https://hdl.handle.net/10481/31150 2026-04-09T18:02:31Z 2026-04-09T18:02:31Z Jerez Calero, Antonio Emilio Galván Gómez, Sara Pérez Barbero, Marta Contreras Chova, Francisco Blanca Jover, Enrique Sanz Soto, Jose Miguel Molina Carballo, Antonio https://hdl.handle.net/10481/112673 2026-04-08T07:48:11Z

Noninvasive High-Frequency Ventilation Versus Classical Ventilation Modalities as Postextubation Support in Preterm Infants: A Systematic Review Jerez Calero, Antonio Emilio; Galván Gómez, Sara; Pérez Barbero, Marta; Contreras Chova, Francisco; Blanca Jover, Enrique; Sanz Soto, Jose Miguel; Molina Carballo, Antonio Aim: This study is aimed at determining whether noninvasive high-frequency oscillatory ventilation (NHFOV) is more effective than nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive pressure ventilation (NIPPV) in reducing the need for invasive mechanical ventilation (IMV) after the first extubation in preterm infants ≤ 33 weeks of gestational age. Methods: This work is a systematic review of randomized controlled clinical trials in the last 6 years. The databases utilized were PubMed, Cochrane, and Scopus. Results: Analysis showed that the reintubation rate (RR) was significantly higher in the NCPAP group compared with NHFOV and NIPPV in all included studies analyzing this comparison. When comparing NHFOV and NIPPV, most studies showed no significant difference. In terms of effectiveness, NIPPV and NHFOV were associated with superior gas exchange efficiency after extubation and shorter duration of IMV and hospital stay compared with NCPAP. NHFOV appears to be associated with a lower incidence of moderate-to-severe bronchopulmonary dysplasia than NCPAP. Conclusion: In very preterm newborns, NHFOV and NIPPV are associated with a lower RR and shorter duration of ventilation compared with NCPAP. NHFOV also demonstrates better postextubation results compared with NCPAP. Further studies evaluating NHFOV in neonatal intensive care units are needed to confirm its generalizability.

Aguado-Rivas, Raquel Checa Ros, Ana Fernández López, Luisa Tortosa-Pinto, Pilar González Villén, Raquel Contreras Chova, Francisco Fernández Ibañez, Ana Molina Carballo, Antonio https://hdl.handle.net/10481/112434 2026-03-24T12:37:02Z

Steroid/thyroid hormones and inflammatory markers in adolescents with ADHD: comparisons with healthy controls and modifications by methylphenidate Aguado-Rivas, Raquel; Checa Ros, Ana; Fernández López, Luisa; Tortosa-Pinto, Pilar; González Villén, Raquel; Contreras Chova, Francisco; Fernández Ibañez, Ana; Molina Carballo, Antonio Background: Increasing evidence suggests that neuroendocrine and inflammatory mechanisms may contribute to attention-deficit/hyperactivity disorder (ADHD) pathophysiology, although findings in adolescents and the effects of methylphenidate (MPH) remain limited. Objective To quantify the baseline profile of activating hormones and levels of pro- and anti-inflammatory cytokines and their changes after treatment with methylphenidate (MPH) in adolescents with ADHD, in comparison with controls. Methods: Eighty-one adolescents (40 with ADHD and 41 healthy controls) were evaluated. Morning serum concentrations of cortisol, thyroid-stimulating hormone (TSH), dehydroepiandrosterone sulfate (DHEAS), S100B, and seven cytokines were measured. Patients with ADHD were reassessed after approximately four months of MPH treatment. Analyses considered ADHD presentation and oppositional defiant disorder (ODD) symptoms. Multivariable regression models were used to adjust biomarker associations for demographic and clinical variables. Results: Adolescents with ADHD showed significantly lower morning cortisol concentrations than controls. Several pro- and anti-inflammatory cytokines (IL-1β, IL-4, IL-5, IL-6, IL-10, and IL-13) were increased, particularly in males, whereas TNF-α and S100B did not differ between groups. Multivariable analyses confirmed independent associations between lower cortisol and higher cytokine levels with ADHD. TSH and DHEAS showed minor variations related to ODD symptoms but no consistent differences between ADHD presentations. MPH treatment improved clinical symptoms but produced no significant overall changes in hormonal or cytokine profiles Conclusion: Adolescents with ADHD exhibit an altered immune-hormonal profile characterized by reduced cortisol and increased circulating cytokines. These alterations appear largely independent of demographic and clinical confounders and only minimally influenced by short-term MPH treatment, suggesting persistent neuroendocrine-immune dysregulation during adolescence.

González Cortés, Rafael García-Salido, Alberto Roca Pascual, David Slöcker Barrio, María de Carlos Vicente, Juan Carlos https://hdl.handle.net/10481/112239 2026-03-18T11:09:46Z

A multicenter national survey of children with SARS-CoV-2 infection admitted to Spanish Pediatric Intensive Care Units González Cortés, Rafael; García-Salido, Alberto; Roca Pascual, David; Slöcker Barrio, María; de Carlos Vicente, Juan Carlos El brote pandémico de SARS-CoV-2 es el mayor desafío al que se han enfrentado las unidades de cuidados intensivos de todo el mundo. La mayoría de los estudios informan de una baja incidencia y poca necesidad de hospitalización en niños. Sin embargo, desde la identificación de los primeros casos de infección por SARS-CoV-2 en niños en España fueron incrementandose significativamente. Aunque los niños parecían estar relativamente a salvo de la enfermedad grave, el Ministerio de Sanidad español informó de más de 200 niños que requirieron ingreso en una sala pediátrica, el 10% de los cuales fueron ingresados en una UCIP . En este estudio se presentaron los resultados preliminares de un registro multicéntrico nacional de infección por SARS-CoV-2 en niños que requieren UCIP. Se trata de una iniciatica del grupo de enfermedades infecciosas de la SECIP e incluyó 47 UCIP españolas. El registro se realizó entre el 1 de marzo y el 1 de mayo de 2020 e incluó 50 pacientes. Nuestros resultados demostraron que aunque la infección por SARS-CoV-2 tiene un curso clínico leve en la mayoría de los casos, algunos niños pueden presentar una enfermedad grave que requiere soporte respiratorio y hemodinámico en UCIP. Se trató de un estudio pionero, realizado cuando eran practicamente inexistentes los estudios en niños , de ahí que su publicación haya tenido un gran impacto, con 15 citas en Dimensions, 3 menciones en Facebook, 177 meenciones en X ( Tweeter) y 1 mención en fuentes de política.

Jerez Calero, Antonio Emilio Contreras Chova, Francisco Benítez Feliponi, Ángela Azaryah, Hatim Hurtado Suazo, José Antonio Moreno Galdó, María Fernanda Molina Carballo, Antonio https://hdl.handle.net/10481/111285 2026-02-20T08:01:39Z

Pro-inflammatory biomarkers and long term neurological outcomes in hypothermia plus melatonin treated asphyxiated newborns. A preliminary approach Jerez Calero, Antonio Emilio; Contreras Chova, Francisco; Benítez Feliponi, Ángela; Azaryah, Hatim; Hurtado Suazo, José Antonio; Moreno Galdó, María Fernanda; Molina Carballo, Antonio OBJECTIVE: To evaluate serum neuronal and inflammatory biomarkers in asphyxiated newborns treated with hypothermia alone or hypothermia plus melatonin, and whether biomarkers correlate with neurodevelopmental outcomes. DESIGN: A pilot multicentre, randomized, controlled, double blind clinical trial. 25 newborns were recruited. Neonatal neural biomarkers were measured in serum samples at hospital admission (T0), 24 h (T1), 72 hours (T2) and 7−10 days of age (T3). Neurodevelopmental scales were performed at 6 and 18 months. Treated patients received a daily dose of intravenous melatonin, for 3 days. RESULTS: In melatonin-treated group, lower plasma levels of GM-CSF, IL-2 and IL-13 at T1 were measured vs placebo-group. We also corroborated, at T2, lower concentrations of GM-CSF, as well as IL-7 and IL-13 at T3. Throughout the study period, we found a significant decrease in GM-CSF concentrations in the treatment group. We have also observed sustained decrease over time of GMCSF and inflammatory cytokines IL-2, IL-7 and IL-13 correlates with better neurodevelopmental outcomes at 6 and 18 months. CONCLUSIONS: In neonates affected by hypoxic-ischemic encephalopathy, the addition of iv melatonin to hypothermia therapy affects plasma biomarker concentration in the first week of life, with a high correlation with long-term neurological prognosis. This research project was obtained in a public and competitive call for grant applications, financed through the national programme (Spanish Ministry of Health): Call for Grants for Independent Clinical Research, 2011. Reference Number EC11-222.

Diaz Rueda, Laura Gómez Luque, José María Abril Molina, Ana https://hdl.handle.net/10481/109426 2026-01-09T13:07:30Z

Descompensación de encefalopatía epiléptica como efecto adverso del linezolid Diaz Rueda, Laura; Gómez Luque, José María; Abril Molina, Ana