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Perin F.,Hospital Universitario Virgen Of Las Nieves | Rodriguez Vazquez M.M.,Hospital Universitario Virgen Of Las Nieves | Ferrer Menduina Q.,Hospital Universitario Of La Vall Dhebron | Deiros Bronte L.,Hospital Universitario La Paz | And 6 more authors.
Acta Pediatrica Espanola | Year: 2015

Introduction and objective: Optimal treatment for fetal tachycardia is still controversial. The aim of this study is to review the actual management and outcome of fetal tachycardia in 9 Spanish centers. Method: Retrospective multicentric study: analysis of all fetuses with tachycardia diagnosed at 9 Spanish centers between January 2008 and September 2010. Results:37 cases were registered, 30% of which were hydropic. We had 26 no hydropic cases, of which 4 atrial flutter-all of them successfully cardioverted intrautero or after delivery- and 22 with supraventricular tachycardia (SVT), of which 17 short ventriculo-auricular (VA) interval and 5 long VA interval. Digoxin was the drug of choice in most cases. Prenatal control of the tachycardia was achieved in 93% of treated SVT with short VA interval and 50% of long VA, being digoxine effective in short VA but not long VA interval (p= 0.019). 1 fetus with supraventricular tachycardia with ventricular dysfunction died. 11 cases were hydropic, all of them diagnosed as SVT. Management strategies were highly diverse in this group. 5 patients died: 1 after delivery, 2 intrautero very shortly after starting treatment, and 2 intrautero in spite of being successfully cardioverted to sinus rhythm (1 with Sotalol, 1 with flecainide). Conclusions: Hydropic fetuses have shown a high mortality rate in our population, which calls for further studies and unification of criteria. Here we propose a common protocol aimed at improving the outcome of fetal tachycardia. © 2015 Ediciones Mayo, S.A. All rights reserved.


Gomez Saez J.M.,Hospital Universitario Of Bellvitge | Jimenez-Fonseca P.,Hospital Universitario Central Of Asturias | Santamaria Sandi J.,Hospital Universitario Of Cruces | Capdevila Castillon J.,Hospital Universitario Of La Vall Dhebron | And 6 more authors.
Endocrinologia y Nutricion | Year: 2015

Anaplastic thyroid cancer (ATC) is the most aggressive solid tumour known and is a rare but highly lethal form of thyroid cancer that requires a multidisciplinary team approach. No Spanish consensus exists for management of patients with ATC. The Thyroid Cancer Group of the Spanish Society of Endocrinology and Nutrition and the GETHI (Grupo Español de Enfermedades Huérfanas e Infrecuentes) of the Spanish Society of Oncology, in agreement with the Boards of these Societies, commissioned an independent task force to develop a wide consensus on ATC. The relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The consensus includes the characteristics, diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, systemic therapy, supportive care during active treatment), approaches to advanced/metastatic disease, palliative care options, monitoring, and long-term follow-up of ATC. For operable disease, a combination of radical surgery with adjuvant radiotherapy or chemotherapy, using agents such as doxorubicin, cisplatin and paclitaxel, is the best treatment strategy. Cytotoxic drugs are poorly effective for advanced/metastatic ATC. On the other hand, targeted agents may represent a viable therapeutic option. Patients with stage IVA/IVB resectable disease have the best prognosis, particularly if a multimodal approach is used, and some stage IVB unresectable patients may respond to aggressive therapy. Patients with stage IVC disease should be considered for clinical trials or for hospice/palliative care depending on their preference. This is the first Spanish consensus for ATC, and provides recommendations for management of this extremely aggressive malignancy. Novel systemic therapies are being tested, and more effective combinations are needed to improve patient outcomes. Although more aggressive radiotherapy has reduced locoregional recurrence, mean overall survival has not improved in the past 50 years. © 2014 SEEN.


Galofre J.C.,University of Navarra | Santamaria Sandi J.,Hospital Universitario Of Cruces | Capdevila J.,Hospital Universitario Of La Vall Dhebron | Navarro Gonzalez E.,Hospital Universitario Virgen Del Rocio | And 6 more authors.
Endocrinologia y Nutricion | Year: 2015

In Spain medullary thyroid carcinoma (MTC) would not exceed 80 new cases per year and less than half of them would be good candidates for systemic treatment with novel agents. Methods: Relevant literature was reviewed, including PubMed searches supplemented with additional articles. Results: The consensus summarizes the clinical outcomes in terms of activity and toxicity of each of the available drugs. A brief summary of the minimum requirements in terms of follow up and genetic counseling around MTC is also included. Conclusions: Only those patients with objective imaging progression in the last 12-14 months with large volume of disease are clear candidates to start systemic treatment. However, those patients with low disease volume should be considered for 'wait and see' strategy until symptoms of the disease appear. Multidisciplinary approach for the management of MTC patient is mandatory nowadays. © 2014 SEEN.


Jimenez-Fonseca P.,Hospital Universitario Central Of Asturias | Gomez Saez J.M.,Hospital Universitario Of Bellvitge | Santamaria Sandi J.,Hospital Universitario Of Cruces | Capdevila J.,Hospital Universitario Of La Vall Dhebron | And 6 more authors.
Clinical and Translational Oncology | Year: 2016

Anaplastic thyroid cancer (ATC) is the most aggressive solid tumor and almost uniformly lethal in humans. The Boards of the Thyroid Cancer Group of the Spanish Society of Endocrinology and Nutrition and the Grupo Español de Enfermedades Huérfanas e Infrecuentes of the Spanish Society of Oncology requested that an independent task force draft a more comprehensive consensus statement regarding ATC. All relevant literature was reviewed, including serial PubMed searches together with additional articles. This is the first, comprehensive Spanish consensus statement for ATC and includes the characteristics, diagnosis, initial evaluation, treatment goals, recommendations and modalities for locoregional and advanced disease, palliative care options, surveillance, and long-term monitoring. Newer systemic therapies are being investigated, but more effective combinations are needed to improve patient outcomes. Though more aggressive radiotherapy has reduced locoregional recurrences, median overall survival has not improved in more than 50 years. © 2016 Federación de Sociedades Españolas de Oncología (FESEO)


Boemo R.L.,Hospital Universitario Of La Vall Dhebron | Navarrete M.L.,Hospital Universitario Of La Vall Dhebron | Garcia-Arumi A.M.,Hospital Universitario Of La Vall Dhebron | Copa S.L.,Hospital Universitario Of La Vall Dhebron | And 2 more authors.
Acta Otorrinolaringologica Espanola | Year: 2010

Introduction: Ramsay Hunt syndrome (RHS) is a disease caused by the Varicella Zoster virus and characterised by skin rash, peripheral facial palsy and otologic symptoms. Objective: This was an epidemiological study on the incidence and prognosis of this syndrome. Methods: A retrospective study was carried out on the patients diagnosed with RHS who were seen in the emergency room between January 1995 and December 2004, and were followed up for more than 6 months. Results: Of the 54 patients included in this study, 7.5% had facial palsy as their first symptom, followed by otologic signs (20.2% had both simultaneously); 72.5% presented otologic signs before facial palsy. Hypoacusis was reported in 26% of the patients, but was objectively present in all of them. The level of facial palsy determined the prognosis. Conclusion: In this syndrome, the prognosis of facial palsy depends on the initial symptoms and clinical findings. Otologic symptoms occur more frequently in patients having a greater degree of facial nerve affectation. Vestibular symptoms have a good prognosis. Hypoacusis is much more frequent than reported; as it may go unnoticed in these patients, it should always be confirmed by complementary tests. © 2010 Elsevier España, S.L.

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