45 results on '"Jiménez-Rodríguez RM"'
Search Results
2. Causa infrecuente de dolor abdominal: Ewing´s sarcoma
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Sánchez Gil Jm, Díaz Pavón Jm, Vázquez Monchul Jm, Socas Macías M, and Jiménez Rodríguez Rm
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Abdominal pain ,medicine.medical_specialty ,business.industry ,General surgery ,Gastroenterology ,Medicine ,Ewing's sarcoma ,General Medicine ,medicine.symptom ,business ,medicine.disease - Published
- 2007
3. Ultrasonographic evidence of Gatekeeper™ prosthesis migration in patients treated for faecal incontinence: a case series.
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Portilla, F, Reyes-Díaz, ML, Maestre, MV, Jiménez-Rodríguez, RM, García-Cabrera, AM, Vázquez-Monchul, JM, Díaz-Pavón, JM, and Padillo-Ruiz, FC
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TREATMENT of fecal incontinence ,DISEASE incidence ,PROSTHETICS ,BIOMATERIALS ,SURGICAL complications - Abstract
Background: Faecal incontinence (FI) is both a medical and social problem, with an underestimated incidence. For patients with internal anal sphincter damage, implantation of biomaterial in the anal canal is a recognised treatment option. One such material, Gatekeeper™, has previously shown promising short- and medium-term results without any major complications, including displacement. The main aim of the present study is to assess the degree to which displacement of Gatekeeper prostheses may occur and to determine whether this is associated with patient outcomes. Methods: Seven patients (six females) with a mean age of 55.6 years [50.5-57.2] and a mean FI duration of 6 ± 2 years were prospectively enrolled in the study. Each subject was anaesthetised and underwent implantation of six prostheses in the intersphincteric region, guided by endoanal 3D ultrasound (3D-EAU). Follow-up was performed at post-interventional months 1, 3, and 12 (median 12 ± 4 months), during which data were obtained from a defaecation diary, Wexner scale assessment, anorectal manometry (ARM), 3D-EAU, and a health status and quality of life questionnaire (FIQL). Results: At 3-month follow-up, 3D-EAU revealed displacement of 24/42 prostheses in 5/7 patients. Of these, 15 had migrated to the lower portion and 9 to the upper portion of the anal canal and rectum. Despite this migration, treatment was considered successful in 3/7 patients. In one patient, it was necessary to remove a prosthesis due to spontaneous extrusion. Conclusions: We have shown that displacement of the Gatekeeper™ prosthesis occurs, but is not associated with poorer clinical outcomes. [ABSTRACT FROM AUTHOR]
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- 2017
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4. Aztreonam-avibactam versus meropenem for the treatment of serious infections caused by Gram-negative bacteria (REVISIT): a descriptive, multinational, open-label, phase 3, randomised trial.
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Carmeli Y, Cisneros JM, Paul M, Daikos GL, Wang M, Torre-Cisneros J, Singer G, Titov I, Gumenchuk I, Zhao Y, Jiménez-Rodríguez RM, Liang L, Chen G, Pyptiuk O, Aksoy F, Rogers H, Wible M, Arhin FF, Luckey A, Leaney JL, Pypstra R, and Chow JW
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Background: There is a need for additional therapeutic options for serious infections caused by Gram-negative pathogens. In the phase 3, descriptive REVISIT study, we investigated the safety and efficacy of aztreonam-avibactam in the treatment of complicated intra-abdominal infections or hospital-acquired pneumonia or ventilator-associated pneumonia (HAP-VAP) caused, or suspected to be caused, by Gram-negative bacteria., Methods: This prospective, multinational, open-label, central assessor-masked study enrolled adults who were hospitalised with a complicated intra-abdominal infection or HAP-VAP. Patients were randomly allocated via block randomisation using interactive response technology stratified by infection type in a 2:1 ratio to aztreonam-avibactam (with metronidazole for complicated intra-abdominal infection) or meropenem with or without colistin for 5-14 days for complicated intra-abdominal infection or 7-14 days for HAP-VAP. The primary endpoint was clinical cure at the test-of-cure visit (within 3 days before or after day 28) in the intention-to-treat (ITT) population. Secondary endpoints included 28-day mortality in the ITT population and safety in patients in the ITT population who received study drug (safety analysis set). No formal hypothesis testing was planned. The study was registered with ClinicalTrials.gov (NCT03329092) and EudraCT (2017-002742-68) and is complete., Findings: Between April 5, 2018, and Feb 23, 2023, we screened 461 patients. 422 patients were enrolled and randomly allocated (282 in the aztreonam-avibactam group and 140 in the meropenem group, forming the ITT analysis set), of whom ten patients (seven in the aztreonam-avibactam group and three in the meropenem group) were randomly allocated but did not receive study treatment. 271 (64%) of 422 patients had at least one Gram-negative pathogen from an adequate specimen identified at baseline. The most frequent baseline pathogens were Enterobacterales (252 [93%] of 271). Overall, 19 (24%) of 80 isolates tested for carbapenemases were carbapenemase-positive (serine, metallo-β-lactamase, or both). 193 (68·4%) of 282 patients in the aztreonam-avibactam group and 92 (65·7%) of 140 in the meropenem group had clinical cure at the test-of-cure visit (treatment difference 2·7% [95% CI -6·6 to 12·4]). For patients with complicated intra-abdominal infection, the adjudicated clinical cure rate was 76·4% (159 of 208) for the aztreonam-avibactam group and 74·0% (77 of 104) for the meropenem group. Cure rates in patients with HAP-VAP were 45·9% (34 of 74) for aztreonam-avibactam and 41·7% (15 of 36) for meropenem. 28-day all-cause mortality rates were 4% (12 of 282) for aztreonam-avibactam and 7% (ten of 140) for meropenem; in patients with complicated intra-abdominal infection, mortality was 2% (four of 208) and 3% (three of 104) for aztreonam-avibactam and meropenem, respectively, and in patients with HAP-VAP, mortality was 11% (eight of 74) and 19% (seven of 36), respectively. Aztreonam-avibactam was generally well tolerated, and safety findings were consistent with the known safety profile of aztreonam monotherapy. There were no treatment-related serious adverse events in the aztreonam-avibactam group., Interpretation: These phase 3 efficacy and safety data provide support for aztreonam-avibactam as a potential therapeutic option for complicated intra-abdominal infection or HAP-VAP caused by Gram-negative bacteria., Funding: Pfizer., Competing Interests: Declaration of interests HR, MWi, and JLL are employees of, and shareholders in, Pfizer. FFA, JWC, RP, and AL are former employees of Pfizer. YC is an advisor for, and has received grant support and honoraria from, Pfizer, Qpex, Roche, and Merck. MP received grant support from Pfizer through Innovative Medicines Initiative. GLD is an advisor and consultant for, and has received honoraria from, Pfizer, and has received honoraria from MSD and Viatris. R-MJ-R has received honoraria from Abex, JnJ, and Braun. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)
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- 2024
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5. Influence of the COVID-19 pandemic on the defined daily dose of antimicrobials in patients requiring elective and emergency surgical procedures.
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Aguilar-Del-Castillo F, Álvarez-Aguilera M, Tinoco-González J, Vaca I, Herrera-Hidalgo L, Paniagua M, Cisneros JM, Padillo-Ruiz FJ, and Jiménez-Rodríguez RM
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- Humans, Female, Male, Middle Aged, Aged, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents administration & dosage, SARS-CoV-2, Prospective Studies, Drug Utilization statistics & numerical data, Anti-Infective Agents therapeutic use, Anti-Infective Agents administration & dosage, Adult, Pandemics, Aged, 80 and over, COVID-19 epidemiology, COVID-19 prevention & control, Elective Surgical Procedures
- Abstract
Background: The COVID-19 pandemic has resulted in great incertitude and overwhelming changes in healthcare that have had a direct impact on antibiotic prescription. However, the influence of this pandemic on antibiotic consumption in patients undergoing surgery has not yet been analysed. The goal of this study was to analyse antimicrobial consumption and prescription in the same period of 2019 (pre-COVID-19), 2020 (beginning of the COVID-19 pandemic) and 2021 (established COVID-19) according to the DDD system in surgical patients at a tertiary-level hospital., Methods: A prospectively maintained database was analysed. All patients who underwent elective or emergency gastrointestinal surgery during the same period (2019, 2020 and 2021) were included. Those who received at least 1 of the 10 most frequently prescribed antimicrobials during those periods were analysed., Results: A total of 2975 patients were included in this study. In 2020, the number of procedures performed decreased significantly (653 versus 1154 and 1168 in 2020 versus 2019 and 2021, respectively; P = 0.005). Of all patients who underwent surgery during these periods, 45.08% received at least one of the antimicrobials studied (45.8% in 2020 versus 22.9% and 22.97% in 2019 and 2021, respectively; P = 0.005). Of these, 22.97% of the patients received a combination of these antimicrobials, with ceftriaxone/metronidazole being the most frequent. Hepato-Pancreato-Biliary and Liver Transplant, Emergency Surgery and Colorectal Surgery units had higher antibiotic consumption., Conclusions: The COVID-19 pandemic has resulted in a significant decrease in surgical activity and higher post-operative antimicrobial prescription compared with previous and subsequent years., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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6. Simultaneous posterior vaginal and perineal reconstruction using gluteal fasciocutaneous flaps following pelvic exenteration with sacrectomy.
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Pappou E, Ben-Yaakov A, Jiménez-Rodríguez RM, and Garcia-Aguilar J
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- Female, Humans, Surgical Flaps surgery, Vagina surgery, Perineum surgery, Pelvic Exenteration, Plastic Surgery Procedures
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- 2024
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7. Efficacy of Sacral Nerve Stimulation in Non-constipated Irritable Bowel Syndrome Patients: A Systematic Review.
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Garcia-Cabrera AM, De la Portilla F, Jiménez-Rodríguez RM, Vázquez-Monchul JM, Reyes-Díaz ML, Ramallo-Solís IM, Pintor-Tortolero J, Dios-Barbeito S, and Padillo-Ruiz FJ
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- Humans, Follow-Up Studies, Quality of Life, Pilot Projects, Treatment Outcome, Irritable Bowel Syndrome diagnosis, Irritable Bowel Syndrome therapy
- Abstract
Background and Aims: Irritable bowel syndrome (IBS) is a prevalent disorder with a complex and heterogeneous physiopathology, including a dysregulation of gut-brain axis. Treatment for IBS is targeted to the predominant symptom and requires a multidisciplinary approach. This review aims to evaluate the efficacy and safety of sacral nerve stimulation in non-constipated IBS patients Methods: A literature search was carried out on MEDLINE, The Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science databases for all relevant articles. Quality of included papers was assessed using standardized guidelines Results: Of 129 initial citations, 7 articles met our predefined inclusion criteria, including five randomized trials, a pilot study and a descriptive follow-up study. Five of 7 studies reported a positive effect of sacral nerve stimulation on symptoms and quality of life improvement in non-constipated IBS patients. No study reported serious adverse events., Conclusions: Despite initial promising results of sacral nerve stimulation in non-constipated IBS patients, studies with larger sample sizes and longer follow-up are required.
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- 2023
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8. Nerve stimulator guided block for anorectal surgery - a video vignette.
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García-Cabrera AM, de la Portilla F, Jiménez-Rodríguez RM, García-Moriana AJ, Cabriada-García G, and Padillo-Ruiz FJ
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- Humans, Ultrasonography, Interventional, Electric Stimulation, Anesthetics, Local, Nerve Block
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- 2023
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9. Global parental leave in surgical careers: differences according to gender, geographical regions and surgical career stages.
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Au S, Bellato V, Carvas JM, Córdoba CD, Daudu D, Dziakova J, Eltarhoni K, El Feituri N, Fung ACH, Fysaraki C, Gallo G, Gultekin FA, Harbjerg JL, Hatem F, Ioannidis A, Jakobsen L, Clinch D, Kristensen HØ, Kuiper SZ, Kwok AMF, Kwok W, Millan M, Milto KM, Ng HJ, Pellino G, Picciariello A, Pronin S, van Ramshorst GH, Ramser M, Jiménez-Rodríguez RM, Sainz Hernandez JC, Samadov E, Sohrabi S, Uchiyama M, Wang JH, Younis MU, Fleming S, Alhomoud S, Mayol J, Moeslein G, Smart NJ, Soreide K, Teh C, Verran D, and Maeda Y
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- Adult, Attitude of Health Personnel, Female, Humans, Male, Sex Factors, Young Adult, Career Choice, Internship and Residency statistics & numerical data, Parental Leave statistics & numerical data, Students, Medical statistics & numerical data, Surgeons statistics & numerical data, Surveys and Questionnaires
- Abstract
Background: There is a lack of information regarding the provision of parental leave for surgical careers. This survey study aims to evaluate the experience of maternity/paternity leave and views on work-life balance globally., Methods: A 55-item online survey in 24 languages was distributed via social media as per CHERRIES guideline from February to March 2020. It explored parental leave entitlements, attitude towards leave taking, financial impact, time spent with children and compatibility of parenthood with surgical career., Results: Of the 1393 (male : female, 514 : 829) respondents from 65 countries, there were 479 medical students, 349 surgical trainees and 513 consultants. Consultants had less than the recommended duration of maternity leave (43.8 versus 29.1 per cent), no paid maternity (8.3 versus 3.2 per cent) or paternity leave (19.3 versus 11.0 per cent) compared with trainees. Females were less likely to have children than males (36.8 versus 45.6 per cent, P = 0.010) and were more often told surgery is incompatible with parenthood (80.2 versus 59.5 per cent, P < 0.001). Males spent less than 20 per cent of their salary on childcare and fewer than 30 hours/week with their children. More than half (59.2 per cent) of medical students did not believe a surgical career allowed work-life balance., Conclusion: Surgeons across the globe had inadequate parental leave. Significant gender disparity was seen in multiple aspects., (© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2021
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10. Fecal incontinence in older patients. A narrative review.
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García Cabrera AM, Jiménez Rodríguez RM, Reyes Díaz ML, Vázquez Monchul JM, Ramos Fernández M, Díaz Pavón JM, Palacios González C, Padillo Ruiz FJ, and de la Portilla de Juan F
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- Aged, Algorithms, Humans, Fecal Incontinence diagnosis, Fecal Incontinence therapy
- Abstract
Fecal incontinence is one of the leading causes for the institutionalization of people in the last decades of life, associated with a great psychosocial and economic burden. The literature is scarce in this population group, due to the absence of universally accepted criteria to define "elderly patients" and difficulties in detection and diagnostic. The aim of this article was to conduct a narrative review of the main aspects related to fecal incontinence in older patients, providing management support. Toileting assistance, dietary change, controlling stool consistency and medical treatment can be used to treat these patients. Nevertheless, other therapies, such as biofeedback, neuromodulation or surgical treatment, can be considered in selected patients., (Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2018
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11. Anal encirclement: a surgical technique for faecal incontinence in patients who are not good candidates for more invasive surgery - a video vignette.
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Ramos Fernández M, Jiménez-Rodríguez RM, Perea Del Pozo E, Palacios González C, and de la Portilla F
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- Humans, Anal Canal surgery, Fecal Incontinence surgery
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- 2017
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12. Mucinous adenocarcinoma arising in an end ileostomy - a video vignette.
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Jiménez Rodríguez RM, Perea Del Pozo E, Díaz Pavón JM, and De la Portilla F
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- Adenocarcinoma, Mucinous etiology, Aged, Carcinoma, Signet Ring Cell etiology, Humans, Ileal Neoplasms etiology, Male, Postoperative Complications etiology, Adenocarcinoma, Mucinous surgery, Carcinoma, Signet Ring Cell surgery, Ileal Neoplasms surgery, Ileostomy adverse effects, Postoperative Complications surgery, Reoperation methods
- Published
- 2017
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13. Is the interval from surgery to ileostomy closure a risk factor for low anterior resection syndrome?
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Jiménez-Rodríguez RM, Segura-Sampedro JJ, Rivero-Belenchón I, Díaz Pavón JM, García Cabrera AM, Vazquez Monchul JM, Padillo J, and de la Portilla F
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- Aged, Anastomosis, Surgical adverse effects, Colon surgery, Digestive System Surgical Procedures methods, Female, Humans, Ileostomy methods, Incidence, Male, Middle Aged, Postoperative Complications epidemiology, Retrospective Studies, Risk Factors, Syndrome, Time Factors, Digestive System Surgical Procedures adverse effects, Ileostomy adverse effects, Postoperative Complications etiology, Rectal Neoplasms surgery, Rectum surgery
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Aim: Low anterior resection syndrome (LARS) comprises a collection of symptoms affecting patients after restorative surgery for rectal cancer. The aim of the present study was to analyse the incidence of LARS in patients undergoing rectal cancer surgery with and without subsequent ileostomy and to determine whether the interval to ileostomy closure is a factor associated with its occurrence., Method: All patients undergoing curative anterior resection for rectal cancer from 2008 to 2012 in our institution were included in the study. They were divided into two groups according to whether or not a defunctioning ileostomy had been performed. Patients were assessed for LARS at a median interval of 23.60 ± 16.73 (12-48) months from anterior resection in those who did not have an ileostomy and at an interval of 11.31 ± 14.24 (12-60) months from closure of the ileostomy in those who did. They underwent a structured telephone interview based on a validated LARS score questionnaire. Univariate and multivariate analysis was carried out to assess possible associations between LARS and the variables studied., Results: There were 150 patients (93 men) of whom 54.7% had no evidence of LARS, 17.3% had minor symptoms and 28% major symptoms of LARS. Univariate analysis showed that male gender, the presence of a temporary ileostomy and neoadjuvant therapy were predisposing factors for LARS. The interval from construction of the ileostomy to its closure did not appear to be a factor associated with LARS. In multivariate analysis, male gender and preoperative neoadjuvant therapy were significant predisposing factors for LARS., Conclusion: Male gender and preoperative neoadjuvant therapy are risk factors for LARS. The presence of ileostomy or time to ileostomy closure is not associated with the development of this syndrome., (Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.)
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- 2017
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14. Factibility and security study of the PICS-AF™ plug for the treatment of cryptoglandular anal fistula.
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de la Portilla F, Reyes-Díaz ML, Maestre MV, Jiménez-Rodríguez RM, García-Cabrera AM, Díaz-Pavón JM, Vázquez-Monchul JM, and Villanueva JA
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- Feasibility Studies, Female, Humans, Male, Middle Aged, Pilot Projects, Prospective Studies, Prosthesis Design, Collagen, Prostheses and Implants adverse effects, Rectal Fistula surgery
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Introduction: The PICS-AF™ (Curaseal Inc.) device is a new plug made of collagen that has a retention system in the internal orifice. This pilot study was designed to assess both the feasibility and safety of this plug in the treatment of trans-sphincteric anal fístulas., Methods: A total of 44 patients (34 men), with a mean age of 54.68±7.3, with trans-sphincteric anal fístulas were included in the study; 34 of them were analyzed. All patients were examined according to a strict preoperative protocol and until 6 months after surgery. The feasibility of the procedure and the adverse events were analyzed., Results: Finally, 34 patients were operated on, and in 30 of them the plug was used. Therefore, the feasibility was calculated at 88%. There was a total of 16 adverse events, 4recorded as not related (3 mild and one moderate) and 12 related to the procedure or to the device implanted. Of these, 5were mild, 5moderate and 2severe. The majority of the events reported were related to proctalgia (4 patients) or infection at the implant site (4 patients)., Conclusions: The present study indicates that the new collagen plug can be placed effectively and with an acceptable complication rate., (Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2017
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15. Learning curve in robotic rectal cancer surgery: current state of affairs.
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Jiménez-Rodríguez RM, Rubio-Dorado-Manzanares M, Díaz-Pavón JM, Reyes-Díaz ML, Vazquez-Monchul JM, Garcia-Cabrera AM, Padillo J, and De la Portilla F
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- Humans, Intraoperative Care, Laparoscopy, Postoperative Complications etiology, Learning Curve, Rectal Neoplasms surgery, Robotics
- Abstract
Introduction: Robotic-assisted rectal cancer surgery offers multiple advantages for surgeons, and it seems to yield the same clinical outcomes as regards the short-time follow-up of patients compared to conventional laparoscopy. This surgical approach emerges as a technique aiming at overcoming the limitations posed by rectal cancer and other surgical fields of difficult access, in order to obtain better outcomes and a shorter learning curve., Material and Methods: A systematic review of the literature of robot-assisted rectal surgery was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The search was conducted in October 2015 in PubMed, MEDLINE and the Cochrane Central Register of Controlled Trials, for articles published in the last 10 years and pertaining the learning curve of robotic surgery for colorectal cancer. It consisted of the following key words: "rectal cancer/learning curve/robotic-assisted laparoscopic surgery"., Results: A total of 34 references were identified, but only 9 full texts specifically addressed the analysis of the learning curve in robot-assisted rectal cancer surgery, 7 were case series and 2 were non-randomised case-comparison series. Eight papers used the cumulative sum (CUSUM) method, and only one author divided the series into two groups to compare both. The mean number of cases for phase I of the learning curve was calculated to be 29.7 patients; phase II corresponds to a mean number 37.4 patients. The mean number of cases required for the surgeon to be classed as an expert in robotic surgery was calculated to be 39 patients., Conclusion: Robotic advantages could have an impact on learning curve for rectal cancer and lower the number of cases that are necessary for rectal resections.
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- 2016
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16. Authors' reply: A new technique to close open abdomen using negative pressure therapy and elastic gums.
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Jiménez-Rodríguez RM, Ciuro FP, and Padillo J
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- Humans, Negative-Pressure Wound Therapy, Abdomen, Abdominal Cavity
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- 2016
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17. A new technique to close open abdomen using negative pressure therapy and elastic gums.
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Jiménez-Rodríguez RM, Ciuró FP, Cruzado VD, Cortes MF, Bernal FL, and Padillo J
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- Equipment Design, Female, Humans, Male, Middle Aged, Negative-Pressure Wound Therapy instrumentation, Spain, Surgical Mesh, Treatment Outcome, Abdominal Cavity surgery, Abdominal Wound Closure Techniques instrumentation, Intra-Abdominal Hypertension surgery, Negative-Pressure Wound Therapy methods
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- 2016
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18. Rectal eversion and coloanal anastomosis: a classical technique we should not forget--a video vignette.
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Jiménez-Rodríguez RM, Díaz Pavón JM, and de la Portilla F
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- Anal Canal surgery, Anastomosis, Surgical methods, Humans, Rectum surgery, Rectal Neoplasms surgery, Robotic Surgical Procedures methods
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- 2016
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19. Validation of a new scoring system: Rapid assessment faecal incontinence score.
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de la Portilla F, Calero-Lillo A, Jiménez-Rodríguez RM, Reyes ML, Segovia-González M, Maestre MV, and García-Cabrera AM
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Aim: To implement a quick and simple test - rapid assessment faecal incontinence score (RAFIS) and show its reliability and validity., Methods: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale (FIQL) questionnaire. The patient without influence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach's alpha (internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% power., Results: We analysed the results obtained by 53 consecutive patients with faecal incontinence (median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers (median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson's correlation coefficient between "state" and "leaks" was excellent (r = 0.92, P < 0.005). Internal consistency in the comparison of "state" and "leaks" yielded also excellent correlation (Cronbach's α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of "r" for the different subscales of the questionnaire were: "lifestyle" r = -0.87, "coping/behaviour" r = -0.91, "depression" r = -0.36 and "embarrassment" r = -0.90, (P < 0.01). A multivariate analysis showed that all the scoring systems measured the same factor. A single factor may explain 80.84% of the variability of FI, so all the scoring systems measure the same factor. Patient's continence improves when RAFIS and Jorge-Wexner scores show low values and when the values obtained in the FIQL questionnaire are high., Conclusion: RAFIS is a valid and reliable tool to assess Faecal Incontinence.
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- 2015
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20. Vacuolar internal anal sphincter myophaty as a rare cause of proctalgia fugax and constipation.
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Navas-Cuéllar JA, Jiménez-Rodríguez RM, Aparicio-Sánchez D, Díaz-Pavón JM, Padillo-Ruiz J, and de-la-Portilla-de-Juan F
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- Anus Diseases, Constipation pathology, Female, Humans, Middle Aged, Muscular Diseases drug therapy, Muscular Diseases pathology, Neuromuscular Agents therapeutic use, Pain drug therapy, Pain pathology, Proctitis drug therapy, Proctitis pathology, Rectal Diseases drug therapy, Rectal Diseases pathology, Anal Canal pathology, Constipation etiology, Muscular Diseases complications, Pain etiology, Proctitis etiology, Rectal Diseases etiology
- Published
- 2015
21. Analysis of conversion factors in robotic-assisted rectal cancer surgery.
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Jiménez Rodríguez RM, De la Portilla De Juan F, Díaz Pavón JM, Rodríguez Rodríguez A, Prendes Sillero E, Cadet Dussort JM, and Padillo J
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- Adult, Aged, Body Mass Index, Female, Humans, Length of Stay, Male, Middle Aged, Operative Time, Pelvic Bones anatomy & histology, Pelvic Bones diagnostic imaging, Prospective Studies, Prostate diagnostic imaging, Rectal Neoplasms diagnostic imaging, Rectal Neoplasms pathology, Tomography, X-Ray Computed, Laparoscopy methods, Rectal Neoplasms surgery, Robotics
- Abstract
Background: Robotic surgical management of rectal cancer has a series of advantages which might facilitate the surgical approach to the pelvic cavity and reduce conversion rates. The aim of the present study is to identify independent factors for conversion during robotic rectal cancer surgery., Methods: A total of 67 patients underwent preoperative CT scan in order to obtain a three-dimensional image of the pelvis, the tumour and prostate. We measured maximum and minimum ilio-iliac, sacral promontory-pubis, coccyx-pubis diameters and maximum lateral axis. Further variables under consideration were age, BMI and use of neoadjuvant therapy. We recorded short-term follow-up outcomes of the resected tumour., Results: The present study included 67 patients (39 males) with an average age of 65.11 ± 10.30 years and a BMI of 27.70 ± 3.97 kg/m(2). Operative procedures included nine abdominoperineal resections and 58 low anterior resections. There were 15 (22.38 %) conversions. Mean operating time was 192.2 ± 42.73 min. Minimum ilio-iliac, maximum ilio-iliac, promontory-pubic and coccyx-pubis diameter as well as maximum lateral axis were 100.38 ± 7.65, 107.10 ± 10.01, 109.97 ± 9.20, 105.61 ± 9.27 and 129.01 ± 9.94 mm, respectively. Mean tumour volume was 37.06 ± 44.08 cc; mean prostate volume was 42.07 ± 17.49 cc. The univariate analysis of the variables showed a correlation between conversion and BMI and minimum ilio-iliac and coccyx-pubis diameters (p = 0.004, 0.047, 0.046). In the multivariate analysis, the only independent predictive factor for conversion was the BMI (p = 0.004).No correlation was found between conversion and sex, age, tumour volume or the rest of pelvic diameters., Conclusion: BMI is an independent factor for conversion in robotic-assisted rectal cancer surgery.
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- 2014
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22. Percutaneous neuromodulation of the posterior tibial nerve for the treatment of faecal incontinence - mid-term results: is retreatment required?
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de la Portilla F, Laporte M, Maestre MV, Díaz-Pavón JM, Gollonet JL, Palacios C, Vázquez-Monchul JM, García-Cabrera AM, Jiménez-Rodríguez RM, and Sánchez Gil JM
- Subjects
- Adult, Aged, Cohort Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Retreatment, Treatment Outcome, Electric Stimulation Therapy methods, Fecal Incontinence therapy, Tibial Nerve
- Abstract
Aim: Posterior tibial nerve stimulation (PTNS) has emerged in recent years as a therapy for faecal incontinence. Its long-term effectiveness is yet to be established, along with what the form of retreatment should be in the event of loss of effectiveness. The present study aimed to establish the mid-term results to identify the proportion of patients who may need further treatment, and if so when., Method: A prospective study including 30 patients was conducted at an academic hospital. The patients underwent 12 weekly outpatient treatment sessions, each lasting 30 min (first PTNS phase). Neuromodulation was discontinued in those patients who did not have a 40% decrease in their pretreatment Wexner score. Patients having a better than 40% response were offered another 12-week course of complete treatment (second PTNS phase), following which they received no further PTNS treatment (phase without PTNS) but were assessed at 6 months and 2 years., Results: All patients finished the first phase and 22/30 patients continued to the second phase. During this phase 11 patients showed an improved Wexner score (baseline/first phase/second phase: 14.3 ± 4.2 vs 9.9 ± 5.4 vs 6.8 ± 5.4). After a 6-month period without any treatment, the score was still improved in 11/30 patients (9.1 ± 6.2). At 2 years there was improvement in 16/30 patients (8.8 ± 7.1). There was a significant improvement in three variables of the quality of life questionnaire: lifestyle, coping behaviour and embarrassment., Conclusion: The response to first and second phase PTNS was maintained for up to 2 years. Retreatment was not required in about half of patients, even when they had finished the treatment 6 months or 2 years previously., (Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.)
- Published
- 2014
- Full Text
- View/download PDF
23. Robotic-assisted total mesorectal excision with the aid of a single-port device.
- Author
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Jiménez-Rodríguez RM, Pavón JM, de la Portilla F, Sillero EP, Dussort JM, and Padillo J
- Subjects
- Aged, Digestive System Surgical Procedures instrumentation, Digestive System Surgical Procedures methods, Humans, Laparoscopy instrumentation, Male, Middle Aged, Umbilicus surgery, Laparoscopy methods, Rectal Neoplasms surgery, Robotics instrumentation
- Abstract
Unlabelled: INTRODUCTION AND INDICATIONS: Robotic surgery has numerous advantages in rectal cancer surgery. Studies have reported the advantages associated with single-port approaches, such as eliminating the need for additional incisions, as well as the difficulties inherent in this technique. The authors present a hybrid technique that they performed using a robotic total mesorectal excision with the aid of a single port-device. Materials and methods. The authors performed the technique on 2 patients using a single-port device through an umbilical incision and 3 accessory ports for the robotic arms. There was no need to place ports for the assistant's equipment or for an assistant incision., Results and Complications: The operation time was 177.5 minutes, and there were no intraoperative or postoperative complications. Both patients were discharged 7 days after the operation., Conclusions: This technical variation is an additional step forward for oncological surgery with minimal damage to the abdominal wall.
- Published
- 2013
- Full Text
- View/download PDF
24. Learning curve for robotic-assisted laparoscopic rectal cancer surgery.
- Author
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Jiménez-Rodríguez RM, Díaz-Pavón JM, de la Portilla de Juan F, Prendes-Sillero E, Dussort HC, and Padillo J
- Subjects
- Aged, Demography, Female, Humans, Intraoperative Care, Male, Neoplasm Staging, Operative Time, Postoperative Care, Rectal Neoplasms pathology, Treatment Outcome, Laparoscopy education, Learning Curve, Rectal Neoplasms surgery, Robotics education
- Abstract
Introduction: One of the main uses of robotic assisted abdominal surgery is the mesorectal excision in patients with rectal cancer. The aim of the present study is to analyse the learning curve for robotic assisted laparoscopic resection of rectal cancer., Patients and Methods: We included in our study 43 consecutive rectal cancer resections (16 females and 27 males) performed from January 2008 through December 2010. Mean age of patients was 66 ± 9.0 years. Surgical procedures included both abdomino-perineal and anterior resections. We analysed the following parameters: demographic data of the patients included in the study, intra- and postoperative data, time taking to set up the robot for operations (set-up or docking time), operative time, intra- and postoperative complications, conversion rates and pathological specimen features. The learning curve was analysed using cumulative sum (CUSUM) methodology., Results: The procedures understudied included seven abdomino-perineal resections and 36 anterior resections. In our series of patients, mean robotic set-up time was 62.9 ± 24.6 min, and the mean operative time was 197.4 ± 44.3 min. Once we applied CUSUM methodology, we obtained two graphs for CUSUM values (operating time and success), both of them showing three well-differentiated phases: phase 1 (the initial 9-11 cases), phase 2 (the middle 12 cases) and phase 3 (the remaining 20-22 cases). Phase 1 represents initial learning; phase 2 plateau represents increased competence in the use of the robotic system, and finally, phase 3 represents the period of highest skill or mastery with a reduction in docking time (p = 0.000), but a slight increase in operative time (p = 0.007)., Conclusion: The CUSUM curve shows three phases in the learning and use of robotic assisted rectal cancer surgery which correspond to the phases of initial learning of the technique, consolidation and higher expertise or mastery. The data obtained suggest that the estimated learning curve for robotic assisted rectal cancer surgery is achieved after 21-23 cases.
- Published
- 2013
- Full Text
- View/download PDF
25. [Pancreatic rupture and Roux-en-Y reconstruction after abdominal trauma].
- Author
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Segura-Sampedro JJ, Jiménez-Rodríguez RM, Martos-Martínez JM, and Padillo-Ruiz FJ
- Subjects
- Abdominal Injuries complications, Female, Humans, Pancreas diagnostic imaging, Radiography, Rupture, Young Adult, Anastomosis, Roux-en-Y, Pancreas injuries, Pancreas surgery
- Published
- 2012
- Full Text
- View/download PDF
26. [Sigmoid achalasia].
- Author
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Casado Maestre MD, Jiménez Rodríguez RM, Ibáñez Delgado F, and Vázquez Medina AJ
- Subjects
- Aged, Female, Humans, Esophageal Achalasia diagnosis, Sigmoid Diseases diagnosis
- Published
- 2012
- Full Text
- View/download PDF
27. [Prospective randomised study: robotic-assisted versus conventional laparoscopic surgery in colorectal cancer resection].
- Author
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Jiménez Rodríguez RM, Díaz Pavón JM, de La Portilla de Juan F, Prendes Sillero E, Hisnard Cadet Dussort JM, and Padillo J
- Subjects
- Aged, Digestive System Surgical Procedures methods, Female, Humans, Male, Middle Aged, Prospective Studies, Colorectal Neoplasms surgery, Laparoscopy, Robotics
- Abstract
Introduction: Robotic-assisted surgery is playing an increasingly important role in the last few years in the treatment of colorectal oncological disease. However, there are still no studies that objectively demonstrate the advantages of this type of surgery. We present a prospective randomised study in order to compare the short-term results between colorectal robotic surgery and laparoscopic surgery., Material and Method: A total of 56 patients diagnosed with colorectal cancer between January 2008 and January 2009, were randomised and assigned to the robotic or laparoscopic group. Age, body mass index, tumour location, conversions in each group, complications during and after surgery, and histological characteristics of the specimens obtained, were all compared., Results: There were no significant differences between age (P=.055), body mass index (P=.12), or tumour location (P=.91). Only one patient in the robotic group required a transfusion and none in the laparoscopic group. The percentage of conversions was the same in both groups, however, the preparation times and operating times were significantly longer in patients intervened using the robotic device (P=.0001 and P=.017, respectively). There were no differences as regards the rate of complications or in the percentage of re-interventions (14.2% and 7.1%). The mean hospital stay of the patients was 9.3 (8.1) days in the robotic group and 9.2 (6.8) days in the laparoscopic (P=.79). The distal resection margin was greater in the specimen obtained using robotic surgery (P =.003) as well as the number of lymph nodes obtained in the specimen (P =.23)., Conclusion: Robotic colorectal was performed safely and effectively, and with similar clinical results. International Trial Number for this study is: ISRCTN60866560., (Copyright © 2010 AEC. Published by Elsevier Espana. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
28. [Acute typhlitis as a cause of pneumoperitoneum in a non-neutropenic patient].
- Author
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Bernardos García C, Jiménez Rodríguez RM, Casado Maestre MD, Gutierrez Moreno M, and Vázquez Medina A
- Subjects
- Acute Disease, Aged, 80 and over, Humans, Male, Pneumoperitoneum etiology, Typhlitis complications
- Published
- 2010
- Full Text
- View/download PDF
29. [Medical magement of the hepatic spontaneous rupture in pacient with HELLP syndrome].
- Author
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Jiménez Rodríguez RM, Pareja Ciuro F, Flores Cortes M, and Valera Sánchez Z
- Subjects
- Adult, Female, Humans, Pregnancy, Rupture, Spontaneous, HELLP Syndrome, Liver Diseases etiology, Liver Diseases therapy
- Published
- 2010
- Full Text
- View/download PDF
30. [Ischemic hepatitis as a consequence of arterial steal syndrome].
- Author
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Jiménez-Rodríguez RM, Alamo Martínez JM, Suárez Artacho G, and Gómez Bravo MA
- Subjects
- Arteries, Humans, Liver Transplantation, Male, Middle Aged, Postoperative Complications etiology, Hepatitis etiology, Ischemia etiology, Liver blood supply, Vascular Diseases complications
- Published
- 2010
- Full Text
- View/download PDF
31. Sunovial two-phase sarcoma in third portion of the duodenum: clinical case and review of the literature.
- Author
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García Ruiz S, Jiménez Rodríguez RM, Alcaide León P, Alamo Martínez JM, Suárez Artacho G, and Gómez Bravo MA
- Subjects
- Aged, Duodenal Neoplasms genetics, Duodenal Neoplasms pathology, Duodenal Neoplasms surgery, Emergencies, Humans, Male, Pancreatitis, Acute Necrotizing diagnosis, Sarcoma, Synovial genetics, Sarcoma, Synovial pathology, Sarcoma, Synovial surgery, Tomography, X-Ray Computed, Translocation, Genetic, Diagnostic Errors, Duodenal Neoplasms diagnosis, Sarcoma, Synovial diagnosis
- Published
- 2010
- Full Text
- View/download PDF
32. [Perforation of the rectosigmoideal junction by ingestión of foreign bodies].
- Author
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Jiménez-Rodríguez RM, Flores-Cortés M, Méndez C, Valera-Sánchez Z, López-Bernal F, and Pareja-Ciuro F
- Subjects
- Adult, Foreign Bodies mortality, Hospitalization, Humans, Intestinal Perforation surgery, Length of Stay, Male, Surgical Wound Infection etiology, Time Factors, Cannabis, Foreign Bodies complications, Intestinal Perforation etiology
- Published
- 2009
- Full Text
- View/download PDF
33. [Chronic pancreatitis over pancreas divisum heat-resistant to medical and endoscopic treatment].
- Author
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Jiménez Rodríguez RM, García Ruiz S, Alamo Martínez JM, Suárez Artacho G, Bernal Bellido C, and Gómez Bravo MA
- Subjects
- Cholangiopancreatography, Endoscopic Retrograde, Cholangiopancreatography, Magnetic Resonance, Drainage, Endoscopy, Humans, Male, Middle Aged, Pancreatectomy, Pancreaticojejunostomy, Pancreatitis, Chronic diagnosis, Pancreatitis, Chronic drug therapy, Treatment Outcome, Pancreas abnormalities, Pancreatitis, Chronic complications, Pancreatitis, Chronic surgery
- Published
- 2009
- Full Text
- View/download PDF
34. [Primary unknown hepatocarcinoma like a cause of spontaneous hemoperitoneum].
- Author
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Jiménez Rodríguez RM, Alamo Martínez JM, Suárez Artacho G, Bernal Bellido C, Marín LM, and Gómez Bravo MA
- Subjects
- Aged, Humans, Male, Carcinoma, Hepatocellular complications, Hemoperitoneum etiology, Liver Neoplasms complications, Neoplasms, Unknown Primary complications
- Published
- 2009
- Full Text
- View/download PDF
35. [Liver graft necrosis caused by a gastroduodenal arterial steal syndrome].
- Author
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Jiménez-Rodríguez RM, Alamo Martínez JM, Suárez Artacho G, Bernal Bellido C, and Gómez Bravo MA
- Subjects
- Arteries, Humans, Male, Middle Aged, Necrosis, Syndrome, Liver Transplantation pathology, Postoperative Complications etiology, Vascular Diseases complications
- Published
- 2009
- Full Text
- View/download PDF
36. [Caecal volvulus as a cause of intestinal obstruction].
- Author
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Jiménez Rodríguez RM, Díaz Pavón JM, Alarcón Del Agua I, Bernardos García C, Alamo Martínez JM, and Sousa Vaquero JM
- Subjects
- Female, Humans, Middle Aged, Cecal Diseases complications, Intestinal Obstruction etiology, Intestinal Volvulus complications
- Published
- 2008
- Full Text
- View/download PDF
37. [Perineal wound in newborns during cesarean section].
- Author
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Jiménez-Rodríguez RM, de Agustín-Asensio JC, Fernández-Hurtado M, and Díaz-Pavón JM
- Subjects
- Birth Injuries surgery, Female, Humans, Infant, Newborn, Perineum surgery, Birth Injuries etiology, Cesarean Section, Perineum injuries
- Published
- 2008
- Full Text
- View/download PDF
38. [Subacute intestinal obstruction secondary to colonic lipoma intussusception].
- Author
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Jiménez-Rodríguez RM, Serrano-Borrero I, Díaz-Pavón JM, Socas-Macías M, and Vázquez-Monchul JM
- Subjects
- Female, Humans, Middle Aged, Colonic Neoplasms complications, Intestinal Obstruction etiology, Intussusception complications, Lipoma complications
- Published
- 2008
- Full Text
- View/download PDF
39. [Uncommon cause of abdominal pain: Ewing's sarcoma].
- Author
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Jiménez Rodríguez RM, Díaz Pavón JM, Vázquez Monchul JM, Socas Macías M, and Sánchez Gil JM
- Subjects
- Abdominal Pain etiology, Adult, Humans, Male, Sarcoma, Ewing complications, Sarcoma, Ewing diagnosis
- Published
- 2007
- Full Text
- View/download PDF
40. [Giant villous adenoma with loss of electrolytes. Review of literature and current status].
- Author
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Jiménez-Rodríguez RM, Díaz-Pavón JM, González D, Vázquez Monchul JM, and Sánchez Gil JM
- Subjects
- Adenoma, Villous metabolism, Adenoma, Villous pathology, Colonic Neoplasms metabolism, Colonic Neoplasms pathology, Female, Humans, Middle Aged, Adenoma, Villous complications, Adenoma, Villous surgery, Colonic Neoplasms complications, Colonic Neoplasms surgery, Water-Electrolyte Imbalance etiology
- Published
- 2007
- Full Text
- View/download PDF
41. [Adenocarcinoma in the fourth portion of duodenum in a patient with familial adenomatous polyposis].
- Author
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Jiménez Rodríguez RM, Suárez Artacho G, Morcillo J, Díaz Pavón JM, and Morales Méndez S
- Subjects
- Humans, Male, Middle Aged, Adenocarcinoma diagnosis, Adenocarcinoma surgery, Adenomatous Polyposis Coli surgery, Duodenal Neoplasms diagnosis, Duodenal Neoplasms surgery, Neoplasms, Second Primary diagnosis, Neoplasms, Second Primary surgery
- Published
- 2007
- Full Text
- View/download PDF
42. [Toxic megacolon and jejunal perforation due to cytomegalovirus].
- Author
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Jiménez Rodríguez RM, Puppo Moreno AM, Salgado Algarrada J, Muñoz González J, Martín Cartes J, and Márquez Vacaro JA
- Subjects
- Humans, Immunocompromised Host, Male, Megacolon, Toxic pathology, Megacolon, Toxic surgery, Middle Aged, Cytomegalovirus Infections complications, Intestinal Perforation virology, Jejunal Diseases virology, Megacolon, Toxic virology
- Abstract
Cytomegalovirus (CMV) infection is a frequent disease in immunocompromised patients and can affect the gastrointestinal tract in 50% of patients, giving rise to colitis due to CMV. However, a perforated jejunum is not frequent. We present the case of an immunocompromised patient who was diagnosed with colitis due to CMV infection after bowel perforation. Outcome was favorable after surgery and antiviral treatment.
- Published
- 2007
- Full Text
- View/download PDF
43. [Klippel-Trenaunay syndrome, a rare cause of rectal bleeding].
- Author
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Jiménez Rodríguez RM, Prieto Rodríguez MF, Fernández Ortega PA, and Díaz Pavón JM
- Subjects
- Adult, Female, Humans, Gastrointestinal Hemorrhage etiology, Klippel-Trenaunay-Weber Syndrome complications, Rectal Diseases etiology
- Published
- 2007
- Full Text
- View/download PDF
44. [Small bowel obstruction caused by metastasis for lobulillar breast cancer].
- Author
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Jiménez Rodríguez RM, Galindo Galindo A, Bermejo Navas A, Bernardos García C, Sousa Vaquero JM, Palacios González C, and Prendes Sillero E
- Subjects
- Aged, Female, Humans, Breast Neoplasms pathology, Carcinoma, Lobular secondary, Ileal Neoplasms secondary, Intestinal Obstruction etiology
- Published
- 2007
- Full Text
- View/download PDF
45. [Metastatic Crohn's disease involving the penile foreskin].
- Author
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Jiménez Rodríguez RM, Argüelles Solido E, Marcilla Plaza D, González Resina R, Lozano Blasco JM, and Campoy Martínez P
- Subjects
- Adult, Humans, Male, Penile Diseases pathology, Penile Diseases surgery, Crohn Disease complications, Foreskin, Penile Diseases etiology
- Abstract
Objective: To describe the case of the patient with history of Crohn's disease presenting metastatic extension to the penile foreskin., Methods: Circumcision was carried out and the skin was sent to the pathology department., Results: Pathologic study of the specimen showed an ulcerated granuloma without caseum, typically associated with metastatic Crohn's disease. After one year of follow-up there is no evidence of recurrence., Conclusions: Crohn's disease is a disease of unknown origin, the main characteristic of which is the development of non necrotizing granulomas that may involved not only the gastrointestinal tract. When the extraintestinal involvement is not produced by continuity we call it metastatic disease. Such metastases may be found in the genitourinary tract, and other sites. This involvement may include lithiasis, amyloidosis, ... and the presence of lesions in the genital skin, as in our case.
- Published
- 2006
- Full Text
- View/download PDF
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