https://hdl.handle.net/2072/478916 2026-04-19T09:14:52Z https://hdl.handle.net/2445/228940 Nasal sublesional Bevacizumab injections as adjuvant treatment for diffuse sinonasal exophytic papillomas Penella, Anna; Michavila, Adriana; Fulla, Marta; Leiva Badosa, Elisabet; Brunet, Aina; Foglia Fernández, Maria; Gonzalez Compta, Francesc Xavier Background/Objectives: Diffuse sinonasal exophytic papillomas (DSNEPs) are rare entities, with similarities to recurrent respiratory papillomatosis (RRPs). DSNEP treatment is usually based on surgical excision, but the recurrence rate is high. Bevacizumab injections have been increasingly used as an adjuvant option for RRP, but their role in DSNEP treatment remains unknown. The current study describes the preliminary experience, safety profile, and exploratory outcomes of sublesional bevacizumab injections following surgical excision. Methods: We undertook a retrospective, single-centre study of a cohort of patients diagnosed with DSNEP between 2011 and 2018. All patients were treated with surgical excision and sublesional bevacizumab injections. The effect of bevacizumab was evaluated using a severity score developed to quantify lesion size and the extent of affected areas in each patient. Results: Seven patients diagnosed with DSNEP were treated. All patients were male, with a median age at diagnosis of 42 years [38–44.5]. Human papillomavirus (HPV) DNA was detected in all patients: HPV-11 in six cases (85.7%) and HPV-6 in one case (14.3%). Bevacizumab was injected into the submucosa of their surgical sites. The median follow-up was 55.5 months [40.85–82.73]. Most patients (85.72%) presented recurrence, with a median of 3 years [1.5–4]. A statistically significant reduction in the severity score was observed (p = 0.017), although this finding cannot be attributed solely to bevacizumab due to study design limitations. No relevant complications were reported. Conclusions: Nasal sublesional bevacizumab injections were well tolerated and feasible as an adjuvant approach to DSNEP. Larger prospective studies are needed to confirm its safety and assess its potential benefit. 2026-04-15T10:13:44Z https://hdl.handle.net/2445/228925 Palmaris longus muscle and its variations: Ultrasound anatomical and histological study with clinical and surgical applications Miguel Pérez, Ma. Isabel; Muñiz Delgado, Ángel; Ortiz Miguel, Sara; López Prades, Sandra; Ortiz Sagristà, Juan Carlos; Miralles, Cristina; Ruiz Roig, Núria; Möller, Ingrid; Pérez Bellmunt, Albert Background/objective: The palmaris longus muscle is a variable and often inconsistent muscle in the anterior compartment of the forearm. This fusiform-shaped muscle originates at the medial epicondyle of the humerus bone following a long and narrow tendon that inserts at the palmar aponeurosis. That tendon is used in reconstructive surgery, and for this reason, detailed information from an ultrasound is used to detect the tendon and the possible variations in the muscle. The present study aimed to investigate the palmaris longus muscle and its variations through ultrasound, anatomical, and histological analysis with clinical and surgical applications. Methods: A total of 72 upper limbs from 33 females and 39 males, 32 right and 40 left, were evaluated in ultrasound, anatomical, and histological studies. The main objective was to prove the existence of the palmaris longus muscle and its variations, as well as to measure the tendon for surgical applications. Results: Ultrasound analysis showed that it is possible to determine the existence of the muscle (76.4%) and its variations (23.6%), as well as its absence (15.3%). The anatomical results proved the ultrasound results. The width of the tendon was between 0.4 and 0.38 mm. by ultrasound and anatomical analysis. Also, normal palmaris longus tendons were not a direct cause of compression of the median nerve. Conclusions: It is important to confirm the existence and possible variations in the palmaris longus muscle and tendon through ultrasound before surgical reconstruction and for clinical diagnostics. 2026-04-15T07:58:59Z https://hdl.handle.net/2445/228894 Antibody and Cellular Immune Responses in Old α1,3-Galactosyltransferase-Knockout Mice Implanted with Bioprosthetic Heart Valve Tissues Casós, Kelly; Llatjós, Roger; Blasco Lucas, Arnau; Kuguel, Sebastián G.; Sbraga, Fabrizio; Galli, Cesare; Padler-Karavani, Vered; Le Tourneau, Thierry; Vadori, Marta; Roussel, Jean-Christian; Bottio, Tomaso; Cozzi, Emanuele; Soulillou, Jean Paul; Galiñanes, Manuel; Mañez, Rafael; Costa, Cristina Structural valve deterioration (SVD) remains a key limitation in bioprosthetic heart valve (BHV) usage influenced by patient age. A deeper understanding of SVD pathogenesis, particularly of the immune-mediated processes altering current BHV materials, is therefore critical. To this end, commercially available BHV tissues of bovine, porcine, and equine origin were investigated following subcutaneous implantation into alpha 1,3-galactosyltransferase-knockout (Gal KO) mice. We compared the immune responses between adult and aged animals via histological assessments of explants and measurement of serum anti-galactose alpha 1,3-galactose (Gal) and anti-non-Gal antibodies at 2 months post-implantation. In contrast to adult mice, old Gal KO mice did not show increased levels of serum anti-Gal or -non-Gal antibodies after receiving specific BHV tissue (i.e., Freedom-Solo). Instead, a significant decrease in serum anti-Gal IgM was found in old recipients of Freedom-Solo. Furthermore, the overall cellular immune response was attenuated in explants from old mice compared with adults (i.e., ATS 3f and Crown). Nevertheless, the Freedom-Solo (bovine) and the Hancock-II (porcine) tissues still elicited strong cellular immune infiltration in the old cohorts. Therefore, the Gal KO mouse model offers a valuable platform to investigate age-related differences regarding cellular and humoral immune responses to various BHV tissues, contributing to our understanding of SVD. 2026-04-14T10:21:14Z https://hdl.handle.net/2445/228880 Population-based national incidence of thyroid dysfunction in Spain Alonso, Silvia Patricia; Colomo, Natalia; Montanya Mias, Eduard; Lago Sampedro, Ana; Maldonado Araque, Cristina; García Fuentes, Eduardo Thyroid dysfunction is a common health disorder. However, data on its incidence remain scarce and geographically limited. This study aimed to assess the incidence of thyroid dysfunction in the Spanish adult population and factors associated with its onset. A nationwide observational population‑based cohort study was conducted, including 1,629 euthyroid individuals (not receiving levothyroxine/thionamides, and TSH levels of 0.2-5.0mIU/mL) at baseline (2008–2010), who were re-evaluated in 2016–2017. Multivariable logistic regression analysis assessed the association between incident thyroid dysfunction and potential exposure factors. ROC analysis identified optimal TPOAb and TSH cut-offs for predicting incident hypothyroidism. The age- and sex-adjusted incidence of hypothyroidism was 13.38cases/1,000persons-year (CI95% 10.52–16.25) for TSH ≥ 5mIU/mL, and 6.78cases/1,000persons-year (CI95% 4.73–8.83) for TSH ≥ 10mIU/mL. The incidence of hyperthyroidism was 2.65cases/1,000persons-year (CI95% 1.46–3.83). Female sex, age between 30 and 40 and > 60 years, TPOAb > 20mIU/L and TSH > 2.8mIU/mL were independently associated with new cases of hypothyroidism. The presence of obesity, diabetes or urinary iodine levels were not associated with the incidence of thyroid disease. Baseline TPOAb and TSH cut-offs best predicting hypothyroidism were 9.1mIU/L (AUC 0.654; CI95% 0.583–0.725; p < 0.001), and 2.03mIU/mL (AUC 0.702; CI95% 0.639–0.766; p < 0.001) respectively. This study provides data on incidence rates and risk factors of thyroid dysfunction in the adult Spanish population. 2026-04-14T07:46:27Z