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1.
Alejandra Gordillo Hernández Eduardo Dominguez-Adame Lanuza Auxiliadora Cano Matias Rosario Perez Huertas Katherine Maria Gallardo Rodriguez Purificacion Gallinato Perez Fernando Oliva Mompean 《World journal of gastrointestinal surgery》2015,7(8):170-173
Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. In the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence. 相似文献
2.
Purificacion Magan Angel Otero Angel Alberquilla Jose Manuel Ribera 《BMC health services research》2008,8(1):42
Background
The study of Hospitalizations for ambulatory care sensitive conditions (ACSH) has been proposed as an indirect measure of access to and receipt of care by older persons at the entryway to the Spanish public health system. The aim of this work is to identify the rates of ACSH in persons 65 years or older living in different small-areas of the Community of Madrid (CM) and to detect possible differences in ACSH. 相似文献3.
González-Pinto A Inmaculada F Cristina R de Corres Blanca F Sonsoles E Fernando R Purificacion L 《The International journal of eating disorders》2004,36(4):445-450
OBJECTIVE: This study examined the predictive factors for the physical and mental summary components (PCS and MCS) of quality of life (SF-36) in patients with anorexia nervosa. METHOD: Forty-seven patients with anorexia nervosa were studied. Assessment comprised psychiatric diagnosis by a clinical structured interview for Axis I disorders (SCID-I) and personality disorders (SCID-II), Clinical Global Impression (CGI), and Quality of Life (SF-36). RESULTS: Anorexia nervosa, restrictive type, was diagnosed in 73.9% of the patients and 51% of the patients presented with comorbidity on Axis I or Axis II or both. The predictive variables for the PCS were poor outcome in previous year, comorbidity on Axes I and II, and female gender. The predictive variables for the MCS were the presence of comorbidity in one or the other of the Axis I or II disorders and purging behaviors. DISCUSSION: The current study suggests the importance of comorbidity and purging behaviors in the quality of life of these patients with anorexia nervosa. 相似文献
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de Guzman A Pablo LA Prieto RJ Purificacion VN Que JJ Quia P 《Nurse education today》2008,28(1):48-54
BACKGROUND: While it is true that understanding the attributes and unique distinction of the nursing faculty has been the subject of most of the studies, little is known about how the use of doodles can help surface the persona of the clinical instructors. OBJECTIVE: This study aims to capture the essence or the lebenswelt of the concept of "clinical instructor" from the lens of students' doodles which have been considered as a powerful qualitative tool in articulating individual experiences. METHOD: A total of 195 senior nursing students recruited from a comprehensive university in the Philippines were the subjects in this qualitative study. Data were gathered from self-generated illustrations and written explanations made by the subjects to identify their concept of effective and ineffective clinical instructors. Phenomenological reduction was observed through a repertory grid, where doodles drawn were listed, categorized and thematised to reveal the qualities of the clinical instructor. CONCLUSIONS: The subjective nature of the findings, though not generalizable, has surfaced how doodling can be a potent tool in identifying collective interpretation of the essence of health professions construct such as the one under study. The doodles revealed that an effective clinical instructor (enlightening, engaging and embracing) is one who is able to facilitate the learning of the students as well as being able to establish a harmonious learning atmosphere for and with the students. On the other hand, an ineffective clinical instructor (detrimental, dangling, and disturbing) impedes students' development in the clinical practice by causing conflict through their personal attitudes and their teaching strategies. This can have benefits for clinical instructors, to improve themselves and realize the impact of their attributes to the clinical learning of students. 相似文献
5.
Purificacion Estevez-Garcia Fernando Rivera Sonia Molina-Pinelo Marta Benavent Javier Gómez Maria Luisa Limón Maria Dolores Pastor Julia Martinez-Perez Luis Paz-Ares Amancio Carnero Rocio Garcia-Carbonero 《Oncotarget》2015,6(8):6151-6159
Fluoropyrimidine-based chemotherapy (CT) has been the mainstay of care of metastatic colorectal cancer (mCRC) for years. Response rates are only observed, however, in about half of treated patients, and there are no reliable tools to prospectively identify patients more likely to benefit from therapy. The purpose of our study was to identify a gene expression profile predictive of CT response in mCRC. Whole genome expression analyses (Affymetrix GeneChip® HG-U133 Plus 2.0) were performed in fresh frozen tumor samples of 37 mCRC patients (training cohort). Differential gene expression profiles among the two study conditions (responders versus non-responders) were assessed using supervised class prediction algorithms. A set of 161 differentially expressed genes in responders (23 patients; 62%) versus non-responders (14 patients; 38%) was selected for further assessment and validation by RT-qPCR (TaqMan®Low Density Arrays (TLDA) 7900 HT Micro Fluidic Cards) in an independent multi-institutional cohort (53 mCRC patients). Seven of these genes were confirmed as significant predictors of response. Patients with a favorable predictive signature had significantly greater response rate (58% vs 13%, p = 0.024), progression-free survival (61% vs 13% at 1 year, HR = 0.32, p = 0.009) and overall survival (32 vs 16 months, HR = 0.21, p = 0.003) than patients with an unfavorable gene signature. This is the first study to validate a gene-expression profile predictive of response to CT in mCRC patients. Larger and prospective confirmatory studies are required, however, in order to successfully provide oncologists with adequate tools to optimize treatment selection in routine clinical practice. 相似文献
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Garrote JI Gutiérrez MP Izquierdo RL Dueñas MA Zarzosa P Cañavate C El Bali M Almaraz A Bratos MA Berbel C Rodríguez-Torres A Domingo AO 《The American journal of tropical medicine and hygiene》2004,71(4):403-406
Leishmaniasis has increased in importance in recent years because infection with human immunodeficiency virus (HIV) has emerged as a risk factor for this disease. However, the actual prevalence of leishmaniasis in the general population of Spain is unknown. We present a study of the seroprevalence of infection with Leishmania infantum in the general population of Castilla-Leon, Spain. A random sample of individuals presenting to health care clinics (4,825 sera) and of HIV-infected patients in the autonomous community of Castilla-Leon was collected in 1996. The sero-prevalence of antibodies to L. infantum was determined by an indirect enzyme immunoassay and found to be 4.9% in the general population. There was a significant increase in seroprevalence with age (P = 0.001), from 3.96% in those 14-20 years old to 7.2% in those > 70 years old. There were no significant differences between women and men (5.0% versus 4.9%; P = 0.9534). Seroprevalence was significantly higher in people from rural areas than in those from cities (6.0% versus 3.4%; P = 0.001). Patients infected with HIV had a seroprevalence for L. infantum of 64.0%. No differences were observed between women and men, and prevalence did not increase with age. 相似文献
8.
Perez-Martinez P Garcia-Rios A Delgado-Lista J Delgado-Casado N Malagon MM Marin C Gomez-Luna P Caballero J Perez-Jimenez F Lopez-Miranda J 《The British journal of nutrition》2011,106(4):468-471
The melanocortin-4 receptor (MC4R) is an essential regulator of food intake and energy homeostasis. Previous data suggest an influence of MC4R activity on TAG levels. Thus, the aim of the present study was to determine whether the presence of the rs12970134 polymorphism near the MC4R gene could influence postprandial lipoprotein metabolism in healthy subjects. A total of eighty-eight volunteers were selected, fifty-three homozygous for the common genotype (G/G) and thirty-five carriers for the minor A-allele (G/A and A/A). They were given a fat-rich meal containing 1 g fat and 7 mg cholesterol/kg body weight and vitamin A (60,000 IU/m(2) body surface). Fat accounted for 60 % of energy, and protein and carbohydrates accounted for 15 and 25 % of energy, respectively. Blood samples were taken at time 0, every 1 h until 6 h and every 2·5 h until 11 h. Total cholesterol and TAG in plasma, and cholesterol, TAG and retinyl palmitate in TAG-rich lipoproteins (TRL, large and small TRL) were separated by ultracentrifugation. Individuals carrying the G/G genotype displayed a higher postprandial response of plasma TAG (P = 0·033), total cholesterol (P = 0·019) and large TRL-TAG (P = 0·023) than did carriers of the minor A-allele. Furthermore, G/G subjects showed a greater postprandial response of small TRL-apoB48 than did carriers of the A-allele (P = 0·032). These results suggest that the rs12970134 polymorphism near the MC4R gene region may partly explain the inter-individual differences in postprandial lipoprotein response in healthy subjects. 相似文献
9.
Fernandez-Flores A Valerdiz S Crespo LG Rodriguez-Cernuda P 《The American Journal of dermatopathology》2012,34(2):e15-e18
Areolar hyperplasia is only reported when exaggerated, and even so, exaggerated areolar sebaceous hyperplasia is rare. We have recently seen a case of areolar sebaceous hyperplasia in a 32-year-old woman with Donohue syndrome (leprechaunism), who also had an invasive ductal carcinoma in the same breast. The patient showed typical "elfin-like" face with wide nostrils and thick lips, large and low-set ears, and dysplastic nails. The areola showed a yellowish thickened plaque of 5-cm diameter that corresponded to a hyperplasia of the sebaceous glands. Immunohistochemistry for the mismatch repair proteins (MLH1, MSH2, MSH6, and PMS2) was performed on the sebaceous hyperplasia and on the breast carcinoma, and no lack of expression of the markers was evidenced. We have found no other reported case of areolar sebaceous hyperplasia either in cases of breast carcinoma or in cases of leprechaunism. 相似文献
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