Rovira A.,Autonomous University of Barcelona |
Auger C.,Autonomous University of Barcelona |
Rovira A.,Corporacio Sanitaria Parc Tauli
Handbook of clinical neurology | Year: 2016
Idiopathic inflammatory-demyelinating diseases (IIDDs) represent a broad spectrum of central nervous system (CNS) disorders, including monophasic, multiphasic, and progressive disorders that range from highly localized forms to multifocal or diffuse variants. In addition to the classic multiple sclerosis (MS) phenotypes, several MS variants have been described, which can be differentiated on the basis of severity, clinical course, and lesion distribution. Other forms of IIDD are now recognized as distinct entities and not MS variants, such as acute disseminated encephalomyelitis, and neuromyelitis optica spectrum disorders. The CNS can also be affected by a variety of inflammatory diseases. These include primary angiitis of the CNS (PACNS), a rare disorder specifically targeting the CNS vasculature, and various systemic conditions which, among other organs and systems, can also affect the CNS, such as systemic vasculitis and sarcoidosis. The diagnosis of PACNS is difficult, as this condition may be confused with reversible cerebral vasoconstriction syndrome (RCVS), a term comprising a group of conditions characterized by prolonged but reversible vasoconstriction of the cerebral arteries. Magnetic resonance imaging of the brain and spine is the radiologic technique of choice for diagnosing these disorders, and, together with the clinical and laboratory findings, enables a prompt and accurate diagnosis. © 2016 Elsevier B.V. All rights reserved.
Aranda E.,Hospital Universitario Reina Sofia |
Manzano J.L.,Hospital Universitario Germans Trias i Pujol |
Rivera F.,Hospital Universitario Marques Of Valdecilla |
Galan M.,Institute Catala dOncologia Hospital Duran i Reynals |
And 8 more authors.
Annals of Oncology | Year: 2012
Background: Skin rash is an adverse event which might be associated with longer survival in patients treated with epidermal growth factor receptor tyrosine kinase inhibitors. The aim of this nonrandomised phase II clinical trial is to prospectively evaluate the relationship between skin rash and overall survival (OS) in advanced/metastatic pancreatic cancer treated with erlotinib plus gemcitabine. Patients and methods: Patients were given gemcitabine (1000 mg/m. 2/week, 3 weeks every 4 weeks) plus erlotinib (100 mg/day orally continuously) until disease progression/unacceptable toxicity. The primary end point was OS. Results: A total of 153 eligible patients were enrolled (grade ≥ 2 rash, 25%; grade < 2 rash, 75%). OS was longer in patients with grade ≥2 rash versus grade <2 (11 versus 5 months; P < 0.001). Progression-free survival was longer in patients with grade ≥2 rash versus grade <2 (6 versus 3 months; P < 0.001) and shorter in those without rash versus grade 1 (2 versus 4 months; P = 0.005) or grade ≥2 (2 versus 6 months; P < 0.001). Patients with grade ≥2 rash showed higher rates of overall response (21% versus 7%; P < 0.05) and disease control (84% versus 43%; P < 0.05) versus grade <2. Conclusions: This study prospectively confirms the relationship between rash and longer OS in unresectable locally advanced/metastatic pancreatic cancer treated with erlotinib plus gemcitabine. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Andion O.,Hospital Universitari Vall dHebron |
Andion O.,Autonomous University of Barcelona |
Canellas M.,Corporacio Sanitaria Parc Tauli |
Banos J.-E.,University Pompeu Fabra
Journal of Clinical Nursing | Year: 2014
Aims and objectives: To determine which unpleasant conditions might contribute to postoperative physical well-being, as judged by patients, nurses and physicians. Background: Healthcare professionals have rarely assessed holistic postoperative well-being. Most studies have focused on specific symptoms, and a broader survey is lacking. Design: A prospective study, which collected information on the causes of decreased physical well-being in the postoperative period. Methods: The study was carried out in 101 patients who subsequently underwent elective surgery, in 82 physicians and in 40 nurses, all from the same hospital. A questionnaire was used for each sample, which included an inventory of 12 items, which have been associated with the worsening of postoperative physical well-being in the literature. Patients were asked to fill out the questionnaire on the second or third postoperative day and score each item from 0-10. Results: Physicians rated pain (8·45), vomiting (6·68) and nausea (6·55) the highest. Nurses scored pain (8·48), nasogastric tube (7·13) and nausea (7·10) at the top. Insomnia and oxygen mask were scored significantly higher by nurses than by physicians. Patients scored pain (5·41) and movement restriction (4·62) the highest. When departments were compared, statistical differences were seen in nausea, vomiting, intravenous drips, nasogastric tube and oxygen mask. Conclusions: This survey shows that there is a general agreement between nurses and physicians regarding what contributes to decreased postoperative physical well-being, with few exceptions. However, healthcare professionals may differently rate some items that patients find as the most troubling. Relevance to clinical practice: This survey shows that, besides pain, other symptoms can affect the physical well-being of patients during the postoperative period. Alleviation of some symptoms and the use of medical devices only when they are really needed may help to improve the well-being of patients. © 2013 John Wiley & Sons Ltd.
Hernando V.,Institute Salud Carlos III |
Hernando V.,CIBER ISCIII |
Perez-Cachafeiro S.,Fundacion Idi Complexo Hospitalario Of Pontevedra |
Lewden C.,French Institute of Health and Medical Research |
And 8 more authors.
Journal of Hepatology | Year: 2012
Background & Aims: We aimed at comparing overall and liver-related mortality rates, observed in HIV positive subjects followed-up in the Cohorts of Spanish Network on HIV/AIDS Research stratified by HCV co-infection status, with the expected mortality of the general population of same age and sex in Spain, for the period 1997 - 2008. Methods: We estimated standardized mortality ratio (SMR) and excess mortality, comparing death rates from our cohort (globally and by HCV co-infection) with death rates from the general population standardized by sex in 5 year-age bands. Results: Overall, 5914 HIV positive subjects were included, 37.3% of which were co-infected with HCV; 231 deaths occurred, 10.4% of which were liver-related. SMR for all causes mortality for the HIV positive subjects was 5.6 (CI 95% 4.9-6.4), 2.4 (1.9-3.1) for HCV negative subjects and 11.5 (9.9-13.4) for HCV positive ones. Having HCV co-infection and AIDS yielded an SMR of 20.8 (16.5-26.1) and having AIDS and being HCV negative had an SMR of 4.8 (3.5-6.7). SMR for liver-related mortality was 1.8 (0.6-5.7) for HCV negative subjects vs. 22.4 (14.6-34.3) for HCV positive ones. Overall, both mortality rates as SMR and excess mortality rates were higher for injecting drug users (IDUs) than men having sex with men (MSM) and heterosexuals, patients with AIDS, with and without cART and for subjects included between 1997 and 2003. Conclusions: There was an excess of all-cause and liver-related mortality in our cohorts compared with the general population. Furthermore, HCV co-infection in HIV positive patients increased the risk of death for both all causes and liver-related causes. © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Estevez L.,Centro Integral Oncologico Clara Campal |
Alvarez I.,Hospital Donostia |
Tusquets I.,Hospital del Mar |
Segui M.A.,Corporacio Sanitaria Parc Tauli |
And 2 more authors.
Cancer Treatment Reviews | Year: 2013
Fulvestrant is a selective estrogen receptor downregulator, behaving as a complete antagonist. It was initially approved, at a dose of 250. mg, to treat hormone dependant breast cancer in second line setting. However, a series of pharmacological and pre-clinical studies have suggested that a higher dose of 500. mg may be more effective. The present work summarizes and discusses clinical trials that have aimed to test the benefits of administering fulvestrant at a higher dose. The data support the use of a higher, and more possibly, effective dose of the agent. © 2012 Elsevier Ltd.
Artigas-Pallares J.,Center Medic Psyncron |
Guitart M.,Corporacio Sanitaria Parc Tauli |
Gabau-Vila E.,Corporacio Sanitaria Parc Tauli
Revista de Neurologia | Year: 2013
In the last decade, progress made in genetics is questioning the current implicit nosological model in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) and the International Classification of Diseases, tenth revision. Both the categorical nature and the comorbidity detected on applying diagnostic criteria become unsustainable in the light of the genetic architecture that is emerging from studies being conducted on the genetics of mental disorders. The classical paradigms -one gene for one disease- or even a specific distinctive genetic pattern for each condition, are concepts restricted to specific cases. In this review the objective is to describe the current scenario that has arisen following the latest advances in genetics. The lines of work being traced by research both in the present and in the near future include: the identification of variations in the number of copies (both frequent and rare), indiscriminately linked to different disorders; the concurrence of multiple variants for a single disorder; the double hit phenomenon; and epigenetic modulation. The new version of the DSM, fully aware of the deficiencies in the current model, will mark a turning point that, while somewhat timid, is decidedly oriented towards incorporating a dimensional conception of mental disorders. © 2013 Revista de Neurología.
Corporacio Sanitaria Parc Tauli, Fundacio Institute Of Bioenginyeria Of Catalonia Ibec and Telstar Technologies | Date: 2011-07-28
A lamp having a first module for being attached to a ceiling or wall element, a second module connected to the first module and being rotatable with respect to the first module along a first axis, a third module having one or more light-emitting elements, the third module being connected to the second module and rotatable with respect to the second module along a second axis, the second axis being substantially perpendicular to the first axis.
Corporacio Sanitaria Parc Tauli | Date: 2014-06-02
A device (1) for use in the surgical treatment of a patient suffering from funnel chest characterised in that it comprises a plate adapted to be fitted underneath the skin of the patient, and further characterised in that, in use, said plate can be attached to the patients sternum and the curvature, length and width of the plate being such that the plate extends on both sides of the sternum and on the outside of the patients thorax and is supported by the ribs to hold up the sternum.
Corporacio Sanitaria Parc Tauli | Date: 2013-07-30
Fastening device for people with reduced mobility conditions, of the variety employed in chairs or arm chairs in domestic, geriatric, care or hospital environments, comprising fixation means (50), which can be adapted to the back of the chair or arm chair and containing means (100) to contain the person to be fastened. Said device (1) comprises a portable support body (10) in which said fixation means (50) and containing means (100) are located and the containing means (100) comprise at least one containing strap (101, 102, 103) connected to an emergency locking retractor (104, 105, 106) which is configured in order to facilitate the free movement of the person fastened to said chair or arm chair and to prevent falling movement of the same.
Lluch A.,Hospital Clinico Universitario Of Valencia |
Alvarez I.,Hospital Universitario Of Donostia |
Segui M.T.,Corporacio Sanitaria Parc Tauli |
Tusquets I.,Hospital Del Mar Parc Of Salut Mar |
Garcia-Estevez L.,Centro Integral Oncologico Clara Campal
Critical Reviews in Oncology/Hematology | Year: 2014
In spite of recent advances in the treatment of metastatic breast cancer, this disease remains essentially incurable. Anthracyclines and taxanes have been widely demonstrated to be the most active cytotoxic drugs for the treatment of breast cancer. Paclitaxel and docetaxel are both hydrophobic drugs that need to be administered with detergent-like substances as solvents. In contrast, nanoparticle albumin-bound (nab) paclitaxel uses the natural characteristics of albumin to reversibly bind paclitaxel, transport it across endothelial cells and concentrate the active ingredient within the tumor. Several trials have demonstrated that nab-paclitaxel results in superior efficacy, with more complete responses, prolonged time to recurrence and survival, than paclitaxel and docetaxel in MBC. As second-line treatment, the novel formulation has almost doubled overall response rate, increased time to progression and overall survival in comparison with paclitaxel. Due to these results, to date nab-paclitaxel stands out as a promising treatment of metastatic breast cancer. © 2013.