325 results match your criteria: "La Paz University Hospital IdiPAZ[Affiliation]"

: The EndoPredict assay has been widely used in recent years to estimate the risk of distant recurrence and the absolute chemotherapy benefit for patients with estrogen (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. However, there are no well-defined criteria for selecting patients who may benefit from the test. The aim of this study was to develop a novel nomogram to estimate the probability of obtaining a high-risk EndoPredict result in clinical practice.

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Background: Clinical research has offered many definitions and fragmented perspectives of joint morbidity in haemophilia. As joint damage, pain and mobility impairment can be present without clinical record of persistent bleeding, a person-centric joint morbidity characterisation remained a priority for the haemophilia community, giving rise to the 'problem joint' concept. As diagnosing and managing joint morbidity is critical, the aim of this study was to analyse the holistic burden of problem joints in people with moderate or severe haemophilia A (HA).

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Objectives: This study aimed to characterize non-commercial Spanish COVID-19 trials and to determine the availability of results. Differences in outcomes according to the interventions assessed (medicines, non-medicines) will also be determined.

Methods: This systematic review was conducted in March 2024 by searching non-commercial Spanish COVID-19 trials on four registers (EUCTR, Clinical.

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Appropriateness of Prescribing Transmucosal Immediate-Release Fentanyl in the Emergency Room, During Hospitalization, and at Discharge: A Retrospective Study.

Pharmaceuticals (Basel)

November 2024

Clinical Pharmacology Department, La Paz University Hospital-IdiPAZ, School of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain.

: This study evaluated the appropriateness of transmucosal immediate-release fentanyl (TIRF) prescriptions in a Madrid emergency room during 2019 and 2022, following a 2018 warning about off-label use. : TIRF prescription in the emergency room search yielded 993 patients in 2019 and 1499 in 2022, of which 140 were randomized for the study, 70 in 2019, and 70 in 2022. Dose appropriateness and indication for TIRF were analyzed according to established criteria.

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Hemophilia A (HA) patients under emicizumab prophylaxis may require the concomitant use of procoagulant factors for breakthrough bleedings or immune tolerance induction (ITI). The aim of this study is to evaluate the ex vivo procoagulant effect of plasma-derived FVIII concentrates containing von Willebrand factor (pdFVIII/VWF) in samples from patients with severe HA without inhibitors on emicizumab prophylaxis. Samples from healthy controls (HC) and HA patients were drawn in sodium citrate plus corn trypsin inhibitor tubes and spiked with increasing concentrations of pdFVIII/VWF concentrates (10-400 IU/dL) (Fanhdi/Alphanate, Grifols), activated prothrombin complex concentrate (aPCC, 0.

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Introduction: Cyclooxygenase-2 (COX-2) inhibitors (COXIBS) are considered a suitable option for the treatment of hemophilic arthropathy.

Areas Covered: The role of traditional non-steroidal anti-inflammatory drugs; (NSAIDS) and COXIBS in people with hemophilia (PWH) and in the non-hemophiliac population has been reviewed in order to know which of them is more advisable in PWH and whether they should be used as the first or second therapeutic step for the treatment of musculoskeletal pain (since there is a discrepancy between what is advised by the WFH and the WHO).

Expert Opinion: For the treatment of chronic musculoskeletal pain related to hemophilic arthropathy, it is reasonable to use as a first step a combination of oral paracetamol (650 mg per every 6 h) or metamizole (575 mg per every 6 h), one of the COXIBS (e.

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Gastric adenocarcinoma (GA) is a significant global health issue with poor prognosis, despite advancements in treatment. Although molecular classifications, such as The Cancer Genome Atlas (TCGA), provide valuable insights, their clinical utility remains limited. We performed a multi-layered functional analysis using TCGA RNA sequencing data to better define molecular subtypes and explore therapeutic implications.

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An international physician survey of current ablation practices in atrial fibrillation: An AIM-AF substudy.

Heart Rhythm

October 2024

Clinical Cardiology Academic Group, Molecular and Clinical Sciences Research Institute, St. George's University of London, London, United Kingdom.

Background: Practice guidelines recommend ablation (ABL) in atrial fibrillation (AF) for rhythm control. Guidance for antiarrhythmic drugs (AADs) post-ABL is limited.

Objective: The purpose of this study was to determine AAD and ABL practices in the United States and Europe.

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Purpose: Globally, it is estimated that 1.0 million individuals are newly infected by Hepatitis C virus (HCV) every year, and nearly 50 million people live with a chronic infection, according to World Health Organization. To overcome underdiagnosis of HCV infection among hard-to-reach populations, it is essential to develop new rapid and easy-to-use molecular diagnostic systems.

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Objectives: The 24-month, prospective, non-interventional, European multicenter A-SURE study evaluated the real-world effectiveness of prophylaxis using an extended half-life recombinant factor VIII (FVIII) Fc fusion protein, efmoroctocog alfa (hereinafter rFVIIIFc), compared with prophylaxis using standard half-life (SHL) FVIII products in patients with hemophilia A.

Methods: Primary endpoints were annualized bleeding rate (ABR), annualized injection frequency, and annualized factor consumption. A comparative study design unique for an observational hemophilia study was implemented to reduce potential confounding in effectiveness estimates, wherein each patient prescribed rFVIIIFc was matched with one receiving SHL FVIII.

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Background: People with HIV-1 (PWH) age differently than the general population. Blood telomere length (BTL) attrition is a surrogate biomarker of immunosenescence and aging in PWH. BTL is reduced immediately after HIV-1 infection and recovers in PWH with long-term virologic suppression, but the extent of this recovery is unknown.

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Article Synopsis
  • Over the years, treatment for people with hemophilia has gotten a lot better because of new scientific discoveries.
  • Despite these improvements, there are still some limits to the treatments that make us want to keep finding new options.
  • The goal is to make sure everyone with hemophilia, no matter their age or how severe it is, can get treatments that stop bleeding and let them live full lives.
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This study presents a detailed case analysis of a 40-year-old male patient with hemophilia A and severe chronic elbow arthropathy, exploring the surgical challenges and outcomes within the context of the current literature. The patient, with a history of multiple comorbidities including Hodgkin's lymphoma and cardiomyopathy, exhibited significant joint damage and functional impairment. A comprehensive approach was employed, collecting all relevant clinical data, including radiographic and MRI findings, to inform treatment decisions.

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An important aspect of improving care for people with hemophilia B (HB) is developing optimal treatment strategies. Here we aimed to provide in-silico evidence, comparing the estimated optimal posology of factor IX (FIX) products to support the patient-physician decision-making process. A population pharmacokinetic (popPK) model-based assessment comparing the performance of FIX products (rFIX, rIX-FP, rFIXFc, N9-GP) was developed.

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To know the frequency and characteristics of neurological manifestations of probable immune origin occurring after exposure to COVID-19 vaccination. In addition, to pre-study the usefulness of the Spanish pharmacovigilance system and lymphocyte transformation test in establishing causality. Retrospective case study, including patients admitted to the Neurology department from January 2021 to May 2022 with a probable neuroimmune disorder.

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Article Synopsis
  • About 10% of people with HIV experience low-level viremia (LLV) despite antiretroviral therapy, yet the causes and impacts of this condition remain largely unknown, especially within specific viral load ranges and modern treatment methods.
  • The study observed 81 participants, comparing those with LLV to those with suppressed viremia and non-HIV controls, focusing on immune response characteristics and inflammation markers through advanced flow cytometry and immunoassays.
  • Findings indicated that LLV individuals exhibit greater T-cell activation and senescence, along with a decline in certain immune cell types, which could impair their ability to control HIV and harm long-term immune memory.
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Purpose: The aim of this case report is to emphasize the significance of the growing teratoma syndrome. Growing teratoma syndrome is frequently misdiagnosed due to its low prevalence, with an estimated incidence of 19% among all immature ovarian teratomas and a lack of experience among healthcare professionals. It is characterized by the growth of benign tumoral tissue during or after chemotherapy for malignant germ cell tumors.

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Article Synopsis
  • The article emphasizes a multimodal approach to pain management in hemophilia, recommending intra-articular injections when other treatments fail and surgery isn't needed yet.
  • It provides a detailed overview of ultrasound-guided procedures for common joints affected by hemophilia, like the elbow, knee, and ankle, focusing on techniques like arthrocentesis and injections.
  • Experts believe that advancements in hematological treatments allow for effective incorporation of these ultrasound-guided techniques, leading to better pain relief outcomes for hemophilia patients.
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Moving towards Normalization of haemostasis and health equity: Evolving treatment goals for haemophilia A.

Haemophilia

September 2024

Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Medical Faculty, University of Bonn, Bonn, Germany.

Background: Treatment options for people with haemophilia are evolving at a rapid pace and a range of prophylactic treatment options using various technologies are currently available, each with their own distinct safety and efficacy profile.

Treatment Goals: The access to replacement therapy and prophylaxis has driven a dramatic reduction in mortality and resultant increase in life expectancy. Beyond this, the abolition of bleeds and preservation of joint health represent the expected, but rarely attained, goals of haemophilia treatment and care.

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Background: It is unknown whether growth differentiation factor 15 (GDF-15) is associated with chronic musculoskeletal pain (CMP) and whether or not its association with incident cardiovascular disease (CVD) changes according to CMP status.

Methods: In total, 1 957 randomly selected adults aged ≥65 years without prior CVD were followed up between 2015 and 2023. CMP was classified according to its intensity, frequency, and interference with daily activities.

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Background: Combining PARP inhibitors (PARPis) with immune checkpoint inhibitors may improve clinical outcomes in selected cancers. We evaluated rucaparib and atezolizumab in advanced gynaecological or triple-negative breast cancer (TNBC).

Methods: After identifying the recommended dose, patients with PARPi-naive BRCA-mutated or homologous recombination-deficient/loss-of-heterozygosity-high platinum-sensitive ovarian cancer or TNBC received rucaparib plus atezolizumab.

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There is controversy in the literature on where to place the tourniquet (thigh, calf, ankle) for foot and ankle surgery. While some authors prefer the ankle tourniquet to the calf tourniquet, others state that the surgeon can decide between using the thigh tourniquet or the ankle tourniquet, since there was no difference in postoperative pain between them. Where to place the tourniquet during foot and ankle surgery to cause the least possible postoperative pain to the patient as a result of the tourniquet is a common question in clinical practice.

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Management of cardiac sarcoidosis.

Eur Heart J

August 2024

Department of Cardiology, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.

Cardiac sarcoidosis (CS) is a form of inflammatory cardiomyopathy associated with significant clinical complications such as high-degree atrioventricular block, ventricular tachycardia, and heart failure as well as sudden cardiac death. It is therefore important to provide an expert consensus statement summarizing the role of different available diagnostic tools and emphasizing the importance of a multidisciplinary approach. By integrating clinical information and the results of diagnostic tests, an accurate, validated, and timely diagnosis can be made, while alternative diagnoses can be reasonably excluded.

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