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Pamplona, Spain

Puga Gonzalez B.,University of Zaragoza | Ferrandez Longas A.,University of Zaragoza | Oyarzabal M.,Hospital Virgen del Camino | Nosas R.,Hospital Parc Tauli
Pediatric Endocrinology Reviews

Traditionally, it has been assumed that intellectual development in children with growth hormone deficiency (GHD) is distributed between the ranges of a normal population based on the observation that it does not differ substantially from that of children of the same age. Nevertheless, few studies have investigated this assumption. This Spanish collaborative study was prospectively planned with two main purposes: to study a possible influence of GHD on intelligence quotient (IQ), personality traits and adaptative capacity and to study the evolution of these parameters during substitution therapy with growth hormone (GH). Although the overall intellectual ability of children with GHD is comparable to that of a normal reference population, some areas such as the motor-component scale (evaluated by McCarthy test) and performance IQ (evaluated by WISC-R) were below the mean at the beginning of the study, showing significant improvement during therapy. Emotional adjustment (normal at study start) also improved significantly during treatment. Females showed better adjustment capacity before and during GH therapy. Longer studies with an increased number of cases are needed to confirm these effects of GHD and its treatment in children. Source

Martinon-Torres F.,Hospital Clinico Universitario Of Santiago | Gimenez-Sanchez F.,Complejo Hospitalario Torrecardenas | Bernaola-Iturbe E.,Hospital Virgen del Camino | Diez-Domingo J.,Centro Superior Of Investigacion En Salud Publica Csisp | And 3 more authors.

Neisseria meningitidis serogroup B (MnB) is a major cause of invasive meningococcal disease in infants. A conserved, surface-exposed lipoprotein, LP2086 (a factor H-binding protein [fHBP]), is a promising MnB vaccine target. A bivalent, recombinant vaccine targeting the fHBP (rLP2086) of MnB was developed. Methods: This phase 1/2 clinical study was designed to assess the immunogenicity, safety, and tolerability of a 4-dose series of the rLP2086 vaccine at 20-, 60-, 120-, or 200-μg dose levels in vaccine-naive infants when given with routine childhood vaccines. The study was to consist of two phases: a single-blind sentinel phase and an open-label full enrollment phase. During the sentinel phase, randomization of subjects to the next higher dose was delayed pending a 14-day safety review of dose 1 of the preceding dose cohort. The full enrollment phase was to occur after completion of the sentinel phase. Results: Local reactions were generally mild and adverse events infrequent; however, after only 46 infants were randomized into the study, fever rates were 64% and 90% in subjects receiving one 20- or 60-μg rLP2086 dose, respectively. Most fevers were <39.0. °C. Only 2 subjects in the 20-μg group and 1 subject in the 60-μg group experienced fevers >39.0. °C; no fevers were >40.0. °C. Due to these high fever rates, the study was terminated early. No immunogenicity data were collected. This report discusses the safety and acceptability of rLP2086 in infants after one 20- or 60-μg dose. Conclusion: Due to the high fever rate experienced in the 20- and 60-μg groups, rLP2086 in the current formulation may not be acceptable for infants. © 2014. Source

Lopez J.I.,University of the Basque Country | Guarch R.,Hospital Virgen del Camino | Larrinaga G.,University of the Basque Country | Corominas-Cishek A.,Hospital Universitario Cruces | Orozco R.,Hospital San Juan de Dios

The aim of this study was to define the histological spectrum, frequency and significance of nonconventional tumour cells in clear cell renal cell carcinomas (CCRCC). Fifty-one totally sampled CCRCC were studied histologically to evaluate the spectrum of cell morphology variability, its frequency and significance, and their correlation with tumour grade and stage, and other histological parameters of aggressive behaviour like necrosis. Aside from conventional clear/eosinophilic granular cells, three additional cellular types were identified and considered in this study: small clear cells, syncytial cells and rhabdoid cells. Small clear cells were detected in 11 cases (21.5%), syncytial cells in 8 (15.6%) and rhabdoid cells in 5 (9.8%). The presence of syncytial and rhabdoid cells statistically correlated with grade (p = 0.003 and p = 0.006) and stage (p = 0.049 and p = 0.05) in CCRCC. Necrosis correlated with stage (p = 0.018) and grade (p = 0.004), but not with syncytial, rhabdoid or small clear cells. The presence of syncytial and rhabdoid cells in CCRCC is a relatively frequent event that significantly correlates with high-grade tumours and high stage status. © 2013 APMIS. Source

Gimenez-Sanchez F.,Pediatric Infectious Diseases Unit | Delgado-Rubio A.,Hospital de Madrid | Martinon-Torres F.,Hospital Clinico Universitario Of Santiago | Bernaola-Iturbe E.,Hospital Virgen del Camino
Acta Paediatrica, International Journal of Paediatrics

Background: Paediatric rotavirus gastroenteritis is the most frequent cause of acute gastroenteritis (AGE) in children up to 5 years of age worldwide. Aim: To analyse the clinical characteristics of AGE caused by rotavirus comparing to AGE caused by other agents. Methods: The study was conducted in 30 health-care centers in Spain (25 hospitals and five primary centers) between January and March 2006. Children with AGE up to 2 years of age were included. Stool samples were analysed using immunochromatographic test to identify rotavirus infection. Clinical and epidemiological data were analysed. Results: A total of 1192 children were enrolled (mean age: 11.2 months). Fever, Vomiting, weakness and dehydration were more frequent in rotavirus-positive AGE cases. Severity score was higher and hospitalization was likely in AGE caused by rotavirus. Family AGE illness was more frequent in children with rotavirus-positive AGE. Breastfeeding was found as a protective factor against Rotavirus AGE. Conclusion: Rotavirus is the primary causal agent of AGE in children under 2 years of age in Spain, causing more severe symptoms and more hospital admissions than other causal agents. Our data support the interest of the introduction of the available rotavirus vaccines in the Spanish immunization schedule. © 2010 Foundation Acta Pædiatrica. Source

Ortiz-Gomez J.R.,Hospital Virgen del Camino | Palacio-Abizanda F.J.,Hospital Gregorio Maranon | Morillas-Ramirez F.,Hospital Gregorio Maranon | Fornet-Ruiz I.,Hospital Puerta de Hierro | And 2 more authors.
International Journal of Obstetric Anesthesia

Background Spinal anaesthesia for caesarean delivery is frequently associated with adverse effects such as maternal hypotension and bradycardia. Prophylactic administration of ondansetron has been reported to provide a protective effect. We studied the effect of different doses of ondansetron in obstetric patients. Methods This prospective double-blind, randomised, placebo-controlled study included 128 healthy pregnant women scheduled for elective caesarean delivery under spinal anaesthesia. Women were randomly allocated into four groups (n = 32) to receive either placebo or ondansetron 2, 4 or 8 mg intravenously before induction of spinal anaesthesia. Demographic, obstetric, intraoperative timing and anaesthetic variables were assessed at 16 time points. Anaesthetic variables assessed included blood pressure, heart rate, oxygen saturation, nausea, vomiting, electrocardiographic changes, skin flushing, discomfort or pruritus and vasopressor requirements. Results There were no differences in the number of patients with hypotension in the placebo (43.8%) and ondansetron 2 mg (53.1%), 4 mg (56.3%) and 8 mg (53.1%) groups (P = 0.77), nor the percentage of time points with systolic hypotension (7.3% in the placebo group and 11.1%, 15.7% and 12.6% in the ondansetron 2, 4 and 8 mg groups, respectively, P = 0.32). There were no differences between groups in ephedrine (P = 0.11) or phenylephrine (P = 0.89) requirements and the number of patients with adverse effects. Conclusions In our study, prophylactic ondansetron had little effect on the incidence of hypotension in healthy parturients undergoing spinal anaesthesia with bupivacaine and fentanyl for elective caesarean delivery. © 2014 Elsevier Ltd. All rights reserved. Source

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