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Pujol O, Vila-Castillo L, Álvaro C, Aguilar M, Joshi N, Minguell J. Time dedicated to physical activity among medical residents: are there differences based on gender or specialty type? Rev Clin Esp 2024:S2254-8874(24)00065-1. [PMID: 38679321 DOI: 10.1016/j.rceng.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Physical activity (PA) is associated with positive health outcomes such as prevention of chronic diseases, psychological well-being and improved work performance. Medical residents are subjected to sleep deprivation, extended work schedule and high burnout prevalence. These conditions may lead to the neglect of personal health and the restriction of time dedicated to PA. The objective of the present study was to analyze the time dedicated to PA of medical residents, comparing women vs men residents and surgical vs clinical residents. METHODS It is a cross-sectional study performed in a Spanish third-level university hospital. All medical residents from our institution were invited to voluntarily participate in the study answering a web-based questionnaire on June 2022. Data regarding demographics, residency and PA practice was recorded. RESULTS The response rate was 20.73% (114/550). The 32.5% of the residents considered themselves to be physically inactive and mean time dedicated to PA in a regular week was 3.62 ± 2.22 h. Men residents dedicated more time to PA than women residents (4.23 ± 2.42 h vs 3.14 ± 1.95 h, p = 0.012) and surgical residents dedicated more time than clinical residents (4.33 ± 2.36 h vs 3.23 ± 2.05 h, p = 0.01). CONCLUSIONS One third of the medical residents consider themself physically inactive. Women and clinical residents practice PA less time than men and surgical residents. Efforts should be made to encourage PA among residents, especially in women and non-surgeons.
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Affiliation(s)
- O Pujol
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - L Vila-Castillo
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Álvaro
- Sant Joan de Deu University Hospital, Barcelona, Spain
| | - M Aguilar
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Joshi
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Minguell
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
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Lara-Taranchenko Y, Pujol O, González-Morgado D, Hernández A, Barro V, Soza D. [Translated article] Validation of the Spanish version of the modified Harris score. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:T121-T127. [PMID: 38000541 DOI: 10.1016/j.recot.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 03/29/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale. MATERIALS AND METHODS The ES-EHM scale was applied to 100 patients who underwent a total hip replacement, in three different situations: (1) prior to surgery (pre-surgical ES-EHM), (2) after surgery, with at least 2 years of follow up (after surgery ES-EHM), and (3) 6 months after the postsurgical registration (final ES-EHM). WOMAC questionnaire was also applied once. We analysed data of scale main score, pain score, function-related score as well as the mean of pre-surgical, postsurgical and final postsurgical ES-EHM scale, in both the ES-EHM and the WOMAC scales. Parameters of reliability, validity and sensitivity to change were obtained. RESULTS Clinically relevant improvement was observed (46.55 points) when comparing pre-surgical and post-surgical ES-EHM scores. However, no differences between postsurgical and final ES-EHM were detected. Even so, strong correlation was obtained between the following: (1) postsurgical ES-EHM and final ES-EHM scores, (2) ES-EHM and WOMAC scores, and (3) pain and function-related parameters of ES-EHM and WOMAC scores. Standardised response mean (SRM) was 2.99, test-retest reliability expressed by the intraclass correlation coefficient was 0.90 and Cronbach index 0.95. CONCLUSIONS The Spanish cross-cultural adaptation of the EHM scale shows to be reliable, valid and sensitive to change. Thus, the Spanish medical staff will be able to apply the ES-EHM scale with good scientific support.
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Affiliation(s)
- Y Lara-Taranchenko
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona, Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - O Pujol
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona, Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - D González-Morgado
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona, Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Hernández
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona, Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - V Barro
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona, Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - D Soza
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona, Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Lara-Taranchenko Y, Pujol O, González-Morgado D, Hernández A, Barro V, Soza D. Validation of the Spanish version of the modified Harris score. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:121-127. [PMID: 37023976 DOI: 10.1016/j.recot.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/13/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale. MATERIALS AND METHODS The ES-EHM scale was applied to 100 patients who underwent a total hip replacement, in three different situations: (1) prior to surgery (pre-surgical ES-EHM), (2) after surgery, with at least 2 years of follow up (after surgery ES-EHM), and (3) 6 months after the postsurgical registration (final ES-EHM). WOMAC questionnaire was also applied once. We analyzed data of scale main score, pain score, function-related score as well as the mean of pre-surgical, postsurgical and final postsurgical ES-EHM scale, in both the ES-EHM and the WOMAC scales. Parameters of reliability, validity and sensitivity to change were obtained. RESULTS Clinically relevant improvement was observed (46.55 points) when comparing pre-surgical and post-surgical ES-EHM scores. However, no differences between postsurgical and final ES-EHM were detected. Even so, strong correlation was obtained between the following: (1) postsurgical ES-EHM and final ES-EHM scores, (2) ES-EHM and WOMAC scores, and (3) pain and function-related parameters of ES-EHM and WOMAC scores. Standardized response mean (SRM) was 2.99, test-retest reliability expressed by the intraclass correlation coefficient was 0.90 and Cronbach index 0.95. CONCLUSIONS The Spanish cross-cultural adaptation of the EHM scale shows to be reliable, valid and sensitive to change. Thus, the Spanish medical staff will be able to apply the ES-EHM scale with good scientific support.
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Affiliation(s)
- Y Lara-Taranchenko
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona. Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, España.
| | - O Pujol
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona. Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - D González-Morgado
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona. Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - A Hernández
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona. Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - V Barro
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona. Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - D Soza
- Unidad de Cirugía de Cadera, Universidad Autónoma de Barcelona. Departamento de Cirugía, Hospital Universitari Vall d'Hebron, Barcelona, España
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Ferrer Rivero R, Pujol O, Ferrer Rivero J, Oliver Far G. [Translated article] Closing wedge high tibial osteotomy: An old-fashioned technique? Survival, clinical and radiological outcomes of a case series analysis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024:S1888-4415(24)00055-9. [PMID: 38325572 DOI: 10.1016/j.recot.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/07/2023] [Accepted: 10/22/2023] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Closing wedge high tibial osteotomy (CW-HTO) is a surgical option for active patients with medial knee pain and mild-moderate osteoarthritis with varus limb deformity. Despite its good reported results, this technique has been losing popularity. The aim of this study was to analyse the survival rate, clinical functional outcomes and radiological results of CW-HTO. METHODS It is a retrospective case series study. Seventy patients with primary knee osteoarthritis, operated on between 2010 and 2020 in a single Spanish tertiary hospital using the CW-HTO technique and with a minimum follow-up of 2 years were analysed. RESULTS Survival rate was 87.6% and 75.5% after a follow-up of 5 and 10 years respectively. Functional outcomes were good-to-excellent (KSS 77.7/100 and OKS 35.6/48) and good pain control (VAS 3.9/10) and high satisfaction (7.2/10) were achieved. Limb varus malalignment was significantly corrected (mean postoperative HKA angle 177.6° and MPTA 90.7°). However, 30% of patients presented hypocorrection, which was associated with inferior survival, functionality and satisfaction. CONCLUSION CW-HTO technique can be useful for patients with knee osteoarthritis and varus limb. It allows to correct varus malalignment while achieving good-to-excellent functional outcomes, good pain control, high patient satisfaction and acceptable medium-long term survival rate. However, it is associated with a non-negligible risk of hypocorrection or medial hinge disruption.
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Affiliation(s)
- R Ferrer Rivero
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Bellvitge, Universidad de Barcelona, Hospitalet de Llobregat, Spain.
| | - O Pujol
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Vall d'Hebron, Universidad Autònoma de Barcelona, Barcelona, Spain
| | - J Ferrer Rivero
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Germans Trias i Pujol, Universidad de Barcelona, Badalona, Spain
| | - G Oliver Far
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Bellvitge, Universidad de Barcelona, Hospitalet de Llobregat, Spain
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Andrés-Peiró JV, Pujol O, Altayó-Carulla M, Castellanos-Alonso S, Reverté-Vinaixa MM, Teixidor-Serra J, Tomàs-Hernández J, Selga-Marsà J, García-Sánchez Y, Molero-García V, Joshi-Jubert N, Minguell-Monyart J. Predictors of first-year postoperative complications after fixation of low-energy ankle fractures: A single-center, retrospective cohort study of 663 consecutive fractures. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024:S1888-4415(24)00056-0. [PMID: 38325573 DOI: 10.1016/j.recot.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/19/2023] [Accepted: 11/24/2023] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Rotational ankle fractures are common, have diverse personalities and affect both robust and fragile patients. Postoperative complications are frequent, creating a sizeable economic burden. The primary purpose of this study was to expand current knowledge on predictors of postoperative complications after low-energy ankle fracture fixation. MATERIALS AND METHODS A retrospective single-center cohort study was completed of patients undergoing internal fixation OF low-energy ankle fractures. The primary outcome was first-year postoperative complications, classified as major (surgical) or minor (non-surgical). Data on patients, their injuries, and treatments were collected. To identify potential predictors of outcomes, logistic regression methods were used, with a backward-stepwise method used for model fitting. RESULTS In total, 663 patients of median age 59 years were analysed. We found a high rate of complications (28.4%), with wound-healing issues and infections predominant. Overall, 14.8% had minor complications, while 13.6% required an unplanned reoperation. On multivariable analysis, the most consistent predictors of complications were older age (OR: 1.02 per year), longer operating time (3.32 per hour), and smoking (2.91). CONCLUSIONS Older patients and smokers who sustain fractures requiring more complex surgery are at higher risk of postoperative complications.
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Affiliation(s)
- J-V Andrés-Peiró
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España.
| | - O Pujol
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - M Altayó-Carulla
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - S Castellanos-Alonso
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - M-M Reverté-Vinaixa
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - J Teixidor-Serra
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - J Tomàs-Hernández
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - J Selga-Marsà
- Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - Y García-Sánchez
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - V Molero-García
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - N Joshi-Jubert
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
| | - J Minguell-Monyart
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, España; Departmeng of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, España
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Pujol O, Andrés-Peiró JV, Tomás J, Selga J, Piedra C, Teixidor J. Letter to the Editor: «Suprapatellar tibial nailing, why have we changed?». Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:86-87. [PMID: 35817362 DOI: 10.1016/j.recot.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/20/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- O Pujol
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, España.
| | - J V Andrés-Peiró
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - J Tomás
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - J Selga
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - C Piedra
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - J Teixidor
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, España
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Pujol O, Andrés-Peiró JV, Tomás J, Selga J, Piedra C, Teixidor J. [Translated article] Letter to the Editor: "Suprapatellar tibial nailing, why have we changed?". Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:T86-T87. [PMID: 37981197 DOI: 10.1016/j.recot.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/20/2022] [Indexed: 11/21/2023] Open
Affiliation(s)
- O Pujol
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - J V Andrés-Peiró
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J Tomás
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J Selga
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - C Piedra
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J Teixidor
- Unidad de Traumatología, Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Andrés-Peiró JV, Pujol O, Altayó-Carulla M, Castellanos-Alonso S, Reverté-Vinaixa MM, Teixidor-Serra J, Tomàs-Hernández J, Selga-Marsà J, García-Sánchez Y, Molero-García V, Joshi-Jubert N, Minguell-Monyart J. Predictors of first-year postoperative complications after fixation of low-energy ankle fractures: A single-center, retrospective cohort study of 663 consecutive fractures. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023:S1888-4415(23)00259-X. [PMID: 38043738 DOI: 10.1016/j.recot.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/19/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023] Open
Abstract
INTRODUCTION Rotational ankle fractures are common, have diverse personalities and affect both robust and fragile patients. Postoperative complications are frequent, creating a sizeable economic burden. The primary purpose of this study was to expand current knowledge on predictors of postoperative complications after low-energy ankle fracture fixation. MATERIALS AND METHODS A retrospective single-center cohort study was completed of patients undergoing internal fixation OF low-energy ankle fractures. The primary outcome was first-year postoperative complications, classified as major (surgical) or minor (non-surgical). Data on patients, their injuries, and treatments were collected. To identify potential predictors of outcomes, logistic regression methods were used, with a backward-stepwise method used for model fitting. RESULTS In total, 663 patients of median age 59 years were analyzed. We found a high rate of complications (28.4%), with wound-healing issues and infections predominant. Overall, 14.8% had minor complications, while 13.6% required an unplanned reoperation. On multivariable analysis, the most consistent predictors of complications were older age (OR=1.02 per year), longer operating time (3.32 per hour), and smoking (2.91). CONCLUSIONS Older patients and smokers who sustain fractures requiring more complex surgery are at higher risk of postoperative complications.
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Affiliation(s)
- J-V Andrés-Peiró
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
| | - O Pujol
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M Altayó-Carulla
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - S Castellanos-Alonso
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - M-M Reverté-Vinaixa
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - J Teixidor-Serra
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - J Tomàs-Hernández
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - J Selga-Marsà
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Y García-Sánchez
- Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - V Molero-García
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - N Joshi-Jubert
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - J Minguell-Monyart
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Orthopaedic Surgery and Traumatology, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
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Joshi N, Pujol O, Prat S. Complex distal femoral fractures in the fragile elderly patient treated by distal femoral replacement: A report of three cases. Rev Esp Cir Ortop Traumatol (Engl Ed) 2022; 66:149-153. [DOI: 10.1016/j.recot.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/22/2021] [Accepted: 07/18/2021] [Indexed: 10/19/2022] Open
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Joshi N, Pujol O, Prat S. [Artículo traducido] Fractura de fémur distal compleja en el paciente frágil y anciano tratada mediante reemplazo femoral distal: reporte de 3 casos. Rev Esp Cir Ortop Traumatol (Engl Ed) 2022; 66:T149-T153. [DOI: 10.1016/j.recot.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/18/2021] [Indexed: 10/19/2022] Open
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Lara-Taranchenko Y, Soza D, Pujol O, González-Morgado D, Hernández A, Barro V. [Translated article] Cross-cultural adaptation for the Spanish population of the modified Harris score for functional and symptomatic hip joint assessment. Rev Esp Cir Ortop Traumatol (Engl Ed) 2022. [DOI: 10.1016/j.recot.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Arias L, Caminal J, Rubio M, Pujol O, Arruga J. Retinal Pigment Epithelial Tears after Intravitreal Bevacizumab Injection for Predominantly Classic Choroidal Neovascularization. Eur J Ophthalmol 2018; 17:992-5. [DOI: 10.1177/112067210701700622] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To detect retinal pigment epithelium (RPE) tears in predominantly classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) treated with intravitreal bevacizumab injections. Methods Forty consecutive patients with predominantly classic CNV secondary to AMD were treated with 1.25 mg of intravitreal bevacizumab. Patients were evaluated with visual acuity (VA) measured with Early Treatment Diabetic Retinopathy Study charts, optical coherence tomography, and fluorescein angiography. Results Three patients developed a RPE tear after the first injection. The first patient had been treated with verteporfin therapy and VA remained unchanged. In the other two cases the CNV was naïve and VA improved since the foveal center was not involved by the tear and macular edema was reduced. Conclusions RPE tears can occur following intravitreal bevacizumab injections in patients with predominantly classic CNV although VA is not always affected.
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Affiliation(s)
- L. Arias
- Department of Ophthalmology, Bellvitge University Hospital, L'Hospitalet de Llobregat
- Ophthalmology Institute of Barcelona, USP Hospitals, Barcelona - Spain
| | - J.M. Caminal
- Department of Ophthalmology, Bellvitge University Hospital, L'Hospitalet de Llobregat
| | - M. Rubio
- Department of Ophthalmology, Bellvitge University Hospital, L'Hospitalet de Llobregat
| | - O. Pujol
- Department of Ophthalmology, Bellvitge University Hospital, L'Hospitalet de Llobregat
| | - J. Arruga
- Department of Ophthalmology, Bellvitge University Hospital, L'Hospitalet de Llobregat
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Munoz M, Pujol O, Mora C, Pastor L, Gudiña S, Maull R, Vega Z, Morilla A, Anton A. Integrated visual field and relative risk for quality of life loss. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Alberti M, Balocco S, Gatta C, Ciompi F, Pujol O, Silva J, Carrillo X, Radeva P. Automatic Bifurcation Detection in Coronary IVUS Sequences. IEEE Trans Biomed Eng 2012; 59:1022-31. [DOI: 10.1109/tbme.2011.2181372] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Alcubierre R, Arias L, Lorenzo D, Pujol O, Rubio M. [Low-fluence photodynamic therapy in chronic central serous chorioretinopathy]. ACTA ACUST UNITED AC 2012; 87:3-8. [PMID: 22248651 DOI: 10.1016/j.oftal.2011.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 05/22/2011] [Accepted: 06/03/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate safety and efficacy of low-fluence photodynamic therapy (LFPDT) with verteporfin in patients affected with chronic central serous chorioretinopathy (CCSC), in terms of visual acuity (VA) and macular morphology measured with optical coherence tomography (OCT). METHODS A retrospective, non-randomized and interventionist analysis was performed on 16 eyes in 15 patients with CCSC treated with LFPDT. Best corrected visual acuity (BCVA) with ETDRS optotypes and central foveal thickness (CFT) in OCT were evaluated as outcome measures. RESULTS The mean follow-up was 10.8 months. The mean BCVA improved from 58.12 to 68.68 ETDRS letters, and CFT decreased from 280.5 to 172.18 microns, with subretinal fluid resolution in 14 eyes (87.5%), two of them after a second LFTPD. No complications related to treatment were recorded. CONCLUSIONS LFPDT with verteporfin can be useful in CCSC to stabilise or improve BCVA, reabsorb subretinal fluid and reduce CFT. Randomised studies with a longer follow-up are required to assure the role of this treatment and to optimise parameters for higher efficacy and safety in CCSC patients.
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Affiliation(s)
- R Alcubierre
- Sección de Retina, Departamento de Oftalmología, Hospital Universitari de Bellvitge, L'Hospitalet De Llobregat, Barcelona, España.
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Seabra JC, Ciompi F, Pujol O, Mauri J, Radeva P, Sanches J. Rayleigh Mixture Model for Plaque Characterization in Intravascular Ultrasound. IEEE Trans Biomed Eng 2011; 58:1314-24. [DOI: 10.1109/tbme.2011.2106498] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Arias L, Caminal JM, Casas L, Masuet C, Badia MB, Rubio M, Pujol O, Arruga J. A study comparing two protocols of treatment with intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration. Br J Ophthalmol 2008; 92:1636-41. [DOI: 10.1136/bjo.2008.141721] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Arias L, Planas N, Prades S, Caminal JM, Rubio M, Pujol O, Roca G. Intravitreal bevacizumab (Avastin) for choroidal neovascularisation secondary to pathological myopia: 6-month results. Br J Ophthalmol 2008; 92:1035-9. [PMID: 18653595 DOI: 10.1136/bjo.2007.130260] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND To determine the efficacy and safety of intravitreal Avastin (bevacizumab) in the treatment of choroidal neovascularisation (CNV) secondary to pathological myopia (PM). METHODS This paper reports on a consecutive prospective study of patients with CNV secondary to PM who were treated with intravitreal bevacizumab (1.25 mg/0.05 ml). Patients underwent complete ophthalmic evaluation, which included best-corrected visual acuity testing measured with Early Treatment Diabetic Retinopathy Study charts, optical coherence tomography (OCT), and fluorescein angiography. RESULTS There were 17 eyes of 17 patients, and the mean age was 55.4 (SD 10.0) years. At the 6-month follow-up, the mean visual acuity improved by 8.4 letters (p = 0.04). Forty-one per cent of patients increased at least one line, and 17% increased more than six lines. There were no cases of moderate vision loss (>or=3 lines) or severe vision loss (>or=6 lines). The mean OCT foveal thickness decreased by 79.6 mum (p = 0.002). Favourable outcomes were obtained in all subgroups. Patients received an average of one injection. As a complication, there was a tear of the retinal pigment epithelium. No other ocular or systemic side effects were observed. CONCLUSION In our study, intravitreal bevacizumab appeared to be safe and efficacious in eyes with CNV secondary to PM.
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Affiliation(s)
- L Arias
- Department of Ophthalmology, Hospital Universitari de Bellvitge, C/Feixa Llarga, sn, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
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Teixidor Casamitjana M, Nahra D, Pujol O, Martinez Giralt O, Vilaplana Blanch D, Poposki V, Alarcon I, Amoros D, Flores Despradel I. 379 Comment corriger l’astigmatisme au cours de l’intervention de la cataracte ? J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Graell X, Caminal JM, Masuet C, Arias L, Rubio M, Pujol O, Roca G, Arruga J. [Age distribution of uveal melanoma and its relationship to survival]. ACTA ACUST UNITED AC 2008; 82:343-7. [PMID: 17573643 DOI: 10.4321/s0365-66912007000600005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To study the age distribution and survival in patients with uveal melanoma. METHODS A retrospective study was performed on 303 patients diagnosed with uveal melanoma. We analysed the clinical characteristics: age, gender, tumor size and origin, follow-up time, systemic state, survival time and cause of death. RESULTS The median age of the patients was 60.09 years. The 2-, 5-, and 10-year survival of patients less than 50 years of age at diagnosis was 91.41%, 81.83% and 61.45% respectively. The 2-, 5- and 10-year survival of patients equal to or older than 50 years was 90.86%, 73.18% and 58.28% respectively. No significant difference was found between these two age groups. When we considered a possible relationship between the sex factor and survival, in patients equal to or older than 50 years of age, we found a higher survival in men than in women (log-rank test; p=0.038). CONCLUSIONS Uveal melanoma in Spain has a similar age distribution to that of other countries, and it is not an infrequent diagnosis in patients under 40 years of age. Survival rates are also similar to that of other series. We have not found any significant difference between the age of our patients and the survival, although if we analysed the subgroups, we found that the men equal to or over 50 years of age had a better survival than the women of the same age.
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Affiliation(s)
- X Graell
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
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Abstract
PURPOSE To study the prevalence of multiple neoplasms in patients affected by uveal melanoma in Spain and to relate these with survival. METHOD We carried out a longitudinal prospective study of the prevalence of multiple neoplasms in patients diagnosed to have a uveal melanoma during the years 1984-2005. The data has been analysed for the following variables: age, sex, date of diagnosis, affected eye, origin and tumoral size, classification according to COMS (Collaborative Ocular Melanoma Study), time of follow-up, presence of other neoplasms, current clinical state, date and cause of death. RESULTS Three hundred and five patients affected by uveal melanoma have been studied in the Ocular Oncology Unit of our institution; 24 patients (7.9%) had evidence in their medical reports of one or more additional neoplasms. Excluding cutaneous neoplasms originating in basal cells, this number reduced to 22 patients (7.2%). We did not find any statistically significant differences among the presentation age, sex or localization of the melanoma (ciliary body or choroid) and the presence or absence of a second neoplasm. When we analysed the proportion of patients with metastatic disease (both alive and dead) who presented with a second neoplasm (40.9%), we found a statistically significant relationship between these variables (Chi-square test, p=0.004). CONCLUSIONS We have observed a percentage of second neoplasms similar to that described in other international studies. We did not find a larger proportion with a second neoplasm according to the sex, age, or tumoral localization, nor did we observe a higher frequency of any particular second neoplasm. We have defined a relationship between metastasic uveal melanoma, and the development of a second neoplasm, which clearly indicates a need for increased systemic follow-up in such patients.
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Affiliation(s)
- J M Caminal
- Hospital Universitario de Bellvitge, Barcelona, Spain.
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Arias L, Garcia-Arumi J, Ramon JM, Badia M, Rubio M, Pujol O. Optical coherence tomography analysis of a randomized study combining photodynamic therapy with intravitreal triamcinolone. Graefes Arch Clin Exp Ophthalmol 2007; 246:245-54. [PMID: 17674020 DOI: 10.1007/s00417-007-0642-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2006] [Revised: 12/31/2006] [Accepted: 01/05/2007] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The objective of the study was to analyze optical coherence tomography (OCT) scan differences between patients with predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) treated with only photodynamic therapy (PDT) and patients treated with PDT combined with intravitreal triamcinolone acetonide (IVTA). METHODS In this prospective study, 61 patients were randomized to receive PDT (n = 30) or PDT combined with IVTA (n = 31). They were evaluated every 3 months with a refraction protocol for best-corrected visual acuity (VA) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts, fluorescein angiography (FA), and OCT. When measuring foveal thickness on OCT scans, neuroretinal foveal thickness (NFT) was differentiated from outer high reflectivity band thickness (OHRBT). The main outcome measures were mean change in OCT measurements and correlation of VA and angiographic area of the lesion with OCT measurements. RESULTS At the 12-month follow-up, the mean change in NFT was not significantly reduced (P = 0.9), but the mean change in OHRBT was significantly lower (P = 0.004) in the group of patients who received combined therapy. There was no correlation between final VA and NFT in either patient group (P = 0.2). The final VA was significantly worse in eyes with a thicker OHRBT (P = 0.04) in the group of patients treated with only PDT. There was no correlation between angiographic area and NFT and OHRBT in either patient group (P > 0.3). There was a statistically significant difference between the pre-treatment angiographic area of the lesion and VA at the 12-month follow-up in the combined therapy group (P = 0.01), and more eyes treated with only PDT presented with intraretinal fluid at the last follow-up (P = 0.01). CONCLUSION Combined PDT+IVTA therapy was more effective than PDT alone at reducing OHRBT. This OCT measurement seems to be have a greater effect on VA than NFT.
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Affiliation(s)
- L Arias
- Department of Ophthalmology, Bellvitge University Hospital, C/Feixa Llarga, S/N L'Hospitalet de Llobregat, Barcelona, Spain.
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Arias L, Garcia-Arumi J, Ramon JM, Badia M, Rubio M, Pujol O. Photodynamic Therapy with Intravitreal Triamcinolone in Predominantly Classic Choroidal NeovascularizationOne-Year Results of a Randomized Study. Ophthalmology 2006; 113:2243-50. [PMID: 16996600 DOI: 10.1016/j.ophtha.2006.04.039] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2006] [Revised: 04/19/2006] [Accepted: 04/21/2006] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To determine whether intravitreal triamcinolone acetonide (IVTA) improves the efficacy of photodynamic therapy (PDT) with verteporfin in predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). DESIGN Prospective randomized study. PARTICIPANTS Sixty-one patients with predominantly classic subfoveal CNV secondary to AMD. METHODS Patients were randomized to receive PDT (n = 30) or PDT followed by approximately 11 mg IVTA (n = 31), with retreatment every 3 months when leakage was documented by fluorescein angiography. At baseline and each follow-up visit, best-corrected visual acuity (VA) was measured with Early Treatment Diabetic Retinopathy Study charts by a certified examiner masked to the patient's treatment, lesion size on fluorescein angiography, and foveal thickness on optical coherence tomography. MAIN OUTCOME MEASURES Mean change in VA (logarithm of the minimum angle of resolution [logMAR]) from baseline, percentage of patients losing fewer than 15 letters (3 lines) of VA, mean change in lesion size, mean change in foveal thickness, and retreatment rate. RESULTS At the 12-month follow-up, VA (mean logMAR change from baseline) was significantly better (P = 0.001) in the group of patients who received combined therapy. Seventy-four percent of patients treated with combined therapy compared with 61% treated with verteporfin alone lost fewer than 15 letters of VA (P = 0.78). Reduction in lesion size (P = 0.001) and in foveal thickness (P = 0.03) was significantly greater with combined therapy than with verteporfin. Retreatment rate was significantly lower (P = 0.04) in the combined therapy group. Triamcinolone-related adverse events included glaucoma (25.8%) and cataract progression (32%). CONCLUSIONS Combined PDT and IVTA therapy seemed to be more effective than PDT alone for managing predominantly classic subfoveal lesions secondary to AMD. The triamcinolone-related adverse events included glaucoma and cataract progression.
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Affiliation(s)
- Luis Arias
- Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain.
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Arias L, Pujol O, Berniell J, Rubio M, Roca G, Castillo L, Acebes E. Impact of lesion size on photodynamic therapy with verteporfin of predominantly classic lesions in age related macular degeneration. Br J Ophthalmol 2005; 89:312-5. [PMID: 15722311 PMCID: PMC1772570 DOI: 10.1136/bjo.2004.050997] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To determine if photodynamic therapy (PDT) outcomes are related to lesion size in patients with subfoveal predominantly classic choroidal neovascularisation (CNV) secondary to age related macular degeneration (AMD). METHODS According to greatest linear dimension (GLD) of the entire lesion determined with fluorescein angiography (FA) patients were divided into two groups. In the first group GLD was <3000 microm and in the second one GLD was 3000-5000 microm. All eyes were treated with standard PDT with the verteporfin protocol. The primary outcome was the proportion of eyes in both groups that did not show significant leakage in FA at the end of follow up. Secondary outcomes were changes in GLD and in best corrected visual acuity (BCVA). RESULTS 64 patients (mean (SD) age, 76.7 (7.7) years; range 58-95 years) were recruited to participate in the study. All participants in the study completed the follow up time (mean 16.6 months). 24 patients (75%) in the group of smaller lesions (n = 32) compared with 15 patients (46.8%) in the group of larger lesions (n = 32) did not show significant leakage in FA at the end of follow up (p = 0.02). A GLD increase >1000 microm was recorded in nine eyes (28.1%) in the group of smaller lesions and in 16 eyes (50%) in the group of larger lesions (p = 0.07). 22 eyes (68.7%) in the group of smaller lesions compared with 19 eyes (59.3%) in the group of larger lesions lost less than three lines of vision (p = 0.06). Relevant side effects related to verteporfin therapy were not recorded, except for four patients (6.2%) with infusion related back pain. CONCLUSIONS These results suggest that lesion size at baseline may be a prognosis factor in PDT in patients with subfoveal predominantly classic CNV secondary to AMD. There are no relevant side effects or safety concerns derived from verteporfin therapy.
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Affiliation(s)
- L Arias
- Department of Ophthalmology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
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Santín M, Badrinas F, Mascaró J, Nolla JM, Pujol O, Roca G, Valverde J, Mañá J, Fernández-Nogués F. [Uveitis: an etiological study of 200 cases following a protocol]. Med Clin (Barc) 1991; 96:641-4. [PMID: 2056797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND To evaluate the usefulness of a systematic study of patients with uveitis and to assess the associated systemic diseases. METHODS 200 patients seen in an outpatient clinic for the evaluation of uveitis between 1981 and 1988 were included in the study. Patients with eye disease associated with drug abuse or human immunodeficiency virus were excluded. The study protocol included an initial clinical and ophthalmological evaluation followed by selected specific investigations. RESULTS Anatomical localization: anterior uveitis 122 (61%), posterior 41 (20.5%), panuveitis 30 (15%) and intermediate 7 (3.5%). ETIOLOGY 74 cases (37%) were secondary, 101 (50.5%) were idiopathic, and 25 (12.5%) were specific syndromes of uveitis of unknown cause. Toxoplasmosis was the most common cause of infective uveitis, and ankylosing spondylitis was the most common noninfective cause. Diagnostic process: group 1, diagnosed by the ophthalmological investigation (25 cases); group 2, diagnosed on the basis of the accompanying clinical features and/or specific investigations (66 cases); and group 3, diagnosed by wider detection methods (8 cases). CONCLUSIONS There was a remarkably high rate uveitis without etiological diagnosis. The evaluation of patients with uveitis requires a careful evaluation of ocular and systemic features, followed by selected specific investigation. The indiscriminate use of diagnostic tests is not warranted.
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Affiliation(s)
- M Santín
- Servicio de Medicina Interna, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona
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