02.04.01. Investigación y comunicación científica

The use of immersive technologies in learning about postpartum hemorrhage: Protocol for a systematic review and meta-analysis

Thu, 18 Jun 2026 00:00:00 GMT

The use of immersive technologies in learning about postpartum hemorrhage: Protocol for a systematic review and meta-analysis Montiel-Bravo, María-José; Ferrandini-Price, Mariana; Pardo-Ríos, Manuel; Sánchez-Gómez, Marina; Piuvezam, Grasiela; Silva-de-Medeiros, Gidyenne-Christine-Bandeira; López-López, Carmen-Amalia Postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality worldwide, and its proper management requires both technical and non-technical skills. This study describes the protocol for a systematic review evaluating the effectiveness of immersive technologies in training healthcare professionals in the management of this obstetric emergency. This protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD420250614446). The search will be performed in the following databases: PubMed, Embase, Scopus, ScienceDirect, Web of Science, Cochrane Library, LILACS, Enfispo and CUIDEN. Intervention studies (clinical trials - randomized or non-randomized) and quasi-experimental studies will be included. The risk of bias will be assessed using appropriate tools according to study design: the Risk of Bias 2 (ROB 2) tool for randomized controlled trials and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for non-randomized and quasi-experimental studies. Two independent researchers will conduct all assessments, and any disagreements will be consulted with a third reviewer. The data analysis and synthesis will be performed using Review Manager software version 5.4. We will conduct the study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. The review will summarize the current evidence on the use of virtual reality, augmented reality, and mixed reality in education and training for postpartum hemorrhage management. The planned systematic review will identify and synthesize the available evidence on how immersive technologies may improve learning about postpartum hemorrhage.

Nationwide Implementation of Double Reflex Testing for Hepatitis Delta in Spain: Results From the Retrospective Phase of the Spain-DDR Study

Fri, 01 May 2026 00:00:00 GMT

Nationwide Implementation of Double Reflex Testing for Hepatitis Delta in Spain: Results From the Retrospective Phase of the Spain-DDR Study Alberola, Ana; De-Salazar, Adolfo; Fuentes, Ana; Carracedo, Raquel; Illescas-lopez, Marta; Rodríguez-Baños, María-del-Carmen; Freyre, Carolina; Becerril, Berta; Viciana, Isabel; López-rodriguez, Inmaculada; Montiel, Natalia; Domínguez-Castaño, Ana-María; Luzón-García, María-Pilar; Ramírez-Arellano, Encarnación; Liébana-martos, Carmen; Franco-Álvarez-de-Luna, Francisco; Lozano, María-del-Carmen; Palop, Begona; Sampedro, Antonio; Pérez, Ana-Belén; Algarate, Sonia; Rojo-Alba, Susana; Fraile, Pablo; Ocete, Dolores; Alcaraz, María-Jesús; Rodríguez, Juan-Carlos; Hernández-Felices, Francisco-Javier; Martínez, Olalla; Domínguez, Victoria; Orta, Nieves; Gómez, Dolores; Cortell, Carmen; Camacho, Jorge; Sabater, Susana; Iglesias-Sánchez, Luis-Ángel; Martin, Yasmina; Vallejo, Aldara; Molina, Lourdes; Aroca, María; Castro, Beatriz; Lara, Magdalena; Pena, María-José; Rodríguez-fernández, Ana; González-Praetorius, Alejandro; Blas, José-Joaquín; Beteta, Alicia; Gómez, Cesar; Rodríguez, María-José; Illescas, Soledad; Abreu, Melanie; García-Díez, Julio; Beltran, Inocencio; Sandoval-Torrientes, Marta; Sáez, Ruth; Martín, Teresa; Tajada-Alegre, Pilar; Lorenzo, Belén; García-Valero, María-Teresa; Jiménez-Sansegundo, Isabel; García-de-Cruz, Susana; Garcinuno, Sonsoles; Saiz, Miguel-Ángel; Muñoz, Santiago; Fernández, Isabel; Lorenzo-Juanes, Helena-Miriam; Vidal-Acuña, María-Reyes; Moldes, Luz-María; Calvo, Noelia; Trigo, Matilde; Gude, María-José; Ordonez, Patricia; Cortizo, Sandra; Blasco, Miriam; Sigcha, Mayra; Falcés, Iker; Galan, Juan-Carlos; Arribi, Ana; Alonso, Roberto; Iborra-Bendicho, María-Asunción; del-Amor-Espín, María-Jesús; Cascales-Alcolea, Eva; Pérez-Pardo, Cayetano; Fernández, Pablo; Navarro-Martínez, María-Dolores; Núñez-Trigueros, María-Luz; Galán-Ros, Jorge; Gil-gallardo, Luis-Javier; Miqueleiz, Ana; Reina, Gabriel; Elorduy, Luis; Macho, Mikele; Gómez, Carmen; Liendo, Paloma; Salicio, Yolanda; Aguilera, Antonio; García, Federico BACKGROUND: Hepatitis delta virus accelerates liver disease progression in chronic hepatitis B, yet remains underdiagnosed. Guidelines recommend double reflex diagnostic testing with antibody testing followed by viral load testing, but uptake remains inconsistent. AIMS: To evaluate double reflex diagnostic implementation in Spain during the retrospective phase of the Spain Double Reflex Diagnostic study. METHODS: Nationwide, multicenter retrospective analysis of individuals positive for hepatitis B surface antigen (2022-2024) from 80 centers. Laboratory data included hepatitis B surface antigen, hepatitis delta virus antibody and hepatitis delta virus viral load. Uptake rates, hepatitis delta virus antibody positivity, viral load confirmation and viral load-confirmed prevalence were calculated with 95% confidence intervals. RESULTS: Among 65,763 individuals positive for hepatitis B surface antigen, hepatitis delta virus antibody testing uptake increased from 55.1% (54.4-55.8) in 2022 (n = 18,986) to 72.5% (71.9-73.1) in 2023 (n = 22,463) and 85.8% (85.1-86.4) in 2024 (n = 24,314; p < 0.0001). Antibody positivity remained stable (5.6%, 4.9%, 5.3%). Viral load confirmation among antibody-positive patients improved from 72.6% in 2022 to 90.8% in 2023 and 91.0% in 2024. Viral load-confirmed prevalence among antibody-positive individuals was 40.3% in 2022, 31.6% in 2023, and 30.1% in 2024. Regional heterogeneity was marked, with several autonomous communities achieving near-universal uptake (> 95%). CONCLUSION: Between 2022 and 2024, double reflex diagnostic implementation expanded rapidly, demonstrating national feasibility and describing hepatitis D virus seroprevalence. However, regional inequities persist. Sustained uptake will require standardised reflex protocols, harmonization of viral load assays and continuous training to reduce underdiagnosis and improve care of coinfected patients.

Rotura espontánea de hemangioma hepático no conocido

Fri, 01 Jan 2016 00:00:00 GMT

Rotura espontánea de hemangioma hepático no conocido Guillén-Paredes, María-Pilar; Martínez-Fernández, Josefa; Morales-González, Álvaro; Pardo-García, José-Luis La rotura espontánea de un hemangioma hepática es un hecho realmente infrecuente, aunque de extrema gravedad pues conlleva una mortalidad cercana al 75% por el shock hipovolémico que produce. Presentamos un caso de rotura espontánea de un hemangioma hepático que no era conocido previamente.

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.