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Santa Cruz de Tenerife, Spain

Concepcion-Medina T.,Hospital Universitario Of La Candelaria | Rodriguez-Hernandez O.,Hospital Universitario Of Canarias
Rehabilitacion | Year: 2011

Charcot's neuroarthropathy is a progressive disease. It is associated with severe peripheral neuropathy. It is characterized by inflammation, joint dislocation and bone destruction with subsequent foot deformity. It should be suspected in any diabetic patient who has swelling, heat and redness in the ankle or foot, with absence of vibratory sensation, to monofilament and patellar and Achilles reflexes. Its prevalence is low. Currently the most common cause is diabetes mellitus. The goal is to reach the stage of consolidation with a plantigrade foot and the possibility of wearing shoes. © 2010 Elsevier España, S.L. and SERMEF. All rights reserved. Source

Parra-Blanco A.,Bernardo OHiggins University | Ruiz A.,Bernardo OHiggins University | Alvarez-Lobos M.,Bernardo OHiggins University | Amoros A.,Hospital Universitario Of La Candelaria | And 4 more authors.
World Journal of Gastroenterology | Year: 2014

Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here. © 2014 Baishideng Publishing Group Inc. All rights reserved. Source

Henriquez-Hernandez L.A.,University of Las Palmas de Gran Canaria | Henriquez-Hernandez L.A.,Canary Institute for Cancer Research ICIC | Perez L.F.,University of Las Palmas de Gran Canaria | Perez L.F.,Canary Institute for Cancer Research ICIC | And 8 more authors.
Cancer Epidemiology | Year: 2010

Purpose: The distribution of TSER (TYMS), C677T (MTHFR), Arg72Pro (p53) and C3435T (MDR1) gene polymorphisms was investigated in 80 consecutive breast cancer patients treated with adjuvant chemotherapy. Results: Observed allelic frequencies were: TSER, (2) 0.55 and (3) 0.45; MTHFR C677T, (C) 0.65 and (T) 0.35; p53 Arg72Pro, (Arg) 0.76 and (Pro) 0.24; MDR1 C3435T, (C) 0.51 and (T) 0.49. MTHFR C677T was found to be a strong predictor of the presence of multifocal tumour (odds ratio, 4.1; 95% CI, 1.1-15.7; P=0.035). Conclusion: Our data indicate that breast cancer patients with the C/C variant may present multifocal tumour most frequently. © 2010 Elsevier Ltd. Source

Henriquez-Hernandez L.A.,University of Las Palmas de Gran Canaria | Henriquez-Hernandez L.A.,Instituto Canario Of Investigacion Del Cancer Icic | Murias-Rosales A.,Instituto Canario Of Investigacion Del Cancer Icic | Murias-Rosales A.,Hospital Universitario Insular Of Gran Canaria | And 8 more authors.
Cancer Epidemiology | Year: 2010

Purpose To investigate the role of TSER (TYMS), C677T (MTHFR), Arg72Pro (p53) and C3435T (MDR1) gene polymorphisms in breast cancer patients treated with 5-fluorouracil and cyclophosphamide-based neoadjuvant chemotherapy. Results Observed allelic frequencies were: TSER, (2) 0.54 and (3) 0.46; MTHFR C677T, (C) 0.59 and (T) 0.41; p53 Arg72Pro, (Arg) 0.73 and (Pro) 0.27; MDR1 C3435T, (C) 0.52 and (T) 0.48. MTHFR allele T and p53 allele Pro were strongly associated with toxicity due to chemotherapy (odds ratio, 7.1 (95% confidence interval, 1.4-36.1; p= 0.018) and 7.0 (95% confidence interval, 1.2-40.5; p= 0.029), respectively). Conclusion We introduced new data related to the contribution of p53 codon 72 to toxicity due to 5-fluorouracil and cyclophosphamide-based neoadjuvant chemotherapy in patients with breast cancer. © 2010 Elsevier Ltd. Source

Casanova C.,Hospital Universitario Ntra Sra Of La Candelaria | Marin J.M.,Hospital Universitario Miguel Servet | Marin J.M.,CIBER ISCIII | Martinez-Gonzalez C.,Hospital Central de Asturias | And 46 more authors.
Respiratory Research | Year: 2014

Rationale: Little is known about the longitudinal changes associated with using the 2013 update of the multidimensional GOLD strategy for chronic obstructive pulmonary disease (COPD).Objective: To determine the COPD patient distribution of the new GOLD proposal and evaluate how this classification changes over one year compared with the previous GOLD staging based on spirometry only.Methods: We analyzed data from the CHAIN study, a multicenter observational Spanish cohort of COPD patients who are monitored annually. Categories were defined according to the proposed GOLD: FEV1%, mMRC dyspnea, COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), and exacerbations-hospitalizations. One-year follow-up information was available for all variables except CCQ data.Results: At baseline, 828 stable COPD patients were evaluated. On the basis of mMRC dyspnea versus CAT, the patients were distributed as follows: 38.2% vs. 27.2% in group A, 17.6% vs. 28.3% in group B, 15.8% vs. 12.9% in group C, and 28.4% vs. 31.6% in group D. Information was available for 526 patients at one year: 64.2% of patients remained in the same group but groups C and D show different degrees of variability. The annual progression by group was mainly associated with one-year changes in CAT scores (RR, 1.138; 95%CI: 1.074-1.206) and BODE index values (RR, 2.012; 95%CI: 1.487-2.722).Conclusions: In the new GOLD grading classification, the type of tool used to determine the level of symptoms can substantially alter the group assignment. A change in category after one year was associated with longitudinal changes in the CAT and BODE index. © 2014 Casanova et al.; licensee BioMed Central Ltd. Source

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