Hospital Universitario Santa Lucia

Santa Lucía, Spain

Hospital Universitario Santa Lucia

Santa Lucía, Spain
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Gil-Ortega I.,Hospital Universitario Santa Lucia | Pedrote-Martinez A.,Hospital Universitario Virgen del Rocio | Fontenla-Cerezuela A.,Hospital Universitario 12 Of Octubre
Revista espanola de cardiologia (English ed.) | Year: 2015

INTRODUCTION AND OBJECTIVES: This report presents the findings of the 2014 Spanish Catheter Ablation Registry.METHODS: For data collection, each center was allowed to choose freely between 2 systems: retrospective, requiring the completion of a standardized questionnaire, and prospective, involving reporting to a central database.RESULTS: Data were collected from 85 centers. A total of 12 871 ablation procedures were performed, for a mean of 149.5±103 procedures per center. The ablation targets most frequently treated were atrioventricular nodal reentrant tachycardia (n=3026; 23.5%), cavotricuspid isthmus (n=2833; 22.0%), and atrial fibrillation (n=2498; 19.4%). The number of ablation procedures for ventricular arrhythmias was similar to that of 2013, but there was a slight increase in the treatment of all the ventricular substrates, especially those associated with idiopathic ventricular tachycardia and scarring following myocardial infarction. The overall success rate was 95%, the rate of major complications was 1.3%, and the mortality rate was 0.02%.CONCLUSIONS: The 2014 registry shows that the number of ablation procedures performed continued its upward trend and that, overall, the success rate was high and the number of complications low. Ablation of complex conditions continued to increase. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

De Miguel-Diez J.,Hospital General Universitario Gregorio Maranon | Jimenez-Garcia R.,Rey Juan Carlos University | Jimenez D.,Ramon y Cajal Hospital | Monreal M.,Hospital Universitari Germans Trias i Pujol | And 6 more authors.
European Respiratory Journal | Year: 2014

The aim of our study was to analyse changes in the incidence, diagnostic procedures, comorbidity, length of hospital stay, costs and in-hospital mortality of patients hospitalised for pulmonary embolism in Spain over a 10-year period. We included all patients who were hospitalised for pulmonary embolism (ICD-9-CM codes 415.11 and 415.19) as the primary diagnosis between 2002 and 2011. Data were collected from the National Hospital Discharge Database, covering the entire Spanish population. 115 671 patients were admitted. The overall crude incidence increased from 20.44 per 100 000 inhabitants in 2002 to 32.69 in 2011 (p,<.05). In 2002, 13.3% of patients had a Charlson comorbidity index .> 2, and in 2011 the prevalence increased to 20.8% (p, <.05). Mean length of hospital stay was 12.7 days in 2002 and decreased to 9.99 in 2011 (p, <.05). During the study period, mean cost per patient increased from ε3915 to ε4372 (p, <.05). In-hospital mortality decreased from 12.9% in 2002 to 8.32% in 2011 (p, <.05). The increase in the use of computed tomographic pulmonary angiography over time was associated with increased incidence and lower mortality. Our results revealed an increase in the incidence of hospitalised pulmonary embolism patients from 2002 to 2011 with concomitant increase in comorbidities and cost. However, length of hospital stay and inhospital mortality decreased. Copyright © 2014 ERS.

PubMed | Hospital Universitario Gregorio Maranon, Hospital Universitario Puerta del Mar, Hospital Clinico Universitario, Hospital Universitario Santa Lucia and 3 more.
Type: | Journal: Anales de pediatria (Barcelona, Spain : 2003) | Year: 2017

Hospital discharge criteria for the pre-term newborn are mainly based on physiological competences (thermoregulation, respiratory stability, and feeding skills), although family support and ability to care for the baby, as well as a well-planned discharge are also cornerstones to ensure a successful discharge. In this article, the Committee of Standards of the Spanish Society of Neonatology reviews the current hospital discharge criteria in order for it to be useful as a clinical guide in Spanish neonatal units.

Knorr J.,Toulouse University Hospital Center | Soldado F.,Autonomous University of Barcelona | Pham T.T.,Toulouse University Hospital Center | Torres A.,Hospital Universitario Santa Lucia | And 2 more authors.
Journal of Pediatric Orthopaedics | Year: 2014

BACKGROUND: Percutaneous techniques for the correction of foot deformities are gaining popularity in the adult population, but remain poorly explored in children. Of the several surgical techniques described to treat persistent severe metatarsus adductus (MA) deformity in children, neither was percutaneous. The purpose of the study was to describe a percutaneous technique for MA correction in children, to report the outcomes, and to discuss the advantages it offers. METHODS: We designed a prospective study on 34 consecutive feet with MA deformity from 26 children undergoing percutaneous correction. All operated feet had severe, rigid MA deformities, most of which were components of residual/recurrent clubfoot deformities. The mean age at surgery was 5.7 years and the mean follow-up was 55.2 months. For clinical evaluation, we used the bisector method; the first cuneometatarsal angle and metatarsal-metaphyseal angle measured in weight-bearing radiographs and AOFASf score were determined preoperatively and postoperatively. In unilateral cases, we used the contralateral foot measurements as control. The operating time and the hospitalization time were also recorded. The surgical technique consisted of performing the Cahuzac procedure for MA correction with a percutaneous approach. RESULTS: At the final follow-up all feet presented a normal heel bisector line. Radiologic parameters were normalized when compared with control feet. The mean surgical and hospitalization time was 14 minutes and 6 hours, respectively. Mean AOFAS score improved from 78 to 98. CONCLUSIONS: A minimally invasive percutaneous technique allowed a successful correction of MA deformity in children and resulted in a substantive decrease in both surgical and hospitalization time and better cosmetic results. LEVEL OF EVIDENCE: Level II. Copyright © 2013 by Lippincott Williams &Wilkins.

Fernandez-Fairen M.,Institute Cirugia Ortopedica Y Traumatologia Of Barcelona | Hernandez-Vaquero D.,Hospital Of San Agustin | Murcia A.,Hospital Of Cabuenes | Torres A.,Hospital Universitario Santa Lucia | Llopis R.,Hospital Universitario Santa Cristina
Clinical Orthopaedics and Related Research | Year: 2013

Background: Porous tantalum is an option of cementless fixation for TKA, but there is no randomized comparison with a cemented implant in a mid-term followup. Questions/purposes: We asked whether a tibial component fixed by a porous tantalum system might achieve (1) better clinical outcome as reflected by the Knee Society Score (KSS) and WOMAC Osteoarthritis Index, (2) fewer complications and reoperations, and (3) improved radiographic results with respect to aseptic loosening compared with a conventional cemented implant. Methods: We randomized 145 patients into two groups, either a porous tantalum cementless tibial component group (Group 1) or cemented conventional tibial component in posterior cruciate retaining TKA group (Group 2). Patients were evaluated preoperatively and 15 days, 6 months, and 5 years after surgery, using the KSS and the WOMAC index. Complications, reoperations, and radiographic failures were tallied. Results: At 5-year followup the KSS mean was 90.4 (range, 68-100; 95% CI, ± 1.6) for Group 1, and 86.5 (range, 56-99; 95% CI, ± 2.4) for Group 2. The effect size, at 95% CI for the difference between means, was 3.88 ± 2.87. The WOMAC mean was 15.1 (range, 0-51; 95% CI, ± 2.6) for the Group 1, and 19.1 (range, 4-61; 95% CI, ± 2.9) for Group 2. The effect size for WOMAC was -4.0 ± 3.9. There were no differences in the frequency of complications or in aseptic loosening between the two groups. Conclusions: Our data suggest there are small differences between the uncemented porous tantalum tibial component and the conventional cemented tibial component. It currently is undetermined whether the differences outweigh the cost of the implant and the results of their long-term performance. Level of Evidence: Level I, therapeutic study. See Instructions to Authors for a complete description of levels of evidence. © 2013 The Association of Bone and Joint Surgeons®.

Villar-Puchades R.,Hospital Universitario Santa Lucia | Sanchez de las Matas M.J.,Hospital Universitario Santa Lucia
Oral Surgery | Year: 2014

We describe a 62-year-old male patient with an extensively ossified venous malformation within the mylohyoid muscle. Phleboliths and calcifications are characteristic of venous malformations, while massive ossification is rare. To our knowledge, no extensive ossified venous malformation within the mylohyoid muscle has been reported. Intramuscular vascular lesions occur with an incidence of 0.8 in 10, occurring in the head and neck region in 15% of cases. Most are venous malformations. The diagnosis is rarely made before surgery and requires a definitive histological analysis, as there are no pathognomonic clinical or radiographic findings, especially with extensive ossification. Spontaneous regression does not occur, and treatment must be based on aesthetic and functional disturbances. We reviewed the classification of vascular anomalies, focusing on differentiating between venous malformations and haemangiomas, which are frequently confused in the literature. © 2013 John Wiley & Sons A/S.

Villar-Puchades R.,Hospital Universitario Santa Lucia | Ramos-Medina B.,Hospital Universitario Santa Lucia
Aesthetic Plastic Surgery | Year: 2014

Abstract: The reconstruction of extensive mandibular defects is a challenge for which virtual surgical planning is extremely helpful. This report describes the case of a 33-year-old woman who experienced the gradual development of a severe mandibular deformity with elongation of the chin and mandibular border because of fibrous dysplasia. Consequently, 19 cm of the mandible extending from the neck of the condyle to the contralateral body was resected together with vestibular and lingual deformities. This bone was replaced with a fibula-free flap. For planning, a virtual resection was performed via a Web conference, followed by virtual reconstruction by superimposition of the fibula on the mandibular defect after the creation of three osteotomies. A stereolithographic model of the reconstructed mandible and cutting guides for the mandibular resection and fibula osteotomies were made. The stereolithographic model of the neo-mandible allowed prebending of a reconstruction plate before the surgery because the deformity did not allow this to be performed intraoperatively. The cutting guides shortened the operating time and enabled accurate reproduction of the virtual plan with exact bone-to-bone contact in the reconstructed mandible. Surgical virtual planning, despite its upfront cost, is a time-saving procedure, which is especially important in complex reconstruction cases, and eliminates the variability of surgical expertise for flap in-setting.Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors © 2014, Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery.

Fernandez-Fairen M.,Institute Cirugia Ortopedica Y Traumatologia Of Barcelona | Murcia A.,Hospital Of Cabuenes | Torres A.,Hospital Universitario Santa Lucia | Hernandez-Vaquero D.,Hospital Of San Agustin | Menzie A.M.,Zimmer Inc.
Spine | Year: 2012

STUDY DESIGN: Retrospective cost-effectiveness analysis. OBJECTIVE: To determine the relative cost-effectiveness of anterior cervical discectomy with fusion (ACDF) using a porous tantalum implant compared with autograft with plating, for single-level cervical disc disease with radiculopathy. SUMMARY OF BACKGROUND DATA: ACDF with autograft as an interbody spacer is a generally accepted method to treat degenerated cervical discs with radiculopathy. Concerns about donor site morbidity and the structural characteristics of autograft stimulated investigations of alternative materials. Techniques may differ in their operative risks, complications, outcomes, and resource use. METHODS: A retrospective review of clinical outcomes and total cost of illness for 5 years postsurgery was performed for 61 consecutive patients enrolled for this study. Twenty-eight patients were treated with single-level ACDF using either a stand-alone, porous tantalum implant, without graft inside the implant, and 33 patients received autograft and plating. A cost-effectiveness analysis comparing the 2 ACDF treatment methods was conducted. This article reports clinical assessments, quality adjusted life years gained, and an incremental cost-effectiveness ratio analysis. RESULTS: Patients in both cohorts reported improved clinical outcomes, including neck disability index, visual analogue scale, Short-Form 36, Odom's clinical assessment, and patient satisfaction at 5 years postindex surgery. The mean cost of illness for the study period, including preoperative through 5 years postoperative assessments, was 6806 &OV0556; per patient treated with tantalum and 10,143 &OV0556; per patient receiving autograft and plate. Quality-adjusted life years (QALY) gained were 9.41 and 7.14 for the tantalum and control cohorts, respectively. The cost per QALY for the tantalum group was 723 &OV0556; and 1420 &OV0556; for the control group. The incremental cost-effectiveness ratio of ACDF with a porous tantalum implant compared with ACDF with autograft and plate was -1473 &OV0556; per patient per year for the duration of this study. CONCLUSION: This cost-effectiveness analysis reports favorable results for ACDF procedures utilizing a tantalum implant. The data reported suggest that using porous tantalum as a stand-alone device is less costly and more effective than autograft and plate in ACDF procedures. © 2012, Lippincott Williams & Wilkins.

Ramos R.,Fresenius Medical Care | Molina M.,Hospital Universitario Santa Lucia
Nefrologia | Year: 2013

Chronic kidney disease (CKD) associated to an increase of cardiovascular morbidity and mortality in these patients is becoming a worldwide major public health problem that is rapidly approaching epidemic proportions. Early detection and prevention may have an impact in both, slowing the progression of CKD and reducing the cardiovascular morbi-mortality. CKD prevention programs can be more cost efficient over time without negative impact in quality of care. Until now, reimbursement in CKD has been segmented and usually focused on the end of the process (dialysis) when cost is higher, therefore new models focused on provider integration, while balancing quality and costs, are needed to respond to today's challenges. Traditionally "pay for services" has been used in dialysis concerted centers but this model has the risk of inducting to increase the demand. Integral management would respond to this challenge with integrated solutions that will manage renal disease at all levels of healthcare risk. It is based in a comprehensive model that typically includes several products and services and, usually, the renal drugs inclusion. The rate of reimbursement directly depends on the achievement of quality control parameters previously defined. The third model is based in a "capitation" that consists when the provider receive a set amount per population for a particular time regardless of the volume of services provided. The complexity and the progressive stage of CKD along with the associated morbidity in these patients force us to consider a global approach rather as a sum of different services. In our opinion, the first method of reimbursement in CKD that should be regarded is a bundle rate and when this model has been consolidated, tending toward a global capitation model. © 2013 Revista Nefrología. Órgano Oficial de la Sociedad Española de Nefrología.

Mata Colodro F.,Hospital Universitario Santa Lucia | Serna Berna A.,Hospital Universitario Santa Lucia | Puchades Puchades V.,Hospital Universitario Santa Lucia
Physica Medica | Year: 2013

A redundant independent dosimetric calculation (RIDC) prior to treatment has become a basic part of the QA process for 3D conventional radiotherapy, and is strongly recommended in several international publications. On the other hand, the rapid growth in the number of intensity modulated treatments has led to a significant increase in the workflow associated with QA treatments. Diamond (" K&S Associates") is RIDC software which is capable of calculating VMAT (Volumetric Modulated Arc Therapy) fields. Modeling, validation and commissioning are necessary steps thereby making it a useful tool for VMAT QA. In this paper, a procedure for the validation of the calculation algorithm is demonstrated. A set 3D conventional field was verified in two ways: firstly, a comparison was made between Diamond calculations and experimental measures obtaining an average deviation of -0.1 ± 0.7%(1SD), and secondly, a comparison made between Diamond and the treatment planning system (TPS) Eclipse, obtaining an average deviation of 0.4 ± 0.8%(1SD). For both steps, a plastic slab phantom was used. VMAT validation was carried out by analyzing 59 VMAT plans in two ways: first, Diamond calculation versus experimental measurement with an average deviation of -0.2 ± 1.7%(1SD), and second, Diamond calculation versus TPS calculation with an average deviation of 0.0 ± 1.6%(1SD). In this phase a homogeneous cylindrical phantom was used. These results led us to consider this calculation algorithm validated for use in VMAT verifications. © 2012 Associazione Italiana di Fisica Medica.

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