http://hdl.handle.net/10366/4019 Wed, 29 Apr 2026 06:26:11 GMT 2026-04-29T06:26:11Z http://hdl.handle.net/10366/171066 [ES]El trabajo presenta un estudio de asociación genética centrado en el cáncer de ovario, orientado a determinar si determinados polimorfismos en genes de reparación del ADN se relacionan con una mayor susceptibilidad a desarrollar la enfermedad y con algunas de sus características clínicas. En concreto, se analizan variantes en los genes XRCC1, APEX1, ERCC2, ERCC1, XRCC3, MLH1 y TP53 mediante genotipado TaqMan, utilizando ADN germinal de 185 pacientes con cáncer de ovario y 129 controles sanos. Los resultados indican que ciertos genotipos concretos, como el GA de XRCC1 rs1799782, el CC de TP53 rs1042522 y el GG de MLH1 rs1800734, se asocian con mayor susceptibilidad al cáncer de ovario. Además, el alelo T de APEX1 rs1130409 se vincula con aparición más tardía de la enfermedad y con cáncer de ovario hereditario, mientras que el genotipo TT de XRCC3 rs1799794 se asocia con mayor susceptibilidad en pacientes de mayor edad y en casos familiares. En conjunto, el abstract sostiene que variantes en genes de reparación del ADN distintos de BRCA1/2 también pueden influir en el riesgo y perfil clínico del cáncer de ovario. Tue, 01 Jan 2019 00:00:00 GMT http://hdl.handle.net/10366/171066 2019-01-01T00:00:00Z http://hdl.handle.net/10366/171016 [EN]Excessive alcohol consumption impairs the immune system, induces oxidative stress, and triggers the activation of peripheral blood (PB) monocytes, thereby contributing to alcoholic liver disease (ALD). We analyzed the M1/M2 phenotypes of circulating classical monocytes and macrophage-derived monocytes (MDMs) in excessive alcohol drinkers (EADs). PB samples from 20 EADs and 22 healthy controls were collected for isolation of CD14+ monocytes and short-term culture with LPS/IFNγ, IL4/IL13, or without stimulation. These conditions were also used to polarize MDMs into M1, M2, or M0 phenotypes. Cytokine production was assessed in the blood and culture supernatants. M1/M2-related markers were analyzed using mRNA expression and surface marker detection. Additionally, the miRNA profile of CD14+ monocytes was analyzed. PB samples from EADs exhibited increased levels of pro-inflammatory cytokines. Following short-term culture, unstimulated blood samples from EADs showed higher levels of soluble TNF-α and IL-8, whereas monocytes expressed increased levels of surface TNF-α and elevated mRNA expression of pro-inflammatory cytokines and inducible nitric oxide synthase. MDMs from EADs showed higher levels of TNF-α and CD206 surface markers and increased IL-10 production. LPS/IFNγ induced higher mRNA expression of Nrf2 only in the controls. miRNA analysis revealed a distinctive miRNA profile that is potentially associated with liver carcinogenesis and ALD through inflammation and oxidative stress. This study confirms the predominantly pro-inflammatory profile of PB monocytes among EADs and suggests immune exhaustion features in MDMs. Fri, 01 Sep 2023 00:00:00 GMT http://hdl.handle.net/10366/171016 2023-09-01T00:00:00Z http://hdl.handle.net/10366/170985 [ES]El documento aportado corresponde al volumen Avances en el tratamiento del cáncer de pulmón no microcítico y, en el fragmento legible, desarrolla especialmente un caso clínico centrado en la monitorización de la toxicidad aguda en un paciente anciano con adenocarcinoma pulmonar estadio IIIA tratado con un esquema basado en cisplatino, docetaxel y radioterapia. El texto expone los antecedentes clínicos del paciente, la valoración clínica y geriátrica previa al tratamiento, la estrategia terapéutica adoptada, la vigilancia de toxicidades hematológicas, digestivas, renales, cutáneas y de hipersensibilidad, así como la evaluación de la respuesta tumoral. La idea principal que se desprende del documento es que la edad avanzada no debe operar por sí sola como criterio de exclusión terapéutica, siempre que exista una adecuada selección clínica del paciente, una evaluación geriátrica razonada y una monitorización estrecha de la toxicidad. En ese contexto, el tratamiento con docetaxel aparece presentado como una opción activa y potencialmente eficaz dentro del abordaje del cáncer de pulmón no microcítico localmente avanzado. Tue, 01 Jan 2008 00:00:00 GMT http://hdl.handle.net/10366/170985 2008-01-01T00:00:00Z http://hdl.handle.net/10366/170982 [ES]La comunicación analiza el uso de niraparib como tratamiento de mantenimiento en pacientes de 75 o más años con cáncer de ovario recurrente sensible al platino, a partir de un subanálisis del estudio GEICO-88R. El trabajo muestra que, en esta cohorte de edad avanzada, las comorbilidades esperables fueron frecuentes, pero el tratamiento presentó una tolerancia comparable a la observada en la población general del estudio. Además, se aportan datos de supervivencia libre de progresión y de toxicidad, concluyéndose que el mantenimiento con niraparib es manejable y bien tolerado en este subgrupo, del que existe escasa información publicada. Sun, 01 Jan 2023 00:00:00 GMT http://hdl.handle.net/10366/170982 2023-01-01T00:00:00Z http://hdl.handle.net/10366/170932 [EN]Crimean-Congo hemorrhagic fever (CCHF) is a viral infectious disease for which distribution of the main vector, Hyalomma spp. ticks, is expanding. We analyzed all 10 cases of CCHF diagnosed in Spain during 2013-2021; case-patient median age was 56.5 years, and 7 were men. We identified CCHF virus genotypes III and V. Six case-patients acquired the infection in urban areas. Sixty percent of patients were infected in summer and 40% in spring. Two patients met criteria for hemophagocytic syndrome. Seven patients survived. The epidemiologic pattern of CCHF in Spain is based on occasional cases with an elevated mortality rate. Genotype III and, to a less extent also genotype V, CCHF circulates in humans in a common geographic area in Spain. Those data suggest that the expansion pathways are complex and may change over time. Physicians should remain alert to the possibility of new CCHF cases. Thu, 02 Feb 2023 00:00:00 GMT http://hdl.handle.net/10366/170932 2023-02-02T00:00:00Z http://hdl.handle.net/10366/170732 [EN]Background/Objectives: Quadriceps arthrogenic muscle inhibition (AMI) represents a key impairment following anterior cruciate ligament reconstruction (ACLR), contributing to quadriceps weakness. Although transcutaneous electrical nerve stimulation (TENS) and percutaneous electrical nerve stimulation (PENS) have been primarily investigated for analgesia, their effects on quadriceps strength in the early postoperative period remain underexplored. Methods: This study describes a single-blinded, parallel-group randomized controlled trial investigating the short-term effects of a single high-frequency TENS session and a novel long-term potentiation (LTP) PENS protocol on quadriceps strength and related clinical outcomes after ACLR. Fifty-four participants will be randomly allocated using block randomization in a 1:1:1 ratio to one of three groups: a control group (conventional post-ACLR rehabilitation only), a TENS group (conventional rehabilitation plus a single high-frequency TENS session), or a PENS group (conventional rehabilitation plus a single LTP PENS session). Participants will receive neuromodulatory intervention during the sixth postoperative week. The LTP PENS protocol consists of five 5 s stimulation bursts at 100 Hz and 250 μs pulse width and has only been investigated once in patients with upper limb pathology, underscoring its novelty in a postoperative setting. Results: The primary outcome is quadriceps maximal voluntary isometric contraction, selected as a clinically relevant surrogate of quadriceps activation deficits associated with AMI. Secondary outcomes include pain intensity, pressure pain threshold, knee range of motion, thigh muscle perimeter, knee effusion and swelling, and self-reported function and knee-related quality of life. Outcomes will be assessed at baseline, immediately post-treatment, and 1 and 7 days post-intervention by a blinded assessor. Mon, 26 Jan 2026 00:00:00 GMT http://hdl.handle.net/10366/170732 2026-01-26T00:00:00Z http://hdl.handle.net/10366/170731 [EN]Chronic lymphocytic leukaemia (CLL) is frequently associated with frailty, impaired physical function, and reduced quality of life. Evidence on the role of exercise in this population is limited. This pilot randomised clinical trial evaluated the effects of a supervised resistance training programme, combined with a home-based physical activity plan, on frailty, body composition, strength, fatigue, quality of life, and mental health in patients with CLL receiving active treatment. Thirty-six patients were randomised to either a home-based physical activity group plus a supervised resistance training programme group (n = 18) or a home-based physical activity group (n = 14) for eight weeks. The primary outcome was frailty assessed with the Short Physical Performance Battery. Secondary outcomes included body composition, grip strength, fatigue, quality of life, anxiety and depression, and sleep quality. Non-parametric analyses were performed, and effect sizes calculated. No differences between-group were found in frailty. However, participants in the supervised group showed significant improvements in lean mass (p = 0.047), dominant hand grip strength (p = 0.004), cognitive fatigue (p = 0.008), and sleep disturbance (p = 0.010). Effect sizes were moderate for anxiety and sleep quality, and small for depression. Adherence exceeded 80% in both groups, and no adverse events related to exercise were reported. Supervised resistance training combined with home-based physical activity is feasible, safe, and well tolerated in patients with CLL. The intervention was associated with preliminary improvements in muscle mass, strength, fatigue, and sleep-related outcomes. Larger and longer trials are needed to confirm these findings. Sun, 08 Feb 2026 00:00:00 GMT http://hdl.handle.net/10366/170731 2026-02-08T00:00:00Z http://hdl.handle.net/10366/170730 [EN]Background: Motor imagery (MI) and mirror therapy (MT) are widely used neurorehabilitation strategies to enhance motor recovery after stroke and are commonly applied as adjuncts to conventional rehabilitation therapy (CRT). However, direct comparative evidence between these interventions remains limited. This systematic review compared the effects of MI and MT on motor function, functional performance, spasticity, and gait-related outcomes in adults after stroke. Methods: A systematic comparative review with narrative synthesis was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251274308). PubMed, Cochrane Library, CINAHL, Scopus, Web of Science, and ScienceDirect were searched up to July 2025. Clinical trials directly comparing MI and MT in adults with stroke were included. Methodological quality was assessed using the PEDro scale, and risk of bias was evaluated with the Cochrane RoB 2 tool. Results: Six clinical trials involving 206 participants were included. Both MI and MT were associated with significant pre-post improvements across motor function, functional performance, spasticity, and gait-related outcomes. Between-group comparisons yielded heterogeneous findings, with no consistent evidence supporting the superiority of either intervention. Isolated advantages of MI were reported for specific upper-limb subdomains, but these effects were not consistently replicated. Overall methodological quality ranged from low to moderate, and all included studies were judged to be at high risk of bias according to the RoB 2 tool. Conclusions: MI and MT appear to provide comparable benefits for motor and functional recovery after stroke when used as adjuncts to CRT. Current evidence does not support the preferential use of one intervention, highlighting the need for well-designed trials with improved methodological rigor. Tue, 10 Feb 2026 00:00:00 GMT http://hdl.handle.net/10366/170730 2026-02-10T00:00:00Z http://hdl.handle.net/10366/170714 [EN]Objectives: This study aimed to explore the association between anxiety symptoms and cervical motor control in individuals without diagnosed psychiatric or neurological disorders. Methods: A cross-sectional study was conducted with 101 participants aged 18-60 without diagnosed psychiatric or neurological disorders. Anxiety levels were assessed using the Hamilton Anxiety Rating Scale (HAM-A), a clinician-oriented measure applied here to a non-clinical sample, and severity cut-offs were interpreted cautiously. Cervical motor control was measured using the Head Repositioning Accuracy-to-Target test. Additional clinical variables such as vertigo, cervical pain, and headache were also recorded. Statistical analyses included Spearman correlations, multiple linear and logistic regressions. Results: Higher anxiety levels were significantly associated with increased angular error in cervical motor control, particularly in flexion, extension, and right rotation movements. A progressive increase in pain perception and motor dysfunction was observed in participants with moderate and severe anxiety. Multivariate analyses showed that cervical motor control errors and vertigo were independently associated with anxiety severity and clinically significant anxiety. Conclusion: Our findings revealed an association between anxiety symptoms and cervical sensorimotor disturbances in individuals without diagnosed psychiatric or neurological disorders. Given the cross-sectional design, these findings should be interpreted as observational and exploratory. Wed, 25 Feb 2026 00:00:00 GMT http://hdl.handle.net/10366/170714 2026-02-25T00:00:00Z http://hdl.handle.net/10366/170708 [EN]Background and Objectives: Although several meta-analyses have evaluated the effects of motor imagery (MI) on upper-limb recovery using the Fugl-Meyer Assessment for the Upper Extremity (FM-UE), evidence based on more specific (Action Research Arm Test, ARAT) and functional (Barthel Index, BI) outcomes remains scarce. This study examined the effect of MI combined with conventional rehabilitation therapy (CRT), which translates into meaningful improvements in upper-limb performance and functional independence after stroke, accounting for methodological quality and publication bias. Materials and Methods: A systematic review and meta-analysis were carried out in accordance with PRISMA recommendations, with prior registration in PROSPERO (CRD420251120044). Comprehensive searches were conducted across six electronic databases up to July 2025. The methodological rigor of the included studies was evaluated using the PEDro scale, and risk of bias was appraised with the Cochrane RoB 2 instrument. Random-effects models estimated pooled effect sizes (ESs) for the ARAT and BI, alongside analyses of heterogeneity, publication bias, and moderators. Results: Eleven RCTs (n = 425) were included. A small pooled improvement in ARAT was observed (ES = 0.25; 95% CI: 0.13-0.37; p < 0.001); however, this effect was rendered non-significant after correction for publication bias (ES = 0.08; 95% CI: -0.14-0.31). No significant differences were found for the BI (ES = 0.41; 95% CI: -0.35-1.18; p = 0.268), with substantial heterogeneity (I2 = 96.6%). The mean PEDro score was 6.6, indicating moderate methodological quality. Conclusions: MI combined with CRT yields small and inconsistent effects on upper-limb recovery and no improvement in functional independence. Current evidence does not support its routine use in stroke rehabilitation. Well-designed, adequately powered randomized controlled trials employing standardized MI protocols are required to determine its true clinical relevance. Thu, 15 Jan 2026 00:00:00 GMT http://hdl.handle.net/10366/170708 2026-01-15T00:00:00Z http://hdl.handle.net/10366/170707 [EN]Background/Objectives: This systematic review and meta-analysis evaluate the impact of ostomy on quality of life in patients with colorectal cancer, synthesizing evidence from case-control and interventional studies, and to assess the consistency, robustness, and clinical implications of the findings. Methods: A systematic search of PubMed, Web of Science, Scopus, and the Cochrane Library was conducted for studies published up to 21 September 2025. Eligibility criteria encompassed cases-control studies comparing ostomized versus non-ostomized colorectal cancer patients and interventional studies assessing quality of life before and after ostomy creation. Data extraction included study design, population characteristics, quality of life outcomes, and main findings. Results: A total of 5841 records were identified, with 71 full-text articles assessed and six studies meeting inclusion criteria. The random-effects meta-analysis using the REML estimator yielded a pooled effect size of -0.29 (95% CI: -0.38 to -0.20; p < 0.001), indicating significantly lower quality of life in ostomized patients. No heterogeneity was observed (τ2 = 0; I2 = 7%). Quality assessment indicated that 66.7% of studies were high quality and 33.3% intermediate. Sensitivity analyses confirmed robustness, as exclusion of influential studies did not alter results. Conclusions: Ostomy significantly reduces quality of life in colorectal cancer patients. Psychosocial and emotional challenges, including body image concerns and social limitations, contribute to this impact. These findings emphasize the need for comprehensive care and targeted interventions to enhance adaptation, social reintegration, and overall well-being in ostomized patients. Tue, 10 Feb 2026 00:00:00 GMT http://hdl.handle.net/10366/170707 2026-02-10T00:00:00Z http://hdl.handle.net/10366/170705 [EN]Postural alignment can be influenced by intrinsic and extrinsic factors; failure to control these confounding factors and the use of invalid tools increase the risk of bias and may distort the results. Objective: The first objective is to identify the confounding factors that may influence the evaluation of body posture in children. The second objective is to determine which methods or tools are used to analyze postural alignment and to review the evidence regarding their validity and reliability, in order to strengthen the credibility of the results obtained. Methods: A systematic review was performed following the PRISMA 2020 criteria. Eligible studies were searched in the Virtual Health Library, Scopus, Medline, Web of Science, PEDro, and the Cochrane Library throughout the entire month of December 2024. Observational studies written in English, Portuguese, or Spanish that analyzed body posture (as the dependent variable) in children under 12 years of age were included. Articles not available in full text or those that assessed only a single body region were excluded. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale, while the ROBINS-E tool was used to assess risk of bias. The synthesis of results was presented as a narrative review. Results: A total of 42 observational articles were included. No meta-analysis was conducted, and the findings are synthesized through a narrative review. The ROBINS-E tool showed a generalized result of high risk of bias, while the Newcastle-Ottawa scale reported moderate quality for longitudinal and case-control studies, with worse scores for cross-sectional studies. Methodological limitations: The differences found in the designs, population, and outcome measures generate high methodological variability that limits the possibility of quantitative synthesis. Likewise, the available evidence on the reliability of the tools is insufficient, which conditions the interpretation of the reported results. Conclusions: The findings with the strongest scientific support suggest that anthropometric variables or those related to body composition may be associated with body alignment. By contrast, there is still controversy regarding the influence of sex and age on postural variables. Sport modality or the weight of the school backpack could also play a role in posture; however, more high-quality studies are needed to contrast the results. The quality of the evidence is limited by heterogeneity in study designs, insufficient control of confounding factors, and the use of tools with inadequate validity and reliability. Other: The study was registered in PROSPERO under the number CRD42024618753. This research received no external funding. Sat, 03 Jan 2026 00:00:00 GMT http://hdl.handle.net/10366/170705 2026-01-03T00:00:00Z http://hdl.handle.net/10366/170702 [ES]Se expone el caso de una paciente de 58 años diagnosticada en 2010 de carcinoma papilar infiltrante de mama izquierda T2N0M0, con perfil luminal A, tratada mediante tumorectomía, biopsia selectiva del ganglio centinela, quimioterapia CMF, radioterapia complementaria y hormonoterapia con letrozol. Durante el tratamiento inicial se detectó una lesión suprarrenal derecha, cuya resección confirmó metástasis de adenocarcinoma mamario hormonosensible. Tras varios años sin evidencia de enfermedad, en 2017 se objetivó una nueva lesión en la glándula suprarrenal izquierda, cuyo crecimiento progresivo y caracterización por resonancia magnética llevaron a una nueva adrenalectomía, confirmándose de nuevo metástasis compatible con primario mamario. Ante la progresión bajo letrozol y la ausencia de otras localizaciones metastásicas, se decidió cambiar a exemestano, manteniéndose la paciente sin evidencia de enfermedad a distancia en el seguimiento. El caso ilustra una forma excepcional de recaída oligometastásica tardía en cáncer de mama luminal A y subraya la importancia del seguimiento prolongado y del abordaje multidisciplinar. Mon, 01 Jan 2018 00:00:00 GMT http://hdl.handle.net/10366/170702 2018-01-01T00:00:00Z http://hdl.handle.net/10366/170691 [ES]Se presenta el caso de una paciente de 57 años con adenocarcinoma endometrioide diagnosticado inicialmente en 2010, tratada mediante cirugía y posteriormente con quimioterapia y radioterapia por sucesivas recidivas locorregionales. A lo largo de la evolución desarrolló nuevas recaídas en pared abdominal, recto sigma e intestino delgado, con resecciones quirúrgicas repetidas y limitaciones terapéuticas derivadas de reacciones anafilácticas graves a compuestos derivados del platino. El estudio inmunohistoquímico demostró pérdida de expresión de MSH2, y el análisis genético confirmó una mutación germinal en dicho gen, compatible con síndrome de Lynch y con un perfil tumoral dMMR. Ante la presencia de enfermedad irresecable y la ausencia de alternativas sistémicas adecuadas, se inició tratamiento con pembrolizumab, alcanzándose una regresión tumoral que se confirmó como respuesta clínica completa, sin toxicidades relevantes y con excelente situación funcional mantenida durante el seguimiento. Mon, 01 Jan 2018 00:00:00 GMT http://hdl.handle.net/10366/170691 2018-01-01T00:00:00Z http://hdl.handle.net/10366/170689 [ES]Se presenta el caso de un varón de 66 años que consultó por molestias retroesternales inespecíficas, detectándose en el estudio radiológico una masa mediastínica derecha. La exéresis quirúrgica confirmó un timoma tipo B2, completamente resecado, con márgenes libres y estadio IIA según la clasificación de Masaoka. El estudio posterior motivado por la hepatoesplenomegalia observada en las pruebas de imagen, junto con la captación difusa en médula ósea y bazo en el PET-TC, permitió diagnosticar de forma concomitante una leucemia mielomonocítica crónica tipo mielodisplásica, clasificada como LMMC 1 según la OMS. Desde el punto de vista oncológico no se indicó radioterapia adyuvante, mientras que la enfermedad hematológica fue tratada con hidroxicarbamida. En el momento descrito, el paciente permanecía asintomático y en seguimiento compartido por Oncología Médica y Hematología. Tue, 01 Jan 2019 00:00:00 GMT http://hdl.handle.net/10366/170689 2019-01-01T00:00:00Z http://hdl.handle.net/10366/170686 [ES]Se presenta el caso de un paciente de 55 años que acude a Urgencias por dolor abdominal intenso, náuseas, mareo y sudoración, siendo diagnosticado de hemoperitoneo secundario a la rotura espontánea de una tumoración hepática. La intervención quirúrgica urgente permitió evacuar un importante sangrado intraabdominal y realizar una resección de los segmentos hepáticos afectados. El estudio anatomopatológico confirmó un carcinoma hepatocelular moderadamente diferenciado, con invasión venosa, en un hígado no cirrótico, además de un implante epiploico sugestivo de diseminación tumoral. Posteriormente, dada la situación de enfermedad avanzada, se inició tratamiento con sorafenib, logrando una respuesta bioquímica prolongada y una evolución favorable durante dos años, pese a la aparición posterior de un nódulo pulmonar en estudio. El caso pone de relieve la rareza del hemoperitoneo como forma de debut del carcinoma hepatocelular, la necesidad de un manejo urgente e individualizado y la posibilidad de supervivencia prolongada en escenarios clínicos de especial gravedad. Fri, 01 Jan 2016 00:00:00 GMT http://hdl.handle.net/10366/170686 2016-01-01T00:00:00Z