Morata Crespo A.B.,Hospital Obispo Polanco
Rehabilitacion | Year: 2012
Introduction: We can define fecal incontinence as the involuntary loss of solid and liquid stools, whenever this loss poses a hygiene or social problem for the person suffering it. Prevalence of this condition is not clear since it means an important affection in the quality of life of the patient suffering it and therefore, they often hide this problem. Material and methods: We have performed a prospective study in which 24 patients diagnosed of fecal incontinence participated. All of them underwent a treatment program that included: education guidelines, pelvic floor strengthening exercises and biofeedback with electrical stimulation. Results: A total of 79.2% were women, with mean age of 60.8 years, and 20.8% of the patients had suffered an intestinal neoplasm. In the complementary tests, the ultrasonography showed that 25% of the cases had a rupture of the anal sphincters. In 70.8%, there was thinning of the sphincters. In the initial manometry, we found that the measurement of maximum baseline pressure in mmHg was 36.37 mmHg (SD 13.13), and the mean maximum pressure involuntary contraction was 82.25 mmHg (SD 21.45), initial mean score obtained on the Wexner scale was 15.79 and after treatment, 8.16. We obtained statistically significant differences in all of the items on the Wexner scale. Conclusion: Combined conservative treatment improves the score obtained on the Wexner scale in moderate to severe fecal incontinence and also shows minimum side effects. Complementary tests are useful to evaluate fecal incontinence, however clinical evaluation is fundamental to determine the severity of this condition and how it affects the patient's life. © 2012 Elsevier España, S.L. and SERMEF. All rights reserved.
PubMed | Hospital Universitario Miguel Servet and Hospital Obispo Polanco
Type: | Journal: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA | Year: 2016
Metaphyseal titanium sleeves have been used to provide cementless fixation in challenging bone defects in revision knee arthroplasty. The aim of this study was to evaluate the mid-term results of radiological and clinical outcomes, for metaphyseal sleeves in type 1B and 2 defects of tibia and femur under the hypothesis that they would provide stable and prolonged fixation.One hundred and thirty-four patients were included in a prospective study to evaluate the outcomes of knee revision with sleeves, together with stems and varus-valgus constrained mobile bearing prosthesis. Median follow-up was 71.5months (range 36-107). Analysis included American Knee Society Score (KSS), Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC), SF12 Health Survey and radiographic assessment.All clinical scores improved significantly in all patients during the follow-up. The median of Knee KSS increased from 33 to 78 and functional KSS from 30 to 80. The median of WOMAC pain index changed from 12 to 4; pre-operative median of WOMAC stiffness and WOMAC function score improved from 5 to 2 and from 45 to 14, respectively. The median of physical SF12 varied from 27 to 44, while mental SF-12 from 43 to 54. Radiological evaluation showed optimal osseous integration in all patients, and neither implant migration nor progressive radiolucency around components was observed. Complications included three cases of end-of-stem pain at tibial side and two revisions due to septic loosening in the first post-operative year. No aseptic loosening was reported.The use of metaphyseal sleeves, in combination with uncemented stems and varus-valgus constrained components with rotating platform, has shown excellent mid-term results allowing osseous ingrowth with no evidence of osteolysis or displacement. This is a promising option for better implant fixation in revision TKA.Case series with no comparison group, Level IV.
PubMed | Hospital Universitario Miguel Servet, Hospital Infantil Universitario Miguel Servet and Hospital Obispo Polanco
Type: | Journal: Neurologia (Barcelona, Spain) | Year: 2016
Global developmental delay (GDD) and intellectual disability (ID) are frequent reasons for consultation in paediatric neurology departments. Nowadays, array comparative genomic hybridisation (array-CGH) is one of the most widely used techniques for diagnosing these disorders. Our purpose was to determine the phenotypic features associated with pathological results in this genetic test.We conducted a blind study of the epidemiological, clinical, anthropometric, and morphological features of 80 patients with unexplained ID to determine which features were associated with pathological results in array-CGH.Pathological results were found in 27.5% of the patients. Factors associated with pathological results in array-CGH were a family history of GDD/ID (OR=12.1), congenital malformations (OR=5.33), having more than 3 facial dysmorphic features (OR=20.9), and hypotonia (OR=3.25).Our findings are consistent with those reported by other published series. We therefore conclude that the probability of having pathological results in array-CGH increases with the presence of any of the features mentioned above in patients with ID/GDD.
Labay Matias M.,Hospital Obispo Polanco |
Labay Matias M.,University of Zaragoza |
Labay Guerrero A.,University of Zaragoza |
Labay Guerrero M.,San Jorge University
Pediatria de Atencion Primaria | Year: 2011
Objective: the present study aims to know the reality of the relation between young people and sex web pages in Spain. Material and methods: anonymous survey, handled to 225 university students, in the University Campus of Teruel, throughout 2010. Results: two hundred surveys were analyzed; females answered 57% of them. The average age was 22 ± 4 years old (18-26). The average starting age of visiting the net was 13 ± 7 years old (7-20). We found that 82% of the survey group visit web pages of sex (from them, 37% do it normally, with a clear predominance of males); 29% initiated their visits between 11 and 15 years old and 32% between 15 to 18 years old. Of the frequent visitors, 68% are males, and 32% females; 19% started their visits at school. From the owners of a personal computer, 63% frequent more those web pages than those who use a familiar computer. Conclusions: the greatest pornography consumers in the Internet are the teenagers between 12 and 17 years old. One of every three responders usually visits this kind of pages, and does it more often when having a personal computer. Considering these results, the concern of parents, educators, doctors, pediatricians, publicists, politicians and industry is demanded in order to protect and control the children and teenagers. Campaigns about this topic are requested.
PubMed | Medical Oncology Service, Complejo Hospitalario Of Jaen, Hospital Universitario Carlos Haya, Hospital Universitario Principe Of Asturias and 7 more.
Type: Journal Article | Journal: Targeted oncology | Year: 2015
More than 50 % of patients with colorectal cancer develop liver metastases. Surgical resection is the only available treatment that improves survival in patients with colorectal liver metastases (CRLM). New antiangiogenic targeted therapies, such as bevacizumab, aflibercept, and regorafenib, in combination with neoadjuvant and conversion chemotherapy may lead to improved response rates in this population of patients and increase the proportion of patients eligible for surgical resection. The present review discusses the available data for antiangiogenic targeted agents in this setting. One of these therapies, bevacizumab, which targets the vascular endothelial growth factor (VEGF) has demonstrated good results in this setting. In patients with initially unresectable CRLM, the combination of 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) plus bevacizumab has led to high response and resection rates. This combination is also effective for patients with unresectable CRLM. Moreover, the addition of bevacizumab to chemotherapy in the neoadjuvant setting of liver metastasis has a higher impact on pathological response rate. This drug also has a manageable safety profile, and according to recent data, bevacizumab may protect against the sinusoidal dilation provoked in the liver by certain cytotoxic agents. In phase II trials, antiangiogenic therapy has demonstrated benefits in the presurgical treatment of CRLM and may represent a new treatment pathway for these patients.
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.
Martin-Hernandez C.,Hospital Obispo Polanco |
Cebamanos-Celma J.,IMAS |
Molina-Ros A.,IMAS |
Ballester-Jimenez J.J.,Hospital Obispo Polanco |
Arthroscopy - Journal of Arthroscopic and Related Surgery | Year: 2010
Purpose: To evaluate the repaired tissues formed in full-thickness cartilage defects in a rabbit model implanted with autogenous periosteal grafts under the influence of continuous passive motion (CPM) establishing a correlation between histology, histomorphometry, and mechanical behavior. Methods: Autogenous periosteal grafts were used to resurface full-thickness defects produced in the trochlear groove in the right knees of 60 New Zealand rabbits. Four groups were formed according to the time to death and postoperative mobilization: group A-active intermittent motion, euthanized at 8 weeks; group B-CPM, euthanized at 8 weeks; group C-active intermittent motion, euthanized at 36 weeks; and group D, CPM, euthanized at 36 weeks. Repaired tissues were evaluated grossly, histologically, and mechanically, as well as by histomorphometry. Results: The repair tissue was hyaline-like cartilage in 68.1% of the specimens in group A, 71.4% in group B, 0% in group C, and 20% in group D. The mean thickness of the regenerated tissue was 1.20 mm in group A, 1.23 mm in group B, 0.20 mm in group C, and 0.25 in group D. Elastic stiffness at 8 weeks was lower than that of the control cartilage and increased significantly at 36 weeks because of degenerative changes. Postoperative motion showed no influence on the results. Repaired tissue developed severe degenerative changes in time, and deterioration of the mechanical properties was observed without any protective effect of the CPM. Conclusions: Full-thickness cartilage defects treated with autologous periosteal grafts were repaired with hyaline-like cartilage tissue. Regenerated tissue showed viscoelastic behavior similar to normal cartilage 8 weeks after surgery. CPM did not improve histologic or mechanical results. Repaired tissue did not last over time. Clinical Relevance: Free periosteal grafts should not be used clinically in the treatment of full-thickness cartilage defects because even though regenerated tissue seems initially to be hyaline-like cartilage, it is not capable of maintaining its histologic and mechanical properties over a long period of time. © 2010 Arthroscopy Association of North America.
Vilar Bonacasa E.Y.,Hospital Obispo Polanco
Radiologia | Year: 2011
Training the best radiologist is the tutor's aim. Considering both residents features -whose intention is becoming a radiologist- and the trainer profile, the method simultaneously combines the most suitable tools, in order to reach the aim. The method knowledge and the available tools facilitate the tutor planning and his cooperation in the whole resident learning process. © 2011 SERAM. Publicado por Elsevier España, S.L. Todos los derechos reservados.
PubMed | Hospital Obispo Polanco
Type: Clinical Trial | Journal: Revista espanola de cirugia ortopedica y traumatologia | Year: 2015
To present the results of a polyurethane meniscal scaffold implant in 10 patients with persistent pain after meniscectomy.Prospective, descriptive study of ten patients who underwent arthroscopic implantation of a polyurethane meniscal scaffold. Functional, MRI, and radiography assessment was performed pre-operatively and at 6-months, 1-year, and a final follow-up at a minimum of two years. Clinical evaluation included Lysholm score, KOOS and VAS. The MRI morphology and signal intensity of the implant were evaluated according to the criteria of Genovese et al.Statistically significant differences were found between the mean Lysholm score before surgery (63.5 points), and that at 6 months (76.8 points) (p=.001), one year (83.3 points) (p<.001) and final follow-up (84.4 points) (p<.001). KOOS showed significant differences between before surgery (64.23 points), 6 months (73.66 points) (p=.001), one year (81.39 points) (p<.001) and final follow-up (83.34 points) (p<.001). The mean values for VAS were 5.7 points in the pre-operative evaluation, 3.6 points at 6 months-follow-up (p<.001), 1.9 points at one year (p<.001), and 1.9 points at final follow-up (p<.001). Radiology showed degenerative changes in one case. In MRI, the size of the implant and the intensity of the MRI signal gradually decreased, but it never changed to that of a normal meniscus.A significant improvement was found in all the clinical parameters 24 months after the surgery, except in one patient who underwent furher surgery. The scaffold reduced its size and but never achieved an MRI image similar to that of a normal meniscus. The procedure proved to be safe and useful for the treatment of persistent pain after meniscectomy.
PubMed | Hospital Obispo Polanco
Type: | Journal: Case reports in rheumatology | Year: 2016
Digital ulcers are a burdensome and painful condition with sparse options of treatment. We report the case of a 78-year-old female patient with limited cutaneous systemic sclerosis that sequentially developed digital ulcers. After the appearance of digital ulcers in the soles of her feet she was successfully treated with bosentan. The report of two new digital ulcers in her hands 9 months later alongside with elevated transaminase levels led to a switch to macitentan treatment. A swift and complete healing of both digital ulcers was observed after 3 months, with the restoration of normal biochemical values.