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Darin M.C.,British Hospital of Buenos Aires | Gomez-Hidalgo N.R.,Universitary Hospital of Mostoles | Westin S.N.,University of Houston | Soliman P.T.,University of Houston | And 3 more authors.
Journal of Minimally Invasive Gynecology

Sentinel lymph node biopsy has proven safe and feasible in a number of gynecologic cancers such as vulvar cancer, cervical cancer, and endometrial cancer. The proposed aim of lymphatic mapping and sentinel node identification is to decrease the associated morbidity of a complete lymphadenectomy, particularly the rate of lymphedema, while also increasing the detection of small tumor deposits in the node. Different tracers have been shown to be useful, including technetium-99 and blue dye, with a detection reported in 66% to 86%. Recently, there has been increasing interest in the use of fluorescent dies such as indocyanine green (ICG). In this report we provide a review of the existing literature regarding the use of ICG in cervical or endometrial cancer with the goal to provide details on its utility and compare it with other tracers. © 2016 AAGL. Source

Varela M.,Universitary Hospital of Mostoles | Ruiz-Esteban R.,Universitary Hospital of Mostoles | Martinez-Nicolas A.,University of Murcia | Cuervo-Arango J.A.,Universitary Hospital of Mostoles | And 2 more authors.
International Journal of Clinical Practice

Objective: To study if a 24-h continuous monitoring of temperature reveals information not accessible through conventional care. This included omitted fever peaks and circadian and complexity characteristics that may correlate with specific aetiologies. Design: Ours was a prospective, observational study. A total of 62 patients, admitted to a general internal medicine ward, in whom a temperature > 38 °C had been observed the day before inclusion underwent a 24-h long continuous monitoring of both central and peripheral temperatures. The time series were recorded in a file, while they otherwise followed conventional care. Time series were analysed for standard statistics, chronobiological analysis (amplitude, mesor, acrophase, intra-daily variability) and complexity analysis (Approximate Entropy of both central and peripheral temperature, cross-ApEn). A month after discharge, the clinical reports were reviewed and a definitive diagnosis of the febrile syndrome was established. Results: A total of 62 patients were initially included. In six cases, no time series could be obtained because of technical problems, leaving 56 patients accessible for analysis. In 10 cases, no definitive diagnosis was established. Continuous monitoring detected a mean of 0.7 (CI = 0.27-1.33) peaks of fever (central temperature > 38.0 °C) unobserved by conventional care per patient. A proportion of 16% (CI = 6-26) of patients considered afebrile by conventional care had at least one fever peak detected by continuous monitoring. Circadian rhythm persisted or was exacerbated in febrile patients. Circadian amplitude was increased in patients with tuberculosis. Complexity analysis did not differ among different diagnostic groups, although in subgroup analysis, viral infections had a higher complexity than other infectious diseases. Conclusions: Temperature Holter monitoring reveals fever peaks that pass otherwise unobserved. Furthermore, chronobiological and complexity analysis of the temperature profile may provide quick and easy 'hidden information', not available to conventional care. © 2011 Blackwell Publishing Ltd. Source

Ruiz-Esteban R.,Universitary Hospital of Mostoles | Sarabia P.R.,Universitary Hospital of Mostoles | Delgado E.G.,Universitary Hospital of Mostoles | Aguado C.B.,Universitary Hospital of Mostoles | And 2 more authors.
Clinical Biochemistry

Objective: We study the extent to which procalcitonin (Pro-CT) and/or C-reactive protein (CRP) may be helpful in the early triage of febrile patients admitted to a general internal medicine ward.Methods: This is a prospective, observational study on 62 admitted patients in whom a temperature >38°C had been observed the day before inclusion.Results: Neither Pro-CT nor CRP was able to discriminate infectious (or bacterial) diseases from the other etiologies as a group, with an area under the ROC curve of 0.63 (95% CI 0.47-0.79, p= 0.15) for Pro-CT and 0.61, (95CI 0.44-0.78, p= 0.23) for CRP.Sensitivity and specificity for Pro-CT varied between 0.59 and 0.67 for a cut-off point of 0.2. ng/mL and 0.03 and 1 for a cut-off point of 10.0. ng/mL.However, in subgroup analysis, Pro-CT was able to discriminate between infectious and inflammatory diseases (Welch two sample t-test t= 2.39, df= 44.3, p= 0.021). © 2011 The Canadian Society of Clinical Chemists. Source

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