Publications by authors named "Martin Iglesias"

Introduction: Antimalarials (AMs) are old drugs with a wide range of beneficial effects in systemic lupus erythematosus (SLE) beyond the control of activity. The most recent debate is focused on defining the optimal doses to assure the best benefit/risk ratio.

Areas Covered: We have reviewed the pharmacological basis underlying the various therapeutic effects of AMs and the beneficial and toxic effects of HCQ, also discussing the role of mepacrine not only as a substitute in cases of maculopathy, but also as a very effective therapy combined with HCQ.

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  • Glucocorticoids (GCs) are commonly used to treat systemic lupus erythematosus (SLE), but their long-term use can lead to damage; therefore, tailored dosing and tapering strategies are crucial.
  • Recent guidelines suggest starting at lower doses and increasing tapering speed to minimize damage, with an emphasis on keeping maintenance doses below 5 mg/day.
  • Additional treatments, like methylprednisolone pulses and immunosuppressive drugs, can enhance effectiveness and reduce GC reliance, with a focus on finding suitable candidates for potential withdrawal in stable remission phases.
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  • Antiphospholipid syndrome (APS) can lead to serious issues like venous thromboembolism (VTE) and stroke, requiring careful management that includes evaluating antiphospholipid antibodies and other autoimmune conditions.
  • The main treatment for thrombotic APS is anticoagulation with vitamin K antagonists, while low-dose aspirin is recommended for primary prevention in asymptomatic patients and as part of combination therapy for arterial thrombosis.
  • Direct oral anticoagulants (DOACs) may be used in specific low-risk cases but are not advised for arterial thrombosis or those with triple positive antiphospholipid antibodies, with additional treatments like hydroxychloroquine and statins considered for more
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The precise mechanisms underlying the cellular response to static electric cues remain unclear, limiting the design and development of biomaterials that utilize this parameter to enhance specific biological behaviours. To gather information on this matter we have explored the interaction of collagen type-I, the most abundant mammalian extracellular protein, with poly(vinylidene fluoride) (PVDF), an electroactive polymer with great potential for tissue engineering applications. Our results reveal significant differences in collagen affinity, conformation, and interaction strength depending on the electric charge of the PVDF surface, which subsequently affects the behaviour of mesenchymal stem cells seeded on them.

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Aim: This study addresses the challenge of predicting the course of Adult-onset Still's disease (AoSD), a rare systemic autoinflammatory disorder of unknown origin. Precise prediction is crucial for effective clinical management, especially in the absence of specific laboratory indicators.

Methods: We assessed the effectiveness of combining traditional biomarkers with the k-medoids unsupervised clustering algorithm in forecasting the various clinical courses of AoSD-monocyclic, polycyclic, or chronic articular.

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Background: The latissimus dorsi free flap is a widely used reconstructive technique for complex lower leg defects in the pediatric population due to its reliability and anatomical features. However, the impact of this technique on the postoperative quality of life in children and adolescents, who require appropriate lower extremity function during their developmental period, remains to be analyzed.

Methods: Patients who underwent microsurgical lower leg reconstruction using the latissimus dorsi flap were analyzed retrospectively.

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Introduction: Hydroxychloroquine (HCQ) and glucocorticoids (GCs) constitute the oldest and more used drugs in the treatment of systemic lupus erythematosus (SLE). Despite this long experience, both are still subject to a number of uncertainties, mainly regarding the dose.

Areas Covered: We review the main mechanisms of action, the clinical and toxic effects of HCQ and GCs and analyze the recommendations for the use of both in guidelines published since 2018.

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Background: The occurrence of lung ultrasound abnormalities in patients without lung disease remains uncertain, while patients with respiratory disease often exhibit such abnormalities.

Objectives: The primary aim was to identify pathological ultrasonographic pulmonary findings and their correlation with baseline diseases and static lung compliance in patients without any pre-existing respiratory conditions.

Methods: This prospective observational study enrolled a series of surgical patients with no history of pulmonary pathology (n = 104).

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Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms.

Methods: The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 healthy controls (HC). The hemodynamic autonomic function was evaluated using the deep breathing technique, Valsalva maneuver, and Tilt test.

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Natural killer (NK) cells are lymphocytes of the innate immune system that play a key role in the elimination of tumor and virus-infected cells. Unlike T cells, NK cell activation is governed by their direct interaction with target cells via the inhibitory and activating receptors present on their cytoplasmic membrane. The simplicity of this activation mechanism has allowed the development of immunotherapies based on the transduction of NK cells with CAR (chimeric antigen receptor) constructs for the treatment of cancer.

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Background: Systemic Sclerosis in the hand is characteristically evidenced by Raynaud's phenomenon, fibrosis of the skin, tendons, ligaments, and joints as well as digital ulcers with prolonged healing. Current medical treatment does not always cure these complications. Local adipose-derived stromal vascular fraction administration into the hands has been proposed as an emerging treatment due to its regenerative properties.

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Introduction: SLIT for the treatment of plant food allergies has been demonstrated to be safe but less effective than OIT, but the latter is associated with more adverse reactions. The aim of the study was to evaluate the efficacy and safety of a new protocol starting with SLIT-peach followed by OIT with commercial peach juice in patients with LTP syndrome.

Methods: This was a prospective, noncontrolled, open study on patients with LTP syndrome who are not sensitized to storage proteins.

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Introduction: Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30%-60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians.

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Objective: To compare the efficacy, toxicity and glucocorticoid (GC)-sparing effects of intravenous cyclophosphamide (iv CYC) with other immunosuppressive regimes as the induction treatment for Idiopathic Inflammatory Myopathy-Related Interstitial Lung Disease (IIM-ILD).

Methods: Observational comparative study of patients with IIM-ILD from the EPIMAR and Cruces cohorts. The main efficacy outcome was a 6 to 12-month improvement >10% in the forced vital capacity (FVC) from baseline.

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Introduction: Burnout is a psychosocial syndrome caused by stressful situations in the workplace. It affects 30% to 60% of medical professionals. The aim of this study is to carry out a comparative analysis of its frequency before and after the COVID-19 outbreak in Spanish internal medicine attending physicians.

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Bone tissue provides support and protection to different organs and tissues. Aging and different diseases can cause a decrease in the rate of bone regeneration or incomplete healing; thus, tissue-engineered substitutes can be an acceptable alternative to traditional therapies. In the present work, we have developed an osteogenic differentiation model based on mesenchymal stem cells (MSCs), to first analyse the influence of the culture media and the origin of the cells on the efficiency of this process and secondly to extrapolate it to a 3D environment to evaluate its possible application in bone regeneration therapies.

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Background: The rates of exclusive breastfeeding at 6 months in Spain are far from recommended by the World Health Organization, which is 50% by 2025. Evidence of the effectiveness of group interventions in late postpartum is limited. The objective of this study was to evaluate the effectiveness of the PROLACT group educational intervention for increasing the proportion of mother-child dyads with exclusive breastfeeding at 6 months compared to the usual practice in primary care.

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Mesenchymal stem cells (MSC) have received particular attention due to their ability to inhibit inflammation caused by cytokine storm induced by COVID-19. In this way some patients have been treated successfully. The aim of this study was to evaluate the safety and describe the clinical changes after IV administration of allogeneic human umbilical cord MSC (ahUCMSC), in patients with bilateral pneumonia caused by COVID-19, complicated with severe ARDS, as compassionate treatment.

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Objective: To compare the influence of aPLs on global and cardiovascular damage in patients with SLE diagnosed before and after the year 2000.

Methods: Two hundred and eighty-six patients from the Lupus-Cruces cohort with a minimum follow-up of 5 years were divided into two subcohorts according to the date of diagnosis, before 2000 (less than 2000) and from 2000 on (2000 or more). We compared the mean Systemic Lupus Erythematosus International Collaborating Clinics-American College of Rheumatology (SLICC-ACR) Damage Index score and global and cardiovascular damage-free survival rates in the presence or absence of aPL in both subcohorts.

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Background: The identification of factors associated with Intensive Care Unit (ICU) mortality and derived clinical phenotypes in COVID-19 patients could help for a more tailored approach to clinical decision-making that improves prognostic outcomes.

Methods: Prospective, multicenter, observational study of critically ill patients with confirmed COVID-19 disease and acute respiratory failure admitted from 63 ICUs in Spain. The objective was to utilize an unsupervised clustering analysis to derive clinical COVID-19 phenotypes and to analyze patient's factors associated with mortality risk.

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Objectives: The objective of this study is to evaluate the impact of the COVID-19 outbreak on mental health and burn-out syndrome in Spanish internists and the factors that could be related to its appearance.

Design: We performed an observational, cross-sectional, descriptive study for which we designed a survey that was distributed in May 2020.

Setting: We included internists who worked in Spain during the COVID-19 outbreak.

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