bluuebunny/crossref_metadata_2025_split huggingface dataset:
MECHANICAL PRINCIPLES OF THE OPERATION OF LINEAR SURGICAL STAPLING
Authors: Cernuda Cabal C , Valdes Vega P , López-Negrete E , Fernández Rodríguez M R , Cortizo Rodríguez J L , Sierra Velasco J M , Rodríguez García J I 
Published: January 2023

Abstract

Introduction
The widespread use of mechanical suture devices in visceral surgery and the continuous improvement of them requires a deeper knowledge of their mechanisms. In this work, these mechanisms are accessed through reverse engineering techniques, to improve knowledge of them, which must be shared by both engineers for their design and surgeons for their use and innovation.

Methods
A search was carried out in the databases of the Spanish Patent and Trademark Office (OEPM), and practical work was developed in the laboratories of the Polytechnic School of Engineering, using specific instruments for an adequate “dissection” of linear mechanical endosuture devices, both manual and motorized or intelligent. Three-dimensional models of singular mechanisms and a descriptive analysis of the mechanisms used were carried out.

Results
The mechanisms used in linear staplers have been characterized and documentary materials and 3D formats have been developed for better understanding by surgeons.

Conclusions
The knowledge of the mechanisms involved in linear mechanical endosutures allows surgeons and engineers to face unforeseen events during interventions, propose innovations to both techniques and equipment, and changes that could lead to improvements in the life cycle (reuse, waste treatment) and associated costs.
A BUNDLE INCLUDING ORAL ANTIBIOTICS AND MECHANICAL BOWEL PREPARATION REDUCES SURGICAL SITE INFECTIONS IN ELECTIVE COLORECTAL SURGERY. PRAGMATIC COHORT STUDY
Authors: Badia J M , Arroyo García N , Vázquez A , Pera M , Parés D , Fraccalvieri D , Limón E , Pujol M 
Published: January 2023

Abstract

Introduction
The efficacy of perioperative bundled interventions implemented at a multicenter level has been poorly studied.

Methods
A colorectal 6-element prevention bundle (antibiotic prophylaxis, oral antibiotic prophylaxis (OAP), mechanical bowel preparation (MBP), laparoscopy, normothermia, and wound retractor), introduced in 61 hospitals, was analysed. Surgical site infection (SSI) rates were compared before (G1, 2011–2016), and after (G2, 2016–2020) the bundle implementation.

Results
37849 procedures were included. 5462 overall SSI (14.43%), and 2838 (7.5%) organ-space SSI (O/S-SSI) were detected. SSI decreased from 18.38% to 10.62% with the application of the bundle (OR 0,503). Similarly, O/S-SSI diminished from 9.15% (G1) to 5.72% (G2), OR 0.602. Compared to the previous year, SSI decreased by 23% after the first year of bundle implementation. 29.26% of SSIs were diagnosed post-discharge. 54.5% required readmission. The reduction was similar between high, medium and low volume hospitals. Overall SSI was 16.71%, when no measure was applied, and 6.23% when all 6 were implemented. Lack of application of the bundle increased the probability of SSI (OR 3.020) and O/S-SSI (OR 1.556). In a univariate analysis, all measures except normothermia were associated with a decrease in overall SSI, while only laparoscopy and OAP were for O/S-SSI. Multivariate analysis confirmed that laparoscopy, OAP, and wound protectors decrease overall SSI, but only OAP and laparoscopy had an effect on O/S-SSI.

Conclusions
A preventive bundle decreased overall and O/S SSI rates in elective colon and rectal surgery. The OR for SSI was 1.5 to 3 times higher before than after the bundle implementation.
INTRACHOLECYSTIC PAPILLARY NEOPLASM: A NEW ENTITY
Authors: del Val Ruiz P , Carrasco Aguilera B , Celis Pinto J C , Ramos Montes C , Cembellín Prieto A , Granero Castro P , González-Pinto Arrillaga I M , Granero Trancón J E 
Published: January 2023

Abstract

Introduction
Gallbladder neoplasms are a rare pathology with an incidence of 1–2 cases per 100,000 inhabitants. In the group of gallbladder neoplasms, adenocarcinoma of the gallbladder is the most common (95% of the total).
Intracholecystic papillary neoplasm (ICPN) is a new entity considered to be a premalignant lesion of the gallbladder. In the few published series, it is found in 0.5–4% of cholecystectomies and up to 6% of intracholecystic adenocarcinomas are located on an ICPN.
We present the case of a patient with an ICPN with a brief review of its epidemiology and characteristics.

Clinical case
A 65-year-old woman with a history of supraglottic squamous cell carcinoma, squamous cell carcinoma of the lung and metastasis in the tail of the pancreas of squamous cell carcinoma who, after 2 years of stable disease with Pembrolizumab and radiotherapy, presented with an atypical thickening of the gallbladder on ultrasound of the abdomen.
It was decided to perform a programmed cholecystectomy, with discharge 24 hours after the intervention.
Subsequent anatomopathological analysis revealed a 0.8 cm nodular thickening with histological findings of non-infiltrating ICPN in the context of chronic inflammatory changes of the gallbladder.

Discussion
ICPN usually presents as an incidental finding, although 50% of cases present with right hypochondrium pain and fever.
It is a poorly described premalignant lesion that requires further studies in order to define its tumorogenesis, clinicopathologic characteristics and actual prevalence.
NLR AND PLR: NEW PREDICTORS OF COMPLICATED DIVERTICULITIS AND THE NEED FOR INTERVENTION
Authors: del Val Ruiz P , Carrasco Aguilera B , Menéndez Corteguera A B , García Alonso L , Valentín Gamazo I , Fernández Hevia M , García Flórez L J , García Trancón J E 
Published: January 2023

Abstract

Introduction
The most commonly used analytical parameters to predict severity (CRP, PCT, leukocyte count, % neutrophils…) are well known, whereas biomarkers such as the neutrophil-lymphocyte index (NLR) and the platelet-lymphocyte index (PLR) are less known and have utility during the diagnosis of acute diverticulitis (AD).

Methods
Retrospective study of 176 patients diagnosed with AD during 2019. The association between multiple acute phase reactants (PLRs) and the presence of complication of AD was studied.

Results
The mean age was 62.8 years, being more frequent in women (59.7%). According to the Hinchey classification 46 (26.1%) AD were complicated; Hinchey Ib: 32 (18.2%), Hinchey II: 10 (5.7%), Hinchey III: 3 (1.7%) and Hinchey IV: 1 (0.6%). Of all of them, 14 patients required surgery.
A statistically significant increase in all RFA was observed in complicated AD and in cases of invasive treatment.
It was shown that CRP has greater discriminative power to detect complicated AD with ROC curves (AUC: 76.6% (95% CI: 0.676–0.856)). However, regarding the need for invasive treatment, the NLR (AUC 77.8%; 95% CI: 0.648–0.908) was found to be more accurate.
For the classification of uncomplicated vs. complicated AD, the cut-off points were CRP (9.05), NLR (6.23) and PLR (141.93), with CRP being the most accurate.

Conclusions
The NLR and PLR are easy and inexpensive indices to obtain to diagnose AD and their accuracy is comparable to that of other RFA commonly used in diagnosis.
PREVENTION OF SEROMA IN BREAST SURGERY
Authors: Martínez Izquierdo G , Calvo Rodríguez D , García Alonso L , Ramos Montes C , Ibero Casadiego P , Menéndez Corteguera A , Alonso Martínez B , Llaneza Folgueras A 
Published: January 2023

Abstract

Introduction
Axillary lymphadenectomy is an essential procedure in the treatment of axillary breast metastases, with seroma formation being its most frequent complication. In the literature there are controversial studies on the best method of prevention of axillary seroma.

Methods
A retrospective observational study was carried out in 77 patients who underwent axillary lymphadenectomy in 2021.
Epidemiological, intraoperative and follow-up-related data and complications were taken into account, with the aim of analyzing the relationship between the application of hemostatic materials, such as Hempatch®, in the axillary site after lymphadenectomy and the presentation of axillary seroma.
For the statistical analysis, the IBM SPSS Statistics version 20 program was used.

Results
Hemopatch® was applied to the axillary site in 55.8% of cases. 35.1% of the patients presented axillary seroma and in 32.5% no complication was observed. The application of Hemopatch® showed a significant relationship with the mean volume of drainage in the first 3 postoperative days (p=0.000), as well as with the total volume in these first 3 days after surgery (p=0.000) and with the early withdrawal of the drainage (p=0.000). No relationship, however, could be demonstrated between the use of Hemopatch® in the axillary site and the prevention of axillary seroma (p=0.728).

Conclusions
The application of Hemopatch® in the axillary site does not imply a decrease in the rate of seroma or in the total volume drained, but a reduction in the volume drained has been observed during the first 3 postoperative days, which facilitates its early removal.
FUNCTIONAL MAPPING OF NOVEL HISTONE POST-TRANSLATIONAL ALTERATIONS IN COLON CANCER
Authors: Díaz Vico T , Fernández Martínez D , Tejedor Vaquero J R , Fernández Hevia M , García Santos G , Fernández Fraga M , García Flórez L J 
Published: January 2023

Abstract

Introduction
Epigenetic alterations are related to the process of tumorigenesis and resistance to oncological therapies. Although more than 60 types of histone post-translational modifications (HPTMs) have been described, the alterations that manifest simultaneously in tumor tissue have not been systematically studied in colorectal cancer (CRC). This project aims to develop a new screening methodology to delineate epigenetic alterations present in CRC and to obtain a set of biomarkers related to malignancy and tumor response.

Methods
Using state-of-the-art tandem mass spectrometry (MS-MS) techniques, a direct injection protocol will be performed to simultaneously identify the presence of &gt;200 HPTMs-related peptides in a cohort of primary tumors and paired healthy CRC tissue. Patterning of spectra and statistical analyses will be performed with the automated processing algorithm EpiProfile 2.0.

Results
A histone extraction protocol optimized for human tumor samples was developed. Likewise, we managed to make MS/MS sample processing more flexible by implementing a multiplatform workflow (Thermo / Sciex), which will increase the screening and data analysis capacity. Through this process we managed to detect &gt;200 peptides related to HPTMs in control samples, and we observed significant differences in certain HPTMs with pharmacological treatments in primary cultures.

Conclusions
These results will allow the identification of epigenetic biomarkers related to grade, stage and recurrence in the context of CRC.
IDENTIFICATION OF EPIGENETIC VULNERABILITIES IN THE ADENOMA-CARCINOMA SEQUENCE
Authors: Díaz Vico T , Fernández Martínez D , Tejedor Vaquero J R , Fernández Hevia M , García Santos G , Fernández Fraga M , García Flórez L J 
Published: January 2023

Abstract

Introduction
Numerous studies have documented the functional effect of different driver mutations on the development and progression of colorectal cancer (CRC). However, the molecular-level impact of each of these mutations on the epigenome/transcriptome, as well as the phenotype-related longitudinal effects of these mutations have not been characterized in detail. This work proposes an experimental design based on the integration of different -omic layers in order to identify molecular vulnerabilities with therapeutic potential in the adenoma-carcinoma sequence.

Methods
The proposed experimental model contemplates the introduction of sequential mutations in the APC/KRAS/TP53 and SMAD4 genes with CRISPR/Cas9 technology in human colon organoids obtained from healthy mucosa. To determine the molecular alterations at each step of the sequence, a paired RNA expression and DNA methylation analysis will be performed at the whole genome level with the respective massive next-generation sequencing technologies / EPIC arrays. Finally, to identify possible functional associations between the epigenome/transcriptome, an integration analysis of these -omics will be performed with novel computational algorithms, also including the integration of these data with information available from international consortia.

Results
The project is currently in the initial stages of development. The model and the most updated results available to date will be discussed in detail during the congress.

Conclusions
These results will allow the identification of molecular vulnerabilities with therapeutic potential in the context of CRC.
ROLE OF MULTI-PARAMETRIC MAGNETIC RESONANCE (MPMR) PREDICTING THE NEED FOR PROSTATE RE-BIOPSY IN PATIENTS WITH ATYPICAL SMALL ACINAR PROLIFERATION (ASAP): A MONOCENTRIC STUDY
Authors: Abad López P , González Padilla D A , Gómez Rivas J , Ibáñez Vázquez L , Arévalo Ruales R , Infante Hernández S , Galante Romo M I , Moreno Sierra J 
Published: January 2023

Abstract

Introduction
The European Urology guidelines recommended until 2020 to re-biopsy patients with ASAP in prostate tissue, given the high possibility of detecting cancer in a biopsy (approximately 30%), however the second rate of clinically significant prostate cancer is relatively low (reported between 5 and 20% of these biopsies).
The role of mpMRI prior to re-biopsy in these patients is currently unknown. To date there are only two publications that have included patients with ASAP and re-biopsy with previous mpMRI.

Methods
Descriptive and retrospective study. Data were collected from 66 patients between March 2015 and May 2021, who were diagnosed with ASAP in a first prostate biopsy (either with MRI before or after it) and a second biopsy (re-biopsy) performed by image fusion. MRI- transrectal ultrasound (cognitive or software) with transrectal or transperineal sample collection.

Results
In 27 of 66 patients (40.9%) the biopsy was positive: in 2 cases ASAP appeared in the re-biopsy, followed by ISUP1 (clinically not significant) in 14 patients (21.21%). Only in 11 patients (16.7%) did the biopsy yield a clinically significant prostate cancer result (ISUP2 or higher).
Among the 29 patients who had positive MRI (PIRADS 3 or higher), 18 cases (62%) had positive biopsies: 10 patients (34.4%) had ISUP1 while 8 (27.5%) patients had ISUP2 or higher.

Conclusions
Performing mpMRI before or after the biopsy in patients with ASAP can help avoid unnecessary biopsies.
PILOT STUDY FOR THE CREATION OF A STROKE MODEL IN RABBITS USING ENDOVASCULAR TECHNIQUES
Authors: Lucas-Cava V , Bote J , Moreno-Lobato B , Picado-Román N , Sun F , Sánchez-Margallo F M 
Published: January 2023

Abstract

Introduction
Due to the clinical implications of stroke in patients, the “2IQBIONEURO” project promoted by the Interreg VA Spain-Portugal programme (POCTEP) aims to study the treatment of neurological diseases associated with ageing. The aim was to evaluate the feasibility of the technique of selective cerebral artery (CA) embolisation for the creation of a stroke model in rabbits.

Methods
In 3 rabbits, through a 4Fr introducer in the femoral artery, a 4Fr Cobra catheter and 0.035″ guide was placed in the aortic arch to perform angiography of the brachiocephalic trunk. Under road-mapping, the right common carotid artery was catheterised, and its bifurcation into its external and internal branches was visualised with angiography in an oblique position (90°). With a 1.5Fr microcatheter and 0.008″ microguidewire inserted coaxially, the internal carotid artery was catheterised to perform superselective angiography of the cerebral vasculature. The microcatheter was positioned in the CA for embolisation by injection of PVA (100–200 µm) until stasis was reached as an end point or when reflux occurred. MRI monitoring was performed before and after embolisation (2, 5 and 24 hours). After 24 hours, neurological evaluation and macroscopic postmortem study with tetrazolium were performed.

Results
Successful occlusion of the CA was achieved in all animals whose lesion was observed on MRI.

Conclusions
The development of a stroke model in rabbits by selective embolisation of the CA is feasible, and can be used for the preclinical study of stroke.
PRELIMINARY RESULTS ON FUNCTIONALIZATION OF POLYPROPYLENE SURGICAL MESHES
Authors: Patrocinio D , Pagador J B , Galván V , Duarte M , Sánchez Francisco 
Published: January 2023

Abstract

Introduction
Due to inflammatory response in patients, many efforts have been devoted to developing advanced (biological or bioactive) surgical meshes. Some of them look for new synthetic materials and others work to improve their biocompatibility through different methods (coating, soaking, plasma). However, it is critical to avoid pore obstruction or lose mechanical properties while its amphiphilic behaviour is increased.

Methods
A deposition method was used to functionalize surgical meshes with a polypropylene derivative block copolymer that improved its amphiphilic behaviour. Therefore, this copolymer was dispersed on several solvents with different polarities and chemical natures. Then, meshes were immersed and a chemical adsorption-based coating was performed. Additionally, a qualitative study was carried out by optical and fluorescence microscopy on two size samples: small (1 cm2 squares) and large (standard T bone shapes).

Results
First, pore obstruction was perfectly avoided in small samples but was partially present in large samples. Second, the deposition was thicker with polar solvent in both sizes. And finally, fluorescence analysis showed a homogeneous and smooth coating with the most polar solvent.

Conclusions
After exposure to UV light, small samples show a better coating while large one's present irregular adherences on their surface. Moreover, the aprotic polar solvent provides a thickness layer and a smooth mesh surface.
MICROVESICLE SURFACE PROTEIN DETECTION AS A POTENTIAL BIOMARKER IN COLORECTAL CANCER
Authors: García-Santos G , Serrano Pertierra E , Pino Peco G , Fernández Hevia M , Duque Alcorta J M , Sánchez Domínguez L , Blanco López M C , García Flórez L J 
Published: January 2023

Abstract

Introduction
Colorectal cancer (CRC) is the third leading cause of death from cancer in the world; early detection is a key factor for patient´s prognosis. Microvesicles (MVs) are subcellular structures delimited by lipid bilayer intimately involved in physio-pathological processes such as cancer. Our objective is the characterization and detection of surface proteins in plasma derived MVs, as well as their usefulness as a tool in the detection of CRC.

Methods
Circulating MVs in peripheral blood of healthy individuals, with adenomas, high grade adenoma or carcinoma were isolated and characterized. MVs CD9, CD147 and EpCaM MVs surface proteins quantification was performed using an innovative lateral flow immunoassay (LFIA) developed in our laboratory.

Results
The characterization of the plasma MVs confirmed our previous observations, presenting a lower concentration of MVs in the groups of high-grade adenoma and mainly CRC. However, the carcinoma group presents a higher amount of protein per MV suggesting a greater MV´s complexity in this group. The analysis of surface antigens by LFIA show an unexpectedly significant reduction of these proteins in the carcinoma group.

Conclusions
The detection of antigens on the surface of MVs by LFIA may be able to discriminate patients with CRC and could emerge as an alternative test that complements CRC screening programs.
USAGE OF ANTERIOR SUBCUTANEOUS INTERNAL FIXATOR FOR TREATMENT OF PELVIC FRACTURES (INFIX): OUR EXPERIENCE
Authors: Adeba García M , García Granja S , García Portal G , Alonso Viana L , Fernández Álvarez M , Laguna Becero M E , Hernández Elena J , Pérez Núñez M 
Published: January 2023

Abstract

Introduction
Anterior subcutaneous internal fixator(INFIX) was proposed to treat anterior pelvic ring injury. INFIX was initially designed as an alternative to the external fixator, but recently its indications have been expanded, using it as a definitive treatment, and multiple complications have been reported.

Methods
Retrospective study of 11 polytrauma patients with pelvic fractures treated with anterior subcutaneous internal fixator after a high energy trauma between January (2018)-September (2021)

Results
11 polytrauma patients. The average age was 50,5 years old. The mechanism of injury was precipitation, 5 run over and 2 vehicle accidents. According to Tile classification: type B:6 and type C:5, according to Young classification: lateral compression:3, anteroposterior compression:6 and vertical shear:2.
The average time of implantation of INFIX was 4,3 days (0–17). In 10 cases a sacroiliac screw was associated at the same time of surgery and in one patient spinopelvic fixation.
The patients sitting was allowed 24 hours after surgery and partial weight-bearing 6 weeks later. The average time until removal was 5 months and the average follow up was 10 months.
Complications rate was 63,63%(n=7):3 Lateral femoral cutaneous nerve(LFCN) paresthesia:two of them temporary and another persistant one, 1 supracetabular screw osteolysis. 2 implant infections, 1 of them treated with implant removal and reosteosynthesis with symphysis plates. 1 common iliac vein thrombosis resolved with antithrombotic treatment.

Conclusions
Anterior subcutaneous internal fixator provides initial stability in pelvic fractures with a fast and simple technique. However, some complications have been reported. The main complication is LFCN paresthesia, especially during implantation and removal of the fixator.
USEFULNESS OF THE AGE-ADJUSTED CHARLSON COMORBIDITY INDEX AS A PREDICTOR OF MORBIDITY AND MORTALITY IN PATIENTS OVER 80 YEARS OF AGE WITH COLORECTAL CANCER
Authors: García González L A , Fernández Arias S , Del Val P , Corteguera A , de Santiago I , García Flórez L J , Granero Trancón J E 
Published: January 2023

Abstract

Introduction
The age adjusted Charlson Comorbidity Index (aCCI) is the most widely used prognostic tool in patients with comorbidity. Our aim is to evaluate its relationship with postoperative morbidity and mortality.

Methods
Retrospective observational analysis of 145 patients &gt;80 years with CRC operated upon between 2018–2020 in a tertiary center with 2-year follow-up. Pre- and postoperative variables such as aCCI, tumor stage and location, Clavien-Dindo and 2-year survival were selected. Survival analysis was performed according to Kaplan-Meier and ROC curves to predict postoperative mortality/complications. To determine association, a Cox univariate regression model was used.

Results
The mean age was 86 years, the right colon was the most frequent tumor location and laparoscopy was the predominant approach. Only 12.4% presented major complications (Clavien-Dindo &gt;=3). There was no statistically significant association between aCCI and surgical complications HR 1.118 (p 0.095), and there was a relationship with the development of medical complications OR 1.28 (p 0.020) with a sensitivity of 71% and a cut-off point of aCCI 7.5 AUC 0. 637. Overall survival at 2 years was 79% (26 deaths). We did not find a statistically significant association between aCCI and mortality (p 0.286), a weak predictor AUC 0.582.

Conclusions
Elevated aCCI is not related to a higher risk of postoperative morbidity and mortality and has little predictive capacity for surgical complications; however, aCCI &gt;7 is associated with a higher probability of medical complications.
Prospective studies are needed to include multivariable analyses associated with aCCI.