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Toribio-Vázquez C, Gómez Rivas J, Amigo F, Carrión DM, Yebes Á, Alonso-Bartolomé M, Ayllon H, Aguilera A, Martinez-Piñeiro L, Antón-Juanilla M, Crespo-Atín V, Otaola-Arca H, Herranz-Yague JA, Munoz Rivero MV, MacKenzie KR, Shah TT, Gao C, Zimmermann E, Jefferies M, Nambiar A, Gallagher KM, Khadhouri S, Kasivisvanathan V. Prevalence of urinary tract cancer in the Spanish cohort of the IDENTIFY study. Actas Urol Esp 2024; 48:228-237. [PMID: 37574012 DOI: 10.1016/j.acuroe.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Malignant tumors of the urinary tract are associated with high morbidity and mortality, and their prevalence can vary worldwide. Recently, the IDENTIFY study has published results on the prevalence of urinary tract cancer at a global level. This study evaluates the prevalence of cancer within the Spanish cohort of the IDENTIFY study to determine whether the published results can be extrapolated to our population. PATIENTS AND METHODS An analysis of the data from the Spanish cohort of patients in the IDENTIFY study was performed. This is a prospective cohort of patients referred to secondary care with suspected cancer, predominantly due to hematuria. Patients were recruited between December 2017 and December 2018. RESULTS A total of 706 patients from 9 Spanish centers were analyzed. Of these, 277 (39.2%) were diagnosed with cancer: 259 (36.7%) bladder cancer, 10 (1.4%) upper tract urothelial carcinoma, 9 (1.2%) renal cancer and 5 (0.7%) prostate cancer. Increasing age (OR 1.05 (95% CI 1.03-1.06; P < 0.001)), visible hematuria (VH) OR 2.19 (95% CI 1.13-4.24; P = 0.02)) and smoking (ex-smokers: OR 2.11(95% CI 1.30-3.40; P = 0.002); smokers: OR 2.36 (95% CI 1.40-3.95; P = 0.001)) were associated with higher probability of bladder cancer. CONCLUSION This study highlights the risk of bladder cancer in patients with VH and smoking habits. Bladder cancer presented the highest prevalence; higher than the prevalence reported in previous series and presented in the IDENTIFY study. Future work should evaluate other associated factors that allow us to create cancer prediction models to improve the detection of cancer in our patients.
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Affiliation(s)
- C Toribio-Vázquez
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain.
| | - J Gómez Rivas
- Servicio de Urología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - F Amigo
- Institut Hospital del Mar d''Investigacions Mèdiques, Barcelona, Spain
| | - D M Carrión
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | - Á Yebes
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | | | - H Ayllon
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | - A Aguilera
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain
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Toribio-Vázquez C, Martinez-Piñeiro L. Re: Pembrolizumab Versus Placebo as Post-nephrectomy Adjuvant Therapy for Clear Cell Renal Cell Carcinoma (KEYNOTE-564): 30-month Follow-up Analysis of a Multicentre, Randomised, Double-blind, Placebo-controlled, Phase 3 Trial. Eur Urol 2024; 85:306. [PMID: 37957046 DOI: 10.1016/j.eururo.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Carlos Toribio-Vázquez
- Urology Department, Hospital Universitario La Paz, Madrid, Spain; Autonomous University of Madrid, Madrid, Spain.
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Toribio-Vázquez C, Yebes Á, Quesada-Olarte J, Rodriguez A, Alonso-Bartolomé M, Ayllon H, Martinez-Piñeiro L. Genital Mutilation in Males. Curr Urol Rep 2023; 24:121-126. [PMID: 36401111 DOI: 10.1007/s11934-022-01129-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE OF THE REVIEW Genital mutilation in males can range from minor injuries (cuts from a blade) to severe urological emergencies (testicular or penile amputation). Due to the rarity of these events, there is a lack of extensive reports, as most of the available literature is regarding single cases. Genital mutilation has been associated with psychotic and non-psychotic causes, psychiatric conditions, drug consumption, sexual practices, or even cultural or religious beliefs. It is crucial to perform a psychiatric evaluation of these patients to obtain the best therapeutic approach. This manuscript serves as a review of the currently available knowledge regarding male genital mutilation. RECENT FINDINGS A great variety of reasons have been associated with genital mutilation. Previous authors have distinguished between those that present with a clear mental health precursor from cases with no psychotic background. Nevertheless, sometimes, it is difficult to make this distinction. Recently, reconstructive techniques for amputation cases have moved towards a microsurgical approach in order to improve outcomes. A holistic therapeutic approach must be performed to increase the chances of effective treatment. Close collaboration between urologists, psychiatrists, and emergency doctors is essential to ensure the best care for patients performing genital mutilation. Future publications must evaluate differences in treatment options and the impact that these have on the long-term well-being of patients undergoing genital self-mutilation.
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Affiliation(s)
- Carlos Toribio-Vázquez
- Urology department, Hospital Universitario La Paz, Paseo de La Castellana 261, Madrid, 28046, Spain.
| | - Álvaro Yebes
- Urology department, Hospital Universitario La Paz, Paseo de La Castellana 261, Madrid, 28046, Spain
| | - José Quesada-Olarte
- Department of Urology, Rush University Medical Center, 1725 W Harrison St, Chicago, IL, 60612, USA
| | - Andrea Rodriguez
- Urology department, Hospital Universitario La Paz, Paseo de La Castellana 261, Madrid, 28046, Spain
| | - María Alonso-Bartolomé
- Urology department, Hospital Universitario La Paz, Paseo de La Castellana 261, Madrid, 28046, Spain
| | - Héctor Ayllon
- Urology department, Hospital Universitario La Paz, Paseo de La Castellana 261, Madrid, 28046, Spain
| | - Luis Martinez-Piñeiro
- Urology department, Hospital Universitario La Paz, Paseo de La Castellana 261, Madrid, 28046, Spain.,Instituto de Investigación Hospital Universitario La Paz (IDiPaz), Calle de Pedro Rico, 6, Madrid, 28029, Spain
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Bocchino A, Fernández-Pascual E, Toribio-Vázquez C, Manfredi C, Urdaneta G, Balmori C, Cocci A, Mondaini N, Martínez-Salamanca J. Efficacy and safety of two disposable circumcision suture devices for circumcision in adults: A prospective comparative multicenter study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01294-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Gomez Zapata D, Joshi P, Fogaing C, Anand A, Rajenderan R, Bhadranavar S, Toribio-Vázquez C, Kulkarni S. Redo panurethral stricture: A challenge in reconstructive urology. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00496-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Toribio-Vázquez C, Gómez Rivas J, Yebes Á, Carrión DM, Yagüe Barrado M, Álvarez-Maestro M, Martinez-Piñeiro L. New strategies for decision making in prostate cancer. The role of oncotypedx. Actas Urol Esp 2022; 46:385-386. [PMID: 35842398 DOI: 10.1016/j.acuroe.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/11/2022] [Indexed: 12/13/2022]
Affiliation(s)
| | - J Gómez Rivas
- Servicio de Urología, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Á Yebes
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain
| | - D M Carrión
- Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - M Yagüe Barrado
- Departamento de Cirugía, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Álvarez-Maestro
- Instituto de Investigación Hospital Universitario La Paz (IDiPaz), Madrid, Spain
| | - L Martinez-Piñeiro
- Servicio de Urología, Hospital Universitario La Paz, Madrid, Spain; Instituto de Investigación Hospital Universitario La Paz (IDiPaz), Madrid, Spain
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Toribio-Vázquez C, Perez-Carral J, Trelles C, Cansino R, Fernandez-Pascual E, Mainez J, Yebes A, Ballesteros Ruiz C, Alonso M, Ayllon H, Giron M, Martinez-Piñeiro L. Analysis of our initial experience with AquaBeam® for the treatment of patients with benign prostatic hyperplasia. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00238-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Aguilera Bazán A, Toribio-Vázquez C, Gomez Rivas J, Carrión DM, Ballesteros Ruiz C, Yebes Á, Martinez-Piñéiro L. [Analysis of renal tumor size as a predictive factor of oncological aggressiveness.]. ARCH ESP UROL 2022; 75:248-255. [PMID: 35435169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The increased incidenceof diagnosis of kidney tumours has driveninvestigation in the area. It is known that the risk ofmalignancy is correlated with tumour size, but thereare still no specific and objective parameters to characterizethe degree of aggressiveness and to be ableto guide a treatment reliably. OBJECTIVE: To identify the relationship betweenrenal tumour size and the incidence of tumour aggressivecharacteristics. PATIENTS AND METHODS A retrospective analysisof our series of renal cancers operated between 1998and 2018 was performed. The specific and cumulativeincidence of aggressive characteristics was studied.The following where considered as aggressive characteristics:Presence of sarcomatoid or epidermoiddifferentiation, tumour necrosis, stage pT3-4, histologicalhigh grade (3-4) and the presence of histologicalaggressive variants. RESULTS A total of 651 patients that had undergonerenal mass surgery were analysed. In tumours below2 cm the appearance of aggressive characteristicsoccurred in less than 5%. For renal masses greaterthan 2 cm, each centimetre increase correlated with arise in cumulative incidence of 2-3% for each characteristicstudied. CONCLUSIONS In tumours below 2cm and patientswith significant comorbidities active surveillance maybe a reliable alternative to surgery.
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Affiliation(s)
- Alfredo Aguilera Bazán
- Servicio de Urología. Hospital Universitario La Paz. Madrid. España. Universidad Autónoma de Madrid. Madrid.España. Instituto de Investigación Hospital Universitario La Paz (IDiPaz). Madrid. España
| | - Carlos Toribio-Vázquez
- Servicio de Urología. Hospital Universitario La Paz. Madrid. España. Universidad Autónoma de Madrid. Madrid.España
| | - Juan Gomez Rivas
- Servicio de Urología. Hospital Clínico San Carlos. Madrid. España
| | - Diego M Carrión
- Servicio de Urología. Hospital de Torrejón. Torrejón de Ardoz, Madrid. España
| | - Cristina Ballesteros Ruiz
- Servicio de Urología. Hospital Universitario La Paz. Madrid. España. Universidad Autónoma de Madrid. Madrid.España. Instituto de Investigación Hospital Universitario La Paz (IDiPaz). Madrid. España
| | - Álvaro Yebes
- Servicio de Urología. Hospital Universitario La Paz. Madrid. España. Universidad Autónoma de Madrid. Madrid.España
| | - Luis Martinez-Piñéiro
- Servicio de Urología. Hospital Universitario La Paz. Madrid. España. Universidad Autónoma de Madrid. Madrid.España. Instituto de Investigación Hospital Universitario La Paz (IDiPaz). Madrid. España
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Toribio-Vázquez C, Gómez Rivas J, Yebes Á, Carrión D, Yagüe Barrado M, Álvarez-Maestro M, Martínez-Piñeiro L. Nuevas estrategias en la toma de decisiones en cáncer de próstata. El papel del Oncotype DX. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gómez Rivas J, Toribio-Vázquez C, Taratkin M, Marenco JL, Grossmann R. Autonomous robots: a new reality in healthcare? A project by European Association of Urology-Young Academic Urologist group. Curr Opin Urol 2021; 31:155-159. [PMID: 33332877 DOI: 10.1097/mou.0000000000000842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Artificial intelligence appears as a potential revolution in the general process of medical training, disease diagnosis and treatment. A novel disruptive technology of the 21st century will be 'learner' robots from artificial intelligence systems able to use all the combination of the available knowledge in medical repositories to give the best standard of care. RECENT FINDINGS The autonomy level of robots depends on three factors: the complexity of the task; the environment in which the robot operates, and the required level of human-robot interaction. Autonomous robots in healthcare may be classified in delivery, nurse, and surgical robots. The increasing capability of robots to perform independent actions and complex tasks raises responsibility and accountability issues in a wide variety of application domains. Ethical analyses of these issues are underway and are mostly oriented toward the development of ethical policies requiring a law frame on robotic autonomous behaviors. SUMMARY Autonomous robots have the potential to improve current medical practice offering a more secure, reliable, and reproducible medicine. Many advancements are required for these new technologies to be fully integrated. Furthermore, the ethical implications of these technologies are yet to be evaluated.
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Affiliation(s)
- Juan Gómez Rivas
- Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands
| | | | - Mark Taratkin
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Jose Luis Marenco
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands
- Department of Urology, Instituto Valenciano De Oncologia, Valencia, Spain
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Quesada-Olarte J, Álvarez-Maestro M, Gómez-Rivas J, Toribio-Vázquez C, Aguilera Bazán A, Martínez-Piñeiro L. Organ-sparing cystectomy techniques: Functional and oncological outcomes, review and current recommendations. ARCH ESP UROL 2020; 73:961-970. [PMID: 33269715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION With increasing survival from bladder cancer, quality of life, should be one of the main goals following radical cystectomy and bilateral pelvic lymph node dissection (PLND). This techniqueis associated with significant morbidity, which may have a critical effect on quality of life. Concerns about functional outcomes, such as continence, potency, and sexual function in women, play a role in decision making for urologists and younger patients with muscle-invasive bladder cancer. Several modifications to the classic radical cystectomy technique, include preservation of genital or pelvic organs, developing in the improvement of postoperative continence, potency rates and sexual functionin female patients. OBJECTIVE: This review summarizes the organ-sparing cystectomy techniques and its functional and oncological outcomes. EVIDENCE ACQUISITION A PubMed-based literature search was conducted up to April 2020. We selected the most recent and relevant original articles, metanalysis and reviews that have provided relevant information to guide organ-sparing cystectomy techniques and its functional and oncological outcomes. EVIDENCE SYNTHESIS In this review, we discuss selection criteria for male and female patients, organ-sparing cystectomy surgical techniques and its functional and oncological outcomes. CONCLUSIONS Radical cystectomy is associated with significant morbidity, which may have a critical effect on quality of life. Preservation of genital or pelvic organsin men and women, yield better sexual outcomes compared to radical cystectomy without compromising oncological outcomes in well selected patients. But no one of these techniques can be recommended over the classical standard radical cystectomy. Large-scale of prospective and multi-institutional studies are needed to conclude which patients are suitable for these techniques.
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Affiliation(s)
| | - Mario Álvarez-Maestro
- Department of Urology. La Paz University Hospital. Madrid. Spain. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ). Madrid. Spain
| | - Juan Gómez-Rivas
- Department of Urology. La Paz University Hospital. Madrid. Spain. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ). Madrid. Spain
| | | | - Alfredo Aguilera Bazán
- Department of Urology. La Paz University Hospital. Madrid. Spain. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ). Madrid. Spain
| | - Luis Martínez-Piñeiro
- Department of Urology. La Paz University Hospital. Madrid. Spain. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ). Madrid. Spain
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Toribio-Vázquez C, Gómez Rivas J, Yebes A, Carrión DM, Quesada-Olarte J, Trelles CR, Álvarez-Maestro M, van der Poel H, Martínez-Piñeiro L. Immunotherapy toxicity. Diagnosis and treatment. ARCH ESP UROL 2020; 73:906-917. [PMID: 33269709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
UNLABELLED Anti CTLA-4, anti PD-L1 and anti PD-1immune check point inhibitors (ICI) down regulate natural inhibitory pathways of the immune system, in turn increasing tumour surveillance and elimination. Cancer treatment through immune regulation has revolutionised many cancer therapies. However, these new treatments have also brought unique immune related adverse events (irAEs). OBJECTIVE This paper presents a review of the available knowledge regarding irAE grading, incidence, diagnosis and management, serving as a clinical aid forall clinicians involved with ICI therapy. EVIDENCE ACQUISITION A comprehensive English-language literature research of original and review articles in the Medline database until June 2020 has been carried out, using the MeSH terms: "immune checkpoint inhibitor toxicities" and "immune related adverseevent". CONCLUSIONS Further research should aim to investigate if the greater effect of combining ICI treatments issufficient to justify the increased risk of complications, as well as to identify specific subgroups that will benefit the most from these.
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Affiliation(s)
- Carlos Toribio-Vázquez
- Department of Urology. La Paz University Hospital. Madrid. Spain. Autonomous University of Madrid. Madrid. Spain
| | - Juan Gómez Rivas
- Department of Urology. La Paz University Hospital. Madrid. Spain. Autonomous University of Madrid. Madrid. Spain. La Paz University Hospital Institute for Health Research (IdiPaz). Madrid. Spain
| | - Alvaro Yebes
- Department of Urology. La Paz University Hospital. Madrid. Spain. Autonomous University of Madrid. Madrid. Spain
| | - Diego M Carrión
- Department of Urology. La Paz University Hospital. Madrid. Spain. Autonomous University of Madrid. Madrid. Spain. La Paz University Hospital Institute for Health Research (IdiPaz). Madrid. Spain
| | - José Quesada-Olarte
- Department of Urology. La Paz University Hospital. Madrid. Spain. Autonomous University of Madrid. Madrid. Spain
| | - Carlos R Trelles
- Department of Urology. La Paz University Hospital. Madrid. Spain. Autonomous University of Madrid. Madrid. Spain
| | - Mario Álvarez-Maestro
- Department of Urology. La Paz University Hospital. Madrid. Spain. Autonomous University of Madrid. Madrid. Spain. La Paz University Hospital Institute for Health Research (IdiPaz). Madrid. Spain
| | - Henk van der Poel
- Department of Urology. Netherlands Cancer Institute Amsterdam. The Netherlands
| | - Luis Martínez-Piñeiro
- Department of Urology. La Paz University Hospital. Madrid. Spain. Autonomous University of Madrid. Madrid. Spain. La Paz University Hospital Institute for Health Research (IdiPaz). Madrid. Spain
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