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Canary Islands, Spain

Plasencia W.,Hospiten Group | Gonzalez-Davila E.,University of La Laguna | Gonzalez Lorenzo A.,University of La Laguna | Armas-Gonzalez M.,University of La Laguna | And 2 more authors.
Prenatal Diagnosis | Year: 2015

Objective: To analyze placental volume and vascularization at first trimester in women with pre-eclampsia, and secondarily, the effect of maternal characteristics on placental development and perinatal outcomes. Methods: This was a prospective cohort study including women seen between 11 and 14weeks of pregnancy. Biophysical and biochemical markers included in the screening program for aneuploidy were recorded. Placental volume and vascularization indices were obtained using three-dimensional power-Doppler imaging and Virtual Organ Computer-aided Analysis (VOCAL) techniques. Results: We compared 84 women with pre-eclampsia versus 904 non-affected. Placental volume and all vascular indices were lower in those with pre-eclampsia. Multivariate analysis showed that parity and maternal weight had a significant effect on placental volume and vascularization indices (p=0.004 and p=0.011). In women with pre-eclampsia, multiparity showed a negative effect on placental volume, gestational age, birth weight and Apgar test score. By contrast, in the non-affected group, multiparity had a protective effect. Low maternal weight had a significantly worse effect on placental vascularization and perinatal outcomes in women with pre-eclampsia. Conclusions: Women with pre-eclampsia showed significantly lower placental volume and vascularization indices at first trimester. Multiparity and low maternal weight independently exacerbated the negative effects of pre-eclampsia on placental characteristics and perinatal outcomes. © 2015 John Wiley & Sons, Ltd. Source

Aragon-Sanchez J.,La Paloma Hospital | Hernandez-Herrero M.J.,La Paloma Hospital | Lazaro-Martinez J.L.,Complutense University of Madrid | Quintana-Marrero Y.,La Paloma Hospital | And 7 more authors.
International Journal of Lower Extremity Wounds | Year: 2010

The purpose of this study was to analyze the outcomes of major lower extremity amputations (MLEAs) in a series, including diabetic patients, with the aim to study whether diabetes mellitus is a risk factor of in-hospital mortality and perioperative complications. A retrospective analysis of 283 MLEAs (221 of these patients were diabetic and 62 were nondiabetic) performed between January 1, 1998, and December 31, 2008, at the General Surgery Department and Diabetic Foot Unit of La Paloma Hospital in Las Palmas de Gran Canaria (Canary Islands) was done. The significant risk factors of mortality were >75 years of age (odds ratio [OR] = 4.1, 95% confidence interval [CI] = 1.4-11.7), postoperative cardiac complications (OR = 12.3, 95% CI = 3.7-40.2) and postoperative respiratory complications (OR = 3.8, 95% CI = 1.0-13.3). No statistically significant risk factors were found related to the presence of systemic and wound-related complications. In diabetic patients, the significant risk factors of mortality were postoperative cardiological complications (OR = 13.6, 95% CI = 3.1-59.6), postoperative respiratory complications (OR = 5.9, 95% CI = 1.0-35.5), and first episode of amputation (OR = 5.9, 95% CI = 1.4-24.3). There were no statistically significant differences in the outcome of major amputations between diabetic and nondiabetic patients. Hospital stay was significantly longer in diabetic patients (P < .01) though when the patients with diabetic foot infections were excluded, this difference was not found. © SAGE Publications 2010. Source

Aragon-Sanchez J.,Diabetic Foot Unit | Maynar-Moliner M.,Diabetic Foot Unit | Maynar-Moliner M.,Hospiten Group | Maynar-Moliner M.,University of Las Palmas de Gran Canaria | And 6 more authors.
Diabetic Medicine | Year: 2011

Aims To analyse the outcome of the proactive management of patients with diabetes, critical limb ischaemia and foot ulcers using percutaneous transluminal angioplasty as the only vascular procedure and adjuvant conservative surgery when indicated. Methods A retrospective study of patients with diabetes included in our database who sought a second opinion in our unit and met the following criteria: foot ulcer and critical limb ischaemia in patients for whom any proactive vascular treatment had not previously been considered by other teams. Results Twenty patients underwent endovascular procedures. Success was achieved in 19 cases (95%). No post-operative mortality (within 30days after the procedure) was found. Additional surgery was required in eight cases (40%): one calcaneal ostectomy and seven minor amputations. The need for surgery was associated with infection (P<0.01). Limb salvage was sustained during a mean period of follow-up of 642days (sd 488) in 19 cases (95%). Healing was achieved in 14 cases (70%), four are still healing (20%), one underwent major amputation (5%) and the last one died before being healed (5%). Three patients died during follow-up (15%). Conclusions Management of patients with diabetes, foot ulcers and critical limb ischaemia by means of a proactive approach including endovascular procedures in specialized settings provides a high rate of limb salvage. This may result in lowering the number of lower limb amputations in our community. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK. Source

Rabellino M.,Hospiten Group | Aragon-Sanchez J.,Diabetic Foot Unit | Gonzalez G.,Hospiten Group | Zander T.,Hospiten Group | And 6 more authors.
Diabetes Research and Clinical Practice | Year: 2010

To present the outcomes of endovascular treatment of diabetics patients with critical limb ischemia who have end-stage renal disease. Limb-salvage was achieved in 58.6% of the limbs during a mean follow-up period of 12.4 months. No major amputations were required on patients with rest pain or with grade 1 lesions. © 2010 Elsevier Ireland Ltd. Source

Rabellino M.,Servicio de Angiografia Digital y Terapia Endovascular | Rabellino M.,Hospiten Group | Zander T.,Hospiten Group | Gonzalez G.,Hospiten Group | And 3 more authors.
Neurologia Argentina | Year: 2014

Mechanical thrombectomy has gained significant importance in the treatment of thromboembolic etiology of acute stroke. The acceptance of this technique is related to the rapid restoration of flow and high rate of recanalization. Especially in large lesions where intravenous thrombolysis has a low rate of recanalization and intra-arterial thrombolysis is associated with a high rate of bleeding complications. We present two cases of stent mechanical thrombectomy Solitaire AB, which was obtained technical and clinical success with no complications related to the procedure. © 2011 Sociedad Neurológica Argentina. Published by Elsevier España, S.L. All rights reserved. Source

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