"Sánchez, García" / Topic: medicine.disease - Searchworks@Jio Institute Digital Library Search Results

412 results on '"Sánchez, García"'

1. Clinical characteristics and comorbidities associated with mortality in patients with COVID-19 in Coahuila (Mexico)

Author: J.E. Salinas-Aguirre, L. Rodríguez-Muñoz, A. Díaz-Castaño, R. Bernal-Gómez, R. Rodríguez-Sanchez, and C. Sánchez-García
Subjects: medicine.medical_specialty, education.field_of_study, Coronavirus disease 2019 (COVID-19), business.industry, Mortality rate, Population, COVID-19, General Medicine, medicine.disease, Obesity, Brief Original, Comorbidities, Comorbilidades, Blood pressure, Risk factors, Internal medicine, Diabetes mellitus, Mortalidad, Medicine, In patient, Mortality, business, education, Factores de riesgo, Kidney disease
Abstract: Background and objective This study aims to describe the characteristics of patients with COVID-19 in a state in northern Mexico and establish the comorbidities associated with mortality. Methods Patients with COVID-19, divided into survivors and non-survivors, were analyzed. The data were analyzed using the chi-square test, Student’s t-test, and Cox’s regression model. Results A total of 17,479 patients were included and mortality rate of 6.3% was reported. Age over 60 years (HR = 8.04; 95%CI 7.03–9.19), diabetes (HR = 1.63; 95%CI 1.40–1.89), high blood pressure (HR = 1.48; 95%CI 1.28–1.72), obesity (HR = 1.37; 95%CI 1.18–1.60) and chronic kidney disease (HR = 2.06; 95%CI 1.64–2.59) were significantly associated with mortality. Conclusions Diabetes, high blood pressure, obesity, and chronic kidney disease increased mortality among patients with COVID-19 in the population of Coahuila, Mexico. The factor that most contributed to risk of death was age over 60 years.
Published: 2022

2. Ultrasound-Guided Thoracic Paravertebral Block for Pulmonary Radiofrequency Ablation

Author: Miriam Estors Guerrero, José Jornet Fayos, Sonsoles Aragón Alvarez, José Marcelo Galbis Caravajal, Néstor Martínez Hernández, Encarna Miñana Aragón, Jose E. Llopis Calatayud, and Fernando José Sánchez García
Subjects: medicine.medical_specialty, Radiofrequency ablation, Sedation, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, law, medicine, Paravertebral Block, Alfentanil, Lung cancer, Lung, business.industry, Retrospective cohort study, medicine.disease, Surgery, surgical procedures, operative, Anesthesiology and Pain Medicine, medicine.anatomical_structure, medicine.symptom, Bolus (digestion), Cardiology and Cardiovascular Medicine, business, therapeutics, medicine.drug
Abstract: Surgical resection is the treatment of choice both for early-stage lung cancer and pulmonary metastatic disease. For patients with lung tumors who are not eligible for surgery, the minimally invasive modality of radiofrequency ablation (RFA) may be curative and, thus, should be considered. However, opinions regarding the optimal anesthetic technique for pulmonary RFA differ. Here the authors report their experience with the use of ultrasound-guided paravertebral block in minimally-sedated patients undergoing pulmonary RFA. This retrospective study was conducted at a single institution. The 17 consecutive patients underwent 19 pulmonary RFA procedures for primary lung tumor or lung metastases. In all patients, RFA was performed according to the protocol of the hospital. Anesthesia in patients receiving RFA for lung tumors consisted of a thoracic paravertebral block (TPVB), performed between T4 and T8, with minimal sedation. This approach allowed intraoperative communication with the patient and apnea pauses as needed. There were no complications after TPVB, which was well-tolerated by all patients. Only two patients required an alfentanil bolus during RFA because of pleuritic pain. No patient required conversion from sedation to general anesthesia. There were no episodes of hemodynamic instability or desaturation (SaO2 ≤95%), and excessive sedation prevented patient collaboration in only one patient. In conclusion, ultrasound-guided single-injection TPVB is a safe and effective anesthetic technique for high-risk patients undergoing RFA for a primary lung tumor or lung metastases.
Published: 2022

3. Sex Differences in the Association Between Risk of Obstructive Sleep Apnea, Insomnia, and Frailty in Older Adults

Author: Eliseo Ramírez-García, Karla Moreno-Tamayo, Selene Guerrero-Zúñiga, Betty Manrique-Espinoza, and Sergio Sánchez-García
Subjects: Neurophysiology and neuropsychology, medicine.medical_specialty, RC435-571, sleepiness, Behavioral Neuroscience, Nature and Science of Sleep, Internal medicine, mental disorders, Insomnia, medicine, Athens insomnia scale, Applied Psychology, obstructive sleep apnea, older adults, Original Research, Psychiatry, Sleep hygiene, business.industry, QP351-495, Odds ratio, medicine.disease, Obesity, nervous system diseases, Obstructive sleep apnea, Sarcopenia, Cohort, sleep disorders, insomnia disorder, medicine.symptom, business
Abstract: Karla Moreno-Tamayo,1 Betty Manrique-Espinoza,2 Selene Guerrero-ZÃºÃ±iga,3 Eliseo RamÃrez-GarcÃa,1 Sergio SÃ¡nchez-GarcÃa1 1Unidad de InvestigaciÃ³n EpidemiolÃ³gica y en Servicios de Salud, Ãrea Envejecimiento, Centro MÃ©dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de MÃ©xico, MÃ©xico; 2Centro de InvestigaciÃ³n en EvaluaciÃ³n y Encuestas, Instituto Nacional de Salud PÃºblica, Cuernavaca, Morelos, MÃ©xico; 3Unidad de Medicina del SueÃ±o, Instituto Nacional de Enfermedades Respiratorias Ismael CosÃo Villegas, Ciudad de MÃ©xico, MÃ©xicoCorrespondence: Sergio SÃ¡nchez-GarcÃaUnidad de InvestigaciÃ³n EpidemiolÃ³gica y en Servicios de Salud, Ãrea Envejecimiento, Centro MÃ©dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Avenida CuauhtÃ©moc No. 330, Edificio CORCE, Tercer piso. Col. Doctores, AlcaldÃa CuauhtÃ©moc, Ciudad de MÃ©xico, 06720, MÃ©xicoTel + 52 556276900 Ext. 21846Email sergio.sanchezga@imss.gob.mxPurpose: To analyze the association between risk of obstructive sleep apnea (OSA), insomnia, sleepiness and self-assessed sleep duration with frailty in older adults.Patients and Methods: Cross-sectional study with 1643 older adults (60 to 97 years old) who participated in round 6 (2019) of the Cohort of Obesity Sarcopenia and Obesity in Older Adults of the Mexican Institute of Social Security. The Berlin Questionnaire was used to assess risk of OSA, the Athens Insomnia Scale for insomnia, the Epworth Scale for sleepiness, and sleep duration by self-report. Frailty was assessed with the frailty criteria proposed by Fried. Sociodemographic and health variables were also collected. Statistical analysis was performed with logistic regression and was stratified by sex.Results: This study included 1643 participants (823 men and 820 women). Mean age was 67.1 Â± 5.9 years. The percentage of frail older adults was 10.5% (n = 172), with risk of OSA 26.1% (n = 429), with insomnia 30.3% (n = 497) and with sleepiness 18.9% (n = 310). In all participants, risk of OSA and insomnia were associated with frailty. In the stratified analysis by sex, the association between risk of OSA and frailty was observed in women (odds ratio (OR) = 1.84, 95% confidence interval (CI) 1.05, 3.22), but not in men (OR = 1.19, 95% CI: 0.65, 2.19). Insomnia was significantly associated with frailty in women (OR = 2.38, 95% CI: 1.35, 4.20) and in men (OR = 1.88, 95% CI: 1.01, 3.52). Neither sleepiness nor sleep duration was associated with frailty.Conclusion: In community-dwelling older adults, both the risk of OSA and insomnia conferred greater odds of presenting frailty in women. It is required to implement strategies aimed at improving sleep hygiene and detecting patients with OSA and insomnia.Keywords: sleep disorders, obstructive sleep apnea, older adults, insomnia disorder, sleepiness
Published: 2021

4. Factors Associated with Recovered Functionality After Hip Fracture in Non-Institutionalized Older Adults: A Case-Control Study Nested in a Cohort

Author: Karla Moreno-Tamayo, Eliseo Ramírez-García, Sergio Sánchez-García, Guadalupe García De La Torre, Erika Judith Rodríguez Reyes, and María Claudia Espinel-Bermúdez
Subjects: Male, medicine.medical_specialty, Activities of daily living, Logistic regression, Barthel scale, Internal medicine, Activities of Daily Living, medicine, Humans, functionality, Socioeconomic status, older adults, Aged, Original Research, Hip fracture, Hip Fractures, business.industry, case-control studies, Case-control study, Fear, Recovery of Function, General Medicine, Anthropometry, medicine.disease, hip fracture, Clinical Interventions in Aging, Cohort, Accidental Falls, Female, Geriatrics and Gerontology, business
Abstract: Eliseo RamÃrez-GarcÃa,1 Guadalupe S GarcÃa de la Torre,2 Erika Judith RodrÃguez Reyes,3 Karla Moreno-Tamayo,1 MarÃa Claudia Espinel-Bermudez,4 Sergio SÃ¡nchez-GarcÃa1 1Epidemiological and Health Services Research Unit, Aging Area, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico; 2Public Health Department, School of Medicine, Universidad Nacional AutÃ³noma de MÃ©xico, Mexico City, Mexico; 3Epidemiological Surveillance Coordination, Instituto Mexicano del Seguro Social, Mexico City, Mexico; 4Clinical Epidemiology Research Unit, UMAE Specialties Hospital, Western Medical Center, Instituto Mexicano del Seguro Social, Guadalajara, MÃ©xicoCorrespondence: Sergio SÃ¡nchez-GarcÃa Email sergio.sanchezga@imss.gob.mxPurpose: To identify factors associated with recovered functionality after a hip fracture in a sample of older adult patients.Patients and Methods: Nested case-control study in a cohort. Older adults (60 years or older) with a hip fracture were recruited between May 2017 and October 2018. The Barthel scale was used to measure performance in activities of daily living (ADL). A questionnaire was applied to collect information about demographic, clinic, psychological and social variables, and anthropometric measurements were taken. A logistic regression model was built to analyze various factors related to recovered functionality.Results: A total of 346 older adults with a hip fracture were studied (n=173 cases and n=173 controls); 69.4% (n=240) women and 30.6% (n=140) men. Mean age was 79.4 years (Â± 8.7) overall; for cases, 77.4 (Â± 7.9) years and for controls, 81.4 (Â± 9.0). Mean schooling was 6.3 (Â± 4.3) years. Recovered functionality was associated with normal nutritional status (OR 4.81, 95% CI = 2.54â 9.12), absence of heart disease (OR 4.08, 95% CI = 1.48â 11.20), self-efficacy for ADL (OR 4.07, 95% CI = 2.15â 7.72), absence of depressive symptoms (OR 2.99, 95% CI = 1.69â 5.28), prior functionality (OR 2.83, 95% CI = 1.51â 5.31), high socioeconomic level (OR 2.41, 95% CI = 1.24â 4.65) and transcervical fracture (OR 2.34, 95% CI = 1.05â 5.22).Conclusion: In older adults who have suffered a hip fracture, clinical, psychological, and demographic characteristics are associated with recovered functionality. These factors should be considered as a priority in the care of older adults who have experienced hip fractures.Keywords: functionality, hip fracture, older adults, case-control studies
Published: 2021

5. Effectiveness of a Telephone-Based Motivational Intervention for Smoking Cessation in Patients With Crohn Disease

Author: Francesc Casellas Jordá, Claudia Herrera de Guise, Virginia Robles Alonso, Ester Navarro Correal, Carmen Fuentelsaz Gallego, Genoveva Vila Morte, Natalia Borruel Sainz, Josep Maria Sánchez García, and Arantxa Ibarz Casas
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, Inflammatory bowel disease, Crohn Disease, Internal medicine, Intervention (counseling), medicine, Humans, In patient, Features, Advanced and Specialized Nursing, Motivation, Crohn disease, business.industry, Smoking, Gastroenterology, medicine.disease, Telephone, Clinical trial, Smoking cessation, Female, Smoking Cessation, Open label, business
Abstract: A randomized, open-label, controlled clinical trial was designed to assess the effectiveness of a motivational intervention based on the 5 R's model (relevance, risks, rewards, roadblocks, and repetition) delivered by specialized inflammatory bowel disease nurses every 3 months over a 1-year period as compared with patients who were followed regularly. Patients diagnosed with Crohn disease, aged 18 years or older, who reported being active smokers with Internet access at home and an e-mail address were eligible. A total of 144 patients (72 per group) were included (50% women, median age 40 years). They smoked a median of 10 cigarettes per day (range = 1–40) and had been smoking for a median of 22 years (range = 1–51). Motivation to quit (Richmond test) was low in 73 patients, moderate in 39 patients, and high in 32 patients. Statistically significant differences between the study groups in the predisposition to change, motivation to quit, and tobacco withdrawal were not found. However, 14 patients (20.9%) in the intervention group and 9 patients (13.2%) among controls stopped smoking at the end of the study. These findings support a higher trend toward smoking cessation associated with the motivational intervention 5 R's. This behavioral strategy can aid patients with Crohn disease to quit smoking.
Published: 2021

6. Effect of hydroxychloroquine on glucose control in patients with and without diabetes: a systematic review and meta-analysis of randomized controlled clinical trials

Author: Enrique Linden-Torres, Luis E. Simental-Mendía, Mario Simental-Mendía, and Adriana Sánchez-García
Subjects: Blood Glucose, medicine.medical_specialty, medicine.medical_treatment, 030226 pharmacology & pharmacy, Gastroenterology, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, law, Diabetes mellitus, Internal medicine, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Randomized Controlled Trials as Topic, Glycemic, Glycated Hemoglobin, Pharmacology, business.industry, Insulin, Hydroxychloroquine, General Medicine, medicine.disease, Clinical trial, Postprandial, Diabetes Mellitus, Type 2, chemistry, Glycated hemoglobin, business, medicine.drug
Abstract: The aim of this meta-analysis of randomized controlled trials was to evaluate the effect of hydroxychloroquine on glucose control. Randomized controlled trials examining the impact of hydroxychloroquine on glycemic markers were searched in PubMed, Web of Science, Scopus, and Google Scholar databases. Meta-analysis was performed using a random-effects model and sensitivity analysis through the leave-one-out method. Meta-analysis revealed a significant reduction of fasting glucose (WMD: − 8.05 mg/dl; 95% CI: − 11.17, − 4.93; I2 = 75%; p ˂0.0001), 2-h postprandial glucose (WMD: − 15.52 mg/dl; 95% CI: − 20.61, − 10.42; I2 = 53%; p ˂0.00001), and glycated hemoglobin (HbA1c) values (WMD: − 0.19%, 95% CI: − 0.37, − 0.02; I2 = 94%; p = 0.03) after hydroxychloroquine treatment. Otherwise, meta-analysis showed no significant effect of hydroxychloroquine on insulin levels (WMD: 16.52 μUI/ml; 95% CI: − 16.35, 49.40; I2 = 90%; p = 0.32) and HOMA-β (WMD: − 14.62; 95% CI: − 45.84, 16.59; I2 = 0%; p = 0.36). The present meta-analysis revealed that treatment with hydroxychloroquine improves glucose control through the reduction of fasting glucose, 2-h postprandial glucose, and HbA1c values. Given that the effect of hydroxychloroquine on beta-cell function is based only on two clinical trials, it is not possible to draw definitive conclusions.
Published: 2021

7. Cycle length of nonsustanied ventricular tachycardias among ICD patients: implications on subsequent appropriate therapies

Author: Jesús M. Hernández, O. Duran, Pedro L. Sánchez, Manuel Sánchez García, Jendri Perez, Javier Jiménez-Candil, Juan Carlos Castro, José Moríñigo, and Armando Oterino
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Electric Countershock, Action Potentials, 030204 cardiovascular system & hematology, Ventricular tachycardia, Implantable cardioverter-defibrillator, 03 medical and health sciences, 0302 clinical medicine, Heart Conduction System, Heart Rate, Predictive Value of Tests, Internal medicine, Medicine, Humans, Diseases of the circulatory (Cardiovascular) system, 030212 general & internal medicine, Lead (electronics), Cycle length, Angiology, Aged, business.industry, Incidence (epidemiology), Research, Appropriate therapy, Middle Aged, medicine.disease, Cardiac surgery, Defibrillators, Implantable, Treatment Outcome, Close relationship, RC666-701, Ventricular Fibrillation, Cardiology, Tachycardia, Ventricular, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Background ICD patients with episodes of nonsustained ventricular tachycardias (NSVT) are at risk of appropriate therapies. However, the relationship between the cycle length (CL) of such NSVTs and the subsequent incidence of appropriate interventions is unknown. Methods 416 ICD patients with LVEF Results We analyzed 2201 NSVTs (mean CL = 323 ms) that occurred in 250 patients; 111 of such episodes were fast (CL ≤ 300 ms). Secondary prevention (HR = 1.7; p p p = 0.04) were independent predictors of appropriate interventions; however, the mean CL of NSVTs was not (p = 0.6). There was a correlation between the mean CL of NSVTs and the CL of the first monomorphic VT: r = 0.88; p 5 NSVTs (r = 0.97; p p Conclusions Unlike the burden, the CL of NSVTs is not a predictor of subsequent appropriate interventions. However, there is a close relationship between the CL of NSVTs and that of arrhythmias that will later lead to appropriate therapies.
Published: 2021

8. Pancreatic ductal adenocarcinoma: Eleven years of experience at a tertiary care hospital center

Author: J. Flores Maza, E. Sánchez-García Ramos, I. Domínguez Rosado, G.E. Sánchez Morales, L.C. Chan Núñez, R.A. Moguel Valladares, and U. Clemente Gutiérrez
Subjects: medicine.medical_specialty, Pancreatic ductal adenocarcinoma, business.industry, Surgical mortality, Cancer, General Medicine, RC799-869, Tertiary care hospital, Diseases of the digestive system. Gastroenterology, medicine.disease, Cáncer de páncreas, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Localized disease, Pancreatic cancer, Internal medicine, Epidemiology, Mortalidad, medicine, Epidemiología, 030212 general & internal medicine, Stage (cooking), business
Abstract: Introduction and aim: Pancreatic cancer is considered one of the most aggressive solid tumors. In Mexico, it is the twelfth cause of cancer, with 4,489 cases diagnosed annually, and accounts for 4.9% of oncologic deaths. Aim: The aim of our study was to describe the clinical and epidemiologic characteristics of the patients diagnosed with pancreatic cancer spanning an 11-year period at the Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. Methods: A retrospective, cross-sectional study was conducted that included 479 patients diagnosed with pancreatic cancer, within the time frame of 2003-2013. The documented findings were summarized through descriptive statistics. Results: Of the patients with pancreatic ductal adenocarcinoma, 50.9% were women, and the mean patient age at diagnosis was 61.5 years. A total of 48.4% of the cases were diagnosed at clinical stage IV, 12.9% presented with clinical stage III, and 25.0% had localized disease. Surgery was performed on 37.5% of the patients, the most frequent of which was pancreatoduodenectomy. The surgical mortality rate was 5.5%. Conclusion: The clinical characteristics in our study group were similar to those described in the literature. However, the number of candidates for surgical treatment was higher than that reported in other hospitals and the percentage of borderline tumors was lower. Those differences, respectively, are possibly associated with the nature of our referral center and the prolonged intervals between diagnosis and treatment that result in the loss of potential surgical patients. Resumen: Introducción y objetivo: El cáncer de páncreas es considerado uno de los tumores sólidos más agresivos. En México representa la doceava causa de cáncer con 4,489 casos diagnosticados por año y representa el 4.9% de las defunciones oncológicas. El objetivo del estudio es describir las características epidemiológicas y clínicas de los pacientes con diagnóstico de cáncer de páncreas en un periodo de once años del Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. Métodos: Estudio retrospectivo – transversal que incluyó 479 pacientes con diagnóstico de cáncer de páncreas en el periodo 2003 - 2013. Se incluyó estadística descriptiva para resumir los hallazgos documentados. Resultados: De los pacientes con adenocarcinoma ductal de páncreas el 50.9% fueron mujeres, la edad promedio al diagnóstico fue de 61.5 años. Se diagnosticaron en un estadio clínico IV el 48.4 % de los casos, mientras que el 12.9% se presentaron como estadio clínico III y el 25.0% como enfermedad localizada. El 37.5% de los pacientes fueron sometidos a cirugía, siendo la pancreatoduodenectomía el procedimiento más frecuentemente realizado. La mortalidad quirúrgica fue del 5.5%. Conclusión: Las características clínicas en nuestro grupo de estudio muestran similitud con la literatura, sin embargo, el número de candidatos a un tratamiento quirúrgico fue superior a las cifras reportadas en otros hospitales, no obstante, la cifra de tumores limítrofes fue menor; probablemente asociado con la naturaleza de centro de referencia que representa nuestra institución, así como a la pérdida de pacientes potencialmente quirúrgicos debido a un periodo de ventana prolongado entre diagnóstico y tratamiento.
Published: 2021

9. Maternal and perinatal outcomes and placental pathologic examination of 29 SARS‐CoV‐2 infected patients in the third trimester of gestation

Author: Laura Sánchez García, Luis Blasco Santana, Jose L. Bartha, Rita M Regojo-Zapata, Jorge Álvarez-Troncoso, and Eduardo Miraval Wong
Subjects: placental pathology, medicine.medical_specialty, China, Placental Finding, Placenta, Pregnancy Trimester, Third, coronavirus, Disease, SARS‐CoV‐2, 03 medical and health sciences, 0302 clinical medicine, COVID‐19, Pregnancy, Medicine, Humans, Pregnancy Complications, Infectious, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Transmission (medicine), SARS-CoV-2, Infant, Newborn, Obstetrics and Gynecology, Outbreak, COVID-19, Original Articles, medicine.disease, Infectious Disease Transmission, Vertical, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Cohort, Gestation, Original Article, vertical transmission, Female, business
Abstract: Aim On December 31, 2019, an unknown outbreak of pulmonary disease was reported in China. The novel coronavirus SARS‐CoV‐2 was the etiologic agent of this disease, and responsible of the current pandemic of COVID‐19. Accumulated evidence on placental features is based most on case‐reports and small case‐series, with differing results. Methods We gathered a cohort of 29 infected pregnant mothers who delivered 32 newborns, and had placentas available for pathologic examination. Placentas were compared with a control group. Results Of the 29 mothers, clinical and radiological features were similar to what was already described in COVID‐19. Pregnancy modified some analytical parameters. One of the mothers succumbed to the disease. Of the 32 newborns, 1 developed an early infection, with positive reverse‐transcriptase polymerase chain reaction (RT‐PCR) at 48 h of life, with an initial RT‐PCR negative. SARS‐CoV‐2 presence was assessed on placental tissue with immunohistochemistry and RT‐PCR, both were negative. All newborns had good clinical outcomes. No differences in morphological placental findings were found among both groups. Conclusion Lack of statistically significant differences among case and control groups suggest that placentas from SARS‐CoV‐2 infected mothers represent a cohort of normal placentas only submitted because of maternal SARS‐CoV‐2 status. To the best of our knowledge, no irrefutable cases of vertical transmission have been yet described. Other authors have failed to demonstrate presence of viral RNA in placental tissue. Accumulated knowledge suggests that if vertical transmission is possible, it is a rare event.
Published: 2021

10. Immediate Oral Refeeding in Patients With Mild and Moderate Acute Pancreatitis

Author: Jordi Elvira, Constantino Fondevila, Susana Mayol, R. Jorba, Robert Memba, Elena Ramírez-Maldonado, Eva M Pueyo, Sergio González, Ariadna Sánchez-García, and Sandra López Gordo
Subjects: Male, medicine.medical_specialty, Randomization, law.invention, Enteral Nutrition, Postoperative Complications, Randomized controlled trial, Cost Savings, law, Internal medicine, medicine, Clinical endpoint, Humans, In patient, Adverse effect, Aged, business.industry, Background data, Length of Stay, Middle Aged, medicine.disease, Pancreatitis, Spain, Hospital admission, Acute pancreatitis, Female, Surgery, business
Abstract: OBJECTIVE To establish the optimal time to start oral refeeding in mild and moderate acute pancreatitis (AP) to reduce hospital length-of-stay (LOS) and complications. SUMMARY BACKGROUND DATA Oral diet is essential in mild and moderate AP. The greatest benefits are obtained if refeeding starts early; however, the definition of "early" remains controversial. METHODS This multicenter, randomized, controlled trial (NCT03829085) included patients with a diagnosis of mild or moderate AP admitted consecutively to 4 hospitals from 2017 to 2019. Patients were randomized into 2 treatment groups: immediate oral refeeding (IORF) and conventional oral refeeding (CORF). The IORF group (low-fat-solid diet initiated immediately after hospital admission) was compared to CORF group (progressive oral diet was restarted when clinical and laboratory parameters had improved) in terms of LOS (primary endpoint), pain relapse, diet intolerance, complications, and, hospital costs. RESULTS One hundred and thirty one patients were included for randomization. The mean LOS for the IORF and CORF groups was 3.4 (SD ± 1.7) and 8.8 (SD ± 7.9) days, respectively (P < 0.001). In the CORF group alone, pain relapse rate was 16%. There were fewer complications (8% vs 26%) and health costs were twice as low, with a savings of 1325.7€/patient in the IORF than CORF group. CONCLUSIONS IORF is safe and feasible in mild and moderate AP, resulting in significantly shorter LOS and cost savings, without causing adverse effects or complications.
Published: 2021

11. Granulomatous Dactylitis: An Unusual Finding in Sarcoidosis

Author: A. Crespo Cruz, J. Escudero, E. Sánchez García, and I. García Morales
Subjects: medicine.medical_specialty, Histology, business.industry, Medicine, Dermatology, Sarcoidosis, business, medicine.disease, Pathology and Forensic Medicine, Dactylitis
Published: 2021

12. Respiratory morbidity associated with viral respiratory infections during neonatal stage in premature infants

Author: María Luz García-García, Clara López-Martínez, Francisco del Pozo, Adelina Pellicer, Laura Sánchez García, Inmaculada Casas, and Cristina Calvo
Subjects: Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, business.industry, Birth weight, Infant, Newborn, Gestational age, Infant, Premature, Diseases, Pneumonia, medicine.disease, Low birth weight, Intensive Care Units, Neonatal, Pediatrics, Perinatology and Child Health, Humans, Infant, Very Low Birth Weight, Medicine, Gestation, Neonatology, Morbidity, medicine.symptom, business, Infant, Premature, Neonatal stage, Asthma
Abstract: Background and objective Very low birth weight (VLBW) infants are highly susceptible to viral respiratory infections (VRIs), even during admission to the neonatal intensive care unit (NICU). Although the role of VRI in childhood in the development of recurrent wheezing and long-term asthma is well known, information on the impact in later morbidity of VRI in the neonatal period is lacking. We aimed to explore the occurrence of recurrent wheezing over the first 2 years of life according to VRI status during NICU admission. Methods During April 2016 and December 2017, infants below 32 weeks of gestation were prospectively studied in VRI surveillance during NICU admission. Families were contacted between September 2018 and May 2019 by a telephone questionnaire. Results A total of 99 patients were enrolled. The mean gestational age and birth weight were 28.8 (1.9) weeks and 1118 (329) g, respectively. During the first 2 years of life, neither episodes of wheezing nor the respiratory impairment-related hospital admissions differed between positive and negative VRI infants. Episodes of wheezing and respiratory impairment-related hospital admissions, as well as specific respiratory treatment prescription, were more frequent within the first 2 years in infants who had suffered symptomatic VRI during NICU admission. Conclusion Symptomatic VRI in VLBW infants is associated with long-term respiratory morbidity. The early surveillance of VRI in the preterm infant during NICU admission is justified for prognostic counseling and closely monitoring after discharge. Routine instruction on asthma-related risk factors and early prescription of antiasthmatic treatments, when indicated, should be established.
Published: 2021

13. Factors Associated With Increased Complications in Patients With BRCA Gene Mutations Undergoing Reconstructive Breast Surgery

Author: Nieves Vanaclocha, Maria Luisa Moreda Rubio, Francisco Ripoll Orts, and Alberto Sánchez García
Subjects: Adult, medicine.medical_specialty, Mammaplasty, medicine.medical_treatment, Breast surgery, Genes, BRCA2, Genes, BRCA1, 030230 surgery, Gene mutation, Cohort Studies, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Breast cancer, medicine, Humans, In patient, Risk factor, skin and connective tissue diseases, Bilateral Prophylactic Mastectomy, Retrospective Studies, Advanced and Specialized Nursing, business.industry, Smoking, Retrospective cohort study, Middle Aged, medicine.disease, Surgery, Medical–Surgical Nursing, 030220 oncology & carcinogenesis, Mutation, Smoking cessation, Female, business
Abstract: Reconstructive breast surgery after bilateral prophylactic mastectomy in patients who carry a mutation of the breast cancer (BRCA) gene has been increasing. Undergoing risk-reducing breast surgery can be of great benefit to young patients who have a high risk of developing breast cancer. There is little available evidence about the rate of complications in these patients and which factors are related to increased complications. The objective of this study was to identify predictors of complications in BRCA gene mutation carriers who underwent reconstructive breast surgery. A single-center, retrospective cohort study was conducted that included all patients with a mutation of the BRCA gene who underwent a breast reconstructive procedure, either immediate or delayed, between January 2013 and March 2019 and received a minimum of 6 months' follow-up. The results of our study showed that smoking is the most important modifiable risk factor associated with an increased complication rate for reconstructive breast surgery in patients with BRCA gene mutation. Smoking cessation will reduce the patient's risk for postoperative complications by 50%; therefore, it should be encouraged in all surgical patients and enforced in patients undergoing prophylactic procedures.
Published: 2021

14. A Protocol for Performing Reconstructive Microsurgery on Patients With COVID-19

Author: Alberto Pérez-García, Enrique Salmerón-González, Elena García-Vilariño, Jorge Balaguer-Cambra, Alberto Sánchez-García, and Alessandro Thione
Subjects: Microsurgery, Infectious Disease Transmission, Patient-to-Professional, medicine.medical_treatment, MEDLINE, Aftercare, Disease, Free Tissue Flaps, Perioperative Care, Hospitals, University, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, Pandemic, Health care, medicine, Infection control, Humans, 030212 general & internal medicine, Advanced and Specialized Nursing, Protocol (science), Infection Control, business.industry, COVID-19, Articles, Plastic Surgery Procedures, medicine.disease, Medical–Surgical Nursing, Spain, 030220 oncology & carcinogenesis, Surgery, Medical emergency, Elective Surgical Procedure, business
Abstract: On March 11, 2020, the World Health Organization declared COVID-19 to be a pandemic, challenging health care systems all over the world. National health care systems have reorganized to cope with the disease. Surgical services departments around the world have been affected and elective surgical procedures have been postponed to conserve medical resources. When a patient with COVID-19 requires an urgent microsurgical free flap due to trauma or a tumor, personnel from the health care facility must have a protocol in place to follow for the patient's care and follow-up. In this article, we present our protocol for patients with COVID-19 requiring reconstructive microsurgery.
Published: 2021

15. Evaluación por gastroscopia simple y cromoendoscopia convencional de la superficie gastroesofágica y duodenal proximal del equino. Estudio piloto

Author: Alejandro Montoya, José Luis Sánchez García, and José Ramón Martínez Aranzalez
Subjects: gastroscopy, suge, medicine.medical_specialty, Veterinary medicine, Hyperkeratosis, SF1-1100, Gastroenterology, lesions, Chromoendoscopy, chemistry.chemical_compound, Atrophy, Internal medicine, SF600-1100, Biopsy, medicine, lesiones, chromoendoscopy, equine, General Environmental Science, Phenol red, medicine.diagnostic_test, business.industry, Hyperplasia, medicine.disease, cromoendoscopia, Animal culture, SUGE, chemistry, Indigo carmine, Pyloric Antrum, equinos, gastroscopia, General Earth and Planetary Sciences, EGUS, business
Abstract: RESUMEN Las enfermedades gastrointestinales equinas tienen una alta incidencia con un pronóstico variable en la práctica clínica. La mayoría de los estudios se limitan a describir lesiones ulcerativas y lesiones inflamatorias. El objetivo de este estudio fue evaluar el potencial diagnóstico complementario de la cromoendoscopia convencional en la mucosa gas-troesofágica y duodenal proximal del equino. El estudio incluyó 20 caballos criollos colombianos de ambos sexos (12 hembras y 8 machos), con edades entre 5 y 20 años, peso entre 250 y 350 kilogramos, condición corporal 4-5/9 y con historial de alteraciones digestivas en los últimos 3 meses; quienes previo a la evaluación por gastroscopia y cromoendoscopia se sometieron a ayuno (sólidos 12h y líquidos 4h) y sedación (xilacina 0,5 mg/kg/iv). Se utilizaron tinciones como rojo fenol, lugol, índigo carmín, azul de metileno y ácido acético y se tomaron biopsias de los segmentos que mostraron reacción. El azul de metileno reveló 52% de las lesiones, el lugol 19%; por su parte, el rojo fenol, el índigo carmín y el ácido acético revelaron el 9,5% restante. El epitelio escamoso fue el más afectado (66,6%), el glandular (19%), antro pilórico (9,5%) y duodeno proximal (4,7%). Los hallazgos histopatológicos fueron hiperplasia, hipertrofia, hiperqueratosis, congestión, degeneración vacuolar, infiltrados celulares, fibrosis, necrosis y atrofia en diferentes grados de severidad. La cromoendoscopia reveló lesiones prematuras, que pasaron desapercibidas con las técnicas convencionales de endoscopia del tracto digestivo. Este es el primer estudio que emplea la cromoendoscopia en equinos; a pesar de que la técnica mejoró la visualización y facilitó la ubicación y descripción de lesiones ulcerativas prematuras a través de la histopatología, se recomiendan mayores estudios controlados y con un número más amplio de muestras. ABSTRACT Equine gastrointestinal diseases have a high occurrence with a variable prognostic in clinic practice. Most of the studies limits to describe ulcerative and inflammatory lesions. The objective of this study was to evaluate the potential complementary diagnostic of conventional chromoendoscopy on the gastroesophageal and proximal duodenal mucosa of the equine. 20 Colombian creole horses, of both sexes (12 females and 8 males), with ages between 5 and 20 years old, weight between 250 and 350 kilograms, body condition 4-5/9, that had presented digestive alterations in the last 3 months, were subjected to fasting (solids 12h and liquids 4h) and sedated (xylazine 0,5 mg/kg/iv) to be evaluated by gastroscopy and chromoendoscopy, using for stains phenol red, lugol, indigo carmine, methylene blue and acetic acid, taking biopsy samples of the segments that showed reaction. The methylene blue revealed 52%, lugol 19%, and phenol red, indigo carmine and acetic acid revealed only 9,5% of the lesions, being the squamous epithelium the most affected (66,6%), glandular epithelium (19%), pyloric antrum (9,5%) and proximal duodenum (4,7%), where histopathological findings were hyperplasia, hypertrophy, hyperkeratosis, congestion, vacuolar degeneration, cellular infiltrates, fibrosis, necrosis and atrophy in different degrees of severity. Chromoendoscopy revealed lesions premature, which go unnoticed with conventional light endoscopy techniques. This is the first study using chromoscopy in horses to show that the reagents used allow a better visualization of injuries than the conventional technique, helping histopathological studies and molecular biology to understand ulcerative premature injuries and possible pathophysiological pathways. However, larger controlled studies and a larger number of samples are needed.
Published: 2020

16. Type 1 diabetic mellitus patients with increased atherosclerosis risk display decreased CDKN2A/2B/2BAS gene expression in leukocytes

Author: Herminia González-Navarro, Juan F. Ascaso, Verónica Sánchez-García, Andrea Herrero-Cervera, Ángela Vinué, Sergio Martínez-Hervás, Deborah J. Burks, and José T. Real
Subjects: Blood Glucose, 0301 basic medicine, endocrine system diseases, Cellular differentiation, lcsh:Medicine, 0302 clinical medicine, Risk Factors, RAR-related orphan receptor gamma, immune system diseases, Leukocytes, IL-2 receptor, Diabetis, FOXP3, Cell Differentiation, General Medicine, Type 1 diabetes, 030220 oncology & carcinogenesis, Cytokines, RNA, Long Noncoding, medicine.symptom, Adult, medicine.medical_specialty, CD14, T cells, Inflammation, Peripheral blood mononuclear cell, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Internal medicine, medicine, Humans, RNA, Messenger, Cyclin-Dependent Kinase Inhibitor p16, Cyclin-Dependent Kinase Inhibitor p15, Glycated Hemoglobin, business.industry, Research, lcsh:R, Atherosclerosis, medicine.disease, Cardiovascular risk, Diabetes Mellitus, Type 1, 030104 developmental biology, Endocrinology, Gene Expression Regulation, Case-Control Studies, business
Abstract: Background Type 1 diabetes mellitus (T1DM) patients display increased risk of cardiovascular disease (CVD) and are characterized by a diminished regulatory T (Treg) cell content or function. Previous studies have shown an association between decreased CDKN2A/2B/2BAS gene expression and enhanced CVD. In the present study the potential relationship between CDKN2A/2B/2BAS gene expression, immune cell dysfunction and increased cardiovascular risk in T1DM patients was explored. Methods A cross-sectional study was performed in 90 subjects divided into controls and T1DM patients. Circulating leukocyte subpopulations analysis by flow cytometry, expression studies on peripheral blood mononuclear cell by qPCR and western blot and correlation studies were performed in both groups of subjects. Results Analysis indicated that, consistent with the described T cell dysfunction, T1DM subjects showed decreased circulating CD4+CD25+CD127− Treg cells. In addition, T1DM subjects had lower mRNA levels of the transcription factors FOXP3 and RORC and lower levels of IL2 and IL6 which are involved in Treg and Th17 cell differentiation, respectively. T1DM patients also exhibited decreased mRNA levels of CDKN2A (variant 1 p16Ink4a), CDKN2A (p14Arf, variant 4), CDKN2B (p15Ink4b) and CDKN2BAS compared with controls. Notably, T1DM patients had augmented pro-atherogenic CD14++CD16+-monocytes, which predict cardiovascular acute events and enhanced common carotid intima-media thickness (CC-IMT). Conclusions Decreased expression of CDKN2A/2B/2BAS in leukocytes associates with increased CC-IMT atherosclerosis surrogate marker and proatherogenic CD14++CD16+ monocytes in T1DM patients. These results suggest a potential role of CDKN2A/2B/2BAS genes in CVD risk in T1DM. Electronic supplementary material The online version of this article (10.1186/s12967-019-1977-1) contains supplementary material, which is available to authorized users.
Published: 2019

17. Impact of ursodeoxycholic acid on circulating lipid concentrations: a systematic review and meta-analysis of randomized placebo-controlled trials

Author: Arrigo F G Cicero, Maria-Corina Serban, Adriana Sánchez-García, Luis E. Simental-Mendía, Mario Simental-Mendía, Amirhossein Sahebkar, Maciej Banach, and Luis E. Simental-Mendía, Mario Simental-Mendía, Adriana Sánchez-García, Maciej Banach, Maria-Corina Serban, Arrigo F. G. Cicero, Amirhossein Sahebkar
Subjects: medicine.medical_specialty, HDL, Clinical chemistry, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, 030209 endocrinology & metabolism, Clinical nutrition, Review, 030204 cardiovascular system & hematology, Placebo, Gastroenterology, Triglyceride, law.invention, LDL, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Primary biliary cirrhosis, Randomized controlled trial, law, Internal medicine, Medicine, Humans, Meta-analysi, Total cholesterol, lcsh:RC620-627, Triglycerides, Hypolipidemic Agents, Randomized Controlled Trials as Topic, medicine.diagnostic_test, business.industry, Biochemistry (medical), Cholesterol, HDL, Ursodeoxycholic acid, Cholesterol, LDL, medicine.disease, Lipid Metabolism, Lipids, Lipid profile, Meta-analysis, lcsh:Nutritional diseases. Deficiency diseases, business, medicine.drug
Abstract: Objective: The aim of this meta-analysis of randomized placebo-controlled trials was to examine whether ursodeoxycholic acid treatment is an effective lipid-lowering agent. Methods: PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases were searched in order to find randomized controlled trials evaluating the effect of ursodeoxycholic acid on lipid profile. A random-effect model and the generic inverse variance weighting method were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. A random-effects meta-regression model was performed to explore the association between potential confounders and the estimated effect size on plasma lipid concentrations. Results: Meta-analysis of 20 treatment arms revealed a significant reduction of total cholesterol following ursodeoxycholic acid treatment (WMD: - 13.85 mg/dL, 95% CI: -21.45, - 6.25, p < 0.001). Nonetheless, LDL-C (WMD: -6.66 mg/dL, 95% CI: -13.99, 0.67, p = 0.075), triglycerides (WMD: - 1.42 mg/dL, 95% CI: -7.51, 4.67, p = 0.648) and HDL-C (WMD: -0.18 mg/dL, 95% CI: -5.23, 4.87, p = 0.944) were not found to be significantly altered by ursodeoxycholic acid administration. In the subgroup of patients with primary biliary cirrhosis, ursodeoxycholic acid reduced total cholesterol (WMD: - 29.86 mg/dL, 95% CI: -47.39, - 12.33, p = 0.001) and LDL-C (WMD: -37.27 mg/dL, 95% CI: -54.16, - 20.38, p < 0.001) concentrations without affecting TG and HDL-C. Conclusion: This meta-analysis suggests that ursodeoxycholic acid therapy might be associated with significant total cholesterol lowering particularly in patients with primary biliary cirrhosis.
Published: 2019

18. Effect of Proton-Pump Inhibitors on Glucose and Insulin Metabolism on Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Author: Adriana Sánchez-García, Luis E. Simental-Mendía, and Mario Simental-Mendía
Subjects: Blood Glucose, medicine.medical_specialty, Variance method, medicine.medical_treatment, 030209 endocrinology & metabolism, Type 2 diabetes, Carbohydrate metabolism, Gastroenterology, Fasting insulin, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Drug Discovery, medicine, Humans, Insulin, Randomized Controlled Trials as Topic, Pharmacology, business.industry, Proton Pump Inhibitors, medicine.disease, Glucose, Diabetes Mellitus, Type 2, 030220 oncology & carcinogenesis, Meta-analysis, Insulin Resistance, business, Insulin metabolism
Abstract: Background: Some studies have revealed an improvement in glucose metabolism after proton-pump inhibitors (PPI) therapy; however, this evidence is inconclusive and limited. Objective: The study aimed to examine the effect of PPI on glucose and insulin metabolism in patients with type 2 diabetes through a systematic review and meta-analysis. Methods: Only randomized controlled trials evaluating the impact of PPI on glucose or insulin concentrations in type 2 diabetes were searched in PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases. A meta-analysis was conducted using a random-effects model and generic inverse variance method. Sensitivity analysis was performed using the leave-one-out method. Results: Meta-analysis revealed no significant effect of PPI intervention on fasting glucose (mean difference [MD] -11.42 [95% CI, -29.68 to 6.83], I2 = 80%, p = 0.22), fasting insulin (MD 1.51 [95% CI, -0.36 to 3.37], I2 = 32%, p = 0.11), HOMA-IR (MD -0.16 [-0.98 to 0.65], I2 = 0%, p = 0.70), HOMA-β (MD 19.97 [-21.59 to 61.52], I2 = 71%, p = 0.35), and HbA1c concentrations (MD -0.34 [-0.99 to 0.31], I2 = 89%, p = 0.30). Conclusion: The treatment with PPI, in the short term, had no significant effects on glucose and insulin metabolism in patients with type 2 diabetes.
Published: 2020

19. Investigating the nutritional advice and support given to colorectal cancer survivors in the UK: is it fit for purpose and does it address their needs?

Author: S.L. Matsell, Elizabeth A. Williams, M A Sánchez-García, Bernard M. Corfe, and Vanessa Halliday
Subjects: Adult, Counseling, Male, 0301 basic medicine, medicine.medical_specialty, Colorectal cancer, Medicine (miscellaneous), 030209 endocrinology & metabolism, 03 medical and health sciences, 0302 clinical medicine, Cancer Survivors, Surveys and Questionnaires, Health care, medicine, Humans, Qualitative Research, Aged, Aged, 80 and over, Health Services Needs and Demand, Cancer survivor, 030109 nutrition & dietetics, Nutrition and Dietetics, Health professionals, business.industry, Cancer, Middle Aged, Patient Acceptance of Health Care, medicine.disease, United Kingdom, Clinical Practice, Cross-Sectional Studies, Family medicine, Female, Nutrition Therapy, Colorectal Neoplasms, business
Abstract: Background\ud The present study assessed the quantity and quality of nutritional advice and support given to colorectal cancer survivors in the UK.\ud \ud Methods\ud A descriptive cross‐sectional survey was completed by 75 colorectal cancer survivors recruited through social media and bowel cancer support groups in the UK. The survey consisted of open‐ended and closed questions that aimed to explore the nutritional needs, nutritional advice given and other sources of information accessed by colorectal cancer survivors.\ud \ud Results\ud Sixty‐nine percent of respondents reported that they did not receive any nutritional advice or support from their healthcare team throughout diagnosis, treatment and post‐treatment. Colorectal cancer survivors accessed nutritional advice from a variety of sources, mainly cancer charity websites. Respondents expressed their desire for individualised advice relating to their nutritional problems.\ud \ud Conclusions\ud The results obtained in the present study indicate that a high proportion of colorectal cancer patients are not receiving the nutritional support that they need to overcome nutritional difficulties. There is an urgent need to improve clinical practice to ensure colorectal patients receive nutritional advice that is both consistent between healthcare professionals and personalised throughout each stage of diagnosis, treatment and post‐treatment.
Published: 2020

20. Thoracoscopic Bullectomy for Persistent Air Leak in a 14-Year-Old Child with COVID-19 Bilateral Pulmonary Disease

Author: Laura Sánchez García, Manuel López, C. Giné, and A Laín
Subjects: Insufflation, medicine.medical_specialty, Adolescent, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Pulmonary disease, Betacoronavirus, Thoracoscopy, Humans, Medicine, Pandemics, Lung, medicine.diagnostic_test, SARS-CoV-2, business.industry, COVID-19, Pneumothorax, medicine.disease, Surgery, medicine.anatomical_structure, Cardiothoracic surgery, Persistent air leak, Female, Coronavirus Infections, Tomography, X-Ray Computed, business
Abstract: Introduction: Thoracic surgery in children with coronavirus disease-19 (COVID-19) pulmonary disease is rare, as very limited virus-related lung lesions require intervention. However, some patients may suffer from other pulmonary abnormalities that can be worsened by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and they may consequently require lung surgery. COVID-19 affects the indications, surgical procedure, and postsurgical care of these patients. Background: We present a case of a 14-year-old girl with COVID-19 pulmonary disease and persistent air leak due to right apical bullae that required resection. Clinical, surgical, and safety implications are discussed. The role of thoracic minimally invasive surgery under COVID-19 conditions is also analyzed. Materials and Methods: The thoracoscopic procedure was scheduled earlier than normally expected. The surgery was performed in a COVID-19 reserved theatre with neutral pressure and only the necessary personnel was allowed inside. The use of the required personal protective equipment was supervised by an expert nurse before and after the intervention. Results: The surgeons used a three-port technique to resect the bullae with an endostapler and no mechanical pleural abrasion was added to the procedure. Electrocautery and CO2 insufflation were avoided, and a chest drain with a closed-circuit aspiration system was installed before removing the ports. The child was discharged home 3 days later after the removal of the chest drain. Conclusions: COVID-19 has an impact on the standard indications, surgical strategies and postoperative care of some conditions requiring intervention. Extra safety measures are needed in the operating room to limit the chance of transmission. Minimally invasive surgery for thoracic surgery remains safe if the current safety guidelines are followed closely.
Published: 2020

21. Discapacidad intelectual y el uso de las tecnologías de la información y comunicación: revisión sistemática

Author: José Carlos Sánchez García, Greisy González Cedeño, Gioconda Vargas Morua, and Brizeida Hernández Sánchez
Subjects: 030506 rehabilitation, Down syndrome, business.industry, 05 social sciences, Scopus, 050301 education, medicine.disease, 03 medical and health sciences, Information and Communications Technology, Intellectual disability, Pedagogy, medicine, The Internet, 0305 other medical science, business, Psychology, 0503 education, Inclusion (education)
Abstract: Este artículo ofrece una visión general existente sobre discapacidad intelectual y su relación con las tecnologías de Información y Comunicación (TIC) y con el objetivo de dar una perspectiva global a través de la revisión sistemática de la literatura qué estudios se han realizado sobre discapacidad intelectual y el uso de las TIC como forma de inclusión, a qué conclusiones se ha llegado, y cuáles son los siguientes pasos a seguir. A fin que los estudiantes con discapacidad tengan acceso a la educación. Además, se analizan algunos datos bibliométrico, para situar esta investigación dentro del gran tema de investigación “educación inclusiva”. Los datos se han obtenido a través de una revisión sistemática de la literatura desde 1993 hasta el 2019. El abordaje es cualitativo por cuanto se emplean todos los artículos científicos de SSCI y Scopus que cumplen con las especificaciones requeridas, asociadas a la búsqueda de las variables “intellectual disabilit*”, y “intellectual impair*” (discapacidad intelectual), asociadas con “ICT” e “internet” y sus derivaciones. Los resultados revelan la existencia de siete grandes cluster relacionados: síndrome de Down y otras discapacidades, educación, aprendizaje; discapacidad intelectual y sus padres o cuidadores; discapacidad intelectual y comorbilidad o doble afectación de patología.
Published: 2020

22. High biochemical recurrence rate after withdrawal of cabergoline in prolactinomas: is it necessary to restart treatment?

Author: Miriam Sánchez-García, Etual Espinosa-Cárdenas, Claudia Ramírez-Rentería, Ernesto Sosa-Eroza, Moisés Mercado, and Victoria Mendoza-Zubieta
Subjects: Biochemical recurrence, medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, Urology, 030209 endocrinology & metabolism, medicine.disease, Prolactin, Discontinuation, 03 medical and health sciences, Basal (phylogenetics), 0302 clinical medicine, Endocrinology, 030220 oncology & carcinogenesis, Cabergoline, Diabetes mellitus, medicine, Clinical significance, business, Prolactinoma, medicine.drug
Abstract: Purpose Treatment with dopamine agonists (DA) is highly effective in patients with prolactinomas. In selected patients, discontinuation of DA after several years of successful treatment is possible, however, hyperprolactinemia recurs in 60-80% of them. It is unclear what is the clinical significance of these recurrences and hence, whether or not reinitiation of therapy is necessary. Objectives To evaluate the recurrence rate in prolactinoma patients after DA withdrawal and the necessity to restart treatment. Methods Patients with >2 years of treatment with cabergoline (CBG) who achieved normoprolactinemia and a > 50% reduction in tumor size were included. DA dose was down titrated until withdrawal. Basal tumor size, as well as PRL and gonadal steroid levels were recorded at diagnosis, at withdrawal of DA and every 3-6 months for 1-3 years. Results Fifty patients were included (38 women, 34 macroprolactinomas). After withdrawal, 34 (68%) presented recurrence of hyperprolactinemia. PRL levels Conclusions Biochemical recurrence in prolactinomas is very frequent, however, in only a few of these patients reinitiation of DA is necessary.
Published: 2020

23. BML‐111 treatment prevents cardiac apoptosis and oxidative stress in a mouse model of autoimmune myocarditis

Author: Verónica Terrón, María Fernández-Velasco, Carlos Zaragoza, Sergio Sánchez-García, Natalia Canales-Bueno, Almudena Val-Blasco, María Teresa Vallejo-Cremades, Lisardo Boscá, Rafael I. Jaén, Patricia Prieto, Ministerio de Ciencia, Innovación y Universidades (España), Agencia Estatal de Investigación (España), European Commission, Comunidad de Madrid, Instituto de Salud Carlos III, and Fundación Ramón Areces
Subjects: Cardiomyopathy, Dilated, 0301 basic medicine, Programmed cell death, Myocarditis, Apoptosis, Inflammation, medicine.disease_cause, Biochemistry, Autoimmune Diseases, Mice, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Fibrosis, Genetics, medicine, Animals, Molecular Biology, Mice, Inbred BALB C, Lipoxin, business.industry, Myocardium, Heart, Dilated cardiomyopathy, medicine.disease, Lipoxins, Disease Models, Animal, Oxidative Stress, 030104 developmental biology, chemistry, Heptanoic Acids, Oxidative stress, Cancer research, Female, medicine.symptom, business, 030217 neurology & neurosurgery, Biotechnology
Abstract: Myocarditis is an inflammation of the myocardium that can progress to a more severe phenotype of dilated cardiomyopathy (DCM). Three main harmful factors determine this progression: inflammation, cell death, and oxidative stress. Lipoxins and their derivatives are endogenous proresolving mediators that induce the resolution of the inflammatory process. This study aims to determine whether these mediators play a protective role in a murine model of experimental autoimmune myocarditis (EAM) by treating with the lipoxin A4 analog BML‐111. We observed that EAM mice presented extensive infiltration areas that correlated with higher levels of inflammatory and cardiac damage markers. Both parameters were significantly reduced in BML‐treated EAM mice. Consistently, cardiac dysfunction, hypertrophy, and emerging fibrosis detected in EAM mice was prevented by BML‐111 treatment. At the molecular level, we demonstrated that treatment with BML‐111 hampered apoptosis and oxidative stress induction by EAM. Moreover, both in vivo and in vitro studies revealed that these beneficial effects were mediated by activation of Nrf2 pathway through CaMKK2‐AMPKα kinase pathway. Altogether, our data indicate that treatment with the lipoxin derivative BML‐111 effectively alleviates EAM outcome and prevents cardiac dysfunction, thus, underscoring the therapeutic potential of lipoxins and their derivatives to treat myocarditis and other inflammatory cardiovascular diseases., This work was supported by grants SAF2017‐82436R from MINECO/AEI/FEDER/EU, S2017/BMD‐3686 from Comunidad de Madrid, CIVP18A3864 from Fundación Ramón Areces and CIBERCV (funded by the Instituto de Salud Carlos III) and Fondos FEDER.
Published: 2020

24. Comprehensive geriatric assessment: an update

Author: Beatriz Montero-Errasquín, Alfonso J. Cruz-Jentoft, and Elisabet Sánchez-García
Subjects: business.industry, medicine, Geriatric assessment, General Medicine, Medical emergency, medicine.disease, business
Published: 2020

25. Colorectal cancer metastases to the thyroid gland: A case report

Author: Susana Sánchez García, Esther Pilar García Santos, Patricia Ciriano Hernández, Enrique Calcerrada Alises, Jesús Martín Fernández, Elisa Jiménez Higuera, Carlos Martínez Pinedo, Daniel Sánchez Peláez, Rafael Picón Rodríguez, and Violeta Herrera Montoro
Subjects: Oncology, medicine.medical_specialty, Thyroid gland, Colorectal cancer, business.industry, Thyroid, Cancer, Rectum, Disease, Colorectal cancer metastases, medicine.disease, Primary tumor, Thyroid metastases, Surgery, Clinical trial, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Internal medicine, Case report, medicine, Adenocarcinoma, 030211 gastroenterology & hepatology, business
Abstract: Background Secondary malignancies of the thyroid gland are a rare finding in clinical practice. In addition, colorectal metastasis to the thyroid (CMT) is even more infrequently diagnosed. The source of the primary tumor follows demographic and ethnic patterns, which reflects the most prevalent malignancies in the different populations. Colorectal cancer is one of the most common types of cancer worldwide; nevertheless, CMT is infrequently diagnosed. Most of them are identified during the follow-up of gastrointestinal primary malignancies. Due to the improvement of image techniques, oncological treatment, and follow-up, survival and consequent diagnosis of metastatic disease are more frequent. Those facts make this entity a diagnostic and therapeutic challenge, due to the lack of information and the difficulties performing clinical trials and research. Case summary Here, we present a case report of a patient diagnosed with CMT of adenocarcinoma of the rectum evidenced during follow-up, 4 years after neoadjuvant chemoradiotherapy, who had subsequent curative surgical treatment of the primary tumor and inter-current lung bilateral metastases. Conclusion Thyroid metastases of extra-thyroid origin are an uncommon finding, even rarer in cases of CMT. The diagnostic process, as well as survival of oncologic patients is improving, and consequently the number of metastases to the thyroid gland is increasing.
Published: 2020

26. Adicción a la comida y estado nutricional en adolescentes de una preparatoria pública en México

Author: Ana Belén Sánchez García, Luis Arturo Pacheco-Pérez, Jesús Melchor Santos Flores, Patricia González de la Cruz, Karla Judith Ruíz-González, and Milton Carlos Guevara Valtier
Subjects: Conducta Adictiva, business.industry, Food addiction, Obesidad, Overweight, Anthropometry, medicine.disease, Obesity, Adicción a la Comida, Normal weight, Medicine, Population study, 6 - Ciencias aplicadas::61 - Medicina::614 - Higiene y salud pública. Contaminación. Prevención de accidentes. Enfermería [CDU], medicine.symptom, Estado Nutricional, business, Body mass index, Adolescente, General Nursing, Trastornos de Alimentación y de la Ingestión de Alimentos, Demography, Yale Food Addiction Scale
Abstract: Objetivos: Conocer la prevalencia de la adicción a la comida de acuerdo a la edad, sexo e índice de masa corporal,y determinar la asociación entre la adicción a la comida y el estado nutricional en adolescentes del norte de México. Método: Estudio descriptivo correlacional de corte transversal, realizado durante agosto y septiembre de 2018. La población se conformó por 630 adolescentes estudiantes de 15 a 17 años de edad, de una preparatoria pública en Nuevo León, México, a los que se les realizaron mediciones antropométricas y se empleó el cuestionario Yale Food Addiction Scale.Resultados: Una muestra de 245 adolescentes, predominando el sexo femenino (53,1%), con una edad media de 15,83 años, la media de índice de masa corporal fue de 23,18 kg/mt2 (S = 3,74) en hombres y 24,57 kg/mt2 (S = 4,00) en mujeres. El 87,8% de los adolescentes presentó positivo el criterio “deseo frustrado de parar el consumo”, el 36,3% la tolerancia, y el 34,3% el consumo a pesar de las consecuencias. El 20,7% de los adolescentes con sobrepeso presentan adicción a la comida. Conclusiones: La mayoría de los adolescentes presentan peso normal, las mujeres presentaron un índice de masa corporal mayor que el de los hombres, menos de la mitad de los participantes presenta adicción a la comida predominando los criterios positivos en mujeres, adolescentes en condición de sobrepeso, obesidad y de mayor edad. No se encontró asociación entre adicción a la comida y estado nutricional. ABSTRACT: Objective: To know the prevalence of food addiction according to age, sex, and body mass index and to determine the association between food addiction and nutritional status in adolescents from northern México. Method: Cross-sectional study with a descriptive and correlational design, carried out during August and September 2018; the study population was comprised by 630 adolescents, students, ranging from 15 to 17 years of age, from a public high school in Nuevo Leon, Mexico. Anthropometric measurements were taken and the Yale Food Addiction Scale questionnaire was used. Results: A sample of 245 adolescents predominantly female (53.1%), with a mean age of 15.83 years; mean body mass index was 23.18 kg/mt2 (S = 3.74) in males and 24.57 kg/mt2 (S = 4.00) in females; 87.8% of adolescents showed positive to the frustrated desire to stop consumption criterion, 36.3% tolerance, and 34.3% consumption despite the consequences; 20.7% of overweight adolescents showed food addiction. Conclusions: The majority of adolescents showed normal weight, while women showed a body mass index (BMI) higher than men; less than half of the participants had food addiction; positive criteria prevailed in women, and adolescents with overweight and obesity, and older. No association was found between food addiction and nutritional status.
Published: 2020

27. Laparoscopic-assisted gastric pull-up: initial experience and technical details

Author: J.A. Molino, Eduardo Perez-Etchepare, C Giné, Lloret J, A Laín, S. López-Fernández, M. Gomez Culebras, O. Rocha, G. Guillén, Laura Sánchez García, and Manuel López
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Anastomosis, medicine.disease, Gastrostomy, VACTERL association, Surgery, medicine.anatomical_structure, Intestinal malrotation, Laparotomy, Esophageal stricture, Medicine, Esophagus, business, Abdominal surgery
Abstract: To describe our initial experience in laparoscopic-assisted gastric pull-up via posterior mediastinal route in comparison with our historic experience performed by open laparotomy gastric pull-up via retrosternal route. The results of the two approaches were evaluated in this study. Between 2000 and 2017, we conducted a retrospective review of all patients that had undergone gastric transposition for esophageal atresia (EA) and long caustic strictures when preservation of the native esophagus was not possible. A total of 17 pediatric patients underwent gastric pull-up transposition as esophageal replacement technique. The patients were divided into two groups. Group A (2000–2015) consisted of 11 patients that underwent open laparotomy gastric pull-up via the retrosternal route. Three Group A patients had EA Type I, two had EA Type II, five had EA Type III, and one long caustic stricture. Associated anomalies included VACTERL association in two cases, Down syndrome in one case and intestinal malrotation in one case. The mean age at surgery was 2.2 years and the mean follow-up was 9.3 years. All patients were able to achieve oral feeds. Group B (2016–2018) consisted of six patients that underwent laparoscopic-assisted gastric transposition via posterior mediastinal pathway. Three had EA Type I, two had EA Type III, and one had a long caustic esophageal stricture. Associated anomalies included a single case of VACTERL association. Previous surgeries included two thoracotomies and two esophagostomies in patients with EA/TEF and one gastro-jejunal anastomosis in a patient with pyloric total disconnection after pyloric balloon dilatation for caustic esophageal and pyloric stricture. All patients underwent gastrostomy. Laparoscopic procedure was successfully completed in all patients without conversion. The mean follow-up in Group B was 27 months. All patients were able to establish oral feeds. Laparoscopic-assisted gastric pull-up as esophageal replacement technique is safe and has few complications. Slight modifications of the technique such as pyloric dilation reduce laparoscopic surgical time.
Published: 2020

28. Outpatient ablation for atrial fibrillation

Author: Javier Jiménez-Candil, Manuel Sánchez García, Pedro L. Sánchez, Jesús M. Hernández, Jendri Perez, and José Moríñigo
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Treatment outcome, MEDLINE, Atrial fibrillation, Catheter ablation, General Medicine, Ablation, medicine.disease, Surgery, Text mining, medicine, business
Published: 2021

29. Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Author: Stephen R Knight, Catherine A Shaw, Riinu Pius, Thomas M Drake, Lisa Norman, Adesoji O Ademuyiwa, Adewale O Adisa, Maria Lorena Aguilera, Sara W Al-Saqqa, Ibrahim Al-Slaibi, Aneel Bhangu, Bruce M Biccard, Peter Brocklehurst, Ainhoa Costas-Chavarri, Kathryn Chu, Anna Dare, Muhammed Elhadi, Cameron J Fairfield, J Edward Fitzgerald, Dhruv Ghosh, James Glasbey, Mark I. van Berge Henegouwen, J.C. Allen Ingabire, T Peter Kingham, Marie Carmela Lapitan, Ismaïl Lawani, Bettina Lieske, Richard Lilford, Janet Martin, Kenneth A McLean, Rachel Moore, Dion Morton, Dmitri Nepogodiev, Faustin Ntirenganya, Francesco Pata, Thomas Pinkney, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Aya Riad, Hosni Khairy Salem, Joana Simões, Richard Spence, Neil Smart, Stephen Tabiri, Hannah Thomas, Thomas G Weiser, Malcolm West, John Whitaker, Ewen M Harrison, Arben Gjata, Maria Marta Modolo, Sebastian King, Erick Chan, Sayeda Nazmun Nahar, Ade Waterman, Dominique Vervoort, Alemayehu Ginbo Bedada, Bernardo De Azevedo, Ana Gabriela Figueiredo, Manol Sokolov, Venerand Barendegere, Gerald Ekwen, Arnav Agarwal, Qinyang Liu, Juan Camilo Correa, Kalisya Luc Malemo, Jacques Bake, Jakov Mihanovic, Kamila Kuncarová, Julius Orhalmi, Hosni Salem, Jyri Teras, Aristotelis Kechagias, Alexis P Arnaud, Judith Lindert, Vasileios Kalles, Maria-Lorena Aguilera-Arevalo, Gustavo Recinos, Zsolt Baranyai, Basant Kumar, Harish Neelamraju Lakshmi, Sanoop Koshy Zachariah, Philip Alexander, Sunil Kumar Venkatappa, C Pramesh, Radhian Amandito, Christina Fleming, Luca Ansaloni, Gianluca Pellino, Ahmed M. Altibi, Ibrahim Nour, Intisar Hamdun, Ali M. Ghellai, Donatas Venskutonis, Tomas Poskus, Justas Zilinskas, Precious Malemia, Yong Yong Tew, Elaine Borg, Sarah Ellul, fatima Zahraa Wafqui, David W Borowski, Anne Sophie van Dalen, Cameron Wells, Harissou Adamou, Adesoji Ademuyiwa, Adewale Adisa, Kjetil Søreide, Sara Al Saqqa, Osaid Alser, Haya Tahboub, Helmut Alfredo Segovia Lohse, Sebastian Shu Yip, Piotr Major, António Sampaio Soares, Matei Razvan Bratu, Andrey Litvin, Armen Vardanyan, JC Allen Ingabire, Ahmad Gudal, Naif Albati, Jovan Juloski, Miran Rems, Sarah Rayne, Stephanie Van Straten, Yoshan Moodley, Irene Ortega Vázquez, Jaime Ruiz-Tovar, Kithsiri Janakantha Senanayake, Sujeewa Priyantha Bandara Thalgaspitiya, Omer Abdelbagi Omer, Anmar Homeida, Yucel Cengiz, Daniel Clerc, Muhammad Alshaar, Hanen Bouaziz, Yuksel Altinel, Matthew Doe, Maryna Freigofer, Ella Teasdale, Rakan Kabariti, Joshua Michael Clements, Stephen Richard Knight, Ahsan Ashfaq, Ijeoma Azodo, Gabriela Wagner, Ivan Trostchansky, Mayaba Maimbo, David Linyama, Helidon Nina, Amanda Zeko, Claudio Gabriel Fermani, Santiago Villalobos, Federico Carballo, Pablo Farina, Sebastian Guckenheimer, Marilla Dickfos, Ankit Ajmera, Chester Chong, Ralph Gourlay, Sikandar Hussaini, Yi Jia Lee, Adeeb Majid, Peter Martin, Rebecca Miles, Owen James Morris, Jamie Phua, William Ridley, Tarunpreet Saluja, Ryan Renxin Tan, Jen Teh, Anna Wells, Bharti Arora, Qaasim Dollie, Debbie Ho, Yanru Ma, Omattage Mahasha Perera, Anthony Truong, Amanda Caroline Dawson, Bryan Lim, Upuli Pahalawatta, Jacqueline Phan, Xiao-Ming Sarah Woon-Shoo-Tong, Andrea Yeoh, Lillian Charman, Andrew Drane, Sharon Laura, Charmaine Chu Wen Lo, Amy Mozes, Rita Poon, Hao Han Tan, Ellen Wall, Prakshi Chopra, Jasmine De Giovanni, Bal Dhital, Brian Draganic, Alexander Duller, Jonathan Gani, Yao Kuan Goh, Jun Young Jeong, Brendan McManus, Prakash Nagappan, Peter Pockney, Anya Rugendyke, Mahsa Sarrami, Stephen Smith, Vanessa Wills, Hsu Ven Wong, Geoffrey Ye, Geoffrey Zhang, Ethan Brooker, Daniel Feng, Bonnie Lau, Carlin Ngai, Sarah Birks, David Gyorki, Jaime Otero de Pablos, Ali Abbosh, Chris Gillespie, Ahmed Mahmoud, Bianca Kwan, Joshua Lawson, Andrea Warwick, Janne Bingham, Andrew J Cockbain, Nagendra Naidu Dudi-Venkata, Jordan Ellaby-Hall, Ben Finlay, Emily Humphries, Jade Pisaniello, Monique Pisaniello, Salma Salih, Tarik Sammour, Haidar Hadri Abd Wahab, April De Silva, Nicola Hayward, Kartik Iyer, Guy Maddern, Gian Andrea Prevost, Naga Annapureddy, Krishna Pranathi Settipalli, Jeremy Yeo, Lucy Hempenstall, Lily Pham, Shaun Purcell, Cherry Talavera, Ashish I Vaska, Gurpreet Chaggar, Phillip Chrapko, Annelise Cocco, Sarah Michelle Crystal Jade Coulter-Nile, Grahame Ctercteko, James French, Houchen Gong, Martijn Gosselink, Thuvarahan Jegathees, Ivan Jin, Michelle Kalachov, Kathryn Kiefhaber, Katherine Lee, Jason Luong, Steven Phan, Henry Pleass, Kelly Veale, Zhi Zeng, Angela Au, Ashe DeBiasio, Idy Deng, Jananee Myooran, Amrita Nair, Peter Stewart, Anton Stift, Lukas Walter Unger, Kerstin Wimmer, Nabila Ahmed, Syed Hasan, Saber Rahman, Margaret O'Shea, Greg Padmore, Adrian Peters, Pietro Perduca, Guenda Pulcina, Nicolas Tinton, Frederic Buxant, Elsa Dabin, Giulia Garofalo, Francis Dossou, Freddy Houehanou Rodrigue Gnangnon, Yacoubou Imorou Souaibou, Pako Motlaleselelo, Omphile Tlhomelang, Igor Lima Buarque, Gustavo Mendonça Ataíde Gomes, Aldo Vieira Barros, Ilia Batashki, Nikolai Damianov, Vladislav Stoyanov, Dragomir Dardanov, Svilen Maslyankov, Plamen Petkov, George Todorov, Evgeni Zhivkov, Aygulya Akisheva, Miguel Angel Castilla Moreno, Geno Genov, Ivelina Ilieva, Tsvetomir Ivanov, Martin Karamanliev, Azhar Khan, Emil Mitkov, Tsanko Yotsov, Boyko Atanasov, Nikolay Belev, Mihail Slavchev, Carlos Nsengiyumva, Elgan Jones, Simon Stock, Steve Kyota, James Brown, Tresor Mabanza K., Lemery Nigo Samuel, Chidi Otuneme, Ngwang Prosper, Franklin Umenze, Marylise Boutros, Natasha Caminsky, Sinziana Dumitra, Richard Garfinkle, Dominique Morency, Ebram Salama, Alexander Banks, Lorenzo Ferri, Haitian He, Amit Katz, Alexander Sender Liberman, Sarkis Meterissian, Allison Pang, Elena Parvez, Usmaan Hameed, Fahima Osman, Sangita Sequeira, Natalie Coburn, Alisha Jaffer, Paul Karanicolas, Matthew Mosseler, Reilly Musselman, Xinyuan Liu, Ching Wan Yip, Juan Sebastian Garces-Otero, Carolina Guzman, Sebastian Sierra, Andres Uribe Valencia, Paulo Andrés Cabrera Rivera, Saul Camelo, Andrea Gonzalez, Alejandro González-Orozco, Manuel Santiago Mosquera Paz, Carlos J- Perez Rivera, Felipe Gonzalez, Andres Isaza-Restrepo, Laura Nino- Torres, Natalia Arias Madrid, Maria Clara Mendoza Arango, Justin Tsandiraki, Damir Jemendžic, Branislav Kocman, Oliver Šuman, Renata Canic, Darko Jurišic, Ivana Karakas, Ana Krizanovic Rupcic, Vlatka Pitlovic, Josip Samardžic, Mario Kopljar, Ivan Bacic, Edgar Domini, Robert Karlo, Danijela Miljanic, Andrea Simic, Mariam Ahmed, Majdi Al Nassrallah, Rabiya Altaf, Talal Amjad, Ruba Eltoum, Heba Haidar, Alhassan Hassan, Omar Khalil, Marwan Qasem, Rommel Ramesh, Gautham Sajith, Maham Wisal, Jan Žatecký, Michele Bujda, Katerina Jirankova, Ales Paclik, Aya Abdallah, Mariam Abdulgawad Almogy, Esraa Ayman El-sawy, Ahmed Moustafa ElFayoumy, Nourhan Elghareeb, Nourhan Ahmed Esmat, Ahmed Fadel, Abdullah Habater, Heba Hamdy, Amr Hefni, Marwa Kamal, Norhan Mohamed Abobakr, Ahmed Sayed, Nancy Shaker, Ehab Taha, Hoda Tharwat, Omar Zakaria, Ibrahem Abdelmotaleb, Ali Al-Dhufri, Hamza S. Al-Himyari, Enas El sheikh, Asmaa Eldmaty, Aya Elkhalawy, Ahmed M.Elkhashen, Kithara Magdy, Safa Mostafa, Habib Doutoum Sadia, Mohamed mahmoud Saleh, Dina Samir, Mohamed Yahia Mohamed Ali, Mahmoud A. Nassar, Samar Abdelhady, Aly Abdelrazek, Israa Abdelsalam, Aya El-Sawy, Eman Essam, Mohamed Gadelkarim, Khaled Ghaly, Mohamed Hassabalnaby, Rana Masarani, Nourhan Mohamed Shaaban, Ahmed Sabry, Menatalla Salem, Nourhan Akram Soliman, Diaaaldin Zahran, Moustafa Ramadan Abou El.soud, Esraa Tarek Badr, Hala Borham, Nehal Elmeslemany, Mohammad Elsayed, Fawzia Elsherif, Sara Eslam, Gehad Gaber, Sondos Ibrahim, Yara Kamh, Abdelrahman Mahmoud, Shimaa gamal Mohamed, Eman Morshedy, Cinderella Omar, Fatima Salem Soliman, Shaza Abdelkawy, Naglaa Abdelmohsen, Mahmoud Abdelshakour, Ahmed Dahy, Norhan Gamal, Mohammed Gamal, Ahmad Hasan, Helal Hetta, Nehad Mousa, Mohamed Omar, Somia Rabie, Mahmoud Saad, Bakeer Saleh, Marwa Sayed Mohamed, Muhammad Shawqi, Heba Abdelhady Mousa, Mostafa Alnoury, Mohamed Elbealawy, Ahmed Elshafey, Muhammad Essam Ibrahim El Desouki Muhammad Ahmed, Mennatullah Ghonaim, Fawzy Hgag, Mohamed Ibrahim, Mahmoud Morsy, Mohamed Reda Loaloa, Ahmed Refaat, Hadeer Samir, Fatma Shahien, Mohamed Sobhy, Fathy Sroor, Esraa Abdellatif, Marina Adel, Amr Abdelghani Afifi, Eman Afifi, Marco Antaky, Amr Dawoud, Naira El Zoghby, Amira El-remaily, Ali Abdelazez Elzanfaly, Ahmed Gadallah, Fatma Alzahraa Gamal, Omar Hashem, Shrouk Medhat Youssef, Aliaa Muhammad Attyah, Malak Munir, Omar Shazly, Esraa Taha, Karim Wilson, Sawsan Adel, Asmaa Ali, Esraa Eid, Esraa Elhelow, Marwa Elmahdy, Bassant Elshatby, Amany Hossam el-din Zakaria, Ahmad Hossny, Eman Ibrahim, Ahmed M.Yonis, Maram Metwalli, Basant Yousry, Esraa Zid, Mina A Yacoub, Ahmed Abdelhakim, Nervana Abouelsoad, Mo'min Alkhatib, Ahmed Ashraf, Alaa Ashraf, Yasmin Elazab, Mahmoud Elfanty, Osama Elkabir, Mai Elsayed, Ahmed Elshimy, Hager Elsobky, John Eskander, Ahmed Gad, Ward Hamsho, Noura Khaled Abdelwahed, Menna Magdy, Dalia Moharam, Abeer Osama, Shereen Ramadan, Radwa Roum, Taqwa Sayed, Tarneem Shehada, Ahmed Mohy Zidan, Khalid Abbas, Amr Ali, Mohamed Attia, Mohamed Balata, Ayman El Nakeeb, Mohamed Ibrahim Elsayed Elewaily, Ahmed Elfallal, Hossam Elfeki, Ahmed Elkhadragy, Sameh Emile, Helmy Ezzat, Hasnaa Hosni, Islam Mansour, Waleed Omar, Gehad Othman, Kareem Sadek, Mostafa Shalaby, Noura Shehab-Eldeen, Rawda Anas khalifa, Helmy Badr, Mostafa Eldeep, Ahmed Eldeep, Amany Eldoseuky mohammed, Salwa Khallaf, Eman Magdy Hegazy, Rokia Mahmoud, Pola Mikhail, Mahmoud Morsi, Sara Mowafy, Dina Raafat, Amina Safy, Marwa Sera, Ahmed shible Sera, Mostafa Salim Mohamed AbdAllah, Muhammad Abdelkader, Abdulrahman Osama Abdou, Ahmedgaber Ahmed, Shireen Gaafar, Fatma Ibrahim negm, Mina Lapic, Ahmed Maher, Hagar Mahmoud, Ahmed Mostafa, Mohamed Samir, Fatma Samy, Nourhan Semeda, Hind I. Shalaby, Alaa El-taweel, Ahmed Galal Elnagar, Ahmed Gamal Hemidan, Mohamed Hussein, Ahmed.A. Kandil, Mf Moawad, Ayat Allah Nasser Hamamah, Mostafa Soliman, Mohamed Abdelkhalek, Noura Abdelmaksoud Tawakel, Ahmed Mohamed Abdelwahed, Alrawy Abdou, Khalid Atallah, Mohammed Yasser Elsherbeny, Eman Emara, Mohamed Hamdy, Omar Hamdy, Amira Haron, Salma Ismail, Islam Hany Metwally, Nihal Mohamed Hamed Elgaml, Ahmed Nassar, Basel Refky, Mirna Sadek, Mahmoud Saleh, Asmaa Yunes, Mai Zakaria, Mohammed Zuhdy, Notila Fayed, Mohammed Mustafa Hassan Mohammed, Sander Kütner, Priit Melnik, Indrek Seire, Toomas Ümarik, Eppu Ainoa, Verner Eerola, Hanna Koppatz, Laura Koskenvuo, Ville Sallinen, Sini Takala, Jevgeni Katunin, Arto Turunen, Niki Christou, Muriel Mathonnet, Vincent Lavoue, Krystel Nyangoh Timoh, Lucie Soulabaille, Romain Lesourd, Aude Merdrignac, Laurent Sulpice, Benoît André, Elodie Chantalat, Charlotte Vaysse, Bertrand Dousset, Sebastien Gaujoux, Gregory Martin, Octavian Clonda, Domantas Juodis, Klaus Kienle, Andras Mravik, Samuel Palmer, Gabor Szabadhegyi, Anita Eseenam Agbeko, Solomon Gyabaah, Frank Enoch Gyamfi, Nuhu Naabo, Atta Owusu senior, Joseph Yorke, Frank Owusu, Francis Abantanga, Theophilus Teddy Kojo Anyomih, Abdul-Jalilu Mohammed Muntaka, Emmanuel Owusu Abem, Mohammed Sheriff, Paul M. Wondoh, Dimitrios Balalis, Dimitrios Korkolis, Georgios Gkiokas, Eirini Pantiora, Theodosios Theodosopoulos, Argyrios Ioannidis, Konstantinos Konstantinidis, Sofia Konstantinidou, Nikolaos Machairas, Anna Paspala, Anastasia Prodromidou, Christos Chouliaras, Konstantinos Papadopoulos, Ioannis Baloyiannis, Ioannis Mamaloudis, George Tzovaras, Ioanna Akrida, Maria-Ioanna Argentou, Stylianos Germanos, Evangelos Iliopoulos, Ioannis Maroulis, George Skroubis, George Theofanis, Christos Chatzakis, Orestis Ioannidis, Lydia Loutzidou, Panagiotis Karathanasis, Nikolaos Michalopoulos, Charalampos Theodoropoulos, Dimitrios Theodorou, Tania Triantafyllou, Zoe Garoufalia, Natasha Hasemaki, Michalis Kontos, Gregory Kouraklis, Stylianos Kykalos, Theodore Liakakos, Eustratia Mpaili, Alexandros Papalampros, Dimitrios Schizas, Athanasios Syllaios, Ekaterini Christina Tampaki, Antonios Tsimpoukelis, Maria Ioanna Antonopoulou, Eirini Deskou, Dimitrios K. Manatakis, Dimitrios Papageorgiou, Menelaos Zoulamoglou, Christos Anthoulakis, Michalis Margaritis, Nikolaos Nikoloudis, Veronica Campo, André Ceballos, Mario-Andrés Flores, Waleska Giron, Donghyun Ko, Gabriel Martinez, Verónica Rivera Lara, Nataly Rueda, Andres Sanchez, Jorge Carlos Guillermo Tejeda Garrido, Alvaro Eduardo Alvarez Rivera, Elvis Benjamin Bamaca Ixcajoc, Lilian Elizabeth Barreda Zelaya, Patricia Chacòn-Herrera, Ligia Margarita Corea Ruiz, Guillermo Echeverria-Davila, Mario Garcia, Danilo García, Edgar Fernando Gutiérrez Mayen, Noriega José, Nery Mazariegos, Diego Méndez, Michael Paniagua Espinoza, David Bardos, Marton Benke, Kristof Illes, Balint András Kokas, Réka Szabó, Akhila Appukuttan, Anjitha Asok, Vijaykumar D.k, Kapil Malik, Praveen Ravishankaran, Ritesh Tapkire, Guru Moorthy, Joyner Abraham, Ramesh Muthuvel, John Alapatt, Abhay Kattepur, Nizamudheen Pareekutty, Mebanshanbor Garod, Caleb Harris, Cliff Wanniang, Ashish Gupta, Deepak Nehra, Sanjeev Parshad, Rajgopal Acharya, Rajendra Badwe, Manish Bhandare, Urvashi Jain, Karishma Kirti, Nita Nair, Shailesh Shrikhande, Purvi Thakkar, Premkumar Anandan, Archana C S, Arun Holenarasipur Narasannaiah, Tejaswi Jagarlamudi, Rashmi M R, Mallikarjuna Manangi, Abhishek Raghavendra, K. Seshagiri Rao, Vinay S, Vinay Sajjan, Aneesh Shenoy, Santhosh Shivashankar Chikkanayakanahalli, Kavya Tharanath, Sushmita V, Peter Adidharma, Raksheeth Agarwal, Phebe Anggita Gultom, Ghafur Rasyid Arifin, Matthew Billy, Zatira Elfizri, Alessa Fahira, Devi Felicia, Triana Hardianti Gunardi, Nadya Johanna, Nadia Rahmadiani Nugrahadi, Sonar Soni Panigoro, Siti Rahmayanti, Retta Catherina Sihotang, Santi Yuanita Brata, Hadi Winoto, Nastaran Barati, Manoochehr Karami, Hamidreza Khorshidi, Homa Naderifar, Mazin A. Abdulla, Maggie Coleman, Ronan J Doherty, Rob Hannon, Brenda Murphy, Aine Stakelum, Des Winter, Lylas Aljohmani, Richard Farnan, Yeshey Seldon, Tanna Tan, Shriya Varghese, Mohammad Alherz, Muaaz Ather, Mohammad Bajilan, Vivien Graziadei, Isobel Pilkington, Omar Quidwai, Paul Ridgway, Haaris Shiwani, Abd al-Rahman Tahir, Eimear Blunnie, Daniel Burke, Niall Kennedy, Kate Macdonagh, Maeve O'Neill, Siobhan Rooney, Giuseppe Falco, Guglielmo Ferrari, Simone Mele, Gabriela Elisa Nita, Lara Ugoletti, Maurizio Zizzo, Gianmaria Confalonieri, Giovanni Pesenti, Fulvio Tagliabue, Gianluca Baronio, Deborah Ongaro, Giacomo Pata, Bruno Compagnoni, Renato Salvadori, Lucio Taglietti, Nicola D'Alessandro, Pierpaolo Di Lascio, Giovanni Pascale, Luca Bortolasi, Tommaso Campagnaro, Massimo Carlini, Giorgio Lisi, Davide Lombardi, Corrado Pedrazzani, Domenico Spoletini, Giulia Turri, Paola Violi, Donato Francesco Altomare, Fabrizio Aquilino, Nicola Musa, Vincenzo Papagni, Arcangelo Picciariello, Leonardo Vincenti, Dario Andreotti, Savino Occhionorelli, Matteo Tondo, Stefano Maria Massimiliano. Basso, Riccardo Cirelli, Marco Enrico Mario Maino, Guglielmo Niccolò Piozzi, Emanuele Picone, Rosa Scaramuzzo, Giovanni Sinibaldi, Alfonso Amendola, Lorenzo Anastasio, Luigi Bucci, Emanuele Caruso, Antonio Castaldi, Sara Di Maso, Vincenza Paola Dinuzzi, Giovanni Esposito, Maria Gaudiello, Mariano Cesare Giglio, Paola Antonella Greco, Gaetano Luglio, Andrea Manfreda, Ester Marra, Federica Mastella, Gianluca Pagano, Roberto Peltrini, Vincenzo Pepe, Michele Sacco, Viviana Sollazzo, Giovanni Spiezio, Ettore Cianchetti, Nunzia Menduni, Michele Maria Carvello, Francesca Di Candido, Antonino Spinelli, Fabio Corsi, Luca Sorrentino, Fabio Marino, Emanuele Luigi Giuseppe Asti, Luigi Bonavina, Emanuele Rausa, Martina Asta, Andrea Belli, Francesco Bianco, Carmela Cervone, Paolo Delrio, Armando Falato, Andrea Fares Bucci, Rita Guarino, Ugo Pace, Daniela Rega, Emilia De Luca, Gaetano Gallo, Giuseppe Sammarco, Giuseppe Sena, Giuseppina Vescio, Letizia Santandrea, Giampaolo Ugolini, Davide Zattoni, Nicola Chetta, Gaetano Logrieco, Serafino Vanella, Gianluca Garulli, Nicola Zanini, Andrea Bondurri, Francesco Cammarata, Francesco Colombo, Diego Foschi, Giulia Maria Beatrice Lamperti, Anna Maffioli, Gianluca Matteo Sampietro, Al'ona Yakushkina, Gloria Zaffaroni, Enrico Cicuttin, Maria Grazia Sibilla, Harmony Impellizzeri, Marco Inama, Gianluigi Moretto, Sylvie Mochet, Elisa Ponte, Antonella Usai, Stefano Mancini, Andrea Sagnotta, Luigi Solinas, Elisa Bolzonaro, Nicolò Tamini, Gianluca Curletti, Raffaele Galleano, Michele Malerba, Sofia Campanella, Gianfranco Cocorullo, Francesco Colli, Paolino De Marco, Nicolò Falco, Tommaso Fontana, Leonel jospin Kamdem Mambou, Antonella La Brocca, Leo Licari, Brenda Randisi, Giovanna Rizzo, Giulia Rotolo, Giuseppe Salamone, Roberta Tutino, Paolina Venturelli, Stefano Malabarba, Alessandro Sgrò, Ivan Vella, Bruno Cirillo, Daniele Crocetti, Giorgio De Toma, Pierfrancesco Lapolla, Andrea Mingoli, Paolo Sapienza, Angela Belvedere, Stefania Bianchini, Margherita Binetti, Arianna Birindelli, Valeria Tonini, Mauro Podda, Fabio Pulighe, Michele De Rosa, Lorenzo Bono, Felice Borghi, Paolo Geretto, Maria Carmela Giuffrida, Corrado Lauro, Alessandra Marano, Luca Pellegrino, Paola Salusso, Diego Sasia, Michela Campanelli, Alberto Realis Luc, Mario Trompetto, Roberto Cardia, Nicola Cillara, Antonio Nicola Giordano, Antonio Costanzo, Mario Alessandro Giovilli, Luca Turati, Silvestro Canonico, Guido Sciaudone, Francesco Selvaggi, Lucio Selvaggi, Nader Albsoul, Ahmad AlBsoul, Ala'a Aldeen Alkhatib, Osama Alsallaq, Justin Z. Amarin, Rami Ayoub, Isam Bsisu, M S El Muhtaseb, Mohammad Jabaiti, Jamal Melhem, Yasmeen Z. Qwaider, Mohammad Hasan Salameh, Ahmad Suleihat, Haya H. Suradi, Mohammad Alammarin, Almoutuz Aljaafreh, Mohammad Bani hani, Zeina Bani hani, Farah Bani Hani, Toqa Fahmawee, Shadi Hamouri, Cyrine Katanani, Ra'fat Tawalbeh, Tamara Tawalbeh, Hassan Zawahrah, Mohamad K. Abou Chaar, Lana Abusalem, Mahmoud Al-Masri, Hani Al-Najjar, Lutfi Barghuthi, Zahra Ahmed, Adnan Maulana, Omar Ngotho, Charbel Kamau, Aruyaru Stanley Mwenda, Fridah Bosire, Elizabeth Mwachiro, Robert Parker, Ian Simel, Kimutai Sylvester, Abdulmunem Ahmed Mustafa Althini, Sofian Elbarouni, Aya Elseed Elbeshina, Ahmed Gwea, Ans Malek, Wedad Albashir Masoud Farag, Abdulwahab Abdalei, Abu Baker Abdel Malik, Areej Abo-khammash, Ma'aly Abuhlaiga, Nour Adnan, Marwa Albaggar, Asma Alfitory, Asma Aljanfi, Fakhruddin Almuzghi, Zohoor Altumei, Fatima Alzabti, Hana Ashoushan, Mohamed Assalhi, Joma Azzubia, Sondos Bnhameida, Malik Delhen, Houssein Elshafei, Hana Elteir, Fatima Esbaga, Abdel Aziz Gobbi, Fatma Hamouda, Hamdan Hilan, Rania Ismail, Fieruz Jebran, Muataz Kasbour, Galia Maderi, Saja Mohammad, Burooj Mohammed, Habib Murtadi, Hamassat Mustafa, Mohamed Rajab, Sarah Trenba, Mariam Wafaa, Eman Al Sagheir, Alabas Almigheerbi, Ahmed Alzahaf, Sumayyah Ghayth Bahroun, Najah Ben Dallah, Mahmoud Elshaibani, Haitem Eswaye, Maha Karar, Samah Omar, Eman Younes, Maha Younes, Dafer Zreeg, Saleh Abujamra, Firas Ashour, Mala Elgammudi, Wesal Omar F. Aljadidi, Enas Saddouh, Randa Sharif, Aya Alabuzidi, AbdulMawlay Alwerfally, Sarra Aribi, Fatma Bibas, Taha Elfaituri, Yasmine Elhajjaji, Ala Khaled, Wegdan Khalil, Tesneem Layas, Enas Soula, Ahmed Tarek, Muad fathi khalleefah Abu hallalah, Hazem Abdelkarem Ahmed, Tagwa Alsharef, Abdulsalam Ali Ben Saoud, Tasnim El Gharmoul, Ahmed Elhadi, Safa Elrais, Abdulhalim Shebani, Heba Zarti, Asaid Zeiton, Marijus Ambrazevicius, Nerijus Kaselis, Migle Stakyte, Oleg Aliosin, Agne Cizauskaite, Sarunas Dailidenas, Vitalijus Eismontas, Migle Kybransiene, Vitalija Nutautiene, Narimantas Samalavicius, Dainius Simcikas, Algirdas Slepavicius, Albinas Tamosiunas, Nerijus Ubartas, Paulius Zeromskas, Saulius Bradulskis, Edvinas Dainius, Juozas Juocas, Egle Kubiliute, Juozas Kutkevicius, Aurimas Opolskis, Audrius Parseliunas, Andrejus Subocius, Egle Virbickaite, Diana Zuikyte, Algirdas Bogusevicius, Kristina Buzaite, Daiva Cepuliene, Ieva Cesleviciene, Vaidotas Cesna, Jolanta Gribauskaite, Povilas Ignatavicius, Mantas Jokubauskas, Monika Liugailaite, Ernest Margelis, Ruta Mazelyte, Lina Pankratjevaite, Matas Pažusis, Agne Rackeviciute, Justina Saladyte, Monika Škimelyte, Vygintas Šlenfuktas, Monika Sudeikyte, Algimantas Tamelis, Tomas Vanagas, Žygimantas Žumbakys, Aivaras Atkociunas, Audrius Dulskas, Justas Kuliavas, Justas Birutis, Sigitas Paškevicius, Mindaugas Šatkauskas, Donatas Danys, Matas Jakubauskas, Lina Jakubauskiene, Marius Kryzauskas, Vytautas Lipnickas, Gabija Makunaite, Fanjandrainy Rasoaherinomenjanahary, Herizo Rasolofonarivo, Luc Hervé Samison, Bitiel Banda, Vanessa Msosa, Ahmad Imran Ahmad Izzuddin, Andre Das, Ying Yee Gan, Tan Shong Sheng, Jia yng Siaw, Mohd Fadliyazid Ab Rahim, Dyg Zahratul Hamrak Abang Jamari, Nurfariza Che Husin, Muhd Yusairi Kamarulzaman, Yi Ping Lim, Nil Amri Mohamed Kamil, Mohd Razeen Mohd Hassan, Saidah Mohd Sahid, Johari Mustafa, Elaine Hui Been Ng, Wan Khamizar Wan Khazim, Ng Chang Ern, P.g. Lingeshan, Syariz Ezuan Sulaiman, Sue Ean Ang, Muhammad Navid Bin Mohamad Sithik, Yih Jeng Cheong, Mahadevan Deva Tata, Law Jia Xian, Aravinthan Kadravello, I-Ern Koh, Li-Yen Ng, Yuki Julius Ng We Yong, Kandasami Palayan, Chi Xuan Sam, Phuah Siow Jin, Jeremy Tan Ern Hwei, Yita Tang, Alvin Zubin Ter, Michael Pak-Kai Wong, Andee Dzulkarnaen Zakaria, Zaidi Zakaria, Fitjerald Henry, Thyivya Kalaiselvan, Muhammad Fairuz Shah Abd Karim, Mohamed Rezal Abdul Aziz, Nora Abdul Aziz, Tak Loon Khong, Peng Choong Lau, Hiong Chin Lim, April Camilla Roslani, Jonathan Chen Ken Seak, Sui-Weng Wong, Lai Fen Wong, Leow Yeen Chin, Mercy Chinemerem Anyanwu, Zachary Busuttil, Thomas Calleja, Kurt Lee Chircop, Ruth Cutajar, Andrew Michael Dimech, Joseph Galea, Kiara Gascon Perai, Ruth Gatt, Lisa Kelman, Elizabeth Micallef, Favour Nwolu, Kim Sammut, Joanna Thompson, Sean Warwicker, Matthew Zammit, Fernando Cordera, Efraín Cruz González, Jorge Sánchez-García, Francisco José Barbosa Camacho, Francisco Javier Barrera López, Carlos Jose Zuloaga Fernandez del Valle, Eric Acosta, Iván Romarico González Espinoza, Perla Moreno, Ana Olivia Cortes-Flores, Clotilde Fuentes Orozco, Alejandro Gonzalez Ojeda, Samantha Corro Díaz González, Laura Martinez, Bonifacio Mosqueda Amador, Armando Novoa, Dennet Arturo Olazo Espejo, Alejandro Jimenez, Federico Lopez Rosales, Elva Gabriela Vanoye, Luis Alberto Garcia Gonzalez, Roberto Carlos Miranda-Ackerman, Manuel Solano-Genesta, Alethia Alvarez-Cano, Hector Hugo Romero-Garza, Heriberto Medina-Franco, Lorelí Mejía-Fernández, Noel Salgado-Nesme, Omar Vergara-Fernandez, Guadalupe Montserrat Gutiérrez-Mota, Francisco Xavier Hernandez Vera, Anabella Llantada Lopez, Gilberto Morgan Villela, Felipe de Jesus Ramirez Padilla, Walezka Tapia Marin, Mónica Martínez Maldonado, Ramses Sánchez Suárez, José Manuel Troche, Chaymae Benyaiche, Oumaima Outani, Souadka Amine, Amine Benkabbou, Anass Mohammed Majbar, Raouf Mohsine, Ali Rafik, Thida Oung, Moe Moe Tin, Philipp Plarre, Anna Alberga, Nina Sluiter, Jurriaan Tuynman, Robin Blok, Didem Cömert, Roel Hompes, Marianne Kalff, Merel Elisabeth Stellingwerf, Pieter Tanis, Mark van Berge Henegouwen, Elise Maria van Praag, Daan Wisselink, Michael Gerhards, Josephine Lopes Cardozo, Emma Westerduin, Joske de Jonge, Aaw van Geloven, Kaz van Schilt, Frank den Boer, Simone Stoots, Stijn Vlek, Jamie Adams, Ibrahim S. Al-Busaidi, Gabrielle Budd, Seung il Choi, Michael Jen Jie Chu, Anurag Ganugapati, Lucy McKinstry, Rebecca Pascoe, Simon Richards, Kenrick Rosser, Annie Stevenson, Rebecca White, Shebani Farik, Jin Kwun, Ahmed Murad, Sarah Cowan, Timothy Hall, Michael Hayton, Laminou Malam Sani, Souleymane Oumarou Garba, Ibrahim Amadou Magagi, Oumarou Habou, Halima Aliyu, Muhammad Daniyan, Tunde T. Sholadoye, Lawal Abdullahi, Lofty-John Anyanwu, Aminu Mohammad Mohammad, Abubakar Bala Muhammad, Abdurrahman Abba Sheshe, Ibrahim Suleiman, Alaba Adesina, Ajibola Awolowo, Clement Onuoha, Omotayo Salami, Ogechukwu Taiwo, Agboola Taiwo, Stephen Kache, Jerry Godfrey Makama, Danjuma Sale, Olajide Abiola, Akinlabi Ajao, Anthony Ajiboye, Amarachukwu Etonyeaku, Julius Olaogun, Ademola Adebanjo, Opeoluwa Adesanya, Michael Olatunji Afolayan, Olanrewaju Balogun, Ayomide Makanjuola, Samuel Nwokocha, Rufus Wale Ojewola, Thomas Olagboyega Olajide, Adewale Aderounmu, Abdul-Rashid Adesunkanmi, Augustine Agbakwuru, Adeleke Akeem Aderogba, Olusegun Isaac Alatise, Olukayode Arowolo, Oladejo Lawal, Tajudeen Mohammed, Chinedu Ndegbu, Olalekan Olasehinde, Funmilola Wuraola, Akinbolaji Akinkuolie, Arinzechukwu Mosanya, Omobolaji Ayandipo, Peter Elemile, Taiwo Akeem Lawal, Samuel Ali SANI, Stephen Garba, Rebecca Hauwa SANI, Samson Olori, Henry Onyebuashi, Ifeanyi Umoke, Adedire Adenuga, Ademola Adeyeye, Olufemi Habeeb, Bashir Lawal, Abdulrasheed Nasir, Eirik Kjus Aahlin, Didrik Kjønås, Elisabeth Myrseth, Jibran Abbasy, Abdul Alvi, Omair Saleem, Asma Afzal, Anam Nazir, Muhammad Farooq, Ayesha Liaqat, Syed Asghar Naqi, Ali Raza, Muzna Sarfraz, Muhammad Sarwar, Muntaha Banglani, Ambreen Munir, Rahmat Sehrish, Bushra Ayub, Raza Sayyed, Amna Altaf, Saima Ayub, Komal Saeed, Bilal Syed, Sana Amir Akbar, Abdul Wahid Anwer, Ruqayya Naheed Khan, Amina Iqbal Khan, Shahid Khattak, Sameen Mohtasham, Muhammad Asad Parvaiz, Aamir Ali Syed, Abdul Basit Ansari, Noman Shahzad, Tanwir Khaliq, Isbah Rashid, Shahzad Hussain Waqar, Hasan Abu Al-saleem, Amjad Abu Alqumboz, Mohammad Alqadi, Adham Amro, Rawan Assa, Eman Awesat, Rawan Ayyad, Mohammed Hammad, Ayat Haymony, Bassel Hijazi, Bara Hmeidat, Rowaa Lahaseh, Aseel Qawasmi, Alaa Rajabi, Mohammed Shehada, Sundus Shkokani, Yasmine Yaghi, Nadine Yaghi, Mohammad AlZohour, Mohammad Farid, Yousef Mahmoud Habes, Wesam Juba, Yanal Nubani, Abdelrahman Rabee, Mohammad Sa'deh, Saeed Abed, Iyad Al basos, Mohammad Alswerki, Dina Ashour, Israa Awad, Samar Diab, Alaa El Jamassi, Sahar El-Kahlout, Somaya Elhout, Ahmed N K Hajjaj, Doaa Hasanain, Baraa Nabil hajjaj, Mohammed Obaid, Eman Saikaly, Ahmed Salhi, Hiba Al-Tammam, Murad Almasri, Muath Baniowda, Doha Beshtawi, Ali Horoub, Rami Misk, Bayan Mohammad, Rami Qasrawi, Tasnim Sholi, Samar Abu-Nimeh, Abrar Abu-srour, Sadi A. Abukhalaf, Samer Adawi, Barah Alsalameh, Kholoud Ayesh, Muawiyah Elqadi, Ahmad Hammouri, Fatima Karim Mustafa, Natalie Marzouqa, Shatha Melhem, Dima Miqdad, Balqees Mohamad, Mhammed Rawhi, Ayman B. Abu Ahammala, Ahmed Abu Ataya, Israa Abu Jayyab, Samar Al-Shwaikh, Othman Alagha, Mohammed Alasttal, Haneen Awadallah, Mahmood Elblbessy, Jehad Fares, Akram Jarbou, Ibtisam Mahfouz, Moath A. Albahnasawi, Asmaa' Abo mahadi, Hasan Abuelhatal, Ayham Abuelqomboz, Abdelrahman Almoqayyad, Abdallah Alwali, Reem Balaawi, Mahmoud Hamouda, Mohammed Humeid, Abdullah Jedyan, Tasneem Mahmoud Abu hamam, Ghadeer Matar, Ali Salem, Tahani Samra, Nureddin Shaheen, Karam Shihada, Ayoob A.Nemer, Mahmoud Abu Al Amrain, Abdulwhhab Abu Alamrain, Najlaa Abu Jamie, Mohammed R. Abu-Rous, Nada Alfarra, Mohammed AlTaweel, Noor Alwhaidi, Ramadan Hamed, Bader Saqqa, Ahmad Shaheen, Dana Aljaber, Loay Aljaberi, Malak Alwaheidi, Assef Jawaada, Hani Khaldi, Rami Qahoush, Jalil Qari, Rana Saadeh, Ahlam Salim, Aseel Yacoub, Abbas Abbas, Rana Abu shua`ib, Baraa Abu Zainah, Mahmoud AbuSirrees, Basheer Babaa, Ola Barhoush, Asef Belal qadomi, Laith Daraghmeh, Reema Haji, Alaa Khatatbeh, Lana Khatib, Salsabeel Qarariah, Yara Quzmar, Khalil Safadi, Roqaya Salameh, Mohammad Hassan, Shifaa Herzallah, Loai Massad, Ahmed Nazzal, Ranin Nazzal, Dennis Escobar, Gustavo Miguel Machain V, Agustin Rodriguez Gonzalez, Jorge Emerson Chachaima Mar, Nathaly Olga Chinchihualpa Paredes, Vicente Cuba, Walter Lopez, Maria Milagros Niquen Jimenez, Nestor Alberto Sanchez Bartra, Olenka Sapallanay Ojeda, Diego Sequeiros, Andrea Toscano Pacheco, María Vergara, Sol Abarca, Rodrigo Alcorta, Giuliano Borda-Luque, Ivan Edward Eusebio Zegarra, Claudia Luján López, Mirella Marrufo, Cinthya Mogrovejo, Andrea Nomura, Yamile Rodríguez Angeles, Maitza Rosario Vidal Meza, Gabriela Zavala, José Neiser Castillo Arrascue, Jomara Caroline Hidrogo Cabrera, José Julio Mariano Larrea vera, Miguel Osorio, Edgar Alcides Ylatoma Díaz, Mark Anthony Fontanilla, Joseph Roy Fuentes, Anna Leah Salazar, Genieve Dominguez, Marc Paul Lopez, Shiela Macalindong, Mark Augustine Onglao, Arjel Ramirez, Marie Dione Sacdalan, Mayou Martin Tampo, Gemma Leonora Uy, Jeremiah Mangahas, Kenneth Yabut, Joannes Paul Cañete, Bernalynn Eris Cansana, Ernes John Castro, Maria Kaiserin Lipana, Manuel Francisco Roxas, Vlu Jean Zara, Maciej Chrol, Paula Franczak, Michal Orlowski, Piotr Budzynski, Andrzej Budzynski, Pawel Bury, Agata Czerwinska, Jadwiga Dworak, Jacek Dziedzic, Michal Kisielewski, Jan Kulawik, Anna Lasek, Piotr Malczak, Marcin Migaczewski, Michal Pedziwiatr, Magdalena Pisarska, Dorota Radkowiak, Mateusz Rubinkiewicz, Anna Rzepa, Tomasz Skoczylas, Maciej Stanek, Katarzyna Truszkiewicz, Mateusz Wierdak, Marek Winiarski, Piotr Zarzycki, Anna Zub-Pokrowiecka, Piotr Kowalewski, Rafal Roszkowski, Maciej Waledziak, Miguel Tomé, Sara Patrocinio, Ines Guerreiro, Filipe Almeida, Xavier de Sousa, Nuno Monteiro, Maria Teresa Costa Santos, Daniela de Oliveira, Marta Lopes Serra, Daniela Morgado, Christian Neves, Ana Carolina Oliveira, Alice Pimentel, Sofia Silva, Márcia Carvalho, Lúcia Carvalho, Joana Magalhães, Leonor Matos, Tânia Monteiro, Carlota Ramos, Vanessa Santos, José Barbosa, Jose Costa-Maia, Vítor Devezas, Ana Fareleira, Cristina Fernandes, Diana Gonçalves, Henrique Mora, Marina Morais, Fabiana Silva de Sousa, Sara Catarino Santos, Ana Logrado, André Tojal, Edgar Amorim, Miguel F. Cunha, Ana Fazenda, João Pedro Melo Neves, Inês Isabel Sampaio da Nóvoa Gomes Miguel, Diogo Veiga, José Azevedo, Hugo Cardoso Louro, Mariana Leite, Maria Bairos Menezes, Bárbara Gama, Diana Brito, Marta Cristina Cruz Martins, André Graça e Magalhães, Ana Catarina Longras, Rita Lourenço, Diana Matos, Luis Castro, Filipa Policarpo, Joana Romano, Cristina Monteiro, Diogo Pinto, Marina Duarte, Sónia Fortuna Martins, Mariline Oliveira, Diogo Galvão, Lisandra Martins, Anaisa Silva, Viorel Taranu, Bárbara Vieira, Jessica Neves, Simone Oliveira, Hugo Ribeiro, Margarida Cinza, Rosa Felix, Arnaldo Machado, Joana Oliveira, Joana Patrício, Rita Pedroso de Lima, Mário Pereira, Miguel Rocha Melo, Cristina Velez, Alberto Abreu da Silva, Mariana Claro, Daniel Costa Santos, Andreia Ferreira, Hugo Capote, Daniela Rosado, Filipa Taré, Oriana Nogueira, Miguel Ângelo, José Miguel Baiao, Andreia Guimarães, João Marques, Miguel Nico Albano, Marta Silva, Ana Valente da Costa, Teresa Vieira Caroço, Sara Almeida Braga, Ines Capunge, Marta Fragoso, João Guimarães, Bruno Pinto, João Ribeiro, Miguel Angel, Guilherme Fialho, Monica Guerrero, Filipa Campos Costa, Diogo Cardoso, Vasco Cardoso, Magda Alves, Inês Estalagem, Tiago Louro, Cláudia Marques, Rita Martelo, Miguel Morgado, Rita Canotilho, Ana Margarida Correia, Pedro Martins, Mariana Peyroteo, João Gomes, Rita Monteiro, Manuela Romano, Daniela Macedo Alves, Rita Peixoto, Catarina Quintela, Maria João Jervis, Débora Melo, André Pacheco, Valter Paixão, Vera Pedro, Joana Pimenta, João Pimenta de Castro, Ana Rocha, Mircea Beuran, Cezar Ciubotaru, Bogdan Diaconescu, Sorin Hostiuc, Ionut Negoi, Bogdan Stoica, NA NA, Evgeny Anokhin, Georgy Kuznetsov, Giorgi Oganezov, Fedor Paramzin, Ekaterina Romanova, Valeryan Rutkovskii, Vasilii Rutkovskii, Mikhail Shushval, Mikhail Zabiyaka, Khasan Dzhumabaev, Valerii Ivanov, Zaman Mamedli, Sergey Achkasov, Artem Balkarov, Elnur Nabiev, Marat Nagudov, Evgeny Rybakov, Karina Saifutdinova, Oleg Sushkov, Lule Joseph, Isaac Ndayishimiye, Ntirenganya Faustin, Alphonse Zeta Mutabazi, Jean Paul Mvukiyehe, Vizir J.P Nsengimana, Carine Uwakunda, Mohammad Monir Abbas, Nouf Akeel, Murad Aljiffry, Kholoud Awaji, Ali Farsi, Ghader Jamjoum, Ahmad Khoja, Ashraf Maghrabi, Nadim Malibary, Mohammed Nassif, Abdulaziz Saleem, Abdullah Sultan, Wail Tashkandi, Hanaa Tashkandi, Nora Trabulsi, Mouhamadou Bachir Ba, Adja Coumba Diallo, Abdourahmane Ndong, Vladica Cuk, Uroš Jankovic, Sharon Zhiling Koh, Frederick Koh, Kuok Chung Lee, Kai Yin Lee, Sean Lee, Wei Qi Leong, Su Ann Lui, Prajwala Prakash, Jan Grosek, Gregor Norcic, Ales Tomazic, Nicolas Fitchat, Robert Jaich, Devorah Wineberg, Modise Zacharia Koto, Daniella Baiocchi, Damian Clarke, Christina Johanna Steenkamp, Sharon Bannister, Adam Boutall, Galya Chinnery, Anna Coccia, Angela Dell, Parveen Karjiker, Christo Kloppers, Nicholas Loxton, Tumi Mabogoane, Francois Malherbe, Eugenio Panieri, Shreya Rayamajhi, Tirsa van Wyngaard, Claire Warden, T E Madiba, Nivashen Pillay, Savannah Brooks, Charlise Kruger, Lisa Hannah Van Der Merwe, Ferhana Gool, Maahir Kariem, Heather Bougard, Nazmie Kariem, Fazlin Noor, Reantha Pillay, Leandi Steynfaardt, Lucía González González, José Miguel Marín Santos, Paula Martín-Borregón, Javier Martínez Caballero, Cristina Nevado García, Pastora Rodriguez Fraga, Gonzalo De Castro Parga, Maria Pilar Fernández Veiga, Lucía Garrido López, Hugo Infante Pino, Irene Lages Cal, Marta López Otero, Manuel Nogueira Sixto, Marta Paniagua García Señorans, Laura Rodríguez Fernández, Alejandro Ruano Poblador, Erika Rufo Crespo, Raquel Sanchez-Santos, Vincenzo Vigorita, Ester Alonso Batanero, Dorisme Asnel, Isabel Cifrian Canales, Elisa Contreras Saiz, Irene De Santiago Alvarez, Tamara Díaz Vico, Sebastian Fernandez Arias, Daniel Fernández Martínez, Carmen García Bernardo, Luis Joaquín García Flórez, Carmen Garcia Gutierrez, Manuel García Munar, Carlos Alberto Márquez Zorrilla Molina, Marta Merayo, José Luis Michi Campos, Maria Moreno Gijon, Jorge L. Otero-Diez, Jose Luis Rodicio Miravalles, Lorena Solar-Garcia, Aida Suárez Sánchez, Nuria Truan, Cristina Alejandre Villalobos, Yurena Caballero Díaz, Marta Jimenez, Dacil Montesdeoca, Antonio Navarro-Sánchez, Victor Vega, Juan Beltrán de Heredia, Zahira Gómez, Carlos Jezieniecki, Ana Patricia Legido Morán, Mario Montes-Manrique, Mario Rodriguez-Lopez, María Ruiz Soriano, Jeancarlos Trujillo Díaz, Andrea Vazquez Fernandez, Nuria Argudo, Miguel Pera, Laia Torrent Jansà, Melody García Domínguez, Ignacio Goded, Marta Roldón Golet, Issa Talal El-Abur, Alejandra Utrilla Fornals, Vanesa Zambrana Campos, Maria Del Mar Aguilar Martinez, Marina Bosch, Luis García-Catalá, Luis Sánchez-Guillén, Eva Artigau, Nuria Gomez Romeu, David Julià Bergkvist, Beatriz Espina Perez, Olga Morató, Carles Olona, Beatriz Diéguez, Alexander Forero-Torres, Manuel Losada, Segundo Gomez-Abril, Paula Gonzálvez, Rosario Martinez, Sergio Navarro Martínez, Carmen Payá-Llorente, Álvaro Pérez Rubio, Sandra Santarrufina Martinez, Juan Carlos Sebastián Tomás, Ramon Trullenque Juan, Alberto Gegúndez Simón, Paloma Maté, Maria Isabel Prieto-Nieto, Ines Rubio-Perez, Aitor Urbieta, Marina Vicario Bravo, David Abelló, Matteo Frasson, Alvaro Garcia-Granero, Alfredo Abad Gurumeta, Ane Abad-Motos, Elena Lucena-de Pablo, Beatriz Nozal, Javier Ripollés-Melchor, Rut Salvachúa, Esther Ferrero, Luis Garcia-Sancho Tellez, Antonio L. Picardo, Jose Alberto Rojo López, Laura Patricia Zorrilla Matilla, Carmen Cagigas Fernandez, Sonia Castanedo Bezanilla, José Estevez Tesouro, Maria Jose Fernandez-Diaz, Juan García Cardo, Marcos Gomez Ruiz, Erik Gonzalez-Tolaretxipi, Jaime Jimeno Fraile, Cristobal Poch, Montserrat Rodriguez-Aguirre, Noemí Troche Pesqueira, Maria Soledad Trugeda-Carrera, Javier de la Torre, Ruth Blanco-Colino, Eloy Espin-Basany, Martin Espinosa-Bravo, Clara Morales Comas, Eduardo Reyes Afonso, Joaquín Rivero Déniz, Christian Siso Raber, Mireia Verdaguer Tremolosa, Pramodh Chandrasinghe, Sumudu Kumarage, Nimeshi Wijekoon Arachchilage, Ahmed Abdalla Ahmed Elkamel, Mohammed A. Adam, Nina Blomme, Anders Thorell, Fredrik Wogensen, Andreas Älgå, Dhirar Ansarei, Fuat Celebioglu, Göran Heinius, Linda Nigard, Emil Pieniowski, Sandra Ahlqvist, Ida Björklund, Andreas Frånberg, Martina Håkansson, Karin Adamo, Oskar Franklin, Malin Sund, Rebecca Wiberg, Yvette Andersson, Abbas Chabok, Maziar Nikberg, Alexander Kugelberg, Claudia Canonica, Dimitrios Christoforidis, Fabrizio Fasolini, Paolo Gaffuri, Mauro Giuliani, Francesco Meani, Sotirios Georgios Popeskou, Silvia Pozza, Wiebke Wandschneider, Lorenz Peterer, Lukas Werner Widmer, Bernd Zimmermann, Panagiotis Bakoleas, Iris Chanousi, Lydia Charalampidou, Lukasz Filip Grochola, Franziska Heid, Sotirios Ntaoulas, Michail Outos, Georgios Peros, Hanna Podolska-Skoczek, Katharina Beate Reinisch, Christian Zielasek, Nicolas Demartines, Jérôme Gilgien, Amaniel Kefleyesus, Pénélope St-Amour, Arnaud Toussaint, Maryam Alhimyar, Bayan Alsaid, Amr Alyafi, Ahmad Alkhaledi, Basel Kouz, Ahmad Omarain, Yusra Al-Sabbagh, Haya Alkhatib, Samer Sara, Ahmad Alhaj, Aghyad Danial, Lama Kadoura, Sarah Maa Albared, Yamen Monawar, Louei Nahas, Barook Abd, Ahmad Saad, Habib Wakkaf, Hatem Bouzaiene, Montassar Ghalleb, Elif Akaydin, Ata Cem Akbaba, Onur Atakul, Ege Baltaci, Sevval Besli, Gökçen Burgu, Ulukan Cenal, Cansu de Muijnck, Hasan Can Demirkaya, Alper Dogruoz, Zeynep Ipek Gezer, Yasemin Gündogdu, Merve Kara, Hasan Kürsad Korkmaz, Gökalp Kagan Kurtoglu, Volkan Ozben, Berk Baris Ozmen, Ahmet Murat Pektas, Eda Kübra Sel, Nilüfer Yenidünya, Fuat Baris Bengur, Berke Mustafa Oral, Tahir Koray Yozgatli, Seymur Abdullayev, Mehmet Emin Gunes, Nuri Alper Sahbaz, Tuba Banaz, Kübra Kargici, Omer Faruk Kuyumcu, Erkan Yanikoglu, Merve Yesilsancak, Duygu Yilmaz, Melik Kagan Aktas, Ahmet Rencuzogullari, Arda Isik, Sezai Leventoglu, Ali Yalçinkaya, Osman Yüksel, Mustafa U Kalayci, Yasin Kara, Inanc Samil Sarici, Alp Akin, Gökçe nur Alemdag, Ekin Arslan, Bahadir Emre Baki, Muhammed Selim Bodur, Adnan Calik, Bahar Candas Altinbas, Irem Cihanyurdu, Oguz Erkul, Burak Gül, Ali Guner, Beyza Köse, Anil Semiz, Sule Sevim, Serkan Tayar, Kadir Tomas, Ozan yavuz Tüfek, Serdar Türkyilmaz, Mehmet Ulusahin, Arif Usta, Reyyan Yildirim, Sertaç Ata Güler, Ozan Can Tatar, Ecenur Varol, Busenur Kirimtay, Muhammed Uysal, Alp Yildiz, Emin Kose, Ahmet Burak Ciftci, Elif Çolak, Huseyin Eraslan, Gultekin Ozan Kucuk, Kürsat Yemez, Herman Lule, Mumbere Bienfait, Emmanuel Bua, Noella Okalany, Maksym Basarab, Oleksii Bielosludtsev, Kateryna Kolhanova, Kateryna Perepelytsia, Kateryna Romanukha, Dmytro Savenkov, Stanislav Siryi, Maksym Tereshchenko, Nezamai Viacheslav, Anton Volovetskyi, Andrey Kebkalo, Yegor Tryliskyy, Volodimir Tyselskiy, Eilidh Bruce, Bing Lun Chow, Emma Iddles, Sarah McGuckin, Nicola Newall, George Ramsay, Parivrudh Sharma, Caitlin Stewart, Jeremy Wong, Abdul Badran, Michael Bath, Fanny Belais, Eman Butt, Kaustuv Joshi, Milan Kapur, Mike Shaw, Adam Townson, Christopher Yee Khang Williams, Timothy Gray, Robert Greig, Mansoor Husain, Elspeth Murray, Ahmed Mustafa, Ashar Asif, Arya Gokul, Max Shah, Mabel Temisanren Akitikori, Alexandros Charalabopoulos, Sophie Davidson, Sinead McNally, Shamil Rupani, Fatema Juma, Sarah Catherine Mills, Laura Muirhead, Kate Sellars, Una Walsh, Oliver Warren, Alice Chambers, Richard Hunt, Stephen Boyce, Hannah Cornwall, Isabel Tol, Eleftherios Orestis Argyriou, Nicola Eardley, Meical Povey, Joanna M S Aithie, Ahmer Irfan, Mari-Claire McGuigan, Robert Starr, Craig Russell Warren, Jess Archibald, Georgia Kirby, Ivan Kisyov, Chun Kheng Khoo, Rachel Lee, Dana Photiou, Rowan Davis, Uday Prasad, P Zichu Yang, Jonathan Bird, Edmund Leung, Virginia Summerour, Chelise Currow, Jianshen Kiam, Gerald Jack Soon Tan, Anitha Muthusami, Ibifunke Pegba-Otemolu, Tomas Urbonas, Joseph Nunoo-Mensah, Edgaras Smolskas, Alex Boddy, Gianpiero Gravante, David Hunter, David Andrew, Amanda Koh, Amari Thompson, Lawrence Adams, Hollie A Clements, Kasun De Silva, Ogbonnia Ekpete, Seraj Haque, Scott Henderson, Bilal Ibrahim, Thummini Jayasinghe, Jennifer Livie, Keir Mailley, Gopikrishnan Nair, Daniel Tan, Caitlin Baggaley, Aleksander Dawidziuk, Bartosz Szyszka, Charlotte Barter, Nirav Gandhi, Karen Hassell, Samantha Hitchin, Jennett Kelsall, Eva Nagy, Ashrafun Nessa, Lisa Whisker, Fady Yanni, Mahmoud Ali, Deeksha Arora, Sunanda Hediwattege, Navam Kumarasinghe, Munir Rathore, Athula Tennakoon, Syed Mustafa Ali Ahmad, Oreoluwa Bajomo, Fahema Nadira, Valerio Celentano, Ewen Griffiths, Rama Santhosh Karri, Jason Kei Chak Mak, Michelle Pipe, Muhammad Iqbal Bhatti, Mohamed Rabie, Connor Boyle, David Hamilton, Aishath Mihuna, James Chean Khun Ng, Gary Nicholson, Agata Oliwa, Robert Pearson, Anna Rose, Shun Qi Yong, Catherine Boereboom, Michael Hanna, Catherine Walter, Thomas Samuel Greensmith, Rachel Mitchell, Eimear Monaghan, James Crawford, Susan Moug, James Blackwell, Hannah Boyd-Carson, Philip Herrod, Omar Al-Allaf, Miriam Beattie, Cameron Bullock, Shivang Burman, Gemma Clark, Nicolas Flamey, Oliver Flannery, Alexander Harding, Ben Kodiatt, Samuel Lawday, Shivani Mahapatra, Navin Mukundu Nagesh, Michael Ng, Dupinderjit Rye, Andrel Yoong, Laura Clark, Chris Deans, Monisha Edirisooriya, Emma Victoria Carrington, Tsz Lun Ernest Wong, Baasil Yusuf, Carla Chamberlain, Kathryn Duke, Elizabeth Kmiotek, Azel Botes, Natalie Condie, Timothy Schrire, Reena Shah, Iolo Thomas-Jones, Charlotte Yates, Natasha Anthony, Edward Matthews, Kapil Sahnan, James Tankel, Sally Tucker, Jasmine Winter Beatty, Paul Ziprin, William Duggan, Anastasia Kantartzi, Shruthi Sridhar, Rachel Alys Khaw, Prakhar Srivastava, Charlotte Underwood, Homero Alves do Canto Brum, Sharat Chopra, Laura Davis, Rebecca Hughes, Joshua Tulley, Justin Alberts, Thomas Athisayaraj, Mojolaoluwa Olugbemi, Kasim Ahmad, Claudia Chan, Gavin Chapman, Hannah Fleming, Benjamin Fox, Julia Grewar, Kate Hulse, Duncan Rutherford, Mackay Sinead, Scott Smith, Doug Speake, Peter G Vaughan-Shaw, Natasha Christodoulides, Simrit 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A., Abu shua'ib R., Abu Zainah B., AbuSirrees M., Babaa B., Barhoush O., Belal qadomi A., Daraghmeh L., Haji R., Khatatbeh A., Khatib L., Qarariah S., Quzmar Y., Safadi K., Salameh R., Hassan M., Herzallah S., Massad L., Nazzal A., Nazzal R., Escobar D., Machain V G.M., Rodriguez Gonzalez A., Chachaima Mar J.E., Chinchihualpa Paredes N.O., Cuba V., Lopez W., Niquen Jimenez M.M., Sanchez Bartra N.A., Sapallanay Ojeda O., Sequeiros D., Toscano Pacheco A., Vergara M., Abarca S., Alcorta R., Borda-Luque G., Eusebio Zegarra I.E., Lujan Lopez C., Marrufo M., Mogrovejo C., Nomura A., Rodriguez Angeles Y., Vidal Meza M.R., Zavala G., Castillo Arrascue J.N., Hidrogo Cabrera J.C., Larrea vera J.J.M., Osorio M., Ylatoma Diaz E.A., Fontanilla M.A., Fuentes J.R., Salazar A.L., Dominguez G., Lopez M.P., Macalindong S., Onglao M.A., Ramirez A., Sacdalan M.D., Tampo M.M., Uy G.L., Mangahas J., Yabut K., Canete J.P., Cansana B.E., Castro E.J., Lipana M.K., Roxas M.F., Zara V.J., Chrol M., Franczak P., 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Adam M., Blomme N., Thorell A., Wogensen F., Alga A., Ansarei D., Celebioglu F., Heinius G., Nigard L., Pieniowski E., Ahlqvist S., Bjorklund I., Franberg A., Hakansson M., Adamo K., Franklin O., Sund M., Wiberg R., Andersson Y., Chabok A., Nikberg M., Kugelberg A., Canonica C., Christoforidis D., Fasolini F., Gaffuri P., Giuliani M., Meani F., Popeskou S.G., Pozza S., Wandschneider W., Peterer L., Widmer L.W., Zimmermann B., Bakoleas P., Chanousi I., Charalampidou L., Grochola L.F., Heid F., Ntaoulas S., Outos M., Peros G., Podolska-Skoczek H., Reinisch K.B., Zielasek C., Demartines N., Gilgien J., Kefleyesus A., St-Amour P., Toussaint A., Alhimyar M., Alsaid B., Alyafi A., Alkhaledi A., Kouz B., Omarain A., Al-Sabbagh Y., Alkhatib H., Sara S., Alhaj A., Danial A., Kadoura L., Maa Albared S., Monawar Y., Nahas L., Abd B., Saad A., Wakkaf H., Bouzaiene H., Ghalleb M., Akaydin E., Akbaba A.C., Atakul O., Baltaci E., Besli S., Burgu G., Cenal U., de Muijnck C., Demirkaya H.C., Dogruoz A., Gezer Z.I., Gundogdu Y., Kara M., Korkmaz H.K., Kurtoglu G.K., Ozben V., Ozmen B.B., Pektas A.M., Sel E.K., Yenidunya N., Bengur F.B., Oral B.M., Yozgatli T.K., Abdullayev S., Gunes M.E., Sahbaz N.A., Banaz T., Kargici K., Kuyumcu O.F., Yanikoglu E., Yesilsancak M., Yilmaz D., Aktas M.K., Rencuzogullari A., Isik A., Leventoglu S., Yalcinkaya A., Yuksel O., Kalayci M.U., Kara Y., Sarici I.S., Akin A., Alemdag G.N., Arslan E., Baki B.E., Bodur M.S., Calik A., Candas Altinbas B., Cihanyurdu I., Erkul O., Gul B., Guner A., Kose B., Semiz A., Sevim S., Tayar S., Tomas K., Tufek O.Y., Turkyilmaz S., Ulusahin M., Usta A., Yildirim R., Guler S.A., Tatar O.C., Varol E., Kirimtay B., Uysal M., Yildiz A., Kose E., Ciftci A.B., Colak E., Eraslan H., Kucuk G.O., Yemez K., Lule H., Bienfait M., Bua E., Okalany N., Basarab M., Bielosludtsev O., Kolhanova K., Perepelytsia K., Romanukha K., Savenkov D., Siryi S., Tereshchenko M., Viacheslav N., Volovetskyi A., Kebkalo A., Tryliskyy Y., Tyselskiy V., Bruce E., Chow B.L., Iddles E., McGuckin S., Newall N., Ramsay G., Sharma P., Stewart C., Wong J., Badran A., Bath M., Belais F., Butt E., Joshi K., Kapur M., Shaw M., Townson A., Williams C.Y.K., Gray T., Greig R., Husain M., Murray E., Mustafa A., Asif A., Gokul A., Shah M., Akitikori M.T., Charalabopoulos A., Davidson S., McNally S., Rupani S., Juma F., Mills S.C., Muirhead L., Sellars K., Walsh U., Warren O., Chambers A., Hunt R., Boyce S., Cornwall H., Tol I., Argyriou E.O., Eardley N., Povey M., Aithie J.M.S., Irfan A., McGuigan M.-C., Starr R., Warren C.R., Archibald J., Kirby G., Kisyov I., Khoo C.K., Lee R., Photiou D., Davis R., Prasad U., Yang P.Z., Bird J., Leung E., Summerour V., Currow C., Kiam J., Tan G.J.S., Muthusami A., Pegba-Otemolu I., Urbonas T., Nunoo-Mensah J., Smolskas E., Boddy A., Gravante G., Hunter D., Andrew D., Koh A., Thompson A., Adams L., Clements H.A., De Silva K., Ekpete O., Haque S., Henderson S., Ibrahim B., Jayasinghe T., Livie J., Mailley K., Nair G., Tan D., Baggaley C., Dawidziuk A., Szyszka B., Barter C., Gandhi N., Hassell K., Hitchin S., Kelsall J., Nagy E., Nessa A., Whisker L., Yanni F., Ali M., Arora D., Hediwattege S., Kumarasinghe N., Rathore M., Tennakoon A., Ali Ahmad S.M., Bajomo O., Nadira F., Celentano V., Griffiths E., Karri R.S., Mak J.K.C., Pipe M., Bhatti M.I., Rabie M., Boyle C., Hamilton D., Mihuna A., Ng J.C.K., Nicholson G., Oliwa A., Pearson R., Rose A., Yong S.Q., Boereboom C., Hanna M., Walter C., Greensmith T.S., Mitchell R., Monaghan E., Crawford J., Moug S., Blackwell J., Boyd-Carson H., Herrod P., Al-Allaf O., Beattie M., Bullock C., Burman S., Clark G., Flamey N., Flannery O., Harding A., Kodiatt B., Lawday S., Mahapatra S., Mukundu Nagesh N., Ng M., Rye D., Yoong A., Clark L., Deans C., Edirisooriya M., Carrington E.V., Wong T.L.E., Yusuf B., Chamberlain C., Duke K., Kmiotek E., Botes A., Condie N., Schrire T., Shah R., Thomas-Jones I., Yates C., Anthony N., Matthews E., Sahnan K., Tankel J., Tucker S., Winter Beatty J., Ziprin P., Duggan W., Kantartzi A., Sridhar S., Khaw R.A., Srivastava P., Underwood C., Alves do Canto Brum H., Chopra S., Davis L., Hughes R., Tulley J., Alberts J., Athisayaraj T., Olugbemi M., Ahmad K., Chan C., Chapman G., Fleming H., Fox B., Grewar J., Hulse K., Rutherford D., Sinead M., Speake D., Vaughan-Shaw P.G., Christodoulides N., Kudhail S., Welch M., Husaini S.M., Lambracos S., Anyanwu C., Suresh R., Thomas J.S., Gleeson E., Platoff R., Saif A., Enumah Z., Etchill E., Gabre-Kidan A., Bernstein M., Carrano F.M., Connors J., Lynn P., Melis M., Newman E., Foster D.S., Perrone K., Titan A., Ahmad S., Bafford A.C.M.D., Dal Molin M., Hanna N., Zafar S.N., Hemmila M., Napolitano L., Wong J.J., Chandler J., Wood L., Wren S., Ottesen T., You L., Yu K., Arcienega Yanez M.D.P., Ferreira Fernandes M., Gonzalez D., Cubas S., Gonzalez M.C., Zubiaurre V., Demolin R., Giroff N., Sciuto P., Campos M., Rodriguez Cantera G., Deepika G., Simuchimba E., Bulaya A., Chibuye C., Chirengendure B., Kabale M.-R., Kabongo K., Munthali J., Mweso O., Pikiti F., Otieno J., Lai L.T., Blackman B., Subramaniam S., Karim R., Kok N., Lee Y.D., Ali S., Sinha A., Corrigan R., Barnes N., Wong F., Dennis G., Jedamzik J., Phillips E., Piette W., Van hentenryck M., Koco H., Lawani S., Kassa M.W., Santos Bezerra T., Gribnev P., Dimitrov D., Krastev P., Oum S., Bonghaseh D.T., Al Farsi M., Alsharqawi N., Acevedo V., Castillo Barbosa A.C., Giron F., Leon Rodriguez J.P., Kucan D., Rosko D., Barsic N., Zupan D., Hegazi A., Truncikova V., Fryba V., Mohamed M., Nagi A., Rashad Temerik A., Elshawy M.E., Mahmoud M.I., Anwar M., Rageh T., Elmokadem A., Gaballa K., Teppo S., Pengerma P., Ballouhey Q., Bergeat D., Weyl A., Hain E., Gyedu A., Yenli E., Osei-Poku D., Rompou V.-A., Zoikas A., Gaitanidis A., Koukis G., Perivoliotis K., Tavlas P., Galanos-Demiris K., Zografos G., Karavokyros I., Xanthopoulou G., Iordanidou E., Ayau F., Garcia A., Damjan P., Wason D., B L A., Rangganata E., Kamath P., O'Connor D.B., Pinto M., Perrone F., Tropeano F.P., Troilo F., Bossi D., Scala D., Pulitano L., Carella M., Pietrabissa A., Gori A., Giraudo G., De Simone V., Russo A.A., Braccio B., Al-Taher R., Athamneh S., Parker A., Sawiee A., Kattia A., Tababa O., Shaeeb Z., Syminas V., Jurgaitis J., Damuleviciene G., Svagzdys S., Razafimanjato N.N.M., Chieng Loo L., Tiong I.C., Wan Muhmad W.F., Vijeyan H., Li Ying T., Grech G., Arrangoiz R., Jimenez Ley V.B., Arizpe D., Lagunes Lara E., Castro Lopez E.V., Eaazim J., Gordinou de Gouberville M., Bastiaenen V., Rottier S., Nahab F., Ji M.Y., Seyoji M., Nwachukwu C., Emeghara O., Muhammed S.E., Idowu A., Sowemimo O., Ogundoyin O., Akande O., Lott A., Nadeem M., Laghari A.A., Loya A., Mushtaq H., Abdullah M.T., Abuhilal B., Atawneh M., Hamdan H., Alhabil B., Srour A., Mousa I., Da Silva Medina L., Bartosiak K., Ferreira P., Francisco V., Lemos R., Frutuoso L., Fernandes S., Fonseca T., Pereira J., Rachadell J., Torre A., Madeira Martins F., Carvalho A.C., Rodrigues Ferreira J., Ribeiro da Silva B., Devesa H., Vieira A., Monica I., Amaro M., Sousa D., Reia M., Louro J., Martins A., Dominguez J., Santos I., Freitas Oliveira N.M., Pereira J.C., Silva-Vaz P., Freire L., Escrevente R., Negoita V.M., Shakhmatov D., Nezerwa Y., Radulovic R., Obery G., Viljoen F., Mendes T., Suarez A., Moncada E., Fernandez-Hevia M., Curtis Martinez C., Gil Garcia J.M., Gonzalez Zunzarren M., Idris T., Eklov K., Grahn O., Amin L., Blomqvist M., Ajani C., Kraus R., Seeger N., Willemin M., Rayya F., Ayash M., Msouti R., Kannas I., Abazid E., Esper A., Slim S., Kavcar A.S., Aytac E., Dural A.C., Ilker A., Eray I.C., Kurnaz E., Altiner S., Tepe M.D., Sahin C., Savli E., Innocent A., Babirye L., Diachenko A., Hordoskiy V., Curry H., Chau C.Y.C., Robertson H., Lennon H., Loi L., Kirkham E., McCann C., Watts D., Gurung B., Wilson M., Tribedi T., Garofalo E., Zahra B., MacDonald S., Daniels I., Ng N., Khosla S., Olivier J., Yue 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V., Ye, G., Zhang, G., Brooker, E., Feng, D., Lau, B., Ngai, C., Birks, S., Gyorki, D., Otero de Pablos, J., Abbosh, A., Gillespie, C., Mahmoud, A., Kwan, B., Lawson, J., Warwick, A., Bingham, J., Cockbain, A. J., Dudi-Venkata, N. N., Ellaby-Hall, J., Finlay, B., Humphries, E., Pisaniello, J., Pisaniello, M., Salih, S., Sammour, T., Abd Wahab, H. H., De Silva, A., Hayward, N., Iyer, K., Maddern, G., Prevost, G. A., Annapureddy, N., Settipalli, K. P., Yeo, J., Hempenstall, L., Pham, L., Purcell, S., Talavera, C., Vaska, A. I., Chaggar, G., Chrapko, P., Cocco, A., Coulter-Nile, S. M. C. J., Ctercteko, G., French, J., Gong, H., Gosselink, M., Jegathees, T., Jin, I., Kalachov, M., Kiefhaber, K., Lee, K., Luong, J., Phan, S., Pleass, H., Veale, K., Zeng, Z., Au, A., Debiasio, A., Deng, I., Myooran, J., Nair, A., Stewart, P., Stift, A., Unger, L. W., Wimmer, K., Ahmed, N., Hasan, S., Rahman, S., O'Shea, M., Padmore, G., Peters, A., Perduca, P., Pulcina, G., Tinton, N., Buxant, F., Dabin, E., Garofalo, G., Dossou, F., Gnangnon, F. H. R., Imorou Souaibou, Y., Motlaleselelo, P., Tlhomelang, O., Lima Buarque, I., Mendonca Ataide Gomes, G., Vieira Barros, A., Batashki, I., Damianov, N., Stoyanov, V., Dardanov, D., Maslyankov, S., Petkov, P., Todorov, G., Zhivkov, E., Akisheva, A., Castilla Moreno, M. A., Genov, G., Ilieva, I., Ivanov, T., Karamanliev, M., Khan, A., Mitkov, E., Yotsov, T., Atanasov, B., Belev, N., Slavchev, M., Nsengiyumva, C., Jones, E., Stock, S., Kyota, S., Brown, J., Mabanza, K. T., Nigo Samuel, L., Otuneme, C., Prosper, N., Umenze, F., Boutros, M., Caminsky, N., Dumitra, S., Garfinkle, R., Morency, D., Salama, E., Banks, A., Ferri, L., He, H., Katz, A., Liberman, A. 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A., Fadel, A., Habater, A., Hamdy, H., Hefni, A., Kamal, M., Mohamed Abobakr, N., Sayed, A., Shaker, N., Taha, E., Tharwat, H., Zakaria, O., Abdelmotaleb, I., Al-Dhufri, A., Al-Himyari, H. S., El sheikh, E., Eldmaty, A., Elkhalawy, A., M. Elkhashen, A., Magdy, K., Mostafa, S., Sadia, H. D., Saleh, M. M., Samir, D., Yahia Mohamed Ali, M., A. Nassar, M., Abdelhady, S., Abdelrazek, A., Abdelsalam, I., El-Sawy, A., Essam, E., Gadelkarim, M., Ghaly, K., Hassabalnaby, M., Masarani, R., Mohamed Shaaban, N., Sabry, A., Salem, M., Soliman, N. A., Zahran, D., Abou, El. soud M. R., Badr, E. T., Borham, H., Elmeslemany, N., Elsayed, M., Elsherif, F., Eslam, S., Gaber, G., Ibrahim, S., Kamh, Y., Mohamed, S. G., Morshedy, E., Omar, C., Salem Soliman, F., Abdelkawy, S., Abdelmohsen, N., Abdelshakour, M., Dahy, A., Gamal, N., Gamal, M., Hasan, A., Hetta, H., Mousa, N., Omar, M., Rabie, S., Saad, M., Saleh, B., Sayed Mohamed, M., Shawqi, M., Abdelhady Mousa, H., Alnoury, M., Elbealawy, M., Elshafey, A., Essam Ibrahim El Desouki Muhammad Ahmed, M., Ghonaim, M., Hgag, F., Ibrahim, M., Morsy, M., Reda Loaloa, M., Refaat, A., Samir, H., Shahien, F., Sobhy, M., Sroor, F., Abdellatif, E., Adel, M., Afifi, A. A., Afifi, E., Antaky, M., Dawoud, A., El Zoghby, N., El-remaily, A., Elzanfaly, A. A., Gadallah, A., Gamal, F. A., Hashem, O., Medhat Youssef, S., Muhammad Attyah, A., Munir, M., Shazly, O., Wilson, K., Adel, S., Ali, A., Eid, E., Elhelow, E., Elmahdy, M., Elshatby, B., Hossam el-din Zakaria, A., Hossny, A., Ibrahim, E., M. 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I., Veiga, D., Azevedo, J., Cardoso Louro, H., Leite, M., Bairos Menezes, M., Gama, B., Brito, D., Cruz Martins, M. C., Graca e Magalhaes, A., Longras, A. C., Lourenco, R., Matos, D., Castro, L., Policarpo, F., Romano, J., Monteiro, C., Pinto, D., Duarte, M., Fortuna Martins, S., Oliveira, M., Galvao, D., Martins, L., Silva, A., Taranu, V., Vieira, B., Neves, J., Oliveira, S., Ribeiro, H., Cinza, M., Felix, R., Machado, A., Oliveira, J., Patricio, J., Pedroso de Lima, R., Pereira, M., Rocha Melo, M., Velez, C., Abreu da Silva, A., Claro, M., Costa Santos, D., Ferreira, A., Capote, H., Rosado, D., Tare, F., Nogueira, O., Angelo, M., Baiao, J. M., Guimaraes, A., Marques, J., Nico Albano, M., Silva, M., Valente da Costa, A., Vieira Caroco, T., Almeida Braga, S., Capunge, I., Fragoso, M., Guimaraes, J., Pinto, B., Ribeiro, J., Angel, M., Fialho, G., Guerrero, M., Campos Costa, F., Cardoso, D., Cardoso, V., Alves, M., Estalagem, I., Louro, T., Marques, C., Martelo, R., Morgado, M., Canotilho, R., Correia, A. M., Martins, P., Peyroteo, M., Gomes, J., Monteiro, R., Romano, M., Alves, D. M., Peixoto, R., Quintela, C., Jervis, M. J., Melo, D., Pacheco, A., Paixao, V., Pedro, V., Pimenta, J., Pimenta de Castro, J., Rocha, A., Beuran, M., Ciubotaru, C., Diaconescu, B., Hostiuc, S., Negoi, I., Stoica, B., Na, N. A., Anokhin, E., Kuznetsov, G., Oganezov, G., Paramzin, F., Romanova, E., Rutkovskii, V., Shushval, M., Zabiyaka, M., Dzhumabaev, K., Ivanov, V., Mamedli, Z., Achkasov, S., Balkarov, A., Nabiev, E., Nagudov, M., Rybakov, E., Saifutdinova, K., Sushkov, O., Joseph, L., Ndayishimiye, I., Faustin, N., Mutabazi, A. 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Altinbas, Bahar, Cihanyurdu, Irem, Erkul, Oguz, Gül, Burak, Guner, Ali, Köse, Beyza, Semiz, Anil, Sevim, Sule, Tayar, Serkan, Tomas, Kadir, Tüfek, Ozan Yavuz, Türkyilmaz, Serdar, Ulusahin, Mehmet, Usta, Arif, Yildirim, Reyyan, Güler, Sertaç Ata, Tatar, Ozan Can, Varol, Ecenur, Kirimtay, Busenur, Uysal, Muhammed, Yildiz, Alp, Kose, Emin, Ciftci, Ahmet Burak, Çolak, Elif, Eraslan, Huseyin, Kucuk, Gultekin Ozan, Yemez, Kürsat, Lule, Herman, Bienfait, Mumbere, Bua, Emmanuel, Okalany, Noella, Basarab, Maksym, Bielosludtsev, Oleksii, Kolhanova, Kateryna, Perepelytsia, Kateryna, Romanukha, Kateryna, Savenkov, Dmytro, Siryi, Stanislav, Tereshchenko, Maksym, Viacheslav, Nezamai, Volovetskyi, Anton, Kebkalo, Andrey, Tryliskyy, Yegor, Tyselskiy, Volodimir, Bruce, Eilidh, Chow, Bing Lun, Iddles, Emma, McGuckin, Sarah, Newall, Nicola, Ramsay, George, Sharma, Parivrudh, Stewart, Caitlin, Wong, Jeremy, Badran, Abdul, Bath, Michael, Belais, Fanny, Butt, Eman, Joshi, Kaustuv, Kapur, Milan, Shaw, Mike, Townson, Adam, Williams, Christopher Yee Khang, Gray, Timothy, Greig, Robert, Husain, Mansoor, Murray, Elspeth, Mustafa, Ahmed, Asif, Ashar, Gokul, Arya, Shah, Max, Akitikori, Mabel Temisanren, Charalabopoulos, Alexandros, Davidson, Sophie, McNally, Sinead, Rupani, Shamil, Juma, Fatema, Mills, Sarah Catherine, Muirhead, Laura, Sellars, Kate, Walsh, Una, Warren, Oliver, Chambers, Alice, Hunt, Richard, Boyce, Stephen, Cornwall, Hannah, Tol, Isabel, Argyriou, Eleftherios Orestis, Eardley, Nicola, Povey, Meical, Aithie, Joanna M S, Irfan, Ahmer, McGuigan, Mari-Claire, Starr, Robert, Warren, Craig Russell, Archibald, Jess, Kirby, Georgia, Kisyov, Ivan, Khoo, Chun Kheng, Lee, Rachel, Photiou, Dana, Davis, Rowan, Prasad, Uday, Yang, P Zichu, Bird, Jonathan, Leung, Edmund, Summerour, Virginia, Currow, Chelise, Kiam, Jianshen, Tan, Gerald Jack Soon, Muthusami, Anitha, Pegba-Otemolu, Ibifunke, Urbonas, Tomas, Nunoo-Mensah, Joseph, Smolskas, Edgaras, Boddy, Alex, Gravante, Gianpiero, Hunter, David, Andrew, David, Koh, Amanda, Thompson, Amari, Adams, Lawrence, Clements, Hollie A, De Silva, Kasun, Ekpete, Ogbonnia, Haque, Seraj, Henderson, Scott, Ibrahim, Bilal, Jayasinghe, Thummini, Livie, Jennifer, Mailley, Keir, Nair, Gopikrishnan, Tan, Daniel, Baggaley, Caitlin, Dawidziuk, Aleksander, Szyszka, Bartosz, Barter, Charlotte, Gandhi, Nirav, Hassell, Karen, Hitchin, Samantha, Kelsall, Jennett, Nagy, Eva, Nessa, Ashrafun, Whisker, Lisa, Yanni, Fady, Ali, Mahmoud, Arora, Deeksha, Hediwattege, Sunanda, Kumarasinghe, Navam, Rathore, Munir, Tennakoon, Athula, Ali Ahmad, Syed Mustafa, Bajomo, Oreoluwa, Nadira, Fahema, Celentano, Valerio, Griffiths, Ewen, Karri, Rama Santhosh, Mak, Jason Kei Chak, Pipe, Michelle, Bhatti, Muhammad Iqbal, Rabie, Mohamed, Boyle, Connor, Hamilton, David, Mihuna, Aishath, Ng, James Chean Khun, Nicholson, Gary, Oliwa, Agata, Pearson, Robert, Rose, Anna, Yong, Shun Qi, Boereboom, Catherine, Hanna, Michael, Walter, Catherine, Greensmith, Thomas Samuel, Mitchell, Rachel, Monaghan, Eimear, Crawford, James, Moug, Susan, Blackwell, James, Boyd-Carson, Hannah, Herrod, Philip, Al-Allaf, Omar, Beattie, Miriam, Bullock, Cameron, Burman, Shivang, Clark, Gemma, Flamey, Nicolas, Flannery, Oliver, Harding, Alexander, Kodiatt, Ben, Lawday, Samuel, Mahapatra, Shivani, Mukundu Nagesh, Navin, Ng, Michael, Rye, Dupinderjit, Yoong, Andrel, Clark, Laura, Deans, Chris, Edirisooriya, Monisha, Carrington, Emma Victoria, Wong, Tsz Lun Ernest, Yusuf, Baasil, Chamberlain, Carla, Duke, Kathryn, Kmiotek, Elizabeth, Botes, Azel, Condie, Natalie, Schrire, Timothy, Shah, Reena, Thomas-Jones, Iolo, Yates, Charlotte, Anthony, Natasha, Matthews, Edward, Sahnan, Kapil, Tankel, James, Tucker, Sally, Winter Beatty, Jasmine, Ziprin, Paul, Duggan, William, Kantartzi, Anastasia, Sridhar, Shruthi, Khaw, Rachel Alys, Srivastava, Prakhar, Underwood, Charlotte, Alves do Canto Brum, Homero, Chopra, Sharat, Davis, Laura, Hughes, Rebecca, Tulley, Joshua, Alberts, Justin, Athisayaraj, Thomas, Olugbemi, Mojolaoluwa, Ahmad, Kasim, Chan, Claudia, Chapman, Gavin, Fleming, Hannah, Fox, Benjamin, Grewar, Julia, Hulse, Kate, Rutherford, Duncan, Sinead, Mackay, Smith, Scott, Speake, Doug, Vaughan-Shaw, Peter G, Christodoulides, Natasha, Kudhail, Simrit, Welch, Matthew, Husaini, Syed Muhibullah, Lambracos, Simon, Anyanwu, Chikamuche, Suresh, Rishi, Thomas, Jimmy Scott, Gleeson, Elizabeth, Platoff, Rebecca, Saif, Areeba, Enumah, Zachary, Etchill, Eric, Gabre-Kidan, Alodia, Bernstein, Mitchell, Carrano, Francesco Maria, Connors, Joseph, Lynn, Patricio, Melis, Marcovalerio, Newman, Elliot, Foster, Deshka S, Perrone, Kenneth, Titan, Ashley, Ahmad, Sarwat, Bafford, Andrea Chao M D, Dal Molin, Marco, Hanna, Nader, Zafar, Syed Nabeel, Hemmila, Mark, Napolitano, Lena, Wong, Jane J, Chandler, Julia, Wood, Lauren, Wren, Sherry, Ottesen, Taylor, You, Lucia, Yu, Kristin, Arciénega Yañez, María Del Pilar, Ferreira Fernandes, Martin, González, Daniel, Cubas, Santiago, González, María Catalina, Zubiaurre, Vanessa, Demolin, Rodrigo, Giroff, Nicolas, Sciuto, Pablo, Campos, Maite, Rodríguez Cantera, Gabriela, Deepika, Garg, Simuchimba, Elliot, Bulaya, Anadi, Chibuye, Chali, Chirengendure, Bright, Kabale, Mary-Rose, Kabongo, Kizito, Munthali, James, Mweso, Oliver, Pikiti, Francis, Otieno, James, Lai, Log Tung, Blackman, Brighid, Richards, Sophie, Subramaniam, Suren, Karim, Rafid, Kok, Nathan, Lee, Yanni Dion, Ali, Shabina, Sinha, Aanjaneya, Corrigan, Robert, Barnes, Nicole, Wong, Florence, Dennis, Grace, Jedamzik, Julia, Phillips, Emil, Piette, Wivine, Van Hentenryck, Marie, Koco, Houenoukpo, Lawani, Souliath, Kassa, Mamo Woldu, Santos Bezerra, Tainá, Gribnev, Petar, Dimitrov, Dobromir, Krastev, Panche, Oum, Sovannarith, Bonghaseh, Divine Tim, Al Farsi, Maryam, Alsharqawi, Nourah, Acevedo, Veronica, Castillo Barbosa, Andrea Carolina, Giron, Felipe, Leon Rodriguez, Jimmy Paul, Kucan, Darko, Rosko, Damir, Barsic, Neven, Župan, Domagoj, Hegazi, Amgad, Truncíková, Vendula, Fryba, Vladimir, Mohamed, Mostafa, Sultan, Ahmed, Nagi, Ahmed, Rashad Temerik, Abdallah, Elshawy, Mohamed Elemam, Mahmoud, Moustafa Ibrahim, Omar, Shrouk, Anwar, Mohamed, Rageh, Tarek, Elmokadem, Aya, Gaballa, Khaled, Teppo, Sandra, Turunen, Antti, Pengermä, Pasi, Ballouhey, Quentin, Bergeat, Damien, Weyl, Ariane, Hain, Elisabeth, Gyedu, Adam, Yenli, Edwin, Osei-Poku, Dorcas, Rompou, Vaia-Aliki, Zoikas, Athanasios, Gaitanidis, Apostolos, Koukis, Georgios, Perivoliotis, Konstantinos, Tavlas, Panagiotis, Galanos-Demiris, Konstantinos, Zografos, George, Karavokyros, Ioannis, Xanthopoulou, Georgia, Iordanidou, Eirini, Ayau, Fernanda, Garcia, Allan, Damján, Pekli, Wason, Deepender, B L, Ashika, Rangganata, Ervandy, Kamath, Prerna, O'Connor, Donal B, Pinto, Margherita, Perrone, Fabrizio, Tropeano, Francesca Paola, Troilo, Francesca, Bossi, Daniela, Scala, Dario, Pulitanò, Lucrezia, Carella, Marcella, Pietrabissa, Andrea, Gori, Alice, Giraudo, Giorgio, De Simone, Veronica, Russo, Alfio Alessandro, Braccio, Bartolomeo, Al-Taher, Raed, Athamneh, Sarah, Parker, Andrea, Sawiee, Adnan, Kattia, Amina, Salem, Malik, Tababa, Osama, Shaeeb, Zuhour, Syminas, Vilius, Jurgaitis, Jonas, Damuleviciene, Gyte, Svagzdys, Saulius, Poskus, Tomas, Razafimanjato, Narindra Njarasoa Mihaja, Chieng Loo, Ling, Tiong, Ing Ching, Wan Muhmad, Wan Farahiyah, Vijeyan, Harinthiran, Li Ying, Teoh, Grech, Gabriella, Arrangoiz, Rodrigo, Jimenez Ley, Vania Brickelia, Arizpe, Daniel, Lagunes Lara, Elizabeth, Castro López, Elizabeth Victoria, Eaazim, Jose, Gordinou de Gouberville, Marije, Bastiaenen, Vivian, Rottier, Simone, Nahab, Fouad, Ji, Maria Yeonhee, Seyoji, Mohammed, Nwachukwu, Callistus, Emeghara, Okechukwu, Muhammed, Sayyid Egbunu, Idowu, Ayodeji, Sowemimo, Olamiposi, Ogundoyin, Olakayode, Akande, Oluwatosin, Lott, Alexander, Nadeem, Maliha, Laghari, Ahsan Ali, Loya, Asif, Mushtaq, Hassan, Abdullah, Muhammad Tariq, Abuhilal, Baseel, Atawneh, Mohammad, Hamdan, Hamdan, Alhabil, Belal, Srour, Abedelrahman, Mousa, Ibrahim, Da Silva Medina, Luis, Bartosiak, Katarzyna, Ferreira, Pedro, Francisco, Vítor, Lemos, Ricardo, Frutuoso, Luísa, Fernandes, Sara, Fonseca, Telma, Pereira, Jorge, Rachadell, Juan, Torre, Ana, Madeira Martins, Filipe, Carvalho, Ana Cristina, Rodrigues Ferreira, Joana, Ribeiro da Silva, Bruno, Devesa, Helena, Vieira, Ana, Mónica, Inês, Amaro, Margarida, Sousa, Diogo, Reia, Marta, Louro, João, Martins, Ana, Dominguez, Joaquina, Santos, Inês, Freitas Oliveira, Nuno Miguel, Pereira, José Carlos, Silva-Vaz, Pedro, Freire, Ligia, Escrevente, Ricardo, Negoita, Valentina Madalina, Shakhmatov, Dmitry, Nezerwa, Yves, Radulovic, Radosav, Obery, Gareth, Viljoen, Francois, Mendes, Tome, Suarez, Antonio, Moncada, Enrique, Fernandez-Hevia, Maria, Curtis Martínez, Carolina, Gil Garcia, Julia Maria, González Zunzarren, Mariana, Idris, Tarig, Eklöv, Karolina, Grahn, Oskar, Amin, Leila, Blomqvist, Malin, Ajani, Costanza, Kraus, Rebecca, Seeger, Nico, Willemin, Melissa, Rayya, Fadi, Ayash, Mohammad, Msouti, Raneem, Kannas, Israa, Abazid, Eias, Esper, Asil, Slim, Skander, Kavcar, Akil Serdar, Aytac, Erman, Dural, Ahmet Cem, Ilker, Ayse, Eray, Ismail Cem, Kurnaz, Eray, Altiner, Saygin, Tepe, Mustafa Deniz, Sahin, Can, Savli, Evrim, Innocent, Aryon, Babirye, Lilian, Diachenko, Andrii, Hordoskiy, Vladislav, Curry, Heather, Chau, Charlene Yat Che, Robertson, Harry, Mahmoud, Arin, Lennon, Hannah, Loi, Lynette, Kirkham, Emily, McCann, Cameron, Watts, Daniel, Gurung, Binay, Wilson, Michael, Tribedi, Thomas, Garofalo, Eleonora, Zahra, Baryab, MacDonald, Scott, Daniels, Ian, Ng, Nathan, Khosla, Shivun, Olivier, James, Yue, Sum Yu Pansy, Suresh, Gayathri, Wellington, Jack, Lorejo, Emmanuel, Mossaad, Mafdi, Crutcher, Madison, Alimi, Marjan, Baiu, Ioana, Abdou, Hossam, Conway, Alison, Peck, Connor, Perdomo Perez, Mauro Andres, Zulu, Stanley, Nakazwe, Mildred, Burger, Sule, Davies, Justine, Donaldson, Rachel, Ede, Chikwendu, Garden, O James, Lesetedi, Chiapo, Mabedi, Charles, Magill, Laura, Makinde Alakaloko, Felix, Makupe, Alex, Monahan, Mark, Mulira, Soloman, Muller, Elmi, Musowoyo, Jospeh, Olory-Togbe, Jean Léon, Roberts, Tracey, Smith, Martin, Tayler, Viki, Windsor, John, Yepez, Raul, Sundar, Sudha, Runigamugabo, Emmy, Verjee, Azmina, Chen, José, Daya, Leonid, El Aroussi, Nouhaila, Farina, Valeria, Gnintedeme Olivier, Tchianze, Gonzales Nacarino, Mauricio, Hammani, Aamr, Honjo, Sarah, Jacobs, Rebecca, Kimura, Hitomi, Nkoronko, Mugisha, Oscullo Yepez, Jasson Javier, Pin Hung, Wei, Raj, Ankit, Romani Pozo, Alina, Rommaneh, Muna, Sassamela Fabiano, Samuel Chimbioputo, Shiroma Gago, Camila Milagros, Srinivas, Abhishekh, Sung, Chia-Yen, Tai, Aswan, Valle Aranda, Yener Cristyell, Venturini, Sara, and Wilguens Lartigue, Jean
Subjects: Pediatrics, Colorectal cancer, IMPACT, Disease, Colorectal Neoplasm, 030204 cardiovascular system & hematology, Cancer, surgery, postoperative mortality, 0302 clinical medicine, Postoperative Complications, Global health, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, General Medicine, DISEASES, Income, cancer surgery, Colorectal Neoplasms, Breast Neoplasm, Cohort study, Human, Adult, Developed Countrie, medicine.medical_specialty, Global surgery, General surgery, International multicentre study, Cancer surgery, Breast Neoplasms, Department of Error, NO, Developing Countrie, 03 medical and health sciences, Breast cancer, Stomach Neoplasms, medicine, Humans, Developing Countries, Neoplasm Staging, business.industry, Developed Countries, Odds ratio, CARE, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Prospective Studie, Postoperative Complication, business
Abstract: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit.
Published: 2021

30. The Effect of Therapeutic Hypothermia after Cardiac Arrest on the Neurological Outcome and Survival—A Systematic Review of RCTs Published between 2016 and 2020

Author: Jonathan Cortés Martín, Blanca Riquelme Gallego, María Montiel Troya, Raquel Rodríguez Blanque, Juan Carlos Sánchez García, and Christian Colls Garrido
Subjects: Adult, Hyperthermia, survival rate, medicine.medical_specialty, induced hypothermia, Health, Toxicology and Mutagenesis, Review, CINAHL, cardiac arrest, law.invention, Randomized controlled trial, Hypothermia, Induced, law, Survival rates, medicine, Humans, Child, Intensive care medicine, Methodological quality, Survival rate, business.industry, Cardiorespiratory arrest, Neurological status, Public Health, Environmental and Occupational Health, Hypothermia, medicine.disease, Cardiac arrest, Heart Arrest, critical care, Critical care, Medicine, medicine.symptom, business, Induced hypothermia
Abstract: Therapeutic hypothermia is a treatment used for patients who have suffered cardiorespiratory arrest and remain conscious after the recovery of spontaneous circulation. However, its effectiveness is controversial. The objective of this systematic review is to summarize the scientific evidence available about the effect of therapeutic hypothermia on neurological status and survival in this type of patients. Methodology: A primary search in CINAHL, CUIDEN, Pubmed, Web of Science, and Scopus databases was carried out. Randomized clinical trials (RCT) published from 2016 to 2020 were selected. Results: 17 studies were selected for inclusion and most relevant data were extracted. Methodological quality was assessed by the RoB tool. Conclusions: Although therapeutic hypothermia is a safe technique with few adverse and manageable effects, it has not shown to improve survival rate and neurological status of adult nor pediatric patients. It is possible that its positive effect on neuroprotection could be achieved only by preventing hyperthermia although further investigation is needed.
Published: 2021

31. Free Vacularized Fibula Flap for Septic Bone Defects of the Lower Limb

Author: Alberto Pérez-García, Nieves Vanaclocha, Iván Copete González, Alberto Sánchez-García, and Alessandro Thione
Subjects: medicine.medical_specialty, Free fibula, business.industry, Osteomyelitis, medicine, Surgery, General Medicine, Fibula flap, Bone defect, business, medicine.disease, Lower limb
Abstract: Free fibula flap (FFF) is one of the reconstructive techniques to treat bone defects, although in septic conditions there are some limitations that have made it less popular. We present our experience with FFF for the reconstruction of lower limb infectious bone defects. From September 2015 to January 2020, 10 patients underwent reconstruction with FFF without rigid internal fixation of septic bone defects of the lower extremities. Demographic, clinical, and operative data were retrospectively collected. All the flaps survived and consolidated. The only major complication was a stress fracture of a fibula that required osteosynthesis. Median time to consolidation and full weight-bearing was 2.5 and 9.8 months, respectively. Bipedal gating was achieved in all the patients, 7 of them without walking aids. Despite it has some limitations and technical difficulties, in our experience FFF is an effective and reliable option in the reconstruction of septic bone defects of the lower limb.
Published: 2021

32. Are the chilblain‐like lesions observed during the COVID‐19 pandemic due to severe acute respiratory syndrome coronavirus 2? Systematic review and meta‐analysis

Author: V Sánchez-García, A Docampo-Simón, R Hernández-Quiles, E de-Miguel-Balsa, I Belinchón-Romero, and J M Ramos-Rincón
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Systematic Reviews, business.industry, Diagnostic Tests, Routine, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, Dermatology, medicine.disease, Confidence interval, Serology, Pathogenesis, Chilblains, Infectious Diseases, Internal medicine, Meta-analysis, Pandemic, medicine, Humans, Systematic Review, business, Pandemics
Abstract: The expansion of the COVID‐19 pandemic has been accompanied by numerous reports of chilblain‐like lesions (CLL) in different countries; however, the pathogenesis of these lesions is still unclear. This systematic review and meta‐analysis aimed to assess the prevalence of COVID‐19 (diagnosed using PCR and/or serology) in patients with CLL. We undertook a literature search in PubMed, Embase, and Scopus (to 15 March 2021), including studies that reported on the number of patients with CLL with positive PCR and/or serology for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) or with a clinical suspicion of COVID‐19. Regardless of data heterogeneity, a random‐effects model was used to pool prevalence estimates. The meta‐analysis included 63 original studies, involving 2919 cases of CLL. A subgroup of these patients underwent diagnostic tests for COVID‐19 (PCR: n = 1154, 39.5%; serology: n = 943, 32.3%). The pooled prevalence of COVID‐19 in the overall sample and in the subgroup who were tested for COVID‐19 was, respectively: (i) positive PCR: 2.6% [95% confidence interval (CI) 1.9% to 3.4%] and 5.5% (95% CI, 3.7–7.7%); (ii) positive serology for SARS‐CoV‐2: 7.2% (95% CI, 4.7–10.2%) and 11.8% (95% CI, 7.9–16.3%); and (iii) positive PCR and/or serology, 15.2% (95% CI, 10.4–20.7%) and 7.5% (95% CI, 5.1–10.3%). Altogether, a small proportion of diagnostic tests for SARS‐CoV‐2, both PCR and serologies, show positive results in patients with CLL.
Published: 2021

33. Autonomic Imbalance in Lymphoma Survivors

Author: Jonathan Cortés-Martín, Juan Carlos Sánchez-García, Lourdes Díaz-Rodríguez, Keyla Vargas-Román, Raquel Rodríguez-Blanque, and Emilia I. De la Fuente-Solana
Subjects: medicine.medical_specialty, lymphoma cancer, HRV, Lymphoma cancer, Article, Internal medicine, medicine, Heart rate variability, Autonomic nervous system, Vagal tone, Non-Hodgkin lymphoma, business.industry, non-Hodgkin lymphoma, autonomic nervous system, Healthy subjects, Cancer, General Medicine, medicine.disease, Lymphoma, Heart failure, Autonomic imbalance, Cardiology, Medicine, business
Abstract: Among the types of blood cancers, non-Hodgkin lymphoma is the most common. The usual treatments for this type of cancer can cause heart failure. A descriptive observational study was conducted that included 16 non-Hodgkin lymphoma survivors and 16 healthy controls matched by age and sex. Vagal tone was evaluated in the short term with a three-channel Holter device, and the time and frequency domains were analyzed following a previously accepted methodology to evaluate cardiac autonomic balance. The results of the analysis revealed that the standard deviation of the NN interval (F = 6.25, p = 0.021) and the square root of the mean of the sum of the differences between NN intervals (F = 9.74, p = 0.004) were significantly higher in healthy subjects than in lymphoma survivors. In the heart rate variability (HRV) index, there were no significant differences between the groups (F = 0.03, p = 0.85), nor in the parameters of the frequency domains LF (F = 1.94, p = 0.17), HF (F = 0.35, p = 0.55), and the ratio LF/HF (F = 3.07, p = 0.09). HRV values were lower in non-Hodgkin lymphoma survivors in the first year after treatment, resulting in autonomic imbalance compared to healthy paired subjects., Education Ministry (Program FPU16/01437), Madrid, Spanish Government
Published: 2021

34. Efficacy and safety of suvratoxumab for prevention of Staphylococcus aureus ventilator-associated pneumonia (SAATELLITE)

Author: Saad Nseir, Thierry Boulain, Georgios Baltopoulos, Julie Vignaud, Adel Maamar, Kathryn Shoemaker, Bertrand Souweine, Frédéric Dailler, Pierre-François Laterre, Pedro Moura, Jacques Creteur, Lucia Viña Soria, Terramika Bellamy, Andreas Meier-Hellmann, Alain Mercat, Matthias Gründling, Johann Motsch, Djillali Annane, Paula Ramirez, Christophe Guitton, Antonio Torres Marti, Marco Maggiorini, Tomas Suchy, Alain Lepape, Petr Svoboda, Michal Hanauer, Jan Pachl, Martin Balik, Jérôme Pugin, Jean-Christophe Navellou, Miguel Sánchez-García, Laurent Argaud, Arnaud Desachy, Vasilios Koulouras, Jean-Luc Pagani, Raúl De Pablo Sanchez, Pierre-François Dequin, Carole Schwebel, Ana Catalina Hernandez Padilla, Georgios Filntisis, Patrick Biston, Tomas Vymazal, Juan Carlos Valia, Vadryn Pierre, Frank E. J. Coenjaerts, Frank Wappler, Vladimir Sramek, Fabienne Tamion, Ildikó Krémer, Hasan S Jafri, Zsuzsa Marjanek, Didier Chochrad, Jose Lorente, Marc Simon, Herbert Spapen, Juan Carlos Montejo González, Omar Ali, Cédric Bretonnière, Maria Consuelo Pintado Delgado, Filip Dubovsky, Leen Timbermont, Apostolos Komnos, Christine Lammens, Pin Ren, Tobias Welte, Spyros Zakynthinos, Olivier Barraud, Tomas Hruby, Alain Dive, Herman Goossens, Alexey Ruzin, Marc J. M. Bonten, Ricard Ferrer Roca, Lorenz Reill, Yves Bouckaert, Epaminondas Zakynthinos, Zoltán Szentkereszty, Oliver A. Cornely, Josep Trenado, Antoine Gros, Marc Bourgeois, Ferhat Meziani, Katrin Schmidt, Bruno François, Philippe Eggimann, Ioanna Soultati, Jean-Marc Tadie, Frank Bloos, Agnes Sarkany, Francis Schneider, Susan Colbert, Maria Deja, Mark T. Esser, Gilles Francony, Caroline Rolfes, Martin Nováček, Ana Loza Vazquez, Yuling Wu, Jean-Yves Lefrant, Dolores Escudero, Jean Chastre, Frédéric Foret, René Robert, Vasileios Bekos, Vincent Huberlant, Ioannis Pnevmatikos, Vriendenkring VUB, Supporting clinical sciences, Intensive Care, Internal Medicine Specializations, COMBACTE Consortium, SAATELLITE Study Group, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, and UCL - (SLuc) Service de soins intensifs
Subjects: 0301 basic medicine, Male, Pilot Projects, Critical Care and Intensive Care Medicine, law.invention, 0302 clinical medicine, Randomized controlled trial, Belgium, law, Germany, Data monitoring committee, 030212 general & internal medicine, Lung, Czech Republic, education.field_of_study, Greece, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, Staphylococcal Infections, Middle Aged, 3. Good health, Infectious Diseases, Treatment Outcome, Broadly Neutralizing Antibodies/administration & dosage, young adult, Female, France, Switzerland, Antibodies, Monoclonal, Humanized/administration & dosage, Adult, medicine.medical_specialty, Staphylococcus aureus, Adolescent, 030106 microbiology, Population, Staphylococcus aureus/drug effects, Placebo, Antibodies, Monoclonal, Humanized, lung, Young Adult, 03 medical and health sciences, Double-Blind Method, Internal medicine, Pneumonia, Ventilator-Associated/prevention & control, medicine, Humans, Adverse effect, education, Aged, Hungary, Portugal, business.industry, medicine.disease, Interim analysis, Respiration, Artificial, Pneumonia, Staphylococcal Infections/prevention & control, Spain, Human medicine, business, Broadly Neutralizing Antibodies
Abstract: Summary Background Staphylococcus aureus remains a common cause of ventilator-associated pneumonia, with little change in incidence over the past 15 years. We aimed to evaluate the efficacy of suvratoxumab, a monoclonal antibody targeting the α toxin, in reducing the incidence of S aureus pneumonia in patients in the intensive care unit (ICU) who are on mechanical ventilation. Methods We did a multicentre, randomised, double-blind, placebo-controlled, parallel-group, phase 2 pilot trial at 31 hospitals in Belgium, the Czech Republic, France, Germany, Greece, Hungary, Portugal, Spain, and Switzerland. Eligible patients were in the ICU, aged ≥18 years, were intubated and on mechanical ventilation, were positive for S aureus colonisation of the lower respiratory tract, as assessed by quantitative PCR (qPCR) analysis of endotracheal aspirate, and had not been diagnosed with new-onset pneumonia. Patients were excluded if they had confirmed or suspected acute ongoing staphylococcal disease; had received antibiotics for S aureus infection for more than 48 h within 72 h of randomisation; had a Clinical Pulmonary Infection Score of 6 or higher; had an acute physiology and chronic health evaluation II score of 25 or higher with a Glasgow coma scale (GCS) score of more than 5, or an acute physiology and chronic health evaluation II score of at least 30 with a GCS score of 5 or less; had a Sequential Organ Failure Assessment score of 9 or higher; or had active pulmonary disease that would impair the ability to diagnose pneumonia. Colonised patients were randomly assigned (1:1:1), by use of an interactive voice or web response system, to receive either a single intravenous infusion of suvratoxumab 2000 mg, suvratoxumab 5000 mg, or placebo. Randomisation was done in blocks of size four, stratified by country and by whether patients had received systemic antibiotics for S aureus infection. Patients, investigators, and study staff involved in the treatment or clinical evaluation of patients were masked to patient assignment. The primary efficacy endpoint was the incidence of S aureus pneumonia at 30 days, as determined by a masked independent endpoint adjudication committee, in all patients who received their assigned treatment (modified intention-to-treat [ITT] population). Primary safety endpoints were the incidence of treatment-emergent adverse events at 30 days, 90 days, and 190 days after treatment, and the incidence of treatment-emergent serious adverse events, adverse events of special interest, and new-onset chronic disease at 190 days after treatment. All primary safety endpoints were assessed in the modified ITT population. This trial is registered with ClinicalTrials.gov ( NCT02296320 ) and the EudraCT database (2014-001097-34). Findings Between Oct 10, 2014, and April 1, 2018, 767 patients were screened, of whom 213 patients with confirmed S aureus colonisation of the lower respiratory tract were randomly assigned to the suvratoxumab 2000 mg group (n=15), the suvratoxumab 5000 mg group (n=96), or the placebo group (n=102). Two patients in the placebo group did not receive treatment after randomisation because their clinical conditions changed and they no longer met the eligibility criteria for dosing. As adjudicated by the data monitoring committee at an interim analysis, the suvratoxumab 2000 mg group was discontinued on the basis of predefined pharmacokinetic criteria. At 30 days after treatment, 17 (18%) of 96 patients in the suvratoxumab 5000 mg group and 26 (26%) of 100 patients in the placebo group had developed S aureus pneumonia (relative risk reduction 31·9% [90% CI −7·5 to 56·8], p=0·17). The incidence of treatment-emergent adverse events at 30 days were similar between the suvratoxumab 5000 mg group (87 [91%]) and the placebo group (90 [90%]). The incidence of treatment-emergent serious adverse events at 30 days were also similar between the suvratoxumab 5000 mg group (36 [38%]) and the placebo group (32 [32%]). No significant difference in the incidence of treatment-emergent adverse events between the two groups at 90 days (89 [93%] in the suvratoxumab 5000 mg group vs 92 [92%] in the placebo group) and at 190 days (93 [94%] vs 93 [93%]) was observed. 40 (40%) patients in the placebo group and 50 (52%) in the suvratoxumab 5000 mg group had a serious adverse event at 190 days. In the suvratoxumab 5000 mg group, one (1%) patient reported at least one treatment-emergent serious adverse event related to treatment, two (2%) patients reported an adverse event of special interest, and two (2%) reported a new-onset chronic disease. Interpretation In patients in the ICU receiving mechanical ventilation with qPCR-confirmed S aureus colonisation of the lower respiratory tract, the incidence of S aureus pneumonia at 30 days was not significantly lower following treatment with 5000 mg suvratoxumab than with placebo. Despite these negative results, monoclonal antibodies still represent one promising therapeutic option to reduce antibiotic consumption that require further exploration and studies. Funding AstraZeneca, with support from the Innovative Medicines Initiative Joint Undertaking.
Published: 2021

35. Soft-Tissue Sarcoma as a Potential Differential Diagnosis of an Exophytic Soft-Tissue Mass: A Case Report

Author: Ana Trapero, Andrea Vicente Pardo, Miriam Alonso-Carpio, Alberto Sánchez-García, and Alejandro Ruíz Valls
Subjects: 0301 basic medicine, medicine.medical_specialty, Poor prognosis, Biopsy, Soft Tissue Neoplasms, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Soft tissue mass, Surgical treatment, Aged, Ultrasonography, Biopsy methods, Advanced and Specialized Nursing, business.industry, Soft tissue sarcoma, Sarcoma, medicine.disease, Medical–Surgical Nursing, 030104 developmental biology, 030220 oncology & carcinogenesis, Treatment strategy, Female, Surgery, Radiology, Differential diagnosis, Tomography, X-Ray Computed, business
Abstract: The detection of a soft-tissue mass requires a detailed and conscientious examination to make a definitive diagnosis and propose appropriate treatment strategies. Benign mesenchymal tumors occur more frequently than malignant tumors. However, because of their aggressive growth and poor prognosis, sarcomas must always be considered as a potential differential diagnosis. To make a formal diagnosis and plan appropriate surgical treatment, the surgeon should obtain cross-sectional imaging studies and biopsies.
Published: 2021

36. In-Vitro Effect of Kalanchoe daigremontiana and Its Main Component, Quercetin against Entamoeba histolytica and Trichomonas vaginalis

Author: Oscar A. Alberto Pérez-Narváez, Eduardo Sánchez-García, Joel Horacio Elizondo-Luévano, Abelardo Chávez-Montes, Rocío Castro-Ríos, and Magda Elizabeth Hernández-García
Subjects: Antioxidant, Antiparasitic, medicine.drug_class, medicine.medical_treatment, Entamoeba histolytica, Infectious and parasitic diseases, RC109-216, Pharmacology, medicine.disease_cause, Quercetin, chemistry.chemical_compound, medicine, Trichomonas vaginalis, heterocyclic compounds, IC50, biology, Chemistry, Kalanchoe, biology.organism_classification, medicine.disease, Kalanchoe daigremontiana, Hemolysis, Infectious Diseases, In-vitro, Parasitology
Abstract: Background: Parasitic infections represent one of the main public health problems in humans according to the WHO. Therefore, the need has arisen to find new treatments that can be used as an alternative cure to parasitosis. We aimed to investigate the in-vitro effects of the methanolic extract of Kalanchoe daigremontiana as well as its main component, quercetin against Entamoeba histolytica and Trichomonas vaginalis. Methods: For this purpose, the in-vitro activity of the methanol extract of K. daigremontiana also its main component, quercetin, against trophozoites of E. histolytica and T. vaginalis was evaluated, using the microassay technique. Furthermore, the antioxidant activity was determined. Finally, the cytotoxic and cytoprotective capacity was determined using the hemolysis technique. Results: The IC50 indicated that quercetin significantly (P < 0.05) inhibited the growth rate of the trophozoite stage of E. histolytica and T. vaginalis in comparison to the methanolic extract of K. daigremontiana (KalL). Also, quercetin significantly (P < 0.05) was a better antioxidant as compared with the positive control. In the evaluation of cytotoxicity effects, it could be observed that KalL as compared with quercetin exhibited more cytotoxicity against human erythrocytes. Quercetin significantly (P < 0.001) exhibited better cytoprotective activity compared to KalL. Conclusion: Both K. daigremontiana methanolic extract and quercetin alone demonstrated high antiparasitic activity against E. histolytica and T. vaginalis. However, the in-vivo efficacy of K. daigremontiana and quercetin also requires to be evaluated using an animal model.
Published: 2021

37. Immediate Pre-Partum SARS-CoV-2 Status and Immune Profiling of Breastmilk: A Case-Control Study

Author: Juan Miguel Rodríguez Gómez, Manuela López-Azorín, Diana Escuder-Vieco, Raquel González-Sánchez, M Teresa Moral-Pumarega, Fernando Cabañas, Claudio Alba, Adelina Pellicer, Natalia Gómez-Torres, Laura Sánchez García, Irma Castro, and Esther Cabañes-Alonso
Subjects: Adult, vertical infectious disease transmission, breastfeeding, Immunology, Breastfeeding, Mothers, Physiology, Breast milk, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Immune system, Pregnancy, 030225 pediatrics, medicine, Humans, Immunology and Allergy, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Original Research, Milk, Human, business.industry, Infant, Newborn, Case-control study, COVID-19, RC581-607, immunologic factors, medicine.disease, immune system, Breast Feeding, Case-Control Studies, Cytokines, Intercellular Signaling Peptides and Proteins, RNA, Viral, Female, Immunologic diseases. Allergy, Chemokines, medicine.symptom, business, Breast feeding
Abstract: ObjetiveTo address the prevalence of SARS-CoV-2 and the evolutionary profile of immune compounds in breastmilk of positive mothers according to time and disease state.MethodsForty-five women with term pregnancies with confirmed non-severe SARS-CoV-2 infection (case group), and 96 SARS-CoV-2 negative women in identical conditions (control group) were approached, using consecutive sample. Weekly (1st to 5th week postpartum) reverse transcription polymerase chain reaction (RT-PCR) in nasopharyngeal swabs (cases) and breastmilk (cases and controls) were obtained. Concentration of cytokines, chemokines, and growth factors in breastmilk (cases and controls) were determined at 1st and 5th week post-partum.ResultsThirty-seven (study group) and 45 (control group) women were enrolled. Symptomatic infection occurred in 56.8% of women in the study group (48% fever, 48% anosmia, 43% cough). SARS-CoV-2 RNA was not found in breastmilk samples. Concentrations of cytokines (IFN-γ, IL-1ra, IL-4, IL-6, IL-9, IL-13, and TNF-α) chemokines (eotaxin, IP-10, MIP-1α, and RANTES) and growth factors (FGF, GM-CSF, IL7, and PDGF-BB) were higher in breastmilk of the study compared with the control group at 1st week postpartum. Immune compounds concentrations decreased on time, particularly in the control group milk samples. Time of nasopharyngeal swab to become negative influenced the immune compound concentration pattern. Severity of disease (symptomatic or asymptomatic infection) did not affect the immunological profile in breast milk.ConclusionsThis study confirms no viral RNA and a distinct immunological profile in breastmilk according to mother’s SARS-CoV-2 status. Additional studies should address whether these findings indicate efficient reaction against SARS-CoV-2 infection, which might be suitable to protect the recipient child.
Published: 2021

38. Exenteración pélvica para cáncer de recto localmente avanzado y recurrente: resultados a largo plazo y factores pronósticos

Author: Heriberto Medina-Franco, Carlos Sanjuán-Sánchez, Francisco Armillas-Canseco, Omar Vergara-Fernández, and Emilio Sánchez-García-Ramos
Subjects: Male, medicine.medical_specialty, Prognostic factor, RD1-811, Lymphovascular invasion, Colorectal cancer, medicine.medical_treatment, Disease-Free Survival, High morbidity, medicine, Humans, Retrospective Studies, Gynecology, Radical treatment, Pelvic exenteration, Rectal Neoplasms, business.industry, Cancer, medicine.disease, Pelvic Exenteration, Exenteración pélvica. Cáncer de recto. Invasión linfovascular. CR-POSSUM, Referral center, Female, Surgery, Neoplasm Recurrence, Local, business
Abstract: Objetivo El objetivo de este trabajo fue analizar los resultados perioperatorios y a largo plazo de los pacientes sometidos a exenteracion pelvica para cancer de recto en un centro de referencia en la Ciudad de Mexico. Metodo Se incluyeron todos los pacientes que se sometieron a exenteracion pelvica por cancer de recto entre 1995 y 2019. Se analizaron variables demograficas, clinicas, quirurgicas y patologicas. Resultados Se incluyeron 18 pacientes operados por cancer de recto (16 localmente avanzados y 2 recurrentes). La relacion hombre: mujer fue de 1:3.5. La morbilidad mayor fue del 27.7%. El sangrado intraoperatorio ≥ 1000 ml se asocio con morbilidad (80 vs. 20%; p = 0,029) y mortalidad posoperatoria (100 vs. 0; p = 0.043). La mediana de sobrevida global fue 102 meses. Las sobrevidas global y libre de enfermedad a los 5 anos fueron del 44.4% y el 38.8%, respectivamente. La invasion linfovascular fue un factor de mal pronostico para sobrevida libre de enfermedad (p = 0.017). Conclusiones La exenteracion pelvica para el cancer de recto es un procedimiento quirurgico con altas morbilidad y mortalidad. La invasion linfovascular es un factor de mal pronostico para la sobrevida libre de enfermedad. Introduction Pelvic exenteration is a radical treatment for locally advanced and recurrent pelvic tumors. The aim of this study was to analyze the perioperative and long-term outcomes of patients undergoing pelvic exenteration for rectal cancer at a referral center in Mexico City. Method We included all patients who underwent pelvic exenteration due to rectal cancer between 1995 and 2019. Demographic, clinical, surgical and pathological variables were analyzed. Results 18 patients were included (16 locally advanced and 2 recurrent). The male-female ratio was 1:3.5. The highest morbidity was 27.7%. Intraoperative bleeding ≥ 1000 ml was associated with postoperative morbidity (80 vs. 20%; p = 0.029) and mortality (100 vs. 0; p = 0.043). The median overall survival was 102 months. Overall survival and disease free survival at 5 years after exenteration were 44.4% and 38.8%, respectively. Lymphovascular invasion of the tumor was a poor prognostic factor for disease free survival (p = 0.017). Conclusions Pelvic exenteration for rectal cancer is a surgical procedure with high morbidity and mortality. Lymphovascular invasion is a poor prognostic factor for disease-free survival.
Published: 2021

39. The Association of Osteosarcopenia With Functional Disability in Community-Dwelling Mexican Adults 50 and Older

Author: Miriam T. López-Teros, Oscar Rosas-Carrasco, Sergio Sánchez-García, Lilia Castro-Porras, Armando Luna-López, and Marcela Agudelo-Botero
Subjects: Gerontology, Medicine (General), Activities of daily living, functional disability, Osteoporosis, sarcopenia, 03 medical and health sciences, R5-920, 0302 clinical medicine, medicine, 030212 general & internal medicine, Original Research, osteosarcopenia, Polypharmacy, 030505 public health, business.industry, Secondary data, General Medicine, Odds ratio, medicine.disease, Comorbidity, community-dwelling, Osteopenia, Mexico City, Sarcopenia, Medicine, 0305 other medical science, business
Abstract: Background: Osteosarcopenia (OS) has recently been described as a predictor of negative outcomes in older adults. However, this alteration in body composition has not been widely studied. In Mexico and Latin America, no information is available on its frequency or associated factors.Objective: To analyze the association between OS with FD in community-dwelling Mexican adults 50 and older.Design: Cross-sectional secondary data analysis was performed using primary data from a prospective study Frailty, Dynapenia and Sarcopenia Study in Mexican Adults (FraDySMex).Setting and Participants: Eight hundred and twenty-five people were included, 77.1% women, aged 70.3 ± 10.8 years old.Methods: OS was defined as when the person was diagnosed with sarcopenia (SP) plus osteopenia/osteoporosis. The SP diagnosis was evaluated in accordance with the criteria of the European Working Group for the Definition and Diagnosis of Sarcopenia (EWGSOP), and the osteoporosis diagnosis using World Health Organization (WHO) criteria. Muscle mass and bone mass were evaluated using dual-energy X-ray absorptiometry (DXA). FD was evaluated using the basic activities of daily living (BADL) and the instrumental activities of daily living (IADL). Additional sociodemographic and health co-variables were also included, such as sex, age, education, cognitive status, depression, comorbidity, hospitalization, polypharmacy, urinary incontinence, and nutrition variables such as risk of malnutrition and obesity. Associations between OS with FD were evaluated using multiple logistic regression.Results: The prevalence of OS was 8.9% and that of FD was 8.9%. OS was associated with FD [odds ratio (OR): 1.92; CI 95%: 1.11–3.33].Conclusions and Implications: Comprehensive OS assessment could help clinicians identify risk factors early, and thus mitigate the impact on FD in older people.
Published: 2021

40. Importance of specialized paediatric and neonatal transport. Current situation in Spain: Towards a more equitable and universal future

Author: Raquerl Jordán Lucas, Nieves de Lucas García, Yolanda Ballesteros Diez, Alberto Salas Ballestín, Raquel Rodríguez Merlo, Laura Sánchez García, Nuria Millán García Del Real, Institut Català de la Salut, [Millán García Del Real N] Servicio de Emergencias Médicas Pediátricas, Cataluña, España. Unidad de Cuidados Intensivos Pediátricos, Hospital San Juan de Dios, Cataluña, España. Grupo de Estabilización y Transporte del Niño y Neonato Crítico de la Sociedad Española de Cuidados Intensivos Pediátricos (SECIP). [Sánchez García L] Servicio de Neonatología del Hospital Universitario La Paz, Madrid, España. Equipo de Transporte Neonatal de la Comunidad de Madrid, Madrid, España. Grupo de Transporte Neonatal de la Sociedad Española de Neonatología, España. [Ballesteros Diez Y] Servicio de Urgencias del Hospital Universitario Cruces, Bilbao, España. Grupo de trabajo de Paciente Crítico de la Sociedad Española de Urgencias de Pediatría. [Rodríguez Merlo R] SUMMA112 Madrid, Madrid, España. Grupo de Emergencias y Urgencias Pediátricas de la Sociedad Española de Medicina de Emergencias. [Salas Ballestín A] Grupo de Estabilización y Transporte del Niño y Neonato Crítico de la Sociedad Española de Cuidados Intensivos Pediátricos (SECIP). Unidad de Transporte Pediátrico de Baleares, Islas Baleares, España. Unidad de Cuidados Intensivos Pediátricos del Hospital Universitario Son Espases, Palma de Mallorca, España. [Jordán Lucas R] Servei de Neonatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grupo de Transporte Neonatal de la Sociedad Española de Neonatología, and Vall d'Hebron Barcelona Hospital Campus
Subjects: media_common.quotation_subject, Paediatric transport, Neonatologia - Espanya, Infants nadons - Transport - Espanya, Pediatrics, RJ1-570, law.invention, Resource (project management), law, Health Care Facilities, Manpower, and Services::Health Services::Community Health Services::Child Health Services [HEALTH CARE], medicine, Quality (business), Function (engineering), media_common, instalaciones, servicios y personal de asistencia sanitaria::servicios de salud::servicios médicos de urgencia::transporte de pacientes [ATENCIÓN DE SALUD], personas::Grupos de Edad::lactante::recién nacido [DENOMINACIONES DE GRUPOS], Persons::Age Groups::Infant::Infant, Newborn [NAMED GROUPS], medicine.disease, Intensive care unit, Continuous training, Neonatal transport, Variety (cybernetics), Health Care Facilities, Manpower, and Services::Health Services::Emergency Medical Services::Transportation of Patients [HEALTH CARE], Critical care, instalaciones, servicios y personal de asistencia sanitaria::servicios de salud::Servicios de Salud Comunitaria::Servicios de Salud del Niño [ATENCIÓN DE SALUD], Homogeneous, Pediatrics, Perinatology and Child Health, Business, Medical emergency, Interfacility transport
Abstract: Transporte neonatal; Transporte interhospitalario; Cuidados críticos Neonatal transport; Interfacility transport; Critical care Transport neonatal; Transport interhospitalari; Cures crítiques El transporte pediátrico y neonatal especializado es un recurso útil y esencial en el traslado interhospitalario de estos pacientes. Permite acercar los recursos materiales y personales de una unidad de cuidados intensivos a los hospitales comarcales donde se pueda encontrar el paciente. Los beneficios de estos equipos están muy bien demostrados en la literatura. Estas unidades deberían formar parte de los sistemas de emergencias, al mismo tiempo que sería recomendable que estuvieran constituidas por personal integrado en los hospitales terciarios con el fin de mantener las habilidades y competencias necesarias. El equipo, compuesto por médicos, enfermeros y técnicos de emergencias sanitarias, tiene que dominar tanto la fisiopatología del transporte como la del paciente crítico en este rango de edad. Es importante una alta calidad tanto humana como asistencial, por lo que la formación continuada y el reciclaje periódico serán imprescindibles para poder cumplir correctamente con los indicadores de calidad en transporte. Así mismo, es fundamental contar con vehículos propios y adaptados a su función, que permitan llevar la gran variedad de material necesario, así como la electromedicina que se requiere. Sin embargo, en España este modelo de transporte pediátrico y neonatal no está estandarizado y por lo tanto no es homogéneo: existen diferentes modelos que no siempre aportan una adecuada calidad, siendo necesaria la implantación de unidades especializadas en todo el país para garantizar un transporte sanitario de calidad a cualquier niño o neonato crítico. Specialized paediatric and neonatal transport is a useful and essential resource in the interhospital transfer of these patients. It allows bringing the material and personal resources of an intensive care unit closer to the regional hospitals where the patient can be found. The benefits of these teams are very well demonstrated in the literature. These units should be part of the emergency systems, while it would be recommended that they would be staff integrated in the tertiary hospitals, in order to maintain the necessary skills and competencies. The team, made up of physicians, nurses and emergency medical technicians, must master both the pathophysiology of transport and that of the critical patient in this age range. A high-quality of both human and care is important, so continuous training and periodic recycling will be essential to be compliant with the quality indicators in transport. Likewise, it is essential to have specific vehicles adapted to this function, which allow carrying the wide variety of necessary material, as well as the electromedicine that is required. However, in Spain this paediatric and neonatal transport model is not standardized and, therefore, is not homogeneous: there are different models that do not always provide adequate quality, making it necessary to implement specialized units throughout the country to guarantee sanitary transport quality to any critical child or neonate.
Published: 2021

41. Hyperthermic Intra-Abdominal Chemotherapy with Gemcitabine as an Adjuvant Locoregional Treatment After Radical Surgery in Pancreatic Cancer

Author: Esther Pilar García Santos, David Padilla-Valverde, Susana Sánchez-García, M. Carmen Manzanares-Campillo, Alejandro Puerto-Puerto, Marta Rodríguez-Martínez, Lucía González-López, and Jesús Martín-Fernández
Subjects: medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, Disease, medicine.disease, Gemcitabine, Surgery, Tumor progression, Pancreatic cancer, Medicine, Adenocarcinoma, Radical surgery, business, Adjuvant, medicine.drug
Abstract: Purpose: The aim of our study is to present a series of patients in whom we have administered HIPEC therapy. Material and Methods: The treatment consists in performing cytoreductive surgery in patients diagnosed with potentially resectable pancreatic adenocarcinoma, together with the administration of HIPEC therapy with Gemcitabine. The dose of the drug is 120 mg/m2 for 30 minutes, followed by a conventional adjuvant treatment. Results: Five patients diagnosed with pancreatic adenocarcinoma have undergone surgery with a curative nature. There were no technical or hemodynamic complications during the procedure. Discussion: The use of HIPEC could achieve a decrease in the tumor progression of pancreatic cancer, improving the survival of the patient, and decreasing the recurrence of the disease. A larger number of patients will be necessary, as well as a long-term evaluation to assess the possible increase in survival in this group of patients.
Published: 2020

42. Please, Don’t Shoot the Meta-analysis: A Response to 'A Commentary to Toddler Screening for Autism Spectrum Disorder: A Meta-analysis of Diagnostic Accuracy by Sánchez-Garcia et al. 2019'

Author: Ana B Nieto-Libreros, Ana B. Sánchez-García, Diana L. Robins, and Purificación Galindo-Villardón
Subjects: medicine.medical_specialty, biology, Autism Spectrum Disorder, Research, Public health, Garcia, MEDLINE, medicine.disease, biology.organism_classification, Autism spectrum disorder, Child, Preschool, Meta-analysis, Developmental and Educational Psychology, medicine, Humans, Mass Screening, Autism, Toddler, Psychology, Mass screening, Clinical psychology
Published: 2020

43. Pelvic Angiosarcoma Around Total Hip Prosthesis

Author: Enrique Salmerón González, Alberto Pérez García, and Alberto Sánchez-García
Subjects: medicine.medical_specialty, Osteolysis, business.industry, medicine.medical_treatment, Autopsy, General Medicine, Pelvic cavity, medicine.disease, Prosthesis, Surgery, medicine.anatomical_structure, Primary bone, medicine, Angiosarcoma, Accidental fall, Differential diagnosis, business
Abstract: Angiosarcomas constitute less than 1% of primary bone malignancies. Their association with prosthetic material has been described, while their etiology remains unclear. We present a case of a 64-year woman with severe bleeding and hip joint osteolysis after an accidental fall. She had undergone prosthetic total hip arthroplasty many years back. The rapid recurrence of pelvic hematoma and the refractory infection of pelvic cavity made necessary to disarticulate the prosthetic hip joint, after several attempts to apply conservative treatment. Despite supportive treatment, she died. Autopsy revealed evidently dissemanted angiosarcoma of pelvic bones. Angiosarcoma of the bone should be considered in the differential diagnosis of patients with uncontrollable bleeding and osteolysis, due to the increase of life expectancy when prompt and combined treatment is initiated.
Published: 2019

44. Acanthosis Nigricans in the Knuckles of Infants: A Novel Clinical Marker of High Metabolic Risk

Author: Alejandro Salcido-Montenegro, Dalia A. Castillo-Gonzalez, Victoria González-Nava, Rene Rodriguez-Gutierrez, Karla M. Santos-Santillana, Minerva Gómez-Flores, Adriana Sánchez-García, Manuel Enrique de la O-Cavazos, and José Gerardo González-González
Subjects: medicine.medical_specialty, Percentile, Endocrinology, Diabetes and Metabolism, Acanthosis nigricans, 030209 endocrinology & metabolism, Physical examination, 030204 cardiovascular system & hematology, Gastroenterology, Hyperinsulinemia, 03 medical and health sciences, 0302 clinical medicine, Insulin resistance, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Metabolic risk, Obesity, Original Research, medicine.diagnostic_test, business.industry, medicine.disease, business, Infants
Abstract: Introduction Acanthosis nigricans (AN) is an early clinical sign of insulin resistance (IR) primarily in adults. The prevalence and association of AN and IR in infants, however, remains uncertain. We aimed to describe the prevalence of AN and its association with IR in a group of Latin-American infants. Methods We studied a random sample of 227 healthy infants between 9 and 24 months of age. After a complete clinical history was obtained and a physical examination was performed, fasting plasma glucose and serum insulin were measured. Three blinded evaluators assessed AN in each patient. Infants with AN were categorized as cases. The HOMA-IR index cutoffs of ≥ 90th and ≥ 95th percentiles were considered IR. Results There were 49 infants with AN (21.6%) (cases) and 178 without AN (78.4%) (controls). Cases had a significantly higher mean serum insulin, fasting plasma glucose, and HOMA-IR levels of 3.67 ± 2.56 µU/ml vs. 2.42 ± 1.45 µU/ml, P = 0.005; 84.2 ± 12.6 mg/dL vs. 77 ± SD 9.9 mg/dL, P ≤ 0.001; HOMA-IR 0.77 ± 0.54 vs. 0.46 ± 0.28, P ≤ 0.001, respectively. More cases than controls presented HOMA-IR levels ≥ 95th percentile (cases 18.4%; controls 0.5%, P ≤ 0.001) and ≥ 90th percentile (cases 32.7%; controls 1.6%, P ≤ 0.001). AN in the knuckles had a high sensitivity and a negative predictive value (NPV) for detecting patients with HOMA-IR levels above the 95th percentile (sensitivity 90%; NPV 99.4%) and above the 90th percentile (sensitivity 84.2%; NPV 98.3%). Conclusion AN in the knuckles is a prevalent, non-invasive, costless, and reliable screening clinical tool that can be used for early detection of infants with IR and a high metabolic risk.
Published: 2019

45. Efficacy and safety of avocado‐soybean unsaponifiables for the treatment of hip and knee osteoarthritis: A systematic review and meta‐analysis of randomized placebo‐controlled trials

Author: Carlos Acosta-Olivo, Luis E. Simental-Mendía, Víctor M. Peña-Martínez, Félix Vilchez-Cavazos, Jorge Osuna‐Garate, Mario Simental-Mendía, and Adriana Sánchez-García
Subjects: Male, medicine.medical_specialty, Visual analogue scale, MEDLINE, Osteoarthritis, Placebo, Osteoarthritis, Hip, law.invention, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Randomized controlled trial, law, Internal medicine, medicine, Humans, Plant Oils, 030212 general & internal medicine, Adverse effect, Aged, Randomized Controlled Trials as Topic, 030203 arthritis & rheumatology, Persea, Plant Extracts, business.industry, Middle Aged, Osteoarthritis, Knee, medicine.disease, Soybean Oil, Treatment Outcome, Antirheumatic Agents, Relative risk, Meta-analysis, Female, business
Abstract: OBJECTIVE We performed a systematic review and meta-analysis from randomized controlled trials to examine the efficacy and safety of avocado-soybean unsaponifiables (ASU) in patients with hip or knee osteoarthritis (OA). DATA SOURCES Medline, SCOPUS, Web of Science, and Google Scholar databases were searched for randomized placebo-controlled trials. STUDY SELECTION Original studies were randomized placebo-controlled trials evaluating the effect of orally administered ASU on knee or hip OA symptoms using the Lequesne index, visual analog scale (VAS) and/or joint space width (JSW). DATA EXTRACTION Meta-analysis was conducted using a random-effects model and generic inverse variance method. Heterogeneity was tested using the I2 statistic index. DATA SYNTHESIS Avocado-soybean unsaponifiables therapy had a significant reduction on pain by VAS assessment (weighted mean difference [WMD]: -9.64 mm, 95% CI: -17.43, -1.84; P = .02; I2 = 92%). A subanalysis according to the type of OA showed that ASU significantly decreased both VAS and Lequesne index in knee OA (WMD: -17.36, 95% CI: -25.91, -8.82; P
Published: 2019

46. Randomized Clinical Trial of an Aquatic Physical Exercise Program During Pregnancy

Author: Juan Carlos Sánchez-García, Raquel Rodríguez-Blanque, María José Aguilar-Cordero, Manuela Expósito-Ruiz, and Antonio Manuel Sánchez-López
Subjects: Adult, Episiotomy, medicine.medical_specialty, Birth weight, medicine.medical_treatment, Physical exercise, Prenatal care, Perineum, Critical Care Nursing, Pediatrics, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Pregnancy, law, Maternity and Midwifery, Humans, Childbirth, Medicine, 030212 general & internal medicine, Swimming, Hydrotherapy, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Prenatal Care, Delivery, Obstetric, medicine.disease, Exercise Therapy, medicine.anatomical_structure, Spain, Female, business
Abstract: Objective To determine the effect of an aquatic physical exercise program performed during pregnancy on rate of intact perineum after childbirth. Design Randomized clinical trial. Setting Health centers in the metropolitan health district of Granada, Spain. Participants A total of 129 pregnant women (control group [CG] = 64; aquatic exercise group [EG] = 65). Methods The intervention was an aquatic physical exercise program specifically designed for pregnant women (Study of Water Exercise During Pregnancy [SWEP] method). Participants were randomly assigned to the CG or EG by simple random sampling. Participants in the EG performed three sessions per week of physical exercises, which were led by the principal investigator. All participants received routine prenatal care. We evaluated status of the perineum after birth, including laceration and episiotomy rates. We also evaluated participants’ weight, body mass index (BMI) in the first and third trimesters, parity, the administration of anesthesia, and birth weight of the neonate as potential confounding variables. Results The women in the EG had a greater rate of intact perineum than those in the CG (odds ratio [OR] = 13.54, 95% confidence interval [CI] [2.75, 66.56]). After adjusting for infant birth weight, the effect of the intervention on intact perineum was an OR of 8.57 (95% CI [1.85, 39.68]. Maternal weight gain did not influence the odds of intact perineum (OR = 1.072, 95% CI [0.896, 1.283]). Women who previously gave birth and followed the SWEP method had an OR of 10.197 (95% CI [2.190, 47.476] for an intact perineum. The administration of anesthesia and previous pregnancy also were associated with intact perineum (OR = 6.68, 95% CI [1.21, 36.84] and OR = 5.42, 95% CI [1.64, 17.89] respectively. Conclusion The women who followed the SWEP method were significantly more likely to have intact perinea after childbirth.
Published: 2019

47. Signs of damage in pelvic floor muscles at the end of pregnancy in rabbits

Author: Margarita Juárez, Kenia López-García, Francisco Castelán, Laura G. Hernández-Aragón, Margarita Martínez-Gómez, and Octavio Sánchez-García
Subjects: Urology, media_common.quotation_subject, Muscle Fibers, Skeletal, Bulbospongiosus muscle, 030232 urology & nephrology, Physiology, Urinary incontinence, Urination, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Animals, Myocyte, Glucuronidase, media_common, 030219 obstetrics & reproductive medicine, Pelvic floor, business.industry, Postpartum Period, Bulbospongiosus, Pubococcygeus muscle, Obstetrics and Gynecology, Pelvic Floor, medicine.disease, Parity, medicine.anatomical_structure, Tyrosine, Female, Rabbits, medicine.symptom, business, Biomarkers
Abstract: Temporary effects to pelvic floor muscles are linked to impairments in micturition, particularly stress urinary incontinence (SUI), during pregnancy. We hypothesize that bulbospongiosus (Bsm) and pubococcygeus (Pcm) are differently damaged in primigravid and primiparous rabbits. Twenty-four rabbits allocated evenly (n = 6) into nulliparous, pregnant, and primiparous groups on postpartum days 3 (P3) and 20 (P20) were used to evaluate the myofiber cross-sectional area (CSA), β-glucuronidase activity, and anti-3-nitrotyrosine (anti-3-NTyr) immunoreactivity in Bsm and Pcm muscles. Appropriate statistical tests were done to determine significant differences among groups (P ≤ 0.05). The average CSA of Bsm was not significantly different, albeit a high percentage of myofibers was enlarged in late-pregnant and primiparous rabbits on P3; β-glucuronidase activity and indirect parameter of muscle damage was also higher. These variables did not change in the Pcm muscle during the different reproductive stages. In contrast, the 3-NTyr immunoreactivity, an indicator of oxidative damage, was increased on P3 for Pcm myofibers and P20 for myofibers of both muscles. Our findings demonstrate reliable signs of damage to Bsm and Pcm muscles in young female rabbits passing different reproductive stages. Damage to the Bsm muscles as detected at the end of pregnancy persisted after delivery. This was not the case for Pcm muscles, in which damage seems to appear after delivery.
Published: 2019

48. Phase 2 Randomized Study of Radiation Therapy and 3-Year Androgen Deprivation With or Without Concurrent Weekly Docetaxel in High-Risk Localized Prostate Cancer Patients

Author: Pablo Maroto, Begoña Mellado, Teresa de Portugal, Mariona Figols, Sonia Maciá, Xavier Maldonado, Palmira Foro, Enrique Gallardo, Ramon Aldabo, Joan Carles, José Sánchez García, Raquel Luque, Teresa Bonfill, Joaquim Bellmunt, Montserrat Domenech, Maria Jose Mendez, Cristina Suárez, Albert Font, Rafael Morales-Barrera, and María Isabel Sáez
Subjects: Male, Biochemical recurrence, Cancer Research, medicine.medical_specialty, Randomization, medicine.medical_treatment, Urology, Docetaxel, Adenocarcinoma, Disease-Free Survival, Drug Administration Schedule, 030218 nuclear medicine & medical imaging, law.invention, Gonadotropin-Releasing Hormone, Androgen deprivation therapy, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Randomized controlled trial, law, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Aged, Radiation, business.industry, Prostate, Prostatic Neoplasms, Androgen Antagonists, Radiotherapy Dosage, Middle Aged, Prostate-Specific Antigen, medicine.disease, Combined Modality Therapy, Radiation therapy, Clinical trial, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Neoplasm Grading, business, medicine.drug
Abstract: Purpose: Docetaxel improves survival in patients with metastatic prostate cancer. This randomized phase 2 trial aimed to assess the activity of weekly docetaxel with radiation therapy (RT) plus androgen deprivation in patients with high-risk localized prostate cancer. The study examined the benefit of 9 weekly docetaxel administrations to RT plus 3 years of luteinizing hormone-releasing hormone analogues. Methods and Materials: A total of 132 patients were recruited for the study. Patients' characteristics included T3-T4 stage (81.1%), Gleason score >= 8 (77.3%), prostate-specific antigen level >20 ng/mL (28.9%), and pN+ (18.2%). All patients included in the trial received either the standard-of-care control arm with luteinizing hormone-releasing hormone analogues plus RT (arm A) or the experimental arm (RT + 9 weekly cycles of docetaxel + 3 years of androgen deprivation therapy, arm B). The primary objective was to achieve a high percentage of patients who were free of biochemical recurrence within 5 years of randomization. Secondary endpoints included biochemical recurrence-free survival (BRFS), progression-free survival (PFS), overall survival (OS), clinical response rate, biochemical response rate, and toxicity. Results: No difference between the arms of the study was found in biochemical recurrence (93.4% at 60 months for arm A vs 85.3% for arm B; P = .3297). PFS at 60 months was 93.4% and 83.7% in arms A and B, respectively (P = .2532). Five-year survival was 93.3% (95% confidence interval, 83.1-97.45) in arm A versus 93.6% (83.8-97.55) in arm B; median PFS and OS have not been reached. Prostate-specific antigen level
Published: 2019

49. An immune window of opportunity to prevent childhood B cell leukemia

Author: Isidro Sánchez-García, César Cobaleda, Carolina Vicente-Dueñas, Agencia Estatal de Investigación (España), Ministerio de Ciencia, Innovación y Universidades (España), Fundación Ramón Areces, Fundación Síndrome de Wolf-Hirschhorn, Banco Santander, European Commission, Instituto de Salud Carlos III, Ministerio de Economía y Competitividad (España), Junta de Castilla y León, Josep Carreras Leukemia Foundation, Fundación Unoentrecienmil, and Federal Office for Radiation Protection (Germany)
Subjects: 0301 basic medicine, Window of opportunity, business.industry, Immunology, B-cell acute lymphoblastic leukemia, Precursor Cell Lymphoblastic Leukemia-Lymphoma, medicine.disease, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Immune system, B-cell leukemia, Leukemia, B-Cell, medicine, Genetic predisposition, Humans, Immunology and Allergy, Genetic Predisposition to Disease, business, 030215 immunology
Abstract: The prevalence of childhood B cell acute lymphoblastic leukemia (B-ALL) is increasing, particularly in developed countries. There is no clear explanation for this increment, but recent data suggest that, besides genetic predisposition, stress in the immune system (e.g., an infection) might have an important role in B-ALL leukemogenesis. Here, we speculate on how this knowledge might impact B-ALL prevention strategies., Research in C.C.’s laboratory was partially supported by FEDER MINECO (SAF2017-83061-R), the ‘Fundación Ramón Areces’, and a Research Contract with the ‘Fundación Síndrome de Wolf-Hirschhorn o 4p-‘. Institutional grants from the ‘Fundación Ramón Areces’ and ‘Banco de Santander’ to the CBMSO are also acknowledged. The C.C. and C.V-D. labs are members of the EU COST Action LEGEND (CA16223). Research in the C.V-D. group is partially supported by FEDER, ‘Miguel Servet’ Grant (CPII19/00024 - AES 2017-2020) from the Instituto de Salud Carlos III (Ministerio de Economía y Competitividad) and ‘Fondo de Investigaciones Sanitarias/Instituto de Salud Carlos III’ (PI17/00167). Research in the I.S-G. group is partially supported by FEDER and by SAF2015-64420-R MINECO/FEDER, UE, RTI2018-093314-B-I00 MCIU/AEI/FEDER, UE, Junta de Castilla y León (UIC-017, CSI001U16, CSI234P18, and CSI144P20), the German Carreras Foundation (DJCLS 07R/2019), and the Fundacion Unoentrecienmil (CUNINA project). The I.S-G. lab is a member of the EuroSyStem and DECIDE Network funded by the European Union under the FP7 program. C.V-D. and I.S-G. have been supported by the German Federal Office for Radiation Protection (BfS)-Germany (FKZ: 3618S32274).
Published: 2021

50. The use of platelet-rich plasma in studies with early knee osteoarthritis versus advanced stages of the disease: a systematic review and meta-analysis of 31 randomized clinical trials

Author: Vilchez-Cavazos F, Gamboa-Alonso A, Simental-Mendía M, Peña-Martínez, Acosta-Olivo C, Sánchez-García A, and Blázquez-Saldaña J
Subjects: Oncology, medicine.medical_specialty, business.industry, Advanced stage, Disease, Osteoarthritis, medicine.disease, law.invention, Text mining, Randomized controlled trial, law, Meta-analysis, Internal medicine, Platelet-rich plasma, medicine, business
Abstract: Purpose. Reports have concluded that platelet-rich plasma (PRP) is an effective and safe biological approach to treating knee osteoarthritis (OA). However, the efficacy of PRP in advanced stages of the disease is not entirely clear. The purpose of this study was to evaluate whether the use of PRP would be as effective in studies with early-moderate knee OA patients compared to studies including patients with end-stage OA based on the Kellgren-Lawrence classification. Methods. A comprehensive search in MEDLINE, EMBASE, Scopus, and Web of Science was conducted to identify randomized controlled trials (RCTs) comparing the effect of PRP injections versus other intra-articular treatments on pain and functionality. A meta-analysis was conducted using a random-effects model and the generic inverse variance method. Results. We included 31 clinical trials that reported data of 2705 subjects. Meta-analysis revealed an overall significant improvement of both pain (MD, -1.05 [95% CI -1.41 to -0.68]; I2 = 86%; P = < 0.00001) and function (SMD, -0.99 [95% CI -1.34, to -0.65]; I2 = 94%; P = < 0.00001), favoring PRP. Subanalysis for pain and functional improvement showed significant pain relief in studies with 1-3 and 1-4 Kellgren-Lawrence OA stages, and a significant functional improvement in studies with 1-2, 1-3, and 1-4 knee OA stages, favoring PRP. Conclusion. Our results indicate that including patients with advanced knee OA does not seem to affect the outcomes of clinical trials in which the efficacy of PRP in knee OA is assessed.
Published: 2021

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