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Villares J.M.P.,Complejo Hospitalario Universitario Of Granada
Cuadernos de Medicina Forense | Year: 2015

Donation after cardiac death, or donation from persons whose death has been diagnosed by cardiocirculatory and respiratory criteria, has been identified as one of the areas with the greatest room for improvement in Spain. Uncontrolled donation after cardio-circulatory death or type II classification donation modified Maastricht Madrid is one that comes from people who have suffered an unexpected cardio-respiratory arrest, after application of cardiopulmonary resuscitation without success. Controlled donation after cardio-circulatory death or type III modified the classification of Madrid Maastricht donation refers to the donation of organs that occurs from people dying from circulatory and respiratory criteria following a limitation of life-sustaining treatment. © 2015 Asociacion Andaluza de Medicos Forenses. All rights reserved. Source

Gomez-Veiga F.,Hospital Universitario Of Salamanca | Alcaraz-Asensio A.,Hospital Clinic Universitari | Burgos-Revilla J.,Hospital Universitario Ramon y Cajal | Cozar-Olmo J.,Complejo Hospitalario Universitario Of Granada
Actas Urologicas Espanolas | Year: 2016

Objective To review the latest evidence on the oncologic urology of prostate, renal and bladder tumours, analysing their impact on daily clinical practice and future medium to long-term regimens. Methods We review the abstracts on prostate, renal and bladder cancer presented at the 2015 congresses (EAU, AUA, ASCO, ESMO y ASTRO) that received the best evaluations by the OncoForum committee. Results Cabozantinib could represent a new second-line (or subsequent) treatment option for patients with advanced renal cancer. In muscle-invasive bladder cancer, the genetic expression profile could predict the clinical benefit of neoadjuvant therapy in treating urothelial tumours. In metastatic castration-resistant prostate cancer, results were presented from various studies that evaluated the addition of chemotherapy to standard treatment with androgen deprivation, showing a reduction in the progression risk and higher PSA response rates. Conclusions New options for the second-line treatment of renal cancer were presented. In metastatic castration-resistant prostate cancer, various studies have been published on treatment with enzalutamide, which has been shown to delay the symptomatic disease and benefit overall survival. © 2016 AEU Source

Carrero-Lopez V.M.,Hospital Universitario Infanta Leonor | Cozar-Olmo J.M.,Complejo Hospitalario Universitario Of Granada | Minana-Lopez B.,Hospital General Universitario Morales Meseguer
Actas Urologicas Espanolas | Year: 2016

Context The treatment of benign prostatic hyperplasia (BPH) is changing due to a greater understanding of the disease and the development of the functional concept of lower urinary tract symptoms (LUTS). Objectives To describe the current state of BPH and the diagnosis and treatment of LUTS. Acquisition of evidence We summarise the issues presented and debated by a group of expert urologists during the First UROVI Congress, sponsored by the Spanish Urological Association. Summary of the evidence LUTS encompasses filling, voiding and postvoiding symptoms that affect patients' quality of life. The aetiological diagnosis is an important element in starting the most ideal treatment. For this reason, new alternative therapies (both pharmacological and surgical) are needed to help individually address the symptoms in the various patient profiles. There is now a new combination of drugs (6 mg of solifenacin and 0.4 mg of the tamsulosin oral controlled absorption system) for treating moderate to severe filling symptoms and emptying symptoms associated with BPH in patients who do not respond to monotherapy. Furthermore, new surgical techniques that are increasingly less invasive help provide surgical options for older patients and those with high comorbidity. Conclusions The availability of drugs that can act on the various LUTS helps integrate the pathophysiological paradigm into the functional one, providing more appropriate treatment for our patients. © 2016 AEU. Publicado por Elsevier España, S.L.U. Todos los derechos reservados. Source

Poveda E.,University of La Coruna | Wyles D.,University of California at San Diego | Morano L.,University of Vigo | Pineda J.A.,Hospital Universitario Of Valme | Garcia F.,Complejo Hospitalario Universitario Of Granada
AIDS Reviews | Year: 2015

New therapeutic options for the treatment of HCV infection are highly effective, possess minimal side effects, and allow for a shortened course of therapy, presenting a favorable scenario to treat and cure all patients chronically infected with HCV. However, there are still many challenges to advancement towards HCV eradication, not only related to the cost and the availability of the drugs, but also pertaining to epidemiologic, diagnostic, and treatment issues that remain to be resolved. Advances in the knowledge of all these topics are essential for the optimization of diagnostic and treatment strategies to fight again HCV infection. The latest data presented at the I Conference of the Group for the Study of Viral Hepatitis (GEHEP) (23-26 September, Spain) highlights relevant progress on many of these fronts for an overview of HCV infection at present. This review summarizes some of the major findings presented and discussed during the conference. © Permanyer Publications 2015. Source

Torres-Degayon V.,Hospital Universitario Of Ceuta | Montero-Perez F.J.,University of Cordoba, Spain | Torres-Murillo J.M.,University of Cordoba, Spain | Faus-Dader M.J.,University of Granada | And 2 more authors.
Emergencias | Year: 2016

Objectives. To detect the frequency of negative outcomes associated with medication in patients with permanent atrial fibrillation (AF) who are attended in a hospital emergency department, and to assess type and severity of such outcomes related to AF medications as well as the rate of preventable negative outcomes. Methods. Descriptive, observational cross-sectional study in patients with permanent AF who were attended in the emergency department of a tertiary care hospital during a 3-month period. A pharmacist interviewed the patients to record demographic characteristics, health problems, degree of functional impairment, and current drug treatments. An emergency physician and a pharmacist reviewed the patients’ questionnaires and medical histories and evaluated them using the Dader method of pharmacotherapeutic follow-up. Results. Of the 210 patients assessed, 198 entered the final analysis. They had a mean (SD) age of 80.5 (7.3) years, and 114 (57.5%) were women. One handred and thirty-four (67.7%) patients had medication-related negative outcomes; 61 (45.5%) of the outcomes were related to treatment for permanent AF. Twenty-four of these 61 patients (39.3%) had problems affecting safety; 36 (59%) of the problems were caused by drugs to control heart rate. Of the 73 patients with negative outcomes unrelated to AF medication, 34 (46.6%) were related to necessary medications and 38 (52.1%) were taking antibiotics. The frequencies of avoidable negative outcomes were significantly different between the group of patients with problems related to drug therapy for AF (where 55.7% were due to medications considered unnecessary) and those with problems unrelated to AF medications (where 78.1% were from avoidable medications) (P=.010). However, the level of seriousness was similar. Conclusions. Nearly two-thirds of patients with permanent AF who come to the emergency department have a medication-related negative outcome that may or may not be related to AF treatment. Problems from drugs taken for reasons other than AF could more easily be avoided. © 2016, Grupo Saned. All rights reserved. Source

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