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Teruel, Spain

Castilla E.,Hospital Clinico Universitario | Gato M.,Hospital Obispo Polanco | Ruiz J.R.,Hospital Clinico Universitario
Journal of Invasive Cardiology | Year: 2010

Pseudoaneurysm of the left ventricle (LV) is a rare cardiac disease that occurs after myocardial infarction or cardiac surgery. Because patients frequently present with nonspecific symptoms, a high index of suspicion is needed to make the diagnosis. This report describes an unusual case demonstrating a large LV pseudoaneurysm after mitral valve replacement performed 30 years earlier. Source


Hernandez-Aguilar M.T.,Breastfeeding Unit | Lasarte-Velillas J.J.,Primary Care Health Center Torre Ramona | Martin-Calama J.,Hospital Obispo Polanco | Flores-Anton B.,Hospital 12 de Octubre | And 3 more authors.
Journal of Human Lactation | Year: 2014

The Baby-Friendly Initiative (BFI-Spain) was founded in 1995 by members of key professional associations (pediatricians, midwives, obstetricians, and nurses) and some mother-to-mother support groups. The United Nations International Children's Fund was instrumental in supporting the establishment of BFI-Spain as a not-for-profit organization. In 2007, the need for change was identified. A detailed analysis of BFI-Spain identified its main strengths, weaknesses, opportunities, and threats. A new strategic plan was devised that included the adoption of a staged accreditation system, a new website, expanding the initiative into the community, consolidating working teams to distribute tasks and responsibilities, and trying to involve the national health authorities. This article describes the analysis that was undertaken, the strategies implemented, and some of the outcomes observed 4 years later. The aim of the article is to support BFI teams in other countries who might be facing similar challenges. © The Author(s) 2014. Source


Rodriguez A.,Clinical Research Laboratories | Cipres L.,Hospital Obispo Polanco | Tofe S.,Hospital Son Dureta | Polavieja P.,Clinical Research Laboratories | Reviriego J.,Clinical Research Laboratories
Current Medical Research and Opinion | Year: 2010

Objective: Therapeutic guidelines recommend the combination of drugs as necessary to control type 2 diabetes (T2D). This research assessed the effectiveness of pioglitazone (Pio), metformin (Met) and sulfonylurea (SU) combinations in the routine clinical practice. Research design and methods: A nationwide, 12-month prospective, observational cohort study was performed in 2294 patients with T2D (50.3 females, mean age: 61.1 years, mean body mass index: 30.2kg/m2, mean time since diagnosis: 8.5 years) who started, at the discretion of treating physician, oral antihyperglycaemic treatment with either PioSU, PioMet or SUMet because of inadequate control with previous therapy. Fasting plasma glucose (FPG), glycohaemoglobin (HbA1c), lipids, blood pressure, and anthropometric parameters were measured, and 10-year cardiovascular risk was estimated. Results: FPG, HbA1c and total cholesterol at baseline had mean values (184.6mg/dl, 8.5 and 246.0mg/dl, respectively) associated with an excess of micro-and macrovascular risk. The mean changes from baseline in the PioSU, PioMet and SUMet cohorts were, respectively,-37.9,-32.7 and-25.8mg/dl for FPG;-1.1,-1.0 and-0.7 for HbA1c;-30.7,-38.7 and-17.1mg/dl for triglycerides; and 2.3, 2.5 and 0.6mg/dl for HDL cholesterol. In consequence, the estimated 10-year cardiovascular risk decreased more in the Pio cohorts, particularly with PioMet (1.7 versus 1.4 PioSU and 1.0 SUMet Framingham equation and 0.6 versus 0.4 SUMet Systematic Coronary Risk Evaluation model). Related adverse events were significantly (p0.016) more frequent in Pio cohorts (4.7 with PioSU, 5.1 with PioMet) than in the SUMet cohort (2.4). Conclusions: In patients with T2D failing therapy, mostly SU or Met monotherapy, pioglitazone add-on treatment was associated with a significant improvement of micro-and macrovascular risk estimations. These results from real-life clinical conditions support the findings of prior randomised trials, although they should be interpreted with caution because of the observational, nonrandomised design. © 2010 Informa UK Ltd All rights reserved. Source


Fernandez C.,Institute Biologya Molecular y Celular Del Cancer and IBSAL | Santos-Silva M.C.,Federal University of Santa Catarina | Lopez A.,Institute Biologya Molecular y Celular Del Cancer and IBSAL | Matarraz S.,Institute Biologya Molecular y Celular Del Cancer and IBSAL | And 18 more authors.
Leukemia | Year: 2013

Adult acute myeloid leukemia (AML) is a highly heterogeneous stem cell malignancy characterized by the clonal expansion of immature myeloid precursors. AML may emerge de novo, following other hematopoietic malignancies or after cytotoxic therapy for other disorders. Here, we investigated the clonal vs reactive nature of residual maturing bone marrow cells in 59 newly diagnosed adult AML and mixed phenotype acute leukemia (MPAL) patients as assessed by interphase fluorescence in situ hybridization analysis of AML and myelodysplastic syndrome-associated cytogenetic alterations and/or the pattern of chromosome X inactivation, in females. In addition, we investigated the potential association between the degree of molecular/genetic involvement of hematopoiesis and coexistence of altered immunophenotypes by flow cytometry. Our results indicate that residual maturing neutrophils, monocytes and nucleated red cell precursors from the great majority of newly diagnosed AML and MPAL cases show a clonal pattern of involvement of residual maturing hematopoietic cells, in association with a greater number of altered immunophenotypes. These findings are consistent with the replacement of normal/reactive hematopoiesis by clonal myelopoiesis and/or erythropoiesis in most newly diagnosed AML and MPAL cases, supporting the notion that in most adults presenting with de novo AML, accumulation of blast cells could occur over a pre-existing clonal hematopoiesis. © 2013 Macmillan Publishers Limited. Source


Alvarez A.G.,Hospital Obispo Polanco | Barrera M.G.,San Jorge University | Blasco J.B.,Hospital de Sagunto | Serret E.J.G.,Hospital Obispo Polanco
Journal of Pharmacy and Nutrition Sciences | Year: 2014

Objective: To assess the financial impact of spacing out the administration intervals of adalimumab (ADA) and etanercept (ETN) in the treatment of rheumatoid arthritis (RA) and spondyloarthropathies (SAP) in our work setting. Materials and method: A budget impact model (BIM) was developed to estimate the financial impact of spacing out the usual administration intervals of ADA 40 mg every 2 weeks and ETN 50 mg weekly (scenario A) to ADA 40 mg every 3 weeks and ETN 50 mg every 2 weeks (scenario B), according to the guidelines and recommendations applied to these studies, specifying the target population, the study perspective, the time frame, and analysing the robustness of the study with a threshold univariate sensitivity analysis. Results: A total of 71 patients were included in the study. The application of a BIM showed annual savings for ADA and ETN of €19,784 and €38,271, respectively. The net cost, that is, the savings this entailed for the time frame considered (2 years), amounted to €116,110. The sensitivity analysis performed shows that the BIM estimated for the study period was very robust, as the net result in the different scenarios varied very little, remaining negative in the new scenarios. Conclusions: The BIM developed in the study shows the importance of the role of healthcare professionals in the context of sustainability of the healthcare system, where the model could generate large annual net savings for the different regional healthcare systems. © 2014 Lifescience Global. Source

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