Browsing by Author "Martín Moreno, José María"

Background: Minimally invasive surgery (MIS) is the standard method for resection of colorectal cancer, but its indications have limitations that are constantly debated. In our study, the center had to meet the following four factors: surgeons should have considerable experience, there should be a high percentage of MIS, a low conversion rate, and good results in the intervention. Methods: Retrospective observational study of a cohort of 948 patients with colorectal cancer who underwent scheduled open surgery (OS) and MIS between 2011-2016. Results: There were no differences based on sex, body mass index, or location of the tumor, but OS was related to older age, higher ASA, a higher stage, previous surgery, and operative adverse events. The location of the primary tumor and the existence of synchronous tumors were related to variability in the technique. The implementation of MIS increased from 36.2% in 2011 to 89.6% in 2016. The surgeon's experience decreased the conversion rate from 6.5% in 2011 to 3.1% in 2016, with 2% in T0-2 tumors. In logistic regression, the factor that most increased the possibility of choosing MIS was the pT grade of the tumor, and the factors that most contraindicated MIS were stages 2-4, ASA 4, stage 1, previous surgery, and advanced age. Conclusions: In hospitals where surgeons have long experience, minimally invasive surgery could be implemented in up to 90% of cases, with low conversion rates (3-4%) and good results for patients.

Background: Forecasting the behavior of epidemic outbreaks is vital in public health. This makes it possible to anticipate the planning and organization of the health system, as well as possible restrictive or preventive measures. During the COVID-19 pandemic, this need for prediction has been crucial. This paper attempts to characterize the alternative models that were applied in the first wave of this pandemic context, trying to shed light that could help to understand them for future practical applications. Methods: A systematic literature search was performed in standardized bibliographic repertoires, using keywords and Boolean operators to refine the findings, and selecting articles according to the main PRISMA 2020 statement recommendations. Results: After identifying models used throughout the first wave of this pandemic (between March and June 2020), we begin by examining standard data-driven epidemiological models, including studies applying models such as SIR (Susceptible-Infected-Recovered), SQUIDER, SEIR, time-dependent SIR, and other alternatives. For data-driven methods, we identify experiences using autoregressive integrated moving average (ARIMA), evolutionary genetic programming machine learning, short-term memory (LSTM), and global epidemic and mobility models. Conclusions: The COVID-19 pandemic has led to intensive and evolving use of alternative infectious disease prediction models. At this point it is not easy to decide which prediction method is the best in a generic way. Moreover, although models such as the LSTM emerge as remarkably versatile and useful, the practical applicability of the alternatives depends on the specific context of the underlying variable and on the information of the target to be prioritized. In addition, the robustness of the assessment is conditioned by heterogeneity in the quality of information sources and differences in the characteristics of disease control interventions. Further comprehensive comparison of the performance of models in comparable situations, assessing their predictive validity, is needed. This will help determine the most reliable and practical methods for application in future outbreaks and eventual pandemics.

Diverticulitis and hemorrhoidal proctitis in the population are significant public health problems. We studied the potential association between the intake of certain plant foods and diverticulitis or hemorrhoidal episodes through a case–control study including 410 cases and 401 controls. We used a semiquantitative food frequency questionnaire. The intake was additionally quantified according to a 24 h recall. The plant foods or derived food products were categorized by their main chemical components into ethanol, caffeine/theine/theobromine, capsaicin, alliin, acids, eugenol, and miscellaneous foods such as curcumin. The mean score for overall intake of plant foods under consideration was 6.3 points, and this was significantly higher in cases (8.5) than in controls (4.1). Overall intake was similar in cases presenting with diverticulitis or hemorrhoidal proctitis. Cases had 13 times the odds of being in the upper quartile for overall intake (>7 points), compared to controls. Explanatory logistic regression models showed that the strongest association with diverticulitis and hemorrhoidal proctitis was shown by the chemical food group of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids. Neither alliin nor miscellaneous food groups showed any association. High, frequent consumption of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids increase the risk of diverticulitis and hemorrhoidal proctitis.

Diverticulitis and hemorrhoidal proctitis in the population are significant public health problems. We studied the potential association between the intake of certain plant foods and diverticulitis or hemorrhoidal episodes through a case–control study including 410 cases and 401 controls. We used a semiquantitative food frequency questionnaire. The intake was additionally quantified according to a 24 h recall. The plant foods or derived food products were categorized by their main chemical components into ethanol, caffeine/theine/theobromine, capsaicin, alliin, acids, eugenol, and miscellaneous foods such as curcumin. The mean score for overall intake of plant foods under consideration was 6.3 points, and this was significantly higher in cases (8.5) than in controls (4.1). Overall intake was similar in cases presenting with diverticulitis or hemorrhoidal proctitis. Cases had 13 times the odds of being in the upper quartile for overall intake (>7 points), compared to controls. Explanatory logistic regression models showed that the strongest association with diverticulitis and hemorrhoidal proctitis was shown by the chemical food group of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids. Neither alliin nor miscellaneous food groups showed any association. High, frequent consumption of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids increase the risk of diverticulitis and hemorrhoidal proctitis.