Arquitectura morfo-funcional de la válvula íleo-cecal : sistemas integradores en el feto y en el recién nacido

Fac. de MedicinaTRUEProQuestpu

Arquitectura morfo-funcional de la válvula íleo-cecal : sistemas integradores en el feto y en el recién nacido

Fac. de MedicinaTRUEProQuestpu

Patients’ opinions about knowing their risk for depression and what to do about it: The PredictD-Qualitative study

Background: The predictD study developed and validated a risk algorithm for predicting the onset of major depression in primary care. We aimed to explore the opinion of patients about knowing their risk for depression and the values and criteria upon which these opinions are based. Methods: A maximum variation sample of patients was taken, stratified by city, age, gender, immigrant status, socioeconomic status and lifetime depression. The study participants were 52 patients belonging to 13 urban health centres in seven different cities around Spain. Seven Focus Groups (FGs) were given held with primary care patients, one for each of the seven participating cities. Results: The results showed that patients generally welcomed knowing their risk for depression. Furthermore, in light of available evidence several patients proposed potential changes in their lifestyles to prevent depression. Patients generally preferred to ask their General Practitioners (GPs) for advice, though mental health specialists were also mentioned. They suggested that GPs undertake interventions tailored to each patient, from a ‘‘patient-centred’’ approach, with certain communication skills, and giving advice to help patients cope with the knowledge that they are at risk of becoming depressed. Conclusions: Patients are pleased to be informed about their risk for depression. We detected certain beliefs, attitudes, values, expectations and behaviour among the patients that were potentially useful for future primary prevention programmes on depression.Junta de Andalucía 2008/0195Gobierno Vasco 2008/111021Spanish Network of Primary Care Research (redIAPP) RD06/0018Salud Mental, Servicios y Atención Primaria (SAMSERAP

Effects of collagen prosthesis crosslinking on long-term tissue regeneration following the repair of an abdominal wall defect

22 p.Collagen prostheses used to repair abdominal wall defects, depending on their pretreatment (noncross-linked vs. cross-linked), besides repair may also achieve tissue regeneration. We assessed the host tissue incorporation of different bioprostheses using a new tool that combines immunofluorescence confocal microscopy with differential interference contrast images, making it possible to distinguish newly formed collagen. Partial hernial defects in the abdominal wall of rabbits were repaired using cross-linked/noncross-linked bioprostheses. Expanded polytetrafluoroethylene (ePTFE) was used as control. After 14/30/90/180 days of implant, specimens were taken for microscopy, immunohistochemistry, and quantitative-reverse transcription-polymerase chain reaction to determine host tissue ingrowth and collagen I/III protein and 1a1/3a1 gene expression. Shrinkage and stress resistance were also examined. At 14 days, crosslinked prostheses had suffered significantly lessshrinkage than ePTFE or noncross-linked prostheses. Significantly higher shrinkage was recorded for ePTFE in the longer term. Microscopy revealed encapsulation of ePTFE by neoformed tissue, while the bioprostheses became gradually infiltrated byhost tissue. Noncross-linked prosthesis showed better tissue ingrowth, more intense inflammatory reaction and more rapid degradation than the cross-linked prostheses. At 14 days, cross-linked prostheses induced up-regulated collagen 1a1 and 3a1 geneexpression, while noncross-linked only showed increased collagen III protein expression at 90 days postimplant. At 6 months, the tensile strengths of cross-linked prostheses were significantly greater compared with ePTFE. Our findings demonstrate that despite the cross-linked collagen prostheses promoting lesstissue ingrowth than the noncross-linked meshes, they became gradually replaced by good quality host tissue and were less rapidly degraded, leading to improved stress resistance in the long term.Fundación Mutua MadrileñaMinisterio de Ciencia y Tecnologí

Cierre percutáneo de defecto tipo Gerbode en un niño de 3 años tras cirugía de Bentall

The Gerbode defect, the left ventricle to the right atrial communication, is a the rare finding. It is usually congenital but can also occur as an acquired disease, especially after cardiac surgery. The surgical closure is accepted as treatment of choice. There are only a few case reports of transcatheter closure published in children. We hereby report a successful transcatheter closure of a Gerbode shunt in a 3 years old child with massive aorta dilatation after surgical Bentall repair. The result was excellent without neither residual leak nor malfunction of the prosthetic valve.El defecto de Gerbode, es decir, la comunicación entre el ventrículo izquierdo y la aurícula derecha es un hallazgo bastante raro. Generalmente es congénito, aunque también puede presentarse en forma adquirida especialmente tras cirugía cardíaca. El cierre quirúrgico es el tratamiento de elección. Existen pocas comunicaciones de cierre percutáneo en la edad pediátrica. En este caso se documenta el cierre percutáneo exitoso de un defecto de Gerbode en un niño de 3 años con dilatación masiva de la aorta después de una reparación quirúrgica de Bentall. El resultado fue excelente, sin fugas residuales ni mal funcionamiento de la válvula protésica

Polymer hernia repair materials: adapting to patient needs and surgical techniques

"Publicación presentada para convocatoria 2023 Proyectos Generación de Conocimiento"Biomaterials and their applications are perhaps among the most dynamic areas of research within the field of biomedicine. Any advance in this topic translates to an improved quality of life for recipient patients. One application of a biomaterial is the repair of an abdominal wall defect whether congenital or acquired. In the great majority of cases requiring surgery, the defect takes the form of a hernia. Over the past few years, biomaterials designed with this purpose in mind have been gradually evolving in parallel with new developments in the different surgical techniques. In consequence, the classic polymer prosthetic materials have been the starting point for structural modifications or new prototypes that have always strived to ccommodate patients? needs. This evolving process has pursued both improvements in the wound repair process depending on the implant interface in the host and in the material?s mechanical properties at the repair site. This last factor is important considering that this site?the abdominal wall?is a dynamic structure subjected to considerable mechanical demands. This review aims to provide a narrative overview of the different biomaterials that have been gradually introduced over the years, long with their modifications as new surgical techniques have unfolded

Efficacy of antimicrobial agents delivered to hernia meshes using an adaptable thermo-responsive hyaluronic acid-based coating

19 p.Purpose Mesh-related infection is a critical outcome for patients with hernia defect stabilized with synthetic or biological meshes. Even though bioactive meshes loaded with antibiotics or antiseptics are slowly emerging in the market, the available solutions still lack versatility. Here, we proposed a polymer solution, i.e., hyaluronic acid-poly(N-isopropylacrylamide) (HApN), which forms a hydrogel to be used as coating for meshes only when it reaches body temperature. Methods We assessed how the gelation of HApN was influenced by the incorporation of different antibiotic and antiseptic formulations, and how this gel can be used to coat several mesh types. The impact of the coating on the elastic behavior of a macroporous mesh was tested under cyclic elongation condition. Finally, we selected two different coating formulations, one based on antibiotics (gentamicin + rifampicin) and one based on antiseptic (chlorhexidine) and tested in vitro their antimicrobial efficacies. Results HApN can be used as carrier for different antimicrobial agents, without having a strong influence on its gelation behavior. Porous or dense meshes can be coated with this polymer, even though the stability was not optimal on macroporous meshes such as Optilene when pores are too large. HApN loaded with drugs inhibited in vitro the growth of several Gram-positive and Gram-negative bacteria. Conclusion Compared to the available technologies developed to endow meshes with antibacterial activity, the proposed HApN offers further versatility with potential to prevent mesh-related infection in hernioplasty.European Hernia SocietyMinisterio de Ciencia, Innovación y Universidade

Archaeological methodology applied to the analysis of battlefields and military camps of the Second Punic War: Baecula

This paper is a synopsis of the archaeological surface survey methodology applied to the location and analysis of a Second Punic War battlefield at Baecula. The strategy undertaken has allowed us to reconstruct the battle scene and analyse its material remains, camps and other elements and load them into a GIS, which we are using to show the initial proposals for a micro-territorial analysis of the scenario. We present the application of the system to the visibilities of the battlefield between the armies, based strictly on the archaeological data recovered from it

The long-term behavior of lightweight and heavyweight meshes used to repair abdominal wall defects is determined by the host tissue repair process provoked by the mesh

17 p.Background. Although heavyweight (HW) or lightweight (LW) polypropylene (PP) meshes are widely used for hernia repair, other alternatives have recently appeared. They have the same large-pore structure yet are composed of polytetrafluoroethylene (PTFE). This study compares the long-term (3 and 6 months) behavior of meshes of different pore size (HW compared with LW) and composition (PP compared with PTFE). Methods. Partial defects were created in the lateral wall of the abdomen in New Zealand White rabbits and then repaired by the use of a HW or LW PP mesh or a new monofilament, large-pore PTFE mesh (Infinit). At 90 and 180 days after implantation, tissue incorporation, gene and protein expression of neocollagens (reverse transcription-polymerase chain reaction/immunofluorescence), macrophage response (immunohistochemistry), and biomechanical strength were determined. Shrinkage was measured at 90 days. Results. All three meshes induced good host tissue ingrowth, yet the macrophage response was significantly greater in the PTFE implants (P .05). Conclusion. Host collagen deposition is mesh pore size dependent whereas the macrophage response induced is composition dependent with a greater response shown by PTFE. In the long term, macroporous meshes show comparable biomechanical behavior regardless of their pore size or composition. (Surgery 2012;152:886-95.

New insights into the application of 3D-printing technology in hernia repair.

"Publicación presentada para sexenios"Abdominal hernia repair using prosthetic materials is among the surgical interventions most widely performed worldwide. These materials, or meshes, are implanted to close the hernial defect, reinforcing the abdominal muscles and reestablishing mechanical functionality of the wall. Meshes for hernia repair are made of synthetic or biological materials exhibiting multiple shapes and configurations. Despite the myriad of devices currently marketed, the search for the ideal mesh continues as, thus far, no device offers optimal tissue repair and restored mechanical performance while minimizing postoperative complications. Additive manufacturing, or 3D-printing, has great potential for biomedical applications. Over the years, different biomaterials with advanced features have been successfully manufactured via 3D-printing for the repair of hard and soft tissues. This technological improvement is of high clinical relevance and paves the way to produce next-generation devices tailored to suit each individual patient. This review focuses on the state of the art and applications of 3D-printing technology for the manufacture of synthetic meshes. We highlight the latest approaches aimed at developing improved bioactive materials (e.g., optimizing antibacterial performance, drug release, or device opacity for contrast imaging). Challenges, limitations, and future perspectives are discussed, offering a comprehensive scenario for the applicability of 3D-printing in hernia repair.Financial support from the CIBER-BB