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Santos A.J.T.,Hospital General Universitario Santa Lucia
Medicina Clinica | Year: 2012

Venous thromboembolism is a frequent complication in cancer patients and affects their morbidity and mortality. The risk of this event differs according to the characteristics of the tumor, the patient's circumstances, and the treatments provided. Although the benefits of thromboprophylaxis in certain subgroups of patients with cancer have been demonstrated, currently generic prescription is not recommended unless other risk factors are present, or the patient has multiple myeloma and has been treated with thalidomide or lenalidomide. The insertion of a central venous catheter in these patients does not imply prescription of thromboprophylaxis, although the risk factors for catheter thrombosis are known. Finally, a risk scoring model for the prediction of venous thromboembolism has been defined in outpatients with cancer starting chemotherapy, which has been externally validated and supplemented with the addition of two biomarkers. © 2012 Elsevier España, S.L. All rights reserved. Source


Trujillo-Santos J.,Hospital General Universitario Santa Lucia | Gussoni G.,FADOI Foundation | Gadelha T.,Hospital Universitario Clementino Fraga Filho | Munoz-Torrero J.F.S.,Hospital San Pedro de Alcantara | And 6 more authors.
Thrombosis Research | Year: 2014

Background: The influence of recent immobilization or surgery on mortality in cancer patients with venous thromboembolism (VTE) has not been thoroughly studied. Methods: We used the RIETE Registry data to compare the 3-month mortality rate in cancer patients with VTE, with patients categorized according to the presence of recent immobilization, surgery or neither. The major outcomes were fatal pulmonary embolism (PE) and fatal bleeding within the first 3 months. Results: Of 6,746 patients with active cancer and acute VTE, 1,224 (18%) had recent immobilization, 1,055 (16%) recent surgery, and 4,467 (66%) had neither. The all-cause mortality was 23.4% (95% CI: 22.4-24.5), and the PE-related mortality: 2.5% (95% CI: 2.1-2.9). Four in every ten patients dying of PE had recent immobilization (37%) or surgery (5.4%). Only 28% of patients with immobilization had received prophylaxis, as compared with 67% of the surgical. Fatal PE was more common in patients with recent immobilization (5.0%; 95% CI: 3.9-6.3) than in those with surgery (0.8%; 95% CI: 0.4-1.6) or neither (2.2%; 95% CI: 1.8-2.6). On multivariate analysis, patients with immobilization were at an increased risk for fatal PE (odds ratio: 1.8; 95% CI: 1.2-2.5). Conclusions: One in every three cancer patients dying of PE had recent immobilization for > 4 days. Many of these deaths could have been prevented with adequate thromboprophylaxis. © 2014 Elsevier Ltd. All rights reserved. © 2014 Elsevier Ltd. Source


Romero-Arenas S.,San Antonio de Murcia Catholic University | Martinez-Pascual M.,Hospital General Universitario Santa Lucia | Alcaraz P.E.,San Antonio de Murcia Catholic University
Aging and Disease | Year: 2013

Declines in maximal aerobic power and skeletal muscle force production with advancing age are examples of functional declines with aging, which can severely limit physical performance and independence, and are negatively correlated with all cause mortality. It is well known that both endurance exercise and resistance training can substantially improve physical fitness and health-related factors in older individuals. Circuit-based resistance training, where loads are lifted with minimal rest, may be a very effective strategy for increasing oxygen consumption, pulmonary ventilation, strength, and functional capacity while improving body composition. In addition, circuit training is a time-efficient exercise modality that can elicit demonstrable improvements in health and physical fitness. Hence, it seems reasonable to identify the most effective combination of intensity, volume, work to rest ratio, weekly frequency and exercise sequence to promote neuromuscular, cardiorespiratory and body composition adaptations in the elderly. Thus, the purpose of this review was to summarize and update knowledge about the effects of circuit weight training in older adults and elderly population, as a starting point for developing future interventions that maintain a higher quality of life in people throughout their lifetime. Source


The iliofemoral location of a deep vein thrombosis (DVT) is particularly serious, as it affects the single drainage stem of the lower limb. Treatment with anticoagulatants alone is often insufficient in preventing severe post-thrombotic syndrome, due to frequent incomplete thrombus resolution. While new thrombectomy techniques are capable of achieving patency of the iliofemoral venous system in a higher percentage of cases than previous techniques, they have not been compared with the current standard of treatment, which is the catheter-directed thrombolysis. This catheter-directed thrombolysis also can be combined with mechanical thrombolysis, increasing its effectiveness. A clinical trial is currently in the recruiting phase and it will assess the most efficient dose of alteplase in catheter-directed thrombolysis in patients with iliofemoral DVT, and the possibility of increasing its effectiveness with mechanical methods. © 2014 SEACV. Published by Elsevier España, S.L.U. All rights reserved. Source


Martinez T.,Hospital General Universitario Santa Lucia
Journal of Nuclear Medicine Technology | Year: 2012

The steam-sterilized 18F-FDG of our laboratory frequently has a pH of around 6.5. To avoid decomposition, we studied the possibility of adjusting the pH by adding a pharmaceutical compound but without modifying the usual production sequence and reagents. Methods: Citric acid in 4 concentrations (0.01, 0.03, 0.05, and 0.06 M) was added to routine batches of 18FFDG. Established pharmacopeia quality controls at 0 and 12 h after synthesis were run, and the dilution effect was checked. Results: A 0.06 M concentration of 1:15 v/v citric acid brought about a pH range of 5.46-5.68; did not change significantly after 1/10 dilution; and did not interfere with quality control. The results of quality control 12 h after dispensing were in the desired range. Conclusion: A 0.06 M concentration of 1:15 v/v citric acid modifies pH in a buffered 18F-FDG solution without the need to change the synthesizer protocol or reagent composition. This new formulation allows pH adjustment; is an easy, reliable, and safe method with no technical difficulties; and does not interfere with the quality of the radiopharmaceutical. © 2012 by the Society of Nuclear Medicine, Inc. Source

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