Publications by authors named "Elena Ramirez-Maldonado"
Pancreatic ductal adenocarcinoma contributes significantly to global cancer-related deaths, featuring only a 10% survival rate over five years. The quest for novel tumor markers is critical to facilitate early diagnosis and tailor treatment strategies for this disease, which is key to improving patient outcomes. In pancreatic ductal adenocarcinoma, these markers have been demonstrated to play a crucial role in early identification, continuous monitoring, and prediction of its prognosis and have led to better patient outcomes.
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- There is a lack of discharge protocols for acute pancreatitis (AP) patients, which the Hungarian Pancreatic Study Group (HPSG) aims to address with a new, validated protocol based on laboratory data and symptoms.
- An international survey revealed that 87.5% of participating medical centers do not have discharge protocols, but those that do see shorter hospital stays and lower readmission rates.
- The HPSG discharge protocol resulted in the lowest average length of hospital stay and demonstrated safety through a low readmission rate, highlighting the need for developing and validating more standardized discharge protocols for AP care.
Introduction: Acute pancreatitis (AP) is the third most common gastrointestinal disease resulting in hospital admission, with over 70% of AP admissions being mild cases. In the USA, it costs 2.5 billion dollars annually.
View Article and Find Full Text PDFSpleen-preserving distal pancreatectomy (SP-DP), for patients with benign or small low-grade malignant tumors of the body or tail of the pancreas, is the ideal procedure although it is technically demanding. The robotic da Vinci system has been introduced to overcome these technical challenges and reduce operative risks. We report our experience of a new variation in surgical technique: the left lateral approach robotic spleen-preserving distal pancreatectomy (RSP-DP) in right lateral decubitus position.
View Article and Find Full Text PDFThere is a clear association between the molecular profile of colorectal cancer liver metastases (CRCLM) and the degree to which aggressive progression of the disease impacts patient survival. However, much of our knowledge of the molecular behaviour of colorectal cancer cells comes from experimental studies with, as yet, limited application in clinical practice. In this article, we review the current advances in the understanding of the molecular behaviour of CRCLM and present possible future therapeutic applications.
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- Acute pancreatitis (AP) is a serious inflammation of the pancreas, and identifying patients at high risk of severe complications early is essential to prevent organ failure and death.
- The study developed a machine learning prediction model called EASY, using data from over 4,700 patients to offer quick assessments of severity through algorithms like XGBoost, achieving an average accuracy of 89.1%.
- The model identifies key risk factors such as respiratory rate, body temperature, and glucose level, and includes a user-friendly web application for easy access to its predictions.
Article Synopsis
- The rising incidence of acute pancreatitis (AP) has led to increased medical costs and a concerning 30% mortality rate in severe cases.
- A study involving 2461 patients revealed that hypoalbuminemia (low albumin levels) is common in AP, affecting 19% on admission and 35.7% during hospitalization.
- Severe hypoalbuminemia significantly increases the risk of complications and mortality, with a clear dose-dependent relationship to severity and hospital stay.
Article Synopsis
- Acute pancreatitis (AP) is primarily characterized by severe abdominal pain, which is crucial for diagnosis, prompting a study on its characteristics among 1435 adult patients from 2012 to 2017.
- A vast majority (97.3%) reported pain on admission, predominantly intense (70%), cramping (61%), and often starting within 24 hours prior. Notably, 50.9% experienced atypical pain despite common expectations for epigastric pain.
- The study underscores the need for thorough patient assessments regarding pain type to inform monitoring and management, especially for patients with sharp and intense pain, which correlates with more severe cases and higher mortality rates.
Background: New chemotherapy schemes have allowed for a better radiological response of unresectable colorectal liver metastases, leading to an interesting scenario known as a complete radiological response. The aim of this study was to review the current management of missing liver metastases (MLM) from the liver surgeon's point of view.
Methods: A systematic search was conducted on all publications of PubMed and Embase between 2003 and 2018.
Article Synopsis
- Chronic pancreatitis (CP) is a severe condition with no specific treatment, making early diagnosis essential for better outcomes.
- A study analyzed data from both acute pancreatitis (AP) and chronic pancreatitis (CP) patients, revealing that experiencing three or more episodes of AP significantly increases the risk of developing CP.
- Findings suggest that patients with three or more recurrent AP episodes could be classified as having early chronic pancreatitis (ECP), allowing for earlier diagnosis without extra healthcare costs.
Objective: To establish the optimal time to start oral refeeding in mild and moderate acute pancreatitis (AP) to reduce hospital length-of-stay (LOS) and complications.
Summary Background Data: Oral diet is essential in mild and moderate AP. The greatest benefits are obtained if refeeding starts early; however, the definition of "early" remains controversial.
Background: Hypertriglyceridemia is the third most common cause of acute pancreatitis (AP). It has been shown that hypertriglyceridemia aggravates the severity and related complications of AP; however, detailed analyses of large cohorts are contradictory. Our aim was to investigate the dose-dependent effect of hypertriglyceridemia on AP.
View Article and Find Full Text PDFIntroduction: The incidence of acute pancreatitis (AP) and the prevalence of metabolic syndrome (MetS) are growing worldwide. Several studies have confirmed that obesity (OB), hyperlipidemia (HL), or diabetes mellitus (DM) can increase severity, mortality, and complications in AP. However, there is no comprehensive information on the independent or joint effect of MetS components on the outcome of AP.
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- Researchers examined the effectiveness of C-reactive protein (CRP) and white blood cell count (WBC) in assessing acute pancreatitis (AP) through a review of existing studies and data analysis of 1435 patient episodes.
- The study found that CRP levels were not reliable indicators of mortality or severity in AP cases, with low accuracy in predictions regardless of when the levels were measured.
- However, using CRP levels within the first 24 hours after pain onset as a criterion for including patients in clinical trials significantly increased the rates of severe cases and mortality, thus potentially simplifying the patient selection process for trials.
Introduction: The treatment of patients with non-functioning pancreatic neuroendocrine tumours (NFPNET) is resection in locally pancreatic disease, or with resectable liver metastases. There is controversy about unresectable liver disease.
Methods: We analysed the perioperative data and survival outcome of 63 patients who underwent resection of NFPNET between 1993 and 2012.
Introduction: The treatment of bile duct calculi associated with cholelithiasis is controversial. The hospital costs could be a decisive factor in choosing between the different therapeutic options.
Objectives: To compare the effectiveness and costs of two options in the treatment of common bile duct calculi: 1) One-stage: Laparoscopic cholecystectomy and bile duct exploration, and 2) Two-stage: sequential endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy.