367 results match your criteria: "Medical Doctor Hospital Universitario Ramón y Cajal[Affiliation]"

Aims: The Peri-Implant and PeriProsthetic Survival AnalysiS (PIPPAS) study aimed to investigate the risk factors for one-year mortality of femoral peri-implant fractures (FPIFs).

Methods: This prospective, multicentre, observational study involved 440 FPIF patients with a minimum one-year follow-up. Data on demographics, clinical features, fracture characteristics, management, and mortality rates were collected and analyzed using both univariate and multivariate analyses.

View Article and Find Full Text PDF

Objective: The diagnosis of secondary progressive multiple sclerosis (SPMS) is often established retrospectively leading to a delay in detection. This work presents a clinical care algorithm that aims to facilitate the recognition of the secondary progressive phase of the disease, analyzing its usefulness and the feasibility of its implementation in routine clinical practice.

Methods: The algorithm was developed in four phases: 1) choice of validated diagnostic tools for the detection of progression; 2) assessment of these tools based on experience of use, applicability, time consumed, perceived usefulness and suitability for a profile of a patient in transition to SPMS; 3) framework and final sequence of application; 4) feasibility evaluation through application in clinical practice.

View Article and Find Full Text PDF

Ecological study to estimate the prevalence of patients with acid sphingomyelinase deficiency in Spain. PREVASMD study.

Rev Clin Esp (Barc)

November 2024

Unidad de Enfermedades Metabólicas, Departamento de Neurología, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.

Background And Objective: Prevalence studies of acid sphingomyelinase deficiency (ASMD) are scarce and different in Spain. The objective of the present study was to determine the estimated prevalence of patients diagnosed with ASMD (types A/B and B) in Spain.

Material And Methods: PREVASMD was a descriptive, multicenter, and ecological study involving 21 physicians from different specialties (mainly Internal Medicine, Paediatrics and Hematology), of different autonomous communities, with experience in ASMD management.

View Article and Find Full Text PDF

Introduction: There are very few studies evaluating lipid-lowering treatments (LLTs) and low-density lipoprotein-cholesterol (LDL-C) goal attainment after the release of the 2019 guidelines of the European Societies of Cardiology (ESC) and Atherosclerosis (EAS). This manuscript shows baseline data of the Spanish subset from SANTORINI study (namely SANTORINI Spain) on LDL-C goal attainment and use of LLTs in patients at high and very high cardiovascular risk.

Methods: SANTORINI was a multinational, prospective, observational study involving patients at high and very high cardiovascular risk from 14 European countries in primary care and specialized healthcare settings.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates sex differences in treatment approaches for pulmonary embolism (PE) among older adults, revealing that existing evidence on disparities is limited and often inconclusive due to small sample sizes and inadequate methods.
  • Analysis of data from a European PE registry and US Medicare beneficiaries shows no significant overall sex differences in the use of anticoagulation or advanced therapies, although fewer women received fibrinolytic therapy compared to men with intermediate-risk PE.
  • The authors suggest that future research should explore whether the observed sex disparities in treatment correlate with different clinical outcomes, especially regarding fibrinolytic therapy and advanced treatment utilization in older adults in the US.
View Article and Find Full Text PDF

Purpose: Pancreatic adenocarcinoma (PDAC) has limited treatment options. We compared the efficacy of comprehensive precision medicine against the conventional treatment in PDAC.

Methods: Phase III trial of advanced PDAC where patients were randomized (1:2) to a conventional treatment treated at physician's discretion (arm A), or to precision medicine (arm B).

View Article and Find Full Text PDF

Introduction And Objective: Certain medical practices, both diagnostic and therapeutic, that have not been proven to be effective and do not add value to healthcare, are not uncommon. The aim of this document is to provide a list of «Not to do» recommendations in the medical specialty of Physical Medicine and Rehabilitation.

Material And Method: For the development of this project, which is coordinated by the Vocalía de Sociedades Filiales, Sociedades Autonómicas y Grupos de Trabajo de la Sociedad Española de Rehabilitación (SERMEF), specific recommendations are requested from Grupos de Trabajo and Sociedades Filiales of each specific field of Physical Medicine and Rehabilitation, as experts in the corresponding intervention areas.

View Article and Find Full Text PDF

Background: Neuropsychiatric symptoms are prevalent in patients with mild cognitive impairment (MCI) and are predictive of the conversion to dementia. Fortasyn Connect, a medical food, has shown efficacy in managing cognitive and behavioral symptoms associated with MCI. Early diagnosis and intervention in primary care are essential for managing MCI.

View Article and Find Full Text PDF
Article Synopsis
  • Acute pulmonary embolism (PE) negatively impacts right ventricular function, which can be evaluated using the TAPSE/PASP ratio to predict patient outcomes.
  • A study analyzed data from over 4,400 patients with PE and found lower TAPSE/PASP ratios correlated with higher 30-day mortality rates, especially in intermediate-risk patients.
  • The TAPSE/PASP ratio is suggested to be a valuable tool for enhancing clinical decision-making and identifying patients at greater risk of mortality, beyond existing risk assessment methods.
View Article and Find Full Text PDF

Introduction: Specific training at surgical super-specialities and its objective evaluation is a challenge nowadays in order to measure the potential benefits that it might add.

Material And Methods: An online survey addressed by the "Grupo Joven de la Asociación Española de Coloproctología" has been performed in order to evaluate the level of formation achieved specifically at colorectal surgery.

Results: 128 surgeons participated, representing 81 colorectal surgery units.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the reliability of pathologists in quantifying tumor percentages in whole slide images (WSI) of non-small cell lung cancer (NSCLC) using digital image analysis after training them with QuPath.
  • Initial assessments showed poor reliability among pathologists, with a low intraclass correlation coefficient (ICC) of 0.09, which only slightly improved to an ICC of 0.24 in a follow-up trial after receiving feedback.
  • The research indicated that errors were mainly due to subjective tasks like annotation, and suggested that future AI technologies could enhance accuracy in digital pathology assessments.
View Article and Find Full Text PDF

Developing a Clinical Service in Interventional Radiology: Results from the 2024 CIRSE Clinical Practice Survey.

Cardiovasc Intervent Radiol

December 2024

Department of Diagnostic and Interventional Radiology, University Hospital Marburg, Philipps-University Marburg, Baldingerstrasse, 35043, Marburg, Germany.

Purpose: Engaging in clinical service development is a prerequisite for Interventional Radiology (IR) to prosper as a full clinical discipline. The CIRSE Clinical Services in IR Task Force conducted a survey of CIRSE members worldwide to assess the current status of their clinical practice and to identify areas of practice requiring further support.

Materials And Methods: An online questionnaire with 63 structured items was sent to 7,501 CIRSE members in November 2023.

View Article and Find Full Text PDF
Article Synopsis
  • Benzodiazepines are drugs often given by doctors, but using them for a long time can cause problems like dependence and side effects.
  • A study looked at tweets from people talking about benzodiazepines to understand what the public thinks about them.
  • Most tweets were positive, focusing on how effective these drugs are, but didn’t mention the bad effects, which shows the need for more education on the risks of using them long-term.
View Article and Find Full Text PDF

Concordance between risk scales for venous thromboembolism in patients treated in emergency departments.

Emergencias

June 2024

Departamento de Medicina Interna, Clínica Universidad de Navarra, Madrid, España. CIBER Enfermedades Respiratorias (CIBERES), Madrid, España. Interdisciplinar Teragnosis and Radiosomics (INTRA) Research Group, Universidad de Navarra, España.

Objective: To evaluate agreement between risk-assessment models for venous thromboembolism (VTE) in patients hospitalized for medical conditions and to analyze variables associated with the decision to prescribe pharmacological thromboprophylaxis in hospital emergency departments (EDs). Conclusions.

Methods: Prospective observational multicenter cohort study.

View Article and Find Full Text PDF
Article Synopsis
  • This study looked at how a medicine called nintedanib might help with breast cancer by making the environment around the tumor less stiff.
  • Researchers tested this by comparing two groups of patients: one got regular treatment while the other received nintedanib with their treatment.
  • They found that although overall survival rates were similar, patients with high stiffness scores (MeCo) had a higher risk of cancer returning, but taking nintedanib lowered that risk.
View Article and Find Full Text PDF

Background: The assessment of serum neurofilament light chain (sNfL) concentration in multiple sclerosis (MS) is a useful tool for predicting clinical outcomes and assessing treatment response. However, its use in clinical practice is still limited. We aimed to assess how measurement of sNfL influences neurologists' treatment decisions in MS.

View Article and Find Full Text PDF
Article Synopsis
  • Tarlatamab, an immunotherapy targeting delta-like ligand 3, shows promising anticancer effects in small cell lung cancer (SCLC) based on the DeLLphi-300 and DeLLphi-301 trials, with manageable safety profiles.
  • In the extended follow-up of DeLLphi-300, the overall response rate was 25%, with a median duration of response of 11.2 months and a median overall survival of 17.5 months across 152 patients.
  • Among those receiving a specific dose regimen (10 mg every two weeks), 35.3% experienced a response, and notable intracranial tumor shrinkage was found in patients with existing brain lesions, highlighting tarlatam
View Article and Find Full Text PDF

Despite remarkable improvement in the human immunodeficiency virus (HIV) and hepatitis C virus (HCV) care continuum, the rate of late diagnosis of HIV and HCV in high-income countries remains unacceptably high. Testing relies mainly on primary care physicians' identification of risk factors. We aimed to adapt an analogic to an online questionnaire to help HIV and HCV screening and perform a pilot study to assess its accuracy and acceptability.

View Article and Find Full Text PDF
Article Synopsis
  • Functional neurological disorder (FND) is a significant cause of neurological disability in Europe, but it receives inadequate attention in medical training compared to conditions like multiple sclerosis (MS).
  • A survey of 25 countries revealed that FND is often not included in mandatory neurology training and has limited representation in examinations and specialized services.
  • There is a notable disparity in access to care and disability benefits for FND patients, highlighting the need for improvements in education, healthcare policies, and patient advocacy.
View Article and Find Full Text PDF

Purpose: Early treatment of high-risk smoldering myeloma has been shown to delay progression to multiple myeloma (MM). We conducted this trial with curative intention using a treatment approach employed for newly diagnosed patients with MM.

Methods: Patients with high-risk smoldering myeloma (>50% progression risk at 2 years) and transplant candidates were included and received induction therapy with carfilzomib, lenalidomide, and dexamethasone (KRd), six cycles, followed by high-dose melphalan (200 mg/m) autologous stem-cell transplantation (HDM-ASCT), two KRd consolidation cycles, and Rd maintenance for 2 years.

View Article and Find Full Text PDF

Purpose: To identify risk factors predisposing patients to poor outcomes after fixation of periprosthetic hip fractures around femoral stems.

Methods: Prospective multicentre cohort study of fractures around a hip replacement stem managed by internal fixation. The primary outcome was one-year mortality, while secondary outcomes were local complications and healthcare burden-related outcomes (nursing facility utilization and hospital length of stay).

View Article and Find Full Text PDF

Introduction: Current literature lacks consensus on initial assessments and routine follow-up care of patients with alpha-mannosidosis (AM). A Delphi panel was conducted to generate and validate recommendations on best practices for initial assessment, routine follow-up care, and integrated care coordination of patients with AM.

Methods: A modified Delphi method involving 3 rounds of online surveys was used.

View Article and Find Full Text PDF

Stroke in critically ill patients with respiratory failure due to COVID-19: Disparities between low-middle and high-income countries.

Heart Lung

October 2024

Division of Neuroscience Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Article Synopsis
  • A study was conducted to compare stroke incidences and mortality rates in critically ill COVID-19 patients from low-and middle-income countries (LMICs) and high-income countries (HICs).
  • The results showed that stroke incidence was significantly higher in LMICs (35.7 per 1000 admitted-days) compared to HICs (17.6 per 1000 admitted-days), with patients from LMICs also facing higher mortality rates (43.6% vs. 29.2%).
  • The findings highlight the need for better stroke diagnosis and healthcare resource allocation in LMICs, as both higher income status and the presence of stroke are associated with increased risk of death
View Article and Find Full Text PDF

The Spanish Society of Tropical Medicine and International Health (SEMTSI), the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Emergency Medicine (SEMES), the Spanish Society of Primary Care Physicians (SEMERGEN) and the Spanish Society of Family and Community Medicine (SEMFYC) have prepared a consensus statement on the diagnosis and management of patients with imported febrile illnesses. Twenty authors with different backgrounds and representing different healthcare perspectives (ambulatory primary care, travel and tropical medicine specialists, emergency medicine, hospital care, microbiology and parasitology and public health), identified 39 relevant questions, which were organised in 7 thematic blocks. After a systematic review of the literature and a thoughtful discussion, the authors prepared 125 recommendations, as well as several tables and figures to be used as a consulting tool.

View Article and Find Full Text PDF