Dr Negrin University Hospital

Las Palmas de Gran Canaria, Spain

Dr Negrin University Hospital

Las Palmas de Gran Canaria, Spain
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Clavo B.,Dr Negrin University Hospital | Clavo B.,Canary Islands Institute for Cancer Research ICIC | Suarez G.,Dr Negrin University Hospital | Suarez G.,Canary Islands Institute for Cancer Research ICIC | And 6 more authors.
Forschende Komplementarmedizin | Year: 2011

Background: Radiation-induced brain injury (RBI) and low-perfusion brain syndromes are mediated by ischemia and hypometabolism and have limited treatment options. Ozone therapy as treatment in vascular diseases has been described, but the effects on brain tissue have not been well documented. Case Report: We describe a 75-year-old patient with vascular risk factors and meningioma who was treated with stereotactic radiosurgery. 14 months later the patient presented with progressive clinical impairment despite the use of acetylsalicylic acid and corticosteroids. Clinical and imaging evaluations before/after ozone therapy were done by magnetic resonance imaging (MRI), computed tomography (CT), single photon emission computed tomography (SPECT), and positron emission tomography (PET); performance status assessment was done using Barthel Index and World Health Organization/Eastern Cooperative Oncology Group Scale (WHO/ECOG Scale). Ozone therapy was performed by autohemotransfusion. Results: Basal images showed brain areas with ischemia and hypometabolism compatible with ischemic processes and/or RBI. There were no changes in MRI or CT scan images following ozone therapy. However, improvements in brain perfusion and metabolism were demonstrable with SPECT and PET; they correlated with clinical development and performance status scales. Conclusion: This report supports our previous works about the effect of ozone therapy in cerebral blood flow, and it suggests the use of ozone therapy in ischemic and hypometabolic brain syndromes such as stroke or RBI. Copyright © 2011 S. Karger AG, Basel.

Rello J.,University of Barcelona | Ulldemolins M.,University of Barcelona | Lisboa T.,Rovira i Virgili University | Lisboa T.,CIBER ISCIII | And 36 more authors.
European Respiratory Journal | Year: 2011

The objectives of this study were to assess the determinants of empirical antibiotic choice, prescription patterns and outcomes in patients with hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) in Europe. We performed a prospective, observational cohort study in 27 intensive care units (ICUs) from nine European countries. 100 consecutive patients on mechanical ventilation for HAP, on mechanical ventilation >48 h or with VAP were enrolled per ICU. Admission category, sickness severity and Acinetobacter spp. prevalence >10% in pneumonia episodes determined antibiotic empirical choice. Trauma patients were more often prescribed nonanti-Pseudomonas cephalosporins (OR 2.68, 95% CI 1.50-4.78). Surgical patients received less aminoglycosides (OR 0.26, 95% CI 0.14-0.49). A significant correlation (p<0.01) was found between Simplified Acute Physiology Score II score and carbapenem prescription. Basal Acinetobacter spp. prevalence .10% dramatically increased the prescription of carbapenems (OR 3.5, 95% CI 2.0-6.1) and colistin (OR 115.7, 95% CI 6.9-1,930.9). Appropriate empirical antibiotics decreased ICU length of stay by 6 days (26.3±19.8 days versus 32.8±29.4 days; p=0.04). The antibiotics that were prescribed most were carbapenems, piperacillin/tazobactam and quinolones. Median (interquartile range) duration of antibiotic therapy was 9 (6-12) days. Antimethicillin-resistant Staphylococcus aureus agents were prescribed in 38.4% of VAP episodes. Admission category, sickness severity and basal Acinetobacter prevalence >10% in pneumonia episodes were the major determinants of antibiotic choice at the bedside. Across Europe, carbapenems were the antibiotic most prescribed for HAP/VAP. Copyright©ERS 2011.

Clavo B.,Dr Negrin University Hospital | Clavo B.,Canary Islands Institute for Cancer Research ICIC | Ceballos D.,Dr Negrin University Hospital | Gutierrez D.,Dr Negrin University Hospital | And 15 more authors.
Journal of Pain and Symptom Management | Year: 2013

Context: Persistent or severe hemorrhagic radiation proctitis (HRP) has limited therapeutic options. Objectives: To describe our experience with ozone therapy (O3T) in the management of refractory HRP. Methods: Patients (n = 17; median age 69 years [range 42-80 years]) previously irradiated for prostate or uterine cancer and suffering persistent or severe HRP without response to conventional treatment were enrolled to receive an O 3/O2 gas mixture via rectal insufflations and topical application of ozonized oil. Most of the patients (83%) had Grade 3 or Grade 4 toxicity. Median follow-up post-O3T was 40 months (range 3-56 months). Results: Endoscopic treatments required were: 43 (median 1; range 0-10) pre-O3T; 17 (median 0; range 0-8; P = 0.063) during O3T; and five (median 0; range 0-2; P = 0.008) during follow-up. Hemoglobin levels were 10.35 g/dL (7-14 g/dL) pre-O3T and 13 g/dL (9-15 g/dL) (P = 0.001) post-O3T. Median toxicity grades were 3 (range 2-4) pre-O 3T, 1 (range 0-2; P < 0.001) at the end of O3T, and 0 (range 0-1; P < 0.001) at the last follow-up. Conclusion: Persistent advanced HRP was significantly improved with O3T. The addition of O 3T can be useful as a complementary treatment in the long-term management of HRP and, as such, merits further evaluation. © 2013 U.S. Cancer Pain Relief Committee.Published by Elsevier Inc. All rights reserved.

PubMed | Quiron Hospital, Dr Negrin University Hospital and Medical Center Beauty Benefit San Biagio Of Osimo
Type: | Journal: Evidence-based complementary and alternative medicine : eCAM | Year: 2015

Introduction. Persistent radiation-induced proctitis and rectal bleeding are debilitating complications with limited therapeutic options. We present our experience with ozone therapy in the management of such refractory rectal bleeding. Methods. Patients (n = 12) previously irradiated for prostate cancer with persistent or severe rectal bleeding without response to conventional treatment were enrolled to receive ozone therapy via rectal insufflations and/or topical application of ozonized-oil. Ten (83%) patients had Grade 3 or Grade 4 toxicity. Median follow-up after ozone therapy was 104 months (range: 52-119). Results. Following ozone therapy, the median grade of toxicity improved from 3 to 1 (p < 0.001) and the number of endoscopy treatments from 37 to 4 (p = 0.032). Hemoglobin levels changed from 11.1 (7-14)g/dL to 13 (10-15)g/dL, before and after ozone therapy, respectively (p = 0.008). Ozone therapy was well tolerated and no adverse effects were noted, except soft and temporary flatulence for some hours after each session. Conclusions. Ozone therapy was effective in radiation-induced rectal bleeding in prostate cancer patients without serious adverse events. It proved useful in the management of rectal bleeding and merits further evaluation.

Clavo B.,Dr Negrin University Hospital | Clavo B.,ICIC Canary Islands Institute for Cancer Research | Robaina F.,ICIC Canary Islands Institute for Cancer Research | Robaina F.,Dr Negrin University Hospital | And 11 more authors.
Journal of Neuro-Oncology | Year: 2012

The effectiveness of radiotherapy and chemotherapy in high grade gliomas (HGG) depends on tumor micro-environment. We summarize our experience of the influence of spinal cord stimulation (SCS) on this micro-environment. Patients with HGG (n = 26) were assessed pre- and post-SCS, using: (1) Doppler in middle cerebral arteries (MCA) and (2) in common carotid arteries (CCA); (3) tumor blood-flow using single photon emission computed tomography (SPECT); (4) tumor-pO 2 (mmHg) using polarographic probes (eight tumor areas from five patients); and (5) tumor glucose metabolism using 18F-fluoro-2- deoxyglucose ( 18FDG) positron emission tomography ( 18FDG-PET). Pre-SCS: tumor blood-flow was lower (P < 0.001) than peri-tumor areas and healthy contra-lateral areas. Tumor-pO 2 was lower (P < 0.042) than healthy tissue. Tumor glucose metabolism was higher than peri-tumor areas (P = 0.017) and healthy contra-lateral areas (P = 0.048). Post-SCS: there were increases in: MCA blood-flow (P ≤ 0.002), CCA blood-flow (P ≤ 0.013), tumor blood-flow (P = 0.033), tumor glucose metabolism (P = 0.027) and tumor-pO 2 (P = 0.022). The percentage of hypoxic values decreased (P = 0.007). SCS can modify tumor micro-environment. The potential usefulness of SCS in improving the effectiveness of radio-chemotherapy in HGG needs to be evaluated. © 2011 Springer Science+Business Media, LLC.

Clavo B.,Dr Negrin University Hospital | Santana-Rodriguez N.,Dr Negrin University Hospital | Gutierrez D.,Dr Negrin University Hospital | Lopez J.C.,Dr Negrin University Hospital | And 4 more authors.
Journal of Alternative and Complementary Medicine | Year: 2013

Background: Headache afflicts approximately 10%-15% of the general population. Mixed results are obtained from various therapies, usually drugs, but also oxygen inhalation, behavioral psychology, physical therapy, and peripheral or central neurostimulation. When refractory to treatment, it has severe impact on quality of life. Objectives/subjects: Five (5) patients are presented who had suffered from severe/persistent headache refractory to standard management (including 5-HT1 agonist triptan drugs) and were treated with ozone therapy. Interventions: Ozone administration was by major autohemotherapy. The procedure involved venous blood drawn into a sterile single-use glass bottle containing anticoagulant, gently mixed with an equal volume of O3/O2 gas mixture (prefiltered through a sterile 0.20-μm filter) and slowly reinfused back into the donor patient via the antecubital vein. Outcome measures: The analyzed parameters were analgesia requirements, days of sick leave due to headache, number of headache events, and pain intensity according to the visual analogue scale (VAS); these recorded at three time points: pre-ozone therapy, post-ozone therapy, and before the last follow-up (mean: 64.6±36.8 months). Results: The number of headache episodes pretreatment (n=80; range 5-200) was significantly decreased during the first 6 months post-treatment (n=0, range 0-1; p=0.042) and over the 6 months before the last follow-up visit (n=1, range 0-2; p=0.043). The corresponding VAS scores were 8.7±0.8 pretreatment versus 1.1±2.5 the 6 months post-treatment (p=0.003) and versus 3.1±3.3 the 6 months before last follow-up visit (p=0.036). Conclusions: Ozone therapy decreased headache episodes and pain severity over a protracted period. This novel approach is effective and merits further research. © Copyright 2013, Mary Ann Liebert, Inc. 2013.

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