Ferrer-Garcia J.C.,Consorcio Hospital General Universitario Of Valencia |
Iranzo Gonzalez-Cruz V.,General Universitario Of Valencia |
Navas-Desolis S.,Hospital Universitario La Paz |
Civera-Andres M.,Hospital Clinico Universitario |
And 5 more authors.
Clinical and Translational Oncology | Year: 2013
Aim: Malignant insulinoma is an infrequent functional endocrine tumor of the pancreas. Adequate therapy is a demanding challenge for oncologists and endocrinologists. Objective: To evaluate the results of multidisciplinary management of malignant insulinoma. Materials and methods: Retrospective review of patients with malignant insulinoma treated from 1995 to 2011. Results: Seven patients with malignant insulinoma were included: four males and three females; median age was 61.8 years (range 37-78). Six tumors were sporadic and one was diagnosed in a patient with a type 1 multiple endocrine neoplasia (MEN-1). Surgery was performed in six cases and one patient was considered unresectable. Hypoglycemias persisted in all cases and somatostatin analogs, glucocorticoids and diazoxide were used. Two patients received everolimus. Other techniques were chemoembolization and internal radiation therapy with yttrium-90. Successful liver transplant was done in the patient with MEN-1. Conclusion: Hypoglycemia management is complex and requires multiple therapies. Further evaluations will be necessary to determine the best treatment. © 2013 Federación de Sociedades Españolas de Oncología (FESEO).
Intravitreal bevacizumab plus grid laser photocoagulation or intravitreal bevacizumab or grid laser photocoagulation for diffuse diabetic macular edema: Results of the pan-american collaborative retina study group at 24 months
Arevalo J.F.,Wilmer Eye Institute |
Arevalo J.F.,King Khaled Eye Specialist Hospital |
Arevalo J.F.,Stellenbosch University |
Lasave A.F.,Clinica Oftalmologica Centro Caracas |
And 5 more authors.
Retina | Year: 2013
PURPOSE:: To evaluate the anatomical and functional outcomes at 24 months in patients with diffuse diabetic macular edema treated with primary intravitreal bevacizumab (IVB) plus grid laser photocoagulation (GLP) or primary IVB alone or GLP alone. METHODS:: Retrospective, interventional, comparative, multicenter study. We included in this analysis 141 eyes of 120 patients with diffuse diabetic macular edema treated with primary IVB alone (Group A), 120 eyes of 94 patients with GLP therapy (Group B), and 157 eyes of 104 patients treated with IVB plus GLP (Group C). RESULTS:: In all 3 groups, the authors observed improvement of Early Treatment Diabetic Retinopathy Study best-corrected visual acuity from baseline to 24-month follow-up (P < 0.0001). The improvement rate in Group A was statistically significantly better than in Group B (analysis of variance, P = 0.013). The authors also found a decrease in central macular thickness in all groups from baseline to the 24-month follow-up (P < 0.0001). The comparison among 3 groups showed higher central macular thickness decrease in Group A than in Groups B and C (analysis of variance, P < 0.001). CONCLUSION:: The study provides evidence to support the use of primary IVB with or without GLP as treatment of diffuse diabetic macular edema. Primary IVB without GLP seems to be superior to GLP alone to provide stability or improvement in best-corrected visual acuity in patients with diffuse diabetic macular edema at 24 months.
Arevalo J.F.,Clinica Oftalmolgica Centro Caracas |
Snchez J.G.,Instituto Nacional Of Investigacin En Oftalmologa |
Wu L.,Institute Cirugia Ocular |
Berrocal M.H.,University of Puerto Rico at San Juan |
And 10 more authors.
Ophthalmology | Year: 2010
Purpose: To report the 24-month anatomic and Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) response after primary intravitreal bevacizumab (IVB) (Avastin; Genentech Inc., San Francisco, CA) (1.25 or 2.5 mg) in patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Design: Retrospective, multicenter, interventional, comparative case series. Participants: We reviewed the clinical records of 180 consecutive patients (207 eyes) with subfoveal CNV secondary to AMD at 9 centers from 8 countries. Methods: Patients were treated with at least 1 injection of IVB 1.25 mg (124 eyes [59.9%]) or 2.5 mg (83 eyes [40.1%]). Patients underwent ETDRS BCVA testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline and 1-, 3-, 6-, 12-, and 24-month visits. Main Outcome Measures: Changes in BCVA and OCT. Results: The mean age of our patients was 74.3±7.5 years. The mean number of IVB injections per eye was 5.1 (range, 124 injections). In the 1.25 mg group, baseline BCVA improved from 20/235 (logarithm of the minimum angle of resolution [logMAR] 1.07) to 20/172 (logMAR 0.92) at 24 months (P<0.0001). Similar BCVA changes were observed in the 2.5 mg group. At baseline, the mean central macular thickness (CMT) by OCT in the 1.25 mg group was 308.4±127.52 μm, which was reduced to 269.35±97.92 μm, 262.1±94.81 μm, 264.03±97.06 μm, 245.91±89.52 μm, and 249.27±89.14 μm at 1, 3, 6, 12, and 24 months, respectively (P<0.0001). Similar changes were observed in the 2.5 mg group. In the 2.5 mg group, systemic complications included 2 new cases (2.6%) of arterial hypertension, 1 case (1.3%) of stroke, and 1 case (1.3%) of death. Conclusions: Primary IVB at a dose of 1.25 or 2.5 mg seems to provide stability or improvement in BCVA, OCT, and FA in subfoveal CNV secondary to AMD at 24 months. Our results show no significant difference regarding BCVA with IVB at doses of 1.25 or 2.5 mg. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. © 2010 American Academy of Ophthalmology.
Uso M.,General Universitario Of Valencia |
Uso M.,University of Valencia |
Jantus-Lewintre E.,General Universitario Of Valencia |
Jantus-Lewintre E.,Polytechnic University of Valencia |
And 4 more authors.
Future Oncology | Year: 2014
Lung cancer is the leading cause of cancer death worldwide. Therefore, advances in the diagnosis and treatment of the disease are urgently needed. miRNAs are a family of small, noncoding RNAs that regulate gene expression at the transcriptional level. miRNAs have been reported to be deregulated and to play a critical role in different types of cancer, including lung cancer. Thus, miRNA profiling in lung cancer patients has become the core of several investigations. To this end, the development of a multitude of platforms for miRNA profiling analysis has been essential. This article focuses on the different technologies available for assessing miRNAs and the most important results obtained to date in lung cancer. © 2014 Future Medicine Ltd.
PubMed | Wilmer Eye Institute, General Universitario Of Valencia, Retina and Vitreous Service, Fundacion Hospital Nuestra Senora Of La Luz and 5 more.
Type: Journal Article | Journal: The British journal of ophthalmology | Year: 2016
To report the long-term anatomical and functional outcomes of patients with centre-involved diabetic macular oedema (DME) treated with intravitreal bevacizumab (IVB).Retrospective case series. Patients diagnosed with centre-involved DME that were treated with at least one injection of 1.25mg IVB and had a minimum follow-up of 60months. Patients underwent measurement of best-corrected visual acuity (BCVA), ophthalmoscopy, optical coherence tomography and fluorescein angiography at baseline, 6-month, 12-month, 24-month, 36-month, 48-month and 60-month visits. The paired samples t test was used to compare the central macular thickness (CMT) and BCVA with baseline values. Statistical significance was indicated by p<0.05.Two hundred and one consecutive patients (296 eyes) were included. The mean number of IVB injections per eye was 8.47.1 (range: 1-47 injections). At 5years, the BCVA remained stable at 20/100 (logarithm of the minimum angle of resolution=0.70.4). Eighty-six (29%) eyes improved 2 lines of BCVA, 129 (43.6%) eyes remained stable and 81 (27.4%) eyes lost 2 lines of BCVA at 60months. Mean CMT decreased from 403.5142.2m at baseline to 313.7117.7m over 5years follow-up (p0.0001).The early visual gains due to IVB were not maintained 5years after treatment.
Trindade F.,Hospital Of Cascais Dr Jose Of Almeida |
Torrelo A.,Hospital Infantil Universitario Nino Jesus |
Requena L.,Fundacion Jimenez Diaz |
Tellechea O.,Hospital Universitario Of Coimbra |
And 6 more authors.
Journal of Cutaneous Pathology | Year: 2013
Background According to the International Society for the study of vascular Anomalies, vascular anomalies are classified as vascular neoplasms and vascular malformations. In some vascular lesions, categorization as a neoplasm or malformation has not been established with confidence so far. In order to further clarify the nosology of verrucous hemangioma, we studied 13 cases. Objective To analyze immunohistochemical characteristics of verrucous hemangiomas in order to gain further insight in its histogenesis. Methods We carried out a retrospective review. Immunohistochemical expression for Wilms tumor 1 (WT1), Glut-1 and D2-40 was performed in 13 cases. Results Immunohistochemistry performed with Glut-1 and WT1 showed positive staining in all lesions. All verrucous hemangiomas lacked D2-40 immunostaining. Conclusions This is the first report in the literature investigating WT1 in verrucous hemangioma in order to further clarify the nosology of this vascular anomaly. Despite the clinical features of verrucous hemangioma, which are similar to those seen in vascular malformations, verrucous hemangioma exhibited an immunoprofile similar to vascular neoplasms, according to WT1 and Glut-1 positivity. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.
Gonzalez-Castano D.M.,University of Santiago de Compostela |
Gonzalez L.B.,General Universitario Of Valencia |
Gago-Arias M.A.,University of Santiago de Compostela |
Pardo-Montero J.,University of Santiago de Compostela |
And 4 more authors.
Medical Physics | Year: 2012
Purpose: This work contains an alternative methodology for obtaining correction factors for ionization chamber (IC) dosimetry of small fields and composite fields such as IMRT. The method is based on the convolution/ superposition (C/S) of an IC response function (RF) with the dose distribution in a certain plane which includes chamber position. This method is an alternative to the full Monte Carlo (MC) approach that has been used previously by many authors for the same objective. Methods: The readout of an IC at a point inside a phantom irradiated by a certain beam can be obtained as the convolution of the dose spatial distribution caused by the beam and the IC two-dimensional RF. The proposed methodology has been applied successfully to predict the response of a PTW 30013 IC when measuring different nonreference fields, namely: output factors of 6 MV small fields, beam profiles of cobalt 60 narrow fields and 6 MV radiosurgery segments. The two-dimensional RF of a PTW 30013 IC was obtained by MC simulation of the absorbed dose to cavity air when the IC was scanned by a 0.6 × 0.6 mm 2 cross section parallel pencil beam at low depth in a water phantom. For each of the cases studied, the results of the IC direct measurement were compared with the corresponding obtained by the C/S method. Results: For all of the cases studied, the agreement between the IC direct measurement and the IC calculated response was excellent (better than 1.5). Conclusions: This method could be implemented in TPS in order to calculate dosimetry correction factors when an experimental IMRT treatment verification with in-phantom ionization chamber is performed. The miss-response of the IC due to the nonreference conditions could be quickly corrected by this method rather than employing MC derived correction factors. This method can be considered as an alternative to the plan-class associated correction factors proposed recently as part of an IAEA work group on nonstandard field dosimetry. © 2012 American Association of Physicists in Medicine.
De Toro-Peinado I.,Hospital Regional Universitario Of Malaga |
Concepcion Mediavilla-Gradolph M.,Hospital Regional Universitario Of Malaga |
Tormo-Palop N.,General Universitario Of Valencia |
Palop-Borras B.,Hospital Regional Universitario Of Malaga
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2015
Urinary tract infections (UTI) are the most common infectious diseases observed in primary care; up to one-third of women will have at least one symptomatic UTI by age 24, and more than one-half of women will be affected by the end of life. In addition, UTIs represent 40% of nosocomial infections, and being usually associated with urinary catheters. Although urine cultures would not be indicated in all cases, these samples are the most abundant in the laboratories of clinical microbiology. Thus, the working protocols applied to these samples have an important impact in the performance of the laboratory. The samples are collected by mid stream urine, and 60-70% of them are negative culture. At present, several commercial systems have been introduced in order to simplify and automate this process. A urine culture with ≥ 105 CFU/ml has classically been considered as positive, although lower counts are valued in certain clinical settings. Factors related to this count e.g. methods to obtain urine, conservation of the sample or use of chemical preservatives as well as low counts are critical points to be discussed in detail. The development of antimicrobial resistance logically affects uropathogens, mainly Escherichia coli, which remains the most frequently isolated in urine cultures. The aim of this paper is to review the most innovating aspects influencing the microbiological diagnosis of UTI. © 2015 Elsevier España, S.L.U. All rights reserved.
Hernandez-Bel P.,General Universitario Of Valencia |
Unamuno B.,General Universitario Of Valencia |
Sanchez-Carazo J.L.,General Universitario Of Valencia |
Febrer I.,General Universitario Of Valencia |
Alegre V.,General Universitario Of Valencia
Actas Dermo-Sifiliograficas | Year: 2013
Syphilitic alopecia occurs in only 4% of patients with syphilis. We present 5 cases of this uncommon manifestation and review the corresponding literature. All of the patients in our series were men aged between 31 and 46 years. The lesions, which were located mainly in the parieto-occipital area of the scalp, manifested as multiple, irregular, nonscarring patches of alopecia that adopted a characteristic patchy moth-eaten pattern. One patient initially presented diffuse alopecia with multiple erythematous scaling lesions. Immunohistochemical staining revealed the presence of numerous spirochetes in the hair follicles in the 2 patients in whom skin biopsy was performed. The lesions improved with treatment in all the patients who attended follow-up. Dermatologists should maintain a high level of clinical suspicion for this uncommon manifestation of syphilis, particularly when it is the only symptom. © 2011 Elsevier España, S.L. and AEDV. All rights reserved.
Noguera J.F.,General Universitario Of Valencia |
Dolz C.,Hospital Son Llatzer |
Cuadrado A.,Hospital Son Llatzer |
Olea J.,Hospital Son Llatzer |
Garcia J.,Hospital Son Llatzer
Surgical Innovation | Year: 2013
Introduction. The development of natural orifice transluminal endoscopic surgery has led to other techniques, such as single-incision surgery. The use of the flexible endoscope for single-incision surgery paves the way for further refinement of both surgical methods. Objective. To describe a new, single-incision surgical technique, namely, flexible single-incision surgery. Patients and Methods. Assessment of the safety and effectiveness of endoscopic cholecystectomy in a series of 30 patients. This technique consists of a single umbilical incision through which a flexible endoscope is introduced and consists of 2 parallel entry ports that provide access to nonarticulated laparoscopic instruments. Results. The technique was applied in all patients for whom it was prescribed. No general or surgical wound complications were noted. Surgical time was no longer than usual for single-port surgery. Conclusions. Flexible single-incision surgery is a new single-site surgical technique offering the same level of patient safety, with additional advantages for the surgeon at minimal cost. © The Author(s) 2012.