Rios Zambudio, Antonio

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Rios Zambudio, Antonio

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Rios Zambudio, Antonio

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Universidad de Murcia. Departamento de Cirugía, Pediatría, Obstetriciay Ginecología

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Controversias en el bocio multinodular, 1, factores de génesis del bocio multinodular, estudio genético mediante HLA-C, 2, estudio prospectivo de las complicaciones postoperatorias tras la tiroidectomía total en el bocio multinodular por cirujanos / Antonio Ríos Zambudio ; dirección Pascual Parrilla Aparicio, José Manuel Rodriguez González.
(Murcia : Universidad, Facultad de Medicina, Departamento de Cirugía, Pediatría, Ginecología y Obstetricia,, 2002) Rios Zambudio, Antonio
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Student nurses at Spanish universities and their attitude toward xenotransplantation
(Wiley, 2019-05) Martinez Alarcon, Laura; Santainés-Borreda, Elena; Parrilla, Pascual; Ramírez, Pablo (Ramírez Romero); Rios Zambudio, Antonio; Cirugía, Pediatría y Obstetricia y Ginecología
Abstract Introduction: Recent immunological and transgenic advances are a promising alternative using limited materials of human origin for transplantation. However, it is essential to achieve social acceptance of this therapy. Objective: To analyze the attitude of nursing students from Spanish universities toward organ xenotransplantation (XTx) and to determine the factors affecting their attitude. Materials and methods: Type of study: A sociological, multicentre, and observational study. Study population: Nursing students enrolled in Spain (n = 28,000). Sample size: A sample of 10 566 students estimating a proportion of 76% (99% confidence and precision of ±1%), stratified by geographical area and year of study. Instrument of measurement: A validated questionnaire (PCID‐XenoTx‐RIOS) was handed out to every student in a compulsory session. This survey was self‐administered and selfcompleted voluntarily and anonymously by each student in a period of 5‐10 min. Statistical analysis: descriptive analysis, Student's t test, the chi‐square test, and a logistic regression analysis. Results: A completion rate: 84% (n = 8913) was obtained. If the results of XTx were as good as in human donation, 74% (n = 6564) would be in favor and 22% (n = 1946) would have doubts. The following variables affected this attitude: age (P < 0.001); sex (P < 0.001); geographical location (P < 0.001); academic year of study (P < 0.001); attitude toward organ donation (P < 0.001); belief in the possibility of needing a transplant (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); and the opinion of one's partner (P < 0.001). The following variables persisted in the multivariate analysis: being a male (OR = 1.436; P < 0.001); geographical location (OR = 1.937; P < 0.001); an attitude in favor of donation (OR = 1.519; P < 0.001); belief in the possibility of needing a transplant (OR = 1.497; P = 0.036); and having spoken about the issue with family (OR = 1.351; P < 0.001) or friends (OR = 1.240; P = 0.001). Conclusions: The attitude of nursing students toward organ XTx is favorable and is associated with factors of general knowledge about organ donation and transplantation and social interaction.
Open Access
Endothelial cell activation mediated by cold ischemia-released mitochondria is partially inhibited by defibrotide and impacts on early allograft function following liver transplantation
(Elsevier, 2023-09-18) Villalba-Lopez, Francisco; Mateo, Sandra V.; Vidal-Correoso, Daniel; Jover-Aguilar, Marta; Martínez-Alarcón, Laura; López-López, Víctor; Pons Miñano, José Antonio; Baroja-Mazo, Alberto; García Bernal, David; Pelegrín Vivancos, Pablo; Alconchel Gago, Felipe; Cascales Campos, Pedro Antonio; Ramírez, Pablo (Ramírez Romero); Rios Zambudio, Antonio; Medicina
DAMPs (danger-associated molecular patterns) are self-molecules of the organism that appear after damage. The endothelium plays several roles in organ rejection, such as presenting alloantigens to T cells and contributing to the development of inflammation and thrombosis. This study aimed to assess whether DAMPs present in the organ preservation solution (OPS) after cold ischemic storage (CIS) contribute to exacerbating the endothelial response to an inflammatory challenge and whether defibrotide treatment could counteract this effect. The activation of cultured human umbilical vein endothelial cells (HUVECs) was analyzed after challenging with endischemic OPS (eiOPS) obtained after CIS. Additionally, transwell assays were performed to study the ability of eiOPS to attract lymphocytes across the endothelium. The study revealed that eiOPS upregulated the expression of MCP-1 and IL-6 in HUVECs. Moreover, eiOPS increased the membrane expression of ICAM-1and HLA-DR, which facilitated leukocyte migration toward a chemokine gradient. Furthermore, eiOPS demonstrated its chemoattractant ability. This activation was mediated by free mitochondria. Defibrotide was found to partially inhibit the eiOPS-mediated activation. Moreover, the eiOPS-mediated activation of endothelial cells (ECs) correlated with early allograft dysfunction in liver transplant patients. Our finding provide support for the hypothesis that mitochondria released during cold ischemia could trigger EC activation, leading to complications in graft outcomes. Therefore, the analysis and quantification of free mitochondria in the eiOPS samples obtained after CIS could provide a predictive value for monitoring the progression of transplantation. Moreover, defibrotide emerges as a promising therapeutic agent to mitigate the damage induced by ischemia in donated organs.
Open Access
Danger signals released during cold ischemia storage activate NLRP3 inflammasome in myeloid cells and influence early allograft function in liver transplantation
(Elsevier, 2022-12-19) Lucas-Ruiz, Fernando; Mateo, Sandra V.; Jover-Aguilar, Marta; Martínez-Alarcón, Laura; Torre-Minguela, Carlos de; Vidal-Correoso, Daniel; Villalva-López, Francisco; López-López, Víctor; Pons Miñano, José Antonio; Baroja-Mazo, Alberto; Pelegrín Vivancos, Pablo; Alconchel Gago, Felipe; Ramírez, Pablo (Ramírez Romero); Rios Zambudio, Antonio; Medicina
Background Innate immunity plays a fundamental role in solid organ transplantation. Myeloid cells can sense danger signals or DAMPs released after tissue or cell damage, such as during ischemia processes. This study aimed to identify DAMPs released during cold ischemia storage of human liver and analyze their ability to activate the inflammasome in myeloid cells and the possible implications in terms of short-term outcomes of liver transplantation. Methods 79 samples of organ preservation solution (OPS) from 79 deceased donors were collected after cold static storage. We used different analytical methods to measure DAMPs in these end-ischemic OPS (eiOPS) samples. We also used eiOPS in the human macrophage THP-1 cell line and primary monocyte cultures to study inflammasome activation. Findings Different DAMPs were identified in eiOPS, several of which induced both priming and activation of the NLRP3 inflammasome in human myeloid cells. Cold ischemia time and donation after circulatory death negatively influenced the DAMP signature. Moreover, the presence of oligomeric inflammasomes and interleukin-18 in eiOPS correlated with early allograft dysfunction in liver transplant patients. Interpretation DAMPs released during cold ischemia storage prime and activate the NLRP3 inflammasome in liver macrophages after transplantation, inducing a pro-inflammatory environment that will complicate the outcome of the graft. The use of pharmacological blockers targeting DAMPs or the NLRP3 inflammasome in liver ischemia during static cold storage or through extracorporeal organ support could be a suitable strategy to increase the success of liver transplantation.
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Cell-specific extracellular vesicles and their miRNA cargo released Into the organ preservations solution during cold ischemia storage as biomarkers for liver transplant outcomes
(Lippincott, Williams & Wilkins, 2024-10) Vidal-Correoso, Daniel; Mateo, Sandra V.; Muñoz-Morales, Ana M.; Lucas-Ruiz, Fernando; Jover-Aguilar, Marta; Martinez-Alarcon, Laura; Sanchez-Redondo, Sara; Santos, Vanesa; Lopez-Lopez, Victor; Pons Miñano, José Antonio; Peinado, Hector; Baroja-Mazo, Alberto; Pelegrín Vivancos, Pablo; Alconchel Gago, Felipe; Cascales Campos, Pedro Antonio; Ramírez, Pablo (Ramírez Romero); Rios Zambudio, Antonio; Medicina
Background. Liver transplantation (LT) is crucial for end-stage liver disease patients, but organ shortages persist. Donation after circulatory death (DCD) aims to broaden the donor pool but presents challenges. Complications like acute rejection, hepatic artery thrombosis, and biliary issues still impact posttransplant prognosis. Biomarkers, including extracellular vesicles (EVs) and microRNAs (miRNAs), show promise in understanding and monitoring posttransplant events. This study explores the role of EVs and their miRNA cargo in LT, including their potential as diagnostic tools. Methods. EVs from intrahepatic end-ischemic organ preservation solution (eiOPS) in 79 donated livers were detected using different techniques (nanosight tracking analysis, transmission electron microscopy, and flow cytometry). EV-derived miRNAs were identified by quantitative real time-polymerase chain reaction. Bioinformatics analysis was performed using the R platform. Results. Differentsized and origin-specific EVs were found in eiOPS, with significantly higher concentrations in DCD compared with donation after brain death organs. Additionally, several EV-associated miRNAs, including let-7d-5p, miR-28-5p, miR-200a-3p, miR- 200b-3p, miR-200c-3p, and miR-429, were overexpressed in DCD-derived eiOPS. These miRNAs also exhibited differential expression patterns in liver tissue biopsies. Pathway analysis revealed enrichment in signaling pathways involved in extracellular matrix organization and various cellular processes. Moreover, specific EVs and miRNAs correlated with clinical outcomes, including survival and early allograft dysfunction. A predictive model combining biomarkers and clinical variables showed promise in acute rejection detection after LT. Conclusions. These findings provide new insights into the use of EVs and miRNAs as biomarkers and their possible influence on posttransplantation outcomes, potentially contributing to improved diagnostic approaches and personalized treatment strategies in LT.
Open Access
Neoplasias primarias del timo de estirpe no linfoide. Estudio de 58 casos
(Elsevier, 2004) Torres Lanzas, Juan; Galindo Fernández, Pedro José; Roca Calvo, María José; Alonso-Romero, José Luis; Sola Pérez, Joaquín; Parrilla Paricio, Pascual; Rios Zambudio, Antonio; Medicina
Fundamento y objetivo: Los tumores primarios del timo de estirpe no linfoide son infrecuentes, aunque presentan una gran variedad. El objetivo de este trabajo es identificar las variables clínicas, terapéuticas e histológicas que tienen valor pronóstico. Pacientes y método: Se estudiaron 58 tumores primarios del timo de estirpe no linfoide que correspondieron a 52 neoplasias epiteliales (NEPT) (90%), 4 timolipomas (7%) y 2 tumores neuroendocrinos(3%). La clínica más frecuente fue la miastenia grave (41%) y la disnea (21%).Cabe destacar la presencia de 13 pacientes asintomáticos (24%). Para el análisis estadístico se utilizaron las curvas de supervivencia de Kaplan-Meier y el modelo de regresión de Cox. Resultados: Se intervino a todos los pacientes con timectomía, excepto en 4 casos en que se efectuó una biopsia. La mortalidad perioperatoria fue del 3% (n = 2) y la morbilidad, del 31%(n = 18), principalmente por afecciones respiratorias y de la herida. Se administró tratamiento adyuvante con quimioterapia y/o radioterapia en las 24 NEPT grados de Masaoka III y IV, y en el carcinoma linfoepitelial. Con un seguimiento medio (DE) de 13 (5) años, fallecieron 12 pacientes con NEPT y 1 con un tumor neuroendocrino, debido a evolución de la enfermedad. La supervivencia acumulada fue del 80% a los 5 años, del 71% a los 7 años y del 63% a los 10años. Actualmente existen 2 recidivas locales en 2 NEPT, tras 9 y 8 años de seguimiento, respectivamente. Los principales factores pronósticos son el tipo y subtipo histológicos, así como el estadio clínico (p < 0,001). Conclusiones: El diagnóstico precoz en los tumores primarios del timo de estirpe no linfoide es fundamental para instaurar un tratamiento correcto antes de que presenten un estadio clínico más avanzado. Los principales factores pronósticos son el tipo y subtipo histológicos, así como el estadio clínico.
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Linfomas primarios del timo
(Elsevier, 2006-07) Torres, J.; Roca, M.J.; Galindo, P.J.; Alonso-Romero, José Luis; Parrilla, P.; Rios Zambudio, Antonio; Medicina
Introducción. Los linfomas primarios tímicos (LPT) son infrecuentes, pero su pronóstico va ligado a un tratamiento precoz. Se realiza una revisión de esta patología en nuestro hospital con el objetivo de determinar cuál es el mejor manejo diagnóstico-terapéutico en estos pacientes. Material y métodos. Se revisan diez LPT, cuatro Hodgkin y seis no Hodgkin (4 linfomas primarios mediastínicos B [LPMB] y 2 linfomas linfoblásticos T [LLT]). La edad media fue de 23 ± 10 años, siendo la mayoría mujeres. Resultados. En los linfomas de Hodgkin la sospecha diagnóstica inicial fue de timoma en dos casos y de linfoma en los dos restantes. Todos fueron intervenidos, realizándose una biopsia intraoperatoria, completándose con una timectomía en los dos que informó de timoma. Se trataron con radioquimioterapia. En dos casos la respuesta fue parcial, completándose el tratamiento con un trasplante de médula ósea (TMO) (uno fue éxitus, y el otro presenta enfermedad activa). Los linfomas no Hodgkin (LNH) presentaban grandes tumoraciones y una evolución corta. Todos fueron intervenidos, realizándose en cuatro una biopsia y en dos una timectomía. Se trataron con quimioterapia, asociándose en dos radioterapia. La respuesta fue total en tres, recidivando dos, que tras TMO están en remisión completa. En los tres restantes la respuesta fue parcial. Conclusiones. Ante un paciente con tumoración tímica sugestiva por el estudio preoperatorio o intraoperatorio de linfoma debe realizarse una biopsia quirúrgica y no cirugía resectiva para evitar resecciones y morbilidad quirúrgica innecesaria. Los LPT son infrecuentes pero agresivos, sobre todo los LNH, siendo su principal tratamiento la radioquimioterapia, asociada a TMO en casos seleccionados.
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Acoustic radiation force impulse imaging for evaluation of the thyroid gland
(Wiley, 2014-06-01) Cepero Calvete, Ángela; Berná Mestre, Juan de Dios; Sáez Martinez, Elena; Torregrosa Sala, Begoña; Rios Zambudio, Antonio; Rodríguez González, José Manuel; Dermatología, Estomatología, Radiología y Medicina Física
To study acoustic radiation force impulse (ARFI) imaging as a new quantitative and noninvasive tool for evaluating thyroid nodules and to compare ARFI imaging with other tools for studying thyroid nodules: sonography, real-time elastography, and fine-needle aspiration biopsy. We conducted a prospective study from June 2011 to June 2012, which analyzed 157 thyroid nodules (129 benign and 28 malignant) using the ARFI technique and a 9-MHz probe. Shear wave velocities (SWVs) were obtained while the patients held their breath to avoid respiratory movement artifacts. All nodules underwent conventional sonography and real-time elastography of the thyroid gland. All patients received either a cytologic examination using fine-needle aspiration biopsy or a histologic examination from thyroid surgery to verify the diagnosis (reference standard). The mean SWV ± SD on ARFI imaging in healthy, nodule-free thyroid glands was 2.04 ± 0.51 m/s (range, 0.76–3.63 m/s). The mean SWV in benign thyroid nodules was 1.70 ± 0.55 m/s (range, 0.50–2.80 m/s), and the mean SWV in malignant nodules was 3.39 ± 1.15 m/s (range, 1.50–6.08 m/s). When we used an SWV greater than 2.50 m/s for the diagnosis of malignant nodules and less than 2.50 m/s for the diagnosis of benign nodules, the sensitivity and specificity of ARFI imaging were 85.7% and 96.0%, respectively. We found that SWVs were substantially higher in malignant nodules than benign ones. Perhaps if ARFI imaging is used in conjunction with sonographic findings and patient demographics, it will be possible to find a combination of factors that would yield a negative predictive value high enough to distinguish benign from malignant nodules with confidence, which may lead to a decrease in the biopsy rate for benign nodules.
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Interobserver agreement for thyroid elastography. Value of the quality factor
(Wiley, 2013-03-01) Cepero Calvete, Angela; Berná Mestre, Juan de Dios; Abellán Rivero, Delores; Reus Pintado, Manuel; Rios Zambudio, Antonio; Rodríguez González, José Manuel; Dermatología, Estomatología, Radiología y Medicina Física
Objectives—The purpose of our study was to investigate interobserver agreement for thyroid ultrasound elastography and to analyze the reproducibility of real-time free hand elastography in thyroid nodules. Methods—A prospective nonrandomized double-blind study was conducted between September 2008 and June 2010. Real-time elastography of 89 thyroid nodules was performed by two radiologists, with the first radiologist evaluating each thyroid nodule 5 minutes before the second. The elastograms were obtained with the patients holding their breath and considered valid when the quality factor was 50 or higher. The region of interest was positioned to include the nodule and 0.5 cm of surrounding normal thyroid parenchyma but to exclude the carotids and esophageal-tracheal structures. The elastograms were classified on a scale of 5 different patterns. Results—Observers 1 and 2 coincided in 79 elastographic patterns and disagreed on 10 nodules (11.2%). The results between the radiologists had a statistically significant agreement (P < .005), with a κ value of 0.838. Conclusions—The introduction of a quality factor in elastographic software and the selection of elastograms with a quality factor of 50 or higher confer almost perfect interobserver agreement for thyroid nodule elastography and make elastography a reproducible technique that could be used in daily clinical practice.
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Controlled donation after circulatory death up to 80 years for liver transplantation: Pushing the limit again
(Wiley, 2019-07-22) Ferreras, David; Royo-Villanova, Mario; Martínez, María; Fernández-Hernández, Juan Á.; Pons, José A.; Martínez-Barba, Enrique; Martínez-Alarcón, Laura; Parrilla, Pascual; Alconchel Gago, Felipe; Cascales Campos, Pedro Antonio; Febrero Sánchez, Beatriz; Ramírez, Pablo (Ramírez Romero); Rios Zambudio, Antonio; Robles Campos, Ricardo; Rodríguez González, José Manuel; Sánchez Bueno, Francisco; Cirugía, Pediatría y Obstetricia y Ginecología
Nuestro principal objetivo fue comparar los resultados del trasplante hepático (TH) entre la donación tras muerte circulatoria (DCD) y la donación tras muerte encefálica (DBD) en nuestro hospital y analizar, dentro del grupo DCD, la influencia de la edad en los resultados obtenidos con DCD Donantes mayores de 70 años y hasta 80 años. Todos los trasplantes con donantes DCD realizados se analizaron prospectivamente. Los resultados del grupo DCD se compararon con los de un grupo de control que recibió un trasplante con donante DBD inmediatamente después de cada DCD-LT. Posteriormente, se analizaron los resultados obtenidos dentro del grupo DCD según la edad de los donantes, considerando 2 subgrupos con punto de corte a los 70 años. Los resultados de supervivencia para TH con DCD y recuperación súperrápida no fueron inferiores a los obtenidos en un grupo similar de pacientes trasplantados con hígados DBD. Sin embargo, el costo del trasplante con donante DCD fue una mayor tasa de complicaciones biliares, incluida la colangiopatía isquémica. La edad del donante no fue un factor negativo para la supervivencia del paciente. Se trata de una publicación multidisciplinar en la que se trabajó con los servicio de Cirugía, UCI, Medicina del Aparato Digestivo y la Coordinación de trasplantes del hospital.