Complejo Asistencial de Leon

Arroyomolinos de León, Spain

Complejo Asistencial de Leon

Arroyomolinos de León, Spain
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PubMed | Hospital Universitario Severo Ochoa Leganes Madrid, Complejo Asistencial de Leon.., Hospital Universitario Virgen Macarena Seville, Hospital Universitari Sant Joan Of Reus Tarragona and 22 more.
Type: Journal Article | Journal: Nutricion hospitalaria | Year: 2014

To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2011 and 2012.We retrieved the data of the patients recorded from January 1st 2011 to December 31st 2012.There were 3021 patients in the registry during the period from 29 hospitals, which gives 65.39 per million inhabitants. 97.95% were adults, 51.4% male. Mean age was 67.64 19.1, median age was 72 years for adults and 7 months for children. Median duration with HEN was 351 days and for 97.5% was their first event with HEN. Most patients had HEN because of neurological disease (57.8%). Access route was nasogastric tube for 43.5% and gastrostomy for 33.5%. Most patients had limited activity level and, concerning autonomy, 54.8% needed total help. Nutritional formula was supplied from chemists office to 73.8% of patients and disposables, when necessary, was supplied from hospitals to 53.8% of patients. HEN was finished for 1,031 patients (34.1%) during the period of study, 56.6% due to decease and 22.2% due to recovery of oral intake.Data from NADYA-SENPE registry must be explained cautiously because it is a non-compulsory registry. In spite of the change in the methodology of the registry in 2010, tendencies regarding HEN have been maintained, other than oral route.

PubMed | Hospital Universitario La Paz, Complejo Hospitalario Of Jaen, Hospital Universitario 12 Of Octubre, Hospital Universitario Central Of Asturias and 16 more.
Type: | Journal: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico | Year: 2016

Metastatic breast cancer is a heterogeneous disease that presents in varying forms, and a growing number of therapeutic options makes it difficult to determine the best choice in each particular situation. When selecting a systemic treatment, it is important to consider the medication administered in the previous stages, such as acquired resistance, type of progression, time to relapse, tumor aggressiveness, age, comorbidities, pre- and post-menopausal status, and patient preferences. Moreover, tumor genomic signatures can identify different subtypes, which can be used to create patient profiles and design specific therapies. However, there is no consensus regarding the best treatment sequence for each subgroup of patients. During the SABCC Congress of 2014, specialized breast cancer oncologists from referral hospitals in Europe met to define patient profiles and to determine specific treatment sequences for each one. Conclusions were then debated in a final meeting in which a relative degree of consensus for each treatment sequence was established. Four patient profiles were defined according to established breast cancer phenotypes: pre-menopausal patients with luminal subtype, post-menopausal patients with luminal subtype, patients with triple-negative subtype, and patients with HER2-positive subtype. A treatment sequence was then defined, consisting of hormonal therapy with tamoxifen, aromatase inhibitors, fulvestrant, and mTOR inhibitors for pre- and post-menopausal patien ts; a chemotherapy sequence for the first, second, and further lines for luminal and triple-negative patients; and an optimal sequence for treatment with new antiHER2 therapies. Finally, a document detailing all treatment sequences, that had the agreement of all the oncologists, was drawn up as a guideline and advocacy tool for professionals treating patients with this disease.

PubMed | Hospital Universitario La Paz, Complejo Hospitalario Of Jaen, Hospital Gregorio Maranon, University Miguel Hernández and 28 more.
Type: Journal Article | Journal: Nutricion hospitalaria | Year: 2015

To present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the year 2013.From January 1st to December 31st 2013 data was recorded for the HEN registry and further descriptive and analytical analysis was done.In this period 3 223 patients (50.6% men) and a total of 3 272 episodes of HEN were registered in 33 Spanish hospitals. The rate of prevalence was of 67,11 patients/million habitants/ year 2013. A high percentage of patients (98,24%) were older than 14 years. Adults mean age was 69,14 years (sd 17,64) and men were younger than women p-value <0,001. Children mean age was 2,38 years (sd 4,35). The most frequent indication for HEN was neurological disease for children (49,1%). and for adults (60,6%). Gastrostomy was the most used administration route for children (51%) while younger ones were fed with NGT (p-value 0,003) also older adults (48%) were fed with this type of tube (p-value <0,001). The most frequent reasons for cessation of treatment was death, 44,4% were children and 54,7% were adults.The number of patients and hospitals registered increased in the last years while the other variables maintain steady. The registry developed allowing contrasted analysis of data in order to get more information.

PubMed | Hospital Gregorio Maranon, University Miguel Hernández, Hospital Infanta Sofia San Sebastian Of Los Reyes, Hospital Universitario Nuestra Senora Of La Candelaria and 30 more.
Type: Journal Article | Journal: Nutricion hospitalaria | Year: 2015

To communicate the results of the Spanish Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE group for the year 2013.Data was recorded online by NADYA group collaborators that were responsible of the HPN follow-up from 1st January to 31st December 2013.A total of 197 patients and 202 episodes of HPN were registered from 35 hospitals that represents a rate of 4,22 patients/million habitants/year 2013. The median age was 53 years (IQR 40-64) for 189 adult patients and 7 months (IQR 6-35,5) for children. The most frequent disease in adults was neoplasm (30,7%) followed by other diseases (20,1%) and mesenteric ischemia (12,7%). Short bowel syndrome and intestinal obstruction (25,9%) were in 35.7% cases the indications for HPN. The most frequent diagnosis for children were the congenital intestinal disorders and other diagnosis, both with a (37,5%) and short bowel syndrome and intestinal obstruction were the indication for treatment, each was present in 50% of the sample. Tunneled catheters (50%) and subcutaneous reservoirs (27,7%) were frequently used. The septic complications related with catheter were commonly frequent with a rate of 0.74 infections/1000 HPN days. HPN duration presented a median of 1,69 days. A total of 86 episodes finalized during the year, death was the principal reason (45%), followed by resumed oral via (43,75%) while it happened inversely for children, 66,7% of them resumed oral via and 16,7% deceased. Fifteen per cent were considered for intestinal transplant, children were proportionally candidates, p-value 0.002.The number of participating centers and registered patients increased progressively respect to preceding years. Since 2003 Neoplasm is still being the principal pathological group. Death is adults principal reason for finalizing HPN and resuming oral via for children. Despite that NADYA registry is consolidate as a essential source of relevant information about the advances in Home Artificial Nutrition in our country, currently is in an improvement process of the available information about patients characteristics with a special emphasis on children even though they still being a minority group.

Alvarez-Silva I.,Hospital Universitario Miguel Servet | Alvarez-Silva S.,Hospital Universitario Miguel Servet | Alvarez-Rodriguez J.,Complejo Asistencial de Leon
Medical Hypotheses | Year: 2010

An analysis is carried out of a set of psychic phenomena appearing always in the same way: an experience suddenly invades the consciousness, unfolding automatically and with great intensity. This psychic automatism, of which the patient is a passive observer, is accompanied by an overwhelming feeling of strangeness. Our hypothesis is that these phenomena are the expression of partial seizures with a psychic content. A comparative study is then made of the phenomenology of these partial seizures with a psychic content, on the one hand, and of that of positive syndrome of schizophrenia, on the other. It reveals a wealth of clinical information indicating an overlap between the two conditions. This inclines us to postulate of an existence of shared etiopathogenic mechanisms for both pathologies. © 2009 Elsevier Ltd. All rights reserved.

Izquierdo F.M.,Complejo Asistencial de Leon | Ramos L.R.,Cirugia Ortopedica y Traumatologia | Sanchez-Herraez S.,Cirugia Ortopedica y Traumatologia | Hernandez T.,University of Salamanca | And 2 more authors.
American Journal of Surgical Pathology | Year: 2010

Adamantinomas of the long bones are low-grade malignant tumours. They seem to be related to osteofibrous dysplasia with a mesenchymal-to-epithelial transformation. We report a case of an adamantinoma with a revertant sarcomatoid transformation that showed a complete loss of epithelial differentiation. It corresponded to a 41-year-old male presented with an 8-cm multilobated lesion in the centre of the distal tibia. On the en bloc resection specimen, areas of classic adamantinoma were found but most of the tumor corresponded to a high-grade neoplasm with 2 histologic patterns: one made up by epithelial nests with a basaloid arrangement and positive for pankeratins and so-called glandular keratins, and a second sarcomatoid component, negative for these epithelial markers. Five months after surgery the patient had a massive relapse that consisted solely of the second sarcomatous component also negative for epithelial antibodies.Three cases of adamantinomas with sarcomatoid transformation of the epithelial component have been described but the tumours still preserved an epithelial immunophenotype. However, our case represents the extreme end of the sarcomatoid dedifferentiation of a classic adamantinoma with complete sarcomatoid transformation and total loss of epithelial markers. To our knowledge this has not been described previously. © 2010 by Lippincott Williams & Wilkins.

Pilo-de-la-Fuente B.,Hospital del Sureste | Jimenez-Escrig A.,Hospital Ramon y Cajal | Lorenzo J.R.,Hospital Policlinico Of Vigo | Pardo J.,Complejo Hospitalario Universitario Of Santiago Of Compostela | And 6 more authors.
European Journal of Neurology | Year: 2011

Background and purpose: Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disorder caused by mutations in the CYP27A1 gene resulting in sterol-27-hydroxylase deficiency. Current information about CTX is based mainly on case reports, with only few large series reported. Although perceived as a potentially treatable condition, efficacy of chenodeoxycholic acid plus statin therapy remains unclear. To perform a nationwide survey of confirmed cases, with a thorough analysis of genotype-phenotype data and prognostic factors. Methods: Retrospective review of the clinical and epidemiological aspects and mutations of all the patients diagnosed since 1992 in the main reference centers for genetic testing of CTX in Spain. Results: Twenty-five patients from 19 families were identified. An average delay of 19years was observed between symptom onset and clinical diagnosis. Two main clinical subgroups were recognizable: a classic form (cerebellar and other supratentorial symptoms) and a spinal form (chronic myelopathy). Cholestanol levels did not correlate with clinical presentation, severity or response to therapy. Despite treatment, five patients died during follow-up, one to 4years after diagnosis. Thirteen different mutations were identified, with a higher frequency of p.R395C in Northwestern Spain and p.R405W in Southern Spain. None of the mutations could be associated with a particular clinical feature combination or prognosis. Conclusions: This is the first nationwide extensive series of CTX reported in Spain. The higher number of cases in some areas suggests a possible founder effect. Spinal forms had a less severe prognosis. A delayed diagnosis could contribute to the lack of significant response to treatment. Click for the corresponding questions to this CME article. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

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