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Hospital de Órbigo, Spain

Almeida A.M.,Instituto Portugues Of Oncologia Francisco Gentil | Ramos F.,Hospital Universitario Of Leon
Leukemia Research Reports | Year: 2016

AML is an aggressive hematological malignancy with highest incidence in the older adults. The adverse features of AML in the elderly, and the frailties and comorbidities frequently present in them, make their management a particularly difficult therapeutic challenge. In this context, it is important to assess carefully patient- as well as disease-associated prognostic features with validated tools. The fittest patients should be considered for curative therapy, such as bone marrow transplantation, whereas low intensity options may be more appropriate for frail patients. Here we review how to assess patients with elderly AML and the treatments options available for them. © 2016 The Authors. Source


Cordero-Coma M.,Hospital Universitario Of Leon
Ocular immunology and inflammation | Year: 2013

To establish evidence-based recommendations regarding the use of anti-Tumor Necrosis Factor alpha (TNF-α) agents for managing uveitis patients. Medline was searched via OVID (1950 - October Week 3, 2011) using a Cochrane highly sensitive search (phases 1 and 2). Additional literature searches were also conducted incuding the following databases: the Cochrane, LILACS and the TRIP Database. A total of 54 studies met all of the inclusion criteria and were included in this review. A different level of recommendation and evidence is assigned to each anti-TNF-α agent. The overall rate of reported side effects with anti-TNF-α agents for the treatment of uvetis which required discontinuation of therapy was 2.2% (26/1147 patients). Based on the evidence gathered, infliximab and adalimumab seem to be effective in the management of immune-mediated uveitis. Further randomized studies evaluating the efficacy of these agents are warranted. It is the most common cause of inflammatory eye disease, with an estimated prevalence of 115 cases per 100,000 persons. Endogenous or associated with a systemic disease, noninfectious uveitis accounts for approximately 75% of total cases comprising of a heterogeneous group of inflammatory conditions responsible for about 10% of legal blindness in developed nations. Endogenous uveitides are thought to have an autoimmune component mediated by T lymphocytes specific to intraocular antigens that have failed to successfully pass basic processes designed to maintain self-tolerance. Source


Cordero-Coma M.,Hospital Universitario Of Leon | Yilmaz T.,Harvard University | Onal S.,V Foundation
Ocular Immunology and Inflammation | Year: 2013

Purpose: To establish evidence-based recommendations regarding the use of anti-Tumor Necrosis Factor alpha (TNF-α) agents for managing uveitis patients. Methods: Medline was searched via OVID (1950-October Week 3, 2011) using a Cochrane highly sensitive search (phases 1 and 2). Additional literature searches were also conducted incuding the following databases: the Cochrane, LILACS and the TRIP Database. Results: A total of 54 studies met all of the inclusion criteria and were included in this review. A different level of recommendation and evidence is assigned to each anti-TNF-α agent. The overall rate of reported side effects with anti-TNF-α agents for the treatment of uvetis which required discontinuation of therapy was 2.2% (26/1147 patients). Conclusion: Based on the evidence gathered, infliximab and adalimumab seem to be effective in the management of immune-mediated uveitis. Further randomized studies evaluating the efficacy of these agents are warranted. It is the most common cause of inflammatory eye disease, with an estimated prevalence of 115 cases per 100,000 persons.1 Endogenous or associated with a systemic disease, noninfectious uveitis accounts for approximately 75% of total cases comprising of a heterogeneous group of inflammatory conditions responsible for about 10% of legal blindness in developed nations.1,2 Endogenous uveitides are thought to have an autoimmune component mediated by T lymphocytes specific to intraocular antigens that have failed to successfully pass basic processes designed to maintain self-tolerance. © 2013 Informa Healthcare USA, Inc. Source


Santos Sanchez J.A.,Hospital Universitario Of Salamanca | Ramos Pascua L.R.,Hospital Universitario Of Leon | Garcia Casado D.,Hospital Universitario Of Salamanca | Bermudez Lopez C.,Hospital Universitario Of Salamanca
Semergen | Year: 2012

Calcification in the soft tissue next to the medial femoral condyle after a history of trauma around the knee is a recognized radiographic finding-PS (Pellegrini-Stieda) sign. When this is associated with pain and a restricted range of motion it is known as the PS syndrome. We describe two cases of PS syndrome, treated conservatively with rest and physiotherapy, as well as the radiographic and ultrasound findings, and the many theories proposed in attempts to explain the pathogenesis of PS disease. © 2011 Elsevier España, S.L. y SEMERGEN. Source


Santamarta D.,University of Leon | Santamarta D.,Hospital Universitario Of Leon | Abasolo D.,University of Surrey | Martinez-Madrigal M.,University of Leon | Hornero R.,University of Valladolid
Acta Neurochirurgica | Year: 2012

Objective In the present study an attempt was made to quantify and characterise the changes in the intracranial pressure (ICP) waveform over the wide pressure range covered during infusion studies by means of the central tendency measure (CTM). CTM is a non-linear approach using continuous chaotic modelling that summarises the degree of variability in a signal. Methods CTM of the ICP wave in the lumbar subarachnoid space was analysed in 77 infusion studies performed in patients with idiopathic and secondary forms of normal pressure hydrocephalus (median age 74 years, range 22- 88). Four artefact-free epochs were selected during the baseline, infusion, plateau and relaxation stages of every infusion study. The average pressure, pulse amplitude and CTM were determined for each epoch. Correlations among these parameters were explored. Results CTM of the ICP waveform decreases, i.e. variability increases, as infusion studies progress from baseline pressure to the plateau stage. Significant correlations were found during all phases of infusion testing, except at baseline, between CTM and pressure, CTM and amplitude and pressure and amplitude. Partial correlations emphasised the relationship between CTM and amplitude. When pulse amplitude is held constant, CTM and the pressure range do not correlate. Conclusions Volume loading leads to increased variability of the ICP signal measured by means of CTM. This finding summarises numerically the long-established phenomenon of increasing amplitude and rounding of ICP pulses associated with ICP elevation during infusion studies. CTM could be a suitable approach to quantify and characterise the pulsatile nature of the ICP wave. © Springer-Verlag 2012. Source

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