240 results match your criteria: "Hospital of Leon[Affiliation]"

Impact of Optimal Procedural Result After Transcatheter Edge-to-Edge Tricuspid Valve Repair: Results From TRI-SPA Registry.

JACC Cardiovasc Interv

December 2024

Department of Cardiology, University Hospital Alvaro Cunqueiro, Vigo, Spain; Cardiovascular Research Group, Department of Cardiology, University Hospital Alvaro Cunqueiro, Fundación Biomédica Galicia Sur, Servizo Galego de Saude, University of Vigo, Vigo, Spain. Electronic address:

Background: Procedural success following tricuspid transcatheter edge-to-edge repair (TEER) has been defined variably over time; however, the consequences of achieving a tricuspid regurgitation (TR) grade of 0/1+ are still unclear.

Objectives: This study aimed to assess the predictors and prognostic impact of achieving TR 0/1+ after TEER and its role in clinical events.

Methods: This multicenter registry included patients undergoing tricuspid TEER in 15 Spanish centers from June 2020 and May 2023.

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Article Synopsis
  • - Musculoskeletal embolization has emerged as a novel treatment for chronic joint pain by targeting joint hypervascularity, interrupting the inflammatory cycle, and providing pain relief.
  • - Genicular artery embolization (GAE) is the most researched procedure, especially for knee osteoarthritis, and has shown positive results in studies, including randomized control trials against sham treatments.
  • - Beyond the knee, embolization is being explored for other joints like the shoulder, elbow, hip, and ankle to treat various conditions, illustrating its expanding role in managing chronic musculoskeletal pain.
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Introduction: Surgical instrument retention continues to occur despite considerable preventive efforts. The resulting infection can be asymptomatic or demonstrate variable clinical presentations, such as intestinal obstruction, malnutrition, gastrointestinal bleeding, peritonitis, adhesions, fistulas, abscesses, erosion and/or intestinal perforation. In this case report, we present a patient whose last surgical event occurred 22 years prior with appendicular symptoms and a palpable abdominal mass.

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Background: Postoperative delirium is a neurobehavioral disorder that can appear after surgery. It is characterized by an altered level of consciousness and impaired cognitive function. The aim of this study was to evaluate the impact of visual projection of images of relatives or loved ones in patients undergoing cardiac surgery in the immediate postoperative period, and its influence on the incidence and development of postoperative delirium.

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Left Atrial Appendage Occlusion vs Standard of Care After Ischemic Stroke Despite Anticoagulation.

JAMA Neurol

September 2024

Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands.

Article Synopsis
  • Patients with a heart condition called atrial fibrillation (AF) who have strokes can still be at very high risk of having more strokes, even when taking medication to prevent them.
  • Left atrial appendage occlusion (LAAO) is a special procedure aimed at helping these patients avoid future strokes.
  • A study compared two groups – one that had LAAO and one that only continued their usual medication – and found that there was still a risk of strokes in both groups over a two-year period.
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Background: The most common complication after endovascular aortic aneurysm repair (EVAR) is continuous sac perfusion, known as endoleak. Evaluating markers released from the aneurysm wall into circulation has been suggested as a possible alternative for detecting endoleaks. The aim of this study was to examine whether circulating concentrations of different proinflammatory interleukins (IL-1β, IL-2, IL-6, IL-8), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor alpha (TNF-α) were elevated in patients with endoleak after EVAR.

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  • A predictive model was created to estimate the risk of major bleeding in cancer patients undergoing anticoagulant treatment for venous thromboembolism (VTE) within six months following their diagnosis.
  • The study analyzed data from electronic health records across nine hospitals in Spain, using natural language processing and machine learning to identify key predictors of bleeding and develop various predictive algorithms.
  • Findings indicated that about 10.9% of the patients experienced major bleeding events after VTE diagnosis, with significant predictors being factors like hemoglobin levels and age, and the new models outperformed the existing CAT-BLEED score.
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Pheochromocytomas and paragangliomas are rare neuroendocrine tumours. Around 20-25 % of patients develop metastases, for which there is an urgent need of prognostic markers and therapeutic stratification strategies. The presence of a MAML3-fusion is associated with increased metastatic risk, but neither the processes underlying disease progression, nor targetable vulnerabilities have been addressed.

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Mycobacterium interjectum Infection in an Immunocompetent Host Following Contact With Aquarium Fish.

Cutis

July 2024

Dr. Linares-Navarro is from the Department of Dermatology, Hospital Clínico San Carlos-Centro Sanitario Sandoval of Madrid, Spain. Drs. Sánchez-Sambucety and Rodríguez-Prieto are from the Department of Dermatology, and Dr. Dios-Diez is from the Department of Internal Medicine and Infectious Diseases, University Hospital of León, Spain.

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Background: Surgical de-escalation aims to reduce morbidity without compromising oncological outcomes. Trials to de-escalate breast cancer (BC) surgery among exceptional responders after neoadjuvant systemic therapy (NST) are ongoing. Combined patient and clinician insights on this strategy are unknown.

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Prognostic impact of tumor location and gene expression profile in sporadic desmoid tumor.

Eur J Cancer

September 2024

Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, Spain; Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain; Medical Oncology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain. Electronic address:

Article Synopsis
  • Prognostic biomarkers are important for understanding sporadic desmoid tumors (DT) due to their unpredictable nature; this study focused on gene expression differences between DTs located in the thoracic versus abdominal wall.
  • A retrospective analysis of 197 sporadic DT patients showed significant relationships between relapse-free survival (RFS) and factors like tumor size, location, and specific gene mutations, notably the CTNNB1 T41A and S45F mutations.
  • Results suggest that tumors in the abdominal wall have a better prognosis compared to extra-abdominal locations, with distinct gene expression profiles influencing cancer pathways related to their behavior and outcomes.
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  • Risk scores like MitraScore and COAPT help identify patients with mitral regurgitation (MR) who are at risk of adverse events but may still benefit from transcatheter edge-to-edge repair (TEER).
  • The study validated MitraScore in the COAPT trial with 614 patients and the COAPT risk score in the MIVNUT registry with 1007 patients, both focusing on predicting all-cause mortality over approximately 2 years.
  • Results indicated that both scores had fair to good predictive accuracy for mortality, with higher effectiveness seen in TEER patients, confirming the benefits of combining TEER with guideline-directed medical therapy (GDMT) across different risk levels.
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  • - The study investigated the effectiveness of using a SyncVision/iFR (S-iFR)-guided strategy for percutaneous coronary intervention (PCI) in patients with complex coronary lesions, compared to a standard angiography-guided approach.
  • - 100 patients were randomized into two groups: one using S-iFR guidance and the other using angiography; the main focus was on the implanted stent length and target vessel failure (TVF) after one year.
  • - Results showed that the S-iFR group had a shorter total stent length but also a slight increase in TVF, although this increase was not statistically significant.
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  • The study investigates how specific immune cell types in blood samples from patients with metastatic castration-resistant prostate cancer (mCRPC) can affect survival rates.
  • Researchers analyzed pre-treatment blood samples from 152 patients and found that lower CD8 T-cell counts and higher monocyte levels were linked to shorter survival.
  • Their results suggest that these immune cell types could act as important biomarkers for mCRPC management, supporting the need for further research in clinical trials.
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  • Patients who underwent left atrial appendage occlusion (LAAO) have an increased risk of bleeding and thromboembolic events, leading researchers to investigate the role of hematological markers in predicting these risks.
  • Data from 1,315 patients revealed that while the platelet count was somewhat associated with thromboembolic events, none of the hematological markers were linked to major bleeding events.
  • Key factors influencing thromboembolism included age and previous thromboembolic history, while major bleeding risks were tied to prior events, renal disease, and dual antiplatelet therapy upon discharge.
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Aim: The aim of this study was to review the existing evidence on burnout levels in midwives and the main related factors.

Design: Mixed studies systematic review.

Data Sources: PubMed, Scopus and Web of Science were sourced from 2018 and 2023.

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Article Synopsis
  • The study evaluated the effectiveness of the Vasopressor test (VPT) in patients with functional mitral regurgitation (MR) and left ventricular dysfunction undergoing transcatheter edge-to-edge repair (TEER).* -
  • Out of 1115 patients, those who underwent VPT had higher rates of significant MR and greater overall mortality at one year compared to those who did not undergo the test, indicating a potentially higher risk profile.* -
  • Despite the increased mortality rates in the VPT group, other key outcomes like heart failure readmissions and cardiovascular mortality showed no significant differences, suggesting VPT can aid in managing high-risk patients without worsening long-term outcomes.*
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Although the treatment landscape has rapidly evolved over the last years, hepatocellular carcinoma (HCC) is one of the most lethal cancers. With recent advances, both immunotherapy and tyrosine kinase inhibitors (TKIs)-based chemotherapy constitute the standard treatment for advanced HCC. A systematic search of randomized clinical trials employing TKIs was performed in 17 databases, obtaining 25 studies evaluating the prognosis, tumor response, and presence of adverse events (AEs) related to TKIs in HCC.

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Current trends in the management of Gastro-oEsophageal cancers: Updates to the ESSO core curriculum (ESSO-ETC-UGI-WG initiative).

Eur J Surg Oncol

July 2024

European Society of Surgical Oncology (ESSO), Education and Training Committee (ETC), Upper Gastrointestinal (UGI), Working Group (WG), Belgium; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; ESSO Past-President, Republic of Korea.

Article Synopsis
  • - Gastro-esophageal cancers (GECs) are serious illnesses with rapidly evolving management techniques, and the European Society of Surgical Oncology (ESSO) is focused on enhancing knowledge in this area through a multidisciplinary approach.
  • - The review covers various aspects of GEC management, including oligometastatic cancers, peritoneal metastases, Siewert Type II tumors, robotic surgery, and the use of molecular markers and immune therapies.
  • - The goal is to provide an updated overview of GEC management practices, highlight recent advancements, and promote discussions among surgical oncologists globally, benefiting both seasoned and training professionals in the field.
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Left Atrial Appendage Occlusion in Patients With Anticoagulation Failure vs Anticoagulation Contraindication.

JACC Cardiovasc Interv

June 2024

Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, the Netherlands; Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands.

Article Synopsis
  • Left atrial appendage occlusion (LAAO) is a treatment for patients with atrial fibrillation (AF) who can't use oral anticoagulation therapy (OAT) and those who face recurring thrombotic events despite OAT.
  • This study compared the efficacy of LAAO in patients experiencing thrombotic events while on OAT against those who had contraindications for OAT, using data from a large registry and propensity score matching for accuracy.
  • Results showed no significant difference in ischemic stroke rates between the two groups, but the LAAO patients on OAT had a higher thromboembolic risk but lower bleeding risk, suggesting LAAO is a viable option for these patients.
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Background: Percutaneous closure of aortic-to-right ventricle (ARV) fistula has emerged as an alternative to surgical management in selected cases. The use of three-dimensional (3D) printing in interventional planning for structural heart disease provides a concrete understanding, and it is useful in diagnostic assessment and to guide treatment approaches and to simulate procedures.

Case Summary: We report a case of a 70-year-old male presenting in cardiogenic shock due to severe aortic stenosis and reduced left ventricular ejection fraction.

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Background: Hyperglycaemia is an early and frequent adverse event during alpelisib treatment. METALLICA aimed to evaluate prophylactic metformin to prevent or reduce hyperglycaemia occurrence in patients with HR+/HER2-/-mutated advanced breast cancer (ABC).

Methods: Between August 13th, 2020 and March 23rd, 2022, this 2-cohort, phase 2, multicentre, single-arm trial (NCT04300790) enrolled patients with HR+/HER2-/PIK3CA-mutated ABC: cohort A, normal glycaemia (fasting plasma glucose <100 mg/dL [<5.

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