840 results on '"Elena Ruiz"'
Search Results
202. Structured Q1 headache services as the solution to the ill-health burden of headache: 1. Rationale and description
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Steiner, Timothy J. Jensen, Rigmor Katsarava, Zaza Stovner, Lars Jacob Uluduz, Derya Adarmouch, Latifa Al Jumah, Mohammed Al Khathaami, Ali M. Ashina, Messoud Braschinsky, Mark Broner, Susan Eliasson, Jon H. Gil-Gouveia, Raquel and Gomez-Galvan, Juan B. Gudmundsson, Larus S. Herekar, Akbar A. and Kawatu, Nfwama Kissani, Najib Kulkarni, Girish Baburao and Lebedeva, Elena R. Leonardi, Matilde Linde, Mattias and Luvsannorov, Otgonbayar Maiga, Youssoufa Milanov, Ivan and Mitsikostas, Dimos D. Musayev, Teymur Olesen, Jes Osipova, Vera Paemeleire, Koen Peres, Mario F. P. Quispe, Guiovanna and Rao, Girish N. Risal, Ajay de la Torre, Elena Ruiz and Saylor, Deanna Togha, Mansoureh Yu, Sheng-Yuan Zebenigus, Mehila Zewde, Yared Zenebe Zidverc-Trajkovic, Jasna Tinelli, Michela Global Campaign Against Headache
- Abstract
In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses.
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- 2021
203. Structured headache services as the solution to the ill-health burden of headache. 2. Modelling effectiveness and cost-effectiveness of implementation in Europe: methodology
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Tinelli, Michela Leonardi, Matilde Paemeleire, Koen and Mitsikostas, Dimos de la Torre, Elena Ruiz Steiner, Timothy J. and European Brain Council Value Treat European Headache Federation and Uropean Federation Neurological As Global Campaign Headache
- Abstract
Background Health economic evaluations support health-care decision-making by providing information on the costs and consequences of health interventions. No universally accepted methodology exists for modelling effectiveness and cost-effectiveness of interventions designed to close treatment gaps for headache disorders in countries of Europe (or elsewhere). Our aim here, within the European Brain Council's Value-of-Treatment project, was to develop headache-type-specific analytical models to be applied to implementation of structured headache services in Europe as the health-care solution to headache. Methods We developed three headache-type-specific decision-analytical models using the WHO-CHOICE framework and adapted these for three European Region country settings (Luxembourg, Russia and Spain), diverse in geographical location, population size, income level and health-care systems and for which we had population-based data. Each model compared current (suboptimal) care vs target care (delivered in accordance with the structured headache services model). Epidemiological and economic data were drawn from studies conducted by the Global Campaign against Headache; data on efficacy of treatments were taken from published randomized controlled trials; assumptions on uptake of treatments, and those made for Healthy Life Year (HLY) calculations and target-care benefits, were agreed with experts. We made annual and 5-year cost estimates from health-care provider (main analyses) and societal (secondary analyses) perspectives (2020 figures, euros). Results The analytical models were successfully developed and applied to each country setting. Headache-related costs (including use of health-care resources and lost productivity) and health outcomes (HLYs) were mapped across populations. The same calculations were repeated for each alternative (current vs target care). Analyses of the differences in costs and health outcomes between alternatives and the incremental cost-effectiveness ratios are presented elsewhere. Conclusions This study presents the first headache-type-specific analytical models to evaluate effectiveness and cost-effectiveness of implementing structured headache services in countries in the European Region. The models are robust, and can assist policy makers in allocating health budgets between interventions to maximize the health of populations.
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- 2021
204. Structured Q1 headache services as the solution to the ill-health burden of headache:1. Rationale and description
- Author
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Steiner, Timothy J., Jensen, Rigmor, Katsarava, Zaza, Stovner, Lars Jacob, Uluduz, Derya, Adarmouch, Latifa, Al Jumah, Mohammed, Al Khathaami, Ali M., Ashina, Messoud, Braschinsky, Mark, Broner, Susan, Eliasson, Jon H., Gil-Gouveia, Raquel, Gómez-Galván, Juan B., Gudmundsson, Larus S., Herekar, Akbar A., Kawatu, Nfwama, Kissani, Najib, Kulkarni, Girish Baburao, Lebedeva, Elena R., Leonardi, Matilde, Linde, Mattias, Luvsannorov, Otgonbayar, Maiga, Youssoufa, Milanov, Ivan, Mitsikostas, Dimos D., Musayev, Teymur, Olesen, Jes, Osipova, Vera, Paemeleire, Koen, Peres, Mario F. P., Quispe, Guiovanna, Rao, Girish N., Risal, Ajay, de la Torre, Elena Ruiz, Saylor, Deanna, Togha, Mansoureh, Yu, Sheng-Yuan, Zebenigus, Mehila, Zewde, Yared Zenebe, Zidverc-Trajković, Jasna, and Tinelli, Michela
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services ,Medizin ,UNITED-STATES ,UTILIZATION ,DISEASE ,TENSION-TYPE HEADACHE ,Headache disorders ,Medicine and Health Sciences ,SYSTEMATIC ANALYSIS ,NATIONAL BURDEN ,Public health ,Global Campaign against headache ,Health-technology assessment ,DISABILITY ,Global ,GLOBAL BURDEN ,CARE ,Primary care ,Health policy ,PREVALENCE ,Campaign against headache ,Needs assessment ,MIGRAINE ,Barriers to care ,Service organization and delivery ,Structured headache services ,Structured headache - Abstract
In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the “patient journey”) with perplexing obstacles. High demand for headache care, estimated here in a needs-assessment exercise, is the biggest of the challenges to reform. It is also the principal reason why reform is necessary. The structured headache services model presented here by experts from all world regions on behalf of the Global Campaign against Headache is the suggested health-care solution to headache. It develops and refines previous proposals, responding to the challenge of high demand by basing headache services in primary care, with two supporting arguments. First, only primary care can deliver headache services equitably to the large numbers of people needing it. Second, with educational supports, they can do so effectively to most of these people. The model calls for vertical integration between care levels (primary, secondary and tertiary), and protection of the more advanced levels for the minority of patients who need them. At the same time, it is amenable to horizontal integration with other care services. It is adaptable according to the broader national or regional health services in which headache services should be embedded. It is, according to evidence and argument presented, an efficient and cost-effective model, but these are claims to be tested in formal economic analyses. CA extern
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- 2021
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205. Structured headache services as the solution to the ill-health burden of headache. 3. Modelling effectiveness and cost-effectiveness of implementation in Europe: findings and conclusions
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Tinelli, Michela Leonardi, Matilde Paemeleire, Koen Raggi, Alberto Mitsikostas, Dimos de la Torre, Elena Ruiz Steiner, Timothy J. European Brain Council Value Treat European Headache Federation European Migraine Headache Allian Global Campaign Against Headache
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health care economics and organizations - Abstract
Background There have been several calls for estimations of costs and consequences of headache interventions to inform European public-health policies. In a previous paper, in the absence of universally accepted methodology, we developed headache-type-specific analytical models to be applied to implementation of structured headache services in Europe as the health-care solution to headache. Here we apply this methodology and present the findings. Methods Data sources were published evidence and expert opinions, including those from an earlier economic evaluation framework using the WHO-CHOICE model. We used three headache-type-specific analytical models, for migraine, tension-type-headache (TTH) and medication-overuse-headache (MOH). We considered three European Region case studies, from Luxembourg, Russia and Spain to include a range of health-care systems, comparing current (suboptimal) care versus target care (structured services implemented, with provider-training and consumer-education). We made annual and 5-year cost estimates from health-care provider and societal perspectives (2020 figures, euros). We expressed effectiveness as healthy life years (HLYs) gained, and cost-effectiveness as incremental cost-effectiveness-ratios (ICERs; cost to be invested/HLY gained). We applied WHO thresholds for cost-effectiveness. Results The models demonstrated increased effectiveness, and cost-effectiveness (migraine) or cost saving (TTH, MOH) from the provider perspective over one and 5 years and consistently across the health-care systems and settings. From the societal perspective, we found structured headache services would be economically successful, not only delivering increased effectiveness but also cost saving across headache types and over time. The predicted magnitude of cost saving correlated positively with country wage levels. Lost productivity had a major impact on these estimates, but sensitivity analyses showed the intervention remained cost-effective across all models when we assumed that remedying disability would recover only 20% of lost productivity. Conclusions This is the first study to propose a health-care solution for headache, in the form of structured headache services, and evaluate it economically in multiple settings. Despite numerous challenges, we demonstrated that economic evaluation of headache services, in terms of outcomes and costs, is feasible as well as necessary. Furthermore, it is strongly supportive of the proposed intervention, while its framework is general enough to be easily adapted and implemented across Europe.
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- 2021
206. Bases anatómicas del colgajo anterolateral de muslo de flujo inverso
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María Jesús Rivera Vegas, María Elena Ruiz Alonso, Andrea Puebla Parral, Alex Didirka Díaz, and Eva Maranillo Alcaide
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Cobertura rodilla ,RD1-811 ,Medicine ,Surgery ,Colgajo anterolateral muslo ,Colgajo ALT flujo inverso - Abstract
Resumen Introducción y objetivo. El colgajo anterolateral de muslo de base distal presenta una alternativa interesante para la reconstrucción de los defectos cutáneos de la rodilla. El motivo de este trabajo es el estudio anatómico de la arteria descendente de la circunfleja femoral lateral y su existencia o no de anastomosis distal, que nos permitirá la realización del colgajo basado distalmente. Material y método. Estudiamos diferentes ítems en 22 miembros inferiores formolizados: origen de la arteria, distancia desde la salida de la perforante de la arteria descendente hasta la piel, longitud y localización de la arteria descendente, anastomosis distal en el caso de que la hubiera, localización del punto pivote tomando como punto de referencia la esquina súpero-lateral de la patela y la suma de la longitud de la perforante, y la longitud de la arteria de la descendente que nos da la longitud del pedículo que podemos obtener al disecar el colgajo. Resultados. En relación con la anastomosis distal describimos 2 modelos. Modelo 1: no anastomosis, con una proporción del 45%; y modelo 2: anastomosis distal existente, con un 55%. En el modelo 2 establecemos a su vez 3 tipos de anastomosis: tipo 1, cuando la anastomosis se realiza con la arteria geniculada lateral superior, en un 42%; tipo 2, anastomosis con la arteria femoral profunda, en un 25%; y tipo 3, anastomosis con ambas, en un 33%. El punto pivote lo encontramos como media a 11 cm del borde superior de la patela. La longitud del pedículo presentó una media de 15 cm. Conclusiones. Nuestros resultados demuestran que el colgajo anterolateral de base distal es una adecuada alternativa para la cobertura de pérdidas de sustancia en la rodilla. Para emplearlo, debido a la diversidad anatómica, sería adecuado realizar una angiografía previa o una revisión intraoperatoria de la anastomosis distal.
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- 2021
207. Burden and attitude to resistant and refractory migraine
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the Burden and Attitude to Resistant and Refractory (BARR) Study Group, Simona Sacco, Christian Lampl, A. (Antoinette) Maassen van den Brink, Valeria Caponnetto, Mark Braschinsky, Anne Ducros, Patrick Little, Patricia Pozo-Rosich, Uwe Reuter, Elena Ruiz de la Torre, Margarita Sanchez Del Rio, Alexandra J. Sinclair, Paolo Martelletti, Zaza Katsarava, Genci Cakciri, Pavllo Djamandi, Serla Grabova, Gleni Halili, Jera Kruja, Altin Kuqo, Diana Naco, Aida Quka, Ladjola Stefanidhi, Gentian Vyshka, Ilirjana Zekja, Osvaldo Bruera, Dilver Gómez, Brenda Guitian, Juan Carlos Roma, Ike Leon Chen, Samira Bashirova, Maxim Linkov, Daan Van Den Abbeele, Geraldine Vanderschueren, Roberta Araujo, Renato Arruda, Antônio Catharino, Jovana Ciriaco, Amauri Dalla Corte, Ricardo Dornas, Bernardo Felsenfeld, André Fonseca Taufner, Yara Fragoso, Rubens Hurtado, Daniel Isoni Martins, Renata Londero, Luciano Melo, Kelton Stivenson Mignoni, Paulo Victor Sgobbi De Souza, Marcio Nattan Souza, the Burden and Attitude to Resistant and Refractory (BARR) Study Group, Simona Sacco, Christian Lampl, A. (Antoinette) Maassen van den Brink, Valeria Caponnetto, Mark Braschinsky, Anne Ducros, Patrick Little, Patricia Pozo-Rosich, Uwe Reuter, Elena Ruiz de la Torre, Margarita Sanchez Del Rio, Alexandra J. Sinclair, Paolo Martelletti, Zaza Katsarava, Genci Cakciri, Pavllo Djamandi, Serla Grabova, Gleni Halili, Jera Kruja, Altin Kuqo, Diana Naco, Aida Quka, Ladjola Stefanidhi, Gentian Vyshka, Ilirjana Zekja, Osvaldo Bruera, Dilver Gómez, Brenda Guitian, Juan Carlos Roma, Ike Leon Chen, Samira Bashirova, Maxim Linkov, Daan Van Den Abbeele, Geraldine Vanderschueren, Roberta Araujo, Renato Arruda, Antônio Catharino, Jovana Ciriaco, Amauri Dalla Corte, Ricardo Dornas, Bernardo Felsenfeld, André Fonseca Taufner, Yara Fragoso, Rubens Hurtado, Daniel Isoni Martins, Renata Londero, Luciano Melo, Kelton Stivenson Mignoni, Paulo Victor Sgobbi De Souza, and Marcio Nattan Souza
- Abstract
Background: New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standard
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- 2021
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208. Propiedades fisicas de algunos suelos de Cuba y su uso en modelos de simulacion
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Cid, Greco, López, Teresa, González, Felicita, Herrera, Julián, and Elena Ruiz, María
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- 2011
209. Capítulo 3 - Tratamiento de la trombosis venosa profunda de miembro inferior
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Belmonte, Elena Ruiz and Viñas, Paloma Escribano
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- 2020
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210. Miocardiopatía hipertrófica grave familiar secundaria a heterocigosis compuesta en el gen MYBPC3
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Elena Ruiz Ballesteros, Miguel Ángel Granados Ruiz, Olga Domínguez García, Gema Íñigo Martín, and Óscar García Campos
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business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
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211. Sistema SWAP-ANIMO para estimar los balances de agua y nitratos en una region de Valencia, Espana. Aplicaciones iniciales
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Elena Ruiz, María, Miguel de la Paz, José, Ramos, Carlos, and Medina, Hanoi
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- 2008
212. Explaining Rural Conservatism: Political Consequences of Technological Change in the Great Plains
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Aditya Dasgupta and Elena Ruiz Ramirez
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How did rural areas become conservative electoral strongholds in the US and other advanced capitalist economies? This paper argues that technological change transformed not only agriculture but rural political preferences during the twentieth century. It studies a natural experiment: the post-WWII introduction of improved groundwater pumps and center-pivot irrigation, which enabled farmers to irrigate otherwise arid land in the Great Plains. These innovations mainly benefited counties overlying the Ogallala aquifer – a pattern we validate with computer-vision estimates of technology diffusion using satellite imagery. Difference-in-difference analyses exploiting this differential impact indicate that technological change played a large role in the region’s long-term conservative electoral transformation. Additional tests, including comparison of individual policy preferences inside/outside of the Ogallala aquifer, support the hypothesis that this was due to increasingly capital-intensive agriculture and the growing power of agribusiness interests which benefit from conservative economic policies. The findings demonstrate how new technologies made new politics in rural America.
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- 2020
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213. Management of Leak after Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy
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José María Balibrea Del Castillo, José Manuel Fort, Arturo Cirera de Tudela, Manuel Armengol Carrasco, Ramon Vilallonga, Anamaria Nedelcu, Elena Ruiz-Úcar, and Jorge Pasquier
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Reoperation ,Leak ,Sleeve gastrectomy ,medicine.medical_specialty ,business.industry ,Duodeno-ileal ,Duodenum ,medicine.medical_treatment ,Anastomosis, Surgical ,Bariatric Surgery ,Anastomotic Leak ,Anastomosis ,Optimal management ,Surgery ,Obesity, Morbid ,Morbid obesity ,Postoperative Complications ,Ileum ,Medicine ,Humans ,Objective information ,business - Abstract
The single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has been introduced in the past few years for the treatment of morbid obesity. SADI-S has shown good results in terms of long-term results and short-term complications. However, the management of patients undergoing SADI-S and suffering from a leak is a great challenge for surgeons. We present an extensive review of the currently available literature on the management of leak after SADI in morbid obese (MO) patients. We aim at providing objective information regarding the optimal management, including diagnosis, technical options for the different strategies that have been proposed, to facilitate the selection of the best individual approach for each MO patient.
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- 2020
214. Subcapsular hepatic hematoma as a complication of ERCP: what do we know about its etiology?
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Alicia Martín Lagos Maldonado, Elena Ruiz-Escolano, and María Del Mar Díaz Alcázar
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Male ,medicine.medical_specialty ,Balloon ,digestive system ,Sphincterotomy, Endoscopic ,medicine ,Humans ,Aged ,Cholangiopancreatography, Endoscopic Retrograde ,Common Bile Duct ,Hematoma ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,Common bile duct ,Bile duct ,business.industry ,Liver Diseases ,Gastroenterology ,General Medicine ,Surgery ,Major duodenal papilla ,medicine.anatomical_structure ,Biliary tract ,Etiology ,Complication ,business ,Gastrointestinal Hemorrhage - Abstract
We present the case of a 79-year-old male who underwent endoscopic retrograde cholangiopancreatography (ERCP) after cholangitis. The papilla was rigid and the biliary tract was dilated with sharpening of the distal bile duct, with no obvious cause. There was no bile flow after sphincterotomy, no stone after sweeping the duct with a balloon and the brush did not expand properly when trying to obtain cytologic material. Finally, a plastic stent was placed and purulent bile flowed. Biopsies of the papilla were taken due to the suspicion of tumor infiltration. The next day, the patient had pain in the right upper quadrant and blood tests highlighted mild anemization.
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- 2020
215. Author response for 'Molecular and histologic insights on early onset cardiomyopathy in Danon disease females'
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Elena Vallespín, Ana Belén Enguita Valls, Pablo Lapunzina, Marta Ortega, Luis García-Guereta, Laura Casamayor Polo, Elena Ruiz-Bravo, Sixto García-Miñaúr, Patricia Muñoz-Cabello, María Bravo García-Morato, Lara Rodriguez-Laguna, Luis Fernández, María Palomares-Bralo, Rubén Martín-Arenas, Kristina Ibáñez, and Angela del Pozo
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Pathology ,medicine.medical_specialty ,business.industry ,medicine ,Cardiomyopathy ,Danon disease ,medicine.disease ,business ,Early onset - Published
- 2020
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216. Molecular and histologic insights on early onset cardiomyopathy in Danon disease females
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Elena Vallespín, Luis García-Guereta, Lara Rodriguez-Laguna, Luis Fernández, María Bravo García-Morato, Kristina Ibáñez, Laura Casamayor Polo, Pablo Lapunzina, Elena Ruiz-Bravo, Sixto García-Miñaur, Marta Ortega, Patricia Muñoz-Cabello, Angela del Pozo, Ana Belén Enguita Valls, Rubén Martín-Arenas, and María Palomares-Bralo
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Pathology ,medicine.medical_specialty ,business.industry ,Cardiomyopathy ,Inheritance Patterns ,Genetic Variation ,High-Throughput Nucleotide Sequencing ,Cardiomyopathy, Hypertrophic ,medicine.disease ,Glycogen Storage Disease Type IIb ,Loss of Function Mutation ,Lysosomal-Associated Membrane Protein 2 ,Genetics ,medicine ,Humans ,Danon disease ,Female ,business ,Genetics (clinical) ,Early onset - Published
- 2020
217. The prevalence of postoperative (PO) chronic hypoparathyroidism (HypoPTH) in bilbao, northern spain
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Andoni Monzon, Fernando Goni, Teresa Gutierrez, Adela L Martinez, Amelia Oleaga, Natalia Iglesias, de Velasco Elena Ruiz, Laura Calles, Ignacio Merlo, Cristina Moreno, and Miguel Paja
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Pediatrics ,medicine.medical_specialty ,Hypoparathyroidism ,business.industry ,medicine ,medicine.disease ,business - Published
- 2020
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218. Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study
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Blanca Colás-Lahuerta, María Concepción Aláez-Usón, Javier de la Cruz, Joaquin Martinez-Lopez, Susana Valenciano, María Carmen Vicente-Ayuso, Lucía Núñez Martín-Buitrago, Carmen Martínez-Chamorro, Pablo Estival Monteliu, Miguel Canales, Pilar Llamas, Arancha Alonso, Jaime Pérez-Oteyza, Pedro Sánchez-Godoy, J. Garcia-Suarez, Cristian Escolano Escobar, Pilar Herrera, José González-Medina, Adrian Alegre, Rafael F. Duarte, Alberto Velasco, Adriana Pascual, Isabel González-Gascón, Víctor Jiménez-Yuste, María García Roa, Rodrigo Gil-Manso, Arturo Matilla, Elena Ruiz, Javier Ortiz-Martín, Rafael Martos-Martínez, Regina Herráez, José Luis Díez-Martín, Mi Kwon, Juan F del Campo, E. Gómez, Keina Susana-Quiroz, Adolfo de la Fuente, Javier López-Jiménez, Ángel Cedillo, Pilar Martínez-Barranco, Laurentino Benito-Parra, and Jose Angel Hernandez-Rivas
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Male ,Cancer Research ,Comorbidity ,Severity of Illness Index ,Risk Factors ,Medicine ,Prospective Studies ,Registries ,Young adult ,Hematologic neoplasms ,Prospective cohort study ,Aged, 80 and over ,education.field_of_study ,Hazard ratio ,Age Factors ,Hematology ,lcsh:Diseases of the blood and blood-forming organs ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Treatment Outcome ,Oncology ,Female ,Coronavirus Infections ,Adult ,medicine.medical_specialty ,Combination therapy ,Adolescent ,Population ,Pneumonia, Viral ,Antineoplastic Agents ,lcsh:RC254-282 ,Antiviral Agents ,Betacoronavirus ,Young Adult ,Internal medicine ,Severity of illness ,Humans ,education ,Molecular Biology ,Pandemics ,Aged ,business.industry ,Proportional hazards model ,lcsh:RC633-647.5 ,SARS-CoV-2 ,Research ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Cancer ,COVID-19 ,medicine.disease ,COVID-19 Drug Treatment ,Spain ,business - Abstract
Background Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality. Methods In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy. Results Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17–10.1 vs 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20). Conclusions In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification.
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- 2020
219. Cutaneous small vessel vasculitis secondary to COVID‐19 infection: a case report
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D. Montero Vega, A. Mayor-Ibarguren, P. Herranz-Pinto, Marta Feito-Rodríguez, Elena Ruiz-Bravo, and L. Quintana Castanedo
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Dermatology ,Letter to Editor ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,COVID‐19 ,Prednisone ,Biopsy ,medicine ,Cutaneous small-vessel vasculitis ,Cutaneous small vessel vasculitis ,medicine.diagnostic_test ,business.industry ,Blisters ,Atrial fibrillation ,Leukocytoclastic vasculitis ,medicine.disease ,body regions ,Pneumonia ,Infectious Diseases ,medicine.symptom ,Vasculitis ,business ,030217 neurology & neurosurgery ,SARS‐COV‐2 ,medicine.drug - Abstract
We present a case of an 83‐year‐old woman with a history of hypertension, transient ischemic attack (TIA), atrial fibrillation, chronic renal impairment presented to our dermatology emergency room on April 9, 2020, for evaluation of purple palpable papules and serohaematic blisters on both her lower legs, feet and toes that had appeared 5 days earlier (Figure 1).
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- 2020
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220. Vancouver Declaration II on Global Headache Patient Advocacy 2019
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David W, Dodick, Messoud, Ashina, Fumihiko, Sakai, Wolfgang, Grisold, Hitoshi, Miyake, Deborah, Henscheid-Lorenz, Audrey, Craven, Elena, Ruiz de la Torre, Rachel, Koh, Nikita, Reznik, Lisa, Bance, Elizabeth, Leroux, and Lars, Edvinsson
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03 medical and health sciences ,0302 clinical medicine ,Headache ,Humans ,030212 general & internal medicine ,Neurology (clinical) ,General Medicine ,Patient Advocacy ,030217 neurology & neurosurgery - Abstract
In 2017, the International Headache Society convened a Global Patient Advocacy Summit (GPAS-1) to begin a collaborative effort involving patients, patient advocates, patient advocacy organizations, healthcare professionals, scientists, professional pain, neurology, and headache societies, pharmaceutical manufacturers, and regulatory agencies to advance issues of importance to patients affected by headache worldwide. In September 2019, the second Global Patient Advocacy Summit (GPAS-2) was convened to revisit issues from the inaugural meeting, assess the progress of the International Headache Society Global Patient Advocacy Coalition (IHS-GPAC) in meeting the goals set forth therein, and discuss strategies for achieving established goals and supporting future development. Short- and long-term mandates from the first Summit were realized, including publishing the Vancouver Declaration on Global Headache Patient Advocacy 2018, determining the governing and operational structures of the IHS-GPAC, and helping to facilitate the first World Federation of Neurology World Brain Day dedicated to migraine. Another short-term mandate, creating a unified advocacy strategy, was fulfilled by the Coalition’s decision to focus on encouraging support from employers and implementing employee support programs for people with migraine. To help execute the strategy, the Coalition is developing an employer engagement toolkit that will educate employers and employees about the impact of migraine in the workplace, reduce stigma directed toward employees with migraine, and facilitate the care of employees with migraine to reduce the burden of illness and improve workplace productivity. Coalition members will disseminate the toolkit and encourage the adoption of migraine workplace programs by employers worldwide. The Coalition has established an alliance with two global, multinational employers to expand migraine awareness and support among policy makers and other stakeholders around the world. The IHS-GPAC met many of the goals established at GPAS-1, and it has initiated a global strategy focused on the psychosocial and economic toll of headache disorders, especially migraine, in the workplace. Ongoing and future activities will explore a range of opportunities with employers and across the full spectrum of advocacy goals.
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- 2020
221. [Preventive Aspects for Migraine and the Workplace: A European Survey]
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María Teófila, Vicente Herrero, María Victoria, Ramírez Iñiguez de la Torre, Luis, Reinoso Barbero, and Elena, Ruiz de la Torre
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Cross-Sectional Studies ,Italy ,Portugal ,Spain ,Germany ,Migraine Disorders ,Humans ,France ,Workplace ,Ireland ,United Kingdom - Abstract
Workplace health promotion integrates initiatives in health and safety in the occupational field, with personal improvements, increased productivity and lower risks and social cost, especially with respect to migraine headaches, a neurological disorder affecting approximately 11% of the population. The objective of this study was to know the preventive resources available to workers with migraine headaches and the preventive management options in their companies.Cross-sectional observational study of 3,342 patients from Spain, Italy, France, Portugal, Ireland, United Kingdom, Germany and other European Union countries, conducted through an anonymous survey on the web of the European MigraineHeadache Alliance (EMHA-web), from September 2018 to January 2019.Occupational stress (77.65%) and use of computer monitors (63.87%) are the most common risks described by workers with migraine. About. 43.71% of workers are not familiar with the type of occupational health service present in their company, 49.06% do not have a medical service; 67.67% reported no work-related limitations due to migraine, neither dismissal nor non-renewal of their contract (88.29%), but 42.14% had experienced some conflict due to decreased productivity; 26.54% were unaware of the concept of vulnerable workers or had not requested this status because of their migraine (63.8%), nor had.INTRODUCCIÓN: La promoción de la salud en el trabajo integra las iniciativas en salud y seguridad en ámbito ocupacional, con mejoras personales, incremento de productividad y menores riesgos y gastos sociales, especialmente en migraña, como enfermedad neurológica con prevalencia estimada en el 11% de la población. El objetivo de este trabajo fue conocer las condiciones preventivas de los trabajadores con migraña y las opciones de gestión preventiva en sus empresas. MÉTODO: Estudio observacional transversal realizado en 3.342 pacientes de España, Italia, Francia, Portugal, Irlanda, Reino Unido, Alemania y otros países de la UE mediante encuesta anónima en la web de la European MigraineHeadache Alliance(EMHA-web), entre septiembre de 2018 y enero de 2019.RESULTADOS: Estrés laboral (77.65%) y uso de PVD (63.87%) son los riesgos más referidos por los trabajadores con migraña. El 43.71% de trabajadores desconoce el tipo de Servicio de Prevención de su empresa, 49.06% no dispone de servicio médico; el 67.67% no ha tenido impedimentos de acceso laboral por migraña, ni despido o no renovación del contrato (88,29%), pero el 42,14% tuvo algún conflicto por pérdida de productividad; el 26,54% desconoce el concepto de especial sensibilidad o no lo ha solicitado por migraña (63,8%), ni ha demandado modificaciones laborales (67,64%) o cambio de puesto de trabajo (80,89%); un 55,42% no se ha sentido comprendido ni apoyado por su empresa en sus limitaciones por migraña, pero sí por los compañeros (63,07%). CONCLUSIÓN:Se observa una deficiente información preventiva y escaso uso de las opciones de gestión adaptativa en las empresas para personas con migraña.
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- 2020
222. An Uncomplicated Delivery in a Patient with Covid-19 in the United States
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Joeffrey J. Chahine, Tamika C. Auguste, Stacey Gold, Maria Elena Ruiz, Masashi Waga, Muhammad Mirza, Neggin Mokhtari, Glenn Wortmann, Sara N. Iqbal, Haleema Saeed, and Rachael T. Overcash
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medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Uncomplicated delivery ,Pneumonia, Viral ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Pregnancy ,Correspondence ,medicine ,Humans ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,Pandemics ,Blood Chemical Analysis ,Obstetrics ,business.industry ,SARS-CoV-2 ,COVID-19 ,General Medicine ,medicine.disease ,Delivery, Obstetric ,United States ,Gestation ,Female ,business ,Coronavirus Infections - Abstract
Uncomplicated Delivery in a Patient with Covid-19 The peripartum care of a woman with Covid-19 at 39 weeks of gestation is described. The woman and the neonate were discharged home on hospital day ...
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- 2020
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223. Una construcción de las reglas de cálculo de los números enteros a partir de la manipulación de expresiones algebraicas
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Patricia Detzel, Elías Colipe, and Maria Elena Ruiz
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Preparación de clases ,Operaciones aritméticas ,Números enteros ,Álgebra - Abstract
En este artículo presentamos parte de un trabajo desarrollado en un proyecto de investigación, en el que abordamos, en forma conjunta investigadores y profesores de matemática de escuelas secundarias, la problemática de la enseñanza de los números enteros desde una perspectiva colaborativa. Dicha problemática era una preocupación de los profesores de matemática, debido a las dificultades que observaban en sus alumnos, en particular en relación a la manipulación de los signos en los cálculos. Para ello acordamos en conjunto, estudiar y adaptar una propuesta de enseñanza en la que se aborda la introducción de los números negativos conjuntamente con el álgebra. Transitamos un proceso de esclarecimiento que nos permitió cargar de sentido un recorrido, en el que surgen las reglas de cálculo para la suma, resta y multiplicación de sumandos y sustraendos apoyadas en los conocimientos de los números naturales, donde las expresiones algebraicas tuvieron un rol fundamental. Desarrollamos en este artículo, parte de los análisis y reflexiones que llevamos a cabo profesores e investigadores en ese proceso para la adaptación de dicha propuesta.
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- 2020
224. Response to the reviewers
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Elena Ruiz-Donoso
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- 2020
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225. Zooming in on Arctic clouds: A case study comparing A-Train and airborne remote sensing measurements
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Leif-Leonard Kliesch, Vera Schemann, Birte Solveig Kulla, Susanne Crewell, Mario Mech, Christoph Ritter, and Elena Ruiz-Donoso
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Arctic ,Remote sensing (archaeology) ,Environmental science ,Zoom ,Remote sensing - Abstract
Despite their importance, our knowledge on arctic clouds and in particular their vertical structure is limited.In the essentially remote regions of the Arctic, the only continuous measurements available usually are those of satellites, like the A-Train constellation. Climatologies have been derived from A-Train products, i.e. the combination of radar and lidar. However, due to the coarser resolution and bigger footprints of the sensors and the blind zone of CLOUDSAT in the boundary layer many features are missed. In the framework of the Collaborative Research Centre TR 172 “Arctic Amplification” four major aircraft campaigns with the AWI research aircraft POLAR5 took and will take place in the vicinity of Svalbard with emphasis on the Atlantic Arctic region close to the marginal sea ice zone. On board of the POLAR5 aircraft active measurements by radar (MiRAC) and lidar (AMALi) were performed and supported by microwave radiometer measurements in 9 frequency channels and a high spectral resolution solar imager (AISA Eagle/Hawk). We have calibrated and processed radar and lidar measurements and deduced highly resolved (7.5 m, 1.3 Hz) vertical profiles of backscatter, attenuation and reflectivity and retrieved a preliminary classification of cloud top. The potential of these measurements for a detailed characterization of Arctic clouds is assessed via the comparison with CALIPSO and CLOUDSAT as well as MODIS measurements for an A-Train underflight. Measurements cover a cold air outbreak in May 2017 with a complex situation with multiple layers of mixed phase clouds and several inversions evident in the thermodynamic structure given by dropsondes. A high resolution model simulation with ICON, which reproduces the general features of this situation, is used together with instrument simulators to investigate how much information on cloud processes can be gained from the measurements.
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- 2020
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226. USE OF ONLINE DIGITAL PLATFORMS TO SUPPORT MATH LEARNING
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Edgar García-Leyva, Elena Ruiz-Ledesma, and Laura Garay-Jimémez
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Mathematics education - Published
- 2020
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227. Comportamiento epidemiológico de las exodoncias en la Clínica Estomatológica de Gibara, 2017
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Cecilia Mayra Córdova Vega, Moraima Caridad Córdova Vega, Laritza Ortega Pérez, María Isabel Pérez Zaldívar, and Elvia Elena Ruiz Campaña
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Medicine (General) ,R5-920 - Abstract
Introducción: la exodoncia es la cirugía bucal que se ocupa de extraer los dientes mediante unas técnicas e instrumental adecuado, y de practicar la avulsión o extracción de un diente o porción del mismo del lecho óseo que lo alberga. Objetivo: determinar el comportamiento epidemiológico de las exodoncias en la Clínica Estomatológica de Gibara, 2017. Método: se realizó un estudio descriptivo de serie de casos en la Clínica Estomatológica de Gibara, provincia Holguín, Cuba, sobre el comportamiento epidemiológico de las exodoncias durante el año 2017 en cuanto a: grupos de edades, sexo, grupo dentario afectado y causa de la pérdida dentaria. El universo estuvo constituido por 1 755 pacientes que acudieron al servicio estomatológico. Resultados: el grupo que resultó más afectado según la edad fue el de 19 a 59 años con 68,88%. En cuanto al sexo predominó el masculino con un 58,68%. El grupo dentario más afectado resultó ser los molares superiores con un 42,22%. La caries dental fue la causa más frecuente con el 71,50% de los casos. Conclusiones: las exodoncias predominaron en adultos no mayores, del sexo masculino, en los molares superiores y la caries dental fue la principal causa de pérdida dentaria. Palabras clave: diente, exodoncia, epidemiología.
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- 2020
228. Airborne Remote Sensing of Arctic Clouds
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Manfred Wendisch, Michael Schäfer, Elena Ruiz-Donoso, and André Ehrlich
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geography ,medicine.medical_specialty ,geography.geographical_feature_category ,business.industry ,Cloud computing ,Snow ,Physics::Geophysics ,Spectral imaging ,Arctic ,Remote sensing (archaeology) ,Physics::Space Physics ,Sea ice ,medicine ,High spatial resolution ,Environmental science ,Satellite ,business ,Astrophysics::Galaxy Astrophysics ,Remote sensing - Abstract
Airborne remote sensing of Arctic clouds builds a bridge between long-term ground-based measurements and space-borne satellite observations and allows to apply innovative active and passive remote sensing techniques. However, Arctic conditions with bright snow and sea ice surfaces, the low or absent Sun, and the presence of mixed-phase clouds are challenging for the retrieval of cloud properties, especially for passive instruments using solar radiations. It will be shown, how spectrally resolved observations of reflected solar radiation can reduce the uncertainties of cloud remote sensing in the Arctic. The potential of directional observations covering a wide range of scattering angles at the cloud top is outlined. Finally, the advantage of spectral imaging observations to study maps of cloud properties with high spatial resolution is demonstrated.
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- 2020
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229. European headache federation consensus on the definition of resistant and refractory migraine
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Sacco, Simona, Braschinsky, Mark, Ducros, Anne, Lampl, Christian, Little, Patrick, van den Brink, Antoinette Maassen, Pozo-Rosich, Patricia, Reuter, Uwe, de la Torre, Elena Ruiz, Del Rio, Margarita Sanchez, Sinclair, Alexandra J., Katsarava, Zaza, Martelletti, Paolo, and Universitat Autònoma de Barcelona
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Intractable migraine ,Resistant migraine ,Migraine ,Refractory migraine ,Chronic migraine - Abstract
Despite advances in the management of headache disorders, some patients with migraine do not experience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, to help Healthcare Authorities in understanding the implications, and to create a basis to develop a better pathophysiological understanding and to support further therapeutic advances. Definitions were established with a consensus process using the Delphi method. Patients with migraine with or without aura or with chronic migraine can be defined as having resistant migraine and refractory migraine according to previous preventative failures. Resistant migraine is defined by having failed at least 3 classes of migraine preventatives and suffer from at least 8 debilitating headache days per month for at least 3 consecutive months without improvement; definition can be based on review of medical charts. Refractory migraine is defined by having failed all of the available preventatives and suffer from at least 8 debilitating headache days per month for at least 6 consecutive months. Drug failure may include lack of efficacy or lack of tolerability. Debilitating headache is defined as headache causing serious impairment to conduct activities of daily living despite the use of pain-relief drugs with established efficacy at the recommended dose and taken early during the attack; failure of at least two different triptans is required. We hope, that the updated EHF definition will be able to solve the conflicts that have limited the use of definitions which have been put forward in the past. Only with a widely accepted definition, progresses in difficult-to-treat migraine can be achieved. This new definition has also the aim to increase the understanding of the impact of the migraine as a disease with all of its social, legal and healthcare implications. It is the hope of the EHF Expert Consensus Group that the proposed criteria will stimulate further clinical, scientific and social attention to patients who suffer from migraine which is difficult-to-treat
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- 2020
230. Rhabdomyolysis in a patient under treatment with sorafenib
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Elena Ruiz Escolano, Eloísa Cervilla Sáez de Tejada, and María Del Mar Díaz Alcázar
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Sorafenib ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,macromolecular substances ,Gastroenterology ,Rhabdomyolysis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Adverse effect ,neoplasms ,business.industry ,Liver Neoplasms ,General Medicine ,Prognosis ,medicine.disease ,digestive system diseases ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
We present a case of rhabdomyolysis related to treatment with sorafenib in a patient with multifocal hepatocellular carcinoma. Rhabdomyolysis is a severe situation and potentially fatal. There are no laboratory data that can predict this condition. Early diagnosis is essential for prognosis. Rhabdomyolysis has been described as an adverse reaction of several drugs but it is not frequently related to sorafenib.
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- 2020
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231. Invasive aspergillosis of gastrointestinal debut without apparent respiratory involvement in an immunocompetent host
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Francisco Javier Casado Caballero, María Del Mar Díaz Alcázar, Elena Ruiz Escolano, and Eloísa Cervilla Sáez de Tejada
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Abdominal pain ,medicine.medical_specialty ,Antifungal Agents ,Exploratory laparotomy ,medicine.medical_treatment ,Autopsy ,Aspergillosis ,Gastroenterology ,Aspergillus fumigatus ,Immunocompromised Host ,03 medical and health sciences ,0302 clinical medicine ,Midline shift ,Internal medicine ,Intestine, Small ,medicine ,Humans ,Aged ,Gastrointestinal tract ,biology ,business.industry ,General Medicine ,medicine.disease ,biology.organism_classification ,030220 oncology & carcinogenesis ,Etiology ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
A 72-year-old female presented with abdominal pain and constipation and intestinal dilation was found. Abdominal computed tomography showed two areas of thickening and stenosis in the proximal jejunum and preterminal ileum, with an unknown etiology. Exploratory laparotomy was proposed but the patient suffered a sudden and progressive decrease in consciousness. Cranial computed tomography showed an ischemic area and a midline shift. Brain biopsies suggested infection by Aspergillus Fumigatus. Despite antifungal drugs, the patient had a progressive clinical deterioration and died. The autopsy concluded a systemic infection due to Aspergillus Fumigatus. Invasive aspergillosis is a serious fungal infection and usually occurs in immunocompromised patients. It mainly affects the lungs, followed by the gastrointestinal tract. The most frequent location in gastrointestinal involvement is the small bowel. Gastrointestinal involvement is more frequent in invasive disease. Although, there are case reports of isolated gastrointestinal aspergillosis, even in immunocompetent patients without risk factors. The prognosis is poor.
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- 2020
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232. sj-pdf-1-cep-10.1177_0333102420921162 - Supplemental material for Vancouver Declaration II on Global Headache Patient Advocacy 2019
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Dodick, David W, Messoud Ashina, Sakai, Fumihiko, Grisold, Wolfgang, Miyake, Hitoshi, Henscheid-Lorenz, Deborah, Craven, Audrey, Torre, Elena Ruiz De La, Koh, Rachel, Reznik, Nikita, Bance, Lisa, Leroux, Elizabeth, and Edvinsson, Lars
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FOS: Psychology ,FOS: Clinical medicine ,170199 Psychology not elsewhere classified ,110319 Psychiatry (incl. Psychotherapy) ,110306 Endocrinology ,111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified ,110904 Neurology and Neuromuscular Diseases ,Neuroscience - Abstract
Supplemental material, sj-pdf-1-cep-10.1177_0333102420921162 for Vancouver Declaration II on Global Headache Patient Advocacy 2019 by David W Dodick, Messoud Ashina, Fumihiko Sakai, Wolfgang Grisold, Hitoshi Miyake, Deborah Henscheid-Lorenz, Audrey Craven, Elena Ruizd e la Torre, Rachel Koh, Nikita Reznik, Lisa Bance, Elizabeth Leroux, Lars Edvinsson and on behalf of the International Headache Society Global Patient Advocacy Coalition in Cephalalgia
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- 2020
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233. Problemáticas psicosociales en el ámbito universitario y programas de prevención
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Maryory Muñoz Londoño, Johanna Paniagua Villalobos, Lucía Quesada Acuña, Carmen Elena Muñoz Preciado, Karen Lucina Padgett Zavala, Gloria Esperanza Castañeda Gómez, Bernardo Castillo Gaitán, Patricio Pérez Reyes, Andrea Ortiz Zúñiga, Jennifer Díaz Cubero, Ana María Enríquez Martínez, Mauricio Fuentes Corella, María José Sandstede Rivas, Katherine Rojas Salazar, Verónica Musre Hernández, Kattia Vargas Fallas, María Elena Ruiz Bernal, María Laura Zúñiga Quesada, Daniel Alfonso Montoya Vásquez, Víctor Jiménez Alemán, María Carolina Montoya Montoya, Guillermo Alonso Castaño Pérez, Jorge Gamboa Barrantes, Jaime Alonso Mejía Ocampo, Alba Luz Zelaya Guardado, Gonzalo Reyes Vidal, Hugo Herrera Stuardo, Gustavo Adolfo Calderón Vallejo, Diana Urrego Velásquez, Jessica Jasmín Cerrato, Juan Guillermo Hernández Gil, Hosman Arcila Muñoz, and Eliana María Hernández Ramírez
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Psychology - Abstract
El texto que se presenta aqui sistematiza las experiencias del proyecto “Diplomatura virtual en prevencion de problematicas psicosociales en el ambito universitario con enfasis en adicciones”, auspiciado por el Centro Coordinador de la Investigacion de la Federacion Internacional de Universidades Catolicas –FIUC-, en el que participaron las Universidades: Universidad Catolica Luis Amigo (Colombia) a partir del reconocimiento como universidad que otorgo el Ministerio de Educacion Nacional a la institucion, el 10 de noviembre de 2016; Catolica de Honduras Nuestra Senora Reina de la Paz; Catolica de Costa Rica y Catolica de Chile Cardenal Silva Henriquez. En la primera parte del texto se da cuenta del proyecto, sus antecedentes, objetivos, metodologia y actividades; una resena sobre las instituciones participantes y una reflexion sobre los problemas psicosociales de los universitarios hoy. En la segunda parte, se presentan los resultados de las pesquisas desarrolladas por cada una de la Universidades participantes, para dar cuenta de las problematicas psicosociales que mas afectan a sus propias comunidades educativas y del programa de prevencion disenado para intervenir dichos problemas. Consulta aqui
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- 2020
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234. Benzocarta: intervención mínima para la desprescripción de benzodiacepinas en pacientes con insomnio
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Julia Fernández Uría, Elena Ruiz de Velasco Artaza, Mikel Baza Bueno, and Ana Gorroñogoitia Iturbe
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Hipnóticos y sedantes ,Trastornos del inicio y del mantenimiento del sueño ,Prescripción inadecuada ,030503 health policy & services ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,Inappropriate prescribing ,lcsh:RA1-1270 ,Hypnotics and sedatives ,Desprescripción ,Educación del paciente ,03 medical and health sciences ,Benzodiazepines ,0302 clinical medicine ,Benzodiacepinas ,Atención primaria de salud ,Deprescription ,Sleep initiation and maintenance disorders ,030212 general & internal medicine ,0305 other medical science ,Primary health care - Abstract
Resumen: Objetivo: Averiguar si una intervención mediante carta dirigida a usuarios de benzodiacepinas consigue disminuir su consumo. Método: Estudio antes-después sin grupo control realizado en atención primaria en mayo de 2016. A 1.582 pacientes que tomaban una única dosis diaria de una benzodiacepina como hipnótico durante más de 3 meses se les envió una carta personalizada de su médico de familia con información sobre los efectos desfavorables de dicho consumo y la recomendación para retirarlo, con una pauta de descenso escalonada (Benzocarta). Se evaluó el porcentaje de pacientes que cesaron el consumo de benzodiacepinas, el porcentaje que las disminuyeron y la diferencia en la dosis total dispensada (miligramos equivalentes de diazepam dispensados en 3 meses) entre el periodo preintervención y postintervención (a los 6 y 12 meses). Resultados: Se obtuvieron datos de dispensaciones de 1.561 pacientes (media de edad: 69,3 años; 74% mujeres). Al año de la intervención, el 22,0% (intervalo de confianza del 95% [IC95%]:19,9-24,0) habían abandonado el consumo de benzodiacepinas y el 18,8% (IC95%:16,9-20,8) lo habían disminuido. Se observó una reducción estadísticamente significativa de la dosis total dispensada (media de la diferencia: 89 mg; IC95%: 72,2-105,7). Conclusión: La Benzocarta se asocia a una disminución relevante en el consumo de hipnóticos. Es una intervención sencilla y factible que puede aplicarse en poblaciones amplias, e incluso de forma repetida en el tiempo. Se requieren estudios controlados para confirmar su eficacia. Abstract: Objective: To determine whether a letter-based intervention to patients taking benzodiazepines reduces their consumption. Method: A before-after study without control group performed in primary care in May 2016. 1582 patients who took a single daily dose of benzodiazepines as hypnotic for more than 3 months were sent a personalized letter from their family doctor. The letter contained information about the risks of long-term benzodiazepine consumption and the recommendation to discontinue them with a gradual drop protocol (Benzoletter). The percentage of patients who stopped or decreased the use of benzodiazepines, and the difference in the total dose dispensed (mg equivalents of diazepam dispensed in three months) between the pre- and post-intervention period (at 6 and 12 months) were evaluated. Results: Dispensing data from 1561 patients were collected (average age: 69.3 years; 74% women). Twelve months after the intervention, 22.0% (95% confidence interval [95%CI]: 19.9-24.0) discontinued benzodiazepine consumption and 18.8% (95%CI: 16.9-20.8) reduced their consumption. A statistically significant reduction was observed in the total dose dispensed (mean difference: 89 mg; 95%CI: 72.2-105.7). Conclusion: The Benzoletter is associated with a significant decrease in the consumption of hypnotics. It is a simple and feasible intervention that allows acting on large populations, and it could even be periodically repeated. Controlled studies are required to confirm its effectiveness.
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- 2020
235. European headache federation consensus on the definition of resistant and refractory migraine Developed with the endorsement of the European Migraine & Headache Alliance (EMHA)
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Zaza Katsarava, Margarita Sanchez del Rio, Patrick Little, Paolo Martelletti, Alexandra J Sinclair, Simona Sacco, Antoinette Maassen van den Brink, Uwe Reuter, Anne Ducros, Christian Lampl, Elena Ruiz de la Torre, Mark Braschinsky, Patricia Pozo-Rosich, and Internal Medicine
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medicine.medical_specialty ,Activities of daily living ,business.industry ,Aura ,Pain medicine ,Medizin ,General Medicine ,Triptans ,Disease ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,Chronic Migraine ,Tolerability ,Migraine ,medicine ,030212 general & internal medicine ,Neurology (clinical) ,Intensive care medicine ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Introduction Despite advances in the management of headache disorders, some patients with migraine do not experience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, to help Healthcare Authorities in understanding the implications, and to create a basis to develop a better pathophysiological understanding and to support further therapeutic advances. Main body Definitions were established with a consensus process using the Delphi method. Patients with migraine with or without aura or with chronic migraine can be defined as having resistant migraine and refractory migraine according to previous preventative failures. Resistant migraine is defined by having failed at least 3 classes of migraine preventatives and suffer from at least 8 debilitating headache days per month for at least 3 consecutive months without improvement; definition can be based on review of medical charts. Refractory migraine is defined by having failed all of the available preventatives and suffer from at least 8 debilitating headache days per month for at least 6 consecutive months. Drug failure may include lack of efficacy or lack of tolerability. Debilitating headache is defined as headache causing serious impairment to conduct activities of daily living despite the use of pain-relief drugs with established efficacy at the recommended dose and taken early during the attack; failure of at least two different triptans is required. Conclusions We hope, that the updated EHF definition will be able to solve the conflicts that have limited the use of definitions which have been put forward in the past. Only with a widely accepted definition, progresses in difficult-to-treat migraine can be achieved. This new definition has also the aim to increase the understanding of the impact of the migraine as a disease with all of its social, legal and healthcare implications. It is the hope of the EHF Expert Consensus Group that the proposed criteria will stimulate further clinical, scientific and social attention to patients who suffer from migraine which is difficult-to-treat.
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- 2020
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236. European headache federation consensus on the definition of resistant and refractory migraine : Developed with the endorsement of the European Migraine & Headache Alliance (EMHA)
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Sacco, S. (Simona), Braschinsky, M. (Mark), Ducros, A. (Anne), Lampl, C. (Christian), Little, P. (Patrick), van den Brink, A.M. (Antoinette Maassen), Pozo-Rosich, P. (Patricia), Reuter, U. (U.), de la Torre, E.R. (Elena Ruiz), Del Rio, M.S. (Margarita Sanchez), Sinclair, A.J. (Alexandra J.), Katsarava, Z. (Zaza), Martelletti, P. (Paolo), Sacco, S. (Simona), Braschinsky, M. (Mark), Ducros, A. (Anne), Lampl, C. (Christian), Little, P. (Patrick), van den Brink, A.M. (Antoinette Maassen), Pozo-Rosich, P. (Patricia), Reuter, U. (U.), de la Torre, E.R. (Elena Ruiz), Del Rio, M.S. (Margarita Sanchez), Sinclair, A.J. (Alexandra J.), Katsarava, Z. (Zaza), and Martelletti, P. (Paolo)
- Abstract
INTRODUCTION: Despite advances in the management of headache disorders, some patients with migraine do not experience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, to help Healthcare Authorities in understanding the implications, and to create a basis to develop a better pathophysiological understanding and to support further therapeutic advances. MAIN BODY: Definitions were established with a consensus process using the Delphi method. Patients with migraine with or without aura or with chronic migraine can be defined as having resistant migraine and refractory migraine according to previous preventative failures. Resistant migraine is defined by having failed at least 3 classes of migraine preventatives and suffer from at least 8 debilitating headache days per month for at least 3 consecutive months without improvement; definition can be based on review of medical charts. Refractory migraine is defined by having failed all of the available preventatives and suffer from at least 8 debilitating headache days per month for at least 6 consecutive months. Drug failure may include lack of efficacy or lack of tolerability. Debilitating headache is defined as headache causing serious impairment to conduct activities of daily living despite the use of pain-relief drugs with established efficacy at the recommended dose and taken early during the attack; failure of at least two different triptans is required. CONCLUSIONS: We hope, that the updated EHF definition will be able to solve the conflicts that have limited the use of definitions which have been put forward in the past. Only with a widely accepted definition, progresses in difficult-to-treat migraine can be achieved. This new definition has also the aim to increase the understanding of the impact of the migraine as a disease with all of
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- 2020
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237. Utilidad de los actuales sistemas de escáner intraoral en la identificación forense
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David Cáceres-Monllor, Bernardo Perea-Pérez, Elena Labajo-González, Andrés Santiago-Sáez, Guillermo Pradíes-Ramiro, Enrique Dorado-Fernández, and Elena Ruiz-Mediavilla
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Pathology and Forensic Medicine - Published
- 2018
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238. Adaptive fuzzy partitions for evolving association rules in big data stream
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Jorge Casillas and Elena Ruiz
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Association rule learning ,Computer science ,Data stream mining ,business.industry ,Applied Mathematics ,Big data ,02 engineering and technology ,Fuzzy control system ,computer.software_genre ,Fuzzy logic ,Theoretical Computer Science ,Data flow diagram ,Variable (computer science) ,Artificial Intelligence ,020204 information systems ,0202 electrical engineering, electronic engineering, information engineering ,020201 artificial intelligence & image processing ,Data mining ,business ,computer ,Categorical variable ,Software - Abstract
The amount of data being generated in industrial and scientific applications is constantly increasing. These are often generated as a chronologically ordered unlabeled data flow which exceeds usual storage and processing capacities. Association stream mining is an appealing field which models complex environments online by finding relationships among the attributes without presupposing any a priori structure. The discovered relationships are continuously adapted to the dynamics of the problem in a pure online way, being able to deal with both categorical and continuous attributes. This paper presents a new advanced version, Fuzzy-CSar-AFP, of an online genetic fuzzy system designed to obtain interesting fuzzy association rules from data streams. It is capable of managing partitions of different granularity for the variables, which allows the algorithm to adapt to the precision requirements of each variable in the rule. It can also work with data streams without needing to know the domains of the attributes as it includes a mechanism which updates them in real-time. Fuzzy-CSar-AFP performance is validated in an original real-world Psychophysiology problem where associations between different electroencephalogram signals in subjects which are put through different stimuli are analyzed.
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- 2018
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239. The Bryophyte Flora of the Montseny Massif (Northeastern Iberian Peninsula): Conservation Issues and an Updated Check-List
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Elena Ruiz, Íñigo Granzow-de la Cerda, Llorenç Sáez, and Montserrat Brugués
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0106 biological sciences ,Flora ,geography.geographical_feature_category ,Ecology ,Biodiversity ,Plant Science ,Massif ,010603 evolutionary biology ,01 natural sciences ,Geography ,Herbarium ,Habitat ,Peninsula ,Threatened species ,Bryophyte ,Ecology, Evolution, Behavior and Systematics ,010606 plant biology & botany - Abstract
An annotated check-list of the bryophytes of the Montseny massif (northeastern Iberian Peninsula) is presented, based on literature and herbarium records revision as well as collections made by the authors. A total of 352 taxa were recorded, out of which three were hornworts, 80 liverworts and 269 mosses. Intensive surveys of original locations of threatened, extinct and protected species in the massif were carried out. Species whose local populations became extinct were those with a strong preference for wet and oligotrophic habitats, such habitats have been severely damaged in recent decades. We discuss possible strategies for effective conservation of those bryophytes whose local population have suffered a decline, like targeted legistation and establishing specific protected areas.
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- 2018
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240. Positive ultrasound halo sign of temporal arteries due to amyloidosis
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Gema Bonilla, Juan Molina Collada, Eugenio de Miguel, Alejandro Balsa, E. Fernández, Elena Ruiz Bravo-Burguillos, and Irene Monjo
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medicine.medical_specialty ,business.industry ,Amyloidosis ,Ultrasound ,medicine.disease ,Text mining ,Rheumatology ,medicine ,Pharmacology (medical) ,Temporal artery ,Radiology ,medicine.symptom ,Ultrasonography ,business ,Halo sign - Published
- 2019
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241. Métodos de investigación en la comunicación y sus medios
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Elena Ruiz Cabezuelo
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General Medicine - Abstract
Se trata de una obra que esboza la metodologia del estudio del entorno mediatico y de la comunicacion. Plantea un recorrido por los metodos clasicos de investigacion, pero tambien se adentra en las posibilidades que ofrecen las nuevas tecnologias en el ambito de la investigacion.
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- 2019
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242. Burden and Attitude to Resistant and Refractory Migraine A Survey From the European Headache Federation With the Endorsement of the European Migraine & Headache Alliance
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Sacco, Simona, primary, Lampl, Christian, additional, Brink, Antoinette Maassen van den, additional, Caponnetto, Valeria, additional, Braschinsky, Mark, additional, Ducros, Anne, additional, Little, Patrick, additional, Pozo-Rosich, Patricia, additional, Reuter, Uwe, additional, Torre, Elena Ruiz de la, additional, Rio, Margarita Sanchez Del, additional, Sinclair, Alexandra J, additional, Martelletti, Paolo, additional, and Katsarava, Zaza, additional
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- 2021
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243. Complicación infrecuente tras quimioembolización de hepatocarcinoma sobre hígado cirrótico: absceso hepático y pileflebitis
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María Del Mar Díaz Alcázar, Alicia Martín Lagos Maldonado, and Elena Ruiz Escolano
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Gynecology ,medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,business - Published
- 2021
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244. The Processing of Animal-Related Expressions.
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Elena Ruiz Gil and Javier Herrero Ruiz
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- 2006
245. Erratum to "Strategic management of the Malaga brand through open innovation: Tourists and residents' perception" [J. Open Innov.: Technol. Mark. Complex. 8(1) (2022) 28].
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Cruz-Ruiz, Elena, de la Cruz, Elena Ruiz-Romero, Zamarreño-Aramendia, Gorka, and Cristòfol, F.J.
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- *
STRATEGIC planning , *OPEN innovation , *PRODUCT management , *TOURISTS , *RESIDENTS - Published
- 2024
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246. 194. Progression of an Uncomplicated Urinary Tract Infection Among Female Patients with Susceptible and Non-Susceptible Urine Isolates: Findings from an Integrated Delivery Network
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Jason Shafrin, Alen Marijam, Ashish V Joshi, Fanny S Mitrani-Gold, Katie Everson, Rifat Tuly, Peter Rosenquist, Michael Gillam, and Maria Elena Ruiz
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Infectious Diseases ,AcademicSubjects/MED00290 ,Oncology ,Oral Abstracts - Abstract
Background Uncomplicated urinary tract infection (uUTI) is often treated empirically without antibiotic (AB) susceptibility testing; however, antimicrobial-resistant bacteria could lead to suboptimal treatment and progression to complicated UTI (cUTI). We examined the likelihood of uUTI progression to cUTI in patients with susceptible and non-susceptible uropathogens. Methods We performed a retrospective cohort study using data from a large Mid-Atlantic US integrated delivery network’s electronic health records from July 1, 2016 to March 31, 2020. Patients included were female, aged ≥ 12 years with incident uUTI (diagnosis code or urine culture), and given an oral AB ± 5 days of diagnosis and ≥ 1 antibiotic susceptibility test. The primary outcome was progression to cUTI, defined as: new fever, nausea, or vomiting, in addition to uUTI symptoms; or receipt of intravenous antibiotic 3–28 days after index uUTI. Probability of progression to cUTI was assessed comparing patients with non-susceptible and susceptible isolates, with 1:1 propensity score matching. Patients retained for analysis had a nonzero predicted probability of being in the case and control group and were retained for analysis only if there were patients in the mirror group with similar propensity scores. Data were analyzed with logistic regression. Sensitivity analyses were performed to test the robustness of the primary analysis (Table). Results A total of 2565 patients were included: 1030 (40.2%) had non-susceptible isolates and 1535 (59.8%) had susceptible isolates. Mean age was 43.5 years and 59.5% of the cohort was White. After propensity score matching, patients with non-susceptible isolates were more than twice as likely to progress to cUTI versus patients with sensitive isolates (10.7% versus 4.9%; odds ratio, 2.35; p < 0.001; Figure). In sensitivity analyses, patients with non-susceptible isolates remained significantly more likely to progress to cUTI (p ≤ 0.009), excluding those receiving fluoroquinolones only (Table). Figure. Probability of progression to cUTI Table. Sensitivity analyses of the probability of uUTI progressing to cUTI in patients with non-susceptible versus susceptible isolates (matched population) Conclusion Patients with uUTI and AB-resistant isolates were significantly more likely to progress to cUTI than those with susceptible isolates. This finding highlights the need for greater understanding of antimicrobial resistance and has implications for the clinical management of uUTI. Disclosures Jason Shafrin, PhD, Precision Medicine Group (Employee, Former employee of Precision Medicine Group, which received funding from GlaxoSmithKline plc. to conduct this study) Alen Marijam, MSc, GlaxoSmithKline plc. (Employee, Shareholder) Ashish V. Joshi, PhD, GlaxoSmithKline plc. (Employee, Shareholder) Fanny S. Mitrani-Gold, MPH, GlaxoSmithKline plc. (Employee, Shareholder) Katie Everson, MSc, Precision Medicine Group (Employee, Employee of Precision Medicine Group, which received funding from GlaxoSmithKline plc. to conduct this study) Rifat Tuly, MPH, Precision Medicine Group (Employee, Employee of Precision Medicine Group, which received funding from GlaxoSmithKline plc. to conduct this study) Peter Rosenquist, MSc, Precision Medicine Group (Employee, Employee of Precision Medicine Group, which received funding from GlaxoSmithKline plc. to conduct this study) Michael Gillam, MD, MedStar Health (Employee, Employee of MedStar Health and received funding from GlaxoSmithKline plc. through Precision Medicine Group to conduct this study) Maria Elena Ruiz, MD, Nothing to disclose
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- 2021
247. Acute and Post-Acute COVID-19 Severity and Mortality in Patients with Hematologic Malignancies: A Population-Based Registry Study
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Joaquin Martinez-Lopez, Lauren Benito, Jaime Pérez de Oteyza, Keina Quiroz, Pedro Sanchez Godoy, Pilar Herrera Puente, Arturo Matilla, Maria Pilar Llamas Sillero, Rafael Martos, E. Gómez, Angel Cedillo, Adriana Pascual, Juan F del Campo, J. Garcia-Suarez, Rodrigo Gil-Manso, Pilar Martínez-Barranco, Alberto Velasco, Maria Regina Herraez, Carmen Martínez-Chamorro, Concha Alaez, Elena Ruiz, Rafael F. Duarte, Víctor Jiménez-Yuste, Blanca Colás Lahuerta, José Ángel Hernández, José Luis Díez Martín, Javier de la Cruz, Adolfo de la Fuente, Adrian Alegre, and Mi Kwon
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Internal medicine ,Immunology ,Medicine ,In patient ,Cell Biology ,Hematology ,business ,905.Outcomes Research-Lymphoid Malignancies ,Biochemistry ,Population-Based Registry - Abstract
Introduction: The severity of acute clinical outcomes and mortality in hematologic malignancy (HM) patients infected by SARS-CoV-2 was exhaustively documented in the first weeks of the pandemic. A consistent increased mortality compared to non-cancer patients was observed across studies. In this study we aimed to estimate survival in COVID-19 HM patients by type of malignancy, to describe acute and post-acute clinical outcomes, and to compare outcomes in early and later pandemic periods. Methods: In this population-based registry study sponsored by the Madrid Society of Hematology (Asociación Madrileña de Hematología y Hemoterapia), we collected de-identified data on clinical characteristics, treatment and acute and post-acute outcomes in adult patients with hematologic malignancies and confirmed SARS-CoV-2 infection within the Madrid region of Spain. Our case series included all eligible patients admitted to 26 regional health service hospitals and 5 private healthcare centers between February 28, 2020 and February 18, 2021 with a coverage of 98% on a population of 6.6 million inhabitants. The study outcomes were all-cause mortality, severity of disease (WHO), oxygen support, ICU admission, and follow-up symptoms and signs and complications. Survival probabilities were estimated with the actuarial method and reported overall and stratified by type of malignancy and for two study periods (early cohort,-COVID-19 diagnosis from February 28 to 31 May, 2020, and later cohort, up to February 18, 2021). Results: Of the 1408 patients reported to the HEMATO-MADRID COVID-19 registry, 1166 were included in the present analyses; 839 (72%) had a lymphoid malignancy, including 325 (28%) with non-Hodgkin lymphoma, 50 (4%) with Hodgkin lymphoma and 263 (23%) with multiple myeloma; and 327 (28%) had a myeloid malignancy, including 115 (10%) with myelodysplastic syndrome, 92 (8%) with acute myeloid leukemia (AML) and 87 (7%) with Philadelphia chromosome (Ph)-negative myeloproliferative neoplasms. Overall COVID-19 clinical severity was classified as critical in 19% of patients, severe in 36%, moderate in 22%, and mild in 22%; 10% were admitted to an ICU; 8% were on mechanical ventilation and 19% on noninvasive ventilation. Mild disease increased between early and later period from 15% to 38% of patients; severe disease decreased from 42% to 24%, p At follow-up, 22% reported persistent symptoms related to COVID-19 at 2 months, 16% at 4 months and 14% at 6 months. 381 of 1166 (33%) patients died. Overall 30-day survival was 68%; 2 and 3-month overall survival probabilities were 56% and 53%, respectively. Survival was more favorable for patients with myeloproliferative neoplasms (82%, 69% and 65% at 30-days, 2 and 3 months, respectively) than for those with lymphoid malignancies (68%, 56% and 54%) or myelodysplastic syndrome/acute myeloid leukemia (61%, 51%, 46%), p=001. 285 (37%) patients died in the early period vs 96 (24%) in the later, p Conclusions. A population-based registry in Spain provided strong evidence that although COVID-19 severity decreased over year 1 of the pandemic, mortality remained high, and survival was stable over time in the group of patients with hematological malignancy infected by SARS-Coc-2. A relevant proportion of the infected patients (1 in 6) referred persistent symptoms attributable to COVID-19. The improved clinical management of severe COVID-19 in non-cancer patients that followed the dissemination of evidence-based recommendations did not translate in more favorable survival in patients with hematological malignancies. Research is needed to address the specific characteristics and improve the clinical management of this vulnerable population. Disclosures Martinez-Lopez: Novartis: Consultancy, Speakers Bureau; BMS: Consultancy, Research Funding, Speakers Bureau; Janssen: Consultancy, Speakers Bureau; Incyte: Consultancy, Research Funding, Speakers Bureau; Roche: Consultancy, Research Funding, Speakers Bureau; Astellas: Research Funding, Speakers Bureau. Jiménez-Yuste: Pfizer: Consultancy, Honoraria, Research Funding; Grifols: Consultancy, Honoraria, Research Funding; CSL Behring: Consultancy, Honoraria, Research Funding; Sanofi: Consultancy, Honoraria, Research Funding; Bayer: Consultancy, Honoraria, Research Funding; NovoNordisk: Consultancy, Honoraria, Research Funding; BioMarin: Consultancy; Sobi: Consultancy, Honoraria, Research Funding; Octapharma: Consultancy, Honoraria, Research Funding; Takeda: Consultancy, Honoraria, Research Funding; F. Hoffmann-La Roche Ltd: Consultancy, Honoraria, Research Funding. Kwon: Gilead: Honoraria.
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- 2021
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248. Influence of past infection with SARS-CoV-2 on the response to the BNT162b2 mRNA vaccine in health care workers: Kinetics and durability of the humoral immune response
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L Sáez, Caridad Sainz de Baranda, Carlos de Cabo, Elena Ruiz-Escribano, Celia Santos, Javier Solera, Luis Marín, Joaquin Blas, Antonio García, Ramon Rada, Jesús Ontañón, José Luis Beato, Laura Navarro, J Solera, and Lourdes Sáez
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Adult ,Male ,Medicine (General) ,Coronavirus disease 2019 (COVID-19) ,Health Personnel ,health care facilities, manpower, and services ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,education ,Population ,Immunological memory ,Antibodies, Viral ,Immune memory ,General Biochemistry, Genetics and Molecular Biology ,R5-920 ,Immune system ,Health care ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,BNT162 Vaccine ,Aged ,education.field_of_study ,SARS-CoV-2 ,business.industry ,Vaccination ,COVID-19 ,virus diseases ,General Medicine ,Middle Aged ,Immunity, Humoral ,SARS-CoV-2 vaccines ,Secondary antibody response ,Immunization ,Immunoglobulin G ,Immunology ,Linear Models ,Previous SARS-CoV-2 infection ,business ,Immunologic Memory ,Research Paper - Abstract
Background: SARS-CoV-2 vaccines are an invaluable resource against COVID-19. Current vaccine shortage makes it necessary to prioritize distribution to the most appropriate segments of the population. Methods: This is a prospective cohort study of 63 health care workers (HCWs) from a General Hospital. We compared antibody responses to two doses of BNT162b2 mRNA COVID-19 vaccine between HCWs with previous SARS-CoV-2 infection (experienced HCWs) and HCWs without previous infection (naïve HCWs). Findings: Seven days after the first vaccine dose, HCWs with previous infection experienced a 126-fold increase in antibody levels (p50 AU). After the second dose, no significant increase in antibody levels was found in experienced HCWs, whereas in naïve HCWs, levels increased by 16-fold (p
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- 2021
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249. Revision of a Previous Capella Bypass due to dysphagia, GERD and Candy Cane Syndrome
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Débora Acín-Gándara, Fernando Pereira-Pérez, Elena Ruiz-Úcar, and Manuel Medina-García
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Reoperation ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Gastric Bypass ,030209 endocrinology & metabolism ,Candy ,Hiatal hernia ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,Reflux ,medicine.disease ,Dysphagia ,digestive system diseases ,Obesity, Morbid ,Endoscopy ,Surgery ,Pneumonia ,Stenosis ,Gastroesophageal Reflux ,Quality of Life ,GERD ,Canes ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,medicine.symptom ,Deglutition Disorders ,business ,Esophagitis - Abstract
Capella ringed gastric bypass is a technical variant of gastric bypass which seeks to improve long-term outcomes with a greater restriction. Frequent complications are due to the band, due to its inclusion or slippage, without being able to reject others. Our purpose is to present the video of a revisional bariatric surgery made by laparoscopic approach in a patient with a previous open retrogastric retrocolic Capella gastric bypass. The patient presents dysphagia, gastroesophagic reflux disease (GERD), and pain, with a BMI of 36 kg/m2. Her supplementary tests show a hiatal hernia, GERD, and a Candy Cane Syndrome. The surgery was difficult due to multiple adhesions. Hiatal hernia was repaired and pillars were closed. The band was visualized intraoperatively close to the gastrojejunal anastomosis, although the high endoscopy did not detect neither stenosis nor difficulty of passage to the gastric pouch. It showed the retrogastric gastrojejunal anastomosis with a normal food loop and a 15-cm widened blind loop (Candy Cane Syndrome), which was resected. She had a left pneumonia and damage in left hepatic lobe (LHL). She was discharged after antibiotic treatment for 7 days. The patient has improved clinically, without dysphagia nor GERD. Her current BMI is 29.8 kg/m2. In conclusion, bariatric revisional surgery can lead to serious complications, but it is justified in patients with poor quality of life. A ringed retrocolic retrogastric bypass poses more difficulties in revisional procedures. It is mandatory to know which technique was performed before. The duration of the procedure can result in more complications like liver damage.
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- 2021
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250. Regulation of mammalian liver methionine adenosyltransferase
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Corrales, Fernando J., Perez-Mato, Isabel, del Pino, Manuel M. Sanchez, Ruiz, Felix, Castro, Carmen, Garcia-Trevijano, Elena Ruiz, Latasa, Uxue, Martinez-Chantar, M. Luz, Martinez-Cruz, Alfonso, Avila, Matias A., and Mato, Jose M.
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Nutrition -- Research ,Mammals -- Physiological aspects ,Liver -- Physiological aspects ,Transferases -- Physiological aspects ,Methylation -- Physiological aspects ,Nitric oxide -- Physiological aspects ,Enzymes -- Physiological aspects ,Food/cooking/nutrition - Abstract
S-adenosylmethionine (SAM) is an essential metabolite in all cells. SAM is the most important biological methyl group donor and is a precursor in the synthesis of polyamines. Methionine adenosyltransferase (MAT; EC 2.5.1.6) catalyzes the only known SAM biosynthetic reaction from methionine and ATP. In mammalian tissues, three different forms of MAT (MAT I, MAT III and MAT II) have been identified that are the product of two different genes (MAT1A and MAT2A). Although MAT2A is expressed in all mammalian tissues, the expression of MAT1A is primarily restricted to adult liver. In mammals, up to 85% of all methylation reactions and as much as 48% of methionine metabolism occurs in the liver, which indicates the important role of this organ in the regulation of blood methionine. Recent evidence indicates that not only is SAM the main biological methyl group donor and an intermediate metabolite in methionine catabolism, but it is also an intracellular control switch that regulates essential hepatic functions such as liver regeneration and differentiation as well as the sensitivity of this organ to injury. Therefore, knowledge of factors that regulate the activity of MAT I/III, the specific liver enzyme, is essential to understand how cellular SAM levels are controlled. KEY WORDS: * methionine adenosyltransferase * S-adenosylmethionine * nitric oxide * liver * glutathione * enzyme regulation * free radicals
- Published
- 2002
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