02.09.01. Investigación y comunicación científica

Multicenter Prospective Study on Transvaginal Radiofrequency Ablation of Uterine Fibroids: Efficacy, Safety, and Reproducibility

2026-01-01T00:00:00Z

Multicenter Prospective Study on Transvaginal Radiofrequency Ablation of Uterine Fibroids: Efficacy, Safety, and Reproducibility Santalla-Hernández, Ángel; Gómez-Gutiérrez-Solana, Iván; De-la-Torre-Bulnes, María; Marín-Martínez, María-Eugenia; Molina-González, Domingo; Gadea-Niñoles, María-Esperanza; López-López, Antonia-María; Pelayo-Delgado, Irene; Torrijo-Rodrigo, Cristina; Lara-Peñaranda, Rosario; Palomo-Viciana, María-José; Naveiro-Fuentes, Mariña OBJECTIVE: To evaluate the reproducibility, mid-term efficacy, and safety of transvaginal ultrasound-guided radiofrequency (RF) ablation of uterine fibroids among multiple centers and operators. DESIGN: Prospective multicenter observational study. SETTING: Eleven public and private hospitals in Spain. PATIENTS: A total of 393 women with symptomatic uterine fibroids treated between May 2021 and June 2024. INTERVENTIONS: All procedures were performed using a standardized transvaginal RF ablation protocol (VIVA RF System, STARmed Co.) after formal training of participating gynecologists. MEASUREMENTS AND MAIN RESULTS: Clinical and ultrasonographic data were prospectively collected at baseline, 12, and 24 months. The mean baseline fibroid volume was 35.2 ± 45.0 cm³, decreasing to 12.2 ± 24.2 cm³ at 12 months (65.3% reduction, p<0.05). Symptom Severity Score (SSS) improved from 25.6 ± 7.7 to 15.5 ± 6.0 at 12 months and 14.7 ± 5.6 at 24 months (p<0.05). The overall complication rate was 5%, with 90% classified as Clavien-Dindo I. Smaller initial fibroid volume (??=?-0.18; 95% CI, -0.35 to -0.02; p?=?0.031) and patient age ? 41 years (??=?+14.7; 95% CI, 0.40-29.0; p?=?0.044) were independent predictors of greater volume reduction. Inter-center analysis revealed significant differences only in one hospital, confirming high reproducibility across operators. CONCLUSION: Transvaginal RF ablation is a safe, effective, and reproducible uterus-preserving treatment for symptomatic fibroids. Standardized training and adherence to unified procedural protocols may further optimize outcomes and minimize variability among centers.

Drawing as a learning tool for anatomy: design and implementation of a method

2025-01-28T00:00:00Z

Drawing as a learning tool for anatomy: design and implementation of a method Martínez, Elena; Fernández-Villacañas, Miguel-Ángel; Moreno, María-Matilde; Flores-Funes, Diego

Age- and disease severity-associated changes in the nasopharyngeal microbiota of COVID-19 patients

2025-03-01T00:00:00Z

Age- and disease severity-associated changes in the nasopharyngeal microbiota of COVID-19 patients Perez-Sanz, Fernando; Tyrkalska, Sylwia D.; Alvarez-Santacruz, Carmen; Moreno-Docon, Antonio; Mulero, Victoriano; Cayuela, Maria L.; Candel, Sergio Although many studies have associated changes in the nasopharyngeal microbiota to patient's susceptibility to COVID-19, their results are highly variable and contradictory. Addressing the limitations in previous research responsible for that variability, this study uses 16S rRNA gene sequencing to analyze the nasopharyngeal microbiota of 395 subjects, 117 controls, and 278 COVID-19 patients, of different age groups that cover the entire lifespan and across varying disease severities. This revealed that bacterial alpha diversity decreases progressively throughout life but only in severely ill COVID-19 patients, in whose nasopharynx, moreover, several opportunistic pathogen bacterial genera are overrepresented. Notably, Scardovia wiggsiae appears only in severe COVID-19 patients over 60 years of age, suggesting its potential utility as a COVID-19 severity biomarker in the elderly, who are the most susceptible individuals to suffer from serious forms of the disease. Thus, our results provide valuable insights into age-associated dynamics within nasopharyngeal microbiota during severe COVID-19.

Characterization and anticoagulation treatment patterns of hospitalized patients with nonvalvular atrial fibrillation in Spain: The CARISMA registry

2025-04-01T00:00:00Z

Characterization and anticoagulation treatment patterns of hospitalized patients with nonvalvular atrial fibrillation in Spain: The CARISMA registry Facila, Lorenzo; Cordero, Alberto; Valverde-Tavira, Adrián; Rilo-Miranda, Irene; Laskibar-Asua, Alain; Tirapu, Laia; Montagud, Vicente; Sánchez-Serna, Juan; Gómez-Mariscal, Eloy; Mainar, Luis; Martín-Dorado, Ernesto; Lorenzo, Natalia; Pello-Lazaro, Ana-María; Rodríguez-Manero, Moises BACKGROUND: This study described the clinical and demographic characteristics of hospitalized patients with nonvalvular atrial fibrillation (NVAF) and prescriptions for vitamin-K antagonists (VKA) and direct-acting oral anticoagulants (DOAC) in Spain. METHODS: This was an observational, multicentric, retrospective study of patients treated with DOAC or VKA due to NVAF at cardiology services of hospitals in Spain. A registry (CARISMA) included patients hospitalized for any reason and discharged before July 1st, 2021, with a prescription for DOAC or VKA. Data was collected on demographic and clinical characteristics and anticoagulant treatments prescribed. Analyses were descriptive. RESULTS: A total of 1,041 patients were included. Mean age (SD) was 77.2 (10.3) years and 57.6 % were men. The most frequent reason for hospital admission was heart failure (43.8 %) and arrhythmias (25.0 %). The mean (SD) CHA(2)DS(2)-VASc score was 4.0 (1.6). Prior to admission, 75.6 % of patients had been prescribed anticoagulant treatment for NVAF. Of these, 56.0 % had received VKA and 44.0 % DOAC. At discharge, 60 % had a DOAC prescription (of these, apixaban, 37.6 %; edoxaban, 26.4 %; rivaroxaban, 25.1 %; dabigatran, 10.9 %) and 40 % a VKA. DOAC prescriptions were off-label with respect to dosing in 19-34 % of cases. Patients with off-label dosing were older and with a higher proportion of women than those with on-label doses. During hospitalization, 12.1 % of patients changed treatment, usually VKA to DOAC. CONCLUSION: Before hospitalization, a quarter of patients with NVAF were not receiving anticoagulation medication. Hospitalization increased the proportion of patients receiving DOAC, but about a quarter of patients had off-label dosing prescriptions.