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Novais A.,University of Porto | Pires J.,University of Porto | Ferreira H.,University of Porto | Costa L.,University of Porto | And 5 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2012

The characterization of a broad representative sample of ST131 Escherichia coli isolates from different origins and settings (1991 to 2010) revealed that this clonal group has likely diversified recently and that the expansion of particular variants has probably been favored by the capture of diverse, multidrug-resistant IncFII plasmids (pC15-1a, pEK499, pKF3-140-like). The low ability to adhere and to grow as biofilm that was detected in this study suggests unknown mechanisms for the persistence of this clonal group which need to be further explored. Copyright © 2012, American Society for Microbiology. All Rights Reserved. Source

An otherwise healthy 63-year-old man who had undergone emergency laparoscopic cholecystectomy for acute calculous cholecystitis 6 weeks earlier developed daily fever for more than 3 weeks, malaise, weight loss, and elevated erythrocyte sedimentation rate. Initial imaging procedures (abdominal ultrasound and chest radiograph) were normal. The diagnosis of fever of unknown origin was established, and a whole-body FDG PET/CT scan was performed. PET/CT showed inflammatory changes corresponding to spilled intraperitoneal gallstones. We have described the PET/CT findings of spilled intraperitoneal gallstones, a relatively common complication of laparoscopic cholecystectomy. © 2012 Lippincott Williams & Wilkins, Inc. Source

Rios A.M.,Lifecenter Hospital | Rosenberg Z.S.,New York University | Bencardino J.T.,New York University | Rodrigo S.P.,Hospital Universitario Ramon jal | Theran S.G.,Hospital Universitario Mayor
American Journal of Roentgenology | Year: 2011

OBJECTIVE. Many disorders produce similar or overlapping patterns of bone marrow edema in the ankle. Bone marrow edema may present in a few hindfoot bones simultaneously or in a single bone. The purpose of this pictorial essay is to provide guidelines based on clinical history and specific MRI patterns and locations to accurately identify the cause of ankle bone marrow edema. We will first focus on bone marrow edema in general disease categories involving multiple bones, such as reactive processes, trauma, neuroarthropathy, and arthritides. A discussion of bone marrow edema in individual bones of the ankle and hindfoot including the tibia, fibula, talus, and calcaneus will follow. Helpful hints for arriving at the correct diagnosis will be provided in each section. CONCLUSION. After review of this article, radiologists should be able to use their knowledge of clinical history and specific MRI patterns and locations to accurately distinguish between the various causes of bone marrow edema in the ankle and hindfoot. © American Roentgen Ray Society. Source

Alonso-Gordoa T.,Ramon jal University Hospital | Diez J.J.,Ramon jal University Hospital | Duran M.,Rey Juan Carlos University | Grande E.,Hospital Universitario Ramon jal
Therapeutic Advances in Medical Oncology | Year: 2015

Advanced thyroid carcinoma is an infrequent tumor entity with limited treatment possibilities until recently. The extraordinary improvement in the comprehension of genetic and molecular alterations involving the RAS/RAF/mitogen-activated protein kinase and phosphatidylinositide 3-kinase/Akt/mammalian target of rapamycin signaling and interacting pathways that are involved in tumor survival, proliferation, differentiation, motility and angiogenesis have been the rationale for the development of new effective targeted therapies. Data coming from phase II clinical trials have confirmed the efficacy of those targeted agents against receptors in cell membrane and cytoplasmic molecules. Moreover, four of those investigational drugs, vandetanib, cabozantinib, sorafenib and lenvatinib, have reached a phase III clinical trial with favorable results in progression-free survival and overall survival in medullary thyroid carcinoma and differentiated thyroid carcinoma. Further analysis for an optimal approach has been conducted according to mutational profile and tumor subtypes. However, consistent results are still awaited and the research for adequate prognostic and predictive biomarkers is ongoing. The following report offers a comprehensive review from the rationale to the basis of targeted agents in the treatment of thyroid carcinoma. In addition, current and future therapeutic developments by the inhibition of further molecular targets are discussed in this setting. © The Author(s), 2014. Source

Mateos-Nozal J.,Hospital Universitario Ramon jal | Cruz-Jentoft A.J.,Hospital Universitario Ramon jal | Ribera Casado J.M.,Complutense University of Madrid
European Geriatric Medicine | Year: 2014

Background: Due to population aging, different international organizations recommend that all medical students should receive training in geriatric knowledge and skills. Methods: A systematic review of national and international surveys on the provision of geriatric education to undergraduate medical students was done for articles published from 2000 to July 2013. The analysis included all studies on the presence and characteristics of geriatric teaching in medical schools. Eighteen surveys were identified: 13 in single countries, 3 European-wide, 1 in two countries, and 1 global. Results: Most surveys were based on the answers of geriatricians and academic staff. Average answer rate was 83%. Forty-one percent of the countries report some geriatric contents in the curricula of their medical schools. Mean national prevalence of geriatric teaching was 81% of medical schools (range 15 to 100%, with wide differences between aged and aging countries); courses were mandatory in only 62%. The main topics taught are geriatric syndromes and geriatric assessment. Between 21% and 65% of the persons responsible for this teaching are geriatricians. An increase in the number of geriatric departments has been observed in Europe and in the USA. Human and financial resources are the main limitations to the inclusion of Geriatrics in the curricula. Conclusion: Geriatric training has been evaluated mainly in North American and European countries. Geriatric contents in the medical curricula, academic structures and qualified teachers are not systematically available in most countries. In a rapidly ageing world, many physicians are not receiving formal education on geriatrics at medical schools. © 2014 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved. Source

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