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Hospital de Órbigo, Spain

Gonzalez Lengua C.A.,Mount Sinai School of Medicine | Rioboo Leston L.,Hospital Meixoeiro | Hecht H.S.,Mount Sinai School of Medicine | Jacobi A.,Mount Sinai School of Medicine
Journal of Cardiovascular Computed Tomography | Year: 2015

A 56-year-old man with a history of complex atrial-septal defect repair, atrial fibrillation, and severe mitral regurgitation presented with progressive shortness of breath. A cardiac CT examination was done as part of a preoperative protocol before mitral valve replacement and it showed a severely enlarged left atrium and an anomalous hepatic vein draining into the left atrium. These findings were totally unsuspected and changed the patient management, highlighting the benefit of cardiac CT beyond the coronary finding. © 2015 Society of Cardiovascular Computed Tomography. Source

Guijarro R.,Hospital Carlos Haya | Montes J.,Hospital Meixoeiro | Roman C.S.,Hospital de la Axarquia | Arcelus J.I.,University of Granada | And 3 more authors.
Thrombosis and Haemostasis | Year: 2011

The impact of venous thromboembolism (VTE) and bleeding in patients undergoing major joint surgery has not been thoroughly studied. The Spanish National Discharge Database during the years 2005-2006 was used to assess the frequency and clinical impact of VTE and bleeding after elective total knee (TKA) or hip (THA) arthroplasty. Of 58,037 patients undergoing TKA, 0.18% (95% confidence interval [CI]: 0.15-0.22) were diagnosed with pulmonary embolism (PE), 0.57% (95% CI: 0.51-0.63) with deep-vein thrombosis (DVT), 1.20% (95% CI: 1.12-1.30) had bleeding complications, and 0.09% (95% CI: 0.07-0.12) died. Of 54 patients who died, 20.4% (95% CI: 10.7-35.4) had been diagnosed with PE, 3.70% (95% CI: 0.63-11.7) with DVT, and 13.0% (95% CI: 5.67-25.6) had bled. Of 31,769 patients undergoing elective THA, 0.23% (95% CI: 0.18-0.29) were diagnosed with PE, 0.44% (95% CI: 0.37-0.52) with DVT, 1.21% (95% CI: 1.10-1.34) bled, and 0.16% (95% CI: 0.12-0.21) died. Of 52 patients who died, 13.5% (95% CI: 6.08-24.8) had been diagnosed with PE, and 9.61% (95% CI: 3.52-21.3) had bled. On multivariable analysis, PE (odds ratio [OR]: 157; 95% CI: 75-328), DVT (OR: 6.3; 95% CI: 1.5-27) and bleeding (OR: 8.5; 95% CI: 3.6-20) were independent predictors for death after TKA. After THA, only PE (OR: 65; 95% CI: 26-160) and bleeding (OR: 6.4; 95% CI: 2.3-17) predicted the risk for death. Bleeding, DVT, and PE, arising after TKA were all independent predictors for death. Their increase in risk was, however, substantially higher for PE. After THA, only PE and bleeding independently predicted death. © Schattauer 2011. Source

Xu Y.,Columbia University | Xu Y.,Shanghai JiaoTong University | Mintz G.S.,Columbia University | Mintz G.S.,Vanderbilt University | And 9 more authors.
Circulation | Year: 2012

Background-Pathological studies suggest that calcified coronary nodules are a rare cause of thrombotic events. The frequency, distribution, predictors, and outcomes of calcified nodules have never been described. Methods and Results-After successful stenting in 697 patients (167 female; median age, 58.1 years) with acute coronary syndromes, 3-vessel gray-scale and virtual histology intravascular ultrasound was performed in the proximal-mid segments of all 3 coronary arteries as part of a prospective, multicenter study. On the basis of recent histological validation, an independent core laboratory identified calcified nodules as distinct calcification with an irregular, protruding, and convex luminal surface. Patients were followed up for 3 years (median). Overall, 314 calcified nodules were detected in 250 of 1573 analyzable arteries (185 of 623 patients). Thus, the prevalence of calcified nodules was 17% per artery and 30% per patient. Two or more calcified nodules were detected in 48 coronary arteries (3%) in 76 patients (12%). The calcified nodules were located <40 mm from the ostium of the coronary artery in 85% of left anterior descending arteries and 86% of left circumflex arteries, whereas calcified nodules within the right coronary arteries were evenly and more distally distributed. Patients with calcified nodules were significantly older and had more plaque volume, more thick-cap fibroatheroma, but fewer nonculprit lesion major adverse events on follow-up. Conclusions-Calcified nodules in untreated nonculprit coronary segments in patients with acute coronary syndromes were more prevalent than previously recognized. Although their distribution mirrored the origin of most thrombotic events, calcified nodules caused fewer major adverse events during 3 years of follow-up. © 2012 American Heart Association, Inc. Source

Lopez R.,Complejo Hospitalario Universitario Of Santiago | Salgado M.,Complejo Hospitalario de Ourense | Reboredo M.,Complejo Hospitalario Universitario runa | Grande C.,Hospital Meixoeiro | And 6 more authors.
British Journal of Cancer | Year: 2010

Background:Combination of bevacizumab and FOLFIRI has currently become one of the standard therapeutic regimens. However, published information is still limited. The objective of the present retrospective observational study is to analyse the response and toxicity of first-line treatment with FOLFIRIbevacizumab in patients with metastatic colorectal cancer (mCRC).Methods:Data were collected from patients from nine Spanish sites diagnosed with mCRC, ECOG2, whose first treatment for advanced disease was at least three cycles of FOLFIRIbevacizumab.Results:A total of 95 patients were enrolled into the study: 64.2% males, median age of 59 years (53.2-67.1 years), ECOG0-1 in 96.9% of patients. The main site of primary tumour was the colon (69.7%), and most metastases occurred in the liver (71.6%). Clinical benefit was detected in 67.4% (57.0-76.6; 95% confidence interval (CI)), with 8.4% of CR and 42.1% of PR. Median TTP was 10.6 months (10.0-11.3; 95% CI), PFS was 10.6 months (9.8-11.3; 95% CI), and OS was 20.7 months (17.1-24.2; 95% CI). Main grade I-II toxicities included haematological toxicity (35.8%), diarrhea (27.3%), mucositis (25.3%), asthenia (19.0%), haemorrhages (11.6%), and emesis (10.6%). Toxicities reaching grades III-IV were haematological toxicity (9.5%), diarrhea (8.5%), mucositis (5.3%), hepatic toxicity (2.1%), asthenia (2.1%), proteinuria (1.1%), emesis (1.1%), pain (1.1%), and colics (1.1%).Conclusion: Results of this study support the beneficial effect of adding bevacizumab to FOLFIRI regimen in terms of efficacy and show a favourable tolerability profile. © 2010 Cancer Research UK All rights reserved. Source

Pilo B.,Hospital del Sureste | De Blas G.,Hospital Ramon y Cajal | Sobrido M.J.,Complejo Hospitalario Universitario Of Santiago Of Compostela | Navarro C.,Hospital Meixoeiro | And 4 more authors.
Muscle and Nerve | Year: 2011

Introduction: Cerebrotendinous xanthomatosis (CTX) is a rare autosomal-recessive disease due to mutations of the 27α-hydroxylase. It is characterized by cataracts, xanthomas, and neurological manifestations. Polyneuropathy has been reported, although it is unclear whether it is axonal or demyelinating. Methods: We report clinical and neurophysiological results of 13 patients with CTX diagnosed in Spain. Results: In 8 patients (62%), peripheral neuropathy was demonstrated (4 demyelinating, 3 axonal, and 1 mixed; 3 predominantly motor and 5 sensorimotor). All patients had clinical signs/symptoms of peripheral neuropathy. Upper limb somatosensory evoked potentials (SSEPs) were affected in 38% of patients, and lower limb SSEPs in 67%. Fifty percent of patients had delayed brain-stem auditory evoked potentials, and 43% had affected visual evoked potentials. Discussion: In this series, polyneuropathy was predominantly sensorimotor and demyelinating. Neurophysiological studies correlated only partially with clinical follow-up. Therefore, we recommend neurophysiological follow-up studies only if clinical symptoms are present. © 2011 Wiley Periodicals, Inc. Source

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