Albacete University Hospital Complex

Albacete, Spain

Albacete University Hospital Complex

Albacete, Spain
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In some patients, acute respiratory distress syndrome (ARDS) leads to life-threatening refractory hypoxemia developing. Physicians may consider hypoxemic rescue therapies in an attempt to improve oxygenation in these patients while on conventional mechanical ventilation support. Use of inhaled nitric oxide (iNO) in ARDS is one of the most widely-studied pharmacological interventions over the past two decades. Its efficacy was examined in several randomized clinical trials and has undergone meta-analyses. Although iNO treatment was associated with improved oxygenation, researchers unfortunately never demonstrated a concomitant decrease in mortality or any improved outcome. Hence the current evidence suggests that iNO should not be routinely used in patients with ARDS however may be considered as adjunct therapy to tentatively improve oxygenation while other therapies are being considered in patients with severely hypoxemic ARDS. This review focuses on the therapeutic use of iNO in adult ARDS patients. We set out some recommendations for its use as rescue therapy against refractory hypoxemia.


Curras-Freixes M.,Hereditary Endocrine Cancer Group | Pineiro-Yanez E.,Translational Bioinformatics Unit | Montero-Conde C.,Hereditary Endocrine Cancer Group | Apellaniz-Ruiz M.,Hereditary Endocrine Cancer Group | And 46 more authors.
Journal of Molecular Diagnostics | Year: 2017

Genetic diagnosis is recommended for all pheochromocytoma and paraganglioma (PPGL) cases, as driver mutations are identified in approximately 80% of the cases. As the list of related genes expands, genetic diagnosis becomes more time-consuming, and targeted next-generation sequencing (NGS) has emerged as a cost-effective tool. This study aimed to optimize targeted NGS in PPGL genetic diagnostics. A workflow based on two customized targeted NGS assays was validated to study the 18 main PPGL genes in germline and frozen tumor DNA, with one of them specifically directed toward formalin-fixed paraffin-embedded tissue. The series involved 453 unrelated PPGL patients, of whom 30 had known mutations and were used as controls. Partial screening using Sanger had been performed in 275 patients. NGS results were complemented with the study of gross deletions. NGS assay showed a sensitivity ≥99.4%, regardless of DNA source. We identified 45 variants of unknown significance and 89 pathogenic mutations, the latter being germline in 29 (7.2%) and somatic in 58 (31.7%) of the 183 tumors studied. In 37 patients previously studied by Sanger sequencing, the causal mutation could be identified. We demonstrated that both assays are an efficient and accurate alternative to conventional sequencing. Their application facilitates the study of minor PPGL genes, and enables genetic diagnoses in patients with incongruent or missing clinical data, who would otherwise be missed. © 2017 American Society for Investigative Pathology and the Association for Molecular Pathology


Garcia de Marcos J.A.,Albacete University Hospital Complex
Journal of oral science | Year: 2010

Peripheral ossifying fibroma (POF) is a lesion of the gingival tissues that predominantly affects women and is usually located in the maxilla anterior to the molars. The definitive diagnosis is established by histological examination, which reveals the presence of cellular connective tissue with focal calcifications. Surgery is the treatment of choice, though the recurrence rate can reach 20%. We present a clinical and histological review - including a detailed immunohistochemical analysis - of four cases of POF diagnosed and treated at our hospital. All four patients were women, and two were pregnant. The immunohistochemical study revealed that the proliferating cells showed myofibroblastic characteristics and did not express estrogen or progesterone receptors. The lesions showed clinically benign behavior. Our results indicate that POF should be considered as a myofibroblastic proliferation, and although the clinical characteristics suggest hormonal influence, we were unable to demonstrate the expression of hormone receptors in the proliferating cellular component.


PubMed | Albacete University Hospital Complex
Type: Case Reports | Journal: Journal of oral science | Year: 2010

Peripheral ossifying fibroma (POF) is a lesion of the gingival tissues that predominantly affects women and is usually located in the maxilla anterior to the molars. The definitive diagnosis is established by histological examination, which reveals the presence of cellular connective tissue with focal calcifications. Surgery is the treatment of choice, though the recurrence rate can reach 20%. We present a clinical and histological review - including a detailed immunohistochemical analysis - of four cases of POF diagnosed and treated at our hospital. All four patients were women, and two were pregnant. The immunohistochemical study revealed that the proliferating cells showed myofibroblastic characteristics and did not express estrogen or progesterone receptors. The lesions showed clinically benign behavior. Our results indicate that POF should be considered as a myofibroblastic proliferation, and although the clinical characteristics suggest hormonal influence, we were unable to demonstrate the expression of hormone receptors in the proliferating cellular component.


PubMed | Albacete University Hospital Complex
Type: Case Reports | Journal: Oral and maxillofacial surgery | Year: 2010

Basal cell nevus syndrome (BCNS), also known as Gorlin-Goltz syndrome, comprises five main pathological features: nevoid basal cell carcinomas, keratocystic odontogenic tumors, congenital skeletal anomalies, calcification of the falx cerebri, and point skin depressions on the palms and/or soles. The disease exhibits a dominant autosomal hereditary trait, with implication of the human homologue of the Drosophila segment polarity Patched (PTCH) gene. BCNS is diagnosed on the basis of clinical and radiological criteria and can be confirmed by genetic study. The patient prognosis is very good, with normal life expectancy in most cases.The present study reports two cases of BCNS with the presence of maxillo-mandibular keratocystic odontogenic tumors.One case was diagnosed according to clinical criteria, while the other required genetic confirmation that revealed a germ line mutation in exon 17 (c.2868delC), not previously described in the databases, which was considered to be responsible for the disease.

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