Cordido F.,Hospital Universitario runa |
Marazuela Aspiroz M.,Hospital Of La Princesa |
Torres Vela E.,Hospital Clinico San Cecilio
Endocrinologia y Nutricion | Year: 2013
Acromegaly and gigantism are due to excess GH secretion, usually by a pituitary adenoma. It is an uncommon disease. Diagnosis is made by showing elevated GH and IGF-I levels in patients with a clinical picture suggesting the condition. Once excess GH is confirmed by biochemical tests, MRI of the hypothalamic-pituitary area should be performed to ascertain the source of excess GH. Transsphenoidal surgery of the pituitary adenoma is the treatment of choice. However, introduction of new drugs has changed the treatment sequence in recent years. Medical treatment with somatostatin analogues may be indicated as primary treatment in patients in whom surgery is not expected to be curative or is contraindicated. The GH receptor antagonist should be use in patients not controlled after surgery who do not adequately respond to somatostatin analogues. Radiotherapy would be indicated in patients not controlled after surgery and medical treatment or with large tumor remnants after surgery. © 2012 SEEN.
Escobar C.,Hospital Infanta Sofia |
Blanes I.,Hospital Of Manises |
Ruiz A.,Hospital Clinico San Cecilio |
Vinuesa D.,Hospital Clinico San Cecilio |
And 4 more authors.
European Journal of Internal Medicine | Year: 2011
Introduction: Peripheral arterial disease (PAD) increases with age and diabetes. The aim of this study was to assess the prevalence of PAD in an elderly population with diabetes. Methods: This multicenter and cross-sectional study included patients > 70 years, with an established diagnosis of diabetes. PAD was defined as those patients with a history of revascularization or amputation due to ischemia, or a pathological ankle-brachial index (ABI). Adequate blood pressure (BP), LDL cholesterol and HbA1c control were considered as < 130/80 mm Hg, < 100 mg/dL and < 7.0%, respectively. Results: A total of 1462 patients were included. The most frequent cardiovascular risk factor and cardiovascular disease were hypertension (80.37%) and PAD (60.60% overall; 83.2% of those assisted by vascular surgeons vs 31.9% of those attended by other medical specialists; p < 0.001), respectively. However, when ABI was measured, 70.99% of the study population had PAD (80.2% of those assisted by vascular surgeons vs 59.6% of those attended by other medical specialists; p < 0.001). The predictors for a pathological ABI included male gender, smoking, dyslipidemia, family history of premature cardiovascular disease, sedentary lifestyle, diabetic-related complications, heart and cerebrovascular diseases. Although risk factors control was very poor, it was even lower in patients with PAD. Conclusions: The prevalence of PAD is high in diabetic elderly patients. The concomitance with other risk factors and cardiovascular diseases was very high. The ABI allowed increasing the diagnosis of PAD. © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Carvajal Pedrosa C.,Hospital Clinico San Cecilio |
Hernandez Cortes P.,Hospital Clinico San Cecilio
Revista Espanola de Cirugia Ortopedica y Traumatologia | Year: 2011
Objective: To evaluate the results obtained in the treatment of intertrochanteric hip fractures with a percutaneous compression plate (PCCP). Material and method: We analysed 611 patients, operated on using PCCP, with a mean age of 79 years (65 to 99 years). The minimum follow up was 10 months (10 to 24). Data associated with blood loss and the post-operative recovery of the patients were analysed. Results: The mean duration of surgery was 32. minutes (15 to 75. min). The mean drop in the haemoglobin value was 1.9. g/dl (0.3 to 8.4). A blood transfusion was required by 14.7% of patients, with a mean of 0.25 transfusion units (0 to 3). The mean hospital stay was 8 days. There were 12.6% medical complications and 5% radiological complications. The overall mortality in the first year was 3.8% (23 patients). Conclusions: An early functional recovery of the patient associated with a low morbidity was achieved with PCCP, making it an alternative for the treatment of intertrochanteric hip fractures. © 2010 SECOT.
Uberos J.,Hospital Clinico San Cecilio |
Miras-Baldo M.,Hospital Clinico San Cecilio |
Jerez-Calero A.,Hospital Clinico San Cecilio |
Narbona-Lopez E.,Hospital Clinico San Cecilio
Pediatrics and Neonatology | Year: 2014
Background: To assess the effectiveness of vitamin A supplementation in very low birth weight (VLBW) infants to prevent complications of prematurity.Methods: This was a retrospective cohort study to determine the effectiveness of vitamin A in preventing complications of prematurity in VLBW infants. Vitamin A was delivered intramuscularly at a dose of 5000 IU, three times weekly during the first 28 days of life.Results: Of the 187 eligible VLBW infants, we excluded from the analysis (due to death or transfer to another hospital), 16 infants weighing <1000 g and 17 weighing 1000e1500 g. Sixty VLBW infants received the vitamin supplement. We observed no differences between the groups in the duration of oxygen therapy or in the risk of bronchopulmonary dysplasia. The risk of sepsis was up to three times higher among the infants who were given the vitamin A supplement.Conclusion: Given the increased risk of sepsis in patients weighing >1000 g, the risk associated with repeated intramuscular injections of vitamin A and the modest clinical results described, we do not believe the universal administration of vitamin A to VLBW infants to be justified as prophylaxis for bronchopulmonary dysplasia. © 2014, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.
Gonzalez-Moles M.,University of Granada |
Scully C.,Eastman Dental Institute |
Ruiz-Avila I.,Hospital Clinico San Cecilio
Oral Diseases | Year: 2012
The development of multiple oral tumours, seen in up to 30% of patients with a primary oral squamous cell carcinoma, is sometimes attributable to the presence of genetically altered premalignant fields and has important prognostic implications. Molecular techniques available for the definitive diagnosis of such a field (loss of heterozygosity analysis of 3p, 9p and 17p and study of TP53 tumour suppressor gene mutation) are expensive, complex and not universally available, hampering their routine application. Nevertheless, molecular diagnosis is essential for modern assessment of the risk of multiple tumours and for decisions on the appropriate preventive and therapeutic approaches. This article reviews current knowledge on molecular findings in premalignant fields in the oral cavity and oropharynx and provides an update on criteria for their identification, discussing the clinical and therapeutic implications. © 2011 John Wiley & Sons A/S.
Uberos J.,Hospital Clinico San Cecilio |
Molina-Carballo A.,Hospital Clinico San Cecilio |
Fernandez-Puentes V.,Hospital Clinico San Cecilio |
Rodriguez-Belmonte R.,Hospital Clinico San Cecilio |
Munoz-Hoyos A.,Hospital Clinico San Cecilio
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2010
We analysed the asymptomatic carrier state of Neisseria meningitidis in a sample of 339 children. We obtained data for the children's weight and height, in order to calculate the body mass index (BMI). The cutoff points defined by Cole were employed in determining the BMI, and the population was divided into three groups: normal, overweight and obese. Twenty carriers of N. meningitidis were identified. There was found to be a statistically significant trend to increased risk of being a carrier with increased BMI (z=2.03; P=0.04); after adjusting for age using the Mantel-Haenszel weighting method, this relationship was strengthened (z=2.38; P=0.01). Paediatric patients with increased BMI in the range of obesity present a three times greater risk of being carriers of N. meningitidis than non-obese patients, with a trend for this risk to increase with higher BMI © Springer-Verlag 2009.
Rodriguez del Aguila M.M.,Hospital Virgen Of Las Nieves |
Gonzalez-Ramirez A.R.,Hospital Clinico San Cecilio
Allergologia et Immunopathologia | Year: 2014
When designing any research project, definition is required of the sample size needed in order to carry out the study. This sample size is an estimate of the number of patients required in accordance with the pursued study objective. In this context, it is more efficient in terms of both cost and time to use samples than to work with the entire population.The present article describes the way to establish sample size in the kinds of studies most frequently found in health research, and how to calculate it using the epicalc package included in the shareware R program. A description is provided of the formulae used to calculate sample sizes for the estimation of a mean and percentage (referring to both finite and infinite populations) and for the comparison of two proportions and two means. Likewise, examples of the application of the mentioned statistical package are provided. © 2013 SEICAP.
Uberos J.,Hospital Clinico San Cecilio |
Augustin-Morales M.C.,Hospital Clinico San Cecilio |
Molina Carballo A.,Hospital Clinico San Cecilio |
Florido J.,Hospital Clinico San Cecilio |
And 2 more authors.
Journal of Pineal Research | Year: 2011
This study evaluated the sleep-wake pattern, plasma melatonin levels and the urinary excretion of its metabolite, 6-sulphatoxy-melatonin among children with severe epileptic disorders, before and after a therapeutic trial with melatonin. Ten paediatric patients, suffering from severe epileptic disorders, were selected and given a nightly dose of 3 mg of a placebo, for 1 wk; for the next 3 months, the placebo was replaced with a nightly dose of 3 mg of melatonin. At the end of each treatment period, the urinary excretion of 6-sulphatoxy-melatonin (for the intervals 09.00 - 21:00 hr or 21:00-09:00 hr) and plasma levels of melatonin (recorded at 01:00, 05:00, 09:00, 13:00, 17:00 and 21:00 hr) were recorded, over a period of 24 hr; an actigraph record was also kept. Sleep efficiency among patients who received melatonin was significantly higher than among those given the placebo, with fewer night-time awakenings. Periodic plasma melatonin levels were regained and a better control gained of convulsive episodes, in that the number of seizures decreased. We conclude that melatonin is a good regulator of the sleep-wake cycle for paediatric patients suffering from severe epilepsy, moreover, it to a better control of convulsive episodes. © 2010 John Wiley & Sons A/S.
Poveda E.,Hospital Carlos III |
Anta L.,Hospital Carlos III |
Blanco J.L.,Hospital Clinic |
Perez-Elias M.J.,Hospital Ramon y Cajal |
And 6 more authors.
AIDS | Year: 2010
The prevalence of etravirine resistance mutations was examined in genotypes derived from 1343 HIV-infected patients failing nevirapine or efavirenz in the resistance database of the Spanish AIDS Research Network (ResRIS). Overall, etravirine-resistant genotypes were recognized in 18.7% of patients, with no significant differences between failures under nevirapine or efavirenz. Thus, more than 80% patients with prior failure to nonnucleoside reverse transcriptase inhibitors could potentially benefit from etravirine rescue therapy. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
PubMed | Hospital Lucus Augusti, Hospital Universitario La Paz, Institute Parasitologia y Biomedicina Lopez Neyra, Hospital Universitario 12 Of Octubre and 11 more.
Type: | Journal: Scientific reports | Year: 2017
A genetic component influences the development of atherosclerosis in the general population and also in rheumatoid arthritis (RA). However, genetic polymorphisms associated with atherosclerosis in the general population are not always involved in the development of cardiovascular disease (CVD) in RA. Accordingly, a study in North-American RA patients did not show the association reported in the general population of coronary artery disease with a series of relevant polymorphisms (TCF21, LPA, HHIPL1, RASD1-PEMT, MRPS6, CYP17A1-CNNM2-NT5C2, SMG6-SRR, PHACTR1, WDR12 and COL4A1-COL4A2). In the present study, we assessed the potential association of these polymorphisms with CVD in Southern European RA patients. We also assessed if polymorphisms implicated in the increased risk of subclinical atherosclerosis in non-rheumatic Caucasians (ZHX2, PINX1, SLC17A4, LRIG1 and LDLR) may influence the risk for CVD in RA. 2,609 Spanish patients were genotyped by TaqMan assays. Subclinical atherosclerosis was determined in 1,258 of them by carotid ultrasonography (assessment of carotid intima media thickness and presence/absence of carotid plaques). No statistically significant differences were found when each polymorphism was assessed according to the presence/absence of cardiovascular events and subclinical atherosclerosis, after adjustment for potential confounder factors. Our results do not show an association between these 15 polymorphisms and atherosclerosis in RA.