Hospital Virgen del Rocio

Sevilla, Spain

Hospital Virgen del Rocio

Sevilla, Spain
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Rodriguez-Caballero A.,University of Seville | Torres-Lagares D.,University of Seville | Robles-Garcia M.,University of Seville | Pachon-Ibanez J.,Hospital Virgen del Roci | And 2 more authors.
International Journal of Oral and Maxillofacial Surgery | Year: 2012

Head and neck cancer represents one of the main oncological problems. Its treatment, radiotherapy and chemotherapy leads to mucositis, and other side effects. The authors reviewed high-quality evidence published over the last 25 years on the treatment of cancer treatment-induced oral mucositis. A Medline search for double blind randomized controlled clinical trials between 1985 and 2010 was carried out. The keywords were oral mucositis, radiotherapy, chemotherapy, and head and neck. The different therapeutic approaches found for cancer treatment-induced oral mucositis included: intensive oral hygiene care; use of topical antiseptics and antimicrobial agents; use of anti-inflammatory agents; cytokines and growth factors; locally applied non-pharmacological methods; antioxidants; immune modulators; and homoeopathic agents. To date, no intervention has been able to prevent and treat oral mucositis on its own. It is necessary to combine interventions that act on the different phases of mucositis. It is still unclear which strategies reduce oral mucositis, as there is not enough evidence that describes a treatment with a proven efficiency and is superior to the other treatments for this condition. © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.


Alonso R.,IIS Fundacion Jimenez Diaz | Andres E.,Bioinformatic Unit | Mata N.,Madrid Health Authority | Fuentes-Jimenez F.,Hospital Universitario Reina Sofia | And 8 more authors.
Journal of the American College of Cardiology | Year: 2014

Objectives The aim of this study was to determine the relationship between lipoprotein(a) [Lp(a)] and cardiovascular disease (CVD) in a large cohort of patients with heterozygous familial hypercholesterolemia (FH). Background Lp(a) is considered a cardiovascular risk factor. Nevertheless, the role of Lp(a) as a predictor of CVD in patients with FH has been a controversial issue. Methods A cross-sectional analysis of 1,960 patients with FH and 957 non-FH relatives recruited for SAFEHEART (Spanish Familial Hypercholesterolemia Cohort Study), a long-term observational cohort study of a molecularly well-defined FH study group, was performed. Lp(a) concentrations were measured in plasma using an immunoturbidimetric method. Results Patients with FH, especially those with CVD, had higher Lp(a) plasma levels compared with their unaffected relatives (p < 0.001). A significant difference in Lp(a) levels was observed when the most frequent null and defective mutations in LDLR mutations were analyzed (p < 0.0016). On multivariate analysis, Lp(a) was an independent predictor of cardiovascular disease. Patients carrying null mutations and Lp(a) levels >50 mg/dl showed the highest cardiovascular risk compared with patients carrying the same mutations and Lp(a) levels <50 mg/dl. Conclusions Lp(a) is an independent predictor of CVD in men and women with FH. The risk of CVD is higher in those patients with an Lp(a) level >50 mg/dl and carrying a receptor-negative mutation in the LDLR gene compared with other less severe mutations.


Cabrera Serrano M.,Hospital Virgen del Rocio
European Journal of Neurology | Year: 2012

Background and purpose: Define the usefulness of pulmonary function tests (PFT) and arterial blood gases (ABG) in patients admitted to the ICU with acute neuromuscular respiratory failure (NMRF). Methods: We reviewed 76 patients admitted to an ICU at Mayo Clinic (Rochester) between 2003 and 2009 with acute NMRF defined as need for mechanical ventilation (MV) because of primary impairment of the peripheral nervous system. Poor functional outcome was defined as a modified Rankin score >3. Results: Median age was 65years. The most frequent diagnosis was myasthenia gravis (25 patients); 54% of patients had no known neuromuscular diagnosis before admission, and 11% had no specific diagnosis at discharge. Median MV time was 16days; 14% of patients died during hospitalization, and 63% were severely disabled at discharge. Maximal expiratory pressure ≤30cm H 2O and maximal inspiratory pressure (MIP) worse than -28cm H 2O before MV were associated with need for invasive MV for longer than 7days (P=0.02). Indicators of chronic respiratory acidosis (low pH, high pCO 2, and high HCO 3) before MV were associated with in-hospital death and poor functional outcome, but mostly in patients with progressive, untreatable neuromuscular diagnoses. Conclusions: In patients with primary acute NMRF, bedside PFT and ABG before MV can be used to predict evolution and outcome. Lower MIP and MEP portend prolonged MV and are more useful than forced vital capacity. Presentation with chronic respiratory acidosis is associated with high risk of in-hospital mortality and severe disability, especially in patients without treatable diagnoses. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.


de Toro Crespo M.,Hospital Virgen del Rocio | Torres M.J.,University of Seville | Maite R.,Hospital Virgen del Rocio | Aznar J.,University of Seville
Clinical Microbiology and Infection | Year: 2011

Candida parapsilosis former groups II and III have recently been established as independent species, named Candida orthopsilosis and Candida metapsilosis, respectively. We investigated the distribution of C. parapsilosis complex species in 122 isolates from blood and other sources in a southern Spain tertiary-care hospital, and we examined the relationship between species, site of isolation and biofilm positivity. We also evaluated the planktonic MICs and sessile MICs (SMICs) of voriconazole, amphotericin B and anidulafungin. One hundred and eleven isolates (91%) were categorized as C. parapsilosis sensu stricto, whereas ten isolates (8.2%) were categorized as C. orthopsilosis and one (0.8%) as C. metapsilosis. Biofilm positivity was observed in 58.5% (65 of 111) of C. parapsilosis sensu stricto isolates vs. 0% (0 of 11) of C. orthopsilosis and C. metapsilosis isolates (p<0.01). There was no difference in biofilm production among C. parapsilosis sensu stricto isolates from blood and other sources. MIC values showed that all isolates were susceptible to voriconazole and amphotericin B, whereas two isolates (1.8%) of C. parapsilosis sensu stricto were non-susceptible to anidulafungin. However, the MIC 90 value of voriconazole was higher (0.125mg/L) for C. orthopsilosis than forC. parapsilosis sensu stricto (0.03mg/L). In contrast to planktonic cells, the SMICs show that amphotericin B and anidulafungin are moderately effective against the biofilm of C. parapsilosis sensu stricto, whereas voriconazole is ineffective. © 2010 The Authors. Clinical Microbiology and Infection © 2010 European Society of Clinical Microbiology and Infectious Diseases.


Martin-de-Carpi J.,Hospital Sant Joan Of Deu | Rodriguez A.,Hospital Virgen del Rocio | Ramos E.,Hospital Universitario La Paz | Jimenez S.,Hospital Central Of Asturias | And 2 more authors.
Inflammatory Bowel Diseases | Year: 2013

Background: Although pediatric inflammatory bowel disease (IBD) diagnosis has increased in the last decades in Spain, there are no consistent epidemiologic data. Our aim was to describe the changing pattern of pediatric IBD incidence in Spain in the last 14 years. Methods: A retrospective survey of patients diagnosed below 18 years of age in the period 1996-2009 was performed. Patients' data were obtained from the hospitals' databases. To avoid reduced accrual of cases diagnosed by adult physicians, adult IBD units in referral centers were invited to participate. Seventy-eight centers participated in our survey. Rates of incidence were calculated using age-stratified population-based epidemiologic data. Incidence rates were compared for the last 14 years (1996-2009). Results: In total, data from 2107 patients were obtained: 1,165 Crohn's disease (CD, 55.3%), 788 ulcerative colitis (UC, 37.4%), and 154 IBD unclassified. The sex distribution was 56.4% male, with higher predominance for CD (59.3%) as compared to UC (52.8%) and IBD unclassified (53.2%) (P = 0.012). The median age at diagnosis was 12.3 years (p25-75 9.7-14.6) with significant differences between diseases. IBD incidence increased from 0.97 to 2.8/100,000 inhabitants <18 years/year in the study period. Although this increase is more evident for CD (from 0.53 to 1.7), UC has also risen considerably (0.39 to 0.88). Conclusions: This is the first attempt to calculate the current incidence of pediatric IBD in Spain. A significant increase of incidence rates in the study period was observed. In the last 14 years pediatric IBD incidence has almost tripled, with a more important CD increase. Copyright © 2013 Crohn's & Colitis Foundation of America, Inc.


Martin-de-Carpi J.,Hospital Sant Joan Of Deu | Rodriguez A.,Hospital Virgen del Rocio | Ramos E.,Hospital Universitario La Paz | Jimenez S.,Hospital Central Of Asturias | And 3 more authors.
Journal of Crohn's and Colitis | Year: 2014

Objectives: A growing incidence of pediatric IBD (PIBD) in southern Europe has been recently reported. The SPIRIT registry (1996-2009) confirmed these tendencies in Spain. Our aim is to obtain data from 1985 to 1995 and describe the complete picture of PIBD presentation changes in Spain in the last 25. years. Methods: A retrospective survey of incident PIBD in the period 1985-1995 was performed. Patients' data were obtained from the hospitals' databases and compared with the published data from the 1996 to 2009 period. Seventy-eight IBD reference centers took part in this survey. Results: Data from 495 patients were obtained: 278 CD (56.2%), 198 UC (40%), and 19 IBDU (3.8%); 51.7% were female, with higher predominance both in UC (58.6%) and in IBDU (57.9%), but not in CD (46.4%). Median (IQR) age at diagnosis was 12.9 (10.0-15.7) years, with significant differences among IBD subtypes: CD: 13.1 (10.8-16.0) vs UC: 12.4 (9.4-15.1) vs IBDU: 7.5 (3.0-13.0) (p ≤ 0.001). These results are significantly different to the ones in the SPIRIT registry, with a higher proportion of IBDU, younger age and male predominance. The data from both periods taken together give a complete picture of a 25-year period. An annual increase of incident patients was observed, with a ten-fold increase over this period. Conclusion: These data extend the epidemiological trends to a full 25-year period (1985-2009). PIBD incidence in Spain has experienced a sixteen-fold increase. The IBD subtype, localization of the affected segment, age- and sex distribution observed are in accordance with our previously published ones of 1996-2009. © 2014 European Crohn's and Colitis Organisation.


Gomez-Tortosa E.,Fundacion Jimenez Diaz | Gallego J.,Fundacion Jimenez Diaz | Guerrero-Lopez R.,Institute Investigaciones Sanitarias Fundacion Jimenez Diaz | Marcos A.,Hospital Clinico San Carlos | And 7 more authors.
Neurology | Year: 2013

Objective: Expansions of more than 30 hexanucleotide repetitions in the C9ORF72 gene are a common cause of frontotemporal dementia (FTD) or amyotrophic lateral sclerosis (ALS). However, the range of 20-30 repetitions is rarely found and still has unclear significance. A screening of our cohort of cases with FTD (n = 109) revealed 4 mutation carriers (>30 repetitions) but also 5 probands with 20-22 confirmed repetitions. This study explored the possible pathogenic correlation of the 20-22 repeats expansion (short expansion). Methods: Comparison of clinical phenotypes between cases with long vs short expansions; search for segregation in the families of probands with short expansion; analysis of the presence of the common founder haplotype, described for expansions >30 repeats, in the cases having the short expansion; and analysis of the distribution of hexanucleotide repeat alleles in a control population. Results: No different patterns were found in the clinical phenotype or aggressiveness of the disease when comparing cases with long or short expansions. Cases in both groups had psychiatric symptoms during 1-3 decades before evolving insidiously to cognitive deterioration. The study of the families with short expansion showed clear segregation of the 20-22 repeats allele with the disease. Moreover, this 20-22 repeats allele was associated in all cases with the pathogenic founder haplotype. None of 216 controls had alleles with more than 14 repetitions. Conclusions: Description of these families suggests that short C9ORF72 hexanucleotide expansions are also related to frontotemporal cognitive deterioration. Copyright © 2013 American Academy of Neurology.


Fernandez Aranda M.I.,Hospital Virgen del Rocio
Matronas Profesion | Year: 2015

Just as occurs in virtually all fields of human activity, new technologies are substantially altering the healthcare area. The most visible application is Internet access to a large amount of information but the change goes well beyond this and, in the case of the field of obstetrics, could modify the relationship between midwife and expectant mother which hitherto existed. Among the tools offered by this technological progress are remote diagnosis, on-line monitoring and healthcare apps for mobile devices, which are starting to be recommended in some specific cases because their prescription has managed to become a systematic and fully integrated component within the field of healthcare. This paper reports the new communication and information technologies in our profession, which are leading to a new care model and a new, more flexible, closer and most trusting professional relationship with expectant mothers and with citizens in general. Adapting to these changes by means of developing new skills and a proactive attitude will enable us to consolidate ourselves as references during the care process for the pregnant woman. ©2015 Ediciones Mayo, S.A. All rights reserved.


Berenguer M.,Hospital La Fe | Charco R.,University of Barcelona | Manuel Pascasio J.,Hospital Virgen del Rocio | Ignacio Herrero J.,University of Navarra
Liver International | Year: 2012

In November 2010, the Spanish Society of Liver Transplantation (Sociedad Española de Trasplante Hepático, SETH) held a consensus conference. One of the topics of debate was liver transplantation in patients with hepatitis C. This document reviews (i) the natural history of post-transplant hepatitis C, (ii) factors associated with post-transplant prognosis in patients with hepatitis C, (iii) the role of immunosuppression in the evolution of recurrent hepatitis C and response to antiviral therapy, (iv) antiviral therapy, both before and after transplantation, (v) follow-up of patients with recurrent hepatitis C and (vi) the role of retransplantation. © 2012 John Wiley & Sons A/S.


In recent years there has been a significant increase in the volume of information on the internet about health and particularly on pregnancy, postpartum and breastfeeding. This fact together with the emergence of a new archetype of more informed and critical pregnant but also more intransigent and demanding forces us to confront substantial changes in our relationship with the mother. The midwives currently have an important role in the education of pregnant women in the proper use of obstetric information the internet provides. In this article I propose to analyze in this role as information evaluators and managers and/or digital content must target the actions to be taken in three directions: A) teach locate reliable information published online; b) prescribe mobile applications tailored to the individual circumstances of the mother to monitor her pregnancy, and c) advise a new empowered pregnant in the use of social networks taking into account related to privacy and confidentiality of the information you share in them. © 2016 Ediciones Mayo, S.A. All rights reserved.

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