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Girones R.,Hospital Lluis Alcanyis Xativa | Aparicio J.,Hospital La FE Valencia | Roure P.,Hospital Of Vic | Germa-Lluch J.R.,Institute Catala Doncologia | And 16 more authors.
Clinical and Translational Oncology | Year: 2014

Background: Brain metastases of testicular germ cell tumor (TGCT) are a rare event. Prognostic is poor and there is not much evidence on optimal management of these patients.Patients and methods: A review of case records of germ cell tumor patients within the Spanish Germ Cell Cancer Group data base from 1994 to 2012 was conducted.Results: Thirty-three out of 6,200 cases (0.5 %). Nineteen patients (57 %) group 1: synchronous, 13 (40 %) group 2: metachronous and only one developed brain metastasis during cisplatin-based chemotherapy (excluded from the analysis). Median serum BHCG levels at initial diagnosis was higher in group 1, whereas elevated AFP serum levels were more common in group 2. Histology in the primary tumor: chorionic carcinoma for group 1 versus embryonal carcinoma for group 2. Mainly solitary brain metastasis in group 2 (54 versus 21 %, respectively). The median overall survival from the diagnosis of central nervous system involvement was 16 months for group 1 (CI 95 % 13.9–18) and 23 months (95 % CI 0–165) for group 2 (log rank p = 0.84). Long-term survivors were practically identical in the two groups (38.9 % group 1 versus 38.5 % group 2). Regardless of the timing of brain metastasis, those patients that achieved complete response to the treatment had better survival (log rank p 0.003).Conclusion: Although some distinctive clinical characteristics have been found between patients with synchronous versus metachronous brain metastasis from TGCT, the timing of brain metastasis did not seem to have prognostic influence, but due to the retrospective nature of the analysis and the results should be interpreted with caution. © 2014, Federación de Sociedades Españolas de Oncología (FESEO).

Villanueva V.,Polytechnic University of Valencia | Lopez-Gomariz E.,Hospital Lluis Alcanyis Xativa | Lopez-Trigo J.,Consorcio Hospital General Universitario Valencia | Palau J.,Polytechnic University of Valencia | And 4 more authors.
Epilepsy and Behavior | Year: 2012

There has been little long-term success with polytherapy for patients with refractory partial-onset epilepsy. The rational combination of antiepileptic drugs based on their mechanism of action may help improve treatment efficacy and tolerability. Lacosamide, a novel sodium channel blocker (SCB), was investigated in 158 patients with partial-onset epilepsy in the prospective, multicenter, observational, RELACOVA cohort study conducted in Spain. After 12. months' treatment with lacosamide, 47% of patients were responders (≥ 50% reduction in seizure frequency) and 24% were seizure free. Lacosamide was well tolerated; dizziness was the most frequent adverse event. Efficacy was better (responder rate, 65% vs 38%; seizure free rate, 35% vs 17%) and there was a lower adverse event rate (33% vs 58%) in patients receiving non-SCBs (n = 49) versus those receiving SCBs (n = 104) as concomitant therapy at baseline. Further investigation of lacosamide combination therapy is warranted. © 2012 Elsevier Inc.

PubMed | Hospital Lluis Alcanyis Xativa
Type: Journal Article | Journal: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva | Year: 2016

The transmural condition of Crohns disease predisposes to fistulae or abscesses. The internal fistulae incidence is about 15%. Among them, enteroovarian fistula is rarely described on the literature. Herein, the authors present three cases of enteroovarian fistulas.Two women are diagnosed with ileal Crohns disease that presented a pelvic abscess diagnosed by ultrasound and CT. On surgery, an inflammatory mass involving the ileum and the ovary was found. The third woman was operated because of a tuboovarian abscess and was diagnosed with ileal Crohns disease afterwards. In the three cases, the histopathological analysis of the ovary showed granulomas with abscess compatible with Crohns disease. In one of the cases, multinucleated giant cells were found in the foreign body reaction to vegetable matter. A right ileocolectomy and an adnexectomy were performed in all three cases. No further involvement of the contralateral ovary or other gynaecological complications was observed.The treatment of Crohns disease complications should be individualised. In the case of ovarian involvement, surgical treatment should include adnexectomy.

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