Complexo Hospitalario Universitario Of Santiago Of Compostela

Santiago de Compostela, Spain

Complexo Hospitalario Universitario Of Santiago Of Compostela

Santiago de Compostela, Spain
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Garcia-Figueiras R.,Complexohospitalario Universitario Of Santiago Of Compostela | Goh V.J.,King's College London | Padhani A.R.,Paul Strickland Scanner Center | Baleato-Gonzalez S.,Complexohospitalario Universitario Of Santiago Of Compostela | And 3 more authors.
American Journal of Roentgenology | Year: 2013

OBJECTIVE. This article summarizes the current status of CT perfusion in oncologic imaging, including lesion characterization, staging, prediction of patient outcome or response to therapy, assessment of response to different therapies, and evaluation of tumor relapse. Technical limitations and drawbacks of CT perfusion are also discussed. CONCLUSION. Tumor angiogenesis is essential for cancer growth and provides an attractive target for oncologic therapies. CT perfusion is an emerging imaging tool that provides both qualitative and quantitative information regarding tumor angiogenesis. © American Roentgen Ray Society.


Figueiras R.G.,Complexo Hospitalario Universitario Of Santiago Of Compostela | Goh V.,Mount Vernon Hospital | Padhani A.R.,Mount Vernon Hospital | Naveira A.B.,Complexo Hospitalario Universitario Of Santiago Of Compostela | And 2 more authors.
American Journal of Roentgenology | Year: 2010

OBJECTIVE. This article reviews the current and future contributions of functional imaging techniques to improve diagnosis, prognosis, and treatment of colorectal cancer. In addition, evolving roles and challenges for their implementation will be covered. CONCLUSION. Functional imaging now has a growing role in colorectal cancer. Recent developments in imaging technologies and validation of these newer imaging techniques may lead to significant improvements in the management of patients with colorectal cancer. © American Roentgen Ray Society.


ABAL-FABEIRO J.L.,University of Santiago de Compostela | MASIDE X.,University of Santiago de Compostela | LLOVO J.,Xenomica Comparada de Parasitos Humanos | LLOVO J.,Complexo Hospitalario Universitario Of Santiago Of Compostela | BARTOLOME C.,University of Santiago de Compostela
Epidemiology and Infection | Year: 2015

Cryptosporidium infects millions of people worldwide causing acute gastroenteritis, but despite its remarkable epidemiological and economic impact, information on the epidemiological trends of human cryptosporidiosis is still scarce in most countries. Here we investigate a panel of 486 cases collected in Galicia (NW Iberian Peninsula) between 2000 and 2008, which sheds new light on the epidemiology in this region of the South Atlantic European façade. Incidence rates in Galicia are one order of magnitude higher than those reported in other regions of Spain, suggesting that this parasite remains largely underdiagnosed in this country, and are also larger than those typical of other European countries with available data. Two species dominate our dataset, Cryptosporidium hominis (65%) and C. parvum (34%). The sex ratio of patients infected by either species was 0·5, but C. hominis was significantly more common in younger males. C. parvum infections were more acute and required more specialized medical attention, which suggests a differential adaptation of each species to human hosts. The parasites display strong seasonal and geographical variation. C. parvum incidence peaked during summer and was mainly detected in rural areas while C. hominis infections were more frequent in autumn and exhibited a more even geographical distribution. Such differences probably reflect their distinct sources of infection – C. parvum is mainly zoonotic and C. hominis anthroponotic – and the effects of climatic variables, like temperature and rainfall. Copyright © Cambridge University Press 2015


Armas Alvarez A.L.,Complexo Hospitalario Universitario Of Santiago Of Compostela
Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica | Year: 2010

Amyand's hernia is a condition of exceptional presentation in children and is defined by the presence of inflamed appendix inside a inguinal hernia. It may manifest clinically as acute scrotum, inguinal lymphadenitis or strangulated hernia. The treatment is surgical and although several approaches are described, appendectomy with herniotomy by inguinal approach is considered of choice.


Arias M.,Complexo Hospitalario Universitario Of Santiago Of Compostela
Revista de Neurologia | Year: 2011

Introduction. Laughter, which is usually a healthy biological phenomenon, may be also a symptom of several severe brain pathologies. Aim. To review the neurobiological bases of laughter and humour, as well as those of pathological laughing and crying syndrome. Development. At the mesencephalic-pontine junction there is a central coordinator of the nuclei that innervate the muscles involved in laughter (facial expression, respiratory and phonatory). This centre receives connections from three systems: Inhibitory (pre-motor and motor cortex), excitatory (temporal cortex, amygdala, hypothalamus) and modulator (cerebellum). Humour is a complex phenomenon with a range of components: the perception of the unexpected incongruence (occipitotemporal area, prefrontal cortex), emotional (reward circuit) and volitional (temporal and frontal cortex). Functional magnetic resonance imaging studies do not reveal a markedly prominent role of the right frontal lobe in processing humour, as had been suggested in the classical studies. The causes of pathological laughing and crying syndrome can be classified in two groups: altered behaviour with unmotivated happiness (Angelman syndrome, schizophrenia, manias, dementia) and interference with the inhibitory/excitatory mechanisms (gelastic epilepsy, fou rire prodromique in strokes, multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease and Parkinson-plus, traumatic injuries, tumours). Serotonin and noradrenalin reuptake inhibitors, levodopa, lamotrigine and the association of dextromethorphan/quinidine can be effective in certain cases of pathological laughing and crying. Conclusions. As human neurobiological phenomena, laughter and humour also belong to the field of clinical neurology; their processing is affected in a number of different diseases and, in certain cases, effective treatment can be established. © 2011 Revista de Neurología.


Cuba J.,Complexo Hospitalario Universitario Of Santiago Of Compostela | Gomez-Ulla F.,Complexo Hospitalario Universitario Of Santiago Of Compostela
Archivos de la Sociedad Espanola de Oftalmologia | Year: 2013

Purpose: To describe the findings of the study of autofluorescence of the different retinal diseases included in the study. To determine in which diseases autofluorescence may be more, or just as, useful as fluorescein angiography (FAG) in terms of diagnostic information. Material and methods: We studied the retinal autofluorescence of 123 eyes of 93 patients, including various diseases of the eye fundus. In all cases we explored the fundus, retinal autofluorescence, and, if indicated, FAG was performed. Analysis of the autofluorescence was performed using the Heidelberg Retina angiography Angiograph 2 (HRA2) Heidelberg Engineering (Germany). Results: The autofluorescence information provided was equal or better (than FAG) in: 68.18% of cases of macular edema, 50% of pigment epithelium detachments, 100% of pigment epithelium atrophies, 100% of central serous chorioretinopathy; 55.55% of choroidal neovascularization, 100% of retinal dystrophies with deposition of lipofuscin, 100% of hard exudates and pre-retinal hemorrhages. Conclusions: Autofluorescence is a quick and non-invasive examination method, comfortable for both patient and examiner, and with a very short learning curve. It provides diagnostic information about many eye fundus diseases. While more studies and more experience with its use are needed, its interest lies in the possibility of avoiding the performing of angiography in patients with these diseases, and in the additional information autofluorescence provides about the functional situation of cells and retinal pigments. © 2011 Sociedad Española de Oftalmologi ́a. Publicado por Elsevier España.


Orosa B.,Complexo Hospitalario Universitario Of Santiago Of Compostela | Gonzalez A.,Complexo Hospitalario Universitario Of Santiago Of Compostela | Mera A.,Complexo Hospitalario Universitario Of Santiago Of Compostela | Gomez-Reino J.J.,University of Santiago de Compostela | Conde C.,Complexo Hospitalario Universitario Of Santiago Of Compostela
Arthritis and Rheumatism | Year: 2012

Objective To investigate the role of lysophosphatidic acid (LPA) receptors in the proliferation and apoptosis of fibroblast-like synoviocytes (FLS) from patients with rheumatoid arthritis (RA). Methods Expression of LPA receptors 1-3 was analyzed by real-time polymerase chain reaction (PCR). LPAR1 and LPAR2 were suppressed in RA FLS by small interfering RNA (siRNA) transfection. Proliferation of RA FLS after tumor necrosis factor (TNF) and LPA stimulation was determined with a luminescent cell viability assay. Apoptosis was analyzed by quantification of nucleosome release and measurement of activated caspase 3/7. Genes involved in the apoptotic response were identified with a human apoptosis PCR array and validated with Western blot assays. The requirement of these genes for apoptosis sensitization was assessed by siRNA transfection. Secretion of mediators of inflammation was analyzed by enzyme-linked immunosorbent assay. Results Only LPAR1 and LPAR2 were expressed by RA FLS, and their levels were higher than those in osteoarthritis (OA) FLS. Suppression of LPAR1 abrogated TNF-induced proliferation and sensitized the RA FLS, but not the OA FLS, to TNF-induced apoptosis. These changes occurred despite an increased early inflammatory response to TNF. Sensitization to apoptosis was associated with changes in expression of multiple apoptosis-related genes. Three of the up-regulated proapoptotic genes were further studied to confirm their involvement. In contrast, suppression of LPAR2 showed no effect in any of these analyses. Conclusion LPA1 is an important receptor in RA FLS. Its suppression is accompanied by a global increase in the response to TNF that is ultimately dominated by sensitization to apoptosis. Copyright © 2012 by the American College of Rheumatology.


Barros Alcalde P.,Complexo Hospitalario Universitario Of Santiago Of Compostela
BMJ case reports | Year: 2014

Hyponatraemia is the most common fluid-electrolyte disorder, and the most frequent related aetiologies are syndrome of inappropriate secretion of antidiuretic hormone (SIADH), which accounts for up to 38%. SIADH has been linked to multiple pathologies that affect the central nervous system; these disorders generally originate in the brain and, more rarely, in the spinal cord. It is often observed in patients undergoing neurosurgery and in patients with head injuries or intracranial tumours, and less common in those with spinal pathologies, especially traumatic. We describe an SIADH case associated with syringomyelia, in a patient admitted for severe, symptomatic hyponatraemia.


Abalo-Lojo J.M.,Complexo Hospitalario Universitario Of Santiago Of Compostela | Limeres C.C.,University of Santiago de Compostela | Gomez M.A.,Complexo Hospitalario Universitario Of Santiago Of Compostela | Baleato-Gonzalez S.,Complexo Hospitalario Universitario Of Santiago Of Compostela | And 4 more authors.
Journal of Neuro-Ophthalmology | Year: 2014

Objective: To study the relationship between retinal nerve fiber layer (RNFL) thickness and brain atrophy using magnetic resonance imaging (MRI) with bicaudate ratio (BCR) in patients with multiple sclerosis (MS) with different levels of disease severity. We also assessed whether RNFL thickness correlated with Expanded Disability Status Scale (EDSS) score. Methods: The participants consisted of 88 patients with MS and 59 age-and sex-matched healthy control subjects. Eleven patients had clinically isolated syndrome (CIS), 68 patients had relapsing-remitting MS (RR-MS), and 9 patients had secondary progressive MS. Patients and controls were evaluated using optical coherence tomography (OCT, Cirrus) and scanning laser polarimetry with variable corneal compensation (GDx VCC). Patients underwent the same brain MRI scanning protocol. Disability was evaluated according to the EDSS. The BCR was calculated by dividing the minimum intercaudate distance by brain width along the same level. Results: The BCR was higher in patients with MS (0.12 ± 0.03) than in controls (0.08 ± 0.009) (P < 0.001). OCT average RNFL thickness in patients with MS was significantly lower (84.51 ± 14.27 μm) than in control subjects (98.44 ± 6.83 μm). BCR was correlated with OCT average RNFL thickness (r =-0.48, P = 0.002) in patients with MS without optic neuritis. Significant correlations were found between average RNFL thickness and EDSS (r =-0.43, P = 0.003). Additionally, there were correlations between BCR with GDx parameters in patients with MS without optic neuritis. Conclusions: This study shows that RNFL thickness correlates with BCR and with MS subtypes. Additionally, our study indicates that OCT is better suited for MS assessment than GDx. We conclude that the damage of retinal axons appears related to brain damage in patients with MS. © 2013 by North American Neuro-Ophthalmology Society.


Arias Gomez M.,Complexo Hospitalario Universitario Of Santiago Of Compostela
Neurologia | Year: 2010

Serious complications (catastrophes) resulting from diverse neurological diagnostic procedures can be caused by erroneous indication and omission, as well as by delay and erroneous execution or interpretation. Headache, caused by cerebrospinal fluid (CSF) hypotension, is a frequent complication of lumbar puncture; hematic patch is a therapeutic option for severe cases. The most serious complication is cerebral herniation and, for its prevention, computed tomography (CT) or cerebral magnetic resonance imaging (MRI) must always be performed before lumbar puncture: a lesion with evident mass effect is a contraindication. Some cases of minor subarachnoid hemorrhages can produce sentinel headache: when the findings of CT scans are normal, lumbar puncture must be performed for diagnosis and prevention of a catastrophic recurrence. Edrophonium testing can be complicated with bradycardia and/or asystole. The lack of indication of this procedure is a cause of under-diagnosis of myasthenia gravis, especially in older people. Electromyography produces few complications (rare cases of paraspinal hematomas and pneumothorax). Ultrasound, CT angiography and MR angiography examinations have decreased the indications for cerebral angiography, whose main complications -in addition to contrast reactions, hemorrhage and infection at the injection site- are neurological deficits caused by vascular dissection or atheromatous embolus. Video-electroencephalogram (EEG) recording with medication suppression can be used in the presurgical evaluation of epilepsy, which can precipitate repeated seizures with the risk of injuries and status epilepticus. The possible complications of studies performed with invasive electrodes are infections and intracranial hemorrhages. Cerebral biopsy is indicated when treatable disease is suspected but the therapeutic options (radiotherapy, chemotherapy) have potential serious adverse effects. Furthermore, cerebral biopsy can aggravate previous neurological deficits or produce new deficits. Genetic testing is not indicated in healthy children when an untreatable disease is suspected. In adults, genetic testing is appropriate in selected cases, but detailed previous information should be gathered and the possibility of triggering serious emotional reactions should always be considered. © 2010 Sociedad Española de Neurología.

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