Analysis of cell-free DNA in maternal blood in screening for aneuploidies: updated meta-analysis.

Objectives: To review clinical validation or implementation studies of maternal blood cell-free (cf) DNA analysis and define the performance of screening for fetal trisomies 21, 18 and 13 and sex chromosome aneuploidies (SCA).

Methods: Searches of PubMed, EMBASE and The Cochrane Library were performed to identify all peer-reviewed articles on cfDNA testing in screening for aneuploidies between January 2011, when the first such study was published, and 31 December 2016. The inclusion criteria were peer-reviewed study reporting on clinical validation or implementation of maternal cfDNA testing in screening for aneuploidies, in which data on pregnancy outcome were provided for more than 85% of the study population.

Screening for trisomies 21 and 18 in a Spanish public hospital: from the combined test to the cell-free DNA test.

Objective: To describe our experience in first-trimester screening for trisomies 21 and 18 firstly by the combined test alone and secondly by cell-free (cf) DNA testing contingent on the results from a previously performed combined test.

Methods: Women with singleton pregnancies attending Torrejon University Hospital in Madrid, Spain, from November 2011 to January 2016, were screened for trisomy (T)21 and T18 by the combined test at 11-13 weeks. Before the introduction of cfDNA testing, women at high risk (>1 in 250) were offered invasive testing (IT) and from January 2015 they were offered cfDNA test as well as IT.

Complex anatomy making it difficult for left atrial appendage closure.

Left atrial appendage closure is a useful technique for patients at high thromboembolic risk and contraindications for oral anticoagulation therapy. However, it can be challenging when anatomical difficulties are encountered. We present a unique case of atypical appendage uptake and how we completed the procedure.

A risk score for prediction of recurrence in patients with unprovoked venous thromboembolism (DAMOVES).

Background: In patients with unprovoked venous thromboembolism (VTE), the optimal duration of anticoagulation is anchored on estimating the risk of disease recurrence. We aimed to develop a simple risk assessment model that improves prediction of the recurrence risk.

Methods: In a prospective cohort study, 398 patients with a first unprovoked VTE were followed up for a median of 21.

Clinical Case of Metastatic Adrenocortical Carcinoma With Unusual Evolution: Review the Literature.

Adrenocortical carcinoma (ACC) is a rare and heterogeneous malignancy, with an incidence of approximately 0.72 per million cases per year leading to 0.2% of all cancer deaths in the United States.

Mitral Regurgitation - A Multidisciplinary Challenge.

Mitral regurgitation is an increasing valvular disease that represents a difficult management challenge. Surgical treatment for degenerative mitral regurgitation is the standard of care treatment. Percutaneous therapies have emerged rapidly over the past years as an option for treatment of mitral regurgitation for selected, predominantly high-risk patients.

Audits in real time for safety in critical care: definition and pilot study.

Unlabelled: Adverse events significantly impact upon mortality rates and healthcare costs.

Purpose: To design a checklist of safety measures based on relevant scientific literature, apply random checklist measures to critically ill patients in real time (safety audits), and determine its utility and feasibility.

Methods: A list of safety measures based on scientific literature was drawn up by investigators.

Treating Refractory Hypertension: Renal Denervation With High-Resolution 3D-Angiography.

A 53-year-old male was referred to our Department for refractory primary hypertension. Despite high doses of 6 anti-hypertensive drugs, ambulatory monitoring of blood pressure (BP) revealed a mean BP of 160/90 mmHg. Under local anaesthesia, renal denervation with radiofrequency was performed supported by high-resolution 3D angiography, which helped confirm the position of the applications in a spiroid fashion.

Reproducibility of percutaneous nephrolithotomy in the Galdakao-modified supine Valdivia position.

To demonstrate that percutaneous nephrolithotomy (PCNL) in the Galdakao-modified supine Valdivia position can be safely and effectively reproduced by different surgeons. A multicentre retrospective cross-sectional case study on 317 patients was conducted. The centres enrolled were four hospitals from the Spanish National Health System and provided data for consecutive PCNL from January 2008 to December 2010.