Person: Martín Saborido, Carlos
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Carlos
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Martín Saborido
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Medicina
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Item Grape Polyphenols to Arrest in Vitro Proliferation of Human Leukemia Cells: A Systematic Review and Meta-analysis.(Food Reviews International, 2022) García Martínez, Daniel Jesús; Calzada Funes, Javier; Martín Saborido, Carlos; Santos Tejedor, CruzLeukemia is a heterogeneous group of hemopoietic cancers, which accounts for 2.6% of new cases per year of total cancer incidence worldwide. Grapes and grape-derived products, such as grape juice, are naturally rich in polyphenols, bioactive compounds with antioxidant properties. Certain polyphenols have been proved to alter oxidative balance, both in inducing apoptosis in cancer cells and in preventing cancer development via controlling oxidative stress. To assess the therapeutic potential of grape polyphenols in the treatment of leukemia, a systematic review and meta-analysis of the reported data on leukemia was carried out. Following the PRISMA guide, a literature review of published papers on leukemia and polyphenols from the last 50 years was conducted, and 17 scientific articles published from 2002 to 2017 were included in the study. Resveratrol 50 μM had the highest growth inhibition effect (67%) followed by quercetin (30%). The results also point to a differential effect of polyphenols based on cell lineage; monocytes- and myelocytic-derived cell lines are the most susceptible, with a mean of 85% and 64% proliferation inhibition, respectively. Moreover, results show that growth inhibition cannot be associated with a molecular effect of polyphenols on the cell cycle arrest.Item PrediCTC, liquid biopsy in precision oncology: a technology transfer experience in the Spanish health system.(Clinical and Translational Oncology, 2017) Alonso Alconada, Lorena; Barbazan, Jorge; Candamio, Sonia; Falco, Josep Lluis; Antón Rodríguez, Cristina; Martín Saborido, Carlos; Fuster, Gustavo; Sampedro, Mabel; Grande, Carlos; Lado, Rubén; Sampietro Colom, Laura; Crego, Eladio; Figueiras, Sergio; León Mateos, Luis; López López, Rafael; Abal, MiguelPurpose: Management of metastatic disease in oncology includes monitoring of therapy response principally by imaging techniques like CT-Scan. In addition to some limitations, the irruption of liquid biopsy and its application in personalized medicine has encouraged the development of more efficient technologies for prognosis and follow-up of patients in advanced disease. Methods: PrediCTC constitutes a panel of genes for the assessment of Circulating Tumor Cells (CTC) in metastatic colorectal cancer patients, with demonstrated improved efficiency compared to CT-Scan for the evaluation of early therapy response in a multicenter prospective study. In this work, we designed and developed a technology transfer strategy to define the market opportunity for an eventual implementation of PrediCTC in the clinical practice. Results: This included the definition of the regulatory framework, the analysis of the regulatory roadmap needed for CE mark, a benchmarking study, the design of a product development strategy, a revision of intellectual property, a cost-effectiveness study and an expert panel consultation. Conclusion: The definition and analysis of an appropriate technology transfer strategy and the correct balance among regulatory, financial and technical determinants are critical for the transformation of a promising technology into a viable technology, and for the decision of implementing liquid biopsy in the monitoring of therapy response in advanced disease.Item Subjective assessment reported by patients shows differences between single-bundle and double-bundle anterior cruciate ligament reconstruction, systematic review and meta-analysis.(Scientific Reports, 2021) Maestro, Antonio; Herruzo Priego, Irene; Varillas Delgado, David; Martín Saborido, CarlosTo determine the functional recovery, active reincorporation, and anteroposterior and rotational stability of patients undergoing anterior cruciate ligament (ACL) reconstruction using arthroscopy techniques with simple-bundle (SB) or double-bundle (DB). The following databases were searched: PubMed, Embase (Elsevier platform), the Cochrane Central Register of Controlled Trials (Wiley platform), Web of Science, and CINAHL. Level I and II studies involving anterior cruciate ligament arthroscopy were included in the search. Records were screened by title and abstract and assessed the risk of bias of selected studies. Meta-analyses using RevMan 5.3 software were conducted on the following outcomes: knee functionality, objective measurements of knee stability, rotational knee stability and knee anterior stability, sports reincorporation, and subjective assessments. Twenty-four studies of patients undergoing ACL reconstruction were included in the qualitative and quantitative synthesis (1707 patients) for Lysholm score, Subjective International Knee Documentation Committee (IKDC) score, Tegner score, KT-1000/2000, Lachman test, Objective IKDC score, and Pivot-Shift test. A return to pre-injury level showed a significant decrease in the Lysholm score (mean difference, − 0.99; 95% CI − 1.71 to − 0.40; P = 0.007) and Tegner score (mean difference, − 0.07; 95% CI, − 0.13 to − 0.01; P = 0.02) at DB reconstruction, similar to the knee functionality outcome of the subjective IKDC score (mean difference − 1.42; 95% CI − 2.46 to − 0.38; P = 0.007). There is no clear or significant difference in clinical stability and knee function or in sports incorporation with the true difference occurring in the subjective assessment.Item Public health economic evaluation of different European Union–level policy options aimed at reducing population dietary trans fat intake.(The American Journal of Clinical Nutrition, 2016-09) Martín Saborido, Carlos; Mouratidou, Theodora; Livaniou, Anastasia; Caldeira, Sandra; Wollgast, JanBackground: The adverse relation between dietary trans fatty acid (TFA) intake and coronary artery disease risk is well established. Many countries in the European Union (EU) and worldwide have implemented different policies to reduce the TFA intake of their populations. Objective: The aim of this study was to assess the added value of EU-level action by estimating the cost-effectiveness of 3 possible EU-level policy measures to reduce population dietary TFA intake. This was calculated against a reference situation of not implementing any EU-level policy (i.e., by assuming only national or selfregulatory measures).Item Indomethacin for intracranial hypertension secondary to severe traumatic brain injury in adults.(Cochrane Database of Systematic Reviews, 2019) Martín Saborido, Carlos; López Alcalde, Jesús; Ciapponi, Agustín; Sánchez Martín, Carlos Enrique; Garcia Garcia, Elena; Escobar Aguilar, Gema; Palermo, Maria Carolina; Baccaro, Fernando GBackground Among people who have suffered a traumatic brain injury, increased intracranial pressure continues to be a major cause of early death; it is estimated that about 11 people per 100 with traumatic brain injury die. Indomethacin (also known as indometacin) is a powerful cerebral vasoconstrictor that can reduce intracranial pressure and, ultimately, restore cerebral perfusion and oxygenation. Thus, indomethacin may improve the recovery of a person with traumatic brain injury. Objectives To assess the effects of indomethacin for adults with severe traumatic brain injury. Search methods We ran the searches from inception to 23 August 2019. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 8) in the Cochrane Library, Ovid MEDLINE, Ovid Embase, CINAHL Plus (EBSCO), four other databases, and clinical trials registries. We also screened reference lists and conference abstracts, and contacted experts in the field. Selection criteria Our search criteria included randomised controlled trials (RCTs) that compared indomethacin with any control in adults presenting with severe traumatic brain injury associated with elevated intracranial pressure, with no previous decompressive surgery. Data collection and analysis Two review authors independently decided on the selection of the studies. We followed standard Cochrane methods. Main results We identified no eligible studies for this review, either completed or ongoing. Authors' conclusions We found no studies, either completed or ongoing, that assessed the effects of indomethacin in controlling intracranial hypertension secondary to severe traumatic brain injury. Thus, we cannot draw any conclusions about the effects of indomethacin on intracranial pressure, mortality rates, quality of life, disability or adverse effects. This absence of evidence should not be interpreted as evidence of no effect for indomethacin in controlling intracranial hypertension secondary to severe traumatic brain injury. It means that we have not identified eligible research for this review.Item Rehabilitative Ultrasound Imaging Evaluation in Physiotherapy: Piloting a Systematic Review.(Applied Sciences, 2019) Fernández Carnero, Samuel; Arias Buría, José Luis; Cuenca Zaldívar , Juan Nicolás; Leal Quiñones, Alejandro; Calvo Lobo, César; Martín Saborido, CarlosBackground: Research of ultrasound use in physiotherapy and daily practice has led to its use as an everyday tool. Methods: The aims were: (1) Checking the proposed systematic review protocol methodology; (2) evaluating the evidence from the last five years; and (3) coordinating the work of the team of reviewers in performing a complete systematic review. Thus, this is a pilot study prior to a full systematic review. The findings in databases related to health sciences with the meta-search engine Discovery EBSCO, Covidence, and Revman were used. Inclusion and exclusion criteria were described for eligibility. Results: Search provided 1029 references regarding the lumbar region on ultrasound scans. Of these, 33 were duplicates. After Covidence, 996 studies were left for screening. A full-text reading brought one randomized clinical trial (RCT). Conclusions: Validity and reliability references were found. The most suitable points were novice versus expert, and ultrasound versus electromyography (EMG) with just one RCT cohort, and observational and case reports. The lines of investigation increasingly endorsed the validity of using ultrasound in physiotherapy. Post-acquisition image analysis could also be a future line of research.Item Revisión sistemática de evaluaciones económicas de los sistemas de telemonitorización en los marcapasos.(Revista Española de Cardiología, 2016) López-Villegas, Antonio; Catalán-Matamoros, Daniel; Martín Saborido, Carlos; Villegas-Tripiana, Irene; Robles-Musso, EmilioIntroducción y objetivos: En la última década, la telemedicina aplicada a la monitorización de marcapasos cardiacos ha experimentado un extraordinario crecimiento. Se desconoce si esta tecnología tiene una eficiencia diferente de la convencional. El objetivo del estudio es realizar una revisión sistemática analizando la evidencia disponible con respecto al consumo de recursos y los resultados en salud en ambas modalidades de seguimiento. Métodos: La búsqueda se realizó en 11 bases de datos y se incluyeron estudios publicados hasta noviembre de 2014. Los criterios de inclusión fueron: a) diseño experimental u observacional; b) estudios basados en evaluaciones económicas completas; c) pacientes con marcapasos, y d) telemonitorización comparada con la modalidad hospitalaria.Item Efficacy and safety outcomes of recanalization procedures in patients with acute symptomatic pulmonary embolism: systematic review and network meta-analysis.(Thorax, 2017) Jiménez, D.; Martín Saborido, Carlos; Muriel, A.; Zamora, J.; Morillo, R.; Barrios, D.; Klok, F. A.; Huisman, M. V.; Tapson, V.; Yusen, R. D.Background We aimed to review the efficacy and safety of recanalisation procedures for the treatment of PE. Methods We searched PubMed, the Cochrane Library, EMBASE, EBSCO, Web of Science and CINAHL databases from inception through 31 July 2015 and included randomised clinical trials that compared the effect of a recanalisation procedure versus each other or anticoagulant therapy in patients diagnosed with PE. We used network meta-analysis and multivariate randomeffects meta-regression to estimate pooled differences between each intervention and meta-regression to assess the association between trial characteristics and the reported effects of recanalisation procedures versus anticoagulation. Results For all-cause mortality, there were no significant differences in event rates between any of the recanalisation procedures and anticoagulant treatment (full-dose thrombolysis: OR 0.60; 95% CI0.36 to 1.01; low-dose thrombolysis: 0.47; 95%CI 0.14 to 1.59; and catheter-associated thrombolysis: 0.31; 95%CI 0.01 to 7.96). Full-dose thrombolysis increased the risk of major bleeding (2.00; 95%CI 1.06 to 3.78) compared with anticoagulation. Catheter-directed thrombolysis was associated with the lowest probability of dying (surface under the cumulative ranking curve (SUCRA), 0.67), followed by low-dose thrombolysis (SUCRA, 0.66) and full-dose thrombolysis (SUCRA, 0.55). Similarly, low-dose thrombolysis was associated with the lowest probability of major bleeding (SUCRA, 0.61), followed by catheterdirected thrombolysis (SUCRA, 0.54) and full-dose thrombolysis (SUCRA, 0.17). The results were similar in sensitivity analyses based on restricting only to studies in haemodynamically stable patients with PE. Conclusions In the treatment of PE, recanalisation procedures do not seem to offer a clear advantage compared with standard anticoagulation. Low-dose thrombolysis was associated with the lowest probability of dying and bleedingItem Evaluación farmacoeconómica con modelización comparando dos esquemas terapéuticos con carbetocina y oxitocina para la prevención de la hemorragia postparto por cesárea (Lima, Perú).(Journal of Comparative Effectiveness Research, 2017) Indacochea, Sonia; Rubio, Richard; Martín Saborido, CarlosPostpartum hemorrhage is one of the main causes of maternal death. Oxytocin has traditionally been used to prevent postpartum hemorrhage. Aim: To compare oxytocin with carbetocin, a long-acting analog of oxytocin, for prevention of uterine hemorrhage after cesarean delivery. Materials & methods: Clinical data were retrieved from the 2012 Cochrane meta-analysis “Carbetocin for preventing postpartum hemorrhage”. A decision tree was constructed. The direct costs were those of medications from the Peruvian official price list (DIGEMID). Costs associated with additional oxytocic drugs, blood transfusions, postpartum hemorrhage kits and hysterectomy were obtained from Hospital Nacional Edgardo Rebagliati Martins. The perspective of the study was that of the payer. The time horizon for calculating quality-adjusted life years (QALYs) was 1 year (2015). Results: Patients who received carbetocin required fewer additional uterotonic agents, had fewer hemorrhages and received fewer blood transfusions. Therefore, the costs associated with these interventions were lower. The incremental cost–effectiveness ratio was S/. 49,918 per QALY gained, which is lower than the threshold we estimated for Peru. Conclusion: Carbetocin is more cost-effective than oxytocin for prevention of uterine hemorrhage after cesarean delivery.Item Economic Evaluation of Fluticasone Propionate/ Formoterol (Flutiform ) vs. Fluticasone/Salmeterol and Budesonide/Formoterol in Spain.(Pulmonary Therapy, 2016-10-17) Martínez-Moragón, Eva; Delgado, Julio; Ojeda, Pedro; Pérez del Llano, Luis; Collar, Juan Manuel; Antón Rodríguez, Cristina; Martín Saborido, CarlosIntroduction: The aim of this economic evaluation was to estimate the cost-effectiveness of fluticasone propionate/formoterol (FP/FORM; Flutiform ) and compare it to those of fluticasone/ salmeterol (FS) and budesonide/formoterol (BF) when used in the treatment of adult patients with moderate-to-severe asthma. Methods: A Markov model was developed with five asthma health states: successful control, suboptimal control, outpatient-managed exacerbation, inpatient-managed exacerbation, and death. The time horizon was set at 12 months. Transition probabilities and indirect resource utilization were derived from previous international and Spanish publications. Univariate and probabilistic sensitivity analyses (SAs) were applied. Results: FP/FORM was less expensive to acquire than FS or BF (20% lower than FS and 30% lower than BF), while the quality-adjusted life years (QALYs) of the three options compared were very similar. Cost per patient in the FP/FORM cohort was 9326€/year, making it the cheapest option, 1.5% cheaper than FS and 2.6% cheaper than BF. The suboptimal control health state dominated the costs (80% of the total cost) in each of the analyzed options and scenarios. The results of the SAs verified the data obtained from the base case scenario. Conclusions: From a Spanish societal perspective, in 2014, FP/FORM produced a similar gain in QALYs but at a lower cost when compared to FS and BF in a highly meaningful number of replications and scenarios. FP/FORM can therefore be considered a cost-effective option in the treatment of moderate-to-severe asthma in Spain. The cost savings were mainly due to the significantly lower acquisition cost of FP/FORM than the other two options.