on quality of life. Study in a population of Galicia
Authorship
G.M.H.D.
Bachelor of Medicine
G.M.H.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction. Periodontitis is a chronic inflammatory pathology that mainly affects the insertion of dental pieces. It has been proved that periodontal disease is closely related with patients’ life quality, taking impact in a physical, social, and psychological framework. Objectives. To investigate whether there are differences in health-related quality of life between people with and without periodontitis and to find out the prevalence of periodontal disease. Material and methods. Cross-sectional observational study of a randomized sample of from a rural village in Galicia. A total amount of 969 individuals over 18 years old organized by decades of life took part in the study. A targeted survey was taken in the A Estrada Health Centre, where all participants were summoned and asked about sociodemographic data, toxic habits, physical activity and periodontal clinical parameters Results. The prevalence of periodontitis among the surveyed individuals was 52,9%. From a socio-demographic point of view, there were significant statistic differences in terms of age and Body Max Index, with higher rates for those individuals diagnosed with periodontal disease. In terms of gender, the proportion of men with periodontitis is higher than that of the group without periodontitis (p=0.003). There is a correlation between periodontitis and toxic habits: smoking (p=0.009) with an ex-smoking rate of 27.5% and alcohol consumption (p=0.009). A higher rate of periodontitis was found in married, widowed, divorced, separated and retired people with no or only basic education. In the resulting scales of the SF-36 a lower quality of life can be observed in individuals suffering from periodontitis affecting physical function, physical role, and general health. With the adjustment in the regression analysis made by age and gender, men get a higher score in every role of the SF-36 apart from general health. Furthermore, there is a significant association between the age, physical functionality roles, physical appearance roles, vitality, bodily pain and general health. Conclusions. The subject profile with periodontal diseases is an adult male, ex-smoker, regular alcohol consumer, with a low level of education, normally retired or doing household chores. The quality of life in terms of health is lower for those individuals diagnosed with periodontitis. With the adjustment by age and gender, it can be concluded that men have a higher score in all roles apart from general health. There is also a statistically significant association between physical functionality roles, vitality, bodily pain, physical appearance roles and general health.
Introduction. Periodontitis is a chronic inflammatory pathology that mainly affects the insertion of dental pieces. It has been proved that periodontal disease is closely related with patients’ life quality, taking impact in a physical, social, and psychological framework. Objectives. To investigate whether there are differences in health-related quality of life between people with and without periodontitis and to find out the prevalence of periodontal disease. Material and methods. Cross-sectional observational study of a randomized sample of from a rural village in Galicia. A total amount of 969 individuals over 18 years old organized by decades of life took part in the study. A targeted survey was taken in the A Estrada Health Centre, where all participants were summoned and asked about sociodemographic data, toxic habits, physical activity and periodontal clinical parameters Results. The prevalence of periodontitis among the surveyed individuals was 52,9%. From a socio-demographic point of view, there were significant statistic differences in terms of age and Body Max Index, with higher rates for those individuals diagnosed with periodontal disease. In terms of gender, the proportion of men with periodontitis is higher than that of the group without periodontitis (p=0.003). There is a correlation between periodontitis and toxic habits: smoking (p=0.009) with an ex-smoking rate of 27.5% and alcohol consumption (p=0.009). A higher rate of periodontitis was found in married, widowed, divorced, separated and retired people with no or only basic education. In the resulting scales of the SF-36 a lower quality of life can be observed in individuals suffering from periodontitis affecting physical function, physical role, and general health. With the adjustment in the regression analysis made by age and gender, men get a higher score in every role of the SF-36 apart from general health. Furthermore, there is a significant association between the age, physical functionality roles, physical appearance roles, vitality, bodily pain and general health. Conclusions. The subject profile with periodontal diseases is an adult male, ex-smoker, regular alcohol consumer, with a low level of education, normally retired or doing household chores. The quality of life in terms of health is lower for those individuals diagnosed with periodontitis. With the adjustment by age and gender, it can be concluded that men have a higher score in all roles apart from general health. There is also a statistically significant association between physical functionality roles, vitality, bodily pain, physical appearance roles and general health.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Castaño Carou, Ana Isabel (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Castaño Carou, Ana Isabel (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
MARTINEZ ROLAN, ROSA MARIA (Secretary)
TABOADA MUÑIZ, MANUEL (Member)
Evidence on the efficacy of antifungal treatment in airtract diseases due to aspergillus
Authorship
I.N.F.
Bachelor of Medicine
I.N.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Aspergillus is a filamentous fungus found in soil, plants, food, water, and decaying organic matter. Pulmonary manifestations of this fungus range from invasive forms and hypersensitivity pneumonitis to simple colonization such as aspergilloma. The main respiratory tract affections include mucosal infection, pseudomembranous tracheobronchitis, hypersensitivity fungal reactions (fungal sensitization asthma to Aspergillus-ASFA, allergic bronchopulmonary aspergillosis-ABPA), Aspergillus bronchitis, and bronchial colonization. Objective: review the evidence on antifungal treatment in forms of Aspergillus respiratory tract involvement, especially in asthma patients. Methods: a search was conducted in PubMed up to February 2024 with the keywords: “Aspergillus fumigatus”, “fungal colonization”, “fungal sensitization”, “fungal bronchitis”, “aspergillus bronchitis”, “aspergillus tracheobronchitis”, “asthma”, “allergic bronchopulmonary aspergillosis”, and “treatment”, using all possible combinations (AND, OR, NOT). Two researchers (I.N and M.B.A) selected articles considering inclusion and exclusion criteria. Results: five studies on oral antifungal treatment in ABPA (3 with itraconazole and 2 with voriconazole) with 345 patients were identified. Variable results were observed in laboratory data, reduction of exacerbations (only in 2 studies), corticosteroid reduction (in 2 studies), and improvement in lung function in only one study. In the case of ASFA, 2 randomized controlled trials (1 with itraconazole and 1 with voriconazole) with 123 patients were found; improvement in quality of life and peak expiratory flow was observed only with itraconazole. Inhaled amphotericin treatment was analyzed in 195 ABPA patients, showing a decrease in severe exacerbations, and in 11 ASFA patients, showing improved quality of life, FEV1, and corticosteroid reduction. Conclusions: the efficacy of antifungal treatment in forms of Aspergillus respiratory tract involvement has limited evidence. Most studies were conducted in ABPA, with itraconazole being the most used drug, followed by voriconazole. Both ABPA and ASFA used nebulized amphotericin in a small number of patients. More clinical studies are needed to validate these approaches and improve the management of this complex condition.
Introduction: Aspergillus is a filamentous fungus found in soil, plants, food, water, and decaying organic matter. Pulmonary manifestations of this fungus range from invasive forms and hypersensitivity pneumonitis to simple colonization such as aspergilloma. The main respiratory tract affections include mucosal infection, pseudomembranous tracheobronchitis, hypersensitivity fungal reactions (fungal sensitization asthma to Aspergillus-ASFA, allergic bronchopulmonary aspergillosis-ABPA), Aspergillus bronchitis, and bronchial colonization. Objective: review the evidence on antifungal treatment in forms of Aspergillus respiratory tract involvement, especially in asthma patients. Methods: a search was conducted in PubMed up to February 2024 with the keywords: “Aspergillus fumigatus”, “fungal colonization”, “fungal sensitization”, “fungal bronchitis”, “aspergillus bronchitis”, “aspergillus tracheobronchitis”, “asthma”, “allergic bronchopulmonary aspergillosis”, and “treatment”, using all possible combinations (AND, OR, NOT). Two researchers (I.N and M.B.A) selected articles considering inclusion and exclusion criteria. Results: five studies on oral antifungal treatment in ABPA (3 with itraconazole and 2 with voriconazole) with 345 patients were identified. Variable results were observed in laboratory data, reduction of exacerbations (only in 2 studies), corticosteroid reduction (in 2 studies), and improvement in lung function in only one study. In the case of ASFA, 2 randomized controlled trials (1 with itraconazole and 1 with voriconazole) with 123 patients were found; improvement in quality of life and peak expiratory flow was observed only with itraconazole. Inhaled amphotericin treatment was analyzed in 195 ABPA patients, showing a decrease in severe exacerbations, and in 11 ASFA patients, showing improved quality of life, FEV1, and corticosteroid reduction. Conclusions: the efficacy of antifungal treatment in forms of Aspergillus respiratory tract involvement has limited evidence. Most studies were conducted in ABPA, with itraconazole being the most used drug, followed by voriconazole. Both ABPA and ASFA used nebulized amphotericin in a small number of patients. More clinical studies are needed to validate these approaches and improve the management of this complex condition.
Direction
González Barcala, Francisco Javier (Tutorships)
Blanco Aparicio, Marina (Co-tutorships)
González Barcala, Francisco Javier (Tutorships)
Blanco Aparicio, Marina (Co-tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
Can TILs predict the response to treatment in breast cancer?
Authorship
S.N.L.
Bachelor of Medicine
S.N.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Breast cancer stands as the most prevalent tumor in Spanish women. Over recent years, numerous prognostic and predictive factors have been delineated concerning this tumor. However, in recent times, the presence of tumor-infiltrating lymphocytes or TILs has garnered increasing importance in prognosticating patients' outcomes. This study specifically delves into these cell types. Objectives: This study aims to explore the prognostic value of TILs in breast cancer and, secondarily, to investigate their correlation with tumor histology, molecular subtype, response to adjuvant chemotherapy, and the optimal treatment selection for patients. Methods: To address the research question, a systematic review was conducted using articles sourced from PubMed. Results: Out of a total of 282 results, 11 articles were ultimately selected for comprehensive review, meeting the specified selection criteria. These articles were categorized into three groups based on their predominant themes. Conclusions: The prognostic significance of TILs in basal-like and HER2 breast cancer has been validated, with higher lymphocyte counts correlating with improved outcomes. Additionally, it has been observed that increased tumor aggressiveness correlates with higher lymphocyte density. Elevated TIL counts at diagnosis indicate a heightened response to neoadjuvant chemotherapy in triple-negative and HER2-positive tumors. Moreover, the efficacy of trastuzumab in the latter appears to be associated with elevated TIL counts.
Introduction: Breast cancer stands as the most prevalent tumor in Spanish women. Over recent years, numerous prognostic and predictive factors have been delineated concerning this tumor. However, in recent times, the presence of tumor-infiltrating lymphocytes or TILs has garnered increasing importance in prognosticating patients' outcomes. This study specifically delves into these cell types. Objectives: This study aims to explore the prognostic value of TILs in breast cancer and, secondarily, to investigate their correlation with tumor histology, molecular subtype, response to adjuvant chemotherapy, and the optimal treatment selection for patients. Methods: To address the research question, a systematic review was conducted using articles sourced from PubMed. Results: Out of a total of 282 results, 11 articles were ultimately selected for comprehensive review, meeting the specified selection criteria. These articles were categorized into three groups based on their predominant themes. Conclusions: The prognostic significance of TILs in basal-like and HER2 breast cancer has been validated, with higher lymphocyte counts correlating with improved outcomes. Additionally, it has been observed that increased tumor aggressiveness correlates with higher lymphocyte density. Elevated TIL counts at diagnosis indicate a heightened response to neoadjuvant chemotherapy in triple-negative and HER2-positive tumors. Moreover, the efficacy of trastuzumab in the latter appears to be associated with elevated TIL counts.
Direction
SAMPAYO MONTENEGRO, MARIA VICTORIA (Tutorships)
SAMPAYO MONTENEGRO, MARIA VICTORIA (Tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
Early diagnosis of schizophrenia. Latest evidence.
Authorship
S.O.R.
Bachelor of Medicine
S.O.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Schizophrenia is the most prevalent psychosis group mental illness in the world, affecting millions of people, and the timing of its diagnosis is crucial to control the impact of the illness on the patient's life. The searching for an early diagnosis, which allows the patient to be approached and treated from the early stage of the disease, could contribute to a better treatment response and attenuation of the symptoms, turning into an overall improvement in the patient's quality of life. The aim of this Final Degree Project consisted of proposing different clinical assessment tools that could be useful for establishing an early diagnosis, mainly in the field of clinical prodromes and biomarkers. The methodology used for the preparation of this literature review consisted of a search, through databases such as PubMed, of the latest scientific evidence related to the early diagnosis of schizophrenia, as well as the clinical prodromes and its assessment. All these aspects were reviewed from a multifactorial perspective characteristic of this illness. The multiple prodrome assessment tools, although they are valid and used nowadays, are insufficient for a definitive early diagnosis. On the other hand, biological markers are set now in early stages of research, but promising results could be expected related to psychotic disorders’ intervention. In conclusion, the lack of satisfactory sensitive and specific diagnostic criteria for the prodromal phase makes maintaining the definitive diagnosis at syndromic phase.
Schizophrenia is the most prevalent psychosis group mental illness in the world, affecting millions of people, and the timing of its diagnosis is crucial to control the impact of the illness on the patient's life. The searching for an early diagnosis, which allows the patient to be approached and treated from the early stage of the disease, could contribute to a better treatment response and attenuation of the symptoms, turning into an overall improvement in the patient's quality of life. The aim of this Final Degree Project consisted of proposing different clinical assessment tools that could be useful for establishing an early diagnosis, mainly in the field of clinical prodromes and biomarkers. The methodology used for the preparation of this literature review consisted of a search, through databases such as PubMed, of the latest scientific evidence related to the early diagnosis of schizophrenia, as well as the clinical prodromes and its assessment. All these aspects were reviewed from a multifactorial perspective characteristic of this illness. The multiple prodrome assessment tools, although they are valid and used nowadays, are insufficient for a definitive early diagnosis. On the other hand, biological markers are set now in early stages of research, but promising results could be expected related to psychotic disorders’ intervention. In conclusion, the lack of satisfactory sensitive and specific diagnostic criteria for the prodromal phase makes maintaining the definitive diagnosis at syndromic phase.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
FONTELA VIVANCO, EVA (Co-tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
FONTELA VIVANCO, EVA (Co-tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
Toxic substances exposure during pregnancy: neonatal abstinence syndrome and impact on the newborn.
Authorship
E.O.V.
Bachelor of Medicine
E.O.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Drug consumption during pregnancy can cause harmful effects on the newborn. Sudden interruption of these substances intake is associated with Neonatal Abstinence Syndrome (NAS). For proper management of the clinical picture, it is important to early identify prenatal exposure, recognize the symptoms of withdrawal, and start pharmacotherapy at the appropriate moment. Objectives: To identify and understand the risk factors, assessment and treatment of NAS. Methodology: A systematic review was conducted using PubMed, Scopus and Cochrane databases. Original studies and meta-analysis related with the main objective of study published during the last 10 years, in English or Spanish and available in full text were included in the search. Results: 11 articles were included in the review. Regarding the prenatal risk factors for NAS, the risk increases with a maternal history of opioid abuse, late and long-term exposure during pregnancy, or recurrent use of other drugs. NAS diagnosis is more common in full-term newborns. 4 articles on pharmacological treatment were reviewed, comparing morphine with other drugs; clonidine and methadone showed a shorter duration of treatment and hospital stay. Conclusions: The main risk factors for the development of NAS are a previous history of opioid abuse, other drugs consumption or psychotropic medications. Morphine is the first-line treatment, but during the past few years other drugs like clonidine or methadone have gained interest with good results.
Introduction: Drug consumption during pregnancy can cause harmful effects on the newborn. Sudden interruption of these substances intake is associated with Neonatal Abstinence Syndrome (NAS). For proper management of the clinical picture, it is important to early identify prenatal exposure, recognize the symptoms of withdrawal, and start pharmacotherapy at the appropriate moment. Objectives: To identify and understand the risk factors, assessment and treatment of NAS. Methodology: A systematic review was conducted using PubMed, Scopus and Cochrane databases. Original studies and meta-analysis related with the main objective of study published during the last 10 years, in English or Spanish and available in full text were included in the search. Results: 11 articles were included in the review. Regarding the prenatal risk factors for NAS, the risk increases with a maternal history of opioid abuse, late and long-term exposure during pregnancy, or recurrent use of other drugs. NAS diagnosis is more common in full-term newborns. 4 articles on pharmacological treatment were reviewed, comparing morphine with other drugs; clonidine and methadone showed a shorter duration of treatment and hospital stay. Conclusions: The main risk factors for the development of NAS are a previous history of opioid abuse, other drugs consumption or psychotropic medications. Morphine is the first-line treatment, but during the past few years other drugs like clonidine or methadone have gained interest with good results.
Direction
Leis Trabazo, María Rosaura (Tutorships)
Sucasas Alonso, Andrea (Co-tutorships)
Leis Trabazo, María Rosaura (Tutorships)
Sucasas Alonso, Andrea (Co-tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
The influence of depression on health related quality of life.
Authorship
R.M.O.C.
Bachelor of Medicine
R.M.O.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Depression is one of the most common illnesses in the world, affecting people of all ages, races, and genders. It can manifest with a wide variety of both somatic and psychological symptoms, thus significantly impacting all dimensions of health related quality of life. Objectives: To study the effect of depression on health related quality of life in individuals from the general population. Materials and Methods: This work is based on the population of the AEGIS study (A Estrada Glycation and Inflammation Study). The initial population consisted of a stratified randomized sample by age groups of 3500 individuals with a minimum age of 18 years. In the present study, we have a sample of 1512 participants, of whom 228 have depression. All participants were summoned at the beginning of the study to the A Estrada health center to undergo a series of questionnaires collecting sociodemographic information and lifestyle, as well as tests: blood tests and electrocardiograms. Depression was diagnosed using the Goldberg scale, and health related quality of life was measured using the SF36 questionnaire. An analysis of the results obtained in this sample was carried out to understand how depression and health related quality of life are affected. Results: The study included 839 women (55.5%) and 673 men (44.5%) with a mean age of 52 years. The prevalence of depression in the study was 15,1% (228 individuals), which increases throughout life. Depression is also more frequent in widowed and married participants and in lower socioeducational levels. Likewise, having depression is associated with lower physical activity levels and, therefore, a higher BMI. Alcohol and tobacco consumption is also higher in individuals with depression. The analysis of the results obtained in this study reveals a series of statistically significant relationships between depression and the dimensions of quality of life, as measured by the SF36 questionnaire. Patients with depression always have lower scores in all dimensions of the SF36 questionnaire, so we can deduce that having depression affects health related quality of life.
Introduction: Depression is one of the most common illnesses in the world, affecting people of all ages, races, and genders. It can manifest with a wide variety of both somatic and psychological symptoms, thus significantly impacting all dimensions of health related quality of life. Objectives: To study the effect of depression on health related quality of life in individuals from the general population. Materials and Methods: This work is based on the population of the AEGIS study (A Estrada Glycation and Inflammation Study). The initial population consisted of a stratified randomized sample by age groups of 3500 individuals with a minimum age of 18 years. In the present study, we have a sample of 1512 participants, of whom 228 have depression. All participants were summoned at the beginning of the study to the A Estrada health center to undergo a series of questionnaires collecting sociodemographic information and lifestyle, as well as tests: blood tests and electrocardiograms. Depression was diagnosed using the Goldberg scale, and health related quality of life was measured using the SF36 questionnaire. An analysis of the results obtained in this sample was carried out to understand how depression and health related quality of life are affected. Results: The study included 839 women (55.5%) and 673 men (44.5%) with a mean age of 52 years. The prevalence of depression in the study was 15,1% (228 individuals), which increases throughout life. Depression is also more frequent in widowed and married participants and in lower socioeducational levels. Likewise, having depression is associated with lower physical activity levels and, therefore, a higher BMI. Alcohol and tobacco consumption is also higher in individuals with depression. The analysis of the results obtained in this study reveals a series of statistically significant relationships between depression and the dimensions of quality of life, as measured by the SF36 questionnaire. Patients with depression always have lower scores in all dimensions of the SF36 questionnaire, so we can deduce that having depression affects health related quality of life.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
LADO BALEATO, OSCAR (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
LADO BALEATO, OSCAR (Co-tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
Analgesic efficacy of intercostal nerve blocks in thoracic and upper abdominal wall procedures: sistematic review.
Authorship
I.O.D.
Bachelor of Medicine
I.O.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction Optimal control of postoperative analgesia is essential to facilitate the recovery of patients undergoing thoracoabdominal surgical procedures. Anaesthetic-analgesic advancements, with the introduction of ultrasound and the subsequent description of fascial blocks, serve as a tool for efficient management of postoperative pain. Objective To study the efficacy and safety of ultrasound intercostal nerve blocks as an opioid-sparing analgesic technique. Material and methods A systematic review of randomized clinical trials, systematic reviews, and meta-analyses published between 2014 and 2024 on intercostal nerve blocks for procedures involving the thoracic and upper abdominal wall was conducted. Results The review includes 43 articles, 32 on thoracic wall surgery and 11 on the abdominal wall. From the set of studies, we can conclude that ICNB is an analgesic alternative to consider as it is not inferior to TPVB or TEA in thoracotomy and video-assisted thoracoscopic surgery. Blocks of the serrato-intercostal space (BRILMA, SIPB) significantly improve analgesic outcomes in cardiac, breast, and upper supraumbilical surgery. Conclusion Fascial blocks of intercostal nerves are an effective analgesic alternative to central blocks (PVB, TEA), with a favorable safety profile. Despite having moderate evidence, the incorporation of fascial blocks as an element of multimodal analgesic strategies for controlling the somatic component of postoperative pain is recommended. Future research will be necessary to obtain a stronger recommendation level. The choice of each block type should be individualized based on the surgical procedure/approach, patient characteristics and professional experience/training.
Introduction Optimal control of postoperative analgesia is essential to facilitate the recovery of patients undergoing thoracoabdominal surgical procedures. Anaesthetic-analgesic advancements, with the introduction of ultrasound and the subsequent description of fascial blocks, serve as a tool for efficient management of postoperative pain. Objective To study the efficacy and safety of ultrasound intercostal nerve blocks as an opioid-sparing analgesic technique. Material and methods A systematic review of randomized clinical trials, systematic reviews, and meta-analyses published between 2014 and 2024 on intercostal nerve blocks for procedures involving the thoracic and upper abdominal wall was conducted. Results The review includes 43 articles, 32 on thoracic wall surgery and 11 on the abdominal wall. From the set of studies, we can conclude that ICNB is an analgesic alternative to consider as it is not inferior to TPVB or TEA in thoracotomy and video-assisted thoracoscopic surgery. Blocks of the serrato-intercostal space (BRILMA, SIPB) significantly improve analgesic outcomes in cardiac, breast, and upper supraumbilical surgery. Conclusion Fascial blocks of intercostal nerves are an effective analgesic alternative to central blocks (PVB, TEA), with a favorable safety profile. Despite having moderate evidence, the incorporation of fascial blocks as an element of multimodal analgesic strategies for controlling the somatic component of postoperative pain is recommended. Future research will be necessary to obtain a stronger recommendation level. The choice of each block type should be individualized based on the surgical procedure/approach, patient characteristics and professional experience/training.
Direction
Álvarez Escudero, Julián (Tutorships)
López Álvarez, Servando (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
López Álvarez, Servando (Co-tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
Large B-cell lymphoma with IRF4 rearrangement: clinical and molecular characteristics of a new entity
Authorship
B.P.G.
Bachelor of Medicine
B.P.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Large B-cell lymphoma with IRF4 rearrangement is a newly categorized rare entity characterized by intense MUM1 expression linked with an IG:IRF4 translocation. It mainly affects children and young adults and, despite its excellent prognosis, it’s consistently treated with aggressive systemic therapies. In this work we aimed to study the characteristics and behavior of tumors diagnosed in the Complejo Hospitalario de Santiago de Compostela in the period 2000-2023, and to check if its true frequency is higher than the apparent one. Materials and methods: We performed a narrative literature review on the entity, a systematic search of cases in the described time interval and a commentary on the reported case. Results: The tumor presented as a persistent cervical mass in a 5-year-old female patient, without B symptoms. Immunohistochemistry was positive for B cell lineage markers, MUM1/IRF4 and BCL6. CD3, CD5, CD10 and BCL2 were negative. FISH showed a hybridization pattern compatible with an IRF4 rearrangement, confirming the LBCL-IRF4r diagnosis. NGS detected mutations and a fusion in IRF4. Conclusions: LBCL-IRF4r is a very infrequent pathology in our background, with only one reported case. No cases were found prior to the tumor’s description with other diagnostic labels. When faced with a lymphoid proliferation with large B cells in a pediatric patient, it is important to include MUM1 in the inmunohistochemistry panel to enable this type of lymphoma’s recognition. Our case was treated with two cycles of a COPAD scheme and is in complete remission 35 months later. According to the literature, the prognosis is good and there are cases treated without systemic therapies that cured. Further studies would be necessary to clarify whether therapeutic de-escalation is appropriate.
Background: Large B-cell lymphoma with IRF4 rearrangement is a newly categorized rare entity characterized by intense MUM1 expression linked with an IG:IRF4 translocation. It mainly affects children and young adults and, despite its excellent prognosis, it’s consistently treated with aggressive systemic therapies. In this work we aimed to study the characteristics and behavior of tumors diagnosed in the Complejo Hospitalario de Santiago de Compostela in the period 2000-2023, and to check if its true frequency is higher than the apparent one. Materials and methods: We performed a narrative literature review on the entity, a systematic search of cases in the described time interval and a commentary on the reported case. Results: The tumor presented as a persistent cervical mass in a 5-year-old female patient, without B symptoms. Immunohistochemistry was positive for B cell lineage markers, MUM1/IRF4 and BCL6. CD3, CD5, CD10 and BCL2 were negative. FISH showed a hybridization pattern compatible with an IRF4 rearrangement, confirming the LBCL-IRF4r diagnosis. NGS detected mutations and a fusion in IRF4. Conclusions: LBCL-IRF4r is a very infrequent pathology in our background, with only one reported case. No cases were found prior to the tumor’s description with other diagnostic labels. When faced with a lymphoid proliferation with large B cells in a pediatric patient, it is important to include MUM1 in the inmunohistochemistry panel to enable this type of lymphoma’s recognition. Our case was treated with two cycles of a COPAD scheme and is in complete remission 35 months later. According to the literature, the prognosis is good and there are cases treated without systemic therapies that cured. Further studies would be necessary to clarify whether therapeutic de-escalation is appropriate.
Direction
FRAGA RODRIGUEZ, MAXIMO FRANCISCO (Tutorships)
FRAGA RODRIGUEZ, MAXIMO FRANCISCO (Tutorships)
Court
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
SEÑARIS RODRIGUEZ, ROSA MARIA (Chairman)
CABANAS RODRIGUEZ, EDUARDO RODRIGO (Secretary)
MATEOS ALVAREZ, RAIMUNDO (Member)
Vaginal microbiome influence in spontaneous pre-term birth
Authorship
P.S.S.A.
Bachelor of Medicine
P.S.S.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction. The microbiome plays a vital role in numerous physiological processes, and an imbalance can lead to pathology. The primary function of the vaginal tract microbiome is to protect against pathogens. Preterm birth is the most common obstetric complication and the leading cause of neonatal morbidity and mortality. The cause is unknown in a high percentage of cases, but genital infection is a known risk factor. Objectives. The main objective is to identify relevant aspects, known or unknown, of the role of the vaginal microbiota in the development of preterm birth in order to predict and prevent it. Secondarily, the aim is to determine the factors that influence the composition of the vaginal microbiota. Materials and Methods. A literature search was conducted for the last 10 years in the databases PubMed, Web of Science, and Cochrane on April 28, 2024, following defined inclusion and exclusion criteria. Results. A stable vaginal microbiome dominated by Lactobacillus Crispatus was shown to be protective against preterm birth. There was disparity in the conclusions regarding factors predisposing to prematurity. The results highlighted the instability of the microbiome during pregnancy and a microbiome dominated by anaerobic species and Lactobacillus Iners. African ancestry and a less favorable socioeconomic status were identified as risk factors for preterm birth. Conclusions. The vaginal microbiome is indeed related to the timing of birth. Lactobacillus Crispatus prevents preterm birth. The first trimester is the best time to measure the microbiota as it is the most informative regarding prematurity. New approaches, such as metabolite measurement, may facilitate a more effective determination of the microbiota. Standardizing risk factors would improve the precision of the results.
Introduction. The microbiome plays a vital role in numerous physiological processes, and an imbalance can lead to pathology. The primary function of the vaginal tract microbiome is to protect against pathogens. Preterm birth is the most common obstetric complication and the leading cause of neonatal morbidity and mortality. The cause is unknown in a high percentage of cases, but genital infection is a known risk factor. Objectives. The main objective is to identify relevant aspects, known or unknown, of the role of the vaginal microbiota in the development of preterm birth in order to predict and prevent it. Secondarily, the aim is to determine the factors that influence the composition of the vaginal microbiota. Materials and Methods. A literature search was conducted for the last 10 years in the databases PubMed, Web of Science, and Cochrane on April 28, 2024, following defined inclusion and exclusion criteria. Results. A stable vaginal microbiome dominated by Lactobacillus Crispatus was shown to be protective against preterm birth. There was disparity in the conclusions regarding factors predisposing to prematurity. The results highlighted the instability of the microbiome during pregnancy and a microbiome dominated by anaerobic species and Lactobacillus Iners. African ancestry and a less favorable socioeconomic status were identified as risk factors for preterm birth. Conclusions. The vaginal microbiome is indeed related to the timing of birth. Lactobacillus Crispatus prevents preterm birth. The first trimester is the best time to measure the microbiota as it is the most informative regarding prematurity. New approaches, such as metabolite measurement, may facilitate a more effective determination of the microbiota. Standardizing risk factors would improve the precision of the results.
Direction
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
COUCEIRO NAVEIRA, EMILIO (Co-tutorships)
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
COUCEIRO NAVEIRA, EMILIO (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
New pharmacological therapies for the treatment of sickle cell disease in pediatric patients. A systematic review of their impact on disease progression.
Authorship
A.S.S.
Bachelor of Medicine
A.S.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Sickle cell disease is a severe hereditary genetic disorder characterized by the presence of hemoglobin S in the erythrocytes. This disease can present with different genotypes, with great variability in their severity and frequency of clinical manifestations, making early diagnosis important. Clinically, it is characterized by the presence of chronic hemolytic anemia and painful vaso-occlusive crises at a multi-organ level, which reduces the life expectancy of these patients. In recent decades, progress has been made in the development of new therapies, including Gene Therapy, Cellular Therapy, and targeted medications aimed at improving the quality of life of these patients and reducing disease progression. Objectives: The main objective of this Final Degree Project is to review new pharmacological therapies approved by the FDA and the EMA for the treatment of sickle cell anemia, considering their efficacy, safety, and their impact on the quality of life of patients. Secondary objectives include identifying possible limitations in the implementation of these therapies, proposing recommendations for clinical practice, and investigating their social impact. Material and methods: A search was conducted in the MEDLINE/PubMed and Cochrane Library databases, with a selection of randomized clinical trials, systematic reviews, and meta-analyses published between 2013 and 2023. Results: A total of 6 publications were included; 5 randomized clinical trials and 1 systematic review. Conclusions: The development of new drugs that improve prognosis of patients with sickle cell disease has been significant in recent years. L-glutamine has been shown to be effective in reducing pain vasoocclusive crises, hospitalizations, and rate of acute chest syndrome. Crizanlizumab reduces the annual rate of pain vasoocclusive crises, appears to increase the average time to the first and second crisis, and also seems to decrease the incidence of uncomplicated crises. Voxelotor has demonstrated in some studies a significant increase in hemoglobin levels and a decrease in some markers of hemolysis. The results are limited by the scarce published scientific evidence.
Introduction: Sickle cell disease is a severe hereditary genetic disorder characterized by the presence of hemoglobin S in the erythrocytes. This disease can present with different genotypes, with great variability in their severity and frequency of clinical manifestations, making early diagnosis important. Clinically, it is characterized by the presence of chronic hemolytic anemia and painful vaso-occlusive crises at a multi-organ level, which reduces the life expectancy of these patients. In recent decades, progress has been made in the development of new therapies, including Gene Therapy, Cellular Therapy, and targeted medications aimed at improving the quality of life of these patients and reducing disease progression. Objectives: The main objective of this Final Degree Project is to review new pharmacological therapies approved by the FDA and the EMA for the treatment of sickle cell anemia, considering their efficacy, safety, and their impact on the quality of life of patients. Secondary objectives include identifying possible limitations in the implementation of these therapies, proposing recommendations for clinical practice, and investigating their social impact. Material and methods: A search was conducted in the MEDLINE/PubMed and Cochrane Library databases, with a selection of randomized clinical trials, systematic reviews, and meta-analyses published between 2013 and 2023. Results: A total of 6 publications were included; 5 randomized clinical trials and 1 systematic review. Conclusions: The development of new drugs that improve prognosis of patients with sickle cell disease has been significant in recent years. L-glutamine has been shown to be effective in reducing pain vasoocclusive crises, hospitalizations, and rate of acute chest syndrome. Crizanlizumab reduces the annual rate of pain vasoocclusive crises, appears to increase the average time to the first and second crisis, and also seems to decrease the incidence of uncomplicated crises. Voxelotor has demonstrated in some studies a significant increase in hemoglobin levels and a decrease in some markers of hemolysis. The results are limited by the scarce published scientific evidence.
Direction
Concheiro Guisán, Ana (Tutorships)
Ocampo Álvarez, Ana María (Co-tutorships)
Concheiro Guisán, Ana (Tutorships)
Ocampo Álvarez, Ana María (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
Epidemiological factors and benzodiazepine consumption in a mental health unit and primary care.
Authorship
F.S.D.
Bachelor of Medicine
F.S.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: benzodiazepines are a group of drugs widely used in modern medicine. They are notably indicated for the treatment of anxiety and insomnia, among other disorders. These drugs are generally safe but are often consumed chronically and are not free of risks, as they can lead to dependency and have side effects such as drowsiness or confusion. Objectives: to profile the characteristics of benzodiazepine users in a Mental Health Unit and a Primary Care Unit of a health center. Methods: an observational, descriptive, cross-sectional study was conducted at the Lérez Health Center in the Pontevedra health area. This study was carried out through an online questionnaire, which the center’s patients could access completely anonymously via a QR code. Results: 76.2% of the patients who completed the mental health unit survey are women, and more than 60% are under 45 years old (a figure that drops to 40% in the primary care unit, with an equal number of men and women). Additionally, the lower income levels of mental health patients stand out (52.4% have an income of less than €12,000/year, compared to 19% of primary care patients) and the high prevalence of anxiety and depression, as well as harmful alcohol consumption in the mental health service. Conclusions: the consumption of benzodiazepines in our current society is very high. This high consumption is particularly evident in patients attending mental health units, where around 90% of patients use these drugs. It is worth noting that these patients are mostly middle-aged women with other pathologies and, in some cases, harmful alcohol consumption.
Introduction: benzodiazepines are a group of drugs widely used in modern medicine. They are notably indicated for the treatment of anxiety and insomnia, among other disorders. These drugs are generally safe but are often consumed chronically and are not free of risks, as they can lead to dependency and have side effects such as drowsiness or confusion. Objectives: to profile the characteristics of benzodiazepine users in a Mental Health Unit and a Primary Care Unit of a health center. Methods: an observational, descriptive, cross-sectional study was conducted at the Lérez Health Center in the Pontevedra health area. This study was carried out through an online questionnaire, which the center’s patients could access completely anonymously via a QR code. Results: 76.2% of the patients who completed the mental health unit survey are women, and more than 60% are under 45 years old (a figure that drops to 40% in the primary care unit, with an equal number of men and women). Additionally, the lower income levels of mental health patients stand out (52.4% have an income of less than €12,000/year, compared to 19% of primary care patients) and the high prevalence of anxiety and depression, as well as harmful alcohol consumption in the mental health service. Conclusions: the consumption of benzodiazepines in our current society is very high. This high consumption is particularly evident in patients attending mental health units, where around 90% of patients use these drugs. It is worth noting that these patients are mostly middle-aged women with other pathologies and, in some cases, harmful alcohol consumption.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
FACHAL VAZQUEZ, DAVID (Co-tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
FACHAL VAZQUEZ, DAVID (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
A different approach to the management of the polycystic ovary syndrome.
Authorship
N.S.L.
Bachelor of Medicine
N.S.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Polycystic ovary syndrome (PCOS) is multifactorial, involving a complex interaction between hormonal, metabolic, and psychological factors. Lifestyle interventions have proven to be effective strategies for improving insulin sensitivity and reducing cardiovascular risk. This comprehensive approach not only improve biochemical parameters but also the quality of life and psychological well-being of patients with PCOS. Objective: To compare the high-protein and normal-protein diets in women suffering from PCOS, understand how these diets affect body composition, hormonal regulation, ovulation, insulin sensitivity, and inflammation, as well as their impact on weight management and satiety. Materials and methods: A systematic review of the available literature has been conducted to include studies from 2003 to the present. Results: The systematic review, where six clinical trials were reviewed, studied the efficacy of the high-protein diet compared to the normoprotein diet in women with PCOS and how these interventions modified both analytical and anthropometric parameters. In 66% of the studies, significant improvements were observed. Conclusions:Studies suggest that a high-protein diet may have metabolic and reproductive benefits for women with PCOS. However, the results are not conclusive due to the heterogeneity of the studies.
Introduction: Polycystic ovary syndrome (PCOS) is multifactorial, involving a complex interaction between hormonal, metabolic, and psychological factors. Lifestyle interventions have proven to be effective strategies for improving insulin sensitivity and reducing cardiovascular risk. This comprehensive approach not only improve biochemical parameters but also the quality of life and psychological well-being of patients with PCOS. Objective: To compare the high-protein and normal-protein diets in women suffering from PCOS, understand how these diets affect body composition, hormonal regulation, ovulation, insulin sensitivity, and inflammation, as well as their impact on weight management and satiety. Materials and methods: A systematic review of the available literature has been conducted to include studies from 2003 to the present. Results: The systematic review, where six clinical trials were reviewed, studied the efficacy of the high-protein diet compared to the normoprotein diet in women with PCOS and how these interventions modified both analytical and anthropometric parameters. In 66% of the studies, significant improvements were observed. Conclusions:Studies suggest that a high-protein diet may have metabolic and reproductive benefits for women with PCOS. However, the results are not conclusive due to the heterogeneity of the studies.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Boullón Batalla, Nuria (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Boullón Batalla, Nuria (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
Postpartum depression and risk of bipolar disorder
Authorship
A.T.C.
Bachelor of Medicine
A.T.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction. Postpartum depression is a prevalent and potentially serious mood disorder. It has considerable implications for the functionality of the mother, parenting, and development of the newborn. This syndrome is a heterogeneous disorder from a clinical point of view, in which various risk factors for its development have been identified, both biological and psychosocial. An increased risk of developing bipolar disorder has been documented in patients with a history of postpartum depressive syndrome. Goals. The main objective is to conduct a review of the available literature to determine the rate of diagnostic conversion to bipolar disorder in women diagnosed with postpartum depression. Secondarily, to evaluate the rate of manic or hypomanic symptoms in patients with affective disorders in the peripartum period, and to describe the clinical and sociodemographical characteristics that help identify greater risk of bipolarity in these patients. Methods. A review of the literature is carried out in different scientific databases (PubMed, PsychInfo, Scopus, Embase). Articles in English and Spanish are included. Results. 12 articles are included in the bibliographic review, 5 prospective longitudinal studies and 7 cross-sectional studies, according to the inclusion and exclusion criteria. The results suggest a diagnostic conversion rate ranging between 4.8 and 54%. Atypical symptoms are defined as one of the clinical elements that help differentiate between bipolar and unipolar depression. Conclusions. This review concludes that the rate of bipolarity in patients with PPD ranges between 4.8 and 54%. Some of the limitations that prevent the determination of a more robust percentage are the small number of articles aimed at investigating this frequency, the sample size, the lack of a universal screening tool for bipolar depression and, consequently, the heterogeneity of the populations under study.
Introduction. Postpartum depression is a prevalent and potentially serious mood disorder. It has considerable implications for the functionality of the mother, parenting, and development of the newborn. This syndrome is a heterogeneous disorder from a clinical point of view, in which various risk factors for its development have been identified, both biological and psychosocial. An increased risk of developing bipolar disorder has been documented in patients with a history of postpartum depressive syndrome. Goals. The main objective is to conduct a review of the available literature to determine the rate of diagnostic conversion to bipolar disorder in women diagnosed with postpartum depression. Secondarily, to evaluate the rate of manic or hypomanic symptoms in patients with affective disorders in the peripartum period, and to describe the clinical and sociodemographical characteristics that help identify greater risk of bipolarity in these patients. Methods. A review of the literature is carried out in different scientific databases (PubMed, PsychInfo, Scopus, Embase). Articles in English and Spanish are included. Results. 12 articles are included in the bibliographic review, 5 prospective longitudinal studies and 7 cross-sectional studies, according to the inclusion and exclusion criteria. The results suggest a diagnostic conversion rate ranging between 4.8 and 54%. Atypical symptoms are defined as one of the clinical elements that help differentiate between bipolar and unipolar depression. Conclusions. This review concludes that the rate of bipolarity in patients with PPD ranges between 4.8 and 54%. Some of the limitations that prevent the determination of a more robust percentage are the small number of articles aimed at investigating this frequency, the sample size, the lack of a universal screening tool for bipolar depression and, consequently, the heterogeneity of the populations under study.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Ortega Ruibal, Francisco José (Co-tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Ortega Ruibal, Francisco José (Co-tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
Metabolic syndrome and its relationship with caries.
Authorship
P.T.M.
Bachelor of Medicine
P.T.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: An overview of Metabolic Syndrome and its relevance in public health is presented, highlighting its association with various chronic diseases, including dental caries. Metabolic Syndrome (MetS) involves insulin resistance, obesity, atherogenic dyslipidemia, and hypertension, related to carbohydrate consumption. This increases cardiovascular risks, diabetes, and proinflammatory states. Its prevalence varies according to diagnostic criteria and ethnicities, with a clear increase with age and concern about its growth in youth. Objectives: To conduct a literature review on the relationship between metabolic syndrome and dental caries. Patients and methods: A search for scientific studies was conducted on platforms such as PubMed, Medline, Scielo, Web of Science, Cochrane, and Google Scholar. Of the 289 articles found, inclusion and exclusion criteria were applied, and only 24 met the inclusion requirements. Results: Studies analyze the relationship between metabolic syndrome and oral health, with diverse approaches and significant findings. An association between metabolic syndrome and dental caries is observed in various populations, such as Chinese and Japanese adults, as well as in children, highlighting a higher prevalence of caries in individuals with metabolic syndrome. Additionally, the relationship between periodontal disease and metabolic syndrome is investigated, with evidence of an association between both conditions. The importance of prevention and management of both metabolic syndrome and oral diseases to promote overall health is emphasized. Conclusions: The relationship between dental caries and metabolic syndrome is bidirectional and influenced by a high-carbohydrate diet. However, there is not enough evidence to affirm that dental caries predicts the development of metabolic syndrome due to the lack of prospective studies.
Introduction: An overview of Metabolic Syndrome and its relevance in public health is presented, highlighting its association with various chronic diseases, including dental caries. Metabolic Syndrome (MetS) involves insulin resistance, obesity, atherogenic dyslipidemia, and hypertension, related to carbohydrate consumption. This increases cardiovascular risks, diabetes, and proinflammatory states. Its prevalence varies according to diagnostic criteria and ethnicities, with a clear increase with age and concern about its growth in youth. Objectives: To conduct a literature review on the relationship between metabolic syndrome and dental caries. Patients and methods: A search for scientific studies was conducted on platforms such as PubMed, Medline, Scielo, Web of Science, Cochrane, and Google Scholar. Of the 289 articles found, inclusion and exclusion criteria were applied, and only 24 met the inclusion requirements. Results: Studies analyze the relationship between metabolic syndrome and oral health, with diverse approaches and significant findings. An association between metabolic syndrome and dental caries is observed in various populations, such as Chinese and Japanese adults, as well as in children, highlighting a higher prevalence of caries in individuals with metabolic syndrome. Additionally, the relationship between periodontal disease and metabolic syndrome is investigated, with evidence of an association between both conditions. The importance of prevention and management of both metabolic syndrome and oral diseases to promote overall health is emphasized. Conclusions: The relationship between dental caries and metabolic syndrome is bidirectional and influenced by a high-carbohydrate diet. However, there is not enough evidence to affirm that dental caries predicts the development of metabolic syndrome due to the lack of prospective studies.
Direction
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
Court
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
LEIRO VIDAL, JOSE MANUEL (Chairman)
PEREZ FENTES, DANIEL ADOLFO (Secretary)
Hermida Ameijeiras, Álvaro (Member)
Applications of Telemedicine in Psychiatry: Ethical and Legal Aspects
Authorship
M.T.D.V.D.C.
Bachelor of Medicine
M.T.D.V.D.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Telemedicine is a form of healthcare delivery that utilizes information and communication technologies to facilitate remote assessment, diagnosis, treatment, and patient monitoring. It is crucial to have secure, reliable, and error-free digital systems, which implies investing more in technology to enhance accessibility. The implementation of telemedicine poses significant challenges, requiring long-term sustainability to be ensured, including appropriate regulations, financial resources, and acceptance by both professionals and patients. Telepsychiatry (TP) offers a wide range of therapeutic and diagnostic applications, benefiting a diverse population and provides suitable tools to improve the psychiatrist-patient relationship, facilitating patient self-expression, self-awareness, and connection. OBJECTIVES: To outline the fundamental challenges arising from the implementation of telemedicine in psychiatric patient care, as well as to understand the ethical and legal aspects involved. METHODS: A literature review was conducted using healthcare databases (PubMed, MedLine, and ScienceDirect), defining search terms, filters, and inclusion/exclusion criteria. Additionally, searches were performed on official websites of scientific societies and government entities to access updated protocols, guidelines, and recommendations on the study topic. RESULTS AND CONCLUSIONS: There is a growing concern among physicians regarding the implementation of telemedicine, stemming from the protection of patients' fundamental rights and ethical-legal aspects. Although some countries have made progress in implementing national digital health strategies, others require support for adoption. It is essential for telemedicine to be accessible, ethical, secure, and sustainable, necessitating investment in resources and training for both professionals and patients, as well as exploring global solutions to address economic, cultural, and social disparities, thereby improving access for vulnerable populations. TP holds potential, but concerns about unexplored consequences persist, emphasizing its role as a complement, not a substitute, for in-person psychiatric consultation.
INTRODUCTION: Telemedicine is a form of healthcare delivery that utilizes information and communication technologies to facilitate remote assessment, diagnosis, treatment, and patient monitoring. It is crucial to have secure, reliable, and error-free digital systems, which implies investing more in technology to enhance accessibility. The implementation of telemedicine poses significant challenges, requiring long-term sustainability to be ensured, including appropriate regulations, financial resources, and acceptance by both professionals and patients. Telepsychiatry (TP) offers a wide range of therapeutic and diagnostic applications, benefiting a diverse population and provides suitable tools to improve the psychiatrist-patient relationship, facilitating patient self-expression, self-awareness, and connection. OBJECTIVES: To outline the fundamental challenges arising from the implementation of telemedicine in psychiatric patient care, as well as to understand the ethical and legal aspects involved. METHODS: A literature review was conducted using healthcare databases (PubMed, MedLine, and ScienceDirect), defining search terms, filters, and inclusion/exclusion criteria. Additionally, searches were performed on official websites of scientific societies and government entities to access updated protocols, guidelines, and recommendations on the study topic. RESULTS AND CONCLUSIONS: There is a growing concern among physicians regarding the implementation of telemedicine, stemming from the protection of patients' fundamental rights and ethical-legal aspects. Although some countries have made progress in implementing national digital health strategies, others require support for adoption. It is essential for telemedicine to be accessible, ethical, secure, and sustainable, necessitating investment in resources and training for both professionals and patients, as well as exploring global solutions to address economic, cultural, and social disparities, thereby improving access for vulnerable populations. TP holds potential, but concerns about unexplored consequences persist, emphasizing its role as a complement, not a substitute, for in-person psychiatric consultation.
Direction
TABERNERO DUQUE, MARIA JESÚS (Tutorships)
TABERNERO DUQUE, MARIA JESÚS (Tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Study in the current treatment of unruptured intracranial aneurysm
Authorship
A.D.L.T.M.
Bachelor of Medicine
A.D.L.T.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Intracranial aneurysms are localized dilations in the walls of cerebral arteries, typically associated with a weakening of these walls and most commonly found at arterial bifurcations. With an estimated prevalence of 2 to 3% in the general population, these aneurysms carry an annual risk of rupture ranging from 1 to 2%. They have been classified based on various characteristics such as shape, size, origin, and location. Typical symptoms include sudden and severe headache, often accompanied by neck stiffness, nausea, vomiting, or focal neurological deficits. Advancements in imaging techniques have led to increased detection of these aneurysms. Various surgical interventions have been developed for their treatment and prevention of rupture. From the introduction of craniotomy and surgical clipping to other methods such as wrapping, microsurgery, and bypass, there is a range of approaches available. The prognosis for patients surgically treated with clipping of intracranial aneurysms varies and is closely related to the severity of subarachnoid hemorrhage at the time of aneurysm diagnosis. Regarding endovascular treatment, there are two main approaches. One aims to preserve the main artery using techniques such as embolization with coils, stent placement, or liquid agents. The other approach involves occluding the main artery using techniques like reverse flow or proximal occlusion. Nowadays, these techniques have become the primary therapeutic option for a variety of aneurysms. Postoperative follow-up is commonly done through angiography, considered the gold standard, along with CT angiography.
Intracranial aneurysms are localized dilations in the walls of cerebral arteries, typically associated with a weakening of these walls and most commonly found at arterial bifurcations. With an estimated prevalence of 2 to 3% in the general population, these aneurysms carry an annual risk of rupture ranging from 1 to 2%. They have been classified based on various characteristics such as shape, size, origin, and location. Typical symptoms include sudden and severe headache, often accompanied by neck stiffness, nausea, vomiting, or focal neurological deficits. Advancements in imaging techniques have led to increased detection of these aneurysms. Various surgical interventions have been developed for their treatment and prevention of rupture. From the introduction of craniotomy and surgical clipping to other methods such as wrapping, microsurgery, and bypass, there is a range of approaches available. The prognosis for patients surgically treated with clipping of intracranial aneurysms varies and is closely related to the severity of subarachnoid hemorrhage at the time of aneurysm diagnosis. Regarding endovascular treatment, there are two main approaches. One aims to preserve the main artery using techniques such as embolization with coils, stent placement, or liquid agents. The other approach involves occluding the main artery using techniques like reverse flow or proximal occlusion. Nowadays, these techniques have become the primary therapeutic option for a variety of aneurysms. Postoperative follow-up is commonly done through angiography, considered the gold standard, along with CT angiography.
Direction
MARTINEZ ROLAN, ROSA MARIA (Tutorships)
MARTINEZ ROLAN, ROSA MARIA (Tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Bispecific Molecules for Multiple Myeloma treatment: A systematic review
Authorship
P.P.D.O.
Bachelor of Medicine
P.P.D.O.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
To perform a systematic review collecting all scientific evidence on bispecif molecules for the treatment of multiple myeloma, to asses efficacy, safety and identify factors influencing outcomes. The search identified records 384. After screening and eligibility process,10 trials bispecif molecules testing were selected for final review, either targeting BCMA (8 trials) or GPCRD5 (2 trials, both phase I trial, testing Talquetamab and Forimtamig). Among BCMA bispecific, only 2phase II trials (testing Elranatamab and LInvoseltamab) plus 1 phase I/phase II expansion trials (testing Teclistamab) were retrieved, with still being tested in early phase 1 trials (F182112, Alnuctamab, AMG 420, AMG 701-both AMG being BiTEs structure- and ABBV-383). Most common adverse event (AE) was myelotoxicity and grade 3-4 infections were surpassed the 40% mark with CD3-BCMA drugs, and 7 and 27% with CD3-GPCRD5 drugs (Talquetamab and Forimtamig, respectively).
To perform a systematic review collecting all scientific evidence on bispecif molecules for the treatment of multiple myeloma, to asses efficacy, safety and identify factors influencing outcomes. The search identified records 384. After screening and eligibility process,10 trials bispecif molecules testing were selected for final review, either targeting BCMA (8 trials) or GPCRD5 (2 trials, both phase I trial, testing Talquetamab and Forimtamig). Among BCMA bispecific, only 2phase II trials (testing Elranatamab and LInvoseltamab) plus 1 phase I/phase II expansion trials (testing Teclistamab) were retrieved, with still being tested in early phase 1 trials (F182112, Alnuctamab, AMG 420, AMG 701-both AMG being BiTEs structure- and ABBV-383). Most common adverse event (AE) was myelotoxicity and grade 3-4 infections were surpassed the 40% mark with CD3-BCMA drugs, and 7 and 27% with CD3-GPCRD5 drugs (Talquetamab and Forimtamig, respectively).
Direction
LOPEZ LOPEZ, RAFAEL (Tutorships)
VILLANUEVA SILVA, MARIA JOSE (Co-tutorships)
LOPEZ LOPEZ, RAFAEL (Tutorships)
VILLANUEVA SILVA, MARIA JOSE (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Assessment of the response to Omalizumab in Chronic Spontaneus Urticaria
Authorship
T.P.L.
Bachelor of Medicine
T.P.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Chronic spontaneous urticaria (CSU) is a condition characterized by the appearance of hives, angioedema, or both, either daily or intermittently, for more than 6 weeks. CSU is a pathology related to the activation of cutaneous mast cells and the release of their mediators, such as histamine. To assess the disease and the response to treatment, it is recommended to use disease-specific questionnaires: activity (UAS/UAS7), control (UCT) and quality of life (CU-Q2OL or DLQI). Second-generation H1 antihistamines are the basic treatment, and if necessary, it is recommended to increase the doses up to 4x. If the response is insufficient, Omalizumab, an anti-IgE monoclonal antibody, is a safe and effective option to control symptoms and improve quality of life. The search for biomarkers of response to treatment is a point of interest for individualized treatment selection. MATERIAL AND METHODS: A narrative review of the scientific literature will be carried out on the biomarkers used in the assessment of the response to AOM in the CSU. In an ambispective observational study of patients with CSU treated with OMA in the Allergology service of the C.H.U.S, the response will be assessed with the validated PROMs after 6 doses of the treatment, and the selected biomarkers will be reviewed in relation to the response to OMA. RESULTS: After the literature search, 19 articles were selected, including two systematic reviews and a meta-analysis. There is evidence that a low level of total IgE is associated with a poor response to AOM. On the other hand, rapid responders (response after 4-6 weeks) have significantly higher baseline total IgE levels than slow responders. Another of the biomarkers under study is the density of the high affinity receptor FcERI in mast cells and basophils, finding that non-responders have significantly lower basal levels. A relationship has also been found between the positivity of the autologous serum test (ASST) and the histamine release test (BHRA) and the time to achieve improvement with AOM, with a higher frequency of positivity in slow responders than in fast responders. There are no conclusive data on the association of response or resistance to AOM with clinical features, markers of autoimmunity, and inflammation (anti-TPO, D-dimer, PCR, cell counts...) In our series of 6 cases reviewed, 1 patient with normal total IgE achieved a complete response (UAS7=0), and one patient with elevated IgE presented a partial response. The 4 patients considered non-responders show different ranges of total IgE. CONCLUSIONS: OMA is an effective option in CSU refractory to H1 antihistamines, but the response is variable. Currently, we do not have markers that allow us to select the best candidates for each treatment. Of the potential biomarkers evaluated, the total IgE value is the best predictor of response to treatment with AOM. Biomarkers must be evaluated in larger samples of patients, to be validated and to guide the indications for CSU treatments.
INTRODUCTION: Chronic spontaneous urticaria (CSU) is a condition characterized by the appearance of hives, angioedema, or both, either daily or intermittently, for more than 6 weeks. CSU is a pathology related to the activation of cutaneous mast cells and the release of their mediators, such as histamine. To assess the disease and the response to treatment, it is recommended to use disease-specific questionnaires: activity (UAS/UAS7), control (UCT) and quality of life (CU-Q2OL or DLQI). Second-generation H1 antihistamines are the basic treatment, and if necessary, it is recommended to increase the doses up to 4x. If the response is insufficient, Omalizumab, an anti-IgE monoclonal antibody, is a safe and effective option to control symptoms and improve quality of life. The search for biomarkers of response to treatment is a point of interest for individualized treatment selection. MATERIAL AND METHODS: A narrative review of the scientific literature will be carried out on the biomarkers used in the assessment of the response to AOM in the CSU. In an ambispective observational study of patients with CSU treated with OMA in the Allergology service of the C.H.U.S, the response will be assessed with the validated PROMs after 6 doses of the treatment, and the selected biomarkers will be reviewed in relation to the response to OMA. RESULTS: After the literature search, 19 articles were selected, including two systematic reviews and a meta-analysis. There is evidence that a low level of total IgE is associated with a poor response to AOM. On the other hand, rapid responders (response after 4-6 weeks) have significantly higher baseline total IgE levels than slow responders. Another of the biomarkers under study is the density of the high affinity receptor FcERI in mast cells and basophils, finding that non-responders have significantly lower basal levels. A relationship has also been found between the positivity of the autologous serum test (ASST) and the histamine release test (BHRA) and the time to achieve improvement with AOM, with a higher frequency of positivity in slow responders than in fast responders. There are no conclusive data on the association of response or resistance to AOM with clinical features, markers of autoimmunity, and inflammation (anti-TPO, D-dimer, PCR, cell counts...) In our series of 6 cases reviewed, 1 patient with normal total IgE achieved a complete response (UAS7=0), and one patient with elevated IgE presented a partial response. The 4 patients considered non-responders show different ranges of total IgE. CONCLUSIONS: OMA is an effective option in CSU refractory to H1 antihistamines, but the response is variable. Currently, we do not have markers that allow us to select the best candidates for each treatment. Of the potential biomarkers evaluated, the total IgE value is the best predictor of response to treatment with AOM. Biomarkers must be evaluated in larger samples of patients, to be validated and to guide the indications for CSU treatments.
Direction
Rodríguez Vázquez, Virginia María (Tutorships)
López Freire, Sara (Co-tutorships)
Rodríguez Vázquez, Virginia María (Tutorships)
López Freire, Sara (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Ethical considerations about forensic DNA phenotyping.
Authorship
M.P.V.
Bachelor of Medicine
M.P.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The field of forensic genetics has experienced multiple advances in recent years. From their initial stages, with methods focused on the use of proteins (enzymes, AB0 system), through the development of DNA analysis techniques (genetic fingerprinting, microsatellites...), the most recent molecular techniques seek to go further and be able to predict phenotypic traits from DNA. It is with this objective that the so-called forensic phenotyping techniques from DNA (FDP) appear. FDP seeks to make probabilistic predictions that relate genetic variations with observable characteristics, and thus function as a “biological witness” during criminal investigations. These techniques currently include among their applications the inference of biogeographic origin, the prediction of external visible characteristics, as well as the estimation of age. However, the inference of these characteristics of the donor of a biological sample is intrinsically associated with a series of ethical connotations that must be explored, and there is still no specific legal regulation for them in most countries. The main objective of this study is to conduct a systematic literature review on the ethical considerations of forensic DNA phenotyping techniques, in order to evaluate the pros and cons of their use as opposed to traditional methods.
Introduction: The field of forensic genetics has experienced multiple advances in recent years. From their initial stages, with methods focused on the use of proteins (enzymes, AB0 system), through the development of DNA analysis techniques (genetic fingerprinting, microsatellites...), the most recent molecular techniques seek to go further and be able to predict phenotypic traits from DNA. It is with this objective that the so-called forensic phenotyping techniques from DNA (FDP) appear. FDP seeks to make probabilistic predictions that relate genetic variations with observable characteristics, and thus function as a “biological witness” during criminal investigations. These techniques currently include among their applications the inference of biogeographic origin, the prediction of external visible characteristics, as well as the estimation of age. However, the inference of these characteristics of the donor of a biological sample is intrinsically associated with a series of ethical connotations that must be explored, and there is still no specific legal regulation for them in most countries. The main objective of this study is to conduct a systematic literature review on the ethical considerations of forensic DNA phenotyping techniques, in order to evaluate the pros and cons of their use as opposed to traditional methods.
Direction
LAREU HUIDOBRO, MARIA VICTORIA (Tutorships)
FREIRE ARADAS, ANA MARIA (Co-tutorships)
LAREU HUIDOBRO, MARIA VICTORIA (Tutorships)
FREIRE ARADAS, ANA MARIA (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Efficacy of Adalimumab and Ustekinumab for endoscopic mucosal healing in Crohn’s Disease: systematic review.
Authorship
M.P.V.
Bachelor of Medicine
M.P.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Mucosal healing in Crohn's Disease (CD) has become a crucial therapeutic target since it improves the prognosis and quality of life of patients. Biological drugs have revolutionized its treatment, offering more effective and targeted therapies that reduce inflammation and promote endoscopic remission, altering the natural history of the disease. This systematic review aims to evaluate the efficacy of Adalimumab and Ustekinumab in achieving endoscopic mucosal healing in patients with CD. Methods: A systematic review of the literature published until May 2024 has been carried out through a search in the PubMed database. Studies that evaluated mucosal healing or endoscopic response through Adalimumab or Ustekinumab as a primary or secondary objective have been included, only if all patients in the sample were analysed. Studies in the paediatric population, letters, opinion articles, bibliographic and systematic reviews, case series and meta-analysis have been excluded. The risk of bias has been evaluated using the tool recommended in the Cochrane Manual and the quality of the evidence with the GRADE methodology. The synthesis of results has been carried out narratively and using tables to facilitate comparison. Results: Eight studies with a sample size between 17 and 252 participants have been included: four prospective observational studies, two cohort studies, one randomized clinical trial and a substudy of three clinical trials. The Ustekinumab studies demonstrated an efficacy in achieving absence of ulcers of 9% and 33.7% at 8 and 52 weeks respectively and remission according to endoscopic scales such as the SES-CD of 7% and 35%, respectively. Adalimumab showed less consistent results for ulcer absence (27% at 12 weeks and 24% and 44.2% at 52 weeks) and endoscopic remission (17.2% and 44.7% at 6 and 12 months, respectively). Discussion: This review has limitations regarding the search, carried out only in PubMed, and the included studies, which were scarce and had an observational design. Adalimumab and Ustekinumab are drugs capable of inducing and maintaining mucosal healing in Crohn's Disease, however, in both cases the success rates have a wide margin for improvement.
Background: Mucosal healing in Crohn's Disease (CD) has become a crucial therapeutic target since it improves the prognosis and quality of life of patients. Biological drugs have revolutionized its treatment, offering more effective and targeted therapies that reduce inflammation and promote endoscopic remission, altering the natural history of the disease. This systematic review aims to evaluate the efficacy of Adalimumab and Ustekinumab in achieving endoscopic mucosal healing in patients with CD. Methods: A systematic review of the literature published until May 2024 has been carried out through a search in the PubMed database. Studies that evaluated mucosal healing or endoscopic response through Adalimumab or Ustekinumab as a primary or secondary objective have been included, only if all patients in the sample were analysed. Studies in the paediatric population, letters, opinion articles, bibliographic and systematic reviews, case series and meta-analysis have been excluded. The risk of bias has been evaluated using the tool recommended in the Cochrane Manual and the quality of the evidence with the GRADE methodology. The synthesis of results has been carried out narratively and using tables to facilitate comparison. Results: Eight studies with a sample size between 17 and 252 participants have been included: four prospective observational studies, two cohort studies, one randomized clinical trial and a substudy of three clinical trials. The Ustekinumab studies demonstrated an efficacy in achieving absence of ulcers of 9% and 33.7% at 8 and 52 weeks respectively and remission according to endoscopic scales such as the SES-CD of 7% and 35%, respectively. Adalimumab showed less consistent results for ulcer absence (27% at 12 weeks and 24% and 44.2% at 52 weeks) and endoscopic remission (17.2% and 44.7% at 6 and 12 months, respectively). Discussion: This review has limitations regarding the search, carried out only in PubMed, and the included studies, which were scarce and had an observational design. Adalimumab and Ustekinumab are drugs capable of inducing and maintaining mucosal healing in Crohn's Disease, however, in both cases the success rates have a wide margin for improvement.
Direction
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Risk of myocarditis after vaccination against SARS-COV2. Systematic review of the literature.
Authorship
E.P.B.
Bachelor of Medicine
E.P.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
3.1 BACKGROUND SARS-COV2 is described at the end of 2019 as a new virus responsible for cases of severe respiratory infection in Wuhan, Hubei province, China. Its great and rapid global impact led to the search for vaccines with the aim of slowing and reducing its expansion. This paper analyzes the possible relationship between coronavirus vaccination and myocarditis. 3.2 OBJECTIVES 1. To assess the risk of myocarditis development after vaccination against SARS-COV2. 2. Describe the clinical profile and evolution of patients with this complication. 3. Evaluate possible clinical factors that increase the risk of myocarditis after vaccination. 4. Analyze if there are differences between different vaccines in relation to myocarditis risk. 3.3 METHODS We analyze the series of cases obtained in PubMed from 2021 to the date of search; December 15, 2023. 3.4 RESULTS After applying the inclusion/exclusion criteria, we obtained a review of 15 case series, with a total of 84 patients. 82% were men, with the average age of revision being 28.26 years. 17% had some previous cardiovascular risk factor, highlighting myocarditis and overweight-obesity. 23% had some other medical history of interest, being asthma the most reported. Clinical appearance was associated with the Pfizer vaccine intervention in 67.86% of cases and with the second dose in 77.38%. The most commonly reported symptom was chest pain (77, 38%), followed by dyspnea and cough. 67% of the patients had ECG abnormalities, 55% had a normal ejection fraction and 88% had troponin elevation in the analysis. 3.5 CONCLUSIONS The review suggests a possible relationship between vaccination and the appearance of a clinical picture of myocarditis; when the patient is a young man, with a mean age around 28 years, and previously healthy.
3.1 BACKGROUND SARS-COV2 is described at the end of 2019 as a new virus responsible for cases of severe respiratory infection in Wuhan, Hubei province, China. Its great and rapid global impact led to the search for vaccines with the aim of slowing and reducing its expansion. This paper analyzes the possible relationship between coronavirus vaccination and myocarditis. 3.2 OBJECTIVES 1. To assess the risk of myocarditis development after vaccination against SARS-COV2. 2. Describe the clinical profile and evolution of patients with this complication. 3. Evaluate possible clinical factors that increase the risk of myocarditis after vaccination. 4. Analyze if there are differences between different vaccines in relation to myocarditis risk. 3.3 METHODS We analyze the series of cases obtained in PubMed from 2021 to the date of search; December 15, 2023. 3.4 RESULTS After applying the inclusion/exclusion criteria, we obtained a review of 15 case series, with a total of 84 patients. 82% were men, with the average age of revision being 28.26 years. 17% had some previous cardiovascular risk factor, highlighting myocarditis and overweight-obesity. 23% had some other medical history of interest, being asthma the most reported. Clinical appearance was associated with the Pfizer vaccine intervention in 67.86% of cases and with the second dose in 77.38%. The most commonly reported symptom was chest pain (77, 38%), followed by dyspnea and cough. 67% of the patients had ECG abnormalities, 55% had a normal ejection fraction and 88% had troponin elevation in the analysis. 3.5 CONCLUSIONS The review suggests a possible relationship between vaccination and the appearance of a clinical picture of myocarditis; when the patient is a young man, with a mean age around 28 years, and previously healthy.
Direction
Barge Caballero, Eduardo (Tutorships)
Vidal Pérez, Rafael Carlos (Co-tutorships)
Barge Caballero, Eduardo (Tutorships)
Vidal Pérez, Rafael Carlos (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Lumbar disc herniation treatment techniques
Authorship
F.P.G.
Bachelor of Medicine
F.P.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Lumbar disc herniation is caused by an alteration in the stability of the metabolic regulatory substances of the intervertebral disc, which leads to degeneration of the annulus fibrosus and the exit of the disc material to the outside. The nucleus pulposus exits into the spinal canal. The herniated material can produce a compression in the nerve root giving local symptoms (pain) and peripheral symptoms (muscular and sensory alterations and pain). The most affected root is therefore the S1 root territory with its corresponding dermatome. Treatment aimed at palliating a lumbar disc herniation will be both conservative and surgical. Conservative treatment is carried out with drugs such as paracetamol, NSAIDs and exercises with stretching tables. The techniques of choice in disc surgery will be discectomy and microdiscectomy, all of which will be performed once the disc herniation has been confirmed by imaging techniques (RMN).
Lumbar disc herniation is caused by an alteration in the stability of the metabolic regulatory substances of the intervertebral disc, which leads to degeneration of the annulus fibrosus and the exit of the disc material to the outside. The nucleus pulposus exits into the spinal canal. The herniated material can produce a compression in the nerve root giving local symptoms (pain) and peripheral symptoms (muscular and sensory alterations and pain). The most affected root is therefore the S1 root territory with its corresponding dermatome. Treatment aimed at palliating a lumbar disc herniation will be both conservative and surgical. Conservative treatment is carried out with drugs such as paracetamol, NSAIDs and exercises with stretching tables. The techniques of choice in disc surgery will be discectomy and microdiscectomy, all of which will be performed once the disc herniation has been confirmed by imaging techniques (RMN).
Direction
MEAÑOS MELON, ENRIQUE RAMON (Tutorships)
MEAÑOS MELON, ENRIQUE RAMON (Tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Determinants of compliance and efficacy of pre-exposure prophylaxis (PrEP) of VIH infection in different populations. A bibliographic review.
Authorship
M.A.G.
Bachelor of Medicine
M.A.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS), has been and continues to be a major public health concern due to the large number of infections (84.2 million people have been infected since the epidemic began) and the clinical consequences it generates (41.1 million people have died from AIDS-related complications). Currently, antiretroviral therapy (ART) has been highly effective in halting the progression of the infection and reducing transmissions (2.9 million people received this treatment in 2022 compared to 7.7 million people in 2010). However, there is still a risk of transmission, and certain populations have a higher risk of infection than the general population, such as men who have sex with men, transgender individuals, serodiscordant couples, sex workers, or intravenous drug users. In July 2012, after multiple studies, the initiation of pre-exposure prophylaxis (PrEP) treatment for HIV in adults at high risk of infection was approved. Subsequently, in 2019, its use was also approved for adolescents at risk of contracting HIV. The results of this prophylaxis have been successful. However, this success is not only due to the medication but also, to a large extent, to treatment adherence, which is determined by various factors that can vary among populations. Objectives: To determine the factors influencing adherence to pre-exposure prophylactic (PrEP) treatment for HIV and how they affect its efficacy in different at-risk populations. Populations and Methods: In this study, we analyzed five groups of the population considered to be at high risk of HIV infection. These are: men who have sex with men (MSM), female sex workers (FSW), people who inject drugs (PWID), transgender women (TGW), and serodiscordant couples (SDC). This analysis was conducted through a literature review of scientific literature following the PRISMA methodology. Results: In MSM, TNF/FTC reduced HIV infection by 44% to 86%, according to the iPREX and PROUD studies. IPERGAY demonstrated an 86% risk reduction with on- demand PrEP, while HPTN 083 showed a 66% lower risk with CAB-LA than with oral TNF/FTC. Adherence ranged from 74.2% to 98%. In TGW, adherence levels were lower, and barriers included access to specific services and prioritization for hormonal treatment. FSWs faced similar obstacles, in addition to a lack of control over condom use due to violence and sex work. PIDs showed low knowledge and use of PrEP. In SDC, PrEP demonstrated 67% to 84% efficacy, with high retention and adherence. Conclusions: PrEP treatment is essential to reduce HIV incidence in MSM, TGW, FSW, PID, and SDC. The effectiveness of this treatment depends largely on adherence, which faces multiple challenges. Determinants of adherence include lack of knowledge, fear of adverse effects, social stigma, and barriers in medical implementation. Individual factors of each at-risk population studied, such as pregnancy, daily regimen in unstable conditions and priority to hormonal treatment also influence. It is necessary to implement health strategies to improve adherence and reduce the stigma associated with HIV.
Introduction: The human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS), has been and continues to be a major public health concern due to the large number of infections (84.2 million people have been infected since the epidemic began) and the clinical consequences it generates (41.1 million people have died from AIDS-related complications). Currently, antiretroviral therapy (ART) has been highly effective in halting the progression of the infection and reducing transmissions (2.9 million people received this treatment in 2022 compared to 7.7 million people in 2010). However, there is still a risk of transmission, and certain populations have a higher risk of infection than the general population, such as men who have sex with men, transgender individuals, serodiscordant couples, sex workers, or intravenous drug users. In July 2012, after multiple studies, the initiation of pre-exposure prophylaxis (PrEP) treatment for HIV in adults at high risk of infection was approved. Subsequently, in 2019, its use was also approved for adolescents at risk of contracting HIV. The results of this prophylaxis have been successful. However, this success is not only due to the medication but also, to a large extent, to treatment adherence, which is determined by various factors that can vary among populations. Objectives: To determine the factors influencing adherence to pre-exposure prophylactic (PrEP) treatment for HIV and how they affect its efficacy in different at-risk populations. Populations and Methods: In this study, we analyzed five groups of the population considered to be at high risk of HIV infection. These are: men who have sex with men (MSM), female sex workers (FSW), people who inject drugs (PWID), transgender women (TGW), and serodiscordant couples (SDC). This analysis was conducted through a literature review of scientific literature following the PRISMA methodology. Results: In MSM, TNF/FTC reduced HIV infection by 44% to 86%, according to the iPREX and PROUD studies. IPERGAY demonstrated an 86% risk reduction with on- demand PrEP, while HPTN 083 showed a 66% lower risk with CAB-LA than with oral TNF/FTC. Adherence ranged from 74.2% to 98%. In TGW, adherence levels were lower, and barriers included access to specific services and prioritization for hormonal treatment. FSWs faced similar obstacles, in addition to a lack of control over condom use due to violence and sex work. PIDs showed low knowledge and use of PrEP. In SDC, PrEP demonstrated 67% to 84% efficacy, with high retention and adherence. Conclusions: PrEP treatment is essential to reduce HIV incidence in MSM, TGW, FSW, PID, and SDC. The effectiveness of this treatment depends largely on adherence, which faces multiple challenges. Determinants of adherence include lack of knowledge, fear of adverse effects, social stigma, and barriers in medical implementation. Individual factors of each at-risk population studied, such as pregnancy, daily regimen in unstable conditions and priority to hormonal treatment also influence. It is necessary to implement health strategies to improve adherence and reduce the stigma associated with HIV.
Direction
DIAZ PEROMINGO, JOSE ANTONIO (Tutorships)
DIAZ PEROMINGO, JOSE ANTONIO (Tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Health effects related to the use of phytosanitary products in vine cultivation: a systematic review.
Authorship
E.M.A.M.
Bachelor of Medicine
E.M.A.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Phytosanitary products have increased their demand in recent years due to improvements in crop yields. Although Spain is a wine-growing power and knowing that the vine is a type of crop that requires many chemicals, we wanted to review the existing literature on the health effects of the use of these products, both for the general population and for winegrowers. Methods: The Pubmed database was consulted and case-control and cohort studies that met the inclusion criteria were selected. The risk of bias and quality of each study was assessed using the Newcastle-Ottawa scale. Results: the difference in cognitive performance through neurological testing in exposed and non-exposed subjects is significant. A 5% increase in neuroblastoma risk was observed for every 10% increase in wine density within the 1000m radius of the residence. Evidence of association between CNS tumors and carbamates was found. Various immunological parameters decreased after exposure to Mancozeb, without having functional repercussions. It increased the rate of micronuclei and DNA damage in exposed people. The prevalence of respiratory symptoms was higher in exposed winegrowers, highlighting dyspnea, chest tightness, chronic cough and phlegm. The risk of childhood leukemia was not increased by passive exposure to pesticides. Conclusions: the effects shown have been obtained in studies with limitations when it comes to establishing confounding factors, quantifying exposure and knowing the substances to which people have been exposed. Therefore, the external validity would be questionable and future lines of research would be necessary to demonstrate the results truthfully.
Phytosanitary products have increased their demand in recent years due to improvements in crop yields. Although Spain is a wine-growing power and knowing that the vine is a type of crop that requires many chemicals, we wanted to review the existing literature on the health effects of the use of these products, both for the general population and for winegrowers. Methods: The Pubmed database was consulted and case-control and cohort studies that met the inclusion criteria were selected. The risk of bias and quality of each study was assessed using the Newcastle-Ottawa scale. Results: the difference in cognitive performance through neurological testing in exposed and non-exposed subjects is significant. A 5% increase in neuroblastoma risk was observed for every 10% increase in wine density within the 1000m radius of the residence. Evidence of association between CNS tumors and carbamates was found. Various immunological parameters decreased after exposure to Mancozeb, without having functional repercussions. It increased the rate of micronuclei and DNA damage in exposed people. The prevalence of respiratory symptoms was higher in exposed winegrowers, highlighting dyspnea, chest tightness, chronic cough and phlegm. The risk of childhood leukemia was not increased by passive exposure to pesticides. Conclusions: the effects shown have been obtained in studies with limitations when it comes to establishing confounding factors, quantifying exposure and knowing the substances to which people have been exposed. Therefore, the external validity would be questionable and future lines of research would be necessary to demonstrate the results truthfully.
Direction
RUANO RAVIÑA, ALBERTO (Tutorships)
CANDAL PEDREIRA, CRISTINA (Co-tutorships)
RUANO RAVIÑA, ALBERTO (Tutorships)
CANDAL PEDREIRA, CRISTINA (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Role of forensic dentistry in the identification of body remains in common graves
Authorship
S.P.P.
Bachelor of Odontology
S.P.P.
Bachelor of Odontology
Defense date
09.05.2024 09:30
09.05.2024 09:30
Summary
INTRODUCTION: Forensic odontology is a fundamental pillar in the identification of victims buried in mass graves on the verge of oblivion. Through it, comparative identification is one of the most clarifying tools to use. However, there are many occasions in which the absence of antemortem data makes it imperative to use reconstructive identification based on anthropological parameters. This review studies the importance of recovering bodies and the dental and forensic protocols used to carry out this mission. METHODOLOGY: The literature search was carried out from October 2023 to July 2024.The database used was mainly PUBMED. However, scientific information portals such as Google Scholar and web portals specialized in the field of forensic odontology that contain essential journals in this bibliographic review were consulted. RESULTS: A total of 24 articles were selected from which the humanitarian reasons for identifying the victims and the difficulties present in identifying them were studied. A total of 14 mass graves were studied, 9 in the Spanish context, 3 at the European level and 1 at the international level. CONCLUSIONS: Genetic analysis is the main method in resolving cases, but there are many occasions in which it is not necessary to perform it, as long as antemortem data and significant dental remains are available with which to make the comparison. The black box of our body is, therefore, the key to recovering the dignity of each missing person.
INTRODUCTION: Forensic odontology is a fundamental pillar in the identification of victims buried in mass graves on the verge of oblivion. Through it, comparative identification is one of the most clarifying tools to use. However, there are many occasions in which the absence of antemortem data makes it imperative to use reconstructive identification based on anthropological parameters. This review studies the importance of recovering bodies and the dental and forensic protocols used to carry out this mission. METHODOLOGY: The literature search was carried out from October 2023 to July 2024.The database used was mainly PUBMED. However, scientific information portals such as Google Scholar and web portals specialized in the field of forensic odontology that contain essential journals in this bibliographic review were consulted. RESULTS: A total of 24 articles were selected from which the humanitarian reasons for identifying the victims and the difficulties present in identifying them were studied. A total of 14 mass graves were studied, 9 in the Spanish context, 3 at the European level and 1 at the international level. CONCLUSIONS: Genetic analysis is the main method in resolving cases, but there are many occasions in which it is not necessary to perform it, as long as antemortem data and significant dental remains are available with which to make the comparison. The black box of our body is, therefore, the key to recovering the dignity of each missing person.
Direction
CRUZ LANDEIRA, ANGELINES (Tutorships)
CRUZ LANDEIRA, ANGELINES (Tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
Pose Rodríguez, José Manuel (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
Pose Rodríguez, José Manuel (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
Comparison of the primary stability of the Bone Level X implant and the Standard Plus implant using resonance frequency analysis. “In vitro” study
Authorship
A.R.T.
Bachelor of Odontology
A.R.T.
Bachelor of Odontology
Defense date
09.05.2024 09:30
09.05.2024 09:30
Summary
The replacement of missing teeth has been a concern throughout the history of humanity, therefore, the history of implantology is broad and difficult to limit. The discovery of titanium and the osseointegration process described by Branemark in 1952 is the main historic event of implantology. The stability of the implant after being placed is known as primary stability and subsequent osseointegration largely depends on this. Multiple factors affect primary stability, including the macrodesign of the implant, which can be conical, parallel or mixed. A reliable and objective mechanism for measuring primary stability is crucial to study what factors intervene in it. This in vitro study compares the primary stability of Bone Level X (BLX) implants in relation to Standard Plus (SP) implants when placed in type IV bone. The BLX implant is a conical implant and the SP is a cylindrical implant. In this study, 30 BLX implants and 30 SP implants were placed in calf rib type IV bone. Primary stability is then measured with the Osstell device that measures resonance frequency analysis. Subsequently, the comparison is carried out using the student t test, which is used to compare independent samples with a significance level of 5%.The results of this study do not show significant differences between BLX and SP implants. These results cannot be extrapolated to real clinical situations since there is always a cortical layer that influences the stability of the implant to a greater or lesser extent.
The replacement of missing teeth has been a concern throughout the history of humanity, therefore, the history of implantology is broad and difficult to limit. The discovery of titanium and the osseointegration process described by Branemark in 1952 is the main historic event of implantology. The stability of the implant after being placed is known as primary stability and subsequent osseointegration largely depends on this. Multiple factors affect primary stability, including the macrodesign of the implant, which can be conical, parallel or mixed. A reliable and objective mechanism for measuring primary stability is crucial to study what factors intervene in it. This in vitro study compares the primary stability of Bone Level X (BLX) implants in relation to Standard Plus (SP) implants when placed in type IV bone. The BLX implant is a conical implant and the SP is a cylindrical implant. In this study, 30 BLX implants and 30 SP implants were placed in calf rib type IV bone. Primary stability is then measured with the Osstell device that measures resonance frequency analysis. Subsequently, the comparison is carried out using the student t test, which is used to compare independent samples with a significance level of 5%.The results of this study do not show significant differences between BLX and SP implants. These results cannot be extrapolated to real clinical situations since there is always a cortical layer that influences the stability of the implant to a greater or lesser extent.
Direction
FERNANDEZ FORMOSO, NOELIA (Tutorships)
Lago González, Laura (Co-tutorships)
FERNANDEZ FORMOSO, NOELIA (Tutorships)
Lago González, Laura (Co-tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
Pose Rodríguez, José Manuel (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
Pose Rodríguez, José Manuel (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
¿AED for dummies? Competencies in the use of an Automated External Defibrillator among Pregraduate Dental Students
Authorship
M.G.A.
Bachelor of Odontology
M.G.A.
Bachelor of Odontology
Defense date
09.05.2024 09:30
09.05.2024 09:30
Summary
Background: Early defibrillation using a Semi-Automatic External Defibrillator (AED) improves the survival of patients with heart failure in out-of-hospital settings. Its use represents a fundamental competence for dentists in the context of medical emergencies. It has not yet been conclusively demonstrated whether potential AED users are prepared to deal with its use adequately. Objective: Analyze the knowledge and skills of the students of the last year of the Dental Degree in the management of AED. Methodology: A cross-sectional descriptive observational study was designed, in which 42 fifth-year students of the Dental Degree at the University of Santiago de Compostela (Spain) participated. All of them faced a simulated scenario of cardiac arrest in an adult. To do this, an AED (Phillips HeartStart FRx) was used and its performance was evaluated with the defibrillator on a resuscitation dummy (Little Anne QCPR). The evaluation was carried out by applying a 10-item survey distributed in 3 blocks: Preparation (4 items), Placement and Discharge (4 items), and Post-discharge (2 items). The time elapsed from the start of the simulation to the moment of discharge was determined. The activity was directed by a monitor with specific training who acted as a second rescuer. Results: Less than 10% of the participants adequately completed 8 of the 10 items evaluated. No students checked the AED battery status and only 4.8% turned on the AED. The average time elapsed until the shock was carried out was 2 minutes and 23 seconds (range: 1 minute 15 seconds to 3 minutes 53 seconds). Conclusion: The skills on the management of AED among the students of the last year of the Dental Degree are very poor. It is necessary to implement specific training on the management of AED in the Degree curriculum.
Background: Early defibrillation using a Semi-Automatic External Defibrillator (AED) improves the survival of patients with heart failure in out-of-hospital settings. Its use represents a fundamental competence for dentists in the context of medical emergencies. It has not yet been conclusively demonstrated whether potential AED users are prepared to deal with its use adequately. Objective: Analyze the knowledge and skills of the students of the last year of the Dental Degree in the management of AED. Methodology: A cross-sectional descriptive observational study was designed, in which 42 fifth-year students of the Dental Degree at the University of Santiago de Compostela (Spain) participated. All of them faced a simulated scenario of cardiac arrest in an adult. To do this, an AED (Phillips HeartStart FRx) was used and its performance was evaluated with the defibrillator on a resuscitation dummy (Little Anne QCPR). The evaluation was carried out by applying a 10-item survey distributed in 3 blocks: Preparation (4 items), Placement and Discharge (4 items), and Post-discharge (2 items). The time elapsed from the start of the simulation to the moment of discharge was determined. The activity was directed by a monitor with specific training who acted as a second rescuer. Results: Less than 10% of the participants adequately completed 8 of the 10 items evaluated. No students checked the AED battery status and only 4.8% turned on the AED. The average time elapsed until the shock was carried out was 2 minutes and 23 seconds (range: 1 minute 15 seconds to 3 minutes 53 seconds). Conclusion: The skills on the management of AED among the students of the last year of the Dental Degree are very poor. It is necessary to implement specific training on the management of AED in the Degree curriculum.
Direction
Diniz Freitas, Márcio (Tutorships)
Diniz Freitas, Márcio (Tutorships)
Relationship between oral lichen planus and systemic diseases
Authorship
M.C.G.
Bachelor of Odontology
M.C.G.
Bachelor of Odontology
Defense date
02.08.2024 10:30
02.08.2024 10:30
Summary
Background: Oral lichen planus (OLP) is a disease with unknown etiology. Various authors suggest the possibility of a causal connection between oral lichen planus and various systemic diseases. This study aims to examine this potential relationship by reviewing clinical records of patients diagnosed clinically and histopathologically with OLP at the Oral Medicine Unit of the Faculty of Dentistry of Santiago de Compostela. In addition to verifying if there is any association between the different clinical forms of presentation of these pathologies in OLP, it aims to observe possible alterations that may be linked to drug consumption in these patients. This comprehensive approach aims to shed light on the complexity of the relationships between OLP, its clinical manifestations, systemic diseases, as well as the impact of pharmacology, thus contributing to a better understanding and approach to this disease in the dental and medical fields. Material and method: 588 clinical records of patients from the Oral Medicine Unit of the Faculty of Dentistry of Santiago de Compostela between 2013 and 2024 were reviewed. After applying the inclusion and exclusion criteria, 287 patients were included. Chi-square test with a significance level of 5% was used for the analysis of associations between systemic pathologies and oral lichen planus. Results: Out of 287 patients, 71% were women, with an average age of 64.84 years. Of these, 78.7% were drug users and 29.4% were considered polypharmacy patients (more than 3 drugs). The most common systemic pathologies among this group were arterial hypertension and hypercholesterolemia (29%). Regarding clinical form, white forms were the most common in patients with OLP, followed by red forms, with erosive being the most common (7.7%). Regarding location, the buccal mucosa was the most common (33.9%), and multiple locations appeared in 48.3% of cases. Regardless of the clinical type, a statistically significant relationship was found between presentation and location (p menor0.005). 76.9% of patients reported no symptoms, especially linked to white forms (70.97%). 33.9% of patients with OLP received treatment for it during the study period. The relationship between OLP clinic and different variables showed that women had the highest percentage, but a statistically significant relationship with the mode of appearance could not be demonstrated. With regard to age, a significant relationship with drug consumption was observed. In the study of systemic diseases, only a significant relationship for arterial hypertension could be demonstrated (p = 0.014). Regarding drug consumption, polypharmacy patients presented different clinical forms, and those without drug consumption showed homogeneity in these presentations. Conclusion: The study demonstrates how oral lichen planus has a direct relationship with arterial hypertension, as well as how drug consumption can influence the clinical presentation of oral pathology.
Background: Oral lichen planus (OLP) is a disease with unknown etiology. Various authors suggest the possibility of a causal connection between oral lichen planus and various systemic diseases. This study aims to examine this potential relationship by reviewing clinical records of patients diagnosed clinically and histopathologically with OLP at the Oral Medicine Unit of the Faculty of Dentistry of Santiago de Compostela. In addition to verifying if there is any association between the different clinical forms of presentation of these pathologies in OLP, it aims to observe possible alterations that may be linked to drug consumption in these patients. This comprehensive approach aims to shed light on the complexity of the relationships between OLP, its clinical manifestations, systemic diseases, as well as the impact of pharmacology, thus contributing to a better understanding and approach to this disease in the dental and medical fields. Material and method: 588 clinical records of patients from the Oral Medicine Unit of the Faculty of Dentistry of Santiago de Compostela between 2013 and 2024 were reviewed. After applying the inclusion and exclusion criteria, 287 patients were included. Chi-square test with a significance level of 5% was used for the analysis of associations between systemic pathologies and oral lichen planus. Results: Out of 287 patients, 71% were women, with an average age of 64.84 years. Of these, 78.7% were drug users and 29.4% were considered polypharmacy patients (more than 3 drugs). The most common systemic pathologies among this group were arterial hypertension and hypercholesterolemia (29%). Regarding clinical form, white forms were the most common in patients with OLP, followed by red forms, with erosive being the most common (7.7%). Regarding location, the buccal mucosa was the most common (33.9%), and multiple locations appeared in 48.3% of cases. Regardless of the clinical type, a statistically significant relationship was found between presentation and location (p menor0.005). 76.9% of patients reported no symptoms, especially linked to white forms (70.97%). 33.9% of patients with OLP received treatment for it during the study period. The relationship between OLP clinic and different variables showed that women had the highest percentage, but a statistically significant relationship with the mode of appearance could not be demonstrated. With regard to age, a significant relationship with drug consumption was observed. In the study of systemic diseases, only a significant relationship for arterial hypertension could be demonstrated (p = 0.014). Regarding drug consumption, polypharmacy patients presented different clinical forms, and those without drug consumption showed homogeneity in these presentations. Conclusion: The study demonstrates how oral lichen planus has a direct relationship with arterial hypertension, as well as how drug consumption can influence the clinical presentation of oral pathology.
Direction
BLANCO CARRION, ANDRES (Tutorships)
Pérez González, Alba (Co-tutorships)
BLANCO CARRION, ANDRES (Tutorships)
Pérez González, Alba (Co-tutorships)
Court
Diniz Freitas, Márcio (Chairman)
CRESPO VAZQUEZ, ELVIRA (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Diniz Freitas, Márcio (Chairman)
CRESPO VAZQUEZ, ELVIRA (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Evaluation of gingival irritation according to the design of the split in at-home external bleaching treatment
Authorship
E.J.P.
Bachelor of Odontology
E.J.P.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Objectives: In this double-blind, randomized full-mouth clinical trial, we evaluated if the design of the bleaching tray influenced the degree of color change, as well as the risk of gingival irritation and the risk of tooth sensitivity. Materials and methods: Seventy-two patients were selected and randomly divided into two groups: non-extended bleaching tray (1 mm from the gingival margin) and extended bleaching tray (3 mm from the gingival margin). An at-home nightguard bleaching (6-8 hours) was performed using 16% carbamide peroxide for 3 weeks. The risk of gingival irritation was objectively evaluated by the clinician (visually and by gingival probing) and subjectively by the patient (daily recording sheet). Dental sensitivity and its intensity were subjectively assessed using a recording sheet and a 5-point numerical scale. Color change was objectively evaluated using a spectrophotometer and a position-finder. Results: The proportion of patients who experienced gingival irritation in the subjective data was 56,9% with no significant differences between groups (p=0.09). However, significant differences were observed in the objective data in the first (p=0.013) and second week (p=0.009). The intensity of the gingival sensitivity was significantly higher in the extended splint group (p less than 0.001); however, no differences between groups were found regarding the risk of sensitivity. The degree of dental bleaching was significant in both groups. Conclusions: A significant color change was observed in both groups. The non-extended tray (1 mm) proved to be better in terms of objective risk of gingival irritation, during at-home external bleaching with 16% carbamide peroxide. A higher intensity of sensitivity was found in extended tray (3 mm).
Objectives: In this double-blind, randomized full-mouth clinical trial, we evaluated if the design of the bleaching tray influenced the degree of color change, as well as the risk of gingival irritation and the risk of tooth sensitivity. Materials and methods: Seventy-two patients were selected and randomly divided into two groups: non-extended bleaching tray (1 mm from the gingival margin) and extended bleaching tray (3 mm from the gingival margin). An at-home nightguard bleaching (6-8 hours) was performed using 16% carbamide peroxide for 3 weeks. The risk of gingival irritation was objectively evaluated by the clinician (visually and by gingival probing) and subjectively by the patient (daily recording sheet). Dental sensitivity and its intensity were subjectively assessed using a recording sheet and a 5-point numerical scale. Color change was objectively evaluated using a spectrophotometer and a position-finder. Results: The proportion of patients who experienced gingival irritation in the subjective data was 56,9% with no significant differences between groups (p=0.09). However, significant differences were observed in the objective data in the first (p=0.013) and second week (p=0.009). The intensity of the gingival sensitivity was significantly higher in the extended splint group (p less than 0.001); however, no differences between groups were found regarding the risk of sensitivity. The degree of dental bleaching was significant in both groups. Conclusions: A significant color change was observed in both groups. The non-extended tray (1 mm) proved to be better in terms of objective risk of gingival irritation, during at-home external bleaching with 16% carbamide peroxide. A higher intensity of sensitivity was found in extended tray (3 mm).
Direction
Castelo Baz, Pablo (Tutorships)
Pereira Lores, Patricia (Co-tutorships)
Castelo Baz, Pablo (Tutorships)
Pereira Lores, Patricia (Co-tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
Influence of oral breathing on periodontal diseases: Bibliographic review
Authorship
N.L.S.
Bachelor of Odontology
N.L.S.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Periodontal diseases are a group of diseases of bacterial and inflammatory infectious origin, determined by the host immune system, that affect the tissues surrounding and supporting the teeth the periodontium. The periodontium may be affected only in the gingiva, which will present redness and edema. However, this condition, which is defined as gingivitis, may extend to other tissues of the periodontium periodontal ligament and alveolar bone tissue resulting in a loss of periodontal attachment, which characterizes periodontitis. Thus, the gingiva is, among the structures of the periodontium, the initial entry route for the development of periodontal diseases; however, it is a tissue also exposed to other detrimental factors, such as poor brushing technique or parafunctions, including mouth breathing. Oral breathing is a breathing pattern characterized by mouth inhalation and exhalation instead of through the nose; it is considered abnormal breathing when it becomes chronical. It can be related to various health problems: allergies, sinusitis, nasal polyps, enlarged adenoids, facial malformations, etc. In addition, this parafunction is associated with a reduction in the amount of saliva that causes a drying of the oral structures, an increase in caries and gingival inflammation. Therefore, the aim of this final degree thesis is to describe the possible influence of oral respiration on periodontal diseases through a literature review, assessing possible lines of future research according to the findings studied in the literature.
Periodontal diseases are a group of diseases of bacterial and inflammatory infectious origin, determined by the host immune system, that affect the tissues surrounding and supporting the teeth the periodontium. The periodontium may be affected only in the gingiva, which will present redness and edema. However, this condition, which is defined as gingivitis, may extend to other tissues of the periodontium periodontal ligament and alveolar bone tissue resulting in a loss of periodontal attachment, which characterizes periodontitis. Thus, the gingiva is, among the structures of the periodontium, the initial entry route for the development of periodontal diseases; however, it is a tissue also exposed to other detrimental factors, such as poor brushing technique or parafunctions, including mouth breathing. Oral breathing is a breathing pattern characterized by mouth inhalation and exhalation instead of through the nose; it is considered abnormal breathing when it becomes chronical. It can be related to various health problems: allergies, sinusitis, nasal polyps, enlarged adenoids, facial malformations, etc. In addition, this parafunction is associated with a reduction in the amount of saliva that causes a drying of the oral structures, an increase in caries and gingival inflammation. Therefore, the aim of this final degree thesis is to describe the possible influence of oral respiration on periodontal diseases through a literature review, assessing possible lines of future research according to the findings studied in the literature.
Direction
Batalla Vázquez, María Pilar (Tutorships)
NOVOA GARRIDO, LOURDES (Co-tutorships)
Batalla Vázquez, María Pilar (Tutorships)
NOVOA GARRIDO, LOURDES (Co-tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
Study of the effects of dental treatment on the levels of blood pressure on patients attending the university clinic.
Authorship
S.M.B.
Bachelor of Odontology
S.M.B.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
INTRODUCTION: Dental anxiety is a relatively common occurrence during dental care and is triggered by previous traumatic experiences, fear of pain and other factors. The stress resulting from the dental visit may produce a number of physiological changes including elevated blood pressure (BP) and increased heart rate (HR) due to the action of the sympathetic nervous system. OBJECTIVE: To explore possible fluctuactions in blood pressure levels in patients receiving care at the university dental clinic. METHODOLOGY: An observational and descriptive study was conducted. 50 patients who met the criteria participated voluntarily, and their BP was measured at three different times: in the waiting room (T1), on entering the dental office (T2) and after the administration of anaesthesia (T3). Additionally, they were given a standardised questionnaire for measutring dental anxiety. RESULTS: A total of 50 patients participated in the study with a mean dental ansiety value of 10,54. Anxiety levels had a particular influence on the increase in blood pressure at T1 calues and on the decrease in BP detected at T3. 36% of the records met basic criteria fot hypertension. A significant elevation of systolic BP was found between T1 and T2 and a decrease after anaesthetic injection. No statistically significant relatioship of the variables with heart rate values was found. CONCLUSION: A significant percetage of dental patients show elevated BP recordings compatible with high blood pressure that may be undiagnosed. The dental consultation can raise BP and anxiety in patients. Both aspects must me considered in order to practice safe and painless dentistry.
INTRODUCTION: Dental anxiety is a relatively common occurrence during dental care and is triggered by previous traumatic experiences, fear of pain and other factors. The stress resulting from the dental visit may produce a number of physiological changes including elevated blood pressure (BP) and increased heart rate (HR) due to the action of the sympathetic nervous system. OBJECTIVE: To explore possible fluctuactions in blood pressure levels in patients receiving care at the university dental clinic. METHODOLOGY: An observational and descriptive study was conducted. 50 patients who met the criteria participated voluntarily, and their BP was measured at three different times: in the waiting room (T1), on entering the dental office (T2) and after the administration of anaesthesia (T3). Additionally, they were given a standardised questionnaire for measutring dental anxiety. RESULTS: A total of 50 patients participated in the study with a mean dental ansiety value of 10,54. Anxiety levels had a particular influence on the increase in blood pressure at T1 calues and on the decrease in BP detected at T3. 36% of the records met basic criteria fot hypertension. A significant elevation of systolic BP was found between T1 and T2 and a decrease after anaesthetic injection. No statistically significant relatioship of the variables with heart rate values was found. CONCLUSION: A significant percetage of dental patients show elevated BP recordings compatible with high blood pressure that may be undiagnosed. The dental consultation can raise BP and anxiety in patients. Both aspects must me considered in order to practice safe and painless dentistry.
Direction
ABELEIRA PAZOS, MARIA TERESA (Tutorships)
ABELEIRA PAZOS, MARIA TERESA (Tutorships)
Literature review for a clinical study proposal: BRINDIS study (left bundle branch block induces systolic dysfunction)
Authorship
A.F.B.
Bachelor of Medicine
A.F.B.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Left ventricular ejection fraction is currently a determining parameter in the diagnosis, treatment and prognosis of heart failure syndrome. In the presence of intraventricular activation disorders, especially left bundle branch block, there is an asynchronous contraction of the cardiac chambers, in which the measurement of the ejection fraction may be insufficient when assessing the real risk of ventricular dysfunction and heart failure. Thus, we observed that, in the consultation room, a certain number of patients with this alteration and with reduced LVEF estimated by imaging tests, would not present the markers or the long-term evolution (in terms of admissions and complications) of what would be expected in heart failure, resembling more closely those of the general population. The aim of this work is to review the available literature on the pathogenesis and the diagnostic and therapeutic approach of bundle branch block, as well as the formulation of a clinical study proposal that aims, mainly, to collect clinical data and diagnostic tests to determine a favorable patient profile that would not require close follow-up in specialized clinics and, secondarily, the analysis of the use of other parameters, such as the calculation of the real systolic volume, as more accurate measures of cardiac function in patients with LBB.
Left ventricular ejection fraction is currently a determining parameter in the diagnosis, treatment and prognosis of heart failure syndrome. In the presence of intraventricular activation disorders, especially left bundle branch block, there is an asynchronous contraction of the cardiac chambers, in which the measurement of the ejection fraction may be insufficient when assessing the real risk of ventricular dysfunction and heart failure. Thus, we observed that, in the consultation room, a certain number of patients with this alteration and with reduced LVEF estimated by imaging tests, would not present the markers or the long-term evolution (in terms of admissions and complications) of what would be expected in heart failure, resembling more closely those of the general population. The aim of this work is to review the available literature on the pathogenesis and the diagnostic and therapeutic approach of bundle branch block, as well as the formulation of a clinical study proposal that aims, mainly, to collect clinical data and diagnostic tests to determine a favorable patient profile that would not require close follow-up in specialized clinics and, secondarily, the analysis of the use of other parameters, such as the calculation of the real systolic volume, as more accurate measures of cardiac function in patients with LBB.
Direction
MAZON RAMOS, MARIA DEL PILAR (Tutorships)
Soto Loureiro, Fernando (Co-tutorships)
MAZON RAMOS, MARIA DEL PILAR (Tutorships)
Soto Loureiro, Fernando (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Microbiota and migraine
Authorship
A.F.P.
Bachelor of Medicine
A.F.P.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Context: Migraine is a debilitating and painful neurological condition that affects approximately 15% of the world's population. It is a chronic disorder of the nervous system, characterized by the appearance of typical, recurrent episodes of headache, which are usually associated with nausea, vomiting, photophobia, sonophobia, in addition to some less frequent discomforts; thus, causing certain problems and disorders in the social and work life of people who suffer from it. Symptoms are mainly managed with the use of pharmaceuticals and biologics. The microbiota is the set of microorganisms that reside in our body. A dysregulation of this (dysbiosis) is involved in chronic and painful inflammatory conditions, such as migraine, through microbial signaling molecules, capable of modulating the immune system and the production of a series of endogenous mediators. Objectives: The aim of our work is to know the involvement of the microbiota in general, and the intestinal and oral microbiota in particular, and the possible dysbiosis in migraine, as well as the possible mechanisms related to these interactions. We also analyzed the results derived from the intervention using probiotics and prebiotics. Methodology: A systematic review of the works published in the last 10 years was carried out, developed from the PubMed, Scopus, Cochrane and Google Scholar databases. We follow the recommendations contained in the PRISMA methodology. After applying inclusion and exclusion filters, we identified the most relevant publications on the objectives of our study. Results: In the research studies analyzed, both clinical and experimental, we have found quite clear evidence on the role of the intestinal and oral microbiota in the severity of migraine. There is some correlation between these findings and changes in the immune system, tryptophan pathway, and the production of short-chain fatty acids involved in the pathogenesis of the disease. In addition, there are some studies that demonstrate the efficacy of some formulations of probiotics, and to a lesser extent of prebiotics, in improving intervention with probiotics, on the intensity of symptoms in patients with migraine. Conclusions: In any case, although the results about the relationship between microbiota and migraine are encouraging, more research is needed, with different approaches, to design diagnostic and therapeutic strategies to improve the prognosis of this disease.
Context: Migraine is a debilitating and painful neurological condition that affects approximately 15% of the world's population. It is a chronic disorder of the nervous system, characterized by the appearance of typical, recurrent episodes of headache, which are usually associated with nausea, vomiting, photophobia, sonophobia, in addition to some less frequent discomforts; thus, causing certain problems and disorders in the social and work life of people who suffer from it. Symptoms are mainly managed with the use of pharmaceuticals and biologics. The microbiota is the set of microorganisms that reside in our body. A dysregulation of this (dysbiosis) is involved in chronic and painful inflammatory conditions, such as migraine, through microbial signaling molecules, capable of modulating the immune system and the production of a series of endogenous mediators. Objectives: The aim of our work is to know the involvement of the microbiota in general, and the intestinal and oral microbiota in particular, and the possible dysbiosis in migraine, as well as the possible mechanisms related to these interactions. We also analyzed the results derived from the intervention using probiotics and prebiotics. Methodology: A systematic review of the works published in the last 10 years was carried out, developed from the PubMed, Scopus, Cochrane and Google Scholar databases. We follow the recommendations contained in the PRISMA methodology. After applying inclusion and exclusion filters, we identified the most relevant publications on the objectives of our study. Results: In the research studies analyzed, both clinical and experimental, we have found quite clear evidence on the role of the intestinal and oral microbiota in the severity of migraine. There is some correlation between these findings and changes in the immune system, tryptophan pathway, and the production of short-chain fatty acids involved in the pathogenesis of the disease. In addition, there are some studies that demonstrate the efficacy of some formulations of probiotics, and to a lesser extent of prebiotics, in improving intervention with probiotics, on the intensity of symptoms in patients with migraine. Conclusions: In any case, although the results about the relationship between microbiota and migraine are encouraging, more research is needed, with different approaches, to design diagnostic and therapeutic strategies to improve the prognosis of this disease.
Direction
FREIRE-GARABAL NUÑEZ, MANUEL (Tutorships)
FREIRE-GARABAL NUÑEZ, MANUEL (Tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Thromboangiitis Obliterans: A systematic review regarding a case.
Authorship
C.G.C.
Bachelor of Medicine
C.G.C.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Thromboangiitis Obliterans is a chronic vasculopathy that primarily affects young smokers, causing significant comorbidity that greatly limits their quality of life. Therefore, after a theoretical introduction about the pathology, a detailed systematic review is carried out using the PRISMA flow diagram to reach a conclusion about the therapeutic algorithm that could be useful to provide a prognostic improvement. A case is presented of a 25-year-old male who first visited the Álvaro Cunqueiro Hospital in Vigo in January 2014 due to pain and cyanosis of the left foot with two weeks of evolution. Examination of the left lower limb showed the absence of pedal pulse, reversible cyanosis and a non-infected lesion on the third toe. An angio-MRI showed the presence of occlusions in both lower limbs. Given these findings and with a suspected diagnosis of Buerger´s Disease, treatment with Alprostadil, LMWH and analgesia was initiated. The unfavourable evolution of this patient over 7 years, due to the persistence of smoking, needed three amputations, ultimately resulting in the loss of follow- up in 2021. The authors conclude that absolute, sustained smoking cessation is the only valid and effective treatment for affected patients, as all other therapies alone will ultimately fail in the long therm. They also emphasize the importance of understanding the etiology of the disease to seek therapeutic strategies that allow prognostic improvement in these patients, even if smoking cessation is not achieved.
Thromboangiitis Obliterans is a chronic vasculopathy that primarily affects young smokers, causing significant comorbidity that greatly limits their quality of life. Therefore, after a theoretical introduction about the pathology, a detailed systematic review is carried out using the PRISMA flow diagram to reach a conclusion about the therapeutic algorithm that could be useful to provide a prognostic improvement. A case is presented of a 25-year-old male who first visited the Álvaro Cunqueiro Hospital in Vigo in January 2014 due to pain and cyanosis of the left foot with two weeks of evolution. Examination of the left lower limb showed the absence of pedal pulse, reversible cyanosis and a non-infected lesion on the third toe. An angio-MRI showed the presence of occlusions in both lower limbs. Given these findings and with a suspected diagnosis of Buerger´s Disease, treatment with Alprostadil, LMWH and analgesia was initiated. The unfavourable evolution of this patient over 7 years, due to the persistence of smoking, needed three amputations, ultimately resulting in the loss of follow- up in 2021. The authors conclude that absolute, sustained smoking cessation is the only valid and effective treatment for affected patients, as all other therapies alone will ultimately fail in the long therm. They also emphasize the importance of understanding the etiology of the disease to seek therapeutic strategies that allow prognostic improvement in these patients, even if smoking cessation is not achieved.
Direction
VARELA PONTE, RAFAEL (Tutorships)
ENCISA DE SA, JOSE MANUEL (Co-tutorships)
VARELA PONTE, RAFAEL (Tutorships)
ENCISA DE SA, JOSE MANUEL (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Literature review on optimal clinical management of small renal lesions found incidentally on imaging tests
Authorship
M.C.E.R.
Bachelor of Medicine
M.C.E.R.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
mall renal masses (SRM), so called by their acronym in English, are solid kidney lesions of less than 4 cm, their incidence has been increasing in parallel with the development and performance of imaging test, which has led to an increase in its detection mainly in older patients. It is estimated that between 70% and 90% of the lesions correspond to malignant cell carcinoma. The higher incidence of this type of injuries in the elderly population, who also present a greater number of comorbidities, added to the appearance of new, less invasive treatment techniques, leads us to consider what the optimal treatment is according to the characteristics of each patient. When considering the type of treatment, three factors must be considered: cancer control, patient comorbidities, and preservation of kidney function. The correct balance between the three must be taken into account when selecting the most appropriate treatment for each individual. Thus among the options from least to most conservative we have: radical surgery, partial nephrectomy, ablation therapies, both percutaneous and laparoscopic, and active surveillance.
mall renal masses (SRM), so called by their acronym in English, are solid kidney lesions of less than 4 cm, their incidence has been increasing in parallel with the development and performance of imaging test, which has led to an increase in its detection mainly in older patients. It is estimated that between 70% and 90% of the lesions correspond to malignant cell carcinoma. The higher incidence of this type of injuries in the elderly population, who also present a greater number of comorbidities, added to the appearance of new, less invasive treatment techniques, leads us to consider what the optimal treatment is according to the characteristics of each patient. When considering the type of treatment, three factors must be considered: cancer control, patient comorbidities, and preservation of kidney function. The correct balance between the three must be taken into account when selecting the most appropriate treatment for each individual. Thus among the options from least to most conservative we have: radical surgery, partial nephrectomy, ablation therapies, both percutaneous and laparoscopic, and active surveillance.
Direction
BALEATO GONZALEZ, SANDRA (Tutorships)
GARCIA FIGUEIRAS, ROBERTO (Co-tutorships)
BALEATO GONZALEZ, SANDRA (Tutorships)
GARCIA FIGUEIRAS, ROBERTO (Co-tutorships)
Court
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
GALLEGO GOMEZ, MARIA ROSALIA (Chairman)
SOTO VARELA, ANDRES (Secretary)
RODRIGUEZ REQUENA, JESUS (Member)
Use of biological drugs for off-label indications in pediatric dermatology
Authorship
M.J.B.
Bachelor of Medicine
M.J.B.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: An off-label drug is one that is prescribed for an unapproved indication, age, dose or route of administration. A therapeutic group of special interest is that of biological drugs, whose off-label use in children and adolescents has been scarcely studied. Objective: To describe the biological drugs used for dermatoses other than those ap-proved, in children under 18 years of age. Secondarily, we tried to describe pathologies subsidiary of treatment with these drugs, and to evaluate the effectiveness and safety of biological treatment in this context. Methodology: An exhaustive review of the literature of cases and case series pub-lished in English or Spanish in PubMed and Web of Science, which described the use of biological drugs for an unapproved dermatological indication, in patients under 18 years of age. From the selected articles, data referring to the publication itself and clinical-demographic variables of the reported patients were collected. Results: A total of 148 articles were obtained (36,5% from Europe), which provided data from 205 patients (mean age 9,7 years; 55,2% male) and 220 treatment cycles. Dupilumab (16,8%), rituximab (15,5%) and omalizumab (15%) were the most frequently used biologic drugs. The most represented pathologies were ichthyosis and ichthyosiform syndromes (12,8%), followed by pityriasis rubra pilaris and related disorders (8,1%). Concomitant systemic treatment was recorded in 50,7% of the biologic treatment cycles (74,8% corticosteroids). 40,6% of the cases ended in resolution, 52,2% in improvement, 5,8% in no effect and 1,4% in worsening. 19 adverse effects were reported, the most frequent being the infusion reaction (21,05%) Conclusions: The most frequently used FFT biologics in children and adolescents were dupilumab, rituximab and omalizumab. Ichthyosis and ichthyosiform syndromes were the most subsidiary entities of these treatments. In more than 90% of cases, the therapeutic response resulted in improvement or resolution. Adverse effects were few and mainly mild.
Introduction: An off-label drug is one that is prescribed for an unapproved indication, age, dose or route of administration. A therapeutic group of special interest is that of biological drugs, whose off-label use in children and adolescents has been scarcely studied. Objective: To describe the biological drugs used for dermatoses other than those ap-proved, in children under 18 years of age. Secondarily, we tried to describe pathologies subsidiary of treatment with these drugs, and to evaluate the effectiveness and safety of biological treatment in this context. Methodology: An exhaustive review of the literature of cases and case series pub-lished in English or Spanish in PubMed and Web of Science, which described the use of biological drugs for an unapproved dermatological indication, in patients under 18 years of age. From the selected articles, data referring to the publication itself and clinical-demographic variables of the reported patients were collected. Results: A total of 148 articles were obtained (36,5% from Europe), which provided data from 205 patients (mean age 9,7 years; 55,2% male) and 220 treatment cycles. Dupilumab (16,8%), rituximab (15,5%) and omalizumab (15%) were the most frequently used biologic drugs. The most represented pathologies were ichthyosis and ichthyosiform syndromes (12,8%), followed by pityriasis rubra pilaris and related disorders (8,1%). Concomitant systemic treatment was recorded in 50,7% of the biologic treatment cycles (74,8% corticosteroids). 40,6% of the cases ended in resolution, 52,2% in improvement, 5,8% in no effect and 1,4% in worsening. 19 adverse effects were reported, the most frequent being the infusion reaction (21,05%) Conclusions: The most frequently used FFT biologics in children and adolescents were dupilumab, rituximab and omalizumab. Ichthyosis and ichthyosiform syndromes were the most subsidiary entities of these treatments. In more than 90% of cases, the therapeutic response resulted in improvement or resolution. Adverse effects were few and mainly mild.
Direction
PEREIRO FERREIROS, MANUEL (Tutorships)
Batalla Cebey, Ana (Co-tutorships)
Martínez Sernández, Victoria (Co-tutorships)
PEREIRO FERREIROS, MANUEL (Tutorships)
Batalla Cebey, Ana (Co-tutorships)
Martínez Sernández, Victoria (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Treatment of cerebral aneurysms: historical evolution and indications.
Authorship
I.L.C.
Bachelor of Medicine
I.L.C.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Due to the high mortality risks associated with aneurysmal subarachnoid hemorrhage, the treatment of cerebral aneurysms has seen significant advancements in recent decades, especially with the development of endovascular embolization techniques. Additionally, with the increased use of imaging techniques in clinical practice, there has been a rise in the diagnosis of unruptured aneurysms, presenting new challenges for vascular neurosurgeons. This work focuses on two crucial aspects: assessing the risk of rupture of unruptured aneurysms compared to surgical risk, to determine the need for treatment; and selecting the therapeutic approach, whether surgical or endovascular. This complex decision-making process will be illustrated through a clinical case treated at CHUAC, where an initial endovascular approach for a PICA artery aneurysm was attempted, but due to its specific vascular anatomy, a surgical intervention was ultimately required. This case highlights the importance of individualizing treatment based on the characteristics of the patient and the aneurysm.
Due to the high mortality risks associated with aneurysmal subarachnoid hemorrhage, the treatment of cerebral aneurysms has seen significant advancements in recent decades, especially with the development of endovascular embolization techniques. Additionally, with the increased use of imaging techniques in clinical practice, there has been a rise in the diagnosis of unruptured aneurysms, presenting new challenges for vascular neurosurgeons. This work focuses on two crucial aspects: assessing the risk of rupture of unruptured aneurysms compared to surgical risk, to determine the need for treatment; and selecting the therapeutic approach, whether surgical or endovascular. This complex decision-making process will be illustrated through a clinical case treated at CHUAC, where an initial endovascular approach for a PICA artery aneurysm was attempted, but due to its specific vascular anatomy, a surgical intervention was ultimately required. This case highlights the importance of individualizing treatment based on the characteristics of the patient and the aneurysm.
Direction
PRIETO GONZALEZ, ANGEL JESUS (Tutorships)
BLANCO GUIJARRO, ADELA (Co-tutorships)
PRIETO GONZALEZ, ANGEL JESUS (Tutorships)
BLANCO GUIJARRO, ADELA (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Wolf-Parkinson-White Syndrome. Bibliographical review focusing on the ablation of accessory pathways as a therapeutic measure and the mapping of these pathways using Open Window method.
Authorship
L.L.B.
Bachelor of Medicine
L.L.B.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
INTRODUCTION: Wolff-Parkinson-White syndrome is a congenital heart condition characterized by preexcitation observed in an ECG. This is due to the presence of an accessory pathway, known as the 'Bundle of Kent.' It has a prevalence of between 0.1 and 3 per thousand in the general population. OBJECTIVES: This study aims to examine this condition through a literature review to describe the disease, its history, underlying pathophysiology, diagnosis, treatment, complications, and prognosis, with a special focus on the Open Window method for mapping accessory pathways. METHODS: A literature review was conducted using the PubMed platform to search for studies published between 2001 and 2024. The search terms included 'Wolff-Parkinson-White' to identify relevant articles, combined with other keywords such as 'accessory pathway,' 'ablation,' 'Open Window,' 'supraventricular tachycardia,' 'electrophysiology,' 'children,' 'pregnant women,' and 'athletes,' to refine the results. Additional bibliography provided by the tutors of this TFG was included, and duplicate articles were removed during the search. RESULTS: After applying the inclusion and exclusion criteria, 54 articles were included. CONCLUSION: WPW is an uncommon condition with a generally benign prognosis and is increasingly diagnosed in the pediatric population. Patients may present with a variety of symptoms, although it is not uncommon for them to be asymptomatic, leading to an incidental diagnosis. Initial management includes medical history, physical examination, and ECG; additional tests will be performed based on comorbidities, clinical presentation, and patient risk. If treatment is indicated, RF ablation is currently the first-line therapy. Additionally, 3D mapping methods and the emergence of the Open Window method are optimizing the approach to this condition.
INTRODUCTION: Wolff-Parkinson-White syndrome is a congenital heart condition characterized by preexcitation observed in an ECG. This is due to the presence of an accessory pathway, known as the 'Bundle of Kent.' It has a prevalence of between 0.1 and 3 per thousand in the general population. OBJECTIVES: This study aims to examine this condition through a literature review to describe the disease, its history, underlying pathophysiology, diagnosis, treatment, complications, and prognosis, with a special focus on the Open Window method for mapping accessory pathways. METHODS: A literature review was conducted using the PubMed platform to search for studies published between 2001 and 2024. The search terms included 'Wolff-Parkinson-White' to identify relevant articles, combined with other keywords such as 'accessory pathway,' 'ablation,' 'Open Window,' 'supraventricular tachycardia,' 'electrophysiology,' 'children,' 'pregnant women,' and 'athletes,' to refine the results. Additional bibliography provided by the tutors of this TFG was included, and duplicate articles were removed during the search. RESULTS: After applying the inclusion and exclusion criteria, 54 articles were included. CONCLUSION: WPW is an uncommon condition with a generally benign prognosis and is increasingly diagnosed in the pediatric population. Patients may present with a variety of symptoms, although it is not uncommon for them to be asymptomatic, leading to an incidental diagnosis. Initial management includes medical history, physical examination, and ECG; additional tests will be performed based on comorbidities, clinical presentation, and patient risk. If treatment is indicated, RF ablation is currently the first-line therapy. Additionally, 3D mapping methods and the emergence of the Open Window method are optimizing the approach to this condition.
Direction
MAZON RAMOS, MARIA DEL PILAR (Tutorships)
MAZON RAMOS, MARIA DEL PILAR (Tutorships)
Correlation between pulse oximetry and partial pressure of oxygen in critically ill patients admitted to the resuscitation unit. Influence of norepinephrine and fluid balance on this correlation: single center observational study
Authorship
A.B.I.
Bachelor of Medicine
A.B.I.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Correct measurement of the oxygenation status of our patients is key to making highly relevant clinical decisions. Currently, we have two systems to quantify oxygenation status: pulse oximetry, a method that allows us to estimate peripheral oxygen saturation, and arterial blood gas, an invasive test that allows direct measurement. Objectives: Determine the correlation between pulse oximetry and arterial oxygen pressure in a critical care unit. Furthermore, it is intended to assess two specific situations that may affect this correlation: the administration of high levels of norepinephrine (due to its powerful vasoconstrictor effect) and the very positive fluid balance (due to the resulting peripheral edema). Material and methods: a single-center, prospective observational study was carried out in the surgical ICU of the University Hospital of Santiago de Compostela. During the study period between July 2023-March 2024, after signing informed consent, the necessary data collection was carried out on each patient admitted to the unit using the ICIP program. Subjects were divided into three groups based on whether they were receiving norepinephrine and their fluid balance. Results: 116 patients were included, with a mean age of 65.60 +- 14.30 years. To establish the correlation, Pearson's linear correlation index was used. In the base group, the correlation between Sa02 and Sp02 levels was 0.69. The same correlation was maintained in both subgroups of the norepinephrine group (0.65 and 0.60) and in both subgroups of the balance group (0.67 and 0.60). Statistical significance was not reached in any of the groups. Conclusions: Consistent with current evidence, in our cohort it is observed that the measurement of patients' oxygenation using pulse oximetry is a non-invasive method, easy to interpret, which is not interfered with by situations of hypervolemia or the presence of vasoconstrictor amines.
Introduction: Correct measurement of the oxygenation status of our patients is key to making highly relevant clinical decisions. Currently, we have two systems to quantify oxygenation status: pulse oximetry, a method that allows us to estimate peripheral oxygen saturation, and arterial blood gas, an invasive test that allows direct measurement. Objectives: Determine the correlation between pulse oximetry and arterial oxygen pressure in a critical care unit. Furthermore, it is intended to assess two specific situations that may affect this correlation: the administration of high levels of norepinephrine (due to its powerful vasoconstrictor effect) and the very positive fluid balance (due to the resulting peripheral edema). Material and methods: a single-center, prospective observational study was carried out in the surgical ICU of the University Hospital of Santiago de Compostela. During the study period between July 2023-March 2024, after signing informed consent, the necessary data collection was carried out on each patient admitted to the unit using the ICIP program. Subjects were divided into three groups based on whether they were receiving norepinephrine and their fluid balance. Results: 116 patients were included, with a mean age of 65.60 +- 14.30 years. To establish the correlation, Pearson's linear correlation index was used. In the base group, the correlation between Sa02 and Sp02 levels was 0.69. The same correlation was maintained in both subgroups of the norepinephrine group (0.65 and 0.60) and in both subgroups of the balance group (0.67 and 0.60). Statistical significance was not reached in any of the groups. Conclusions: Consistent with current evidence, in our cohort it is observed that the measurement of patients' oxygenation using pulse oximetry is a non-invasive method, easy to interpret, which is not interfered with by situations of hypervolemia or the presence of vasoconstrictor amines.
Direction
VEIRAS DEL RIO, SONIA (Tutorships)
Álvarez Escudero, Julián (Co-tutorships)
VEIRAS DEL RIO, SONIA (Tutorships)
Álvarez Escudero, Julián (Co-tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Contributions of Spectral CT in the local staging of pancreatic adenocarcinoma. Systematic review.
Authorship
K.N.B.T.
Bachelor of Medicine
K.N.B.T.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Pancreatic adenocarcinoma presents a challenging prognosis due to its late detection and rapid spread, mostly diagnosed in advanced stages. Its management requires multidisciplinary approaches and innovative strategies. In this context, Dual-Energy Computed Tomography (DECT) has emerged as a promising tool, offering precise tumor characterization and improving clinical management. Given the growing importance of DECT in the diagnosis and monitoring of this disease, our research focused on exploring the latest information in this area, aiming to provide a comprehensive overview of current developments and their impact on clinical practice. To conduct the systematic review, systematic searches were carried out across multiple databases, although ultimately only PubMed was used due to its relevance in the field. Subsequently, inclusion and exclusion criteria were applied to select 10 articles, with their data extracted into a table. The results of this systematic review revealed that, in DECT, low energies, especially between 40-50 keV, enhance the detection of pancreatic adenocarcinoma. Iodine maps provide a detailed view of the pathophysiology and assist in clinical management. Monoenergetic images improve the visualization of pancreatic lesions with higher image quality than polyenergetic ones. DECT promises significant advances in the future of pancreatic adenocarcinoma diagnosis and monitoring, offering a more precise tumor characterization and improving clinical management of patients. It would be advisable to delve deeper into the subject until more research is conducted.
Pancreatic adenocarcinoma presents a challenging prognosis due to its late detection and rapid spread, mostly diagnosed in advanced stages. Its management requires multidisciplinary approaches and innovative strategies. In this context, Dual-Energy Computed Tomography (DECT) has emerged as a promising tool, offering precise tumor characterization and improving clinical management. Given the growing importance of DECT in the diagnosis and monitoring of this disease, our research focused on exploring the latest information in this area, aiming to provide a comprehensive overview of current developments and their impact on clinical practice. To conduct the systematic review, systematic searches were carried out across multiple databases, although ultimately only PubMed was used due to its relevance in the field. Subsequently, inclusion and exclusion criteria were applied to select 10 articles, with their data extracted into a table. The results of this systematic review revealed that, in DECT, low energies, especially between 40-50 keV, enhance the detection of pancreatic adenocarcinoma. Iodine maps provide a detailed view of the pathophysiology and assist in clinical management. Monoenergetic images improve the visualization of pancreatic lesions with higher image quality than polyenergetic ones. DECT promises significant advances in the future of pancreatic adenocarcinoma diagnosis and monitoring, offering a more precise tumor characterization and improving clinical management of patients. It would be advisable to delve deeper into the subject until more research is conducted.
Direction
VARELA PONTE, RAFAEL (Tutorships)
Quintero Rivera, Juan Carlos (Co-tutorships)
VARELA PONTE, RAFAEL (Tutorships)
Quintero Rivera, Juan Carlos (Co-tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Maternal-fetal complications in pregnant women over 45 years old
Authorship
M.B.L.
Bachelor of Medicine
M.B.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Pregnant women over 45 years old have been an increasing obstetric population since the late 20th century. These women benefit from even more careful obstetric evaluation since their biological age represents a risk factor for the development of various obstetric complications. These complications include gestational diabetes (GD), cesarean sections, placenta previa (PP), hypertensive disorders of pregnancy (preeclampsia, eclampsia, HELLP syndrome), increased maternal mortality, antepartum and postpartum hemorrhage, premature detachment of a normally implanted placenta (DPPNI), lipid and glucose metabolism disorders, and the need for hospitalization (either during pregnancy or postpartum). The aim of this systematic review is to try to establish a causal relationship between maternal age over 45 years and the mentioned obstetric complications, provide useful information for clinical practice, and offer appropriate counseling for this aging obstetric population. An advanced search in PubMed yielded 88 articles, of which 15 were selected according to inclusion and exclusion criteria. According to citation searching, 9 articles were included. In total, 24 articles were included, selected according to the Prisma method. It was concluded that, in this age range, in addition to an increase in the prevalence of chronic diseases such as hypertension and diabetes mellitus, there is also an increase in the incidence of GD, hypertensive disorders of pregnancy, cesarean sections (mainly urgent), placenta previa, lipid disorders, hospitalizations, and maternal morbidity and mortality.
Pregnant women over 45 years old have been an increasing obstetric population since the late 20th century. These women benefit from even more careful obstetric evaluation since their biological age represents a risk factor for the development of various obstetric complications. These complications include gestational diabetes (GD), cesarean sections, placenta previa (PP), hypertensive disorders of pregnancy (preeclampsia, eclampsia, HELLP syndrome), increased maternal mortality, antepartum and postpartum hemorrhage, premature detachment of a normally implanted placenta (DPPNI), lipid and glucose metabolism disorders, and the need for hospitalization (either during pregnancy or postpartum). The aim of this systematic review is to try to establish a causal relationship between maternal age over 45 years and the mentioned obstetric complications, provide useful information for clinical practice, and offer appropriate counseling for this aging obstetric population. An advanced search in PubMed yielded 88 articles, of which 15 were selected according to inclusion and exclusion criteria. According to citation searching, 9 articles were included. In total, 24 articles were included, selected according to the Prisma method. It was concluded that, in this age range, in addition to an increase in the prevalence of chronic diseases such as hypertension and diabetes mellitus, there is also an increase in the incidence of GD, hypertensive disorders of pregnancy, cesarean sections (mainly urgent), placenta previa, lipid disorders, hospitalizations, and maternal morbidity and mortality.
Direction
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Rodríguez Fernández, Vanesa (Co-tutorships)
Marín Ortiz, Elena (Co-tutorships)
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Rodríguez Fernández, Vanesa (Co-tutorships)
Marín Ortiz, Elena (Co-tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Is Transcutaneous Electrical Nerve Stimulation effective in primary dysmenorrhea?
Authorship
C.B.S.D.A.P.
Bachelor of Medicine
C.B.S.D.A.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The interest and wide use of electrotherapy in the treatment of pain is well known. Transcutaneous electrical nerve stimulation (TENS) involves applying electrical impulses through the skin for analgesic purposes, which can provide temporary or even permanent relief of the pain in question. Dysmenorrhea is a common gynecological concern that affects many women. The number of women affected varies considerably, with rates ranging from 16% to 91% in women of reproductive age. In addition, about 2% to 29% of these women experience severe menstrual pain. Objective: To assess whether transcutaneous electrical nerve stimulation (TENS) is effective in relieving symptoms of primary dysmenorrhea. Methodology: Systematic review of the available scientific literature on the use of TENS for pain associated with dysmenorrhea was carried out by means of the PUBMED and PEDro bibliographic search engines. PRISMA guidelines were followed. Inclusion criteria selected: clinical trials and research supports done in humans and applied to women of childbearing age, published between 2013-2023 and freely accessible. Results: a total of 68 results were identified where inclusion criteria were applied achieving 33 results. These 33 articles were analyzed by reading their titles and abstract and applying exclusion criteria, obtaining 8 studies. The comprehensive reading of the 8 articles was performed, leaving 5 in this systematic review. Conclusions: High-frequency transcutaneous electrical nerve stimulation (TENS) was found to be effective in treating dysmenorrhea in all studies. However, more research is needed to better understand the mild side effects reported in one specific trial. Currently, there is not enough evidence to conclude whether low-frequency TENS is effective in relieving dysmenorrhea.
Introduction: The interest and wide use of electrotherapy in the treatment of pain is well known. Transcutaneous electrical nerve stimulation (TENS) involves applying electrical impulses through the skin for analgesic purposes, which can provide temporary or even permanent relief of the pain in question. Dysmenorrhea is a common gynecological concern that affects many women. The number of women affected varies considerably, with rates ranging from 16% to 91% in women of reproductive age. In addition, about 2% to 29% of these women experience severe menstrual pain. Objective: To assess whether transcutaneous electrical nerve stimulation (TENS) is effective in relieving symptoms of primary dysmenorrhea. Methodology: Systematic review of the available scientific literature on the use of TENS for pain associated with dysmenorrhea was carried out by means of the PUBMED and PEDro bibliographic search engines. PRISMA guidelines were followed. Inclusion criteria selected: clinical trials and research supports done in humans and applied to women of childbearing age, published between 2013-2023 and freely accessible. Results: a total of 68 results were identified where inclusion criteria were applied achieving 33 results. These 33 articles were analyzed by reading their titles and abstract and applying exclusion criteria, obtaining 8 studies. The comprehensive reading of the 8 articles was performed, leaving 5 in this systematic review. Conclusions: High-frequency transcutaneous electrical nerve stimulation (TENS) was found to be effective in treating dysmenorrhea in all studies. However, more research is needed to better understand the mild side effects reported in one specific trial. Currently, there is not enough evidence to conclude whether low-frequency TENS is effective in relieving dysmenorrhea.
Direction
FIGUEROA RODRIGUEZ, JESUS (Tutorships)
FIGUEROA RODRIGUEZ, JESUS (Tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Anaphylaxis due to Vespa Velutina nigrithorax: analysis of the efficacy of immunotherapy based on a case.
Authorship
I.B.A.
Bachelor of Medicine
I.B.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Anaphylaxis induced by Vespa Velutina nigrithorax has emerged as a serious problem in Europe, especially in areas of northern Spain. Its prevalence has been increasing since its arrival on our continent in 2004. Despite the preventive measures adopted, immunotherapy stands out as the only effective preventive medical treatment for systemic reactions caused by the sting of this hymenopteran. VVN presents cross-reactivity with different hymenopterans, among which Vespula spp stands out, which is why its venom is used for VIT, with demonstrated efficacy. Currently, there is a new VIT treatment for Vespa Velutina venom, with tolerance and efficacy still unpublished. Objectives: To synthesize the available evidence on anaphylaxis caused by Vespa Velutina nigrithorax in the last 5 years (2019-2024) in order to evaluate the efficacy of specific immunotherapy in patients with a history of anaphylaxis caused by Vespa Velutina nigrithorax, assessing and objectifying the reduction in the incidence of severe anaphylactic reactions. Material and methods: Systematic review regarding a clinical case of studies published in the Medline and Scopus databases. Results: Only three studies focus on evaluating the efficacy of specific immunotherapy and the determination of immunological components such as IgE or IgG4 after its administration, among others. They mainly analyze men from rural environments, over 18 years old, with a history of anaphylaxis. One of them has not yet been published in the various medical databases as it is a study presented as a poster at the National Allergology Congress. In the remaining articles, the administration of specific immunotherapy is mentioned or even evaluated in a less rigorous way. However, the main objective is not to determine analytical or clinical changes. Thus, one of them assesses the allergenicity of the components nVesp v5 and nVesp v1, while the other tries to discern which type of immunotherapy may be most indicated for patients allergic to Vespa Velutina nigrithorax (not administering VIT in this study). Conclusions: Specific immunotherapy with Vespula spp venom, and more recently with the complete venom of Vespa Velutina, reduces the severity and frequency of allergic reactions induced by Vespa Velutina nigrithorax (VVN). Despite this, further research is needed to evaluate the long-term effects of immunotherapy and its impact on the overall allergic sensitization of the patient. Additionally, more studies are required to address the variability in clinical response to treatment and the potential side effects associated with immunotherapy.
Introduction: Anaphylaxis induced by Vespa Velutina nigrithorax has emerged as a serious problem in Europe, especially in areas of northern Spain. Its prevalence has been increasing since its arrival on our continent in 2004. Despite the preventive measures adopted, immunotherapy stands out as the only effective preventive medical treatment for systemic reactions caused by the sting of this hymenopteran. VVN presents cross-reactivity with different hymenopterans, among which Vespula spp stands out, which is why its venom is used for VIT, with demonstrated efficacy. Currently, there is a new VIT treatment for Vespa Velutina venom, with tolerance and efficacy still unpublished. Objectives: To synthesize the available evidence on anaphylaxis caused by Vespa Velutina nigrithorax in the last 5 years (2019-2024) in order to evaluate the efficacy of specific immunotherapy in patients with a history of anaphylaxis caused by Vespa Velutina nigrithorax, assessing and objectifying the reduction in the incidence of severe anaphylactic reactions. Material and methods: Systematic review regarding a clinical case of studies published in the Medline and Scopus databases. Results: Only three studies focus on evaluating the efficacy of specific immunotherapy and the determination of immunological components such as IgE or IgG4 after its administration, among others. They mainly analyze men from rural environments, over 18 years old, with a history of anaphylaxis. One of them has not yet been published in the various medical databases as it is a study presented as a poster at the National Allergology Congress. In the remaining articles, the administration of specific immunotherapy is mentioned or even evaluated in a less rigorous way. However, the main objective is not to determine analytical or clinical changes. Thus, one of them assesses the allergenicity of the components nVesp v5 and nVesp v1, while the other tries to discern which type of immunotherapy may be most indicated for patients allergic to Vespa Velutina nigrithorax (not administering VIT in this study). Conclusions: Specific immunotherapy with Vespula spp venom, and more recently with the complete venom of Vespa Velutina, reduces the severity and frequency of allergic reactions induced by Vespa Velutina nigrithorax (VVN). Despite this, further research is needed to evaluate the long-term effects of immunotherapy and its impact on the overall allergic sensitization of the patient. Additionally, more studies are required to address the variability in clinical response to treatment and the potential side effects associated with immunotherapy.
Direction
VIDAL PAN, Mª DEL CARMEN (Tutorships)
Liñares Mata, Tania (Co-tutorships)
VIDAL PAN, Mª DEL CARMEN (Tutorships)
Liñares Mata, Tania (Co-tutorships)
Court
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
ARAUJO VILAR, DAVID (Chairman)
SOTO VARELA, ANDRES (Secretary)
SUAREZ PEÑARANDA, JOSE MANUEL (Member)
Utility of advanced sequencing techniques in prenatal diagnosis: a systematic review
Authorship
P.C.L.
Bachelor of Medicine
P.C.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
-Introduction: Prenatal diagnosis has historically consisted of the detection of chromosomal abnormalities, in particular trisomy 21, by metaphase karyotyping. More recently, chromosomal microarray analysis has emerged. New generation sequencing tests can now study a single gene, a panel of selected genes, the exome or the whole genome. -Objectives: The aim of this work is to assess by means of a systematic review of the literature the diagnostic yield of the exome in the prenatal period and which foetal phenotypes are the most indicated for the performance of this technique. -Methodology: Systematic review of the literature from 2020 to 2024. Through the use of electronic databases: Medline (via PubMed search engine) and Web of Science (WOS). -Results: Increased diagnostic yield compared to conventional genetic testing. Fetal phenotypes with the highest diagnostic yield are those with skeletal abnormalities on ultrasound, followed by fetuses with multisystem abnormalities. -Conclusions: Exome sequencing is of great importance in prenatal diagnosis as it currently detects pathogenic/potentially pathogenic variations not detected by conventional genetic testing.
-Introduction: Prenatal diagnosis has historically consisted of the detection of chromosomal abnormalities, in particular trisomy 21, by metaphase karyotyping. More recently, chromosomal microarray analysis has emerged. New generation sequencing tests can now study a single gene, a panel of selected genes, the exome or the whole genome. -Objectives: The aim of this work is to assess by means of a systematic review of the literature the diagnostic yield of the exome in the prenatal period and which foetal phenotypes are the most indicated for the performance of this technique. -Methodology: Systematic review of the literature from 2020 to 2024. Through the use of electronic databases: Medline (via PubMed search engine) and Web of Science (WOS). -Results: Increased diagnostic yield compared to conventional genetic testing. Fetal phenotypes with the highest diagnostic yield are those with skeletal abnormalities on ultrasound, followed by fetuses with multisystem abnormalities. -Conclusions: Exome sequencing is of great importance in prenatal diagnosis as it currently detects pathogenic/potentially pathogenic variations not detected by conventional genetic testing.
Direction
Concheiro Guisán, Ana (Tutorships)
Gago Ageitos, Susana (Co-tutorships)
Concheiro Guisán, Ana (Tutorships)
Gago Ageitos, Susana (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Endoscopic vs surgical treatment of pain in chronic pancreatitis. Systematic review.
Authorship
A.I.C.C.
Bachelor of Medicine
A.I.C.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Chronic pancreatitis is a disease characterized by chronic inflammation of the pancreas, with pain being the main symptom. The aim of the present work is to evaluate, by means of a systematic review of the literature, the efficacy of endoscopic versus surgical treatment for pain secondary to chronic pancreatitis. Methods: following the guidelines established in the PRISMA statement for the preparation of systematic reviews, a systematic search was carried out in the MEDLINE/PubMed and Cochrane Library databases. The inclusion criteria for the selection of articles were clinical trial-type study designs, comparison of endoscopic and surgical treatment, writing in English and/or Spanish, full text available, and adults over 18 years of age. Result: 4 randomized clinical trials with a total of 238 patients were included. The main parameter studied is pain relief. According to the Izbicki scale, early surgery reduces pain with a lower score in the Issa test with P=0.02; in the CahenDjuna trial P=less 0.001; in the Cahen test with P=0.042 and in the Dite test with P=0.002. The secondary parameters studied are complication rate, hospital stay, quality of life and economic costs. Thus, patients undergoing endoscopy subsequently require surgery with a P=0.001.; quality of life is better in patients undergoing surgical interventions with P=0.03; and surgery was also more profitable with a P=0.29. Discussion: the limited current evidence available supporting our hypothesis establishes that surgical treatment is more effective in improving pain caused by chronic pancreatitis. However, the quality of this evidence is low, so more studies are necessary to establish firm conclusions.
Introduction: Chronic pancreatitis is a disease characterized by chronic inflammation of the pancreas, with pain being the main symptom. The aim of the present work is to evaluate, by means of a systematic review of the literature, the efficacy of endoscopic versus surgical treatment for pain secondary to chronic pancreatitis. Methods: following the guidelines established in the PRISMA statement for the preparation of systematic reviews, a systematic search was carried out in the MEDLINE/PubMed and Cochrane Library databases. The inclusion criteria for the selection of articles were clinical trial-type study designs, comparison of endoscopic and surgical treatment, writing in English and/or Spanish, full text available, and adults over 18 years of age. Result: 4 randomized clinical trials with a total of 238 patients were included. The main parameter studied is pain relief. According to the Izbicki scale, early surgery reduces pain with a lower score in the Issa test with P=0.02; in the CahenDjuna trial P=less 0.001; in the Cahen test with P=0.042 and in the Dite test with P=0.002. The secondary parameters studied are complication rate, hospital stay, quality of life and economic costs. Thus, patients undergoing endoscopy subsequently require surgery with a P=0.001.; quality of life is better in patients undergoing surgical interventions with P=0.03; and surgery was also more profitable with a P=0.29. Discussion: the limited current evidence available supporting our hypothesis establishes that surgical treatment is more effective in improving pain caused by chronic pancreatitis. However, the quality of this evidence is low, so more studies are necessary to establish firm conclusions.
Direction
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
Suárez Pazos, Natalia (Co-tutorships)
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
Suárez Pazos, Natalia (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Effectiveness of Online Interventions for STI Prevention and Risky Sexual Behaviors in Adolescents and Young Adults: A Systematic Review.
Authorship
C.C.A.
Bachelor of Medicine
C.C.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Sexually transmitted infections have shown an increase in incidence in recent decades among younger sexually active individuals. New digital media platforms, such as social networks, mobile applications, and websites, have changed the way we communicate and present new opportunities for health interventions. This study examines how these tools can positively influence the sexual health of younger populations (ages 12 to 29). A systematic review of the available literature was conducted, identifying 18 articles published between 2019 and 2024 based on online interventions, addressing their design, methodology, and effectiveness in reducing risk behaviors and the incidence of STIs among this demographic group. The results indicate scientific support for the positive impact that new technologies have on the sexual education of adolescents, with most of the analyzed studies (16 out of 18) showing positive results. A wide range of technologies used in sexual education programs was also observed, highlighting the role of mobile phones and their applications, social media platforms, and websites. Digital interventions could constitute a tool for the sexual education of young populations. Interventions using new digital media must present high-quality, evidence-based content that attracts this demographic group, suggesting the need for future research for the development of innovative policies in this area.
Sexually transmitted infections have shown an increase in incidence in recent decades among younger sexually active individuals. New digital media platforms, such as social networks, mobile applications, and websites, have changed the way we communicate and present new opportunities for health interventions. This study examines how these tools can positively influence the sexual health of younger populations (ages 12 to 29). A systematic review of the available literature was conducted, identifying 18 articles published between 2019 and 2024 based on online interventions, addressing their design, methodology, and effectiveness in reducing risk behaviors and the incidence of STIs among this demographic group. The results indicate scientific support for the positive impact that new technologies have on the sexual education of adolescents, with most of the analyzed studies (16 out of 18) showing positive results. A wide range of technologies used in sexual education programs was also observed, highlighting the role of mobile phones and their applications, social media platforms, and websites. Digital interventions could constitute a tool for the sexual education of young populations. Interventions using new digital media must present high-quality, evidence-based content that attracts this demographic group, suggesting the need for future research for the development of innovative policies in this area.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Gajino Suárez, Clara (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Gajino Suárez, Clara (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Genetic diagnosis of Autism Spectrum Disorder (ASD): Whole genome sequencing analysis.
Authorship
L.E.D.R.
Bachelor of Medicine
L.E.D.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
BACKGROUND: Autism Spectrum Disorders (ASD) are a group of diverse conditions related to neurodevelopment and whose diagnosis is established based on clinical criteria. They are currently one of the most important diseases in research due to the notable increase in their incidence in recent years and the impact they have not only on the patients’ lives but also on their families and environment. Although it is a disease of complex and multiple etiology, we know that genetics plays a crucial role in these disorders, in fact, it is considered to be the neurodevelopmental disorder with the highest heritability (83%). OBJECTIVE: The main objective of this work is to perform a whole genome analysis of five ASD trios (testing affected and healthy parents) with the aim of finding a causal variant that will provide us with the genetic diagnosis. Together with this, we want to check if the analysis of the complete genome in trios could offer us greater efficiency, reliability, and diagnostic speed as a first level test in the diagnosis of ASD, analyzing, for this purpose, the case of a patient who has been studied by WES (whole exome sequencing) previously with negative results. METHODS: In this project, we started from five genetic trios, that is, five patients with a clinical diagnosis of ASD (affected probands) and their respective fathers and mothers (healthy or affected parents). For each affected proband, we have the set of variants of their genome, which we will prioritize, filter and functionally annotate thanks to the Emedgene Analyze software tool (Illumina, inc.), with the aim of reducing the number and keeping candidate variants to analyze them in detail and find the causal variant(s) if they exist. Once we have obtained a manageable number of candidate variants, we will carry out the process of study and selection of these based on criteria such as classification of pathogenicity, inheritance, compatibility of the phenotype with that described in the literature and databases, etc., with the aim of arriving at the final genetic diagnosis. RESULTS: Genetic diagnosis has been achieved in four of the five affected probands, including the one with a negative result in a previous WES (whole exome sequencing) study, finding and characterizing the causal variant of the clinical phenotype in each of these cases. In the other proband, the causal variant has not been found, although this does not imply that it does not exist. The appearance, eventually, of new patient data, as well as technological and research advances, could contribute more data to the study of this case.
BACKGROUND: Autism Spectrum Disorders (ASD) are a group of diverse conditions related to neurodevelopment and whose diagnosis is established based on clinical criteria. They are currently one of the most important diseases in research due to the notable increase in their incidence in recent years and the impact they have not only on the patients’ lives but also on their families and environment. Although it is a disease of complex and multiple etiology, we know that genetics plays a crucial role in these disorders, in fact, it is considered to be the neurodevelopmental disorder with the highest heritability (83%). OBJECTIVE: The main objective of this work is to perform a whole genome analysis of five ASD trios (testing affected and healthy parents) with the aim of finding a causal variant that will provide us with the genetic diagnosis. Together with this, we want to check if the analysis of the complete genome in trios could offer us greater efficiency, reliability, and diagnostic speed as a first level test in the diagnosis of ASD, analyzing, for this purpose, the case of a patient who has been studied by WES (whole exome sequencing) previously with negative results. METHODS: In this project, we started from five genetic trios, that is, five patients with a clinical diagnosis of ASD (affected probands) and their respective fathers and mothers (healthy or affected parents). For each affected proband, we have the set of variants of their genome, which we will prioritize, filter and functionally annotate thanks to the Emedgene Analyze software tool (Illumina, inc.), with the aim of reducing the number and keeping candidate variants to analyze them in detail and find the causal variant(s) if they exist. Once we have obtained a manageable number of candidate variants, we will carry out the process of study and selection of these based on criteria such as classification of pathogenicity, inheritance, compatibility of the phenotype with that described in the literature and databases, etc., with the aim of arriving at the final genetic diagnosis. RESULTS: Genetic diagnosis has been achieved in four of the five affected probands, including the one with a negative result in a previous WES (whole exome sequencing) study, finding and characterizing the causal variant of the clinical phenotype in each of these cases. In the other proband, the causal variant has not been found, although this does not imply that it does not exist. The appearance, eventually, of new patient data, as well as technological and research advances, could contribute more data to the study of this case.
Direction
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
RODRIGUEZ LOPEZ, JULIO (Co-tutorships)
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
RODRIGUEZ LOPEZ, JULIO (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
All that is left unseen behind renal artery stenosis: Literature review and case study analysis
Authorship
V.M.E.C.
Bachelor of Medicine
V.M.E.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Renal artery stenosis is the most frequent cause of secondary hypertension, and therefore, it is potentially treatable. However, its presentation can come in many shapes and hides physiopathological aspects which are currently misunderstood. This pathology has seen a change in its management in recent years due to randomized clinical trials which are not always well designed and accounting for biases. In any case, it is imperative to manage them in an interdisciplinary manner in specialized units. The objective of this project is to present a clinical case of invasive management and to present a discussion based on the scientific literature that collects all the different opinions and recent studies. This will lead us to uncovering what is really hiding behind this fascinating and challenging pathology.
Renal artery stenosis is the most frequent cause of secondary hypertension, and therefore, it is potentially treatable. However, its presentation can come in many shapes and hides physiopathological aspects which are currently misunderstood. This pathology has seen a change in its management in recent years due to randomized clinical trials which are not always well designed and accounting for biases. In any case, it is imperative to manage them in an interdisciplinary manner in specialized units. The objective of this project is to present a clinical case of invasive management and to present a discussion based on the scientific literature that collects all the different opinions and recent studies. This will lead us to uncovering what is really hiding behind this fascinating and challenging pathology.
Direction
CAICEDO VALDES, DIEGO JESUS (Tutorships)
Fernández González, Angel Luis (Co-tutorships)
CAICEDO VALDES, DIEGO JESUS (Tutorships)
Fernández González, Angel Luis (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Rosai-Dorfman Disease: Clinical and pathological study of an enigmatic disease
Authorship
L.E.F.
Bachelor of Medicine
L.E.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Rosai-Dorfman Disease (RDD) contitutes an enigmatic entity, both for being an histiocytosis, an extremely infrequent disease with a wide variety of presentations, as for the recent finding that, in some cases, the cells harbor gain-of- function mutations in the MAPK pathway. Transitioning from being considered solely a reactive process to its classification by the World Health Organization in 2022 within histiocytic neoplasms, RDD manifests as a proliferation of macrophagic cells, typically with a bening course, where definitive diagnosis can only be made trough biopsy. Materials and methods: Diagnosed cases of RDD at the Santiago University Hospital Complex (CHUS) during the period from 1990 to 2023 (n=6). The clinical presentation, histopathological, immunohistochemical, and molecular characteristics, as well as the treatment and evolution, were analyzed. This was compared with the existing literature, using PubMed as the primary source. Results: All cases, except one, were of extranodal location. Histopathologically, histiocytic aggregates with emperipolesis were observed in all samples. Staining showed positivity for S100 in macrophages and negativity for CD1a. OCT2, a novel marker, was positive in the neoplastic histiocytes of the case in which it was tested. This was also the only case where mutation determination was performed, resulting negative. In two of the cases, close monitoring was chosen, while in the others, lesion excision was performed, adding corticosteroids and methotrexate on one occasion. Overall, the evolution followed a benign course. Conclusions: This study highlights the rarity of this pathology in our setting, with 6 cases found. It contributes to the current understanding of RDD, emphasizing the value of immunohistochemical markers, which aids a more precise differential diagnosis with other histiocytosis, as well as the importance of searching for the reported mutations, as they pave the way for new therapeutic targets.
Background: Rosai-Dorfman Disease (RDD) contitutes an enigmatic entity, both for being an histiocytosis, an extremely infrequent disease with a wide variety of presentations, as for the recent finding that, in some cases, the cells harbor gain-of- function mutations in the MAPK pathway. Transitioning from being considered solely a reactive process to its classification by the World Health Organization in 2022 within histiocytic neoplasms, RDD manifests as a proliferation of macrophagic cells, typically with a bening course, where definitive diagnosis can only be made trough biopsy. Materials and methods: Diagnosed cases of RDD at the Santiago University Hospital Complex (CHUS) during the period from 1990 to 2023 (n=6). The clinical presentation, histopathological, immunohistochemical, and molecular characteristics, as well as the treatment and evolution, were analyzed. This was compared with the existing literature, using PubMed as the primary source. Results: All cases, except one, were of extranodal location. Histopathologically, histiocytic aggregates with emperipolesis were observed in all samples. Staining showed positivity for S100 in macrophages and negativity for CD1a. OCT2, a novel marker, was positive in the neoplastic histiocytes of the case in which it was tested. This was also the only case where mutation determination was performed, resulting negative. In two of the cases, close monitoring was chosen, while in the others, lesion excision was performed, adding corticosteroids and methotrexate on one occasion. Overall, the evolution followed a benign course. Conclusions: This study highlights the rarity of this pathology in our setting, with 6 cases found. It contributes to the current understanding of RDD, emphasizing the value of immunohistochemical markers, which aids a more precise differential diagnosis with other histiocytosis, as well as the importance of searching for the reported mutations, as they pave the way for new therapeutic targets.
Direction
FRAGA RODRIGUEZ, MAXIMO FRANCISCO (Tutorships)
FRAGA RODRIGUEZ, MAXIMO FRANCISCO (Tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Adjuvant treatment with tyrosine kinase inhibitors in patients with non-small cell lung cancer and EGFR mutation
Authorship
A.E.G.
Bachelor of Medicine
A.E.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Lung cancer is a determinant cause of morbidity and mortality worldwide. NSCLC is the histological subtype present in 85% of diagnosed tumors. Occasionally, genetic mutations such as EGFR are associated, present in approximately 10-14% of diagnosed patients. Recent studies that have been published about the use of TKIs as targeted therapy in EGFR-mutated NSCLC in advanced stages have led to research on their use as adjuvant therapy in early stages of the disease, following complete tumor resection. This systematic review includes 6 randomized controlled trials, all in phase III except one in phase II, published between 2015 and 2023, comparing TKI use versus conventional chemotherapy or placebo in stages I-IIIA of EGFR-mutated NSCLC. The main study objectives of all included trials are DFS and OS. The results of this review identify a statistically significant increase in DFS with TKIs compared to chemotherapy or placebo in 4 out of the 6 trials. In 2 out of the 6 trials a significant increase in OS is also demonstrated. The findings suggest that TKI treatment is essential as adjuvant therapy in EGFR-mutated NSCLC following complete resection, offering relevant benefits in terms of survival. With this treatment, quality of life is also favoured, as adverse events as less frequent and less severe than with chemotherapy-based treatment; furthermore, the good tolerance of these drugs improve adherence, a crucial factor given the long-lasting adjuvant treatment.
Lung cancer is a determinant cause of morbidity and mortality worldwide. NSCLC is the histological subtype present in 85% of diagnosed tumors. Occasionally, genetic mutations such as EGFR are associated, present in approximately 10-14% of diagnosed patients. Recent studies that have been published about the use of TKIs as targeted therapy in EGFR-mutated NSCLC in advanced stages have led to research on their use as adjuvant therapy in early stages of the disease, following complete tumor resection. This systematic review includes 6 randomized controlled trials, all in phase III except one in phase II, published between 2015 and 2023, comparing TKI use versus conventional chemotherapy or placebo in stages I-IIIA of EGFR-mutated NSCLC. The main study objectives of all included trials are DFS and OS. The results of this review identify a statistically significant increase in DFS with TKIs compared to chemotherapy or placebo in 4 out of the 6 trials. In 2 out of the 6 trials a significant increase in OS is also demonstrated. The findings suggest that TKI treatment is essential as adjuvant therapy in EGFR-mutated NSCLC following complete resection, offering relevant benefits in terms of survival. With this treatment, quality of life is also favoured, as adverse events as less frequent and less severe than with chemotherapy-based treatment; furthermore, the good tolerance of these drugs improve adherence, a crucial factor given the long-lasting adjuvant treatment.
Direction
LEON MATEOS, LUIS ANGEL (Tutorships)
Firvida Perez, José Luís (Co-tutorships)
LEON MATEOS, LUIS ANGEL (Tutorships)
Firvida Perez, José Luís (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Evaluation of sleep disorders in patients with Multiple Sclerosis
Authorship
C.E.L.
Bachelor of Medicine
C.E.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
The link between Multiple Sclerosis (MS) and sleep disorders has historically been underdiagnosed despite the growing evidence suggesting a significant association. It is postulated that the chronic inflammation and neurodegenerative changes in the central nervous system, characteristic of MS, could directly affect the neural circuits regulating sleep. Additionally, sleep disorders are considered to act as risk factors or triggers for exacerbations in MS patients, impacting the progression of the disease. The objectives of this thesis are to establish the relationship between MS and sleep disorders, identify the underlying factors contributing to this connection, analyze the prevalence and incidence of these disorders in the disease, and examine the clinical implications of sleep disorders in MS patients, including quality of life and impact on the clinical course of the disease.
The link between Multiple Sclerosis (MS) and sleep disorders has historically been underdiagnosed despite the growing evidence suggesting a significant association. It is postulated that the chronic inflammation and neurodegenerative changes in the central nervous system, characteristic of MS, could directly affect the neural circuits regulating sleep. Additionally, sleep disorders are considered to act as risk factors or triggers for exacerbations in MS patients, impacting the progression of the disease. The objectives of this thesis are to establish the relationship between MS and sleep disorders, identify the underlying factors contributing to this connection, analyze the prevalence and incidence of these disorders in the disease, and examine the clinical implications of sleep disorders in MS patients, including quality of life and impact on the clinical course of the disease.
Direction
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Evaluation of the cytokine response induced by specific allergic immunotherapy in patients with Vespa velutina anaphylaxis.
Authorship
O.F.A.
Bachelor of Medicine
O.F.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Vespa velutina is considered an invasive species in our environment, bringing economical, ecological and health consequences with it. Anaphylaxis caused by Vespa velutina venom is an increasingly common medical emergency. The treatment of choice is allergenic extract vaccination. The main aim of this therapy is to induce peripheral tolerance in patients, switching type 2 cytokines to type 1 and increasing regulatory cells levels. Aim of the study: The current study is aimed to evaluate the cytokine profile in the serum of patients who have suffered from anaphylaxis due to Vespa velutina sting, to check whether after a year of Vespula spp venom immunotherapy any immunological changes could be able to demonstrate a switching pattern headed to the production of type 1 and regulatory cytokines. Patients and Methods: 20 patients who had suffered from anaphylaxis due to Vespa velutina venom between March and December 2021 haven been consecutively included in the study. All of them showed specific IgE against Vespa velutina venom and were treated with subcutaneous Vespula spp venom immunotherapy. Serum cytokines (IL-4, IL-5, IL-10, IL-13 and IFN-gamma) were measured at baseline, six months and one year after starting immunotherapy, using Cytokine multiplex magnetic bead panels kit (Bio-plex Pro Human Cytokine 17-plex Assay, Bio-Rad Laboratories SA, Madrid). Results: A notorious increase of IFN-gamma was reported six months and a year after starting treatment. After a year of allergic immunotherapy an increase of IL-10 was noticed meanwhile IL-5 decreased. IL-4 remained undetected at all measurements and IL-13 roughly increased its levels after a year compared to the sixth month measurement. Conclusions: Vespula spp venom immunotherapy in patients who have suffered from anaphylaxis due to Vespa velutina sting is capable to induce a cytokine profile change. An increase of type 1 cytokines such as IFN-gamma and regulatory cytokines (IL-10) were respectively confirmed after 6 and 12 months of immunotherapy. However, a decrease of type 2 cytokines was noticed.
Introduction: Vespa velutina is considered an invasive species in our environment, bringing economical, ecological and health consequences with it. Anaphylaxis caused by Vespa velutina venom is an increasingly common medical emergency. The treatment of choice is allergenic extract vaccination. The main aim of this therapy is to induce peripheral tolerance in patients, switching type 2 cytokines to type 1 and increasing regulatory cells levels. Aim of the study: The current study is aimed to evaluate the cytokine profile in the serum of patients who have suffered from anaphylaxis due to Vespa velutina sting, to check whether after a year of Vespula spp venom immunotherapy any immunological changes could be able to demonstrate a switching pattern headed to the production of type 1 and regulatory cytokines. Patients and Methods: 20 patients who had suffered from anaphylaxis due to Vespa velutina venom between March and December 2021 haven been consecutively included in the study. All of them showed specific IgE against Vespa velutina venom and were treated with subcutaneous Vespula spp venom immunotherapy. Serum cytokines (IL-4, IL-5, IL-10, IL-13 and IFN-gamma) were measured at baseline, six months and one year after starting immunotherapy, using Cytokine multiplex magnetic bead panels kit (Bio-plex Pro Human Cytokine 17-plex Assay, Bio-Rad Laboratories SA, Madrid). Results: A notorious increase of IFN-gamma was reported six months and a year after starting treatment. After a year of allergic immunotherapy an increase of IL-10 was noticed meanwhile IL-5 decreased. IL-4 remained undetected at all measurements and IL-13 roughly increased its levels after a year compared to the sixth month measurement. Conclusions: Vespula spp venom immunotherapy in patients who have suffered from anaphylaxis due to Vespa velutina sting is capable to induce a cytokine profile change. An increase of type 1 cytokines such as IFN-gamma and regulatory cytokines (IL-10) were respectively confirmed after 6 and 12 months of immunotherapy. However, a decrease of type 2 cytokines was noticed.
Direction
VIDAL PAN, Mª DEL CARMEN (Tutorships)
López Freire, Sara (Co-tutorships)
VIDAL PAN, Mª DEL CARMEN (Tutorships)
López Freire, Sara (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Effectiveness of OTS (over-the-scope) clips versus conventional endoscopic hemostasis as first-line treatment in patients with non-variceal acute upper gastrointestinal bleeding: systematic review and meta-analysis.
Authorship
F.C.M.
Bachelor of Medicine
F.C.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Objective: To evaluate the effectiveness of the Over-The-Scope (OTS) clip system compared to conventional endoscopic treatment as first-line therapy in non-variceal upper gastrointestinal bleeding, in terms of the percentage of successful cessation of bleeding. Design: A systematic review of the available scientific literature and a meta-analysis of randomized studies obtained from various databases were conducted, using both fixed-effects and random-effects models with statistical software (Stata 16.1). Additionally, effect measures and 95% confidence intervals were calculated. Results: A total of 4 studies were included in the final analysis. There is a trend, although not reaching statistical significance, towards a lower risk of persistent bleeding with the use of OTSC, with a risk ratio (RR) of 0.37 (95% confidence interval [CI]: 0.13-1.02). The use of OTSC was associated with a significantly lower risk of rebleeding at 7 and 30 days compared to standard therapy, with RRs of 0.30 (95% CI: 0.16-0.59) and 0.42 (95% CI: 0.24-0.72), respectively. There was no significantly difference in the risk of 30-day mortality or hospitalization duration. Conclusions: The use of OTSC may reduce rebleeding rates after endoscopic hemostasis. However, they may not reduce the risk of persistent bleeding or mortality. New studies are needed to help confirm or rule out the greater efficacy of OTSC over conventional endoscopic therapy in stopping bleeding in patients with acute non-variceal upper gastrointestinal bleeding, as well as studies that evaluate their cost/benefit ratio.
Objective: To evaluate the effectiveness of the Over-The-Scope (OTS) clip system compared to conventional endoscopic treatment as first-line therapy in non-variceal upper gastrointestinal bleeding, in terms of the percentage of successful cessation of bleeding. Design: A systematic review of the available scientific literature and a meta-analysis of randomized studies obtained from various databases were conducted, using both fixed-effects and random-effects models with statistical software (Stata 16.1). Additionally, effect measures and 95% confidence intervals were calculated. Results: A total of 4 studies were included in the final analysis. There is a trend, although not reaching statistical significance, towards a lower risk of persistent bleeding with the use of OTSC, with a risk ratio (RR) of 0.37 (95% confidence interval [CI]: 0.13-1.02). The use of OTSC was associated with a significantly lower risk of rebleeding at 7 and 30 days compared to standard therapy, with RRs of 0.30 (95% CI: 0.16-0.59) and 0.42 (95% CI: 0.24-0.72), respectively. There was no significantly difference in the risk of 30-day mortality or hospitalization duration. Conclusions: The use of OTSC may reduce rebleeding rates after endoscopic hemostasis. However, they may not reduce the risk of persistent bleeding or mortality. New studies are needed to help confirm or rule out the greater efficacy of OTSC over conventional endoscopic therapy in stopping bleeding in patients with acute non-variceal upper gastrointestinal bleeding, as well as studies that evaluate their cost/benefit ratio.
Direction
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Parkinsonism secondary to drugs: a systematic review.
Authorship
C.F.A.
Bachelor of Medicine
C.F.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Drug-induced parkinsonism is the second most common cause of parkinsonism, only behind Parkinsonism itself. Drugs that most frequently cause it are antipsychotics and calcium-antagonists, however, this disease has been described in association with a long list of drugs. Although both pathologies are clinically similar, they differ in their pathophysiology, prognosis and treatment, so we must know the differential characteristics to perform proper management. Objective: A bibliographic review will be made to understand the development of this pathology, describe the drugs most frequently involved, know the red flags that should alert us about their presence and finally clarify the current diagnostic methods. Material and methods: A review of the existing literature was carried out using the PubMed and Cochrane database using keywords to guide the search, as well as certain inclusion and exclusion criteria. Results: After reviewing the literature, 12 articles were selected in which the role of DaT-SPECT as a screening tool was highlighted, the lack of diagnostic tools regarding the clinical presentation of parkinsonism secondary to drugs in the elderly patient without psychiatric pathology was reflected and a series of guidelines were given about clinical management in the event of a suspected case. Conclusions: The elderly woman, with basic and polymedicated pathology, was recognized as the main patient at risk of suffering this pathology, beyond the psychiatric patient treated with antipsychotics. The need to create diagnostic tools aimed at this profile was underlined and a management strategy was created for suspected or confirmed cases. Finally, the potential of pharmacogenetics and nuclear medicine in this field was highlighted.
Introduction: Drug-induced parkinsonism is the second most common cause of parkinsonism, only behind Parkinsonism itself. Drugs that most frequently cause it are antipsychotics and calcium-antagonists, however, this disease has been described in association with a long list of drugs. Although both pathologies are clinically similar, they differ in their pathophysiology, prognosis and treatment, so we must know the differential characteristics to perform proper management. Objective: A bibliographic review will be made to understand the development of this pathology, describe the drugs most frequently involved, know the red flags that should alert us about their presence and finally clarify the current diagnostic methods. Material and methods: A review of the existing literature was carried out using the PubMed and Cochrane database using keywords to guide the search, as well as certain inclusion and exclusion criteria. Results: After reviewing the literature, 12 articles were selected in which the role of DaT-SPECT as a screening tool was highlighted, the lack of diagnostic tools regarding the clinical presentation of parkinsonism secondary to drugs in the elderly patient without psychiatric pathology was reflected and a series of guidelines were given about clinical management in the event of a suspected case. Conclusions: The elderly woman, with basic and polymedicated pathology, was recognized as the main patient at risk of suffering this pathology, beyond the psychiatric patient treated with antipsychotics. The need to create diagnostic tools aimed at this profile was underlined and a management strategy was created for suspected or confirmed cases. Finally, the potential of pharmacogenetics and nuclear medicine in this field was highlighted.
Direction
DELGADO BLANCO, MANUEL BENJAMIN (Tutorships)
Veleiro Tenreiro, María José (Co-tutorships)
DELGADO BLANCO, MANUEL BENJAMIN (Tutorships)
Veleiro Tenreiro, María José (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Impact of diabetes mellitus on health-related quality of life using the SF-36 questionnaire
Authorship
S.L.G.
Bachelor of Medicine
S.L.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Diabetes mellitus is the most common endocrine disease in the world, with an increasing prevalence as well as numerous complications and impact on the quality of life of these people. Objective: To know if there are differences in the health-related quality of life of people with diabetes compared to non-diabetics in a general population using the SF-36 questionnaire as a measure. Material and methods: Population study carried out between 2012 and 2015, with random sampling of the population stratified by decades of life, with ages from 18 to 91 years. An interview was conducted with the participants where the clinical variables, history, blood tests, and the SF-36 health-related quality of life questionnaire were obtained. Participation of 1512 people, 181 (12%) have diabetes. For statistical analysis we used the Mann Whitney U test for continuous variables and the Chi-Square test for categorical variables. For multivariate analysis, generalized additive models Results: The prevalence of diabetes is 12%. Statistically significant differences have been found between people with and without diabetes in age, BMI, alcohol consumption and number of retired people, physical activity and smoking habits. People with diabetes present worse results in health-related quality of life than non-diabetics in the physical function, vitality and general health components, which persist after adjusting for potential confounding factors, such as age and sex. Conclusion: Diabetes is a disease that is associated with a significant deterioration in healthrelated quality of life, specifically in physical function, vitality and general health.
Introduction: Diabetes mellitus is the most common endocrine disease in the world, with an increasing prevalence as well as numerous complications and impact on the quality of life of these people. Objective: To know if there are differences in the health-related quality of life of people with diabetes compared to non-diabetics in a general population using the SF-36 questionnaire as a measure. Material and methods: Population study carried out between 2012 and 2015, with random sampling of the population stratified by decades of life, with ages from 18 to 91 years. An interview was conducted with the participants where the clinical variables, history, blood tests, and the SF-36 health-related quality of life questionnaire were obtained. Participation of 1512 people, 181 (12%) have diabetes. For statistical analysis we used the Mann Whitney U test for continuous variables and the Chi-Square test for categorical variables. For multivariate analysis, generalized additive models Results: The prevalence of diabetes is 12%. Statistically significant differences have been found between people with and without diabetes in age, BMI, alcohol consumption and number of retired people, physical activity and smoking habits. People with diabetes present worse results in health-related quality of life than non-diabetics in the physical function, vitality and general health components, which persist after adjusting for potential confounding factors, such as age and sex. Conclusion: Diabetes is a disease that is associated with a significant deterioration in healthrelated quality of life, specifically in physical function, vitality and general health.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Sueiro Justel, Jesús (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Sueiro Justel, Jesús (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Risk factors for delayed negativization of sputum cultures in patients with pulmonary tuberculosis.
Authorship
A.L.L.
Bachelor of Medicine
A.L.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Patients with drug-sensitive pulmonary tuberculosis (TB) who persist with positive sputum cultures after two months of treatment are at high risk of relapse after completion of the conventional six-month treatment. However, in practice, for multiple reasons microbiological sputum control is often not carried out in the second month of treatment. The aim of this study is to analyze predictor variables of positive cultures in the second month of treatment, allowing patients at high risk of relapse to be identified at the beginning of treatment. Their recognition would help clinicians direct their efforts to obtain second-month sputum samples from them. A retrospective descriptive study was conducted on patients with drug-sensitive pulmonary TB followed at the Tuberculosis Unit of Pontevedra who started treatment between 1st of January of 2018, and 31st of October of 2023, and had at least one sputum culture after two months of treatment. Sociodemographic variables, radiographic and microbiological characteristics, evolution at six months and the outcome of the patient were analyzed. Initially, 240 patients were identified, of which 104 met inclusion criteria. There were 15 patients (14.4%) with positive cultures at the second month. In the univariant analysis, 10 predictive variables of positive cultures at the second month were found, including sex smoking habit, cough, constitutional syndrome, cavitated images on chest X-ray, positive initial AFB, leukocytosis, thrombocytosis, high C-reactive protein levels and low hemoglobin levels (p=,026). In the multivariant analysis, being a man (p=,030), low hemoglobin levels (p=,026) and cavitated images (p=,014) were statistically significant. We have concluded that patients starting anti-tuberculosis treatment with any of the described characteristics should be closely monitored due to their increased risk of positive cultures at the second month. It is essential to emphasize the importance of second-month sampling in these patients.
Patients with drug-sensitive pulmonary tuberculosis (TB) who persist with positive sputum cultures after two months of treatment are at high risk of relapse after completion of the conventional six-month treatment. However, in practice, for multiple reasons microbiological sputum control is often not carried out in the second month of treatment. The aim of this study is to analyze predictor variables of positive cultures in the second month of treatment, allowing patients at high risk of relapse to be identified at the beginning of treatment. Their recognition would help clinicians direct their efforts to obtain second-month sputum samples from them. A retrospective descriptive study was conducted on patients with drug-sensitive pulmonary TB followed at the Tuberculosis Unit of Pontevedra who started treatment between 1st of January of 2018, and 31st of October of 2023, and had at least one sputum culture after two months of treatment. Sociodemographic variables, radiographic and microbiological characteristics, evolution at six months and the outcome of the patient were analyzed. Initially, 240 patients were identified, of which 104 met inclusion criteria. There were 15 patients (14.4%) with positive cultures at the second month. In the univariant analysis, 10 predictive variables of positive cultures at the second month were found, including sex smoking habit, cough, constitutional syndrome, cavitated images on chest X-ray, positive initial AFB, leukocytosis, thrombocytosis, high C-reactive protein levels and low hemoglobin levels (p=,026). In the multivariant analysis, being a man (p=,030), low hemoglobin levels (p=,026) and cavitated images (p=,014) were statistically significant. We have concluded that patients starting anti-tuberculosis treatment with any of the described characteristics should be closely monitored due to their increased risk of positive cultures at the second month. It is essential to emphasize the importance of second-month sampling in these patients.
Direction
Anibarro García, Luís (Tutorships)
Melián Rodríguez, Luis (Co-tutorships)
Anibarro García, Luís (Tutorships)
Melián Rodríguez, Luis (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Treatment of Kounis syndrome: review and case report
Authorship
A.L.M.
Bachelor of Medicine
A.L.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Kounis syndrome (KS) involves the development of an acute coronary syndrome (ACS) following mast cell activation and the consequent release of allergic mediators. The diagnosis of KS is based on clinical presentation, as well as on findings from complementary tests, using coronary angiography to classify KS into one of its types: I (normal coronary arteries), II (underlying coronary disease), or III (restenosis or thrombosis intra-stent). Treating KS is challenging, since some drugs used to adress cardiac manifestations could worsen allergic reactions and vice versa. Additionally, there are no specific clinical guidelines for treating KS so theoretically, recommendations for classic ACS should be followed. By means of a case report and performing a literature review, the aim of this project was to determine whether the management of KS is indeed similar to that of classic or non-allergic ACS. METHODS: A bibliographic search was conducted in Embase, PubMed, and WoS for case series of patients with KS, in which the treatment for all of them was specified. RESULTS: Thirty-eight cases of KS from 14 articles were included. Type I KS was managed with antiallergic drugs and vasodilators, while for types II and III, ACS guidelines were followed, occasionally adding glucocorticoids and antihistamines. In these patients, beta- blockers, morphine, and bolus antihistamines were avoided, and adrenaline administration was delayed if possible. CONCLUSIONS: Specific therapeutic guidelines for KS should be developed or, at least, KS management should be specified in the guidelines for ACS, as its treatment may not be exactly the same.
INTRODUCTION: Kounis syndrome (KS) involves the development of an acute coronary syndrome (ACS) following mast cell activation and the consequent release of allergic mediators. The diagnosis of KS is based on clinical presentation, as well as on findings from complementary tests, using coronary angiography to classify KS into one of its types: I (normal coronary arteries), II (underlying coronary disease), or III (restenosis or thrombosis intra-stent). Treating KS is challenging, since some drugs used to adress cardiac manifestations could worsen allergic reactions and vice versa. Additionally, there are no specific clinical guidelines for treating KS so theoretically, recommendations for classic ACS should be followed. By means of a case report and performing a literature review, the aim of this project was to determine whether the management of KS is indeed similar to that of classic or non-allergic ACS. METHODS: A bibliographic search was conducted in Embase, PubMed, and WoS for case series of patients with KS, in which the treatment for all of them was specified. RESULTS: Thirty-eight cases of KS from 14 articles were included. Type I KS was managed with antiallergic drugs and vasodilators, while for types II and III, ACS guidelines were followed, occasionally adding glucocorticoids and antihistamines. In these patients, beta- blockers, morphine, and bolus antihistamines were avoided, and adrenaline administration was delayed if possible. CONCLUSIONS: Specific therapeutic guidelines for KS should be developed or, at least, KS management should be specified in the guidelines for ACS, as its treatment may not be exactly the same.
Direction
Barge Caballero, Eduardo (Tutorships)
Marzoa Rivas, Raquel (Co-tutorships)
Barge Caballero, Eduardo (Tutorships)
Marzoa Rivas, Raquel (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
The fentanyl crisis in the U.S., could something similar occur in Spain?
Authorship
P.L.M.
Bachelor of Medicine
P.L.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The opioid crisis in the United States dates back to the 1990s, when pharmaceutical company Purdue Pharma mass marketed OxyContin to treat various types of pain, from mild to severe. Since then, this crisis has gone through a series of stages, and the U.S. is currently facing a critical situation resulting from the abuse of fentanyl and its analogues. These synthetic opioids have contributed to the increase in overdose mortality rates. Their easy accessibility and high addiction potential represent a significant threat to public health. There is a risk that the illegal use of fentanyl will spread to other countries, including Spain, where it could generate a similar crisis to that faced by the USA. Objectives: To understand the impact of fentanyl both in the United States and globally. To establish the profile of the addict and the profile of the victim. To identify the main countries contributing to the fentanyl crisis. To analyze the situation both in Europe and Spain. To offer a comparison of the control mechanisms in Spain and in the US. To analyze the actions taken by different countries to address this crisis. To assess the existence of new drugs of emerging threat. Results and discussion: Deaths from fentanyl and its analogues continue to increase each year in the United States. Two distinct user profiles were identified, on the one hand, elderly white women who use fentanyl legally prescribed by their doctors to treat chronic pain, with the risk of developing addiction, and on the other hand, middle-aged black men who prefer the illegal fentanyl for recreational use. The situation in Europe and Spain is far from resembling that of the United States. In Spain, prescription monitoring programs act as the main control mechanism in the dispensing of opioids by preventing opioid abuse. In the case of the United States, it does not have such a robust mechanism, so it is common for many patients to go to different doctors in order to obtain multiple prescriptions for medications. For this reason, it is suggested to limit the ability to prescribe to specialized doctors, since in the United States any specialist can prescribe them. It is also important that other measures be taken, such as the implementation of prevention, education and treatment policies, as well as efforts to reduce both the supply and demand of illicit drugs. This requires international cooperation, but as long as China, the main supplier of fentanyl, does not collaborate with the United States and Mexico, this will not be possible. It is important to keep an eye out for new emerging threat drugs, such as nitazenes and xylazine, as fentanyl is often adulterated with these substances, increasing the risk of overdose death. Conclusions: Both fentanyl coming from legal and illegal use are responsible for the increase in overdose deaths. China, Mexico and the US are major contributors to the opioid crisis. Europe and Spain are protected from a similar crisis by having strict opioid dispensing mechanisms. Global cooperation is needed, and measures should be taken to address the causes rather than the consequences. There are emerging threat drugs such as xylazine and nitazenes capable of producing a more deadly crisis than fentanyl.
Introduction: The opioid crisis in the United States dates back to the 1990s, when pharmaceutical company Purdue Pharma mass marketed OxyContin to treat various types of pain, from mild to severe. Since then, this crisis has gone through a series of stages, and the U.S. is currently facing a critical situation resulting from the abuse of fentanyl and its analogues. These synthetic opioids have contributed to the increase in overdose mortality rates. Their easy accessibility and high addiction potential represent a significant threat to public health. There is a risk that the illegal use of fentanyl will spread to other countries, including Spain, where it could generate a similar crisis to that faced by the USA. Objectives: To understand the impact of fentanyl both in the United States and globally. To establish the profile of the addict and the profile of the victim. To identify the main countries contributing to the fentanyl crisis. To analyze the situation both in Europe and Spain. To offer a comparison of the control mechanisms in Spain and in the US. To analyze the actions taken by different countries to address this crisis. To assess the existence of new drugs of emerging threat. Results and discussion: Deaths from fentanyl and its analogues continue to increase each year in the United States. Two distinct user profiles were identified, on the one hand, elderly white women who use fentanyl legally prescribed by their doctors to treat chronic pain, with the risk of developing addiction, and on the other hand, middle-aged black men who prefer the illegal fentanyl for recreational use. The situation in Europe and Spain is far from resembling that of the United States. In Spain, prescription monitoring programs act as the main control mechanism in the dispensing of opioids by preventing opioid abuse. In the case of the United States, it does not have such a robust mechanism, so it is common for many patients to go to different doctors in order to obtain multiple prescriptions for medications. For this reason, it is suggested to limit the ability to prescribe to specialized doctors, since in the United States any specialist can prescribe them. It is also important that other measures be taken, such as the implementation of prevention, education and treatment policies, as well as efforts to reduce both the supply and demand of illicit drugs. This requires international cooperation, but as long as China, the main supplier of fentanyl, does not collaborate with the United States and Mexico, this will not be possible. It is important to keep an eye out for new emerging threat drugs, such as nitazenes and xylazine, as fentanyl is often adulterated with these substances, increasing the risk of overdose death. Conclusions: Both fentanyl coming from legal and illegal use are responsible for the increase in overdose deaths. China, Mexico and the US are major contributors to the opioid crisis. Europe and Spain are protected from a similar crisis by having strict opioid dispensing mechanisms. Global cooperation is needed, and measures should be taken to address the causes rather than the consequences. There are emerging threat drugs such as xylazine and nitazenes capable of producing a more deadly crisis than fentanyl.
Direction
CRUZ LANDEIRA, ANGELINES (Tutorships)
CRUZ LANDEIRA, ANGELINES (Tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Awake intubation. Videolaringoscope compared to flexible fiberoptic bronchoscope. Systematic review and Meta-analysis.
Authorship
P.L.C.
Bachelor of Medicine
P.L.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Difficulty in airway management continues to be one of the greatest concerns in the daily practice of anesthesiology. All scientific societies recommend carrying out a thorough prior evaluation to identify a difficult airway. Awake intubation with a flexible fiberoptic bronchoscope is considered the gold standard when an airway is expected to be difficult. However, in recent years videolaryngoscopes have emerged as novel devices in this clinical situation. This review considers whether videolaryngoscopes are an effective and safe alternative for intubation of awake patients. Objectives: The main objective of the study was to compare the efficacy and safety of the videolaryngoscope against the fiberoptic bronchoscope for awake tracheal intubation. The primary outcomes were tracheal intubation success on the first attempt and tracheal intubation time. Secondary outcomes included the final success of the technique and its complications (arterial oxygen saturation rate less than 90-92%, and hoarseness, sore throat, or both (%)). Materials and methods: Systematic searches have been carried out in the Medline, Cochrane and Web of Science databases. Studies performed in awake patients that include intubation success on the first attempt among one of their objectives are included. The review was carried out following PRISMA guidelines. Risk of bias was analyzed using the Cochrane RoB2 tool. The evidence was analyzed using a random effects model and heterogeneity was quantified using the I2 test. Results: 1254 publications were identified, of which 10 met the inclusion criteria to be included in the qualitative review (566 patients) and 9 were finally included in the meta-analysis (555 patients). There were no significant differences between the two techniques in intubation on the first attempt (7 studies, 490 patients, risk ratio (95%CI) 0.9946 (0.87, 1.13), p = 0.05), nor in the final success of intubation (8 studies, 493 patients, risk ratio (95%CI) 0.9971 (0.9714; 1.0234), p = 0.47). Intubation time was shorter when the videolaryngoscope was used (9 studies, 534 patients, mean differences (95%CI): -55 (-90.8; -19.2) s, p = 0.0026). There were no differences between the two groups in the incidence of hypoxia, sore throat or hoarseness, or other complications. Conclusions: Awake tracheal intubation with videolaryngoscope and fiberoptic bronchoscope are equally effective in relation to intubation success on the first attempt or overall success of the technique. A shorter intubation time has been associated with the use of the videolaryngoscope.
Introduction: Difficulty in airway management continues to be one of the greatest concerns in the daily practice of anesthesiology. All scientific societies recommend carrying out a thorough prior evaluation to identify a difficult airway. Awake intubation with a flexible fiberoptic bronchoscope is considered the gold standard when an airway is expected to be difficult. However, in recent years videolaryngoscopes have emerged as novel devices in this clinical situation. This review considers whether videolaryngoscopes are an effective and safe alternative for intubation of awake patients. Objectives: The main objective of the study was to compare the efficacy and safety of the videolaryngoscope against the fiberoptic bronchoscope for awake tracheal intubation. The primary outcomes were tracheal intubation success on the first attempt and tracheal intubation time. Secondary outcomes included the final success of the technique and its complications (arterial oxygen saturation rate less than 90-92%, and hoarseness, sore throat, or both (%)). Materials and methods: Systematic searches have been carried out in the Medline, Cochrane and Web of Science databases. Studies performed in awake patients that include intubation success on the first attempt among one of their objectives are included. The review was carried out following PRISMA guidelines. Risk of bias was analyzed using the Cochrane RoB2 tool. The evidence was analyzed using a random effects model and heterogeneity was quantified using the I2 test. Results: 1254 publications were identified, of which 10 met the inclusion criteria to be included in the qualitative review (566 patients) and 9 were finally included in the meta-analysis (555 patients). There were no significant differences between the two techniques in intubation on the first attempt (7 studies, 490 patients, risk ratio (95%CI) 0.9946 (0.87, 1.13), p = 0.05), nor in the final success of intubation (8 studies, 493 patients, risk ratio (95%CI) 0.9971 (0.9714; 1.0234), p = 0.47). Intubation time was shorter when the videolaryngoscope was used (9 studies, 534 patients, mean differences (95%CI): -55 (-90.8; -19.2) s, p = 0.0026). There were no differences between the two groups in the incidence of hypoxia, sore throat or hoarseness, or other complications. Conclusions: Awake tracheal intubation with videolaryngoscope and fiberoptic bronchoscope are equally effective in relation to intubation success on the first attempt or overall success of the technique. A shorter intubation time has been associated with the use of the videolaryngoscope.
Direction
TABOADA MUÑIZ, MANUEL (Tutorships)
bermudez lopez, maria (Co-tutorships)
TABOADA MUÑIZ, MANUEL (Tutorships)
bermudez lopez, maria (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Massive blood transfusion protocol in the polytraumatized pacient
Authorship
P.L.C.
Bachelor of Medicine
P.L.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
The management of massive hemorrhage in polytrauma patients is a critical aspect of hospital care that requires immediate attention due to its high prevalence and complexity. The existence of massive transfusion protocols in the hospital setting is becoming standard practice in most hospitals to standardize actions in these life-threatening situations. However, there is significant heterogeneity in the implementation of these protocols. This topic is continuously reviewed and modified, with constant updates in resuscitation strategies, the use of blood products, hemostatic agents, new monitoring techniques, and resuscitation goals for these patients. The discovery of trauma-induced coagulopathy at the beginning of this century has led to a shift in the understanding of the pathophysiological processes involved in bleeding and, consequently, in the resuscitation strategies for these patients. This work involves a literature review on the recommendations for managing massive hemorrhage in polytrauma patients, focusing on the protocol of the University Hospital Complex of A Coruña. It delves into the assessment of polytrauma patients, identification and characterization of massive hemorrhage, activation of the massive hemorrhage protocol, components to transfuse, hemostasis monitoring, and resuscitation objectives.
The management of massive hemorrhage in polytrauma patients is a critical aspect of hospital care that requires immediate attention due to its high prevalence and complexity. The existence of massive transfusion protocols in the hospital setting is becoming standard practice in most hospitals to standardize actions in these life-threatening situations. However, there is significant heterogeneity in the implementation of these protocols. This topic is continuously reviewed and modified, with constant updates in resuscitation strategies, the use of blood products, hemostatic agents, new monitoring techniques, and resuscitation goals for these patients. The discovery of trauma-induced coagulopathy at the beginning of this century has led to a shift in the understanding of the pathophysiological processes involved in bleeding and, consequently, in the resuscitation strategies for these patients. This work involves a literature review on the recommendations for managing massive hemorrhage in polytrauma patients, focusing on the protocol of the University Hospital Complex of A Coruña. It delves into the assessment of polytrauma patients, identification and characterization of massive hemorrhage, activation of the massive hemorrhage protocol, components to transfuse, hemostasis monitoring, and resuscitation objectives.
Direction
PINO MINGUEZ, JESUS (Tutorships)
Cordero Lorenzana, María Lourdes (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
Cordero Lorenzana, María Lourdes (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Strength training in phase II of a cardiac rehabilitation protocol.
Authorship
A.L.D.C.
Bachelor of Medicine
A.L.D.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Cardiac rehabilitation (CR) and strength training (ST) represent two essential facets in the care of patients with cardiovascular disease (CVD) at present. One of the most salient aspects of CR at this time is the growing importance of ST. Traditionally, rehabilitation focused on aerobic exercise, but muscle strengthening has been increasingly recognized as playing a crucial role in recovery. ST has become a great tool to improve cardiovascular health, increase functional capacity, and reduce the risk of future cardiovascular events. In this review, we will explore the importance of ST in a cardiac rehabilitation protocol (CRP) in the context of CVD. Furthermore, we will assess how these approaches are positively transforming patient care today, resulting in significant benefits to their health and quality of life. OBJECTIVES: To evaluate in the available literature the effects of including ST in phase II of CRP, together with aerobic training (AT) previously performed in isolation. DESIGN AND DATA SOURCES: The work will consist of a systematic review. A search was conducted in the month of December 2023 in the following electronic databases: Medline (via PubMed) and Web of Science from 2014 to 2023. The inclusion/exclusion criteria allowed us to select human studies that studied the efficacy of combined training (CT) in patients with heart disease. RESULTS: We identified 1348 potentially relevant articles of which 6 met all inclusion criteria. They included a total of 9020 patients with a predominance of male sex, where the age range of the subjects was 27-86 years. The results show that ST combined with AT has positive effects on several aspects of health in patients with cardiac pathology. Significant improvements were observed in several parameters such as peak oxygen consumption (VO2 peak), muscle strength and quality of life compared to performing exclusive AT or not participating in any CRP. In addition, few adverse effects were found, most of which were mild, such as musculoskeletal pain or mild cardiovascular symptoms. CONCLUSIONS: CT in CR offers significant benefits compared with only aerobic exercise or no rehabilitation. Although CT is more effective than no rehabilitation in most respects, there is variability in outcomes compared with aerobic exercise alone. Limitations were identified in the included studies, and more rigorous future research with standardized protocols that eliminate heterogeneity between studies is recommended to optimize training protocols and better understand their effects.
INTRODUCTION: Cardiac rehabilitation (CR) and strength training (ST) represent two essential facets in the care of patients with cardiovascular disease (CVD) at present. One of the most salient aspects of CR at this time is the growing importance of ST. Traditionally, rehabilitation focused on aerobic exercise, but muscle strengthening has been increasingly recognized as playing a crucial role in recovery. ST has become a great tool to improve cardiovascular health, increase functional capacity, and reduce the risk of future cardiovascular events. In this review, we will explore the importance of ST in a cardiac rehabilitation protocol (CRP) in the context of CVD. Furthermore, we will assess how these approaches are positively transforming patient care today, resulting in significant benefits to their health and quality of life. OBJECTIVES: To evaluate in the available literature the effects of including ST in phase II of CRP, together with aerobic training (AT) previously performed in isolation. DESIGN AND DATA SOURCES: The work will consist of a systematic review. A search was conducted in the month of December 2023 in the following electronic databases: Medline (via PubMed) and Web of Science from 2014 to 2023. The inclusion/exclusion criteria allowed us to select human studies that studied the efficacy of combined training (CT) in patients with heart disease. RESULTS: We identified 1348 potentially relevant articles of which 6 met all inclusion criteria. They included a total of 9020 patients with a predominance of male sex, where the age range of the subjects was 27-86 years. The results show that ST combined with AT has positive effects on several aspects of health in patients with cardiac pathology. Significant improvements were observed in several parameters such as peak oxygen consumption (VO2 peak), muscle strength and quality of life compared to performing exclusive AT or not participating in any CRP. In addition, few adverse effects were found, most of which were mild, such as musculoskeletal pain or mild cardiovascular symptoms. CONCLUSIONS: CT in CR offers significant benefits compared with only aerobic exercise or no rehabilitation. Although CT is more effective than no rehabilitation in most respects, there is variability in outcomes compared with aerobic exercise alone. Limitations were identified in the included studies, and more rigorous future research with standardized protocols that eliminate heterogeneity between studies is recommended to optimize training protocols and better understand their effects.
Direction
FIGUEROA RODRIGUEZ, JESUS (Tutorships)
Bermejo de la Fuente, Pilar (Co-tutorships)
FIGUEROA RODRIGUEZ, JESUS (Tutorships)
Bermejo de la Fuente, Pilar (Co-tutorships)
Court
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
GELABERT GONZALEZ, MIGUEL (Chairman)
CABANAS RODRIGUEZ, PALOMA (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Prognostic impact of the TAPSE PASP ratio in patients with heart failure.
Authorship
P.L.E.
Bachelor of Medicine
P.L.E.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Right ventricular pulmonary arterial coupling is a hemodynamic parameter that assesses the ability of the right ventricle to adapt its contractility to the progressive increase in afterload, as reflected by pulmonary arterial pressure. Recently, an echocardiographic parameter, the ratio of tricuspid annular plane systolic excursion TAPSE to pulmonary arterial systolic pressure PASP, has been defined to assess right ventricular pulmonary arterial coupling non invasively. The TAPSE PASP ratio has shown prognostic value in some previous studies in patients with HF and in patients with pulmonary hypertension. The aim of this work is to elaborate a research protocol to establish the prognostic value of the TAPSE PSAP ratio in the cohort of HF patients who have been seen in a specialised clinical unit in the last decade. In this text, it is proposed to carry out a retrospective observational study based on a historical cohort of patients treated at the Complexo Hospitalario Universitario de A Coruña between 2010 and 2022.
Right ventricular pulmonary arterial coupling is a hemodynamic parameter that assesses the ability of the right ventricle to adapt its contractility to the progressive increase in afterload, as reflected by pulmonary arterial pressure. Recently, an echocardiographic parameter, the ratio of tricuspid annular plane systolic excursion TAPSE to pulmonary arterial systolic pressure PASP, has been defined to assess right ventricular pulmonary arterial coupling non invasively. The TAPSE PASP ratio has shown prognostic value in some previous studies in patients with HF and in patients with pulmonary hypertension. The aim of this work is to elaborate a research protocol to establish the prognostic value of the TAPSE PSAP ratio in the cohort of HF patients who have been seen in a specialised clinical unit in the last decade. In this text, it is proposed to carry out a retrospective observational study based on a historical cohort of patients treated at the Complexo Hospitalario Universitario de A Coruña between 2010 and 2022.
Direction
Barge Caballero, Eduardo (Tutorships)
Enríquez Vázquez, Daniel (Co-tutorships)
Barge Caballero, Eduardo (Tutorships)
Enríquez Vázquez, Daniel (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Electrophysiological and functional outcomes of the shoulder after performing an elective cervical lymph node dissection: a systematic review
Authorship
C.R.F.
Bachelor of Medicine
C.R.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Elective cervical lymph node dissection is a surgical procedure conducted in patients with head and neck cancers when preoperative metastases are not detected. Research indicates that approximately 20-30% of these tumors, despite showing negative outcomes in traditional diagnostic procedures, contain lymph node micrometastases. While the dissection has demonstrated enhanced survival rates in these individuals, it is associated with specific morbidity related to cervical structures. The studies incorporated in this analysis examined the risk factors, functional outcomes, and electrophysiological findings following various techniques of cervical lymphadenectomy. Objective: The main objective of this study was to evaluate functional outcomes, postoperative quality of life and EMG alterations after different types of cervical lymph node dissection. Material and methods: The search for articles was performed in the electronic databases Pubmed, CINAHL, Cochrane and Medline. Studies on cervical lymph node dissection performed in adults and including information on functional and electrophysiological outcomes of the shoulder were selected and assessed according to the PRISMA guideline. Outcomes: A total of 16 articles were used for this systematic review. The different surgical techniques of cervical dissection were compared in relation to the results obtained on shoulder function and quality of life. Risk factors that could help predict postoperative disability were also studied, as well as intraoperative monitoring and subsequent rehabilitation. Conclusions: Outcomes following cervical lymph node stripping vary according to the technique used and individual risk factors. Spinal nerve preservation leads to better quality of life, less postoperative pain and better shoulder function compared to nerve resection. However, more prospective studies are needed to validate this evidence.
Introduction: Elective cervical lymph node dissection is a surgical procedure conducted in patients with head and neck cancers when preoperative metastases are not detected. Research indicates that approximately 20-30% of these tumors, despite showing negative outcomes in traditional diagnostic procedures, contain lymph node micrometastases. While the dissection has demonstrated enhanced survival rates in these individuals, it is associated with specific morbidity related to cervical structures. The studies incorporated in this analysis examined the risk factors, functional outcomes, and electrophysiological findings following various techniques of cervical lymphadenectomy. Objective: The main objective of this study was to evaluate functional outcomes, postoperative quality of life and EMG alterations after different types of cervical lymph node dissection. Material and methods: The search for articles was performed in the electronic databases Pubmed, CINAHL, Cochrane and Medline. Studies on cervical lymph node dissection performed in adults and including information on functional and electrophysiological outcomes of the shoulder were selected and assessed according to the PRISMA guideline. Outcomes: A total of 16 articles were used for this systematic review. The different surgical techniques of cervical dissection were compared in relation to the results obtained on shoulder function and quality of life. Risk factors that could help predict postoperative disability were also studied, as well as intraoperative monitoring and subsequent rehabilitation. Conclusions: Outcomes following cervical lymph node stripping vary according to the technique used and individual risk factors. Spinal nerve preservation leads to better quality of life, less postoperative pain and better shoulder function compared to nerve resection. However, more prospective studies are needed to validate this evidence.
Direction
Parente Arias, Pablo Luis (Tutorships)
Mayo Yañez, Miguel (Co-tutorships)
Parente Arias, Pablo Luis (Tutorships)
Mayo Yañez, Miguel (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
The utility of Next-Generation Sequencing in the treatment of non-small cell lung cancer
Authorship
S.R.C.
Bachelor of Medicine
S.R.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Lung cancer is the fourth most prevalent tumor but the one with the highest mortality rate, accounting for 18.2% of cancer mortality according to data from the Global Cancer Observatory (GLOBOCAN 2020) (1). Due to these data, the study of molecular alterations and targeted therapies represent the future approach for non-small cell lung cancer (NSCLC). Objectives: to determine the percentage of patients in whom a biomarker susceptible to be treated with a targeted therapy is discovered using massive sequencing techniques (next generation sequencing, NGS) in a cohort of NSCLC patients. And to determine the progression-free survival and the rate of response in those patients on whom it has been possible to perform targeted treatment. In addition to this, we will study at what point in the treatment the study was requested and how the result has affected the patient's therapy. Methods: To approach our work, a descriptive retrospective observational study has been proposed on a population of patients with NSCLC treated in the Medical Oncology service of the University Hospital of A Coruña who underwent NGS using Foundation Medicine between September 1, 2019, and December 31, 2023. Results: It was found that in 8 (40%) of the patients, a treatable molecular alteration was identified after applying NGS, leaving 12 (60%) in whom no treatable molecular alteration was detected. The new molecular alterations detected with NGS using Foundation Medicine were: 2 patients (10%) presented an EGFR exon 20 mutation, another 2 patients (10%) had an EGFR mutation, 1 (5%) had an FGFR3 mutation, 1 (5%) had an ALK translocation, 1 (5%) had MET amplification, and 1 patient (5%) had a BRAF N581S mutation. Regarding the type of response in the 8 patients who started a new treatment, 4 (50%) showed a partial response, which occurred 69.5 days after starting treatment (confidence interval of 26 to 162 days). Another 2 patients (25%) experienced disease progression as the best response, occurring 76 days after starting treatment (confidence interval of 63 to 89 days). Only 1 patient (12.5%) had stable disease as the best response, occurring 51 days after starting treatment. For one patient, who started treatment 37 days before the cut-off date, we do not have data on the type of response or whether there has been disease progression. Conclusions: NGS is a technique that provides benefits to patients with non-small cell lung cancer in patients with advanced disease, allowing the detection of molecular alterations in a large percentage of patients, thus allowing them to benefit from the use of targeted therapies.
Background: Lung cancer is the fourth most prevalent tumor but the one with the highest mortality rate, accounting for 18.2% of cancer mortality according to data from the Global Cancer Observatory (GLOBOCAN 2020) (1). Due to these data, the study of molecular alterations and targeted therapies represent the future approach for non-small cell lung cancer (NSCLC). Objectives: to determine the percentage of patients in whom a biomarker susceptible to be treated with a targeted therapy is discovered using massive sequencing techniques (next generation sequencing, NGS) in a cohort of NSCLC patients. And to determine the progression-free survival and the rate of response in those patients on whom it has been possible to perform targeted treatment. In addition to this, we will study at what point in the treatment the study was requested and how the result has affected the patient's therapy. Methods: To approach our work, a descriptive retrospective observational study has been proposed on a population of patients with NSCLC treated in the Medical Oncology service of the University Hospital of A Coruña who underwent NGS using Foundation Medicine between September 1, 2019, and December 31, 2023. Results: It was found that in 8 (40%) of the patients, a treatable molecular alteration was identified after applying NGS, leaving 12 (60%) in whom no treatable molecular alteration was detected. The new molecular alterations detected with NGS using Foundation Medicine were: 2 patients (10%) presented an EGFR exon 20 mutation, another 2 patients (10%) had an EGFR mutation, 1 (5%) had an FGFR3 mutation, 1 (5%) had an ALK translocation, 1 (5%) had MET amplification, and 1 patient (5%) had a BRAF N581S mutation. Regarding the type of response in the 8 patients who started a new treatment, 4 (50%) showed a partial response, which occurred 69.5 days after starting treatment (confidence interval of 26 to 162 days). Another 2 patients (25%) experienced disease progression as the best response, occurring 76 days after starting treatment (confidence interval of 63 to 89 days). Only 1 patient (12.5%) had stable disease as the best response, occurring 51 days after starting treatment. For one patient, who started treatment 37 days before the cut-off date, we do not have data on the type of response or whether there has been disease progression. Conclusions: NGS is a technique that provides benefits to patients with non-small cell lung cancer in patients with advanced disease, allowing the detection of molecular alterations in a large percentage of patients, thus allowing them to benefit from the use of targeted therapies.
Direction
FRAGA RODRIGUEZ, MAXIMO FRANCISCO (Tutorships)
Mosquera Martínez, Joaquín (Co-tutorships)
FRAGA RODRIGUEZ, MAXIMO FRANCISCO (Tutorships)
Mosquera Martínez, Joaquín (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Appraisement of disproportionate damage in the galician public system.
Authorship
L.R.V.
Bachelor of Medicine
L.R.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
This work consists of a systematic and descriptive study of judicial claims filed before the Galician judicial bodies, based on the existence of disproportionate damage derived from the health care received in the Galician public health system and which have been resolved in judgments that expressly analyzes whether the doctrine of the clamorous or disproportionate result is applicable in the specific case. The final objective is to know to what extent and in what terms, in the field of Galician public health, these claims are being supported and, where appropriate, applying the aforementioned doctrine in court rulings. After a rigorous selection process, 95 judgments were finally analyzed from different variables, showing that Galician judicial bodies have modified their criteria in recent years in the sense of being stricter in the application of the aforementioned doctrine, being the gynecology and obstetrics and traumatology and orthopedic surgery services the ones that concentrate the highest number of judicial claims (47.52%) as well as estimated judgments (51.20%).
This work consists of a systematic and descriptive study of judicial claims filed before the Galician judicial bodies, based on the existence of disproportionate damage derived from the health care received in the Galician public health system and which have been resolved in judgments that expressly analyzes whether the doctrine of the clamorous or disproportionate result is applicable in the specific case. The final objective is to know to what extent and in what terms, in the field of Galician public health, these claims are being supported and, where appropriate, applying the aforementioned doctrine in court rulings. After a rigorous selection process, 95 judgments were finally analyzed from different variables, showing that Galician judicial bodies have modified their criteria in recent years in the sense of being stricter in the application of the aforementioned doctrine, being the gynecology and obstetrics and traumatology and orthopedic surgery services the ones that concentrate the highest number of judicial claims (47.52%) as well as estimated judgments (51.20%).
Direction
MUÑOZ BARUS, JOSE IGNACIO (Tutorships)
MUÑOZ BARUS, JOSE IGNACIO (Tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Surgical management of Peyronie’s disease: the role of corporoplasty with TachoSil patch, about a case.
Authorship
A.R.C.
Bachelor of Medicine
A.R.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Peyronie’s disease is an acquired inflammatory disorder characterized by an excessive and disorganized deposition of collagen within the tunica albuginea of the penis, resulting in the formation of a dense fibrous plaque, which can lead to the curvature and deformity during erection, as well as discomfort, pain or erectile dysfunction. Furthermore, these changes are often accompanied by emotional and psychosocial consequences. Patients who are in a stable disease phase and whose symptoms persist (difficulties in sexual intercourse, anxiety, psycho-emotional symptoms, etc.) are candidates for surgical repair. When choosing the technique, it is important that it adapts to the patient, regarding his clinical situation, type of deformity, characteristics of the plaque or penile length, among others. AIM AND JUSTIFICATION: Take as a reference a clinical case from the Ferrol health area to review and evaluate the available literature and determine the advantages and disadvantages of corporoplasty with TachoSil patch as a surgical treatment of Peyronie’s disease, comparing it with other techniques. METHODS: Systematic review. A comprehensive search has been performed using electronic databases, including Pubmed, Embase and Cochrane Library, without a date limit, prioritizing clinical studies in English or Spanish. The inclusion criteria allowed us to select articles that studied patients with PD undergoing corporoplasty with TachoSil patch. Thus, a first superficial reading of 21 articles was carried out, of which 10 were analyzed in full text, and finally 5 were admitted for the review: 2 single-armed and 3 including comparison with other techniques. RESULTS AND DISCUSSION: The results obtained are presented using the PRISMA flow chart and the technique is analyzed. The 5 articles studied a total of 589 patients. Optimal results were obtained in terms of resolution of the curve, respecting the preoperative length of the penis, and with high satisfaction rates among patients. However, alterations in erectile function and glans sensitivity were reported, although the impact on sexual life was modest. Furthermore, the reduction in surgical time compared to other techniques was confirmed, as well as low complication rates. CONCLUSIONS: TachoSil is presented as a good graft to use in corporoplasties as a treatment for PD. The surgery is safe and effective, obtaining complete correction of the curve, reducing complications and surgical times. However, the lack of studies comparing it with other techniques represents a limitation to imposing this graft over others.
INTRODUCTION: Peyronie’s disease is an acquired inflammatory disorder characterized by an excessive and disorganized deposition of collagen within the tunica albuginea of the penis, resulting in the formation of a dense fibrous plaque, which can lead to the curvature and deformity during erection, as well as discomfort, pain or erectile dysfunction. Furthermore, these changes are often accompanied by emotional and psychosocial consequences. Patients who are in a stable disease phase and whose symptoms persist (difficulties in sexual intercourse, anxiety, psycho-emotional symptoms, etc.) are candidates for surgical repair. When choosing the technique, it is important that it adapts to the patient, regarding his clinical situation, type of deformity, characteristics of the plaque or penile length, among others. AIM AND JUSTIFICATION: Take as a reference a clinical case from the Ferrol health area to review and evaluate the available literature and determine the advantages and disadvantages of corporoplasty with TachoSil patch as a surgical treatment of Peyronie’s disease, comparing it with other techniques. METHODS: Systematic review. A comprehensive search has been performed using electronic databases, including Pubmed, Embase and Cochrane Library, without a date limit, prioritizing clinical studies in English or Spanish. The inclusion criteria allowed us to select articles that studied patients with PD undergoing corporoplasty with TachoSil patch. Thus, a first superficial reading of 21 articles was carried out, of which 10 were analyzed in full text, and finally 5 were admitted for the review: 2 single-armed and 3 including comparison with other techniques. RESULTS AND DISCUSSION: The results obtained are presented using the PRISMA flow chart and the technique is analyzed. The 5 articles studied a total of 589 patients. Optimal results were obtained in terms of resolution of the curve, respecting the preoperative length of the penis, and with high satisfaction rates among patients. However, alterations in erectile function and glans sensitivity were reported, although the impact on sexual life was modest. Furthermore, the reduction in surgical time compared to other techniques was confirmed, as well as low complication rates. CONCLUSIONS: TachoSil is presented as a good graft to use in corporoplasties as a treatment for PD. The surgery is safe and effective, obtaining complete correction of the curve, reducing complications and surgical times. However, the lack of studies comparing it with other techniques represents a limitation to imposing this graft over others.
Direction
López de los Reyes, Ramón Andrés (Tutorships)
Abeijón Piñeiro, Carla (Co-tutorships)
López de los Reyes, Ramón Andrés (Tutorships)
Abeijón Piñeiro, Carla (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
Clinical use for PET in depression.
Authorship
J.C.R.T.
Bachelor of Medicine
J.C.R.T.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: given the growing interest in biomarkers for psychiatric disorders, this paper seeks to know the hypothetical usefulness of PET in the management of depression, either as a diagnostic tool or as a predictor for prognosis and/or treatment response. Methods: structured as a systematic review, publications of the last decade in which PET had been used as a clinical tool for managing patients with depression were searched for in PUBMED. The results and the quality of the studies, including the risk of bias, were assessed following a standardization method developed ad hoc. Results: nine studies, eight of them clinical studies and a cohort study, were included in the review. Only the latter deals with prognostic aspects, while the rest focus on evaluating treatment response. Twenty four brain areas were studied with at least one of the six radiotracers that were used in total. Discussion: the quality of the studies was adequate, but still insufficient to respond to the research questions with certainty. Besides the limitations of sample size being and the retrospective analysis that most of the studies used, gathered evidence suggests that PET could indeed be useful as a predictor for antidepressant treatment response. No conclusive data was found about its usefulness in other aspects. However, new studies that amend the errors of the already existing ones are needed before proposing a real application for PET in depressed patients.
Background: given the growing interest in biomarkers for psychiatric disorders, this paper seeks to know the hypothetical usefulness of PET in the management of depression, either as a diagnostic tool or as a predictor for prognosis and/or treatment response. Methods: structured as a systematic review, publications of the last decade in which PET had been used as a clinical tool for managing patients with depression were searched for in PUBMED. The results and the quality of the studies, including the risk of bias, were assessed following a standardization method developed ad hoc. Results: nine studies, eight of them clinical studies and a cohort study, were included in the review. Only the latter deals with prognostic aspects, while the rest focus on evaluating treatment response. Twenty four brain areas were studied with at least one of the six radiotracers that were used in total. Discussion: the quality of the studies was adequate, but still insufficient to respond to the research questions with certainty. Besides the limitations of sample size being and the retrospective analysis that most of the studies used, gathered evidence suggests that PET could indeed be useful as a predictor for antidepressant treatment response. No conclusive data was found about its usefulness in other aspects. However, new studies that amend the errors of the already existing ones are needed before proposing a real application for PET in depressed patients.
Direction
Aguiar Fernández, Pablo (Tutorships)
Aguiar Fernández, Pablo (Tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
MDMA in the treatment of Post-Traumatic Stress Disorder: A systematic review
Authorship
E.R.A.
Bachelor of Medicine
E.R.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: According to the DSM-5, PTSD is a disorder developed after experiencing, witnessing, or being confronted with a traumatic event in which there was a real or perceived threat of death, serious injury, or sexual violence. Not everyone exposed to a stressful factor will develop PTSD. Global prevalence is estimated between 1 and 14%, depending on diagnostic criteria and the studied population. The treatment of PTSD includes psychopharmacological and psychotherapeutic interventions. This systematic review aims to assess the therapeutic potential of MDMA in PTSD. Objectives: To review and analyze the available evidence on the efficacy of the psychedelic N-Methyl-3,4methylenedioxyamphetamine (MDMA) in the treatment of post-traumatic stress disorder (PTSD). Methods: To guide the search, the PICO question scheme was used. A systematic literature review was conducted using the PubMed database, including open-access articles, in English and Spanish, published in the last 5 years. PRISMA guidelines were followed. Abstracts were reviewed, and if necessary, full articles were included, encompassing studies using MDMA as a drug for PTSD treatment in adult subjects diagnosed with PTSD. Results: Thirteen studies were finally selected: 4 systematic reviews with meta-analyses, 1 systematic review, 1 phase 3 clinical trial, 1 grouped longitudinal study, 2 grouped analyses, and 4 analyses of 1 clinical trial. Conclusions: This study concludes that MDMA-AT is an effective therapy for chronic and refractory PTSD cases, improving PTSD symptoms in less time than conventional therapies. The benefits of this treatment persist long-term, with a low risk of severe adverse effects, and there appears to be a significant improvement in the quality of life of patients. There seems to be a relationship between MDMA-AT and the improvement of PTSD symptoms in patients with depression and PTSD.
Introduction: According to the DSM-5, PTSD is a disorder developed after experiencing, witnessing, or being confronted with a traumatic event in which there was a real or perceived threat of death, serious injury, or sexual violence. Not everyone exposed to a stressful factor will develop PTSD. Global prevalence is estimated between 1 and 14%, depending on diagnostic criteria and the studied population. The treatment of PTSD includes psychopharmacological and psychotherapeutic interventions. This systematic review aims to assess the therapeutic potential of MDMA in PTSD. Objectives: To review and analyze the available evidence on the efficacy of the psychedelic N-Methyl-3,4methylenedioxyamphetamine (MDMA) in the treatment of post-traumatic stress disorder (PTSD). Methods: To guide the search, the PICO question scheme was used. A systematic literature review was conducted using the PubMed database, including open-access articles, in English and Spanish, published in the last 5 years. PRISMA guidelines were followed. Abstracts were reviewed, and if necessary, full articles were included, encompassing studies using MDMA as a drug for PTSD treatment in adult subjects diagnosed with PTSD. Results: Thirteen studies were finally selected: 4 systematic reviews with meta-analyses, 1 systematic review, 1 phase 3 clinical trial, 1 grouped longitudinal study, 2 grouped analyses, and 4 analyses of 1 clinical trial. Conclusions: This study concludes that MDMA-AT is an effective therapy for chronic and refractory PTSD cases, improving PTSD symptoms in less time than conventional therapies. The benefits of this treatment persist long-term, with a low risk of severe adverse effects, and there appears to be a significant improvement in the quality of life of patients. There seems to be a relationship between MDMA-AT and the improvement of PTSD symptoms in patients with depression and PTSD.
Direction
ARROJO ROMERO, MANUEL (Tutorships)
Núñez Sande, Carmen (Co-tutorships)
ARROJO ROMERO, MANUEL (Tutorships)
Núñez Sande, Carmen (Co-tutorships)
Court
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
PEREZ RIOS, MONICA (Chairman)
POSE REINO, ANTONIO DOMINGO (Secretary)
Gómez-Reino Rodríguez, Ignacio (Member)
The influence of anxiety and depressive disorders, during the perinatal period, on the development of the child
Authorship
M.M.R.M.D.A.
Bachelor of Medicine
M.M.R.M.D.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Data published by the World Health Organisation (WHO) over the last few years show a significant increase in the number of mental disorders worldwide, especially anxiety and depressive disorders. With regard to the existence of these disorders during the perinatal period it is evident that it is increasing: 4-39% of women are diagnosed with anxiety disorders during pregnancy and more than 10% experience clinical depression at some point during this period. Considering that the perinatal period is a crucial stage for the proper development of the child, numerous questions have arisen as to how these disorders influence the child's biophysiological, neurological and socioemotional development. The main goal of this study is to determine the possible repercussions of depressive and anxiety disorders during the perinatal period on child development, as well as to understand the mechanisms underlying these disorders. In addition, it aims to analyse other important factors and variables that contribute to the appearance of these disorders in mothers, as well as to identify strategies for prevention and early identification. A bibliographic review of the multiple scientific literature available in various specific databases such as PubMed, MedLine and search engines such as Google Scholar was carried out to consult other official sources of diagnostic criteria or other scientific information. The inclusion criteria selected: prospective studies, systematic reviews and meta-analyses available in English, Spanish and Portuguese published between 2012-2024 and open access. Data from 14 articles were analysed. The results reveal the alterations identified at physiological, neurodevelopmental and socioemotional levels in children whose mothers present with perinatal mental disorders. Additionally, the results reveal the possible biological mechanisms underlying these alterations, as well as the presence of variables that may also influence them. It has been confirmed that the presence of maternal anxiety and/or depression during pregnancy actively influences the biopsychosocial development of the child, often leading to increased morbidity and mortality. It is important to note that these effects are neither universal nor deterministic. Other factors, such as socioeconomic conditions, maternal physical health or postnatal environment also play an important role in determining child development.
Data published by the World Health Organisation (WHO) over the last few years show a significant increase in the number of mental disorders worldwide, especially anxiety and depressive disorders. With regard to the existence of these disorders during the perinatal period it is evident that it is increasing: 4-39% of women are diagnosed with anxiety disorders during pregnancy and more than 10% experience clinical depression at some point during this period. Considering that the perinatal period is a crucial stage for the proper development of the child, numerous questions have arisen as to how these disorders influence the child's biophysiological, neurological and socioemotional development. The main goal of this study is to determine the possible repercussions of depressive and anxiety disorders during the perinatal period on child development, as well as to understand the mechanisms underlying these disorders. In addition, it aims to analyse other important factors and variables that contribute to the appearance of these disorders in mothers, as well as to identify strategies for prevention and early identification. A bibliographic review of the multiple scientific literature available in various specific databases such as PubMed, MedLine and search engines such as Google Scholar was carried out to consult other official sources of diagnostic criteria or other scientific information. The inclusion criteria selected: prospective studies, systematic reviews and meta-analyses available in English, Spanish and Portuguese published between 2012-2024 and open access. Data from 14 articles were analysed. The results reveal the alterations identified at physiological, neurodevelopmental and socioemotional levels in children whose mothers present with perinatal mental disorders. Additionally, the results reveal the possible biological mechanisms underlying these alterations, as well as the presence of variables that may also influence them. It has been confirmed that the presence of maternal anxiety and/or depression during pregnancy actively influences the biopsychosocial development of the child, often leading to increased morbidity and mortality. It is important to note that these effects are neither universal nor deterministic. Other factors, such as socioeconomic conditions, maternal physical health or postnatal environment also play an important role in determining child development.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Use of advanced therapies in pregnant patients with Inflammatory Bowel Disease
Authorship
O.R.A.
Bachelor of Medicine
O.R.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Inflammatory Bowel Diseases constitute a chronic inflammatory disorder of the gastrointestinal tract, which also have a systemic nature. Due to their frequent diagnosis in young patients, they often occur in women who wish to become pregnant, making proper treatment essential for the correct development of the pregnancy. Objetive: The objective of this systematic review is to carry out an analysis of the safety, efficacy and possible complications derived from the different advanced treatments used in IBD for its use in pregnant patients. Methods: A systematic search is carried out in the electronic database MedLine and the Cochrane Library, based on the use of keywords and the Boolean operators OR and AND. Included studies provide information about the impact, maternal-fetal safety profile and neonatal outcomes of treatments used for the therapy of inflammatory bowel diseases during pregnancy. Results: 18 studies were included in this systematic review, of which 14 are observational and 4 are systematic reviews. They study the safety of different treatments based on the maternal complications that could appear throughout pregnancy and the neonatal results obtained. Conclusions: Adequate treatment during pregnancy is essential to prevent the appearance of outbreaks. Thiopurines, anti-TNF, anti-Integrin and anti-IL12/23 drugs are considered safe and their use is recommended during pregnancy. Metotrexate, JAK inhibitors and S1P inhibitors are contraindicated during pregnancy.
Introduction: Inflammatory Bowel Diseases constitute a chronic inflammatory disorder of the gastrointestinal tract, which also have a systemic nature. Due to their frequent diagnosis in young patients, they often occur in women who wish to become pregnant, making proper treatment essential for the correct development of the pregnancy. Objetive: The objective of this systematic review is to carry out an analysis of the safety, efficacy and possible complications derived from the different advanced treatments used in IBD for its use in pregnant patients. Methods: A systematic search is carried out in the electronic database MedLine and the Cochrane Library, based on the use of keywords and the Boolean operators OR and AND. Included studies provide information about the impact, maternal-fetal safety profile and neonatal outcomes of treatments used for the therapy of inflammatory bowel diseases during pregnancy. Results: 18 studies were included in this systematic review, of which 14 are observational and 4 are systematic reviews. They study the safety of different treatments based on the maternal complications that could appear throughout pregnancy and the neonatal results obtained. Conclusions: Adequate treatment during pregnancy is essential to prevent the appearance of outbreaks. Thiopurines, anti-TNF, anti-Integrin and anti-IL12/23 drugs are considered safe and their use is recommended during pregnancy. Metotrexate, JAK inhibitors and S1P inhibitors are contraindicated during pregnancy.
Direction
BARREIRO DE ACOSTA, MANUEL FRANCISCO (Tutorships)
Ferreiro Iglesias, Rocío (Co-tutorships)
BARREIRO DE ACOSTA, MANUEL FRANCISCO (Tutorships)
Ferreiro Iglesias, Rocío (Co-tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Injury epidemiology of Galician Rink Hockey teams
Authorship
A.F.V.V.
Bachelor of Medicine
A.F.V.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Roller Hockey is a minority sport in Spain and, therefore, there are few publications about its most common injuries and their underlying causes. It is crucial to expand this knowledge to better understand the injury pattern of this sport. Aim: Describe the injury epidemiology in roller hockey players to analyse the influence of various factors and be able to establish a solid basis for developing specific prevention plans. Methods: A retrospective study was carried out on injuries that occurred during the 2021/2022 and 2022/2023 seasons in four professional and semi-professional Roller Hockey teams in Galicia. 38 athletes were studied, using a strict definition of time-loss injuries and a standardized injury registration system. Results: A total of 46 injuries were recorded, with an overall incidence of 0,61 +- 0,98 injuries per player and season. Muscle injuries were the most common (n= 14, 30,4%), with the adductor longus being the most affected muscle. Most injuries occurred progressively without contact (n=26, 56,5%) and in the last phase of the season (n=16, 34,8%). The median return-to-play was 21,39 +- 37,98 days. Conclusions: Most injuries in rink hockey are acute and occur without contact, especially at the end of the season. Muscle injuries, particularly in the adductors, are confirmed as the most frequent. Therefore, it would be crucial to carry out more epidemiological research in order to establish specific preventive measures for this type of injuries.
Background: Roller Hockey is a minority sport in Spain and, therefore, there are few publications about its most common injuries and their underlying causes. It is crucial to expand this knowledge to better understand the injury pattern of this sport. Aim: Describe the injury epidemiology in roller hockey players to analyse the influence of various factors and be able to establish a solid basis for developing specific prevention plans. Methods: A retrospective study was carried out on injuries that occurred during the 2021/2022 and 2022/2023 seasons in four professional and semi-professional Roller Hockey teams in Galicia. 38 athletes were studied, using a strict definition of time-loss injuries and a standardized injury registration system. Results: A total of 46 injuries were recorded, with an overall incidence of 0,61 +- 0,98 injuries per player and season. Muscle injuries were the most common (n= 14, 30,4%), with the adductor longus being the most affected muscle. Most injuries occurred progressively without contact (n=26, 56,5%) and in the last phase of the season (n=16, 34,8%). The median return-to-play was 21,39 +- 37,98 days. Conclusions: Most injuries in rink hockey are acute and occur without contact, especially at the end of the season. Muscle injuries, particularly in the adductors, are confirmed as the most frequent. Therefore, it would be crucial to carry out more epidemiological research in order to establish specific preventive measures for this type of injuries.
Direction
CAEIRO REY, JOSE RAMON (Tutorships)
CAEIRO REY, JOSE RAMON (Tutorships)
Court
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
DOMINGUEZ PUENTE, FERNANDO (Chairman)
González Barcala, Francisco Javier (Secretary)
PINO MINGUEZ, JESUS (Member)
Study of the repercussion of the ligamentum flavum hypertrophy in lumbar spinal stenosis.
Authorship
A.V.P.
Bachelor of Medicine
A.V.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Hypertrophy of the ligamentum flavum (LFH) is one of the most important etiopathogenic factors in lumbar spinal stenosis (LSS). Thus, conducting studies in terms of composition and celular microenvironment, as well as quantifying its degree of involvement and how it contributes to the narrowing of the vertebral canal is crucial to find potentially effective therapeutic strategies. The current study analyzed the most recent avaliable literature about LFH, along with an “in vitro” analysis of ligamentum flavum cells obtained from patients undergoing surgical desompression for symptomatic lumbar spinal stenosis and an examination of the spine using magnetic resonance imaging (MRI). Measuring of the ligament thickness, spinal canal size and disc bulging was performed at the L4-L5 space. In the first place, we defined the importance of metabolomic factors in ligamentum flavum hypertrophy and the possibility of using dexamethasone as an anti-fibrotic agent. Additionally, we noticed the negative correlation between hypertrophy on the right side of the axis and the size of the lumbar spinal canal as significant.
Hypertrophy of the ligamentum flavum (LFH) is one of the most important etiopathogenic factors in lumbar spinal stenosis (LSS). Thus, conducting studies in terms of composition and celular microenvironment, as well as quantifying its degree of involvement and how it contributes to the narrowing of the vertebral canal is crucial to find potentially effective therapeutic strategies. The current study analyzed the most recent avaliable literature about LFH, along with an “in vitro” analysis of ligamentum flavum cells obtained from patients undergoing surgical desompression for symptomatic lumbar spinal stenosis and an examination of the spine using magnetic resonance imaging (MRI). Measuring of the ligament thickness, spinal canal size and disc bulging was performed at the L4-L5 space. In the first place, we defined the importance of metabolomic factors in ligamentum flavum hypertrophy and the possibility of using dexamethasone as an anti-fibrotic agent. Additionally, we noticed the negative correlation between hypertrophy on the right side of the axis and the size of the lumbar spinal canal as significant.
Direction
PINO MINGUEZ, JESUS (Tutorships)
GUALILLO , ORESTE (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
GUALILLO , ORESTE (Co-tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Health-related quality of life in patients with osteoarthritis. A study in adult population
Authorship
A.V.F.
Bachelor of Medicine
A.V.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Osteoarthritis is a chronic and degenerative joint disease that causes chronic pain, swelling, joint stiffness, and decreased range of motion, significantly deteriorating health-related quality of life (HRQoL). HRQoL is defined as patients' perception of their autonomy, overall well-being, and ability to perform basic daily activities. To objectively measure HRQoL in patients with osteoarthritis, the SF-36 questionnaire is used, allowing comparison of results from patients with osteoarthritis to those from the general population. Objectives: To investigate HRQoL in people with osteoarthritis and compare it to people without the disease using the SF-36 questionnaire in a representative sample of the population over 18 years old. Materials and Methods: Data come from the A-Estrada Glycation and Inflammation (AEGIS) study, a cross-sectional population-based study conducted in the municipality of A Estrada between 2012 and 2015. Participants attended the health center, where they underwent a clinical interview with a structured questionnaire (including the SF-36 form), a physical examination, and a blood draw. In this study, statistical analysis was performed with the obtained data. Sociodemographic, socioeconomic, and lifestyle variables were analyzed for both the general sample and separated by the presence or absence of OA, as well as the results of the SF-36 questionnaire scales. Finally, a multivariate analysis of the SF-36 scales was performed based on the presence of OA, also adjusting for age and sex. Results: The results show that the age in patients with OA is higher and 96.9% are women. Significant associations were also found with marital status, education level, and tobacco and alcohol consumption, but not with BMI and lifestyle. People with OA obtained significantly lower scores in all SF-36 dimensions, except for emotional role and health transition. In the multivariate analysis adjusted for sex and age, lower scores were maintained in all SF-36 dimensions, being statistically significant in physical function, vitality, bodily pain and general health. Conclusion: This study highlights the significant impact of OA on HRQoL, evidenced by the lower scores obtained in the SF-36 questionnaire.
Introduction: Osteoarthritis is a chronic and degenerative joint disease that causes chronic pain, swelling, joint stiffness, and decreased range of motion, significantly deteriorating health-related quality of life (HRQoL). HRQoL is defined as patients' perception of their autonomy, overall well-being, and ability to perform basic daily activities. To objectively measure HRQoL in patients with osteoarthritis, the SF-36 questionnaire is used, allowing comparison of results from patients with osteoarthritis to those from the general population. Objectives: To investigate HRQoL in people with osteoarthritis and compare it to people without the disease using the SF-36 questionnaire in a representative sample of the population over 18 years old. Materials and Methods: Data come from the A-Estrada Glycation and Inflammation (AEGIS) study, a cross-sectional population-based study conducted in the municipality of A Estrada between 2012 and 2015. Participants attended the health center, where they underwent a clinical interview with a structured questionnaire (including the SF-36 form), a physical examination, and a blood draw. In this study, statistical analysis was performed with the obtained data. Sociodemographic, socioeconomic, and lifestyle variables were analyzed for both the general sample and separated by the presence or absence of OA, as well as the results of the SF-36 questionnaire scales. Finally, a multivariate analysis of the SF-36 scales was performed based on the presence of OA, also adjusting for age and sex. Results: The results show that the age in patients with OA is higher and 96.9% are women. Significant associations were also found with marital status, education level, and tobacco and alcohol consumption, but not with BMI and lifestyle. People with OA obtained significantly lower scores in all SF-36 dimensions, except for emotional role and health transition. In the multivariate analysis adjusted for sex and age, lower scores were maintained in all SF-36 dimensions, being statistically significant in physical function, vitality, bodily pain and general health. Conclusion: This study highlights the significant impact of OA on HRQoL, evidenced by the lower scores obtained in the SF-36 questionnaire.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Díaz Louzao, Carla (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Díaz Louzao, Carla (Co-tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Analysis of the impact of cancer screening in the general population on subsequent patterns of thought and behaviour. Proposal for an awareness campaign on this.
Authorship
T.V.C.
Bachelor of Medicine
T.V.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
We present an analysis of the main thought and behavioral patterns related to cancer screenings currently performed in Spain using health belief models. The main tool used to collect the information was an anonymous online form addressed to the general population. The main findings are divided into thought and behavioral patterns, which are further subdivided into the five areas of study of these models (perceived susceptibility, perceived severity, perceived benefit, perceived severity and cues to action), as well as the analysis of the consequent behaviors, and the analysis of the knowledge about the inclusion criteria of the screenings and risk factors of these diseases. With the results obtained, a proposal for a prevention campaign designed to be carried out in primary care has been developed with the aim of minimizing the stress and uncertainty experienced by individuals in society and, therefore, maximizing participation in screening.
We present an analysis of the main thought and behavioral patterns related to cancer screenings currently performed in Spain using health belief models. The main tool used to collect the information was an anonymous online form addressed to the general population. The main findings are divided into thought and behavioral patterns, which are further subdivided into the five areas of study of these models (perceived susceptibility, perceived severity, perceived benefit, perceived severity and cues to action), as well as the analysis of the consequent behaviors, and the analysis of the knowledge about the inclusion criteria of the screenings and risk factors of these diseases. With the results obtained, a proposal for a prevention campaign designed to be carried out in primary care has been developed with the aim of minimizing the stress and uncertainty experienced by individuals in society and, therefore, maximizing participation in screening.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Metabolic syndrome in patients treated with long-acting injectable paliperidone: relationship with pharmacogenetics and plasma levels
Authorship
C.V.M.
Bachelor of Medicine
C.V.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Paliperidone is an atypical antipsychotic and main active metabolite of risperidone, with therapeutic indication for schizophrenia and schizoaffective disorder in adults and schizophrenia in adolescents from 15 years. Paliperidone palmitate (PP) is a long-acting injectable formulation (ILD) especially useful for improving adherence to treatment. We currently have a monthly presentation; a quarterly presentation and a half-yearly presentation has recently been introduced. Certain antipsychotics, including this drug, have been associated with adverse metabolic changes such as weight gain, insulin resistance and dyslipidemia. These are conditions that increase the risk of metabolic syndrome (MS), a combination of medical disorders that increase the likelihood of cardiovascular disease, type 2 diabetes mellitus, and stroke.
Paliperidone is an atypical antipsychotic and main active metabolite of risperidone, with therapeutic indication for schizophrenia and schizoaffective disorder in adults and schizophrenia in adolescents from 15 years. Paliperidone palmitate (PP) is a long-acting injectable formulation (ILD) especially useful for improving adherence to treatment. We currently have a monthly presentation; a quarterly presentation and a half-yearly presentation has recently been introduced. Certain antipsychotics, including this drug, have been associated with adverse metabolic changes such as weight gain, insulin resistance and dyslipidemia. These are conditions that increase the risk of metabolic syndrome (MS), a combination of medical disorders that increase the likelihood of cardiovascular disease, type 2 diabetes mellitus, and stroke.
Direction
VIDAL MILLARES, MARIA (Tutorships)
Mondelo García, Cristina (Co-tutorships)
VIDAL MILLARES, MARIA (Tutorships)
Mondelo García, Cristina (Co-tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Characteristics of Helicobacter Pylori infection in pediatrict patients urdergoing endoscopy
Authorship
R.V.S.
Bachelor of Medicine
R.V.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Helicibacter pylori infection is currently one of the mort prevalent infections worldwide. Although it is asymtomatic in most patients, it can cause various gastrointestinal pathologies: from chronic or peptic gastritis to a predisposition for develop adenocarcinoma and gastric lymphoma. Objective: The main objective of this study is to analyze the epidemiological data of pediatric patients aged between 5 and 18 years who underwent upper gastrontestinal endoscopy for Helicobacter pylori infection in a Pediatric Gastroenterology Unit of a terciary care hospital. Methods: Retrospective observational study of patients at the Pediatric Gastroenterology, Hepatology, and Nutrition Unit of Teresa Herrera Maternity and Children Hospital diagnosed with Helicobacter pylori infection from January 2017 to December 2023. Results: A total of 14 patients were included, of whom 11 were girls and 3 boys, with a mean age of 12 years and 4 months. Half of them presented with abdominal pain as the main symptom. Endoscopically, the studies were macoscopially normal, with the common histological finding being the presence of active chronic gastritis. The main resistances observed were to metronidazole and clarithromycin, and the main treatment regimens used were triple therapy for 14 days based on antibiogram results. Resolution of the infection was associated with clinical improvement in symtomatic patients. Conclusions: Helicobacter pylori infection is very common in the pediatric population, with abdominal pain being the main reported symtom. There is a high percentage of resistance to both metronidazole and claritromycin in the studied population, indicating the need for targeted antibiotic therapy to achieve eradication.
Background: Helicibacter pylori infection is currently one of the mort prevalent infections worldwide. Although it is asymtomatic in most patients, it can cause various gastrointestinal pathologies: from chronic or peptic gastritis to a predisposition for develop adenocarcinoma and gastric lymphoma. Objective: The main objective of this study is to analyze the epidemiological data of pediatric patients aged between 5 and 18 years who underwent upper gastrontestinal endoscopy for Helicobacter pylori infection in a Pediatric Gastroenterology Unit of a terciary care hospital. Methods: Retrospective observational study of patients at the Pediatric Gastroenterology, Hepatology, and Nutrition Unit of Teresa Herrera Maternity and Children Hospital diagnosed with Helicobacter pylori infection from January 2017 to December 2023. Results: A total of 14 patients were included, of whom 11 were girls and 3 boys, with a mean age of 12 years and 4 months. Half of them presented with abdominal pain as the main symptom. Endoscopically, the studies were macoscopially normal, with the common histological finding being the presence of active chronic gastritis. The main resistances observed were to metronidazole and clarithromycin, and the main treatment regimens used were triple therapy for 14 days based on antibiogram results. Resolution of the infection was associated with clinical improvement in symtomatic patients. Conclusions: Helicobacter pylori infection is very common in the pediatric population, with abdominal pain being the main reported symtom. There is a high percentage of resistance to both metronidazole and claritromycin in the studied population, indicating the need for targeted antibiotic therapy to achieve eradication.
Direction
Moreno Álvarez, Ana (Tutorships)
SOLAR BOGA, ALFONSO JESUS (Co-tutorships)
Moreno Álvarez, Ana (Tutorships)
SOLAR BOGA, ALFONSO JESUS (Co-tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Development of a radiomic model based on non-contrast computerized tomography images for the prediction of the etiology of acute ischemic stroke
Authorship
P.V.P.
Bachelor of Medicine
P.V.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Acute ischemic stroke is a pathology of great importance in society, as it is one of the main causes of mortality and disability in adults. Determining the etiology of acute ischemic strokes is vital for the clinical management of these patients. In many cases, the etiology of the stroke cannot be established during the acute phase of the stroke, and even on numerous occasions, it is not possible to determine the etiology after completing all diagnostic tests. On the other hand, artificial intelligence is playing an increasingly relevant role in our society. An artificial intelligence tool that has been developing in recent years in radiology is radiomics. Radiomics is a discipline that seeks to transform the usual qualitative analysis performed in radiodiagnosis of a medical image into a quantitative analysis that provides information on the underlying pathological process. Publications on the use of radiomics in non-tumoral pathology, and specifically in patients with neurological pathology, are becoming more numerous. The objective of this work is to develop and apply a radiomic model based on the quantitative data obtained from computerized tomography (CT) images of patients with acute ischemic stroke performed in the Radiology Department of the Clinical Hospital of Santiago de Compostela, to predict the etiology of the stroke. Having tools that can predict etiology could have direct implications for clinical practice by enabling earlier implementation of preventive treatments.
Acute ischemic stroke is a pathology of great importance in society, as it is one of the main causes of mortality and disability in adults. Determining the etiology of acute ischemic strokes is vital for the clinical management of these patients. In many cases, the etiology of the stroke cannot be established during the acute phase of the stroke, and even on numerous occasions, it is not possible to determine the etiology after completing all diagnostic tests. On the other hand, artificial intelligence is playing an increasingly relevant role in our society. An artificial intelligence tool that has been developing in recent years in radiology is radiomics. Radiomics is a discipline that seeks to transform the usual qualitative analysis performed in radiodiagnosis of a medical image into a quantitative analysis that provides information on the underlying pathological process. Publications on the use of radiomics in non-tumoral pathology, and specifically in patients with neurological pathology, are becoming more numerous. The objective of this work is to develop and apply a radiomic model based on the quantitative data obtained from computerized tomography (CT) images of patients with acute ischemic stroke performed in the Radiology Department of the Clinical Hospital of Santiago de Compostela, to predict the etiology of the stroke. Having tools that can predict etiology could have direct implications for clinical practice by enabling earlier implementation of preventive treatments.
Direction
Souto Bayarri, José Miguel (Tutorships)
Mosqueira Martínez, Antonio Jesús (Co-tutorships)
Porto Álvarez, Jacobo (Co-tutorships)
Souto Bayarri, José Miguel (Tutorships)
Mosqueira Martínez, Antonio Jesús (Co-tutorships)
Porto Álvarez, Jacobo (Co-tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Systematic review of the therapeutic approach in Pancoast tumor.
Authorship
S.V.D.
Bachelor of Medicine
S.V.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Lung cancer is one of the tumors with the highest mortality rate. A particular form is the Pancoast tumor, which is located in the upper lung apex. Its location produces characteristic symptoms with a predominance of musculoskeletal and neurological alterations prior to the respiratory symptoms. This variable form of presentation delays early diagnosis, which is performed through image-guided percutaneous transthoracic biopsy. Curative intent treatment is based on a multimodal scheme: neoadjuvant chemoradiotherapy followed by surgical resection and postoperative chemotherapy. Starting from an initially unresectable condition to achieving a notable 5-year survival rate justifies the review of its therapeutic approach. Objective: To review the management, diagnosis, and treatment of patients with Pancoast tumor, with a special emphasis on the evolution of available treatments. Design and data source: Systematic review of articles published in the PubMed scientific database. Those obtained under the MeSH search terms: tumor AND Pancoast. After review, the most relevant articles are selected for analysis. Results: The review focuses on 24 articles selected after study. These are classified into three groups: Diagnosis and other aspects, Multimodal treatment, and Surgical aspects. The classification facilitates comparison among them and optimal conclusions. Conclusion: Survival in patients with Pancoast tumor has substantially improved due to multimodal treatment. The introduction of preoperative chemoradiotherapy followed by adjuvant chemotherapy forms the trimodal scheme, the conjunction of the three modalities represents a novelty in therapeutic management. In particular, new surgical approaches have a greater curative capacity with an increase in the rate of complete resection, in addition to reducing postoperative comorbidity. The surgical future focuses on minimally invasive techniques, still to be developed in this pathology. The same applies to targeted therapies and immunotherapy, two very promising therapeutic modalities, although with limitations, such as low effectiveness in treating brain metastases.
Introduction: Lung cancer is one of the tumors with the highest mortality rate. A particular form is the Pancoast tumor, which is located in the upper lung apex. Its location produces characteristic symptoms with a predominance of musculoskeletal and neurological alterations prior to the respiratory symptoms. This variable form of presentation delays early diagnosis, which is performed through image-guided percutaneous transthoracic biopsy. Curative intent treatment is based on a multimodal scheme: neoadjuvant chemoradiotherapy followed by surgical resection and postoperative chemotherapy. Starting from an initially unresectable condition to achieving a notable 5-year survival rate justifies the review of its therapeutic approach. Objective: To review the management, diagnosis, and treatment of patients with Pancoast tumor, with a special emphasis on the evolution of available treatments. Design and data source: Systematic review of articles published in the PubMed scientific database. Those obtained under the MeSH search terms: tumor AND Pancoast. After review, the most relevant articles are selected for analysis. Results: The review focuses on 24 articles selected after study. These are classified into three groups: Diagnosis and other aspects, Multimodal treatment, and Surgical aspects. The classification facilitates comparison among them and optimal conclusions. Conclusion: Survival in patients with Pancoast tumor has substantially improved due to multimodal treatment. The introduction of preoperative chemoradiotherapy followed by adjuvant chemotherapy forms the trimodal scheme, the conjunction of the three modalities represents a novelty in therapeutic management. In particular, new surgical approaches have a greater curative capacity with an increase in the rate of complete resection, in addition to reducing postoperative comorbidity. The surgical future focuses on minimally invasive techniques, still to be developed in this pathology. The same applies to targeted therapies and immunotherapy, two very promising therapeutic modalities, although with limitations, such as low effectiveness in treating brain metastases.
Direction
LEON MATEOS, LUIS ANGEL (Tutorships)
LEON MATEOS, LUIS ANGEL (Tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Association between triage priority assigned in hospital emergency rooms and need for hospitalization and mortality during the episode.
Authorship
I.A.F.
Bachelor of Medicine
I.A.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Hospital triage has been shown to be effective as a discriminator of priority of care in the Emergency Department. It is worth considering the possibility that, in addition, they may serve as determinants of mortality and probability of admission, making them predictors of the severity of the episode. OBJECTIVES: To analyse, by means of a systematic review of the literature and a statistical analysis of aggregate data from the adult Emergency Department of the Vigo Health Area in 2023 (triaged using MTS), whether there is correlation between triage levels and Emergency Department mortality, need for hospitalization, mortality in the first 24 hours of admission, and overall admission mortality. METHODS: To carry out the literature review, after performing a PubMed search, 7 articles were selected. The most relevant data found was structured in tables and conclusions were drawn. The statistical analysis was carried out both descriptively, with graphics representing the data, and analytically, calculating the relative risks of each triage level with respect to the others, that is, how much greater the probability of each adverse outcome is at one level with respect to another. RESULTS: Most articles included in the review conclude that at urgent triage levels, mortality and risk of admission, therefore, severity, is higher than at lower levels. The statistical analysis demonstrates a clear association between the level of priority assigned at triage and the adverse clinical outcomes studied. Lower levels of triage imply lower risk, they are protective factors, and higher levels, risk factors. CONCLUSIONS: The findings of the literature review and statistical analysis are congruent with each other, finding an association between high triage priority and adverse clinical outcomes (hospitalization, immediate mortality, overall admission mortality). Triage is shown to predict severity, as well as determine urgency.
INTRODUCTION: Hospital triage has been shown to be effective as a discriminator of priority of care in the Emergency Department. It is worth considering the possibility that, in addition, they may serve as determinants of mortality and probability of admission, making them predictors of the severity of the episode. OBJECTIVES: To analyse, by means of a systematic review of the literature and a statistical analysis of aggregate data from the adult Emergency Department of the Vigo Health Area in 2023 (triaged using MTS), whether there is correlation between triage levels and Emergency Department mortality, need for hospitalization, mortality in the first 24 hours of admission, and overall admission mortality. METHODS: To carry out the literature review, after performing a PubMed search, 7 articles were selected. The most relevant data found was structured in tables and conclusions were drawn. The statistical analysis was carried out both descriptively, with graphics representing the data, and analytically, calculating the relative risks of each triage level with respect to the others, that is, how much greater the probability of each adverse outcome is at one level with respect to another. RESULTS: Most articles included in the review conclude that at urgent triage levels, mortality and risk of admission, therefore, severity, is higher than at lower levels. The statistical analysis demonstrates a clear association between the level of priority assigned at triage and the adverse clinical outcomes studied. Lower levels of triage imply lower risk, they are protective factors, and higher levels, risk factors. CONCLUSIONS: The findings of the literature review and statistical analysis are congruent with each other, finding an association between high triage priority and adverse clinical outcomes (hospitalization, immediate mortality, overall admission mortality). Triage is shown to predict severity, as well as determine urgency.
Direction
MARTINEZ ROLAN, ROSA MARIA (Tutorships)
Pichel Loureiro, Ángel (Co-tutorships)
Maza Vera, María Teresa (Co-tutorships)
MARTINEZ ROLAN, ROSA MARIA (Tutorships)
Pichel Loureiro, Ángel (Co-tutorships)
Maza Vera, María Teresa (Co-tutorships)
Court
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
PEREZ FERNANDEZ, ROMAN (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
Antela López, Antonio Rafael (Member)
Attention deficit hyperactivity disorder and substance abuse
Authorship
M.T.A.C.
Bachelor of Medicine
M.T.A.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: ADHD is one of the most common neuropsychiatric pathologies during childhood, and with a non-negligible prevalence in adulthood. At the same time, drug use is one of the greatest global public health concerns in recent times due to its high global prevalence. OBJECTIVE: The objective of this review is to evaluate the available literature to verify that there is a clear association between suffering from ADHD and the consumption of narcotic substances, and if the association is positive, to raise awareness about the importance of early diagnosis and treatment of this disease. , in order to avoid future comorbidities such as SUD. METHODS: A bibliographic review was carried out. A search was carried out in PUBMED and GOOGLE ACADEMIC for studies published in the last four years, from 2020 to 2024. The inclusion criteria allowed us to finally select 12 studies, in Spanish, Portuguese and English. RESULTS: Of all the studies reviewed, 10 systematic reviews and two meta-analyses, we observed that they all unanimously agree that there is a positive association between ADHD and substance use. CONCLUSION: Early identification and treatment of ADHD may be key to reducing the risk of SUD and improving the quality of life of these patients
INTRODUCTION: ADHD is one of the most common neuropsychiatric pathologies during childhood, and with a non-negligible prevalence in adulthood. At the same time, drug use is one of the greatest global public health concerns in recent times due to its high global prevalence. OBJECTIVE: The objective of this review is to evaluate the available literature to verify that there is a clear association between suffering from ADHD and the consumption of narcotic substances, and if the association is positive, to raise awareness about the importance of early diagnosis and treatment of this disease. , in order to avoid future comorbidities such as SUD. METHODS: A bibliographic review was carried out. A search was carried out in PUBMED and GOOGLE ACADEMIC for studies published in the last four years, from 2020 to 2024. The inclusion criteria allowed us to finally select 12 studies, in Spanish, Portuguese and English. RESULTS: Of all the studies reviewed, 10 systematic reviews and two meta-analyses, we observed that they all unanimously agree that there is a positive association between ADHD and substance use. CONCLUSION: Early identification and treatment of ADHD may be key to reducing the risk of SUD and improving the quality of life of these patients
Direction
FLOREZ MENENDEZ, GERARDO (Tutorships)
FLOREZ MENENDEZ, GERARDO (Tutorships)
Growing foot deformities of neurological origin.
Authorship
M.P.S.
Bachelor of Medicine
M.P.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
The Charcot-Marie-Tooth disease is a hereditary peripheral neuropathy with a very significant prevalence worldwide. It is characterized by progressive muscle weakness, muscle atrophy, and sensory disorders, such as loss of sensitivity to pain, temperature, and vibration. One of the most distinctive manifestations of CMT is the cavus foot deformity, which can cause difficulties in walking and limitations in mobility and will be exhaustively described in this review. With this work, we aim to thoroughly examine strategies for an accurate diagnosis of CMT, including detailed clinical evaluations, imaging tests, nerve conduction studies, and genetic analysis to identify associated mutations. Furthermore, we contrast treatment options, ranging from surgical interventions to correct severe deformities to conservative approaches, such as physical therapy, orthotic use, and medications to control symptoms. Despite the advances we will describe in the management of CMT, it is clear that there is still a long way to go in terms of understanding, diagnosis, and treatment of this disease. Therefore, we emphasize the need to continue research in this field, exploring new potential therapies, such as gene therapy and molecular interventions, as well as deepening our understanding of the underlying mechanisms of the disease. This continuous research approach is crucial to improving the quality of life of patients with CMT and offering hope for more effective future treatments.
The Charcot-Marie-Tooth disease is a hereditary peripheral neuropathy with a very significant prevalence worldwide. It is characterized by progressive muscle weakness, muscle atrophy, and sensory disorders, such as loss of sensitivity to pain, temperature, and vibration. One of the most distinctive manifestations of CMT is the cavus foot deformity, which can cause difficulties in walking and limitations in mobility and will be exhaustively described in this review. With this work, we aim to thoroughly examine strategies for an accurate diagnosis of CMT, including detailed clinical evaluations, imaging tests, nerve conduction studies, and genetic analysis to identify associated mutations. Furthermore, we contrast treatment options, ranging from surgical interventions to correct severe deformities to conservative approaches, such as physical therapy, orthotic use, and medications to control symptoms. Despite the advances we will describe in the management of CMT, it is clear that there is still a long way to go in terms of understanding, diagnosis, and treatment of this disease. Therefore, we emphasize the need to continue research in this field, exploring new potential therapies, such as gene therapy and molecular interventions, as well as deepening our understanding of the underlying mechanisms of the disease. This continuous research approach is crucial to improving the quality of life of patients with CMT and offering hope for more effective future treatments.
Direction
PINO MINGUEZ, JESUS (Tutorships)
Pardo Fernández, Julio (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
Pardo Fernández, Julio (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
The efficacy of topical budesonide versus elimination diet in the treatment of eosinophilic esophagitis: a systematic review
Authorship
D.P.V.
Bachelor of Medicine
D.P.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Eosinophilic esophagitis is a chronic inflammatory disease of the esophagus with an immunoallergic pathophysiological basis. Its clinical manifestations include dysphagia and food impaction, symptoms that severely worsen the quality of life of affected patients. Diagnosis is based on clinical presentation and the histopathological study of the esophageal mucosa, requiring the observation of more than 15 eosinophils per field. Treatment consists of three main pillars: dietary exclusion, topical corticosteroid therapy, and proton pump inhibitors (PPIs). OBJECTIVES: To conduct a systematic review of the literature on the efficacy of budesonide versus a six-food elimination diet in the histological remission of eosinophilic esophagitis. METHODS: A search was conducted in PubMed and World of Science (WoS) for clinical trials evaluating the efficacy of budesonide and diet, considering histological remission as an infiltrate of less than 15 eosinophils per field. The risk of bias in the studies was assessed using the Cochrane Risk of Bias Tool. RESULTS: Seven articles were obtained after applying inclusion and exclusion criteria. The sample size was 417 patients, 146 of whom were treated with topical budesonide and 196 with a six-food elimination diet. Among patients treated with topical budesonide, histological remission was 74.7% compared to 65.8% in patients treated with the six-food elimination diet. CONCLUSION: Topical budesonide appears to be slightly more effective than the six-food elimination diet in terms of histological response. However, more studies comparing both treatments are needed.
INTRODUCTION: Eosinophilic esophagitis is a chronic inflammatory disease of the esophagus with an immunoallergic pathophysiological basis. Its clinical manifestations include dysphagia and food impaction, symptoms that severely worsen the quality of life of affected patients. Diagnosis is based on clinical presentation and the histopathological study of the esophageal mucosa, requiring the observation of more than 15 eosinophils per field. Treatment consists of three main pillars: dietary exclusion, topical corticosteroid therapy, and proton pump inhibitors (PPIs). OBJECTIVES: To conduct a systematic review of the literature on the efficacy of budesonide versus a six-food elimination diet in the histological remission of eosinophilic esophagitis. METHODS: A search was conducted in PubMed and World of Science (WoS) for clinical trials evaluating the efficacy of budesonide and diet, considering histological remission as an infiltrate of less than 15 eosinophils per field. The risk of bias in the studies was assessed using the Cochrane Risk of Bias Tool. RESULTS: Seven articles were obtained after applying inclusion and exclusion criteria. The sample size was 417 patients, 146 of whom were treated with topical budesonide and 196 with a six-food elimination diet. Among patients treated with topical budesonide, histological remission was 74.7% compared to 65.8% in patients treated with the six-food elimination diet. CONCLUSION: Topical budesonide appears to be slightly more effective than the six-food elimination diet in terms of histological response. However, more studies comparing both treatments are needed.
Direction
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Use of emergency EEG in Hospital Clínico Universitario de Santiago.
Authorship
D.P.O.
Bachelor of Medicine
D.P.O.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Emergency video-electroencephalography (v-EEG) plays a fundamental role in the diagnosis and management of various acute neurological pathologies. In this prospective study, the use of emergency v-EEG was analyzed at Hospital Clínico Universitario de Santiago, a level three hospital. A questionnaire was designed to collect information on basic patient characteristics, requesting services, indications for the requests, obtained tracings and administration of treatments that could interfere with the study. A total of 140 v-EEG were collected between February 1st and March 31st, 2024.The services that made the most use of emergency v-EEG were ICU, Neurology and Emergencies. The most frequent indications were clinical suspicion of non convulsive status epilepticus, hypoxic-ischemic encephalopathy due to cardiopulmonary arrest, and recurrent epileptic seizures. Electroencephalographic tracings associated with each of these indications were identified, and their implication in diagnosis and prognosis was evaluated. This study aims to provide information on the clinical use of urgent v-EEG in a specific hospital setting, with the goal of improving the understanding and management of the implicated pathologies.
Emergency video-electroencephalography (v-EEG) plays a fundamental role in the diagnosis and management of various acute neurological pathologies. In this prospective study, the use of emergency v-EEG was analyzed at Hospital Clínico Universitario de Santiago, a level three hospital. A questionnaire was designed to collect information on basic patient characteristics, requesting services, indications for the requests, obtained tracings and administration of treatments that could interfere with the study. A total of 140 v-EEG were collected between February 1st and March 31st, 2024.The services that made the most use of emergency v-EEG were ICU, Neurology and Emergencies. The most frequent indications were clinical suspicion of non convulsive status epilepticus, hypoxic-ischemic encephalopathy due to cardiopulmonary arrest, and recurrent epileptic seizures. Electroencephalographic tracings associated with each of these indications were identified, and their implication in diagnosis and prognosis was evaluated. This study aims to provide information on the clinical use of urgent v-EEG in a specific hospital setting, with the goal of improving the understanding and management of the implicated pathologies.
Direction
RELOVA QUINTEIRO, JOSE LUIS (Tutorships)
Pardellas Santiago, Elva (Co-tutorships)
RELOVA QUINTEIRO, JOSE LUIS (Tutorships)
Pardellas Santiago, Elva (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Evolution of inflammatory bowel disease (IBD) and pregnancy in patients receiving advanced therapy in the IBD unit of CHUAC.
Authorship
C.P.L.
Bachelor of Medicine
C.P.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction. IBD includes chronic inflammatory conditions of the intestine of unknown cause, such as Crohn's disease (CD) and ulcerative colitis (UC). Its incidence is increasing. They are diagnosed with endoscopy and biopsy, differentiating both conditions by a set of factors. Treatment includes anti-inflammatories, immunosuppressants, and biologicals, which are used in typically stepped treatments. Women with IBD have fertility like the general population, but they may face additional risks during pregnancy. Objective. To prospectively analyze a cohort of patients with IBD and pregnancy followed at HUAC and identify possible complications of pregnancy, IBD, and in newborns. Methods. This prospective observational study focuses on the activity of the IBD unit at HUAC, using data from the DUMBO registry. Epidemiological data will be collected, a descriptive analysis of quantitative variables will be performed using Excel, and a comparative analysis using Chi-square or Fisher's Exact Test for qualitative variables. Results. 10 cases of UC and 21 of CD were collected. There were 12 cases of treatment change, mainly between the 2nd and 3rd trimester (30% relapses). 6 complications during pregnancy and another 6 complications of newborns were reported. There were fewer relapses in the group treated with immunosuppressants or biologicals compared to other therapies. No differences were observed between CD and UC. Conclusion. The results of this study are consistent with other international findings. Although IBD presents challenges during pregnancy, proper management and multidisciplinary care can lead to positive outcomes for both mother and fetus.
Introduction. IBD includes chronic inflammatory conditions of the intestine of unknown cause, such as Crohn's disease (CD) and ulcerative colitis (UC). Its incidence is increasing. They are diagnosed with endoscopy and biopsy, differentiating both conditions by a set of factors. Treatment includes anti-inflammatories, immunosuppressants, and biologicals, which are used in typically stepped treatments. Women with IBD have fertility like the general population, but they may face additional risks during pregnancy. Objective. To prospectively analyze a cohort of patients with IBD and pregnancy followed at HUAC and identify possible complications of pregnancy, IBD, and in newborns. Methods. This prospective observational study focuses on the activity of the IBD unit at HUAC, using data from the DUMBO registry. Epidemiological data will be collected, a descriptive analysis of quantitative variables will be performed using Excel, and a comparative analysis using Chi-square or Fisher's Exact Test for qualitative variables. Results. 10 cases of UC and 21 of CD were collected. There were 12 cases of treatment change, mainly between the 2nd and 3rd trimester (30% relapses). 6 complications during pregnancy and another 6 complications of newborns were reported. There were fewer relapses in the group treated with immunosuppressants or biologicals compared to other therapies. No differences were observed between CD and UC. Conclusion. The results of this study are consistent with other international findings. Although IBD presents challenges during pregnancy, proper management and multidisciplinary care can lead to positive outcomes for both mother and fetus.
Direction
DELGADO BLANCO, MANUEL BENJAMIN (Tutorships)
Diz-Lois Palomares, María Teresa (Co-tutorships)
DELGADO BLANCO, MANUEL BENJAMIN (Tutorships)
Diz-Lois Palomares, María Teresa (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Cannabinoid hyperemesis syndrome: A complication in chronic patients
Authorship
M.P.A.
Bachelor of Medicine
M.P.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Cannabinoid hyperemesis syndrome (CHS) was first reported over 20 years ago; however, it remains a poorly understood clinical entity. Studies on CHS, its pathophysiology, and treatment are still scarce. The legalization of marijuana may increase the prevalence of CHS, so a good understanding of this syndrome is important for healthcare professionals. OBJECTIVES: To describe CHS by analyzing its diagnostic criteria in depth, identifying risk factors or etiological factors associated with chronic cannabis use, contrasting the different available treatments, and finally, reflecting on their impact. METHODOLOGY: Bibliographic search of scientific articles published from 2018 to the present in databases such as PubMed, Scopus, and Web of Science, as well as the use of textbooks and available online resources. RESULTS: The Rome IV classification categorizes CHS as a functional gastroduodenal disorder characterized by episodes of stereotyped vomiting associated with abdominal pain, which can lead to complications and fatal cases. The prevalence of the syndrome is increasing. Its pathophysiology is based on the effect of THC on different receptors in the body, including cannabinoid receptor type 1, cannabinoid receptor type 2 and Transient Receptor Potential V1 receptor. Treatment for CHS consists of supportive measures for the acute phase, haloperidol, lorazepam, droperidol, and capsaicin cream. Nabilone and dronabinol may help in relapse prevention, with cannabis abstinence being the definitive method. CONCLUSIONS: It is important to emphasize the need for further research in the area of CHS, as it is key to acquiring diagnostic and early treatment skills, thereby saving resources and preventing complications and fatal cases.
INTRODUCTION: Cannabinoid hyperemesis syndrome (CHS) was first reported over 20 years ago; however, it remains a poorly understood clinical entity. Studies on CHS, its pathophysiology, and treatment are still scarce. The legalization of marijuana may increase the prevalence of CHS, so a good understanding of this syndrome is important for healthcare professionals. OBJECTIVES: To describe CHS by analyzing its diagnostic criteria in depth, identifying risk factors or etiological factors associated with chronic cannabis use, contrasting the different available treatments, and finally, reflecting on their impact. METHODOLOGY: Bibliographic search of scientific articles published from 2018 to the present in databases such as PubMed, Scopus, and Web of Science, as well as the use of textbooks and available online resources. RESULTS: The Rome IV classification categorizes CHS as a functional gastroduodenal disorder characterized by episodes of stereotyped vomiting associated with abdominal pain, which can lead to complications and fatal cases. The prevalence of the syndrome is increasing. Its pathophysiology is based on the effect of THC on different receptors in the body, including cannabinoid receptor type 1, cannabinoid receptor type 2 and Transient Receptor Potential V1 receptor. Treatment for CHS consists of supportive measures for the acute phase, haloperidol, lorazepam, droperidol, and capsaicin cream. Nabilone and dronabinol may help in relapse prevention, with cannabis abstinence being the definitive method. CONCLUSIONS: It is important to emphasize the need for further research in the area of CHS, as it is key to acquiring diagnostic and early treatment skills, thereby saving resources and preventing complications and fatal cases.
Direction
BERMEJO BARRERA, ANA MARIA (Tutorships)
BERMEJO BARRERA, ANA MARIA (Tutorships)
Amelogenesis imperfecta: presentation of cases and review of the literature.
Authorship
R.A.D.V.M.G.
Bachelor of Odontology
R.A.D.V.M.G.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Objectives: Describe the types of amelogenesis imperfecta. Identify the types of treatments used, according to scientific evidence and the degree of enamel involvement. Present evidence through the resolution of clinical cases. Material and methods: A search was performed in the PubMed, Cochrane and Lilacs databases, limiting it to human studies in English and Spanish. Discussion: Amelogenesis imperfecta (AI) is defined as a group of alterations in the structure of the enamel during its formation. It is predominantly genetic in nature, affecting both temporary and permanent dentition. The enamel may be thin, irregular with undercuts on the surface and may be discolored or pigmented. 70 genes involved in AI have been identified. Some are associated with syndromes such as: Trico-dento-osseous syndrome, Jalili syndrome and enamel-renal syndrome. There are 4 main types of IA according to their phenotype: hypoplastic, hypocalcified, hypomature or hypomature-hypoplastic with taurodontism, differentiating clinically and radiographically. The loss of enamel causes different repercussions in patients, such as sensitivity to thermal changes, tooth wear, loss of vertical dimension, greater retention of bacterial plaque, as well as psychological repercussions. For this reason, various authors propose a series of restorative treatments such as: the use of composite resins with direct and indirect techniques (composite veneers and porcelain veneers), full coverage crowns and interdisciplinary orthodontic treatments, in case of presence of malocclusions or open bites. And some authors also propose extractions and the use of implants. Conclusions: It is important to know the characteristics of the types of AI, to help determine an accurate diagnosis. Given the alternatives for restoring teeth with AI, clinicians should use an evidence-based approach.
Objectives: Describe the types of amelogenesis imperfecta. Identify the types of treatments used, according to scientific evidence and the degree of enamel involvement. Present evidence through the resolution of clinical cases. Material and methods: A search was performed in the PubMed, Cochrane and Lilacs databases, limiting it to human studies in English and Spanish. Discussion: Amelogenesis imperfecta (AI) is defined as a group of alterations in the structure of the enamel during its formation. It is predominantly genetic in nature, affecting both temporary and permanent dentition. The enamel may be thin, irregular with undercuts on the surface and may be discolored or pigmented. 70 genes involved in AI have been identified. Some are associated with syndromes such as: Trico-dento-osseous syndrome, Jalili syndrome and enamel-renal syndrome. There are 4 main types of IA according to their phenotype: hypoplastic, hypocalcified, hypomature or hypomature-hypoplastic with taurodontism, differentiating clinically and radiographically. The loss of enamel causes different repercussions in patients, such as sensitivity to thermal changes, tooth wear, loss of vertical dimension, greater retention of bacterial plaque, as well as psychological repercussions. For this reason, various authors propose a series of restorative treatments such as: the use of composite resins with direct and indirect techniques (composite veneers and porcelain veneers), full coverage crowns and interdisciplinary orthodontic treatments, in case of presence of malocclusions or open bites. And some authors also propose extractions and the use of implants. Conclusions: It is important to know the characteristics of the types of AI, to help determine an accurate diagnosis. Given the alternatives for restoring teeth with AI, clinicians should use an evidence-based approach.
Direction
ALONSO DE LA PEÑA, VICTOR (Tutorships)
ALONSO DE LA PEÑA, VICTOR (Tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
Solvents in endodontic retreatment
Authorship
A.P.O.
Bachelor of Odontology
A.P.O.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction: Endodontic retreatment is a procedure carried out when previous root canal treatment has failed to resolve the infection or associated symptoms. Solvents are chemical substances that come in liquid form; their function is the softening of the intraduct filling material. Currently, there is a variety of solvents on the market that soften the filling material, but none meets all the requirements to be the ideal solvent. Throughout history, the literature has been ambiguous about the use of solvents in this treatment. The objective of this review is to evaluate whether the use of solvents is effective in removing filling material, evaluate its safety, and its impact on dentin. Material and methods: The search was carried out in PubMed, with certain inclusion and exclusion criteria; studies had to be in English or Spanish, studies published in the last 10 years, studies dealing with the mentioned solvents and/or including the keywords, studies relevant to the objectives of the work, and studies with impact factor Q1 or Q2 in Journal Citation Reports (JCR). Results: Of the 238 articles obtained in the bibliographic searches, 27 met the initial inclusion criteria, the quality was evaluated in JCR, and only 10 articles were included in the study. Of the 10 articles, 5 of them are about effectiveness, 4 about the impact on dentin, and 1 on safety. Conclusion: The literature does not agree on the effectiveness of solvents; it varies according to different factors, such as the type of solvent, the clinical situation, the material used, the exposure time, and the characteristics of the canal.
Introduction: Endodontic retreatment is a procedure carried out when previous root canal treatment has failed to resolve the infection or associated symptoms. Solvents are chemical substances that come in liquid form; their function is the softening of the intraduct filling material. Currently, there is a variety of solvents on the market that soften the filling material, but none meets all the requirements to be the ideal solvent. Throughout history, the literature has been ambiguous about the use of solvents in this treatment. The objective of this review is to evaluate whether the use of solvents is effective in removing filling material, evaluate its safety, and its impact on dentin. Material and methods: The search was carried out in PubMed, with certain inclusion and exclusion criteria; studies had to be in English or Spanish, studies published in the last 10 years, studies dealing with the mentioned solvents and/or including the keywords, studies relevant to the objectives of the work, and studies with impact factor Q1 or Q2 in Journal Citation Reports (JCR). Results: Of the 238 articles obtained in the bibliographic searches, 27 met the initial inclusion criteria, the quality was evaluated in JCR, and only 10 articles were included in the study. Of the 10 articles, 5 of them are about effectiveness, 4 about the impact on dentin, and 1 on safety. Conclusion: The literature does not agree on the effectiveness of solvents; it varies according to different factors, such as the type of solvent, the clinical situation, the material used, the exposure time, and the characteristics of the canal.
Direction
Martín Biedma, Benjamín José (Tutorships)
Anache D' Abate, Marcos Anibal (Co-tutorships)
Martín Biedma, Benjamín José (Tutorships)
Anache D' Abate, Marcos Anibal (Co-tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
Artificial intelligence-based malocclusion diagnosis through intraoral records: A systematic review
Authorship
A.P.B.
Bachelor of Odontology
A.P.B.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction and Justification: Artificial Intelligence has undergone significant development in recent years, which has extended to orthodontics, enabling automatic analysis of radiographs, images or clinical data, and thus obtaining diagnostic proposals or treatment plans. Objectives: We aim to assess the current capacity of Artificial Intelligence for diagnosing malocclusions using intraoral images or digital models and their potential implications in orthodontics. Methodology: A systematic review will be conducted following PRISMA 2020 criteria. The search for articles will be carried out in the PubMed, Embase and Web of Science databases, focusing on those utilizing Artificial Intelligence as a tool for diagnosing malocclusions in photographs or intraoral scans. Results: Six studies were analyzed in which Artificial Intelligence was applied for the analysis of arch shape and size, as well as the diagnosis of Angle’s molar class and other conditions such as crowding, crossbite, open bite, overjet or overbite. Conclusions: It is possible to automatically detect malocclusions from both digital models and intraoral photographs quickly and reproducibly. However, the analyzed studies show high heterogeneity and a reduced dataset.
Introduction and Justification: Artificial Intelligence has undergone significant development in recent years, which has extended to orthodontics, enabling automatic analysis of radiographs, images or clinical data, and thus obtaining diagnostic proposals or treatment plans. Objectives: We aim to assess the current capacity of Artificial Intelligence for diagnosing malocclusions using intraoral images or digital models and their potential implications in orthodontics. Methodology: A systematic review will be conducted following PRISMA 2020 criteria. The search for articles will be carried out in the PubMed, Embase and Web of Science databases, focusing on those utilizing Artificial Intelligence as a tool for diagnosing malocclusions in photographs or intraoral scans. Results: Six studies were analyzed in which Artificial Intelligence was applied for the analysis of arch shape and size, as well as the diagnosis of Angle’s molar class and other conditions such as crowding, crossbite, open bite, overjet or overbite. Conclusions: It is possible to automatically detect malocclusions from both digital models and intraoral photographs quickly and reproducibly. However, the analyzed studies show high heterogeneity and a reduced dataset.
Direction
SEOANE ROMERO, JUAN MANUEL (Tutorships)
SEOANE ROMERO, JUAN MANUEL (Tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
Cross-sectional study of the use of bioceramic materials in endodontic treatments by dentists practicing in Galicia.
Authorship
I.V.M.
Bachelor of Odontology
I.V.M.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction: This study examines the use of bioceramic materials in endodontic treatments by dentists practicing in Galicia. The preference for these materials in various endodontic treatments was analyzed, as well as the relationship between their use and sociodemographic factors, professional training, and available clinical equipment. Objectives: Evaluate the prevalence of the use of bioceramic materials in endodontics, analyze the relationship between training and the use of these materials, investigate the influence of clinical equipment on material choice, and identify possible demographic differences in the use of bioceramics. Material and Methods: A survey was conducted with 280 registered dentists in Galicia. The survey covered sociodemographic aspects, types of treatments performed, preferred materials, specific training, and available clinical equipment. Results: Of the respondents, 48.2% are general dentists and 24.3% are endodontists. A total of 43.2% prefer bioceramic materials for direct pulp capping in permanent teeth. For apexification, 38.9% opt for bioceramics. 57.7% use bioceramics in cases of dental trauma with pulp exposure. 73.6% prefer bioceramics for sealing internal root perforations. 50.7% use them in retrograde filling after endodontic surgery. However, 54.3% have not received specific training on bioceramics. Additionally, 32.5% of clinics lack CBCT or a microscope. Conclusions: Bioceramic materials are widely preferred in various endodontic treatments. The lack of specific training and technological updates in some clinics limits their use. Continued education and greater investment in advanced equipment are recommended to optimize endodontic treatments in Galicia.
Introduction: This study examines the use of bioceramic materials in endodontic treatments by dentists practicing in Galicia. The preference for these materials in various endodontic treatments was analyzed, as well as the relationship between their use and sociodemographic factors, professional training, and available clinical equipment. Objectives: Evaluate the prevalence of the use of bioceramic materials in endodontics, analyze the relationship between training and the use of these materials, investigate the influence of clinical equipment on material choice, and identify possible demographic differences in the use of bioceramics. Material and Methods: A survey was conducted with 280 registered dentists in Galicia. The survey covered sociodemographic aspects, types of treatments performed, preferred materials, specific training, and available clinical equipment. Results: Of the respondents, 48.2% are general dentists and 24.3% are endodontists. A total of 43.2% prefer bioceramic materials for direct pulp capping in permanent teeth. For apexification, 38.9% opt for bioceramics. 57.7% use bioceramics in cases of dental trauma with pulp exposure. 73.6% prefer bioceramics for sealing internal root perforations. 50.7% use them in retrograde filling after endodontic surgery. However, 54.3% have not received specific training on bioceramics. Additionally, 32.5% of clinics lack CBCT or a microscope. Conclusions: Bioceramic materials are widely preferred in various endodontic treatments. The lack of specific training and technological updates in some clinics limits their use. Continued education and greater investment in advanced equipment are recommended to optimize endodontic treatments in Galicia.
Direction
GARCIA VARELA, SANDRA (Tutorships)
Méndez Díaz, Ramón (Co-tutorships)
GARCIA VARELA, SANDRA (Tutorships)
Méndez Díaz, Ramón (Co-tutorships)
Court
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
CASTRO PEREZ, MARIA DE LOS ANGELES (Chairman)
BORRAJO GARCIA, MARIA ISABEL (Secretary)
OUTUMURO RIAL, MERCEDES (Member)
Oral health and professional sport. A bibliographic review.
Authorship
A.F.C.
Bachelor of Odontology
A.F.C.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
INTRODUCTION The importance of oral health has been recognised by the World Health Organisation, which has established it as one of the key indicators of well-being and quality of life. In the context of sport, a high prevalence of diseases such as dental caries, trauma, dental erosion and periodontal disease has been observed due to risk factors present in the lives of professional athletes. OBJECTIVES (I) Analysis of oral pathology in professional athletes, focusing on the impact of oral health status on the athletic performance of elite athletes. (II) To analyse the prevalence of oral pathology in relation to the general population. (III) To analyse the risk factors for oral health in professional athletes. MATERIAL AND METHODS A literature search was conducted in the PUBMED and SCOPUS databases. The keywords used were oral health, elite athlete, sport, performance, limiting the search to articles published in the last 10 years. RESULTS A total of 670 publications were found, from which 15 studies were selected according to the PRISMA guidelines and the registered inclusion and exclusion criteria. Most of the studies were conducted in Europe (12/15). Athletics (53.3%), football (20%) and aquatic sports (20%) were the most common disciplines of athletes in the studies. Dental erosion and trauma are more common pathologies than in the general population. The studies show no differences in the prevalence of caries and periodontal disease. CONCLUSIONS This study suggests that dental erosion and oral trauma have been identified as the pathologies with the greatest impact in professional athletes compared to the general population. The sport environment, oral hygiene habits and oral health knowledge are factors associated with the oral health status of elite athletes.
INTRODUCTION The importance of oral health has been recognised by the World Health Organisation, which has established it as one of the key indicators of well-being and quality of life. In the context of sport, a high prevalence of diseases such as dental caries, trauma, dental erosion and periodontal disease has been observed due to risk factors present in the lives of professional athletes. OBJECTIVES (I) Analysis of oral pathology in professional athletes, focusing on the impact of oral health status on the athletic performance of elite athletes. (II) To analyse the prevalence of oral pathology in relation to the general population. (III) To analyse the risk factors for oral health in professional athletes. MATERIAL AND METHODS A literature search was conducted in the PUBMED and SCOPUS databases. The keywords used were oral health, elite athlete, sport, performance, limiting the search to articles published in the last 10 years. RESULTS A total of 670 publications were found, from which 15 studies were selected according to the PRISMA guidelines and the registered inclusion and exclusion criteria. Most of the studies were conducted in Europe (12/15). Athletics (53.3%), football (20%) and aquatic sports (20%) were the most common disciplines of athletes in the studies. Dental erosion and trauma are more common pathologies than in the general population. The studies show no differences in the prevalence of caries and periodontal disease. CONCLUSIONS This study suggests that dental erosion and oral trauma have been identified as the pathologies with the greatest impact in professional athletes compared to the general population. The sport environment, oral hygiene habits and oral health knowledge are factors associated with the oral health status of elite athletes.
Direction
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Tutorships)
FERNANDEZ RIVEIRO, PAULA (Co-tutorships)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Tutorships)
FERNANDEZ RIVEIRO, PAULA (Co-tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Geometric relationships among the ANB angle of C Steiner, the Wits Appraisal of Jacobson and the horizontal reference planes (Frankfurt, Natural Head Position and FOP)
Authorship
A.R.A.
Bachelor of Odontology
A.R.A.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction: Cephalometric analysis is an essential tool in modern orthodontics. The study of different cephalometric points allows obtaining diagnostic, evolutionary and preventive information. In the daily practice of these studies, the Wits Appraisal of Jacobson is compared with the ANB angle to determine maxillo-mandibular discrepancies. It was recognized that variations in the inclination of the functional occlusal plane (FOP) induce changes in Wits values. Objectives: To establish the relationship between the angle of the FOP and the Wits Appraisal. To analyze the correlation between Wits and the ANB angle, to measure SNA and SNB and to know the incisors position. Material and methods: Descriptive-analytical study of a random sample of 32 teleradiographs studied using Steiner´s cephalometric analysis with the assistance of the Nemoceph program. A trigonometric equation was generated correlating the FOP and Wits assuming a right triangle. Results: According to the Pearson coefficient between the angle of the occlusal plane and Wits, there is a slight-moderate relationship. The formula that describes the linear relationship between them is Wits = 33,18 x cos (occlusal plane angle) - 28,263. A linear regression analysis determined that the reliability of the data is low. Using the same coefficient, it was determined that the relationship between ANB and Wits is moderate-high (0,563). Based on the SNA and SNB angles, it is known that the skeletal bases are in biretrusion, maxillary protrusion or mandibular retrusion. Angles II and IS show in most cases protruded lower incisors, retruded or protruded upper incisors and a minority with both linguoversioned. Although it did not affect the interincisal angle in 40,62% of cases, most of cases present values associated with protrusion (43,76%). Conclusions: As Wits increases, the occlusal plane angle decreases. Further research is needed to establish a concrete relationship. The need to compare Wits with ANB is reaffirmed. Malocclusions present typical characteristics of Class 2 subdivisons.
Introduction: Cephalometric analysis is an essential tool in modern orthodontics. The study of different cephalometric points allows obtaining diagnostic, evolutionary and preventive information. In the daily practice of these studies, the Wits Appraisal of Jacobson is compared with the ANB angle to determine maxillo-mandibular discrepancies. It was recognized that variations in the inclination of the functional occlusal plane (FOP) induce changes in Wits values. Objectives: To establish the relationship between the angle of the FOP and the Wits Appraisal. To analyze the correlation between Wits and the ANB angle, to measure SNA and SNB and to know the incisors position. Material and methods: Descriptive-analytical study of a random sample of 32 teleradiographs studied using Steiner´s cephalometric analysis with the assistance of the Nemoceph program. A trigonometric equation was generated correlating the FOP and Wits assuming a right triangle. Results: According to the Pearson coefficient between the angle of the occlusal plane and Wits, there is a slight-moderate relationship. The formula that describes the linear relationship between them is Wits = 33,18 x cos (occlusal plane angle) - 28,263. A linear regression analysis determined that the reliability of the data is low. Using the same coefficient, it was determined that the relationship between ANB and Wits is moderate-high (0,563). Based on the SNA and SNB angles, it is known that the skeletal bases are in biretrusion, maxillary protrusion or mandibular retrusion. Angles II and IS show in most cases protruded lower incisors, retruded or protruded upper incisors and a minority with both linguoversioned. Although it did not affect the interincisal angle in 40,62% of cases, most of cases present values associated with protrusion (43,76%). Conclusions: As Wits increases, the occlusal plane angle decreases. Further research is needed to establish a concrete relationship. The need to compare Wits with ANB is reaffirmed. Malocclusions present typical characteristics of Class 2 subdivisons.
Direction
Suárez Quintanilla, David (Tutorships)
Suárez Quintanilla, David (Tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Study of circulating free DNA as a biomarker in recurrent and/or metastatic head and neck cancer.
Authorship
P.R.M.
Bachelor of Odontology
P.R.M.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Objectives: i) To evaluate the concentration of circulating free DNA (cfDNA) as a biomarker in patients with recurrent and/or metastatic head and neck cancer (HNC). ii) To evaluate the kinetics of cfDNA in patients with recurrent and/or metastatic HNC in the evolution of the disease. Material and method: Plasma cfDNA was isolated from a total of 11 patients with recurrent and/or metastatic HNC and 10 healthy controls with the QIAamp Circulating Nucleic Acid Kit (Qiagen). Total cfDNA concentration was quantified by fluorometry using the Qubit dsDNA Assay Kit (Thermo Fisher Scientific) and the Qubit 4 Fluorometer (Thermo Fisher Scientific). Descriptive and statistical data analyses were performed to evaluate differences between groups. Results/Discussion: Higher levels were observed in patients with recurrent and/or metastatic HNC compared to healthy individuals, although the differences were not statistically significant. Analysis of plasma cfDNA kinetics revealed an increase in plasma levels from basal diagnosis to the time of disease progression in those patients who progressed with metastatic disease in distant organs, while in patients who progressed at locoregional, this increase was not observed. Furthermore, in patients who received immunotherapy combined with chemotherapy, a decrease in cfDNA levels was observed between the basal sample and the progression of the disease. However, these differences were not significant. Conclusion: Our preliminary results show a modest potential of plasma cfDNA concentration as a biomarker in recurrent and/or metastatic HNC. Along these lines, it is necessary to carry out studies with wider and multicenter cohorts that allow us to better define the potential clinical usefulness of this biomarker in recurrent/metastatic HNC.
Objectives: i) To evaluate the concentration of circulating free DNA (cfDNA) as a biomarker in patients with recurrent and/or metastatic head and neck cancer (HNC). ii) To evaluate the kinetics of cfDNA in patients with recurrent and/or metastatic HNC in the evolution of the disease. Material and method: Plasma cfDNA was isolated from a total of 11 patients with recurrent and/or metastatic HNC and 10 healthy controls with the QIAamp Circulating Nucleic Acid Kit (Qiagen). Total cfDNA concentration was quantified by fluorometry using the Qubit dsDNA Assay Kit (Thermo Fisher Scientific) and the Qubit 4 Fluorometer (Thermo Fisher Scientific). Descriptive and statistical data analyses were performed to evaluate differences between groups. Results/Discussion: Higher levels were observed in patients with recurrent and/or metastatic HNC compared to healthy individuals, although the differences were not statistically significant. Analysis of plasma cfDNA kinetics revealed an increase in plasma levels from basal diagnosis to the time of disease progression in those patients who progressed with metastatic disease in distant organs, while in patients who progressed at locoregional, this increase was not observed. Furthermore, in patients who received immunotherapy combined with chemotherapy, a decrease in cfDNA levels was observed between the basal sample and the progression of the disease. However, these differences were not significant. Conclusion: Our preliminary results show a modest potential of plasma cfDNA concentration as a biomarker in recurrent and/or metastatic HNC. Along these lines, it is necessary to carry out studies with wider and multicenter cohorts that allow us to better define the potential clinical usefulness of this biomarker in recurrent/metastatic HNC.
Direction
SUAREZ CUNQUEIRO, MARIA MERCEDES (Tutorships)
Rapado González, Óscar (Co-tutorships)
Rodríguez Ces, Ana María (Co-tutorships)
SUAREZ CUNQUEIRO, MARIA MERCEDES (Tutorships)
Rapado González, Óscar (Co-tutorships)
Rodríguez Ces, Ana María (Co-tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Glaucoma and risk of retinal vein oclussion
Authorship
J.M.G.
Bachelor of Medicine
J.M.G.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Retinal vein occlusion is one of the most common retinal vascular pathologies and implies a significant risk of irreversible vision loss. Glaucoma is a chronic optic neuropathy in which a progressive deterioration of vision occurs, which in advanced cases can lead to blindness. Although retinal vein occlusions are mainly associated with systemic risk factors, such as HTN, patients with glaucoma appear to be at greater risk. Objective: To evaluate the available scientific evidence on the association between glaucoma and retinal vein occlusion. Material and methods: A systematic review of the literature was carried out following the PRISMA recommendations, which included studies that evaluated glaucoma and ocular hypertension as risk factors for retinal vein occlusion. An electronic search was carried out for articles published between 2000 and 2023, in PubMed, EMBASE, LILACs and Cochrane library. Results: After the bibliographic search, 21 articles were included: 9 case-control studies, 5 cohorts, 6 cross-sectional, and one a randomized clinical trial. In cohort studies, the frequency of RVO in patients with glaucoma was 3 times higher than the one found in patients without glaucoma. In case-control studies, the prevalence of glaucoma in patients with RVO ranged from 4.1% to 29%. In cross-sectional studies, the frequency of glaucoma in patients with RVO ranged from 9% to 15.6%. Conclusions: Chronic glaucoma is a factor associated with an increased risk of RVO, especially in patients with CRVO and HRVO. The most common types of glaucoma associated with RVO are POAG, PACG and NTG.
Retinal vein occlusion is one of the most common retinal vascular pathologies and implies a significant risk of irreversible vision loss. Glaucoma is a chronic optic neuropathy in which a progressive deterioration of vision occurs, which in advanced cases can lead to blindness. Although retinal vein occlusions are mainly associated with systemic risk factors, such as HTN, patients with glaucoma appear to be at greater risk. Objective: To evaluate the available scientific evidence on the association between glaucoma and retinal vein occlusion. Material and methods: A systematic review of the literature was carried out following the PRISMA recommendations, which included studies that evaluated glaucoma and ocular hypertension as risk factors for retinal vein occlusion. An electronic search was carried out for articles published between 2000 and 2023, in PubMed, EMBASE, LILACs and Cochrane library. Results: After the bibliographic search, 21 articles were included: 9 case-control studies, 5 cohorts, 6 cross-sectional, and one a randomized clinical trial. In cohort studies, the frequency of RVO in patients with glaucoma was 3 times higher than the one found in patients without glaucoma. In case-control studies, the prevalence of glaucoma in patients with RVO ranged from 4.1% to 29%. In cross-sectional studies, the frequency of glaucoma in patients with RVO ranged from 9% to 15.6%. Conclusions: Chronic glaucoma is a factor associated with an increased risk of RVO, especially in patients with CRVO and HRVO. The most common types of glaucoma associated with RVO are POAG, PACG and NTG.
Direction
RODRIGUEZ CID, Mª JOSEFA (Tutorships)
López Valladares, María Jesús (Co-tutorships)
RODRIGUEZ CID, Mª JOSEFA (Tutorships)
López Valladares, María Jesús (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Hashimoto’s Thyroiditis as a risk factor for thyroid cancer: a systematic review
Authorship
A.M.L.
Bachelor of Medicine
A.M.L.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Background: The prevalence of thyroid cancer (TC) and Hashimoto's thyroiditis (HT) has increased significantly over the past few decades. The association between these two entities has been a subject of research and debate since it was first proposed in 1955. Objective: This review aims to synthesize the current evidence on the link between Hashimoto's thyroiditis and thyroid cancer. Methods: A systematic search was conducted using the MEDLINE/PubMed database, limited to articles published in English or Spanish between January 1, 2014, and December 31, 2023. Results: After an exhaustive analysis, 12 articles were included in this review. Despite the discrepancies among them, a consistent association was identified between the presence of Hashimoto's thyroiditis and specific demographic and tumoral characteristics of thyroid cancer, including female predominance, multifocality, and extrathyroidal extension. Elevated levels of thyroid antibodies (TPOAb and TgAb) were associated with poorer clinical and prognostic features of the papillary subtype. Conclusions: A potential protective effect of HT against lymph node and distant metastasis in patients with papillary thyroid carcinoma was highlighted. However, the lack of consensus among the studies underscores the need for additional prospective and multicenter research to clarify these findings and their impact on clinical practice, management, and prognosis of patients.
Background: The prevalence of thyroid cancer (TC) and Hashimoto's thyroiditis (HT) has increased significantly over the past few decades. The association between these two entities has been a subject of research and debate since it was first proposed in 1955. Objective: This review aims to synthesize the current evidence on the link between Hashimoto's thyroiditis and thyroid cancer. Methods: A systematic search was conducted using the MEDLINE/PubMed database, limited to articles published in English or Spanish between January 1, 2014, and December 31, 2023. Results: After an exhaustive analysis, 12 articles were included in this review. Despite the discrepancies among them, a consistent association was identified between the presence of Hashimoto's thyroiditis and specific demographic and tumoral characteristics of thyroid cancer, including female predominance, multifocality, and extrathyroidal extension. Elevated levels of thyroid antibodies (TPOAb and TgAb) were associated with poorer clinical and prognostic features of the papillary subtype. Conclusions: A potential protective effect of HT against lymph node and distant metastasis in patients with papillary thyroid carcinoma was highlighted. However, the lack of consensus among the studies underscores the need for additional prospective and multicenter research to clarify these findings and their impact on clinical practice, management, and prognosis of patients.
Direction
Mosquera Nogueira, Jacinto José (Tutorships)
Penín Álvarez, Manuel Avelino (Co-tutorships)
Mosquera Nogueira, Jacinto José (Tutorships)
Penín Álvarez, Manuel Avelino (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
How can hiv infection influence the control of pregnancy and the time of delivery?
Authorship
J.M.F.
Bachelor of Medicine
J.M.F.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction Human immunodeficiency virus (HIV) infection first emerged in the 1980s. Since then the introduction of antiretroviral therapy (ART) has exponentially improved the lives of people living with HIV, including pregnant women. Although maternal health has improved, ART is associated with adverse perinatal outcomes. Pregnancy follow-up and monitoring are necessary up to the time of delivery to ensure maternal health and prevent vertical transmission (VT). Objectives To review the latest available evidence on how HIV infection may influence gestation and delivery, follow-up and possible gestational complications, as well as intrapartum prophylaxis. Methodology Systematic review of the most current scientific literature available on the influence of HIV on gestational control and the timing of delivery, using the World of Science (WOS) search engine and the Medline database through the PUBMED search engine. Inclusion criteria selected were: systematic review (SR) and meta-analysis (MA), conducted in humans, available in English and Spanish, published between 2023 and 2024. Results Of 35.158 studies from the initial search and 170 that met the inclusion criteria, 8 were analysed comprehensively. The results support the World Health Organization (WHO) guidelines recommending immediate ART initiation in all pregnant women. Although the relationship between ART and time to ART initiation and adverse perinatal outcomes was systematically recorded, the benefits of therapy outweigh the risks. Conclusions Multidisciplinary monitoring of women living with HIV is necessary from conception to delivery. Monitoring of lymphocyte and viral load levels should be done throughout pregnancy to support the selection of the best antiretroviral therapy and to decide on the mode of delivery. Newer ART is the best tolerated and most effective, and the risk of adverse perinatal outcomes is lower. More studies are needed on ART and pregnancy and its impact on the health, including mental health, of the pregnant woman.
Introduction Human immunodeficiency virus (HIV) infection first emerged in the 1980s. Since then the introduction of antiretroviral therapy (ART) has exponentially improved the lives of people living with HIV, including pregnant women. Although maternal health has improved, ART is associated with adverse perinatal outcomes. Pregnancy follow-up and monitoring are necessary up to the time of delivery to ensure maternal health and prevent vertical transmission (VT). Objectives To review the latest available evidence on how HIV infection may influence gestation and delivery, follow-up and possible gestational complications, as well as intrapartum prophylaxis. Methodology Systematic review of the most current scientific literature available on the influence of HIV on gestational control and the timing of delivery, using the World of Science (WOS) search engine and the Medline database through the PUBMED search engine. Inclusion criteria selected were: systematic review (SR) and meta-analysis (MA), conducted in humans, available in English and Spanish, published between 2023 and 2024. Results Of 35.158 studies from the initial search and 170 that met the inclusion criteria, 8 were analysed comprehensively. The results support the World Health Organization (WHO) guidelines recommending immediate ART initiation in all pregnant women. Although the relationship between ART and time to ART initiation and adverse perinatal outcomes was systematically recorded, the benefits of therapy outweigh the risks. Conclusions Multidisciplinary monitoring of women living with HIV is necessary from conception to delivery. Monitoring of lymphocyte and viral load levels should be done throughout pregnancy to support the selection of the best antiretroviral therapy and to decide on the mode of delivery. Newer ART is the best tolerated and most effective, and the risk of adverse perinatal outcomes is lower. More studies are needed on ART and pregnancy and its impact on the health, including mental health, of the pregnant woman.
Direction
MORANO AMADO, LUIS ENRIQUE (Tutorships)
González Rodríguez, Laura (Co-tutorships)
Marín Ortiz, Elena (Co-tutorships)
MORANO AMADO, LUIS ENRIQUE (Tutorships)
González Rodríguez, Laura (Co-tutorships)
Marín Ortiz, Elena (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
Castleman’s Disease, TAFRO variant, in paediatric age: clinical case and review
Authorship
M.I.M.P.D.C.
Bachelor of Medicine
M.I.M.P.D.C.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Castleman's disease (CD) is a rare non-clonal systemic lymphoproliferative disorder. Within the spectrum of this pathology lies one of its variants, TAFRO, an acronym for thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly. It is a severe subtype of idiopathic multicentric Castleman disease (iMCD-TAFRO), and although it is mostly described in adult patients, exceptionally it has been reported in paediatric age. Therefore, evidence regarding the applicability of diagnostic and therapeutic methods is lacking in this group. Objective and Methods: Following a clinical case of a male who debuted at the age of 12 with TAFRO syndrome, we proceed to review similar cases following PRISMA guidelines, and explore the utility of the anti-IL-6 monoclonal antibody, siltuximab, in the paediatric context, as it is currently the only approved drug for the treatment of Castleman's disease in patients over 18 years of age. Results: We delved into a total of 16 articles, from which, along with the present study's case, a sample of 20 patients aged between 0.92 and 17 years was obtained. All received a diagnosis of one of the forms of TAFRO syndrome. Siltuximab was used in 30% (6/20) of the cases, showing favorable responses without any short- or medium-term adverse effects. Among the responding patients, an increase in IL-6 and CRP was observed in 60% (3/5) and anemia in 80% (4/5) before treatment. Conclusions: Besides a favorable response to the use of siltuximab and an acceptable safety profile, some clinical and histopathological characteristics overlapping with those of adult patient cohorts were found. Controlled studies involving a larger number of patients and longer follow-up periods are needed to confirm these findings.
Introduction: Castleman's disease (CD) is a rare non-clonal systemic lymphoproliferative disorder. Within the spectrum of this pathology lies one of its variants, TAFRO, an acronym for thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly. It is a severe subtype of idiopathic multicentric Castleman disease (iMCD-TAFRO), and although it is mostly described in adult patients, exceptionally it has been reported in paediatric age. Therefore, evidence regarding the applicability of diagnostic and therapeutic methods is lacking in this group. Objective and Methods: Following a clinical case of a male who debuted at the age of 12 with TAFRO syndrome, we proceed to review similar cases following PRISMA guidelines, and explore the utility of the anti-IL-6 monoclonal antibody, siltuximab, in the paediatric context, as it is currently the only approved drug for the treatment of Castleman's disease in patients over 18 years of age. Results: We delved into a total of 16 articles, from which, along with the present study's case, a sample of 20 patients aged between 0.92 and 17 years was obtained. All received a diagnosis of one of the forms of TAFRO syndrome. Siltuximab was used in 30% (6/20) of the cases, showing favorable responses without any short- or medium-term adverse effects. Among the responding patients, an increase in IL-6 and CRP was observed in 60% (3/5) and anemia in 80% (4/5) before treatment. Conclusions: Besides a favorable response to the use of siltuximab and an acceptable safety profile, some clinical and histopathological characteristics overlapping with those of adult patient cohorts were found. Controlled studies involving a larger number of patients and longer follow-up periods are needed to confirm these findings.
Direction
FERNANDEZ MARTIN, JORGE JULIAN (Tutorships)
FERNANDEZ MARTIN, JORGE JULIAN (Tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
Systematic review of the genetic factors in the etiology of autism spectrum disorders
Authorship
N.M.B.
Bachelor of Medicine
N.M.B.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction Autism spectrum disorders (ASD) comprehend a series of neurodevelopment disorders which are known for social interaction deficit, restrictive interests and repetitive behaviors. ASD is a disorder with complex etiology, in which environment, genetics and epigenetics all play a relevant part. Although, it is known that genetics influence ASD, it is yet to be known the specific genetic mechanisms that take place nor the weight of them in the development of mentioned disorders. Objectives Identify and evaluate the genetic variations and specific genes implicated in the development of ASD and determine how these genetic variations contribute to the risk of the disorder. Material and methods: A systematic review of the evidence available in PubMed has been carried out, using as a search strategy combination of keywords with Boolean operators, MeSH terms and establishing that the keywords appear either in the title or in the abstract. For the selection, the inclusion and exclusion criteria were applied, as well as full text reading and screening to end up with 14 articles. Outcomes: Research on ASD reveals a multifactorial etiology including genetic, environmental and epigenetic factors. Estimated heritability ranges from 45-91%, with high concordance rates in monozygotic twins. Common and rare genetic variants such as SNVs and CNVs contribute significantly to ASD risk, but many underlying mechanisms remain unknown. Advanced genomic studies identified numerous candidate genes and loci associated with ASD, highlighting its complexity and heterogeneity. In addition, prenatal, perinatal and postnatal environmental factors play an important role. Conclusions: The etiology of ASD is multifactorial, with interrelated genetic and environmental factors. Technological advances are improving the understanding of this disorder, but more research is needed to unravel the precise mechanisms and develop effective strategies for prevention, diagnosis and treatment.
Introduction Autism spectrum disorders (ASD) comprehend a series of neurodevelopment disorders which are known for social interaction deficit, restrictive interests and repetitive behaviors. ASD is a disorder with complex etiology, in which environment, genetics and epigenetics all play a relevant part. Although, it is known that genetics influence ASD, it is yet to be known the specific genetic mechanisms that take place nor the weight of them in the development of mentioned disorders. Objectives Identify and evaluate the genetic variations and specific genes implicated in the development of ASD and determine how these genetic variations contribute to the risk of the disorder. Material and methods: A systematic review of the evidence available in PubMed has been carried out, using as a search strategy combination of keywords with Boolean operators, MeSH terms and establishing that the keywords appear either in the title or in the abstract. For the selection, the inclusion and exclusion criteria were applied, as well as full text reading and screening to end up with 14 articles. Outcomes: Research on ASD reveals a multifactorial etiology including genetic, environmental and epigenetic factors. Estimated heritability ranges from 45-91%, with high concordance rates in monozygotic twins. Common and rare genetic variants such as SNVs and CNVs contribute significantly to ASD risk, but many underlying mechanisms remain unknown. Advanced genomic studies identified numerous candidate genes and loci associated with ASD, highlighting its complexity and heterogeneity. In addition, prenatal, perinatal and postnatal environmental factors play an important role. Conclusions: The etiology of ASD is multifactorial, with interrelated genetic and environmental factors. Technological advances are improving the understanding of this disorder, but more research is needed to unravel the precise mechanisms and develop effective strategies for prevention, diagnosis and treatment.
Direction
GOMEZ LADO, MARIA DEL CARMEN (Tutorships)
GOMEZ LADO, MARIA DEL CARMEN (Tutorships)
Post-cataract surgery endophthalmitis at University Hospital Complex of Santiago de Compostela: analysis of the results after 20 years
Authorship
A.N.A.
Bachelor of Medicine
A.N.A.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction and objectives: post-cataract surgery endophthalmitis is a serious complication that can result in loss of vision or the eyeball and whose etiology is of infectious origin. Its incidence, although low, continues to be a concern in ophthalmology. The objective of this study was to examine the incidence of endophthalmitis after cataract surgery in the Ophthalmology Service of Santiago de Compostela in the last two decades, identifying the causal agents and the effectiveness of the treatments. Material and methods: a sample of 49 patients who developed endophthalmitis after cataract surgery (36 simple surgery and 13 combined surgery) were examined at the Ophthalmology Service of Santiago de Compostela between 2005 and 2023. Demographic and clinical data of the patients were collected and risk factors, diagnosis and treatment were examined, as well as microbiological cultures and visual results obtained. Results: in the sanitary district of Santiago de Compostela over two decades, a decreasing incidence of 0.0558% of postsurgical endophthalmitis was found, being more common in simple surgery. Diabetes mellitus, abusive consumption of alcohol and/or tobacco and immunosuppression were found as risk factors. The germ most frequently involved was Serratia marcescens and Staphylococcus aureus in acute forms and Candida parapsilosis in chronic cases. The majority were treated with intravitreal antibiotics such as vancomycin-ceftazidime, although more than half required vitrectomy after intravitreal injections. Visual outcomes were markedly better post-treatment and were significantly influenced by initial visual acuity and the specific type of microorganism involved. Conclusion: post-cataract surgery endophthalmitis is a serious complication, although rare in our environment. Its development is influenced by the surgical technique, comorbidities and toxic habits. The final visual prognosis depends on the causative microorganism and the early administration of intravitreal antibiotics.
Introduction and objectives: post-cataract surgery endophthalmitis is a serious complication that can result in loss of vision or the eyeball and whose etiology is of infectious origin. Its incidence, although low, continues to be a concern in ophthalmology. The objective of this study was to examine the incidence of endophthalmitis after cataract surgery in the Ophthalmology Service of Santiago de Compostela in the last two decades, identifying the causal agents and the effectiveness of the treatments. Material and methods: a sample of 49 patients who developed endophthalmitis after cataract surgery (36 simple surgery and 13 combined surgery) were examined at the Ophthalmology Service of Santiago de Compostela between 2005 and 2023. Demographic and clinical data of the patients were collected and risk factors, diagnosis and treatment were examined, as well as microbiological cultures and visual results obtained. Results: in the sanitary district of Santiago de Compostela over two decades, a decreasing incidence of 0.0558% of postsurgical endophthalmitis was found, being more common in simple surgery. Diabetes mellitus, abusive consumption of alcohol and/or tobacco and immunosuppression were found as risk factors. The germ most frequently involved was Serratia marcescens and Staphylococcus aureus in acute forms and Candida parapsilosis in chronic cases. The majority were treated with intravitreal antibiotics such as vancomycin-ceftazidime, although more than half required vitrectomy after intravitreal injections. Visual outcomes were markedly better post-treatment and were significantly influenced by initial visual acuity and the specific type of microorganism involved. Conclusion: post-cataract surgery endophthalmitis is a serious complication, although rare in our environment. Its development is influenced by the surgical technique, comorbidities and toxic habits. The final visual prognosis depends on the causative microorganism and the early administration of intravitreal antibiotics.
Direction
Touriño Peralba, María del Rosario (Tutorships)
BANDE RODRIGUEZ, MANUEL FRANCISCO (Co-tutorships)
Touriño Peralba, María del Rosario (Tutorships)
BANDE RODRIGUEZ, MANUEL FRANCISCO (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
Use of Medicinal Cannabis in children with Autism Spectrum Disorder (ASD): Systematic Review
Authorship
A.C.O.C.
Bachelor of Medicine
A.C.O.C.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Autism Spectrum Disorder (ASD) is a neuropsychiatric condition characterized by deficits in social communication and repetitive behaviors. Despite conventional treatments, many children with ASD do not achieve adequate symptom control. Medical cannabis, particularly cannabidiol (CBD), has emerged as a potential option to relieve ASD symptoms. Materials and Methods: This study is a systematic review on the efficacy and safety of medical cannabis in children with ASD. An exhaustive search was conducted in databases (Medline via PubMed, Embase, Cochrane and Scopus), selecting studies that evaluated the use of medical cannabis in patients with ASD under 16 years old. Clinical trials and observational studies (series, studies and case reports) were included. Results: Twelve relevant studies involving a total of 695 participants were selected. Most studies used cannabis preparations with a CBD:THC ratio of 20:1. The results showed significant improvements in social skills, concentration and sleep quality. Some studies also observed improvements in anxiety, hyperactivity, anger episodes and seizures. The side effects were generally mild and transient. Discussion: The findings suggest that medical cannabis, particularly CBD, may be a safe and effective therapeutic option for children with ASD. However, variability in assessment methods and the lack of more controlled studies limit the generalization of these results. Furthermore, most studies included a wide age range, highlighting the need for research focused on specific age groups. Conclusions: Medical cannabis shows potential to improve ASD symptoms in children, but more controlled and specific studies are needed to validate these findings and establish clear treatment guidelines. Long-term safety and efficacy should be prioritized in future research.
Introduction: Autism Spectrum Disorder (ASD) is a neuropsychiatric condition characterized by deficits in social communication and repetitive behaviors. Despite conventional treatments, many children with ASD do not achieve adequate symptom control. Medical cannabis, particularly cannabidiol (CBD), has emerged as a potential option to relieve ASD symptoms. Materials and Methods: This study is a systematic review on the efficacy and safety of medical cannabis in children with ASD. An exhaustive search was conducted in databases (Medline via PubMed, Embase, Cochrane and Scopus), selecting studies that evaluated the use of medical cannabis in patients with ASD under 16 years old. Clinical trials and observational studies (series, studies and case reports) were included. Results: Twelve relevant studies involving a total of 695 participants were selected. Most studies used cannabis preparations with a CBD:THC ratio of 20:1. The results showed significant improvements in social skills, concentration and sleep quality. Some studies also observed improvements in anxiety, hyperactivity, anger episodes and seizures. The side effects were generally mild and transient. Discussion: The findings suggest that medical cannabis, particularly CBD, may be a safe and effective therapeutic option for children with ASD. However, variability in assessment methods and the lack of more controlled studies limit the generalization of these results. Furthermore, most studies included a wide age range, highlighting the need for research focused on specific age groups. Conclusions: Medical cannabis shows potential to improve ASD symptoms in children, but more controlled and specific studies are needed to validate these findings and establish clear treatment guidelines. Long-term safety and efficacy should be prioritized in future research.
Direction
TABERNERO DUQUE, MARIA JESÚS (Tutorships)
TABERNERO DUQUE, MARIA JESÚS (Tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
Psoriasiform paradoxical reactions to anti-TNF drugs in inflammatory bowel diseases.
Authorship
I.C.L.
Bachelor of Medicine
I.C.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Paradoxical psoriasis is a cutaneus adverse reaction usually described in relation to tumor necrosis factor inhibitors’ prescription in different pathologies, among which are inflammatory bowel diseases. The paradoxical nature of this lesions is based on the efficacy of this pharmacological group in the treatment of psoriasis. In the present systematic review, an incidence of up to 10,7% has been observed in this kind of patients. These lesions develope with the different components of said family of drugs, more frequently during the maintenance therapy of this diseases, and with the influence of risk factors such as smoking and gender. Currently the most widely accepted pathophysiological pathway involves the increase in IFN-alpha. Regarding clinical manifestations, plaque psoriasis and palmoplantar pustulosis are the most frequently described subtypes, the latter being the most characteristic. Topical management, generally with corticosteroids, is usually enough to control the lessions, allowing to continue anti-TNF therapy. Neverthless, new lines of treatment are important in more severe cases, such as ustekinumab and vedolizumab.
Paradoxical psoriasis is a cutaneus adverse reaction usually described in relation to tumor necrosis factor inhibitors’ prescription in different pathologies, among which are inflammatory bowel diseases. The paradoxical nature of this lesions is based on the efficacy of this pharmacological group in the treatment of psoriasis. In the present systematic review, an incidence of up to 10,7% has been observed in this kind of patients. These lesions develope with the different components of said family of drugs, more frequently during the maintenance therapy of this diseases, and with the influence of risk factors such as smoking and gender. Currently the most widely accepted pathophysiological pathway involves the increase in IFN-alpha. Regarding clinical manifestations, plaque psoriasis and palmoplantar pustulosis are the most frequently described subtypes, the latter being the most characteristic. Topical management, generally with corticosteroids, is usually enough to control the lessions, allowing to continue anti-TNF therapy. Neverthless, new lines of treatment are important in more severe cases, such as ustekinumab and vedolizumab.
Direction
Anibarro García, Luís (Tutorships)
Carpio López, Daniel (Co-tutorships)
Anibarro García, Luís (Tutorships)
Carpio López, Daniel (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
New developments in photoprotection
Authorship
M.C.G.
Bachelor of Medicine
M.C.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: this Final Degree Project consists of a review of the new use of natural molecules in photoprotection. Main objective: to compile updated information about the action mechanisms of the studied natural molecules and their possible use in the development of new photoprotective agents, establishing their use in topical and oral administration. Additionally, to emphasize the importance of obtaining new sustainable and ecologic filters to substitute the chemical filters used nowadays. Material and methods: a review of the available literature was carried out through research in Medline (via Pubmed). Articles published in the last 5 years (2019-2024) that met the established section criteria were collected. Outcomes: Marine and terrestrial ecosystems are an untapped source of natural compounds with photoprotective and antioxidant properties, including polyphenols and mycosporine-like amino acids. These compounds act by neutralizing the negative effects of radiation and stimulating the skin’s endogenous defenses against sun damage, as well as being biodegradable and safe. Conclusion: All the reviewed articles affirm the potential of polyphenols and mycosporine-like amino acids to protect against UV radiation. Additional studies under real conditions are needed to confirm the properties already demonstrated in vitro and in vivo and further research is needed to characterize natural compounds and achieve well tolerated and biodegradable galenic formulas.
Introduction: this Final Degree Project consists of a review of the new use of natural molecules in photoprotection. Main objective: to compile updated information about the action mechanisms of the studied natural molecules and their possible use in the development of new photoprotective agents, establishing their use in topical and oral administration. Additionally, to emphasize the importance of obtaining new sustainable and ecologic filters to substitute the chemical filters used nowadays. Material and methods: a review of the available literature was carried out through research in Medline (via Pubmed). Articles published in the last 5 years (2019-2024) that met the established section criteria were collected. Outcomes: Marine and terrestrial ecosystems are an untapped source of natural compounds with photoprotective and antioxidant properties, including polyphenols and mycosporine-like amino acids. These compounds act by neutralizing the negative effects of radiation and stimulating the skin’s endogenous defenses against sun damage, as well as being biodegradable and safe. Conclusion: All the reviewed articles affirm the potential of polyphenols and mycosporine-like amino acids to protect against UV radiation. Additional studies under real conditions are needed to confirm the properties already demonstrated in vitro and in vivo and further research is needed to characterize natural compounds and achieve well tolerated and biodegradable galenic formulas.
Direction
PEREIRO FERREIROS, MANUEL (Tutorships)
Flórez Menéndez, María Ángeles (Co-tutorships)
PEREIRO FERREIROS, MANUEL (Tutorships)
Flórez Menéndez, María Ángeles (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
In situ clinical simulation in urgent pediatric care. Bibliographic review and assessment of professionals
Authorship
A.C.N.
Bachelor of Medicine
A.C.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Simulation has emerged as a promising tool in the training of emergency pediatric healthcare professionals, providing a controlled environment for rigorous and effective training. The initial hours of care for a critically ill child determine the prognosis of their illness, thus emphasizing the need for a systematic approach to enhance decision-making, optimize resources, and increase patient safety. In this context, medical simulation emerges as a fundamental pillar in the training of healthcare professionals. This study reviews existing literature and analyzes the results of a survey conducted among professionals from the Galician Health Service and national hospitals. Findings demonstrate the effectiveness of simulation in early recognition and management of critical situations, significantly contributing to the safety of the most vulnerable patients and ensuring high-quality care. Additionally, there is a call for the standardization of programs to ensure consistent and effective training across various clinical settings. This work advocates for the integration of simulation into medical education, highlighting its impact on the quality of care and patient safety.
Simulation has emerged as a promising tool in the training of emergency pediatric healthcare professionals, providing a controlled environment for rigorous and effective training. The initial hours of care for a critically ill child determine the prognosis of their illness, thus emphasizing the need for a systematic approach to enhance decision-making, optimize resources, and increase patient safety. In this context, medical simulation emerges as a fundamental pillar in the training of healthcare professionals. This study reviews existing literature and analyzes the results of a survey conducted among professionals from the Galician Health Service and national hospitals. Findings demonstrate the effectiveness of simulation in early recognition and management of critical situations, significantly contributing to the safety of the most vulnerable patients and ensuring high-quality care. Additionally, there is a call for the standardization of programs to ensure consistent and effective training across various clinical settings. This work advocates for the integration of simulation into medical education, highlighting its impact on the quality of care and patient safety.
Direction
Moreno Álvarez, Ana (Tutorships)
Barrueco Ramos, Clara (Co-tutorships)
Moreno Álvarez, Ana (Tutorships)
Barrueco Ramos, Clara (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Prevention and treatment of osteoporosis in postmenopausal women.
Authorship
A.C.S.
Bachelor of Medicine
A.C.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Osteoporosis (OP), a chronic disease characterized by the loss of bone mass and changes in bone microstructure, represents a public health challenge, especially for postmenopausal women. With high incidence and the risk of osteoporotic fractures, prevention becomes crucial. In this context, physical exercise emerges as a fundamental non- pharmacological strategy to prevent disease progression and preserve physical function in postmenopausal women.
Osteoporosis (OP), a chronic disease characterized by the loss of bone mass and changes in bone microstructure, represents a public health challenge, especially for postmenopausal women. With high incidence and the risk of osteoporotic fractures, prevention becomes crucial. In this context, physical exercise emerges as a fundamental non- pharmacological strategy to prevent disease progression and preserve physical function in postmenopausal women.
Direction
MARTINEZ OLMOS, MIGUEL ANGEL (Tutorships)
Villar Taibo, Rocío (Co-tutorships)
Rodríguez Carnero, María Gemma (Co-tutorships)
MARTINEZ OLMOS, MIGUEL ANGEL (Tutorships)
Villar Taibo, Rocío (Co-tutorships)
Rodríguez Carnero, María Gemma (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Effects of physical activity on survival, quality of life and physical function in women diagnosed with endometrial cancer: a systematic review.
Authorship
A.C.C.
Bachelor of Medicine
A.C.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Endometrial cancer is the most common gynecological neoplasm today. The increasing incidence of this disease, as well as its high 5-year survival rate, means that there are more and more survivors of endometrial cancer. These women usually correspond to a typical profile that tends towards obesity and a sedentary lifestyle, added to the psychological and physical impact that the diagnosis and treatment of this disease entails. Objectives: Observing this context, the objective of this systematic review was to determine whether the implementation of physical activity in women diagnosed with endometrial cancer could have beneficial effects in terms of quality of life, general health, physical function and survival. Methods: A systematic review was carried out according to PRISMA guidelines of the studies collected in PubMed and Cochrane. To do this, a search dated February 8, 2024, was performed using the following equation: Endometrial Neoplasms[Mesh] AND Exercise[Mesh]. Results: 116 studies were obtained, of which 12 were included in the systematic review after applying the exclusion and inclusion criteria and analyzing whether they fit our PICO question: one case study, 2 cohort studies and 9 randomized clinical trials. Conclusions: Physical activity after the diagnosis of endometrial cancer seems to improve the quality of life, functionality and survival of these women. More studies are needed to investigate what type of exercise and what frequency and duration of training would be the most convenient in order to make firmer and more specific recommendations to patients.
Introduction: Endometrial cancer is the most common gynecological neoplasm today. The increasing incidence of this disease, as well as its high 5-year survival rate, means that there are more and more survivors of endometrial cancer. These women usually correspond to a typical profile that tends towards obesity and a sedentary lifestyle, added to the psychological and physical impact that the diagnosis and treatment of this disease entails. Objectives: Observing this context, the objective of this systematic review was to determine whether the implementation of physical activity in women diagnosed with endometrial cancer could have beneficial effects in terms of quality of life, general health, physical function and survival. Methods: A systematic review was carried out according to PRISMA guidelines of the studies collected in PubMed and Cochrane. To do this, a search dated February 8, 2024, was performed using the following equation: Endometrial Neoplasms[Mesh] AND Exercise[Mesh]. Results: 116 studies were obtained, of which 12 were included in the systematic review after applying the exclusion and inclusion criteria and analyzing whether they fit our PICO question: one case study, 2 cohort studies and 9 randomized clinical trials. Conclusions: Physical activity after the diagnosis of endometrial cancer seems to improve the quality of life, functionality and survival of these women. More studies are needed to investigate what type of exercise and what frequency and duration of training would be the most convenient in order to make firmer and more specific recommendations to patients.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Castro Díaz, María Covadonga (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Castro Díaz, María Covadonga (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Heart failure with supranormal ejection fraction. Systematic bibliographic review
Authorship
J.C.C.
Bachelor of Medicine
J.C.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: heart failure (HF) with supranormal ejection fraction (LVEF) higher than or equal to 65 percent is a recently described entity whose clinical characteristics and prognosis appear to differ from other phenotypes of patients with HF with preserved or reduced LVEF. Objectives: a systematic literature review is proposed on the topic with the aim of characterizing the clinical profile and describing the pathological etiology and prognosis of patients with HF and supranormal LVEF (HF-snLVEF). Finally, we aim to compare the above aspects with patients with HF-pLVEF who show an LVEF between 50 and 64 percent. Material and methods: we selected the articles indexed in Pubmed that describe case series including adult patients with snLVEF either in acute HF, healthy, or with non-severe CVD from 2020 to August 2023. We excluded from the review the case series published before 2020 or that do not include a specific characterization of snLVEF. The most relevant clinical variables of the present study were analyzed through simple aggregation of the data from the analyzed studies. The results are presented in the form of Tables and Figures. Results: the literature search included 4 articles that included patients with snLVEF. Two of them included patients with acute HF and snLVEF, another study included patients with non-severe cardiovascular disease (CVD), and the last one included healthy adults from the general population. The two acute HF case series included 17,701 patients, of whom 2,098 (11.9 percent) had snLVEF. In this group, 65 percent were women and the average age was 83 years. The most prevalent cardiovascular risk factor was hypertension (HTN) (76 percent). Up to 88 percent of the deaths were of cardiovascular cause, being more frequent in women. One case series included 210 patients with non-severe CVD, among whom 38 (18.1 percent) had snLVEF. In this study, the average age of patients with snLVEF was 55 years, with no gender differences. Again, HTN was the most prevalent CV risk factor (65 percent). Patients with snLVEF had a higher risk of major adverse cardiovascular events (MACE) and a lower coronary flow reserve compared to adults with LVEF in lower ranges. The last of the analyzed studies included 6,990 healthy adults with an LVEF higher than or equal to 57 percent. In this cohort, the average age was 55 years and 55.5 percent were women. Individuals with a higher LVEF had a greater likelihood of MACE, especially when their left ventricular systolic index was reduced. Conclusions: this systematic review suggests that patients with HF and LVEF higher than or equal to 65 percent constitute a specific population with a distinct clinical profile and a worse prognosis than patients with HF and preserved LVEF (50-64 percent). These results support considering HF with snLVEF as a distinct clinical entity.
Background: heart failure (HF) with supranormal ejection fraction (LVEF) higher than or equal to 65 percent is a recently described entity whose clinical characteristics and prognosis appear to differ from other phenotypes of patients with HF with preserved or reduced LVEF. Objectives: a systematic literature review is proposed on the topic with the aim of characterizing the clinical profile and describing the pathological etiology and prognosis of patients with HF and supranormal LVEF (HF-snLVEF). Finally, we aim to compare the above aspects with patients with HF-pLVEF who show an LVEF between 50 and 64 percent. Material and methods: we selected the articles indexed in Pubmed that describe case series including adult patients with snLVEF either in acute HF, healthy, or with non-severe CVD from 2020 to August 2023. We excluded from the review the case series published before 2020 or that do not include a specific characterization of snLVEF. The most relevant clinical variables of the present study were analyzed through simple aggregation of the data from the analyzed studies. The results are presented in the form of Tables and Figures. Results: the literature search included 4 articles that included patients with snLVEF. Two of them included patients with acute HF and snLVEF, another study included patients with non-severe cardiovascular disease (CVD), and the last one included healthy adults from the general population. The two acute HF case series included 17,701 patients, of whom 2,098 (11.9 percent) had snLVEF. In this group, 65 percent were women and the average age was 83 years. The most prevalent cardiovascular risk factor was hypertension (HTN) (76 percent). Up to 88 percent of the deaths were of cardiovascular cause, being more frequent in women. One case series included 210 patients with non-severe CVD, among whom 38 (18.1 percent) had snLVEF. In this study, the average age of patients with snLVEF was 55 years, with no gender differences. Again, HTN was the most prevalent CV risk factor (65 percent). Patients with snLVEF had a higher risk of major adverse cardiovascular events (MACE) and a lower coronary flow reserve compared to adults with LVEF in lower ranges. The last of the analyzed studies included 6,990 healthy adults with an LVEF higher than or equal to 57 percent. In this cohort, the average age was 55 years and 55.5 percent were women. Individuals with a higher LVEF had a greater likelihood of MACE, especially when their left ventricular systolic index was reduced. Conclusions: this systematic review suggests that patients with HF and LVEF higher than or equal to 65 percent constitute a specific population with a distinct clinical profile and a worse prognosis than patients with HF and preserved LVEF (50-64 percent). These results support considering HF with snLVEF as a distinct clinical entity.
Direction
Barge Caballero, Eduardo (Tutorships)
Barge Caballero, Eduardo (Tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Risk of neoplasms in patients with rheumatologic indications treated with ixekizumab. Systematic review and meta-analysis.
Authorship
J.C.M.
Bachelor of Medicine
J.C.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Ixekizumab, an IL17 inhibitor monoclonal antibody, is used in the treatment of autoimmune diseases such as Psoriatic Arthritis and Axial Spondylitis. This study aims to verify the possible association between ixekizumab and tumor development, and to determine what types of tumors (solid or hematological) might arise in patients with these conditions. The objective is to improve the understanding, management and use of this drug in patients with neoplasms or at risk of developing them. Material and method: 416 articles were identified. After excluding duplicates, applying the inclusion and exclusion criteria, and performing a complete reading, 18 studies were included. Six were assigned to comparative phase (CT) and twelve focused on long-term extension studies (LTE). For each meta-analysis, publication bias was assessed using funnel plots, statistical significance using Egger's test, and heterogeneity using I2. Results: studies in CT revealed no significant difference between the use of ixekizumab and placebo (RO 1.99, 95% CI 0.26, 15.00), nor in comparison with adalimumab, an iTNF also used in the treatment of these diseases (RO 0.45, 95% CI 0.11 - 1.86). In the LTE studies, no specific variations were found either. The incidence of neoplasms was 1.24 per 100 patients/ year at week 52 (95% CI 0.51 - 2.30), and 0.79 (0.38 - 1.32) at week 156, with no significant differences in tumor types. The most frequent were non-melanoma skin cancer, followed by solid tumors and hematologic tumors. Conclusion: this study found no significant association between the use of ixekizumab and the risk of tumor development, even suggesting a possible lower risk with the use of IL-17 inhibitors.
Ixekizumab, an IL17 inhibitor monoclonal antibody, is used in the treatment of autoimmune diseases such as Psoriatic Arthritis and Axial Spondylitis. This study aims to verify the possible association between ixekizumab and tumor development, and to determine what types of tumors (solid or hematological) might arise in patients with these conditions. The objective is to improve the understanding, management and use of this drug in patients with neoplasms or at risk of developing them. Material and method: 416 articles were identified. After excluding duplicates, applying the inclusion and exclusion criteria, and performing a complete reading, 18 studies were included. Six were assigned to comparative phase (CT) and twelve focused on long-term extension studies (LTE). For each meta-analysis, publication bias was assessed using funnel plots, statistical significance using Egger's test, and heterogeneity using I2. Results: studies in CT revealed no significant difference between the use of ixekizumab and placebo (RO 1.99, 95% CI 0.26, 15.00), nor in comparison with adalimumab, an iTNF also used in the treatment of these diseases (RO 0.45, 95% CI 0.11 - 1.86). In the LTE studies, no specific variations were found either. The incidence of neoplasms was 1.24 per 100 patients/ year at week 52 (95% CI 0.51 - 2.30), and 0.79 (0.38 - 1.32) at week 156, with no significant differences in tumor types. The most frequent were non-melanoma skin cancer, followed by solid tumors and hematologic tumors. Conclusion: this study found no significant association between the use of ixekizumab and the risk of tumor development, even suggesting a possible lower risk with the use of IL-17 inhibitors.
Direction
MANEIRO FERNANDEZ, JOSE RAMON (Tutorships)
MANEIRO FERNANDEZ, JOSE RAMON (Tutorships)
The role of high-intensity focused ultrasound subthalamotomy in Parkinson’s disease
Authorship
I.D.F.
Bachelor of Medicine
I.D.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Parkinson's disease (PD) is a neurodegenerative pathology whose first-line treatment is pharmacological therapy with levodopa and dopamine agonists. However, some patients respond poorly and the effectiveness of these drugs gradually decreases over time. Therefore, in advanced PD we would move on to other therapies, among which treatment with high-intensity ultrasound (MRgFUS) may be an innovative and minimally invasive option. The subthalamic nucleus is one of the most effective therapeutic targets, as it plays a key role in modulating the output activity of the basal ganglia and it controls the cardinal motor symptoms of PD. Through an exhaustive review of the scientific literature, the main objective is to verify whether subthalamotomy by MRgFUS is safe and effective in the long term in the treatment of motor symptoms and in improving the quality of life of patients with Parkinson's disease.
Parkinson's disease (PD) is a neurodegenerative pathology whose first-line treatment is pharmacological therapy with levodopa and dopamine agonists. However, some patients respond poorly and the effectiveness of these drugs gradually decreases over time. Therefore, in advanced PD we would move on to other therapies, among which treatment with high-intensity ultrasound (MRgFUS) may be an innovative and minimally invasive option. The subthalamic nucleus is one of the most effective therapeutic targets, as it plays a key role in modulating the output activity of the basal ganglia and it controls the cardinal motor symptoms of PD. Through an exhaustive review of the scientific literature, the main objective is to verify whether subthalamotomy by MRgFUS is safe and effective in the long term in the treatment of motor symptoms and in improving the quality of life of patients with Parkinson's disease.
Direction
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
Fernández Pajarín, Gustavo (Co-tutorships)
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
Fernández Pajarín, Gustavo (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Treatment of extraintestinal manifestations in the inflammatory intestinal disease
Authorship
J.F.F.
Bachelor of Medicine
J.F.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Objective: A considerable proportion of patients with inflammatory bowel disease experience extraintestinal manifestations which can involve various organs. These manifestations may precede, coincide with, or follow the intestinal activity of the disease and range from dermatological and joint involvement to ocular, hepatic, and renal complications. The objective of this work has been to gather the scientific evidence to date on the treatment of the main extraintestinal manifestations of this disease. Methods: A Systematic Review has been conducted of all studies published to date in the PubMed database that have evaluated the treatment of extraintestinal manifestations in patients with inflammatory bowel disease. All studies conducted in humans over 18 years of age and of any gender were included, excluding systematic reviews, meta-analyses, opinion articles, and literature reviews, as well as all studies that did not meet the inclusion criteria. Results: At the conclusion of the search and screening process, a total of 31 articles out of the 1591 identified were included. The extraintestinal manifestations were divided by systems and organs. The vast majority of the selected studies reported the use of the main IBD drugs as therapy for extraintestinal manifestations. Corticosteroids (4/31 studies), sulfasalazine (2/31 studies), methotrexate (3/31 studies), and anti-TNFa agents (9/31 studies) are the most commonly used drugs in the management of the complications studied. Specifically, anti-TNFa agents were studied in almost all EIMs, showing response rates between 70-90% for dermatological and joint manifestations. For other EIMs, the response is more variable. Conclusions: Despite the heterogeneity of the different EIMs, we have a vast therapeutic arsenal that allows for an improvement in symptoms and quality of life in patients with inflammatory bowel disease.
Objective: A considerable proportion of patients with inflammatory bowel disease experience extraintestinal manifestations which can involve various organs. These manifestations may precede, coincide with, or follow the intestinal activity of the disease and range from dermatological and joint involvement to ocular, hepatic, and renal complications. The objective of this work has been to gather the scientific evidence to date on the treatment of the main extraintestinal manifestations of this disease. Methods: A Systematic Review has been conducted of all studies published to date in the PubMed database that have evaluated the treatment of extraintestinal manifestations in patients with inflammatory bowel disease. All studies conducted in humans over 18 years of age and of any gender were included, excluding systematic reviews, meta-analyses, opinion articles, and literature reviews, as well as all studies that did not meet the inclusion criteria. Results: At the conclusion of the search and screening process, a total of 31 articles out of the 1591 identified were included. The extraintestinal manifestations were divided by systems and organs. The vast majority of the selected studies reported the use of the main IBD drugs as therapy for extraintestinal manifestations. Corticosteroids (4/31 studies), sulfasalazine (2/31 studies), methotrexate (3/31 studies), and anti-TNFa agents (9/31 studies) are the most commonly used drugs in the management of the complications studied. Specifically, anti-TNFa agents were studied in almost all EIMs, showing response rates between 70-90% for dermatological and joint manifestations. For other EIMs, the response is more variable. Conclusions: Despite the heterogeneity of the different EIMs, we have a vast therapeutic arsenal that allows for an improvement in symptoms and quality of life in patients with inflammatory bowel disease.
Direction
BARREIRO DE ACOSTA, MANUEL FRANCISCO (Tutorships)
Bastón Rey, Iria (Co-tutorships)
BARREIRO DE ACOSTA, MANUEL FRANCISCO (Tutorships)
Bastón Rey, Iria (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
In silico discovery, phenotypic and functional characterization of de novo mutations in PKD1 in an ASD exome cohort.
Authorship
P.F.F.
Bachelor of Medicine
P.F.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Autism spectrum disorders (ASD) have a high prevalence (up to 1%) and are among the most heritable neurodevelopmental disorders (80% of heritability). To date, Polycystic Kidney disease (PKD1), which causes autosomal dominant polycystic kidney disease (ADPKD), has never been described as a risk gene for ASD. Objective: To describe and study 10 de novo mutations in PKD1 found in individuals with ASD to determine if this gene is implicated in ASD. To characterize the probands, annotate the variants with bioinformatics tools and predict the functional effect using artificial intelligence (AI). Methodology: 10 mutations were identified in PKD1 (4 in the exome cohort of 360 trios and the other 6 from the cohort of the Autism Sequencing Consortium). Phenotype and genotype analyses were performed on some probands. PKD1 expression was studied. The prevalence of the variants was analyzed and annotated using the ANNOVAR tool to examine their characteristics. Functional analysis of the mutations was performed using 3 machine learning tools, two of which (AlphaMissense and SpliceAI) are AI systems. Results: Phenotype and genotype analysis of the probands suggests that mutations in PKD1 are the strongest candidates to explain ASD in the probands. It was observed that this gene is expressed 5.44 times more in the brain than in renal tissue. Variants annotation revealed that one mutation is in an intron, one in a splicing site, and 8 in exons (4 of which are silent and 4 missense). The frequency of all mutations is really low. The prediction of the functional effect of the missense mutations varied between Polyphen-2 and AlphaMissense. Polyphen-2 classified one variant as probably benign, one as possibly pathogenic, and two as probably pathogenic, with malignancy probabilities of 0.007, 0.925, 0.998, and 0.994, respectively. AlphaMissense considered all variants possibly benign. SpliceAI indicated that the splice site mutation had a 93% probability of being harmful. Conclusions: The variants study in PKD1 suggests that some mutations have high pathogenic potential in ASD (the malignancy probabilities are above 92% in 4 cases). Although some results from pathogenicity prediction tools are contradictory, we present PKD1 for the first time as a potential risk gene in ASD.
Background: Autism spectrum disorders (ASD) have a high prevalence (up to 1%) and are among the most heritable neurodevelopmental disorders (80% of heritability). To date, Polycystic Kidney disease (PKD1), which causes autosomal dominant polycystic kidney disease (ADPKD), has never been described as a risk gene for ASD. Objective: To describe and study 10 de novo mutations in PKD1 found in individuals with ASD to determine if this gene is implicated in ASD. To characterize the probands, annotate the variants with bioinformatics tools and predict the functional effect using artificial intelligence (AI). Methodology: 10 mutations were identified in PKD1 (4 in the exome cohort of 360 trios and the other 6 from the cohort of the Autism Sequencing Consortium). Phenotype and genotype analyses were performed on some probands. PKD1 expression was studied. The prevalence of the variants was analyzed and annotated using the ANNOVAR tool to examine their characteristics. Functional analysis of the mutations was performed using 3 machine learning tools, two of which (AlphaMissense and SpliceAI) are AI systems. Results: Phenotype and genotype analysis of the probands suggests that mutations in PKD1 are the strongest candidates to explain ASD in the probands. It was observed that this gene is expressed 5.44 times more in the brain than in renal tissue. Variants annotation revealed that one mutation is in an intron, one in a splicing site, and 8 in exons (4 of which are silent and 4 missense). The frequency of all mutations is really low. The prediction of the functional effect of the missense mutations varied between Polyphen-2 and AlphaMissense. Polyphen-2 classified one variant as probably benign, one as possibly pathogenic, and two as probably pathogenic, with malignancy probabilities of 0.007, 0.925, 0.998, and 0.994, respectively. AlphaMissense considered all variants possibly benign. SpliceAI indicated that the splice site mutation had a 93% probability of being harmful. Conclusions: The variants study in PKD1 suggests that some mutations have high pathogenic potential in ASD (the malignancy probabilities are above 92% in 4 cases). Although some results from pathogenicity prediction tools are contradictory, we present PKD1 for the first time as a potential risk gene in ASD.
Direction
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
RODRIGUEZ FONTENLA, MARIA CRISTINA (Co-tutorships)
DOMINGUEZ ALONSO, SARA (Co-tutorships)
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
RODRIGUEZ FONTENLA, MARIA CRISTINA (Co-tutorships)
DOMINGUEZ ALONSO, SARA (Co-tutorships)
Court
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Dieguez Gonzalez, Carlos (Chairman)
VALDES CUADRADO, LUIS GUILLERMO (Secretary)
LOPEZ LOPEZ, RAFAEL (Member)
Perioperative anesthetic management of diabetic patients. Effect of GLP-1 analogues on glycaemic control: Systematic review
Authorship
M.F.R.
Bachelor of Medicine
M.F.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction and aims: Diabetes mellitus is characterized by the presence of hyperglycemia derived from defects in secretion and/or action of insulin. Diabetic patients present a higher risk of peri and postoperative morbidity and mortality associated with it. To optimize the results a careful preoperative evaluation is essential to avoid unwanted episodes of hypoglycemia or hyperglycemia. GLP-1 agonist drugs work by stimulating insulin secretion in response to food intake. Because they act independently of blood glucose levels, they have a lower risk of hypoglycemia, so they could be a safe alternative to consider in patients undergoing surgery. Aims: This systematic review’s main aim is to compare the effect of using GLP-1 analogues on perioperative glycaemic control versus insulin or placebo treatments. Methods: A literature search was carried out on Pubmed, Ovid and Clarivate following the PRISMA criteria to find randomized controlled clinical trials, systematic reviews and meta-analyses on the perioperative management of diabetic patients and the efficacy of GLP-1 analogues in glycaemic control. Results: A total of 7656 articles were identified through the literature search, of which, after applying the corresponding filters, 31 were added to the bibliography. A specific search was conducted on the efficacy of GLP-1 analogues in perioperative management, resulting in seven studies. This review found, except for one of the studies, that adding GLP-1 analogues to conventional insulin or placebo treatment improves perioperative glycaemic control without the risk of hypoglycemia and/or gastrointestinal adverse effects. Conclusion: The use of GLP-1 analogues improves overall glycaemic control in patients undergoing surgery, especially cardiac surgery, without an increased risk of hypoglycemia or adverse effects.
Introduction and aims: Diabetes mellitus is characterized by the presence of hyperglycemia derived from defects in secretion and/or action of insulin. Diabetic patients present a higher risk of peri and postoperative morbidity and mortality associated with it. To optimize the results a careful preoperative evaluation is essential to avoid unwanted episodes of hypoglycemia or hyperglycemia. GLP-1 agonist drugs work by stimulating insulin secretion in response to food intake. Because they act independently of blood glucose levels, they have a lower risk of hypoglycemia, so they could be a safe alternative to consider in patients undergoing surgery. Aims: This systematic review’s main aim is to compare the effect of using GLP-1 analogues on perioperative glycaemic control versus insulin or placebo treatments. Methods: A literature search was carried out on Pubmed, Ovid and Clarivate following the PRISMA criteria to find randomized controlled clinical trials, systematic reviews and meta-analyses on the perioperative management of diabetic patients and the efficacy of GLP-1 analogues in glycaemic control. Results: A total of 7656 articles were identified through the literature search, of which, after applying the corresponding filters, 31 were added to the bibliography. A specific search was conducted on the efficacy of GLP-1 analogues in perioperative management, resulting in seven studies. This review found, except for one of the studies, that adding GLP-1 analogues to conventional insulin or placebo treatment improves perioperative glycaemic control without the risk of hypoglycemia and/or gastrointestinal adverse effects. Conclusion: The use of GLP-1 analogues improves overall glycaemic control in patients undergoing surgery, especially cardiac surgery, without an increased risk of hypoglycemia or adverse effects.
Direction
Álvarez Escudero, Julián (Tutorships)
López Álvarez, Servando (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
López Álvarez, Servando (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
Systematic review of the impact of mindfulness on patients with breast cancer
Authorship
I.F.S.
Bachelor of Medicine
I.F.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Breast cancer, the most common malignant tumour among Spanish women, presents a wide associated symptomatology (psychological and physical symptoms and a significant impact on quality of life) for whose management there is a growing interest in the use of Mindfulness therapies (MBIs), such as MBSR (Mindfulness-Based Stress Reduction) and MBCT (Mindfulness-Based Cognitive Therapy). Mindfulness is a psychological technique that tries to reach a state of full consciousness. Its usefulness in the treatment and prevention of several diseases has been demonstrated with scientific evidence. These effects are achieved by different mechanisms. PURPOSE: The aim of this study is to compile the effects of different mindfulness therapies on the wide symptoms associated with breast cancer, both in women with active disease and in survivors. METHODS: a systematic review has been conducted by consulting PubMed, PsycINFO, Cochrane library and Web of Science. 13 studies have been included: 10 on patients with “active disease” and 3 on “survivors”. RESULTS: on the psychological clinic MBIs produce statistically significant benefits in the short and medium term, especially on depressive symptoms, anxiety and stress. Among physical symptoms, a significant effect is only seen in the reduction of fatigue with MBSR therapies. Other symptoms such as cognitive function and sleep quality also improve with these therapies (low level of evidence). Regarding quality of life, only short-term improvements are observed. MBCT protocols are included in few works. The study of survivors is limited by the low number of investigations and the lack of a homogeneous definition of “survivor”. CONCLUSIONS: Because of the benefit that mindfulness therapies (MBIs) (specially MBSR and MBCT) have on anxiety, stress, depressive symptoms, fatigue and other symptoms associated with breast cancer, it is proposed to use it as a complementary therapy in the management of these patients.
INTRODUCTION: Breast cancer, the most common malignant tumour among Spanish women, presents a wide associated symptomatology (psychological and physical symptoms and a significant impact on quality of life) for whose management there is a growing interest in the use of Mindfulness therapies (MBIs), such as MBSR (Mindfulness-Based Stress Reduction) and MBCT (Mindfulness-Based Cognitive Therapy). Mindfulness is a psychological technique that tries to reach a state of full consciousness. Its usefulness in the treatment and prevention of several diseases has been demonstrated with scientific evidence. These effects are achieved by different mechanisms. PURPOSE: The aim of this study is to compile the effects of different mindfulness therapies on the wide symptoms associated with breast cancer, both in women with active disease and in survivors. METHODS: a systematic review has been conducted by consulting PubMed, PsycINFO, Cochrane library and Web of Science. 13 studies have been included: 10 on patients with “active disease” and 3 on “survivors”. RESULTS: on the psychological clinic MBIs produce statistically significant benefits in the short and medium term, especially on depressive symptoms, anxiety and stress. Among physical symptoms, a significant effect is only seen in the reduction of fatigue with MBSR therapies. Other symptoms such as cognitive function and sleep quality also improve with these therapies (low level of evidence). Regarding quality of life, only short-term improvements are observed. MBCT protocols are included in few works. The study of survivors is limited by the low number of investigations and the lack of a homogeneous definition of “survivor”. CONCLUSIONS: Because of the benefit that mindfulness therapies (MBIs) (specially MBSR and MBCT) have on anxiety, stress, depressive symptoms, fatigue and other symptoms associated with breast cancer, it is proposed to use it as a complementary therapy in the management of these patients.
Direction
LEON MATEOS, LUIS ANGEL (Tutorships)
Pérez López, María Eva (Co-tutorships)
LEON MATEOS, LUIS ANGEL (Tutorships)
Pérez López, María Eva (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
Prophylaxis with acetylsalicylic acid in the prevention of preeclampsia: systematic review and metanalysis
Authorship
U.F.V.
Bachelor of Medicine
U.F.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Preeclampsia is a pregnancy hypertensive disorder related to an elevated maternal-fetal morbidity and mortality. Low-dose acetylsalicylic acid (ASA) used as prophylaxis is one of the recommendations in current clinical guides to prevent its appearance in high-risk patients. The vagueness in former researches and the publication of new researches make necessary a new analysis. Outcomes: The main objective of this study is to analyse the effect of low-dose ASA in preeclampsia prophylaxis, as well as find the effect that maternal high risk of preeclampsia, maternal-fetal mortality rates and maternal age have on preeclampsia heterogeneity. We will study the effect of ASA prophylaxis on low weigh for gestational age, fetal or neonatal death and preterm delivery. We will analyse the connection between ASA and its potential secondary effects abruptio placentae and bleeding. Material and methods: A systematic review and metanalysis based on randomized clinical trials was carried out following the PRISMA 2020 recommendations and a protocol was elaborated and registered in OSF platform. Using as databases PUBMED, WOS, study records in Cochrane and Clinical trials and bibliographic cites reviews. Metanalysis was done using Meta-Essentials Workbooks and RevMan v4.5 software. Evidence quality was done using GRADE system. Results: We examined 69 studies, which involved 53 181 participants, with high heterogeneity that wasn´t modified using subgroups´ analysis. Significant differences were observed between the ASA group and the control group (OR 0,70 [IC 95% 0,61; 0,80], p less than 0,001). The same was found for the risk of low weigh for gestational age (OR 0,80 [IC 95% 0,7; 0,91], p=0,001), fetal or neonatal death (OR 0,86 [IC 95% 0,79; 0,93], p=0,002) and preterm delivery (OR 0,82 [IC 95% 0,72; 0,93], p less than 0,001). We didn´t found significative differences in abruptio placentae (OR 0,96 [IC 95% 0,72; 1,29], p=0,787) and bleeding (OR 1,07 [IC 95% 0,89; 1,29], p=0,422) risks. Conclusions: Low-dose ASA reduces the risk of preeclampsia (moderate quality of evidence) and maternal risk of preeclampsia, maternal-fetal mortality rates and maternal age don´t have great influence on this effect. About events related to preeclampsia, we observed reduction to low weigh for gestational age risk (moderate quality of evidence), fetal or neonatal death risk (high quality of evidence) and preterm delivery risk (moderate quality of evidence). We didn´t found increase in abruptio placentae and bleeding risks, both with moderate quality of evidence.
Introduction: Preeclampsia is a pregnancy hypertensive disorder related to an elevated maternal-fetal morbidity and mortality. Low-dose acetylsalicylic acid (ASA) used as prophylaxis is one of the recommendations in current clinical guides to prevent its appearance in high-risk patients. The vagueness in former researches and the publication of new researches make necessary a new analysis. Outcomes: The main objective of this study is to analyse the effect of low-dose ASA in preeclampsia prophylaxis, as well as find the effect that maternal high risk of preeclampsia, maternal-fetal mortality rates and maternal age have on preeclampsia heterogeneity. We will study the effect of ASA prophylaxis on low weigh for gestational age, fetal or neonatal death and preterm delivery. We will analyse the connection between ASA and its potential secondary effects abruptio placentae and bleeding. Material and methods: A systematic review and metanalysis based on randomized clinical trials was carried out following the PRISMA 2020 recommendations and a protocol was elaborated and registered in OSF platform. Using as databases PUBMED, WOS, study records in Cochrane and Clinical trials and bibliographic cites reviews. Metanalysis was done using Meta-Essentials Workbooks and RevMan v4.5 software. Evidence quality was done using GRADE system. Results: We examined 69 studies, which involved 53 181 participants, with high heterogeneity that wasn´t modified using subgroups´ analysis. Significant differences were observed between the ASA group and the control group (OR 0,70 [IC 95% 0,61; 0,80], p less than 0,001). The same was found for the risk of low weigh for gestational age (OR 0,80 [IC 95% 0,7; 0,91], p=0,001), fetal or neonatal death (OR 0,86 [IC 95% 0,79; 0,93], p=0,002) and preterm delivery (OR 0,82 [IC 95% 0,72; 0,93], p less than 0,001). We didn´t found significative differences in abruptio placentae (OR 0,96 [IC 95% 0,72; 1,29], p=0,787) and bleeding (OR 1,07 [IC 95% 0,89; 1,29], p=0,422) risks. Conclusions: Low-dose ASA reduces the risk of preeclampsia (moderate quality of evidence) and maternal risk of preeclampsia, maternal-fetal mortality rates and maternal age don´t have great influence on this effect. About events related to preeclampsia, we observed reduction to low weigh for gestational age risk (moderate quality of evidence), fetal or neonatal death risk (high quality of evidence) and preterm delivery risk (moderate quality of evidence). We didn´t found increase in abruptio placentae and bleeding risks, both with moderate quality of evidence.
Direction
Álvarez Escudero, Julián (Tutorships)
DIZ GOMEZ, JOSE CARLOS (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
DIZ GOMEZ, JOSE CARLOS (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
Pharmacology in disorders of consciousness: What do we have? A systematic review
Authorship
G.F.V.
Bachelor of Medicine
G.F.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
The disorders of consciousness constitute a current challenge. Advances in neuroimaging, neurophysiology, and research are revealing new information about the physiopathology of these patients and evaluating therapeutic options. The unresponsive wakefulness syndrome and the minimally conscious state require a comprehensive therapeutic approach aimed at accurate diagnosis, stabilization, recovery, and improving consciousness and quality of life. Most research has focused on dopaminergic agonists and traumatic brain injury, with fewer studies on other etiologies. -Objetives: To evaluate the available literature on pharmacological therapeutic options and their efficacy in awakening patients with disorders of consciousness from any etiology of acquired brain injury. -Material and methods: Qualitative systematic review. A search was conducted using the PUBMED database, following PRISMA criteria to identify published academic literature on pharmacological therapies for emerging from disorders of consciousness from January 2000 to October 2023. Inclusion/exclusion criteria allowed for the selection of 26 articles for analysis. -Results: The selected articles generally show positive results for multiple pharmacological therapeutic options, analysed using various methods and with highly variable follow-up times. However, the lack of control for confounding variables and the low statistical power limit the quality of their results. -Conclusions: The most studied drugs are amantadine and zolpidem. They represent therapeutic options that can be considered as part of the overall patient approach, but they lack high-quality evidence. The use of other pharmacological alternatives is plausible, but the quality of evidence supporting their use is low.
The disorders of consciousness constitute a current challenge. Advances in neuroimaging, neurophysiology, and research are revealing new information about the physiopathology of these patients and evaluating therapeutic options. The unresponsive wakefulness syndrome and the minimally conscious state require a comprehensive therapeutic approach aimed at accurate diagnosis, stabilization, recovery, and improving consciousness and quality of life. Most research has focused on dopaminergic agonists and traumatic brain injury, with fewer studies on other etiologies. -Objetives: To evaluate the available literature on pharmacological therapeutic options and their efficacy in awakening patients with disorders of consciousness from any etiology of acquired brain injury. -Material and methods: Qualitative systematic review. A search was conducted using the PUBMED database, following PRISMA criteria to identify published academic literature on pharmacological therapies for emerging from disorders of consciousness from January 2000 to October 2023. Inclusion/exclusion criteria allowed for the selection of 26 articles for analysis. -Results: The selected articles generally show positive results for multiple pharmacological therapeutic options, analysed using various methods and with highly variable follow-up times. However, the lack of control for confounding variables and the low statistical power limit the quality of their results. -Conclusions: The most studied drugs are amantadine and zolpidem. They represent therapeutic options that can be considered as part of the overall patient approach, but they lack high-quality evidence. The use of other pharmacological alternatives is plausible, but the quality of evidence supporting their use is low.
Direction
FIGUEROA RODRIGUEZ, JESUS (Tutorships)
Martín Mourelle, Rosa (Co-tutorships)
FIGUEROA RODRIGUEZ, JESUS (Tutorships)
Martín Mourelle, Rosa (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
Healthcare professionals of paediatric and neonatal intensive care units satisfaction with in situ simulation: a systematic review.
Authorship
L.F.I.
Bachelor of Medicine
L.F.I.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Clinical simulation consists in representing a real situation in a safe and controlled environment with the end purpose of improving patient care. It is a tool which has been on the uprise the last few decades. When it takes place in the workplace of the participants it is called in situ simulation (ISS). Although many benefits are attributed to this practice, there are still some knowledge gaps surrounding it, one of which is the satisfaction of healthcare professionals with the performance of this activity in their units. Objectives: The main objective of this systematic review is to determine the level of satisfaction of healthcare professionals from the neonatal and pediatric intensive care units with ISS. Methods: A systematic bibliographic search of the articles published in the databases PubMed, Scopus, Cinhal and Cochrane was done. Afterwards, a review and analysis of the found studies was conducted. Results: A total of 52 articles were found of which 19 were ruled out for being duplicates and 16 articles were dismissed based on not following the inclusion criteria or for being low quality articles. Finally, 17 articles were included in the review. The test utilized by each study to measure the satisfaction are diverse, there are ad hoc questionnaires (9 studies) as well as standardized ones (all of them different). A total of 1630 participants were included; the global satisfaction is high although the heterogenicity of the scales makes it impossible to compare them. Conclusions: There is a good reception of ISS among the healthcare professionals, with high satisfaction scores as well as an increase of participants' confidence, comfort and readiness to confront critical situations that can arise in the intensive care units.
Introduction: Clinical simulation consists in representing a real situation in a safe and controlled environment with the end purpose of improving patient care. It is a tool which has been on the uprise the last few decades. When it takes place in the workplace of the participants it is called in situ simulation (ISS). Although many benefits are attributed to this practice, there are still some knowledge gaps surrounding it, one of which is the satisfaction of healthcare professionals with the performance of this activity in their units. Objectives: The main objective of this systematic review is to determine the level of satisfaction of healthcare professionals from the neonatal and pediatric intensive care units with ISS. Methods: A systematic bibliographic search of the articles published in the databases PubMed, Scopus, Cinhal and Cochrane was done. Afterwards, a review and analysis of the found studies was conducted. Results: A total of 52 articles were found of which 19 were ruled out for being duplicates and 16 articles were dismissed based on not following the inclusion criteria or for being low quality articles. Finally, 17 articles were included in the review. The test utilized by each study to measure the satisfaction are diverse, there are ad hoc questionnaires (9 studies) as well as standardized ones (all of them different). A total of 1630 participants were included; the global satisfaction is high although the heterogenicity of the scales makes it impossible to compare them. Conclusions: There is a good reception of ISS among the healthcare professionals, with high satisfaction scores as well as an increase of participants' confidence, comfort and readiness to confront critical situations that can arise in the intensive care units.
Direction
Ávila Álvarez, Alejandro (Tutorships)
Ogando Martínez, Alicia (Co-tutorships)
Ávila Álvarez, Alejandro (Tutorships)
Ogando Martínez, Alicia (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
The psychiatric reform: Historical evolution and psychodynamic techniques applied to the patient
Authorship
L.L.E.
Bachelor of Medicine
L.L.E.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Throughout the history of medicine, mental health and psychiatry have undergone continuous evolution influenced by social, economic, and cultural contexts. In the 20th century, a movement known as psychiatric reform took place in Western Europe and North America, characterized by the dismantling of asylums, promotion of community care, conceptual and legislative changes aimed at humanizing psychiatric treatment, and the application of alternative therapeutic approaches. The main objective of this work is to conduct a literature review of this historical trajectory, focusing especially on the European, Spanish, and Galician territorial framework, and to provide a general overview of the aforementioned psychodynamic therapeutic alternatives that emerged in the 20th century. A bibliographic search was conducted using various articles from scientific journals, books, and other materials from online bibliographic sources. In conclusion, psychodynamic coadjuvant therapies such as psychoanalysis or art therapy can optimally complement the treatment of psychiatric patients, but it is essential to note that their effectiveness is very limited without the presence of other treatments supported by greater scientific evidence. Ultimately, the current challenges in mental health care are improving the quality of life of psychiatric patients, combating the still present social stigma, defending the rights of the mentally ill, and promoting comprehensive psychological and psychiatric care, of quality, and accessible to all citizens.
Throughout the history of medicine, mental health and psychiatry have undergone continuous evolution influenced by social, economic, and cultural contexts. In the 20th century, a movement known as psychiatric reform took place in Western Europe and North America, characterized by the dismantling of asylums, promotion of community care, conceptual and legislative changes aimed at humanizing psychiatric treatment, and the application of alternative therapeutic approaches. The main objective of this work is to conduct a literature review of this historical trajectory, focusing especially on the European, Spanish, and Galician territorial framework, and to provide a general overview of the aforementioned psychodynamic therapeutic alternatives that emerged in the 20th century. A bibliographic search was conducted using various articles from scientific journals, books, and other materials from online bibliographic sources. In conclusion, psychodynamic coadjuvant therapies such as psychoanalysis or art therapy can optimally complement the treatment of psychiatric patients, but it is essential to note that their effectiveness is very limited without the presence of other treatments supported by greater scientific evidence. Ultimately, the current challenges in mental health care are improving the quality of life of psychiatric patients, combating the still present social stigma, defending the rights of the mentally ill, and promoting comprehensive psychological and psychiatric care, of quality, and accessible to all citizens.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Neurostimulation in the treatment of chronic pain
Authorship
M.L.F.
Bachelor of Medicine
M.L.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Throughout history, the concept of chronic pain and its understanding has evolved, undergoing numerous studies and experiments; however, its management and treatment have always remained a mystery. From belief in supernatural causes to the current scientific approach, the understanding of chronic pain has gone through various stages, as has its treatment. Nowadays, medical and rapid technological advancements allow for the development of new techniques aimed at achieving better pain control, such as neurostimulation, an intriguing and cutting-edge proposition in medicine. Objectives: This project aims to analyze different types of neurostimulation techniques used to treat chronic pain. Specifically, we will focus on comparing three of the most innovative stimulation patterns: high frequency, burst, and DTM (differential target multiplexed), examining their efficacy, safety, and clinical applications in chronic pain treatment. Methods: An exhaustive literature review is conducted on scientific databases (PubMed, SciELO, The Cochrane Library, JAMA, and Google Scholar), selecting and critically evaluating relevant studies, and synthesizing the results in a structured manner. Results and Discussion: A total of 9 articles were selected that met the search requirements and established criteria. From these studies, the parameters and specific characteristics of each technique were compared, and clear evidence of their efficacy was observed, showing a significant improvement in pain and patient functionality. Conclusions: It can be concluded that burst, high frequency, and DTM are effective and safe therapeutic options, leading to a significant improvement in patients' quality of life with minimal adverse effects. However, further research is needed to fully understand the mechanisms of action and to develop and optimize the use of these techniques.
Introduction: Throughout history, the concept of chronic pain and its understanding has evolved, undergoing numerous studies and experiments; however, its management and treatment have always remained a mystery. From belief in supernatural causes to the current scientific approach, the understanding of chronic pain has gone through various stages, as has its treatment. Nowadays, medical and rapid technological advancements allow for the development of new techniques aimed at achieving better pain control, such as neurostimulation, an intriguing and cutting-edge proposition in medicine. Objectives: This project aims to analyze different types of neurostimulation techniques used to treat chronic pain. Specifically, we will focus on comparing three of the most innovative stimulation patterns: high frequency, burst, and DTM (differential target multiplexed), examining their efficacy, safety, and clinical applications in chronic pain treatment. Methods: An exhaustive literature review is conducted on scientific databases (PubMed, SciELO, The Cochrane Library, JAMA, and Google Scholar), selecting and critically evaluating relevant studies, and synthesizing the results in a structured manner. Results and Discussion: A total of 9 articles were selected that met the search requirements and established criteria. From these studies, the parameters and specific characteristics of each technique were compared, and clear evidence of their efficacy was observed, showing a significant improvement in pain and patient functionality. Conclusions: It can be concluded that burst, high frequency, and DTM are effective and safe therapeutic options, leading to a significant improvement in patients' quality of life with minimal adverse effects. However, further research is needed to fully understand the mechanisms of action and to develop and optimize the use of these techniques.
Direction
Álvarez Escudero, Julián (Tutorships)
Vizcaíno Martínez, Lucia (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
Vizcaíno Martínez, Lucia (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
The prevalence of gallstones and its associated risk factors. Theme update.
Authorship
A.L.L.
Bachelor of Medicine
A.L.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Gallstone disease involves the deposition of solid material in the gallbladder. It is a prevalent condition, particularly among Indo-American and Latin American populations, as well as in females (especially during pregnancy or when undergoing hormone replacement therapies). Other associated risk factors include obesity, treatment with somatostatin analogs, prolonged fasting periods, gastric resections, and genetics. It can lead to a series of complications, the most common being cholecystitis.
Gallstone disease involves the deposition of solid material in the gallbladder. It is a prevalent condition, particularly among Indo-American and Latin American populations, as well as in females (especially during pregnancy or when undergoing hormone replacement therapies). Other associated risk factors include obesity, treatment with somatostatin analogs, prolonged fasting periods, gastric resections, and genetics. It can lead to a series of complications, the most common being cholecystitis.
Direction
MEAÑOS MELON, ENRIQUE RAMON (Tutorships)
MEAÑOS MELON, ENRIQUE RAMON (Tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Analysis of the geographical distribution of vitamin D deficit worldwide.
Authorship
C.L.S.
Bachelor of Medicine
C.L.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The implication of vitamin D in numerous physiological processes and its relationship with multiple pathologies has sparked the interest of the scientific community. Despite its importance, vitamin D deficiency is a pronounced global problem. This situation raises the need to study the factors and causes that modify vitamin D levels and promote the development of preventive measures against deficiency. Objectives: To compare the geographic distribution of the vitamin D deficiency with the socioeconomic status, advanced age, and solar radiation levels worldwide. Material and methods: a literary review was made on de scientific databases PubMed, Medline, Web of Science and Scopus, finding 61 articles which 8 met the inclusion criteria. Results: The deficiency of vitamin D is a global issue accentuated in the Middle East. The deficit is due to modifiable and non-modifiable factors, and a single factor by itself can´t result in vitamin D deficiency.
Introduction: The implication of vitamin D in numerous physiological processes and its relationship with multiple pathologies has sparked the interest of the scientific community. Despite its importance, vitamin D deficiency is a pronounced global problem. This situation raises the need to study the factors and causes that modify vitamin D levels and promote the development of preventive measures against deficiency. Objectives: To compare the geographic distribution of the vitamin D deficiency with the socioeconomic status, advanced age, and solar radiation levels worldwide. Material and methods: a literary review was made on de scientific databases PubMed, Medline, Web of Science and Scopus, finding 61 articles which 8 met the inclusion criteria. Results: The deficiency of vitamin D is a global issue accentuated in the Middle East. The deficit is due to modifiable and non-modifiable factors, and a single factor by itself can´t result in vitamin D deficiency.
Direction
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Evaluation of the tools used to measure outcomes in Vertebroplasty and their validity: a Systematic Review
Authorship
A.T.L.S.
Bachelor of Medicine
A.T.L.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Vertebral fractures due to osteoporosis are a prevalent condition, often treated with vertebroplasty. This study evaluates the specificity of the tools used to measure outcomes in vertebroplasty through a systematic review, with a particular focus on adequacy and the data collection process. OBJECTIVES: The aim of this study is to evaluate the validity of measurement tools in Percutaneous Vertebroplasty studies in osteoporotic vertebral fractures, in order to determine the adequacy and data collection process. MATERIAL AND METHODS: Systematic Review. A search was conducted in PubMed and Cochrane databases with the following terms: Vertebroplasty AND Osteoporosis AND Osteoporotic AND Fracture AND Compression Fracture. We included articles published between January 2009 and January 2024. RESULTS: Of a selection of 365 initial articles, 10 studies that met criteria for review (all of them RCTs) were finally eligible. 1229 patients were evaluated, of which 615 were treated with vertebroplasty and 614 with conservative treatment. The 10 studies evaluated patients with vertebral fractures due to fragility of osteoporotic cause. Most studies agree that treatment with vertebroplasty is effective in both acute chronic cone fractures. CONCLUSIONS: in the majority of RCT included in this Vertebroplasty has proven its effectiveness in both the treatment of acute and chronic fractures, improving pain and quality of life. Special emphasis is placed on the importance of adequate physical examination in the diagnosis of vertebral fractures. It is necessary to continue researching and establishing agreed criteria for an accurate classification of these fractures, in order to improve treatments and clinical care in this population. However, more research is needed to support these observations.
INTRODUCTION: Vertebral fractures due to osteoporosis are a prevalent condition, often treated with vertebroplasty. This study evaluates the specificity of the tools used to measure outcomes in vertebroplasty through a systematic review, with a particular focus on adequacy and the data collection process. OBJECTIVES: The aim of this study is to evaluate the validity of measurement tools in Percutaneous Vertebroplasty studies in osteoporotic vertebral fractures, in order to determine the adequacy and data collection process. MATERIAL AND METHODS: Systematic Review. A search was conducted in PubMed and Cochrane databases with the following terms: Vertebroplasty AND Osteoporosis AND Osteoporotic AND Fracture AND Compression Fracture. We included articles published between January 2009 and January 2024. RESULTS: Of a selection of 365 initial articles, 10 studies that met criteria for review (all of them RCTs) were finally eligible. 1229 patients were evaluated, of which 615 were treated with vertebroplasty and 614 with conservative treatment. The 10 studies evaluated patients with vertebral fractures due to fragility of osteoporotic cause. Most studies agree that treatment with vertebroplasty is effective in both acute chronic cone fractures. CONCLUSIONS: in the majority of RCT included in this Vertebroplasty has proven its effectiveness in both the treatment of acute and chronic fractures, improving pain and quality of life. Special emphasis is placed on the importance of adequate physical examination in the diagnosis of vertebral fractures. It is necessary to continue researching and establishing agreed criteria for an accurate classification of these fractures, in order to improve treatments and clinical care in this population. However, more research is needed to support these observations.
Direction
DIEZ ULLOA, MAXIMO ALBERTO (Tutorships)
Pazos Mohri, Alba (Co-tutorships)
DIEZ ULLOA, MAXIMO ALBERTO (Tutorships)
Pazos Mohri, Alba (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Moral distress among health professionals in spanish UCI according to the intensity of the COVID-19 pandemic
Authorship
A.L.V.
Bachelor of Medicine
A.L.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Aim:Moral distress is a current problem for health professionals, which arises from the inability to act in accordance with one’s own morals due to external obstacles. This has a negative impact on both, the health of workers and the quality of care. The COVID-19 pandemic led to a shortage of resources, human and material, which was a great source of physical and emotional stress, aggravating this problem. The objective of this study is to determine the correlation between the intensity of the COVID-19 pandemic in the first and second waves in the different Autonomous Communities and the level and frequency of moral distress suffered by health professionals who worked in UCI. . Methods: This is an observational study of a cross-sectional nature to assess the intensity of the COVID-19 pandemic in the different autonomous communities, correlating it with the level of moral distress suffered by health professionals who were working in the UCI. The participants are health professionals who worked during the COVID-19 pandemic in Spanish UCI. The epidemic intensity for each region was defined based on the relationship between the maximum number of patients admitted to the UCI during the first and second wave of the pandemic in each autonomous community and the maximum number of UCI beds available in the same area before crisis. To assess moral distress, the MMD-HP-SPA scale was used. Results: 1,115 health professionals participated in this study (989 worked in areas of low epidemic intensity and 126 in high epidemic intensity). An increase in the level of moral distress was observed, which has been similar in doctors and nurses, being more pronounced in singles, those under 35 years of age, with children, temporary contracts and less experience in the ICU. Also in those who worked in multiple occupancy rooms and those who requested sick leave due to mental health problems. Overall, the biggest source of moral distress was caring for more patients than can be handled safely. The highest levels of moral unrest were recorded in Cantabria, Galicia, Castilla y León and Madrid. The participation rate was very variable, predominating in Madrid, Galicia and Cataluña. Finally, no correlation was observed between the epidemic intensity in the different autonomous communities and the level of moral distress suffered by health professionals who worked in the ICUs. Conclusions: The level of moral distress has increased ecuality in doctors and nurses after the pandemic. However, we found no correlation between the level of moral unrest and the epidemic intensity in the different autonomous communities. This could be due to the variability in the level of participation between the different autonomous communities.
Aim:Moral distress is a current problem for health professionals, which arises from the inability to act in accordance with one’s own morals due to external obstacles. This has a negative impact on both, the health of workers and the quality of care. The COVID-19 pandemic led to a shortage of resources, human and material, which was a great source of physical and emotional stress, aggravating this problem. The objective of this study is to determine the correlation between the intensity of the COVID-19 pandemic in the first and second waves in the different Autonomous Communities and the level and frequency of moral distress suffered by health professionals who worked in UCI. . Methods: This is an observational study of a cross-sectional nature to assess the intensity of the COVID-19 pandemic in the different autonomous communities, correlating it with the level of moral distress suffered by health professionals who were working in the UCI. The participants are health professionals who worked during the COVID-19 pandemic in Spanish UCI. The epidemic intensity for each region was defined based on the relationship between the maximum number of patients admitted to the UCI during the first and second wave of the pandemic in each autonomous community and the maximum number of UCI beds available in the same area before crisis. To assess moral distress, the MMD-HP-SPA scale was used. Results: 1,115 health professionals participated in this study (989 worked in areas of low epidemic intensity and 126 in high epidemic intensity). An increase in the level of moral distress was observed, which has been similar in doctors and nurses, being more pronounced in singles, those under 35 years of age, with children, temporary contracts and less experience in the ICU. Also in those who worked in multiple occupancy rooms and those who requested sick leave due to mental health problems. Overall, the biggest source of moral distress was caring for more patients than can be handled safely. The highest levels of moral unrest were recorded in Cantabria, Galicia, Castilla y León and Madrid. The participation rate was very variable, predominating in Madrid, Galicia and Cataluña. Finally, no correlation was observed between the epidemic intensity in the different autonomous communities and the level of moral distress suffered by health professionals who worked in the ICUs. Conclusions: The level of moral distress has increased ecuality in doctors and nurses after the pandemic. However, we found no correlation between the level of moral unrest and the epidemic intensity in the different autonomous communities. This could be due to the variability in the level of participation between the different autonomous communities.
Direction
Gonzalez Quintela, Arturo (Tutorships)
Rodríguez Ruíz, Emilio (Co-tutorships)
Gonzalez Quintela, Arturo (Tutorships)
Rodríguez Ruíz, Emilio (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Study of the SNOT-22 questionnaire in patients with obstructive sleep apneaAPNEA
Authorship
R.A.L.B.
Bachelor of Medicine
R.A.L.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Sleep apnea is a highly prevalent chronic disorder that has a significant impact on people's lives, affecting several aspects of their physical, mental and emotional health. The SNOT-22 questionnaire is considered as one of the most useful tests to know the repercussion of nasal and sinus symptomatology in patients. Objectives: The main purpose of this article is to compare the SNOT-22 score in patients without nasal pathology with obstructive sleep apnea vs the mean score of healthy volunteers. On the other hand, the secondary objectives are to compare SNOT-22 scores in patients with obstructive sleep apnea with and without nasal pathology and in patients with obstructive sleep apnea with and without CPAP. Methods: This is a multicentric cross-sectional study with a total of 590 participants, 282 healthy controls without apnea or nasal pathology and 308 patients with apnea with and without nasal pathology. Results: After classification of the results, it is evident that patients with obstructive sleep apnea have higher SNOT-22 scores than healthy controls. On the other hand, no significant difference was found in the questionnaire between patients with obstructive sleep apnea with nasal pathology and those without nasal pathology. Finally, in patients with CPAP and those without CPAP, no conclusive results were obtained that could indicate a pattern. Conclusions: After discussion of the data, it was concluded that patients with apnea have a higher SNOT-22 at the expense of all the subdomains and independently of the existence of nasal pathology, severity of apnea or CPAP treatment. It is proposed as a reference value 20 in patients with apnea regardless of severity.
Introduction: Sleep apnea is a highly prevalent chronic disorder that has a significant impact on people's lives, affecting several aspects of their physical, mental and emotional health. The SNOT-22 questionnaire is considered as one of the most useful tests to know the repercussion of nasal and sinus symptomatology in patients. Objectives: The main purpose of this article is to compare the SNOT-22 score in patients without nasal pathology with obstructive sleep apnea vs the mean score of healthy volunteers. On the other hand, the secondary objectives are to compare SNOT-22 scores in patients with obstructive sleep apnea with and without nasal pathology and in patients with obstructive sleep apnea with and without CPAP. Methods: This is a multicentric cross-sectional study with a total of 590 participants, 282 healthy controls without apnea or nasal pathology and 308 patients with apnea with and without nasal pathology. Results: After classification of the results, it is evident that patients with obstructive sleep apnea have higher SNOT-22 scores than healthy controls. On the other hand, no significant difference was found in the questionnaire between patients with obstructive sleep apnea with nasal pathology and those without nasal pathology. Finally, in patients with CPAP and those without CPAP, no conclusive results were obtained that could indicate a pattern. Conclusions: After discussion of the data, it was concluded that patients with apnea have a higher SNOT-22 at the expense of all the subdomains and independently of the existence of nasal pathology, severity of apnea or CPAP treatment. It is proposed as a reference value 20 in patients with apnea regardless of severity.
Direction
SANTOS PEREZ, SOFIA MARIA SOLEDAD (Tutorships)
Calvo Henríquez, Christian Ezequiel (Co-tutorships)
SANTOS PEREZ, SOFIA MARIA SOLEDAD (Tutorships)
Calvo Henríquez, Christian Ezequiel (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Neuromodulation in the management of chronic spinal pain, a case series and review of the literature.
Authorship
S.L.M.
Bachelor of Medicine
S.L.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: pain is an important aversive experience for humans and chronic pain is a highly prevalent health problem worldwide. The perception of this stimulus consists of four important sections, in which modulation stands out, where the nervous signal can be increased or inhibited physiologically, but also exogenously with neurostimulation devices. There are different types of spinal neurostimulation devices, highlighting the division between paresthetic or subparesthetic neurostimulation. OBJECTIVES AND HYPOTHESES: the main objective of the present study is to evaluate the response of pain symptoms after seven days of placement of neurostimulation implants using the brief pain inventory, short edition (BPI-SF). The secondary objective is to evaluate the quality of life of the patients seven days after the implantation of the neurostimulation devices, using the BPI-SF. MATERIAL AND METHODS: this study is an observational study, a serie of cases with longitudinal and prospective significance, in which the symptoms of patients are compared at baseline and 7 days after the implantation of a neurostimulation device, using the BPI-SF. RESULTS: a total of 8 participants are admitted, all of them with type II persistent spinal pain syndrome, with insufficient response to pharmacological treatment. Added to this pharmacological treatment is the implantation of a spinal neurostimulation device. Pain reduction was statistically significant at 7 days in terms of maximum (P inf. 0.001), minimum (P = 0.013), average (P inf. 0.001), and current (P = 0.005) pain. Improvements in quality of life were statistically significant for interference with general activity (P = 0.029), mood (P = 0.011), walking ability (P = 0.002), interference with work (P = 0.015), relationships (P = 0.032), and sleep (P inf 0.001) DISCUSSION: neurostimulation, due to its characteristics, cost and complexity, is a technique that continues to raise controversy, with numerous low-quality studies, which make it difficult to obtain solid conclusions. CONCLUSIONS: it cannot be said that the improvements obtained in the present study are due solely to the application of neurostimulation since the present study lacks a control group. 7 days after the intervention, pain symptoms and quality of life improve in a statistically significant way.
INTRODUCTION: pain is an important aversive experience for humans and chronic pain is a highly prevalent health problem worldwide. The perception of this stimulus consists of four important sections, in which modulation stands out, where the nervous signal can be increased or inhibited physiologically, but also exogenously with neurostimulation devices. There are different types of spinal neurostimulation devices, highlighting the division between paresthetic or subparesthetic neurostimulation. OBJECTIVES AND HYPOTHESES: the main objective of the present study is to evaluate the response of pain symptoms after seven days of placement of neurostimulation implants using the brief pain inventory, short edition (BPI-SF). The secondary objective is to evaluate the quality of life of the patients seven days after the implantation of the neurostimulation devices, using the BPI-SF. MATERIAL AND METHODS: this study is an observational study, a serie of cases with longitudinal and prospective significance, in which the symptoms of patients are compared at baseline and 7 days after the implantation of a neurostimulation device, using the BPI-SF. RESULTS: a total of 8 participants are admitted, all of them with type II persistent spinal pain syndrome, with insufficient response to pharmacological treatment. Added to this pharmacological treatment is the implantation of a spinal neurostimulation device. Pain reduction was statistically significant at 7 days in terms of maximum (P inf. 0.001), minimum (P = 0.013), average (P inf. 0.001), and current (P = 0.005) pain. Improvements in quality of life were statistically significant for interference with general activity (P = 0.029), mood (P = 0.011), walking ability (P = 0.002), interference with work (P = 0.015), relationships (P = 0.032), and sleep (P inf 0.001) DISCUSSION: neurostimulation, due to its characteristics, cost and complexity, is a technique that continues to raise controversy, with numerous low-quality studies, which make it difficult to obtain solid conclusions. CONCLUSIONS: it cannot be said that the improvements obtained in the present study are due solely to the application of neurostimulation since the present study lacks a control group. 7 days after the intervention, pain symptoms and quality of life improve in a statistically significant way.
Direction
Álvarez Escudero, Julián (Tutorships)
Valero Gómez, Manuel Alberto (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
Valero Gómez, Manuel Alberto (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Sedoanalgesia in pediatric emergencies. Utility of nitrous oxide.
Authorship
L.R.C.
Bachelor of Medicine
L.R.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Study design: Systematic review. Justification: Pain represents 30% to 78% of pediatric emergency department visits and, in spanish hospitals, it has a prevalence of around 53%. Currently, both pain relief and its prevention during the diagnostic-therapeutic process are considered quality markers for healthcare services. To achieve this, there are a large number of pharmacological and non-pharmacological strategies available, with N2O being a great alternative due to its ease of administration, rapid onset of action and few adverse events. Objective: The main objective was to verify the efficacy and safety of nitrous oxide in different procedures carried out in the pediatric emergency department based on the existing evidence in the literature. Methods: A systematic review of the scientific evidence in relation to the study question in PICO format was carried out between the months of december 2023 and march 2024. Using standardized descriptors, a primary search strategy was developed that included the Pubmed, Cochrane and WOS databases. Following the diagram of PRISMA flow a total of 15 articles were finally selected for the review. The quality of the included studies has been assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results: A total of 15 articles that met the criteria for review were included: 4 randomized clinical trials, 5 prospective cohort studies, and 6 retrospective cohort studies. The results of the different studies agree that it is not recommended to exceed a concentration of 50% N2O or prolong inhalation for more than 15 minutes, with a preference for combining its administration with fentanyl in cases of insufficient analgesia. The drug can be administered to patients of all ages studied (0-18 years), but it is preferred in those over 5 years old due to better cooperation. The efficacy of N2O in pain and anxiety control has been demonstrated in a variety of short procedures, including fracture reduction, burn care, wound repair, and obtaining venous access, among others. The frequency of adverse effects varies according to the literature (0-78%), but all are mild, with nausea, vomiting, and dizziness being the most common. Conclusions: Nitrous oxide is a safe and effective drug for sedoanalgesia in minor pediatric emergency procedures, especially in children over 5 years old or with sufficient maturity, at concentrations of 50% and with a short duration of inhalation (less than 15 minutes).
Study design: Systematic review. Justification: Pain represents 30% to 78% of pediatric emergency department visits and, in spanish hospitals, it has a prevalence of around 53%. Currently, both pain relief and its prevention during the diagnostic-therapeutic process are considered quality markers for healthcare services. To achieve this, there are a large number of pharmacological and non-pharmacological strategies available, with N2O being a great alternative due to its ease of administration, rapid onset of action and few adverse events. Objective: The main objective was to verify the efficacy and safety of nitrous oxide in different procedures carried out in the pediatric emergency department based on the existing evidence in the literature. Methods: A systematic review of the scientific evidence in relation to the study question in PICO format was carried out between the months of december 2023 and march 2024. Using standardized descriptors, a primary search strategy was developed that included the Pubmed, Cochrane and WOS databases. Following the diagram of PRISMA flow a total of 15 articles were finally selected for the review. The quality of the included studies has been assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results: A total of 15 articles that met the criteria for review were included: 4 randomized clinical trials, 5 prospective cohort studies, and 6 retrospective cohort studies. The results of the different studies agree that it is not recommended to exceed a concentration of 50% N2O or prolong inhalation for more than 15 minutes, with a preference for combining its administration with fentanyl in cases of insufficient analgesia. The drug can be administered to patients of all ages studied (0-18 years), but it is preferred in those over 5 years old due to better cooperation. The efficacy of N2O in pain and anxiety control has been demonstrated in a variety of short procedures, including fracture reduction, burn care, wound repair, and obtaining venous access, among others. The frequency of adverse effects varies according to the literature (0-78%), but all are mild, with nausea, vomiting, and dizziness being the most common. Conclusions: Nitrous oxide is a safe and effective drug for sedoanalgesia in minor pediatric emergency procedures, especially in children over 5 years old or with sufficient maturity, at concentrations of 50% and with a short duration of inhalation (less than 15 minutes).
Direction
Leis Trabazo, María Rosaura (Tutorships)
Prada Tellado, Marta (Co-tutorships)
Leis Trabazo, María Rosaura (Tutorships)
Prada Tellado, Marta (Co-tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Early management of Acute Spinal Cord Injury: respiratory and hemodynamic control
Authorship
X.R.C.
Bachelor of Medicine
X.R.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Acute Spinal Cord Injury (SCI) is a neurological condition that presents an enormous morbidity and mortality, posing not only physical and psychosocial problems for the patient, but also for their entire environment, as well as a great care and economic burden. It is in this context where the initial management carried out in the ICUs is presumed essential to reduce the consequences of this type of injury. In SCI we distinguish a primary injury and a secondary injury, and both can be intervened in the management of these patients. Respiratory complications are the main cause of morbidity and mortality, with respiratory dysfunction having a multifactorial origin, and despite promising results with some other techniques, mechanical ventilation remains the main weapon for patients with respiratory failure after SCI. Regarding hemodynamic management, it seems that ischemia due to compromise of spinal perfusion pressure is a major component of the aforementioned secondary injury, so recognizing and understanding the vascular processes present in it is one of the main objectives of clinical research, thus establishing the concept of hemodynamic control in the management of SCI. Objectives: To provide updated information on the initial respiratory and hemodynamic management of patients with acute spinal cord injury. Methods: A literature review has been conducted regarding the initial management of patients with SCI in the last 10 years. Finally, 30 articles out of 101 results have been included. Conclusions: Orotracheal intubation, mechanical ventilation with high tidal volumes, and early tracheostomy appear to be beneficial in respiratory management. A MAP maintained between 70-95 mmHg and an SPP between 50-90 mmHg could yield better results, with norepinephrine being the vasopresor of choice.
Introduction: Acute Spinal Cord Injury (SCI) is a neurological condition that presents an enormous morbidity and mortality, posing not only physical and psychosocial problems for the patient, but also for their entire environment, as well as a great care and economic burden. It is in this context where the initial management carried out in the ICUs is presumed essential to reduce the consequences of this type of injury. In SCI we distinguish a primary injury and a secondary injury, and both can be intervened in the management of these patients. Respiratory complications are the main cause of morbidity and mortality, with respiratory dysfunction having a multifactorial origin, and despite promising results with some other techniques, mechanical ventilation remains the main weapon for patients with respiratory failure after SCI. Regarding hemodynamic management, it seems that ischemia due to compromise of spinal perfusion pressure is a major component of the aforementioned secondary injury, so recognizing and understanding the vascular processes present in it is one of the main objectives of clinical research, thus establishing the concept of hemodynamic control in the management of SCI. Objectives: To provide updated information on the initial respiratory and hemodynamic management of patients with acute spinal cord injury. Methods: A literature review has been conducted regarding the initial management of patients with SCI in the last 10 years. Finally, 30 articles out of 101 results have been included. Conclusions: Orotracheal intubation, mechanical ventilation with high tidal volumes, and early tracheostomy appear to be beneficial in respiratory management. A MAP maintained between 70-95 mmHg and an SPP between 50-90 mmHg could yield better results, with norepinephrine being the vasopresor of choice.
Direction
LOPEZ LAGO, ANA MARIA (Tutorships)
Mourelo Fariña, Mónica (Co-tutorships)
LOPEZ LAGO, ANA MARIA (Tutorships)
Mourelo Fariña, Mónica (Co-tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Systematic review on early induction of labor in advanced maternal age nulliparous women.
Authorship
M.D.C.R.G.
Bachelor of Medicine
M.D.C.R.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction and objectives: The need for early induction in elderly nulliparous pregnant women has been assessed on different occasions due to the possibility of reducing comorbidities associated with these pregnancies considered at risk. A systematic review is carried out to evaluate the possible benefits (reduction of fetal deaths and maternal comorbidities) and the possible disadvantages (increase in cesarean sections, duration of induction and costs) of this practice with respect to expectant management. Material and methods: A systematic search was conducted in PubMed, Embase and Cochrane from September 2023 including articles that explored the effects of early induction in elderly nulliparous pregnant women. Studies published in English with 100 patients or more were included. Results: 3 977 articles were identified, 4 (n= 78 935 patients) were included in this review. The sample characteristics of interest were extracted. Conclusions: In the studies analyzed, the number of stillbirths and in-hospital perinatal deaths in the group of induced women were lower than in the expectant management group. In observational studies, higher rates of: maternal readmission, obstetric hemorrhages, cesarean sections, and longer duration of labor, delivery, and hospital stay were found after labor induction. Furthermore, an increase of hospital costs after the application of induction is estimated based on indirect data. In the included clinical trial, no significant differences in cesarean section rates were observed, nor were there any observed intrauterine fetal deaths or perinatal deaths, since it was not designed to study the latter. Clinical guidelines from different countries offer diverse recommendations due to the limited scientific evidence in this regard and that is why there is a need to develop more clinical trials with a larger sample size on the subject.
Introduction and objectives: The need for early induction in elderly nulliparous pregnant women has been assessed on different occasions due to the possibility of reducing comorbidities associated with these pregnancies considered at risk. A systematic review is carried out to evaluate the possible benefits (reduction of fetal deaths and maternal comorbidities) and the possible disadvantages (increase in cesarean sections, duration of induction and costs) of this practice with respect to expectant management. Material and methods: A systematic search was conducted in PubMed, Embase and Cochrane from September 2023 including articles that explored the effects of early induction in elderly nulliparous pregnant women. Studies published in English with 100 patients or more were included. Results: 3 977 articles were identified, 4 (n= 78 935 patients) were included in this review. The sample characteristics of interest were extracted. Conclusions: In the studies analyzed, the number of stillbirths and in-hospital perinatal deaths in the group of induced women were lower than in the expectant management group. In observational studies, higher rates of: maternal readmission, obstetric hemorrhages, cesarean sections, and longer duration of labor, delivery, and hospital stay were found after labor induction. Furthermore, an increase of hospital costs after the application of induction is estimated based on indirect data. In the included clinical trial, no significant differences in cesarean section rates were observed, nor were there any observed intrauterine fetal deaths or perinatal deaths, since it was not designed to study the latter. Clinical guidelines from different countries offer diverse recommendations due to the limited scientific evidence in this regard and that is why there is a need to develop more clinical trials with a larger sample size on the subject.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
DUEÑAS CARAZO, MARIA BEGOÑA (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
DUEÑAS CARAZO, MARIA BEGOÑA (Co-tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Updated literature review of osteochondritis dissecans of the knee.
Authorship
J.M.R.L.
Bachelor of Medicine
J.M.R.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Osteochondritis dissecans (OCD) of the knee is a pathology that affects the subchondral bone and overlying cartilage and evolves towards the formation of an articular free body. It is a pathology that mainly affects young people and its clinical manifestations are highly variable, ranging from asymptomatic lesions to joint locking. Despite its clinical importance, its etiology remains unknown and there is still no standardized diagnostic and therapeutic management for this pathology. Objectives: To perform an updated bibliographic review on the possible etiology of OCD and to establish a diagnostic-therapeutic management based on the findings found in the literature. Methods: A literature review was carried out in the PubMed and Cochrane databases in April 2024. Results: 22 articles have been selected for the elaboration of the work, 5 deal about etiology; 5 about diagnosis and 12 deal with the treatment of knee OCD. Conclusions: The evidence on the etiology, diagnosis and treatment of OCD of the knee remains limited and of low quality, therefore, further research on this pathology is needed. The ethology appears to be multifactorial, leading to subchondral bone ischemia/fracture mechanisms that will result in OCD lesions. In the diagnosis and determination of stability of OCD lesions, Magnetic Resonance Imaging plays a fundamental role. It is very important to determine the patient's characteristics when planning treatment, which can range from conservative treatment to surgical cartilage restoration techniques.
Introduction: Osteochondritis dissecans (OCD) of the knee is a pathology that affects the subchondral bone and overlying cartilage and evolves towards the formation of an articular free body. It is a pathology that mainly affects young people and its clinical manifestations are highly variable, ranging from asymptomatic lesions to joint locking. Despite its clinical importance, its etiology remains unknown and there is still no standardized diagnostic and therapeutic management for this pathology. Objectives: To perform an updated bibliographic review on the possible etiology of OCD and to establish a diagnostic-therapeutic management based on the findings found in the literature. Methods: A literature review was carried out in the PubMed and Cochrane databases in April 2024. Results: 22 articles have been selected for the elaboration of the work, 5 deal about etiology; 5 about diagnosis and 12 deal with the treatment of knee OCD. Conclusions: The evidence on the etiology, diagnosis and treatment of OCD of the knee remains limited and of low quality, therefore, further research on this pathology is needed. The ethology appears to be multifactorial, leading to subchondral bone ischemia/fracture mechanisms that will result in OCD lesions. In the diagnosis and determination of stability of OCD lesions, Magnetic Resonance Imaging plays a fundamental role. It is very important to determine the patient's characteristics when planning treatment, which can range from conservative treatment to surgical cartilage restoration techniques.
Direction
PINO MINGUEZ, JESUS (Tutorships)
PINO MINGUEZ, JESUS (Tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Results in percutaneous versus surgical treatment of atrial septal defect in pediatric population. A systematic review
Authorship
M.R.M.
Bachelor of Medicine
M.R.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Atrial septal defect (ASD) is a communication between both atria. It represents 10-15% of all congenital heart defects and is more common in females (2:1), most cases are sporadic and isolated. It can cause a shunt with hemodynamic repercussion in some cases, necessitating intervention. To repair the defect, percutaneous closure with device or surgical closure are considered. Currently, both options are valid, although with different indications, approaches and complications. Objectives: the main objective of this systematic review was to synthesize the available evidence on the results of percutaneous treatment versus surgery in atrial septal defect in pediatric population. For this purpose, the following variables were studied: mortality, complications and length of hospital stay associated with each intervention. As secondary objectives, the effect of age and the size of the atrial septal defect in both approaches was also analyzed. Material and methods: An exhaustive search of the literature was carried out following the PRISMA guidelines. The search strategy was based on a structured question and the descriptors were applied in different databases. Selection criteria were established and allowed the included studies to be chosen. Results: After an initial screening, a total of 21 publications are included: 12 compare both interventions, 5 percutaneous treatment and 4 surgical treatment. Conclusions: Percutaneous and surgical treatment have proven to be safe and effective techniques in closing atrial septal defects. Comparing both techniques, the percutaneous approach has shown a shorter hospital stay and number of complications, these being less serious; along with a superior cosmetic result. Open surgery is an alternative in cases of percutaneous complications and non-ostium secundum type ASD.
Introduction: Atrial septal defect (ASD) is a communication between both atria. It represents 10-15% of all congenital heart defects and is more common in females (2:1), most cases are sporadic and isolated. It can cause a shunt with hemodynamic repercussion in some cases, necessitating intervention. To repair the defect, percutaneous closure with device or surgical closure are considered. Currently, both options are valid, although with different indications, approaches and complications. Objectives: the main objective of this systematic review was to synthesize the available evidence on the results of percutaneous treatment versus surgery in atrial septal defect in pediatric population. For this purpose, the following variables were studied: mortality, complications and length of hospital stay associated with each intervention. As secondary objectives, the effect of age and the size of the atrial septal defect in both approaches was also analyzed. Material and methods: An exhaustive search of the literature was carried out following the PRISMA guidelines. The search strategy was based on a structured question and the descriptors were applied in different databases. Selection criteria were established and allowed the included studies to be chosen. Results: After an initial screening, a total of 21 publications are included: 12 compare both interventions, 5 percutaneous treatment and 4 surgical treatment. Conclusions: Percutaneous and surgical treatment have proven to be safe and effective techniques in closing atrial septal defects. Comparing both techniques, the percutaneous approach has shown a shorter hospital stay and number of complications, these being less serious; along with a superior cosmetic result. Open surgery is an alternative in cases of percutaneous complications and non-ostium secundum type ASD.
Direction
Concheiro Guisán, Ana (Tutorships)
García-Cuenllas Álvarez, Luisa María (Co-tutorships)
Concheiro Guisán, Ana (Tutorships)
García-Cuenllas Álvarez, Luisa María (Co-tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Awake craniotomy: tumor-guided resection
Authorship
E.R.C.
Bachelor of Medicine
E.R.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Intra-axial brain tumors present a significant challenge in the field of neurosurgery. They are complex tumors located in delicate areas, known as eloquent areas, that have a high clinical impact on the patient’s life. Within this context, the ongoing search for new surgical strategies, such as awake craniotomy, stands as a vital element. This revolutionary technique allows precise tumor removal while minimizing the risk of neurological damage to specific brain regions, representing a breakthrough in patient care.
Intra-axial brain tumors present a significant challenge in the field of neurosurgery. They are complex tumors located in delicate areas, known as eloquent areas, that have a high clinical impact on the patient’s life. Within this context, the ongoing search for new surgical strategies, such as awake craniotomy, stands as a vital element. This revolutionary technique allows precise tumor removal while minimizing the risk of neurological damage to specific brain regions, representing a breakthrough in patient care.
Direction
RODRIGUEZ PEREZ, ANA ISABEL (Tutorships)
RODRIGUEZ PEREZ, ANA ISABEL (Tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
The battle against rabies in the late 19th century and early 20th century in Ourense (Galicia)
Authorship
A.R.G.
Bachelor of Medicine
A.R.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
This paper intends to revise the management and treatment of rabies patients in the late19th century in Galicia and early 20th century, which are the immediate years after the discovery of rabies' vaccine by Doctor Louis Pasteur in 1885. Before the rabies’s vaccine most people who were infected by the virus died from it. Nowadays, rabies still poses a great menace to a significant number of people even though it is not endemic in Spain anymore. The World Health Organization (WHO) affirms that rabies is present in more than 150 countries and territories despite being preventable by the widespread use of the vaccine.
This paper intends to revise the management and treatment of rabies patients in the late19th century in Galicia and early 20th century, which are the immediate years after the discovery of rabies' vaccine by Doctor Louis Pasteur in 1885. Before the rabies’s vaccine most people who were infected by the virus died from it. Nowadays, rabies still poses a great menace to a significant number of people even though it is not endemic in Spain anymore. The World Health Organization (WHO) affirms that rabies is present in more than 150 countries and territories despite being preventable by the widespread use of the vaccine.
Direction
Simón Lorda, David (Tutorships)
Simón Lorda, David (Tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Systematic Review on the Prevention of Bronchiolitis due to Respiratory Syncytial Virus (RSV) in Neonates and Infants: Comparison between Nirsevimab and Palivizumab.
Authorship
V.M.S.F.
Bachelor of Medicine
V.M.S.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The Respiratory Syncytial Virus (RSV) is the etiological agent of Bronchiolitis, a pathology of the lower respiratory tract whose epidemiological target lies in pediatric patients, specifically, in those under 24 months of age. Its morbidity and mortality are higher in very premature babies and in infants with risk conditions, such as those with heart disease or immunodeficiencies. Prophylaxis against RSV is vital, since its absence implies a large number of respiratory sequelae and admissions in the short and long term. Objectives: Synthesize the available evidence on the effects and effectiveness of RSV Bronchiolitis Prophylaxis in neonates and infants, using Monoclonal Antibodies and its consequent comparison between the classic (Palivizumab) and the most recent (Nirsevimab), which opens the way to a future of prophylactic possibilities. Material and Methods: An extensive bibliographic search was carried out, using PubMed and the Indexa Magazine, Cochrane Library. The selected articles were clinical trials and comparative case studies (made up of an intervention group: infants, under 12 months of age, with prophylaxis using Nirsevimab; versus a control group: with prophylaxis using placebo or Palivizumab (whose indication is exclusive in at-risk infants). The languages included in the search were Spanish and English. Results: 9 studies that assess the efficacy of the monoclonal antibody were finally included, according to the following criteria: i. the incidence of primary care visits and hospital admissions: which was notably reduced. ii Its safety (assessed by adverse effects of grade greater than 2): the number of adverse reactions was less than 1% of the cases with Nirsevimab. iii. Analysis of acquired resistance to Nirsevimab: the episodes of virus resistance to Nirsevimab were less than 5%, and affected regions other than Fusion Protein F, so they did not alter the efficacy of the monoclonal antibody. iv.Its cost-effectiveness (profitability): considered profitable. All articles found statistically significant differences in favor of Nirsevimab compared to placebo or Palivizumab. Conclusions: Nirsevimab is an extraordinarily effective prophylaxis, with an outstanding safety profile, great tolerability and high susceptibility. Furthermore, its application at the Healthcare level is considered profitable, compared to Palivizumab or the absence of prophylaxis.
Introduction: The Respiratory Syncytial Virus (RSV) is the etiological agent of Bronchiolitis, a pathology of the lower respiratory tract whose epidemiological target lies in pediatric patients, specifically, in those under 24 months of age. Its morbidity and mortality are higher in very premature babies and in infants with risk conditions, such as those with heart disease or immunodeficiencies. Prophylaxis against RSV is vital, since its absence implies a large number of respiratory sequelae and admissions in the short and long term. Objectives: Synthesize the available evidence on the effects and effectiveness of RSV Bronchiolitis Prophylaxis in neonates and infants, using Monoclonal Antibodies and its consequent comparison between the classic (Palivizumab) and the most recent (Nirsevimab), which opens the way to a future of prophylactic possibilities. Material and Methods: An extensive bibliographic search was carried out, using PubMed and the Indexa Magazine, Cochrane Library. The selected articles were clinical trials and comparative case studies (made up of an intervention group: infants, under 12 months of age, with prophylaxis using Nirsevimab; versus a control group: with prophylaxis using placebo or Palivizumab (whose indication is exclusive in at-risk infants). The languages included in the search were Spanish and English. Results: 9 studies that assess the efficacy of the monoclonal antibody were finally included, according to the following criteria: i. the incidence of primary care visits and hospital admissions: which was notably reduced. ii Its safety (assessed by adverse effects of grade greater than 2): the number of adverse reactions was less than 1% of the cases with Nirsevimab. iii. Analysis of acquired resistance to Nirsevimab: the episodes of virus resistance to Nirsevimab were less than 5%, and affected regions other than Fusion Protein F, so they did not alter the efficacy of the monoclonal antibody. iv.Its cost-effectiveness (profitability): considered profitable. All articles found statistically significant differences in favor of Nirsevimab compared to placebo or Palivizumab. Conclusions: Nirsevimab is an extraordinarily effective prophylaxis, with an outstanding safety profile, great tolerability and high susceptibility. Furthermore, its application at the Healthcare level is considered profitable, compared to Palivizumab or the absence of prophylaxis.
Direction
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Durán Fernández-Feijóo, Cristina (Co-tutorships)
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Durán Fernández-Feijóo, Cristina (Co-tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
Pharmacogenetics of Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder (ADHD)
Authorship
A.R.P.
Bachelor of Medicine
A.R.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction Attention Deficit Hyperactivity Disorder (ADHD) is a neuropsychiatric disorder that affects children and adults, characterized, depending on the type, by inattention, hyperactivity, and impulsivity. In this context, methylphenidate is the most common pharmacological treatment, and the pharmacogenetics of this drug emerges as a promising field of study by examining how genetic variations influence drug response. Objectives Conduct a systematic review to evaluate the relationship between specific genetic variations and the response of ADHD patients to treatment with methylphenidate. Methodology Following the PRISMA statement, a systematic search was conducted using a search equation in two databases, Pubmed and Scopus, and a series of criteria were established to filter the obtained results. Results and Discussion Out of a total of 144 articles, five were included in this review. Significant associations were found with a better response to methylphenidate in variants such as a 6-repeat VNTR in the SLC6A3 gene, a SNP in the COMT gene (Val158Met), and another SNP in the NET/SLC6A2 gene (rs2836840). Similarly, associations with a worse response were found, such as a 10- repeat VNTR in the SLC6A3 gene, rs1800497 in the DRD2 gene, and a 7-repeat VNTR in the DRD4 gene. However, these articles present certain limitations, and the evidence for these polymorphisms is not yet conclusive, so they cannot yet be applied to clinical practice. Conclusions Pharmacogenetics offers significant promise for the personalization of ADHD treatment with methylphenidate, but more studies are needed to confirm these findings and translate them into concrete clinical recommendations. Thus, it is essential to continue exploring this area and addressing the existing limitations to further advance this field of knowledge. Keywords ADHD, Methylphenidate, Pharmacogenetics, Personalized Treatment, Genetic Polymorphisms.
Introduction Attention Deficit Hyperactivity Disorder (ADHD) is a neuropsychiatric disorder that affects children and adults, characterized, depending on the type, by inattention, hyperactivity, and impulsivity. In this context, methylphenidate is the most common pharmacological treatment, and the pharmacogenetics of this drug emerges as a promising field of study by examining how genetic variations influence drug response. Objectives Conduct a systematic review to evaluate the relationship between specific genetic variations and the response of ADHD patients to treatment with methylphenidate. Methodology Following the PRISMA statement, a systematic search was conducted using a search equation in two databases, Pubmed and Scopus, and a series of criteria were established to filter the obtained results. Results and Discussion Out of a total of 144 articles, five were included in this review. Significant associations were found with a better response to methylphenidate in variants such as a 6-repeat VNTR in the SLC6A3 gene, a SNP in the COMT gene (Val158Met), and another SNP in the NET/SLC6A2 gene (rs2836840). Similarly, associations with a worse response were found, such as a 10- repeat VNTR in the SLC6A3 gene, rs1800497 in the DRD2 gene, and a 7-repeat VNTR in the DRD4 gene. However, these articles present certain limitations, and the evidence for these polymorphisms is not yet conclusive, so they cannot yet be applied to clinical practice. Conclusions Pharmacogenetics offers significant promise for the personalization of ADHD treatment with methylphenidate, but more studies are needed to confirm these findings and translate them into concrete clinical recommendations. Thus, it is essential to continue exploring this area and addressing the existing limitations to further advance this field of knowledge. Keywords ADHD, Methylphenidate, Pharmacogenetics, Personalized Treatment, Genetic Polymorphisms.
Direction
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
MAROÑAS AMIGO, OLALLA (Co-tutorships)
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
MAROÑAS AMIGO, OLALLA (Co-tutorships)
Court
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
VARO PEREZ, EVARISTO (Chairman)
ARIAS RIVAS, SUSANA (Secretary)
DIAZ RUIZ, MARIA DEL CARMEN (Member)
The use of Transcranial Magnetic Stimulation in Bipolar Depression: a systematic review
Authorship
J.V.M.
Bachelor of Medicine
J.V.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Transcranial magnetic stimulation is a non-invasive brain stimulation technique. Currently, it is advocated as a safe technique, capable of depolarizing neurons and effectuate therapeutic effect in disease of the central nervous system, for instance, major depression. Given the increase in scientific production and the discordance about the results regarding its efficacy in the treatment of bipolar depression, we sought to analyze the evidence concerning it use in this pathology in a systematic review. Objectives: to conduct a systematic review of the current literature on the efficacy of transcranial magnetic stimulation in the treatment of bipolar disorder and to evaluate the different protocols Methods: a search was performed in the MEDLINE/PubMed and Cochrane Library databases according to the PRISMA guidelines, selecting systematic reviews and meta-analyses published between 2014 and 2024. Results: seven systematic reviews were included, covering a total of sixty-six independent articles, which evaluated the use of transcranial magnetic stimulation in bipolar disorder Conclusions: transcranial magnetic stimulation offers promising results in the treatment of bipolar depression. Sequential and deep stimulation seems to have a greater beneficial effect, but further studies are required. It has been observed that it is a safe technique for patients with few adverse effects. The available evidence comes from studies with small sample sizes and low methodological quality; hence, further research is essential to draw a definitive conclusion.
Introduction: Transcranial magnetic stimulation is a non-invasive brain stimulation technique. Currently, it is advocated as a safe technique, capable of depolarizing neurons and effectuate therapeutic effect in disease of the central nervous system, for instance, major depression. Given the increase in scientific production and the discordance about the results regarding its efficacy in the treatment of bipolar depression, we sought to analyze the evidence concerning it use in this pathology in a systematic review. Objectives: to conduct a systematic review of the current literature on the efficacy of transcranial magnetic stimulation in the treatment of bipolar disorder and to evaluate the different protocols Methods: a search was performed in the MEDLINE/PubMed and Cochrane Library databases according to the PRISMA guidelines, selecting systematic reviews and meta-analyses published between 2014 and 2024. Results: seven systematic reviews were included, covering a total of sixty-six independent articles, which evaluated the use of transcranial magnetic stimulation in bipolar disorder Conclusions: transcranial magnetic stimulation offers promising results in the treatment of bipolar depression. Sequential and deep stimulation seems to have a greater beneficial effect, but further studies are required. It has been observed that it is a safe technique for patients with few adverse effects. The available evidence comes from studies with small sample sizes and low methodological quality; hence, further research is essential to draw a definitive conclusion.
Direction
ARROJO ROMERO, MANUEL (Tutorships)
Núñez Sande, Carmen (Co-tutorships)
ARROJO ROMERO, MANUEL (Tutorships)
Núñez Sande, Carmen (Co-tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Definition and treatment of severe uncontrolled asthma. Use of biologic treatment options in the Sanitary Area of Santiago regarding a series of cases
Authorship
A.V.O.
Bachelor of Medicine
A.V.O.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Asthma is one of the most prevalent respiratory diseases in Spain. Its large number of patients means that its involvement and symptoms are heterogeneous. To facilitate the approach, patients can be divided into several subgroups according to their phenotype and the level of control of their asthma. The therapeutic approach of asthmatic patients must be multifactorial and pharmacological treatment strategies are divided into six levels according to the severity and difficulty of symptomatic control in each patient. In recent years, biologic drugs have opened a window of opportunity for the treatment of severe uncontrolled asthma. These drugs, framed in the last step of treatment and supported by multiple studies, act on different inflammatory mediators involved in the pathogenesis of this disease. The available evidence shows that they improve symptomatic control and lung function as well as reduce exacerbations and the need for oral glucocorticoids. This work seeks to synthesize the available evidence on severe asthma and the use of biological treatments, using as a guiding principle several noteworthy cases of patients from the Área Sanitaria de Santiago e Barbanza.
Asthma is one of the most prevalent respiratory diseases in Spain. Its large number of patients means that its involvement and symptoms are heterogeneous. To facilitate the approach, patients can be divided into several subgroups according to their phenotype and the level of control of their asthma. The therapeutic approach of asthmatic patients must be multifactorial and pharmacological treatment strategies are divided into six levels according to the severity and difficulty of symptomatic control in each patient. In recent years, biologic drugs have opened a window of opportunity for the treatment of severe uncontrolled asthma. These drugs, framed in the last step of treatment and supported by multiple studies, act on different inflammatory mediators involved in the pathogenesis of this disease. The available evidence shows that they improve symptomatic control and lung function as well as reduce exacerbations and the need for oral glucocorticoids. This work seeks to synthesize the available evidence on severe asthma and the use of biological treatments, using as a guiding principle several noteworthy cases of patients from the Área Sanitaria de Santiago e Barbanza.
Direction
VALDES CUADRADO, LUIS GUILLERMO (Tutorships)
Lama López, Adriana (Co-tutorships)
VALDES CUADRADO, LUIS GUILLERMO (Tutorships)
Lama López, Adriana (Co-tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Global socio-geographical analysis of tuberculosis: Causes of the high prevalence of multidrug-resistant tuberculosis in the countries of the former Soviet Union countries.
Authorship
T.V.N.
Bachelor of Medicine
T.V.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
In 2022, approximately 10.6 million people contracted tuberculosis worldwide. The most affected regions are Southeast Asia, with 234 cases per 100,000 inhabitants, and Africa, with 208 cases per 100,000 inhabitants. However, the region with the highest proportion of MDR tuberculosis relative to the total is Eastern Europe and Central Asia, where several countries exceed 30% in new tuberculosis cases and 50% in previously treated cases. The fifteen countries with the highest rates of MDR tuberculosis were part of the former Soviet Union. The objective is to analyze the factors stemming from the fall of the Soviet Union that contributed to the increase in the prevalence of MDR tuberculosis in the region. Initially, a review of the global burden of tuberculosis was conducted using the Web of Science, PubMed, and Scopus databases. A total of 26,211 articles were found, of which 50 met the selection criteria. Their review focused on the incidences of MDR tuberculosis and tuberculosis in prisons in the Eastern European and Central Asian region. This initial analysis was expanded through the review of the bibliographies of the selected articles, which allowed the identification of additional relevant studies addressing factors associated with the development of multidrug resistance in the region. The analysis of the included articles showed that the collapse of the healthcare system and the socioeconomic conditions brought with the fall of the Soviet Union appear to have had a significant impact on the increase in the prevalence of MDR tuberculosis in the countries of Eastern Europe and Central Asia. The reviewed literature reveals that the factors contributing to this increase were inadequate treatment, delays in antibiotic sensitivity testing, nosocomial transmission, an increase in incarcerations, HIV co-infection, and increased alcohol and drug consumption.
In 2022, approximately 10.6 million people contracted tuberculosis worldwide. The most affected regions are Southeast Asia, with 234 cases per 100,000 inhabitants, and Africa, with 208 cases per 100,000 inhabitants. However, the region with the highest proportion of MDR tuberculosis relative to the total is Eastern Europe and Central Asia, where several countries exceed 30% in new tuberculosis cases and 50% in previously treated cases. The fifteen countries with the highest rates of MDR tuberculosis were part of the former Soviet Union. The objective is to analyze the factors stemming from the fall of the Soviet Union that contributed to the increase in the prevalence of MDR tuberculosis in the region. Initially, a review of the global burden of tuberculosis was conducted using the Web of Science, PubMed, and Scopus databases. A total of 26,211 articles were found, of which 50 met the selection criteria. Their review focused on the incidences of MDR tuberculosis and tuberculosis in prisons in the Eastern European and Central Asian region. This initial analysis was expanded through the review of the bibliographies of the selected articles, which allowed the identification of additional relevant studies addressing factors associated with the development of multidrug resistance in the region. The analysis of the included articles showed that the collapse of the healthcare system and the socioeconomic conditions brought with the fall of the Soviet Union appear to have had a significant impact on the increase in the prevalence of MDR tuberculosis in the countries of Eastern Europe and Central Asia. The reviewed literature reveals that the factors contributing to this increase were inadequate treatment, delays in antibiotic sensitivity testing, nosocomial transmission, an increase in incarcerations, HIV co-infection, and increased alcohol and drug consumption.
Direction
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Perinatal mortality analysis in A Coruña’s University Hospital Complex between 2019 and 2023.
Authorship
G.V.N.
Bachelor of Medicine
G.V.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction and Objectives: Perinatal mortality, which includes intrauterine fetal deaths, intrapartum deaths, and neonatal deaths, presents a significant challenge in obstetric and neonatal care. Hospitals must implement rigorous protocols, including genetic analysis, placental anatomopathological examination, and fetal necropsy, to address the causes of perinatal mortality (especially the unknown cause). This study aims to describe perinatal mortality at a health centre between 2019-2023 and analyze some subgroups of interest to enhance understanding and care in this field. Materials and Methods: A descriptive retrospective study was conducted using a hospital’s perinatal mortality database for the period 2019-2023, with N=88. Key variables, such as prenatal, birth and neonatal data, as well as maternal variables of interest, were described. Bivariant analysis of specific subgroups: extreme preterm births (less than 26 weeks), deaths due to infection, and deaths due to fetal growth restriction, was performed to identify relevant associations and patterns. Results: The perinatal mortality rate was 7.57/1000 live births, and by death moment they were 3.26/1000 live births for intrauterine fetal mortality, 1.53/1000 live births for intrapartum mortality and 2.78/1000 live births for neonatal mortality. Significant differences were observed in subgroups, with associations with disorders such as hypertension or chorioamnionitis and the presence of anatomopathological alterations in the placenta. Conclusions: The results highlight the importance of implementing and applying effective protocols to address perinatal mortality (especially the unknown cause) and improve obstetric and neonatal care. Despite some slightly elevated mortality rates, positive practices were identified, such as the high percentage of necropsies performed. The results emphasize the need for exhaustive anatomopathological analysis of the placenta for a better understanding of the causes of perinatal mortality and more effective care.
Introduction and Objectives: Perinatal mortality, which includes intrauterine fetal deaths, intrapartum deaths, and neonatal deaths, presents a significant challenge in obstetric and neonatal care. Hospitals must implement rigorous protocols, including genetic analysis, placental anatomopathological examination, and fetal necropsy, to address the causes of perinatal mortality (especially the unknown cause). This study aims to describe perinatal mortality at a health centre between 2019-2023 and analyze some subgroups of interest to enhance understanding and care in this field. Materials and Methods: A descriptive retrospective study was conducted using a hospital’s perinatal mortality database for the period 2019-2023, with N=88. Key variables, such as prenatal, birth and neonatal data, as well as maternal variables of interest, were described. Bivariant analysis of specific subgroups: extreme preterm births (less than 26 weeks), deaths due to infection, and deaths due to fetal growth restriction, was performed to identify relevant associations and patterns. Results: The perinatal mortality rate was 7.57/1000 live births, and by death moment they were 3.26/1000 live births for intrauterine fetal mortality, 1.53/1000 live births for intrapartum mortality and 2.78/1000 live births for neonatal mortality. Significant differences were observed in subgroups, with associations with disorders such as hypertension or chorioamnionitis and the presence of anatomopathological alterations in the placenta. Conclusions: The results highlight the importance of implementing and applying effective protocols to address perinatal mortality (especially the unknown cause) and improve obstetric and neonatal care. Despite some slightly elevated mortality rates, positive practices were identified, such as the high percentage of necropsies performed. The results emphasize the need for exhaustive anatomopathological analysis of the placenta for a better understanding of the causes of perinatal mortality and more effective care.
Direction
Leis Trabazo, María Rosaura (Tutorships)
Fuentes Carballal, Jesús Alberto (Co-tutorships)
Leis Trabazo, María Rosaura (Tutorships)
Fuentes Carballal, Jesús Alberto (Co-tutorships)
Court
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
MERA VARELA, ANTONIO JOSE (Chairman)
CAICEDO VALDES, DIEGO JESUS (Secretary)
SAAVEDRA NIEVES, PAULA (Member)
Analysis of the role of social media as a teaching tool in medicine.
Authorship
I.B.V.
Bachelor of Medicine
I.B.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
BACKGROUND: Social media have become an essential tool for relationships, advertising, divulgation... Their rise in the health field makes possible their usefulness not only in health promotion, but also in teaching. OBJECTIVE: To analyse the assessment that medical USC students make about their use as a complementary teaching tool to their university education. METHODS: A questionnaire (n=406) is given asking about the frequency of use for this purpose, the networks and content they consume, the purpose that motivates their use, the advantages and disadvantages or the reliability of their sources, among others. RESULTS: The majority confessed to using them as a complementary didactic resource (97.54%) at least once a week (74.14%), as 94.08% considered them useful or very useful, especially for the acquisition of new knowledge (39.90%). YouTube (85.10%), Instagram (72.98%) and TikTok (53.28%) are the preferred social networks for medical learning and short videos (92.17%), images (79.55%) and explanatory texts or threads (44.70%) are the favourite content for this, especially from healthcare personnel (91.16%). The main perceived advantage is the access to more visual and dynamic (87.44%) and easily accessible (80.05%) information and, as disadvantages, unreliable sources or inappropriate content (85.47%) and loss of time or distraction (47.78%). 85.96% are in favour of promoting this tool through short videos (86.45%), images (71.92%) and questions or questionnaires with explanation (41.63%) and believe that the area of Morphology, structure and function of the human body would be the most benefited by its use (82.27%). CONCLUSIONS: Social media are a teaching resource that interests students, but there is a lack of more analytical studies studying the results of various interventions in learning, which would lead to being able to implement them in teaching.
BACKGROUND: Social media have become an essential tool for relationships, advertising, divulgation... Their rise in the health field makes possible their usefulness not only in health promotion, but also in teaching. OBJECTIVE: To analyse the assessment that medical USC students make about their use as a complementary teaching tool to their university education. METHODS: A questionnaire (n=406) is given asking about the frequency of use for this purpose, the networks and content they consume, the purpose that motivates their use, the advantages and disadvantages or the reliability of their sources, among others. RESULTS: The majority confessed to using them as a complementary didactic resource (97.54%) at least once a week (74.14%), as 94.08% considered them useful or very useful, especially for the acquisition of new knowledge (39.90%). YouTube (85.10%), Instagram (72.98%) and TikTok (53.28%) are the preferred social networks for medical learning and short videos (92.17%), images (79.55%) and explanatory texts or threads (44.70%) are the favourite content for this, especially from healthcare personnel (91.16%). The main perceived advantage is the access to more visual and dynamic (87.44%) and easily accessible (80.05%) information and, as disadvantages, unreliable sources or inappropriate content (85.47%) and loss of time or distraction (47.78%). 85.96% are in favour of promoting this tool through short videos (86.45%), images (71.92%) and questions or questionnaires with explanation (41.63%) and believe that the area of Morphology, structure and function of the human body would be the most benefited by its use (82.27%). CONCLUSIONS: Social media are a teaching resource that interests students, but there is a lack of more analytical studies studying the results of various interventions in learning, which would lead to being able to implement them in teaching.
Direction
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
Souto Bayarri, José Miguel (Co-tutorships)
Sánchez Varela, Nerea (Co-tutorships)
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
Souto Bayarri, José Miguel (Co-tutorships)
Sánchez Varela, Nerea (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Multiple Sclerosis associated insomnia impact in the patient perception of quality of life and fatigue, a systematic review.
Authorship
M.B.C.
Bachelor of Medicine
M.B.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Precedents: The relationship between Multiple Sclerosis (MS) and insomnia has been widely studied in the last years; although, few evidence is still available about how and how much this association may be influencing the quality of life of MS patients, or even if this association may explain, at less partially, the presence of chronic fatigue. Objectives: 1)To reunite the existent evidence about the relationship between MS and insomnia. 2)To get to know which is insomnia’s impact in the life quality of MS patients. 3)To describe the possible relationship between insomnia and fatigue in MS. 4)To elaborate a proposal of a systematic screening for fatigue, quality of life and sleep disorders in MS population. Methods: Two systematic protocols were elaborated so they fit our objectives the best possible. We performed the correspondent searches at the platforms PubMed, Scopus, Dialnet and Google Scholar. We selected the findings according to PRISMA group premises. Results: A total of 300 articles about quality of life and 531 about fatigue were found; although only 14 and 7 (respectively) accomplished our requirements and, for instance, were included in the systematic review. The articles were mainly cross-sectional. The global analysis shows a positive relationship between insomnia and worse quality of life, so as between insomnia and a greater fatigue perceived. Conclusions: 1) There is a greater prevalence of insomnia in MS population in comparison with the general population (52%). 2) The presence of insomnia in MS patients correlates with worse results at life quality scales. 3) In MS patients, insomnia is significatively associated with a “secondary fatigue”; although, it is not possible to isolate this relationship from some possible confounders. 4)We have made a proposal of a protocol for the detection of fatigue, life quality and sleep disorders in MS.
Precedents: The relationship between Multiple Sclerosis (MS) and insomnia has been widely studied in the last years; although, few evidence is still available about how and how much this association may be influencing the quality of life of MS patients, or even if this association may explain, at less partially, the presence of chronic fatigue. Objectives: 1)To reunite the existent evidence about the relationship between MS and insomnia. 2)To get to know which is insomnia’s impact in the life quality of MS patients. 3)To describe the possible relationship between insomnia and fatigue in MS. 4)To elaborate a proposal of a systematic screening for fatigue, quality of life and sleep disorders in MS population. Methods: Two systematic protocols were elaborated so they fit our objectives the best possible. We performed the correspondent searches at the platforms PubMed, Scopus, Dialnet and Google Scholar. We selected the findings according to PRISMA group premises. Results: A total of 300 articles about quality of life and 531 about fatigue were found; although only 14 and 7 (respectively) accomplished our requirements and, for instance, were included in the systematic review. The articles were mainly cross-sectional. The global analysis shows a positive relationship between insomnia and worse quality of life, so as between insomnia and a greater fatigue perceived. Conclusions: 1) There is a greater prevalence of insomnia in MS population in comparison with the general population (52%). 2) The presence of insomnia in MS patients correlates with worse results at life quality scales. 3) In MS patients, insomnia is significatively associated with a “secondary fatigue”; although, it is not possible to isolate this relationship from some possible confounders. 4)We have made a proposal of a protocol for the detection of fatigue, life quality and sleep disorders in MS.
Direction
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Effectiveness of a Suicide Prevention Program in the Health Area of Vigo
Authorship
J.C.D.B.R.
Bachelor of Medicine
J.C.D.B.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Suicide is one of the leading causes of death worldwide, representing a major public health problem. The Suicide Prevention Unit of Vigo carries out specific suicide prevention activities through a six-month work program with people at risk of suicidal behavior. This study aims to evaluate the results of this program, both in terms of the reduction of suicide attempts and in the subjective perception of improvement by the participants. We also looked at whether variations in this subjective perception could predict the recurrence of suicide attempts. An observational and descriptive study was carried out, using data collected from the medical records of patients treated in the unit. Data from the first 300 people served were analyzed. The subjective perception of improvement was measured using the Outcome Rating Scale (ORS) questionnaire in each clinical psychology session. During the program, 15.33% of people made a suicide attempt. An improvement in ORS was observed when comparing pre- and post-program evaluations. However, no correlations were found between changes in ORS scores and recurrence of suicide attempts. The results of Vigo's UPS program are comparable to those of other suicide prevention programs that have shown a reduction in suicide attempts. In conclusion, the implementation of a suicide prevention unit in outpatient settings can have a positive impact on reducing suicide attempts and improving the overall well-being of patients. It is recommended that these types of units be expanded and that additional studies be conducted to further evaluate their long-term effectiveness.
Suicide is one of the leading causes of death worldwide, representing a major public health problem. The Suicide Prevention Unit of Vigo carries out specific suicide prevention activities through a six-month work program with people at risk of suicidal behavior. This study aims to evaluate the results of this program, both in terms of the reduction of suicide attempts and in the subjective perception of improvement by the participants. We also looked at whether variations in this subjective perception could predict the recurrence of suicide attempts. An observational and descriptive study was carried out, using data collected from the medical records of patients treated in the unit. Data from the first 300 people served were analyzed. The subjective perception of improvement was measured using the Outcome Rating Scale (ORS) questionnaire in each clinical psychology session. During the program, 15.33% of people made a suicide attempt. An improvement in ORS was observed when comparing pre- and post-program evaluations. However, no correlations were found between changes in ORS scores and recurrence of suicide attempts. The results of Vigo's UPS program are comparable to those of other suicide prevention programs that have shown a reduction in suicide attempts. In conclusion, the implementation of a suicide prevention unit in outpatient settings can have a positive impact on reducing suicide attempts and improving the overall well-being of patients. It is recommended that these types of units be expanded and that additional studies be conducted to further evaluate their long-term effectiveness.
Direction
OLIVARES DIEZ, JOSE MANUEL (Tutorships)
Rivera Baltanás, Tania (Co-tutorships)
OLIVARES DIEZ, JOSE MANUEL (Tutorships)
Rivera Baltanás, Tania (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Evidence on the role of Exclusive Breastfeeding as a protective factor against relapses of Recurrent Remitting Multiple Sclerosis.
Authorship
N.B.B.
Bachelor of Medicine
N.B.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Multiple Sclerosis is an autoimmune pathology of the nervous system. The most common variant of this disease is due to events of clinical activity interspersed with asymptomatic periods and is called Recurrent-Remitting Multiple Sclerosis. The review focuses on this subtype because it´s very prevalent among women (with a ratio 3:1 versus men) of childbearing age (maximum between 20-40 years). Therefore, issues such as pregnancy or breastfeeding are very relevant for patients. There is enough evidence about the existence of a phenomenon of immunotolerance during gestation, related to the levels of female sex hormones; however, this tolerance is lost after childbirth and some women experience an increase in relapses. Because of this, there is a need to implement a strategy for the prevention of such exacerbations. The AEMPS advises against most disease-modifying treatments during pregnancy and breastfeeding, which leads us to wonder if breastfeeding is safe against disease exacerbations. The main purpose of the review is to find the best available scientific evidence on whether exclusive breastfeeding can be used as a way to prevent relapses of the disease during postpartum. After a systematic research, we included 11 observational studies that compare the incidence of postpartum relapses among a group of women who breastfed exclusively, against a group of patients who did not breastfeed, or this was not exclusive for a minimum of 2-4 months. As a result, it was found that exclusive breastfeeding has a moderate protective effect against postpartum relapses, which could last a maximum of 6 months, although this duration needs to be confirmed by future studies.
Multiple Sclerosis is an autoimmune pathology of the nervous system. The most common variant of this disease is due to events of clinical activity interspersed with asymptomatic periods and is called Recurrent-Remitting Multiple Sclerosis. The review focuses on this subtype because it´s very prevalent among women (with a ratio 3:1 versus men) of childbearing age (maximum between 20-40 years). Therefore, issues such as pregnancy or breastfeeding are very relevant for patients. There is enough evidence about the existence of a phenomenon of immunotolerance during gestation, related to the levels of female sex hormones; however, this tolerance is lost after childbirth and some women experience an increase in relapses. Because of this, there is a need to implement a strategy for the prevention of such exacerbations. The AEMPS advises against most disease-modifying treatments during pregnancy and breastfeeding, which leads us to wonder if breastfeeding is safe against disease exacerbations. The main purpose of the review is to find the best available scientific evidence on whether exclusive breastfeeding can be used as a way to prevent relapses of the disease during postpartum. After a systematic research, we included 11 observational studies that compare the incidence of postpartum relapses among a group of women who breastfed exclusively, against a group of patients who did not breastfeed, or this was not exclusive for a minimum of 2-4 months. As a result, it was found that exclusive breastfeeding has a moderate protective effect against postpartum relapses, which could last a maximum of 6 months, although this duration needs to be confirmed by future studies.
Direction
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
PRIETO GONZALEZ, JOSE MARIA OSCAR (Tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
The impact of COVID-19 on joint inflammatory pathology. A literature review.
Authorship
L.P.A.
Bachelor of Medicine
L.P.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
The pandemic caused by SARS-CoV-2 has led to the emergence of pathology in various systems; therefore, this study focuses on the impact of COVID-19 on inflammatory pathology. The research is based on a systematic review of the scientific literature available in the PubMed, ScienceDirect and Scopus databases, following PRISMA guidelines. A total of 58 articles describing cases of arthritis following SARS-CoV-2 infection were analyzed, considering aspects such as sex distribution, ethnic origin, time until the onset of joint symptoms, affected joints, diagnostic methods and treatments administered. The results show that post-COVID-19 arthritis predominantly affects individuals in their fourth decade of life, with an almost equal distribution between both sexes. Joint symptoms typically appear approximately one month after the onset of the infection by the virion, with the most frequently affected joints being the knee, ankle and wrist. However, reports of extra-articular manifestations have been scarce. Regarding diagnostic methods, serological markers were negative in the majority of the individuals in the sample. The most common therapeutic management includes the combined treatment of non-steroidal anti-inflammatory drugs (NSAID) and corticosteroids. Most patients reported a benign course, with symptom resolution in approximately one month. However, a small percentage of cases show a more prolonged and complicated course, requiring the use of disease-modifying antirheumatic drugs (DMARD) and, in some cases, biological therapies or surgical interventions.
The pandemic caused by SARS-CoV-2 has led to the emergence of pathology in various systems; therefore, this study focuses on the impact of COVID-19 on inflammatory pathology. The research is based on a systematic review of the scientific literature available in the PubMed, ScienceDirect and Scopus databases, following PRISMA guidelines. A total of 58 articles describing cases of arthritis following SARS-CoV-2 infection were analyzed, considering aspects such as sex distribution, ethnic origin, time until the onset of joint symptoms, affected joints, diagnostic methods and treatments administered. The results show that post-COVID-19 arthritis predominantly affects individuals in their fourth decade of life, with an almost equal distribution between both sexes. Joint symptoms typically appear approximately one month after the onset of the infection by the virion, with the most frequently affected joints being the knee, ankle and wrist. However, reports of extra-articular manifestations have been scarce. Regarding diagnostic methods, serological markers were negative in the majority of the individuals in the sample. The most common therapeutic management includes the combined treatment of non-steroidal anti-inflammatory drugs (NSAID) and corticosteroids. Most patients reported a benign course, with symptom resolution in approximately one month. However, a small percentage of cases show a more prolonged and complicated course, requiring the use of disease-modifying antirheumatic drugs (DMARD) and, in some cases, biological therapies or surgical interventions.
Direction
PINO MINGUEZ, JESUS (Tutorships)
GUALILLO , ORESTE (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
GUALILLO , ORESTE (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Comparison of different devices for orotracheal intubation during cardiopulmoar resuscitation performed by non-expert healthcare personnel in airway management, in a simulation environment
Authorship
L.R.P.N.
Bachelor of Medicine
L.R.P.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Several studies have compared the conventional laryngoscope with various video laryngoscopy devices; however, there is insufficient scientific evidence to demonstrate that either one presents significantly superior advantages over the other. This study aims to analyze, through both objective and subjective variables, whether there are appreciable differences in their clinical and educational application for airway management during cardiopulmonary resuscitation (CPR). Method: The performance of the McGrath video laryngoscope and the Macintosh laryngoscope was compared by evaluating 30 medical students with no prior experience in airway management, using simulation manikins in a cardiac arrest scenario. The variables assessed included intubation success, time required, and the number of attempts needed. Additionally, subjective information on the difficulty and preferences for the use of the devices was obtained through an anonymous survey. Results: Both instruments were comparable in terms of intubation success, elapsed time, and the number of attempts. However, there was a statistically significant subjective preference for the video laryngoscope, particularly in the context of a real CPR intubation. Conclusions: From a technical perspective, both devices proved to be comparable. Nonetheless, the preference for the video laryngoscope and the ease of use reported by participants suggest that it could be a good alternative in critical real-life situations. Its integration is recommended in services with a high incidence of cardiac arrest and in CPR training programs.
Introduction: Several studies have compared the conventional laryngoscope with various video laryngoscopy devices; however, there is insufficient scientific evidence to demonstrate that either one presents significantly superior advantages over the other. This study aims to analyze, through both objective and subjective variables, whether there are appreciable differences in their clinical and educational application for airway management during cardiopulmonary resuscitation (CPR). Method: The performance of the McGrath video laryngoscope and the Macintosh laryngoscope was compared by evaluating 30 medical students with no prior experience in airway management, using simulation manikins in a cardiac arrest scenario. The variables assessed included intubation success, time required, and the number of attempts needed. Additionally, subjective information on the difficulty and preferences for the use of the devices was obtained through an anonymous survey. Results: Both instruments were comparable in terms of intubation success, elapsed time, and the number of attempts. However, there was a statistically significant subjective preference for the video laryngoscope, particularly in the context of a real CPR intubation. Conclusions: From a technical perspective, both devices proved to be comparable. Nonetheless, the preference for the video laryngoscope and the ease of use reported by participants suggest that it could be a good alternative in critical real-life situations. Its integration is recommended in services with a high incidence of cardiac arrest and in CPR training programs.
Direction
TABOADA MUÑIZ, MANUEL (Tutorships)
Nieto Mouronte, Carlos Manuel (Co-tutorships)
TABOADA MUÑIZ, MANUEL (Tutorships)
Nieto Mouronte, Carlos Manuel (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Anesthesia in electroconvulsive therapy in psychiatric patient
Authorship
D.P.C.
Bachelor of Medicine
D.P.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background Electroconvulsive therapy (ECT) is currently a highly effective treatment for various psychiatric conditions, especially indicated in severe and treatment-resistant disorders, without absolute contraindications. To optimize its therapeutic outcome, close collaboration among psychiatry, anesthesia, and nursing staff is necessary. A fundamental pillar for obtaining maximum benefit, with minimal adverse effects, must be a correct anesthetic technique. Objectives To provide the best and most up-to-date scientific evidence regarding anesthetic induction in ECT, particularly by comparing the different available anesthetic agents in terms of psychiatric clinical outcomes, cognitive function, effect on seizure parameters, and adverse effects. Material and methods A systematic review of the scientific literature in PubMed and Cochrane on clinical trials over the past 10 years was conducted. Finally, 22 articles were included in this work. Results Ketamine could improve depressive symptoms and be particularly useful in patients with a high risk of suicide. Additionally, it might reduce the cognitive impairment associated with ECT and has not been linked to an increase in major adverse effects. Measuring brain-derived neurotrophic factor (BDNF) and certain electrocardiographic parameters could be useful to enhance the quality and safety of ECT. Conclusions Given the disparate results of the analyzed research and the existing limitations in most of them, it is necessary to conduct studies with greater scientific rigor that evaluate, in the long term and in different psychiatric conditions, the various drugs available for anesthetic induction in ECT.
Background Electroconvulsive therapy (ECT) is currently a highly effective treatment for various psychiatric conditions, especially indicated in severe and treatment-resistant disorders, without absolute contraindications. To optimize its therapeutic outcome, close collaboration among psychiatry, anesthesia, and nursing staff is necessary. A fundamental pillar for obtaining maximum benefit, with minimal adverse effects, must be a correct anesthetic technique. Objectives To provide the best and most up-to-date scientific evidence regarding anesthetic induction in ECT, particularly by comparing the different available anesthetic agents in terms of psychiatric clinical outcomes, cognitive function, effect on seizure parameters, and adverse effects. Material and methods A systematic review of the scientific literature in PubMed and Cochrane on clinical trials over the past 10 years was conducted. Finally, 22 articles were included in this work. Results Ketamine could improve depressive symptoms and be particularly useful in patients with a high risk of suicide. Additionally, it might reduce the cognitive impairment associated with ECT and has not been linked to an increase in major adverse effects. Measuring brain-derived neurotrophic factor (BDNF) and certain electrocardiographic parameters could be useful to enhance the quality and safety of ECT. Conclusions Given the disparate results of the analyzed research and the existing limitations in most of them, it is necessary to conduct studies with greater scientific rigor that evaluate, in the long term and in different psychiatric conditions, the various drugs available for anesthetic induction in ECT.
Direction
Álvarez Escudero, Julián (Tutorships)
Otero Ibáñez, Ildefonso Fernando (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
Otero Ibáñez, Ildefonso Fernando (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Wrist and Hand injuries associated with combat sports: a systematic literature review.
Authorship
F.P.M.
Bachelor of Medicine
F.P.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
The notable increase in the practice of contact sports in recent years has resulted in a corresponding rise in injuries associated with this activity, both in professional athletes and amateurs. Among the most frequent injuries are those affecting the wrist and hand, such as fractures of the metacarpal and phalanges, sprains, and tendon injuries. The objective of this Final Degree Project (TFG) is to evaluate through a systematic review of the scientific literature the most common types of wrist and hand injuries in contact sports (professional and amateur boxing, mixed martial arts, karate, judo, and wrestling), addressing their causes, predisposing factors, clinical manifestations, complications, therapeutic management, and preventive measures. While the initial hypothesis suggests that hand and wrist injuries are more common in professional boxing, certain epidemiological studies have questioned this due to the high rate of injuries in Mixed Martial Arts (MMA). However, it is confirmed that the frequency of these injuries is higher in professional boxing than in other combat disciplines. Nonetheless, there is a lack of information in the current literature about certain variables, such as the height of the strike or the influence of the dominant hand, which could significantly impact the incidence of injuries. During the development of the research, limitations related to the combat sports that should be analyzed and the definition of injury used in different studies were observed. It is concluded that, thanks to the implementation of new preventive techniques, the frequency of hand and wrist injuries has decreased in recent years, despite the increase in the practice of combat sports.
The notable increase in the practice of contact sports in recent years has resulted in a corresponding rise in injuries associated with this activity, both in professional athletes and amateurs. Among the most frequent injuries are those affecting the wrist and hand, such as fractures of the metacarpal and phalanges, sprains, and tendon injuries. The objective of this Final Degree Project (TFG) is to evaluate through a systematic review of the scientific literature the most common types of wrist and hand injuries in contact sports (professional and amateur boxing, mixed martial arts, karate, judo, and wrestling), addressing their causes, predisposing factors, clinical manifestations, complications, therapeutic management, and preventive measures. While the initial hypothesis suggests that hand and wrist injuries are more common in professional boxing, certain epidemiological studies have questioned this due to the high rate of injuries in Mixed Martial Arts (MMA). However, it is confirmed that the frequency of these injuries is higher in professional boxing than in other combat disciplines. Nonetheless, there is a lack of information in the current literature about certain variables, such as the height of the strike or the influence of the dominant hand, which could significantly impact the incidence of injuries. During the development of the research, limitations related to the combat sports that should be analyzed and the definition of injury used in different studies were observed. It is concluded that, thanks to the implementation of new preventive techniques, the frequency of hand and wrist injuries has decreased in recent years, despite the increase in the practice of combat sports.
Direction
CAEIRO REY, JOSE RAMON (Tutorships)
CAEIRO REY, JOSE RAMON (Tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Myocardial infarction with non-obstructive coronary arteries (MINOCA): current perspective of an emerging challenge in Cardiology. Review of a case report
Authorship
A.P.C.
Bachelor of Medicine
A.P.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is characterised by the absence of significant coronary artery obstruction, elevated markers of myocardial damage and symptoms typical of Acute Coronary Syndrome (ACS). It is an increasingly important entity, accounting for 1-14% of patients admitted with suspected ACS who undergo coronary angiography. The diagnosis of MINOCA is complex. Therefore, an appropriate approach to identify the mechanism (ischaemic vs non-ischaemic) and the optimal treatment is crucial. The use of algorithms and other complementary tests could help to target this entity, whose mortality and incidence of major adverse cardiac events (MACE) are similar to those of acute myocardial infarction with atherosclerotic coronary artery disease (AMI-ACD). Objectives To provide up-to-date information on the epidemiology, risk factors, etiopathogenesis, diagnosis, management and prognosis of MINOCA based on a literature review and presentation of a typical case. Material and methods Updated information on the epidemiology, etiology, pathophysiology, clinical presentation, diagnosis, treatment, and prognosis of MINOCA is gathered through a descriptive literature review on PubMed and Google Scholar, and by presenting a typical clinical case. Discussion and results A typical case of MINOCA is presented, the evolution is described, and the characteristics and management of the case are compared with current evidence. Conclusions MINOCA is an entity of increasing clinical relevance. The use of various invasive and non-invasive tests may help to elucidate the underlying mechanism. It is essential to differentiate ischaemic from non-ischaemic causes in order to establish appropriate treatment and assess prognosis. The lack of large clinical trials makes management difficult. There is ongoing research that could change the current panorama.
Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is characterised by the absence of significant coronary artery obstruction, elevated markers of myocardial damage and symptoms typical of Acute Coronary Syndrome (ACS). It is an increasingly important entity, accounting for 1-14% of patients admitted with suspected ACS who undergo coronary angiography. The diagnosis of MINOCA is complex. Therefore, an appropriate approach to identify the mechanism (ischaemic vs non-ischaemic) and the optimal treatment is crucial. The use of algorithms and other complementary tests could help to target this entity, whose mortality and incidence of major adverse cardiac events (MACE) are similar to those of acute myocardial infarction with atherosclerotic coronary artery disease (AMI-ACD). Objectives To provide up-to-date information on the epidemiology, risk factors, etiopathogenesis, diagnosis, management and prognosis of MINOCA based on a literature review and presentation of a typical case. Material and methods Updated information on the epidemiology, etiology, pathophysiology, clinical presentation, diagnosis, treatment, and prognosis of MINOCA is gathered through a descriptive literature review on PubMed and Google Scholar, and by presenting a typical clinical case. Discussion and results A typical case of MINOCA is presented, the evolution is described, and the characteristics and management of the case are compared with current evidence. Conclusions MINOCA is an entity of increasing clinical relevance. The use of various invasive and non-invasive tests may help to elucidate the underlying mechanism. It is essential to differentiate ischaemic from non-ischaemic causes in order to establish appropriate treatment and assess prognosis. The lack of large clinical trials makes management difficult. There is ongoing research that could change the current panorama.
Direction
Barge Caballero, Eduardo (Tutorships)
Aldama López, Guillermo (Co-tutorships)
Barge Caballero, Eduardo (Tutorships)
Aldama López, Guillermo (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Introduction of molecular techniques in the diagnosis of lung cancer
Authorship
A.P.S.
Bachelor of Medicine
A.P.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Lung cancer is the second most common cancer and the leading cause of cancer-related deaths in Spain, with smoking being the main risk factor for its development. The recent emergence of immunotherapy has contributed to increase the life expectancy of patients and, in turn, has made necessary for Pathology Laboratories the application of techniques that allow the identification of specific molecular patterns in order to develop new targeted treatment for individual patients, as well as to detect potential resistances to current treatments. The objective of this project is reviewing the current literature to describe the biomarkers of different types of lung cancer, their therapeutic implications, and the application of these molecular techniques for diagnosis.
Lung cancer is the second most common cancer and the leading cause of cancer-related deaths in Spain, with smoking being the main risk factor for its development. The recent emergence of immunotherapy has contributed to increase the life expectancy of patients and, in turn, has made necessary for Pathology Laboratories the application of techniques that allow the identification of specific molecular patterns in order to develop new targeted treatment for individual patients, as well as to detect potential resistances to current treatments. The objective of this project is reviewing the current literature to describe the biomarkers of different types of lung cancer, their therapeutic implications, and the application of these molecular techniques for diagnosis.
Direction
Anibarro García, Luís (Tutorships)
Álvarez Álvarez, Carlos (Co-tutorships)
Anibarro García, Luís (Tutorships)
Álvarez Álvarez, Carlos (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Rigor mortis and livor mortis in the estimation of time since death
Authorship
L.D.P.L.
Bachelor of Medicine
L.D.P.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
The estimation of the time since death until the body is discovered is an important task in legal medicine, as it has both ethical implication and legal repercussions in different law areas. In the present work, we will focus on two of the classic cadaveric phenomena and their utility in dating the time since death in the recent corpse: rigor mortis and livor mortis. Both were addressed by Mallach in the 1960s, who collected all data available up to that point about the study of this phenomena and their application to estimate the post mortem interval. The aim of this work is to gather evidence about both phenomena for estimating the post mortem interval published since Mallach’s classic study and to compare with his findings, emphasizing the evolution in this area and their utility in the forensic practice.
The estimation of the time since death until the body is discovered is an important task in legal medicine, as it has both ethical implication and legal repercussions in different law areas. In the present work, we will focus on two of the classic cadaveric phenomena and their utility in dating the time since death in the recent corpse: rigor mortis and livor mortis. Both were addressed by Mallach in the 1960s, who collected all data available up to that point about the study of this phenomena and their application to estimate the post mortem interval. The aim of this work is to gather evidence about both phenomena for estimating the post mortem interval published since Mallach’s classic study and to compare with his findings, emphasizing the evolution in this area and their utility in the forensic practice.
Direction
MUÑOZ BARUS, JOSE IGNACIO (Tutorships)
MUÑOZ BARUS, JOSE IGNACIO (Tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Souto Bayarri, José Miguel (Chairman)
Martinón Torres, Nazareth (Secretary)
GARCIA ACUÑA, JOSE MARIA (Member)
Oral health-related quality of life during treatment with conventional fixed orthodontic appliances compared with self-ligating fixed orthodontic appliances: a systematic review and meta-analysis.
Authorship
N.R.I.
Bachelor of Odontology
N.R.I.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Background/objectives This systematic review and meta-analysis aimed to evaluate the quality of life related to oral health and the pain of patients treated with fixed orthodontic appliances and to evaluate the potential differences between conventional and self-ligating braces. Methods Following the PRISMA methodology, a systematic electronic search was carried out until December 2023 in the PubMed, WOS and Embase databases. Cohort studies’ risk of bias was assessed with the Newcastle-Ottawa scale and the quality of the evidence of the randomized controlled trials (RCTs) with the GRADE system. In addition, meta-analyses were performed for the total OHIP scores one month after starting treatment and for four of its subcategories (pain, functional limitation, psychological discomfort, and physical disability). Results 7 studies were included (4 RCTs, 2 prospective cohort studies and 1 retrospective cohort study). Meta-analyses revealed that a lower OHIP is shown in self-ligation patients, but it is not statistically significant. The same happens with the subcategories analyzed. Discussion The main difference between the two types of Brackets is the way of attaching the arch to the device itself. Self-ligating Brackets do so with a closing cap or click that generates less friction between the bracket and the wire, which could be related to less pain for the patient by producing less compression on the periodontal ligament. Conclusions Patients treated with self-ligating braces had higher levels of OHRQoL and less pain than those treated with conventional braces. The levels of both groups became equal as the treatment progressed.
Background/objectives This systematic review and meta-analysis aimed to evaluate the quality of life related to oral health and the pain of patients treated with fixed orthodontic appliances and to evaluate the potential differences between conventional and self-ligating braces. Methods Following the PRISMA methodology, a systematic electronic search was carried out until December 2023 in the PubMed, WOS and Embase databases. Cohort studies’ risk of bias was assessed with the Newcastle-Ottawa scale and the quality of the evidence of the randomized controlled trials (RCTs) with the GRADE system. In addition, meta-analyses were performed for the total OHIP scores one month after starting treatment and for four of its subcategories (pain, functional limitation, psychological discomfort, and physical disability). Results 7 studies were included (4 RCTs, 2 prospective cohort studies and 1 retrospective cohort study). Meta-analyses revealed that a lower OHIP is shown in self-ligation patients, but it is not statistically significant. The same happens with the subcategories analyzed. Discussion The main difference between the two types of Brackets is the way of attaching the arch to the device itself. Self-ligating Brackets do so with a closing cap or click that generates less friction between the bracket and the wire, which could be related to less pain for the patient by producing less compression on the periodontal ligament. Conclusions Patients treated with self-ligating braces had higher levels of OHRQoL and less pain than those treated with conventional braces. The levels of both groups became equal as the treatment progressed.
Direction
SEOANE ROMERO, JUAN MANUEL (Tutorships)
SEOANE ROMERO, JUAN MANUEL (Tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Perception of gender and age based on the analysis of the teeth shape.
Authorship
L.R.N.
Bachelor of Odontology
L.R.N.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction. Since the appearance of classical theories regarding gender and tooth shape, the association between these two parameters has always been a source of controversy. The first investigations conffirmed this correlation based on temperament, facial contour and the SPA factor: sex, personality and age. However, numerous current studies define a non-existent relationship between gender and tooth shape, thus calling into question the classical theories. Objective. To evaluate the possibility of determining the gender and age of patients by observing photographs of their anterior teeth, as well as to analyze the perceptions among dental students and a general population group. Material and methods. A cross-sectional observational study was carried out. Thirty intraoral photographs were selected from a database and a survey was designed. Students of 3rd, 4th and 5th year of the dental degree of the USC and a general population group were invited to participate. The data was analyzed statistically and Pearson's Chi-square test was used to compare the accuracy between groups. Results. A total of 50 participants completed the survey. The percentage of total correct answers for gender was 55.63% and for age 41.80%. Considering the four variables given to justify gender, the predominant percentage of responses was based on shape (48.07%), followed by size (25.40%), incisal edge angles (14.27%) and arrangement of teeth in the arches (12.27%). There were no significant differences in the responses according to the degree of dental knowledge. Conclusion. The ability to determine gender and age from photographs of the anterior teeth seems to be very limited. It would be advisable for future research to address this issue with a larger sample of participants.
Introduction. Since the appearance of classical theories regarding gender and tooth shape, the association between these two parameters has always been a source of controversy. The first investigations conffirmed this correlation based on temperament, facial contour and the SPA factor: sex, personality and age. However, numerous current studies define a non-existent relationship between gender and tooth shape, thus calling into question the classical theories. Objective. To evaluate the possibility of determining the gender and age of patients by observing photographs of their anterior teeth, as well as to analyze the perceptions among dental students and a general population group. Material and methods. A cross-sectional observational study was carried out. Thirty intraoral photographs were selected from a database and a survey was designed. Students of 3rd, 4th and 5th year of the dental degree of the USC and a general population group were invited to participate. The data was analyzed statistically and Pearson's Chi-square test was used to compare the accuracy between groups. Results. A total of 50 participants completed the survey. The percentage of total correct answers for gender was 55.63% and for age 41.80%. Considering the four variables given to justify gender, the predominant percentage of responses was based on shape (48.07%), followed by size (25.40%), incisal edge angles (14.27%) and arrangement of teeth in the arches (12.27%). There were no significant differences in the responses according to the degree of dental knowledge. Conclusion. The ability to determine gender and age from photographs of the anterior teeth seems to be very limited. It would be advisable for future research to address this issue with a larger sample of participants.
Direction
ALONSO DE LA PEÑA, VICTOR (Tutorships)
ALONSO DE LA PEÑA, VICTOR (Tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Importance of the implant abutment design in the crestal bone loss
Authorship
J.S.R.
Bachelor of Odontology
J.S.R.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
INTRODUCTION: To ensure the success of dental implant treatment, it is crucial to maintain an adequate level of surrounding bone. However, it is common for bone loss to occur after surgery as a bone remodeling process begins, influenced by various factors. A fundamental part of the implant is the abutment, which connects the prosthesis to the implant body and is in contact with the surrounding soft and hard tissues. Over time, new types of abutments with different geometric shapes, such as concave, convex, convergent, parallel, etc., have been designed to reduce peri-implant bone loss. OBJECTIVE: The objective of this study is to conduct a systematic review and meta-analysis of the different types of abutment designs, their differences, and how they can influence bone loss. Additionally, two clinical cases from a study conducted in the Master's Program in Periodontology at USC will be presented. METHODOLOGY: A PICO question was defined and a systematic review was conducted in PubMed and manually. Studies that met the inclusion criteria were included. A meta-analysis was also performed, and two clinical cases were presented. RESULTS: Seven articles met the inclusion criteria, and three of them were included in a sub-analysis. A significant difference in bone loss was found in favor of the test group, with a mean difference of -0.66 mm (95% CI: -1.1 to -0.21 mm, P menor a 0.01). In the sub-analysis, the difference was not significant. CONCLUSIONS: With the limitations of this review, the test abutments suggest less bone loss compared to the control abutments. In the clinical cases presented, no significant differences were observed 12 months after prosthesis placement.
INTRODUCTION: To ensure the success of dental implant treatment, it is crucial to maintain an adequate level of surrounding bone. However, it is common for bone loss to occur after surgery as a bone remodeling process begins, influenced by various factors. A fundamental part of the implant is the abutment, which connects the prosthesis to the implant body and is in contact with the surrounding soft and hard tissues. Over time, new types of abutments with different geometric shapes, such as concave, convex, convergent, parallel, etc., have been designed to reduce peri-implant bone loss. OBJECTIVE: The objective of this study is to conduct a systematic review and meta-analysis of the different types of abutment designs, their differences, and how they can influence bone loss. Additionally, two clinical cases from a study conducted in the Master's Program in Periodontology at USC will be presented. METHODOLOGY: A PICO question was defined and a systematic review was conducted in PubMed and manually. Studies that met the inclusion criteria were included. A meta-analysis was also performed, and two clinical cases were presented. RESULTS: Seven articles met the inclusion criteria, and three of them were included in a sub-analysis. A significant difference in bone loss was found in favor of the test group, with a mean difference of -0.66 mm (95% CI: -1.1 to -0.21 mm, P menor a 0.01). In the sub-analysis, the difference was not significant. CONCLUSIONS: With the limitations of this review, the test abutments suggest less bone loss compared to the control abutments. In the clinical cases presented, no significant differences were observed 12 months after prosthesis placement.
Direction
Blanco Carrion, Juan (Tutorships)
NOVOA GARRIDO, LOURDES (Co-tutorships)
Blanco Carrion, Juan (Tutorships)
NOVOA GARRIDO, LOURDES (Co-tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Accuracy of brush cytology in screening of oral squamous cell carcinoma and oral potentially malignant disorders: systematic review and meta-analysis.
Authorship
H.T.H.
Bachelor of Odontology
H.T.H.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Background. Head and neck cancer, particularly oral cavity squamous cell carcinoma (OSCC), is prevalent with high mortality rates. It affects globally across the planet, particularly in regions of Asia, and is linked to tobacco and alcohol, among other factors. Brush cytology presents as a promising tool for the early diagnosis and monitoring of these lesions. Objectives. This study aims to evaluate its efficacy by identifying collection instruments, complementary techniques, and differences in diagnoses of OSCC and oral potentially malignant disorders (OPMDs). Materials and Method. Studies were gathered from various databases up to January 2024. Cohort studies that evaluated the accuracy of brush cytology in OSCC and OPMDs were selected. The quality of the studies was assessed using the QUADAS-2 checklist. The HSROC model was used for the meta-analysis, providing data on sensitivity (S), specificity (E), diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Results. From 2461 studies found, 52 were selected. Collection and complementary techniques were evaluated. The quality of the studies resulted in 4 studies with low quality, 27 with moderate quality, and 36 with high quality. Brush cytology demonstrated good diagnostic accuracy, with an S of 0.879 (IC 95%: 0.841, 0.909), E of 0.930 (IC 95%: 0.906, 0.948), a DOR of 131.270 (95% CI: 76.480, 225.311), a PLR of 11.941 (95% CI: 8.976, 15.885), and a NLR of 0.101 (95% CI: 0.067, 0.165). Discussion. Compared to other meta-analysis, brush cytology showed similar results. Combining it with DNA studies improved sensitivity and specificity and the dermatological curette demonstrated superior accuracy. Although both types of cytology are effective, liquid-based cytology showed some improvements. Limitations include bias in some studies and heterogeneity. Conclusion. Its use is suggested as a screening method, since it does not replace biopsy as the gold standard. Therefore, additional studies will improve and standardize brush cytology, increasing its applications in early detection and diagnostic accuracy, benefiting patients with neoplastic pathology or at risk.
Background. Head and neck cancer, particularly oral cavity squamous cell carcinoma (OSCC), is prevalent with high mortality rates. It affects globally across the planet, particularly in regions of Asia, and is linked to tobacco and alcohol, among other factors. Brush cytology presents as a promising tool for the early diagnosis and monitoring of these lesions. Objectives. This study aims to evaluate its efficacy by identifying collection instruments, complementary techniques, and differences in diagnoses of OSCC and oral potentially malignant disorders (OPMDs). Materials and Method. Studies were gathered from various databases up to January 2024. Cohort studies that evaluated the accuracy of brush cytology in OSCC and OPMDs were selected. The quality of the studies was assessed using the QUADAS-2 checklist. The HSROC model was used for the meta-analysis, providing data on sensitivity (S), specificity (E), diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Results. From 2461 studies found, 52 were selected. Collection and complementary techniques were evaluated. The quality of the studies resulted in 4 studies with low quality, 27 with moderate quality, and 36 with high quality. Brush cytology demonstrated good diagnostic accuracy, with an S of 0.879 (IC 95%: 0.841, 0.909), E of 0.930 (IC 95%: 0.906, 0.948), a DOR of 131.270 (95% CI: 76.480, 225.311), a PLR of 11.941 (95% CI: 8.976, 15.885), and a NLR of 0.101 (95% CI: 0.067, 0.165). Discussion. Compared to other meta-analysis, brush cytology showed similar results. Combining it with DNA studies improved sensitivity and specificity and the dermatological curette demonstrated superior accuracy. Although both types of cytology are effective, liquid-based cytology showed some improvements. Limitations include bias in some studies and heterogeneity. Conclusion. Its use is suggested as a screening method, since it does not replace biopsy as the gold standard. Therefore, additional studies will improve and standardize brush cytology, increasing its applications in early detection and diagnostic accuracy, benefiting patients with neoplastic pathology or at risk.
Direction
Pérez-Sayáns García, Mario (Tutorships)
Lorenzo Pouso, Alejandro Ismael (Co-tutorships)
Pérez-Sayáns García, Mario (Tutorships)
Lorenzo Pouso, Alejandro Ismael (Co-tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
Batalla Vázquez, María Pilar (Member)
Use of chemiluminiscence and autofluorescence in the detection of dysplasia in oral leukoplakia. A review of the literature.
Authorship
A.A.B.
Bachelor of Odontology
A.A.B.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction: Leukoplakia is the most frequent potentially malignant lesion of the oral mucosa and the most important prognostic factor for its malignant transformation is the presence of epithelial dysplasia. Both diagnoses are based on clinical evaluation with histological confirmation. Other diagnostic methods are based on the premise that neoplasic and preneoplasic tissues, that have undergone abnormal metabolic or structural changes, exhibit different absorption and reflectance properties when exposed to specific wavelengths of light. Methodology: A review of the literature was carried out with the aim of answering SECIB PICO question: Are there any complementary tests that improve the conventional clinical diagnosis of leukoplakia? in relation to dysplasia, focusing on light-based diagnostic methods and updating the evidence in this regard. The search used PubMed and EMBASE databases, between November 27, 2014, and November 27, 2023, using Mesh and free terms, and Boolean operators “OR”, “NOT” and “AND”. Four articles were that met the determined inclusion and exclusion criteria. Results: The autofluorescence studies used the commercial brand VELscope and provide sensitivities of 87.1% and 85.36% and specificities of 21.4% and 75%. As for chemiluminescence, they used Vizlite and described sensitivities of 77.1%, 84.84 and 12% and specificities of 26.8%, 41.17% and 76%. Conclusion: These techniques cannot replace conventional biopsy in the diagnosis of dysplasia in leukoplakia, if used correctly and with adequate knowledge they can be a resource to improve the quality of the diagnostic process in oral pathology in the future. The guideline was not updated due to similarities in the conclusions.
Introduction: Leukoplakia is the most frequent potentially malignant lesion of the oral mucosa and the most important prognostic factor for its malignant transformation is the presence of epithelial dysplasia. Both diagnoses are based on clinical evaluation with histological confirmation. Other diagnostic methods are based on the premise that neoplasic and preneoplasic tissues, that have undergone abnormal metabolic or structural changes, exhibit different absorption and reflectance properties when exposed to specific wavelengths of light. Methodology: A review of the literature was carried out with the aim of answering SECIB PICO question: Are there any complementary tests that improve the conventional clinical diagnosis of leukoplakia? in relation to dysplasia, focusing on light-based diagnostic methods and updating the evidence in this regard. The search used PubMed and EMBASE databases, between November 27, 2014, and November 27, 2023, using Mesh and free terms, and Boolean operators “OR”, “NOT” and “AND”. Four articles were that met the determined inclusion and exclusion criteria. Results: The autofluorescence studies used the commercial brand VELscope and provide sensitivities of 87.1% and 85.36% and specificities of 21.4% and 75%. As for chemiluminescence, they used Vizlite and described sensitivities of 77.1%, 84.84 and 12% and specificities of 26.8%, 41.17% and 76%. Conclusion: These techniques cannot replace conventional biopsy in the diagnosis of dysplasia in leukoplakia, if used correctly and with adequate knowledge they can be a resource to improve the quality of the diagnostic process in oral pathology in the future. The guideline was not updated due to similarities in the conclusions.
Direction
GANDARA VILA, PILAR (Tutorships)
López Rodríguez, Clara (Co-tutorships)
GANDARA VILA, PILAR (Tutorships)
López Rodríguez, Clara (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
Pterygoid Implants
Authorship
J.A.R.
Bachelor of Odontology
J.A.R.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Pterygoid implants are an innovative technique in dental implantology, designed to address challenges in rehabilitating the posterior maxilla in patients with severe bone resorption and complex anatomy. They emerged as a result of advances in understanding maxillary anatomy and the development of specialized surgical techniques. These implants are placed in the pterygoid region of the maxillary bone, providing a stable foundation for dental restoration. Objectives: To conduct a literature review of the past 10 years regarding the approach to the pterygoid process as a base for implant placement in edentulous patients with atrophic maxilla. Material and methods: Between February and May 2024, a literature search was conducted in PubMed and Google Scholar. As a search strategy, the terms: ‘implant’, ‘pterygoid’, ‘oral rehabilitation’ and ‘atrophic maxilla’ were used together with the Boolean operator ‘AND’. The search was limited to studies published in the last 10 years, with a language limit of Spanish or English. Results: The initial search yielded 212 articles of which 13 were evaluated in full text according to the inclusion and exclusion criteria. Discussion: Progress in pterygoid implant insertion since 2014 is highlighted, emphasizing the importance of disseminating knowledge about this technique. Additionally, the success and failure rate in various studies are evaluated. Conclusions: Pterygoid implants represent an effective solution for rehabilitating the atrophic posterior maxilla with high success rates, although they require careful evaluation and may entail complications. The growing interest in this technique underscores the need for greater training among professionals.
Pterygoid implants are an innovative technique in dental implantology, designed to address challenges in rehabilitating the posterior maxilla in patients with severe bone resorption and complex anatomy. They emerged as a result of advances in understanding maxillary anatomy and the development of specialized surgical techniques. These implants are placed in the pterygoid region of the maxillary bone, providing a stable foundation for dental restoration. Objectives: To conduct a literature review of the past 10 years regarding the approach to the pterygoid process as a base for implant placement in edentulous patients with atrophic maxilla. Material and methods: Between February and May 2024, a literature search was conducted in PubMed and Google Scholar. As a search strategy, the terms: ‘implant’, ‘pterygoid’, ‘oral rehabilitation’ and ‘atrophic maxilla’ were used together with the Boolean operator ‘AND’. The search was limited to studies published in the last 10 years, with a language limit of Spanish or English. Results: The initial search yielded 212 articles of which 13 were evaluated in full text according to the inclusion and exclusion criteria. Discussion: Progress in pterygoid implant insertion since 2014 is highlighted, emphasizing the importance of disseminating knowledge about this technique. Additionally, the success and failure rate in various studies are evaluated. Conclusions: Pterygoid implants represent an effective solution for rehabilitating the atrophic posterior maxilla with high success rates, although they require careful evaluation and may entail complications. The growing interest in this technique underscores the need for greater training among professionals.
Direction
Pose Rodríguez, José Manuel (Tutorships)
OTERO CASAL, MARIA DE LA PAZ (Co-tutorships)
Pose Rodríguez, José Manuel (Tutorships)
OTERO CASAL, MARIA DE LA PAZ (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
Quantification of circulating free DNA in head and neck cancer patients: Quantitative real-time polymerase chain reaction and fluorometry
Authorship
M.B.F.
Bachelor of Odontology
M.B.F.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Objectives: i) Quantifying the levels of circulating cellular free DNA (cfDNA) in plasma samples from patients with head and neck cancer and healthy controls using fluorometry and polymerase chain reaction (qPCR) techniques and to analyze the correlation between the two; ii) Evaluating the capacity of total concentration of cfDNA as a diagnostic biomarker in head and neck cancer. Material and methods: Peripheral blood was obtained from 36 subjects (26 patients with HNC and 10 healthy individuals). After isolation of cfDNA, the total concentration was determined by fluorometry (Qubit 3.0) and (qPCR) through quantification of the human telomerase reverse transcriptase gene (hTERT). Data analysis was performed using descriptive statistics and statistical inference to assess differences and diagnostic ability. Results/Discussion: The group of patients with head and neck cancer and the group of healthy controls showed higher median total plasma DNA concentrations quantified by fluorometry fluorometry (17171 GE/mL y 1069 GE/mL, respectively) than the concentrations obtained by qPCR (763,9 GE/mL y 580,1 GE/mL). The correlation between cfDNA concentrations obtained by both techniques in both groups was statistically significant with an R2 greater than 0,72 (p less than 0,005). According to the diagnostic analysis, the area under the curve obtained from cfDNA measurements by fluorometry 0.81, while the measurements obtained from qPCR was 0,62. Conclusion: The quantification of total cfDNA concentration by the two techniques revealed a significant correlation between the two measurements, showing the quantification by fluorometry a higher diagnostic potential to discriminate head and neck cancer patients from healthy individuals.
Objectives: i) Quantifying the levels of circulating cellular free DNA (cfDNA) in plasma samples from patients with head and neck cancer and healthy controls using fluorometry and polymerase chain reaction (qPCR) techniques and to analyze the correlation between the two; ii) Evaluating the capacity of total concentration of cfDNA as a diagnostic biomarker in head and neck cancer. Material and methods: Peripheral blood was obtained from 36 subjects (26 patients with HNC and 10 healthy individuals). After isolation of cfDNA, the total concentration was determined by fluorometry (Qubit 3.0) and (qPCR) through quantification of the human telomerase reverse transcriptase gene (hTERT). Data analysis was performed using descriptive statistics and statistical inference to assess differences and diagnostic ability. Results/Discussion: The group of patients with head and neck cancer and the group of healthy controls showed higher median total plasma DNA concentrations quantified by fluorometry fluorometry (17171 GE/mL y 1069 GE/mL, respectively) than the concentrations obtained by qPCR (763,9 GE/mL y 580,1 GE/mL). The correlation between cfDNA concentrations obtained by both techniques in both groups was statistically significant with an R2 greater than 0,72 (p less than 0,005). According to the diagnostic analysis, the area under the curve obtained from cfDNA measurements by fluorometry 0.81, while the measurements obtained from qPCR was 0,62. Conclusion: The quantification of total cfDNA concentration by the two techniques revealed a significant correlation between the two measurements, showing the quantification by fluorometry a higher diagnostic potential to discriminate head and neck cancer patients from healthy individuals.
Direction
SUAREZ CUNQUEIRO, MARIA MERCEDES (Tutorships)
Rapado González, Óscar (Co-tutorships)
Rodríguez Ces, Ana María (Co-tutorships)
SUAREZ CUNQUEIRO, MARIA MERCEDES (Tutorships)
Rapado González, Óscar (Co-tutorships)
Rodríguez Ces, Ana María (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
“Handwashing evaluation among dental students: unlearned lessons from the COVID-19 pandemic”
Authorship
F.B.G.
Bachelor of Odontology
F.B.G.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Handwashing is an essential practice to reduce cross-infection risk in dentistry, as it shows its relevance during the COVID-19 pandemic. Aim: To establish dentistry students´ adherence to handwashing after the COVID-19 global emergency. Methodology: A transversal study was designed in which 100 dental students from USC dental degree participated. They were randomly selected. From April to June in 2023 the handwashing procedure after a practical session was registered by direct observation. The independent variables considered were: sex, grade, activity type and the students´role. Furthemore, the dependent variables taken into consideration were: duration, cleaning agent and emplacement where handwashing was performed. Results were compared to a similar-characteristic study performed before the COVID-19 outbreak. Results: In 2023, 29% of the students washed their hands after clinical practice, compared to 42% in 2015 (p=0,046). None of them applied WHO´s handwashing recommendations. Senior students showed higher rates of handwashing (p=0,019) and duration (p=0,013) than junior students. At the end of a clinical practice, handwashing rates were higher (p=0,01) and duration was also higher (p=0,038), compared to pre-clinical practice. Conclusion: Despite the impact of the COVID-19 pandemic, handwashing is not a routine habit to dentistry students. Consequently, it is imperative to implement educational measures that provide a real adherence to this hygiene practice.
Handwashing is an essential practice to reduce cross-infection risk in dentistry, as it shows its relevance during the COVID-19 pandemic. Aim: To establish dentistry students´ adherence to handwashing after the COVID-19 global emergency. Methodology: A transversal study was designed in which 100 dental students from USC dental degree participated. They were randomly selected. From April to June in 2023 the handwashing procedure after a practical session was registered by direct observation. The independent variables considered were: sex, grade, activity type and the students´role. Furthemore, the dependent variables taken into consideration were: duration, cleaning agent and emplacement where handwashing was performed. Results were compared to a similar-characteristic study performed before the COVID-19 outbreak. Results: In 2023, 29% of the students washed their hands after clinical practice, compared to 42% in 2015 (p=0,046). None of them applied WHO´s handwashing recommendations. Senior students showed higher rates of handwashing (p=0,019) and duration (p=0,013) than junior students. At the end of a clinical practice, handwashing rates were higher (p=0,01) and duration was also higher (p=0,038), compared to pre-clinical practice. Conclusion: Despite the impact of the COVID-19 pandemic, handwashing is not a routine habit to dentistry students. Consequently, it is imperative to implement educational measures that provide a real adherence to this hygiene practice.
Direction
OUTUMURO RIAL, MERCEDES (Tutorships)
García Mato, Eliane (Co-tutorships)
OUTUMURO RIAL, MERCEDES (Tutorships)
García Mato, Eliane (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
Prevalence study of cardiovascular risk factors in C.S. Casa del Mar
Authorship
J.P.V.
Bachelor of Medicine
J.P.V.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction and objectives. The main goal of this study is to learn the prevalence of cardiovascular risk factors (arterial hypertension, dyslipidemia, smoking, obesity, diabetes and chronic renal failure) among the patients in Casa del Mar Clinic (Centro de Salud Casa del Mar) of A Coruña (Spain). The second part of this study is to evaluate whether the prevalence findings in this clinic match with those expected according to data from different populations. Material and methods. Cross-sectional descriptive observational prevalence study of arterial hypertension, dyslipidemia, smoking, obesity, diabetes and chronic renal failure among the patients of Centro de Salud Casa del Mar of A Coruña. In order to achieve this, the CIAP classification of patients registered in the IANUS is used, obtained as anonymous data through the SIGAP (Primary Management Information System). Results. 9.094 of the 20.903 adult patients of the clinic present at least one cardiovascular risk factor. Prevalence of arterial hypertension: 27.25% (27.81% women and 26.57% men), prevalence of dyslipidemia: 27.12% (27.87% women and 26.20% men), prevalence of smoking: 9.42% (8.38% women and 10.37% men), prevalence of obesity: 8.97% (9.40% women and 8.45% men), prevalence of diabetes: 5.07% (5.11% women and 5.02% men), prevalence of chronic renal failure: 3.99% (4.06% women and 3.92% men). Conclusions. The prevalence of cardiovascular risk factors is higher among women than men in general, with the exception of smoking. Furthermore, the prevalence of these diseases tends to increase with age, with the exception of smoking, which falls after the age of 65, and obesity, which also falls after the age of 85. The prevalences found in this study are lower than those reported in the literature, especially the prevalence of smoking. This phenomenon may be due to under-registration with CIAP-2 codes of these cardiovascular risk factors.
Introduction and objectives. The main goal of this study is to learn the prevalence of cardiovascular risk factors (arterial hypertension, dyslipidemia, smoking, obesity, diabetes and chronic renal failure) among the patients in Casa del Mar Clinic (Centro de Salud Casa del Mar) of A Coruña (Spain). The second part of this study is to evaluate whether the prevalence findings in this clinic match with those expected according to data from different populations. Material and methods. Cross-sectional descriptive observational prevalence study of arterial hypertension, dyslipidemia, smoking, obesity, diabetes and chronic renal failure among the patients of Centro de Salud Casa del Mar of A Coruña. In order to achieve this, the CIAP classification of patients registered in the IANUS is used, obtained as anonymous data through the SIGAP (Primary Management Information System). Results. 9.094 of the 20.903 adult patients of the clinic present at least one cardiovascular risk factor. Prevalence of arterial hypertension: 27.25% (27.81% women and 26.57% men), prevalence of dyslipidemia: 27.12% (27.87% women and 26.20% men), prevalence of smoking: 9.42% (8.38% women and 10.37% men), prevalence of obesity: 8.97% (9.40% women and 8.45% men), prevalence of diabetes: 5.07% (5.11% women and 5.02% men), prevalence of chronic renal failure: 3.99% (4.06% women and 3.92% men). Conclusions. The prevalence of cardiovascular risk factors is higher among women than men in general, with the exception of smoking. Furthermore, the prevalence of these diseases tends to increase with age, with the exception of smoking, which falls after the age of 65, and obesity, which also falls after the age of 85. The prevalences found in this study are lower than those reported in the literature, especially the prevalence of smoking. This phenomenon may be due to under-registration with CIAP-2 codes of these cardiovascular risk factors.
Direction
Gonzalez Quintela, Arturo (Tutorships)
Barral Castro, Manuel (Co-tutorships)
Gonzalez Quintela, Arturo (Tutorships)
Barral Castro, Manuel (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
MONTES MARTINEZ, AGUSTIN (Member)
Learning effective and safe airway management by residents through videolaryngoscopy: the role of expert guidance via smartglasses.
Authorship
A.P.R.
Bachelor of Medicine
A.P.R.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Aim: To appraise the potencial of smartglasses as a safe and interactive tool for training residents in endotracheal intubation in difficult airway conditions in a simulated model. Methods: Randomized study, third-party blinded with parallel groups of resident physicians to evaluate the use of smart glasses as a training tool in simulated difficult intubation scenarios. Involving two measurements: a basal one, the same for both groups, and a second measurement where the intervention group was carried out by an expert by means of the smart glasses. Results: The intervention group improves the intubation success rate, performing faster and in a more structured manner than the control group. Conclusions: The use of smartglasses as a training tool is effective and safe in airway management, showing that the intervention group is more effective and methodical than the control group.
Aim: To appraise the potencial of smartglasses as a safe and interactive tool for training residents in endotracheal intubation in difficult airway conditions in a simulated model. Methods: Randomized study, third-party blinded with parallel groups of resident physicians to evaluate the use of smart glasses as a training tool in simulated difficult intubation scenarios. Involving two measurements: a basal one, the same for both groups, and a second measurement where the intervention group was carried out by an expert by means of the smart glasses. Results: The intervention group improves the intubation success rate, performing faster and in a more structured manner than the control group. Conclusions: The use of smartglasses as a training tool is effective and safe in airway management, showing that the intervention group is more effective and methodical than the control group.
Direction
Gonzalez Quintela, Arturo (Tutorships)
Rodríguez Ruíz, Emilio (Co-tutorships)
Gonzalez Quintela, Arturo (Tutorships)
Rodríguez Ruíz, Emilio (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
What gestational implications do Chlamydia trachomatis and Neisseria gonorrhoeae infections have?
Authorship
M.L.R.J.V.V.
Bachelor of Medicine
M.L.R.J.V.V.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction Sexually transmitted diseases are a growing problem in society. Chlamydia trachomatis and Neisseria gonorrhoeae infections are often asymptomatic and go undetected and untreated, leading to complications and significant sequelae. Pregnant women and their children are a group at risk for the transmission of these diseases. Objectives To review the evidence to date on the possible consequences of an infection by Chlamydia trachomatis or Neisseria gonorrhoeae in pregnancy and childbirth. It is also intended to review the diagnosis method and the most appropriate treatment in these situations. Methodology Systematic review of the available scientific articles on the consequences of Chlamydia trachomatis or Neisseria gonorrhoeae infection in pregnancy and childbirth, carried out through the PUBMED and WOS bibliographic search engines and following PRISMA guidelines. The selected inclusion criteria are: systematic reviews, literature reviews and meta-analyses, published between 2014-2024, human species and Spanish or English publication languages. Results Of the 12 articles reviewed, which sampled pregnant women with Chlamydia trachomatis or Neisseria gonorrhoeae infection, both systematic reviews, meta-analyses and literature reviews suggest that these sexually transmitted infections increase the risk of gestational and neonatal complications. Conclusions Chlamydia trachomatis or Neisseria gonorrhoeae infections in pregnant women increase the likelihood of complications such as premature delivery, miscarriage, premature rupture of membranes, small-for-gestational-age infants and intrauterine growth restriction. There is also a risk of ophthalmia neonatorum in neonates.
Introduction Sexually transmitted diseases are a growing problem in society. Chlamydia trachomatis and Neisseria gonorrhoeae infections are often asymptomatic and go undetected and untreated, leading to complications and significant sequelae. Pregnant women and their children are a group at risk for the transmission of these diseases. Objectives To review the evidence to date on the possible consequences of an infection by Chlamydia trachomatis or Neisseria gonorrhoeae in pregnancy and childbirth. It is also intended to review the diagnosis method and the most appropriate treatment in these situations. Methodology Systematic review of the available scientific articles on the consequences of Chlamydia trachomatis or Neisseria gonorrhoeae infection in pregnancy and childbirth, carried out through the PUBMED and WOS bibliographic search engines and following PRISMA guidelines. The selected inclusion criteria are: systematic reviews, literature reviews and meta-analyses, published between 2014-2024, human species and Spanish or English publication languages. Results Of the 12 articles reviewed, which sampled pregnant women with Chlamydia trachomatis or Neisseria gonorrhoeae infection, both systematic reviews, meta-analyses and literature reviews suggest that these sexually transmitted infections increase the risk of gestational and neonatal complications. Conclusions Chlamydia trachomatis or Neisseria gonorrhoeae infections in pregnant women increase the likelihood of complications such as premature delivery, miscarriage, premature rupture of membranes, small-for-gestational-age infants and intrauterine growth restriction. There is also a risk of ophthalmia neonatorum in neonates.
Direction
MORANO AMADO, LUIS ENRIQUE (Tutorships)
González Rodríguez, Laura (Co-tutorships)
Rodríguez Fernández, Vanesa (Co-tutorships)
MORANO AMADO, LUIS ENRIQUE (Tutorships)
González Rodríguez, Laura (Co-tutorships)
Rodríguez Fernández, Vanesa (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Influence of Vitamin D levels on the subsequent development of osteoporosis.
Authorship
P.M.D.R.C.
Bachelor of Medicine
P.M.D.R.C.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: vitamin D plays a crucial role in regulating the metabolism of calcium and phosphate, minerals essential for the formation and maintenance of bone density. Hypovitaminosis D leads to inadequate intestinal absorption of calcium, resulting in hypocalcemia. This condition causes an increase in the secretion of parathyroid hormone (PTH), which stimulates bone resorption to release calcium into the bloodstream. Although this process is physiologically necessary to maintain calcium homeostasis, it has the adverse effect of reducing bone mineral density, predisposing individuals to osteoporosis. Methods: a literature search has been carried out using academic databases, such as PubMed, Ovid, the Cochrane Library, and the available literature in the IACOBUS library catalogue from the USC, including the terms “vitamin D deficiency,” “osteoporosis,” “musculoskeletal diseases,” “autoimmune diseases” and “chronic diseases.” I focused on articles that examined the relationship between vitamin D deficiency and various pathologies, especially those related to the musculoskeletal system. Results: a review of the selected articles has been conducted, synthesizing their results, and analysing their application to clinical practice, as well as the action of vitamin D on various factors influencing bone health. Discussion: hypovitaminosis D is a common condition in the elderly population that has a significant impact on bone health. Vitamin D deficiency contributes to the development of osteoporosis, a disease that increases bone fragility and the risk of fractures, which can have serious consequences, including disability and increased mortality. Vitamin D supplementation, along with adequate nutrition, exercise, and fall prevention measures, is essential for improving bone health and reducing the risk of fractures in the elderly population. Moreover, vitamin D also plays an essential role in the development of various non-skeletal pathologies. Conclusion: the use of vitamin D supplements, especially when taken in conjunction with calcium, has been shown to be beneficial for strengthening bones and reducing the risk of fractures. It is essential to adhere to recommended dosages and monitor vitamin D levels to maximize benefits and avoid potential adverse effects.
Introduction: vitamin D plays a crucial role in regulating the metabolism of calcium and phosphate, minerals essential for the formation and maintenance of bone density. Hypovitaminosis D leads to inadequate intestinal absorption of calcium, resulting in hypocalcemia. This condition causes an increase in the secretion of parathyroid hormone (PTH), which stimulates bone resorption to release calcium into the bloodstream. Although this process is physiologically necessary to maintain calcium homeostasis, it has the adverse effect of reducing bone mineral density, predisposing individuals to osteoporosis. Methods: a literature search has been carried out using academic databases, such as PubMed, Ovid, the Cochrane Library, and the available literature in the IACOBUS library catalogue from the USC, including the terms “vitamin D deficiency,” “osteoporosis,” “musculoskeletal diseases,” “autoimmune diseases” and “chronic diseases.” I focused on articles that examined the relationship between vitamin D deficiency and various pathologies, especially those related to the musculoskeletal system. Results: a review of the selected articles has been conducted, synthesizing their results, and analysing their application to clinical practice, as well as the action of vitamin D on various factors influencing bone health. Discussion: hypovitaminosis D is a common condition in the elderly population that has a significant impact on bone health. Vitamin D deficiency contributes to the development of osteoporosis, a disease that increases bone fragility and the risk of fractures, which can have serious consequences, including disability and increased mortality. Vitamin D supplementation, along with adequate nutrition, exercise, and fall prevention measures, is essential for improving bone health and reducing the risk of fractures in the elderly population. Moreover, vitamin D also plays an essential role in the development of various non-skeletal pathologies. Conclusion: the use of vitamin D supplements, especially when taken in conjunction with calcium, has been shown to be beneficial for strengthening bones and reducing the risk of fractures. It is essential to adhere to recommended dosages and monitor vitamin D levels to maximize benefits and avoid potential adverse effects.
Direction
PINO MINGUEZ, JESUS (Tutorships)
PINO MINGUEZ, JESUS (Tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Role of preoperative oral antibiotics in the prevention of complications in elective colorectal surgery. Bibliographical review.
Authorship
L.R.C.
Bachelor of Medicine
L.R.C.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Despite the widespread use of minimally invasive techniques and Enhanced Recovery After Surgery (ERAS) protocols, elective colorectal surgery is frequently associated with complications such as surgical site infection or anastomotic leak. Therefore, the preoperative preparation of patients undergoing this procedure is a crucial issue that has generated controversy for decades. Objectives: To assess the effect of preoperative oral antibiotics, alone or in combination with mechanical bowel preparation, on the incidence of surgical site infection and anastomotic leak. Material and methods: During February 2024, a bibliographic research was conducted using several electronic databases, such as MEDLINE-PubMed, Cochrane Library and Scopus. Only analysis in Spanish or English published between 2000 and 2024 were considered. Results: The 9 studies included in this systematic review were classified into 3 categories: oral antibiotics versus no preparation (studies 1 and 2), mechanical bowel preparation combined with oral antibiotics versus mechanical bowel preparation (studies 3-6) and mechanical bowel preparation combined with oral antibiotics versus oral antibiotics (studies 7-9). Three items were evaluated in each comparison: surgical site infection, anastomotic leak and other complications (hospital stay, readmission rate, mortality...). Conclusions: Preoperative administration of oral antibiotics, alone or in combination with mechanical bowel preparation, reduces the incidence of surgical site infection in patients undergoing elective colorectal surgery. However, the prophylactic role of oral antibiotics for preventing anastomotic leak is unclear.
Introduction: Despite the widespread use of minimally invasive techniques and Enhanced Recovery After Surgery (ERAS) protocols, elective colorectal surgery is frequently associated with complications such as surgical site infection or anastomotic leak. Therefore, the preoperative preparation of patients undergoing this procedure is a crucial issue that has generated controversy for decades. Objectives: To assess the effect of preoperative oral antibiotics, alone or in combination with mechanical bowel preparation, on the incidence of surgical site infection and anastomotic leak. Material and methods: During February 2024, a bibliographic research was conducted using several electronic databases, such as MEDLINE-PubMed, Cochrane Library and Scopus. Only analysis in Spanish or English published between 2000 and 2024 were considered. Results: The 9 studies included in this systematic review were classified into 3 categories: oral antibiotics versus no preparation (studies 1 and 2), mechanical bowel preparation combined with oral antibiotics versus mechanical bowel preparation (studies 3-6) and mechanical bowel preparation combined with oral antibiotics versus oral antibiotics (studies 7-9). Three items were evaluated in each comparison: surgical site infection, anastomotic leak and other complications (hospital stay, readmission rate, mortality...). Conclusions: Preoperative administration of oral antibiotics, alone or in combination with mechanical bowel preparation, reduces the incidence of surgical site infection in patients undergoing elective colorectal surgery. However, the prophylactic role of oral antibiotics for preventing anastomotic leak is unclear.
Direction
GARCIA GARCIA, MANUEL (Tutorships)
Rigueiro López, Lucía (Co-tutorships)
GARCIA GARCIA, MANUEL (Tutorships)
Rigueiro López, Lucía (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Liquid biopsy and its role in early stage lung Cancer diagnosis
Authorship
C.R.O.
Bachelor of Medicine
C.R.O.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Lung cancer is a malignant disease that represents one of the leading causes of morbidity and mortality worldwide, with a higher incidence in men, although cases in women are on the rise. To address this problem, the field of oncology is currently experiencing a revolution with the advent of targeted therapies and immunotherapy, marking a paradigm shift in cancer treatment. However, despite this revolution, the mortality rate for these types of neoplasms remains very high, largely because many are diagnosed at advanced stages. Therefore, it is necessary to not only optimize treatment but also to achieve early diagnosis. In this context, liquid biopsy emerges as a promising tool to be incorporated into clinical practice, capable of complementing or surpassing the limitations of currently used methods for early lung cancer detection. In this review, we evaluate the role of liquid biopsy through the analysis of biomarkers in the early diagnosis landscape.
Lung cancer is a malignant disease that represents one of the leading causes of morbidity and mortality worldwide, with a higher incidence in men, although cases in women are on the rise. To address this problem, the field of oncology is currently experiencing a revolution with the advent of targeted therapies and immunotherapy, marking a paradigm shift in cancer treatment. However, despite this revolution, the mortality rate for these types of neoplasms remains very high, largely because many are diagnosed at advanced stages. Therefore, it is necessary to not only optimize treatment but also to achieve early diagnosis. In this context, liquid biopsy emerges as a promising tool to be incorporated into clinical practice, capable of complementing or surpassing the limitations of currently used methods for early lung cancer detection. In this review, we evaluate the role of liquid biopsy through the analysis of biomarkers in the early diagnosis landscape.
Direction
LEON MATEOS, LUIS ANGEL (Tutorships)
Francisco Fernández, Alejandro (Co-tutorships)
LEON MATEOS, LUIS ANGEL (Tutorships)
Francisco Fernández, Alejandro (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Efficacy of pharmacotherapies in preventing risky driving behavior in patients with Attention Deficit Hyperactivity Disorder (ADHD): a systematic review.
Authorship
L.R.M.
Bachelor of Medicine
L.R.M.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental disorder, defined by a persistent clinical pattern of inattention, hyperactivity and impulsivity. Individuals with ADHD, particularly adolescents and young adults, have significant driving difficulties, which predispose them to an increased risk of traffic violations and accidents. While evidence on how pharmacological therapies reduce ADHD symptomatology has been proven, research on how they affect on driving behaviour is limited. Objectives: The aim of this systematic review is to analyse the available evidence on the efficacy of pharmacological therapies for ADHD for reducing risky driving behaviour and traffic accidents. Matherials and methods: A systematic review was conducted according to the criteria established in the PRISMA 2020 statement. A literature search in PubMed and Cochrane databases identified randomised clinical trials, published between 2004 and 2024, about the effect of pharmacological therapies for ADHD on driving behaviour. Results: Fourteen randomised controlled trials were selected, which studied psychostimulants and non-stimulant agents: atomoxetine (ATX), lisdexamfetamine dimesylate (LDX), amphetamine derivatives (AMPH-ER), immediate-release methylphenidate (IR-MPH), extended-release methylphenidate (OROS-MPH, MPH-ER and MPH-MLR) and transdermal-release methylphenidate (MTS). The methods used to assess driving behaviour varied widely, including the use of driving simulators, driving tests on real traffic and self-referenced subjective questionnaires. Although some clinical trials reported mixed results, overall all pharmacotherapies showed positive effects on the driving performance of ADHD patients. Conclussion: Our studies sugest that pharmamacotherapies for ADHD is an effective and safe option to improve driving behaviour and reduce the risk of traffic accidents in adolescents and adults with the disorder. However, future higher quality clinical trials are needed to validate this evidence.
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent neurodevelopmental disorder, defined by a persistent clinical pattern of inattention, hyperactivity and impulsivity. Individuals with ADHD, particularly adolescents and young adults, have significant driving difficulties, which predispose them to an increased risk of traffic violations and accidents. While evidence on how pharmacological therapies reduce ADHD symptomatology has been proven, research on how they affect on driving behaviour is limited. Objectives: The aim of this systematic review is to analyse the available evidence on the efficacy of pharmacological therapies for ADHD for reducing risky driving behaviour and traffic accidents. Matherials and methods: A systematic review was conducted according to the criteria established in the PRISMA 2020 statement. A literature search in PubMed and Cochrane databases identified randomised clinical trials, published between 2004 and 2024, about the effect of pharmacological therapies for ADHD on driving behaviour. Results: Fourteen randomised controlled trials were selected, which studied psychostimulants and non-stimulant agents: atomoxetine (ATX), lisdexamfetamine dimesylate (LDX), amphetamine derivatives (AMPH-ER), immediate-release methylphenidate (IR-MPH), extended-release methylphenidate (OROS-MPH, MPH-ER and MPH-MLR) and transdermal-release methylphenidate (MTS). The methods used to assess driving behaviour varied widely, including the use of driving simulators, driving tests on real traffic and self-referenced subjective questionnaires. Although some clinical trials reported mixed results, overall all pharmacotherapies showed positive effects on the driving performance of ADHD patients. Conclussion: Our studies sugest that pharmamacotherapies for ADHD is an effective and safe option to improve driving behaviour and reduce the risk of traffic accidents in adolescents and adults with the disorder. However, future higher quality clinical trials are needed to validate this evidence.
Direction
TORRES IGLESIAS, ANGELA JUANA (Tutorships)
NUÑEZ ARIAS, DANIEL (Co-tutorships)
TORRES IGLESIAS, ANGELA JUANA (Tutorships)
NUÑEZ ARIAS, DANIEL (Co-tutorships)
Court
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Souto Bayarri, José Miguel (Chairman)
Carro Méndez, María Beatriz (Secretary)
PEREIRO FERREIROS, MANUEL (Member)
Aggressions against healthcare professionals in Spain
Authorship
M.S.E.D.T.S.
Bachelor of Medicine
M.S.E.D.T.S.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Aggressions against healthcare professionals are increasing both in our country and worldwide and represent a major problem, which negatively affects the physical and emotional integrity of these professionals and the quality of medical care provided to the population Objectives: The main goal of this work is to deepen the study of assaults on healthcare professionals, in order to know the reality of this problem and to implement prevention and management strategies capable of reducing the current alarming numbers. Methodology: An exhaustive bibliographic search of the most recent literature on assaults on healthcare professionals in Spain was carried out in different scientific databases and protocols for the prevention of workplace violence were reviewed, as well as the most recent studies, guides and reports on the subject under study. Results and Discussion: There is a low rate of reports due to the lack of trust in confidentiality and the normalization of violence in the healthcare environment. Spanish legislation in its reform of the Penal Code redefined the crime of assault for this type of conduct. This exposure to violent behavior has a negative impact on professionals, which has repercussions on the quality of medical care. Professionals often do not know how to act in potentially violent situations. Aggressions are more frequent in certain environments and professional groups. The development of institutional policies for safety, prevention and psychological support is a primary need, as well as the promotion of a culture of respect and safety in the work environment. Conclusions: Identifying the triggers of aggression is essential for its prevention and management. Workplaces should ensure appropriate safety and prevention measures. Exposure to violent situations has both psychological and physical consequences for professionals, and continuous and specific training for healthcare professionals and the development and implementation of action protocols are necessary.
Introduction: Aggressions against healthcare professionals are increasing both in our country and worldwide and represent a major problem, which negatively affects the physical and emotional integrity of these professionals and the quality of medical care provided to the population Objectives: The main goal of this work is to deepen the study of assaults on healthcare professionals, in order to know the reality of this problem and to implement prevention and management strategies capable of reducing the current alarming numbers. Methodology: An exhaustive bibliographic search of the most recent literature on assaults on healthcare professionals in Spain was carried out in different scientific databases and protocols for the prevention of workplace violence were reviewed, as well as the most recent studies, guides and reports on the subject under study. Results and Discussion: There is a low rate of reports due to the lack of trust in confidentiality and the normalization of violence in the healthcare environment. Spanish legislation in its reform of the Penal Code redefined the crime of assault for this type of conduct. This exposure to violent behavior has a negative impact on professionals, which has repercussions on the quality of medical care. Professionals often do not know how to act in potentially violent situations. Aggressions are more frequent in certain environments and professional groups. The development of institutional policies for safety, prevention and psychological support is a primary need, as well as the promotion of a culture of respect and safety in the work environment. Conclusions: Identifying the triggers of aggression is essential for its prevention and management. Workplaces should ensure appropriate safety and prevention measures. Exposure to violent situations has both psychological and physical consequences for professionals, and continuous and specific training for healthcare professionals and the development and implementation of action protocols are necessary.
Direction
TABERNERO DUQUE, MARIA JESÚS (Tutorships)
TABERNERO DUQUE, MARIA JESÚS (Tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
What carotid body tumors hide. Atypical case report and literature review.
Authorship
R.C.D.
Bachelor of Medicine
R.C.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: Carotid body tumors are rare neuroendocrine tumors. Classically, the only available treatment was surgery, but now it can be enhanced with recently developed techniques. New challenge arises from recent finding about these tumors genetics, that sets mandatory individualised and multidisciplinary management. Objectives: The aim of this review is to join updated scientific evidence of these tumors treatment, as well as presenting a unique clinical case. Methods: Scientific data for this review was identified on Medline (by PubMed) and Cochrane Library. Data research and analysis was made following PRISMA guidelines, PICO method and Critical Appraisal Tools. Results: Quality analysis of published data is made on this review. Main features and lately news on diagnosis and treatment of carotid body tumors are presented, as well as risks and benefits of surgery plus surgical indications. Conclusion: This review highlights great scientific interest of carotid body tumors and the potential they hide to create new lines of research. Current literature is valuable for guiding clinical practice; however, it must be reinforced in the future with more valid scientific evidence. These tumors should always be approached from multidisciplinary committees to improve their prognosis and require blood tests and molecular imaging follow-up due to the possibility of growth and hormone production, as well as the probability of new tumors emergence.
Background: Carotid body tumors are rare neuroendocrine tumors. Classically, the only available treatment was surgery, but now it can be enhanced with recently developed techniques. New challenge arises from recent finding about these tumors genetics, that sets mandatory individualised and multidisciplinary management. Objectives: The aim of this review is to join updated scientific evidence of these tumors treatment, as well as presenting a unique clinical case. Methods: Scientific data for this review was identified on Medline (by PubMed) and Cochrane Library. Data research and analysis was made following PRISMA guidelines, PICO method and Critical Appraisal Tools. Results: Quality analysis of published data is made on this review. Main features and lately news on diagnosis and treatment of carotid body tumors are presented, as well as risks and benefits of surgery plus surgical indications. Conclusion: This review highlights great scientific interest of carotid body tumors and the potential they hide to create new lines of research. Current literature is valuable for guiding clinical practice; however, it must be reinforced in the future with more valid scientific evidence. These tumors should always be approached from multidisciplinary committees to improve their prognosis and require blood tests and molecular imaging follow-up due to the possibility of growth and hormone production, as well as the probability of new tumors emergence.
Direction
CAICEDO VALDES, DIEGO JESUS (Tutorships)
Fernández González, Angel Luis (Co-tutorships)
CAICEDO VALDES, DIEGO JESUS (Tutorships)
Fernández González, Angel Luis (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Parathyroid hormone dermination as a predictor of post-thyroidectomy hypocalcemia: literature review
Authorship
A.C.G.
Bachelor of Medicine
A.C.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Total thyroidectomy is the most common endocrinological surgery and can be indicated for both benign and malignant pathologies. The most common complication associated with this procedure is hypocalcaemia. Its prevalence varies greatly depending on the series, due to the lack of consensus both in its definition and in its classification as permanent or transitory. Some authors consider hypocalcaemia to be permanent if it persists for more than 6 months after surgery, while others consider it to be permanent if it persists for more than 1 year. The incidence ranges from 1 to 50% of operations. In Spain, the prevalence of hypoparathyroidism at hospital discharge after total thyroidectomy is estimated at 48%, while that of permanent hypoparathyroidism is around 15%. This hypofunction is caused by devascularisation or inadvertent resection of the parathyroid glands, resulting in secondary hypoparathyroidism. Hypocalcemia may manifest with mild symptoms, such as paraesthesias and tingling, or with life-threatening symptoms, such as tetany or seizures, and represents the main obstacle to early discharge, as it manifests clinically during the first 48 hours after surgery. Its rapid recognition allows prophylactic treatment with calcium and/or vitamin D supplementation to be initiated, reducing the risk of complications and hospital stay. Serial measurement of serum calcium is an important tool for assessing the risk of symptomatic hypocalcemia after total thyroidectomy, although PTH measurement is a useful indicator for identifying patients at risk of developing hypocalcemia after total thyroidectomy.
Total thyroidectomy is the most common endocrinological surgery and can be indicated for both benign and malignant pathologies. The most common complication associated with this procedure is hypocalcaemia. Its prevalence varies greatly depending on the series, due to the lack of consensus both in its definition and in its classification as permanent or transitory. Some authors consider hypocalcaemia to be permanent if it persists for more than 6 months after surgery, while others consider it to be permanent if it persists for more than 1 year. The incidence ranges from 1 to 50% of operations. In Spain, the prevalence of hypoparathyroidism at hospital discharge after total thyroidectomy is estimated at 48%, while that of permanent hypoparathyroidism is around 15%. This hypofunction is caused by devascularisation or inadvertent resection of the parathyroid glands, resulting in secondary hypoparathyroidism. Hypocalcemia may manifest with mild symptoms, such as paraesthesias and tingling, or with life-threatening symptoms, such as tetany or seizures, and represents the main obstacle to early discharge, as it manifests clinically during the first 48 hours after surgery. Its rapid recognition allows prophylactic treatment with calcium and/or vitamin D supplementation to be initiated, reducing the risk of complications and hospital stay. Serial measurement of serum calcium is an important tool for assessing the risk of symptomatic hypocalcemia after total thyroidectomy, although PTH measurement is a useful indicator for identifying patients at risk of developing hypocalcemia after total thyroidectomy.
Direction
GARCIA GARCIA, MANUEL (Tutorships)
Darriba Fernández, María Isaura (Co-tutorships)
GARCIA GARCIA, MANUEL (Tutorships)
Darriba Fernández, María Isaura (Co-tutorships)
Court
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
BERMEJO BARRERA, ANA MARIA (Chairman)
LEIRA MUIÑO, ROGELIO MANUEL (Secretary)
LADO LADO, FRANCISCO LUIS (Member)
Current state of benign paroxysmal positional vertigo. Pathogenesis and genetics. A sistematic review.
Authorship
F.C.G.
Bachelor of Medicine
F.C.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vestibular-origin vertigo. It is characterized by brief episodes of vertigo triggered by changes in head position. This systematic review aims to provide a comprehensive understanding of the current knowledge on BPPV, focusing on its pathogenesis, genetic components, and consequent clinical implications. Our review reveals that there is a hereditary component to the disease. Thanks to the reviewed studies, we know that this familial pattern has a genetic cause, and we have identified the genes SLC26a4, PCDHGA10, LOXL1, CACNA1A, ZNF91, TECTA, OTOG, OTOGL, ARMC9, and OTOP1 as possible contributors to BPPV. Additionally, the fact that this pathology is strongly associated with other conditions, such as Ménière's disease, which also has a genetic component, supports our research hypothesis. Our findings suggest that while this genetic component is not sufficient for the development of the disease, it is a significant predisposing factor, potentially leading to earlier onset and more complex cases. This research has significant clinical implications as the identification of genes associated with BPPV can contribute to a better understanding of the disease, thereby improving diagnosis, treatment, and consequently, the prognosis of these patients. We believe this work provides a good starting point for new studies focused on finding genetic associations, better explaining pathogenesis, and identifying biomarkers to achieve the goals outlined in the previous paragraph.
Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vestibular-origin vertigo. It is characterized by brief episodes of vertigo triggered by changes in head position. This systematic review aims to provide a comprehensive understanding of the current knowledge on BPPV, focusing on its pathogenesis, genetic components, and consequent clinical implications. Our review reveals that there is a hereditary component to the disease. Thanks to the reviewed studies, we know that this familial pattern has a genetic cause, and we have identified the genes SLC26a4, PCDHGA10, LOXL1, CACNA1A, ZNF91, TECTA, OTOG, OTOGL, ARMC9, and OTOP1 as possible contributors to BPPV. Additionally, the fact that this pathology is strongly associated with other conditions, such as Ménière's disease, which also has a genetic component, supports our research hypothesis. Our findings suggest that while this genetic component is not sufficient for the development of the disease, it is a significant predisposing factor, potentially leading to earlier onset and more complex cases. This research has significant clinical implications as the identification of genes associated with BPPV can contribute to a better understanding of the disease, thereby improving diagnosis, treatment, and consequently, the prognosis of these patients. We believe this work provides a good starting point for new studies focused on finding genetic associations, better explaining pathogenesis, and identifying biomarkers to achieve the goals outlined in the previous paragraph.
Direction
Anibarro García, Luís (Tutorships)
Arán González, Ismael (Co-tutorships)
Anibarro García, Luís (Tutorships)
Arán González, Ismael (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Trimethoprim-Sulfamethoxazole drug fever. Successful desensitization protocol. About a case.
Authorship
R.C.M.
Bachelor of Medicine
R.C.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Drug fever is a common condition that is often misdiagnosed. It is a febrile response that temporarily coincides with the administration of a drug and disappears after suspension of the offending agent. It is suspected when no other cause of the fever can be elucidated. Early diagnosis can reduce inappropriate and potentially harmful and costly diagnostic and therapeutic interventions. We present the case of a 40-year-old woman with cystic fibrosis who presents with drug fever due to Trimethoprim-Sulfamethoxazole and had colonization by a multiresistant germ only sensitive to Septrim, for which a desensitization protocol was carried out in drug fever due to Trimethoprim-Sulfamethoxazole with a successful result.
Drug fever is a common condition that is often misdiagnosed. It is a febrile response that temporarily coincides with the administration of a drug and disappears after suspension of the offending agent. It is suspected when no other cause of the fever can be elucidated. Early diagnosis can reduce inappropriate and potentially harmful and costly diagnostic and therapeutic interventions. We present the case of a 40-year-old woman with cystic fibrosis who presents with drug fever due to Trimethoprim-Sulfamethoxazole and had colonization by a multiresistant germ only sensitive to Septrim, for which a desensitization protocol was carried out in drug fever due to Trimethoprim-Sulfamethoxazole with a successful result.
Direction
VIDAL PAN, Mª DEL CARMEN (Tutorships)
García Paz, Vanesa (Co-tutorships)
VIDAL PAN, Mª DEL CARMEN (Tutorships)
García Paz, Vanesa (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Influence of diet on Meniere's disease
Authorship
A.C.L.
Bachelor of Medicine
A.C.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Ménière's disease is an inner ear disorder characterized by episodes of vertigo, sensorineural hearing loss and tinnitus. It is believed to be due to an increase in endolymph pressure in the cochlea and posterior labyrinth, responsible for triggering these symptoms. Despite being a frequent entity in our society, there is still no consensus on its etiopathogenesis and therapeutic strategy. However, for decades, dietary modifications have been recommended as the first line of treatment.
Ménière's disease is an inner ear disorder characterized by episodes of vertigo, sensorineural hearing loss and tinnitus. It is believed to be due to an increase in endolymph pressure in the cochlea and posterior labyrinth, responsible for triggering these symptoms. Despite being a frequent entity in our society, there is still no consensus on its etiopathogenesis and therapeutic strategy. However, for decades, dietary modifications have been recommended as the first line of treatment.
Direction
SANTOS PEREZ, SOFIA MARIA SOLEDAD (Tutorships)
SANTOS PEREZ, SOFIA MARIA SOLEDAD (Tutorships)
Role of the glymphatic system in different types of hydrocephalus: role of aquaporins, a systematic review.
Authorship
A.M.C.A.
Bachelor of Medicine
A.M.C.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The term hydrocephalus refers to group of pathologies that affect many people worldwide, but at the present moment there is no etiological treatment for most of them, especially communicating hydrocephalus, its treatment being almost exclusively surgical. Until recently it was thought that the central nervous system lacked lymphatic drainage, now it is known that this is not the case thanks to the discovery in 2015 of the glymphatic system, a system of fluid flow through the brain parenchyma, from one perivascular space to another. One of the most important molecules in this system is aquaporin 4, a molecule that acts as a water channel, found primarily at the feet of the astrocytes that form the blood-brain barrier. Objectives: To understand the role played by the lymphatic system and aquaporins in hydrocephalus and to describe the current state of the subject. Material and methods: Systematic review of 6 articles, including 5 studies and one systematic review following the indications of the PRISMA 2020 guidelines. The search was conducted using the Medline database, PubMed. Results and conclusions: In hydrocephalus there is an alteration of the glymphatic system and aquaporin-4. In idiopathic normal pressure hydrocephalus, there is a decrease in aquaporin-4 levels and malfunction of the glymphatic system, possibly due to astrogliosis, while in other types, such as hydrocephalus secondary to a subarachnoid haemorrhage, aquaporin-4 levels are elevated, possibly as a compensatory mechanism. This makes aquaporin-4 and the glymphatic system therapeutic targets of great interest, but more research is required.
Introduction: The term hydrocephalus refers to group of pathologies that affect many people worldwide, but at the present moment there is no etiological treatment for most of them, especially communicating hydrocephalus, its treatment being almost exclusively surgical. Until recently it was thought that the central nervous system lacked lymphatic drainage, now it is known that this is not the case thanks to the discovery in 2015 of the glymphatic system, a system of fluid flow through the brain parenchyma, from one perivascular space to another. One of the most important molecules in this system is aquaporin 4, a molecule that acts as a water channel, found primarily at the feet of the astrocytes that form the blood-brain barrier. Objectives: To understand the role played by the lymphatic system and aquaporins in hydrocephalus and to describe the current state of the subject. Material and methods: Systematic review of 6 articles, including 5 studies and one systematic review following the indications of the PRISMA 2020 guidelines. The search was conducted using the Medline database, PubMed. Results and conclusions: In hydrocephalus there is an alteration of the glymphatic system and aquaporin-4. In idiopathic normal pressure hydrocephalus, there is a decrease in aquaporin-4 levels and malfunction of the glymphatic system, possibly due to astrogliosis, while in other types, such as hydrocephalus secondary to a subarachnoid haemorrhage, aquaporin-4 levels are elevated, possibly as a compensatory mechanism. This makes aquaporin-4 and the glymphatic system therapeutic targets of great interest, but more research is required.
Direction
PRIETO GONZALEZ, ANGEL JESUS (Tutorships)
BLANCO GUIJARRO, ADELA (Co-tutorships)
PRIETO GONZALEZ, ANGEL JESUS (Tutorships)
BLANCO GUIJARRO, ADELA (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Surgical approach of arachnoid cysts in paediatric age. Systematic review, regarding a case.
Authorship
C.C.S.
Bachelor of Medicine
C.C.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Optimization in the treatment of intracranial arachnoid cysts, including surgery at the appropriate time, could have implications on the future prognosis of patients. This motivates a systematic review regarding a case, treated at the Santiago de Compostela University Hospital Complex, which aims to update the effectiveness of treatments in children under eighteen years of age. Consequently, we will carry out a comparison of the results of the three most used surgical techniques currently (membrane fenestration by craniotomy vs. membrane fenestration by endoscopy vs. shunt) and we will propose future lines of research that may be interesting, in accordance with the discussion held. Methods: For the structuring of the review process of the available scientific evidence, a systematic approach based on the PRISMA statement was chosen. Relevant studies included in the Medline database (through its PubMed search engine) were selected, describing MeSH terms and inclusion/exclusion criteria, as well as limiting the articles to the last 10 years (2014-2024). Results and discussion: The systematic review included 15 articles, totaling up to 324 subjects under 18 years of age. As the lack of a model that directs the topographical classification and therapeutic protocol of these collections (indications and type of approach) is evident, a larger scale study is required with strict selection criteria that includes patients treated by three techniques. Conclusion: There is no clear evidence that one technique is superior to another. All three surgical approaches are valid and should be taken into consideration; the crucial point is the individualization of each case. We do not recommend using intracystic volume reduction for comparison between techniques.
Optimization in the treatment of intracranial arachnoid cysts, including surgery at the appropriate time, could have implications on the future prognosis of patients. This motivates a systematic review regarding a case, treated at the Santiago de Compostela University Hospital Complex, which aims to update the effectiveness of treatments in children under eighteen years of age. Consequently, we will carry out a comparison of the results of the three most used surgical techniques currently (membrane fenestration by craniotomy vs. membrane fenestration by endoscopy vs. shunt) and we will propose future lines of research that may be interesting, in accordance with the discussion held. Methods: For the structuring of the review process of the available scientific evidence, a systematic approach based on the PRISMA statement was chosen. Relevant studies included in the Medline database (through its PubMed search engine) were selected, describing MeSH terms and inclusion/exclusion criteria, as well as limiting the articles to the last 10 years (2014-2024). Results and discussion: The systematic review included 15 articles, totaling up to 324 subjects under 18 years of age. As the lack of a model that directs the topographical classification and therapeutic protocol of these collections (indications and type of approach) is evident, a larger scale study is required with strict selection criteria that includes patients treated by three techniques. Conclusion: There is no clear evidence that one technique is superior to another. All three surgical approaches are valid and should be taken into consideration; the crucial point is the individualization of each case. We do not recommend using intracystic volume reduction for comparison between techniques.
Direction
GELABERT GONZALEZ, MIGUEL (Tutorships)
GELABERT GONZALEZ, MIGUEL (Tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Biomarkers and breast cancer susceptibility: analyses by subtypes and potential interactions
Authorship
M.C.G.
Bachelor of Medicine
M.C.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Multiple studies have found that the neutrophil-to-lymphocyte ratio (NLR) is associated with poor breast cancer (BC) prognosis and survival. In our previous publication (1), through the BREOGAN study (Breast Oncology Galicia Network: https://proyectobreogan.es/), we have shown that N levels and NLR are associated with the risk of suffering from BC. In the present study, we analyzed the N-CM and NLR-CM association by levels of the different circulating lipoproteins including total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides (TG), and by breast cancer subtypes, menopausal status, histological grade, and clinical stage. A nested case-control study will be carried out in a cohort that includes 300 cases and the same number of controls, both belonging to the Galician study BREOGAN. Cases will be patients diagnosed with BC in Santiago (Complejo Hospitalario Universitario de Santiago, CHUS) and Vigo hospitals (Complejo Hospitalario Universitario de Vigo, CHUVI), and controls will be healthy women from the same base population. A high NLR is associated with a higher risk of breast cancer. To our knowledge, this is the first study to examine the association between NLR and breast cancer risk in non-Asian women stratified by circulating lipoprotein levels and by major breast cancer subtypes, grade, and stage. The NLR-breast cancer associations were more pronounced among women with high total cholesterol and triglyceride levels. The NLR-CM association was more pronounced for the Luminal A subtype than for other subtypes. It was also more pronounced for grade 2 and 3 tumors than grade 1 tumors. Although we did not have adequate precision, the association also appeared to be more pronounced for stage 1 than stage 2 and 3. Similar results were found for N# and N%.
Multiple studies have found that the neutrophil-to-lymphocyte ratio (NLR) is associated with poor breast cancer (BC) prognosis and survival. In our previous publication (1), through the BREOGAN study (Breast Oncology Galicia Network: https://proyectobreogan.es/), we have shown that N levels and NLR are associated with the risk of suffering from BC. In the present study, we analyzed the N-CM and NLR-CM association by levels of the different circulating lipoproteins including total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides (TG), and by breast cancer subtypes, menopausal status, histological grade, and clinical stage. A nested case-control study will be carried out in a cohort that includes 300 cases and the same number of controls, both belonging to the Galician study BREOGAN. Cases will be patients diagnosed with BC in Santiago (Complejo Hospitalario Universitario de Santiago, CHUS) and Vigo hospitals (Complejo Hospitalario Universitario de Vigo, CHUVI), and controls will be healthy women from the same base population. A high NLR is associated with a higher risk of breast cancer. To our knowledge, this is the first study to examine the association between NLR and breast cancer risk in non-Asian women stratified by circulating lipoprotein levels and by major breast cancer subtypes, grade, and stage. The NLR-breast cancer associations were more pronounced among women with high total cholesterol and triglyceride levels. The NLR-CM association was more pronounced for the Luminal A subtype than for other subtypes. It was also more pronounced for grade 2 and 3 tumors than grade 1 tumors. Although we did not have adequate precision, the association also appeared to be more pronounced for stage 1 than stage 2 and 3. Similar results were found for N# and N%.
Direction
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
Gago Domínguez, Manuela (Co-tutorships)
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
Gago Domínguez, Manuela (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Robotic surgery in the surgical treatment of endometrial cancer
Authorship
A.M.F.D.
Bachelor of Medicine
A.M.F.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction Robotic surgery for the surgical treatment of endometrial cancer offers advantages for both the patient and the surgeon. Mapping and SLNB (Sentinel Lymph Node Biopsy) is a staging alternative that can reduce post-operative complications presented by lymphadenectomy. The new FIGO 2023 molecular classification allows for a more accurate prognosis and an increasingly individualized therapeutic approach for the patient. Objectives: To verify the efficacy and safety of robotic surgery using the Da Vinci system for the surgical treatment of endometrial cancer compared to other surgical techniques, including elderly and obese patients, assuming the hypothesis that it presents advantages at all levels. To find out if it provides a good approach for staging endometrial cancer and performing sentinel lymph node biopsy (SLNB). Methodology: A bibliographic review of the available scientific literature on the use of robotic surgery in the surgical treatment of endometrial cancer, conducted through the PUBMED bibliographic search engine and following PRISMA guidelines. Original articles published in English, articles published from 2019 to 2024, articles whose titles contain the keywords, and articles that are clinical trials, randomized controlled trials, meta-analyses, and systematic reviews were included. Results: Data from a total of 8 articles were analyzed. Robotic surgery is a safe technique for treating endometrial cancer in obese or elderly patients, as well as offering advantages in terms of post-operative complications and overall survival compared to other surgical techniques. Mapping and SLNB with ICG (indocyanine green) injection has a high negative predictive value, with low recurrence rates and fewer post-surgical complications. Conclusions: Robotic surgery is safe and offers advantages over other surgical techniques for the treatment of endometrial cancer, proving to be especially effective in elderly and obese patients, with its only disadvantages being longer surgery time and high cost. Robotic surgery associated with SLNB is a good approach for staging endometrial cancer.
Introduction Robotic surgery for the surgical treatment of endometrial cancer offers advantages for both the patient and the surgeon. Mapping and SLNB (Sentinel Lymph Node Biopsy) is a staging alternative that can reduce post-operative complications presented by lymphadenectomy. The new FIGO 2023 molecular classification allows for a more accurate prognosis and an increasingly individualized therapeutic approach for the patient. Objectives: To verify the efficacy and safety of robotic surgery using the Da Vinci system for the surgical treatment of endometrial cancer compared to other surgical techniques, including elderly and obese patients, assuming the hypothesis that it presents advantages at all levels. To find out if it provides a good approach for staging endometrial cancer and performing sentinel lymph node biopsy (SLNB). Methodology: A bibliographic review of the available scientific literature on the use of robotic surgery in the surgical treatment of endometrial cancer, conducted through the PUBMED bibliographic search engine and following PRISMA guidelines. Original articles published in English, articles published from 2019 to 2024, articles whose titles contain the keywords, and articles that are clinical trials, randomized controlled trials, meta-analyses, and systematic reviews were included. Results: Data from a total of 8 articles were analyzed. Robotic surgery is a safe technique for treating endometrial cancer in obese or elderly patients, as well as offering advantages in terms of post-operative complications and overall survival compared to other surgical techniques. Mapping and SLNB with ICG (indocyanine green) injection has a high negative predictive value, with low recurrence rates and fewer post-surgical complications. Conclusions: Robotic surgery is safe and offers advantages over other surgical techniques for the treatment of endometrial cancer, proving to be especially effective in elderly and obese patients, with its only disadvantages being longer surgery time and high cost. Robotic surgery associated with SLNB is a good approach for staging endometrial cancer.
Direction
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Cordeiro Vidal, Gloria (Co-tutorships)
LOPEZ RAMON Y CAJAL, CARLOS NICOLAS (Tutorships)
Cordeiro Vidal, Gloria (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
The influence of health resources on inequality in Europe
Authorship
A.F.P.
Bachelor of Medicine
A.F.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction and objectives. The growing interest in the sustainability of countries' health systems has led to a proliferation of studies focused on improving the health of citizens, as well as on the search for equity in the social and health spheres. Therefore, the main objective of this research is to analyse the extent to which health resources influence income inequality and, through this, to understand the relevance of public health policies on social equity. Material and methods. The work begins with a review of the literature in the field of interest that will allow us to justify both the selection of the variables used and to contrast the results obtained subsequently. For the analysis, a panel database is set up for the period between 2005 and 2020, consisting of 32 countries on the European continent and 13 variables. Finally, R software will be used to clean the variables and perform the analysis. Results. All the variables used are significant to explain income inequality, although they have different values depending on the type of expenditure considered in the model and whether or not robust errors are applied during estimation. Discussion. In general, the health variables affect inequality negatively; while the dummy variable indicates that inequality is lower in countries with a Social Security Health System than in those with the National Health System, although the difference is not significant with robust errors. Conclusions. Public health policies aimed at increasing investment in health can be a great support in the fight against income inequality, especially those that impact on equity in the financing and distribution of health resources.
Introduction and objectives. The growing interest in the sustainability of countries' health systems has led to a proliferation of studies focused on improving the health of citizens, as well as on the search for equity in the social and health spheres. Therefore, the main objective of this research is to analyse the extent to which health resources influence income inequality and, through this, to understand the relevance of public health policies on social equity. Material and methods. The work begins with a review of the literature in the field of interest that will allow us to justify both the selection of the variables used and to contrast the results obtained subsequently. For the analysis, a panel database is set up for the period between 2005 and 2020, consisting of 32 countries on the European continent and 13 variables. Finally, R software will be used to clean the variables and perform the analysis. Results. All the variables used are significant to explain income inequality, although they have different values depending on the type of expenditure considered in the model and whether or not robust errors are applied during estimation. Discussion. In general, the health variables affect inequality negatively; while the dummy variable indicates that inequality is lower in countries with a Social Security Health System than in those with the National Health System, although the difference is not significant with robust errors. Conclusions. Public health policies aimed at increasing investment in health can be a great support in the fight against income inequality, especially those that impact on equity in the financing and distribution of health resources.
Direction
FERNANDEZ PEREZ, CRISTINA (Tutorships)
Reyes Santías, Francisco (Co-tutorships)
FERNANDEZ PEREZ, CRISTINA (Tutorships)
Reyes Santías, Francisco (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
Febrile seizures: treatment and complications. Sistematic review.
Authorship
I.F.B.
Bachelor of Medicine
I.F.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Febrile seizures are the most common cause of epileptic seizures in childhood. They occur in the context of fever in children between 6 months and 5 years old and are subdivided into two groups: simple and complex. Simple seizures are generalized, last less than 15 minutes, and do not occur more than once a day. They are not due to previous neurological disease and the risk of epilepsy is only 1-1.5%, so they do not require treatment initially. In contrast, complex seizures can be focal or generalized, last more than 15 minutes, are associated with neurological impairment, and have a risk of epilepsy of 4-15%. In these ones, an underlying cause must be sought and their treatment will depend on the cause. Despite the high frequency of febrile seizures, there is no unanimity of opinion on treatment options. This systematic review aims to address possible therapeutic interventions, as well as the complications that these patients may present.
Febrile seizures are the most common cause of epileptic seizures in childhood. They occur in the context of fever in children between 6 months and 5 years old and are subdivided into two groups: simple and complex. Simple seizures are generalized, last less than 15 minutes, and do not occur more than once a day. They are not due to previous neurological disease and the risk of epilepsy is only 1-1.5%, so they do not require treatment initially. In contrast, complex seizures can be focal or generalized, last more than 15 minutes, are associated with neurological impairment, and have a risk of epilepsy of 4-15%. In these ones, an underlying cause must be sought and their treatment will depend on the cause. Despite the high frequency of febrile seizures, there is no unanimity of opinion on treatment options. This systematic review aims to address possible therapeutic interventions, as well as the complications that these patients may present.
Direction
Leis Trabazo, María Rosaura (Tutorships)
Presno López, Iván (Co-tutorships)
Leis Trabazo, María Rosaura (Tutorships)
Presno López, Iván (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
Spontaneous intracranial hemorrhages in patients over 80 years anticoagulated with antivitamin K
Authorship
A.F.D.
Bachelor of Medicine
A.F.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: There are epidemiological studies about Spontaneous intracranial hemorrhage associated with anticoagulant treatment with vitamin K antagonists (HICE-AVK) in several countries, however, the impact in the healthcare area of the Complejo Hospitalario Universitario de Pontevedra is unknown. Objectives: To compare two groups separated by age, over and under 80 years, with the diagnosis of HICE-AVK. To know in both groups the factors related to patients' cardiovascular health, bleeding, clinical and analytical parameters on their arrival at the hospital as well as during their hospitalization, the anatomical study of the ICH, the type of treatment applied during their hospital stay, and mortality. Material and methods: Observational, longitudinal, retrospective study of a cohort of 169 patients with the diagnosis of HICE-AVK, between January 1, 2010, and December 31, 2018. Data were collected in a database using Excel program and statistical analysis was performed using the IBM SPSS Statistics package. In univariate analysis, comparison of averages was done using T-Student test. Chi- square test (X2) was used for testing qualitative variables; when cells contained expected values less than 5, Fisher's exact test was used. Results: Statistically significant differences were observed in some variables. For the age group younger than 80 years old: tobacco consumption was more frequent (p-value 0.03); the location of the hemorrhage was more frequent in deep brain structures (p-value 0.011); the number of days hospitalized was higher (p-value 0.002) and the number of patients admitted to the ICU was higher (p-value under 0.001). For the age group of 80 years old or older: the location of the hemorrhage in lobar structures was more frequent (p-value 0.011). Conclusions: The risk factors for bleeding were more frequent in the younger age group, and therapeutic efforts were also higher in this group, although not too many differences were found. It would be advisable for future research to address this issue with a larger sample of patients in order to better understand the clinical implications of these differences.
Introduction: There are epidemiological studies about Spontaneous intracranial hemorrhage associated with anticoagulant treatment with vitamin K antagonists (HICE-AVK) in several countries, however, the impact in the healthcare area of the Complejo Hospitalario Universitario de Pontevedra is unknown. Objectives: To compare two groups separated by age, over and under 80 years, with the diagnosis of HICE-AVK. To know in both groups the factors related to patients' cardiovascular health, bleeding, clinical and analytical parameters on their arrival at the hospital as well as during their hospitalization, the anatomical study of the ICH, the type of treatment applied during their hospital stay, and mortality. Material and methods: Observational, longitudinal, retrospective study of a cohort of 169 patients with the diagnosis of HICE-AVK, between January 1, 2010, and December 31, 2018. Data were collected in a database using Excel program and statistical analysis was performed using the IBM SPSS Statistics package. In univariate analysis, comparison of averages was done using T-Student test. Chi- square test (X2) was used for testing qualitative variables; when cells contained expected values less than 5, Fisher's exact test was used. Results: Statistically significant differences were observed in some variables. For the age group younger than 80 years old: tobacco consumption was more frequent (p-value 0.03); the location of the hemorrhage was more frequent in deep brain structures (p-value 0.011); the number of days hospitalized was higher (p-value 0.002) and the number of patients admitted to the ICU was higher (p-value under 0.001). For the age group of 80 years old or older: the location of the hemorrhage in lobar structures was more frequent (p-value 0.011). Conclusions: The risk factors for bleeding were more frequent in the younger age group, and therapeutic efforts were also higher in this group, although not too many differences were found. It would be advisable for future research to address this issue with a larger sample of patients in order to better understand the clinical implications of these differences.
Direction
Anibarro García, Luís (Tutorships)
Núñez Fernández, Manuel Jesús (Co-tutorships)
Anibarro García, Luís (Tutorships)
Núñez Fernández, Manuel Jesús (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
Deep Brain Stimulation as a treatment of Cerebral Palsy: a systematic review
Authorship
G.F.R.
Bachelor of Medicine
G.F.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Cerebral palsy (CP) is a persistent disorder of posture, muscle tone and movement due to a non-progressive lesion on an immature brain. The treatment of motor dysfunction is multidimensional, trying to improve the quality of life and the functional and cognitive development of the patient. In its dyskinetic form, conventional pharmacological therapies have proven unsatisfactory. Deep Brain Stimulation (DBS) is a neurosurgical technique indicated in psychiatric diseases and movement disorders such as primary dystonia. In dystonia secondary to CP, neurostimulation is an option for refractory patients. Objectives: To evaluate the efficiency and safety of Deep Brain Stimulation in dyskinetic CP. The improvement in motor function and quality of life will be analysed, assessing possible predictors of the technique's success. Material and methods: Updated and systematic literature review based on a selection of articles obtained from the Medline and WOS databases, limited to the last 15 years. Case series, cohort studies and clinical trials were included. The PRISMA 2020 statement was also followed to ensure the quality of the review. Results: A total of 15 studies that met the inclusion criteria were included, referring to patients under 21 years of age with dystonia secondary to CP treated with DBS. The following variables were analysed for each study: design, inclusion and exclusion criteria, sample size, main and secondary objectives, results, conclusions and limitations. Conclusion: Although studies with larger sample sizes are needed, as well as identifying markers and patient characteristics that predict a better response, DBS seems to improve motor function and quality of life in certain patients with Cerebral Palsy.
Introduction: Cerebral palsy (CP) is a persistent disorder of posture, muscle tone and movement due to a non-progressive lesion on an immature brain. The treatment of motor dysfunction is multidimensional, trying to improve the quality of life and the functional and cognitive development of the patient. In its dyskinetic form, conventional pharmacological therapies have proven unsatisfactory. Deep Brain Stimulation (DBS) is a neurosurgical technique indicated in psychiatric diseases and movement disorders such as primary dystonia. In dystonia secondary to CP, neurostimulation is an option for refractory patients. Objectives: To evaluate the efficiency and safety of Deep Brain Stimulation in dyskinetic CP. The improvement in motor function and quality of life will be analysed, assessing possible predictors of the technique's success. Material and methods: Updated and systematic literature review based on a selection of articles obtained from the Medline and WOS databases, limited to the last 15 years. Case series, cohort studies and clinical trials were included. The PRISMA 2020 statement was also followed to ensure the quality of the review. Results: A total of 15 studies that met the inclusion criteria were included, referring to patients under 21 years of age with dystonia secondary to CP treated with DBS. The following variables were analysed for each study: design, inclusion and exclusion criteria, sample size, main and secondary objectives, results, conclusions and limitations. Conclusion: Although studies with larger sample sizes are needed, as well as identifying markers and patient characteristics that predict a better response, DBS seems to improve motor function and quality of life in certain patients with Cerebral Palsy.
Direction
Concheiro Guisán, Ana (Tutorships)
Concheiro Guisán, Ana (Tutorships)
Role of p53 in Energy Balance
Authorship
C.F.C.
Bachelor of Medicine
C.F.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The p53 gene, commonly known as the guardian of the genome, has been extensively studied for its role in the response to DNA damage and tumor suppression. Recent studies suggest that it also exerts a major influence on cellular and body metabolism, thus understanding p53 and its mechanisms of action may pave the way for the development of therapies to modify the course of metabolic pathologies. Objectives: To review the available evidence in the scientific literature regarding the role of p53 in the brain and liver, key organs for maintaining energy homeostasis, under physiological conditions and in the development of metabolic pathologies such as obesity, type 2 diabetes (DM2), and metabolic dysfunction-associated steatotic liver disease (MASLD). Methods: A systematic review was conducted following the PRISMA method in the Medline (PubMed) database of primary studies that investigated the role of hypothalamic and hepatic p53 in metabolism through human data and in vivo preclinical experimentation, specifically functional gain- and loss-of-function assays of p53. Results: A total of 22 articles were found, 6 related to the hypothalamus and 16 to the liver. At the brain level, p53 in AgRP neurons of the hypothalamus protects against diet-induced obesity and mediates the effects of ghrelin on food intake and body weight. At the hepatic level, p53 controls glucose homeostasis through gluconeogenesis and is elevated in patients with T2D. Regarding lipid metabolism, there is discordance about the protective or promoting role of p53 in the development of MASLD. Conclusions: p53 in the hypothalamus and liver is important for maintaining the body's energy balance, and its alteration is implicated in the development of metabolic diseases. These results suggest that p53 could be an interesting therapeutic target, although additional research is needed to fully understand its mechanisms and therapeutic potential in these diseases.
Introduction: The p53 gene, commonly known as the guardian of the genome, has been extensively studied for its role in the response to DNA damage and tumor suppression. Recent studies suggest that it also exerts a major influence on cellular and body metabolism, thus understanding p53 and its mechanisms of action may pave the way for the development of therapies to modify the course of metabolic pathologies. Objectives: To review the available evidence in the scientific literature regarding the role of p53 in the brain and liver, key organs for maintaining energy homeostasis, under physiological conditions and in the development of metabolic pathologies such as obesity, type 2 diabetes (DM2), and metabolic dysfunction-associated steatotic liver disease (MASLD). Methods: A systematic review was conducted following the PRISMA method in the Medline (PubMed) database of primary studies that investigated the role of hypothalamic and hepatic p53 in metabolism through human data and in vivo preclinical experimentation, specifically functional gain- and loss-of-function assays of p53. Results: A total of 22 articles were found, 6 related to the hypothalamus and 16 to the liver. At the brain level, p53 in AgRP neurons of the hypothalamus protects against diet-induced obesity and mediates the effects of ghrelin on food intake and body weight. At the hepatic level, p53 controls glucose homeostasis through gluconeogenesis and is elevated in patients with T2D. Regarding lipid metabolism, there is discordance about the protective or promoting role of p53 in the development of MASLD. Conclusions: p53 in the hypothalamus and liver is important for maintaining the body's energy balance, and its alteration is implicated in the development of metabolic diseases. These results suggest that p53 could be an interesting therapeutic target, although additional research is needed to fully understand its mechanisms and therapeutic potential in these diseases.
Direction
Dieguez Gonzalez, Carlos (Tutorships)
Fernández Fondevila, Marcos (Co-tutorships)
Dieguez Gonzalez, Carlos (Tutorships)
Fernández Fondevila, Marcos (Co-tutorships)
Court
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
GARCIA RIESTRA, CARLOS (Chairman)
Rodríguez Vázquez, Virginia María (Secretary)
PAZOS CASTELOS, ANTONIO JUAN (Member)
Myopia in the 21st century: Treatment alternatives for controlling its progression
Authorship
C.F.M.
Bachelor of Medicine
C.F.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction and objectives. Myopia is currently experiencing an exponential growth due to various genetic and enviromental factors. Therefore the objective of this review was to analyze and compare the most commonly used therapies today, optimizing their effectiveness by measuring axial length (AL) and changes in the refractive spherical equivalent (SER). Material and methods. A bibliographic search was conducted in the Pubmed database, dividing it into four subgroups to search for articles, (Atropine, orthokeratology (OK), contact lenses and atropine combined with orthokeratology (AOK)). Randomized and non-randomized clinical trials, cohort studies and case-control studies were included according to established inclusion and exclusion criteria. Changes in AL and in the SER were studied. Results. Twenty-eight studies were analyzed. Regarding atropine, a reduction in myopia progression was observed based on the analysis of AL and SER, with changes of -0.11mm/year and -0.35 D/year, respectively. In the análisis of OK, a deceleration of myopia progression was observed only though AL. On the other hand, contact lenses slowed the growth of the refractive error, with mean differences in SER and AL of -0.41D/year and -0.65 mm/year. Lastly, the combined therapy achieved positive effects, with AOK (Atropine and Orthokeratology) users experiencing an overall average inhibition of -0.23D/ year in SER and 0.10 mm/year in AL. Conclusions: Contact lenses proved to be the most effective therapy in slowing the growth of the refractive error with mean differences in SER and AL of -0.41D/year and -0.65mm/year, respectively. However, all therapies studied yielded positive results in controllling myopia.
Introduction and objectives. Myopia is currently experiencing an exponential growth due to various genetic and enviromental factors. Therefore the objective of this review was to analyze and compare the most commonly used therapies today, optimizing their effectiveness by measuring axial length (AL) and changes in the refractive spherical equivalent (SER). Material and methods. A bibliographic search was conducted in the Pubmed database, dividing it into four subgroups to search for articles, (Atropine, orthokeratology (OK), contact lenses and atropine combined with orthokeratology (AOK)). Randomized and non-randomized clinical trials, cohort studies and case-control studies were included according to established inclusion and exclusion criteria. Changes in AL and in the SER were studied. Results. Twenty-eight studies were analyzed. Regarding atropine, a reduction in myopia progression was observed based on the analysis of AL and SER, with changes of -0.11mm/year and -0.35 D/year, respectively. In the análisis of OK, a deceleration of myopia progression was observed only though AL. On the other hand, contact lenses slowed the growth of the refractive error, with mean differences in SER and AL of -0.41D/year and -0.65 mm/year. Lastly, the combined therapy achieved positive effects, with AOK (Atropine and Orthokeratology) users experiencing an overall average inhibition of -0.23D/ year in SER and 0.10 mm/year in AL. Conclusions: Contact lenses proved to be the most effective therapy in slowing the growth of the refractive error with mean differences in SER and AL of -0.41D/year and -0.65mm/year, respectively. However, all therapies studied yielded positive results in controllling myopia.
Direction
Touriño Peralba, María del Rosario (Tutorships)
Touriño Peralba, María del Rosario (Tutorships)
Three-year results of a sample of patients with Metabolic dysfunction Associated Steatotic Liver Disease (MASLD) after intervention on lifestyle habits, in a Family Medicine consultation.
Authorship
J.L.A.
Bachelor of Medicine
J.L.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Metabolic-associated steatotic liver disease (MASLD) is one of the most frequent causes of liver disease worldwide. Diagnosis and early management on subjects with risk factors (such as obesity, type 2 diabetes mellitus, and metabolic syndrome) is of great importance on this disease’s prognosis. Objectives: assess the impact of lifestyle intervention on patients diagnosed with MASLD, comparing anthropometric, analytic and elastographic indicators three years after the establishment of hygienic-dietary measures. Patients and Methods: ambispective study performed at the Adormideras Health Centre, on A Coruña-Cee Health Area, from February 1st, 2020 to March 31st, 2023. 22 patients diagnosed with MASLD were included. Anthropometric and analytic values were measured, and fibrosis degree was estimated on two time points: on 2020, at the beginning of the study, and on 2023, after the establishment of a healthy lifestyle habits: hypocaloric diet, saturated fat consume reduction, physical activity increase and weekly weight control. Results: the measured values show a decrease in the average weight and an increase in the percentage of BMI normalization. It was observed that basal blood glucose and glycated hemoglobin values had decreased, as did those of hepatic enzymes. An improvement of lipid values was also seen, due to the total cholesterol, LDL fraction and trygliceride reduction and the HDL fraction increase. Regarding the analysis of hepatic fibrosis, no significant difference has been found in the percentage of fibrosis measured with Fibroscan between the years 2020 and 2023. Conclusion: lifestyle intervention is the first step in the management of MASLD, resulting in an improvement in weight. Likewise, a decrease in blood glucose levels and an improvement in lipid values are observed. The hepatic fibrosis values found in 2023 do not differ from those measured in 2020.
Metabolic-associated steatotic liver disease (MASLD) is one of the most frequent causes of liver disease worldwide. Diagnosis and early management on subjects with risk factors (such as obesity, type 2 diabetes mellitus, and metabolic syndrome) is of great importance on this disease’s prognosis. Objectives: assess the impact of lifestyle intervention on patients diagnosed with MASLD, comparing anthropometric, analytic and elastographic indicators three years after the establishment of hygienic-dietary measures. Patients and Methods: ambispective study performed at the Adormideras Health Centre, on A Coruña-Cee Health Area, from February 1st, 2020 to March 31st, 2023. 22 patients diagnosed with MASLD were included. Anthropometric and analytic values were measured, and fibrosis degree was estimated on two time points: on 2020, at the beginning of the study, and on 2023, after the establishment of a healthy lifestyle habits: hypocaloric diet, saturated fat consume reduction, physical activity increase and weekly weight control. Results: the measured values show a decrease in the average weight and an increase in the percentage of BMI normalization. It was observed that basal blood glucose and glycated hemoglobin values had decreased, as did those of hepatic enzymes. An improvement of lipid values was also seen, due to the total cholesterol, LDL fraction and trygliceride reduction and the HDL fraction increase. Regarding the analysis of hepatic fibrosis, no significant difference has been found in the percentage of fibrosis measured with Fibroscan between the years 2020 and 2023. Conclusion: lifestyle intervention is the first step in the management of MASLD, resulting in an improvement in weight. Likewise, a decrease in blood glucose levels and an improvement in lipid values are observed. The hepatic fibrosis values found in 2023 do not differ from those measured in 2020.
Direction
DELGADO BLANCO, MANUEL BENJAMIN (Tutorships)
Prada Vigil, Ana Leonor (Co-tutorships)
DELGADO BLANCO, MANUEL BENJAMIN (Tutorships)
Prada Vigil, Ana Leonor (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Study of pelvic obliquity as a prognostic factor in Legg-Calvé-Perthes disease.
Authorship
E.L.F.
Bachelor of Medicine
E.L.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Legg-Calvé-Perthes LCP disease is a hip disorder in pediatric age, caused by ischemia of the femoral epiphysis, sometimes causing deformity in the femoral head. In addition to the deformities of the femoral head described in the literature, we have observed differences in acetabular retroversion and pelvic obliquity between the healthy and affected hips. Material and methods: A retrospective observational study was carried out on patients with LCP disease, 4 pelvic parameters were studied, ilioischial angle, obturator index, Sharp's angle and acetabular depth width ratio, analyzing whether there is a difference in their values between the healthy hip and the affected one and whether these parameters can have a prognostic value in the final outcome of the disease Results: Statistically significant differences have been obtained in the ilioischial angle, obturator index and ADR, between the affected and healthy hips. But regarding its value in the prognosis of the disease, only the acetabular depth width ratio has been shown to have predictive value for the outcome of the disease. Conclusions: The present study showed that the pelvic parameters studied differ between the healthy and the diseased hip in LCP disease, but only the ADR seems to have significance on the evolution of the disease. We consider that more studies are necessary and with a larger sample size, but we consider that studies on pelvic obliquity can open a new line of research in LCP disease.
Introduction: Legg-Calvé-Perthes LCP disease is a hip disorder in pediatric age, caused by ischemia of the femoral epiphysis, sometimes causing deformity in the femoral head. In addition to the deformities of the femoral head described in the literature, we have observed differences in acetabular retroversion and pelvic obliquity between the healthy and affected hips. Material and methods: A retrospective observational study was carried out on patients with LCP disease, 4 pelvic parameters were studied, ilioischial angle, obturator index, Sharp's angle and acetabular depth width ratio, analyzing whether there is a difference in their values between the healthy hip and the affected one and whether these parameters can have a prognostic value in the final outcome of the disease Results: Statistically significant differences have been obtained in the ilioischial angle, obturator index and ADR, between the affected and healthy hips. But regarding its value in the prognosis of the disease, only the acetabular depth width ratio has been shown to have predictive value for the outcome of the disease. Conclusions: The present study showed that the pelvic parameters studied differ between the healthy and the diseased hip in LCP disease, but only the ADR seems to have significance on the evolution of the disease. We consider that more studies are necessary and with a larger sample size, but we consider that studies on pelvic obliquity can open a new line of research in LCP disease.
Direction
PINO MINGUEZ, JESUS (Tutorships)
Castro Torre, Miguel (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
Castro Torre, Miguel (Co-tutorships)
Court
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
VIDAL PAN, Mª DEL CARMEN (Chairman)
de la Iglesia Martínez, Fernando Antonio (Secretary)
CAMESELLE TEIJEIRO, JOSE MANUEL (Member)
Effect of treatment with balanced crystalloids versus normal saline on the mortality of critically ill patients with and without traumatic brain injury: a systematic review and meta-analysis of clinical trials.
Authorship
P.L.R.
Bachelor of Medicine
P.L.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Fluid therapy with balanced crystalloids emerged as a promising therapeutic strategy in critically ill patients, showing potential to reduce mortality compared to saline. However, the evidence on this favorable trend is inconclusive in all subgroups of patients, including those with or without TBI, as well as in the general population. It is crucial to conduct further research to confirm and better understand how this form of treatment affects mortality in critically ill patients. Outcomes: The main objective of this study is to compare the effect of balanced crystalloids versus normal saline on mortality in adult patients under critical care, both globally and in subgroups of patients with and without TBI. In addition, other secondary clinical parameters will be explored, such as length of hospital and ICU stay, renal adverse effects, ICU-free days, mechanical ventilation or vasopressors, and mortality in patients with sepsis. Methods: A systematic review and meta-analysis of randomized clinical trials was carried out following the PRISMA method, for which a protocol published in OSF was implemented and Meta-Essentials Workbooks were managed in Microsoft Excel, together with RevMan software. Using MEDLINE as a database, reviews of bibliographic lists and specific web searches. Results: We examined data from 15 clinical trials involving 35207 patients, with no heterogeneity between groups in terms of mortality. Significant differences were found in patients without TBI, where balanced crystalloids showed a reduction in mortality [OR: 0.93; CI: (0.87; 0.98); p=0.01], while in patients with TBI, saline showed a decrease in mortality [OR: 1.33; CI: (1.05; 1.69); p=0.02]. In the total group of patients, no significant differences were found [OR: 0.95; CI: (0.89; 1.00); p=0.05]. Differences were identified in the days free of mechanical ventilation and vasopressors in favor of balanced crystalloids, but not in the other parameters studied. Conclusions: In critically ill patients with a high quality of evidence (GRADE evidence), the use of balanced crystalloids was associated with lower mortality in those without TBI and higher mortality in patients with TBI compared to saline. However, no significant association was found in the total number of patients. In addition, an increase in ventilator-free days and vasopressors with balanced crystalloids was observed, but no significant differences were found in other secondary outcomes such as length of hospital or ICU stay, adverse renal events, ICU-free days, or mortality in patients with sepsis.
Introduction: Fluid therapy with balanced crystalloids emerged as a promising therapeutic strategy in critically ill patients, showing potential to reduce mortality compared to saline. However, the evidence on this favorable trend is inconclusive in all subgroups of patients, including those with or without TBI, as well as in the general population. It is crucial to conduct further research to confirm and better understand how this form of treatment affects mortality in critically ill patients. Outcomes: The main objective of this study is to compare the effect of balanced crystalloids versus normal saline on mortality in adult patients under critical care, both globally and in subgroups of patients with and without TBI. In addition, other secondary clinical parameters will be explored, such as length of hospital and ICU stay, renal adverse effects, ICU-free days, mechanical ventilation or vasopressors, and mortality in patients with sepsis. Methods: A systematic review and meta-analysis of randomized clinical trials was carried out following the PRISMA method, for which a protocol published in OSF was implemented and Meta-Essentials Workbooks were managed in Microsoft Excel, together with RevMan software. Using MEDLINE as a database, reviews of bibliographic lists and specific web searches. Results: We examined data from 15 clinical trials involving 35207 patients, with no heterogeneity between groups in terms of mortality. Significant differences were found in patients without TBI, where balanced crystalloids showed a reduction in mortality [OR: 0.93; CI: (0.87; 0.98); p=0.01], while in patients with TBI, saline showed a decrease in mortality [OR: 1.33; CI: (1.05; 1.69); p=0.02]. In the total group of patients, no significant differences were found [OR: 0.95; CI: (0.89; 1.00); p=0.05]. Differences were identified in the days free of mechanical ventilation and vasopressors in favor of balanced crystalloids, but not in the other parameters studied. Conclusions: In critically ill patients with a high quality of evidence (GRADE evidence), the use of balanced crystalloids was associated with lower mortality in those without TBI and higher mortality in patients with TBI compared to saline. However, no significant association was found in the total number of patients. In addition, an increase in ventilator-free days and vasopressors with balanced crystalloids was observed, but no significant differences were found in other secondary outcomes such as length of hospital or ICU stay, adverse renal events, ICU-free days, or mortality in patients with sepsis.
Direction
Álvarez Escudero, Julián (Tutorships)
DIZ GOMEZ, JOSE CARLOS (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
DIZ GOMEZ, JOSE CARLOS (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Analysis of the
Authorship
C.M.T.S.
Bachelor of Medicine
C.M.T.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: HIV infection causes progressive dysfunction of the immune system that, without treatment, leads to acquired immunodeficiency syndrome (AIDS). Post-exposure prophylaxis against HIV is one of the prevention measures that exist today and is recommended to be administered within the first 72 hours after an exposure with risk for HIV transmission. A population accident is defined as a potential contact with HIV, of non-work origin, which is characteristic of health personnel, and contact may occur through sexual means, puncture, splash or bite. Objectives: The main objective was to determine the incidence of population accidents in a healthcare area, its characteristics, management and care provided. Materials and methods: A descriptive cross-sectional study of all cases registered as biological accidents of non-work origin in the Preventive Medicine Service in Vigo’s Healthcare Area in which PEP against HIV was assessed was carried out, excluding suspected or confirmed cases of sexual assault. Results: Ninety-eight biological accidents occurred, with an annual incidence rate of 17.1 cases per 100,000 inhabitants. Most of the accidents involved consensual sexual exposures with a source person whose HIV status was unknown. In 62.2% of the accidents PEP against HIV was administered. Conclusions: The population accidents analyzed in Vigo’s Healthcare Area show correct care in terms of care time and comply with the PEP protocols for HIV reflected in the guidelines. PEP is administered more to men and in relation to risk sexual relations. Antibiotic prophylaxis is indicated in a quarter of accidents and shows significant variability. The dissemination of basic preventive measures is necessary, including the correct use of barrier methods, to avoid these accidents, their health care and the consequences on people's health.
Background: HIV infection causes progressive dysfunction of the immune system that, without treatment, leads to acquired immunodeficiency syndrome (AIDS). Post-exposure prophylaxis against HIV is one of the prevention measures that exist today and is recommended to be administered within the first 72 hours after an exposure with risk for HIV transmission. A population accident is defined as a potential contact with HIV, of non-work origin, which is characteristic of health personnel, and contact may occur through sexual means, puncture, splash or bite. Objectives: The main objective was to determine the incidence of population accidents in a healthcare area, its characteristics, management and care provided. Materials and methods: A descriptive cross-sectional study of all cases registered as biological accidents of non-work origin in the Preventive Medicine Service in Vigo’s Healthcare Area in which PEP against HIV was assessed was carried out, excluding suspected or confirmed cases of sexual assault. Results: Ninety-eight biological accidents occurred, with an annual incidence rate of 17.1 cases per 100,000 inhabitants. Most of the accidents involved consensual sexual exposures with a source person whose HIV status was unknown. In 62.2% of the accidents PEP against HIV was administered. Conclusions: The population accidents analyzed in Vigo’s Healthcare Area show correct care in terms of care time and comply with the PEP protocols for HIV reflected in the guidelines. PEP is administered more to men and in relation to risk sexual relations. Antibiotic prophylaxis is indicated in a quarter of accidents and shows significant variability. The dissemination of basic preventive measures is necessary, including the correct use of barrier methods, to avoid these accidents, their health care and the consequences on people's health.
Direction
MORANO AMADO, LUIS ENRIQUE (Tutorships)
González Vázquez, Antía (Co-tutorships)
MORANO AMADO, LUIS ENRIQUE (Tutorships)
González Vázquez, Antía (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Proton pump inhibitors in pediatrics gastroesophageal reflux disease: a sistematic review of randomised controlled trials
Authorship
R.M.V.
Bachelor of Medicine
R.M.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Gastroesophageal reflux (GER) is physiological and common, but occasionally it evolves to gastroesophageal reflux disease (GERD). Its prevalence is difficult to establish due to its heterogeneous presentation and the lack of specific diagnostic test. In pediatrics, proton pump inhibitors (PPIs) are increasingly used as treatment, they seem effective and well-tolerated, but their use is controversial. The aim of this study is to assess the efficacy and the safety of PPIs in children. Secondarily, to identify the main diagnostic tools and to improve the understanding of the most commonly used PPIs and other treatments. We conducted a search for randomized controlled trials (RCTs) in MEDLINE (PubMed) published between June 1, 2010, and June 30, 2023. The study population included patients from birth to 18 years with GERD treated with PPIs. Seventy-six studies were found, and 13 were included. In infants under 1 year, there were no differences between PPIs and placebo in improving GERD symptoms in four articles. In one, the number of GER episodes and esophageal acid exposure was lower in those who received PPIs and left lateral position. In another one, the combination of PPIs and feeding modifications was not more effective than PPIs alone. In children and adolescents, PPIs were effective in improving symptoms and achieving endoscopic healing. Regarding safety, all studies determined that PPIs were safe and well-tolerated in the short term. In conclusion, PPIs are not effective in improving GERD symptoms in infants but they are effective in children and adolescents, where histological healing was also achieved. Generally, PPIs are safe in the short term, although their potential adverse events (AEs) should be considered, especially if they are used for a long time.
Gastroesophageal reflux (GER) is physiological and common, but occasionally it evolves to gastroesophageal reflux disease (GERD). Its prevalence is difficult to establish due to its heterogeneous presentation and the lack of specific diagnostic test. In pediatrics, proton pump inhibitors (PPIs) are increasingly used as treatment, they seem effective and well-tolerated, but their use is controversial. The aim of this study is to assess the efficacy and the safety of PPIs in children. Secondarily, to identify the main diagnostic tools and to improve the understanding of the most commonly used PPIs and other treatments. We conducted a search for randomized controlled trials (RCTs) in MEDLINE (PubMed) published between June 1, 2010, and June 30, 2023. The study population included patients from birth to 18 years with GERD treated with PPIs. Seventy-six studies were found, and 13 were included. In infants under 1 year, there were no differences between PPIs and placebo in improving GERD symptoms in four articles. In one, the number of GER episodes and esophageal acid exposure was lower in those who received PPIs and left lateral position. In another one, the combination of PPIs and feeding modifications was not more effective than PPIs alone. In children and adolescents, PPIs were effective in improving symptoms and achieving endoscopic healing. Regarding safety, all studies determined that PPIs were safe and well-tolerated in the short term. In conclusion, PPIs are not effective in improving GERD symptoms in infants but they are effective in children and adolescents, where histological healing was also achieved. Generally, PPIs are safe in the short term, although their potential adverse events (AEs) should be considered, especially if they are used for a long time.
Direction
Moreno Álvarez, Ana (Tutorships)
Fernández González, Sara María (Co-tutorships)
Moreno Álvarez, Ana (Tutorships)
Fernández González, Sara María (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Neoadjuvant Radiotherapy in Breast Cancer
Authorship
A.M.V.
Bachelor of Medicine
A.M.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Breast cancer is the cancer with the most diagnoses in most parts of the world, and incidence is increasing with special emphasis in developed countries, mainly due to the increase in of risk factors. As this disease progresses, there is an increasing search for new methods to combat this disease. This review has its focus on the use of neoadjuvant radiotherapy. Objectives: The main goal of this review is to determine whether neoadjuvant radiotherapy could be an effective tool in the fight against breast cancer. Methods: The search for scientific literature was carried out using databases such as Medline (Pubmed) and Cochrane. Results: Seven articles have been selected to carry out the systematic review. All articles show positive results with neoadjuvant radiotherapy treatment. Conclusions: Neoadjuvant radiotherapy shows to be an effective tool in the treatment of breast cancer, its combination with chemotherapy in a neoadjuvant manner shows a positive response in the treatment of breast cancer in more advanced stages. The use of neoadjuvant radiotherapy shows a positive response before surgery in obtaining a complete pathological response and is effective in reducing tumor size in inoperable cancer.
Introduction: Breast cancer is the cancer with the most diagnoses in most parts of the world, and incidence is increasing with special emphasis in developed countries, mainly due to the increase in of risk factors. As this disease progresses, there is an increasing search for new methods to combat this disease. This review has its focus on the use of neoadjuvant radiotherapy. Objectives: The main goal of this review is to determine whether neoadjuvant radiotherapy could be an effective tool in the fight against breast cancer. Methods: The search for scientific literature was carried out using databases such as Medline (Pubmed) and Cochrane. Results: Seven articles have been selected to carry out the systematic review. All articles show positive results with neoadjuvant radiotherapy treatment. Conclusions: Neoadjuvant radiotherapy shows to be an effective tool in the treatment of breast cancer, its combination with chemotherapy in a neoadjuvant manner shows a positive response in the treatment of breast cancer in more advanced stages. The use of neoadjuvant radiotherapy shows a positive response before surgery in obtaining a complete pathological response and is effective in reducing tumor size in inoperable cancer.
Direction
PEÑA FERNANDEZ, MAITE (Tutorships)
PEÑA FERNANDEZ, MAITE (Tutorships)
Theta Burst Protocol (TBS) of Deep Transcranial Magnetic Stimulation (TMS) in Treatment-Resistant depression (TRD): A Systematic Review of Clinical Trials
Authorship
M.M.R.
Bachelor of Medicine
M.M.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Approximately 30% of patients diagnosed with depression are resistant to treatment. Because with each successive therapeutic attempt the remission decreases considerably, it is important to know and consider new treatment options. Transcraneal magnetic stimulation (EMT) is a non-invasive treatment alternative that induces neuromodulation by using magnetic fields with the potential to restore and stimulate neuronal circuits. Objectives: A systematic review is conducted with the main objective of evaluating the effectiveness of EMT in treatment-resistant depression (SDR). As secondary targets, potential side effects and intervention safety are determined. Methods: A systematic search was carried out in scientific databases: PubMed, EMBASE, PsycINFO, WoS and Scorpus, from the start of records until 01/01/2024. Results: Four studies, three randomized clinical trials and one quasi-experimental study met the inclusion criteria. In total, 184 adult participants with diagnosis of SDR participated, with a higher proportion of women (64.67%), who were treated with Theta Burst (TBS) EMT in one of the intermittent and continuous trials. The studies showed positive data regarding improvement in depressive symptoms, as well as reduction in autolithic ideas and anxiety in participants. The therapy proved safe, with only mild and tolerable adverse effects. Conclusions: The systematic review concludes that the Theta Burst Repetitive Transcraneal Magnetic Stimulation protocol is effective and safe in treating resistant depression and associated symptoms. The Accelerated Theta Burst Stimulation (SNT) protocol is the most cost-effective, reducing the time and number of sessions required. It is recommended that future clinical trials improve the quality and quantity of cohorts and compare accelerated (continuous and intermittent) stimulation modalities to develop more personalized therapies.
Introduction: Approximately 30% of patients diagnosed with depression are resistant to treatment. Because with each successive therapeutic attempt the remission decreases considerably, it is important to know and consider new treatment options. Transcraneal magnetic stimulation (EMT) is a non-invasive treatment alternative that induces neuromodulation by using magnetic fields with the potential to restore and stimulate neuronal circuits. Objectives: A systematic review is conducted with the main objective of evaluating the effectiveness of EMT in treatment-resistant depression (SDR). As secondary targets, potential side effects and intervention safety are determined. Methods: A systematic search was carried out in scientific databases: PubMed, EMBASE, PsycINFO, WoS and Scorpus, from the start of records until 01/01/2024. Results: Four studies, three randomized clinical trials and one quasi-experimental study met the inclusion criteria. In total, 184 adult participants with diagnosis of SDR participated, with a higher proportion of women (64.67%), who were treated with Theta Burst (TBS) EMT in one of the intermittent and continuous trials. The studies showed positive data regarding improvement in depressive symptoms, as well as reduction in autolithic ideas and anxiety in participants. The therapy proved safe, with only mild and tolerable adverse effects. Conclusions: The systematic review concludes that the Theta Burst Repetitive Transcraneal Magnetic Stimulation protocol is effective and safe in treating resistant depression and associated symptoms. The Accelerated Theta Burst Stimulation (SNT) protocol is the most cost-effective, reducing the time and number of sessions required. It is recommended that future clinical trials improve the quality and quantity of cohorts and compare accelerated (continuous and intermittent) stimulation modalities to develop more personalized therapies.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Ortega Ruibal, Francisco José (Co-tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Ortega Ruibal, Francisco José (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Allergic diseases in Europe: clinical characteristics, sensitization profile and immunotherapy prescription.
Authorship
J.L.B.F.
Bachelor of Medicine
J.L.B.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction Allergic respiratory pathology is a prevalent health problem in our population. Allergen-specific immunotherapy is an effective treatment to reduce symptoms and delay disease progression. This immunotherapy can be done with products administered sublingually or subcutaneously and with different types of formulations. There have hardly been any studies focused on identifying what motivates prescribing physicians to choose one or another immunotherapy product. Goals The main objective of this TFG was to identify the main reasons why a doctor decides on one vaccine or another for the treatment of the respiratory pathology of his patients, in Europe. Secondary objectives are defined to identify the characteristics of the treated population: type of respiratory disease and sensitization profile, fundamentally. Subjects and Methods Prospective and cross-sectional study using an online survey in which doctors must answer a series of questions in relation to the clinical characteristics of their patients and the purpose they intend to achieve with the prescribed treatment. The questionnaire was prepared according to the “CHERRIES” list, acronym in English for: “CHEcklist for Reporting Results of Internet E-Surveys”. The online instrument SurveyMonkey allowed the collected data to be stored in a centralized electronic database. The study was not remunerated and had approval from the CEIC of Andalusia for its development in Spain. Results A total of 127 doctors from six European countries recruited a total of 2482 patients (433 in France, 1302 in Spain, 5 in Portugal, 36 in Norway, 314 in Italy, and 392 in Germany) of all ages. The severity of the respiratory disease, the safety of the treatment, the biological activity of the selected extract and the quantification of the major allergens are the parameters that doctors consider most relevant before choosing the treatment for their patients. Subcutaneous immunotherapy was chosen for 1308 patients, and the most frequent composition was in its depot form with grass pollen and dust mite extracts. Main conclusion The severity of the respiratory disease is the most relevant factor that determines the choice of immunotherapy product in Europe.
Introduction Allergic respiratory pathology is a prevalent health problem in our population. Allergen-specific immunotherapy is an effective treatment to reduce symptoms and delay disease progression. This immunotherapy can be done with products administered sublingually or subcutaneously and with different types of formulations. There have hardly been any studies focused on identifying what motivates prescribing physicians to choose one or another immunotherapy product. Goals The main objective of this TFG was to identify the main reasons why a doctor decides on one vaccine or another for the treatment of the respiratory pathology of his patients, in Europe. Secondary objectives are defined to identify the characteristics of the treated population: type of respiratory disease and sensitization profile, fundamentally. Subjects and Methods Prospective and cross-sectional study using an online survey in which doctors must answer a series of questions in relation to the clinical characteristics of their patients and the purpose they intend to achieve with the prescribed treatment. The questionnaire was prepared according to the “CHERRIES” list, acronym in English for: “CHEcklist for Reporting Results of Internet E-Surveys”. The online instrument SurveyMonkey allowed the collected data to be stored in a centralized electronic database. The study was not remunerated and had approval from the CEIC of Andalusia for its development in Spain. Results A total of 127 doctors from six European countries recruited a total of 2482 patients (433 in France, 1302 in Spain, 5 in Portugal, 36 in Norway, 314 in Italy, and 392 in Germany) of all ages. The severity of the respiratory disease, the safety of the treatment, the biological activity of the selected extract and the quantification of the major allergens are the parameters that doctors consider most relevant before choosing the treatment for their patients. Subcutaneous immunotherapy was chosen for 1308 patients, and the most frequent composition was in its depot form with grass pollen and dust mite extracts. Main conclusion The severity of the respiratory disease is the most relevant factor that determines the choice of immunotherapy product in Europe.
Direction
VIDAL PAN, Mª DEL CARMEN (Tutorships)
López Freire, Sara (Co-tutorships)
VIDAL PAN, Mª DEL CARMEN (Tutorships)
López Freire, Sara (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Navigated surgery use in the context of the anterior cruciate ligament
Authorship
M.B.V.
Bachelor of Medicine
M.B.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Anterior cruciate ligament (ACL) injury is one of the most common injuries to the knee joint, affecting both athletes and the general population. Arthroscopic ACL reconstruction using tendon grafts is the method of choice for the treatment of anterior knee instability. Biomechanical and clinical studies have proven that tunnels correctly positioned at the femoral and tibial insertion of the ACL (anatomical ACL reconstruction) are the only way to restore ACL function properly. Special guiding devices (portal guides) allow the proper creation of these tunnels during classic arthroscopic surgery. Navigated ACL reconstruction surgery has been shown to improve ACL accuracy and correct graft positioning. We intend to analyze, through a systematic review of the scientific literature, the biomechanical, functional, and radiological results of ACL reconstruction through navigated surgery, thoroughly evaluating the potential benefits of this technique compared to conventional ones, carefully considering the improvement of anatomical precision and the optimization of postoperative results. Technical challenges and limitations associated with this emerging reconstruction technique are addressed as well.
Anterior cruciate ligament (ACL) injury is one of the most common injuries to the knee joint, affecting both athletes and the general population. Arthroscopic ACL reconstruction using tendon grafts is the method of choice for the treatment of anterior knee instability. Biomechanical and clinical studies have proven that tunnels correctly positioned at the femoral and tibial insertion of the ACL (anatomical ACL reconstruction) are the only way to restore ACL function properly. Special guiding devices (portal guides) allow the proper creation of these tunnels during classic arthroscopic surgery. Navigated ACL reconstruction surgery has been shown to improve ACL accuracy and correct graft positioning. We intend to analyze, through a systematic review of the scientific literature, the biomechanical, functional, and radiological results of ACL reconstruction through navigated surgery, thoroughly evaluating the potential benefits of this technique compared to conventional ones, carefully considering the improvement of anatomical precision and the optimization of postoperative results. Technical challenges and limitations associated with this emerging reconstruction technique are addressed as well.
Direction
CAEIRO REY, JOSE RAMON (Tutorships)
CAEIRO REY, JOSE RAMON (Tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Presence of the HLA DQA105 haplotype in patients with Crohn's disease and its association with the phenotypic pattern of the disease and the response to antiTNF treatment
Authorship
D.B.G.
Bachelor of Medicine
D.B.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION. Crohn's disease is a chronic inflammatory bowel disease of idiopathic etiology, whose therapeutic approach includes the use of drugs combined with biological therapies, including anti-TNF, with the aim of reducing complications and preventing the progression of the disease. disease. In the search for biomarkers that predict the efficacy and safety of these therapies, recent studies have associated the presence of certain HLA haplotypes in patients with inflammatory bowel disease with the failure of anti-TNF treatment, due to an immunogenic mechanism. AIM. To evaluate the prevalence of the HLA DQA105 haplotype in patients with Crohn's disease in the Vigo health area, as well as its association with the phenotypic pattern and response to anti-TNF treatment. MATERIAL AND METHODS. Prospective cross-sectional observational study of a cohort of patients with Crohn's disease and anti-TNF drugs. RESULTS. The study included 79 patients with Crohn's disease, of whom 34.2 percent were carriers of the HLA DQA105 allele. Median follow-up time was 14 months, interquartile range 6 to 28 months. In the short term, the treatment showed high efficacy, remission and response. In the long term, 31.4 percent experienced treatment discontinuation, with 11.6 percent due to a loss of response. The presence of the HLA DQA105 haplotype was not associated with the development of antibodies directed against the drug, the effectiveness of anti-TNF treatment or its persistence, but it was associated with a greater probability of presenting side effects derived from its use. The existence of a difference in the pattern of response to anti-TNF treatment according to sex was observed, with the persistence of the drug being greater in men than in women. CONCLUSION. In this cohort of patients with Crohn's disease, HLA DQA105 status was not associated with response to anti-TNF treatment or drug persistence, although it was associated with a higher prevalence of adverse events.
INTRODUCTION. Crohn's disease is a chronic inflammatory bowel disease of idiopathic etiology, whose therapeutic approach includes the use of drugs combined with biological therapies, including anti-TNF, with the aim of reducing complications and preventing the progression of the disease. disease. In the search for biomarkers that predict the efficacy and safety of these therapies, recent studies have associated the presence of certain HLA haplotypes in patients with inflammatory bowel disease with the failure of anti-TNF treatment, due to an immunogenic mechanism. AIM. To evaluate the prevalence of the HLA DQA105 haplotype in patients with Crohn's disease in the Vigo health area, as well as its association with the phenotypic pattern and response to anti-TNF treatment. MATERIAL AND METHODS. Prospective cross-sectional observational study of a cohort of patients with Crohn's disease and anti-TNF drugs. RESULTS. The study included 79 patients with Crohn's disease, of whom 34.2 percent were carriers of the HLA DQA105 allele. Median follow-up time was 14 months, interquartile range 6 to 28 months. In the short term, the treatment showed high efficacy, remission and response. In the long term, 31.4 percent experienced treatment discontinuation, with 11.6 percent due to a loss of response. The presence of the HLA DQA105 haplotype was not associated with the development of antibodies directed against the drug, the effectiveness of anti-TNF treatment or its persistence, but it was associated with a greater probability of presenting side effects derived from its use. The existence of a difference in the pattern of response to anti-TNF treatment according to sex was observed, with the persistence of the drug being greater in men than in women. CONCLUSION. In this cohort of patients with Crohn's disease, HLA DQA105 status was not associated with response to anti-TNF treatment or drug persistence, although it was associated with a higher prevalence of adverse events.
Direction
DE CASTRO PARGA, MARIA LUISA (Tutorships)
García Morales, Natalia (Co-tutorships)
DE CASTRO PARGA, MARIA LUISA (Tutorships)
García Morales, Natalia (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Study on health-related quality of life of caregivers.
Authorship
M.D.P.B.I.
Bachelor of Medicine
M.D.P.B.I.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: A caregiver is that person who assists another person who needs help in caring for themselves. This labor can affect the physical, emotional or social health of the caregiver, which means, its quality of life. Objectives: Evaluating if being a caregiver affects the health-related quality of life, using the generic questionnaire SF-36 in a representative sample from a rural population. Material and methods: Transversal study carried out in a randomized sample of 1512 individuals over the age of 18 from the municipality of A Estrada (Pontevedra) recruited between the years 2012 and 2015, and divided into two groups: caregivers and non-caregivers. Through determinations, data from their medical history, and the SF-36 questionnaire, we studied the sociodemographic and lifestyle variables of both groups and confectioned generalized additive linear models adjusted for age and sex. Results: Caregivers present worse scores in their physical function (median 85) with respect to non-caregivers (median 90); vitality (55 versus 60), mental health (72 vs. 76), social function (87 vs. 100) and body pain (67 vs. 70). There are no significant differences in their physical role, general health and self-perception of health. When adjusting by age and sex, only their emotional role and social function (average decrease of 6.1 and 3.8 points, respectively, with respect to non-caregivers) where significantly lower. Conclusion: Being an informal caregiver associates a worse perceived quality of life, specifically significant in its emotional role and social function. Additionally, our study allows us to recognize their sociodemographic profile and to uphold the creation of support networks for families of chronic disease patients. Further research is needed to be able to create a more vigorous information base.
Introduction: A caregiver is that person who assists another person who needs help in caring for themselves. This labor can affect the physical, emotional or social health of the caregiver, which means, its quality of life. Objectives: Evaluating if being a caregiver affects the health-related quality of life, using the generic questionnaire SF-36 in a representative sample from a rural population. Material and methods: Transversal study carried out in a randomized sample of 1512 individuals over the age of 18 from the municipality of A Estrada (Pontevedra) recruited between the years 2012 and 2015, and divided into two groups: caregivers and non-caregivers. Through determinations, data from their medical history, and the SF-36 questionnaire, we studied the sociodemographic and lifestyle variables of both groups and confectioned generalized additive linear models adjusted for age and sex. Results: Caregivers present worse scores in their physical function (median 85) with respect to non-caregivers (median 90); vitality (55 versus 60), mental health (72 vs. 76), social function (87 vs. 100) and body pain (67 vs. 70). There are no significant differences in their physical role, general health and self-perception of health. When adjusting by age and sex, only their emotional role and social function (average decrease of 6.1 and 3.8 points, respectively, with respect to non-caregivers) where significantly lower. Conclusion: Being an informal caregiver associates a worse perceived quality of life, specifically significant in its emotional role and social function. Additionally, our study allows us to recognize their sociodemographic profile and to uphold the creation of support networks for families of chronic disease patients. Further research is needed to be able to create a more vigorous information base.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Fernández Merino, María del Carmen (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Fernández Merino, María del Carmen (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Association between endometriosis and autoimmune thyroid disease: a systematic review.
Authorship
L.B.F.
Bachelor of Medicine
L.B.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Endometriosis is a chronic gynaecological disease that affects 11% of women of reproductive age. The aetiology is unknown, but there are hypotheses that support an autoimmune origin of the disease. Objectives: The aim of this work was to evaluate the existing evidence on the association between thyroid autoimmune diseases and endometriosis from a systematic literature review. Methods: An exhaustive search of the electronic databases Medline (via PubMed), Cochrane and Embase was carried out using modified PICO criteria for association studies. A total of six articles were obtained for review, registration and data analysis. Results: There is data supporting an association between endometriotic cyst size and anti-TPO antibody levels in women with endometriosis. Studies support an association between hypothyroidism (including autoimmune hypothyroidism) and endometriosis, as well as between Graves' disease and endometriosis. Women with endometriosis showed significantly higher titres of TRAb lgG antibodies compared to women without endometriosis. Conclusion: The reviewed publications suggest an association between thyroid autoimmune diseases and endometriosis. However, the results found should be interpreted with caution. In addition to the limited number of studies, they contain a high risk of bias. Further research of prospective design is needed to confirm this relationship.
Introduction: Endometriosis is a chronic gynaecological disease that affects 11% of women of reproductive age. The aetiology is unknown, but there are hypotheses that support an autoimmune origin of the disease. Objectives: The aim of this work was to evaluate the existing evidence on the association between thyroid autoimmune diseases and endometriosis from a systematic literature review. Methods: An exhaustive search of the electronic databases Medline (via PubMed), Cochrane and Embase was carried out using modified PICO criteria for association studies. A total of six articles were obtained for review, registration and data analysis. Results: There is data supporting an association between endometriotic cyst size and anti-TPO antibody levels in women with endometriosis. Studies support an association between hypothyroidism (including autoimmune hypothyroidism) and endometriosis, as well as between Graves' disease and endometriosis. Women with endometriosis showed significantly higher titres of TRAb lgG antibodies compared to women without endometriosis. Conclusion: The reviewed publications suggest an association between thyroid autoimmune diseases and endometriosis. However, the results found should be interpreted with caution. In addition to the limited number of studies, they contain a high risk of bias. Further research of prospective design is needed to confirm this relationship.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Rodríguez Blanco, Helena (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Rodríguez Blanco, Helena (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Health-related Quality of Life in Patiens with Ischemic Heart Disease. An Observational Study in the Population of A Estrada.
Authorship
L.C.V.
Bachelor of Medicine
L.C.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Ischemic heart disease is the leading cause of premature death and a significant contributor to disability worldwide. Survival beyond the acute phase entails a transition to a chronic condition, with implications for quality of life. It is important to employ validated questionnaires to assess health-related quality of life in these individuals, in order to comprehensively address their needs. Objective: To compare health-related quality of life between adults with and without ischemic heart disease in a random sample from a municipality in Galicia, taking into account confounding factors and individual characteristics. Material and Methods: Cross-sectional study with 1512 adults randomly selected from the general population of A Estrada (Pontevedra) between 2012 and 2015. The SF-36 questionnaire was used to measure health-related quality of life. Data were analysed using generalized additive regression models. Results: The median age of the participants was 52 years, with 44.5% being men and 55.5% women. 4.2% had ischemic heart disease, more common in older men, retirees, former smokers, and those with a high body mass index. Regression analysis adjusted by age and sex revealed poorer quality of life in individuals with ischemic heart disease in five of the nine scales of the SF-36. Conclusions: Health-related quality of life was inferior in adults with ischemic heart disease compared to those without, representing a significant limitation in their daily life both physically and mentally. Differences in questionnaire results were observed based on age and sex, highlighting disparities between men and women, as well as across different age groups.
Introduction: Ischemic heart disease is the leading cause of premature death and a significant contributor to disability worldwide. Survival beyond the acute phase entails a transition to a chronic condition, with implications for quality of life. It is important to employ validated questionnaires to assess health-related quality of life in these individuals, in order to comprehensively address their needs. Objective: To compare health-related quality of life between adults with and without ischemic heart disease in a random sample from a municipality in Galicia, taking into account confounding factors and individual characteristics. Material and Methods: Cross-sectional study with 1512 adults randomly selected from the general population of A Estrada (Pontevedra) between 2012 and 2015. The SF-36 questionnaire was used to measure health-related quality of life. Data were analysed using generalized additive regression models. Results: The median age of the participants was 52 years, with 44.5% being men and 55.5% women. 4.2% had ischemic heart disease, more common in older men, retirees, former smokers, and those with a high body mass index. Regression analysis adjusted by age and sex revealed poorer quality of life in individuals with ischemic heart disease in five of the nine scales of the SF-36. Conclusions: Health-related quality of life was inferior in adults with ischemic heart disease compared to those without, representing a significant limitation in their daily life both physically and mentally. Differences in questionnaire results were observed based on age and sex, highlighting disparities between men and women, as well as across different age groups.
Direction
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Calvo Malvar, María del Mar (Co-tutorships)
GUDE SAMPEDRO, FRANCISCO (Tutorships)
Calvo Malvar, María del Mar (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Predictive markers for risk of adverse effects following anti-CD19 CAR-T therapy: EASIX score
Authorship
A.C.G.
Bachelor of Medicine
A.C.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background CAR-T therapy has revolutionized the treatment of multiple refractory hematological malignancies. Currently, we have 6 therapies approved by the FDA and EMA that demonstrate great success every day. However, the growing understanding of the therapy reveals issues stemming from its adverse effects, logistical challenges, and high costs. Recently, efforts are being made to better characterize and manage these effects, with a primary focus on CRS and ICANS, which are extremely common and severe toxicities. Despite already knowing numerous risk factors involved, there is a need for a simple and reproducible tool that allows the prevention of these complications in routine clinical practice. Aim and methods The main objective of this review is to evaluate the effectiveness of the EASIX index and its modifications in predicting the incidence and severity of cytokine release syndrome and therapy-related encephalopathy syndrome in patients undergoing CAR-T treatment targeting CD19. To this end, all published articles on the use of the EASIX score to predict complications of CAR-T CD19 therapy have been reviewed. Outcomes All the reviewed publications found a significant association between the EASIX score and the development of severe CRS or ICANS at different measurement times. This supports the reliability and validity of the EASIX index as a clinical tool and also reinforces the theory of endothelial dysfunction as a trigger for toxicities. However, further studies are still needed to establish universal cut-off points and improve its practical utility. Conclusions The EASIX index and its variants can predict the onset of severe CRS and ICANS in patients treated with CAR-T CD19 therapy. It is suggested that EASIX is a functional, simple, and reproducible tool with the potential to be easily used in daily clinical practice.
Background CAR-T therapy has revolutionized the treatment of multiple refractory hematological malignancies. Currently, we have 6 therapies approved by the FDA and EMA that demonstrate great success every day. However, the growing understanding of the therapy reveals issues stemming from its adverse effects, logistical challenges, and high costs. Recently, efforts are being made to better characterize and manage these effects, with a primary focus on CRS and ICANS, which are extremely common and severe toxicities. Despite already knowing numerous risk factors involved, there is a need for a simple and reproducible tool that allows the prevention of these complications in routine clinical practice. Aim and methods The main objective of this review is to evaluate the effectiveness of the EASIX index and its modifications in predicting the incidence and severity of cytokine release syndrome and therapy-related encephalopathy syndrome in patients undergoing CAR-T treatment targeting CD19. To this end, all published articles on the use of the EASIX score to predict complications of CAR-T CD19 therapy have been reviewed. Outcomes All the reviewed publications found a significant association between the EASIX score and the development of severe CRS or ICANS at different measurement times. This supports the reliability and validity of the EASIX index as a clinical tool and also reinforces the theory of endothelial dysfunction as a trigger for toxicities. However, further studies are still needed to establish universal cut-off points and improve its practical utility. Conclusions The EASIX index and its variants can predict the onset of severe CRS and ICANS in patients treated with CAR-T CD19 therapy. It is suggested that EASIX is a functional, simple, and reproducible tool with the potential to be easily used in daily clinical practice.
Direction
ARAUJO VILAR, DAVID (Tutorships)
Noriega Concepción, Víctor (Co-tutorships)
ARAUJO VILAR, DAVID (Tutorships)
Noriega Concepción, Víctor (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Impact of the SARS-CoV-2 pandemic on Tuberculosis diagnosis in the Healthcare Area of A Coruña and Cee. An observational study.
Authorship
M.V.G.B.
Bachelor of Medicine
M.V.G.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
After the impact of the SARS-CoV-2 pandemic in 2020, there has been a delay in the diagnosis of various diseases, including tuberculosis, according to the Global Tuberculosis Report 2022 (World Health Organization, WHO). Given this situation, we have designed a cross-sectional observational study with the aim of assessing the impact of the pandemic on the diagnostic delay of tuberculosis in the sanitary area of A Coruña and Cee (Galicia, Spain) and documenting the modifications in the patient profile. As main findings, we saw that a similar profile of patients was maintained, and that the overall total delay in our healthcare area was greater due to COVID-19, with a statistically significant difference. Regarding specific population groups, although the results were not statistically significant, we saw an increase in the delay in the diagnosis of tuberculosis, especially in immigrant patients and drug users, and a lower one in patients with HIV, psychiatric illness, and alcoholism.
After the impact of the SARS-CoV-2 pandemic in 2020, there has been a delay in the diagnosis of various diseases, including tuberculosis, according to the Global Tuberculosis Report 2022 (World Health Organization, WHO). Given this situation, we have designed a cross-sectional observational study with the aim of assessing the impact of the pandemic on the diagnostic delay of tuberculosis in the sanitary area of A Coruña and Cee (Galicia, Spain) and documenting the modifications in the patient profile. As main findings, we saw that a similar profile of patients was maintained, and that the overall total delay in our healthcare area was greater due to COVID-19, with a statistically significant difference. Regarding specific population groups, although the results were not statistically significant, we saw an increase in the delay in the diagnosis of tuberculosis, especially in immigrant patients and drug users, and a lower one in patients with HIV, psychiatric illness, and alcoholism.
Direction
RUANO RAVIÑA, ALBERTO (Tutorships)
Enjo Barreiro, José Ramón (Co-tutorships)
RUANO RAVIÑA, ALBERTO (Tutorships)
Enjo Barreiro, José Ramón (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
H558R: a common polymorphism could modify the efficacy and toxicity of flecainide in maintaining sinus rhythm. A cohort study
Authorship
M.P.H.
Bachelor of Medicine
M.P.H.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: The SCN5A gene, which regulates the cardiac voltage-dependent sodium channel type V, is influenced by several genetic polymorphisms, including H558R, which is associated with a high prevalence of atrial fibrillation (AF) in European populations. AIMS: To investigate the prevalence of the H558R polymorphism in the SCN5A gene in a cohort of Galician patients with atrial fibrillation (AF), as well as to analyze its possible influence on the efficacy and adverse effects of flecainide, in order to improve the understanding of the underlying genetic factors in the treatment of this cardiac arrhythmia and to advance towards personalized therapy. METHODS: Cohort study involving AF patients who were prescribed flecainide and followed in our health area between 2017-2021. A primary composite endpoint of inefficacy in the first 6 months and early toxicity and a secondary combined endpoint of toxicity or inefficacy during the follow-up were predefined. In addition, the prevalence of this polymorphism in our cohort was compared with that of the general healthy population. RESULTS: 104 patients met the criteria and agreed to participate: 59 (56.4%) did not have the polymorphism (H558R-/-), 38 (36.5%) heterozygous (H558R+/-), and 7 (6.7%) homozygous (H558R+/+). The prevalence of this polymorphism was higher in our AF sample than in the healthy general population (43.27 vs 24.37%, p<0.01). H558R+/- patients had a lower incidence of the primary endpoint (p=0.023), with an absolute risk reduction of -21.5% which was also significant in the multivariate analysis (p=0.032). H558R+/- genotype also was associated with lower toxicity or inefficacy in long term follow up (p=0.0394, hazard ratio 0.53). CONCLUSIONS: H558R+/- polymorphism shows a higher prevalence in AF patients. Its presence is clinically relevant in terms of both efficacy and toxicity of flecainide for rhythm control.
INTRODUCTION: The SCN5A gene, which regulates the cardiac voltage-dependent sodium channel type V, is influenced by several genetic polymorphisms, including H558R, which is associated with a high prevalence of atrial fibrillation (AF) in European populations. AIMS: To investigate the prevalence of the H558R polymorphism in the SCN5A gene in a cohort of Galician patients with atrial fibrillation (AF), as well as to analyze its possible influence on the efficacy and adverse effects of flecainide, in order to improve the understanding of the underlying genetic factors in the treatment of this cardiac arrhythmia and to advance towards personalized therapy. METHODS: Cohort study involving AF patients who were prescribed flecainide and followed in our health area between 2017-2021. A primary composite endpoint of inefficacy in the first 6 months and early toxicity and a secondary combined endpoint of toxicity or inefficacy during the follow-up were predefined. In addition, the prevalence of this polymorphism in our cohort was compared with that of the general healthy population. RESULTS: 104 patients met the criteria and agreed to participate: 59 (56.4%) did not have the polymorphism (H558R-/-), 38 (36.5%) heterozygous (H558R+/-), and 7 (6.7%) homozygous (H558R+/+). The prevalence of this polymorphism was higher in our AF sample than in the healthy general population (43.27 vs 24.37%, p<0.01). H558R+/- patients had a lower incidence of the primary endpoint (p=0.023), with an absolute risk reduction of -21.5% which was also significant in the multivariate analysis (p=0.032). H558R+/- genotype also was associated with lower toxicity or inefficacy in long term follow up (p=0.0394, hazard ratio 0.53). CONCLUSIONS: H558R+/- polymorphism shows a higher prevalence in AF patients. Its presence is clinically relevant in terms of both efficacy and toxicity of flecainide for rhythm control.
Direction
MAZON RAMOS, MARIA DEL PILAR (Tutorships)
Trincado Ave, Mauro (Co-tutorships)
MAZON RAMOS, MARIA DEL PILAR (Tutorships)
Trincado Ave, Mauro (Co-tutorships)
Court
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
GARCIA-CABALLERO PARADA, TOMAS M. M. (Chairman)
RODRIGUEZ CID, Mª JOSEFA (Secretary)
VICENTE ALBA, FRANCISCO JAVIER (Member)
Thoracic sympathetic surgery to treat hyperhidrosis: a decade's experience
Authorship
B.B.R.
Bachelor of Medicine
B.B.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The minimally invasive surgery technique is one of the best options for the treatment of hyperhidrosis. After this surgical procedure, certain side effects appear, among which the most frequent is compensatory sweating. Objectives: The objective of this work is to review the experience of the Thoracic Surgery service of the University Clinical Hospital of Santiago de Compostela in performing video-thoracoscopic surgery of the thoracic sympathetic for the treatment of palmar and axillary hyperhidrosis and to assess the development of compensatory hyperhidrosis as side effect to surgery. Methods: Bidirectional (retrospective and prospective) review on an anonymized database of a case series including 55 patients with essential hyperhidrosis treated with bilateral VATS at CHUS from January 2012 to December 2023 (a 12-year period). Results: Out of a total of 55 patients with essential hyperhidrosis, 26 (47.3%) had no relevant history, 10 (18.2%) had psychiatric backgrounds, and 19 (34.5%) had other pathologies. The common surgical technique was bilateral VATS. 85.5% received thoracic drains. 21.8% of patients experienced perioperative complications during admission. Long-term, out of 43 surveyed patients, 11.6% experienced hyperhidrosis recurrence, and 86% developed compensatory sweating, mainly on the back. Other adverse effects included neuropraxia and hand dryness. The level of satisfaction with intervention results is significantly affected by recurrent patients (average score of 7,4 out of 10) compared to patients without recurrences (average score of 9,26 out of 10). However, this is not affected by the development of compensatory hyperhidrosis. Conclusions: Surgical intervention in the thoracic sympathetic nervous system has proven to be a safe and effective option for addressing essential hyperhidrosis. Although compensatory sweating, mainly in the palmar location, is the most common and frequent adverse effect, its impact does not affect patient satisfaction with the intervention.
Introduction: The minimally invasive surgery technique is one of the best options for the treatment of hyperhidrosis. After this surgical procedure, certain side effects appear, among which the most frequent is compensatory sweating. Objectives: The objective of this work is to review the experience of the Thoracic Surgery service of the University Clinical Hospital of Santiago de Compostela in performing video-thoracoscopic surgery of the thoracic sympathetic for the treatment of palmar and axillary hyperhidrosis and to assess the development of compensatory hyperhidrosis as side effect to surgery. Methods: Bidirectional (retrospective and prospective) review on an anonymized database of a case series including 55 patients with essential hyperhidrosis treated with bilateral VATS at CHUS from January 2012 to December 2023 (a 12-year period). Results: Out of a total of 55 patients with essential hyperhidrosis, 26 (47.3%) had no relevant history, 10 (18.2%) had psychiatric backgrounds, and 19 (34.5%) had other pathologies. The common surgical technique was bilateral VATS. 85.5% received thoracic drains. 21.8% of patients experienced perioperative complications during admission. Long-term, out of 43 surveyed patients, 11.6% experienced hyperhidrosis recurrence, and 86% developed compensatory sweating, mainly on the back. Other adverse effects included neuropraxia and hand dryness. The level of satisfaction with intervention results is significantly affected by recurrent patients (average score of 7,4 out of 10) compared to patients without recurrences (average score of 9,26 out of 10). However, this is not affected by the development of compensatory hyperhidrosis. Conclusions: Surgical intervention in the thoracic sympathetic nervous system has proven to be a safe and effective option for addressing essential hyperhidrosis. Although compensatory sweating, mainly in the palmar location, is the most common and frequent adverse effect, its impact does not affect patient satisfaction with the intervention.
Direction
RIVO VAZQUEZ, JOSE EDUARDO (Tutorships)
Gándara Castro, Cristian (Co-tutorships)
Mundet Tudela, Ariadna (Co-tutorships)
RIVO VAZQUEZ, JOSE EDUARDO (Tutorships)
Gándara Castro, Cristian (Co-tutorships)
Mundet Tudela, Ariadna (Co-tutorships)
Court
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
RODRIGUEZ PALLARES, JANNETTE (Chairman)
RODRIGUEZ GARCIA, JAIME JOSE (Secretary)
LOPEZ MARTIN, MARIA ELENA (Member)
Efficacy and safety of fecal microbiota transplantation in patients with ulcerative colitis
Authorship
A.G.D.
Bachelor of Medicine
A.G.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: UC (ulcerative colitis) is a chronic inflammatory bowel disease that affects millions of people around the world. Fecal microbiota transplantation (FMT) has emerged as a promising therapy for this condition. The objective of this study is to comprehensively evaluate the available evidence on the efficacy and safety of FMT in adult patients with UC. Primary outcomes will include clinical remission rate and secondary outcomes the incidence of FMT-related adverse events and endoscopic remission rate. Methods: Systematic review and meta-analysis of scientific articles published from 2015 to the present consulting the PubMed and Scopus databases. 14 randomized controlled clinical trials were included, gathering a total of 626 patients, of which 324 received FMT and 302 were assigned to the control group. To carry out the meta-analysis, the statistical analysis was carried out with the statistical software Stata 16.1 (StataCorp, College Station, TX, USA). Results: All included studies report the results of clinical remission which was achieved in 166 of 324 patients in the FMT group (51.23%) and 89 of 302 in the control group (29.47%). With these data, the study suggests that the FMT group had a significantly better clinical remission than the control group [RR  = 1.64; CI del 95% (1,31-2.06) p <0.001]. Same with endoscopic remission where 12 studies report endoscopic remission outcome data. We found that 91 of the 295 patients in the FMT group achieved endoscopic remission (30.85%) compared to 47 of the 264 in the control group (17.8%). This difference was significant [RR  = 1.48; CI del 95% (1,04-2.12) p = 0.029]. Regarding safety, there were no significant differences between the two groups [RR = 0,93; CI del 95% = (0,82; 1,06) p = 0.281]. Furthermore, in none of the studies were serious adverse effects related to the intervention, but only mild and self-limited ones. The results of this study are encouraging, however, achieving long-term remission, ensuring safety and knowing the bacteria responsible for the improvement remains a challenge. Conclusion: In short, this study suggests that fecal microbiota transplantation (FMT) is a promising therapy for ulcerative colitis, showing a significant improvement in clinical and endoscopic remission compared to the control group, with a similar safety profile between both groups. However, challenges remain regarding the sustainability of long-term remission, continued safety, and understanding of the mechanisms responsible for improvement.
Background: UC (ulcerative colitis) is a chronic inflammatory bowel disease that affects millions of people around the world. Fecal microbiota transplantation (FMT) has emerged as a promising therapy for this condition. The objective of this study is to comprehensively evaluate the available evidence on the efficacy and safety of FMT in adult patients with UC. Primary outcomes will include clinical remission rate and secondary outcomes the incidence of FMT-related adverse events and endoscopic remission rate. Methods: Systematic review and meta-analysis of scientific articles published from 2015 to the present consulting the PubMed and Scopus databases. 14 randomized controlled clinical trials were included, gathering a total of 626 patients, of which 324 received FMT and 302 were assigned to the control group. To carry out the meta-analysis, the statistical analysis was carried out with the statistical software Stata 16.1 (StataCorp, College Station, TX, USA). Results: All included studies report the results of clinical remission which was achieved in 166 of 324 patients in the FMT group (51.23%) and 89 of 302 in the control group (29.47%). With these data, the study suggests that the FMT group had a significantly better clinical remission than the control group [RR  = 1.64; CI del 95% (1,31-2.06) p <0.001]. Same with endoscopic remission where 12 studies report endoscopic remission outcome data. We found that 91 of the 295 patients in the FMT group achieved endoscopic remission (30.85%) compared to 47 of the 264 in the control group (17.8%). This difference was significant [RR  = 1.48; CI del 95% (1,04-2.12) p = 0.029]. Regarding safety, there were no significant differences between the two groups [RR = 0,93; CI del 95% = (0,82; 1,06) p = 0.281]. Furthermore, in none of the studies were serious adverse effects related to the intervention, but only mild and self-limited ones. The results of this study are encouraging, however, achieving long-term remission, ensuring safety and knowing the bacteria responsible for the improvement remains a challenge. Conclusion: In short, this study suggests that fecal microbiota transplantation (FMT) is a promising therapy for ulcerative colitis, showing a significant improvement in clinical and endoscopic remission compared to the control group, with a similar safety profile between both groups. However, challenges remain regarding the sustainability of long-term remission, continued safety, and understanding of the mechanisms responsible for improvement.
Direction
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
DOMINGUEZ MUÑOZ, JUAN ENRIQUE (Tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Microbiological analysis in implants with and without intermediate abutment
Authorship
I.C.C.
Bachelor of Odontology
I.C.C.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
INTRODUCTION Prevalence of peri-implant diseases with bone loss around implants is increasing and some of the factors that influence this loss aren’t known yet. When implants have a microgap at the of the peri-implant bone crest level, this space can constitute a bacterial reservoir and disturb the health of the peri-implant tissue. In the scientific literature existing to date, the clinical relevance of bacterial contamination in the implant-abutment connection and/or inside the implant lacks sufficient documentation. In fact, there are no studies that compare presence/absence of the abutment in microleakage. OBJECTIVES The main objective is to review the literature on microbiological contamination of the interior of implants in relation to the intermediate abutment (implants and intermediate abutments) and present the results of a cross-sectional observational study, where the contamination of rehabilitated implants with an intermediate or direct abutment (with and without intermediate abutment) is compared, in which at least 2 years have passed since loading. MATERIAL AND METHODS Review of the literature according to the PICO question and study selection criteria; as well as a cross-sectional observational study, to analyze bacterial microleakage in implants rehabilitated with abutment and without intermediate abutment. RESULTS The review of the literature shows that internal connections present less microleakage than external connections, and that in any case their comparison is difficult due to the great heterogeneity of the studies. Regarding the observational study, a greater microleakage is found in the indirect connections (with intermediate abutment). CONCLUSIONS The presence of an intermediate abutment doesn’t mean statistically significant differences in the peri-implant groove, although there are significant differences in terms of the screw and the connection. Future research with greater methodological rigor is necessary to homogenize results (preferably quantitative).
INTRODUCTION Prevalence of peri-implant diseases with bone loss around implants is increasing and some of the factors that influence this loss aren’t known yet. When implants have a microgap at the of the peri-implant bone crest level, this space can constitute a bacterial reservoir and disturb the health of the peri-implant tissue. In the scientific literature existing to date, the clinical relevance of bacterial contamination in the implant-abutment connection and/or inside the implant lacks sufficient documentation. In fact, there are no studies that compare presence/absence of the abutment in microleakage. OBJECTIVES The main objective is to review the literature on microbiological contamination of the interior of implants in relation to the intermediate abutment (implants and intermediate abutments) and present the results of a cross-sectional observational study, where the contamination of rehabilitated implants with an intermediate or direct abutment (with and without intermediate abutment) is compared, in which at least 2 years have passed since loading. MATERIAL AND METHODS Review of the literature according to the PICO question and study selection criteria; as well as a cross-sectional observational study, to analyze bacterial microleakage in implants rehabilitated with abutment and without intermediate abutment. RESULTS The review of the literature shows that internal connections present less microleakage than external connections, and that in any case their comparison is difficult due to the great heterogeneity of the studies. Regarding the observational study, a greater microleakage is found in the indirect connections (with intermediate abutment). CONCLUSIONS The presence of an intermediate abutment doesn’t mean statistically significant differences in the peri-implant groove, although there are significant differences in terms of the screw and the connection. Future research with greater methodological rigor is necessary to homogenize results (preferably quantitative).
Direction
Blanco Carrion, Juan (Tutorships)
Carballo Viñas, Álvaro (Co-tutorships)
Blanco Carrion, Juan (Tutorships)
Carballo Viñas, Álvaro (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
Irrigation protocol for teeth with open apex using pulp regeneration techniques vs apical plugging
Authorship
E.V.R.
Bachelor of Odontology
E.V.R.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
AIM: Narrative review on irrigation in teeth with open apex. The main objective is to develop an ideal protocol for the endodontic treatment of this type of teeth by comparing regenerative and apical plugging procedures. MATERIAL AND METHODS: For the elaboration of this narrative review, a search for scientific articles was conducted through the PubMed database between February and March 2024. The selected keywords were: ''irrigation'', ''open apex'', ''revascularization''. The inclusion criteria were: documents published from 2019 onwards, containing the keywords and addressing the aim of the study. Only articles published in journals belonging to quartiles Q1 and Q2 were included. RESULTS: 179 references were identified through the database search and an additional 4 were handpicked, which, once the selection criteria were applied, resulted in 11 publications retrieved for analysis. Treatments in teeth with open apex are becoming more frequent due to the conservative focus in dentistry, which is associated with increased life expectancy (both of patients and their teeth) and the demand for treatment from an increasingly early age. The rise in treatments for patients still in development makes regenerative endodontic procedures and apical closure stimulation increasingly common. Therefore, an irrigation protocol as suitable as possible should be established to achieve clinical success. CONCLUSIONS: Currently, it is a topic under constant debate, and there is no universal irrigation protocol for this type of teeth beyond the recommendations of the AAE/ESE. The proposed irrigation protocols aim at meeting the desirable objectives for regenerative endodontic treatment and apical plugging.
AIM: Narrative review on irrigation in teeth with open apex. The main objective is to develop an ideal protocol for the endodontic treatment of this type of teeth by comparing regenerative and apical plugging procedures. MATERIAL AND METHODS: For the elaboration of this narrative review, a search for scientific articles was conducted through the PubMed database between February and March 2024. The selected keywords were: ''irrigation'', ''open apex'', ''revascularization''. The inclusion criteria were: documents published from 2019 onwards, containing the keywords and addressing the aim of the study. Only articles published in journals belonging to quartiles Q1 and Q2 were included. RESULTS: 179 references were identified through the database search and an additional 4 were handpicked, which, once the selection criteria were applied, resulted in 11 publications retrieved for analysis. Treatments in teeth with open apex are becoming more frequent due to the conservative focus in dentistry, which is associated with increased life expectancy (both of patients and their teeth) and the demand for treatment from an increasingly early age. The rise in treatments for patients still in development makes regenerative endodontic procedures and apical closure stimulation increasingly common. Therefore, an irrigation protocol as suitable as possible should be established to achieve clinical success. CONCLUSIONS: Currently, it is a topic under constant debate, and there is no universal irrigation protocol for this type of teeth beyond the recommendations of the AAE/ESE. The proposed irrigation protocols aim at meeting the desirable objectives for regenerative endodontic treatment and apical plugging.
Direction
Martín Biedma, Benjamín José (Tutorships)
Anache D' Abate, Marcos Anibal (Co-tutorships)
Martín Biedma, Benjamín José (Tutorships)
Anache D' Abate, Marcos Anibal (Co-tutorships)
Court
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
RODRÍGUEZ FERNÁNDEZ, Mª DE LA ALMUDENA (Chairman)
GARCIA VARELA, SANDRA (Secretary)
facal garcia, miguel (Member)
Prevalence study to determine the relationship between lichen planus and oral candidiasis
Authorship
I.C.C.
Bachelor of Odontology
I.C.C.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introdution: Lichen planus is a chronic, recurrent, common, and variable inflammatory disease with an unknown etiology. The manifestations are usually bilateral, located in the buccal mucosa in the form of typical Wickham's striae (white lichen planus), although it can also present in an erythematous form. Diagnosis is carried out through clinical and histopathological examination. Treatment is used in symptomatic cases (erythematous lichen planus) with corticosteroids, a factor that can trigger the appearance of candidiasis. Candidiasis is an opportunistic infection that occurs in people with a series of predisposing factors. It is frequently localized on the tongue and is treated with antifungal agents. Method: This study was conducted to examine the relationship between candidiasis and oral lichen planus. A total of 573 medical records were reviewed, and the data collected was entered into an Excel spreadsheet for later analysis using a software program (SPSS). After establishing the inclusion and exclusion criteria, the number of patients analyzed was 177. Results: The majority of the patients analyzed were women over 50 years old who presented white lesions in the buccal mucosa. The most commonly used treatment was triamcinolone acetonide, and regarding the relationship with candidiasis, it was associated with red lesions, pharmacological treatment, systemic diseases, dry mouth, and removable prostheses. Discussion: Most studies present ideas similar to those observed in this research, while other factors, such as the relationship of candidiasis with the typology of lichen planus, differ among studies. Conclusion: A significant relationship was found between candidiasis and lichen planus in patients with predisposing factors and with erythematous lesions.
Introdution: Lichen planus is a chronic, recurrent, common, and variable inflammatory disease with an unknown etiology. The manifestations are usually bilateral, located in the buccal mucosa in the form of typical Wickham's striae (white lichen planus), although it can also present in an erythematous form. Diagnosis is carried out through clinical and histopathological examination. Treatment is used in symptomatic cases (erythematous lichen planus) with corticosteroids, a factor that can trigger the appearance of candidiasis. Candidiasis is an opportunistic infection that occurs in people with a series of predisposing factors. It is frequently localized on the tongue and is treated with antifungal agents. Method: This study was conducted to examine the relationship between candidiasis and oral lichen planus. A total of 573 medical records were reviewed, and the data collected was entered into an Excel spreadsheet for later analysis using a software program (SPSS). After establishing the inclusion and exclusion criteria, the number of patients analyzed was 177. Results: The majority of the patients analyzed were women over 50 years old who presented white lesions in the buccal mucosa. The most commonly used treatment was triamcinolone acetonide, and regarding the relationship with candidiasis, it was associated with red lesions, pharmacological treatment, systemic diseases, dry mouth, and removable prostheses. Discussion: Most studies present ideas similar to those observed in this research, while other factors, such as the relationship of candidiasis with the typology of lichen planus, differ among studies. Conclusion: A significant relationship was found between candidiasis and lichen planus in patients with predisposing factors and with erythematous lesions.
Direction
OTERO REY, EVA MARIA (Tutorships)
Gamallo Moure, Ana Belén (Co-tutorships)
OTERO REY, EVA MARIA (Tutorships)
Gamallo Moure, Ana Belén (Co-tutorships)
Court
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Colour analysis of 3D printed dental resins.
Authorship
A.F.K.
Bachelor of Odontology
A.F.K.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Objective: The objective of the present study is to analyze the available literature on the color of 3D printed dental resins and its correlation with the VITAPAN Classical guide. Material and methods: A systematic bibliographic review was carried out in Pubmed, Wob and Scopus between the years 2021 and 2023. The PRISMA criteria and the PICO question were followed: Do 3D printed (I) dental resins (P) present correspondence in their color (O) when compared with the VITAPAN Classical guide (C)? Results: 1667 articles were found, 17 of them met the inclusion criteria. All the articles found are in vitro studies that evaluate the influence of different factors (printing angle, post-polymerization, surface treatment and artificial aging) on the color and color stability of 3D printed dental resins. Conclusions: Processing, post-processing and exposure to staining media are conditioning factors in the color of 3D printed dental resins.
Objective: The objective of the present study is to analyze the available literature on the color of 3D printed dental resins and its correlation with the VITAPAN Classical guide. Material and methods: A systematic bibliographic review was carried out in Pubmed, Wob and Scopus between the years 2021 and 2023. The PRISMA criteria and the PICO question were followed: Do 3D printed (I) dental resins (P) present correspondence in their color (O) when compared with the VITAPAN Classical guide (C)? Results: 1667 articles were found, 17 of them met the inclusion criteria. All the articles found are in vitro studies that evaluate the influence of different factors (printing angle, post-polymerization, surface treatment and artificial aging) on the color and color stability of 3D printed dental resins. Conclusions: Processing, post-processing and exposure to staining media are conditioning factors in the color of 3D printed dental resins.
Direction
GALLAS TORREIRA, MARIA MERCEDES (Tutorships)
Fernández Millán, David (Co-tutorships)
GALLAS TORREIRA, MARIA MERCEDES (Tutorships)
Fernández Millán, David (Co-tutorships)
Court
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Evaluation of the precision of a guided surgery system in the placement of dental implants: an in vitro study
Authorship
B.F.G.
Bachelor of Odontology
B.F.G.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction. Guided surgery in oral implantology is experiencing an expansion due to the simplification of procedures and the increase in predictability of results implied by its use in the field of oral rehabilitation. It allows us to observe, visualize and plan the position of the implant digitally, but currently it presents a certain discrepancy between the planned position of the implant and its final real position. Objectives. Evaluate the accuracy of a guided surgery system in the placement of in vitro dental implants in an operator without experience in the placement of implants. Material and methods. A preclinical experimental study was carried out where 30 dental implants were placed in 5 resin models, 6 implants for model, with guided surgery using a tooth-supported resin splint, designed with guided surgery planning software. Measurements were made in reference to the horizontal deviation of the head and apex of the implant, the angular deviation, and the vertical deviation with respect to the previously planned position. Results.The mean horizontal deviation at the implant head was 0.54 mm. and the mean horizontal deviation at the apex of the implant was 0.92 mm. The mean vertical deviation in the apico-coronal position of the implant was 0.44 mm. Finally, the average angular deviation was 5.18 grades. Conclusions. The precision of guided surgery by an inexperienced operator showed results similar to those reported in the literature. The angular deviation was the variable where the greatest divergence was observed. The data on the horizontal deviation, both at the head and at the apex of the implant, and the vertical deviation, showed values very similar to those reported in other guided surgery studies.
Introduction. Guided surgery in oral implantology is experiencing an expansion due to the simplification of procedures and the increase in predictability of results implied by its use in the field of oral rehabilitation. It allows us to observe, visualize and plan the position of the implant digitally, but currently it presents a certain discrepancy between the planned position of the implant and its final real position. Objectives. Evaluate the accuracy of a guided surgery system in the placement of in vitro dental implants in an operator without experience in the placement of implants. Material and methods. A preclinical experimental study was carried out where 30 dental implants were placed in 5 resin models, 6 implants for model, with guided surgery using a tooth-supported resin splint, designed with guided surgery planning software. Measurements were made in reference to the horizontal deviation of the head and apex of the implant, the angular deviation, and the vertical deviation with respect to the previously planned position. Results.The mean horizontal deviation at the implant head was 0.54 mm. and the mean horizontal deviation at the apex of the implant was 0.92 mm. The mean vertical deviation in the apico-coronal position of the implant was 0.44 mm. Finally, the average angular deviation was 5.18 grades. Conclusions. The precision of guided surgery by an inexperienced operator showed results similar to those reported in the literature. The angular deviation was the variable where the greatest divergence was observed. The data on the horizontal deviation, both at the head and at the apex of the implant, and the vertical deviation, showed values very similar to those reported in other guided surgery studies.
Direction
MAREQUE BUENO, SANTIAGO (Tutorships)
MAREQUE BUENO, SANTIAGO (Tutorships)
Court
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Analysis of the cariogenic potential in primary education school menus for 6 to 12 year old students in public, private and semi-private schools in the Santiago de Compostela area.
Authorship
Y.G.A.
Bachelor of Odontology
Y.G.A.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction: Nutrition is vital for adequate development, with a balanced, complete, and healthy diet being key. According to the WHO, diet influences the proper development of the organism and the likelihood of suffering from non-communicable diseases such as diabetes, cardiovascular diseases, or cavities. In Galicia, half of the schoolchildren eat lunch in school canteen, highlighting the importance of analyzing their menus, especially after the COVID-19 pandemic where the habit of brushing after meals was banned in many centers. Our study evaluates the cariogenic potential of the menus in children aged 6 to 12 years in Santiago de Compostela. Material and methods: This descriptive study collected school menus from primary schools in the Santiago área. A total of 27 menus were collected, of which 19 were evaluated based on the type of food and frequency of consumption. Results: Of the 19 menus, 5 belonged to public shcools, 12 to semi-private schools, and 2 to private schools. 68,4% (13 menus) had moderate cariogenic potential, and 31,6% (6menus) had high cariogenic potential. That is, none of the menus had low cariogenic risk. No significant relationship was found between the type of school canteen management, the type of school, and the cariogenic risk of the menus. We found that foods with complex carbohydrates with added sugars and moderately adhesive sugary solids have the highest cariogenic risk. Conclusions: Regardless of the type of school or school canteen management, all the menus had moderate or high cariogenic potential. We found that the foods contributing the most to cariogenic potential were those with carbohydrates with added sugars and moderately adhesive sugary solids.
Introduction: Nutrition is vital for adequate development, with a balanced, complete, and healthy diet being key. According to the WHO, diet influences the proper development of the organism and the likelihood of suffering from non-communicable diseases such as diabetes, cardiovascular diseases, or cavities. In Galicia, half of the schoolchildren eat lunch in school canteen, highlighting the importance of analyzing their menus, especially after the COVID-19 pandemic where the habit of brushing after meals was banned in many centers. Our study evaluates the cariogenic potential of the menus in children aged 6 to 12 years in Santiago de Compostela. Material and methods: This descriptive study collected school menus from primary schools in the Santiago área. A total of 27 menus were collected, of which 19 were evaluated based on the type of food and frequency of consumption. Results: Of the 19 menus, 5 belonged to public shcools, 12 to semi-private schools, and 2 to private schools. 68,4% (13 menus) had moderate cariogenic potential, and 31,6% (6menus) had high cariogenic potential. That is, none of the menus had low cariogenic risk. No significant relationship was found between the type of school canteen management, the type of school, and the cariogenic risk of the menus. We found that foods with complex carbohydrates with added sugars and moderately adhesive sugary solids have the highest cariogenic risk. Conclusions: Regardless of the type of school or school canteen management, all the menus had moderate or high cariogenic potential. We found that the foods contributing the most to cariogenic potential were those with carbohydrates with added sugars and moderately adhesive sugary solids.
Direction
CHAMORRO PETRONACCI, CINTIA MICAELA (Tutorships)
CHAMORRO PETRONACCI, CINTIA MICAELA (Tutorships)
Therapy response prediction in patients with Locally Advanced and Metastatic Head and Neck Cancer through PET radiomic study
Authorship
N.G.N.
Bachelor of Odontology
N.G.N.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Introduction: Radiomics and texture analysis based on PET (Positron Emission Tomography) imaging play a crucial role in diagnosing, therapeutic management, and response prediction in patients with head and neck cancer. Materials and methods: A prospective analysis was conducted on a cohort of patients with locally advanced and metastatic head and neck cancer from the University Clinical Hospital of Santiago de Compostela (CHUS). The study sample comprises 13 Caucasian male patients with squamous cell carcinomas of the head and neck (HNSCCs). PET/CT images were used to determine the tumor lesions’ location, delineation, and segmentation. Texture characteristics, volume, and Standardized Uptake Value (SUV) were analysed. Three statistical analyses were performed: linear regression analysis, analysis of variance (ANOVA), and BoxPlot analysis. Results: Although no statistically significant differences were observed among the variables to reject the null hypothesis, slight trends suggest a potential correlation between metrics such as SUV or tumour volume and patient prognosis. Conclusions: HNSCC presents high biological heterogeneity, complicating prognosis, and therapeutic management. Therefore, although the increasing utilization of PET and radiomics in cancer is promising, further studies are needed to address limitations and reinforce findings in order to develop standardized models that improve the reliability of radiomics applications in head and neck cancer.
Introduction: Radiomics and texture analysis based on PET (Positron Emission Tomography) imaging play a crucial role in diagnosing, therapeutic management, and response prediction in patients with head and neck cancer. Materials and methods: A prospective analysis was conducted on a cohort of patients with locally advanced and metastatic head and neck cancer from the University Clinical Hospital of Santiago de Compostela (CHUS). The study sample comprises 13 Caucasian male patients with squamous cell carcinomas of the head and neck (HNSCCs). PET/CT images were used to determine the tumor lesions’ location, delineation, and segmentation. Texture characteristics, volume, and Standardized Uptake Value (SUV) were analysed. Three statistical analyses were performed: linear regression analysis, analysis of variance (ANOVA), and BoxPlot analysis. Results: Although no statistically significant differences were observed among the variables to reject the null hypothesis, slight trends suggest a potential correlation between metrics such as SUV or tumour volume and patient prognosis. Conclusions: HNSCC presents high biological heterogeneity, complicating prognosis, and therapeutic management. Therefore, although the increasing utilization of PET and radiomics in cancer is promising, further studies are needed to address limitations and reinforce findings in order to develop standardized models that improve the reliability of radiomics applications in head and neck cancer.
Direction
SUAREZ CUNQUEIRO, MARIA MERCEDES (Tutorships)
Aguiar Fernández, Pablo (Co-tutorships)
SUAREZ CUNQUEIRO, MARIA MERCEDES (Tutorships)
Aguiar Fernández, Pablo (Co-tutorships)
Court
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
New drugs for the management of hereditary angioedema: a bibliographic review
Authorship
A.M.C.
Bachelor of Medicine
A.M.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Hereditary angioedema (HAE) is a rare disease of autosomal dominant inheritance that presents with recurrent and self-limited attacks of subcutaneous and/or submucosal edema. It is a disabling and serious disease, in which airway involvement is the main cause of mortality associated with the disease. Hereditary angioedema can appear due to a quantitative or qualitative defect of the C1 inhibitory serpin, which regulates the complement system (HAE-C1-INH types I and II, respectively) or with normal values of C1-INH (HAE-nC1-INH). Clinical features and response to treatment reveal bradykinin as the key mediator in angioedema formation. The management of the disease is based on the treatment of the acute episode and prophylaxis, against causes recognized as possible triggers or in the long term to avoid outbreaks. The goal of treatment is to reduce morbidity and mortality, but new drugs available and in development provide a change in the prognosis of the disease, by reducing the burden of the disease and improving the quality of life of patients. Objectives: The objective of this final degree project is to carry out a bibliographic review of the new therapeutic options that are being developed for the treatment of HAE, and to show their results on the control of the disease and the improvement in quality of life. Results: A narrative review of the 22 selected publications about drugs in development for both PLP and the acute treatment of angioedema attacks is presented. There are molecules targeting the kinin-kallikrein axis, including specific kallikrein inhibitors, such as Berotralstat, with recently approved funding, and others in advanced stages of clinical trials, Sebetrlastat and Donidalorsen, which also show promising results. Other targets signal the beginning of the inflammatory cascade, with the production of C1-INH by gene therapy or the inhibition of FXIIa (Garadacimab), or the end with the blockade of the B2 receptor (PHA-022121). Finally, the xenic therapies encourage further research in this line, as they seem to have a sustained effect with a single dose, but more long-term safety studies are needed. The oral route appears as a treatment option (Sebetralstat, PHA-022121), which allows rapid administration and reduces the time until resolution of the outbreak. Conclusions: Advances in the knowledge of the pathophysiology of the disease allow us to point out the therapeutic targets where the molecules act in the clinical trial phase, the results of which are presented in this review. New treatments offer the opportunity to radically reduce the number of outbreaks, their intensity and duration, and significantly improve patients' quality of life.
Introduction: Hereditary angioedema (HAE) is a rare disease of autosomal dominant inheritance that presents with recurrent and self-limited attacks of subcutaneous and/or submucosal edema. It is a disabling and serious disease, in which airway involvement is the main cause of mortality associated with the disease. Hereditary angioedema can appear due to a quantitative or qualitative defect of the C1 inhibitory serpin, which regulates the complement system (HAE-C1-INH types I and II, respectively) or with normal values of C1-INH (HAE-nC1-INH). Clinical features and response to treatment reveal bradykinin as the key mediator in angioedema formation. The management of the disease is based on the treatment of the acute episode and prophylaxis, against causes recognized as possible triggers or in the long term to avoid outbreaks. The goal of treatment is to reduce morbidity and mortality, but new drugs available and in development provide a change in the prognosis of the disease, by reducing the burden of the disease and improving the quality of life of patients. Objectives: The objective of this final degree project is to carry out a bibliographic review of the new therapeutic options that are being developed for the treatment of HAE, and to show their results on the control of the disease and the improvement in quality of life. Results: A narrative review of the 22 selected publications about drugs in development for both PLP and the acute treatment of angioedema attacks is presented. There are molecules targeting the kinin-kallikrein axis, including specific kallikrein inhibitors, such as Berotralstat, with recently approved funding, and others in advanced stages of clinical trials, Sebetrlastat and Donidalorsen, which also show promising results. Other targets signal the beginning of the inflammatory cascade, with the production of C1-INH by gene therapy or the inhibition of FXIIa (Garadacimab), or the end with the blockade of the B2 receptor (PHA-022121). Finally, the xenic therapies encourage further research in this line, as they seem to have a sustained effect with a single dose, but more long-term safety studies are needed. The oral route appears as a treatment option (Sebetralstat, PHA-022121), which allows rapid administration and reduces the time until resolution of the outbreak. Conclusions: Advances in the knowledge of the pathophysiology of the disease allow us to point out the therapeutic targets where the molecules act in the clinical trial phase, the results of which are presented in this review. New treatments offer the opportunity to radically reduce the number of outbreaks, their intensity and duration, and significantly improve patients' quality of life.
Direction
Rodríguez Vázquez, Virginia María (Tutorships)
Méndez Brea, Paula (Co-tutorships)
Rodríguez Vázquez, Virginia María (Tutorships)
Méndez Brea, Paula (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Sistematic review of hemostatic topic agents in the treatment of postpartum hemorrhage.
Authorship
Y.H.M.C.
Bachelor of Medicine
Y.H.M.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality globally. It is a much bigger problem in developing areas, where medical resources are limited. Therefore, this review is conducted with the aim of determining the true efficacy of topical hemostatic, as they could be a viable option in areas where there is no access to other methods to stop hemorrhage. In this way, they would not only help to stop the bleeding in conjunction with other methods, but in places where these methods are lacking, they would be an easy and affordable option.
Postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality globally. It is a much bigger problem in developing areas, where medical resources are limited. Therefore, this review is conducted with the aim of determining the true efficacy of topical hemostatic, as they could be a viable option in areas where there is no access to other methods to stop hemorrhage. In this way, they would not only help to stop the bleeding in conjunction with other methods, but in places where these methods are lacking, they would be an easy and affordable option.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Dono Pérez, Alma María (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Dono Pérez, Alma María (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Medium and long term results of the applicacion of The Who Surgical Safety Checklist. Systematic Review
Authorship
E.M.F.
Bachelor of Medicine
E.M.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background: From 2008/2009, The World Health Organization (WHO) has published guidelines and protocols in order to avoid mistakes and perioperative complications, following a checklist (Surgical Safety Checklist), which was introduced in different countries. This systematic review tries to answer the question: Is The Who Surgical Safety Checklist (SSC) being effective to avoid surgery complications and mistakes, and definitely, saving lifes of patients undergoing surgery, following the motto Safe Surgery Save Lives? Methods: The Cochrane Library, PubMed and Web of Science (WOS) were searched using predefined inclusion criteria from January 2014 to March 2024. This systematic review included articles reporting a quantitative measure of the impact of The Who SSC regarding postoperative complications, including mortality. Furthermore, articles related to costs, avoiding adverse events, barriers and solutions to the implementation were included. Results: Eight of 251 studies identified met the inclusion criteria. The main outcomes were different types of complications, the length of hospital stay and mortality. What’s more, the effectiveness of the SSC in developed countries and developing countries was analysed. The impact of this checklist in a war area was examined as well. Conclusion: The SSC keeps proving that it reduces the morbimortality. Based upon the results of this study, it could be beneficial to avoid surgery mistakes and complications, so this checklist saves lives, even in developing countries or in low-resource settings since it’s an easy, cheap and effective tool. However, more quality studies should be done to know its real effect.
Background: From 2008/2009, The World Health Organization (WHO) has published guidelines and protocols in order to avoid mistakes and perioperative complications, following a checklist (Surgical Safety Checklist), which was introduced in different countries. This systematic review tries to answer the question: Is The Who Surgical Safety Checklist (SSC) being effective to avoid surgery complications and mistakes, and definitely, saving lifes of patients undergoing surgery, following the motto Safe Surgery Save Lives? Methods: The Cochrane Library, PubMed and Web of Science (WOS) were searched using predefined inclusion criteria from January 2014 to March 2024. This systematic review included articles reporting a quantitative measure of the impact of The Who SSC regarding postoperative complications, including mortality. Furthermore, articles related to costs, avoiding adverse events, barriers and solutions to the implementation were included. Results: Eight of 251 studies identified met the inclusion criteria. The main outcomes were different types of complications, the length of hospital stay and mortality. What’s more, the effectiveness of the SSC in developed countries and developing countries was analysed. The impact of this checklist in a war area was examined as well. Conclusion: The SSC keeps proving that it reduces the morbimortality. Based upon the results of this study, it could be beneficial to avoid surgery mistakes and complications, so this checklist saves lives, even in developing countries or in low-resource settings since it’s an easy, cheap and effective tool. However, more quality studies should be done to know its real effect.
Direction
PINO MINGUEZ, JESUS (Tutorships)
GARCIA RODRIGUEZ, LUIS ANTONIO MIGUEL (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
GARCIA RODRIGUEZ, LUIS ANTONIO MIGUEL (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Effectiveness of ketamine and esketamine in obsessive-compulsive disorder: systematic review
Authorship
E.M.F.
Bachelor of Medicine
E.M.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Obsessive-compulsive disorder is a psychiatric illness characterized by obsessions and compulsions. Obsessions are intrusive thoughts that occur repeatedly and involuntarily. Compulsions are thoughts or actions that the person performs with the aim of reducing the anxiety generated by obsessions. This disease is very common in the population, having a prevalence of 3% in some countries, being more common between 20 and 50 years of age. Although a genetic component has been identified in obsessive-compulsive disorder, no specific genetic abnormalities have been found. Studies suggest that serotonergic, dopaminergic and glutamatergic pathways influence its pathophysiology, although how this disease occurs is largely unknown. The first-line treatment is selective serotonin reuptake inhibitors along with cognitive behavioral therapy. However, there are patients resistant to all treatments recommended by the guidelines. Ketamine or esketamine may have a certain role in this disease due to its involvement with receptor N-methyl-D-aspartate receptor. Although there are some studies where these drugs are being used, the results obtained are very varied. Furthermore, the sample size of the current studies is not sufficient to draw conclusions. The objective of this article is to conduct a systematic review to explore the effectiveness of ketamine and esketamine in OCD. Although the data are promising, there are patients who do not respond to any available drug. Studies with a larger sample size and better methodology are needed to clarify whether ketamine or esketamine are useful in obsessive-compulsive disorder.
Obsessive-compulsive disorder is a psychiatric illness characterized by obsessions and compulsions. Obsessions are intrusive thoughts that occur repeatedly and involuntarily. Compulsions are thoughts or actions that the person performs with the aim of reducing the anxiety generated by obsessions. This disease is very common in the population, having a prevalence of 3% in some countries, being more common between 20 and 50 years of age. Although a genetic component has been identified in obsessive-compulsive disorder, no specific genetic abnormalities have been found. Studies suggest that serotonergic, dopaminergic and glutamatergic pathways influence its pathophysiology, although how this disease occurs is largely unknown. The first-line treatment is selective serotonin reuptake inhibitors along with cognitive behavioral therapy. However, there are patients resistant to all treatments recommended by the guidelines. Ketamine or esketamine may have a certain role in this disease due to its involvement with receptor N-methyl-D-aspartate receptor. Although there are some studies where these drugs are being used, the results obtained are very varied. Furthermore, the sample size of the current studies is not sufficient to draw conclusions. The objective of this article is to conduct a systematic review to explore the effectiveness of ketamine and esketamine in OCD. Although the data are promising, there are patients who do not respond to any available drug. Studies with a larger sample size and better methodology are needed to clarify whether ketamine or esketamine are useful in obsessive-compulsive disorder.
Direction
ARROJO ROMERO, MANUEL (Tutorships)
Facal Molina, Fernando (Co-tutorships)
ARROJO ROMERO, MANUEL (Tutorships)
Facal Molina, Fernando (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
The potencial use of cannabidiol in normal and pathological sleep
Authorship
G.M.M.G.
Bachelor of Medicine
G.M.M.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Sleep disorders affect millions of people around the world, leading to serious consequences such as mental health problems or decreased daily performance. The current treatments available are not completely effective and are not free of adverse effects. In the search for new solutions and after increased research due to its demonstrated therapeutic potential, cannabidiol is postulated as an effective alternative to improve sleep in people with normal sleep, sleep disorders and other medical conditions. Methods: The search for articles was carried out using the Pubmed, Cochrane and Scopus databases, selecting the most recent evidence of the use of CBD in human sleep, meeting the established inclusion and exclusion criteria. Results: A total of 182 studies were identified, of which 16 were included. 3 of them evaluated the effect of CBD on the sleep of healthy subjects, 6 in subjects with insomnia or other sleep disorders and 7 in other medical conditions such as epilepsy, chronic pain, Parkinson's disease, post-traumatic stress disorder, multiple sclerosis or autism. 80% of them detected improvement in the subjective quality of sleep, and 71% who used objective methods reported some benefit in their sleep architecture. Conclusions: Cannabidiol could be a safe and effective option for improving the perceived quality of sleep, especially in populations with sleep disorders or specific medical conditions. New research is needed that specifically evaluates the effect of CBD on sleep, using both objective and subjective assessment measures.
Introduction: Sleep disorders affect millions of people around the world, leading to serious consequences such as mental health problems or decreased daily performance. The current treatments available are not completely effective and are not free of adverse effects. In the search for new solutions and after increased research due to its demonstrated therapeutic potential, cannabidiol is postulated as an effective alternative to improve sleep in people with normal sleep, sleep disorders and other medical conditions. Methods: The search for articles was carried out using the Pubmed, Cochrane and Scopus databases, selecting the most recent evidence of the use of CBD in human sleep, meeting the established inclusion and exclusion criteria. Results: A total of 182 studies were identified, of which 16 were included. 3 of them evaluated the effect of CBD on the sleep of healthy subjects, 6 in subjects with insomnia or other sleep disorders and 7 in other medical conditions such as epilepsy, chronic pain, Parkinson's disease, post-traumatic stress disorder, multiple sclerosis or autism. 80% of them detected improvement in the subjective quality of sleep, and 71% who used objective methods reported some benefit in their sleep architecture. Conclusions: Cannabidiol could be a safe and effective option for improving the perceived quality of sleep, especially in populations with sleep disorders or specific medical conditions. New research is needed that specifically evaluates the effect of CBD on sleep, using both objective and subjective assessment measures.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Uzal Fernández, Cristina (Co-tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Uzal Fernández, Cristina (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
ASA physical status classification: study of interobserver variability
Authorship
M.M.L.
Bachelor of Medicine
M.M.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
ASA-PS is a classification used by healthcare professionals all around the world with the aim of assessing the preoperative physical status of a patient, allowing us to improve the care provided and to reduce perioperative risks. Since its creation in 1941, the scale has undergone various modifications, constituting in 2020 the current classification, composed of 6 categories with definitions for each of them and examples of the adult, pediatric and obstetric patient. The simplicity of the scale is his best advantage, but the inter-observer variability is its main disadvantage. The objective of this study was to analyze the interobserver variability of the scale among anesthesiologists at CHUAC and CHUF. To this end, a descriptive observational study was carried out through an anonymous, voluntary and unpaid questionnaire where anesthesiologist and anesthesia residents from these hospitals were invited to participate. The questionnaire consisted of two parts: a series of questions about the respondent’s profile and a second part where 10 fictitious clinical cases were proposed for the assignment of an ASA stage. After data analysis, a low level of agreement between raters and an average of around 50% correct answers was demonstrated, confirming the variability of the scale. No statistically significant differences were found between variability and professional experience or activity in pre-anesthesia consultation activity. Clinical cases related to acute pathologies were the ones that were related to a greater variability and a higher number of incorrect responses.
ASA-PS is a classification used by healthcare professionals all around the world with the aim of assessing the preoperative physical status of a patient, allowing us to improve the care provided and to reduce perioperative risks. Since its creation in 1941, the scale has undergone various modifications, constituting in 2020 the current classification, composed of 6 categories with definitions for each of them and examples of the adult, pediatric and obstetric patient. The simplicity of the scale is his best advantage, but the inter-observer variability is its main disadvantage. The objective of this study was to analyze the interobserver variability of the scale among anesthesiologists at CHUAC and CHUF. To this end, a descriptive observational study was carried out through an anonymous, voluntary and unpaid questionnaire where anesthesiologist and anesthesia residents from these hospitals were invited to participate. The questionnaire consisted of two parts: a series of questions about the respondent’s profile and a second part where 10 fictitious clinical cases were proposed for the assignment of an ASA stage. After data analysis, a low level of agreement between raters and an average of around 50% correct answers was demonstrated, confirming the variability of the scale. No statistically significant differences were found between variability and professional experience or activity in pre-anesthesia consultation activity. Clinical cases related to acute pathologies were the ones that were related to a greater variability and a higher number of incorrect responses.
Direction
TABOADA MUÑIZ, MANUEL (Tutorships)
Mato Búa, Rocío (Co-tutorships)
TABOADA MUÑIZ, MANUEL (Tutorships)
Mato Búa, Rocío (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Use of Ranibizumab biosimilars in the treatment of neovascular Age-Related Macular Degeneration.
Authorship
L.V.M.P.
Bachelor of Medicine
L.V.M.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Neovascular age-related macular degeneration is one of the most frequent chronic diseases causing blindness worldwide, mainly in patients older than 50 years. The therapeutic target of this disease is mainly based on intravitreal anti-vascular endothelial growth factor (anti-vascular endothelial growth factor drugs. The high number of injections required for its management makes the treatment of this pathology an excessive economic expense for the health system and for this reason biosimilars have been developed: biological drugs equivalent in efficacy and safety to the reference drug. Objectives: To collect, analyze and compare the different articles related to the use of Ranibizumab biosimilars in the treatment of AMD. Material and Methods: A systematic review was carried out by performing three database searches: two in PubMed and one in Embase. The PICoR question was posed and the inclusion and exclusion criteria were established for the selection of articles. Results: We delved into a total of 14 articles, in each of them we analyzed the methodology in terms of the type of study, the intervention referring to the treatment regimen and drugs involved, and compared the efficacy of Ranibizumab biosimilars with the reference Ranibizumab or Lucentis taking into account parameters such as: best corrected visual acuity at different phases of treatment, morphological parameters such as intraretinal fluid, subretinal fluid, pigment epithelium detachment, pharmacokinetics, safety, immunogenicity. No significant differences were found between the two groups of drugs studied. Conclusions: The use of Ranibizumab biosimilars does not imply a loss of efficacy in the treatment of AMDEn at the same time they have proven to be safe drugs for use in daily practice, as a consequence, they allow the management of this very prevalent disease to be less costly for health authorities.
Introduction: Neovascular age-related macular degeneration is one of the most frequent chronic diseases causing blindness worldwide, mainly in patients older than 50 years. The therapeutic target of this disease is mainly based on intravitreal anti-vascular endothelial growth factor (anti-vascular endothelial growth factor drugs. The high number of injections required for its management makes the treatment of this pathology an excessive economic expense for the health system and for this reason biosimilars have been developed: biological drugs equivalent in efficacy and safety to the reference drug. Objectives: To collect, analyze and compare the different articles related to the use of Ranibizumab biosimilars in the treatment of AMD. Material and Methods: A systematic review was carried out by performing three database searches: two in PubMed and one in Embase. The PICoR question was posed and the inclusion and exclusion criteria were established for the selection of articles. Results: We delved into a total of 14 articles, in each of them we analyzed the methodology in terms of the type of study, the intervention referring to the treatment regimen and drugs involved, and compared the efficacy of Ranibizumab biosimilars with the reference Ranibizumab or Lucentis taking into account parameters such as: best corrected visual acuity at different phases of treatment, morphological parameters such as intraretinal fluid, subretinal fluid, pigment epithelium detachment, pharmacokinetics, safety, immunogenicity. No significant differences were found between the two groups of drugs studied. Conclusions: The use of Ranibizumab biosimilars does not imply a loss of efficacy in the treatment of AMDEn at the same time they have proven to be safe drugs for use in daily practice, as a consequence, they allow the management of this very prevalent disease to be less costly for health authorities.
Direction
CADARSO SUAREZ, LUIS (Tutorships)
Campo Gesto, Ana (Co-tutorships)
CADARSO SUAREZ, LUIS (Tutorships)
Campo Gesto, Ana (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
López González, Francisco Javier (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Phenotypic changes throughout the years in a patient who carries a pathological variant (p.Glu542Gln) in MYBPC3 gene.
Authorship
A.M.P.
Bachelor of Medicine
A.M.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Hypertrophic cardiomyopathy (HCM) is an inherited cardiac disease characterized by an increased thickness of the left ventricular wall. Early diagnosis and management in family members of patients with a definitive diagnosis of the disease are crucial for its prognosis. Objectives: to evaluate the clinical, electrocardiographic, and imaging evolution of a patient carrying a pathogenic variant in the MYBPC3 gene inherited from her father, from the state of asymptomatic carrier to the current disease; to assess the importance of family screening in this type of diseases; to evaluate the potential therapeutic benefits of the new drug aficamten. Materials and methods: a typical case of HCM is presented, with a literature review conducted in digital databases. Results and discussion: it was observed that, in the studied patient, the first alterations were seen in the ECG, followed by ventricular hypertrophy detected in cardiac imaging tests and the onset of clinical symptoms, aligning with the natural history of the disease described in the reviewed articles. After treatment with the new drug aficamten, a notable improvement was observed in both clinical symptoms and the obstructive gradient of the left ventricular outflow tract. Conclusions: in HCM, family investigation is essential, as well as identifying potential carriers and inheritance patterns. The first detectable change in these patients is seen in the ECG, followed by increased ventricular thickness in cardiac imaging tests and subsequently the appearance of clinical symptoms. The new drug aficamten offers an effective alternative to other treatment modalities, improving symptoms and reducing obstructive gradient and peak oxygen consumption in patients with obstructive HCM.
Hypertrophic cardiomyopathy (HCM) is an inherited cardiac disease characterized by an increased thickness of the left ventricular wall. Early diagnosis and management in family members of patients with a definitive diagnosis of the disease are crucial for its prognosis. Objectives: to evaluate the clinical, electrocardiographic, and imaging evolution of a patient carrying a pathogenic variant in the MYBPC3 gene inherited from her father, from the state of asymptomatic carrier to the current disease; to assess the importance of family screening in this type of diseases; to evaluate the potential therapeutic benefits of the new drug aficamten. Materials and methods: a typical case of HCM is presented, with a literature review conducted in digital databases. Results and discussion: it was observed that, in the studied patient, the first alterations were seen in the ECG, followed by ventricular hypertrophy detected in cardiac imaging tests and the onset of clinical symptoms, aligning with the natural history of the disease described in the reviewed articles. After treatment with the new drug aficamten, a notable improvement was observed in both clinical symptoms and the obstructive gradient of the left ventricular outflow tract. Conclusions: in HCM, family investigation is essential, as well as identifying potential carriers and inheritance patterns. The first detectable change in these patients is seen in the ECG, followed by increased ventricular thickness in cardiac imaging tests and subsequently the appearance of clinical symptoms. The new drug aficamten offers an effective alternative to other treatment modalities, improving symptoms and reducing obstructive gradient and peak oxygen consumption in patients with obstructive HCM.
Direction
Barge Caballero, Eduardo (Tutorships)
Barriales Villa, Roberto (Co-tutorships)
Barge Caballero, Eduardo (Tutorships)
Barriales Villa, Roberto (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Systematic review on long-term neurological a digestive outcomes in patients with necrotizing enterocolitis and their possible association with de treatment received
Authorship
D.F.S.
Bachelor of Medicine
D.F.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Necrotizing enterocolitis (NEC) is a disease with a high impact on preterm infants that is associated with high morbidity and mortality. This condition is characterized by necrosis of the mucosa or deeper layers of the intestine, which is the most frequent digestive emergency in the newborn. Depending on the severity of the condition, these patients are required medical treatment (conservative) or surgical intervention that usually requires extensive resection of the affected intestine, in order to limit the evolution of the condition. As in many diseases within Neonatology, there is great uncertainty and interest in the long-term evolution of these patients, as well as their possible complications. Objectives: To carry out a systematic review of the published literature on the long term evolution of patients with Necrotizing Enterocolitis (NEC) in newborns exposed to medical and surgical treatment. Material and Methods: A search was conducted in the MEDLINE/Pubmed databases, selecting the available evidence, quantitative and qualitative aspects of prospective or review studies of patients affected by necrotizing enterocolitis published between 2014-2024. Results: After an initial screening and critical reading, a total of 16 publications were included; 9 focused on neurological development and 7 on the main gastrointestinal complication of this disease, short bowel syndrome (SBS). Conclusions: Patients who, due to the severity of NEC, require surgical intervention appear to have a higher probability of poorer development at both the gastrointestinal and neurological levels. The laparotomy type of intervention seems to have better long-term outcomes. The remaining extension of the intestine could be of relevance for the future neurological development of the patient. These patients could benefit from a multidisciplinary approach supported by the results of the different cohorts.
Introduction: Necrotizing enterocolitis (NEC) is a disease with a high impact on preterm infants that is associated with high morbidity and mortality. This condition is characterized by necrosis of the mucosa or deeper layers of the intestine, which is the most frequent digestive emergency in the newborn. Depending on the severity of the condition, these patients are required medical treatment (conservative) or surgical intervention that usually requires extensive resection of the affected intestine, in order to limit the evolution of the condition. As in many diseases within Neonatology, there is great uncertainty and interest in the long-term evolution of these patients, as well as their possible complications. Objectives: To carry out a systematic review of the published literature on the long term evolution of patients with Necrotizing Enterocolitis (NEC) in newborns exposed to medical and surgical treatment. Material and Methods: A search was conducted in the MEDLINE/Pubmed databases, selecting the available evidence, quantitative and qualitative aspects of prospective or review studies of patients affected by necrotizing enterocolitis published between 2014-2024. Results: After an initial screening and critical reading, a total of 16 publications were included; 9 focused on neurological development and 7 on the main gastrointestinal complication of this disease, short bowel syndrome (SBS). Conclusions: Patients who, due to the severity of NEC, require surgical intervention appear to have a higher probability of poorer development at both the gastrointestinal and neurological levels. The laparotomy type of intervention seems to have better long-term outcomes. The remaining extension of the intestine could be of relevance for the future neurological development of the patient. These patients could benefit from a multidisciplinary approach supported by the results of the different cohorts.
Direction
Concheiro Guisán, Ana (Tutorships)
Sánchez Abuín, Alberto (Co-tutorships)
Concheiro Guisán, Ana (Tutorships)
Sánchez Abuín, Alberto (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Prevalence of bronchial infection in patients with asthma and use of inhaled antibiotics.
Authorship
J.F.P.
Bachelor of Medicine
J.F.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Asthma is a heterogeneous disease characterised by reversible airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. A percentage of patients with asthma have concomitant bronchiectasis (BQ) and, therefore, may have bronchial infection with potentially pathogenic microorganisms (PPMs) that condition the disease course and prognosis. Inhaled antibiotics are widely used for bronchial infection in patients with cystic fibrosis (CF) and CF of other aetiology but the efficacy and safety in patients with asthma is unknown. Objective: Objective 1 - Conduct a review of publications on bronchial infection in asthma with a description of the main PPMs. Objective 2 - Analyze the proportion of asthma patients in studies conducted with inhaled antibiotics. Method: A literature search was conducted in PubMed and Clinical Trials until 15 February 2024 using the keywords described. Randomised and non-randomised clinical trials (RCTs), post hoc studies, observational studies and case series were included. Two investigators (J.F.P and M.B.A) checked the inclusion/exclusion criteria. Filters were applied: human, English language, Italian and Spanish. Results were expressed as mean + SD (range) and percentages. Results: Nine articles were selected for the first objective and 20 articles for the second objective. The prevalence of MPP isolation in asthma ranged from 19.7% to 60.7% with variation in FEV1 (mean + SD) between 65 + 20.3 and 84.2 + 7. The most frequently isolated MPPs were H Influenzae (15-88%), Pseudomonas spp (2.8-44.6%), Moraxella catarrhalis (2.3-65%), S. peumoniae (7.8-35.8%), with sporadic isolation of St.aureus, Klebsiella, Acinetobacter or Actinomyces. Of the 20 selected articles on inhaled antibiotics, only 6 studies with a total of 45 patients specified the inclusion of patients with asthma. The efficacy and safety of this subgroup is not reported separately in any study. Conclusions: There are few studies analysing the prevalence of airway infection by PPMs in asthma patients. The main MPPs isolated in asthma patients are H. influenzae; Moraxella catarrhalis and St. pneumoniae although this depends largely on the severity of asthma. In severe asthma another micro-organism implicated is Pseudomonas aeruginosa. So far there are no clinical trials on inhaled antibiotics exclusively in the asthmatic population. The available information comes from studies in BQ and the results have not been analysed separately. There is a need to generate more evidence on the efficacy and side effects of inhaled antibiotics in asthma because there is no proven evidence for their indication so far.
Introduction: Asthma is a heterogeneous disease characterised by reversible airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. A percentage of patients with asthma have concomitant bronchiectasis (BQ) and, therefore, may have bronchial infection with potentially pathogenic microorganisms (PPMs) that condition the disease course and prognosis. Inhaled antibiotics are widely used for bronchial infection in patients with cystic fibrosis (CF) and CF of other aetiology but the efficacy and safety in patients with asthma is unknown. Objective: Objective 1 - Conduct a review of publications on bronchial infection in asthma with a description of the main PPMs. Objective 2 - Analyze the proportion of asthma patients in studies conducted with inhaled antibiotics. Method: A literature search was conducted in PubMed and Clinical Trials until 15 February 2024 using the keywords described. Randomised and non-randomised clinical trials (RCTs), post hoc studies, observational studies and case series were included. Two investigators (J.F.P and M.B.A) checked the inclusion/exclusion criteria. Filters were applied: human, English language, Italian and Spanish. Results were expressed as mean + SD (range) and percentages. Results: Nine articles were selected for the first objective and 20 articles for the second objective. The prevalence of MPP isolation in asthma ranged from 19.7% to 60.7% with variation in FEV1 (mean + SD) between 65 + 20.3 and 84.2 + 7. The most frequently isolated MPPs were H Influenzae (15-88%), Pseudomonas spp (2.8-44.6%), Moraxella catarrhalis (2.3-65%), S. peumoniae (7.8-35.8%), with sporadic isolation of St.aureus, Klebsiella, Acinetobacter or Actinomyces. Of the 20 selected articles on inhaled antibiotics, only 6 studies with a total of 45 patients specified the inclusion of patients with asthma. The efficacy and safety of this subgroup is not reported separately in any study. Conclusions: There are few studies analysing the prevalence of airway infection by PPMs in asthma patients. The main MPPs isolated in asthma patients are H. influenzae; Moraxella catarrhalis and St. pneumoniae although this depends largely on the severity of asthma. In severe asthma another micro-organism implicated is Pseudomonas aeruginosa. So far there are no clinical trials on inhaled antibiotics exclusively in the asthmatic population. The available information comes from studies in BQ and the results have not been analysed separately. There is a need to generate more evidence on the efficacy and side effects of inhaled antibiotics in asthma because there is no proven evidence for their indication so far.
Direction
González Barcala, Francisco Javier (Tutorships)
Blanco Aparicio, Marina (Co-tutorships)
González Barcala, Francisco Javier (Tutorships)
Blanco Aparicio, Marina (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Smartphone addiction in adolescents according to the SAS scale (Smartphone Addiction Scale)
Authorship
I.F.F.
Bachelor of Medicine
I.F.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background Thanks to technological development, 85% of the world's population has at least one smartphone, and according to big data analysis studies, the average user spends between 5 and 7 hours a day on their smartphone. Although numerous cases of problems derived from smartphone use in children and adolescents have been reported (late language acquisition, sleep problems, overweight, addictive behaviors, school failure, depression...), cell phone addiction is a newly emerging pathology, and there is still no clear consensus on its definition and diagnostic criteria, and few studies have evaluated smartphone addiction among Spanish adolescents. Methods The aim of this TFG is to design an observational study project to study the prevalence of mobile phone addiction among Spanish adolescents from 3rd ESO to 2nd year of Bachillerato, measured using the SAS scale(Smartphone Addiction Scale). To do so, we will survey 371 adolescents between 14 and 18 years of age in the Coruña area, assessing their degree of addiction to cell phones in relation to other aspects such as sleep quality, academic results or family structure. Results Thanks to the use of instruments such as the SAS in the adolescent population, we will be able to detect smartphone addiction risk behaviours, which will allow us to develop prevention and early intervention strategies, as well as to know its prevalence in order to raise public awareness of this growing problem.
Background Thanks to technological development, 85% of the world's population has at least one smartphone, and according to big data analysis studies, the average user spends between 5 and 7 hours a day on their smartphone. Although numerous cases of problems derived from smartphone use in children and adolescents have been reported (late language acquisition, sleep problems, overweight, addictive behaviors, school failure, depression...), cell phone addiction is a newly emerging pathology, and there is still no clear consensus on its definition and diagnostic criteria, and few studies have evaluated smartphone addiction among Spanish adolescents. Methods The aim of this TFG is to design an observational study project to study the prevalence of mobile phone addiction among Spanish adolescents from 3rd ESO to 2nd year of Bachillerato, measured using the SAS scale(Smartphone Addiction Scale). To do so, we will survey 371 adolescents between 14 and 18 years of age in the Coruña area, assessing their degree of addiction to cell phones in relation to other aspects such as sleep quality, academic results or family structure. Results Thanks to the use of instruments such as the SAS in the adolescent population, we will be able to detect smartphone addiction risk behaviours, which will allow us to develop prevention and early intervention strategies, as well as to know its prevalence in order to raise public awareness of this growing problem.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Barral Picado, María del Carmen (Co-tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Barral Picado, María del Carmen (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Child maltreatment as a risk factor for suicidal behaviour in adolescents and adults. A systematic review.
Authorship
E.F.S.
Bachelor of Medicine
E.F.S.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Suicide is one of the most prevalent causes of death in the world. The WHO estimates that every year more than 703,000 people die from suicide, to which we must add the countless suicide attempts. This makes it a serious public health problem that highlights the importance of identifying risk factors on which to develop prevention strategies. In turn, child maltreatment is a social problem that affects millions of children worldwide and has long-term negative consequences for the health and well-being of the victims. Its relationship with suicidal behaviour has been the subject of numerous studies suggesting that it may significantly increase the risk of suicidal behaviour. Objectives: to study the relationship between child maltreatment and suicidal behaviour, analysing the mechanisms that connect them and the possible variables involved in their appearance. In addition, we will try to find effective preventive and therapeutic measures to reduce the effects of maltreatment on the mental health of the victims. Material and methods: systematic review following the PRISMA model through a search in several databases of clinical trials and observational studies referring to child abuse as a risk factor for the development of suicidal behaviour in adolescence and adulthood. Finally, the PUBMED database was used and from a total of 4723 articles found, 11 were included in the study after applying the inclusion and exclusion criteria. Results and discussion: statistically significant relationships were obtained between child maltreatment and the subsequent development of mental problems and suicidal behaviour, in addition to behaviours harmful to health. Physical abuse is more frequent in males while sexual abuse is more frequent in females and, as each type of abuse is associated with the development of different health problems, the consequences will be different in both population groups. Early and family-based intervention is essential for the prevention of maltreatment and the development of suicidal behaviour. Overall, these results are largely in line with current scientific evidence, although there are some variations due to the heterogeneity of the results obtained. Conclusions: being an only child, having parents with a mental disorder or a low socioeconomic level increases the risk of suffering child maltreatment. Sexual abuse is the type of maltreatment most related to suicidal ideation and attempts, although all forms of maltreatment increase these behaviours. In addition to increasing suicidal behaviour, maltreatment is associated with the development of mental and behavioural disorders. Prevention and early intervention to protect children and reduce risk behaviours is therefore essential, as is research to better understand the mechanisms linking child maltreatment and harmful behaviours and to develop new treatment strategies.
Introduction: Suicide is one of the most prevalent causes of death in the world. The WHO estimates that every year more than 703,000 people die from suicide, to which we must add the countless suicide attempts. This makes it a serious public health problem that highlights the importance of identifying risk factors on which to develop prevention strategies. In turn, child maltreatment is a social problem that affects millions of children worldwide and has long-term negative consequences for the health and well-being of the victims. Its relationship with suicidal behaviour has been the subject of numerous studies suggesting that it may significantly increase the risk of suicidal behaviour. Objectives: to study the relationship between child maltreatment and suicidal behaviour, analysing the mechanisms that connect them and the possible variables involved in their appearance. In addition, we will try to find effective preventive and therapeutic measures to reduce the effects of maltreatment on the mental health of the victims. Material and methods: systematic review following the PRISMA model through a search in several databases of clinical trials and observational studies referring to child abuse as a risk factor for the development of suicidal behaviour in adolescence and adulthood. Finally, the PUBMED database was used and from a total of 4723 articles found, 11 were included in the study after applying the inclusion and exclusion criteria. Results and discussion: statistically significant relationships were obtained between child maltreatment and the subsequent development of mental problems and suicidal behaviour, in addition to behaviours harmful to health. Physical abuse is more frequent in males while sexual abuse is more frequent in females and, as each type of abuse is associated with the development of different health problems, the consequences will be different in both population groups. Early and family-based intervention is essential for the prevention of maltreatment and the development of suicidal behaviour. Overall, these results are largely in line with current scientific evidence, although there are some variations due to the heterogeneity of the results obtained. Conclusions: being an only child, having parents with a mental disorder or a low socioeconomic level increases the risk of suffering child maltreatment. Sexual abuse is the type of maltreatment most related to suicidal ideation and attempts, although all forms of maltreatment increase these behaviours. In addition to increasing suicidal behaviour, maltreatment is associated with the development of mental and behavioural disorders. Prevention and early intervention to protect children and reduce risk behaviours is therefore essential, as is research to better understand the mechanisms linking child maltreatment and harmful behaviours and to develop new treatment strategies.
Direction
TORRES IGLESIAS, ANGELA JUANA (Tutorships)
NUÑEZ ARIAS, DANIEL (Co-tutorships)
TORRES IGLESIAS, ANGELA JUANA (Tutorships)
NUÑEZ ARIAS, DANIEL (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Open-label, multicenter, retrospective study about the use of alemtuzumab in relapsing-remitting multiple sclerosis in real-world clinical practice. A 4-year follow up.
Authorship
P.G.A.
Bachelor of Medicine
P.G.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: the efficacy and safety of alemtuzumab in patients with relapsing-remitting multiple sclerosis (RRMS) was demonstrated in clinical trials. However, due to the limitations of these trials, it is important to test how it performs in a long-term real-world setting. Objective: to describe the effectiveness of alemtuzumab measured in number of annual flares in real clinical practice in patients with multiple sclerosis. As secondary objectives we assessed effectiveness on disability status and neuroimaging tests, as well as tolerability, safety and risk of immunosuppression. Material and methods: an open multicentre retrospective study was carried out for which the clinical records of patients who received treatment with alemtuzumab for RRMS were reviewed. Results: a total of 32 patients were included in the study at the beginning of the 4-year follow-up. The mean number of annual relapses remained below 0.35 versus 1.25 relapses per year before treatment. Disability as measured by the EDSS scale improved during the first and second year and remained stable thereafter. A decrease in disease activity was observed by imaging tests. Adverse effects and immunosuppression were also observed in line with other routine clinical practice studies, with a retention rate of 87.5%. Conclusions: alemtuzumab has been shown to be effective in real-world setting in patients with multiple sclerosis reducing the number of annual relapses, improving the degree of disability measured by the EDSS scale, controlling and decreasing cranial magnetic resonance activity and controlling the different parameters of the NEDA (No Evidence of Disease Activity) concept. It also has a high persistence rate and an adequate tolerability and safety profile, although with a risk of immunosuppression, requiring prevention and control measures.
Introduction: the efficacy and safety of alemtuzumab in patients with relapsing-remitting multiple sclerosis (RRMS) was demonstrated in clinical trials. However, due to the limitations of these trials, it is important to test how it performs in a long-term real-world setting. Objective: to describe the effectiveness of alemtuzumab measured in number of annual flares in real clinical practice in patients with multiple sclerosis. As secondary objectives we assessed effectiveness on disability status and neuroimaging tests, as well as tolerability, safety and risk of immunosuppression. Material and methods: an open multicentre retrospective study was carried out for which the clinical records of patients who received treatment with alemtuzumab for RRMS were reviewed. Results: a total of 32 patients were included in the study at the beginning of the 4-year follow-up. The mean number of annual relapses remained below 0.35 versus 1.25 relapses per year before treatment. Disability as measured by the EDSS scale improved during the first and second year and remained stable thereafter. A decrease in disease activity was observed by imaging tests. Adverse effects and immunosuppression were also observed in line with other routine clinical practice studies, with a retention rate of 87.5%. Conclusions: alemtuzumab has been shown to be effective in real-world setting in patients with multiple sclerosis reducing the number of annual relapses, improving the degree of disability measured by the EDSS scale, controlling and decreasing cranial magnetic resonance activity and controlling the different parameters of the NEDA (No Evidence of Disease Activity) concept. It also has a high persistence rate and an adequate tolerability and safety profile, although with a risk of immunosuppression, requiring prevention and control measures.
Direction
LEIRA MUIÑO, ROGELIO MANUEL (Tutorships)
Pato Pato, Antonio (Co-tutorships)
LEIRA MUIÑO, ROGELIO MANUEL (Tutorships)
Pato Pato, Antonio (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Psilocybin’s role in the treatment of Major Depression Disorder
Authorship
G.M.G.L.
Bachelor of Medicine
G.M.G.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Major depressive disorder, MDD, is, today, one of the diseases that most contributes to the global disease burden. Additionally, it is characterized by high levels of recurrence and treatment resistance. These premises lead to the conclusion that new forms of treatment are necessary for this disorder. With the emergence of a new wave in psychiatric research, multiple trials are emerging on the capacity of psychedelic compounds to address depressive conditions. Among these compounds, psilocybin assumes a central role. It is necessary to deepen the understanding of the potential of psilocybin in the treatment of major depression. For these reasons, this work aims to synthesize the existing scientific evidence on the use of psilocybin as a treatment for major depressive disorder, not exclusively treatment-resistant. Additionally, it aims to describe the results of the comparison between psilocybin and escitalopram treatment and the action of psilocybin on anxiety symptoms, suicidal ideation, and disability associated with MDD. Finally, it aims to describe the tolerance and adverse effects of psilocybin. To carry out this review, a search was conducted through the PubMed, Scopus, and Cochrane databases. Experimental studies published within the last 10 years on the use of psilocybin in patients with major depressive disorder were collected, using inclusion and exclusion criteria. Five trials on the use of psilocybin in the treatment of MDD were obtained. These show significant antidepressant effects compared to placebo, and one trial showed rapid antidepressant action compared to delayed treatment. Compared to escitalopram, psilocybin did not show therapeutic superiority. The trial results indicate that psilocybin reduces depressive symptoms, improves anxiety and mental well-being associated with MDD, and has good tolerability without severe adverse effects.
Major depressive disorder, MDD, is, today, one of the diseases that most contributes to the global disease burden. Additionally, it is characterized by high levels of recurrence and treatment resistance. These premises lead to the conclusion that new forms of treatment are necessary for this disorder. With the emergence of a new wave in psychiatric research, multiple trials are emerging on the capacity of psychedelic compounds to address depressive conditions. Among these compounds, psilocybin assumes a central role. It is necessary to deepen the understanding of the potential of psilocybin in the treatment of major depression. For these reasons, this work aims to synthesize the existing scientific evidence on the use of psilocybin as a treatment for major depressive disorder, not exclusively treatment-resistant. Additionally, it aims to describe the results of the comparison between psilocybin and escitalopram treatment and the action of psilocybin on anxiety symptoms, suicidal ideation, and disability associated with MDD. Finally, it aims to describe the tolerance and adverse effects of psilocybin. To carry out this review, a search was conducted through the PubMed, Scopus, and Cochrane databases. Experimental studies published within the last 10 years on the use of psilocybin in patients with major depressive disorder were collected, using inclusion and exclusion criteria. Five trials on the use of psilocybin in the treatment of MDD were obtained. These show significant antidepressant effects compared to placebo, and one trial showed rapid antidepressant action compared to delayed treatment. Compared to escitalopram, psilocybin did not show therapeutic superiority. The trial results indicate that psilocybin reduces depressive symptoms, improves anxiety and mental well-being associated with MDD, and has good tolerability without severe adverse effects.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Campos Pérez, José Antonio (Co-tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Campos Pérez, José Antonio (Co-tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Mobil clinic in Ethiopia: Program proposal.
Authorship
C.G.F.
Bachelor of Medicine
C.G.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
This work proposes a project to create a mobile health clinic in a rural village in Ethiopia. First, it will focus on the hygienic situation in which the population lives, addressing how these problems can be solved through educational means and even training families or workers to implement health education. It is also important to understand the most prevalent diseases, as well as their diagnosis, prevention, clinical features, and treatment, since most studies are focused on Caucasian individuals and racialized people are often forgotten and not fully represented. Finally, it is vital to create a transversal project that considers all the aforementioned aspects and also takes into account the local socio-cultural factors, integrating fully into the society.
This work proposes a project to create a mobile health clinic in a rural village in Ethiopia. First, it will focus on the hygienic situation in which the population lives, addressing how these problems can be solved through educational means and even training families or workers to implement health education. It is also important to understand the most prevalent diseases, as well as their diagnosis, prevention, clinical features, and treatment, since most studies are focused on Caucasian individuals and racialized people are often forgotten and not fully represented. Finally, it is vital to create a transversal project that considers all the aforementioned aspects and also takes into account the local socio-cultural factors, integrating fully into the society.
Direction
Antela López, Antonio Rafael (Tutorships)
Antela López, Antonio Rafael (Tutorships)
Court
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
Fernández González, Angel Luis (Chairman)
GARCIA CAMPOS, JUAN (Secretary)
RELOVA QUINTEIRO, JOSE LUIS (Member)
“Effect of morbidity and mortality of Inflammatory bowel disease in pregnancy”
Authorship
A.M.R.
Bachelor of Medicine
A.M.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
In recent decades there has been a significant increase in the diagnosis of the two forms of Inflammatory Bowel Disease (IBD): Ulcerative Colitis (UC) and Crohn's Disease (CD). As a result, it is increasingly common to see people diagnosed with IBD who are planning a pregnancy and often express fears about whether the disease or its treatment may affect the foetus or the course of pregnancy and delivery. Introduction: Ulcerative colitis and Crohn's disease are the clinical forms of presentation of inflammatory bowel disease. Diagnosis is based on a combination of clinical, analytical, endoscopic and/or radiological findings. It is an entity of unknown cause, characterised by inflammatory lesions in the wall of the gastrointestinal tract. Its behaviour is chronic and recurrent and it is usually diagnosed at reproductive age. At present, most patients diagnosed with IBD can have successful pregnancies, and planning and close collaboration between gastroenterologists and obstetricians specialised in high-risk pregnancies is recommended. Strict control of the disease is necessary from the preconception stage, reviewing the treatments being taken and changes and/or adjustments may be necessary depending on the evolution of the disease. Regarding the route of delivery, vaginal delivery may be possible, as well as breastfeeding. However, in cases of active disease or some type of digestive complication, a caesarean section may be necessary. Objectives: To analyze in depth the morbimortality that both forms of IBD have on the course of gestation, from the beginning of gestation planning to postpartum. Material and methods: An exhaustive search of the bibliography of the medical literature will be carried out through Pubmed and Scopus search engines, including several publications on IBD and pregnancy. Results: According to the selection criteria previously set, a systematic review of the available articles has been carried out for the evaluation of the risks that having been diagnosed with IBD may entail before, during and after pregnancy. Conclusions: After reviewing the scientific literature found so far, it can be concluded that pregnancy can be carried out safely and with few risks for both the mother and the foetus, by carrying out an adequate preconception preparation, modifying medication when necessary and carrying out a joint follow-up between obstetricians and digestive specialists.
In recent decades there has been a significant increase in the diagnosis of the two forms of Inflammatory Bowel Disease (IBD): Ulcerative Colitis (UC) and Crohn's Disease (CD). As a result, it is increasingly common to see people diagnosed with IBD who are planning a pregnancy and often express fears about whether the disease or its treatment may affect the foetus or the course of pregnancy and delivery. Introduction: Ulcerative colitis and Crohn's disease are the clinical forms of presentation of inflammatory bowel disease. Diagnosis is based on a combination of clinical, analytical, endoscopic and/or radiological findings. It is an entity of unknown cause, characterised by inflammatory lesions in the wall of the gastrointestinal tract. Its behaviour is chronic and recurrent and it is usually diagnosed at reproductive age. At present, most patients diagnosed with IBD can have successful pregnancies, and planning and close collaboration between gastroenterologists and obstetricians specialised in high-risk pregnancies is recommended. Strict control of the disease is necessary from the preconception stage, reviewing the treatments being taken and changes and/or adjustments may be necessary depending on the evolution of the disease. Regarding the route of delivery, vaginal delivery may be possible, as well as breastfeeding. However, in cases of active disease or some type of digestive complication, a caesarean section may be necessary. Objectives: To analyze in depth the morbimortality that both forms of IBD have on the course of gestation, from the beginning of gestation planning to postpartum. Material and methods: An exhaustive search of the bibliography of the medical literature will be carried out through Pubmed and Scopus search engines, including several publications on IBD and pregnancy. Results: According to the selection criteria previously set, a systematic review of the available articles has been carried out for the evaluation of the risks that having been diagnosed with IBD may entail before, during and after pregnancy. Conclusions: After reviewing the scientific literature found so far, it can be concluded that pregnancy can be carried out safely and with few risks for both the mother and the foetus, by carrying out an adequate preconception preparation, modifying medication when necessary and carrying out a joint follow-up between obstetricians and digestive specialists.
Direction
AGUILAR BLANCO, MARIA FE (Tutorships)
Pardo Pumar, María Isabel (Co-tutorships)
AGUILAR BLANCO, MARIA FE (Tutorships)
Pardo Pumar, María Isabel (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Review of Therapeutic Management in Neonatal Seizures: Improvement with New Treatments?
Authorship
P.M.M.
Bachelor of Medicine
P.M.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction Due to the neurological immaturity of newborns, neonatal seizures (NS) are a common condition at this stage of life. They can affect neurodevelopment, having long-term repercussions. Early diagnosis and treatment are of vital importance. Objectives The objective is to assess whether there have been changes in the treatment of neonatal seizures in recent years. Methodology This review includes articles published from January 2015 to January 2024 that addressed the topic of neonatal seizure treatment. To achieve this, a search was conducted in the PubMed database following the PRISMA statement, with inclusion and exclusion criteria previously established using the PICOs system. Results A total of 18 articles were included in the systematic review out of 124 evaluated. In recent years, the superiority of levetiracetam over phenobarbital as a first-line antiepileptic treatment for NS has been studied, yielding contradictory results among various articles. The efficacy of midazolam and lidocaine in treating NS, both individually and when administered together, was demonstrated. Hydrocortisone also proved effective in treating three cases with refractory seizures. The use of protocols for treating neonatal seizures showed improvement in short-term outcomes. Conclusions Phenobarbital is the most commonly used drug for the treatment of NS, but studies are beginning to explore whether levetiracetam could replace it in the future. More studies on the treatment of neonatal seizures are needed, as there is currently insufficient evidence.
Introduction Due to the neurological immaturity of newborns, neonatal seizures (NS) are a common condition at this stage of life. They can affect neurodevelopment, having long-term repercussions. Early diagnosis and treatment are of vital importance. Objectives The objective is to assess whether there have been changes in the treatment of neonatal seizures in recent years. Methodology This review includes articles published from January 2015 to January 2024 that addressed the topic of neonatal seizure treatment. To achieve this, a search was conducted in the PubMed database following the PRISMA statement, with inclusion and exclusion criteria previously established using the PICOs system. Results A total of 18 articles were included in the systematic review out of 124 evaluated. In recent years, the superiority of levetiracetam over phenobarbital as a first-line antiepileptic treatment for NS has been studied, yielding contradictory results among various articles. The efficacy of midazolam and lidocaine in treating NS, both individually and when administered together, was demonstrated. Hydrocortisone also proved effective in treating three cases with refractory seizures. The use of protocols for treating neonatal seizures showed improvement in short-term outcomes. Conclusions Phenobarbital is the most commonly used drug for the treatment of NS, but studies are beginning to explore whether levetiracetam could replace it in the future. More studies on the treatment of neonatal seizures are needed, as there is currently insufficient evidence.
Direction
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Monteagudo Vilavedra, Einés (Co-tutorships)
COUCE PICO, MARIA DE LA LUZ (Tutorships)
Monteagudo Vilavedra, Einés (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Patient Reported Outcomes (PROs): its use on HIV infection and long-acting antiretroviral therapy.
Authorship
M.M.N.
Bachelor of Medicine
M.M.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The Patient Reported Outcomes (PROs), based on direct information collected from patients without interpretation by the physician, encompass their health status, quality of life and other relevant aspects for their well-being. In HIV patients, PROs can offer valuable insights into the disease’s impact and its treatment on daily life, as well as aid in identifying areas for improvement in their medical care. Objectives: As the primary objective, to review the current evidence on the utility of measuring PROs in the care of people living with HIV. As a secondary target, to present the results obtained from the questionnaires used by patients included in a long-term antiretroviral therapy clinical trial, both the overall study results and those of patients in the Infectious Diseases Unit of the University Clinical Hospital of Santiago de Compostela (CHUS), in order to ascertain the similarities and disparities in these responses. Methodology:The evidence regarding the utility of PROs in assessing treatments for people living with HIV, especially long-term treatments (Long-Acting Therapy: “LAT”), and the progression of these people, regardless of the treatment they receive, is reviewed. Additionally, the responses provided by patients in the ATLAS and ATLAS 2-M trials to ad hoc questionnaires are examined, along with those from our cohort of 11 patients from the University Clinical Hospital of Santiago de Compostela. Results:A total of 5 articles were analyzed. The reliability of four of them was reinforced by being randomized clinical trials, which support the use of Patient Reported Outcomes as a strategy to improve treatment adherence. Meanwhile, a systematic review supports the use of technologies to uphold this adherence strategy. Furthermore, our study group has demonstrated that perceptions show no substantial variance compared to the remaining outcomes. Conclusions:Patient Reported Outcomes (PROs) can provide us relevant information regarding treatment adherence, satisfaction with the process and the quality of life of our patients. However, the validation of these questionnaires and their systematic application are required to integrate them more reliably across various Medicine fields.
Introduction: The Patient Reported Outcomes (PROs), based on direct information collected from patients without interpretation by the physician, encompass their health status, quality of life and other relevant aspects for their well-being. In HIV patients, PROs can offer valuable insights into the disease’s impact and its treatment on daily life, as well as aid in identifying areas for improvement in their medical care. Objectives: As the primary objective, to review the current evidence on the utility of measuring PROs in the care of people living with HIV. As a secondary target, to present the results obtained from the questionnaires used by patients included in a long-term antiretroviral therapy clinical trial, both the overall study results and those of patients in the Infectious Diseases Unit of the University Clinical Hospital of Santiago de Compostela (CHUS), in order to ascertain the similarities and disparities in these responses. Methodology:The evidence regarding the utility of PROs in assessing treatments for people living with HIV, especially long-term treatments (Long-Acting Therapy: “LAT”), and the progression of these people, regardless of the treatment they receive, is reviewed. Additionally, the responses provided by patients in the ATLAS and ATLAS 2-M trials to ad hoc questionnaires are examined, along with those from our cohort of 11 patients from the University Clinical Hospital of Santiago de Compostela. Results:A total of 5 articles were analyzed. The reliability of four of them was reinforced by being randomized clinical trials, which support the use of Patient Reported Outcomes as a strategy to improve treatment adherence. Meanwhile, a systematic review supports the use of technologies to uphold this adherence strategy. Furthermore, our study group has demonstrated that perceptions show no substantial variance compared to the remaining outcomes. Conclusions:Patient Reported Outcomes (PROs) can provide us relevant information regarding treatment adherence, satisfaction with the process and the quality of life of our patients. However, the validation of these questionnaires and their systematic application are required to integrate them more reliably across various Medicine fields.
Direction
Antela López, Antonio Rafael (Tutorships)
Antela López, Antonio Rafael (Tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Systematic review of the management of hidradenitis suppurativa
Authorship
S.M.B.
Bachelor of Medicine
S.M.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Hidradenitis suppurativa, also known as inverse acne or Verneuil's disease, is a chronic condition that causes recurrent inflammation of the hair follicles in intertriginous areas such as the armpits, groin region, and anogenital area. Its multifactorial origin, involving both genetic factors and physiological processes, is not yet fully understood. The therapeutic management of this condition remains an active area of research due to its refractory nature and its tendency to become a chronic condition. Objectives: To conduct a comprehensive literature review to evaluate the evidence related to the various therapeutic modalities used to date in the management of hidradenitis suppurativa, considering its etiology and pathogenesis, with the aim of establishing an evidence-based therapeutic protocol. Materials and methos: A comprehensive review of the scientific literature on the treatment of hidradenitis suppurativa was conducted using the PUBMED database, considering articles published between January 2020 and December 2023. Studies written in English, with available abstracts, and providing relevant information for the clinical management of the disease were included. Studies using non-human samples, systematic reviews that were not meta-analyses, individual cases, and short case series, phase I clinical trials, single-case studies, as well as books and manuals were excluded. Additionally, duplicate works or updates from the same author, and articles involving a population of fewer than 10 patients were also excluded. Results: A total of 20 articles were included in the study, distributed in such a way that 10 of them addressed the use of biologic drugs, 3 focused on antibiotic therapy, another 3 explored laser therapies. The remaining 4 dealt with studies on dapsone, botulinum toxin, surgery, and intralesional corticosteroids. These studies provided us with relevant information on the treatment of hidradenitis suppurativa, allowing us to draw valuable conclusions for standardizing the management of this disease. Conclusions: After an updated and detailed review of the different treatments for hidradenitis suppurativa, we conclude that there is a wide variety of therapeutic approaches, for which there is no well-reported guideline. Therefore, the importance of future additional research, especially controlled and randomized clinical trials, is highlighted to help clarify the pathogenesis of the disease and establish standardized treatment protocols based on this.
Introduction: Hidradenitis suppurativa, also known as inverse acne or Verneuil's disease, is a chronic condition that causes recurrent inflammation of the hair follicles in intertriginous areas such as the armpits, groin region, and anogenital area. Its multifactorial origin, involving both genetic factors and physiological processes, is not yet fully understood. The therapeutic management of this condition remains an active area of research due to its refractory nature and its tendency to become a chronic condition. Objectives: To conduct a comprehensive literature review to evaluate the evidence related to the various therapeutic modalities used to date in the management of hidradenitis suppurativa, considering its etiology and pathogenesis, with the aim of establishing an evidence-based therapeutic protocol. Materials and methos: A comprehensive review of the scientific literature on the treatment of hidradenitis suppurativa was conducted using the PUBMED database, considering articles published between January 2020 and December 2023. Studies written in English, with available abstracts, and providing relevant information for the clinical management of the disease were included. Studies using non-human samples, systematic reviews that were not meta-analyses, individual cases, and short case series, phase I clinical trials, single-case studies, as well as books and manuals were excluded. Additionally, duplicate works or updates from the same author, and articles involving a population of fewer than 10 patients were also excluded. Results: A total of 20 articles were included in the study, distributed in such a way that 10 of them addressed the use of biologic drugs, 3 focused on antibiotic therapy, another 3 explored laser therapies. The remaining 4 dealt with studies on dapsone, botulinum toxin, surgery, and intralesional corticosteroids. These studies provided us with relevant information on the treatment of hidradenitis suppurativa, allowing us to draw valuable conclusions for standardizing the management of this disease. Conclusions: After an updated and detailed review of the different treatments for hidradenitis suppurativa, we conclude that there is a wide variety of therapeutic approaches, for which there is no well-reported guideline. Therefore, the importance of future additional research, especially controlled and randomized clinical trials, is highlighted to help clarify the pathogenesis of the disease and establish standardized treatment protocols based on this.
Direction
PEREIRO FERREIROS, MANUEL (Tutorships)
PEREIRO FERREIROS, MANUEL (Tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Impact of the Night of San Juan on the Burns Unit of the CHUAC
Authorship
M.M.O.
Bachelor of Medicine
M.M.O.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Burns are injuries to the skin and underlying tissues caused by various agents, the severity of which depends on several factors. Due to the complexities in the treatment and the multiple organic repercussions they produce, they require a multidisciplinary approach, with Burn Units specialized in the specific treatment of burn patients, one of them being in the Hospital Complex of A Coruña. The night of San Juan, celebrated on June 23, is a popular festivity in Galicia, which consists of lighting bonfires to mark the summer solstice, so it is intimately linked to an inherent risk of burn injuries. A retrospective observational-analytical study was carried out, with the aim of studying the care load of the CHUAC Burn Unit during these festivities from 2018 to 2022, identifying the most affected population group, the type of burns, creating a patient profile to focus prevention campaigns and analyzing the impact of the COVID-19 pandemic. The data were obtained from 54 patients burned between June 22, 23 and 24 of those years. Of these, 16 were women (29.6%) and 38 men (70.4%), with a mean age of 38 years and mostly from the province of A Coruña (81.5%). Most of the burns occurred in the area of bonfires (66.7%) and were caused by flames (55.6%). 2nd degree burns were the most common (83%), affecting an average of 4.4% of the body surface, especially in the upper limbs (42.6%). The year with the most burns was 2018 (46.3%). Subsequently, the sample was separated into two groups defined by: directly related to the holiday or not, comparing their variables with each other. In conclusion, in our study we observed an increase in the burden of care due to the festivities of San Juan, mainly affecting men between 30 and 39 years of age in A Coruña. The COVID- 19 pandemic led to a reduction in burns treated at the Unit between 2020 and 2021.
Burns are injuries to the skin and underlying tissues caused by various agents, the severity of which depends on several factors. Due to the complexities in the treatment and the multiple organic repercussions they produce, they require a multidisciplinary approach, with Burn Units specialized in the specific treatment of burn patients, one of them being in the Hospital Complex of A Coruña. The night of San Juan, celebrated on June 23, is a popular festivity in Galicia, which consists of lighting bonfires to mark the summer solstice, so it is intimately linked to an inherent risk of burn injuries. A retrospective observational-analytical study was carried out, with the aim of studying the care load of the CHUAC Burn Unit during these festivities from 2018 to 2022, identifying the most affected population group, the type of burns, creating a patient profile to focus prevention campaigns and analyzing the impact of the COVID-19 pandemic. The data were obtained from 54 patients burned between June 22, 23 and 24 of those years. Of these, 16 were women (29.6%) and 38 men (70.4%), with a mean age of 38 years and mostly from the province of A Coruña (81.5%). Most of the burns occurred in the area of bonfires (66.7%) and were caused by flames (55.6%). 2nd degree burns were the most common (83%), affecting an average of 4.4% of the body surface, especially in the upper limbs (42.6%). The year with the most burns was 2018 (46.3%). Subsequently, the sample was separated into two groups defined by: directly related to the holiday or not, comparing their variables with each other. In conclusion, in our study we observed an increase in the burden of care due to the festivities of San Juan, mainly affecting men between 30 and 39 years of age in A Coruña. The COVID- 19 pandemic led to a reduction in burns treated at the Unit between 2020 and 2021.
Direction
BREA GARCIA, BEATRIZ (Tutorships)
Fernández Quinto, Alejandro (Co-tutorships)
BREA GARCIA, BEATRIZ (Tutorships)
Fernández Quinto, Alejandro (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Systematic review of ovarian rejuvenation therapies.
Authorship
A.M.R.
Bachelor of Medicine
A.M.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Since their appearance, assisted reproduction treatments have achieved favourable results in women with infertility around the world. However, in patients with poor ovarian response (POR) and premature ovarian insufficiency (POI), usual therapies such as ovarian stimulation and in vitro fertilization have limited success. In response to this situation, in recent year one of the main axes of research in the field of fertility has been ovarian rejuvenation. Ovarian rejuvenation therapies focus on the use of ovarian fragmentation, stem cells, platelet-rich plasma, in vitro follicular culture or mitochondrial transfer. Cryopreservation and ovarian tissue transplantation are also presented as an interesting option to preserve fertility and prevent ovarian damage in cancer patients undergoing chemotherapy. The purpose of this review is to analyze the scientific evidence available behind these experimental reproductive techniques and their possible use to date in clinical studies for the treatment of POR, POI and DOR.
Since their appearance, assisted reproduction treatments have achieved favourable results in women with infertility around the world. However, in patients with poor ovarian response (POR) and premature ovarian insufficiency (POI), usual therapies such as ovarian stimulation and in vitro fertilization have limited success. In response to this situation, in recent year one of the main axes of research in the field of fertility has been ovarian rejuvenation. Ovarian rejuvenation therapies focus on the use of ovarian fragmentation, stem cells, platelet-rich plasma, in vitro follicular culture or mitochondrial transfer. Cryopreservation and ovarian tissue transplantation are also presented as an interesting option to preserve fertility and prevent ovarian damage in cancer patients undergoing chemotherapy. The purpose of this review is to analyze the scientific evidence available behind these experimental reproductive techniques and their possible use to date in clinical studies for the treatment of POR, POI and DOR.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Vilar Lagares, Ana (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Vilar Lagares, Ana (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Implications of the sFlt-1:PlGF ratio in the diagnosis and prognosis of Intrauterine Growth Restriction: a systematic review.
Authorship
B.M.P.
Bachelor of Medicine
B.M.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Placental markers related to vasculogenesis have gained increasing importance as diagnostic and prognostic tools in preeclampsia, specifically a ratio between an antiangiogenic factor and a proangiogenic one: sFlt-1:PlGF. sFlt-1 is a molecule that antagonizes the proangiogenic effect of PlGF, hence the ratio is higher in pathologies related to placental ischemia, such as preeclampsia or Intrauterine Growth Restriction (IUGR). Since both conditions share a pathophysiological basis related to improper vascular development, the hypothesis of this systematic review is the potential application of studying the sFlt-1:PlGF ratio to diagnose and predict adverse outcomes in IUGR, as has been demonstrated for preeclampsia. The reviewed studies showed that elevated sFlt-1:PlGF values allowed the prediction of adverse outcomes in pregnancies with established IUGR, such as preterm birth, perinatal death, or neonatal pathologies. In women with risk factors for IUGR, an elevation of placental markers was observed prior to the diagnosis of intrauterine growth restriction. Additionally, a relationship was observed between the elevation of these markers and clinical severity and precocity of the diagnosis. In conclusion, the available evidence suggests that the sFlt-1:PlGF ratio may have utility for early diagnosis, monitoring, and prognosis of IUGR.
Placental markers related to vasculogenesis have gained increasing importance as diagnostic and prognostic tools in preeclampsia, specifically a ratio between an antiangiogenic factor and a proangiogenic one: sFlt-1:PlGF. sFlt-1 is a molecule that antagonizes the proangiogenic effect of PlGF, hence the ratio is higher in pathologies related to placental ischemia, such as preeclampsia or Intrauterine Growth Restriction (IUGR). Since both conditions share a pathophysiological basis related to improper vascular development, the hypothesis of this systematic review is the potential application of studying the sFlt-1:PlGF ratio to diagnose and predict adverse outcomes in IUGR, as has been demonstrated for preeclampsia. The reviewed studies showed that elevated sFlt-1:PlGF values allowed the prediction of adverse outcomes in pregnancies with established IUGR, such as preterm birth, perinatal death, or neonatal pathologies. In women with risk factors for IUGR, an elevation of placental markers was observed prior to the diagnosis of intrauterine growth restriction. Additionally, a relationship was observed between the elevation of these markers and clinical severity and precocity of the diagnosis. In conclusion, the available evidence suggests that the sFlt-1:PlGF ratio may have utility for early diagnosis, monitoring, and prognosis of IUGR.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Sánchez-Andrade Santiso, Mariña (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Sánchez-Andrade Santiso, Mariña (Co-tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Comprehensive assessment of burnout syndrome in hospital staff: influence of lifestyle and search for new diagnostic tools
Authorship
M.M.P.
Bachelor of Medicine
M.M.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: burnout syndrome (BS) represents chronic stress derived from work, characterized by high emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA). It has a special implication in the scientific-health field, with negative consequences for the worker, the company, and the patient. Objective: evaluation of BS in hospital staff and search for new parameters that may help in its identification. Methods: we conducted a cross-sectional analytical study through a telematic survey, self-administered and in Spanish. It was directed to healthcare personnel (HP), university students (US), and researchers (R) from the Complexo Hospitalario Universitario de Santiago (N=884, 75.11% female). The questionnaire included the MBI (Maslach Burnout Inventory), factors related to lifestyle and work conditions, self-perception scales, and demographic factors. Results: we demonstrated a high prevalence of BS in HP (38.41%), US (41.67%), and R (57.72%). The presence of this syndrome was shown to be associated with age (PR=1.65), marital status (PR=1.80), suicidal ideation (PR=1.70), psychiatric history (PR=1.50), workplace aggression (PR=1.80), job position (PR=1.80), and experience (PR=1.75). Self-perception-based scales appear to correlate with the corresponding MBI scores in terms of EE (rho=0.7130), DP (rho=0.4380), and PA (rho=0.4610). The AP-SDO-3p tool showed results consistent with its use for BS diagnosis (AUC=0.8155; Se=76.70%, Sp=73.90%, PPV=70.80%, NPV=78.60%, LR+=3.00, LR-=0.32), while the AP-SDO proved useful for syndrome screening (AUC=0.7475; Se=85.40%, NPV=81.30%), although both showed the best results in the healthcare and researcher cohorts. Conclusion: Due to the high burden of burnout in hospital staff, this biopsychosocial study suggests that the combination of factors related to BS and self-perception-based tools may lead to early diagnosis of the syndrome. Its simple application in routine clinical practice could lead to a reduction in related morbidity and mortality, with a positive cost-benefit balance.
Introduction: burnout syndrome (BS) represents chronic stress derived from work, characterized by high emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA). It has a special implication in the scientific-health field, with negative consequences for the worker, the company, and the patient. Objective: evaluation of BS in hospital staff and search for new parameters that may help in its identification. Methods: we conducted a cross-sectional analytical study through a telematic survey, self-administered and in Spanish. It was directed to healthcare personnel (HP), university students (US), and researchers (R) from the Complexo Hospitalario Universitario de Santiago (N=884, 75.11% female). The questionnaire included the MBI (Maslach Burnout Inventory), factors related to lifestyle and work conditions, self-perception scales, and demographic factors. Results: we demonstrated a high prevalence of BS in HP (38.41%), US (41.67%), and R (57.72%). The presence of this syndrome was shown to be associated with age (PR=1.65), marital status (PR=1.80), suicidal ideation (PR=1.70), psychiatric history (PR=1.50), workplace aggression (PR=1.80), job position (PR=1.80), and experience (PR=1.75). Self-perception-based scales appear to correlate with the corresponding MBI scores in terms of EE (rho=0.7130), DP (rho=0.4380), and PA (rho=0.4610). The AP-SDO-3p tool showed results consistent with its use for BS diagnosis (AUC=0.8155; Se=76.70%, Sp=73.90%, PPV=70.80%, NPV=78.60%, LR+=3.00, LR-=0.32), while the AP-SDO proved useful for syndrome screening (AUC=0.7475; Se=85.40%, NPV=81.30%), although both showed the best results in the healthcare and researcher cohorts. Conclusion: Due to the high burden of burnout in hospital staff, this biopsychosocial study suggests that the combination of factors related to BS and self-perception-based tools may lead to early diagnosis of the syndrome. Its simple application in routine clinical practice could lead to a reduction in related morbidity and mortality, with a positive cost-benefit balance.
Direction
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
VICENTE ALBA, FRANCISCO JAVIER (Tutorships)
Court
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
CUEVAS ALVAREZ, JUAN BAUTISTA (Chairman)
Rodriguez Garcia, Javier (Secretary)
SOBRINO NOGUEIRA, ADOLFO (Member)
Gastroesophageal reflux disease refractory to proton pump inhibitors. Can baclofen be useful?
Authorship
P.S.T.
Bachelor of Medicine
P.S.T.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Gastroesophageal reflux disease (GERD) is a chronic disorder highly prevalent in medical consultations, resulting from the flow of gastric contents into the esophagus. The lower esophageal sphincter is the structure most often involved in its pathophysiology. It is diagnosed clinically, with instrumental diagnostic testing, such as multichannel intraluminal impedance-pHmetry (MII-pH), being necessary in some instances. Treatment includes different options: lifestyle changes, drugs and surgical procedures; with PPIs being the first-line treatment. However, there is no evidence to support recommendations for second-line treatment: doubling PPI dose, prokinetics, surgery and gamma-aminobutyric acid type B (GABA-B) agonists. Between these, because of its mechanism of action, baclofen arises as a good option in some studies. OBJECTIVES: To analyse scientific evidence on the benefit and safety of baclofen in the clinical remission of GERD and the capacity of this drug to induce changes in different parameters assessed by pH-metry and/or manometry. METHODS: A systematic review of the literature was performed, searching in Medline and Cochrane Library. Clinical trials and observational studies, published from 2003 to 2023, in Spanish and English languages, that evaluated the use of baclofen in GERD, were analysed. Twelve studies that met inclusion and exclusion criteria were included. RESULTS: All articles but one showed improvement in clinical features and in the number of reflux episodes. Side effects were common, with incidence in around 20% of participants, but they were mainly mild reactions, causing only 5% of dropouts. The use of MII-pH enables the selection of a group of patients with nonacid reflux, in which, this drug turns out to be more effective. CONCLUSIONS: Baclofen is effective in GERD treatment and can be used as a complementary drug in patients with symptoms despite PPI treatment, especially in those that show a positive association between symptoms and nonacid reflux episodes assessed by MII- pH. Further research is needed to assess the dosing schedule and its use as maintenance therapy in the long term.
INTRODUCTION: Gastroesophageal reflux disease (GERD) is a chronic disorder highly prevalent in medical consultations, resulting from the flow of gastric contents into the esophagus. The lower esophageal sphincter is the structure most often involved in its pathophysiology. It is diagnosed clinically, with instrumental diagnostic testing, such as multichannel intraluminal impedance-pHmetry (MII-pH), being necessary in some instances. Treatment includes different options: lifestyle changes, drugs and surgical procedures; with PPIs being the first-line treatment. However, there is no evidence to support recommendations for second-line treatment: doubling PPI dose, prokinetics, surgery and gamma-aminobutyric acid type B (GABA-B) agonists. Between these, because of its mechanism of action, baclofen arises as a good option in some studies. OBJECTIVES: To analyse scientific evidence on the benefit and safety of baclofen in the clinical remission of GERD and the capacity of this drug to induce changes in different parameters assessed by pH-metry and/or manometry. METHODS: A systematic review of the literature was performed, searching in Medline and Cochrane Library. Clinical trials and observational studies, published from 2003 to 2023, in Spanish and English languages, that evaluated the use of baclofen in GERD, were analysed. Twelve studies that met inclusion and exclusion criteria were included. RESULTS: All articles but one showed improvement in clinical features and in the number of reflux episodes. Side effects were common, with incidence in around 20% of participants, but they were mainly mild reactions, causing only 5% of dropouts. The use of MII-pH enables the selection of a group of patients with nonacid reflux, in which, this drug turns out to be more effective. CONCLUSIONS: Baclofen is effective in GERD treatment and can be used as a complementary drug in patients with symptoms despite PPI treatment, especially in those that show a positive association between symptoms and nonacid reflux episodes assessed by MII- pH. Further research is needed to assess the dosing schedule and its use as maintenance therapy in the long term.
Direction
Hermida Ameijeiras, Álvaro (Tutorships)
Fernández Rial, José Álvaro (Co-tutorships)
Hermida Ameijeiras, Álvaro (Tutorships)
Fernández Rial, José Álvaro (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Liver involvement in ANCA-associated vasculitis patients: prevalence and prognostic value
Authorship
C.S.C.
Bachelor of Medicine
C.S.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Background Anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis are rare diseases that can target any organ. Liver involvement often goes unnoticed in clinical practice. However, it has been reported that elevated transaminases are associated with increased severity. We have not found any national series that studies this aspect. Objectives Retrospective observational study in order to determine the prevalence of elevated transaminases in patients with ANCA associated vasculitis (AAV) and evaluate its association with increased severity. Patients and methods Patients with AAV diagnosed in Internal Medicine from 09/01/2015 to 12/31/2023 were studied. Group 1 included those with normal transaminases before treatment; group 2 elevated. Clinical and analytical data, severity criteria and progression were collected. Also, whether or not transaminases normalized after six months of treatment. Results 34 patients were included with a mean age of 59 years (range 24-81 years), 17 were women (50%). Regarding the type of vasculitis, 17 (50%) had microscopic polyangiitis (MAP), 13 (38%) granulomatosis with polyangiitis, and 4 (12%) eosinophilic granulomatosis with polyangiitis. ANCA were positive in 82%. Group 2 included 16 patients (47%), of whom 11 (69%) had PAM. C-reactive protein was higher in group 2 (21 vs 6 mg/dL; p less than 0.01). Furthermore, patients in group 2 had a higher vasculitis severity index (BVAS) (25 points vs 17; p less than 0.05). Chronic renal failure during follow-up was more frequent in group 2 (8, 53% vs 4, 22%; p less than 0.05). Mortality was higher in group 2 than in group 1 (71% vs 29%; p less than 0.05). Conclusions Elevation of transaminases at vasculitis onset was associated with PAM subtype, increased severity and mortality in patients with AAV.
Background Anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis are rare diseases that can target any organ. Liver involvement often goes unnoticed in clinical practice. However, it has been reported that elevated transaminases are associated with increased severity. We have not found any national series that studies this aspect. Objectives Retrospective observational study in order to determine the prevalence of elevated transaminases in patients with ANCA associated vasculitis (AAV) and evaluate its association with increased severity. Patients and methods Patients with AAV diagnosed in Internal Medicine from 09/01/2015 to 12/31/2023 were studied. Group 1 included those with normal transaminases before treatment; group 2 elevated. Clinical and analytical data, severity criteria and progression were collected. Also, whether or not transaminases normalized after six months of treatment. Results 34 patients were included with a mean age of 59 years (range 24-81 years), 17 were women (50%). Regarding the type of vasculitis, 17 (50%) had microscopic polyangiitis (MAP), 13 (38%) granulomatosis with polyangiitis, and 4 (12%) eosinophilic granulomatosis with polyangiitis. ANCA were positive in 82%. Group 2 included 16 patients (47%), of whom 11 (69%) had PAM. C-reactive protein was higher in group 2 (21 vs 6 mg/dL; p less than 0.01). Furthermore, patients in group 2 had a higher vasculitis severity index (BVAS) (25 points vs 17; p less than 0.05). Chronic renal failure during follow-up was more frequent in group 2 (8, 53% vs 4, 22%; p less than 0.05). Mortality was higher in group 2 than in group 1 (71% vs 29%; p less than 0.05). Conclusions Elevation of transaminases at vasculitis onset was associated with PAM subtype, increased severity and mortality in patients with AAV.
Direction
SOPEÑA PEREZ-ARGÜELLES, BERNARDO (Tutorships)
FREIRE DAPENA, MARIA DEL CARMEN (Co-tutorships)
SOPEÑA PEREZ-ARGÜELLES, BERNARDO (Tutorships)
FREIRE DAPENA, MARIA DEL CARMEN (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Efficacy of surgical prophylaxis of gynecological cancer associated with Lynch syndrome
Authorship
A.S.G.
Bachelor of Medicine
A.S.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Lynch syndrome (LS) is a common, autosomal dominant, inherited cancer predisposition syndrome. It is present in approximately 1 in every 300 people. However, currently around 95% of people with LS are unaware of their diagnosis. Carriers have an increased risk of developing several types of cancer, the most closely associated being colorectal cancer and endometrial or ovarian cancer in women. Objectives: To conduct a systematic review to evaluate the effectiveness and possible benefits obtained from the main surgical interventions in preventing the development of gynecological cancer in patients with Lynch syndrome. Methodology: A search was performed in the PubMed Central and Scopus databases, selecting studies related to the effectiveness of gynecological prophylactic surgery in women with Lynch syndrome published between 2018 and 2023. Results: Of the 254 studies found, 15 were selected after applying the inclusion and exclusion criteria to finally include 7 studies in the review. Conclusions: Risk-reducing surgery is the most effective and cost-effective way to prevent endometrial or ovarian cancer in patients with Lynch syndrome. A multidisciplinary approach is necessary and considering the MMR pathogenic variant and the patient's age to offer care more adjusted to the individual risk of each patient.
Introduction: Lynch syndrome (LS) is a common, autosomal dominant, inherited cancer predisposition syndrome. It is present in approximately 1 in every 300 people. However, currently around 95% of people with LS are unaware of their diagnosis. Carriers have an increased risk of developing several types of cancer, the most closely associated being colorectal cancer and endometrial or ovarian cancer in women. Objectives: To conduct a systematic review to evaluate the effectiveness and possible benefits obtained from the main surgical interventions in preventing the development of gynecological cancer in patients with Lynch syndrome. Methodology: A search was performed in the PubMed Central and Scopus databases, selecting studies related to the effectiveness of gynecological prophylactic surgery in women with Lynch syndrome published between 2018 and 2023. Results: Of the 254 studies found, 15 were selected after applying the inclusion and exclusion criteria to finally include 7 studies in the review. Conclusions: Risk-reducing surgery is the most effective and cost-effective way to prevent endometrial or ovarian cancer in patients with Lynch syndrome. A multidisciplinary approach is necessary and considering the MMR pathogenic variant and the patient's age to offer care more adjusted to the individual risk of each patient.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Bobillo Varela, Carmen (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Bobillo Varela, Carmen (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Evaluation of the usefulness of OCTA in the early detection of type 3 macular neovascularization in patients with AMD: a case study in the Santiago area
Authorship
S.S.V.
Bachelor of Medicine
S.S.V.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Age-Related Macular Degeneration (AMD) is a chronic ocular condition affecting people over 50 years old, causing progressive loss of visual acuity. Traditionally, it is divided into neovascular (exudative) and dry (atrophic) forms. Within neovascular AMD (nAMD), type 3 macular neovascularization (MNV type 3) is one of the most severe subtypes due to the high incidence of bilaterality and progression to atrophic forms. Objective To evaluate the utility of optical coherence tomography angiography (OCTA) in the early detection of MNV type 3 through a multimodal analysis including OCT, fluorescein angiography (FA), and indocyanine green angiography (ICGA); and to analyze the concordance between the findings of the imaging techniques. Material and methodology A retrospective observational study was conducted on a series of patients (n = 36) diagnosed with MNV type 3 by the Ophthalmology Service of CHUS between 2017 and 2024, who were previously untreated and had undergone FA/ICGA, OCT, and OCTA. Contingency tables and correlation analysis were used to examine the concordance between techniques. Results and Discussion The profile of our patients was: female, age 78 years, Caucasian, with visual acuity of 67.14 ETDRS letters. A significant association was observed between the presence of PED and the staging classification of MNV type 3. OCTA showed high sensitivity (85.7%) in detecting early-stage MNV type 3 but lower specificity. ICGA was superior in advanced stages. Conclusions OCTA is a promising tool for the detection of early stage MNV type 3, although it needs to achieve greater specificity. The combination of multimodal imaging techniques improves the early diagnosis of the disease.
Age-Related Macular Degeneration (AMD) is a chronic ocular condition affecting people over 50 years old, causing progressive loss of visual acuity. Traditionally, it is divided into neovascular (exudative) and dry (atrophic) forms. Within neovascular AMD (nAMD), type 3 macular neovascularization (MNV type 3) is one of the most severe subtypes due to the high incidence of bilaterality and progression to atrophic forms. Objective To evaluate the utility of optical coherence tomography angiography (OCTA) in the early detection of MNV type 3 through a multimodal analysis including OCT, fluorescein angiography (FA), and indocyanine green angiography (ICGA); and to analyze the concordance between the findings of the imaging techniques. Material and methodology A retrospective observational study was conducted on a series of patients (n = 36) diagnosed with MNV type 3 by the Ophthalmology Service of CHUS between 2017 and 2024, who were previously untreated and had undergone FA/ICGA, OCT, and OCTA. Contingency tables and correlation analysis were used to examine the concordance between techniques. Results and Discussion The profile of our patients was: female, age 78 years, Caucasian, with visual acuity of 67.14 ETDRS letters. A significant association was observed between the presence of PED and the staging classification of MNV type 3. OCTA showed high sensitivity (85.7%) in detecting early-stage MNV type 3 but lower specificity. ICGA was superior in advanced stages. Conclusions OCTA is a promising tool for the detection of early stage MNV type 3, although it needs to achieve greater specificity. The combination of multimodal imaging techniques improves the early diagnosis of the disease.
Direction
FERNANDEZ RODRIGUEZ, MARIA ISABEL (Tutorships)
Almuiña Varela, Pablo (Co-tutorships)
FERNANDEZ RODRIGUEZ, MARIA ISABEL (Tutorships)
Almuiña Varela, Pablo (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Restart of oral anticoagulation after intracranial hemorrhage in patients with atrial fibrillation.
Authorship
R.S.A.
Bachelor of Medicine
R.S.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Atrial fibrillation is the most prevalent sustained cardiac arrhythmia, associated with a high risk of thromboembolic events. The current treatment to prevent these events is oral anticoagulants, which carry a risk of bleeding, the most feared being intracranial. Currently, evidence indicates favorable results towards restarting anticoagulation, especially if direct anticoagulants are used, and the optimal time to restart it after the acute phase of intracranial hemorrhage is unknown. Objectives: To evaluate the effect of restarting oral anticoagulants in patients with atrial fibrillation after suffering an intracranial hemorrhage on the incidence of mortality, embolisms, and recurrences of cranial bleeding. Methods: A retrospective cohort study was conducted in which 254 clinical histories were analyzed. After excluding patients who did not survive more than one month or who were treated with left atrial appendage closure, the final sample of 136 patients was obtained, which were divided into a cohort that restarted anticoagulant treatment (90) and another that did not (46). Results: The restart of oral anticoagulation was associated with lower mortality (14.2 vs 42.7 events per-100 person-years; p=0.003). There were no significant differences in the incidence of embolisms (2.9 vs 7.3; p=0.764) or recurrence of intracranial hemorrhages (1.9 vs 6.3; p=0.451). The cumulative incidence of events was lower in the anticoagulation restart group (HR 0.23; 95%CI 0.17-0.31; p0.001). Conclusion: The restart of oral anticoagulation after suffering an intracranial hemorrhage in patients with atrial fibrillation is associated with lower mortality and cumulative incidence of adverse effects compared to its suspension,
Introduction: Atrial fibrillation is the most prevalent sustained cardiac arrhythmia, associated with a high risk of thromboembolic events. The current treatment to prevent these events is oral anticoagulants, which carry a risk of bleeding, the most feared being intracranial. Currently, evidence indicates favorable results towards restarting anticoagulation, especially if direct anticoagulants are used, and the optimal time to restart it after the acute phase of intracranial hemorrhage is unknown. Objectives: To evaluate the effect of restarting oral anticoagulants in patients with atrial fibrillation after suffering an intracranial hemorrhage on the incidence of mortality, embolisms, and recurrences of cranial bleeding. Methods: A retrospective cohort study was conducted in which 254 clinical histories were analyzed. After excluding patients who did not survive more than one month or who were treated with left atrial appendage closure, the final sample of 136 patients was obtained, which were divided into a cohort that restarted anticoagulant treatment (90) and another that did not (46). Results: The restart of oral anticoagulation was associated with lower mortality (14.2 vs 42.7 events per-100 person-years; p=0.003). There were no significant differences in the incidence of embolisms (2.9 vs 7.3; p=0.764) or recurrence of intracranial hemorrhages (1.9 vs 6.3; p=0.451). The cumulative incidence of events was lower in the anticoagulation restart group (HR 0.23; 95%CI 0.17-0.31; p0.001). Conclusion: The restart of oral anticoagulation after suffering an intracranial hemorrhage in patients with atrial fibrillation is associated with lower mortality and cumulative incidence of adverse effects compared to its suspension,
Direction
ABUASSI ALNAKEEB, EMAD (Tutorships)
Raposeiras Roubín, Sergio (Co-tutorships)
ABUASSI ALNAKEEB, EMAD (Tutorships)
Raposeiras Roubín, Sergio (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Parental satisfaction in the paediatric pre-anesthetic consultation of Major Outpatient Surgery at the Álvaro Cunqueiro University Hospital in Vigo. An observational study.
Authorship
L.S.A.
Bachelor of Medicine
L.S.A.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: The preanesthetic assessment is the anesthesiologist's first contact with the child and his or her parents before the intervention. It is based on a detailed anamnesis and physical examination, with the aim of detecting any problem that may pose an anesthetic-surgical risk. Within the Major Ambulatory Surgery (AMS) model, all the processes carried out have as their fundamental objective the improvement of the quality of care, favorably influencing the degree of parental satisfaction. Objectives: This study analyzes parental satisfaction in the paediatric pre-anesthetic consultation at the Álvaro Cunqueiro University Hospital in Vigo using different quality indicators. Material and methods: Cross-sectional observational study according to the STROBE statement among pediatric AMC patients at the Hospital Clínico Universitario Álvaro Cunqueiro de Vigo (Pontevedra, Galicia, Spain). The surveys to the families were carried out through telephone. A number of 200 parents of children between 0 and 14 years old who were operated on an outpatient basis from November 2023 to February 2024 in our hospital participated in the study. Results: A total of 184 surveys were collected, obtaining an average overall satisfaction score of 9. The average age of the patients who underwent surgery was 7.46 years, with a predominance of 63% of male sex. Regarding the degree of satisfaction with the treatment or information received, both verbal and written, 98.9% of respondents were satisfied or very satisfied. The time spent in going to the clinic is about 1.48 hours on average; and the average economic expense for going to the clinic is 11.68 euros. There is a relationship between the time spent in going to the clinic and the overall satisfaction score. Thus, families who need more time to go to the clinic tend to rate the service with a lower score. Likewise, there is also a significant relationship between the time invested in going to the clinic and the expense involved. Neither the distance nor the financial expenditure influence the final grade. Conclusions: The general degree of satisfaction with the pre-anesthetic consultation is high, after the evaluation of the factors that influence it.
Introduction: The preanesthetic assessment is the anesthesiologist's first contact with the child and his or her parents before the intervention. It is based on a detailed anamnesis and physical examination, with the aim of detecting any problem that may pose an anesthetic-surgical risk. Within the Major Ambulatory Surgery (AMS) model, all the processes carried out have as their fundamental objective the improvement of the quality of care, favorably influencing the degree of parental satisfaction. Objectives: This study analyzes parental satisfaction in the paediatric pre-anesthetic consultation at the Álvaro Cunqueiro University Hospital in Vigo using different quality indicators. Material and methods: Cross-sectional observational study according to the STROBE statement among pediatric AMC patients at the Hospital Clínico Universitario Álvaro Cunqueiro de Vigo (Pontevedra, Galicia, Spain). The surveys to the families were carried out through telephone. A number of 200 parents of children between 0 and 14 years old who were operated on an outpatient basis from November 2023 to February 2024 in our hospital participated in the study. Results: A total of 184 surveys were collected, obtaining an average overall satisfaction score of 9. The average age of the patients who underwent surgery was 7.46 years, with a predominance of 63% of male sex. Regarding the degree of satisfaction with the treatment or information received, both verbal and written, 98.9% of respondents were satisfied or very satisfied. The time spent in going to the clinic is about 1.48 hours on average; and the average economic expense for going to the clinic is 11.68 euros. There is a relationship between the time spent in going to the clinic and the overall satisfaction score. Thus, families who need more time to go to the clinic tend to rate the service with a lower score. Likewise, there is also a significant relationship between the time invested in going to the clinic and the expense involved. Neither the distance nor the financial expenditure influence the final grade. Conclusions: The general degree of satisfaction with the pre-anesthetic consultation is high, after the evaluation of the factors that influence it.
Direction
BLANCO BARCA, MANUEL OSCAR (Tutorships)
Doniz Campos, María Constantina (Co-tutorships)
BLANCO BARCA, MANUEL OSCAR (Tutorships)
Doniz Campos, María Constantina (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Efficacy of Brandt-Daroff exercises in the treatment of benign paroxysmal positional vertigo: A systematic review.
Authorship
S.S.C.
Bachelor of Medicine
S.S.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Benign paroxysmal positional vertigo (BPPV) is a common disorder of the vestibular system characterized by brief episodes of severe vertigo triggered by changes in head position, such as lying down or standing up. Brandt-Daroff exercises are a widely used rehabilitation therapy for BPPV. These exercises involve a specific sequence of head and body movements aimed at dislodging calcium carbonate crystals built up in the inner ear, which is believed to be the cause of BPPV. Although this therapy has been shown to be effective in many cases, there is variability in the literature regarding its effectiveness, and its clinical usefulness is not completely clarified. Objectives: The objective of this systematic review will be based on the collection of randomized controlled clinical trials investigating the effectiveness of Brandt-Daroff exercises in patients with BPPV. Methodology: The bibliographic search was carried out in different indexed databases (PubMed/MEDLINE, the Cochrane Library, ClinicalTrials and ScienceDirect). All the studies in which researchers evaluated the efficacy, safety and/or outcomes of the treatment with Brand- Daroff exercises in patients with BPPV were included. This type of treatment had to be monotherapy, without combination with replacement maneuvers and/or medications. Results: A total of 12 articles have been obtained to carry out the systematic review. In them, Brandt-Daroff exercises were compared with other treatments available for BPPV, such as the Epley or Semont maneuver, or even with placebo. The follow-up times of the participants, the geography or years of execution were quite variable between the studies. Most trials showed greater effectiveness of particle replacement maneuvers. Conclusions: Exercises B-D are not more effective than particle replacement maneuvers. The evidence found of its effectiveness is limited. Therefore, maneuver preference is recommended when choosing treatment for BPPV. More research is required in the future, with emphasis on which factors influence on the treatment, longer follow-up time, and assessment of the recurrences.
Introduction: Benign paroxysmal positional vertigo (BPPV) is a common disorder of the vestibular system characterized by brief episodes of severe vertigo triggered by changes in head position, such as lying down or standing up. Brandt-Daroff exercises are a widely used rehabilitation therapy for BPPV. These exercises involve a specific sequence of head and body movements aimed at dislodging calcium carbonate crystals built up in the inner ear, which is believed to be the cause of BPPV. Although this therapy has been shown to be effective in many cases, there is variability in the literature regarding its effectiveness, and its clinical usefulness is not completely clarified. Objectives: The objective of this systematic review will be based on the collection of randomized controlled clinical trials investigating the effectiveness of Brandt-Daroff exercises in patients with BPPV. Methodology: The bibliographic search was carried out in different indexed databases (PubMed/MEDLINE, the Cochrane Library, ClinicalTrials and ScienceDirect). All the studies in which researchers evaluated the efficacy, safety and/or outcomes of the treatment with Brand- Daroff exercises in patients with BPPV were included. This type of treatment had to be monotherapy, without combination with replacement maneuvers and/or medications. Results: A total of 12 articles have been obtained to carry out the systematic review. In them, Brandt-Daroff exercises were compared with other treatments available for BPPV, such as the Epley or Semont maneuver, or even with placebo. The follow-up times of the participants, the geography or years of execution were quite variable between the studies. Most trials showed greater effectiveness of particle replacement maneuvers. Conclusions: Exercises B-D are not more effective than particle replacement maneuvers. The evidence found of its effectiveness is limited. Therefore, maneuver preference is recommended when choosing treatment for BPPV. More research is required in the future, with emphasis on which factors influence on the treatment, longer follow-up time, and assessment of the recurrences.
Direction
Parente Arias, Pablo Luis (Tutorships)
Mayo Yañez, Miguel (Co-tutorships)
Parente Arias, Pablo Luis (Tutorships)
Mayo Yañez, Miguel (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Factors associated with the presence of occult neoplasm in cryptogenic ischemic stroke
Authorship
G.S.R.
Bachelor of Medicine
G.S.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: sometimes, cryptogenic stroke is the first manifestation of a previously unknown malignancy. The identification of cancer-associated stroke markers would improve their early detection and potentially improve their prognosis. Objective: to identify clinical and paraclinical factors associated with the presence of occult neoplasm in cryptogenic ischemic stroke. Material and methods: the search was carried out in the databases Scopus, Web of Science and PubMed. Patients with cryptogenic ischemic stroke and known or newly diagnosed cancer were included. Those with hemorrhagic stroke or with stroke due to other known causes were excluded. The quality of the studies was assessed using the Newcastle-Ottawa scale. Results: 6374 studies were identified and 15 were included in the analysis. All of them were case-control studies. The presence of occult neoplasia was associated with high values of D-dimer, extracellular vesicles derived from cancer (ECV) and alkaline phosphatase in the blood, as well as the existence of infarcts in multiple brain territories. Less frequently, some of these studies found an association with female sex, older age, and the absence of high blood pressure. The results were contradictory for platelet values. Conclusions: if we are faced a patient with cryptogenic ischemic stroke with elevated D-dimer or infarcts in multiple vascular territories, the possibility that it was caused by a hidden neoplasia should be considered. Further studies should evaluate other analytical markers such as ECV, alkaline phosphatase, C-reactive protein (CRP), and hypoalbuminemia. The quality of the studies could be improved by including community-level controls.
Introduction: sometimes, cryptogenic stroke is the first manifestation of a previously unknown malignancy. The identification of cancer-associated stroke markers would improve their early detection and potentially improve their prognosis. Objective: to identify clinical and paraclinical factors associated with the presence of occult neoplasm in cryptogenic ischemic stroke. Material and methods: the search was carried out in the databases Scopus, Web of Science and PubMed. Patients with cryptogenic ischemic stroke and known or newly diagnosed cancer were included. Those with hemorrhagic stroke or with stroke due to other known causes were excluded. The quality of the studies was assessed using the Newcastle-Ottawa scale. Results: 6374 studies were identified and 15 were included in the analysis. All of them were case-control studies. The presence of occult neoplasia was associated with high values of D-dimer, extracellular vesicles derived from cancer (ECV) and alkaline phosphatase in the blood, as well as the existence of infarcts in multiple brain territories. Less frequently, some of these studies found an association with female sex, older age, and the absence of high blood pressure. The results were contradictory for platelet values. Conclusions: if we are faced a patient with cryptogenic ischemic stroke with elevated D-dimer or infarcts in multiple vascular territories, the possibility that it was caused by a hidden neoplasia should be considered. Further studies should evaluate other analytical markers such as ECV, alkaline phosphatase, C-reactive protein (CRP), and hypoalbuminemia. The quality of the studies could be improved by including community-level controls.
Direction
VARELA LEMA, MARIA LEONOR (Tutorships)
Rivero de Aguilar Pensado, Alejandro (Co-tutorships)
VARELA LEMA, MARIA LEONOR (Tutorships)
Rivero de Aguilar Pensado, Alejandro (Co-tutorships)
Court
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
PAREDES COTORE, JESUS PEDRO (Chairman)
URISARRI RUIZ DE CORTAZAR, ADELA (Secretary)
PARGA MARTIN, JUAN ANDRES (Member)
Effect of Preoperative Prehabilitation on Physical Condition and Perioperative Complications in Adults Undergoing Cardiac Surgery; a systematic review and meta-analysis.
Authorship
C.G.C.
Bachelor of Medicine
C.G.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Prehabilitation is a strategy aimed at improving the health and well-being of patients before undergoing surgery, seeking to increase patients' physiological reserve to counteract the stress of surgery and attempt to reduce perioperative complications and improve patients' quality of life. However, the evidence of its effectiveness in cardiac surgery is inconclusive, and further investigation is needed to better demonstrate and understand its usefulness for patients in this type of intervention. Objectives: This study aims to primarily analyze the effect of prehabilitation on the physical condition and quality of life of adults over 18 years old with an indication for elective cardiac surgery, who participated in physical exercise or respiratory physiotherapy programs. Secondary objectives include analyzing hospital and ICU stay, the incidence of postoperative complications (atrial fibrillation, infections, acute renal failure, and rehospitalization rate), as well as mortality. Methods: A systematic review and meta-analysis of randomized clinical trials were conducted following the PRISMA methodology. The study protocol was registered and published on OSF. Data management was performed using Excel and RevMan software. PubMed, WOS, and Cochrane databases were used, along with specific web searches and bibliographic list reviews. Results: Fourteen trials with 1648 cases were included. An improvement of 36.65 meters (95% CI (1.72; 71.58); p=0.04) was found in the 6MWT test in favor of prehabilitation, but it did not reach a clinically relevant distance. No effect on quality of life was found. Physical exercise shortened hospital stay by 1.01 days (95% CI (-2; -0.02); p=0.04), but not respiratory physiotherapy. Prehabilitation did not decrease ICU stay. The incidence of pneumonia was reduced in the postoperative period (OR 0.34; 95% CI (0.12; 0.95); p=0.04), although this did not occur in the case of atrial fibrillation. The rest of the complications were not assessable due to lack of studies. There was also no demonstrated benefit on mortality with either physical exercise or respiratory physiotherapy. Conclusions: Prehabilitation in adult patients undergoing cardiac surgery improved their preoperative physical condition, but did not reach clinically relevant levels, with a GRADE evidence quality ranging from low to moderate. Physical exercise also shortened hospital stay and reduced the incidence of postoperative pneumonia. However, quality of life, hospital stay (with respiratory physiotherapy), ICU stay, incidence of atrial fibrillation, and mortality were not influenced by this strategy.
Introduction: Prehabilitation is a strategy aimed at improving the health and well-being of patients before undergoing surgery, seeking to increase patients' physiological reserve to counteract the stress of surgery and attempt to reduce perioperative complications and improve patients' quality of life. However, the evidence of its effectiveness in cardiac surgery is inconclusive, and further investigation is needed to better demonstrate and understand its usefulness for patients in this type of intervention. Objectives: This study aims to primarily analyze the effect of prehabilitation on the physical condition and quality of life of adults over 18 years old with an indication for elective cardiac surgery, who participated in physical exercise or respiratory physiotherapy programs. Secondary objectives include analyzing hospital and ICU stay, the incidence of postoperative complications (atrial fibrillation, infections, acute renal failure, and rehospitalization rate), as well as mortality. Methods: A systematic review and meta-analysis of randomized clinical trials were conducted following the PRISMA methodology. The study protocol was registered and published on OSF. Data management was performed using Excel and RevMan software. PubMed, WOS, and Cochrane databases were used, along with specific web searches and bibliographic list reviews. Results: Fourteen trials with 1648 cases were included. An improvement of 36.65 meters (95% CI (1.72; 71.58); p=0.04) was found in the 6MWT test in favor of prehabilitation, but it did not reach a clinically relevant distance. No effect on quality of life was found. Physical exercise shortened hospital stay by 1.01 days (95% CI (-2; -0.02); p=0.04), but not respiratory physiotherapy. Prehabilitation did not decrease ICU stay. The incidence of pneumonia was reduced in the postoperative period (OR 0.34; 95% CI (0.12; 0.95); p=0.04), although this did not occur in the case of atrial fibrillation. The rest of the complications were not assessable due to lack of studies. There was also no demonstrated benefit on mortality with either physical exercise or respiratory physiotherapy. Conclusions: Prehabilitation in adult patients undergoing cardiac surgery improved their preoperative physical condition, but did not reach clinically relevant levels, with a GRADE evidence quality ranging from low to moderate. Physical exercise also shortened hospital stay and reduced the incidence of postoperative pneumonia. However, quality of life, hospital stay (with respiratory physiotherapy), ICU stay, incidence of atrial fibrillation, and mortality were not influenced by this strategy.
Direction
Álvarez Escudero, Julián (Tutorships)
DIZ GOMEZ, JOSE CARLOS (Co-tutorships)
Álvarez Escudero, Julián (Tutorships)
DIZ GOMEZ, JOSE CARLOS (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
DNA repair defects in cancer and therapeutic opportunities: a systematic review
Authorship
I.G.P.
Bachelor of Medicine
I.G.P.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
BACKGROUND: mutations in DNA repair genes cause defects leading to genomic instability fueling tumorigenesis. Treatment targeting those defects may improve outcomes. OBJECTIVE: conduct a systematic review to summarize all the available evidence capturing efficacy and safety on treatments driven by defects in DNA HRR (homologous recombination repair), MMR (mismatch repair) pathways or DNA damage checkpoint pathways. MATERIAL AND METHODS: after designing a protocol in accordance with the PRISMA guidelines, an electronic search of published research articles from January 2014 to January 2024 was performed, limited to English and Spanish language. RESULTS: the search identified 95 records. with 18 articles for final review, classified into 4 groups. Group I: 11 phase II or III trials in homologous recombination repair (HRR) genes pathway deficient tumors showing with high response rates and prolonged progression free survival (PFS) in ovarian cancer (Olaparib, in first and further lines: 1 trial each), breast cancer (Olaparib, adjuvant setting and metastatic stage, 1 trial each; Lurbinectedin in advanced setting 1 trial), prostate cancer (recurrent setting, Talazoparib, Niraparib, Rucaparib, 1 trial each), pancreatic cancer (Olaparib, first or further line, 1 trial each), 1 basket trial with Olaparib. Group II: 1 trial with Olaparib targeting mutations in DNA damage checkpoint genes such as ATM, ATR, CHK1, CHK2 and WEE1 in advanced colorectal with ORR less than 5%. Group III: 5 trials targeting mutations in mismatch repair (MMR) genes with high response rates and prolonged PFS in endometrial cancer (Durvalumab, Dostarlimab, 1 trial each), colorectal (Pembrolizumab, 1 trial), non-colorectal (Nivolumab-Ipilimumab, 1 trial), Basket trial (Pembrolizumab, 1 trial). Group IV: 1 basket trial with Olaparib targeting different of the groups, mainly I and II with ORR less than 10%. CONCLUSION: DNA damage response is a key target, as PARP inhibitor treatment in homologous recombination-deficient cancers and immune checkpoint inhibitor therapy in dMMR/MSI-H tumors have changed oncology practice.
BACKGROUND: mutations in DNA repair genes cause defects leading to genomic instability fueling tumorigenesis. Treatment targeting those defects may improve outcomes. OBJECTIVE: conduct a systematic review to summarize all the available evidence capturing efficacy and safety on treatments driven by defects in DNA HRR (homologous recombination repair), MMR (mismatch repair) pathways or DNA damage checkpoint pathways. MATERIAL AND METHODS: after designing a protocol in accordance with the PRISMA guidelines, an electronic search of published research articles from January 2014 to January 2024 was performed, limited to English and Spanish language. RESULTS: the search identified 95 records. with 18 articles for final review, classified into 4 groups. Group I: 11 phase II or III trials in homologous recombination repair (HRR) genes pathway deficient tumors showing with high response rates and prolonged progression free survival (PFS) in ovarian cancer (Olaparib, in first and further lines: 1 trial each), breast cancer (Olaparib, adjuvant setting and metastatic stage, 1 trial each; Lurbinectedin in advanced setting 1 trial), prostate cancer (recurrent setting, Talazoparib, Niraparib, Rucaparib, 1 trial each), pancreatic cancer (Olaparib, first or further line, 1 trial each), 1 basket trial with Olaparib. Group II: 1 trial with Olaparib targeting mutations in DNA damage checkpoint genes such as ATM, ATR, CHK1, CHK2 and WEE1 in advanced colorectal with ORR less than 5%. Group III: 5 trials targeting mutations in mismatch repair (MMR) genes with high response rates and prolonged PFS in endometrial cancer (Durvalumab, Dostarlimab, 1 trial each), colorectal (Pembrolizumab, 1 trial), non-colorectal (Nivolumab-Ipilimumab, 1 trial), Basket trial (Pembrolizumab, 1 trial). Group IV: 1 basket trial with Olaparib targeting different of the groups, mainly I and II with ORR less than 10%. CONCLUSION: DNA damage response is a key target, as PARP inhibitor treatment in homologous recombination-deficient cancers and immune checkpoint inhibitor therapy in dMMR/MSI-H tumors have changed oncology practice.
Direction
Concheiro Guisán, Ana (Tutorships)
VILLANUEVA SILVA, MARIA JOSE (Co-tutorships)
Concheiro Guisán, Ana (Tutorships)
VILLANUEVA SILVA, MARIA JOSE (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Importance of Primary Care in the detection and management of people with self-harm ideation.
Authorship
C.G.B.
Bachelor of Medicine
C.G.B.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Autolytic ideation and suicide represent a major Public Health problema. It is estimated that there are currently more tan 700.000 suicides/year in the world. Many of these people come looking for help at Primary Care consultations, an ideal mean, due to its characteristics, for the detection and monitoring of multiple pathologies. Goals: 1. Carry out a bibliographic review about self-harm ideation and suicide, focusing on verifying its posible approach from Primary Care. 2. To know the opinión of Primary Care professionals about the attention to that problem from this leve lof care 3. To know the difficulties that arise for the above. Methods: A bibliographic review has been caried out. To this end, various virtual libraries, virtual portals anda databases have been consulted. Inclusion criterio for the PubMed search: clinical trial type article, systematic or bibliographic review, free access and published between the years 2014-2024. A survery has been prepared and distributed to find out the opinión of Primary Care professionals on the subject. Results: Although Primary Care seems to be an ideal mean to address self-harm ideation and suicide, no studies have been found on which this statement can be based. Among those surveyed, 94,7% say they have ever cared for patients at risk of autolysis, and 98,5% believe that Primary Care plays an important role in their care and support. Lack of time, care overload and lack of training stand out as the most important limitations. Conclusions: Primary Care seems to be a good mean for detecting and supporting people with self-harm ideation. However, it has important limitations that make it difficult for this to be carried out.
Introduction: Autolytic ideation and suicide represent a major Public Health problema. It is estimated that there are currently more tan 700.000 suicides/year in the world. Many of these people come looking for help at Primary Care consultations, an ideal mean, due to its characteristics, for the detection and monitoring of multiple pathologies. Goals: 1. Carry out a bibliographic review about self-harm ideation and suicide, focusing on verifying its posible approach from Primary Care. 2. To know the opinión of Primary Care professionals about the attention to that problem from this leve lof care 3. To know the difficulties that arise for the above. Methods: A bibliographic review has been caried out. To this end, various virtual libraries, virtual portals anda databases have been consulted. Inclusion criterio for the PubMed search: clinical trial type article, systematic or bibliographic review, free access and published between the years 2014-2024. A survery has been prepared and distributed to find out the opinión of Primary Care professionals on the subject. Results: Although Primary Care seems to be an ideal mean to address self-harm ideation and suicide, no studies have been found on which this statement can be based. Among those surveyed, 94,7% say they have ever cared for patients at risk of autolysis, and 98,5% believe that Primary Care plays an important role in their care and support. Lack of time, care overload and lack of training stand out as the most important limitations. Conclusions: Primary Care seems to be a good mean for detecting and supporting people with self-harm ideation. However, it has important limitations that make it difficult for this to be carried out.
Direction
Fernández Merino, María del Carmen (Tutorships)
Miranda Pena, Flora María (Co-tutorships)
Fernández Merino, María del Carmen (Tutorships)
Miranda Pena, Flora María (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Sistematic review of Ovarian drilling as a fertility treatment for Polycistic ovary syndrome
Authorship
M.G.D.H.
Bachelor of Medicine
M.G.D.H.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Polycystic ovary syndrome is an endocrinopathy that affects 5-10% of women of reproductive age. It is also the most common cause of infertility due to anovulation, with around 70-80% of women with PCOS experiencing reproductive problems. Among the fertility treatment options, we find lifestyle changes, pharmacological treatment (ovulation inducers), and surgical treatment (ovarian drilling). Objectives: To demonstrate whether the results of Ovarian Drilling are comparable to those obtained with other available treatments for fertility in women with PCOS. Materials and Methods: Systematic review of the scientific literature available in PubMed and Cochrane. Results: The results in fertility parameters are mostly comparable. Conclusions: Ovarian drilling is a treatment that presents certain limits as a fertility treatment in PCOS patients. However, its results are comparable with those of other techniques, which makes it a useful treatment in certain circumstances, although it remains to be a second-line option.
Introduction: Polycystic ovary syndrome is an endocrinopathy that affects 5-10% of women of reproductive age. It is also the most common cause of infertility due to anovulation, with around 70-80% of women with PCOS experiencing reproductive problems. Among the fertility treatment options, we find lifestyle changes, pharmacological treatment (ovulation inducers), and surgical treatment (ovarian drilling). Objectives: To demonstrate whether the results of Ovarian Drilling are comparable to those obtained with other available treatments for fertility in women with PCOS. Materials and Methods: Systematic review of the scientific literature available in PubMed and Cochrane. Results: The results in fertility parameters are mostly comparable. Conclusions: Ovarian drilling is a treatment that presents certain limits as a fertility treatment in PCOS patients. However, its results are comparable with those of other techniques, which makes it a useful treatment in certain circumstances, although it remains to be a second-line option.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Turrado Sánchez, Elena María (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Turrado Sánchez, Elena María (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Role of GLP-1 receptor agonists in the control of Type 1 Diabetes Mellitus
Authorship
J.J.G.G.
Bachelor of Medicine
J.J.G.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Type 1 Diabetes Mellitus (DM1) is the most common autoimmune disease worldwide, causes a mean loss of life expectancy of 12 years and greatly reduces the quality of life of patients. With these data, it is urgent and essential to seek an improvement in the pharmacological options for DM1. In recent years, Glucagon-like peptide-1 (GLP-1) receptor agonists have been approved for Type 2 diabetes (DM2), although it is not known whether they could exert beneficial effects in DM1. Objectives and Methodology: A systematic review of the scientific literature was carried out to analyze the existing evidence on the use of GLP-1 receptor agonists as combined therapies with insulin for the maintenance of glycaemia in patients with T1D. The search criteria included the PubMed database, specifically the MeSH (Medical Subject Headlines) terms type 1 diabetes or T1D and GLP-1 agonist or GLP-1R were used and only clinical trials in human patients in the period 2017-2024 in humans were included. Results: A total of fifteen articles were found, including the use of the GLP-1 receptor agonists Exenatide (4), Liraglutide (5), Dulaglutide (2), Semaglutide (2), Albiglutide (1) and Lixisenatide (1) in clinical trials in patients with DM1. For Liraglutide and Semaglutide a consistent decreases in blood glycosylated hemoglobin A1 (HbA1) levels were found, inconsistent differences for Albiglutide, Dulaglutide and Lixisenatide, and no differences for Exenatide. In addition, patients receiving Liraglutide, Semaglutide and Exenatide experienced significant weight loss, which was not studied for Albiglutide and Lixisenatide. For all drugs, mild gastrointestinal side effects were found, although mostly self-limited, and some occasional hypoglycaemic events no greater than in the placebo group. Conclusion: The available clinical trials show a promising beneficial effect of Liraglutide and Semaglutide in significantly lowering HbA1 and body weight in patients with DM1.
Introduction: Type 1 Diabetes Mellitus (DM1) is the most common autoimmune disease worldwide, causes a mean loss of life expectancy of 12 years and greatly reduces the quality of life of patients. With these data, it is urgent and essential to seek an improvement in the pharmacological options for DM1. In recent years, Glucagon-like peptide-1 (GLP-1) receptor agonists have been approved for Type 2 diabetes (DM2), although it is not known whether they could exert beneficial effects in DM1. Objectives and Methodology: A systematic review of the scientific literature was carried out to analyze the existing evidence on the use of GLP-1 receptor agonists as combined therapies with insulin for the maintenance of glycaemia in patients with T1D. The search criteria included the PubMed database, specifically the MeSH (Medical Subject Headlines) terms type 1 diabetes or T1D and GLP-1 agonist or GLP-1R were used and only clinical trials in human patients in the period 2017-2024 in humans were included. Results: A total of fifteen articles were found, including the use of the GLP-1 receptor agonists Exenatide (4), Liraglutide (5), Dulaglutide (2), Semaglutide (2), Albiglutide (1) and Lixisenatide (1) in clinical trials in patients with DM1. For Liraglutide and Semaglutide a consistent decreases in blood glycosylated hemoglobin A1 (HbA1) levels were found, inconsistent differences for Albiglutide, Dulaglutide and Lixisenatide, and no differences for Exenatide. In addition, patients receiving Liraglutide, Semaglutide and Exenatide experienced significant weight loss, which was not studied for Albiglutide and Lixisenatide. For all drugs, mild gastrointestinal side effects were found, although mostly self-limited, and some occasional hypoglycaemic events no greater than in the placebo group. Conclusion: The available clinical trials show a promising beneficial effect of Liraglutide and Semaglutide in significantly lowering HbA1 and body weight in patients with DM1.
Direction
Dieguez Gonzalez, Carlos (Tutorships)
Fernández Fondevila, Marcos (Co-tutorships)
Dieguez Gonzalez, Carlos (Tutorships)
Fernández Fondevila, Marcos (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Complications and sequels of orthognathic surgery. Systematic review.
Authorship
S.G.C.
Bachelor of Medicine
S.G.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Orthognathic surgery is a surgical discipline focused on correcting various dentofacial deformities, and it is accompanied by both intraoperative and postoperative complications. Although in most cases these do not present a life-threatening risk to the patient, their relevance drives us to describe them. Objectives: To conduct a systematic review of the different complications of orthognathic surgery based on patient characteristics and the timing of these complications. To study the influence of demographic factors and patient pathology on the occurrence of these complications. Materials and Methods: A systematic review was carried out following the PRISMA guide through the PICO question, applying the appropriate filters to obtain articles published in the last ten years. Results and Discussion: After applying the described criteria, nine articles are included in this review, of which six were retrospective cohort observational studies, two were retrospective cross-sectional observational studies, and one was a prospective cohort observational study. Despite following a common line, not all articles mention the same complications nor set the same parameters for the patients, which complicates the analysis and mad impossible to complete a meta-analysis subsequently. Complications: Complications of orthognathic surgery occur more frequently in interventions performed on both jaws simultaneously or, if performed in isolation, are more common in surgeries on the mandible. It would be necessary to conduct a greater number of studies that standardize their parameters and complete long-term follow-up of patients to carry out more thorough analyses.
Introduction: Orthognathic surgery is a surgical discipline focused on correcting various dentofacial deformities, and it is accompanied by both intraoperative and postoperative complications. Although in most cases these do not present a life-threatening risk to the patient, their relevance drives us to describe them. Objectives: To conduct a systematic review of the different complications of orthognathic surgery based on patient characteristics and the timing of these complications. To study the influence of demographic factors and patient pathology on the occurrence of these complications. Materials and Methods: A systematic review was carried out following the PRISMA guide through the PICO question, applying the appropriate filters to obtain articles published in the last ten years. Results and Discussion: After applying the described criteria, nine articles are included in this review, of which six were retrospective cohort observational studies, two were retrospective cross-sectional observational studies, and one was a prospective cohort observational study. Despite following a common line, not all articles mention the same complications nor set the same parameters for the patients, which complicates the analysis and mad impossible to complete a meta-analysis subsequently. Complications: Complications of orthognathic surgery occur more frequently in interventions performed on both jaws simultaneously or, if performed in isolation, are more common in surgeries on the mandible. It would be necessary to conduct a greater number of studies that standardize their parameters and complete long-term follow-up of patients to carry out more thorough analyses.
Direction
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
López-Cedrún Cembranos, José Luis (Co-tutorships)
Sánchez Ortega, Helena (Co-tutorships)
SUAREZ QUINTANILLA, JUAN ANTONIO (Tutorships)
López-Cedrún Cembranos, José Luis (Co-tutorships)
Sánchez Ortega, Helena (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Role of odor-binding protein in cow epithelium allergy
Authorship
C.S.G.F.
Bachelor of Medicine
C.S.G.F.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: In a previous study conducted by the Allergy Section of HULA, sensitization to a 25 kDa protein, which had not been previously described, was detected. Mass spectrometry identified it as the odor-binding protein (OBP), a lipocalin from Bos taurus. Although its association with symptoms is unclear, recent research suggests that its inclusion in diagnostic and treatment extracts could be beneficial. AIM OF THE STUDY: Assess the role of odor-binding protein (OBP) in cow epithelium allergy (CEA) among patients sensitized to cow epithelium. MATERIAL AND METHODS: Descriptive and cross-sectional observational study of a case series, including a total of 17 patients sensitized to cow allergens as demonstrated by immunoblotting. Seven candidates were selected from the total. Age, sex, profession, years of exposure, test results, and the group to which they belonged were recorded for each individual. OBP was purified and isolated from bull urine, and a lyophilized extract was prepared to perform skin prick tests and conjunctival provocation tests. RESULTS: Intraepidermal tests were performed with a purified OBP extract on seven patients allergic to cow epithelium, yielding positive results in six of them. Six underwent a conjunctival allergic provocation test (CAPT) with the same extract, which was positive in four of them. Both tests yielded negative results in all controls. CONCLUSION: The odor-binding protein acts as a major antigen in this population of cow epithelium allergic individuals. This study demonstrates the involvement of this protein in the clinical symptoms of patients. Hence, the importance of including it in extracts for diagnosis and treatment.
INTRODUCTION: In a previous study conducted by the Allergy Section of HULA, sensitization to a 25 kDa protein, which had not been previously described, was detected. Mass spectrometry identified it as the odor-binding protein (OBP), a lipocalin from Bos taurus. Although its association with symptoms is unclear, recent research suggests that its inclusion in diagnostic and treatment extracts could be beneficial. AIM OF THE STUDY: Assess the role of odor-binding protein (OBP) in cow epithelium allergy (CEA) among patients sensitized to cow epithelium. MATERIAL AND METHODS: Descriptive and cross-sectional observational study of a case series, including a total of 17 patients sensitized to cow allergens as demonstrated by immunoblotting. Seven candidates were selected from the total. Age, sex, profession, years of exposure, test results, and the group to which they belonged were recorded for each individual. OBP was purified and isolated from bull urine, and a lyophilized extract was prepared to perform skin prick tests and conjunctival provocation tests. RESULTS: Intraepidermal tests were performed with a purified OBP extract on seven patients allergic to cow epithelium, yielding positive results in six of them. Six underwent a conjunctival allergic provocation test (CAPT) with the same extract, which was positive in four of them. Both tests yielded negative results in all controls. CONCLUSION: The odor-binding protein acts as a major antigen in this population of cow epithelium allergic individuals. This study demonstrates the involvement of this protein in the clinical symptoms of patients. Hence, the importance of including it in extracts for diagnosis and treatment.
Direction
VIDAL PAN, Mª DEL CARMEN (Tutorships)
Carballada Gonzalez, Francisco Javier (Co-tutorships)
VIDAL PAN, Mª DEL CARMEN (Tutorships)
Carballada Gonzalez, Francisco Javier (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Current treatment of pediatric flat foot.
Authorship
B.G.J.
Bachelor of Medicine
B.G.J.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
ABSTRACT Introduction: Children's flat feet are defined as the loss of the internal longitudinal arch of the foot. It is one of the most frequent reasons for consultation in pediatric orthopedics consul- tations and a great cause of concern among parents. The prevalence decreases with age and most patients are asymptomatic. It is a pathology of multifactorial origin and in most children the attitude is expectant, waiting for it to resolve spontaneously. Justification and objectives: Childhood flat feet is a prevalent pathology, being the source of significant concern in the parents of children who present it. The treatment of this is currently a matter of controversy. Therefore, the main objective of the present work is to carry out a systematic review of the current evidence on the most appropriate type of treatment according to the type of flat feet according to its etiology. Carry out a clinical path that serves the profes- sionals in charge of treating this pathology and find out in which cases a greater benefit is obtained with this treatment. Material and methods: This is a systematic review carried out through the PubMed database, filtering articles published in the last 15 years in pediatric patients. Patients over 18 years of age and languages other than Spanish or English were excluded. Meta-analyses, clinical trials, randomized controlled trials and systematic reviews were included. Results and discussion: After applying the inclusion and exclusion criteria, 11 articles have been selected to carry out this work. Most authors describe flexible flat feet as physiological, with the capacity to resolve over the years. Most cases are asymptomatic patients without func- tional limitations in their daily life, so they recommend not treating and waiting for it to resolve spontaneously. If flat feet are pathological, studies find it convenient to individualize the treat- ment according to the patient, since some could benefit from the use of prefabricated orthoses, insoles, exercises, training, and other techniques mentioned, but there is not enough research that supports an international consensus. Conclusions: The prevalence of pediatric flexible flatfoot decreases as children grow older. At school ages, we should wait for this to resolve spontaneously, in addition to reassuring par- ents and informing them that not treating this pathology will not lead to any biomechanical malformation of the foot or other functional alterations. In pathological flat feet, treatment must be individualized and there is not enough evidence to support the use of foot orthoses.
ABSTRACT Introduction: Children's flat feet are defined as the loss of the internal longitudinal arch of the foot. It is one of the most frequent reasons for consultation in pediatric orthopedics consul- tations and a great cause of concern among parents. The prevalence decreases with age and most patients are asymptomatic. It is a pathology of multifactorial origin and in most children the attitude is expectant, waiting for it to resolve spontaneously. Justification and objectives: Childhood flat feet is a prevalent pathology, being the source of significant concern in the parents of children who present it. The treatment of this is currently a matter of controversy. Therefore, the main objective of the present work is to carry out a systematic review of the current evidence on the most appropriate type of treatment according to the type of flat feet according to its etiology. Carry out a clinical path that serves the profes- sionals in charge of treating this pathology and find out in which cases a greater benefit is obtained with this treatment. Material and methods: This is a systematic review carried out through the PubMed database, filtering articles published in the last 15 years in pediatric patients. Patients over 18 years of age and languages other than Spanish or English were excluded. Meta-analyses, clinical trials, randomized controlled trials and systematic reviews were included. Results and discussion: After applying the inclusion and exclusion criteria, 11 articles have been selected to carry out this work. Most authors describe flexible flat feet as physiological, with the capacity to resolve over the years. Most cases are asymptomatic patients without func- tional limitations in their daily life, so they recommend not treating and waiting for it to resolve spontaneously. If flat feet are pathological, studies find it convenient to individualize the treat- ment according to the patient, since some could benefit from the use of prefabricated orthoses, insoles, exercises, training, and other techniques mentioned, but there is not enough research that supports an international consensus. Conclusions: The prevalence of pediatric flexible flatfoot decreases as children grow older. At school ages, we should wait for this to resolve spontaneously, in addition to reassuring par- ents and informing them that not treating this pathology will not lead to any biomechanical malformation of the foot or other functional alterations. In pathological flat feet, treatment must be individualized and there is not enough evidence to support the use of foot orthoses.
Direction
PINO MINGUEZ, JESUS (Tutorships)
GOMEZ LADO, MARIA DEL CARMEN (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
GOMEZ LADO, MARIA DEL CARMEN (Co-tutorships)
Court
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
MENDEZ ALVAREZ, ESTEFANIA MARIA SALOME (Chairman)
PEÑA FERNANDEZ, MAITE (Secretary)
Anibarro García, Luís (Member)
Tooth-supported fixed restorations and dental finishing lines. A bibliographic review.
Authorship
G.G.L.
Bachelor of Odontology
G.G.L.
Bachelor of Odontology
Defense date
06.21.2024 09:30
06.21.2024 09:30
Summary
Tooth-supported fixed prostheses aim to restore lost health, function and aesthetics, protecting the tooth and the soft tissues that surround it, so they must be in harmony with neighboring teeth, and the margins remain stable over time. In general, studies show that tooth-supported fixed prostheses can remain in the mouth in good conditions for many years; however, the tissues surrounding these prostheses often undergo changes over time. In this bibliographic review we will analyze the most commonly used materials in tooth-supported fixed rehabilitation for crowns (metal-ceramic, zirconia, lithium disilicate and feldespathic ceramics) as well as different finishing preparation lines (horizontal, vertical and BOPT), assess how the combination of these elements affects and determine the factors that could lead to failure of these treatments.
Tooth-supported fixed prostheses aim to restore lost health, function and aesthetics, protecting the tooth and the soft tissues that surround it, so they must be in harmony with neighboring teeth, and the margins remain stable over time. In general, studies show that tooth-supported fixed prostheses can remain in the mouth in good conditions for many years; however, the tissues surrounding these prostheses often undergo changes over time. In this bibliographic review we will analyze the most commonly used materials in tooth-supported fixed rehabilitation for crowns (metal-ceramic, zirconia, lithium disilicate and feldespathic ceramics) as well as different finishing preparation lines (horizontal, vertical and BOPT), assess how the combination of these elements affects and determine the factors that could lead to failure of these treatments.
Direction
BAHILLO VARELA, MARTA MARIA (Tutorships)
BAHILLO VARELA, JOSE JAVIER (Co-tutorships)
BAHILLO VARELA, MARTA MARIA (Tutorships)
BAHILLO VARELA, JOSE JAVIER (Co-tutorships)
Court
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Diniz Freitas, Márcio (Chairman)
BLANCO CARRION, ANDRES (Secretary)
FERNANDEZ RIVEIRO, PAULA (Member)
Dental Smile Design (DSD): a new clinic tool
Authorship
J.C.M.
Bachelor of Odontology
J.C.M.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Digital technology has broken into 21st-century dentistry, facilitating the planning and execution of integrated complex treatments, both functionally and aesthetically. Digital Smile Design allows for 3D visualization, creating and projecting through a simulation and preview of the final result of the proposed treatment before its realization. In this work, based on scientific evidence, we propose to analyze the concept of DSD (Digital Smile Design), determining its advantages and limitations as well as possibilities for clinical application and integration of treatment protocols. To this end, a systematic review of the literature will be conducted using the PubMed database in order to carry out an individualized study of various digital smile design software according to the criteria and parameters used in each one for 3D design.
Digital technology has broken into 21st-century dentistry, facilitating the planning and execution of integrated complex treatments, both functionally and aesthetically. Digital Smile Design allows for 3D visualization, creating and projecting through a simulation and preview of the final result of the proposed treatment before its realization. In this work, based on scientific evidence, we propose to analyze the concept of DSD (Digital Smile Design), determining its advantages and limitations as well as possibilities for clinical application and integration of treatment protocols. To this end, a systematic review of the literature will be conducted using the PubMed database in order to carry out an individualized study of various digital smile design software according to the criteria and parameters used in each one for 3D design.
Direction
LOPEZ CASTRO, GONZALO (Tutorships)
LOPEZ CASTRO, GONZALO (Tutorships)
Maxillary sinus atraumatic elevation. Bibliographic review.
Authorship
P.J.P.P.
Bachelor of Odontology
P.J.P.P.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
As a consequence of the loss of teeth in the posterior maxillary area and the resulting lack of occlusion and posterior stimulation, there is a resorption of alveolar bone that can compromise the placement of an implant. This limitation is due to a lack of height in the bone crest and a possible invasion of Schneider's membrane and the maxillary sinus. Faced with this situation, one of the most widely used therapeutic alternatives in recent years is the atraumatic or transcrestal sinus lift, which allows for the safeguarding of Schneider's membrane integrity and induces bone regeneration that provides enough millimeters for optimal osseointegration and implant stability. This literature review analyzes a series of studies on patients with the aim of questioning and evaluating the indication of performing the atraumatic technique with a bone crest height greater than 5 mm, or whether, on the contrary, it can be performed with a lesser bone height. It also analyzes whether the use of bone regeneration inducing materials is necessary.
As a consequence of the loss of teeth in the posterior maxillary area and the resulting lack of occlusion and posterior stimulation, there is a resorption of alveolar bone that can compromise the placement of an implant. This limitation is due to a lack of height in the bone crest and a possible invasion of Schneider's membrane and the maxillary sinus. Faced with this situation, one of the most widely used therapeutic alternatives in recent years is the atraumatic or transcrestal sinus lift, which allows for the safeguarding of Schneider's membrane integrity and induces bone regeneration that provides enough millimeters for optimal osseointegration and implant stability. This literature review analyzes a series of studies on patients with the aim of questioning and evaluating the indication of performing the atraumatic technique with a bone crest height greater than 5 mm, or whether, on the contrary, it can be performed with a lesser bone height. It also analyzes whether the use of bone regeneration inducing materials is necessary.
Direction
Pose Rodríguez, José Manuel (Tutorships)
OTERO CASAL, MARIA DE LA PAZ (Co-tutorships)
Pose Rodríguez, José Manuel (Tutorships)
OTERO CASAL, MARIA DE LA PAZ (Co-tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
BORRAJO GARCIA, MARIA ISABEL (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
BORRAJO GARCIA, MARIA ISABEL (Member)
Artificial Intelligence in Dentistry: Evaluation of ChatGPT in Clinical Decision-Making for Medically Compromised Patients
Authorship
A.M.Q.S.
Bachelor of Odontology
A.M.Q.S.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Introduction: The potential of artificial intelligence in the field of Dentistry has been gaining significant importance in recent years. A prominent example is ChatGPT, an innovative artificial intelligence tool that is freely accessible and fed with large amounts of data, capable of understanding and generating human language with high precision and consistency. One of the advantages attributed to ChatGPT in the clinical setting is that it provides quick and appropriate answers to questions posed, facilitating decision-making and eliminating the need for the clinician to consult original sources. Since its introduction, various studies have evaluated the reliability of ChatGPT in generating responses to clinical questions in different areas of dentistry, such as Oral Medicine, Periodontology, Oral Surgery, Endodontics, etc. However, to date, its application in the dental management of medically compromised patients has not been evaluated. Aims: To evaluate the validity of the responses generated by ChatGPT in clinical decision- making for the dental management of medically compromised patients. Materials and Methods: A cross-sectional study has been conducted in which 4 clinical cases of medically compromised patients with implications for dental treatment were developed. The responses obtained with ChatGPT were compared with those provided by 5th-year students of the Dentistry Degree at the University of Santiago de Compostela. The reliability of each response was evaluated using the following scoring system: 1. Complete response; 2. Correct but insufficient response; 3. Response includes both correct and incorrect/outdated information; and 4. Completely incorrect response, based on the guidelines of the American Dental Association. Results: The 5th-year Dentistry students at USC achieved an average score of 2.62, the same as ChatGPT version 4.0. ChatGPT version 3.5 had an average score of 2.75. Conclusions: ChatGPT 3.5 has less clinical accuracy than the students. On the other hand, ChatGPT 4.0 has shown the same diagnostic capability in medically compromised patients as the 5th-year Dentistry students, even surpassing their responses in certain areas where extensive medical knowledge is required; however, it shows a decrease in competence in cases where clinical judgment is needed.
Introduction: The potential of artificial intelligence in the field of Dentistry has been gaining significant importance in recent years. A prominent example is ChatGPT, an innovative artificial intelligence tool that is freely accessible and fed with large amounts of data, capable of understanding and generating human language with high precision and consistency. One of the advantages attributed to ChatGPT in the clinical setting is that it provides quick and appropriate answers to questions posed, facilitating decision-making and eliminating the need for the clinician to consult original sources. Since its introduction, various studies have evaluated the reliability of ChatGPT in generating responses to clinical questions in different areas of dentistry, such as Oral Medicine, Periodontology, Oral Surgery, Endodontics, etc. However, to date, its application in the dental management of medically compromised patients has not been evaluated. Aims: To evaluate the validity of the responses generated by ChatGPT in clinical decision- making for the dental management of medically compromised patients. Materials and Methods: A cross-sectional study has been conducted in which 4 clinical cases of medically compromised patients with implications for dental treatment were developed. The responses obtained with ChatGPT were compared with those provided by 5th-year students of the Dentistry Degree at the University of Santiago de Compostela. The reliability of each response was evaluated using the following scoring system: 1. Complete response; 2. Correct but insufficient response; 3. Response includes both correct and incorrect/outdated information; and 4. Completely incorrect response, based on the guidelines of the American Dental Association. Results: The 5th-year Dentistry students at USC achieved an average score of 2.62, the same as ChatGPT version 4.0. ChatGPT version 3.5 had an average score of 2.75. Conclusions: ChatGPT 3.5 has less clinical accuracy than the students. On the other hand, ChatGPT 4.0 has shown the same diagnostic capability in medically compromised patients as the 5th-year Dentistry students, even surpassing their responses in certain areas where extensive medical knowledge is required; however, it shows a decrease in competence in cases where clinical judgment is needed.
Direction
Diniz Freitas, Márcio (Tutorships)
Diniz Freitas, Márcio (Tutorships)
Treatment of skeletal maxillary compression: rapid maxillary expansion using MARPE
Authorship
M.T.B.
Bachelor of Odontology
M.T.B.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Skeletal maxillary compression represents a significant clinical challenge, not only affecting facial harmony and occlusal balance but also potentially being related to disorders such as apnea/hypoapnea and hearing loss. This study aims to investigate the use of the microimplant-assisted rapid palatal expander (MARPE) in the treatment of this pathology. Objectives: to study the development and growth of the maxilla and the mid-palatal suture; to investigate the possible etiology of skeletal maxillary compression; to evaluate its repercussions and to assess its treatment with MARPE, with special emphasis on different designs, biomechanics, applications, and dento-alveolar and morpho-skeletal changes. Methods: an exhaustive literature review on the treatment of this condition was conducted using specialized scientific search engines. Results: the effectiveness of MARPE in correcting skeletal maxillary compression is consistently highlighted, with favorable clinical outcomes and minimal side effects. Conclusions: MARPE is an effective and predictable treatment for skeletal maxillary compression, producing fewer side effects compared to other treatments.
Skeletal maxillary compression represents a significant clinical challenge, not only affecting facial harmony and occlusal balance but also potentially being related to disorders such as apnea/hypoapnea and hearing loss. This study aims to investigate the use of the microimplant-assisted rapid palatal expander (MARPE) in the treatment of this pathology. Objectives: to study the development and growth of the maxilla and the mid-palatal suture; to investigate the possible etiology of skeletal maxillary compression; to evaluate its repercussions and to assess its treatment with MARPE, with special emphasis on different designs, biomechanics, applications, and dento-alveolar and morpho-skeletal changes. Methods: an exhaustive literature review on the treatment of this condition was conducted using specialized scientific search engines. Results: the effectiveness of MARPE in correcting skeletal maxillary compression is consistently highlighted, with favorable clinical outcomes and minimal side effects. Conclusions: MARPE is an effective and predictable treatment for skeletal maxillary compression, producing fewer side effects compared to other treatments.
Direction
Pose Rodríguez, José Manuel (Tutorships)
OTERO CASAL, MARIA DE LA PAZ (Co-tutorships)
Pose Rodríguez, José Manuel (Tutorships)
OTERO CASAL, MARIA DE LA PAZ (Co-tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
BORRAJO GARCIA, MARIA ISABEL (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
BORRAJO GARCIA, MARIA ISABEL (Member)
Non-surgical treatment peri-implantitis in cases of extreme bone loss, where is the limit?
Authorship
P.I.A.R.
Bachelor of Odontology
P.I.A.R.
Bachelor of Odontology
Defense date
07.19.2024 09:30
07.19.2024 09:30
Summary
Peri-implantitis is a pathological condition associated with plaque that occurs in the tissues surrounding the dental implant, characterized by inflammation of the peri-implant mucosa and progressive loss of supporting bone. There is a wide variety of therapeutic protocols when it comes to treating it, from non-surgical treatments, mechanical debridement, antibiotics and antimicrobials, even surgical procedures. The main objective of this study was to describe four cases of patients diagnosed with advanced peri-implantitis where the treatment of choice could be explantation and subsequent complex anatomical bone reconstruction. These cases were treated with the application of non-surgical treatment, in combination with systemic metronidazole. The clinical and radiographic result was very satisfactory, avoiding the loss of the implant and subsequent advanced reconstructive surgery. This has an impact on the morbidity of the cases and the economic costs to replace implants with an “hopeless” prognosis. Therefore, even in cases of advanced peri-implantitis, non-surgical treatment could avoid the imminent loss of the implant and the economic and morbidity consequences for the patient.
Peri-implantitis is a pathological condition associated with plaque that occurs in the tissues surrounding the dental implant, characterized by inflammation of the peri-implant mucosa and progressive loss of supporting bone. There is a wide variety of therapeutic protocols when it comes to treating it, from non-surgical treatments, mechanical debridement, antibiotics and antimicrobials, even surgical procedures. The main objective of this study was to describe four cases of patients diagnosed with advanced peri-implantitis where the treatment of choice could be explantation and subsequent complex anatomical bone reconstruction. These cases were treated with the application of non-surgical treatment, in combination with systemic metronidazole. The clinical and radiographic result was very satisfactory, avoiding the loss of the implant and subsequent advanced reconstructive surgery. This has an impact on the morbidity of the cases and the economic costs to replace implants with an “hopeless” prognosis. Therefore, even in cases of advanced peri-implantitis, non-surgical treatment could avoid the imminent loss of the implant and the economic and morbidity consequences for the patient.
Direction
LIÑARES GONZALEZ, ANTONIO (Tutorships)
LIÑARES GONZALEZ, ANTONIO (Tutorships)
Court
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
BORRAJO GARCIA, MARIA ISABEL (Member)
Fernández Feijoo, Javier (Chairman)
FERNANDEZ FORMOSO, NOELIA (Secretary)
BORRAJO GARCIA, MARIA ISABEL (Member)
Current classifications and guidelines for the management of thyroid nodule: Systematic review of the main differences and comparison.
Authorship
N.V.P.
Bachelor of Medicine
N.V.P.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
The thyroid nodule (TN) is a highly prevalent entity in the population. However, only a small percentage of them are malignant. Being ultrasound the test par excellence for its diagnosis, multiple ultrasound classifications have been developed over the years whose objective is to stratify thyroid nodules according to the risk of malignancy based on their ultrasound characteristics and provide recommendations regarding the performance of a fine needle aspiration cytology (FNAC). Given that these classifications use different criteria for the stratification of NTs, there is a high variability observed in their diagnostic capacity and there is no consensus on which of them should be used in clinical practice. For this reason, and after verifying the scarcity of studies that evaluate all the currently relevant classifications, it was decided to carry out a systematic review of the TN malignancy risk stratification systems based on ultrasound in order to evaluate the evidence currently available on the performance of these classifications as a diagnostic method and their ability to avoid unnecessary biopsies. To do this, a systematic search for observational studies on the subject was carried out in PubMed and Scopus. After applying certain inclusion and exclusion criteria, 12 articles were selected for review, presenting their data in tables. The results of this work exposed a great variation in terms of sensitivity, specificity and rate of unnecessary biopsies obtained by the different studies reviewed in the evaluation of each classification. The Kwak-TIRADS and ACR-TIRADS stand out for presenting greater sensitivity with lower rates of unnecessary biopsies; as well as the 2021 K-TIRADS, for its great sensitivity along with the Kwak-TIRADS. However, the need for more studies to support these results is evident.
The thyroid nodule (TN) is a highly prevalent entity in the population. However, only a small percentage of them are malignant. Being ultrasound the test par excellence for its diagnosis, multiple ultrasound classifications have been developed over the years whose objective is to stratify thyroid nodules according to the risk of malignancy based on their ultrasound characteristics and provide recommendations regarding the performance of a fine needle aspiration cytology (FNAC). Given that these classifications use different criteria for the stratification of NTs, there is a high variability observed in their diagnostic capacity and there is no consensus on which of them should be used in clinical practice. For this reason, and after verifying the scarcity of studies that evaluate all the currently relevant classifications, it was decided to carry out a systematic review of the TN malignancy risk stratification systems based on ultrasound in order to evaluate the evidence currently available on the performance of these classifications as a diagnostic method and their ability to avoid unnecessary biopsies. To do this, a systematic search for observational studies on the subject was carried out in PubMed and Scopus. After applying certain inclusion and exclusion criteria, 12 articles were selected for review, presenting their data in tables. The results of this work exposed a great variation in terms of sensitivity, specificity and rate of unnecessary biopsies obtained by the different studies reviewed in the evaluation of each classification. The Kwak-TIRADS and ACR-TIRADS stand out for presenting greater sensitivity with lower rates of unnecessary biopsies; as well as the 2021 K-TIRADS, for its great sensitivity along with the Kwak-TIRADS. However, the need for more studies to support these results is evident.
Direction
VARELA PONTE, RAFAEL (Tutorships)
Martínez Lago, Nieves Purificación (Co-tutorships)
VARELA PONTE, RAFAEL (Tutorships)
Martínez Lago, Nieves Purificación (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Evaluation of diagnostic performance of fecal immunochemical test (FIT) for colorectal cancer (CRC) detection in different colonoscopy indication scenarios
Authorship
N.V.V.
Bachelor of Medicine
N.V.V.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
The Faecal immunochemical test (FIT) has a strong scientific support for the detection of colorectal cancer (CRC) in the population screening. Nevertheless, there is still controversy regarding its indication in other clinical scenarios, as well as its diagnostic performance for premalignant lesions. Objective: To evaluate the diagnostic performance of FIT among different groups undergoing colonoscopy: patients from CRC screening program, surveillance after resection of advanced lesions and patients presenting with newly digestive symptoms. Study design: Sub-analysis within the TEDCRC1 research project. This is a prospective observational multicentre diagnostic performance study based on a new blood biomarker for the detection of CRC. Results: From January 22, 2024 to May 8, 2024, a total of 144 participants were included: 92 from the screening group, 28 from surveillance group and 24 from the symptomatic group. Three CRC were detected, along with 35 advanced neoplasias (AN: CRC and/or advanced adenoma and/or advanced serrated lesion) and 37 significant colonic lesions (SCL: AN and/or 3 or more non advanced adenomas, polyposis, colitis, diverticular disease, colonic ulcer or bleeding angiodysplasia). Overall, the sensitivity and specificity for CRC, AN, SCL diagnosis were as follows: 100.00% (95%CI 31.00-96.82%) and 83.69% (95%CI 76.32-89.17%), 48.57% (95%CI 31.72-65.72%) and 91.74% (95%CI 84.49-95.92%), 45.95% (95%CI 29.85-62.87%) and 91.59% (95%CI 84.21-95.84%). Conclusions: This study has demonstrated overall good diagnostic accuracy for CRC, but more limited for AN and SCL. This aspect agrees with current evidence. However, it was not possible to perform a subgroup analysis due to the small sample size.
The Faecal immunochemical test (FIT) has a strong scientific support for the detection of colorectal cancer (CRC) in the population screening. Nevertheless, there is still controversy regarding its indication in other clinical scenarios, as well as its diagnostic performance for premalignant lesions. Objective: To evaluate the diagnostic performance of FIT among different groups undergoing colonoscopy: patients from CRC screening program, surveillance after resection of advanced lesions and patients presenting with newly digestive symptoms. Study design: Sub-analysis within the TEDCRC1 research project. This is a prospective observational multicentre diagnostic performance study based on a new blood biomarker for the detection of CRC. Results: From January 22, 2024 to May 8, 2024, a total of 144 participants were included: 92 from the screening group, 28 from surveillance group and 24 from the symptomatic group. Three CRC were detected, along with 35 advanced neoplasias (AN: CRC and/or advanced adenoma and/or advanced serrated lesion) and 37 significant colonic lesions (SCL: AN and/or 3 or more non advanced adenomas, polyposis, colitis, diverticular disease, colonic ulcer or bleeding angiodysplasia). Overall, the sensitivity and specificity for CRC, AN, SCL diagnosis were as follows: 100.00% (95%CI 31.00-96.82%) and 83.69% (95%CI 76.32-89.17%), 48.57% (95%CI 31.72-65.72%) and 91.74% (95%CI 84.49-95.92%), 45.95% (95%CI 29.85-62.87%) and 91.59% (95%CI 84.21-95.84%). Conclusions: This study has demonstrated overall good diagnostic accuracy for CRC, but more limited for AN and SCL. This aspect agrees with current evidence. However, it was not possible to perform a subgroup analysis due to the small sample size.
Direction
Fernández Rodríguez, Eva (Tutorships)
Regueiro Expósito, Cristina (Co-tutorships)
Cubiella Fernández, Joaquin (Co-tutorships)
Fernández Rodríguez, Eva (Tutorships)
Regueiro Expósito, Cristina (Co-tutorships)
Cubiella Fernández, Joaquin (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Comparative analysis of Bronchogenic Carcinoma surgery according to the type of neoadjuvant treatment.
Authorship
A.V.R.
Bachelor of Medicine
A.V.R.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Introduction: Currently, the leading cause of death by cancer in developed countries is lung cancer. At the time of diagnosis, more than 40% of patients have locally advanced disease, which significantly reduces the chances of cure due to the possibility of micrometastases. Therefore, a combined approach is currently chosen for the treatment of these patients, consisting of neoadjuvant therapy followed by surgical resection. Objectives: To conduct a comparative analysis between two groups of patients, one receiving neoadjuvant chemotherapy and the other receiving neoadjuvant chemoradiotherapy, in order to determine which of the two treatment plans achieves better surgical outcomes, both in terms of approach and technique, as well as complications, deaths, hospital stay, and readmissions. Methods: Observational, descriptive study of an anonymized database that includes 3,304 patients diagnosed with bronchogenic carcinoma, of which 253 received neoadjuvant therapy. Surgical outcomes are compared between the two groups of neoadjuvant recipients. The group receiving chemotherapy consisted of 172 patients and the other receiving chemoradiotherapy consisted of 81 patients. Results: Our results show that there are no significant differences between the two treatment plans except for achieving more complete responses and less use of VATS in the group that received neoadjuvant chemoradiotherapy. Significant differences in favor of neoadjuvant chemoradiotherapy were also found in patients with clinical stage IIIB. Conclusion: Overall, this study determines that there are no significant differences in the surgical outcome of bronchogenic carcinoma between patients who receive neoadjuvant chemotherapy and those who receive neoadjuvant chemoradiotherapy.
Introduction: Currently, the leading cause of death by cancer in developed countries is lung cancer. At the time of diagnosis, more than 40% of patients have locally advanced disease, which significantly reduces the chances of cure due to the possibility of micrometastases. Therefore, a combined approach is currently chosen for the treatment of these patients, consisting of neoadjuvant therapy followed by surgical resection. Objectives: To conduct a comparative analysis between two groups of patients, one receiving neoadjuvant chemotherapy and the other receiving neoadjuvant chemoradiotherapy, in order to determine which of the two treatment plans achieves better surgical outcomes, both in terms of approach and technique, as well as complications, deaths, hospital stay, and readmissions. Methods: Observational, descriptive study of an anonymized database that includes 3,304 patients diagnosed with bronchogenic carcinoma, of which 253 received neoadjuvant therapy. Surgical outcomes are compared between the two groups of neoadjuvant recipients. The group receiving chemotherapy consisted of 172 patients and the other receiving chemoradiotherapy consisted of 81 patients. Results: Our results show that there are no significant differences between the two treatment plans except for achieving more complete responses and less use of VATS in the group that received neoadjuvant chemoradiotherapy. Significant differences in favor of neoadjuvant chemoradiotherapy were also found in patients with clinical stage IIIB. Conclusion: Overall, this study determines that there are no significant differences in the surgical outcome of bronchogenic carcinoma between patients who receive neoadjuvant chemotherapy and those who receive neoadjuvant chemoradiotherapy.
Direction
RIVO VAZQUEZ, JOSE EDUARDO (Tutorships)
Quiroga Martínez, Jorge (Co-tutorships)
RIVO VAZQUEZ, JOSE EDUARDO (Tutorships)
Quiroga Martínez, Jorge (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Evaluation of the safety and efficiency of Artificial Intelligence in radiology: a bibliographic review.
Authorship
A.V.F.
Bachelor of Medicine
A.V.F.
Bachelor of Medicine
Defense date
07.18.2024 09:00
07.18.2024 09:00
Summary
Background: the implementation of artificial intelligence (AI) in medicine has meant a before and after in the development of professional practice. This technology has been integrated into radiology services for years in different ways. Specifically, its application in the image interpretation process constitutes one of the greatest revolutions in this specialty, and it can radically change the practice of professionals. Purpose: analyze the impact of AI on diagnostic accuracy and efficiency in the interpretation of radiological images, as well as evaluate aspects related to safety. Additionally, try to know the perception of future health professionals about the implementation of AI in medicine. Materials and methods: an exhaustive search was carried out using the bibliographic databases PubMed and Scopus. In addition, to find out the students' opinion about AI in medicine, a questionnaire was developed in digital format. Results: a total of 153 articles were rescued through a keyword search in the Pubmed and Scopus databases. After reading the titles and abstracts, a total of 15 articles were retrieved for full-text review applying the inclusion and exclusion criteria. Finally, the remaining 7 articles were selected to be included in the review. On the other hand, the questionnaire was completed by 95 students from different faculties of Medicine and Dentistry. After its review, it was found that the application of AI provides an increase in efficiency in the interpretation of radiological images, with high values of sensitivity, specificity, precision and AUC (up to 100%, 100%, 0.99 and 0.99), respectively. Both positive points and negative points were found with potential for improvement in terms of security. On the other hand, the students demonstrated a positive perception about the integration of this technology, although they do not have adequate training, which generates certain concerns. Conclusions: the application of AI in radiology has been shown to increase diagnostic efficiency and accuracy. However, there is potential for improvement achievable through higher quality research. Regarding security, factors have been found that positively affect it, but also negative variables that require further analysis. Finally, it has been seen that the maximum benefit is obtained from the combination of human experts and AI models. Therefore, it seems necessary to expand the training in this regard for future professionals, who are aware of the relevance of this new technology in medicine and who, in addition, demand such preparation.
Background: the implementation of artificial intelligence (AI) in medicine has meant a before and after in the development of professional practice. This technology has been integrated into radiology services for years in different ways. Specifically, its application in the image interpretation process constitutes one of the greatest revolutions in this specialty, and it can radically change the practice of professionals. Purpose: analyze the impact of AI on diagnostic accuracy and efficiency in the interpretation of radiological images, as well as evaluate aspects related to safety. Additionally, try to know the perception of future health professionals about the implementation of AI in medicine. Materials and methods: an exhaustive search was carried out using the bibliographic databases PubMed and Scopus. In addition, to find out the students' opinion about AI in medicine, a questionnaire was developed in digital format. Results: a total of 153 articles were rescued through a keyword search in the Pubmed and Scopus databases. After reading the titles and abstracts, a total of 15 articles were retrieved for full-text review applying the inclusion and exclusion criteria. Finally, the remaining 7 articles were selected to be included in the review. On the other hand, the questionnaire was completed by 95 students from different faculties of Medicine and Dentistry. After its review, it was found that the application of AI provides an increase in efficiency in the interpretation of radiological images, with high values of sensitivity, specificity, precision and AUC (up to 100%, 100%, 0.99 and 0.99), respectively. Both positive points and negative points were found with potential for improvement in terms of security. On the other hand, the students demonstrated a positive perception about the integration of this technology, although they do not have adequate training, which generates certain concerns. Conclusions: the application of AI in radiology has been shown to increase diagnostic efficiency and accuracy. However, there is potential for improvement achievable through higher quality research. Regarding security, factors have been found that positively affect it, but also negative variables that require further analysis. Finally, it has been seen that the maximum benefit is obtained from the combination of human experts and AI models. Therefore, it seems necessary to expand the training in this regard for future professionals, who are aware of the relevance of this new technology in medicine and who, in addition, demand such preparation.
Direction
Souto Bayarri, José Miguel (Tutorships)
Barreiro Ares, Andrés (Co-tutorships)
Souto Bayarri, José Miguel (Tutorships)
Barreiro Ares, Andrés (Co-tutorships)
Court
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
LAREU HUIDOBRO, MARIA VICTORIA (Chairman)
LIROLA DELGADO, ANTONIO GUSTAVO (Secretary)
RODRIGUEZ COBOS, MARIA ANGELES (Member)
Clinical response to immunotherapy in women affected by advanced non-small cell lung cancer
Authorship
A.C.A.D.S.
Bachelor of Medicine
A.C.A.D.S.
Bachelor of Medicine
Defense date
02.09.2024 09:00
02.09.2024 09:00
Summary
Lung cancer (LC) is a social scourge due to its high incidence (2nd place worldwide, with 2.206.771 new cases) and its high lethality (1st place with 1.796.144 deaths) (Globocan, 2020). In Spain, in 2022, 22.316 new cases were observed in men and 8.632 in women (Spanish Society of Medical Oncology (SEOM) and Spanish Network of Cancer Registries (REDECAN, 2022)). However, for a few years, there has been a greater rise in its incidence in the female sex, mainly due to the recent incorporation of women into the tobacco habit and to the greater susceptibility to the damage produced by it. Immunotherapy has been a breakthrough in a field where therapeutics had modest efficacy and were dominated by chemotherapy and radiotherapy. The most striking effect of immunotherapy is to prolong the survival of some patients, especially the subgroup of the so-called long responders. However, the biological reasons why the treatment is more or less effective in different individuals are not fully known, and there are hypotheses that the effectiveness of immunotherapy may be less in women. In order to offer information in this complex scenario, we have carried out a retrospective observational study on a sample of 189 patients treated at the Medical Oncology Service of Complejo Hospitalario Universitario de A Coruña (CHUAC) with advanced-stage non-small cell lung cancer (NSCLC) comparing clinical response to immunotherapy in women versus men in terms of overall survival (OS) and progression-free survival (PFS) and adjusted for confounding factors.
Lung cancer (LC) is a social scourge due to its high incidence (2nd place worldwide, with 2.206.771 new cases) and its high lethality (1st place with 1.796.144 deaths) (Globocan, 2020). In Spain, in 2022, 22.316 new cases were observed in men and 8.632 in women (Spanish Society of Medical Oncology (SEOM) and Spanish Network of Cancer Registries (REDECAN, 2022)). However, for a few years, there has been a greater rise in its incidence in the female sex, mainly due to the recent incorporation of women into the tobacco habit and to the greater susceptibility to the damage produced by it. Immunotherapy has been a breakthrough in a field where therapeutics had modest efficacy and were dominated by chemotherapy and radiotherapy. The most striking effect of immunotherapy is to prolong the survival of some patients, especially the subgroup of the so-called long responders. However, the biological reasons why the treatment is more or less effective in different individuals are not fully known, and there are hypotheses that the effectiveness of immunotherapy may be less in women. In order to offer information in this complex scenario, we have carried out a retrospective observational study on a sample of 189 patients treated at the Medical Oncology Service of Complejo Hospitalario Universitario de A Coruña (CHUAC) with advanced-stage non-small cell lung cancer (NSCLC) comparing clinical response to immunotherapy in women versus men in terms of overall survival (OS) and progression-free survival (PFS) and adjusted for confounding factors.
Direction
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
Cordeiro González, Patricia (Co-tutorships)
CARRACEDO ALVAREZ, ANGEL MARIA (Tutorships)
Cordeiro González, Patricia (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Dysphagia and airway obstruction in Forestier disease: systematic review of literature
Authorship
R.A.G.B.
Bachelor of Medicine
R.A.G.B.
Bachelor of Medicine
Defense date
02.09.2024 09:00
02.09.2024 09:00
Summary
OBJECTIVES: Detect the incidence and prevalence of dysphagia in DISH, collect predominant symptomatology and review the most current options on the available treatment. METHODOLOGY: A systematic review of the most current bibliography was carried out, in the main databases using the inclusion and exclusion criteria. RESULTS: Firstly, it was possible to demonstrate the lack of unanimity that exists when diagnosing DISH based on available criteria. Then it was verified the lack of studies that demonstrate the clear pathophysiology of the disease, as well as the absence of a protocol to follow in the option of conservative medical treatment. DISCUSSION: Forestier's disease has an incidence that increases every day, affecting men to a greater extent; related to AHT, DM, and currently there is no consensus regarding the diagnostic criteria, regarding the treatment it is preferable to choose to be conservative, leaving surgery as a second chance. CONCLUSIONS: Knowing the exact prevalence of DISH is complicated because most cases are not diagnosed because they are asymptomatic; it affects more elderly people and also more men than women; it is positively related to hypertension, DM2 and metabolic syndrome; when it debuts clinically, the most frequent symptom is dysphagia and the first-choice treatment is conservative.
OBJECTIVES: Detect the incidence and prevalence of dysphagia in DISH, collect predominant symptomatology and review the most current options on the available treatment. METHODOLOGY: A systematic review of the most current bibliography was carried out, in the main databases using the inclusion and exclusion criteria. RESULTS: Firstly, it was possible to demonstrate the lack of unanimity that exists when diagnosing DISH based on available criteria. Then it was verified the lack of studies that demonstrate the clear pathophysiology of the disease, as well as the absence of a protocol to follow in the option of conservative medical treatment. DISCUSSION: Forestier's disease has an incidence that increases every day, affecting men to a greater extent; related to AHT, DM, and currently there is no consensus regarding the diagnostic criteria, regarding the treatment it is preferable to choose to be conservative, leaving surgery as a second chance. CONCLUSIONS: Knowing the exact prevalence of DISH is complicated because most cases are not diagnosed because they are asymptomatic; it affects more elderly people and also more men than women; it is positively related to hypertension, DM2 and metabolic syndrome; when it debuts clinically, the most frequent symptom is dysphagia and the first-choice treatment is conservative.
Direction
RODRIGUEZ COBOS, MARIA ANGELES (Tutorships)
RODRIGUEZ COBOS, MARIA ANGELES (Tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
quality review of clinical practice guidelines of plastic surgery
Authorship
M.H.C.
Bachelor of Medicine
M.H.C.
Bachelor of Medicine
Defense date
02.09.2024 09:00
02.09.2024 09:00
Summary
Summary: Clinical practice guidelines (CPGs) are systematic recommendations based on available scientific evidence that are used to make informed decisions. They are particularly important in the field of plastic surgery, as their proper implementation can help prevent complications resulting from procedures and alleviate patient s dissatisfaction when desired outcomes are not achieved, contributing to improve their quality of life. Objetives: To assess the quality of clinical practice guidelines in plastic surgery. Material and methods: A review of available CPG from 2017 to 2023 was conducted using the PubMed and Web of Science (WOS) databases. The selected CPGs were then assessed using the AGREE II program. Results: Of the 10 CPG analyzed, 5 (50%) were recommended after the analysis and only one of them obtained the maximum score in the tool. Three (30%) were recommended with modifications. Finally, two (20%) were not recommended for use in routine clinical practice due to insufficient quality. Conclusions: The analyzed guidelines showed room for improvement, particularly in terms of development rigor and applicability. The use of quality analysis tools such as AGREE II should be more widespread to ensure that published documents meet the required quality standards.
Summary: Clinical practice guidelines (CPGs) are systematic recommendations based on available scientific evidence that are used to make informed decisions. They are particularly important in the field of plastic surgery, as their proper implementation can help prevent complications resulting from procedures and alleviate patient s dissatisfaction when desired outcomes are not achieved, contributing to improve their quality of life. Objetives: To assess the quality of clinical practice guidelines in plastic surgery. Material and methods: A review of available CPG from 2017 to 2023 was conducted using the PubMed and Web of Science (WOS) databases. The selected CPGs were then assessed using the AGREE II program. Results: Of the 10 CPG analyzed, 5 (50%) were recommended after the analysis and only one of them obtained the maximum score in the tool. Three (30%) were recommended with modifications. Finally, two (20%) were not recommended for use in routine clinical practice due to insufficient quality. Conclusions: The analyzed guidelines showed room for improvement, particularly in terms of development rigor and applicability. The use of quality analysis tools such as AGREE II should be more widespread to ensure that published documents meet the required quality standards.
Direction
GARCIA GARCIA, MANUEL (Tutorships)
Maes Carballo, Marta (Co-tutorships)
GARCIA GARCIA, MANUEL (Tutorships)
Maes Carballo, Marta (Co-tutorships)
Court
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Rodriguez Calvo, Maria Sol (Chairman)
LAGE FERNANDEZ, RICARDO (Secretary)
Ponte Hernando, Fernando Julio (Member)
Fertility after treatment of ectopic pregnancy
Authorship
M.C.G.
Bachelor of Medicine
M.C.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: ectopic pregnancy is any pregnancy of extrauterine location, being by far the most frequent the tubal location. Since it is a pathology that can cause the death of the woman, early diagnosis and treatment are fundamental in its management. The main therapeutic options will consist of a medical treatment based on methotrexate or a surgical approach being this more conservative (salpingostomy) or more radical (salpingectomy). All these treatments may affect the woman's future fertility. Objectives: to conduct a systematic review of how the different therapeutic alternatives for ectopic pregnancy affect the woman's future fertility. Material and methods: Systematic review carried out in the Medline database through its Pubmed search engine including articles published between 2000 and July 2023 in English or Spanish in which tubal ectopic pregnancy was treated and fertility was evaluated after treatment. Clinical studies, clinical trials, comparative and observational studies, and randomized controlled trials were included. Results and conclusions: After applying the inclusion and exclusion criteria, 16 articles were finally selected, of which 11 found no statistically significant difference between medical and surgical treatment or between the different surgical options. Of the remaining studies, some found significant differences in favor of salpingostomy, although the evidence is limited.
Introduction: ectopic pregnancy is any pregnancy of extrauterine location, being by far the most frequent the tubal location. Since it is a pathology that can cause the death of the woman, early diagnosis and treatment are fundamental in its management. The main therapeutic options will consist of a medical treatment based on methotrexate or a surgical approach being this more conservative (salpingostomy) or more radical (salpingectomy). All these treatments may affect the woman's future fertility. Objectives: to conduct a systematic review of how the different therapeutic alternatives for ectopic pregnancy affect the woman's future fertility. Material and methods: Systematic review carried out in the Medline database through its Pubmed search engine including articles published between 2000 and July 2023 in English or Spanish in which tubal ectopic pregnancy was treated and fertility was evaluated after treatment. Clinical studies, clinical trials, comparative and observational studies, and randomized controlled trials were included. Results and conclusions: After applying the inclusion and exclusion criteria, 16 articles were finally selected, of which 11 found no statistically significant difference between medical and surgical treatment or between the different surgical options. Of the remaining studies, some found significant differences in favor of salpingostomy, although the evidence is limited.
Direction
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Vilar Lagares, Ana (Co-tutorships)
ARIAS BALTAR, MARIA EFIGENIA (Tutorships)
Vilar Lagares, Ana (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
The forensic autopsy in suspicious death: sudden functional death with a pathological basis.
Authorship
P.C.C.
Bachelor of Medicine
P.C.C.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Sudden death is characterized by being unexpected and quick, ensuing within 24 hours of the onset of clinical manifestations. The most frequent is of cardiac origin, which causes between 4 and 5 million deaths worldwide each year, with coronary atherosclerosis being the most common. Sudden cardiac death, being a suspicious death, requires a forensic autopsy. However, in many instances there is no evidence of a lesion capable of explaining the cause of death with complete certainty. At the same time, other non- specific lesions may be found which could explain the death but that could also be present in living people without causing their demise. Therefore, these cases are being classified as pathologically based functional sudden cardiac death. This systematic review, which focuses on functional sudden cardiac death with a coronary pathological basis demonstrates the lack of homogeneous and standardised criteria for its diagnosis and assesses the available evidence on the use of imaging techniques and postmortem molecular and biochemical markers for its study. A review of the sentences and rulings issued in the autonomous community of Galicia is also conducted, which demonstrates the importance of correctly classifying these deaths in view of the legal repercussions they may have. In addition, this review describes and compares the statistical data provided by the different forensic medicine institutes of Spain, allowing us to deduce from the current situation that there is a high number of deaths that are misclassified as suspicious deaths in Spain, one of the countries with the lowest incidence of sudden cardiac death within Europe.
Sudden death is characterized by being unexpected and quick, ensuing within 24 hours of the onset of clinical manifestations. The most frequent is of cardiac origin, which causes between 4 and 5 million deaths worldwide each year, with coronary atherosclerosis being the most common. Sudden cardiac death, being a suspicious death, requires a forensic autopsy. However, in many instances there is no evidence of a lesion capable of explaining the cause of death with complete certainty. At the same time, other non- specific lesions may be found which could explain the death but that could also be present in living people without causing their demise. Therefore, these cases are being classified as pathologically based functional sudden cardiac death. This systematic review, which focuses on functional sudden cardiac death with a coronary pathological basis demonstrates the lack of homogeneous and standardised criteria for its diagnosis and assesses the available evidence on the use of imaging techniques and postmortem molecular and biochemical markers for its study. A review of the sentences and rulings issued in the autonomous community of Galicia is also conducted, which demonstrates the importance of correctly classifying these deaths in view of the legal repercussions they may have. In addition, this review describes and compares the statistical data provided by the different forensic medicine institutes of Spain, allowing us to deduce from the current situation that there is a high number of deaths that are misclassified as suspicious deaths in Spain, one of the countries with the lowest incidence of sudden cardiac death within Europe.
Direction
MUÑOZ BARUS, JOSE IGNACIO (Tutorships)
Trincado Ave, Mauro (Co-tutorships)
MUÑOZ BARUS, JOSE IGNACIO (Tutorships)
Trincado Ave, Mauro (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Advanced maternal age as an obstetric risk factor
Authorship
L.C.D.
Bachelor of Medicine
L.C.D.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Motherhood at more advanced ages has become a topic of increasing interest in recent years in the obstetric and perinatal field. This can be explained by the social and demographic changes that women have experienced in recent years, as well as the evolution of assisted reproduction techniques, which have allowed women to delay the age at which they conceive, making the delay in motherhood multifactorial. However, this obstetric and reproductive change may not be without complications for both maternal and fetal health. Objectives: To review and synthesize the available published evidence on advanced maternal age as an obstetric and perinatal risk factor over the last 7 years (2017-2024). Materials and Methods: A systematic review in the MEDLINE-PubMed database using meta-analyses and systematic reviews. Results: Seven articles were finally included (systematic reviews and meta-analyses). It was recorded that maternal morbidity (chronic hypertension, gestational hypertension, gestational diabetes, obesity, preeclampsia) increases as maternal age increases. Furthermore, fetal and perinatal mortality is higher in women of advanced maternal age, as are admissions to the Neonatal Intensive Care Unit and increased prematurity. Cesarean sections were also more frequent in the advanced maternal age groups. Placenta previa was associated with the AMA groups. No significant differences were observed between parity and the effects of AMA. Conclusions: AMA increases certain medical conditions that affect the mother, such as hypertension (both chronic and gestational), obesity, and gestational diabetes, among others. The reviewed literature reveals that AMA seems to be related to some obstetric complications, preeclampsia, a higher number of cesarean deliveries, or maternal mortality, especially in mothers over 45 years old. The reviewed studies indicate that AMA correlates with a higher number of adverse perinatal outcomes, including preterm birth, fetal death, low birth weight, or NICU admission. AMA could be considered an obstetric and perinatal risk factor, always evaluating each case in an individualized and integrated manner, taking into account numerous factors that can influence the correct development of the pregnancy in addition to age. More powerful studies are needed to determine the age at which to consider advanced maternal age and to investigate different interventions in these older age groups, such as the development of a specific management protocol for pregnancy.
Introduction: Motherhood at more advanced ages has become a topic of increasing interest in recent years in the obstetric and perinatal field. This can be explained by the social and demographic changes that women have experienced in recent years, as well as the evolution of assisted reproduction techniques, which have allowed women to delay the age at which they conceive, making the delay in motherhood multifactorial. However, this obstetric and reproductive change may not be without complications for both maternal and fetal health. Objectives: To review and synthesize the available published evidence on advanced maternal age as an obstetric and perinatal risk factor over the last 7 years (2017-2024). Materials and Methods: A systematic review in the MEDLINE-PubMed database using meta-analyses and systematic reviews. Results: Seven articles were finally included (systematic reviews and meta-analyses). It was recorded that maternal morbidity (chronic hypertension, gestational hypertension, gestational diabetes, obesity, preeclampsia) increases as maternal age increases. Furthermore, fetal and perinatal mortality is higher in women of advanced maternal age, as are admissions to the Neonatal Intensive Care Unit and increased prematurity. Cesarean sections were also more frequent in the advanced maternal age groups. Placenta previa was associated with the AMA groups. No significant differences were observed between parity and the effects of AMA. Conclusions: AMA increases certain medical conditions that affect the mother, such as hypertension (both chronic and gestational), obesity, and gestational diabetes, among others. The reviewed literature reveals that AMA seems to be related to some obstetric complications, preeclampsia, a higher number of cesarean deliveries, or maternal mortality, especially in mothers over 45 years old. The reviewed studies indicate that AMA correlates with a higher number of adverse perinatal outcomes, including preterm birth, fetal death, low birth weight, or NICU admission. AMA could be considered an obstetric and perinatal risk factor, always evaluating each case in an individualized and integrated manner, taking into account numerous factors that can influence the correct development of the pregnancy in addition to age. More powerful studies are needed to determine the age at which to consider advanced maternal age and to investigate different interventions in these older age groups, such as the development of a specific management protocol for pregnancy.
Direction
Anibarro García, Luís (Tutorships)
Ferreiro García, Esteban (Co-tutorships)
Anibarro García, Luís (Tutorships)
Ferreiro García, Esteban (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Efficacy of sodium oxybate treatment in the management of symptoms of narcolepsy type 1. Systematic review.
Authorship
P.C.N.
Bachelor of Medicine
P.C.N.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
INTRODUCTION: Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy (in NT1) and other REM sleep disturbances. There are two types of narcolepsy: type 1 and type 2. The difference lies in the presence of low levels of orexin/hypocretin, as well as cataplexy in NT1. For type 1 narcolepsy, an autoimmune etiology has been postulated, in which there would be a selective destruction of the orexin-producing neurons in the lateral hypothalamus. At present there is no cure, its treatment is symptomatic, combining non-pharmacological (sleep hygiene) and pharmacological strategies (sodium oxybate plays a relevant role in the management of symptoms). OBJECTIVES: To conduct a systematic review about the efficacy of sodium oxybate on the core symptoms of narcolepsy type 1. MATERIAL AND METHODS: A search in the Pubmed databases was performed. Primary studies conducted in the last 10 years on the adult population were included. RESULTS: A total of 103 articles were obtained, of which, after applying the inclusion and exclusion criteria, 7 were selected to carry out the systematic review. The studies consisted of clinical trials in adult population that analyzed the effectiveness of sodium oxybate versus placebo. CONCLUSIONS: Studies demonstrate the efficacy and safety of treatment with sodium oxybate in patients with narcolepsy. An improvement in excessive daytime sleepiness has been observed in ESS and reduction in the frequency of cataplexy attacks and nocturnal sleep fragmentation were significant compared to placebo.
INTRODUCTION: Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy (in NT1) and other REM sleep disturbances. There are two types of narcolepsy: type 1 and type 2. The difference lies in the presence of low levels of orexin/hypocretin, as well as cataplexy in NT1. For type 1 narcolepsy, an autoimmune etiology has been postulated, in which there would be a selective destruction of the orexin-producing neurons in the lateral hypothalamus. At present there is no cure, its treatment is symptomatic, combining non-pharmacological (sleep hygiene) and pharmacological strategies (sodium oxybate plays a relevant role in the management of symptoms). OBJECTIVES: To conduct a systematic review about the efficacy of sodium oxybate on the core symptoms of narcolepsy type 1. MATERIAL AND METHODS: A search in the Pubmed databases was performed. Primary studies conducted in the last 10 years on the adult population were included. RESULTS: A total of 103 articles were obtained, of which, after applying the inclusion and exclusion criteria, 7 were selected to carry out the systematic review. The studies consisted of clinical trials in adult population that analyzed the effectiveness of sodium oxybate versus placebo. CONCLUSIONS: Studies demonstrate the efficacy and safety of treatment with sodium oxybate in patients with narcolepsy. An improvement in excessive daytime sleepiness has been observed in ESS and reduction in the frequency of cataplexy attacks and nocturnal sleep fragmentation were significant compared to placebo.
Direction
Hermida Ameijeiras, Álvaro (Tutorships)
Guijarro del Amo, Mónica (Co-tutorships)
Hermida Ameijeiras, Álvaro (Tutorships)
Guijarro del Amo, Mónica (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Controversy regarding tube feeding in elderly patients with advanced dementia
Authorship
M.C.G.
Bachelor of Medicine
M.C.G.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
-Introduction: this Final Degree Project consists of a systematic review focused on evaluating the risk-benefit that tube feeding provides in elderly patients with advanced dementia, as well as their impact on professionals and families, reflecting on the adequacy of therapeutic effort and suggesting future research lines in this field. -Main objective: to evaluate the impact, in terms of mortality and quality of life, that tube feeding has on elderly patients with advanced dementia. -Material and methods: a systematic review of the available literature was carried out through research in Medline (via PubMed), Web of Science and Cochrane databases. Articles published in the last 10 years (2013-2023) that met the established selection criteria were collected. -Outcomes: the use of feeding tubes in elderly patients with dementia is still an extended technique used in daily clinical practice, although it has not been shown to improve either survival or quality of life in these patients. There are multiple factors involved that difficult the decision making about it, so it is necessary to involve families and caregivers in the process. -Conclusion: the majority of the reviewed papers agree that tube feeding in elderly patients with dementia leads to more complications than benefits, so its use in this patient profile should be discouraged. Additional studies are needed to establish clear indications in this regard and so further research on nutritional alternatives, as well as the inclusion of these patients in quality palliative care plans.
-Introduction: this Final Degree Project consists of a systematic review focused on evaluating the risk-benefit that tube feeding provides in elderly patients with advanced dementia, as well as their impact on professionals and families, reflecting on the adequacy of therapeutic effort and suggesting future research lines in this field. -Main objective: to evaluate the impact, in terms of mortality and quality of life, that tube feeding has on elderly patients with advanced dementia. -Material and methods: a systematic review of the available literature was carried out through research in Medline (via PubMed), Web of Science and Cochrane databases. Articles published in the last 10 years (2013-2023) that met the established selection criteria were collected. -Outcomes: the use of feeding tubes in elderly patients with dementia is still an extended technique used in daily clinical practice, although it has not been shown to improve either survival or quality of life in these patients. There are multiple factors involved that difficult the decision making about it, so it is necessary to involve families and caregivers in the process. -Conclusion: the majority of the reviewed papers agree that tube feeding in elderly patients with dementia leads to more complications than benefits, so its use in this patient profile should be discouraged. Additional studies are needed to establish clear indications in this regard and so further research on nutritional alternatives, as well as the inclusion of these patients in quality palliative care plans.
Direction
POSE REINO, ANTONIO DOMINGO (Tutorships)
POSE REINO, ANTONIO DOMINGO (Tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
In-hospital suicide in psychiatric units
Authorship
N.C.M.
Bachelor of Medicine
N.C.M.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: In 2023 suicide has been the leading cause of external death in Spain and it is estimated that up to 90% of people who commit suicide suffer from some mental illness. Among hospitalized psychiatric patients, the suicide rate is much higher than that of the general population. Therefore, it is very important to know which factors are most associated with hospital suicide in these patients in order to be able to evaluate them and manage this risk. Objectives: A review of the literature is carried out with the main objectives of knowing the rates of completed suicide in psychiatric hospitalization units and identifying the risk factors for in-hospital suicide in these patients. As a secondary objective, characteristics of suicidal behavior in psychiatric inpatient units are described. Methods: A search was carried out in the following databases: Pubmed, Scopus, Embase, Web Of Science, PsycInfo and Google, since records began until 11/10/2023. Results: The suicide rate in hospitalized psychiatric patients is estimated to be between 0.1% and 0.4%. Multiple risk factors have been described, including suicidal ideation, previous attempts, multiple admissions, depressive symptoms, hopelessness and diagnoses of schizophrenia or affective disorder. The most common method is hanging and the times of greatest risk are at the beginning of admission, during a furlough or after an escape. Conclusions: The present review shows that, although no way has yet been discovered to calculate the risk of in-hospital suicide in psychiatric patients accurately, there are a number of factors that, assessed periodically, can give us information about it. In addition, the hospital environment must be adapted to minimize the risks.
Introduction: In 2023 suicide has been the leading cause of external death in Spain and it is estimated that up to 90% of people who commit suicide suffer from some mental illness. Among hospitalized psychiatric patients, the suicide rate is much higher than that of the general population. Therefore, it is very important to know which factors are most associated with hospital suicide in these patients in order to be able to evaluate them and manage this risk. Objectives: A review of the literature is carried out with the main objectives of knowing the rates of completed suicide in psychiatric hospitalization units and identifying the risk factors for in-hospital suicide in these patients. As a secondary objective, characteristics of suicidal behavior in psychiatric inpatient units are described. Methods: A search was carried out in the following databases: Pubmed, Scopus, Embase, Web Of Science, PsycInfo and Google, since records began until 11/10/2023. Results: The suicide rate in hospitalized psychiatric patients is estimated to be between 0.1% and 0.4%. Multiple risk factors have been described, including suicidal ideation, previous attempts, multiple admissions, depressive symptoms, hopelessness and diagnoses of schizophrenia or affective disorder. The most common method is hanging and the times of greatest risk are at the beginning of admission, during a furlough or after an escape. Conclusions: The present review shows that, although no way has yet been discovered to calculate the risk of in-hospital suicide in psychiatric patients accurately, there are a number of factors that, assessed periodically, can give us information about it. In addition, the hospital environment must be adapted to minimize the risks.
Direction
Gómez-Reino Rodríguez, Ignacio (Tutorships)
Ortega Ruibal, Francisco José (Co-tutorships)
Gómez-Reino Rodríguez, Ignacio (Tutorships)
Ortega Ruibal, Francisco José (Co-tutorships)
Court
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
GONZALEZ GARCIA, FRANCISCO (Chairman)
DIAZ PEROMINGO, JOSE ANTONIO (Secretary)
GINARTE VAL, MANUEL JAVIER (Member)
Utility of the preoperatory magnetic resonance imaging to predict the appearance of physeal bridges in Legg Calve Perthes disease
Authorship
A.C.L.
Bachelor of Medicine
A.C.L.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Legg Calve Perthes disease is a vascular disorder that occurs in the developing hip, usually under 10 years old and involves necrosis of the proximal femoral epiphysis. After necrosis, its natural history carries on with the phases of fragmentation, rheossification and sequelae. The viability of the femoral head in adulthood will depend on how this reossification is performed (Stulberg's classification). There is a large literature based on the etiology, pathogenesis, evolution and treatment of this disease, but it runs low in therms of prognostic factors such as physeal bridges development in proximal femoral epiphysis.
Legg Calve Perthes disease is a vascular disorder that occurs in the developing hip, usually under 10 years old and involves necrosis of the proximal femoral epiphysis. After necrosis, its natural history carries on with the phases of fragmentation, rheossification and sequelae. The viability of the femoral head in adulthood will depend on how this reossification is performed (Stulberg's classification). There is a large literature based on the etiology, pathogenesis, evolution and treatment of this disease, but it runs low in therms of prognostic factors such as physeal bridges development in proximal femoral epiphysis.
Direction
PINO MINGUEZ, JESUS (Tutorships)
Castro Torre, Miguel (Co-tutorships)
PINO MINGUEZ, JESUS (Tutorships)
Castro Torre, Miguel (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Seasonal viruses in pediatric age and inmunization. Parental knowledge ant attitude
Authorship
C.C.R.
Bachelor of Medicine
C.C.R.
Bachelor of Medicine
Defense date
06.20.2024 09:00
06.20.2024 09:00
Summary
Introduction: Seasonal infections such as those caused by influenza or RSV are of great importance in the pediatric age both due to their prevalence and the expenditure of resources they entail. For both, there is the probability of prevention through immunization, a strategy that has been proven effective but that in recent times has had its detractors at a social level with the emergence of anti-vaccine movements. Materials and methods: Descriptive observational study carried out based on surveys carried out in a health center with fathers and mothers with children under 15 years of age. This study seeks, through a survey, to evaluate both basic knowledge about influenza and bronchiolitis and attitudes and opinions regarding vaccination. Results: Ninety surveys were collected, from which 87% reported that one of their children had been diagnosed with the flu and/or bronchiolitis on some occasion and the majority had some prior knowledge about these diseases and although many were healthy patients, almost 30 % reported some pathology that they considered risky. In general, they considered bronchiolitis to be more serious than the flu and there was a lack of knowledge regarding useful treatments for these pathologies. Almost all of those surveyed, more than 90%, valued the vaccines positively and considered them safe, but more than half reported concern about possible side effects. Regarding seasonal vaccines, 74% reported intention to vaccinate their children and the majority considered primary care professionals their main source of information about immunizations. Conclusion: Pathologies derived from RSV and influenza are well known by the population, and society is increasingly aware of the measures that help prevent them. Even so, there are still certain aspects to clarify, and it is an essential job of health professionals to provide more information on this matter, and reinforce the trust and safety of vaccines as the best prevention way.
Introduction: Seasonal infections such as those caused by influenza or RSV are of great importance in the pediatric age both due to their prevalence and the expenditure of resources they entail. For both, there is the probability of prevention through immunization, a strategy that has been proven effective but that in recent times has had its detractors at a social level with the emergence of anti-vaccine movements. Materials and methods: Descriptive observational study carried out based on surveys carried out in a health center with fathers and mothers with children under 15 years of age. This study seeks, through a survey, to evaluate both basic knowledge about influenza and bronchiolitis and attitudes and opinions regarding vaccination. Results: Ninety surveys were collected, from which 87% reported that one of their children had been diagnosed with the flu and/or bronchiolitis on some occasion and the majority had some prior knowledge about these diseases and although many were healthy patients, almost 30 % reported some pathology that they considered risky. In general, they considered bronchiolitis to be more serious than the flu and there was a lack of knowledge regarding useful treatments for these pathologies. Almost all of those surveyed, more than 90%, valued the vaccines positively and considered them safe, but more than half reported concern about possible side effects. Regarding seasonal vaccines, 74% reported intention to vaccinate their children and the majority considered primary care professionals their main source of information about immunizations. Conclusion: Pathologies derived from RSV and influenza are well known by the population, and society is increasingly aware of the measures that help prevent them. Even so, there are still certain aspects to clarify, and it is an essential job of health professionals to provide more information on this matter, and reinforce the trust and safety of vaccines as the best prevention way.
Direction
Moreno Álvarez, Ana (Tutorships)
Pérez Tato, Helena (Co-tutorships)
Moreno Álvarez, Ana (Tutorships)
Pérez Tato, Helena (Co-tutorships)
Court
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)
Alvarez Villamarin, Clara (Chairman)
SAAVEDRA NIEVES, ALEJANDRO (Secretary)
FERNANDEZ PEREZ, CRISTINA (Member)