Instituto Murciano de Investigación Biosanitaria

To evaluate the effectiveness and safety of external cephalic version (ECV) performed with tocolysis and sedation or spinal anesthesia, and to identify predictors of ECV success, complications, and delivery outcomes after successful ECV. This 10-year cohort study included 990 pregnant women with term non-cephalic presentation at a tertiary hospital in Spain. Data were collected retrospectively (2014-2020) and prospectively (2020-2024). All ECVs followed a standardized protocol using ritodrine plus either propofol sedation or spinal anesthesia. Multivariable logistic regression identified predictors of ECV success and complications, and delivery outcomes were recorded. ECV was successful in 691/990 (69.8%). Factors associated with higher success included a deepest amniotic fluid pocket >30 mm (OR = 1.80; 95%CI 1.04-3.11) and transverse lie (OR = 3.60; 95%CI 1.74-7.45). Lower success was observed in nulliparous women (OR = 0.55; 95%CI 0.40-0.76) and those with BMI between 30 and 35, and >35 kg/m2 (OR = 0.53 and 0.49 respectively). Complications occurred in 101/990 (10.2%), including 67/990 (6.7%) emergent cesarean sections. After successful ECV, 556/691 (80.5%) delivered vaginally. In this high-volume tertiary center, ECV performed with systematic tocolysis and sedation or spinal anesthesia achieved high success and low complication rates, supporting the safety and feasibility of this optimized protocol.

Postmenopausal women are approximately twice as likely to develop cardiometabolic diseases (CMDs) as premenopausal women. Plant-based diets rich in fruits and vegetables, due to their high content of bioactive compounds such as (poly)phenols, represent a promising strategy to reduce the risk of CMDs in this population. However, the cardioprotective effects of (poly)phenols depend largely on inter-individual variability, which is strongly influenced by the gut microbiota composition. Menopause is often associated with gut dysbiosis, characterized by a reduced microbial diversity and a lower abundance of beneficial bacteria. This imbalance in the gut microbiota profile of postmenopausal women could influence (poly)phenol metabolism and, consequently, the health benefits attributed to (poly)phenol-rich food (PP-rich food) consumption. Therefore, this study aimed to assess the impact of a daily consumption of PP-rich foods (dark chocolate, green tea and fruit juice) for 2 months on the urinary phenolic profile in postmenopausal women at high cardiometabolic risk. To this end, 116 urinary phenolic metabolites were determined using UHPLC-ESI-QqQ-MS/MS. Dietary intervention with PP-rich foods led to a significant increase in the urinary excretion of phenolic metabolites derived from gut microbiota activity and phase II metabolism. Notably, there was a significant increase in the excretion of glucuronidated and/or sulfated conjugates of phenyl-γ-valerolactones, phenylvaleric acids, phenylacetic acids, benzoic acids, and urolithins. It is expected that these phenolic metabolites could be the bioactive compounds responsible for the potential beneficial effects derived from the daily intake of dark chocolate, green tea, and fruit juice on the reduction of the risk of CMDs in postmenopausal women.

This study exploresthe therapeutic potential of seven bis-cyclometalatedIr­(III) complexes (1–7), derived from the 2,2′-(benzothiazolyl)­benzimidazolescaffold, as highly promising next-generation photoactivatable agentsfor type I and type II-guided photodynamic therapy (PDT) in lung andcolorectal cancers. Their high phototoxicity in 2D and 3D cancer cellmodels, achieving IC50 values in the nanomolar region,was closely linked to the generation of singlet oxygen and type Ireactive oxygen species (ROS) and the photooxidation of NADH, withcomplex 4 identified as the strongest ROS inducer andthe most photocytotoxic complex. Notably, the iridium complexes provedto maintain their phototoxicity in hypoxic conditions. Using 3D spheroids,complex 4 demonstrated deep tissue penetration soughtto overcome PDT limitations in solid tumors. Overall, the synthesizedcomplexes showcase high efficacy and favorable pharmacological profiles,positioning them as promising candidates for the ROS-guided photodynamictreatment of cancers, including those located within hypoxic environments.

Polyphenols represent the largest and most diverse class of dietary antioxidants. Epidemiological evidence linking specific (poly)phenol classes, such as flavonoids and lignans, to breast cancer (BC) risk remains limited and largely inconclusive in prospective studies. The aim of this study is to examine the association between the intake of total (poly)phenols-and its classes and subclasses-and BC risk-overall and by subtypes (estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2))-in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The EPIC cohort includes 257,960 adult women from seven European countries. During a mean follow-up of 14 years, there were 10,722 incident overall BC cases. Associations were computed using Cox regression models adjusted for potential confounders. No significant associations were found between total (poly)phenol intake and overall BC risk (HRQ5 vs. Q1 = 1.02; 95% CI: 0.95-1.11). In addition, null associations were mostly found between classes and subclasses of (poly)phenols and BC subtypes. After stratifying by menopausal status, no significant associations were observed. In conclusion, this study found no evidence of associations between the intake of any class or subclass of (poly)phenols and BC risk in the European population.

Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder characterized by recurrent upper airway collapse, intermittent hypoxia, and sleep fragmentation. Increasing evidence suggests a bidirectional association between OSA and lower respiratory tract infections (LRTIs), including pneumonia, bronchitis, and exacerbations of chronic lung disease. Multiple mechanisms may underlie this relationship. Intermittent hypoxia and sleep disruption promote systemic inflammation and immune dysregulation. Impaired mucociliary clearance, microaspiration, alterations in airway microbiota, together with obesity and related comorbidities, further contribute to increased susceptibility to and severity of infections. Observational studies demonstrate that individuals with untreated OSA have higher rates of pneumonia, more severe infections, and delayed recovery from infections compared with non-OSA populations. These risks are particularly evident among older adults and patients with cardiopulmonary comorbidities. Continuous positive airway pressure (CPAP) therapy may mitigate infection risk by maintaining airway patency, reducing hypoxemia, and improving mucociliary clearance. However, concerns remain regarding CPAP device-associated microbial colonization, highlighting the importance of strict hygiene practices and equipment maintenance. OSA appears to be an underrecognized risk factor for LRTIs; this association is driven by overlapping pathophysiological mechanisms and is supported by emerging epidemiological data. Recognizing this interplay may guide infection prevention strategies and improve clinical outcomes in high-risk populations.

Pleural mesothelioma (PM) is a rare, asbestos-linked cancer with a long asymptomatic latency, delaying diagnosis and limiting treatment options. Identifying blood‐based biomarkers that signal disease before symptoms onset could improve surveillance of at‐risk individuals. In our work, we conducted a prospective proteomic study of pre-diagnostic serum from 21 PM cases (< 5 years before diagnosis) and 21 asbestos‐exposed controls in the EPIC cohort using SWATH‐MS, followed by ELISA validation. Findings were tested in an independent MoMar cohort of 32 pre‐diagnostic plasma samples (< 1 year before diagnosis) and 32 matched controls. SWATH-MS identified 12 differentially expressed proteins (nominal p < 0.05, fold change > 1.3 or < 0.75). Transferrin and complement C4A were elevated, while beta‐2‐microglobulin and dermcidin were reduced in pre‐diagnostic cases. ELISA confirmed a borderline significant rise in beta‐2‐microglobulin within two years of diagnosis in EPIC. Calretinin and mesothelin were also detected in both cohorts, with the five‐marker panel achieving an AUC of 0.91 (p = 0.001) in MoMar but not reaching significance in EPIC (AUC = 0.88, p = 0.17). Integrating novel proteomic biomarker candidates with established markers enhances early PM detection in high-risk populations. Larger, multi‐cohort validation is warranted to refine this biomarker panel for clinical surveillance.

Background/Objectives: Obesity is an increasingly concerning public health issue due to its high prevalence and its association with multiple comorbidities. A significant proportion of patients with obesity who undergo bariatric surgery could exhibit suboptimal mid-term outcomes. This study aims to comprehensively assess anthropometric, clinical, biochemical, nutritional, and quality of life parameters in patients with severe obesity undergoing bariatric surgery, with a particular focus on outcomes at 24 months post-surgery to capture mid-term effects that may not be apparent during the first year of follow-up. Methods: A prospective study was conducted in 95 patients with obesity undergoing bariatric surgery (Roux-en Y gastric bypass; RYGB) at the Virgen de la Arrixaca University Clinical Hospital (Murcia, Spain) between 2020 and 2023. Participants were followed up at 6, 12, and 24 months after RYGB. The study incorporated anthropometric assessments (BMI, body composition via bioelectrical impedance), full biochemical profiling, dietary analysis (using a validated food frequency questionnaire), and quality of life assessment (SF-36 questionnaire). Results: Our results showed significant weight loss after the intervention, accompanied by improvements in metabolic parameters, and dietary habits. Regarding quality of life, significant improvements were observed in both the physical (baseline: 39.62%; 6 months: 52.40%; 12 months: 53.12%) and mental components (baseline: 42.08; 6 months: 53.40; 12 months: 52.14%) at 6 and 12 months post-surgery. However, our prospective 24-month follow-up revealed that, despite these initial benefits, mental health significantly declined compared with the 12-month follow-up (24 months: 46.85%). In contrast, the physical component remained relatively stable at 24 months (24 months: 50.91%). However, our prospective 24-month follow-up revealed that, despite these initial benefits, there was a decline in mental health compared to the 12-month follow-up. Conclusions: While bariatric surgery is associated with improvements in anthropometric measures and some aspects of quality of life, our findings underscore the need for continued mid-term support to address emerging challenges in mental well-being.