Valencia de Alcántara, Spain
Valencia de Alcántara, Spain

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Garcia-Mora B.,Polytechnic University of Valencia | Santamaria C.,Polytechnic University of Valencia | Rubio G.,Polytechnic University of Valencia | Pontones J.L.,Hospital Universitario La Fe Of Valencia
International Journal of Computer Mathematics | Year: 2014

The study of the sum of two independent phase-type (PH)-distributed variables, each of them being associated with a Markovian process with one absorbing state, is considered in this paper. The distribution function of the variable sum is computed, obtaining a new PH-distributed function of higher order. As the order increases in the new function, the exponential function of a block upper triangular matrix is calculated in terms of its respective blocks to reduce the dimension of the problem. The obtained results are applied to bladder carcinoma data. © 2013 © 2013 Taylor & Francis.


San Juan F.,Hospital Universitario La Paz | San Juan F.,Hospital Universitario La Fe Of Valencia | Cortes M.,Hospital Universitario La Paz
Transplantation Proceedings | Year: 2011

The excellent outcomes of liver transplantation (OLT) have increased its demand and the size of the waiting list, resulting in a substantial mortality rate before OLT, which is a treatment failure owing to disease development. We have reviewed the medical literature on this theme, focusing on prioritization methods. © 2011 Elsevier Inc. All rights reserved.


Gil M.J.,Lhospitalet Of Llobregat | De Las Penas R.,Consorcio Hospitalario Provincial Of Castellon | Reynes G.,Hospital Universitario La Fe Of Valencia | Balana C.,Institute Catala dOncologia | And 11 more authors.
Anti-Cancer Drugs | Year: 2012

There is no 'standard of care' for recurrent malignant glioma (MG). Our aim is to confirm the efficacy and safety of bevacizumab 10 mg/kg plus irinotecan 125 mg/m (or 340 mg/m if enzyme-inducing antiepileptic drugs) every 2 weeks for a maximum of 1 year in a retrospective pooled series of patients with recurrent MG. The inclusion criteria were as follows: age 18 years and above, histology of MG, progression after radiation and temozolomide, Karnofsky performance status (KPS) of at least 60, and signed informed consent for bevacizumab compassionate use. Response was assessed by MRI using the Macdonald criteria and evaluation of the FLAIR sequence every 8 weeks. A total of 130 patients were enrolled; 72% had glioblastoma (GBM). The median age of the patients was 53 years (20-78); the median KPS was 80%; the median number of prior chemotherapy lines was 2 (1-5); the median interval between the diagnosis of MG and inclusion was 14.6 months (2-166); and the median number of bevacizumab infusions was 8 (1-39). The median follow-up duration was 7.2 months (1-47). The median overall survival (OS) was 8.8 months for GBM and 11.2 months for anaplastic glioma (AG). The median progression-free survival was 5.1 months for GBM and 4.6 months for AG. The response rate was 56% for GBM and 68% for AG. Neurological and KPS improvements were observed in 49 and 45% of patients. Only KPS less than 80% was associated with a worse significant response rate (odds ratio, 0.57; 95% confidence interval, 0.22-0.96). The most frequent grades 3-4 toxicities were asthenia (7%), diarrhea (6%), and thromboembolic events (5%). There were five toxic deaths (4%). Bevacizumab plus irinotecan in recurrent MG improves responses, progression-free survival, and OS compared with historical data. KPS of at least 80% was a predictive factor for response and OS. © 2012 Wolters Kluwer Health | Lippincott Williams &Wilkins.


Ye-Lin Y.,Polytechnic University of Valencia | Garcia-Casado J.,Polytechnic University of Valencia | Martinez-De-Juan J.L.,Polytechnic University of Valencia | Prats-Boluda G.,Polytechnic University of Valencia | Ponce J.L.,Hospital Universitario La Fe Of Valencia
Physics in Medicine and Biology | Year: 2010

Myoelectrical recording could provide an alternative technique for assessing intestinal motility, which is a topic of great interest in gastroenterology since many gastrointestinal disorders are associated with intestinal dysmotility. The pacemaker activity (slow wave, SW) of the electroenterogram (EEnG) has been detected in abdominal surface recordings, although the activity related to bowel contractions (spike bursts, SB) has to date only been detected in experimental models with artificially favored electrical conductivity. The aim of the present work was to assess the possibility of detecting SB activity in abdominal surface recordings under physiological conditions. For this purpose, 11 recording sessions of simultaneous internal and external myolectrical signals were conducted on conscious dogs. Signal analysis was carried out in the spectral domain. The results show that in periods of intestinal contractile activity, high-frequency components of EEnG signals can be detected on the abdominal surface in addition to SW activity. The energy between 2 and 20 Hz of the surface myoelectrical recording presented good correlation with the internal intestinal motility index (0.64 0.10 for channel 1 and 0.57 0.11 for channel 2). This suggests that SB activity can also be detected in canine surface EEnG recording. © 2010 Institute of Physics and Engineering in Medicine.


Debon A.,Polytechnic University of Valencia | Molina I.,Polytechnic University of Valencia | Molina I.,Hospital Universitario La Fe Of Valencia | Cabrera S.,Polytechnic University of Valencia | Pellicer A.,Hospital Universitario La Fe Of Valencia
Mathematical and Computer Modelling | Year: 2013

In Vitro Fertilization (IVF) units need to decrease multiple pregnancies without affecting their overall success rate. In this study we propose a mathematical model to evaluate an embryo's potential ability to implant in the uterus. Embryos are graded by the embryologist based on the number of blastomeres, evenness of growth and degree of fragmentation. Therefore, the following variables were considered: number of blastomeres produced by division of the egg after fertilisation (blastomeres), symmetry and fragmentation of the embryo (grade). This model evaluates the embryos assigning them a score which represents their quality. The main result derived from this model is the estimation of the significant improvement in the implantation rate due to the increase in blastomere values and the decrease in grade factor values. But the increase from two-three to four produces more improvement in the implantation rate than two-three to five-six blastomeres.First, statistical models were used to study embryo traceability from transfer to implantation and to evaluate the effect of the quality of the embryos (embryo score) and women's age on implantation potential. This score was obtained by making predictions from the fitted model which was used to rank embryos in terms of implantation potential. Then we totalled the scores of embryos that had been transferred to each woman for obtaining the Embryo Quality Index (EQI). In addition, we studied the effects of EQI and women's age on pregnancy. Finally, statistical techniques such as Receiver Operating Characteristics (ROC) and bootstrap procedures were used to assess the accuracy of this model. This embryo score is a quick, efficient and accurate tool to optimise embryo selection for transfers on the second day after fertilisation. This tool is especially useful for transfers involving non-top embryos. © 2012.


PubMed | Hospital Universitario La Paz, Hospital Universitario Vall ebron, Hospital del Mar, Hospital Universitario Mutua Of Terrassa and 4 more.
Type: | Journal: Revista iberoamericana de micologia | Year: 2016

Although in the last decade the management of invasive fungal infections has improved, a number of controversies persist regarding the management of complicated intra-abdominal infection and surgical extended length-of-stay (LOS) patients in intensive care unit (ICU).To identify the essential clinical knowledge and elaborate a set of recommendations, with a high level of consensus, necessary for the management of postsurgical patients with complicated intra-abdominal infection and surgical patients with ICU extended stay.A Spanish prospective questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all of them specialists in fungal invasive infections from six scientific national societies; these experts were intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases. They answered 11 questions drafted by the coordination group after conducting a thorough review of the literature published in the last few years. For a category to be selected, the level of agreement among the experts in each should be equal to or greater than 70%. In a second round, 73 specialists attended a face-to-face meeting which was held after extracting recommendations from the chosen topics and in which they validated the pre-selected recommendations and derived algorithm.After the second Delphi round, the following 11 recommendations with high degree of consensus were validated. For surgical patients seven recommendations were validated: (1) risk factors for invasive candidiasis (IC), (2) usefulness of blood culture and direct examination of abdominal fluid to start empirical treatment; (3) PCR for treatment discontinuation; (4) start antifungal treatment in patients with anastomotic leaks; (5) usefulness of Candida score (CS) but not (6) the Dupont score for initiating antifungal therapy in the event of anastomotic leakage or tertiary peritonitis, and (7) the administration of echinocandins as first line treatment in this special population. For surgical ICU extended LOS patients four recommendations were validated: (1) risk factors for IC, (2) presence of multi-colonization by Candida as a required variable of the CS, (3) starting antifungal treatment with CS4, and (4) to perform non-culture-based microbiological techniques in stable septic patients without evident focus.The diagnosis and management of IC in ICU surgical patients requires the application of a broad range of knowledge and skills that we summarize in our recommendations. These recommendations, based on the DELPHI methodology, may help to identify potential patients, standardize their global management and improve their outcomes.


PubMed | Genetic and Genomic Unit, IMDEA Madrid Institute for Advanced Studies, University of Helsinki, Institute Investigaciones Biomedicas and 6 more.
Type: Journal Article | Journal: Oncotarget | Year: 2016

Human gliomas harbour cancer stem cells (CSCs) that evolve along the course of the disease, forming highly heterogeneous subpopulations within the tumour mass. These cells possess self-renewal properties and appear to contribute to tumour initiation, metastasis and resistance to therapy. CSC cultures isolated from surgical samples are considered the best preclinical in vitro model for primary human gliomas. However, it is not yet well characterized to which extent their biological and functional properties change during in vitro passaging in the serum-free culture conditions. Here, we demonstrate that our CSC-enriched cultures harboured from one to several CSC clones from the human glioma sample. When xenotransplanted into mouse brain, these cells generated tumours that reproduced at least three different dissemination patterns found in original tumours. Along the passages in culture, CSCs displayed increased expression of stem cell markers, different ratios of chromosomal instability events, and a varied response to drug treatment. Our findings highlight the need for better characterization of CSC-enriched cultures in the context of their evolution in vitro, in order to uncover their full potential as preclinical models in the studies aimed at identifying molecular biomarkers and developing new therapeutic approaches of human gliomas.


PubMed | Hospital Universitario La Fe Of Valencia and King's College
Type: Journal Article | Journal: Cirugia espanola | Year: 2014

The imbalance between the number of potential beneficiaries and available organs, originates the search for new therapeutic alternatives, such as Hepatocyte transplantation (HT).Even though this is a treatment option for these patients, the lack of unanimity of criteria regarding indications and technique, different cryopreservation protocols, as well as the different methodology to assess the response to this therapy, highlights the need of a Consensus Conference to standardize criteria and consider future strategies to improve the technique and optimize the results.Our aim is to review and update the current state of hepatocyte transplantation, emphasizing the future research attempting to solve the problems and improve the results of this treatment.


PubMed | Unitat de Salut Internacional Drassanes, Hospital Universitario Infanta Sofia, Hospital Universitario Ramon y Cajal, Hospital Universitario Principe Of Asturias and 6 more.
Type: Journal Article | Journal: Enfermedades infecciosas y microbiologia clinica | Year: 2016

The improvement in the prognosis of HIV infection, coupled with the increase in international travel and migration, has led to a rising number of HIV infected travelers. The objective of this study was to describe the epidemiological and clinical features of returning travelers, according to their HIV status.An observational prospective study was conducted including travelers and immigrants who traveled to visit friends and relatives (VFRs) registered in the +REDIVI collaborative network (January-2009; October-2014). +REDIVI is a national network that registers information regarding infections imported by travelers and immigrants at 21 different centers using a standardized protocol.A total of 3464 travellers were identified: 72 were HIV+ (2.1%) and 3.392 HIV- (98%). HIV+ vs. HIV- travelers were often older (40.5y vs. 34.2y P=.001), VFRs (79.1% vs. 44.4%; P<.001), and consulted less for pre-travel advice (27% vs. 37%; P=.078). The main destinations for both groups were sub-Saharan Africa and Latin America. The most frequent reasons for consultation after travel were fever, request for a health examination, gastrointestinal complaints, and abnormal laboratory tests (mainly eosinophilia and anemia), which differed between groups. The most frequent diagnoses in HIV+ travelers were malaria (38.8%), newly diagnosed HIV infection (25%), and intestinal parasites (19.4%), while for HIV- travelers the main diagnoses were healthy (17.9%), malaria (14%), and intestinal parasites (17.3%).The typical profile of an HIV+ traveler in +REDIVI was that of a VFR traveler who did not seek pre-travel advice and made high-risk trips. This may increase the chance of acquiring travel-related infections which may pose a special risk for HIV-infected travelers. The post-travel visit was a good opportunity for HIV infection screening.


PubMed | Complejo Hospitalario Of Granada, Hospital Miguel Servet, Fundacion Instituto Valenciano Of Oncologia, Hospital Sant Joan Despi Moises Broggi ICO Hospitalet and 6 more.
Type: Journal Article | Journal: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico | Year: 2016

Localized rectal adenocarcinoma is a heterogeneous disease and current treatment recommendations are based on a preoperative multidisciplinary evaluation. High-resolution magnetic resonance imaging and endoscopic ultrasound are complementary to do a locoregional accurate staging. Surgery remains the mainstay of treatment and preoperative therapies with chemoradiation (CRT) or short-course radiation (SCRT) must be considered in more locally advanced cases. Novel strategies with induction chemotherapy alone or preceding or after CRT (SCRT) and surgery are in development.

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