Publications by authors named "Fontdevila J"

Introduction: Different vessel diameters may challenge the completion of a high-quality anastomosis in microsurgery. In clinical practice, discrepancies in vessel size are commonly encountered. These variations can range from small to moderate, and microsurgeons typically employ established techniques, such as dilating the smaller vessel or creating an oblique cut in its wall, to address these differences.

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Our group has developed a new nitinol endoluminal self-expandable device for microvascular anastomosis. It attaches to each vessel ending with opposite directed microspikes and reaches complete expansion at body temperature, using the nitinol shape memory capacity. The main purpose of this first in vivo trial is to evaluate the mechanical viability of the device and its immediate and early functionality.

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Background: Clinical examination remains the cornerstone for postoperative monitoring of free flaps but is highly dependent on the surgeon's ability and experience. Duplex echography provides a noninvasive objective evaluation of tissue perfusion. The authors hypothesized that duplex echography may be a more sensitive and specific monitoring method for early detection of postoperative flap compromise compared to clinical examination alone.

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Nasal amputation and nasomaxillary defects, need to reconstruct the internal lining, osteochondral structure, and external coating of the nose. Authors report a 70-year-old male and a 65-year-old female treated for nasomaxillary defects (Brown JS, Shaw RJ. The Lancet Oncology 2010;11:1001-1008) due to squamous cell carcinoma (SCC) where the tip of the nose was preserved.

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Background: Among the various steps of a penile inversion feminizing genitoplasty, reconstruction of the clitoris and labia minora remains the most challenging procedure.

Aim: This study aims to evaluate surgical outcomes of neoclitoroplasty performed before and after the introduction of the labia minora's creation in our surgical technique.

Methods: A retrospective analysis was carried out comparing 2 groups of patients that underwent penile inversion feminizing surgery: group A (64 patients) who had labia minora and clitoral hood creation and group B (103 patients) who did not.

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Background: The tuberous breast syndrome is a condition that affects young women and can bring on serious disorders of self-esteem. There are numerous surgical techniques to correct this condition, but most of them include the use of breast implants to replace lack of volume. Nowadays, patients are increasingly becoming more demanding to get a definitive solution with minimal aesthetic sequelae.

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Background: Lipofilling use has become a revolutionary technique for the correction of breast defect including breast cancer sequelae. The potential risk that progenitor cells included in fat graft tissue may contribute to disease progression by stimulation of residuary breast cancer cells in a tumor bed has set alarms regarding its safety. The aim of this study was to identify lipofilling interference over breast recurrence in patients with cancer history.

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Objective: To assess whether changes in antiretroviral drugs other than thymidine nucleoside reverse transcriptase inhibitors (NRTI) may have a body fat impact in HIV-infected patients with lipoatrophy.

Methods: Ninety-six-week phase IV, open-label, multicentre, pilot randomized trial. HIV-infected patients with moderate/severe lipoatrophy at one or more body sites despite long-term thymidine NRTI-free therapy were randomized to continue their efavirenz (EFV)-based antiretroviral regimen or to switch from EFV to lopinavir/ritonavir (LPV/r).

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Introduction: Lipofilling has become a widely used procedure in breast reconstruction after mastectomy or breast-conserving treatment. The possibility that this technique may increase stimulation of cancer development between the potential tumor bed and the lipoaspirates grafts has been raised regarding its safety. The aim of this study was to identify the oncological risks associated with this procedure in our institution.

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Highly active antiretroviral therapy has remarkably improved quality of life of HIV-1-infected patients. However, this treatment has been associated with the so-called lipodystrophic syndrome, which conveys a number of adverse metabolic effects and morphological alterations. Among them, lipoatrophy of subcutaneous fat in certain anatomical areas and hypertrophy of visceral depots are the most common.

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Background: Patients with male-to-female gender dysphoria (GD) require multidisciplinary assessment and management. Nowadays, more and more patients decide to undergo genital reassignment surgery (GRS) to have aesthetic and functional external female genitalia. Different techniques of this procedure have been described.

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Gene expression studies of subcutaneous adipose tissue may help to better understand the mechanisms behind body fat changes in HIV-infected patients who initiate antiretroviral therapy (ART). Here, we evaluated early changes in adipose tissue gene expression and their relationship to fat changes in ART-naive HIV-infected patients randomly assigned to initiate therapy with emtricitabine/tenofovir plus efavirenz (EFV) or ritonavir-boosted lopinavir (LPV/r). Patients had abdominal subcutaneous adipose tissue biopsies at baseline and week 16 and dual-energy-X-ray absorptiometry at baseline and weeks 16 and 48.

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Background: This work evaluates the effect of adding platelet-derived growth factor to autologous adipose tissue grafts in the treatment of human immunodeficiency virus facial lipoatrophy by means of objective measurements.

Methods: This is a randomized clinical trial conducted at the Hospital Clinic of Barcelona. Patients with facial human immunodeficiency virus atrophy were randomized into two groups, one treated with autologous fat injection (group A), and another treated with autologous fat injection with plasma rich in growth factors (group B).

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Background: Facial lipoatrophy, a common alteration among HIV-1-infected, antiretroviral-treated patients, is often corrected using autologous transplantation. In some cases, especially when enlarged adipose tissue from the dorso-cervical area (that is, a 'buffalo hump') is used as a source of fat for transplantation, the transplanted fat develops progressive hypertrophy. To gain insight into the molecular basis of this phenomenon, we evaluated the cell morphology and gene expression in this hypertrophied facial fat.

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Background: Autologous fat grafting has many clinical applications, and its use in Plastic Surgery is increasing. Currently, autologous fat grafts are used in breast surgery, facial rejuvenation, and facial lipoatrophy secondary to antiretroviral therapy and as a treatment for liposuction sequelae, buttock augmentation, and congenital facial hemiatrophy. Their use is expanding rapidly, and their applications in other fields are an ever growing interest within the Plastic Surgery community.

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Objective: antiretrovirals, especially thymidine-analogue nucleoside reverse transcriptase inhibitors (tNRTIs), may cause the mitochondrial damage in adipose tissue that has been associated with lipodystrophy development. HIV itself may damage blood cell mitochondria. However, the viral capacity to induce adipose tissue mitochondrial lesion is still a matter of doubt.

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The topic of same-sex sexual initiation has generally remained understudied in the literature on sexual identity formation among sexual minority youth. This article analyzes the narratives of same-sex sexual initiation provided by 76 gay and bisexual Mexican immigrant men who participated in interviews for the Trayectos Study, an ethnographic study of sexuality and HIV risk. These participants were raised in a variety of locations throughout Mexico, where they also realized their same-sex attraction and initiated their sexual lives with men.

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