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Obregon-Palain L.,Hospital Universitario Of La Vall Dhebron | Ruiz-Castilla M.,Medico Adjunto | Perez-Sempere M.,Hospital Universitario Of La Vall Dhebron | Serracanta-Domenech J.,Medico Adjunto
Cirugia Plastica Ibero-Latinoamericana | Year: 2016

The first therapeutic option of lymphedema consists on a series of conservative measures known as complex descongestive therapy. Many patients benefit from this program. However, refractory severe cases require surgical management. Many techniques are available with different rates of recurrence. The Charles procedure is an appropriate alternative for severe cases. We present our experience with a 21 years old man with left lower limb massive elephantiasis secondary to congenital lymphedema refractory to conservative treatment. After clinical and radiological assessment, ablative surgery was proposed according to the Charles procedure, performed on 3 surgical times over 8 months, with favorable outcomes. By the way, we review the accepted practice to treat lymphedema in lower limb and the available therapeutic options.


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)


PubMed | Hospital Universitario Central Of Asturias, University of Navarra, Hospital Universitario Ramon y Cajal, Hospital Universitario Of La Vall Dhebron and 5 more.
Type: Consensus Development Conference | Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de 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 Espaol de Enfermedades Hurfanas 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.


PubMed | Hospital Universitario Central Of Asturias, Hospital Universitario Virgen del Rocio, Hospital Ramon y Cajal, Hospital Universitario Of Bellvitge and 5 more.
Type: Consensus Development Conference | Journal: Endocrinologia y nutricion : organo de la Sociedad Espanola de 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.Relevant literature was reviewed, including PubMed searches supplemented with additional articles.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.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.


PubMed | Hospital Universitario Central Of Asturias, University of Navarra, Hospital Universitario Ramon y Cajal, Hospital Universitario Of La Vall Dhebron and 5 more.
Type: Review | Journal: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico | 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 Espaol de Enfermedades Hurfanas 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 50years.


Vila C.,Hospital Clinico San Carlos | Renones C.,Complejo Hospitalario Universitario | Ferro T.,Lhospitalet Of Llobregat | Penuelas M.A.,Hospital Universitario Of La Vall Dhebron | And 4 more authors.
Clinical and Translational Oncology | Year: 2016

Purpose: The needs and concerns of patients with advanced breast cancer are changing at every phase of the care intervention. Management and coordination of hospital resources and services are also steadily evolving. The objective of the present expert report is to define a new oncology nursing role specialising in advanced breast cancer, to help guide patients throughout the whole healthcare itinerary. Methods: A group of eight experts in oncology nursing and medical oncology defined the content index of the curriculum document. A systematic review of bibliography was carried out, and the relevant contents were extracted. Based on these contents and the participants’ experience, recommendations were formulated and validated through a Delphi questionnaire and a participative meeting. Results: The advanced breast cancer clinical nurse (ABCCN) should develop a clinical, psychosocial role focused on coordinating patients in the healthcare network. The nurse would be in charge of evaluating and supervising the care administered and the healthcare resources used. The ABCCN should be aware and participate in the protocols and available resources, be able to solve conflicts, deal with burn-out signs and have clinical, coaching and team-working abilities. The proposed curriculum provides a specific process for the care of patients, as well as an implementation process. Conclusions: The ABCCN’s role is crucial to assume the best care and the optimisation of available resources. This review and consensus document provides the required tools for the implementation in hospitals. © 2016 The Author(s)


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.


PubMed | Hospital Universitario Of La Vall Dhebron
Type: Journal Article | Journal: Neurologia (Barcelona, Spain) | Year: 2013

In the current population, strokes are one of the most important causes of morbidity and mortality, to which new risk factors are increasingly being attributed. Of late, there is increased interest in the relationship between sleep disorders and strokes as regards risk and prognosis.This article presents the changes in sleep architecture and brain activity in stroke patients, as well as the interaction between stroke and sleep disorders, including those which may also influence the outcome and recovery from strokes. The different treatments discussed in the literature are also reviewed, as correct treatment of such sleep disorders may not only improve quality of life and reduce after-effects, but can also increase life expectancy.Sleep disorders are becoming increasingly associated with stroke. In addition to being a risk factor, they can also interfere in the outcome and recovery of stroke patients. This article aims to present an exhaustive and current review on strokes and their relationship with sleep alterations and sleep disorders.


PubMed | Hospital Universitario Of La Vall Dhebron
Type: Journal Article | Journal: Acta otorrinolaringologica espanola | Year: 2010

Ramsay Hunt syndrome (RHS) is a disease caused by the Varicella Zoster virus and characterised by skin rash, peripheral facial palsy and otologic symptoms.This was an epidemiological study on the incidence and prognosis of this syndrome.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.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.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.

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