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Hospital de Órbigo, Spain

Martin-Mateos I.,University of La Laguna | Mendez Perez J.A.,University of La Laguna | Reboso Morales J.A.,Hospital Universitario Of Canarias Huc | Gomez-Gonzalez J.F.,University of La Laguna
Computers in Biology and Medicine | Year: 2016

Background and objective: Propofol is widely used for hypnosis induction and maintenance of general anesthesia. Its effect can be assessed using the bispectral index (BIS). Many automatic infusion systems are based in pharmacokinetics (PK) and pharmacodynamics (PD) models to predict the response of the patient to the drug. However, all these models do not take into account intra and inter-patient variability. An adjusted intraoperative drug administration allows faster recovery and provides post-operative side-effect mitigation. Methods: BIS evolution and surgery-recorded propofol infusion data of a group of 60 adult patients (30 males/30 females) with ASA I/II physical status were used to test a real time PK/PD compartmental model. This new algorithm tunes three model parameters (ce50, γ and ke0), minimizing a performance function online. Results: The error in the BIS signal predicted by the real time PK/PD model was smaller than the error measured with fixed parameter equations. This model shows that ce50, γ and ke0 change with time and patients, given a mean (95% confidence interval) of 3.89 (3.52-4.26) mg/l, 4.63 (4.13-5.13) and 0.36 (0.31-0.4) min-1, respectively. Conclusions: The real time PK/PD model proposed provides a closer description of the patient real state at each sample time. This allows for greater control of the drug infusion, and thus the quantity of drug administered can be titrated to achieve the desired effect for the desired duration, and reduce unnecessary waste or post-operative effects. © 2016 Elsevier Ltd.

Zamora R.B.,Hospital Universitario Of Canarias Huc
Zygote (Cambridge, England) | Year: 2011

A little studied aspect of developmental arrest (DA) in ART is zygote arrest (ZA). Etiologically, blockage at the first cleavage stage includes molecular and chromosomal anomalies, some of which manifest morphologically. Given considerations on embryo culture, transfer and cryopreservation, optimal zygote selection is very important. The aim of this study was to ascertain whether zygote morphological features were indicators of increased ZA. In this study we performed a prospective, observational study of 2105 zygotes obtained from consecutive patients who were undergoing IVF/ICSI treatment, of which 43 (2%) suffered ZA. Morphological features observed under the inverted microscope were qualitatively categorized: pronuclear size, nucleolar precursor bodies (NPB) alignment, light and dark halos, polar body placement and fragmentation observed at 16-18 h post-insemination. We compared these features in blocked versus cleaved zygotes at 48 h and found significant correlations (p < 0.05) between ZA and three features: the absence of a light halo (p = 0.001), the absence of a dark halo (p < 0.005), and non-aligned NPB (p < 0.05). We can say that certain morphological features are indicators of significantly increased zygote arrest. These findings may be of utility for optimal zygote selection and culture strategies, especially in countries under restrictive conditions.

Rodriguez Y.,University of La Laguna | Rodriguez Y.,Fundacion Canaria Del Instituto Canario Of Investigacion Del Cancer | Baez D.,University of La Laguna | Baez D.,Fundacion Canaria Del Instituto Canario Of Investigacion Del Cancer | And 13 more authors.
International Journal of Gynecological Pathology | Year: 2011

Deregulated steroids are involved in different hormone-dependent tumors, including benign and malignant uterine neoplasms. Leiomyomas (LM) are estrogen and progesterone-dependent benign tumors, whereas "bizarre or atypical LMs" (AL) are considered a subgroup of LM and clinically benign, although their malignant potential is suspect. Uterine leiomyosarcomas (LMS) are malignant smooth muscle tumors, and ovarian steroids may control their growth. Estrogen effects are mediated by 2 receptors, estrogen receptors (ER) α and β, and the ratio of both receptors seems to be a critical parameter in the estrogen-mediated carcinogenic process. Estradiol induces the expression of neurotensin (NTS), and the coupling of this peptide with its high-affinity receptor, NTS1, has been involved in the regulation of tumoral cell growth. Given the importance of these markers in tumor development, we aim to determine the status of ERα and ERβ in the myometrium and LM, AL, and LMS, concomitantly with the expression of NTS/NTS receptor 1 in these tumors. For that purpose, we use immunohistochemistry for all markers analyzed and in-situ hybridization to detect NTS mRNA. These data suggest that LMS are estrogen-dependent tumors, which may use NTS as an autocrine growth factor. In addition, the phenotype of AL with regard to ERα and ERβ status and NTS expression is closer to LMS than LM; thus, a potential malignization of this tumor is feasible. ©2011International Society of Gynecological Pathologists.

Arteaga-Gonzalez I.,Hospital Universitario Of Canarias Huc | Martin-Malagon A.,Hospital Universitario Of Canarias Huc | Fernandez E.M.L.-T.,Hospital Universitario Insular Of Gran Canaria Huigc | Carrillo-Pallares A.,Hospital Universitario Of Canarias Huc
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques | Year: 2010

Purpose: To establish which patients suffering ventral hernia benefit the most from laparoscopic approach. Methods: From January 2005 to October 2008, 126 patients underwent surgery due to incisional hernia at our University Hospital. Patients were assigned to laparoscopic surgery (n=60) or conventional surgery (n=66) at the surgeon's discretion. Patients were subdivided according to the greater diameter of the defect: (G1, defect <5 cm; G2, defect 5 to 15 cm; and G3, defect >15 cm). Data on patient demographic, clinical, and perioperative variables were collected prospectively. Results: Groups were comparable in terms of sex, body mass index, American Society of Anesthesiologists score, size of defect, and proportion of primary repairs. Four patients were converted to open surgery. Mean hospital stay in the group with the smaller hernias (G1 was 3.16 d laparoscopic surgery vs. 2.87 d conventional surgery, P>0.05). Hospital stay for patients who underwent laparoscopy was shorter in G3 (4.25 d Lap vs. 12.6 d Open; P=0.02). Conclusions: Patients with very large incisional hernias are those who benefit the most from laparoscopic treatment. Copyright © 2010 by Lippincott Williams & Wilkins.

Rueda Dominguez A.,Area de Oncologia y Hematologia | Alfaro Lizaso J.,Instituto Oncologico Of Guipuzcoa | de la Cruz Merino L.,Servicio de Oncologia Medica | Guma i Padro J.,Hospital Universitari Of Sant Joan Of Reus | And 6 more authors.
Clinical and Translational Oncology | Year: 2015

Hodgkin lymphoma (HL) is an uncommon B cell lymphoid malignancy representing approximately 10–15 % of all lymphomas. HL is composed of two distinct disease entities; the more commonly diagnosed classical HL and the rare nodular lymphocyte-predominant HL. An accurate assessment of the stage of disease and prognostic factors that identify patients at low or high risk for recurrence are used to optimize therapy. Patients with early stage disease are treated with combined modality strategies using abbreviated courses of combination chemotherapy followed by involved-field radiation therapy, while those with advanced stage disease receive a longer course of chemotherapy often without radiation therapy. High-dose chemotherapy (HDCT) followed by an autologous stem cell transplant (ASCT) is the standard of care for most patients who relapse following initial therapy. Brentuximab vedotin should be considered for patients who fail HDCT with ASCT. © 2015, The Author(s).

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