Publications by authors named "Robles L"

Cervical spinal stenosis most commonly occurs at the subaxial spine. C1-C2 stenosis is relatively unusual but can be present in certain congenital or syndromic conditions such as rheumatoid arthritis. In this manuscript, we highlight the case of a 42-year-old lady who presented with neck pain and signs of high cervical myelopathy.

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  • * Research indicates that levels of IRAK-M decrease with age and oxidative stress, with genetic variants linked to a higher risk of developing AMD.
  • * Restoring IRAK-M in RPE cells shows promise in protecting against oxidative damage and retinal degeneration, indicating it could be a potential therapeutic avenue for AMD.
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  • Periodontoid pannus formation is typically caused by rheumatoid arthritis and leads to neural compression in the spinal cord, particularly in the retro-odontoid space.
  • A case report describes a patient with progressive high cervical myelopathy who was found to have both a retro-odontoid pannus and a posterior mass at C1-C2 leading to severe spinal cord compression.
  • The patient underwent successful treatment through a C1-C2 laminectomy and occipitocervical fusion, marking the first reported instance of circumferential pannus at C1-C2 causing such neural compression.
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Background: Retrospective data suggest an association between bevacizumab efficacy and the incidence of arterial hypertension (AHT). Additionally, epigenetic mechanisms have been related to AHT.

Methods: This prospective observational study conducted by GEICAM Spanish Breast Cancer Research Group included metastatic breast (MBC) or colorectal (mCRC) cancer patients treated with bevacizumab-containing chemotherapy as first-line treatment.

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Background: Conservative therapies are recommended as initial treatment for male lower urinary tract symptoms. However, there is a lack of evidence on effectiveness and uncertainty regarding approaches to delivery.

Objective: The objective was to determine whether or not a standardised and manualised care intervention delivered in primary care achieves superior symptomatic outcome for lower urinary tract symptoms to usual care.

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Objectives: To estimate the cost-effectiveness of a primary care intervention for male lower urinary tract symptoms (LUTS) compared with usual care.

Design: Economic evaluation alongside a cluster randomised controlled trial from a UK National Health Service (NHS) perspective with a 12-month time horizon.

Setting: Thirty NHS general practice sites in England.

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  • Hereditary leiomyomatosis and renal cell cancer syndrome (HLRCC) is a rare genetic condition linked to mutations in the FH gene, with a prevalent mutation identified in a large cohort from Spain.
  • The study confirmed that a common variant, FH c.1118A > G p.(Asn373Ser), likely originated from a single ancestor 12-26 generations ago, causing specific health issues such as uterine leiomyomatosis and renal cell cancer in affected individuals.
  • In Alicante, Spain, this founder mutation is prevalent, and genetic testing for this specific mutation is suggested as a more efficient diagnostic method than full gene sequencing for those suspected of having HLRCC.
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Background: Autologous cranioplasty has been used for decades and is the gold standard treatment in patients who underwent decompressive craniectomy (DC). One of the most common methods to store the cranial bone flap is cryopreservation at very low temperatures (-70 to -80°). The only way to achieve these low temperatures is by using special freezers which are not always available in all medical facilities, especially in low-resource centers.

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Objective: To determine whether a standardised and manualised care intervention in men in primary care could achieve superior improvement of lower urinary tract symptoms (LUTS) compared with usual care.

Design: Cluster randomised controlled trial.

Setting: 30 National Health Service general practice sites in England.

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Background: Lateral lumbar interbody fusion supplemented with insertion of pedicle screws is a surgical procedure that has gained popularity in the last years, becoming an important tool in the armamentarium of spine surgeons. In recent years, there is a trend to complete both procedures in a single position, thus avoiding flipping the patient prone to insert the pedicle screws.

Methods: We describe a step-by-step workflow of the robotic-assisted technique for multilevel lateral lumbar interbody fusion supplemented with posterior instrumentation.

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Unchecked, chronic inflammation is a constitutive component of age-related diseases, including age-related macular degeneration (AMD). Here we identified interleukin-1 receptor-associated kinase (IRAK)-M as a key immunoregulator in retinal pigment epithelium (RPE) that declines with age. Rare genetic variants of IRAK-M increased the likelihood of AMD.

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Background: Multidisciplinary approaches to weight loss have been shown to improve outcomes in bariatric patients. Few studies have been performed assessing the utility and compliance of fitness tracking devices after bariatric surgery. We aim to determine whether use of an activity tracking device assists bariatric patients in improving postoperative weight loss behaviors.

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It is estimated that multiple sclerosis (MS) affects over 2.8 million people worldwide, with a prevalence that is expected to continue growing over time. Unfortunately, there is no cure for this autoimmune disease.

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Background: The use of inflammatory markers in order to accurate the diagnosis, decrease the reoperation rate and enable earlier interventions during the postoperative period of a colorectal surgery is increasingly necessary, with the purpose of reducing morbimortality, nosocomial infections, costs and time of a readmission.

Objective: To analyze C-reactive protein level on the third postoperative day of an elective colorectal surgery and compare the marks between reoperated and non-reoperated patients and to establish a cutoff value to predict or avoid surgical reoperations.

Methods: Retrospective study based on the analysis of electronic charts of over 18-year-old patients who underwent an elective colorectal surgery with primary anastomoses during the period from January 2019 to May 2021 by the proctology team of Santa Marcelina Hospital Department of General Surgery with C-reactive protein (CRP) dosage taken on the third postoperative day.

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Background: Most renal cell carcinomas (RCCs) are localized and managed by active surveillance, surgery, or minimally invasive techniques. Stereotactic ablative radiation (SAbR) may provide an innovative non-invasive alternative although prospective data are limited.

Objective: To investigate whether SAbR is effective in the management of primary RCCs.

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Hereditary breast and ovarian cancer syndrome (HBOC) is a clinical entity characterized by an increased risk of developing breast and ovarian cancer. The genetic diagnosis is based on the identification of heterozygous germinal variants in HBOC susceptibility genes. However, it has recently been described that constitutional mosaic variants can contribute to the aetiology of HBOC.

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Background: Due to the SARS-CoV-2 virus pandemic and its rapid spread worldwide, an early and effective detection strategy was the nasopharyngeal reverse transcription polymerase swab tests, a procedure still performed today. A relatively safe procedure when done correctly, however, one of the rare complications reported in the literature includes a cerebrospinal fluid (CSF) leak.

Case Description: A 69-year-old female patient presented to the emergency department with clear fluid rhinorrhea, clinically diagnosed with a CSF fistula after a SARS-CoV-2 nasopharyngeal swab.

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Background: Evidence-based guidelines for the management of systemic therapy-naïve oligometastatic renal cell carcinoma (RCC) are lacking.

Objective: To evaluate the potential of stereotactic ablative radiotherapy (SAbR) to provide longitudinal disease control while preserving quality of life (QOL) in patients with systemic therapy-naïve oligometastatic RCC.

Design, Setting, And Participants: RCC patients with three or fewer extracranial metastases were eligible.

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Background: Evidence from observational studies have shown that moderate intensity physical activity can reduce risk of progression and cancer-specific mortality in participants with prostate cancer. Epidemiological studies have also shown participants taking metformin to have a reduced risk of prostate cancer. However, data from randomised controlled trials supporting the use of these interventions are limited.

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Background: Patients with epilepsy have a higher risk of skeletal injuries, and some of these fractures occur in the spine during a seizure. Seizure-induced spinal fractures (SISF) are unusual injuries that typically occur in the thoracolumbar spine. Because these skeletal injuries are not well described in the literature, this article aims to analyze the characteristics of this uncommon clinical entity.

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Objectives: Interventions designed to improve men's diet and physical activity (PA) have been recommended as methods of cancer prevention. However, little is known about specific factors that support men's adherence to these health behaviour changes, which could inform theory-led diet and PA interventions. We aimed to explore these factors in men following prostatectomy for prostate cancer (PCa).

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Purpose: Observational studies and randomized controlled trials (RCTs) have shown an association between vitamin D levels and prostate cancer progression. However, evidence of direct causality is sparse and studies have not examined biological mechanisms, which can provide information on plausibility and strengthen the evidence for causality.

Methods: We used the World Cancer Research Fund International/University of Bristol two-stage framework for mechanistic systematic reviews.

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Aim: Inflammatory bowel diseases present progressive and potentially debilitating characteristics with an impact on health-related quality of life (QoL) throughout the course of the disease, and this parameter may even be used as a method of evaluating response to treatment. The aim of this study was to analyze epidemiological data, medications in use, previous surgeries, and hospitalizations in patients with inflammatory bowel diseases, and to determine the impairment in QoL of these patients.

Methods: This is a prospective, cross-sectional, observational study in patients with inflammatory bowel disease followed up in a tertiary hospital in São Paulo-SP, Brazil.

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Multicellular organisms use dedicator of cytokinesis (DOCK) family guanine nucleotide exchange factors (GEFs) to activate Rac/Rho-of-plants small GTPases and coordinate cell shape change. In developing tissues, DOCK signals integrate cell-cell interactions with cytoskeleton remodeling, and the GEFs cluster reversibly at specific organelle surfaces to orchestrate cytoskeletal reorganization. The domain organizations among DOCK orthologs are diverse, and the mechanisms of localization control are poorly understood.

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