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Arranz J.T.,Hospital General Universitario Gregorio Maranon | Climent M.T.,Fundacion Instituto Valenciano Of Oncologia Ivo | Gonzalez-Larriba J.L.,Hospital Universitario San Carlos Of Madrid | Leon L.,Complejo Hospitalario Universitario Of Santiago Of Compostela | Maroto J.P.,Hospital de la Santa Creu i Sant Pau
Critical Reviews in Oncology/Hematology | Year: 2011

Metastatic renal cell carcinoma is resistant to conventional treatment with chemotherapy. Recently the use of molecular-targeted therapies with multikinase inhibitors has been recommended as first-choice therapy because they inhibit cell proliferation and tumour angiogenesis. Sorafenib is a well tolerated tyrosine kinase inhibitor that initially demonstrated efficacy in the treatment of patients with metastatic RCC who progressed after immunotherapy. Expanded-access studies in Europe and North America showed the safety and efficacy of sorafenib in special populations such as elderly, renal failure and cerebral metastases, as well as patients with no prior therapy. No cross-resistance has been suggested in non-randomized trials when used in second line treatment after other targeted therapies. Ongoing clinical trials will better define the role of sorafenib in first and second line either as monotherapy or in combination, as well as the best strategies for the sequential use of this drug. © 2011 Elsevier Ireland Ltd. Source


Cervera Deval J.,Fundacion Instituto Valenciano Of Oncologia Ivo | Sentis Criville M.,Area de Radiologia de la Mama y Ginecologia | Zulueta J.J.,University of Navarra
Radiologia | Year: 2014

In screening programs, overdiagnosis is defined as the detection of a disease that would have gone undetected without screening when that disease would not have resulted in morbimortality and was treated unnecessarily. Overdiagnosis is a bias inherent in screening and an undesired effect of secondary prevention and improved sensitivity of diagnostic techniques. It is difficult to discriminate a priori between clinically relevant diagnoses and those in which treatment is unnecessary. To minimize the effects of overdiagnosis, screening should be done in patients at risk. © 2014 SERAM. Source


Arana E.,Fundacion Instituto Valenciano Of Oncologia Ivo | Arana E.,Fundacion Institute Investigacion en Salud
Radiologia | Year: 2015

In the era of evidence-based medicine, one of the most important skills a radiologist should have is the ability to analyze the diagnostic literature critically. This tutorial aims to present guidelines for determining whether primary diagnostic articles are valid for clinical practice. The following elements should be evaluated: whether the study can be applied to clinical practice, whether the technique was compared to the reference test, whether an appropriate spectrum of patients was included, whether expectation bias and verification bias were limited, the reproducibility of the study, the practical consequences of the study, the confidence intervals for the parameters analyzed, the normal range for continuous variables, and the placement of the test in the context of other diagnostic tests. We use elementary practical examples to illustrate how to select and interpret the literature on diagnostic imaging and specific references to provide more details. © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved. Source


Penalver-Cuesta J.C.,Fundacion Instituto Valenciano Of Oncologia Ivo | Nicolau-Ribera M.J.,Servicio de Anatomia Patologica | Padilla-Alarcon J.D.,Fundacion Instituto Valenciano Of Oncologia Ivo
Revista Espanola de Patologia | Year: 2013

Pericardial fat necrosis is an uncommon benign condition of unknown cause. It presents as acute pleuritic chest pain in previously healthy persons associated with a well-defined anterior paracardiac density on posteroanterior chest radiography. Exceptionally, it constitutes an incidental finding. The objective of this study is to report a clinical case of pericardial fat necrosis in an asymptomatic 38-year-old man, found intraoperatively during a lung carcinoma resection. © 2012 SEAP y SEC. Source


Escrig J.L.D.,Fundacion Instituto Valenciano Of Oncologia Ivo | Romero R.,Fundacion Instituto Valenciano Of Oncologia Ivo
Archivos Espanoles de Urologia | Year: 2014

Active surveillance was born as a therapeutic strategy for a well selected group of patients with low risk prostate cancer with the aim to defer or completely avoid the negative impact of secondary effects of curative therapies. Nevertheless, the patient who chooses this treatment does it at the expense of greater anxiety and doubts about the possible progression of the disease. The main psychological features influencing the quality of life of these patients are, on one hand anxiety, due to the uncertainty and fear to disease progression, and on the other hand, the difficult decision making process. Among the factors that seem to influence the election are: urologist's recommendation, effects on urinary function, age and impact of the therapy on sexual func tion. In the timorous journey walked, it is recommended to apply psycho-educational programs, with the objective of increasing the perceived control and adaptive confrontation. We propose an intervention with 4 group sessions, the objectives of which would be first to improve the decision making process and diminish the fear to progression and, second to reinforce the information already given at the time of diagnosis and increase the sensation of control, e.g promoting healthy habits. Source

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