Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina

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Dissociation between clinical and ultrasonographic response after radial shock wave therapy in refractory plantar fasciitis
(MDPI, 2026-04-17) Novo Rigueiro, Manuel; Pires Pereira, Fabio; Lete Achirica, Ignacio; Gómez Caamaño, Antonio; Rodríguez Rigueiro, Francisco Javier; Rodríguez Figueroa, Jesús; González Quintela, Arturo; Novo Veleiro, Ignacio; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Background: Chronic plantar fasciitis refractory to conservative treatment is a frequent cause of persistent heel pain and functional limitation. Although radial extracorporeal shock wave therapy (rESWT) has shown potential benefit, the relationship between clinical improvement and structural ultrasonographic changes remains unclear. The aim of this study was to evaluate the clinical, functional, and ultrasonographic outcomes associated with rESWT in patients with refractory plantar fasciitis. Methods: We conducted a prospective observational single-center study including 287 patients with plantar fasciitis refractory to conservative treatment for at least 6 months and confirmed by ultrasonography (plantar fascia thickness >4 mm). All patients received four weekly sessions of rESWT. Pain intensity (visual analog scale [VAS]), foot function (Foot Function Index [FFI]), quality of life (EQ-5D), and plantar fascia thickness were assessed at baseline and 3 months after treatment. Results: Significant improvements were observed in pain (mean VAS change, −3.73 points), function (mean FFI-disability change, −32.37 points), and quality of life (improvement in at least one EQ-5D dimension in 81.5% of patients) (all p < 0.001). The mean reduction in plantar fascia thickness was 0.14 mm. Most responders (71.8%) showed clinical improvement despite the absence of a relevant structural change, defined as a reduction in plantar fascia thickness <0.5 mm. In multivariate analysis, physically demanding occupations were associated with a lower probability of response (odds ratio, 0.32; 95% confidence interval, 0.17–0.63). The prognostic model showed moderate discrimination (area under the curve, 0.71). Conclusions: In this observational cohort, rESWT was associated with improvements in pain, function, and quality of life in patients with refractory plantar fasciitis. Clinical improvement frequently occurred despite minimal changes in plantar fascia thickness, suggesting that ultrasonographic thickness may not adequately reflect symptomatic evolution. However, the absence of a control group prevents causal interpretation of these findings.
Advanced electronic consultation between primary care and cardiology: impact of tele-echocardiography and event-based electrocardiographic monitoring
(Oxford Academic, 2025-12-06) Sánchez Castro, Juan José Augusto; Virgos Lamela, Alejandro; Rey Aldana, Daniel; Mazón Ramos, Pilar; Gude Sampedro, Francisco; González Juanatey, José Ramón; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Electronic consultation (econsultation) has proven effective in optimizing communication between primary care and cardiology, reducing waiting times and unnecessary face-to-face referrals. This study assessed the impact of incorporating tele-echocardiography and event-based electrocardiographic monitoring (EEM) into an advanced e-consultation model. A prospective observational cohort of 1200 consecutive e-consultations was analysed; in 354 cases, the advanced pathway was activated, including 300 tele-echocardiograms and 54 EEM studies. Remote resolution increased from 38.0% in the traditional model to 54.3% in the advanced model (P < 0.01). Diagnostic agreement was high (κ=0.85 for tele-echo vs. standard echo; κ =0.75 for primary care vs. cardiologist interpretation), with only 6.7% non-interpretable studies and no major adverse events during a mean follow- up of 19 months. This structured implementation of tele-echocardiography and EEM suggests a feasible, scalable, and safe innovation aligned with digital transformation goals in cardiology.
Reanimación neonatal realizando 15 compresiones y 2 ventilaciones: ¿es comparable con el estándar 3:1?
(Asociación Española de Pediatría, 2026-01) Santos Folgar, Myriam; Alonso Calvete, Alejandra; Otero Agra, Martín; Fernández Méndez, Felipe; Rodríguez Núñez, Antonio; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Introducción La asfixia es una causa importante de mortalidad y morbilidad neonatal en todo el mundo. La mayoría de los nacimientos en regiones con recursos limitados carecen de asistencia profesional, por lo que podría ser eficiente la aplicación de una técnica universal (para toda la infancia) de reanimación cardiopulmonar (RCP). El objetivo de este estudio fue comparar la calidad de la RCP neonatal con ratios compresiones:ventilaciones 15:2 vs. 3:1. Métodos Estudio cruzado aleatorizado con 36 estudiantes del enfermería entrenados. Se realizaron simulaciones de RCP con maniquíes neonatales. Cada participante completó 4 simulaciones de 2 min de RCP ventilando y comprimiendo: RCP 15:2 y RCP 3:1. Se estableció un período de descanso para evitar la fatiga. Se midieron variables de compresión y ventilación utilizando el maniquí Resusci® Baby QCPR y SimPad® PLUS. Se recogieron datos sobre las preferencias de los participantes. Resultados La RCP 15:2 mostró un mayor porcentaje de compresiones con profundidad adecuada (26 vs. 11%; p = 0,005). En cuanto a las ventilaciones, la RCP 3:1 produjo un mayor volumen tidal medio (27 vs. 24 ml; p = 0,002), así como un ritmo medio de ventilaciones por minuto superior (32 vs. 15; p < 0,001) y un mayor volumen medio minuto (809 vs. 351 ml/min; p < 0,001). Las ventilaciones con volumen tidal adecuado fueron superiores en la RCP 15:2 (74 vs. 64%; p = 0,14), aunque esta diferencia no fue estadísticamente significativa. Conclusiones En un modelo simulador de RCP neonatal la relación compresiones:ventilaciones RCP 15:2 consigue parámetros de calidad comparables a la 3:1 en términos de calidad. La implementación de una relación compresiones:ventilaciones unificada de RCP desde el nacimiento y a lo largo de la infancia (15:2) podría simplificar la formación y mejorar la efectividad de la reanimación neonatal, especialmente en entornos con recursos de formación de atención al parto limitados. Nuestros resultados en un entorno simulado, apoyan la realización de estudios con pacientes reales.
Perception of pregnant individuals, health providers and decision makers on interventions to cease substance consumption during pregnancy: a qualitative study
(BioMed Central Ltd., part of Springer Nature, 2024-04-09) Vila Farinas, Andrea; Pérez Ríos, Mónica; Montes Martínez, Agustín; Mourino Castro, Nerea; Rey Brandariz, Julia; Candal Pedreira, Cristina; Ruano Raviña, Alberto; Gómez Salgado, Patricia; Míguez Varela, María del Carmen; Varela Lema, María Leonor; Universidade de Santiago de Compostela. Departamento de Psicoloxía Clínica e Psicobioloxía; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Background Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders’ perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement Methods A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified. Results The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals. Conclusions Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.
Second-hand tobacco smoke exposure in Israel: A systematic review and meta-analysis of prevalence data, 2012-2024
(Elsevier, 2026-02-24) Amir, Yonatan; Rey Brandariz, Julia; Varela Lema, María Leonor; Rosen, Laura J.; García, Guadalupe; Candal Pedreira, Cristina; Teijeiro Teijeira, Ana; Pérez Ríos, Mónica; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Objectives Exposure to second-hand tobacco smoke (SHS) remains a significant global public health concern. Although previous studies have estimated the prevalence of SHS exposure in Israel, a systematic synthesis has not been performed. This study aims to identify and describe the different studies performed in Israel to ascertain the prevalence of exposure to SHS. Study design Systematic review and meta-analysis. Methods A systematic literature review was conducted using Ovid Medline, Embase, and Web of Science, covering publications between 2012 and 2024. All studies reporting data on the prevalence of exposure to SHS in Israel were included. Data were extracted, summarised in tables, and differentiated by type of population (adults vs. children). A qualitative and quantitative synthesis of the results was performed. For the quantitative synthesis, a random effects model was used. Quality assessment was performed using a modified version of the Newcastle-Ottawa Scale. Results Eighteen studies met the inclusion criteria. The prevalence of exposure to SHS ranged from 20.5% to 94.9% among adults, and the respective range among children was 29.0% to 85.6%. Among adults, the pooled prevalence of SHS exposure was 56.0% (95% CI: 54.0% to 57.0%) by self-report and 51.0% (95% CI: 47.0% to 55.0%) by biomarker assessment. The corresponding estimates among children were 74.0% (95% CI: 73.0% to 75.0%) and 55.0% (95% CI: 50.0% to 60.0%). Heterogeneity was high in all analyses (I2 >90%). Conclusions The prevalence of exposure to SHS in Israel varies significantly due to differences in population type, definition of exposure, and assessment methods.
Teaching basic life support to children with autism spectrum disorder: A novel pictogram-based approach
(Elsevier, 2026-04-02) Arias Varela, Lara; Álvarez López, Laura; Carballo Fazanes, Aida; Fernández de la Iglesia, Josefa del Carmen; Martínez Isasi, Santiago; Rodríguez Núñez, Antonio; Martínez Santos, Alba Elena; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina; Universidade de Santiago de Compostela. Departamento de Pedagoxía e Didáctica
Background Survival after cardiac arrest depends on timely bystander basic life support (BLS), yet children with autism spectrum disorder (ASD) are often excluded from BLS training strategies. This study assessed a pictogram-based, narrative approach using simulation to teach BLS to children with ASD. Method A quasiexperimental pretest/post-test design was conducted with a sample of eight children aged 8-12 years recruited from the Galician Autism Federation - ASPERGA Association. The intervention consisted of a 50-minute pictogram-based BLS simulation training, with participants assessed on their ability to perform the BLS sequence and cardiopulmonary resuscitation in a scenario-based cardiac arrest. Results Baseline assessments revealed inadequate proficiency in performing fundamental steps of the BLS sequence. Following targeted training, substantial improvements were noticeable, particularly in victim response (p = .010), airway opening (p = .015), and the look-listen-feel manoeuvre (p = .014). Nevertheless, challenges persisted in ventilation performance and overall cardiopulmonary resuscitation quality. Conclusion A pictogram-based simulation approach is a feasible strategy for teaching BLS to children with ASD. These children demonstrate the ability to learn and perform BLS with comparable proficiency to their peers without functional diversity.
Administration of adrenaline by trainee teachers in a simulated anaphylactic reaction: intramuscular versus intranasal use
(Codon Publications, 2026-01-01) Carballo Fazanes, Aida; Chico Vigo, Pablo; Rodríguez Núñez, Antonio; Gómez Silva, Graciela; García Magán, Carlos; Abelairas Gómez, Cristian; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina; Universidade de Santiago de Compostela. Departamento de Didácticas Aplicadas
Introduction: Anaphylactic reactions represent a serious risk for children within the school environment. It is essential that teachers are prepared to respond quickly and effectively. The objective of this study was to evaluate the ability of trainee teachers to administer adrenaline, both intramuscularly and intranasally, in a simulated anaphylactic shock scenario. Material and methods: This quasi-experimental pilot study included 23 undergraduate stu-dents in Primary Education who received training in managing severe allergic reactions. They were evaluated twice in a simulated anaphylaxis scenario. In the first test, participants chose the adrenaline device (intramuscular or intranasal). In the second, they repeated the scenario using the alternative device. Variables related to the execution of each step and the time required were recorded. Results: More than 80% of participants correctly completed all steps with the intranasal device. However, greater difficulties appeared with the intramuscular autoinjector, particu-larly maintaining it in position for at least 5 seconds and massaging the area afterward, which only 20% completed. The correct compliance rate was significantly higher with the intranasal device (100% vs. 71.43%, p = 0.012), and the administration time was shorter (p = 0.022). Initially, almost 70% chose the intramuscular autoinjector, but after testing both devices, 60.9% preferred the intranasal route. Conclusions: A brief theoretical–practical training session is effective in training future teach-ers to respond appropriately to anaphylaxis in schools. Participants preferred the intranasal route for its simplicity and lower invasiveness
Adapting Technology for Dementia Care: The Case of Emobook App in Reminiscence focused Music Therapy
(European Alliance for Innovation (EAI), 2024-03-19) Gerbaudo González, Noelia; Catalá Bolós, Alejandro; Condori Fernández, Nelly; Gandoy Crego, Manuel; Universidade de Santiago de Compostela. Centro de Investigación en Tecnoloxías Intelixentes da USC (CiTIUS); Universidade de Santiago de Compostela. Departamento de Electrónica e Computación; Universidade de Santiago de Compostela. Departamento de Psicoloxía Evolutiva e da Educación; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
INTRODUCTION: Life Story books are frequently employed to facilitate reminiscence interventions, but their use in Music Therapy remains limited in the scientific literature. There is a paucity of research detailing the design processes involved in this context. OBJECTIVES: This paper aims to report on the adaptation of the Emobook Life Story Book App for a Reminiscence Music Therapy Program for people living with dementia. METHODS: An interdisciplinary team comprising an interaction designer, a software engineer, a music therapist, and a research assistant engaged in a Participatory Design process. The study comprised two distinct phases: "Adaptation Phase," aimed to identify features requiring adjustment to integrate Emobook into MT effectively and the "Implementation Phase," focused on evaluating the adequacy of these changes for Emobook's use within the Music Therapy Program RESULTS: By merging the requirements identified during each phase, additional improvements were generated, leading to the decision to evolve Emobook Post-Prototype towards a version tailored specifically for Music Therapy. CONCLUSION: Collaborative, interdisciplinary efforts are essential in advancing the incorporation of technology into music therapy practice. This study demonstrates the value of a Participatory Design approach in this regard
Case Report: From metabolic normalization to incidental type A aortic dissection in immune checkpoint inhibitor–associated aortitis
(Frontiers Media, 2026-03-13) Freijido Álvarez, Pablo; León Mateos, Luis Ángel; González García, Nerea; García González, Jorge; Huelga Zapico, Emilio; Garrido Pumar, Miguel; López López, Rafael; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Immune checkpoint inhibitors can precipitate large-vessel vasculitis. It remains unknown whether metabolic remission on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) reliably indicates long-term structural stability or absence of later complications. A 58-year-old man with KRAS-G12C–mutated stage IVB lung adenocarcinoma initiated first-line treatment with carboplatin + pemetrexed + pembrolizumab. After the fourth cycle he developed persistent fever with normal procalcitonin and negative cultures. Contrast-enhanced computed tomography showed concentric thickening of the aorta and major branches; 18F-FDG PET/CT demonstrated increased inflammatory uptake consistent with large-vessel vasculitis. Testing for autoimmune and infectious etiologies yielded no diagnostic findings. Given the strong clinicoradiologic agreement and the unfavorable risk–benefit profile of deep arterial biopsy, histologic confirmation was not pursued. Intravenous methylprednisolone led to rapid defervescence and biochemical improvement. On follow-up, 18F-FDG PET/CT demonstrated complete metabolic normalization. Subsequent surveillance imaging incidentally identified an asymptomatic Stanford type A aortic dissection. In the absence of indications for elective repair (diameter below surgical thresholds, no rapid expansion, malperfusion, or significant regurgitation) and after discussion within the multidisciplinary Heart Team, management consisted of structured imaging surveillance and optimal medical therapy. Thereafter, he initiated adagrasib, achieving a durable partial response. This case illustrates discordance between metabolic quiescence and later structural damage in immune checkpoint inhibitor-associated aortitis. This supports long-term structural surveillance, as 18F-FDG PET/CT normalization does not guarantee structural safety.
Diagnostic accuracy and practical utility of depression screening questionnaires across renal replacement therapy modalities
(Elsevier, 2026) Vázquez Rodríguez, María Isabel; García Becerra, Lorena; Calviño, Jesús; Bouza, Pablo; Otero-Alonso, Pablo; Arza, María Dolores; Salgado Barreira, Ángel; Universidade de Santiago de Compostela. Departamento de Psicoloxía Clínica e Psicobioloxía; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Background. Depression is common yet underdiagnosed in patients receiving renal replacement therapies (RRT). Several questionnaires have shown utility for depression screening, mainly among in-centre haemodialysis patients; however, no instruments have been evaluated for diagnostic accuracy in home dialysis or kidney transplant populations. This study aimed to assess the diagnostic performance of the Beck Depression Inventory–Second Edition (BDI-II), the Beck Depression Inventory–Fast Screen (BDI-FS), and the Depression Subscale of the Hospital Anxiety and Depression Scale (HADS-D) across RRT modalities and to identify the most efficient tool for clinical use. Methods. Adult patients across RRT modalities completed the BDI-II, BDI-FS, and HADS-D, and were evaluated with the Structured Clinical Interview as the reference standard. Results. Among the 203 included patients (mean age 67.3 years; 65% male), 18.2% met SCID-I criteria for depression. Optimal cut-offs were BDI-II ≥15 for in-centre haemodialysis and ≥ 16 for home dialysis and transplantation; BDI-FS ≥3 for in-centre and home dialysis and ≥ 4 for transplantation; and HADS-D ≥ 5 for in-centre haemodialysis and ≥ 6 for home dialysis and transplantation. Sensitivity and negative predictive values exceeded 90% for all instruments except the HADS-D, which showed lower sensitivity in transplanted (86.7%) and home dialysis patients (70%). Conclusions. The BDI-II, BDI-FS, and HADS-D are useful for depression screening in renal populations, though the HADS-D demonstrated reduced performance in home dialysis. Standard cut-offs were inadequate, and modality-specific thresholds improved diagnostic accuracy. The BDI-FS, combining strong accuracy with brevity and ease of use, emerged as the most efficient tool for routine screening across RRT modalities.
Conservation of strain properties of bank vole-adapted chronic wasting disease in the absence of glycosylation and membrane anchoring
(Elsevier, 2025-04-11) Vidal, Enric; López Lorenzo, Nuria; Rodríguez Requena, Jesús; Castilla, Joaquín; Universidade de Santiago de Compostela. Centro de Investigación en Medicina Molecular e Enfermidades Crónicas (CiMUS); Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Prion disease phenotypes (prion strains) are primarily determined by the specific misfolded conformation of the cellular prion protein (PrPC). However, post-translational modifications, including glycosyl phosphatidyl inositol (GPI) membrane anchoring and glycosylation, may influence strain characteristics. We investigated whether these modifications are essential for maintaining the unique properties of bank vole-adapted Chronic Wasting Disease (CWD-vole), the fastest known prion strain. Using a novel transgenic mouse model expressing I109 bank vole PrPC lacking the GPI anchor and largely devoid of glycans, we performed serial passages of CWD-vole prions. Despite elongated initial incubation periods, the strain maintained 100 % attack rate through three passages. Although the pathological phenotype showed characteristic GPI-less features, including abundant extracellular plaque formation, three subsequent serial passages in fully glycosylated and GPI-anchored bank vole I109 PrPC expressing transgenic mice TgVole (1×) demonstrated that the strain's distinctive rapid propagation properties were preserved. These findings suggest that neither GPI anchoring nor glycosylation are essential for maintaining CWD-vole strain properties, supporting the concept that strain characteristics are primarily encoded in the protein's misfolded structure.
International Severe Asthma Registry (ISAR): 2017–2024 Status and Progress Update
(The Korean Academy of Tuberculosis and Respiratory Diseases, 2025-02-06) Larenas-Linnemann, Désirée; Pérez de Llano, Luis Alejandro; Price, David B.; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.
Outcomes of infective endocarditis in patients with end-stage renal disease in Spain: a population-based study
(BioMed Central, 2025-04-23) Gómez-Ramírez, Daniel; Olmos, Carmen; Fernández Pérez, Cristina; Prado, Náyade del; Rosillo, Nicolás; Bernal, José Luis; Zulet, Pablo; Vilacosta, Isidre; Elola, Francisco Javier; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Background: Patients with end-stage renal disease (ESRD) have a higher risk of infective endocarditis (IE) and a worse prognosis associated with it. Our aim is to analyze the clinical characteristics and outcomes of patients with IE and ESRD in Spain, while exploring potential differences between patients undergoing dialysis and other patients with ESRD. Methods: Retrospective observational population-based study analyzing 9,008 episodes of IE recorded between 2016 and 2019, using data from the Spanish Minimum Basic DataSet. Among these, 428 patients had ESRD, including 332 who were undergoing dialysis. A multivariable and multilevel logistic regression model was constructed to assess the association between various factors and in-hospital mortality in ESRD patients. Results: Compared to patients without ESRD, those with ESRD were younger, had more comorbidities, and showed a higher prevalence of infections caused by Staphylococcus aureus (31.8% vs. 18.4%; p < 0.001) and coagulase-negative staphylococci (19.2% vs. 14%; p = 0.006). ESRD patients also experienced septic shock more frequently as an in-hospital complication (12.1% vs. 8.9%; p = 0.007). Additionally, they underwent cardiac surgery less often (12.6% vs. 19.6%; p < 0.001) and had significantly higher in-hospital mortality rates (33.4% vs. 26.9%; p = 0.003) than patients without ESRD. Among ESRD patients, those undergoing dialysis had more comorbidities and a higher proportion of S. aureus infections (36.1% vs. 16.7%; p < 0.001). The multilevel analysis revealed that neither dialysis nor cardiac surgery were independently associated with in-hospital mortality. Conclusions: Patients with ESRD and IE exhibit distinct clinical and microbiological characteristics compared to other IE patients. Additionally, they are less likely to undergo cardiac surgery and experience significantly higher in-hospital mortality rates. In ESRD patients with IE, neither dialysis treatment nor cardiac surgery were identified as independent risk factors for mortality.
Intensity normalization methods in brain FDG-PET quantification
(Elsevier, 2020) López González, Francisco Javier; Silva Rodríguez, Jesús; Paredes Pacheco, José; Niñerola-Baizán, Aida; Efthimiou, Nikos; Martín-Martín, Carmen; Moscoso Rial, Alexis; Ruibal Morell, Álvaro; Roé-Vellvé, Núria; Aguiar Fernández, Pablo; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Background The lack of standardization of intensity normalization methods and its unknown effect on the quantification output is recognized as a major drawback for the harmonization of brain FDG-PET quantification protocols. The aim of this work is the ground truth-based evaluation of different intensity normalization methods on brain FDG-PET quantification output. Methods Realistic FDG-PET images were generated using Monte Carlo simulation from activity and attenuation maps directly derived from 25 healthy subjects (adding theoretical relative hypometabolisms on 6 regions of interest and for 5 hypometabolism levels). Single-subject statistical parametric mapping (SPM) was applied to compare each simulated FDG-PET image with a healthy database after intensity normalization based on reference regions methods such as the brain stem (RRBS), cerebellum (RRC) and the temporal lobe contralateral to the lesion (RRTL), and data-driven methods, such as proportional scaling (PS), histogram-based method (HN) and iterative versions of both methods (iPS and iHN). The performance of these methods was evaluated in terms of the recovery of the introduced theoretical hypometabolic pattern and the appearance of unspecific hypometabolic and hypermetabolic findings. Results Detected hypometabolic patterns had significantly lower volumes than the introduced hypometabolisms for all intensity normalization methods particularly for slighter reductions in metabolism . Among the intensity normalization methods, RRC and HN provided the largest recovered hypometabolic volumes, while the RRBS showed the smallest recovery. In general, data-driven methods overcame reference regions and among them, the iterative methods overcame the non-iterative ones. Unspecific hypermetabolic volumes were similar for all methods, with the exception of PS, where it became a major limitation (up to 250 cm3) for extended and intense hypometabolism. On the other hand, unspecific hypometabolism was similar far all methods, and usually solved with appropriate clustering. Conclusions Our findings showed that the inappropriate use of intensity normalization methods can provide remarkable bias in the detected hypometabolism and it represents a serious concern in terms of false positives. Based on our findings, we recommend the use of histogram-based intensity normalization methods. Reference region methods performance was equivalent to data-driven methods only when the selected reference region is large and stable.
Partial volume correction in longitudinal tau PET studies: is it really needed?
(Elsevier, 2024) Costoya Sánchez, Alejandro; Moscoso Rial, Alexis; Sobrino Moreiras, Tomás; Ruibal Morell, Álvaro; Grothe, Michel J.; Schöll, Michael L.; Silva Rodríguez, Jesús; Aguiar Fernández, Pablo; Universidade de Santiago de Compostela. Centro de Investigación en Medicina Molecular e Enfermidades Crónicas (CiMUS); Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Background [18F]flortaucipir (FTP) tau PET quantification is known to be affected by non-specific binding in off-target regions. Although partial volume correction (PVC) techniques partially account for this effect, their inclusion may also introduce noise and variability into the quantification process. While the impact of these effects has been studied in cross-sectional designs, the benefits and drawbacks of PVC on longitudinal FTP studies is still under scrutiny. The aim of this work was to study the performance of the most common PVC techniques for longitudinal FTP imaging. Methods A cohort of 247 individuals from the Alzheimer's Disease Neuroimaging Initiative with concurrent baseline FTP-PET, amyloid-beta (Aβ) PET and structural MRI, as well as with follow-up FTP-PET and MRI were included in the study. FTP-PET scans were corrected for partial volume effects using Meltzer's, a simple and popular analytical PVC, and both the region-based voxel-wise (RBV) and the iterative Yang (iY) corrections. FTP SUVR values and their longitudinal rates of change were calculated for regions of interest (ROI) corresponding to Braak Areas I-VI, for a temporal meta-ROI and for regions typically displaying off-target FTP binding (caudate, putamen, pallidum, thalamus, choroid plexus, hemispheric white matter, cerebellar white matter, and cerebrospinal fluid). The longitudinal correlation between binding in off-target and target ROIs was analysed for the different PVCs. Additionally, group differences in longitudinal FTP SUVR rates of change between Aβ-negative (A-) and Aβ-positive (A+), and between cognitively unimpaired (CU) and cognitively impaired (CI) individuals, were studied. Finally, we compared the ability of different partial-volume-corrected baseline FTP SUVRs to predict longitudinal brain atrophy and cognitive decline. Results Among off-target ROIs, hemispheric white matter showed the highest correlation with longitudinal FTP SUVR rates from cortical target ROIs (R2=0.28–0.82), with CSF coming in second (R2=0.28–0.42). Application of voxel-wise PVC techniques minimized this correlation, with RBV performing best (R2=0.00–0.07 for hemispheric white matter). PVC also increased group differences between CU and CI individuals in FTP SUVR rates of change across all target regions, with RBV again performing best (No PVC: Cohen's d = 0.26–0.66; RBV: Cohen's d = 0.43–0.74). These improvements were not observed for differentiating A- from A+ groups. Additionally, voxel-wise PVC techniques strengthened the correlation between baseline FTP SUVR and longitudinal grey matter atrophy and cognitive decline. Conclusion Quantification of longitudinal FTP SUVR rates of change is affected by signal from off-target regions, especially the hemispheric white matter and the CSF. Voxel-wise PVC techniques significantly reduce this effect. PVC provided a significant but modest benefit for tasks involving the measurement of group-level longitudinal differences. These findings are particularly relevant for the estimations of sample sizes and analysis methodologies of longitudinal group studies.
Implementation of health warnings on alcoholic beverages in Spain
(Elsevier, 2025-06) Sordo del Castillo, Luis; Padilla Cruz, Jarileen; Bosque Prous, Marina; Díaz Geada, Ainara; Barrio Anta, Gregorio; Lafon Guasch, Aina; Rogés Olivares, Judit; Galán Labaca, Iñaki; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Introduction: The objective of this study is to estimate the frequency and characteristics of health warning labeling on alcoholic beverages in Spain. Study design: Cross-sectional study conducted in Madrid, Spain, between March and April 2023. Methods: A convenience sample was designed by selecting four supermarket chains with a 40 % share of food distribution and two specialized alcohol stores. A total of 627 products were examined: 170 beers, 306 wines and sparkling wines, 68 liquors, 48 vermouths and aperitifs, and 35 other types of alcoholic beverages. Fisher's exact test statistically evaluated differences in labeling across beverage types. Results: One or more health warnings were observed on 63.0 % of the products, with the most frequent being a recommendation against consumption during pregnancy (56.5 %), followed by recommendations against consumption by minors (19.0 %), and while driving (9.1 %). Only 9.1 % of the labels displayed two warnings, and 6.2 % displayed three. Significant differences were observed according to beverage type (p < 0.001), with the beer products presenting the highest frequency of displaying at least one warning (81.8 %), and liquors presenting the lowest frequency (50 %). Conclusions: In Spain, alcohol industry's adherence to its own voluntary labeling guidelines of health warnings is low and inconsistent across type of beverages.
White matter hyperintensities are associated with subthreshold amyloid accumulation
(Elsevier, 2020) Moscoso Rial, Alexis; Rey Bretal, David; Silva Rodríguez, Jesús; Aldrey Vázquez, José Manuel; Cortés Hernández, Julia; Pías Peleteiro, Juan Manuel; Ruibal Morell, Álvaro; Aguiar Fernández, Pablo; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
The association between white matter hyperintensities (WMH) and amyloid accumulation over time in cognitively normal, amyloid-negative elderly people remains largely unexplored. In order to study whether baseline WMH were associated with longitudinal subthreshold amyloid accumulation, 159 cognitively normal participants from the Alzheimer’s Disease Neuroimaging Initiative who were amyloid-negative at baseline were examined. All the participants underwent a T1 and a Fluid-Attenuated Inversion Recovery MRI scan at baseline. Amyloid PET imaging was performed at baseline and follow-up visits in 2-year intervals for up to 8 years. Partial volume correction was applied for quantifying cortical Standardised Uptake Value Ratios (SUVR). The associations between global and regional WMH burden and amyloid accumulation were assessed using linear mixed models adjusted by demographic characteristics and baseline SUVR. Partial volume correction increased the measured annual rate of change (+2.4%) compared to that obtained from non-corrected data (+0.5%). There were no significant correlations between baseline WMHs and baseline subthreshold cortical amyloid uptake. In a longitudinal analysis, increased baseline cortical SUVR and increased baseline burden of global (p = 0.006), frontal (p = 0.006), and parietal WMH (p = 0.003) were associated with faster amyloid accumulation. WMH-related amyloid accumulation occurred in parietal, frontal, and, to a lesser extent, cingulate cortices. These results remained unchanged after a sensitivity analysis excluding participants with the highest cortical SUVRs. This is the first study to identify a specific spatial distribution of WMH which is associated with future amyloid accumulation in cognitively normal elderly subjects without PET-detectable amyloid pathology. These findings may have important implications in prevention trials for the early identification of amyloid accumulation.
Social and experiential drivers of adolescent alcohol use: evidence from an exploratory concept mapping study
(MDPI, 2026-03-20) Ares Maneiro, Sheila; Espelt Hernández, Albert; Antelo Iglesias, Lucía; Teixidó Compañó, Ester; Bosque Prous, Marina; Colomeda Cortada, Èlia; Moure Rodríguez, Lucía; Díaz Geada, Ainara; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Background/Objectives: To identify and prioritize adolescents’ motivations for alcohol consumption using a participatory qualitative approach. Methods: We conducted a concept mapping study with 39 adolescents aged 15–16 years from a public secondary school in Santiago de Compostela, Spain. Participants generated statements in response to a focal question about reasons for drinking, grouped them into categories, and then rated each statement according to perceived frequency and importance using a five-point Likert scale. Results: A total of 41 statements were generated and organized into eight clusters: peer approval, influence, enjoyment, experimentation, fun, disinhibition, social pressure, and coping. Motivations related to fun, peer dynamics, and disinhibition received the highest ratings for both frequency and importance. In contrast, motivations linked to advertising, social media, and influencers were rated lowest. A strong positive association was observed between perceived importance and reported frequency across statements. Conclusions: Adolescents identified enjoyment and peer dynamics as the primary motivations for alcohol use, emphasising the significance of social influences in adolescent drinking behaviours. Despite the necessity for cautious interpretation of findings due to the context-specific nature of the sample, the results suggest that prevention efforts may benefit from the promotion of alcohol-free social environments, the strengthening of social emotional skills, and the involvement of adolescents in preventive initiatives.
Quantitative PET tracking of intra-articularly administered 89Zr-peptide-decorated nanoemulsions
(Elsevier, 2023) Díez Villares, Sandra; García Varela, Lara; Groba de Antas, Soraya; Caeiro Rey, José Ramón; Carpintero-Fernandez, Paula; Mayán, María D.; Aguiar Fernández, Pablo; Fuente, María de la; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina; Universidade de Santiago de Compostela. Centro de Investigación en Medicina Molecular e Enfermidades Crónicas (CiMUS)
Intra-articular (IA) administration of drugs for the treatment of diseases such as rheumatoid arthritis, osteoarthritis and psoriatic arthritis is a common strategy; however, the rapid clearance from the synovial fluid restricts their effectivity due to the limited retention time. Drug Delivery Systems (DDS) are currently being developed to increase their joint retention time. This study compares the biodistribution and retention time of a senolytic peptide (PEP), with potential application in osteoarthritis disease, and this senolytic peptide encapsulated in a DDS based on a lipid nanoemulsion (PEPsingle bondNE) by using positron emission tomography (PET) imaging. To this aim, the PEP was conjugated with a chelating agent (DFO) and radiolabeled with zirconium-89 (89Zr). Then, [89Zr]-PEP was encapsulated in a novel nanoemulsion formulation, composed by vitamin E, sphingomyelin, and a lipid-PEG. Afterward, healthy rats were administered with either the [89Zr]-PEP or the [89Zr]-PEP-NE via IA injection and underwent PET scans at 0.5-, 24-, 48-, 72-, 168-, 240- and 336 h post-injection. To assess the biodistribution of both radiotracers, several volume-of-interest were manually drawn in different organs of the rat body and the %ID/organ was calculated. The [89Zr]-PEP was successfully encapsulated in the NE and their physicochemical properties were minimally affected by the radiolabeling buffer. Adequate stability of both [89Zr]-PEP and [89Zr]-PEP-NE was found in synovial fluid over 72 h. Quantitative data from PET images revealed a significantly higher [89Zr]-PEP-NE retention in the injected knee than with [89Zr]-PEP in all follow-up PET scans. The [89Zr]-PEP %ID/organ values in the liver and kidney were significantly higher than those from [89Zr]-PEP-NE, which might indicate a faster elimination of the [89Zr]-PEP. Therefore, the study highlights the higher retention time on the target site of the [89Zr]-PEP-NE which may improve the therapeutic effects of the peptide. Thereby, the novel nanoemulsion formulation seems to be a successful DDS for IA injection. In addition, these results represent the first study that evaluates the distribution of a PET-guided DDS after its IA administration.
Increased Medial Temporal Tau Positron Emission Tomography Uptake in the Absence of Amyloid-β Positivity
(American Medical Association, 2023) Costoya Sánchez, Alejandro; Moscoso Rial, Alexis; Silva Rodríguez, Jesús; Pontecorvo, Michael J.; Devous Sr., Michael D.; Aguiar Fernández, Pablo; Schöll, Michael; Grothe, Michel J.; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Importance An increased tau positron emission tomography (PET) signal in the medial temporal lobe (MTL) has been observed in older individuals in the absence of amyloid-β (Aβ) pathology. Little is known about the longitudinal course of this condition, and its association with Alzheimer disease (AD) remains unclear. Objective To study the pathologic and clinical course of older individuals with PET-evidenced MTL tau deposition (TMTL+) in the absence of Aβ pathology (A−), and the association of this condition with the AD continuum. Design, Setting, and Participants A multicentric, observational, longitudinal cohort study was conducted using pooled data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), Harvard Aging Brain Study (HABS), and the AVID-A05 study, collected between July 2, 2015, and August 23, 2021. Participants in the ADNI, HABS, and AVID-A05 studies (N = 1093) with varying degrees of cognitive performance were deemed eligible if they had available tau PET, Aβ PET, and magnetic resonance imaging scans at baseline. Of these, 128 participants did not meet inclusion criteria based on Aβ PET and tau PET biomarker profiles (A+ TMTL−). Exposures Tau and Aβ PET, magnetic resonance imaging, cerebrospinal fluid biomarkers, and cognitive assessments. Main Outcomes and Measures Cross-sectional and longitudinal measures for tau and Aβ PET, cortical atrophy, cognitive scores, and core AD cerebrospinal fluid biomarkers (Aβ42/40 and tau phosphorylated at threonine 181 p-tau181 available in a subset). Results Among the 965 individuals included in the study, 503 were women (52.1%) and the mean (SD) age was 73.9 (8.1) years. A total of 51% of A− individuals and 78% of A+ participants had increased tau PET signal in the entorhinal cortex (TMTL+) compared with healthy younger (aged <39 years) controls. Compared with A− TMTL−, A− TMTL+ participants showed statistically significant, albeit moderate, longitudinal (mean [SD], 1.83 [0.84] years) tau PET increases that were largely limited to the temporal lobe, whereas those with A+ TMTL+ showed faster and more cortically widespread tau PET increases. In contrast to participants with A+ TMTL+, those with A− TMTL+ did not show any noticeable Aβ accumulation over follow-up (mean [SD], 2.36 [0.76] years). Complementary cerebrospinal fluid analysis confirmed longitudinal p-tau181 increases in A− TMTL+ in the absence of increased Aβ accumulation. Participants with A− TMTL+ had accelerated MTL atrophy, whereas those with A+ TMTL+ showed accelerated atrophy in widespread temporoparietal brain regions. Increased MTL tau PET uptake in A− individuals was associated with cognitive decline, but at a significantly slower rate compared with A+ TMTL+. Conclusions and Relevance In this study, individuals with A− TMTL+ exhibited progressive tau accumulation and neurodegeneration, but these processes were comparably slow, remained largely restricted to the MTL, were associated with only subtle changes in global cognitive performance, and were not accompanied by detectable accumulation of Aβ biomarkers. These data suggest that individuals with A− TMTL+ are not on a pathologic trajectory toward AD.

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