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Febrero B, Rodríguez JM, Amate E, Ríos A. Neuromas linguales en la infancia como indicador en el diagnóstico del síndrome MEN 2B. Cir Esp 2015; 93:e31. [DOI: 10.1016/j.ciresp.2015.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 11/26/2022]
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Febrero B, Rodríguez JM, Ríos A, Parrilla P. [Cribiform-morular variant of papillary thyroid carcinoma as initial presentation of the familial adenomatous polyposis]. Med Clin (Barc) 2015; 144:279-80. [PMID: 25073821 DOI: 10.1016/j.medcli.2014.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 05/20/2014] [Accepted: 05/22/2014] [Indexed: 11/26/2022]
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Sánchez Fuentes PA, López López V, Febrero B, Ramírez P, Parrilla Paricio P. Omental infarction: Surgical or conservative management? Cir Esp 2015; 93:475-7. [PMID: 25649332 DOI: 10.1016/j.ciresp.2014.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 08/23/2014] [Accepted: 09/07/2014] [Indexed: 11/24/2022]
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Navas D, Ríos A, Febrero B, Rodríguez JM, Lloret F, Parrilla P. [Severe lower gastrointestinal bleeding due to GIST tumor. Radiological embolization and surgery]. CIR CIR 2014; 82:686-689. [PMID: 25393869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Gastrointestinal stromal tumors (GIST) were identified only recently. These tumors usually have no symptoms, although they are localized, operable and curable. Although rare, if they are not diagnosed and treated early, they become very aggressive. The most common manifestation is gastrointestinal bleeding from mucosal erosion. Their presentation as severe lower gastrointestinal bleeding is exceptional. CLINICAL CASE We report a patient with severe lower gastrointestinal bleeding stabilized by interventional radiology that subsequently required surgery for definitive care. CONCLUSIONS Therapeutic use of radiological embolization is increasingly widespread in bleeding at various levels, achieving hemodynamic stabilization of patients. However, it must be kept in mind that, in cases of unknown etiology of lower gastrointestinal bleeding, possible causes must be investigated.
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Ríos A, Rodríguez JM, Febrero B, Parrilla P. Primary thyroid lymphoma. ACTA ACUST UNITED AC 2014; 61:497-9. [PMID: 24935697 DOI: 10.1016/j.endonu.2014.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/16/2014] [Accepted: 04/20/2014] [Indexed: 10/25/2022]
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Febrero B, Ríos A, Rodríguez JM, Flores B, Parrilla P. Retroperitoneal neuroblastoma in the adult. An uncommon entity. Cir Esp 2014; 93:e147-8. [PMID: 24798954 DOI: 10.1016/j.ciresp.2014.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/12/2014] [Accepted: 03/13/2014] [Indexed: 02/09/2023]
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Febrero B, Ríos A, López-Navas A, Martínez-Alarcón L, Almela J, Sánchez Á, Sánchez J, Parrilla JJ, Ramírez P, Parrilla P. A multicenter study of the attitude of secondary school teachers toward solid organ donation and transplantation in the southeast of Spain. Clin Transplant 2014; 28:259-66. [PMID: 24476384 DOI: 10.1111/ctr.12308] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Teachers play a fundamental role in providing information to adolescents and could influence their attitudes. OBJECTIVES To analyze the attitude of teachers toward organ donation and the concept of brain death (BD); the psychosocial variables related to attitude; and the information provided to pupils. METHODS A multicenter study was carried out using a random sample of secondary school teaching staff from 10 schools (n = 327) in the southeast of Spain. Attitude toward organ donation was assessed using a validated questionnaire that was self-administered and completed anonymously. RESULTS The questionnaire completion rate was 88% (n = 288), with 75% (n = 215) in favor of organ donation, 23% had doubts, and 2% were not in favor. Regarding the knowledge of BD, 62% (n = 179) accepted that this meant a person's death. The variables associated with a more favorable attitude included conversations with family and friends (p < 0.05); a partner's favorable opinion (OR 3.194); knowledge of the concept of BD (p = 0.006); being a blood donor (OR 8.264); and a favorable attitude toward autopsy (OR 4.716). Teachers provided information about organ donation to pupils in 16% of cases (n = 47). CONCLUSIONS Seventy-five percent of teachers are in favor of organ donation. Their attitude is affected by psychosocial factors.
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López-Navas A, Ríos A, Martínez-Alarcón L, Febrero B, Pons JA, Miras M, Ramis G, Ramírez P, Parrilla P. Patients with terminal chronic liver pathology faced with this disease. Transplant Proc 2013; 45:3630-2. [PMID: 24314979 DOI: 10.1016/j.transproceed.2013.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND "Anxious preoccupation" is a maladaptive coping strategy for patients with terminal chronic liver pathology causing psychopathologic emotional responses. The aim of this study was to identify "anxious preoccupation" as a coping strategy when faced with this disease and to investigate its relationship with emotional-type psychopathologic symptoms in patients awaiting a liver transplant (LT). METHODS A total of 63 patients awaiting an LT were evaluated. The instrument used to evaluate coping style was the Mental Adjustment to Cancer questionnaire. One of the coping scales of this questionnaire is "anxious preoccupation" (9 items). An Instrument for psychopathologic assessment was used, the SA-45 questionnaire, which assessed 9 psychopathologic dimensions: somatizations, obsessions-compulsions, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. RESULTS "Anxious preoccupation" was used as an inadequate coping style by 51% of patients when faced with the disease. Five psychopathologic dimensions were associated with this coping strategy: 1) obsessive-compulsivity: 75% of patients with "anxious preoccupation" had obsessive-compulsivity symptoms compared with 29% of patients with other coping strategies (P < .001); 2) interpersonal sensitivity: 25% vs 6%, respectively (P = .044); 3) depression: 59% vs 29% (P = .015); 4) anxiety: 75% vs 32% (P = .001); and 5) phobic anxiety: 19% vs 3% (P = .050). CONCLUSIONS More than one-half of the patients on the LT waiting list used "anxious preoccupation" as a coping style for this disease. This strategy was associated with a greater presence of emotional-type psychopathologic symptoms in these patients.
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Martínez-Alarcón L, Ríos A, Ramis G, López-Navas A, Febrero B, Ramírez P, Parrilla P. Factor Analysis of Sources of Information on Organ Donation and Transplantation in Journalism Students. Transplant Proc 2013; 45:3579-81. [DOI: 10.1016/j.transproceed.2013.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ríos A, Martínez-Alarcón L, López-Navas A, Febrero B, Sánchez J, Ramis G, Ramírez P, Parrilla P. Attitudes of Scottish Residents in the Southeast of Spain Concerning Living Donation. Transplant Proc 2013; 45:3575-8. [DOI: 10.1016/j.transproceed.2013.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Ríos A, Martínez-Alarcón L, López-Navas A, Febrero B, Sánchez J, Ramis G, Ramírez P, Parrilla P. Irish Citizens Resident in the Southeast of Spain and Xenotransplantation. Transplant Proc 2013; 45:3582-5. [DOI: 10.1016/j.transproceed.2013.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ríos A, Rodríguez JM, Ferri B, Matínez-Barba E, Febrero B, Parrilla P. Are prognostic scoring systems of value in patients with follicular thyroid carcinoma? Eur J Endocrinol 2013; 169:821-7. [PMID: 24050927 DOI: 10.1530/eje-13-0372] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Most prognostic systems for differentiated carcinoma have been designed for papillary carcinoma. OBJECTIVE To analyze the value of the existing prognostic systems for evaluating follicular carcinoma and to determine whether any of them have a better predictive effect. METHODS A total of 66 follicular carcinomas were analyzed. The following prognostic systems were studied: EORTC, AGES, AMES, MACIS, TNM, and NTCTCS. RESULTS The AGES and AMES systems did not demonstrate a good prognostic correlation. In the EORTC system, the rate of disease-free patients was 89% in group 1, 75% in group 2, 69% in group 3, and 0% in group 4. The MACIS system showed 83, 60, 67, and 0% of disease-free patients respectively. The TNM system showed 81, 71, 50, and 0% of disease-free patients respectively. Finally, the NTCTCS system demonstrated 100, 84, 53, and 0% of disease-free patients respectively. Cox's regression analysis was used to calculate the proportion of variation in survival time explained (PVE). The prognostic classification system with the greatest survival prediction was EORTC at 67.64% of PVE, followed by TNM at 62.5% of PVE, and MACIS at 57.82% of PVE. CONCLUSIONS MACIS and TNM are good prognostic systems for evaluating follicular thyroid carcinoma, although the one with the most prognostic value was the EORTC system.
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Febrero B, Ríos A, Martínez-Alarcón L, López-Navas A, Almela J, Sánchez J, Ramis G, Ramírez P, Parrilla P. Information Received by Secondary School Teaching Personnel About Organ Donation and Transplantation: A Study in the Southeast of Spain. Transplant Proc 2013; 45:3589-91. [DOI: 10.1016/j.transproceed.2013.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Ríos A, Febrero B, Ramírez P, Rodriguez JM, Robles R, Bueno FS, Medina JG, Capel A, Parrilla P. Successful Embolization of a Cytomegalovirus-Related Duodenal Ulcer in a Kidney-Pancreas Transplant Recipient. Prog Transplant 2013; 23:217-9. [DOI: 10.7182/pit2013574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
One of the complications that can occur in pancreas transplant is a massive intestinal hemorrhage, although such a hemorrhage is very rarely caused by ulcers due to cytomegalovirus infection. Treatment is fundamentally based on relaparatomy, although in some cases interventional radiology can be an efficient alternative because it allows the exact bleeding point to be located and therapeutic embolization to be performed. In this case, a man with diabetes type 1 who was given a simultaneous kidney-pancreas transplant had an ulcer due to cytomegalovirus infection develop in the duodenal graft (in the early postoperative period), causing a severe hemorrhage in the lower part of the gastrointestinal tract that was controlled via selective embolization of a branch of the pancreaticoduodenal artery.
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López-Navas A, Ríos A, Moya-Faz FJ, Febrero B, Jiménez-Morales MI, Orteso FJ, Ros-Martínez A, Martínez-Alarcón L, Pons JA, Miras M, Ramírez P, Parrilla P. Emotional-type psychopathologic symptoms among patients with terminal chronic alcohol-induced liver cirrhosis. Transplant Proc 2013; 44:1510-2. [PMID: 22841199 DOI: 10.1016/j.transproceed.2012.05.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Patients with toxic substance abuse syndrome, such as alcohol abuse, have elevated psychopathologic morbidity and mortality such as mood disorders. OBJECTIVE To evaluate the emotional-type psychopathologic symptoms in patients with alcohol-induced hepatic cirrhosis on the liver transplant waiting list. MATERIALS AND METHODS Patients with alcoholic liver cirrhosis who were candidates for liver transplant (n = 41) completed the SA-45 questionnaire (González y Cuevas; 88), which assesses nine dimensions: somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. A control group consisted of patients with chronic nonalcoholic terminal hepatopathies (n = 22). RESULTS Seventy-six percent of patients had some kind of psychopathologic symptom compared to 68% of the patients in the control group with other nonalcoholic etiologies (P > .05). The emotional-type clinical symptoms were: (1) somatizations: 37% of patients with alcoholic cirrhosis had this type of clinical symptoms compared to 32% of the control group (P > .05); (2) obsessive-compulsivity: 56% versus 46%, respectively (P > .05); (3) interpersonal sensitivity: 19% versus 9%, respectively (P > .05); (4) depression: 54% versus 27%, respectively (P = .045); (5) anxiety: 59% versus 46%, respectively (P > .05); (6) hostility: 29% versus 5%, respectively (P = .021); (7) phobic anxiety: 10% versus 14%, respectively (P > .05); (8) paranoid Ideation: 7% versus 5%, respectively (P > .05); (9) psychoticism: 5% versus 4%, respectively (P > .05). CONCLUSIONS The patients with alcoholic liver cirrhosis on the liver transplant waiting list had elevated psychopathologic symptoms. Depressive- and hostile-type emotional alterations were most frequent in this type of patients.
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Abstract
Crohn's disease is one of the causes of secondary amyloidosis, which can lead to amyloid infiltration of the thyroid gland. It is essential to follow strict controls to prevent the appearance of a large amyloid goiter. Two patients with amyloid goiter secondary to Crohn's disease, with a large adipose tissue component and who required surgical treatment, were studied. Both surgical interventions were difficult because of the fragility of the thyroid tissue. A patient with Crohn's disease and secondary amyloidosis could begin to develop amyloid goiter. This is usually fast growing and commonly causes compressive symptoms, although in some cases it only grows in the neck with no evidence of these symptoms. When surgery is indicated, patients should be remitted to hospitals with experienced endocrine surgeons, given that there is a high risk of developing complications.
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González M, Cascales P, Abellán I, Pons J, Miras M, Capel A, Sánchez Bueno F, Robles R, Febrero B, Ríos A, Ramírez P, Parrilla P. The Evolution of Therapeutic Strategies for Biliary Tract Complications After Liver Transplantation Over a Period of 20 Years. Transplant Proc 2012; 44:2093-5. [DOI: 10.1016/j.transproceed.2012.07.073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ríos A, López-Navas A, Ayala-García MA, Sebastián M, Febrero B, Ramírez EJ, Muñoz G, Palacios G, Rodríguez JS, Martínez MA, Nieto A, Martínez-Alarcón L, Ramis G, Ramírez P, Parrilla P. Multivariate analysis to determine the factors affecting the attitudes toward organ donation of healthcare assistants in Spanish and Mexican healthcare centers. Transplant Proc 2012; 44:1479-81. [PMID: 22841189 DOI: 10.1016/j.transproceed.2012.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Healthcare assistants are an important group of workers who can influence public opinion. Their attitudes toward organ donation may influence public awareness of healthcare matters; negative attitudes toward donation and transplantation could have a negative impact on public attitudes. Our objective was analyze the attitudes of healthcare assistants, in Spanish and Mexican healthcare centers toward organ donation and determine factors affecting them using a multivariate analysis. MATERIAL AND METHODS As part of the "International Collaborative Donor Project," 32 primary care centers and 4 hospitals were selected in Spain and 5 hospitals in Mexico. A randomized sample of healthcare assistants was stratified according to healthcare services. Attitudes were evaluated using a validated questionnaire of the psychosocial aspects of donation, which was self-completed anonymously by the respondent. Statistical analysis used the chi-square test, Student t test, and logistic regression analysis. RESULTS Of 532 respondents, 66% in favored donation and 34% were against it or undecided. Upon multivariate analysis, the following variables had the most weight: 1) country of origin (Mexicans were more in favor than Spanish; odds ratio [OR]) = 1.964; P = .014); 2) a partner with a favorable attitude (OR = 2.597; P = .013); 3) not being concerned about possible bodily mutilation after donation (OR = 2.631; P = .006); 4) preference for options apart from burial for handling the body after death (OR = 4.694; P < .001) and 5) accepting an autopsy if one was needed (OR = 3.584; P < .001). CONCLUSIONS The attitudes of healthcare assistants toward organ donation varied considerably according to the respondent's country of origin. The psycho-social profile of a person with a positive attitude to donation was similar to that described within the general public.
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Febrero B, Robles R, Brusadin R, Marín C, López-Conesa A, Martínez C, Parrilla P. Liver and pancreatic metastasis of a solitary fibrous tumour. Cir Esp 2012; 92:438-41. [PMID: 22824532 DOI: 10.1016/j.ciresp.2012.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Revised: 04/13/2012] [Accepted: 04/30/2012] [Indexed: 11/25/2022]
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Ríos A, Febrero B, López-Navas A, Martínez-Alarcón L, Sánchez J, Guzmán D, Ramírez P, Parrilla P. Evaluation of Attitude toward Living Organ Donation among Adolescents in Southeast Spain. Transplant Proc 2012; 44:1489-92. [DOI: 10.1016/j.transproceed.2012.05.067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Ríos A, Rodríguez JM, Febrero B, Parrilla P. [Extracranial schwannoma of a cervical sympathetic origin]. Rev Neurol 2012; 54:638-639. [PMID: 22573511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Cascales Campos P, Ramirez P, Gonzalez R, Febrero B, Pons JA, Miras M, Sanchez Bueno F, Robles R, Parrilla P. Value of 18-FDG-positron emission tomography/computed tomography before and after transarterial chemoembolization in patients with hepatocellular carcinoma undergoing liver transplantation: initial results. Transplant Proc 2012; 43:2213-5. [PMID: 21839236 DOI: 10.1016/j.transproceed.2011.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Liver transplantation is the treatment of choice for various types of end-stage liver disease and the most appropriate alternative for the treatment of hepatocellular carcinoma (HCC)-associated liver cirrhosis. The aim of this study was to describe our initial experience with the use of 18-FDG positron emission tomography (PET)/computed tomography CT before and after transarterial chemoembolization (TACE) in HCC patients undergoing liver transplantation, seeking to predict the percentage of tumor necrosis achieved by TACE procedures. PATIENTS AND METHODS From January 2007 through December 2009, 39 patients with HCC and liver cirrhosis were included in our liver transplantation program. We selected the 6 subjects who underwent 18-fluorodeoxyglucose PET/CT (18-FDG PET/CT) pre- and post-TACE. RESULTS The median SUV (standardized uptake value) in the lesions studied were 4 (range, 2.79-6.95) before TACE with a median post-TACE SUV of 0 (range, 0-4). Among patients whose post-TACE SUV decreased to <3, the percentage of necrosis after studying the hepatectomy was >80%. CONCLUSION Performance of an 18-FDG PET/CT before and after TACE and comparison of SUV in patients with HCC awaiting liver transplantation provided valuable information regarding the effectiveness of TACE.
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Ríos A, Rodríguez JM, Febrero B, Acosta JM, Torregrosa N, Balsalobre M, Parrilla P. Perfil histológico e inmuno-histoquímico del carcinoma medular de tiroides esporádico y familiar. ACTA ACUST UNITED AC 2011; 58:521-8. [DOI: 10.1016/j.endonu.2011.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 07/03/2011] [Accepted: 07/04/2011] [Indexed: 12/26/2022]
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Ríos A, Rodríguez JM, Febrero B, Acosta JM, Torregrosa N, Parrilla P. [Prognostic value of clinical, histopathological and immunohistochemical features in medullary thyroid cancer]. Med Clin (Barc) 2011; 139:277-83. [PMID: 22032817 DOI: 10.1016/j.medcli.2011.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 07/10/2011] [Accepted: 07/12/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVE To analyze the importance of various clinical, histopathological and immunohistochemical features in the prognosis of resected medullary thyroid carcinoma. PATIENTS AND METHODS A total of 55 cases of medullary thyroid carcinoma consecutively operated were investigated. The data referring to clinical features were collected in the patient's clinical history. The histopathological and immunohistochemical features of the tumors were taken from their pathological anatomy report. RESULTS Survival at one year was 96 ± 2%; at 5 years 91 ± 4%; at 10 years 88 ±6%; at 15 years 83 ± 7%; and at 20 years 61 ± 14%. Among epidemiological features, tumor type was significantly related with the disease (best familial prognosis; P=.035); among histopathological features, the presence of C cell hyperplasia and the presence of tumor necrosis had a significant relationship (P=.0005 and P=.039); among immunohistochemical features, positivity for p53 and for c-erb-b2 (P=.023 and P=.022); and finally, among staging data, TNM clinical staging (P=.015), size (P=.046) and the presence of distant metastases (P=.002). According to Cox's regression model, the only variables indicating a poor prognosis were: the existence of necrosis (P=.039; OR=6.513) and tumor size>4 cm (P=.027; OR=14.196). CONCLUSIONS The survival rate was mainly determined by tumor size and the presence of tumor necrosis. None of the immunohistochemical markers had a significant influence on survival.
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López-Navas A, Ríos A, Riquelme A, Martínez-Alarcón L, Pons JA, Miras M, Sanmartín A, Febrero B, Ramírez P, Parrilla P. Psychological care: social and family support for patients awaiting a liver transplant. Transplant Proc 2011; 43:701-4. [PMID: 21486578 DOI: 10.1016/j.transproceed.2011.01.095] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION In patients awaiting a transplant, the help received from friends and/or family members is considered to be an important factor in the transplantation process. Our objective was to determine the level of social/family support for patients on the liver transplant waiting list and to determine the relationship between clinical psychopathology and the level of social/family support. MATERIALS AND METHODS The study population consisted of 70 patients on the liver transplant waiting list. We used the following instruments: (1) Medical Outcomes Study-Social Support Survey (MOS) Questionnaire. For size of the social network, four support dimensions and a global support index for emotional support, material/instrumental support, leisure/free time activities, and love/care; (2) Family Apgar Questionnaire for personal perception of family function; (3) SA-45 questionnaire of psychopathologic symptoms for somatizations, obsessive-compulsivity, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. RESULTS The MOS showed that the mean size of the social network of these patients was 12 people. In these patients, social/family support was nonfunctional in 20% of the cases. By dimensions, the patients had the following percentage of nonfunctional support: 24% in emotional support; 10% material/instrumental support; 23% social relations of leisure/free-time activities; and 11% compassionate love/care support. The patients with nonfunctional support had the following associated psychopathologic symptoms (SA-45): depression (79% vs 39%; P = .008), anxiety (86% vs 46%; P = .008), hostility (43% vs 12%; P = .009), and psychoticism (14% vs 2%; P = .039) compared to functional patients. The Family Apgar showed that 27% of patients perceived a family dysfunction. These patients had greater interpersonal sensitivity-type emotional symptoms (32% vs 8%; P = .012), depression (79% vs 35%; P = .001), anxiety (79% vs 45%; P = .011), and hostility (42% vs 10%; P = .002) compared to normally functioning patients. CONCLUSIONS Nearly a quarter of patients on the liver transplant waiting list have social/family support that is nonfunctional, which leads to greater emotional psychopathologic symptoms that would need to be treated.
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Ríos A, López-Navas A, Ayala-Garcia MA, Sebastián MJ, Martínez-Alarcón L, Ramírez EJ, Muñoz G, Camacho A, Rodríguez JS, Martínez MA, Nieto A, Febrero B, Ramis G, Ramírez P, Parrilla P. Donation and transplantation among personnel in the hospital emergency department: a multicenter study conducted in Spain and Mexico. Transplant Proc 2011; 43:48-51. [PMID: 21335151 DOI: 10.1016/j.transproceed.2010.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The promotion of different means of procuring both deceased and living organs (kidney and liver) is a necessity given the current organ shortage. Emergency department personnel are involved in the donation and transplantation process. Our objective was to analyze the attitude to the different kinds of organ donation of emergency services personnel in hospital centers in Spain and Mexico. MATERIALS AND METHODS A randomized sample was obtained from the "International Collaborative Donor Project" and was stratified according to emergency services and job category in nine hospitals, in Spain and in Mexico (n = 22). Attitude was evaluated using a validated survey. RESULTS Of the respondents, 76% were in favor of deceased organ donation and 24% were not in favor. This attitude toward deceased donation was associated with the respondent's country of origin, age, and job category; Mexicans (P = .036), younger respondents (P = .023), and physicians were most in favor (P < .001). With regard to attitude toward living kidney donation, 89% were in favor of related donation. Regarding living liver donation, 85% were in favor of related donation. In attitude toward living kidney and liver donation, relevant factors were related to donation and transplantation. CONCLUSIONS Professionals in emergency departments in hospital centers in Spain and Mexico had a favorable attitude toward the different kinds of donation, although it was less favorable than the attitude reported in other professional hospital groups.
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Ríos A, Martínez-Alarcón L, López-Navas A, Sánchez J, Guzmán D, Febrero B, Ramis G, Ramírez P, Parrilla P. Knowledge of the Concept of Brain Death in the British and Irish Population Resident in Southeast Spain. Transplant Proc 2011; 43:692-4. [DOI: 10.1016/j.transproceed.2011.02.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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78
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López-Navas A, Ríos A, Riquelme A, Martínez-Alarcón L, Pons J, Miras M, Sanmartín A, Febrero B, Ramis G, Ramírez P, Parrilla P. Psychological Characteristics of Patients on the Liver Transplantation Waiting List With Depressive Symptoms. Transplant Proc 2011; 43:158-60. [DOI: 10.1016/j.transproceed.2010.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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79
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Ríos A, Manuel Rodríguez J, Balsalobre MD, Febrero B, Tébar J, Parrilla P. [Distant metastases as the initial manifestation of follicular thyroid carcinoma]. ACTA ACUST UNITED AC 2009; 56:213-4. [PMID: 19627740 DOI: 10.1016/s1575-0922(09)70988-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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