Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)

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Selection of the Most Suitable Culture Medium for Patient-Derived Lung Cancer Organoids
(Karger, 2024-09-05) Acosta Plasencia, Melissa; He, Yangyi; Martínez Hernández, Daniel; Orozco, Juan Pablo; Carrasco, Antonio; Altuna Coy, Antonio; Yang, Tianmiao; Díaz Sánchez, Tania; Molins López-Rodó, Laureano; Ramos Izquierdo, Ricard; Marrades Sicart, Ramon Ma.; Navarro Ponz, Alfons
Introduction: Patient-derived organoids have emerged as a promising in vitro model for precision medicine, particularly in cancer, but also in noncancer-related diseases. However, the optimal culture medium for culturing patient-derived lung organoids has not yet been agreed upon. This study aimed to shed light on the optimal selection of a culture media for developing studies using patient-derived lung organoids. Methods: Tumor and normal paired tissue from 71 resected non-small cell lung cancer patients were processed for organoid culture. Lung cancer organoids (LCOs) were derived from tumor tissue and normal lung organoids (LNOs) from nonneoplastic lung tissue. Three different culture media were compared: permissive culture medium (PCM), limited culture medium (LCM), and minimum basal medium (MBM). We assessed their effectiveness in establishing organoid cultures, promoting organoid growth and viability, and compared their differential phenotypic characteristics. Results: While PCM was associated with the highest success rate and useful for long-term expansion, MBM was the best option to avoid normal organoid overgrowth in the organoid culture. The density, size, and viability of LNOs were reduced using LCM and severely affected with MBM. LNOs cultured in PCM tend to differentiate to bronchospheres, while alveolosphere differentiation can be observed in those cultured with LCM. The morphological phenotype of LCO was influenced by the culture media of election. Mesenchymal cell overgrowth was observed when LCM was used. Conclusion: This work highlights the importance of considering the research objectives when selecting the most suitable culture medium for growing patient-derived lung organoids.
Diversity, equity, and inclusion in transplantation
(Frontiers Media, 2024-10-09) Bellini, Maria Irene; Ballesté, Chloë; Martins, Paulo N.; Ulasi, Ifeoma; Valantine, Hannah A; Potena, Luciano
Diversity, equity, and inclusion in transplantation
Editorial: Equity in Transplantation: A Commitment for Progress in Troubled Times
(Frontiers Media, 2022-08-24) Berney, Thierry; Ulasi, Ifeoma; Ballesté, Chloë; Martins, Paulo N.; Bellini, Maria Irene; Valantine, Hannah A; Potena, Luciano
Transplantation is a therapeutic strategy founded on an altruistic gift. In this troublesome context we, who are involved in transplantation, have more than ever an urgent and specific duty to safeguard the value of this gift by acting to ensure equity in the delivery of care, preserve the value of diversity and inclusion, and remove the biases that limit access to transplantation.
Explorando la sexualidad de las mujeres: el erotismo de la lactancia materna
(Selene, 2024-06-01) Zayas Ros, María; Castelo-Branco Flores, Camil
Objetivo: El abordaje de la sexualidad durante la lactancia materna es mínimo y se desconoce mucho al respecto, en especial porque nos centramos en la parte nutriz. El propósito de este estudio es indagar en aspectos concretos de la sexualidad y erótica en pareja durante la lactancia materna y explorar el papel de los pechos durante los juegos eróticos en esta etapa. Diseño: se trata de un estudio cualitativo descriptivo con enfoque fenomenológico. Emplazamiento: se llevó a cabo en grupos de crianza y lactancia materna de diferentes barrios de Barcelona. Participantes: la muestra se obtuvo por propósito y debían ser madres que estuvieran amamantando con una experiencia positiva de la lactancia materna y que su perfil se ajustara a los criterios de inclusión y exclusión. Se consiguió una muestra de 18 participantes. Mediciones principales: la recogida de datos se hizo mediante entrevistas individuales y privadas que posteriormente se analizaron con la metodología de Giorgi. Resultados: sólo una minoría de las entrevistadas confirma que el pecho siga teniendo función erótica durante las relaciones sexuales en este período. La mayor parte de las mujeres rechaza, ha disminuido o modificado los juegos eróticos con el pecho y recalcan desligarlos de contenido sexual durante esta etapa. Conclusiones: los cambios sensitivos y de significado de los pechos en esta etapa influirán y modificarán los encuentros sexuales y dinámicas de pareja que previamente se tenían establecidas. Se requiere de investigaciones más focalizadas y concretas para abordar y comprender los juegos eróticos de lactancia.
Endoscopic endonasal surgery to treat intrinsic brainstem lesions: correlation between anatomy and surgery
(International Rhinologic Society, 2021-04-01) Topczewski, Thomaz E.; Di Somma, Alberto; Culebras, Diego; Reyes, Luis; Torales, Jorge; Tercero Uribe, Ana; Langdon Montero, Cristobal; Alobid, Isam; Torné, Ramón; Roldán Ramos, Pedro; Prats Galino, Alberto; Enseñat Nora, Joaquim
OBJECTIVE: The endoscopic endonasal approach (EEA) has been proposed as an alternative in the surgical removal of ventral brainstem lesions. However, the feasibility and limitations of this approach to treat such pathologies are still poorly understood. This study aimed to report our experience in five consecutive cases of intrinsic brainstem lesions that were managed via an EEA, as well as the specific anatomy of each case. METHODS: All patients were treated in a single center by a multidisciplinary surgical team between 2015 and 2019. Before surgery, a dedicated anatomical analysis of the brainstem safe entry zone was performed, and proper surgical planning was carried out. Neurophysiological monitoring was used in all cases. Anatomical dissections were performed in three human cadaveric heads using 0° and 30° endoscopes, and specific 3D reconstructions were executed using Amira 3D software. RESULTS: All lesions were located at the level of the ventral brainstem. Specifically, one mesencephalic cavernoma, two pontine ca- vernomas, one pontine gliomas, and one medullary diffuse midline glioma were reported. Cerebrospinal fluid leak was the major complication that occurred in one case (medullary diffuse midline glioma). From an anatomical standpoint, three main safe entry zones were used, namely the anterior mesencephalic zone (AMZ), the peritrigeminal zone (PTZ, used in two cases), and the olivar zone (OZ). Reviewing the literature, 17 cases of various brainstem lesions treated using an EEA were found. CONCLUSIONS: To our knowledge, this was the first preliminary clinical series of intrinsic brainstem lesions treated via an EEA presented in the literature. The EEA can be considered a valid surgical alternative to traditional transcranial approaches to treat selected intra-axial brainstem lesions located at the level of the ventral brainstem. To achieve good results, surgery must involve comprehensive anatomical knowledge, meticulous preoperative surgical planning, and intraoperative neurophysiological moni- toring.
Defining the lateral limits of the endoscopic endonasal transtuberculum transplanum approach: anatomical study with pertinent quantitative analysis.
(American Association of Neurological Surgeons, 2019-03-28) Di Somma, Alberto; Torales, Jorge; Cavallo, Luigi Maria; Pineda, Jose; Solari, Domenico; Gerardi, Rosa Maria; Frio Federico; Enseñat Nora, Joaquim; Prats Galino, Alberto; Cappabianca, Paolo
OBJECTIVE The extended endoscopic endonasal transtuberculum transplanum approach is currently used for the surgical treatment of selected midline anterior skull base lesions. Nevertheless, the possibility of accessing the lateral aspects of the planum sphenoidale could represent a limitation for such an approach. To the authors’ knowledge, a clear definition of the eventual anatomical boundaries has not been delineated. Hence, the present study aimed to detail and quantify the maximum amount of bone removal over the planum sphenoidale required via the endonasal pathway to achieve the most lateral extension of such a corridor and to evaluate the relative surgical freedom. METHODS Six human cadaveric heads were dissected at the Laboratory of Surgical NeuroAnatomy of the University of Barcelona. The laboratory rehearsals were run as follows: 1) preliminary predissection CT scans, 2) the endoscopic endonasal transtuberculum transplanum approach (lateral limit: medial optocarotid recess) followed by postdissection CT scans, 3) maximum lateral extension of the transtuberculum transplanum approach followed by postdissection CT scans, and 4) bone removal and surgical freedom analysis (a nonpaired Student t-test). A conventional subfrontal bilateral approach was used to evaluate, from above, the bone removal from the planum sphenoidale and the lateral limit of the endonasal route. RESULTS The endoscopic endonasal transtuberculum transplanum approach was extended at its maximum lateral aspect in the lateral portion of the anterior skull base, removing the bone above the optic prominence, that is, the medial portion of the lesser sphenoid wing, including the anterior clinoid process. As expected, a greater bone removal volume was obtained compared with the approach when bone removal is limited to the medial optocarotid recess (average 533.45 vs 296.07 mm2; p < 0.01). The anteroposterior diameter was an average of 8.1 vs 15.78 mm, and the laterolateral diameter was an average of 18.77 vs 44.54 mm (p < 0.01). The neurovascular contents of this area were exposed up to the insular segment of the middle cerebral artery. The surgical freedom analysis revealed a possible increased lateral maneuverability of instruments inserted in the contralateral nostril compared with a midline target (average 384.11 vs 235.31 mm2; p < 0.05). CONCLUSIONS Bone removal from the medial aspect of the lesser sphenoid wing, including the anterior clinoid process, may increase the exposure and surgical freedom of the extended endoscopic endonasal transtuberculum transplanum approach over the lateral segment of the anterior skull base. Although this study represents a preliminary anatomical investigation, it could be useful to refine the indications and limitations of the endoscopic endonasal corridor for the surgical management of skull base lesions involving the lateral portion of the planum sphenoidale.
Endoscopic transorbital superior eyelid approach: anatomical study from a neurosurgical perspective
(American Association of Neurological Surgeons, 2018-11-01) Di Somma, Alberto; Andaluz, Norberto; Cavallo, Luigi Maria; de Notaris, Matteo; Dallan, Iacopo; Solari, Domenico; Zimmer, Lee A.; Keller, Jeffrey T.; Zuccarello, Mario; Prats Galino, Alberto; Cappabianca, Paolo
OBJECTIVERecent studies have proposed the superior eyelid endoscopic transorbital approach as a new minimally invasive route to access orbital lesions, mostly in otolaryngology and maxillofacial surgeries. The authors undertook this anatomical study in order to contribute a neurosurgical perspective, exploring the anterior and middle cranial fossa areas through this purely endoscopic transorbital trajectory.METHODSAnatomical dissections were performed in 10 human cadaveric heads (20 sides) using 0° and 30° endoscopes. A step-by-step description of the superior eyelid transorbital endoscopic route and surgically oriented classification are provided.RESULTSThe authors' cadaveric prosection of this approach defined 3 modular routes that could be combined. Two corridors using bone removal lateral to the superior and inferior orbital fissures exposed the middle and anterior cranial fossa (lateral orbital corridors to the anterior and middle cranial base) to unveil the temporal pole region, lateral wall of the cavernous sinus, middle cranial fossa floor, and frontobasal area (i.e., orbital and recti gyri of the frontal lobe). Combined, these 2 corridors exposed the lateral aspect of the lesser sphenoid wing with the Sylvian region (combined lateral orbital corridor to the anterior and middle cranial fossa, with lesser sphenoid wing removal). The medial corridor, with extension of bone removal medially to the superior and inferior orbital fissure, afforded exposure of the opticocarotid area (medial orbital corridor to the opticocarotid area).CONCLUSIONSAlong with its minimally invasive nature, the superior eyelid transorbital approach allows good visualization and manipulation of anatomical structures mainly located in the anterior and middle cranial fossae (i.e., lateral to the superior and inferior orbital fissures). The visualization and management of the opticocarotid region medial to the superior orbital fissure are more complex. Further studies are needed to prove clinical applications of this relatively novel surgical pathway.
Microanatomical Nerve Architecture of 6 Mammalian Species: Is Trans-Species Translational Anatomic Extrapolation Valid?
(W.B. Saunders, 2018-07-01) Server, Anna; Reina, Miguel Angel; Boezaart, André P.; Prats Galino, Alberto; Coelho, Marielle Esteves; Sala Blanch, Xavier
Background and Objectives Various animal models have historically been used to study iatrogenic nerve injury during performance of conduction nerve blocks. Our aims were to compare the microstructures of nerves in commonly used species to those of humans and to explore the validity of the extrapolating these findings to humans. Methods High-resolution, light-microscopic images were obtained from cross sections of sciatic nerves at their bifurcation from fresh rat, rabbit, pig, sheep, dog, and human cadavers. Various microanatomical characteristics were measured and compared between the species. P < 0.0033 indicated significant differences. Results Forty-four samples were studied. There were some interspecies similarities, but the majority of the microanatomical measurements of all 5 species differed significantly from those of humans. Exceptions were rat fascicle cross-sectional area (P = 0.367) and fascicle circumference (P = 0.396); ratio of dog, pig, and sheep fascicle area to total nerve area (dog: P = 0.350; pig: P = 0.958; sheep: P = 0.052); and number of fascicles (pig: P = 0.454; sheep P = 0.077). Conclusions Although some of the metrics could reasonably be expected to differ because of the size of the species—for example, nerve cross-sectional area—there was little microanatomical similarity between the sciatic nerves of humans and those of the nonprimate mammalian species studied. This may question the validity of some conclusions reached over the years by direct translation from these species to humans. Further studies on nerve function, intraneural injection, and microanatomy of nonhuman primate species are warranted.
3D reconstruction of peripheral nerves from optical projection tomography images: A method for studying fascicular interconnections and intraneural plexuses.
(Wiley, 2018-04-01) Prats Galino, Alberto; Čapek, Martin; Reina, Miguel Angel; Cvetko, Erika; Radochova, Barbora; Tubbs, Robert Shane; Damjanovska Marija; Stopar Pintaric, Tatjana
The general microscopic characteristics of nerves are described in several textbooks of histology, but the specific microanatomies of most nerves that can be blocked by anesthesiologists are usually less well known. Our objective was to evaluate the 3D reconstruction of nerve fascicles from optical projection tomography images (OPT) and the ability to undertake an internal navigation exploring the morphology in detail, more specifically the fascicular interconnections. Median and lingual nerve samples were obtained from five euthanized piglets. OPT images of the samples were acquired and 3D reconstruction was performed. The OPT technique revealed the inner structure of the nerves at high resolution, including large and small fascicles, perineurium, interfascicular tissue, and epineurium. The fascicles were loosely packed inside the median nerve and more densely so in the lingual nerve. Analysis of the 3D models demonstrated that the nerve fascicles can show six general spatial patterns. Fascicular interconnections were clearly identified. The 3D reconstruction of nerve fascicles from OPT images opens a new path for research into the microstructure of the inner contents of fascicular nerve groups and their spatial disposition within the nerve including their interconnections. These techniques enable 3D images of partial areas of nerves to be produced and could became an excellent tool for obtaining data concerning the 3D microanatomy of nerves, essential for better interpretation of ultrasound images in clinical practice and thus avoiding possible neurological complications. Clin. Anat. 31:424-431, 2018. © 2017 Wiley Periodicals, Inc.
Efficacy and Safety of Mechanical Thrombectomy in Acute Ischemic Stroke Secondary to Infective Endocarditis
(European Society of Clinical Microbiology and Infectious Diseases, 2025-02-07) Lapeña, Pau; Urra, Xabier; Llopis, Jaume; Hernández-Meneses, Marta; Cuervo Requena, Guillermo; Maisterra, Olga; Escrihuela Vidal, Francesc; Prats-Sánchez, Luis; Sáez, Carmen; Olmos, Carmen; Hernández-Fernández, Francisco; Werner, Mariano; Pérez de la Ossa, Natalia; Quintana, Eduard; Moreno Camacho, Ma. Asunción; Chamorro Sánchez, Ángel; Miró Meda, José M. (José María), 1956-; Mechanical Thrombectomy in IE Investigators; Cat-SCR Consortium
Objectives: Acute ischaemic strokes (stroke) are frequent and severe extracardiac complications in infective endocarditis (IE). Because intravenous thrombolysis (i.v.-thrombolysis) is contraindicated, mechanical thrombectomy (thrombectomy) offers potential benefits. We aimed to compare thrombectomy efficacy and safety between IE-related and general stroke cases. Methods: Multicentre study of consecutive IE cases treated with thrombectomy at nine stroke centres in Spain from 2011 to 2022. Using propensity score matching, 50 IE cases were 1:4 matched with patients without IE stroke (n = 200). Efficacy was defined by successful recanalization rates (modified treatment in cerebral ischaemia scale ≥2 b), neurological improvement at 24 hours (decrease of National Institutes of Health Stroke Scale compared with baseline), and good neurological outcome rates at 3 months (modified Rankin scale ≤2). Safety was assessed by intracranial haemorrhage (IC-haemorrhage), symptomatic IC-haemorrhage, crude mortality, and stroke-related mortality. Results: Among 54 IE cases, 50 were matched with 200 controls. Successful recanalization was similarly achieved in both groups (76% vs. 83%). Median National Institutes of Health Stroke Scale at 24 hours was comparable, with analogous rates of neurological improvement (78% vs. 78%), and early dramatic response (48% vs. 46.5%). No differences were seen regarding IC-haemorrhage rates, except for when prior i.v.-thrombolysis was given. Although crude mortality was higher in the IE cohort, no differences were seen in stroke-related mortality (12% vs. 15%). At 3 months, modified Rankin scale scores of the two groups were superimposable. Discussion: Thrombectomy in IE is as effective and safe as in patients without IE, and prior i.v.-thrombolysis could decrease the procedural safety. Clinical practice guidelines may consider including the recommendation to perform thrombectomy alone in IE-related stroke.
Endoscopic transorbital avenue to the skull base: Four-step conceptual analysis of the anatomic journey.
(Frontiers Media, 2022-09-02) Guizzardi, Giulia; Di Somma, Alberto; de Notaris, Matteo; Corrivetti, Francesco; Sánchez, Juan Carlos; Alobid, Isam; Ferres, Abel; Roldán Ramos, Pedro; Reyes, Luis; Enseñat Nora, Joaquim; Prats Galino, Alberto
Background: In the last decades, skull base surgery had passed through an impressive evolution. The role of neuroanatomic research has been uppermost, and it has played a central role in the development of novel techniques directed to the skull base. Indeed, the deep and comprehensive study of skull base anatomy has been one of the keys of success of the endoscopic endonasal approach to the skull base. In the same way, dedicated efforts expended in the anatomic lab has been a powerful force for the growth of the endoscopic transorbital approach to the lateral skull base.Therefore, in this conceptual paper, the main steps for the anatomic description of the endoscopic transorbital approach to the skull base have been detailed. Methods: The anatomic journey for the development of the endoscopic transorbital approach to the skull base has been analyzed, and four "conceptual" steps have been highlighted. Results: As neurosurgeons, the eyeball has always represented a respectful area: to become familiar with this complex and delicate anatomy, we started by examining the orbital anatomy on a dry skull (step 1). Hence, step 1 is represented by a detailed bone study; step 2 is centered on cadaveric dissection; step 3 consists in 3D quantitative assessment of the novel endoscopic transorbital corridor; and finally, step 4 is the translation of the preclinical data in the real surgical scenario by means of dedicated surgical planning. Conclusions: The conceptual analysis of the anatomic journey for the description of the endoscopic transorbital approach to the skull base resulted in four main methodological steps that should not be thought strictly consequential but rather interconnected. Indeed, such steps should evolve following the drives that can arise in each specific situation. In conclusion, the four-step anatomic rehearsal can be relevant for the description, diffusion, and development of a novel technique in order to facilitate the application of the endoscopic transorbital approach to the skull base in a real surgical scenario.
Quantitative analysis of the brachialis and triceps brachii insertion sites on the proximal epiphysis of the ulna in modern hominid primates and fossil hominins
(Wiley, 2024-11-03) Ciurana, Neus; Casado, Aroa; Rodríguez Corbera, Patricia; García-Cuesta, Marcel; Pastor, Francisco; Potau Ginés, Josep Maria
In several species of hominid primates with different types of locomotor behavior, we quantitatively studied the insertion sites of the brachialis and triceps brachii on the proximal epiphysis of the ulna. Our main objective was to evaluate the possibility of using the anatomical features of these insertion sites to infer the locomotor behavior of different species of fossil hominins. We measured the area of these muscle insertion sites using 3D bone meshes and obtained the value of each insertion site relative to the total size of the two insertion sites for each of the species studied. We also compared these relative values of the osteological samples with the relative mass of the brachialis and triceps brachii, which we obtained by dissecting these muscles in the same primate species. The relative values for the brachialis insertion were highest in orangutans, followed by bonobos, chimpanzees, gorillas, and humans. Fossil Australopithecus and Paranthropus had values similar to those of bonobos, while fossil Homo had values similar to those of Homo sapiens. The observed similarity in ulnar attachment sites between Australopithecus and Paranthropus and extant bonobos suggest that these hominins used arboreal locomotion to complement their bipedalism. These adaptations to arboreal locomotion were not observed in Homo.
Increased lung [18F]-FDG uptake in chronic thromboembolic pulmonary hypertension with distal involvement
(European Respiratory Society, 2025-12-04) Osorio, Jeisson; Tura Ceide, Olga; Pavía Segura, Javier; Vollmer, Ivan; Blanco Vich, Isabel; Niñerola Baizán, Aida; Paredes Barranco, Pilar ; Lomeña, Francisco; Ruiz Cabello, Jesús; Castellà Pericàs, Manuel; Peinado Cabré, Víctor Ivo; Barberà i Mir, Joan Albert
Patients with distal chronic thromboembolic pulmonary hypertension (CTEPH) show greater FDG lung uptake on PET scans than those with proximal disease, suggesting a proliferative microvasculopathy. These findings support further investigation on the role of PET/CT in characterising CTEPH.
The morphofunctional implications of the glenoid labrum of the glenohumeral joint in hominoids
(Wiley, 2023-03-20) Raventós Izard, Georgina; Potau Ginés, Josep Maria; Casado, Aroa; Pastor, Juan Francisco; Arias Martorell, Júlia
Objectives: A morphocline of the glenoid cavity has been used to infer differences in locomotor behaviors; however, the glenoid cavity is surrounded by the glenoid labrum, a fibrocartilaginous structure that could influence the functionality of the glenoid. The objectives of this study are to explore the effects of the glenoid labrum on the area, depth, and morphology of the glenoid cavity in primates. Materials and methods: Photogrammetry was used to build 3D models of the glenoid, with and without the labrum, and three- (3D) and two-dimensional (2D) geometric morphometrics (GM) was applied. 2D areas were collected from zenithal images for glenoids with and without labrum to evaluate the availability of articular surface area. Results: In the 2D GM the morphocline is present in the dry-bone sample but not with the presence of the glenoid labrum. In the 3D GM there are differences between species mainly concerning the depth of the glenoid cavity. 2D areas reveal that the amount of articular area of the glenoid cavity increases with the presence of the labrum, particularly in humans. Discussion: The glenoid labrum changes the shape, increases the depth and the surface area of the glenoid cavity, particularly in humans. Therefore, the glenoid labrum might hold a functional role, increasing the stability of the glenohumeral joint of primates in general, and especially in humans.
Premature Ovarian Insufficiency: The Spanish Menopause Society (AEEM) and the European Society of Gynecology (ESG) position statement
(ESG, 2025-05) Castelo-Branco Flores, Camil; Guinot Gasull, Misericordia; Baquedano Mainar, Laura; Cancelo Hidalgo, María J.; Cano, Antonio; Gil Arribas, Elisa; Lobo Martínez, Sonia; Llaneza Suárez, Cristina; Llaneza Coto, Plácido; Mendoza Ladrón de Guevara, Nicolás; Perelson del Pozo, Irene; Quereda, Francisco; Roca Comella, Beatriz; Romagosa, Carla; Romero Duarte, Pablo; Chabbert-Buffet, Nathalie; Serfaty, David; Genazzani Andrea
Premature ovarian insufficiency (POI) is an uncommon condition affecting 1–2% of women younger than 40, 1 in 1,000 in their thirties and 1 in 10,000 under 20 years of age. The multiple etiologies of this clinical condition can be classified as primary (chromosomal, genetic, endocrine, infectious, autoimmune) and secondary or iatrogenic (surgery, chemotherapy and/or radiotherapy). Despite important progress in genetics, most of the cases of primary POI are still classified as idiopathic. POI is defined by the association of one clinical and one biological criterion: primary or secondary amenorrhea or cycle irregularities of more than 4 months with onset before 40 years of age, and elevated follicle-stimulating hormone (FSH) on 2 assays at different times. Commonly, estradiol levels are low, and anti-Müllerian hormone (AMH) levels are almost undetectable. Initial diagnostic procedures comprise hormonal and auto-immune assessment, karyotype, FMR1 premutation screening and gene-panel study. The term ovarian insufficiency suggests that the lack of function is not necessarily definitive; therefore, it is important not to use the term premature menopause when a young patient is reporting this condition, since in some cases ovarian function may be restored spontaneously, and pregnancy may occur in about 6% of cases. In confirmed POI, hormone replacement therapy is mandatory at least up to the physiological age of the menopause onset. Management in a tertiary center is suggested.
COVID-19 in Relation to Chronic Antihistamine Prescription
(MDPI, 2024-12-13) Puigdellívol Sánchez, Anna; Juanes González, Marta; Calderón Valdiviezo, Ana ; Losa Puig, Helena ; Valls Foix, Roger; González Salvador, Marta ; Lozano Paz, Celia ; Vidal Alaball, Josep
No hospitalizations or deaths occurred in residents with the COVID-19 infection, treated with antihistamines and azithromycin, of two external nursing homes during the first wave. We assessed whether patients receiving chronic antihistamines in our institution showed better clinical evolution. COVID-19 admissions and related deaths in the public Hospital of Terrassa (n = 1461) during the pandemic period (11 March 2020–5 May 2023) and cases (n = 32,888) during the period of full suspicion diagnosis (1 June 2020–23 March 2022) were referred to as the number of chronic treatments (nT) including or not including antihistamines (AntiHm or NOAntiHm), and their vaccination status before the first infection (VAC or NoVAC) in our assigned population (n = 140,681 at March 2020) was recorded. No deaths occurred in patients treated with up to ≤6 nT in the AntiHm group in all ages. A significant reduction in hospital admission was observed in the 2–7 nT groups either below or over 60 years old [Odds Ratio (OR) NoAntiHm/AntiHm = 1.76–1.32, respectively, in NoVAC or VAC (OR = 2.10 overall] and in the older ≥8 nT group (OR = 2.08 in NoVac]. In conclusion, patients with chronic antihistamine prescriptions, alone or with polypharmacy, showed reduced hospital admission and mortality rates, suggesting the safety of antihistamine treatment and the need to confirm its effectiveness in a prospective trial.
Long COVID Syndrome Prevalence in 2025 in an IntegralHealthcare Consortium in the Metropolitan Area of Barcelona:Persistent and Transient Symptoms
(MDPI, 2025-08-26) Arévalo Genicio, Antonio; García Arqué, Mª Carmen; Gragea Nocete, Marta; Llistosella, Maria; Moro Casasola, Vanessa; Pérez Díaz, Cristina; Puigdellívol Sánchez, Anna; Roca Puig, Ramon
Background: Long COVID can persist for years, but little is known about its prevalence in relation to the number of infections. This study examines the prevalence of long COVID in association with the number of infections and vaccination status. Methods: We analyzed anonymized data on long COVID cases, thrombotic events and polypharmacy from March 2020, provided by the Data Analysis Control Department for the population assigned to the CST (192,651 at March 2025). Additionally, we analyzed responses to a long COVID symptom-specific survey distributed in March 2024 to individuals aged 18 to 75 years from the CST population diagnosed with COVID-19 as of December 2023 (n = 43,398; 3227 respondents). Symptomatic patients suspected of having long COVID underwent blood tests to exclude alternative diagnoses. Results: The overall detected prevalence of long COVID was 2.4‰, with higher frequency among women aged 30–59 years (p < 0.001). The survey, combined with specific blood tests, improved detection rates by 26.3%. Long COVID prevalence was 3–10 times higher in individuals with three or more infections than in those with only one recorded infection (based on survey/CST data, respectively). The absolute number of thrombotic events among individuals aged >60 doubled from 2020 to 2024, occurring in both vaccinated and unvaccinated individuals, as well as in those with or without prior documented COVID-19 infection, including in patients without chronic treatments. Conclusions: We found a link between SARS-CoV-2 reinfection and long COVID, and a post-pandemic rise in thrombotic events across all populations, regardless of vaccination or prior infection. Findings support continued COVID-19 diagnosis in suspected cases and mask use by healthcare workers treating respiratory patients.
COVID-19 Pandemic Waves and 2024-2025 Winter Season in Relation to Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers and Amantadine
(MDPI, 2025-05-27) Puigdellívol Sánchez, Anna; Juanes González, Marta; Calderón Valdiviezo, Ana; Losa Puig, Helena; González Salvador, Marta; León Pérez, Marc; Pueyo Antón, Luís; Franco Romero, Maite; Lozano Paz, Celia; Cortés Borra, Albert; Valls Foix, Roger
Early pandemic reports suggested improved outcomes inhypertensive COVID-19 patients treated with angiotensin-converting enzyme inhibitors(ACEI) or amantadine. This study evaluates their impact on disease progression.Methods: We analyzed 55,936 infected patients (March 2020–January 2025) and 2024hospital admissions within a free-access Barcelona metropolitan health consortium (n =192,651 as of March 2025). Hospitalizations, stratified by polypharmacy level (nT), werecompared via Chi-square tests. ICU admissions and length of stay in hospitalized patientswere assessed during the first month of key waves: initial A2a + B3a + B9 (n = 184, March2020), Delta (n = 158, July 2021), Omicron21K (n = 142, January 2022), and Omicron 24F (n= 8, January 2025). Results: Non-survivors were predominantly aged >60 years (96.3%) inthe first wave and >70 years (100%) in Delta/Omicron waves. Post-vaccination, mortalitydecreased in high-comorbidity groups, though hospitalizations/ICU admissions inyounger patients surpassed first-wave levels during Delta. Vaccinated ACEI/ARB-treatedpatients showed reduced hospitalizations across all polypharmacy groups: OR(noACEI/ACEI) = 1.21 (≥2 nT) to 4.26 (1 nT, p = 0.014); OR (noARB/ARB) = 1.24 (≥8 nT) to1.74 (2–7 nT, p = 0.01). No hospitalizations occurred in amantadine-treated patients aged<70. Conclusions: These findings suggest a potential protective effect of ACEI, ARBs, andamantadine against severe COVID-19 and support the safety and continuity of thesetreatments. Multicentric studies incorporating post-COVID syndrome data are needed tovalidate these observations if hospitalizations persist.
COVID-19 in Relation to Polypharmacy and Immunization (2020-2024)
(MDPI, 2024-09-27) Puigdellívol Sánchez, Anna; Juanes González, Marta; Calderón Valdiviezo, Ana; Valls Foix, Roger; González Salvador, Marta; Lozano Paz, Celia; Vidal Alaball, Josep
Background: Observational studies reported worse COVID-19 evolution in relation to polypharmacy and reductions in COVID-19 hospital admissions and death in patients receiving chronic antihistamine treatment. The current profile of hospitalized patients with regard to different variants was analyzed to identify specific targets for future prospective trials. Methods: COVID-19 admissions to the Hospital of Terrassa (11 March 2020–28 August 2024 (n = 1457), from the integral Consorci Sanitari de Terrassa population (n = 167,386 people) were studied. Age, gender, the number of chronic treatments (nT), and immunization status were analyzed. Results: After 5 May 2023, 291 patients (54% females) required COVID hospitalization. Of these, 39% received >8 nT (23% receiving 5–7 nT), 70.2% were >70 years, and 93.4% survived. In total, 12% of patients admitted after 5 May 2024 were not vaccinated, while 59% received ≥4 vaccines (43% within the last 12 months). In total, 49% of admitted patients presented no previous infection (while 3% presented infection during the last year). Delta or Omicron variants would have accounted for ≥80% of admissions > 60 years compared to the first pandemic wave if no vaccines existed. Conclusions: Patients > 70 years who receive ≥5 nT, without prior COVID-19 infections, should be the priority for prevention, with updated vaccination and early treatments to reduce hospitalizations.
Expression of Myosin Heavy Chain Isoform mRNA Transcripts in the Masseter and Medial Pterygoid Muscles
(Sociedad Chilena de Anatomía, 2021-10-01) Ciurana, Neus; Artells i Prats, Rosa; Casado, Aroa; Potau Ginés, Josep Maria
Both the masseter and medial pterygoid muscles elevate the mandible, raising the lower jaw by acting simultaneously on the lateral and medial surfaces of the mandibular ramus. Nevertheless, electromyographic studies indicate that these muscles, as well as the superficial and deep heads of the masseter, act in a different way during mastication. We have analyzed by real time quantitative polymerase chain reaction (RT-qPCR) the expression of myosin heavy chain (MHC) isoforms in the masseter and medial pterygoid muscles in humans in order to identify possible differences in the expression patterns that may be related to functional differences identified with electromyography. Our findings indicate that the expression pattern of MHC isoforms in the two muscles is characteristic of fast and powerful phasic muscles. We have also observed a high percentage of expression of the MHC-IIx isoform and the expression of the MHC-M isoform at the mRNA level in both muscles, an isoform that does not translate into protein in the masticatory muscles of humans. The high percentage of expression of the MHC-IIx isoform in humans can be related to a high contractile speed of the masseter and medial pterygoid in humans. On the other hand, the low percentage of expression of the MHC-M isoform at the mRNA level in both muscles can be related to the complex evolutionary process that has reduced the size and force of the masticatory muscles in humans.

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