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Barcelona, Spain

Arguelles-Arias F.,Hospital Universitario Virgen Macarena | Donat E.,Polytechnic University of Valencia | Fernandez-Urien I.,Complejo Hospitalario de Navarra | Alberca F.,Hospital Universitario Virgen Of La Arrixaca | And 6 more authors.
Revista Espanola de Enfermedades Digestivas | Year: 2015

Introduction: Capsule endoscopy (CE) in children has limitations based mainly on age. The objective of this consensus was reviewing the scientific evidence. Material and methods: Some experts from the Spanish Society of Gastroenterology (SEPD) and Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP) were invited to answer different issues about CE in children. These sections were: a) Indications, contraindications and limitations; b) efficacy of CE in different clinical scenarios; c) CE performance; d) CE-related complications; e) Patency capsule; and f) colon capsule endoscopy. They reviewed relevant questions on each topic. Results: The main indication is Crohn’s disease (CD). There is no contraindication for the age and in the event that the patient not to swallow it, it should be administered under deep sedation with endoscopy and specific device. The CE is useful in CD, for the management of OGIB in children and in Peutz-Jeghers syndrome (in this indication has the most effectiveness). The main complication is retention, which should be specially taken into account in cases of CD already diagnosed with malnutrition. A preparation regimen based on a low volume of polyethylene glycol (PEG) the day before plus simethicone on the same day is the best one in terms of cleanliness although does not improve the results of the CE procedure. Conclusions: CE is safe and useful in children. Indications are similar to those of adults, the main one is CD to establish both a diagnosis and disease extension. Moreover, only few limitations are detected in children. © 2015 Arán Ediciones, S. L.

Zuccarino F.,Hospital Del Mar | Vollmer I.,Hospital Del Mar | Sanchez G.,Hospital Dr. Josep Trueta | Navallas M.,Hospital San Joan de Deu | And 2 more authors.
American Journal of Roentgenology | Year: 2015

OBJECTIVE. The objectives of this article are to review the imaging findings of left ventricular noncompaction (LVNC) at echocardiography, cardiac MRI, and MDCT; to discuss diagnostic criteria for and the advantages and limitations of these imaging techniques; and to describe pitfalls that can lead to misinterpretation of findings of LVNC. CONCLUSION. LVNC is a cardiac disease of emerging importance, and imaging has a key role in its diagnosis. Accordingly, radiologists should be familiar with LVNC imaging findings to realize an accurate diagnosis. © American Roentgen Ray Society.

Oyarzabal Irigoyen M.,Complejo Hospitalario de Navarra | Garcia Cuartero B.,Hospital Universitario Severo Ochoa | Barrio Castellanos R.,Hospital Universitario Ramon y Cajal | Torres Lacruz M.,Hospital San Joan de Deu | And 7 more authors.
Pediatric Endocrinology Reviews | Year: 2012

DKA at diagnosis of T1DM is a life-threatening situation that represents the main cause of morbidity and mortality in pediatric patients with T1DM. Objective: To determine whether the occurrence and severity of DKA at diagnosis of T1DM has suffered any changes in recent years in the Spanish paediatric population. Patients and methods: Data from 1169 patients with T1DM under 15 years of age was retrospectively studied (2004-2008) for the presence and severity of DKA at the onset of T1DM, and compared to previous available studies in Spain. This study is multicentric, nationwide with eleven major Paediatric Diabetes Units involved. Results: Complete data were available from 1151 patients (98%). Frequency of DKA was 39.5%, which is not significantly different from previous Spanish studies. 33.8%, children of 0-4.9 years of age, 40.8% aged 5-10.9 and 25.2% aged 11-14.9 years. Mean age of patients with DKA was significantly lower than the one of patients without DKA (7.44±4.10 versus 8.47±3.63 years). Mild DKA was occurring more frequently than moderate and severe forms (47.8%, versus 34.4% versus 17.8%, p<0.0001). Incidence of severe DKA was significantly higher in children under 4.9 years of age, especially in those younger than 2 years (p<0.001). Severe DKA led to complications in three children (cerebral oedema [n=1]), cerebral infarction (n=1) and femoral vein thrombosis (n=1). Conclusion: Frequency of DKA at diagnosis of T1DM in Spain is still high although most cases were mild. Children under 2 years of age seem to be at increased risk for severe DKA.

Nogue M.,Hospital General de Vic | Salud A.,Hospital Arnau de Vilanova | Vicente P.,Hospital General de Granollers | Arrivi A.,Hospital Son Llatzer | And 8 more authors.
Oncologist | Year: 2011

Background. Concomitant chemoradiotherapy followed by total mesorectal excision is standard treatment for locally advanced rectal cancer. This approach, however, focuses on local disease control and delays systemic treatment. Induction chemotherapy has the advantage of earlier administration of systemic therapy and may improve distant control. The objective of the current study was to assess the efficacy and toxicity of adding bevacizumab to induction chemotherapy followed by preoperative bevacizumab-based chemoradiotherapy in patients with locally advanced rectal cancer. Patients and Methods. Eligible patients had high-risk rectal adenocarcinoma defined by magnetic resonance imaging criteria. Treatment consisted of four 21-day cycles of bevacizumab (7.5 mg/kg) and XELOX (capecitabine plus oxaliplatin), followed by concomitant radiotherapy (50.4 Gy) plus bevacizumab (5 mg/kg every 2 weeks) and capecitabine (825 mg/m2 twice daily on days 1-15). Surgery was scheduled for 6-8 weeks after chemoradiotherapy. The primary endpoint was pathologic complete response (pCR). Results. Between July 2007 and July 2008, 47 patients were recruited. Among 45 patients who underwent surgery, pCR was achieved in 16 patients (36%; 95% confidence interval: 22.29%-51.27%), and an additional 17 patients (38%) had Dworak tumor regression grade 3. R0 resection was performed in 44 patients (98%). Most grade 3/4 adverse events occurred during the induction phase and included diarrhea (11%), asthenia (4%), neutropenia (6%), and thrombocytopenia (4%). Eleven patients (24%) required surgical reintervention. Conclusions. Addition of bevacizumab to induction chemotherapy and chemoradiotherapy is feasible, with impressive activity and manageable toxicity. However, caution is recommended regarding surgical complications. © AlphaMed Press.

Hernandez-Martin A.,Hospital Infantil Del Nino Jesus | Gilliam A.E.,Palo Alto Medical Foundation | Baselga E.,Hospital Santa Creu i San Pau | Vicente A.,Hospital San Joan de Deu | And 4 more authors.
Journal of the American Academy of Dermatology | Year: 2014

Background Acquired hyperpigmented lesions in early childhood can be the presenting sign of serious diseases or benign conditions and often cause significant parental anxiety. Objective We sought to report a series of 25 young children with hyperpigmented macules on the forehead and temples without preceding erythema, edema, or desquamation. Methods We conducted a retrospective review of 25 children with similar clinical findings, seen from 2009 to 2013, from 5 medical centers in 3 countries. Results There were 13 boys and 12 girls of many races. Their ages ranged from 2 to 24 months (mean 12.2 months, median 6 months). The hyperpigmentation presented abruptly in the summer (12 cases), spring (5 cases), winter (5), and fall (2), and was not clearly specified in 1 case. Histopathologic analysis in 3 cases was consistent with postinflammatory hyperpigmentation. After a follow-up period ranging from 3 months to 4.5 years, the lesions persist to a variable degree in 19 cases in which follow-up was possible. Limitations The age of our patients precluded patch testing and/or invasive diagnostic methods. Conclusions The clinical features and prolonged clinical course over years do not correspond with any known or previously described cause of acquired facial hyperpigmented macules in young children.© 2013 by the American Academy of Dermatology, Inc.

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