02.04. Área de Salud IV Noroeste

Symptomatic Pheochromocytoma: A Risk Model.

Fri, 06 Feb 2026 00:00:00 GMT

Symptomatic Pheochromocytoma: A Risk Model. Muñoz, María-Consuelo; Febrero, Beatriz; Abellán, Miriam; Rodríguez, José-Manuel Background/Objectives: Pheochromocytoma (PHEO) is increasingly detected incidentally or through genetic screening; however, predictors of symptomatic presentation and its perioperative impact remain unclear. We aimed to quantify the prevalence of symptomatic PHEO, identify associated factors, compare perioperative outcomes, and develop a predictive nomogram. Methods: We retrospectively analyzed patients diagnosed and/or operated on for PHEO at a tertiary referral center between 1984 and 2021. Associations with symptomatic presentation were assessed using univariate and multivariable logistic regression analyses. A nomogram was constructed based on independent predictors and evaluated using receiver operating characteristic (ROC) analysis and the area under the curve (AUC). Results: Among 173 patients (mean age 44.4 ± 15.8 years; 53.2% women), 67.1% were symptomatic. In multivariable analysis, male sex (odds ratio [OR] 0.33; p = 0.023) and the presence of a germline mutation (OR 0.15; p = 0.004) were associated with a lower likelihood of symptoms, whereas a noradrenergic secretion profile was associated with a higher likelihood (OR 12.73; p = 0.02). Symptomatic patients had higher rates of intraoperative (OR 2.60; p = 0.032) and postoperative complications (OR 3.09; p = 0.04). The nomogram incorporating sex, genetic status, and noradrenergic profile demonstrated moderate discrimination (AUC 0.799; 95% confidence interval 0.722-0.877; p < 0.001). Conclusions: Symptomatic PHEO is associated with sex, genetic status, and noradrenergic secretion profile and is linked to increased perioperative morbidity. A simple nomogram based on readily available variables may help estimate individual risk and support perioperative management.

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

Tue, 28 Jan 2025 00:00:00 GMT

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

Pharmacokinetics and Childhood Obesity: Pathophysiological Basis and Challenges in Choosing the Ideal Body Size Descriptor

Sun, 21 Dec 2025 00:00:00 GMT

Pharmacokinetics and Childhood Obesity: Pathophysiological Basis and Challenges in Choosing the Ideal Body Size Descriptor Hernández-Gago, Yolanda; Sánchez-Hernández, José-Germán; Alcalá-Minagorre, Pedro-J; Rodríguez-Marrodan, Belén; Hernández-Sabater, Laura; Cabanas-Poy, María-José; Rodríguez-Negrín, Ana-Cristina Despite the progressive increase in obesity and associated chronic diseases in children, there is limited evidence on the optimal dosage of most medications for obese children and adolescents. This review analyzes the influence of pathophysiological changes on pharmacokinetics and pharmacodynamics and evaluates the body size descriptors used in clinical practice. Patients with obesity present significant pathophysiological alterations, such as a substantial increase in fat/lean mass ratio, increased blood flow and cardiac output, and changes in plasma protein binding, which may affect the volume of distribution of drugs and the adjustment of the loading dose. In these patients, the distribution volume of hydrophilic drugs appears to slightly increase, while it varies widely-depending on the drug and other factors such as affinity for other tissues-for lipophilic drugs. On the other hand, a reduction in tissue perfusion, alterations to liver enzyme activity, and an increase in liver and kidney mass and blood flow have been reported, indicating a possible modification in drug clearance and necessitating adjustments to maintenance regimens. Furthermore, while there are multiple size descriptors, it is difficult to establish a single dosing strategy for the obese population, given the lack of studies confirming the extent of changes in pharmacokinetic processes, which will also depend on the properties of each drug, such as liposolubility and elimination pathways. New strategies need to be developed to characterize pharmacokinetic and pharmacodynamic changes in the obese pediatric population in order to optimize dosing regimens and improve the safety and efficacy of treatments.

Readability of Informed Consent Forms for Medical and Surgical Clinical Procedures: A Systematic Review

Fri, 24 Jan 2025 00:00:00 GMT

Readability of Informed Consent Forms for Medical and Surgical Clinical Procedures: A Systematic Review García-Álvarez, José-Joaquín; García-Sánchez, Alfonso Background/Objectives: The wording of informed consent forms for medical or surgical clinical procedures can be difficult to read and comprehend, making it difficult for patients to make decisions. The objective of this study was to analyze the readability of informed consent forms for medical or surgical clinical procedures. Methods: A systematic review was performed according to the PRISMA statement using PubMed, Embase, and Google Scholar databases. Primary studies analyzing the readability of informed consent forms using mathematical formulas published in any country or language during the last 10 years were selected. The results were synthesized according to the degree of reading difficulty to allow for the comparison of the studies. Study selection was performed independently by the reviewers to avoid the risk of selection bias. Results: Of the 664 studies identified, 26 studies were selected that analyzed the legibility of 13,940 forms. Of these forms, 76.3% had poor readability. Of the six languages analyzed, only English, Spanish, and Turkish had adapted readability indexes. Flesch Reading Ease was the most widely used readability index, although it would be more reliable to use language-specific indices. Conclusions: Most of the analyzed informed consent forms had poor readability, which made them difficult for a large percentage of patients to read and comprehend. It is necessary to modify these forms to make them easier to read and comprehend, to adapt them to each specific language, and to carry out qualitative studies to find out the real legibility of each specific population.