Publications by authors named "Manuel Miralles"

Carotid artery stenosis is mainly produced due to the progressive accumulation of atherosclerotic plaque in the vascular wall. The atherosclerotic plaque is characterized by the accumulation of lipids, low density proteins, expression of chemokines and adhesion molecules, and migration of monocytes and lymphocytes into the plaque. Its rupture can produce stroke, but embolic propensity depends principally on the composition and vulnerability of plaque rather than the severity of stenosis.

View Article and Find Full Text PDF

Introduction: Abdominal aortic aneurysm (AAA) is a relevant clinical problem due to the risk of rupture of progressively dilated infrarenal aorta. It is characterized by degradation of elastic fibers, extracellular matrix, and inflammation of the arterial wall. Though neutrophil infiltration is a known feature of AAA, markers of neutrophil activation are scarcely analyzed; hence, the main objective of this study.

View Article and Find Full Text PDF

Foot lesions are among the most frequent causes of morbidity and disability in the diabetic population. Thus, the exploration of preventive control measures is vital for detecting early signs and symptoms of this disease. Infrared thermography is one of the complementary diagnostic tools available that has proven to be effective in the control of diabetic foot.

View Article and Find Full Text PDF

Globally, a leg is amputated approximately every 30 seconds, with an estimated 85 percent of these amputations being attributed to complications arising from diabetic foot ulcers (DFU), as stated by the American Diabetes Association. Peripheral arterial disease (PAD) is a risk factor resulting in DFU and can, either independently or in conjunction with diabetes, lead to recurring, slow-healing ulcers and amputations. According to guidelines amputation is the recommended treatment for patients with no-option critical ischemia of the limb (CTLI).

View Article and Find Full Text PDF

Introduction: Our objective was to compare the in vitro efficacy of electrothermal bipolar [EB] vessel sealing and ultrasonic harmonic scalpel [HS] versus mechanical interruption, with conventional ties or surgical clips (SC), in sealing saphenous vein (SV) collaterals, during its eventual preparation for bypass surgery.

Methods: Experimental in vitro study on 30 segments of SV. Each fragment included two collaterals at least 2 mm in diameter.

View Article and Find Full Text PDF

Purpose: The aim of this study was to assess the agreement of multiplanar reconstruction (MPR) and semiautomated central lumen line (CLL) analysis of abdominal aortic aneurysms (AAA), with 3 different software workstations (WS1, WS2, WS3) and 2 experienced practitioners as well as to analyze its eventual impact in graft selection.

Materials And Methods: Twenty computed tomography (CT) angiography data sets were randomly chosen from a series of 100 consecutive studies. Measurements were performed twice by each reader, in random order, and included 8 parameters (5 diameters and 3 lengths).

View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to explore the relationship between calcification in carotid atheromatous plaques and the progression of atheromatous disease using quantitative CT Angiography in 43 asymptomatic patients with significant internal carotid artery stenosis.
  • - Results showed that over 12 months, there was an increase in both the volumetric stenosis of carotid arteries and the intraplaque calcium content, with specific correlations found between calcium levels and vitamin D, as well as an inverse relationship with stenosis progression.
  • - The findings indicate that higher calcium content in plaques may help stabilize carotid atheromatous disease, potentially reducing the risk of symptoms and stroke.
View Article and Find Full Text PDF

Thrombospondins are a family of matricellular proteins with a multimeric structure that is known to be involved in several biological and pathological processes. Their relationship with vascular disorders has raised special interest recently. Aortic aneurysms are related to the impairment of vascular remodeling, in which extracellular matrix proteins seem to play an important role.

View Article and Find Full Text PDF

Background: Red cell distribution width (RDW) reflecting impaired erythropoyesis, has been associated with poor prognosis and mortality in several conditions. The aim of this study was to determine the relationship between RDW and the 5-year survival after the endovascular repair of abdominal aortic aneurysms (EVAR) and its ability to improve the discriminative power of a survival predictive score.

Methods: Retrospective analysis of 284 patients undergoing EVAR at a single centre.

View Article and Find Full Text PDF
Article Synopsis
  • - Chronic lower limb ischemia is a serious complication for patients with type 2 diabetes, leading to high rates of non-traumatic amputations, and existing treatments like antiplatelet therapy and statins have not been very effective.
  • - This study aims to explore a new treatment method using mesenchymal stromal cells from adipose tissue to improve blood flow in patients who cannot undergo surgery for critical limb ischemia.
  • - The research will involve a randomized trial with 90 patients divided into three groups to assess the safety and effectiveness of cell therapy over one year, while also considering the impact on patients' quality of life.
View Article and Find Full Text PDF

During the last years, several kinds of Embolic Protection Devices (EPD) have been developed, with the aim of minimizing complication caused by thrombi generated during Carotid Artery Stenting (CAS). These devices are capable of capturing small particles generated during the intervention, avoiding cerebral stroke and improving the outcomes of the surgery. However, they have associated complications, like the increase on flow resistance associated by their use or the lack of knowledge on their actual filtration efficiency for thrombi of low size.

View Article and Find Full Text PDF
Article Synopsis
  • The study evaluated if the type of surgery (open or endovascular) for abdominal aortic aneurysms (AAAs) matched evidence-based recommendations in five Spanish university hospitals.
  • Among 179 patients, 65.9% of procedures were deemed appropriate; EVAR had a higher approval rate (83.5%) compared to OSR (50%).
  • The findings suggest a need for standardized guidelines to improve surgical choices and reduce variation between hospitals, while also considering patient preferences.
View Article and Find Full Text PDF

Purpose: MEDI3726 is an antibody-drug conjugate targeting the prostate-specific membrane antigen and carrying a pyrrolobenzodiazepine warhead. This phase I study evaluated MEDI3726 monotherapy in patients with metastatic castration-resistant prostate cancer after disease progression on abiraterone and/or enzalutamide and taxane-based chemotherapy.

Patients And Methods: MEDI3726 was administered at 0.

View Article and Find Full Text PDF
Article Synopsis
  • - Anticancer drug development is expensive and often faces setbacks during late clinical testing stages, prompting the exploration of more efficient methods like the Pharmacological Audit Trail (PhAT), which utilizes tumor tissue-based biomarkers.
  • - Liquid biopsy techniques, such as analyzing circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) from blood samples, are becoming crucial for drug development as they offer insights into biomarkers related to prognosis, treatment response, and disease progression.
  • - This discussion highlights the potential benefits of merging liquid biopsy methods with the PhAT framework while addressing the need for rigorous testing and validation of blood-based biomarkers through clinical trials to ensure their reliability.
View Article and Find Full Text PDF

The detection of germline BRCA1/2 pathogenic variant has relevant implications for the patients and their family members. Family planning, prophylactic surgery and the possibility of preimplantation genetic testing for monogenic disorders (PGT-M) to avoid transmittance of pathogenic variants to the offspring are relevant topics in this setting. PGT-M is valuable option for BRCA carriers, but it remains a controversial and underdiscussed topic.

View Article and Find Full Text PDF

Marfan syndrome (MFS) is a systemic connective tissue disorder caused by mutations in the fibrillin-1 (FBN1) gene, and cardiovascular involvement is the leading cause of mortality. We sought to examine the genotype/phenotype realtionship in 61 consecutive patients with a phenotype and genotype compatible with MFS. The FBN1 gene was analyzed by massive sequencing using a hybridization capture-based target enrichment custom panel.

View Article and Find Full Text PDF

Objectives: We present the technical description and preliminary results of a hybrid approach for the treatment of chronic total occlusions of superficial femoral artery in the setting of critical limb-threatening ischemia (CLTI).

Methods: A retrospective analysis of selected case series was performed. A trans-popliteal hybrid technique was carried out in seven limbs (six patients).

View Article and Find Full Text PDF

Abdominal aortic aneurysm (AAA) is a vascular disorder caused by a dilatation of the aortic diameter that can be potentially lethal in case of rupture. Molecular mechanisms underlying the development of AAA are complex and not completely understood. However, inflammation plays a pivotal role in AAA development.

View Article and Find Full Text PDF

microRNAs (miRNAs) are small RNAs that regulate different biological processes. Our objective was to identify miRNAs dysregulated in plasma and tissue of patients with abdominal aortic aneurysm (AAA) and explore new potential targets involved in AAA. Fifty-seven subjects were recruited for a plasma study (30 AAA patients, 16 healthy volunteers and 11 patients with atherosclerosis).

View Article and Find Full Text PDF
Article Synopsis
  • Activated protein C (APC) is an anticoagulant that helps prevent excessive blood clotting and is linked to lower risks of venous thromboembolism when present in adequate levels.
  • APC also has protective roles in various inflammatory conditions and is being tested for its therapeutic potential in diseases like severe sepsis, obesity, and Alzheimer’s.
  • The text reviews 16 methods for measuring APC in plasma, discussing the pros and cons of each, and aims to clarify their clinical applications and usefulness.
View Article and Find Full Text PDF

Background: The aim of this study was to assess potential variability in the clinical characteristics and treatment of patients undergoing elective surgery for abdominal aortic aneurysm (AAA) across five hospitals in Spain.

Methods: Multicenter, retrospective cohort study of patients diagnosed with AAA and treated with open surgical repair (OSR) or endovascular aneurysm repair (EVAR). We evaluated clinical and demographic variables, including comorbidity (Charlson Comorbidity Index [CCI]); anatomic characteristics; surgical risk (ASA Score); aneurysm characteristics; and in-hospital and overall mortality.

View Article and Find Full Text PDF

Cell therapy is a progressively growing field that is rapidly moving from preclinical model development to clinical application. Outcomes obtained from clinical trials reveal the therapeutic potential of stem cell-based therapy to deal with unmet medical treatment needs for several disorders with no therapeutic options. Among adult stem cells, mesenchymal stem cells (MSCs) are the leading cell type used in advanced therapies for the treatment of autoimmune, inflammatory and vascular diseases.

View Article and Find Full Text PDF