109 results on '"Asensio M"'
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2. Artículo especial por el Día Mundial del Riñón: Las sociedades científicas españolas ante la guía ESC 2021 de prevención de la enfermedad vascular: generalizar la medida de la albuminuria para identificar el riesgo vascular y prevenir la enfermedad vascular
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Ortiz, Alberto, Quiroga, Borja, Díez, Javier, Escalada San Martín, Francisco Javier, Ramirez, Leblic, Pérez Maraver, Manuel, Martínez-Berganza Asensio, M. Lourdes, Arranz Arija, José Ángel, Alvarez-Ossorio Fernández, José Luis, Córdoba, Raúl, Brotons Muntó, Franscisco, Cancelo Hidalgo, María Jesús, Reverter, Joan Carles, Plasencia-Rodríguez, Chamaida, Carretera Gómez, Juana, Guijarro, Carlos, Freijo Guerrero, M. del Mar, and de Sequera, Patricia
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- 2023
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3. Papel de la estimulación del nervio vago en el tratamiento de la epilepsia refractaria. Resultados clínicos e impacto en la calidad de vida
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Martorell-Llobregat, C., González-López, P., Luna, E., Asensio-Asensio, M., Jadraque-Rodríguez, R., García-March, G., and Moreno-López, P.
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- 2022
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4. Infecciones por Erythrovirus B19. Seis años de seguimiento en población adulta y pediátrica
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Claver Belver, Natàlia, Sanfeliu Sala, Isabel, Merino Asensio, M. Jesús, Monterde Pedra, Carla, Pineda Solas, Valentí, Capilla Rubio, Silvia, and Fontanals Aymerich, Dionisia
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- 2019
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5. Estudio LAM: conducta y calidad de vida en pacientes diagnosticados de epilepsia tratados con lacosamida
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Alfaro, A., Asensio, M., García-Escrivá, A., Medrano, V., Salom, J.M., Tortosa, D., Palao, S., Lezcano, M., Berenguer, L., Navarro, M., Cerdán, M., Buendía, J.F., and Giner, J.C.
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- 2019
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6. Documento de consenso sobre pautas de actuación y seguimiento del varón con síntomas del tracto urinario inferior secundarios a hiperplasia prostática benigna
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Brenes Bermúdez, Francisco José, Brotons Muntó, Francisco, Castiñeiras Fernández, Jesús, Cozar Olmo, José Manuel, Fernández-Pro Ledesma, Antonio, Martín Jiménez, Juan Antonio, Martínez-Berganza Asensio, M. Lourdes, Miñana López, Bernardino, and Molero García, José María
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- 2016
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7. Diagnostico y seguimiento termografico de electrocucion y fractura de radio en un Aguila imperial iberica (Aquila adalberti)
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Melero Asensio, M., Mendoza Vega, J.L., and Sánchez-Vizcaíno Rodríguez, J.M.
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- 2010
8. Aplicacion de la termografia en el diagnostico y valoracion de la pododermatitis plantar en rapaces
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Melero Asensio, M., López Márquez, I., and Sánchez-Vizcaíno Rodríguez, J.M.
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- 2010
9. 'Emprende en Verde'. Proyecto de Innovación Docente de fomento del emprendimiento en el ámbito de las Ingenierías Agrarias
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Rico González, M., Losada Burgos, R., Gómez Ramos, A., Sáiz Rojo, A., Campelo Rodríguez, M. P., Robles Robles, R., and Villahoz Asensio, M.
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patrono ,creatividad ,relación empleo-formación ,agronomía ,oportunidades de empleo ,innovación pedagógica - Abstract
Resumen de los autores Universidad de Valladolid. Escuela Técnica Superior de Ingenierías Agrarias Actualmente el autoempleo se configura como un mecanismo accesible para la incorporación de los jóvenes al mercado de trabajo. Concretamente, la creación de empresas en los diferentes sectores agrarios constituye un verdadero yacimiento de empleo para aquéllos recien titulados en alguna de las Ingenierías Verdes que cuenten con ideas innovadoras y carácter emprendedor. Consecuentemente, en la Escuela Técnica Superior de Ingenierías Agrarias de Palencia se está desarollando un Proyecto de Innovación Docente cuyo principal objetivo se centra en fomentar la creatividad, la innovación y el espíritu emprendedor dentro de los sectores agrícola, agroindustrial y forestal. Para alcanzar tal fin, se han llevado a cabo diversas acciones y dinámicas en las que han participado tanto personal docente como profesionales relacionados con el emprendimiento y con actividades empresariales relacionadas con los sectores del ámbito agroforestal y agroalimentario. Los resultados obtenidos hasta el momento muestran que si bien los alumnos en primera instancia no tienen una elevado predisposición emprendedora, sí que son sensibles a formarse en este tema y a desarrollar ideas creativas una vez terminados sus estudios. ESP
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- 2018
10. Opinión de las parejas sobre el futuro de sus embriones pasados 5 años de congelación
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Asensio, M., Boada, M., Veiga, A., and Barri, P.N.
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- 2001
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11. Abdomen agudo inesperado
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Latorre Asensio, M., Pellón Dabén, R., and Nieto Martínez, S.
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- 2019
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12. Empleo de la oxigenoterapia mediante cámara hiperbárica en cirugía oral y maxilofacial
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Iriarte Ortabe, J.I., Batle Vidal, J.M., Urdiain Asensio, M., Caubet Biayna, J., Morey Mas, M.A., Collado Lopez, J., Lasa Menéndez, V., Hamdan, H., Pastor Fortea, MªJ., Bosch Lozano, C., and Sánchez Mayoral, J.
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Osteitis maxillar ,Hyperbaric oxygentherapy ,Osteomielitis mandibular ,Osteitis maxilar ,Oxigenoterapia hiperbárica ,Osteomyelitis mandibular - Abstract
La oxigenoterapia hiperbárica (OHB) es una modalidad de terapéutica física que se fundamenta en la obtención de presiones parciales de oxígeno elevadas, al respirar oxígeno puro en el interior de una cámara a una presión superior a la atmosférica. El objetivo de esta revisión es clarificar los mecanismos de acción y los efectos de esta terapéutica física, los problemas que puede plantear y sobre todo las indicaciones actuales. En cirugía oral y maxilofacial, la OHB se utiliza como tratamiento complementario en procesos de osteítis y osteomielitis maxilo-mandibular, en infecciones necrotizantes de partes blandas (a nivel cervical, periodontal, gingival,…), en la prevención (muy importante) y el tratamiento de la osteradionecrosis, en los retrasos de cicatrización (de fracturas, de implantes dentales, de injertos/colgajos de difícil viabilidad), en la rehabilitación implantológica de pacientes oncológicos irradiados. Es preciso utilizar los protocolos establecidos y generar estudios que sostengan científicamente su utilización; de este modo se podría paliar la poca consistencia de los estudios publicados que hemos encontrado. Hyperbaric oxygen therapy (HBO) is a physical therapeutic modality based on obtaining high partial pressures of oxygen, on breathing pure oxygen inside a chamber at a pressure that is greater than that of the atmosphere. The object of this revision is to clarify the action mechanisms and the effects of the physical therapy, the problems that may arise and more especially the current indications for its use. In oral and maxillofacial surgery, HBO is used as complementary treatment for maxillo-mandibular osteitis and osteomyelitis, for necrotizing infections of soft tissue (on a cervical, periodontal, gingival... level), for the prevention (very important) and treatment of osteoradionecrosis, for healing delays (fractures, dental implants, grafts/flaps with difficult viability), for implantological rehabilitation of irradiated oncological patients. It is necessary to use the protocols that have been established and to generate studies that scientifically support its use; in this sense the lack of consistency that we have found is the studies that have been published could be reduced.
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- 2006
13. Mealiness assessment in apples and peaches using MRI techniques
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Barreiro Elorza, Pilar, Ruiz-Altisent, Margarita, Fernandez Valle, M. Encarnacion, Ruiz Cabello Osuna, Jesus Maria, Recasens Guinjuan, Inmaculada, and Asensio, M.
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Agricultura - Abstract
Since Januarv 1946 a wade EC Project entitled "Mealiness in fruits Consumers perception and means for detection is being carried out. Mealiness is a sensory attribute that cannot be defined by a single parameter but through a combination of variables (multidimensional structure) Previous studies propose the definition of mealiness as the lack of crispiness of hardness and of juiciness. A destructive instrumental procedure combined with a integration technique has been already developed enabling to identify mealy fruits by destructive instrumental means use other contributions of Barreiro and Ortiz to this Ag Eng 98. Current aims .are focused on establishing non destructive tests for mealiness assessment. Magnetic resonance Imaging (MRI) makes use of the magnetic properties that some atomic nuclei have. especially hidrogen nuclei from water molecules to obtain high quality images in the field of internal quality evaluation the MRI has been used to assess internal injury due to conservation as o treatments as chilling injury un Persimmons Clark&Forbes (1994) and water-core in apples (Wang et al. 1998. In the case of persimmons the chilling injury is described as an initial tissue breakdown and lack of cohesion between cells followed by formation of a firm gel and by a lack of juiciness without changes in the total amount ol water content. Also a browning of the flesh is indicated (Clark&Forhes 1994). This definition fits into the previous description of mealiness.
- Published
- 1998
14. Laurent Rouede: un fotógrafo francés en la Murcia del siglo XIX
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Asensio Martínez Jódar
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Laurent Rouede ,Jean Laurent ,Siglo XIX ,Retrato fotográfico ,Carte de visite ,History of the arts ,NX440-632 - Abstract
El artículo estudia a fondo figura de Laurent Rouede, fotógrafo francés nacido en Avignon en 1819 que trabajó en varias ciudades españolas en los años sesenta y setenta del siglo XIX. Se presta especial interés a su relación con la ciudad de Murcia donde fotografió los edificios más destacados y realizó la primera serie fotográfica de las esculturas de Salzillo. Como fuentes para este estudio se han empleado un gran número de documentos del siglo XIX, entre las que destaca la prensa periódica.
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- 2015
15. La prensa como fuente para el estudio de la historia de la fotografía en Murcia durante el siglo XIX
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Asensio Martínez Jodar
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siglo XIX ,Murcia ,patrimonio ,fotografía ,prensa ,anuncio ,History of the arts ,NX440-632 - Abstract
Historia de la fotografía en la ciudad de Murcia. A través de este estudio ponemos de manifesto la importancia de la prensa periódica local para la reconstrucción de la historia de la fotografía murciana del siglo XIX.
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- 2014
16. Learning in archaeological sites with mobile devices = Aprendizaje con dispositivos móviles en yacimientos arqueológicos
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IBÁÑEZ-ETXEBERRIA, A., VICENT, N., ASENSIO, M., CUENCA, J.M., FONTAL, O.
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Yacimiento arqueológico ,Dispositivo móvil ,Mobile learning ,Educación Patrimonial ,Educación secundaria ,Auxiliary sciences of history ,Archaeology ,CC1-960 - Abstract
La relevancia social del mobile learning es cada vez más evidente. Estos mecanismos, a través de TICs y dispositivos móviles, se aplican ya en programas educativos en yacimientos arqueológicos y museos, pero la pregunta es si estos programas son efectivos para el aprendizaje. Para investigar esta cuestión, hemos evaluado la implementación de un programa educativo con contenidos histórico- patrimoniales ofertado para estudiantes de secundaria. Noventa estudiantes participaron en este estudio respondiendo un cuestionario que abordaba cuestiones relacionadas con la asimilación de contenidos conceptuales, la atención y la eficacia del programa, así como aspectos relacionados con la satisfacción, utilidad percibida y dificultad de uso de la tecnología móvil. Los resultados son satisfactorios respecto a la asimilación de contenidos, y se aprecian mejores resultados con la combinación de metodologías receptivas y el uso de tecnología móvil. La satisfacción y la percepción de la utilidad confirman los buenos resultados de anteriores trabajos.
- Published
- 2014
17. Pulmonary arterial hypertension associated with pretricuspid shunts: risk profile and survival.
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Calvo-Asensio M, Buendía Fuentes F, Arnau Vives MÁ, Andrés Lalaguna L, Martínez Dolz L, and Rueda Soriano J
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- 2024
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18. [Screening for Chronic Kidney Disease in the Community Pharmacy. CRIERFAC Study: Description of the Methodology].
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Salar Ibáñez L, Espejo Guerrero J, Satué E, Pérez León N, and Martínez-Berganza Asensio ML
- Abstract
Abstract: Chronic kidney disease (CKD) is the existence of abnormalities in renal structure or function with an impact on health. This is usually considered when estimated glomerular filtration (eGF) falls under 60 mL/min/1.73m
2 . Its clinical course leads to renal replacement therapy (dialysis or transplant) when eGF falls under 15 mL/min/1.73m2 . Screening in at risk populations has been proven to be cost-effective. The aim of this work is to perform CKD screening in the community pharmacy. In this publication we report and justify the methodology in detail., Methodology: Pharmacists from the community pharmacies taking part selected patients who complied with inclusion and not exclusion criteria. Creatinine was measured by means of a finger prick and eGF calculated with the formula CKD-EPI. If this is lower than a set value, which depends on age, referral to the general practitioner takes place., Results: A total of 141 out of 200 pharmacies took part in the study. In all 2116 patients were recruited and 116 patients were lost. The final sample size was 2000 patients., Discussion: The protocol was successfully implemented by community pharmacists and was extremely well received by community pharmacy users. The age adjustment for eGF thresholds provides a novel additional filter. The aim is not to overburden primary care centres with potential referrals of false positives. Confirmation of the diagnosis is subject to voluntary communication by the patient to the pharmacist., (Copyright SEFAC. Sociedad Española de Farmacia Clínica, Familiar y Comunitaria. This article is available from url https://www.farmaceuticoscomunitarios.org/.)- Published
- 2024
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19. The role of vagus nerve stimulation in the treatment of refractory epilepsy: Clinical outcomes and impact on quality of life.
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Martorell-Llobregat C, González-López P, Luna E, Asensio-Asensio M, Jadraque-Rodríguez R, García-March G, and Moreno-López P
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- Humans, Anticonvulsants therapeutic use, Quality of Life, Treatment Outcome, Retrospective Studies, Seizures drug therapy, Drug Resistant Epilepsy drug therapy, Vagus Nerve Stimulation
- Abstract
Background: Vagus nerve stimulation (VNS) is used as a complementary therapy to pharmacological treatment in patients with refractory epilepsy. This study aims to evaluate the efficacy of VNS in reducing seizure frequency, severity, and duration; reducing the number of antiepileptic drugs administered; and improving patients' quality of life., Material and Methods: We analysed the clinical progression of 70 patients with refractory epilepsy treated with VNS at Hospital Universitario de Alicante and Hospital Clínico de Valencia. Data were collected before and after the procedure. The difference in seizure frequency pre- and post-VNS was classified using the McHugh scale. Data were also collected on seizure duration and severity, the number of drugs administered, and quality of life., Results: According to the McHugh classification, 12.86% of the patients were Class I, 44.29% were Class II, 40% were Class III, and the remaining 2.86% of patients were Class IV-V. A≥50% reduction in seizure frequency was observed in 57.15% of patients. Improvements were observed in seizure duration in 88% of patients and in seizure severity in 68%; the number of drugs administered was reduced in 66% of patients, and 93% reported better quality of life., Conclusions: VNS is effective for reducing seizure frequency, duration, and severity and the number of antiepileptic drugs administered. It also enables an improvement in patients' quality of life., (Copyright © 2019 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2022
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20. Page kidney after pediatric kidney transplantation: a case report.
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Gander R, Asensio M, Royo GF, Molino JA, López M, Coma A, Muñoz M, Cruz A, Ríos H, and Ariceta G
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- Adolescent, Child, Female, Hematoma etiology, Hematoma surgery, Humans, Kidney, Male, Hypertension etiology, Kidney Failure, Chronic complications, Kidney Transplantation
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Introduction: Page kidney (PK) is a rare condition caused by parenchymal compression due to a subcapsular hematoma. Irreversible damage of the graft may occur if this condition is not recognized and treated properly., Clinical Case: We describe the case of a 16-year-old man with chronic renal failure secondary to corticosteroid-resistant nephrotic syndrome (CRNS) caused by NPHS2 mutations. The patient underwent a 5th fifth living-related KT. The graft was placed intraperitoneally and reperfused well without complications. On the 4th postoperative day his labs demonstrated raising creatinine associated with refractory hypertension, gross hematuria and anemia. Urgent ultrasound revealed a subcapsular hematoma with signs of parenchymal compression. PK phenomenon was suspected and urgent surgical intervention decided., Comments: PK is a rare but an emergence potentially treatable and reversible complication after pediatric KT. Early diagnosis based on clinical suspicion and suggestive imaging are the key points for a favorable outcome.
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- 2022
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21. Chronic critical illness, how to manage it?
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García-de-Lorenzo A, Añón JM, Asensio MJ, and Burgueño P
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- 2021
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22. [Alzemon: a prospective follow-up study of eslicarbazepine acetate monotherapy in patients with newly diagnosed epilepsy].
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Hernández-Rubio L, Asensio-Asensio M, Tortosa-Conesa D, Alfaro-Sáez A, García-Escrivá A, Díaz-Román M, Montoya J, Méndez-Miralles MA, Bertol-Alegre V, Castro-Vilanova MD, Galiano ML, Blanco-Cantó ME, and López-González F
- Subjects
- Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Anticonvulsants therapeutic use, Dibenzazepines therapeutic use, Epilepsy drug therapy
- Abstract
Introduction: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce., Aim: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice., Patients and Methods: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects., Results: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population., Conclusion: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.
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- 2021
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23. Multidisciplinary rounds in oncology and hematology: Are they superior to rapid response teams?
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García-de-Lorenzo A, Jiménez V, Feliu J, Asensio MJ, Civantos B, and Añón JM
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- 2021
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24. [Can SARS-CoV-2 be a Risk Factor for Pulmonary Aspergillosis?]
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García Clemente M, Hermida Valverde T, Leizaola-Irigoyen O, Enríquez Rodríguez AI, Arias Guillén M, Telenti Asensio M, García Carus E, and Peláez García T
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- 2021
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25. Unexpected acute abdomen.
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Latorre Asensio M, Pellón Dabén R, and Nieto Martínez S
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- 2019
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26. [Erythrovirus B19 infections. Six years of follow-up in adults and children].
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Claver Belver N, Sanfeliu Sala I, Merino Asensio MJ, Monterde Pedra C, Pineda Solas V, Capilla Rubio S, and Fontanals Aymerich D
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- Adult, Age Factors, Arthralgia epidemiology, Arthralgia virology, Child, Child, Preschool, Erythema Infectiosum physiopathology, Exanthema epidemiology, Exanthema virology, Female, Fever epidemiology, Fever virology, Follow-Up Studies, Humans, Infant, Male, Middle Aged, Pregnancy, Retrospective Studies, Erythema Infectiosum epidemiology, Parvovirus B19, Human isolation & purification, Pregnancy Complications, Infectious virology
- Abstract
Introduction: The aetiological agent of erythema infectiosum is Erythrovirus B19 (also known as parvovirus B19), frequently found in children and adolescents, but also associated with arthropathy, aplastic crisis, and abortion in adults., Material and Methods: A retrospective study of Erythrovirus B19 cases in the years 2010-2015., Results: Of the 56 cases of Erythrovirus B19 diagnosed, 34 were adults (32 women and 2 men) and 22 younger than 18 years (12 girls and 10 boys). Six cases were in pregnant women. Infections mainly occurred between spring and summer. In childhood, fever (64%), rash (50%), and anaemia (55%) were the most frequent symptoms. However, arthralgia (59%) was the most frequent symptom in adults, and less frequent were anaemia (41%), fever (32%), and rash (29%)., Conclusions: The characteristic clinical presentation in childhood was rash and fever, whereas in adults it was arthralgia. Anaemia is also frequent, but only severe in previous haematological disease. It should be pointed out that Erythrovirus B19 infection during pregnancy could severely affect the foetus., (Copyright © 2017 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2019
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27. LAM study: Effects of lacosamide on behaviour and quality of life in patients with epilepsy.
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Alfaro A, Asensio M, García-Escrivá A, Medrano V, Salom JM, Tortosa D, Palao S, Lezcano M, Berenguer L, Navarro M, Cerdán M, Buendía JF, and Giner JC
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- Adult, Anxiety psychology, Depression psychology, Drug Therapy, Combination, Epilepsy psychology, Female, Humans, Male, Middle Aged, Prospective Studies, Psychiatric Status Rating Scales, Quality of Life, Treatment Outcome, Anticonvulsants therapeutic use, Epilepsy drug therapy, Lacosamide therapeutic use
- Abstract
Introduction: Psychiatric comorbidities are common in epileptic patients, and evaluating the impact of antiepileptic drugs on patients' moods is therefore essential. The aim of this study is to assess the effects of lacosamide on behaviour and quality of life in people with epilepsy., Methods: We conducted a multicentre prospective observational study of poorly-controlled epileptic patients who received lacosamide as an adjuvant treatment. Patients were evaluated on 4 occasions during a 12-month period. The impact of lacosamide on patients' mood and quality of life was assessed with the Quality of Life in Epilepsy Inventory-10 (QOLIE-10), the Hospital Anxiety and Depression Scale (HADS), and the Barratt Impulsiveness Scale (BIS-11). As a secondary objective, we evaluated the effectiveness and safety of lacosamide., Results: We included 55 patients with a mean age of 47.1±18.4 years. At baseline, 34.5% of the patients had psychiatric comorbidities; the mean number of crises in the previous month was 3.6±4.3. The QOLIE-10 and HADS scales revealed statistically significant improvements in patients with a poor baseline condition (anxiety, depression, and/or poor quality of life). The BIS-11 scale detected no impulsive behaviour during follow-up. After 12 months of treatment, 51.9% of the patients were seizure-free and 77.8% experienced a reduction of at least 50% in seizure frequency. Adverse effects were mild in most cases; lacosamide was discontinued in 10 patients (18.2%)., Conclusions: Lacosamide is a safe and effective treatment option for patients with epilepsy and psychiatric comorbidities., (Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
- Full Text
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28. [Evidence-based medicine and patient-centred medicine in the management of lower urinary tract symptoms due to benign prostatic hyperplasia in Primary Care].
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Alcántara Montero A, Estacio García M, and Martínez-Berganza Asensio ML
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- Evidence-Based Medicine methods, Humans, Lower Urinary Tract Symptoms etiology, Male, Prostatic Hyperplasia complications, Lower Urinary Tract Symptoms therapy, Patient-Centered Care methods, Primary Health Care methods, Prostatic Hyperplasia therapy
- Published
- 2018
- Full Text
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29. [Is the Mathieu urethroplasty a useful technique for urethrocutaneous fistula repair after hypospadias surgery?]
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Aguilera-Pujabet M, Gander R, Royo GF, López M, and Asensio M
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- Child, Child, Preschool, Cutaneous Fistula etiology, Cutaneous Fistula surgery, Follow-Up Studies, Humans, Infant, Male, Postoperative Complications surgery, Recurrence, Retrospective Studies, Treatment Outcome, Urinary Fistula etiology, Hypospadias surgery, Urethra surgery, Urinary Fistula surgery, Urologic Surgical Procedures, Male methods
- Abstract
Aim: There are multiple surgical techniques for distal urethrocutaneous fistulas (DUCF) repair after hypospadias surgery. Our aim was to analyze our results of simple closure (SC) and salvage mathieu urethroplasty (MU)., Material and Methods: Retrospective study (2014-2017) of pediatric patients with DUCF who underwent SC and MU. Only subcoronal to distal fistulas were collected, excluding the proximal ones non-tributary of MU. Demographics, clinical data, treatment and results were registered., Main Results: Over 4 years, 177 hypospadias and 28 UCFs were repaired. 15/28 met the inclusion criteria. Hypospadias type: anterior (10, 66.7%), midshaft (3, 20%) and posterior (2, 13.3%). Mean age at primary urethroplasty was 31.9 months (SD: 16.2). The most common techniques in primary surgery were Thiersch-Duplay (6) and Snodgrass (4). Median time from primary surgery to apparition of the fistula was 5 months (rank: 0-14). The surgical technique used for fistula repair was: SC (7) and MU (8). DUCF succeeded in all patients treated with MU, while among those treated with SC, 71.4% recurred, and only 4 patients underwent finally successful repair with a median of 1.5 interventions. Median follow-up was 25 months (rank: 12-55)., Conclusions: MU is a useful, effective and safe technique for DUCF repair. Most importantly, it is easily reproducible. The results of MU seem to be superior to CS and could be considered as a first choice.
- Published
- 2018
30. [Management of benign prostate hyperplasia shared between primary care and urology].
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Alcántara Montero A, Brenes Bermúdez FJ, and Martínez-Berganza Asensio ML
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- Consensus, Cooperative Behavior, Humans, Male, Primary Health Care organization & administration, Prostatic Hyperplasia therapy, Urology organization & administration
- Published
- 2017
- Full Text
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31. [Consensus document on the management and follow-up of the male with lower urinary tract symptoms secondary to benign prostate hyperplasia].
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Brenes Bermúdez FJ, Brotons Muntó F, Castiñeiras Fernández J, Cozar Olmo JM, Fernández-Pro Ledesma A, Martín Jiménez JA, Martínez-Berganza Asensio ML, Miñana López B, and Molero García JM
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- Consensus, Humans, Lower Urinary Tract Symptoms etiology, Male, Primary Health Care, Prostatic Hyperplasia complications, Prostatic Hyperplasia diagnosis, Referral and Consultation, Spain, Lower Urinary Tract Symptoms therapy, Practice Guidelines as Topic, Prostatic Hyperplasia therapy
- Abstract
Benign prostate hyperplasia (BPH) is a high-incidence condition. Its diagnosis and treatment is shared between urologists and Primary Care physicians. Its management uses up a significant amount of resources. The Spanish Society of Primary Care Physicians (SEMERGEN), the Spanish Society of General Practitioners and Family Doctors (SEMG), the Spanish Society of Family and Community Medicine (semFYC), and the Spanish Association of Urology (AEU) have prepared a document on the management and monitoring of BPH, in which the aim is to incorporate the latest evidence in order to update the previously published guidelines, and present them here in condensed form. The main objective of these new recommendations is to raise the awareness of Primary Care physicians and assist them in its diagnostic evaluation, treatment and monitoring, as well as providing unified consensus criteria for referral to the secondary care level., (Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
32. First resuscitation of critical burn patients: progresses and problems.
- Author
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Sánchez-Sánchez M, García-de-Lorenzo A, and Asensio MJ
- Subjects
- Albumins, Humans, Thermodilution, Burns therapy, Fluid Therapy
- Abstract
Currently, the aim of the resuscitation of burn patients is to maintain end-organ perfusion with fluid intake as minimal as possible. To avoid excess intake, we can improve the estimation using computer methods. Parkland and Brooke are the commonly used formulas, and recently, a new, an easy formula is been used, i.e. the 'Rule of TEN'. Fluid resuscitation should be titrated to maintain the urine output of approximately 30-35 mL/h for an average-sized adult. The most commonly used fluids are crystalloid, but the phenomenon of creep flow has renewed interest in albumin. In severely burn patients, monitoring with transpulmonary thermodilution together with lactate, ScvO2 and intraabdominal pressures is a good option. Nurse-driven protocols or computer-based resuscitation algorithms reduce the dependence on clinical decision making and decrease fluid resuscitation intake. High-dose vitamin C, propranolol, the avoidance of excessive use of morphine and mechanical ventilation are other useful resources., (Copyright © 2016 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
33. [Update on the medical treatment of lower urinary tract symptoms (LUTS) in men].
- Author
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Alcántara Montero A, Brenes Bermúdez FJ, Fernández Fernández L, Martínez-Berganza Asensio ML, and Pérez León N
- Subjects
- Adult, Humans, Lower Urinary Tract Symptoms epidemiology, Lower Urinary Tract Symptoms etiology, Male, Lower Urinary Tract Symptoms therapy, Prostatic Hyperplasia complications, Quality of Life
- Abstract
Lower urinary tract symptoms (LUTS) are a frequent cause of consultation in Primary Care, especially in men >40 years of age. Benign prostatic hyperplasia (BPH) has been recognized as the most common cause of bothersome LUTS, causing significant interference with everyday activities and quality of life. The purpose of this study is to provide an update on recent developments regarding the medical management of male LUTS., (Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
34. [Effect of lacosamide on the quality of life of patients with epilepsy].
- Author
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García-Escrivá A, López-Hernández N, Llorca V, Alfaro A, Asensio-Asensio M, García C, Lezcano-Rodas M, Medrano V, and Palao S
- Subjects
- Acetamides adverse effects, Adolescent, Adult, Aged, Aged, 80 and over, Anticonvulsants adverse effects, Anxiety etiology, Depression etiology, Disorders of Excessive Somnolence chemically induced, Drug Therapy, Combination, Epilepsies, Partial psychology, Female, Humans, Lacosamide, Male, Middle Aged, Nausea chemically induced, Prospective Studies, Quality of Life, Severity of Illness Index, Sodium Channel Blockers adverse effects, Young Adult, Acetamides therapeutic use, Anticonvulsants therapeutic use, Anxiety prevention & control, Depression prevention & control, Epilepsies, Partial drug therapy, Sodium Channel Blockers therapeutic use
- Abstract
Introduction: Epilepsy causes psychiatric disorders in 20-40% of patients impacting negatively on their quality of life. Lacosamide is a new antiepileptic as adjunctive therapy in partial seizures with or without generalization., Aim: We conducted a study to assess the impact of lacosamide as to the quality of life of epileptic patients. We used the HAD scale for anxiety and depression and QOLIE-10 scale for quality of life. We evaluated the efficacy and tolerability., Patients and Methods: We collected prospectively poorly controlled epileptic patients are and added lacosamide treatment. Baseline visit, at 3 and 6 months were performed. The questionnaires are completed and the epilepsy information has been collected., Results: 31 patients, age 45.5 ± 17.2 years, 64.5% males are included. Number of previous monthly crisis 1.6 ± 1.8. HAD anxiety scale shows a significant improvement at 3 and 6 months. HAD scale for depression reflects a significant improvement in quality parameters. QOLIE-10 shows significant improvement for the group with low quality of life after 3 and 6 months. After 6 months 61.3% of patients have a seizure reduction equal or more than 50% and 54.8% are seizure free. Dizziness is the most common side effect (22.8%). 74.2% continued treatment., Conclusions: Lacosamide may improve anxiety, depression and quality of life of epileptic patients regardless of seizure control. Response to treatment, adherence and side effects are similar to previous studies.
- Published
- 2014
35. [Positioning of scientific societies and working groups reviews: statement on conflicts of interest and need for transparency].
- Author
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Gracia Ballarín R, García Asensio M, Martinez Nimatuj I, and Galván Lago F
- Subjects
- Humans, Anticoagulants therapeutic use, Drug Prescriptions, Thrombosis prevention & control
- Published
- 2014
- Full Text
- View/download PDF
36. [Exceptional causes of hematuria in childhood and infancy].
- Author
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Gander R, Asensio M, Fatou Royo G, Martín Osorio JA, and Lloret J
- Abstract
Introduction: Hematuria is not uncommon in pediatric patients, even though it remains a diagnostic challenge in many cases. In this study we aim to draw attention to health professionals to have in mind rare diseases as a cause of hematuria., Case Reports: We report 3 representative clinical cases of hematuria from very different origins: traumatic, congenital and infectious, illustrating the broad spectrum of causes of hematuria., Comments: There are exceptional causes of hematuria which should be considered in clinical practice. The study of hematuria should always include a complete personal and familiar medical history, a careful physical examination and urine cultures. It is important to try to propose an algorithm study, avoiding unnecessary and invasive diagnostic tests that can be associated with complications.
- Published
- 2014
37. [Robotic pyeloplasty: first experiences].
- Author
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Asensio M, Gander R, and Royo G
- Subjects
- Adolescent, Child, Child, Preschool, Female, Humans, Male, Retrospective Studies, Urologic Surgical Procedures methods, Kidney Pelvis surgery, Laparoscopy, Robotics, Ureteral Obstruction surgery
- Abstract
Objective: To analyze our initial experience with the practice of robotic pyeloplasty and describe its advantages over laparoscopic and open surgery., Patients and Methods: Retrospective study of the pediatric cases of pyeloplasty assisted by the robot da Vinci between March 2010 and May 2013. In all cases a transperitoneal approach was used with placement of 4 trocars (3 robotic trocars and 1 conventional laparoscopic). The technique used was the dismembered pyeloplasty Anderson-Hynes type., Results: We operated 15 patients (12 men and 3 women) with a median age at surgery of 11 years (r: 5-18). The median weight was 40 kilos (r: 19-82). Five patients had a previous open pyeloplasty performed several years ago. All patients except but one were completed by robot. The only conversion to open surgery was performed because of difficulty in placing the double-J catheter due to a stenosis at the ureterovesical junction. They were no other intraoperative complications. The median operative time was 180 minutes (r: 110-252) and the median time for the robot docking 14 minutes (r: 4-50). The average hospital stay was 3.47 days (SD: 3). Mean follow-up was 16.97 months (SD: 10.24) and currently all patients are asymptomatic., Conclusions: Our initial experience seems to demonstrate that, coinciding with the literature, robotic pyeloplasty improves the results of laparoscopic pyeloplasty, retaining all its advantages and radically shortening the learning curve.
- Published
- 2013
38. [Hot water-induced epileptic crisis].
- Author
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Picorelli Ruiz S, Sellés Galiana MF, and Asensio Asensio M
- Subjects
- Adult, Epilepsy, Reflex etiology, Female, Humans, Epilepsy, Reflex diagnosis, Hot Temperature adverse effects, Water adverse effects
- Published
- 2012
- Full Text
- View/download PDF
39. [Robotic surgery: first pediatric series in Spain].
- Author
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Marhuenda C, Giné C, Asensio M, Guillén G, and Martínez Ibáñez V
- Subjects
- Adolescent, Child, Humans, Retrospective Studies, Spain, Robotics, Surgical Procedures, Operative methods
- Abstract
Objectives: Despite several surgical robots operating in Spain, the experience in pediatric pathology is limited. We found interesting to review the first full pediatric series in our country. We would like to share as well our views on the transition from conventional to robotic laparoscopy., Methods: Retrospective review of all the pediatric laparoscopic surgery assisted by the da Vinci robot (Intuitive Surgical), in our center, between April 2009 and February 2010., Results: 8 patients were operated (7-15 years), with an average weight of 42 Kg (18 to 83 Kg). 11 procedures were performed: bilateral salpingo-oophorectomy (1), inguinal hernia (1), cholecystectomy (4), splenectomy (2), resection of pancreatic mass (1), fundoplication (1), adrenalectomy (1). All proceedings, except two, were completed with the robot. As complications, there was one intraoperative bleeding that required blood transfusion, and in the postoperative period, there was a surgical wound infection. There were no conversions to open surgery. The average time of preparation before surgery was 130 minutes. The three-dimensional vision and lack of tremor are the main advantages cited by all surgeons., Conclusions: The learning curve of Robotic Surgery is shorter than that of conventional laparoscopy. Trained surgeons can perform complex procedures laparoscopically from the outset. The main difficulty in children is the proper planning of trocar placement, due to the smaller size of the surgical field. The organization of surgery is complex and success depends on close collaboration of all stakeholders.
- Published
- 2011
40. [Disseminated abdominal hydatid disease].
- Author
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Colomina Pascual M, Giner Galvañ V, Domenech Iglesias A, and Planelles Asensio M
- Subjects
- Abdomen, Humans, Male, Middle Aged, Echinococcosis diagnosis
- Published
- 2011
- Full Text
- View/download PDF
41. [The use of intravenous levetiracetam in a general hospital].
- Author
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Giner-Bernabeu JC, Hernández-Rubio L, Sempere AP, Bosacoma-Ros N, Berenguer-Ruiz L, Lezcano-Rodas M, Martínez-Lazcano T, Mira-Berenguer F, Baño E, Abarca-Olivas J, Duart M, and Asensio-Asensio M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Hospitals, General, Humans, Infusions, Intravenous, Levetiracetam, Male, Middle Aged, Piracetam administration & dosage, Retrospective Studies, Young Adult, Anticonvulsants administration & dosage, Epilepsy drug therapy, Piracetam analogs & derivatives
- Abstract
Introduction and Aims: Although antiepileptic drugs are usually administered orally, sometimes they must be given intravenously. Levetiracetam is the only one of the new antiepileptic drugs that can be administered intravenously. In this study we report on the use of intravenous levetiracetam in a general hospital, while also evaluating its effectiveness and safety., Patients and Methods: A retrospective analysis was conducted of the medical records of all hospital admissions that were treated with intravenous levetiracetam between July 2007 and May 2008., Results: A total of 53 patients were treated with intravenous levetiracetam. Approximately half the patients (47%) had been admitted to neurology, followed by neurosurgery (21%) and oncology (9%). The mean age was 52.2 years (range: 9-87 years) and 40% were females. Seizures were symptomatic in 81% of cases and the most common aetiologies were strokes (40%) and brain tumours (33%). The most frequent presenting symptoms were repeated epileptic seizures (47.2%) and epileptic status (26.4%). Overall, control of seizures was achieved in 87% of patients. No severe side-effects that could be attributed to levetiracetam therapy were detected., Conclusions: Intravenous levetiracetam seems to be an effective, safe antiepileptic drug in hospitalised patients, and especially so in those who present an associated comorbidity and/or who are on multiple drug therapy.
- Published
- 2009
42. [Indirect CT venography in patients with clinical suspicion of pulmonary thromboembolism: our experience and possible indications for the test].
- Author
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Herrero HG, Asensio SG, Asensio MT, de Toledo LS, Cabrejas RC, and Morales AF
- Subjects
- Aged, Female, Humans, Male, Phlebography methods, Prospective Studies, Sensitivity and Specificity, Pulmonary Embolism diagnostic imaging, Tomography, X-Ray Computed
- Abstract
Objective: Our objective was to evaluate the sensitivity of indirect computed tomography (CT) venography in the evaluation of deep vein thrombosis and to establish possible general indications for this technique in cases with clinical suspicion of thromboembolic disease., Material and Methods: We studied 76 patients with clinical suspicion of pulmonary thromboembolism who underwent CT angiography of the pulmonary arteries and indirect CT venography. We correlated the results with those of ultrasound examination of the limbs in 63 cases to determine the sensitivity of the test. We analyzed the cases in which the findings at indirect CT venography changed the management of the patient., Results: The concordance between indirect CT venography and ultrasound was 92%. Thromboembolic disease was diagnosed in 40% of the cases. In these cases, CT angiography of the pulmonary arteries was positive in 80% and in the remaining 20% only CT venography was positive. In two cases, abdominal pathology that changed the clinical management of the patients was found., Conclusions: Indirect CT venography is sensitive in the detection of deep vein thrombosis in patients with clinical suspicion of pulmonary thromboembolism. This technique can shorten the time to diagnosis, increase diagnostic precision, and provide additional clinical data that may be important in the patient's management. However, its generalized use is limited because it involves the use of ionizing radiation.
- Published
- 2008
- Full Text
- View/download PDF
43. [Five years of renal trauma in a paediatric trauma center: new tools in the diagnostic and therapeutic process].
- Author
-
Guillén G, Asensio M, Piró C, Martin JA, and Pérez M
- Subjects
- Adolescent, Child, Child, Preschool, Decision Trees, Humans, Retrospective Studies, Time Factors, Wounds and Injuries diagnosis, Wounds and Injuries therapy, Kidney injuries
- Abstract
Introduction: There is general agreement in the conservative management of most renal traumas, but questions like the role of angiography are still controversial. Our objective is to review the paediatric renal trauma characteristics, propose a therapeutic protocol and suggest new therapeutic tools., Material and Methods: Retrospective review of clinical records (epidemiology, diagnostic methods, renal injury grade according to the AAST Organ Injury Scale, treatment and follow up) of the paediatric renal injuries at Vail d'Hebron Hospital in the last 5 years. Outline of a diagnostic-therapeutic protocol consistent with the literature., Results: Since 2001, 18 cases of paediatric renal trauma have been diagnosed. Median of age was 10 years (range 2-17). Renal injury grade was: I (4), II (5), III (4), IV (4), V (1). Main mechanisms of injury were car and motorcicle accidents (4), fall (3), bicycle (3) and sports (3). There were different severity associated injuries in 10 patients. Abdominal exploration was normal in 6 cases, and in 5 (including the grade V injury) hematuria was absent or was microscopic. Mean hematocrit and hemoglobine were 34.5% y 11.8 g/dl. Abdominal CT was performed in all cases, detecting injuries that were unnoticed with ultrasound exploration. Complications were: renal artery pseudoaneurism (1), urinoma (1), uretero-pelvic joint disruption (1), arterial hypertension (3), renal colic (1). Management was: conservative in 13 cases, angiography in 4 (2 embolizations of bleeding vessels, 1 pseudoaneurism embolization, 1 placement of endovascular stents in an injury of the arterial intima), delayed surgery in 2 (1 nefrectomy, 1 uretero-pyeloplasty). All of them received prophylactic antibiotics; 10 had self-limited fever with negative cultures. Only in 2 cases DMSA at 6 months was inferior to 20%. There were no deaths., Conclusions: In paediatric patients, there can be severe renal injuries despite absence of hematuria and a normal physical exam and hemogram. Abdominal CT with endovenous contrast is the keystone of diagnosis, and identifies vascular injuries that might need immediate treatment, like renal ischemia. Angiography is an important tool to consider in case of persistent bleeding or renal infarctation.
- Published
- 2007
44. [Childhood cholelithiasis in a district hospital].
- Author
-
Cozcolluela Cabrejas MR, Sanz Salanova LA, Martínez-Berganza Asensio MT, Gómez Herrero H, Mellado Santos JM, Miranda Orella L, and Forradellas Morales A
- Subjects
- Adolescent, Causality, Child, Child, Preschool, Female, Humans, Infant, Male, Retrospective Studies, Spain, Ultrasonography, Cholelithiasis diagnosis, Cholelithiasis etiology, Cholelithiasis surgery
- Abstract
Cholelithiasis is a rare finding in children, even though recent series show increased detection of this disease. A retrospective study was performed in children with a diagnosis of cholelithiasis between 1993 and 2005 in the Reina Sofia Hospital in Tudela (Spain). Eighteen patients with cholelithiasis and three with biliary sludge were detected. Predisposing factors for cholelithiasis were prematurity and parenteral nutrition (one patient), sepsis (two patients), obesity (one patient), and a family history of the disease (one patient). The disease was idiopathic in 11 patients. Gallstones were detected in two patients presenting with appendicular symptoms. One child with biliary sludge had received treatment with ceftriaxone as a predisposing factor. All patients were diagnosed by ultrasound. Plain abdominal X-ray detected lithiasis in 12 of the 15 patients (80 %) with cholelithiasis who underwent this procedure. The most frequent symptoms were abdominal pain (seven patients), abdominal pain and vomiting (five patients), and diarrhea (one patient). Two patients presented with appendicular symptoms. Fourteen patients underwent surgery (open cholecystectomy in two and laparoscopic cholecystectomy in 12). None of the patients required emergency surgery. Cholelithiasis in children is an unusual finding, but is not exceptional and is associated with nonspecific symptoms. Plain abdominal X-ray is useful in diagnosis but the main diagnostic technique is ultrasonography.
- Published
- 2007
- Full Text
- View/download PDF
45. [Sigmoid colon vaginoplasty: experience with five cases].
- Author
-
Piro C, Asensio M, Martín JA, Giné C, Ormaetxea E, and Chicaiza E
- Subjects
- Adolescent, Adult, Female, Follow-Up Studies, Humans, Syndrome, Treatment Outcome, Colon, Sigmoid transplantation, Gynecologic Surgical Procedures methods, Plastic Surgery Procedures methods, Vagina abnormalities, Vagina surgery
- Abstract
Vaginal atresia compounds a rare congenital anomaly and results from anomalies in the development of Müller ducts as happens in the Mayer-Rokitansky syndrome or in other cases of intersexual states. Some different tissues have been issued for the creation of a neovagina, but none of them has been accepted as ideal. We have chosen sigmoid colon in order to create a new vagina functionally appropriate. We present five cases affected of vaginal atresia. Two of them were Mayer-Rokitansky syndromes and the other were diagnosed during the study for primary amenorrhea as a result of an intersexual state. In all cases a vaginoplasty was performed according to Baldwin's technique in the ages between 15 and 20 year-old. The follow up has been from 1 to 16 years. No postoperative complications have been observed. The external aspect of the genitalia is normal and a proper sized with length and lubrificated vagina was attained in all cases without any retraction in any patient. Two of the patients maintain sexual relations without problems. In our experience, the cosmetic and functional result of sigmoid vaginoplasty were excellent.
- Published
- 2006
46. [Carrión disease: two centuries later].
- Author
-
Blanco Badillo A, Telenti Asensio M, Anda P, and Figueroa Fábregas E
- Subjects
- Humans, Male, Middle Aged, Spain, Bartonella Infections diagnosis
- Published
- 2005
- Full Text
- View/download PDF
47. [Health care activity in a headache-specific clinic].
- Author
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Garcia-Escrivà A, Asensio-Asensio M, López-Hernández N, González-Aznar OJ, Oliver-Navarrete C, Alvarez-Saúco M, and Pampliega-Pérez A
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Delivery of Health Care, Female, Humans, Middle Aged, Prospective Studies, Ambulatory Care Facilities statistics & numerical data, Analgesics therapeutic use, Headache Disorders classification, Headache Disorders diagnosis, Headache Disorders drug therapy, Headache Disorders epidemiology, Health Services Needs and Demand
- Abstract
Introduction: It is reckoned that headaches affect, at least once a year, around 90% of the population. The socioeconomic repercussion occasioned by this malady justifies the appearance in recent years of headache units., Aim: To conduct a descriptive epidemiological and health care study of the activity carried out in a headache-specific clinic., Patients and Methods: All the relevant points from the histories of patients who visited our surgery over a period of two years were collected prospectively and consecutively. The different types of headaches were classified according to the 1988 IHS criteria. Both the symptomatic and the preventive treatment were analysed., Results: In all, a total of 866 patients were found; 691 (79.8%) were females and the mean age was 39.8 +/- 15.9 years (range: 6-90 years); 208 (24%) had a history of migraine in the family; 399 (49.9%) were diagnosed as suffering from migraine: 256 (64.2%) had migraine without aura, 152 (19%) were diagnosed as having tension-type headache, and 218 (27.3%) presented chronic daily headache (CDH). The most frequently used symptomatic treatments were NSAI drugs (36.7%) and triptanes (28.4%). Amitriptyline (47.7%), beta-blockers (14.5%) and calcium antagonists (11.3%) were the main drugs used as preventive treatment., Discussion: After several years' operation of our Headache Unit, we thought there was a need to analyse the population seen in the visits. The fact that the majority of our patients were middle-aged females matched our expectations. Although most of the patients were diagnosed as suffering from M, we also want to highlight the high proportion of cases of CDH, above all associated with the abuse of analgesics.
- Published
- 2004
48. [Good results with Passerini's technique in severely masculinised female pseudohermaphroditism].
- Author
-
Piró C, Asensio M, Barceló C, Martín JA, and Chicaiza E
- Subjects
- Child, Preschool, Female, Humans, Infant, Methods, Postoperative Care, Adrenal Hyperplasia, Congenital surgery, Disorders of Sex Development surgery, Genitalia, Female surgery, Virilism surgery
- Abstract
In female pseudohermaphroditism due to congenital adrenal hyperplasia (CAH), some cases develope a very important masculinization degree with a high outlet of the vagina above the outern urethral sphincter. There are several surgical techniques to solve this problem. Our group uses Passerini's thecnique since 1990. 9 Girls with CAH with extreme masculitation (IV and V Prader degree) have been operated with this technique. The age at intervention varies between 9 months and 3 years, with a follow-up between 1 and 12 years. All these patients had hormonal studies, demostrating a deficiency of 21-hydroxilase in 8 cases and a deficiency of 11-B-hydroxilase in one case. To determine the vaginal outlet a genitography was performed in all cases, vaginoscopy in 7 cases and MNR in 2 cases. Passerini's technique consists of two phases: the first step has the objective of forming the distal 2/3 of the vagina using the skin and the urethral mucosa of the phallus. At the second time transtrigonal way is performed to access the vagina which is desinserted from its urethral outlet and anastomosed with the distal neovagina. There were no significative complications in immediate time. The esthetic result is acceptable in all cases, although one case had to be surgically repaired because of a prominent vulvar flap. We use vaginoscopy to prove vaginal permeability in all cases although one of them developed adherences around the anastomosis. This severe genital malformation, very uncommon, has a difficult surgical solution. Passerini's technique allows, with less complications, to create an acceptable outer genitals at early age and only in one surgical time.
- Published
- 2004
49. [Lamotrigine in refractory epilepsy].
- Author
-
García-Escrivà A, López-Hernández N, Alvarez-Saúco M, Pampliega-Pérez A, Oliver-Navarrete C, Asensio-Asensio M, Moltó-Jordá JM, and Palao-Sánchez A
- Subjects
- Adolescent, Adult, Anticonvulsants adverse effects, Child, Drug Therapy, Combination, Epilepsy pathology, Epilepsy physiopathology, Humans, Lamotrigine, Male, Middle Aged, Treatment Outcome, Triazines adverse effects, Anticonvulsants therapeutic use, Epilepsy drug therapy, Triazines therapeutic use
- Abstract
Introduction: Lamotrigine (LTG) is a new antiepileptic drug indicated in all kinds of partial and generalised clonic-tonic seizures, both in monotherapy and polytherapy. Between 20 and 30% of epileptic patients have poor control over their seizures despite adequate treatment., Aims: We report on our experience regarding the long-term efficacy and tolerability of LTG in refractory seizures., Patients and Methods: We conducted a consecutive 10-year study of patients who began LTG therapy following poor control of their seizures, in spite of being treated with two or more antiepileptic drugs in monotherapy or in combination. Both their epidemiological and clinical data were collected for study. We studied the efficacy of the treatment, differentiating between remission (absence of seizures), improvement (reduction>50% of the seizures), inefficacy (reduction<50%), exacerbation (increase in seizures) and its tolerability (side effects and dropout)., Results: In all, data was collected from 39 patients, 18 males (46.2%), mean age 30.9 +/- 13.7 years; mean follow up time: 27.6 +/- 23.4 months. 43.7% presented cryptogenic epilepsy, in 28.5% it was symptomatic and in the remaining 28.5% it was idiopathic. EEG readings and neuroimaging scans were pathological in 53.8% and 43.6%, respectively. After beginning therapy with LTG, 33% remained free of seizures, 43.6% improved, in 18.3% it was seen to be ineffective and 5.1% got worse. Dropout rate was 56.4%:23.1% due to insufficient control over the seizures, 17.9% owing to side effects and 15.4% because of non-compliance., Conclusion: Treatment with LTG offers a high degree of efficacy in the control of seizures in patients with refractory epilepsy, although it is limited by a high dropout rate.
- Published
- 2004
50. [Peripheral and optical myeloneuropathy in a folic acid deficient alcoholic patient].
- Author
-
López-Hernández N, García-Escrivá A, Pampliega-Pérez A, Alvarez-Saúco M, Martín-Estefanía C, and Asensio-Asensio M
- Subjects
- Adult, Alcoholic Neuropathy diagnosis, Alcoholic Neuropathy etiology, Alcoholism complications, Diet, Female, Humans, Peripheral Nervous System Diseases diagnosis, Peripheral Nervous System Diseases etiology, Spinal Cord pathology, Vitamin B 12 metabolism, Alcoholic Neuropathy pathology, Folic Acid Deficiency, Optic Nerve pathology, Peripheral Nerves pathology, Peripheral Nervous System Diseases pathology
- Abstract
Introduction: In Western countries, neurological disorders secondary to toxic nutritional problems usually present as isolated cases that are generally associated to identifiable causes (alcoholism, eating disorders, absorption disorders, use of medicines) that reduce the availability of basic nutrients, especially B group vitamins, but also folic acid (FA). The optic nerves and the peripheral axons are frequent target organs in this type of pathology, but leukoencephalopathy and spinal cord involvement may also appear, often in combination., Case Report: We describe the case of a 38-year-old female smoker with a heavy alcohol habit, who developed a subacute clinical pattern of, predominantly axonal, sensitive peripheral polyneuropathy, with vegetative fibre involvement. She also presented involvement of the posterior spinal cord, which gave rise to an ataxic disorder in the gait, as well as a severe bilateral retrobulbar optic neuropathy. Likewise, she presented macrocytosis (MCV: 118) due to megaloblastosis. She was also found to have a FA deficit but a normal vitamin B12 metabolism. With the help of supplementary vitamins, stopping drinking and the regularisation of her diet, the patient presented progressive clinical improvement, and was able to walk without support at 3 months and almost completely recovered her sight, which was corroborated by an improvement in the studies of both visual and somatosensorial evoked potentials., Conclusions: In our community, alcoholism is a frequent cause of nutritional deficiencies, which lead to neurological problems. FA is one of the nutrients that become deficient in alcoholics. More and more descriptions are being reported of peripheral polyneuropathy, retrobulbular optic neuropathy, myelopathy or leukoencephalopathy associated to FA deficiency, above all in patients with a history of alcoholism.
- Published
- 2003
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