Pérez-Riveros, B.P. (Blanca Paola)
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- Pop-off mechanisms as renoprotective mediators in children with posterior urethral valves: A systematic review and meta-analysis(Elsevier, 2024) Pérez-Riveros, B.P. (Blanca Paola); Rico-Jiménez, M. (María); Martin-Calvo, N. (Nerea); Arredondo-Montero, J. (Javier); Emilio-Bueso, Ó. (Óscar)Background: Pop-off mechanisms are potential pressure-relieving mediators in patients diagnosed with posterior urethral valves (PUV). This systematic review aimed to synthesize the existing evidence regarding the protective effect of pop-off mechanisms on renal function in children with PUV. Methods: We conducted a systematic review of the literature that involved an extensive search in the main databases of the medical bibliography. Three independent reviewers selected the relevant articles. Methodological quality was rated using the Newcastle Ottawa Scale index. We used random meta-analyses to compare different outcomes (serum creatine, Nadir serum creatinine, and Chronic Kidney Disease) between children with PUV and pop-off mechanisms and those with PUV without pop-off mechanisms. Results: 10 studies with data from 896 participants were included in this review. Seven articles reported serum creatinine values for each group and 3 of them found significant differences between groups. The random-effects meta-analysis for serum creatinine showed significant lower mean (diff = -52.88 μmol/L [95 % CI -73.65 to -32.11]) in the group of children with pop-off mechanisms, and the random-effects meta-analysis for Nadir serum creatinine showed a marginally significantly lower mean in the group of children with pop-off mechanisms (diff = -12.00 μmol/L [95 % CI -24.04 to 0.04]). The random-effect meta-analysis for Chronic Kidney Disease resulted in a significant risk reduction for the group of children with pop-off mechanisms (odds ratio = 0.48 [95 % CI 0.23 to 0.98]). Conclusions: Children with PUV and pop-off mechanisms show better renal function and lower risk of Chronic Kidney Disease than those with PUV without pop-off mechanisms suggesting these mechanisms may act as renoprotective mediators. The high heterogeneity between studies in the assessment of renal function and long-term outcomes calls for a cautious interpretation of these findings. Future studies that stratify by different types of pop-off mechanisms and use standardized metrics, such as Nadir creatinine, are needed.
- Correction to: Leucine-rich alpha-2-glycoprotein as a non-invasive biomarker for pediatric acute appendicitis: a systematic review and meta-analysis(2023) Pérez-Riveros, B.P. (Blanca Paola); Rico-Jiménez, M. (María); Martin-Calvo, N. (Nerea); Arredondo-Montero, J. (Javier); Lopez-Andres, N. (Natalia); Emilio-Bueso, Ó. (Óscar)
- Development and validation of a realistic type III esophageal atresia simulator for the training of pediatric surgeons(Springer, 2024) López-de-Aguileta-Castaño, N. (Nicolas); Pérez-Riveros, B.P. (Blanca Paola); Arredondo-Montero, J. (Javier); Martín‐Calvo, N. (Nerea); Pueyo-Villoslada, F.J. (Francisco Javier); Emilio-Bueso, Ó. (Óscar)Background The technical complexity and limited casuistry of neonatal surgical pathology limit the possibilities of developing the necessary technical competencies by specialists in training. Esophageal atresia constitutes the paradigm of this problem. The use of synthetic 3D models for training is a promising line of research, although the literature is limited. Methods We conceptualized, designed, and produced an anatomically realistic model for the open correction of type III oesophageal atresia. We validated it with two groups of participants (experts and non-experts) through face, construct, and content-validity questionnaires. Results The model was validated by nine experts and nine non-experts. The mean procedure time for the experts and non-experts groups was 34.0 and 38.4 min, respectively. Two non-experts did not complete the procedure at the designed time (45 min). Regarding the face validity questionnaire, the mean rating of the model was 3.2 out of 4. Regarding the construct validity, we found statistically signifcant diferences between groups for the equidistance between sutures, 100% correct in the expert group vs. 42.9% correct in the non-expert group (p=0.02), and for the item “Confrms that tracheoesophageal fstula closure is watertight before continuing the procedure”, correctly assessed by 66.7% of the experts vs. by 11.1% of non-experts (p=0.05). Concerning content validity, the mean score was 3.3 out of 4 for the experts and 3.4 out of 4 for the non-experts. Conclusions The present model is a cost-efective, simple-to-produce, and validated option for training open correction of type III esophageal atresia. However, future studies with larger sample sizes and blinded validators are needed before drawing defnitive conclusions.
- Leucine-Rich Alpha-2-Glycoprotein as a non-invasive biomarker for pediatric acute appendicitis: a systematic review and meta-analysis(2023) Pérez-Riveros, B.P. (Blanca Paola); Rico-Jiménez, M. (María); Martin-Calvo, N. (Nerea); Arredondo-Montero, J. (Javier); Lopez-Andres, N. (Natalia); Emilio-Bueso, Ó. (Óscar)The aim of this study was to analyze the diagnostic performance of Leucine-Rich Alpha-2-Glycoprotein (LRG1) in pediatric acute appendicitis (PAA). We conducted a systematic review of the literature in the main databases of medical bibliography. Two independent reviewers selected the articles and extracted relevant data. Methodological quality was assessed using the QUADAS2 index. A synthesis of the results, standardization of the metrics and 4 random-effect meta-analyses were performed. Eight studies with data from 712 participants (305 patients with confirmed diagnosis of PAA and 407 controls) were included in this review. The random-effect meta-analysis of serum LRG1 (PAA vs control) resulted in a significant mean difference (95% CI) of 46.76 ¿g/mL (29.26-64.26). The random-effect meta-analysis for unadjusted urinary LRG1 (PAA vs control) resulted in a significant mean difference (95% CI) of 0.61 ¿g/mL (0.30-0.93). The random-effect meta-analysis (PAA vs control) for urinary LRG1 adjusted for urinary creatinine resulted in a significant mean difference (95% CI) of 0.89 g/mol (0.11-1.66). Conlusion: Urinary LRG1 emerges as a potential non-invasive biomarker for the diagnosis of PAA. On the other hand, due to the high between-study heterogeneity, the results on serum LRG1 should be interpreted with caution. The only study that analyzed salivary LRG1 showed promising results. Further prospective studies are needed to confirm these findings. What is Known: ¿ Pediatric acute appendicitis continues to be a pathology with a high rate of diagnostic error. ¿ Invasive tests, although useful, are a source of stress for patients and their parents. What is New: ¿ LRG1 emerges as a promising urinary and salivary biomarker for the noninvasive diagnosis of pediatric acute appendicitis.