Publications by authors named "Ignacio Santos"

Introduction: While the general immune response to Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is well-understood, the long-term effects of Human Immunodeficiency Virus-1/Severe Acute Respiratory Syndrome-Coronavirus-2 (HIV-1/SARS-CoV-2) co-infection on the immune system remain unclear. This study investigates the immune response in people with HIV-1 (PWH) co-infected with SARS-CoV-2 to understand its long-term health consequences.

Methods: A retrospective longitudinal study of PWH with suppressed viral load and SARS-CoV-2 infection was conducted.

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  • - Device entrapment during Transcatheter Aortic Valve Implantation (TAVI) is a rare but serious issue, particularly with calcified aorta, as shown in a case involving an 86-year-old female patient where a pigtail catheter got stuck.
  • - After failed attempts to retrieve the catheter, an innovative solution was implemented by inflating a post-dilation balloon to stabilize the valve while safely extracting the trapped catheter without damage or the need for surgery.
  • - The case highlights the need for preventative measures, such as ensuring catheters can move freely and retracting them before fully deploying the valve, to avoid complications in future procedures.
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Background: Fractional flow reserve (FFR) or non-hyperaemic pressure ratios are recommended to assess functional relevance of intermediate coronary stenosis. Both diagnostic methods require the placement of a pressure wire in the coronary artery during invasive coronary angiography. Quantitative flow ratio (QFR) is an angiography-based computational method for the estimation of FFR that does not require the use of pressure wires.

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Purpose: Globally, it is estimated that 1.0 million individuals are newly infected by Hepatitis C virus (HCV) every year, and nearly 50 million people live with a chronic infection, according to World Health Organization. To overcome underdiagnosis of HCV infection among hard-to-reach populations, it is essential to develop new rapid and easy-to-use molecular diagnostic systems.

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Background: In patients with hepatitis C virus (HCV) chronic infection and advanced liver disease, the impact of human immunodeficiency virus (HIV) coinfection on the clinical outcome after sustained virological response (SVR) has not been sufficiently clarified. The aim of this study was to compare the mortality after SVR of patients bearing HCV chronic infection and advanced liver fibrosis, with and without HIV-coinfection after a prolonged follow-up.

Methods: This was a prospective multicenter cohort study including individuals with HIV/HCV-coinfection and patients with HCV-monoinfection from Spain, fulfilling: 1) Liver stiffness (LS) ≥9.

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  • * Key findings indicated that certain genetic variations in the TYK2 and VIP genes were linked to a reduced severity of the disease, while variations in TLR7 and OAS1 were associated with increased severity.
  • * The research suggests that these genetic markers could help identify individuals at greater risk for severe COVID-19 outcomes.
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  • About 10% of people with HIV experience low-level viremia (LLV) despite antiretroviral therapy, yet the causes and impacts of this condition remain largely unknown, especially within specific viral load ranges and modern treatment methods.
  • The study observed 81 participants, comparing those with LLV to those with suppressed viremia and non-HIV controls, focusing on immune response characteristics and inflammation markers through advanced flow cytometry and immunoassays.
  • Findings indicated that LLV individuals exhibit greater T-cell activation and senescence, along with a decline in certain immune cell types, which could impair their ability to control HIV and harm long-term immune memory.
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  • Patients with high bleeding risk (HBR) following a myocardial infarction (MI) face poor outcomes, and it's uncertain if they benefit from complete revascularization.
  • The study aimed to compare the outcomes of physiology-guided complete revascularization versus a culprit-only strategy for HBR patients with MI and multivessel disease.
  • Results showed that HBR patients had a higher risk of complications, but those who underwent complete revascularization experienced significantly better outcomes, reducing primary endpoint events.
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Objective: Multiple strategies have been utilised to reduce the incidence of HIV, including PrEP and rapid antiretroviral therapy initiation. The study objectives were to evaluate the efficacy, safety, satisfaction, treatment adherence, and system retention obtained with rapid initiation of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) in naïve patients.

Methods: This phase IV, multicenter, open-label, single-arm, 48-week clinical trial enrolled patients between January 2020 and June 2022.

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  • The study assesses the effectiveness of self-expanding (SE) Evolut PRO/PRO+ versus balloon-expandable (BE) SAPIEN ULTRA valves in patients with small aortic annuli, using data from the OPERA-TAVI registry.
  • It finds that the 1-year primary effectiveness outcomes are similar for both valve types, but the SE group shows better results for 30-day device-related outcomes.
  • The SE valves have higher rates of disabling strokes and paravalvular leaks, while the BE valves exhibit more issues with prosthesis-patient mismatch and elevated residual mean gradients.
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  • - The study investigates how HIV affects the severity of mpox outcomes in a large group of patients from 18 hospitals in Spain, focusing on factors like duration of illness and the presence of complications.
  • - Out of 1,823 patients with PCR-confirmed mpox, around 43% were people living with HIV, with a significant portion having uncontrolled viral loads, leading to higher rates of long or complicated mpox.
  • - The findings suggest that individuals with uncontrolled HIV are at increased risk for severe mpox complications, highlighting the need for timely HIV testing and immediate antiretroviral therapy for those diagnosed.
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Age estimation is a major challenge in anthropology and forensic odontology laboratories, as well as in judicial settings, as one of the tools used in human identification. The aim of this study was to evaluate the usefulness of age estimation methods based on the accurate measurement of tooth color changes. A systematic review was carried out following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and in compliance with Cochrane criteria recommendations (PROSPERO registration number CRD 42022343371).

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Increased recruitment of transitional and non-classical monocytes in the lung during SARS-CoV-2 infection is associated with COVID-19 severity. However, whether specific innate sensors mediate the activation or differentiation of monocytes in response to different SARS-CoV-2 proteins remain poorly characterized. Here, we show that SARS-CoV-2 Spike 1 but not nucleoprotein induce differentiation of monocytes into transitional or non-classical subsets from both peripheral blood and COVID-19 bronchoalveolar lavage samples in a NFκB-dependent manner, but this process does not require inflammasome activation.

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Aims: The present analysis from the Functional Assessment in Elderly Myocardial Infarction Patients with Multivessel Disease (FIRE) trial aims to explore the significance of pre-admission physical activity and assess whether the benefits of physiology-guided complete revascularization apply consistently to sedentary and active older patients.

Methods And Results: Patients aged 75 years or more with myocardial infarction (MI) and multivessel disease were randomized to receive physiology-guided complete revascularization or culprit-only strategy. The primary outcome was a composite of death, MI, stroke, or any revascularization within a year.

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Evidence regarding gender-related differences in response to transcatheter aortic valve implantation according to the valve type is lacking. This study aimed to evaluate the impact of gender on the treatment effect of Evolut PRO/PRO+ (PRO) or SAPIEN 3 Ultra (ULTRA) devices on clinical outcomes. The Comparative Analysis of Evolut PRO vs SAPIEN 3 Ultra Valves for Transfemoral Transcatheter Aortic Valve Implantation (OPERA-TAVI) is a multicenter, multinational registry including patients who underwent the latest-iteration PRO or ULTRA implantation.

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Paracetamol, or acetaminophen (N-acetyl-para-aminophenol, APAP), is an analgesic and antipyretic drug that is commonly used worldwide, implicated in numerous intoxications due to overdose, and causes serious liver damage. APAP can cross the blood-brain barrier and affects brain function in numerous ways, including pain signals, temperature regulation, neuroimmune response, and emotional behavior; however, its effect on adult neurogenesis has not been thoroughly investigated. We analyze, in a mouse model of hepatotoxicity, the effect of APAP overdose (750 mg/kg/day) for 3 and 4 consecutive days and after the cessation of APAP administration for 6 and 15 days on cell proliferation and survival in two relevant neurogenic zones: the subgranular zone of the dentate gyrus and the hypothalamus.

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  • Patients with atrial fibrillation on chronic anticoagulation often need coronary procedures, and managing their OAC is challenging due to bleeding and clotting risks.
  • Current guidelines suggest keeping Vitamin-K Antagonists uninterrupted but recommend stopping direct oral anticoagulants (DOACs) 12-24 hours before procedures.
  • The DOAC-NOSTOP study aims to evaluate the safety of continuing DOACs in 200 patients during trans-radial coronary procedures, with a focus on bleeding complications within 30 days.
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Background: Switching strategy with bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) has become a gold standard for people living with HIV (PLWH), achieving high efficacy and safety rates. However, data regarding immune status in long-term real-life cohorts of pretreated patients are needed.

Methods: We performed a multicentre, non-controlled, retrospective study in virologically suppressed PLWH switching to B/F/TAF.

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  • A multicenter study in Madrid analyzed the clinical and epidemiological characteristics of men who have sex with men (MSM) living with HIV who recently acquired hepatitis C (RAHC).
  • Of the 133 enrolled patients, many had prior sexually transmitted diseases and the most common hepatitis C genotype found was G1a; about 11% experienced spontaneous cure, while the treatment success rate was over 90%.
  • The findings suggest high-risk sexual behaviors are prevalent among MSM with RAHC, highlighting the importance of effective treatment strategies for this population.
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  • The study investigates the connection between SARS-CoV-2 viral load (viremia) and genetic variations (SNPs) linked to the severity of COVID-19 in a group of hospitalized patients at University Hospital La Princesa.
  • Out of 340 patients analyzed, only 37.1% had positive viremia, with specific SNPs (like rs2071746 and rs78958998) associated with a higher risk of viremia, while others (like rs11052877 and rs33980500) were linked to a lower risk.
  • The findings suggest that certain genetic variants contribute to differences in SARS-CoV-2 viremia among individuals, highlighting the
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Hepatitis C virus (HCV) coinfection with human immunodeficiency virus (HIV) has a detrimental impact on disease progression. Increasing evidence points to extracellular vesicles (EVs) as important players of the host-viral cross-talk. The microRNAs (miRNAs), as essential components of EVs cargo, are key regulators of normal cellular processes and also promote viral replication, viral pathogenesis, and disease progression.

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Objectives: HIV infection has been associated with lower rates of sustained viral response (SVR) with direct-acting antivirals (DAAs). There are few data on glecaprevir/pibrentasvir (G/P) in HIV/HCV coinfection outside clinical trials.

Methods: The HEPAVIR-DAA cohort, which recruits HIV/HCV-coinfected patients (NCT02057003) and the GEHEP-MONO cohort (NCT02333292), including HCV-monoinfected individuals, are two concurrent ongoing multicentre cohorts of patients receiving anti-HCV treatment.

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Coinfection with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) increases immune activation, inflammation, and oxidative stress that could lead to premature senescence. Different HCV infections, either acute or chronic infection, could lead to distinct premature cellular senescence in people living with HIV (PLWHIV). Observational study in 116 PLWHIV under antiretroviral treatment with different HCV status: (i) n = 45 chronically infected with HCV (CHC); (ii) n = 36 individuals who spontaneously clarify HCV (SC); (iii) n = 35 HIV controls.

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Background: The high effectiveness and safety of the two-drug (2DRs) strategy using dolutegravir (DTG) plus lamivudine (3TC) have led to international guidelines recommending their use for treatment-naive HIV patients. In virologically suppressed patients, de-escalating from 3DRs to DTG plus either rilpivirine (RPV) or 3TC has shown high rates of virological suppression.

Objectives: This study aimed to compare the real-life data of two multicenter Spanish cohorts of PLWHIV treated with DTG plus 3TC (SPADE-3) or RPV (DORIPEX) as a switch strategy, not only in terms of virological suppression, safety, and durability but also in terms of immune restoration.

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Background: We identified that acute or chronic Hepatitis C (HCV) infection in people living with HIV (PLWHIV) results in different senescence profiles. However, variations in these profiles after HCV elimination, spontaneously or with direct-acting antivirals (DAAs), remain unclear.

Methods: Longitudinal observational study (48 weeks) in 70 PLWHIV: 23 PLWHIV with active HCV-chronic infection (CHC) before and after HCV eradication with DAAs, 12 PLWHIV who spontaneously clarify the HCV (SC), and 35 controls (HIV).

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