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Diez Campelo M.,Hospital Universitario Of Salamanca | Sanchez-Barba M.,University of Salamanca | de Soria V.G.G.,Hospital de la Princesa | Martino R.,Hospital de la Santa Cruz y San Pablo | And 13 more authors.
Leukemia Research | Year: 2014

Although new agents have been approved for the treatment of MDS, the only curative approach is allogeneic hematopoietic stem cell transplantation (HSCT) and thus, in particular circumstances this procedure has been proposed as a treatment option for low risk patients. We have retrospectively analyzed the results of HSCT in 291 patients from the Spanish MDS registry with special attention to low risk MDS (LR-MDS) in order to define the variables that could impact their clinical evolution after transplantation. At 2 years OS was 51% and EFS was 50% (95% CI 0.7-4.5 years for OS and 95% CI 0.1-3.9 years for EFS).Among 43 LR-MDS, transplant-related mortality was 28%. At 3 years, OS was 67% (95% CI 264.7-8927.2 days for OS) and EFS was 64% (95% CI 0-9697.2 days for EFS). In the multivariate analysis only cytogenetics retained statistical significant effect on both OS (p=.047) and EFS (p=.046). Conditioning regimen could improve outcome among this subset of patients (OS 86% and RFS 100% for patients receiving RIC regimen).The present study confirms that specific disease characteristic as well as transplant characteristics have a significant impact on transplant outcome. Regarding low risk patients a non-myeloablative conditioning would be preferable especially in cases without high-risk cytogenetics. © 2014 Elsevier Ltd. Source

Verd S.,Hospital de la Santa Cruz y San Pablo | Garcia M.,Neonatal Unit | Gutierrez A.,Molecular Biology Unit | Moliner E.,Neonatal Unit | And 2 more authors.
Clinical Biochemistry | Year: 2014

Objectives: To determine whether feeding type of trophic feeds affect haematological and biochemical markers in the very preterm infant. Design and methods: Fifty-six very preterm infants were enrolled in this retrospective study (30 infants were included in the only human milk-fed group and 26 in the formula-fed group). Routine haematological and biochemical variables were collected in both groups on days 1 and 4 of life and fourteen serum markers were measured. Results: There were no significant differences between the two groups before starting trophic feeds. After starting trophic feeds, sodium and lactate levels were significantly higher in the human milk-fed group compared with those measured in the formula-fed group. Conclusion: The study demonstrates that supplementation of minimal enteral feeding with human milk does affect biochemical profiles in very preterm infants. Small amounts of enteral feedings of formula and/or human milk may result in different metabolic responses; these differences are reflected by different serum biochemistries. © 2014 The Canadian Society of Clinical Chemists. Source

Montes J.M.,Hospital Universitario del Sureste | Alegria A.,Hospital Universitario Ramon y Cajal | Garcia-Lopez A.,Hospital Universitario Ramon y Cajal | Ezquiaga E.,Autonomous University of Madrid | And 6 more authors.
Journal of Nervous and Mental Disease | Year: 2013

The aim of this study was to examine the demographic, clinical, and treatment correlates of bipolar disorder (BD) in outpatients 65 years or older and to compare patients with BD subtype I (BD-I) versus BD subtype II (BD-II) and patients with early onset (EO; ≤50 years old) versus late onset (LO; >50 years old) of the illness. Sixty-nine consecutive outpatients with BD were included. Diagnosis was delayed for a mean of 14.1 years, significantly longer in patients with EO (18.6 years) than with LO (3.3 years). Mild to moderate depressive symptoms were detected in 29% of the patients. The patients were receiving a mean of 3 different psychotropic medications. Antidepressantswere more frequently prescribed to patients with BD-II than to patients with BD-I (75.80% vs. 48.60%) and to patients with EO (71.7%) than to LO (35.3%). Geriatric BD has similar clinical characteristics with those of younger ages, and these do not seem to greatly differ with subtype or age of onset. Copyright © 2013 Lippincott Williams and Wilkins. Source

Verd S.,Hospital de la Santa Cruz y San Pablo | Barriuso L.,Baleares Breastfeeding Study Group | Gich I.,Hospital de la Santa Cruz y San Pablo | Gutierrez A.,Molecular Biology Unit | And 2 more authors.
Annals of Human Biology | Year: 2013

Background: Many studies have shown that children born small for gestational age are at a metabolic disadvantage. Breastfeeding is associated with reduced risk of developing metabolic syndrome. Objective: To determine whether ponderal index, weight, length or head circumference at birth affect early exclusive breastfeeding discontinuation. Design: Information from medical records of full-term infants attending the same paediatric clinic was used to examine the relationship between birth size and failure to breastfeed within 28 days after birth. Details of demographics and diagnoses were prospectively recorded. Feeding method was assessed at each child visit by their healthcare provider. Feeding practices were compared between infants of high, normal and low ponderal index at birth. Results: Multivariate models (p's ≤ 0.02) confirmed that the chance of exclusive breastfeeding continuation within 4 weeks of life was less in infants whose birth weight was below 2780 g or whose neonatal head circumference was < 33 cm. Birth length did not account for this effect. Ponderal index was not associated with a higher risk of early discontinuation of exclusive breastfeeding. Conclusions: This study reports that birth weight ≥ 2780 g and head circumference at birth ≥ 33 cm are independent predictors of breastfeeding onset success. © Informa UK, Ltd. Source

Verd S.,Hospital de la Santa Cruz y San Pablo | Lopez E.,Hospital de la Santa Cruz y San Pablo
Journal of Alternative and Complementary Medicine | Year: 2012

Objectives: If a mother has contracted chickenpox, the antibodies in her milk confer immunity against chickenpox to her breastfed babies. This passive immunization may avoid or spare the breastfed babies' symptoms of chickenpox. It is hypothesized that frozen breast milk may shorten chickenpox duration because specific antibodies against varicella zoster have been detected in human milk and they are resistant to digestion and are stable in frozen milk. Design: The clinical outcomes of chickenpox in a 9-year-old boy and his father on frozen breast milk are reported. Settings: The study comprised a varicella-vaccine- refusing family attending a private office of pediatrics. Interventions and results: The boy presented with a crusted varicella rash. The medical history revealed premature cessation of the typical varicella rash on day 3. It was coincidental with a supply of frozen human milk by his mother. Next, the father (41 years old) of this patient contracted chickenpox: he was on frozen breast milk from day 2, and no new pox emerged thereafter. Conclusions: The rash spread and numbered 50 to 150 lesions on day 2. Instead, the typical rash was expected to appear in three successive crops of lesions throughout the first week. The disease usually numbers approximately 250-500 lesions in unvaccinated healthy persons. Frozen breast milk may shorten chickenpox duration. © 2012, Mary Ann Liebert, Inc. Source

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