41 results on '"García-Carretero R"'
Search Results
2. Uricemia y síndrome metabólico en pacientes con hipertensión arterial
- Author
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López-Jiménez, M., Vigil-Medina, L., Condés-Moreno, E., García-Carretero, R., Fernández-Mejías, C., and Ruiz-Galiana, J.
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- 2012
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3. Recomendaciones específicas para el manejo del paciente con síndrome metabólico
- Author
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Vigil Medina, L., López Jiménez, M., and García Carretero, R.
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- 2007
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4. Respuesta hipertensiva al ejercicio: ¿tiene implicaciones pronósticas?
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Vigil Medina, L., primary and García Carretero, R., additional
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- 2020
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5. Primary bone metastasis as first manifestation of an unknown primary tumour
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El Bouayadi Mohamed L, Romero Brugera M, García Carretero R, and Rebollo-Aparicio N
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Pathology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Biopsy ,Cancer ,Physical examination ,Bone Neoplasms ,General Medicine ,Middle Aged ,medicine.disease ,Occult ,Article ,Metastasis ,Primary bone ,Fatal Outcome ,medicine ,Unknown primary ,Immunohistochemistry ,Humans ,Neoplasms, Unknown Primary ,Female ,business ,Tomography, X-Ray Computed - Abstract
Unknown primary tumour refers to a group of cancers for which the anatomical site of origin remains occult after detailed investigations. Thanks to sophisticated imaging, immunohistochemical testing and molecular-profiling tools, there is a more accurate approach to unknown primary cancer. Metastasis to bone is not a rare phenomenon, because any tumour can metastasise to bone, so it is a common clinical scenario. The role of clinical history, physical examination, laboratory tests, radiographic studies and immunohistochemistry is critical for a successful diagnostic strategy. Subsets of unknown primary cancers can be identified primarily on the basis of histopathological findings, the pattern of spread and serum markers. New immunohistochemical markers and tissue-of-origin profiles may establish presumable primary sites to unknown primary cancer on the basis of immunohistochemical and molecular patterns. We present a case of a 57-year-old woman without a cancer history, who had primary bone metastasis as the first manifestation of an occult primary tumour.
- Published
- 2015
6. Arteritis de Takayasu como causa de hipertensión secundaria
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García-Carretero, R., Caamaño-Selma, O., Vázquez-Gómez, Ó., and Ruiz-Galiana, J.
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- 2013
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7. Hypertensive response to exercise: does it have prognostic implications?
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Vigil Medina, L. and Garcia Carretero, R.
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- 2020
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8. VITAMIN D DEFICIENCY AND INSULIN RESISTANCE IN PATIENTS WHIT ESSENTIAL HYPERTENSION
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Vigil, L., primary, Lopez, M., additional, García-Carretero, R., additional, Varela, M., additional, Ferrero, D., additional, Rodriguez, C., additional, and Ruiz, J, additional
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- 2011
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9. GLYCATED HAEMOGLOBIN, FASTING GLUCOSE AND CARDIOVASCULAR RISK FACTORS IN A HYPERTENSIVE POPULATION
- Author
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Vigil, L., primary, Lopez, M., additional, Varela, M., additional, García-Carretero, R., additional, Ferrero, D., additional, and Ruiz, J., additional
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- 2011
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10. METABOLIC SYNDROME AND THE RISK OF CHRONIC RENAL DISEASE IN A HYPERTENSIVE POPULATION: PP.9.357
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Vigil, L, primary, Lopez, M, additional, Condes, E, additional, Ferrero, D, additional, Caamaño, O, additional, García Carretero, R, additional, Lorence, D, additional, and Ruiz, J, additional
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- 2010
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11. CYSTATIN C IS ASSOCIATED WITH SERUM URIC ACID IN A HYPERTENSIVE POPULATION: PP.15.54
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Vigil, L, primary, Lopez, M, additional, Condés, E, additional, Ferrero, D, additional, Caamaño, O, additional, Lorence, D, additional, García-Carretero, R, additional, and Ruiz, J, additional
- Published
- 2010
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12. Incidental Finding of a Left Atrial Myxoma while Characterising an Autoimmune Disease
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Garcia-Carretero Rafael, Naranjo-Mansilla Gema, Luna-Heredia Esther, Arias-Baldo Paloma, and Beamonte-Vela Blanca-Nieves
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left atrial myxoma ,cardiac benign tumor ,constitutional symptoms ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Although cardiac tumours are uncommon, cardiac myxomas account for more than fifty percent of all cases and are the most frequent primary cardiac tumour. They have a broad clinical spectrum, usually related to cardiac symptoms, peripheral embolic events or systemic manifestations. We present a case report of a 68-year-old man who presented with systemic symptoms and analytical features suggestive of an autoimmune disease. In the ensuing diagnostic procedures, a cardiac myxoma was found, and after surgical resection, both the systemic manifestations and the analytical abnormalities disappeared.
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- 2018
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13. Clinical Features and Outcomes of Fusobacterium Species Infections in a Ten-Year Follow-up
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Garcia-Carretero Rafael, Lopez-Lomba Marta, Carrasco-Fernandez Blanca, and Duran-Valle Maria Teresa
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bacteremia ,fusobacterium ,incidence ,risk factors ,epidemiology ,sepsis ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objective: Although uncommon, Fusobacterium infections have a wide clinical spectrum, ranging from local pharyngeal infections to septic shock. Our aim was to characterize and analyze the clinical features and outcomes in patients with Fusobacterium infections, and determine which variables were able to predict a poor outcome.
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- 2017
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14. Near infrared spectroscopy (NIRS) and machine learning as a promising tandem for fast viral detection in serum microsamples: A preclinical proof of concept.
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Gomez J, Barquero-Pérez O, Gonzalo J, Salgüero S, Riado D, Luisa Casas M, Luisa Gutiérrez M, Jaime E, Pérez-Martínez E, García-Carretero R, Ramos J, Fernández-Rodriguez C, and Catalá M
- Subjects
- Humans, Principal Component Analysis, Proof of Concept Study, Spectroscopy, Near-Infrared methods, Machine Learning, Hepatitis C blood, Hepatitis C virology, Hepatitis C diagnosis, Hepacivirus isolation & purification
- Abstract
Fast detection of viral infections is a key factor in the strategy for the prevention of epidemics expansion and follow-up. Hepatitis C is paradigmatic within viral infectious diseases and major challenges to elimination still remain. Near infrared spectroscopy (NIRS) is an inexpensive, clean, safe method for quickly detecting viral infection in transmission vectors, aiding epidemic prevention. Our objective is to evaluate the combined potential of machine learning and NIRS global molecular fingerprint (GMF) from biobank sera as an efficient method for HCV activity discrimination in serum. GMF of 151 serum biobank microsamples from hepatitis C patients were obtained with a FT-NIR spectrophotometer in reflectance mode. Multiple scatter correction, smoothing and Saviztsky-Golay second derivative were applied. Spectral analysis included Principal Component Analysis (PCA), Bootstrap and L1-penalized classification. Microsamples of 70 µl were sufficient for GMF acquisition. Bootstrap evidenced significant difference between HCV PCR positive and negative sera. PCA renders a neat discrimination between HCV PCR-positive and negative samples. PCA loadings together with L1-penalized classification allow the identification of discriminative bands. Active virus positive sera are associated to free molecular water, whereas water in solvation shells is associated to HCV negative samples. Divergences in the water matrix structure and the lipidome between HCV negative and positive sera, as well as the relevance of prooxidants and glucose metabolism are reported as potential biomarkers of viral activity. Our proof of concept demonstrates that NIRS GMF of hepatitis C patients' sera aided by machine learning allows for efficient discrimination of viral presence and simultaneous potential biomarker identification., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Oscar Barquero reports financial support was provided by Spanish Ministry of Education and Science. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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15. Paucisymptomatic clinical presentation of an advanced malignant lung disease: solitary skull metastasis as the initial exploratory sign.
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García Carretero R, Ordonez-Garcia M, Hernandez-Puche S, and Arias-Baldo P
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- Humans, Skull diagnostic imaging, Skull pathology, Carcinoma, Non-Small-Cell Lung secondary, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2022
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16. Assessment of Classification Models and Relevant Features on Nonalcoholic Steatohepatitis Using Random Forest.
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García-Carretero R, Holgado-Cuadrado R, and Barquero-Pérez Ó
- Abstract
Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is the most common cause of chronic liver disease in developed countries. Certain conditions, including mild inflammation biomarkers, dyslipidemia, and insulin resistance, can trigger a progression to nonalcoholic steatohepatitis (NASH), a condition characterized by inflammation and liver cell damage. We demonstrate the usefulness of machine learning with a case study to analyze the most important features in random forest (RF) models for predicting patients at risk of developing NASH. We collected data from patients who attended the Cardiovascular Risk Unit of Mostoles University Hospital (Madrid, Spain) from 2005 to 2021. We reviewed electronic health records to assess the presence of NASH, which was used as the outcome. We chose RF as the algorithm to develop six models using different pre-processing strategies. The performance metrics was evaluated to choose an optimized model. Finally, several interpretability techniques, such as feature importance, contribution of each feature to predictions, and partial dependence plots, were used to understand and explain the model to help obtain a better understanding of machine learning-based predictions. In total, 1525 patients met the inclusion criteria. The mean age was 57.3 years, and 507 patients had NASH (prevalence of 33.2%). Filter methods (the chi-square and Mann-Whitney-Wilcoxon tests) did not produce additional insight in terms of interactions, contributions, or relationships among variables and their outcomes. The random forest model correctly classified patients with NASH to an accuracy of 0.87 in the best model and to 0.79 in the worst one. Four features were the most relevant: insulin resistance, ferritin, serum levels of insulin, and triglycerides. The contribution of each feature was assessed via partial dependence plots. Random forest-based modeling demonstrated that machine learning can be used to improve interpretability, produce understanding of the modeled behavior, and demonstrate how far certain features can contribute to predictions.
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- 2021
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17. Elusive diagnosis of lymphadenopathy in a young woman.
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Peña Arce C, Vazquez-Gomez O, García Carretero R, and Diego Hernandez C
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- Adult, Axilla diagnostic imaging, Biopsy, Clavicle diagnostic imaging, Diagnosis, Differential, Female, Humans, Lymphadenopathy etiology, Positron-Emission Tomography, Ultrasonography, Lymphadenopathy diagnostic imaging, Lymphadenopathy pathology, Tattooing adverse effects
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2019
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18. Behavioural changes as the first manifestation of a silent frontal lobe stroke.
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García Carretero R, Beamonte-Vela BN, Silvano-Cocinero JD, and Alvarez-Mendez A
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- Aged, Atorvastatin therapeutic use, Brain diagnostic imaging, Brain pathology, Cerebral Infarction complications, Cerebral Infarction diagnostic imaging, Cerebral Infarction psychology, Frontal Lobe diagnostic imaging, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Magnetic Resonance Imaging, Male, Neuroimaging methods, Stroke pathology, Syndrome, Tomography, X-Ray Computed, Frontal Lobe pathology, Problem Behavior psychology, Stroke complications, Stroke psychology
- Abstract
A 67-year-old man was admitted to our hospital after his relatives found him to have severe personality and behavioural changes. His behaviour was inappropriate and uninhibited. The patient reported no symptoms and he showed poor insight into his own behaviour. Neuroimaging showed an orbitofrontal lesion, due to an infarction of the anterior cerebral artery. The patient was diagnosed with frontal lobe syndrome., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
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19. Methacrylate dressing on refractory venous leg ulcers.
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García Carretero R, Garrido-Ollero M, Martinez-Alvarez A, and Cadenas-Vara A
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- Chronic Disease, Humans, Male, Middle Aged, Treatment Outcome, Varicose Ulcer pathology, Wound Healing, Bandages, Methacrylates, Varicose Ulcer therapy
- Abstract
Chronic leg ulcers can have a major impact on the quality of life of patients. These wounds can be complex and hard to heal, as several factors may affect the outcome. Underlying conditions, bacterial growth and excess moisture may prevent wounds from healing. We describe the case of a patient with known chronic venous disease, who was admitted to our hospital for several complex, irregular and infected chronic venous ulcers in his lower legs. The management was frustrating for several months, until we began to use methacrylate powder dressing for his hard-to-heal wounds., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2018
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20. Lactobacillus salivarius infection as a postoperative complication after bariatric surgery.
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García Carretero R, Regodon Dominguez M, Ruiz Bastian M, and Lopez Lomba M
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- Adult, Humans, Male, Postoperative Complications diagnosis, Postoperative Complications drug therapy, Gastric Bypass, Gram-Positive Bacterial Infections diagnosis, Gram-Positive Bacterial Infections drug therapy, Ligilactobacillus salivarius
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- 2018
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21. Fatal outcome of an anaplastic thyroid tumour.
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García Carretero R, Peña-Arce C, Martinez-Quesada G, and Garcia-Alvarez J
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- Aged, Autopsy, Fatal Outcome, Humans, Male, Neoplasm Metastasis pathology, Neoplasm Staging, Prognosis, Radiography, Thoracic, Thyroid Carcinoma, Anaplastic mortality, Thyroid Carcinoma, Anaplastic pathology, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms pathology
- Abstract
Anaplastic thyroid cancer is a rare form of thyroid cancer, known for its very poor prognosis, even with the appropriate management. It is very aggressive, with a tendency to invade locally and lymph node metastasis is often present at the time of diagnosis. We present an elderly patient, who presented with rapid enlarging neck mass, which, within weeks, led to his death. His family gave their consent to perform an autopsy, and here we describe and illustrate the profound aggressiveness of this tumour., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
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22. Extensive aortic dissection of fulminant course.
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García Carretero R, Romero Brugera M, Vazquez Gomez O, and Rebollo Aparicio N
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- Fatal Outcome, Humans, Male, Middle Aged, Aortic Dissection diagnostic imaging, Aortic Aneurysm, Abdominal diagnostic imaging, Tomography, X-Ray Computed
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- 2017
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23. Cerebellar abscesses, infective endocarditis and bacteraemia due to a rare pathogen: Streptococcus constellatus .
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García Carretero R
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- Abscess diagnostic imaging, Abscess drug therapy, Abscess pathology, Accidental Falls, Adenocarcinoma pathology, Aged, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Bacteremia, Cerebellar Diseases diagnostic imaging, Cerebellar Diseases drug therapy, Colorectal Neoplasms pathology, Diagnosis, Differential, Echocardiography methods, Endocarditis diagnosis, Endocarditis, Bacterial diagnosis, Endocarditis, Bacterial diagnostic imaging, Fatal Outcome, Female, Gait Ataxia diagnosis, Gait Ataxia etiology, Humans, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Abscess microbiology, Cerebellar Diseases microbiology, Colorectal Neoplasms diagnostic imaging, Endocarditis microbiology, Endocarditis, Bacterial microbiology, Streptococcal Infections complications, Streptococcus constellatus isolation & purification
- Abstract
Intracranial infections may result from contiguity, such as mastoiditis or acute otitis media, or from haematogenous dissemination from an infectious source. Streptococcus constellatus , a coccus from the normal genital, oral and gastrointestinal flora, has a tendency to form abscesses, but not to cause infective endocarditis (IE). Also, S. constellatus is an extremely rare causative agent of brain abscess. We report the case of a woman with a colorectal tumour who presented with IE and cerebellar abscesses due to a S. constellatus bacteraemia., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
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24. A typical presentation of a hepatocellular carcinoma in a middle-aged patient.
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García Carretero R, Vazquez-Gomez O, Romero Brugera M, and Rebollo-Aparicio N
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- Antineoplastic Agents, Biopsy, Fine-Needle, Bone Neoplasms diagnostic imaging, Bone Neoplasms drug therapy, Bone Neoplasms pathology, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular drug therapy, Clavicle diagnostic imaging, Clavicle injuries, Fatal Outcome, Fractures, Bone diagnostic imaging, Humans, Liver Neoplasms diagnostic imaging, Liver Neoplasms drug therapy, Male, Middle Aged, Niacinamide analogs & derivatives, Phenylurea Compounds, Sorafenib, Bone Neoplasms secondary, Carcinoma, Hepatocellular pathology, Liver Neoplasms pathology
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2017
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25. Bacteraemia and liver abscess due to Fusobacterium necrophorum .
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García Carretero R, Lopez-Lomba M, Vazquez-Gomez O, and Rodriguez-Maya B
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- Anti-Bacterial Agents therapeutic use, Ceftriaxone therapeutic use, Fusobacterium Infections complications, Fusobacterium Infections drug therapy, Humans, Liver Abscess complications, Liver Abscess drug therapy, Male, Metronidazole therapeutic use, Middle Aged, Nausea microbiology, Penicillanic Acid analogs & derivatives, Penicillanic Acid therapeutic use, Piperacillin therapeutic use, Piperacillin, Tazobactam Drug Combination, Sepsis drug therapy, Treatment Outcome, Vomiting microbiology, Abdominal Pain microbiology, Bacteremia microbiology, Fusobacterium Infections microbiology, Fusobacterium necrophorum isolation & purification, Liver Abscess microbiology, Sepsis microbiology
- Abstract
Fusobacterium necrophorum is the oropharyngeal pathogen usually associated with Lemierre's syndrome, a pharyngeal infection which evolves to sepsis, septic emboli and thrombophlebitis of the adjacent neck vessels. It is an uncommon causative bacteria of a liver abscess, and an extensive workup should, therefore, be performed in order to rule out potential sources of the infection. This case report describes the workup that led to the diagnosis of a colorectal carcinoma, which was deemed to be the source of the Fusobacterium bacteraemia., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
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26. Paucisymptomatic meningioma in a young patient.
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García Carretero R, Luna Heredia E, Olid Velilla M, and Villa Escamilla M
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- Female, Humans, Middle Aged, Magnetic Resonance Imaging, Meningeal Neoplasms diagnostic imaging, Meningioma diagnostic imaging, Tomography, X-Ray Computed
- Published
- 2017
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27. Non-surgical treatment of a relapsed cystic hygroma in an adult.
- Author
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García Carretero R, Rodriguez-Maya B, and Vazquez-Gomez O
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- Adult, Axilla, Female, Humans, Lymphangioma, Cystic therapy, Neoplasm Recurrence, Local therapy, Soft Tissue Neoplasms therapy
- Abstract
Lymphatic malformations, also known as lymphangiomas or cystic hygromas, are benign masses that typically affect newborns and infants and involve the head and neck regions. They are, however, rare in adults and even rarer in the axillary region. Although surgery is considered to be the treatment of choice, we present a rare case of a recurrent cystic hygroma 32 years after the first surgical operation. Due to the cosmetic concerns and the risks of a surgical approach, non-surgical therapy with percutaneous sclerosants was performed, with a good outcome after a 2-year follow-up period., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
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28. Non-malignant superior vena cava syndrome in a patient with incidental diagnosis of a congenital vascular defect.
- Author
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García Carretero R
- Subjects
- Aged, 80 and over, Humans, Male, Superior Vena Cava Syndrome diagnostic imaging, Superior Vena Cava Syndrome etiology, Vena Cava, Superior diagnostic imaging, Superior Vena Cava Syndrome diagnosis, Vascular Malformations diagnosis, Vena Cava, Superior abnormalities
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2017
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29. Glucose time series complexity as a predictor of type 2 diabetes.
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Rodríguez de Castro C, Vigil L, Vargas B, García Delgado E, García Carretero R, Ruiz-Galiana J, and Varela M
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- Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 2 epidemiology, Female, Follow-Up Studies, Glycated Hemoglobin analysis, Humans, Male, Middle Aged, Models, Theoretical, Prevalence, Prognosis, Risk Factors, Spain epidemiology, Blood Glucose analysis, Diabetes Mellitus, Type 2 diagnosis, Hypertension complications, Monitoring, Physiologic methods, Obesity complications
- Abstract
Background: Complexity analysis of glucose profile may provide valuable information about the gluco-regulatory system. We hypothesized that a complexity metric (detrended fluctuation analysis, DFA) may have a prognostic value for the development of type 2 diabetes in patients at risk., Methods: A total of 206 patients with any of the following risk factors (1) essential hypertension, (2) obesity or (3) a first-degree relative with a diagnosis of diabetes were included in a survival analysis study for a diagnosis of new onset type 2 diabetes. At inclusion, a glucometry by means of a Continuous Glucose Monitoring System was performed, and DFA was calculated for a 24-h glucose time series. Patients were then followed up every 6 months, controlling for the development of diabetes., Results: In a median follow-up of 18 months, there were 18 new cases of diabetes (58.5 cases/1000 patient-years). DFA was a significant predictor for the development of diabetes, with ten events in the highest quartile versus one in the lowest (log-rank test chi2 = 9, df = 1, p = 0.003), even after adjusting for other relevant clinical and biochemical variables. In a Cox model, the risk of diabetes development increased 2.8 times for every 0.1 DFA units. In a multivariate analysis, only fasting glucose, HbA
1c and DFA emerged as significant factors., Conclusions: Detrended fluctuation analysis significantly performed as a harbinger of type 2 diabetes development in a high-risk population. Complexity analysis may help in targeting patients who could be candidates for intensified treatment. Copyright © 2016 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd., (Copyright © 2016 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.)- Published
- 2017
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30. Pancytopenia associated with levetiracetam in an epileptic woman.
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García Carretero R, Romero Brugera M, Olid-Velilla M, and Salamanca-Ramirez I
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- Aged, Anticonvulsants adverse effects, Anticonvulsants therapeutic use, Female, Humans, Leukocyte Count, Levetiracetam, Pancytopenia blood, Piracetam adverse effects, Piracetam therapeutic use, Epilepsy drug therapy, Pancytopenia chemically induced, Piracetam analogs & derivatives
- Abstract
Haematological toxicity due to antiepileptic drugs is uncommon, but the increased risk of aplastic anaemia has been reported. Few case reports have been published regarding pancytopenia associated with levetiracetam treatment, and its intrinsic pathogenesis is still unknown. We describe the case of a woman aged 77 years who presented with abdominal pain and loss of appetite. She had been taking valproic acid, due to a previous episode of epileptic seizures, and presented with drowsiness and dizziness. Valproate was discontinued and therapy with levetiracetam was initiated. 2 days later, we observed severe anaemia, leucopenia and thrombocytopenia, which were attributed to levetiracetam. Although she recovered soon after the treatment was discontinued, it took 2 weeks for cell counts to return to normal., Competing Interests: Conflicts of Interest: None declared., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
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31. Massive haemolysis, gas-forming liver abscess and sepsis due to Clostridium perfringens bacteraemia.
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García Carretero R, Romero Brugera M, Vazquez-Gomez O, and Rebollo-Aparicio N
- Subjects
- Aged, Bacteremia microbiology, Clostridium Infections microbiology, Hemolysis, Humans, Male, Soft Tissue Infections microbiology, Bacteremia complications, Clostridium Infections complications, Clostridium perfringens, Liver Abscess microbiology, Sepsis microbiology, Soft Tissue Infections complications
- Abstract
Clostridial soft tissue infections are infrequent, but can be life-threatening when associated with certain underlying conditions, such as immunosuppression or malignancy. When bacteraemia occurs, it can be accompanied by haemolysis. Only surgical removal of the focus of infection and early onset of antibiotic therapy can prevent a very poor outcome. We describe the case of a man aged 65 years who presented with sepsis, haemolysis and rapid worsening. The identification of a gas-forming liver abscess, the early percutaneous drainage and the prompt initiation of antibiotic treatment were the key factors in the outcome of this patient., Competing Interests: Conflicts of Interest: None declared., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
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32. Bacteraemia due to Parvimonas micra, a commensal pathogen, in a patient with an oesophageal tumour.
- Author
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García Carretero R, Luna-Heredia E, Olid-Velilla M, and Vazquez-Gomez O
- Subjects
- Bacteremia complications, Carcinoma, Squamous Cell diagnosis, Esophageal Neoplasms diagnosis, Gastroscopy, Humans, Male, Middle Aged, Peptostreptococcus, Bacteremia microbiology, Carcinoma, Squamous Cell complications, Esophageal Neoplasms complications, Esophagus pathology, Gram-Positive Bacteria growth & development, Mouth microbiology
- Abstract
A man aged 53 years was admitted to our hospital due to general malaise, fever and chills for the past 24 hours. He had a history of chronic alcoholic liver disease. The blood tests showed leucocytosis with neutrophilia, lactic acidosis and acute-phase reactants. The blood cultures were positive for Parvimonas micra, an anaerobic pathogen which is part of the flora of the oral cavity. There was no evidence of abscess formation in either the examination or the imaging tests, but in the work-up that followed, a gastroscopy showed a stenotic oesophageal mass that turned out to be an invasive squamous cell carcinoma., Competing Interests: Conflicts of Interest: None declared., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
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33. Neurogenic fever in a patient with a chordoid glioma.
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García Carretero R, Romero Brugera M, Vazquez-Gomez O, and Rebollo-Aparicio N
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- Adult, Body Temperature Regulation, Humans, Magnetic Resonance Imaging, Male, Cerebral Ventricle Neoplasms diagnosis, Fever etiology, Glioma diagnosis, Hypothalamic Diseases etiology, Hypothalamus, Third Ventricle pathology
- Abstract
Chordoid gliomas are rare tumours. Despite being considered low-grade neoplasms, recent reviews have reported generally poor prognosis due to complications involving severe hypothalamic symptoms. We report a patient aged 30 years with chordoid glioma. What makes this case report interesting is the presence of neurogenic fever, which was already present before the final diagnosis of the brain tumour and also several months after the surgical removal. Since the patient underwent a subtotal resection of the tumour, it remains unclear whether the fever was due to hypothalamic dysfunction or remnants of the tumour. We also performed temperature logging with a continuous-monitoring recording device., Competing Interests: Conflicts of Interest: None declared., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
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34. Eosinophilia and multiple lymphadenopathy: Kimura disease, a rare, but benign condition.
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García Carretero R, Romero Brugera M, Rebollo-Aparicio N, and Vazquez-Gomez O
- Subjects
- Adult, Angiolymphoid Hyperplasia with Eosinophilia drug therapy, Anti-Inflammatory Agents therapeutic use, Diagnosis, Differential, Humans, Lymph Nodes pathology, Male, Prednisone therapeutic use, Rare Diseases diagnostic imaging, Tomography, X-Ray Computed, Angiolymphoid Hyperplasia with Eosinophilia diagnosis
- Abstract
Kimura disease is a benign rare chronic inflammatory disorder of unknown aetiology. This disease is mainly endemic in Asia, although cases have also been reported in Europe and America. We describe a case in a 34-year-old Chinese man presenting with severe eosinophilia and multiple lymphadenopathy. Since our initial aim was to rule out the diagnosis of lymphoma, and given the limitations of our laboratory, we decided to perform an excision of one of the cervical lymph nodes. The histological diagnosis was consistent with Kimura disease. We review the epidemiology, the aetiology and clinical features of this entity., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
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35. Pleural effusion of malignant aetiology: cell block technique to establish the diagnosis.
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García Carretero R, Manotas-Hidalgo M, Romero Brugera M, and El Bouayadi Mohamed L
- Subjects
- Adult, Aged, Female, Humans, Pleural Cavity cytology, Pleural Effusion, Malignant cytology, Tomography, X-Ray Computed, Cytological Techniques methods, Exudates and Transudates cytology, Pleural Cavity pathology, Pleural Effusion, Malignant diagnosis
- Abstract
We describe cases of two previously healthy women presenting with progressively worsening breathlessness for 1-2 months. In both cases, physical examination was suggestive of a left-sided pleural effusion, confirmed by chest X-ray. Analysis of aspirated fluid showed a lymphocytic exudate, but cytological analysis was negative for malignancy in both patients. CT scan revealed malignancies as the underlying cause of the effusions. Both patients were managed with intercostal drainage in order to collect a sufficient amount of pleural fluid to perform a new technique in our hospital: cell block. This proved to be extremely useful in assessing the definitive diagnosis and management of both women. We briefly discuss the approach to a malignant pleural effusion and the aid of this not-so-new technique., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
- Full Text
- View/download PDF
36. Dysphagia and aspiration as the only manifestations of a stroke.
- Author
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García Carretero R, Romero Brugera M, Rebollo-Aparicio N, and Rodeles-Melero J
- Subjects
- Brain diagnostic imaging, Brain Stem Infarctions diagnosis, Brain Stem Infarctions diagnostic imaging, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuroimaging, Tomography, X-Ray Computed, Brain Stem Infarctions complications, Deglutition Disorders etiology, Pneumonia, Aspiration etiology
- Abstract
A 56-year-old patient was admitted to our hospital, presenting with dysphagia as the only symptom. He was very concerned about this difficulty in swallowing. Diseases of the upper digestive tract were suspected, but further investigations revealed a neurological disorder. He had suffered a brain stem stroke and, as a consequence, developed an aspiration pneumonia. What seemed a digestive disorder was indeed a brain stem stroke, therefore we had to deal with the diverse impacts of this condition., (2016 BMJ Publishing Group Ltd.)
- Published
- 2016
- Full Text
- View/download PDF
37. Delay in the Detrended Fluctuation Analysis Crossover Point as a Risk Factor for Type 2 Diabetes Mellitus.
- Author
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Varela M, Vigil L, Rodriguez C, Vargas B, and García-Carretero R
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Models, Theoretical, Risk Factors, Blood Glucose analysis, Diabetes Mellitus, Type 2 blood, Insulin-Secreting Cells metabolism
- Abstract
Detrended Fluctuation Analysis (DFA) measures the complexity of a glucose time series obtained by means of a Continuous Glucose Monitoring System (CGMS) and has proven to be a sensitive marker of glucoregulatory dysfunction. Furthermore, some authors have observed a crossover point in the DFA, signalling a change of dynamics, arguably dependent on the beta-insular function. We investigate whether the characteristics of this crossover point have any influence on the risk of developing type 2 diabetes mellitus (T2DM). To this end we recruited 206 patients at increased risk of T2DM (because of obesity, essential hypertension, or a first-degree relative with T2DM). A CGMS time series was obtained, from which the DFA and the crossover point were calculated. Patients were then followed up every 6 months for a mean of 17.5 months, controlling for the appearance of T2DM diagnostic criteria. The time to crossover point was a significant predictor risk of developing T2DM, even after adjusting for other variables. The angle of the crossover was not predictive by itself but became significantly protective when the model also considered the crossover point. In summary, both a delay and a blunting of the crossover point predict the development of T2DM.
- Published
- 2016
- Full Text
- View/download PDF
38. Lung carcinoma presenting as a solitary, painless frontal bone lump.
- Author
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García Carretero R, Sanchez-Redondo J, Barrio-Alonso MJ, and Lopez-Marti MP
- Subjects
- Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell pathology, Diagnosis, Differential, Fatal Outcome, Humans, Lung Neoplasms pathology, Lung Neoplasms secondary, Middle Aged, Scalp pathology, Solitary Pulmonary Nodule pathology, Frontal Bone pathology, Lung Neoplasms diagnosis, Solitary Pulmonary Nodule diagnosis
- Abstract
A 50-year-old patient, a smoker, was admitted to the hospital, with a solitary scalp lump. Subcutaneous lumps of the scalp are common but usually benign; however, the painless lump in our patient turned out to be a malignant osteolytic lesion of the skull. Frontal bone was involved, and the disease had spread to the dura. Neuroimaging showed osteolytic lesions involving the axial skeleton, skull and several vertebrae. MRI showed the involvement of the second cervical vertebra, which prompted us to start treatment with dexamethasone. Since the spinal cord was not involved, Oncologists decided not to start radiotherapy treatment until we had reached the final diagnosis. A frontal bone biopsy confirmed the diagnosis of lung carcinoma. Chest X-ray did not identify the pulmonary nodule, but CT scan revealed a 1 cm peripheral, spiculated, pulmonary nodule within a pathological parenchyma (severe diffuse pulmonary emphysema)., (2015 BMJ Publishing Group Ltd.)
- Published
- 2015
- Full Text
- View/download PDF
39. Primary bone metastasis as first manifestation of an unknown primary tumour.
- Author
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García Carretero R, Romero Brugera M, Rebollo-Aparicio N, and El Bouayadi Mohamed L
- Subjects
- Biopsy, Bone Neoplasms pathology, Fatal Outcome, Female, Humans, Middle Aged, Tomography, X-Ray Computed, Bone Neoplasms secondary, Neoplasms, Unknown Primary
- Abstract
Unknown primary tumour refers to a group of cancers for which the anatomical site of origin remains occult after detailed investigations. Thanks to sophisticated imaging, immunohistochemical testing and molecular-profiling tools, there is a more accurate approach to unknown primary cancer. Metastasis to bone is not a rare phenomenon, because any tumour can metastasise to bone, so it is a common clinical scenario. The role of clinical history, physical examination, laboratory tests, radiographic studies and immunohistochemistry is critical for a successful diagnostic strategy. Subsets of unknown primary cancers can be identified primarily on the basis of histopathological findings, the pattern of spread and serum markers. New immunohistochemical markers and tissue-of-origin profiles may establish presumable primary sites to unknown primary cancer on the basis of immunohistochemical and molecular patterns. We present a case of a 57-year-old woman without a cancer history, who had primary bone metastasis as the first manifestation of an occult primary tumour., (2015 BMJ Publishing Group Ltd.)
- Published
- 2015
- Full Text
- View/download PDF
40. [Nursing care of a patient with bipolar disorder and lithium-induced nephrogenic diabetes insipidus].
- Author
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García de la Orden L and García Carretero R
- Subjects
- Humans, Male, Middle Aged, Bipolar Disorder drug therapy, Bipolar Disorder nursing, Diabetes Insipidus, Nephrogenic etiology, Diabetes Insipidus, Nephrogenic nursing, Lithium Compounds adverse effects
- Abstract
Bipolar disorder is one of the most common, severe and persistent mental disorders. The evaluation of all data and variables related to bipolar disorder is a difficult task, because there is no clear agreement on what should be included in this category. One of the traditional treatments for this disease is the lithium metal that is administered in the form of lithium salt. Lithium has a narrow therapeutic window and there is a significant risk of complications arising from its use, mainly neurological and renal. In the case presented, the preparation of a care plan is described for a patient diagnosed with bipolar disorder who suffered a complication with lithium treatment. To do this, it was decided to use a standardized care plan and later completed it with diagnostic, objectives and interventions to the specific needs of the patient, aimed at achieving optimal levels of independence., (Copyright © 2014 Elsevier España, S.L.U. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
41. [Vacuum assisted closure therapy in dehiscence of abdominal wound after cesarean section treated in a hospital-at-home].
- Author
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Sánchez-Cabezón C, Montes-Olangua MI, García-Suarez S, and García-Carretero R
- Subjects
- Female, Humans, Cesarean Section, Home Care Services, Negative-Pressure Wound Therapy, Surgical Wound Dehiscence therapy, Wound Healing
- Abstract
The Hospital at Home is a range of hospital care provided to patients in the comfort of their own homes, so patient and family can actively participate in the process. Cesarean section is a surgical procedure that requires a short hospital stay. However if complications arise during the process, such as a dehiscence of surgical wound, the hospital stay is prolonged, delaying mother-child bonding, which is very important for the growth of the child. Nursing care in wound healing by secondary intention is a priority for the patient's recovery. VAC therapy (vacuum assisted closure) promotes a rapid recovery, although it requires dressings and active medical surveillance, as well as training by the nursing staff for carrying it out at home. We describe the outcome and the process of the healing of a surgical wound after cesarean section, not only because of a complex wound, but the previously mentioned factors that make us consider the Hospital at Home as the best alternative care., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
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