Publications (16)43.03 Total impact
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Article: [Unusual diagnosis of gastric linitis plastica].
Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 02/2009; 101(1):79-80. · 1.55 Impact Factor -
Article: [Laparoscopic radiofrequency of a liver focal lesion of colorrectal origin].
Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 05/2008; 100(4):250-2. · 1.55 Impact Factor -
Article: [Ultrasound-guided biopsy of the pancreas: a multicenter study].
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ABSTRACT: Members of "Asociación de Ecografía Digestiva" decided to carry out a multicenter retrospective study on fine-needle aspiration biopsy for pancreatic space-occupying lesions under ultrasonographic guidance and via the percutaneous route in order to assess this technique s performance versus endoscopic ultrasound-guided biopsy. 10 hospitals for a total of 222 patients with suspiciously malignant, 8-120-mm pancreatic lesions were included in the study. The analysis of results shows a sensitivity of 89%, a specificity of 98%, a positive predictive value of 99%, and a negative predictive value of 74%, for an overall diagnostic accuracy of 91%. No major complications occurred. Percutaneous fine-needle aspiration for pancreatic lesions is highly cost-effective and has few and mild complications.Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 10/2007; 99(9):520-4. · 1.55 Impact Factor -
Article: Clinical trial: pharmacodynamics and pharmacokinetics of re-treatment with fixed-dose induction of peginterferon alpha-2a in hepatitis C virus genotype 1 true non-responder patients.
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ABSTRACT: Patients infected with hepatitis C virus genotype 1 who are true non-responders to previous therapy suffer from a very difficult-to-cure disease. New approaches to treatment are necessary. To explore the efficacy, pharmacokinetics and safety of fixed-dose induction with peginterferon alpha-2a and ribavirin in this difficult-to-cure population. Seventy-five hepatitis C virus genotype 1 true non-responder patients to a previous interferon-based combination regimen were randomised to receive peginterferon alpha-2a 360, 270 or 180 microg/week for 12 weeks, followed by 180 microg/week for 36 weeks, in combination with ribavirin (1000/1200 mg/day). Peginterferon alpha-2a concentration was measured throughout the study. Sustained virological response rates were 38%, 30% and 18%, in the 360, 270 and 180 microg/week groups, respectively (relapse rates: 25%, 50% and 64%, respectively). The area under the serum concentration-time curve of peginterferon alpha-2a from 0-12 weeks increased in a dose-dependent manner (P < 0.0001) and was associated with the sustained virological response (odds ratio: 1.35; 95% CI: 0.89, 2.06). The three regimens were equally well tolerated. Fixed-dose induction of peginterferon alpha-2a resulted in increased drug exposure and improved the likelihood of achieving a cure, without compromising safety in hepatitis C virus genotype 1 true non-responder patients.Alimentary Pharmacology & Therapeutics 10/2007; 26(8):1131-8. · 3.77 Impact Factor -
Article: Treatment of chronic he1patitis C genotype 1 with peginterferon-alpha2a (40 kDa) plus ribavirin under routine clinical practice in Spain: early prediction of sustained virological response rate.
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ABSTRACT: Sustained virological response rates of up to 52% have been obtained with peginterferon alpha2a (40 kDa) plus ribavirin in patients suffering from chronic hepatitis C genotype 1 in randomized-controlled trials. Aim: To assess early virological response and its clinical utility in predicting an sustained virological response in patients suffering from chronic hepatitis C genotype 1 in routine clinical practice in Spain. Treatment-naïve patients received pegylated interferon alpha2a (40 kDa) 180 microg/week plus ribavirin 1000/1200 mg/day for 48 weeks, and were followed for a further 24 weeks. Overall, 475 patients received at least one dose of medication and were included in the efficacy population. The overall sustained virological response rate was 48%. Of those with week 12 virological data, 83% had an early virological response. The negative predictive value of an early virological response was 93%. If sustained virological response is the goal, a treatment-decision based on a 12-week evaluation during routine clinical practice is feasible.Alimentary Pharmacology & Therapeutics 04/2007; 25(8):899-906. · 3.77 Impact Factor -
Article: [Interferon, ribavirin and amantadine in prior nonresponders to interferon and ribavirin therapy with chronic hepatitis C (genotype 1)].
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ABSTRACT: Despite advances in the treatment of chronic hepatitis C virus (HCV), the disease persists after treatment with interferon and ribavirin in a large percentage of patients and other therapeutic options are lacking. We investigated the efficacy of retreatment with antiviral therapy including amantadine. prospective and open pilot study. Thirty-nine patients with chronic HCV, genotype 1, who were nonresponders to interferon and ribavirin were included. The patients were given repeat treatment with interferon-alpha 2A (9 MU/week), ribavirin (1,000-1,200 mg/day) and amantadine (200 mg/day) for 48 weeks. HCV-RNA was undetectable in 5 patients in week 48 (12.8%) and in only 2 patients after 24 weeks of follow-up (5.1% of sustained responses). In patients with basal viremia of < 8 105 U/ml the probability of response at the end of treatment and of sustained response was 26.3 and 10.5%, respectively; in patients with elevated viremias response was 0%. In patients with chronic HCV genotype 1 without response to interferon and ribavirin, triple antiviral therapy with interferon, ribavirin and amantadine is not useful.Gastroenterología y Hepatología 10/2003; 26(8):465-8. · 0.73 Impact Factor -
Article: Lithogenic risk factors for renal stones in patients with Crohn's disease.
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ABSTRACT: Calcium oxalate kidney stones are more common in patients with Crohn's disease (CD). The aims of this study were to verify the prevalence of the main risk factors for calcium oxalate nephrolithiasis in patients with CD and to evaluate the degree of urinary relative supersaturation for calcium oxalate (CaOx), dihydrogen uric acid (DHUA) and monohydrogen calcium phosphate (MHCaP). SUBJECTS AND STUDY PROTOCOL: 42 patients with CD (22 male and 20 female, aged 15-72 years) and 18 controls (8 male and 10 female, aged 26-65) were studied. Nine patients were evaluated during an active episode and 33 in a quiescent phase. All patients had normal glomerular filtration rate. All subjects collected a 24-hr urine sample and fasting venous blood was drawn. Good compliance of urine collection was assessed by the Cockcroft and Gault formula. In urine pH and oxalate (Ox), calcium (Ca), phosphate (P), uric acid (UA), citrate (Cit), magnesium (Mg), sulphate (Sulph), sodium, potassium and chloride concentrations were measured and their excretions calculated. Urinary RS index was obtained using the software EQUIL93. A decreased urinary volume (61.9%) was the most frequent finding. A decreased excretion of Cit, Mg and Sulph (38.1%, 31.0% and 31.0%, respectively) and increased excretion of P, Ox, UA and Ca (33.3%, 23.8%, 16.7% and 14.3%, respectively) were found. Thirty four patients (81.0%) showed at least 2 lithogenic risk factors and only 2 patients showed none. Urine of patients had a higher urinary CaOx and DHUA relative super saturation. Patients studied in an active episode showed a higher urinary CaOx and MHCaP RS than those studied in the quiescent period. The majority of patients with CD have a multifactorial high risk for calcium oxalate and a single patient usually has several metabolic disturbances which are more evident in an active episode.Archivos españoles de urología 05/2001; 54(3):282-92. -
Article: [Hereditary hemochromatosis associated with hypoceruloplasminemia with absence of mutations in the HFE gene]].
Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 10/2000; 92(9):610-1. · 1.55 Impact Factor -
Article: [Gastrointestinal anisakiasis. Seven cases in three months].
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ABSTRACT: Human anisakiasis or anisakidosis is an unusual parasitation. During the autumn of 1996 seven patients came to our Hospital for such a condition. Five of these patients had the parasites in the gastroduodenal area (1 in the gastric body, 3 in the antrum and 1 in the duodenal bulb, this one with two parasites). Four out of the five patients consulted us for intense epigastric pain; only one developed a cutaneous rash. The fifth patient was diagnosed unexpectedly during an endoscopy appointment. Eosinophilia was detected in none. All the parasites were extracted endoscopically and identified as belonging to the Anisakis genera. Excepting for the patient with no complaint, the other four showed adhered larvas to mucosa. The two other patients were operated because of acute abdominal pain. At laparotomy an ileitis was seen and then resected. Under microscopic examination both ileon were found to be edematous and infiltrated by eosinophils. Anisakis larvae were observed in the submucosa of one of the removed intestines. The other patient was diagnosed after an immunologic study consisting of radioimmunoassay and Western Blot. Five of the seven patients (71%) acquired the parasites after consumption of anchovies with vinegar.Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 02/1999; 91(1):70-2. · 1.55 Impact Factor -
Article: [A patient with five synchronous adenocarcinomas of the colon].
Revista espanola de enfermedades digestivas: organo oficial de la Sociedad Espanola de Patologia Digestiva 03/1998; 90(2):124. · 1.55 Impact Factor -
Article: Bilirubinate granules: main pathologic bile component in patients with idiopathic acute pancreatitis.
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ABSTRACT: The aim of this study was to evaluate the main pathologic component of bile obtained by biliary drainage in patients with acute idiopathic pancreatitis and therapeutic implications. Eighteen patients diagnosed with idiopathic acute pancreatitis underwent biliary drainage. Microscopic evaluation of bile was performed and pathologic components were classified in cholesterol microcrystals, bilirubinate granules, and calcium microspherolites. Five patients showed no abnormalities. In 11 patients, bilirubinate granules were found, cholesterol microcrystals in two, and Giardia lamblia in two. Bilirubinate granules are the main pathologic component of bile in patients with acute idiopathic pancreatitis. Cholecystectomy is the preferred therapeutic approach.The American Journal of Gastroenterology 03/1998; 93(3):360-2. · 7.28 Impact Factor -
Article: Calcium metabolism and celiac disease.
The American Journal of Gastroenterology 07/1996; 91(6):1278-9. · 7.28 Impact Factor -
Article: Folliculitis and mesalamine.
The American Journal of Gastroenterology 05/1996; 91(4):819-20. · 7.28 Impact Factor -
Article: [Usefulness of abdominal echography in the diagnosis of active Crohn's disease].
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ABSTRACT: The aim of this study was to evaluate the relevance of the ultrasonography in assessing activity in a series of patients with Crohn's disease. A series of 24 patients with active (Crohn's disease activity index > 150) ileal or ileocolonic Crohn disease underwent abdominal ultrasonography. There was a significant correlation between bowel wall thickening and the Crohn's disease activity index: the higher the bowel wall thickening was the higher were the values of Crohn's disease activity index. Two or more ultrasound studies were performed in 10 patients with bowel wall > 4 mm during treatment, and a progressive normalization of bowel wall size was observed with new thickening when recurrence occurred. A bowel wall thickening (> or = 4 mm) was found in patients with active Crohn's disease. A patient with bowel wall thickness > 6 mm should make us suspect the presence of stenosis. Abdominal ultrasonography is an accurate method in the first assessment of Crohn's disease because its high correlation with the Crohn's disease activity index.Gastroenterología y Hepatología 21(6):272-6. · 0.73 Impact Factor -
Article: Protein-losing enteropathy is associated with peritoneal functional abnormalities in peritoneal dialysis patients.
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ABSTRACT: To evaluate the relationship between acquired peritoneal transport disorders and the presence of protein-losing enteropathy (PLE), and their contribution to the protein malnutrition in peritoneal dialysis (PD) patients. We studied 31 clinically stable PD patients that received a fat overload diet for 3 days. We measured intestinal absorption of fecal fat (normal < 6 g/24-hour stool) and nitrogen (normal < 2 g/24-hr stool), intestinal protein permeability [fecal clearance of alpha1-antitrypsin (Calpha1AT) (normal < 12 mL/24-hr stool)], and nutritional markers [normalized protein nitrogen appearance (nPNA), half-life medium-term proteins, and body mass index]. Peritoneal solute transport was measured by mass transfer coefficient (MTC), and water transport by peritoneal ultrafiltration (UF) capacity. To define protein maldigestion it was necessary to find high fecal nitrogen values with normal Calpha1AT; PLE was defined when both values were elevated. High fecal nitrogen (mean 2.1+/-1 g/24-hr stool) and fat (mean 5.8+/-3.6 g/24-hr stool) were found in 15 patients; 6 patients had high Calpha1AT levels (PLE). These 6 patients showed a worse nutritional status: lower albumin (3.57+/-0.57 g/dL vs 3.98+/-0.38 g/dL, p < 0.05) and transferrin (243+/-70 mg/dL vs 272+/-44.3 mg/dL, p < 0.05), as well as lower triglycerides (131.3+/-31.7 mg/dL vs 187+/-116 mg/dL, p< 0.05). Higher urea MTCs were found in 10 patients, normal in 7, and lower in 14. Higher creatinine MTCs were found in 8 patients, normal in 15, and lower in 8. Normal peritoneal UF capacity was found in 25 and lower in 6 patients. These 6 patients showed higher urea and creatinine MTCs and Calpha1AT. A positive linear correlation between Calpha1AT, urea MTC (r = 0.56, p < 0.01), and creatinine MTC (r = 0.46, p < 0.01) was found. A similar situation occurred between Calpha1AT, fecal fat (r = 0.45, p < 0.05), and fecal nitrogen (r = 0.43, p < 0.05). Thirteen patients with previous history of peritonitis showed higher Calpha1AT than those without peritonitis (10.2+/-8 mL/24-hr stool vs 5.2+/-4.4 mL/24-hr stool, p < 0.05). We confirm that protein and fat malabsorption, maldigestion, and PLE are present in some PD patients. Higher fecal Calpha1AT is associated with malnutrition and poorer showings of the viability markers of peritoneal membrane function.Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 20(3):284-9. · 2.10 Impact Factor -
Article: Hydrogastric sonography in the preoperative staging of gastric cancer.
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ABSTRACT: Depth of wall invasion is the main prognostic factor in gastric cancer. We studied the utility of hydrogastric sonography in the evaluation of transmural infiltration by gastric cancer. Thirty-seven patients with gastric adenocarcinoma were examined before surgery with a 5-MHz probe after the ingestion of 100-400 ml of water (mean, 330 ml). Sonographic results were compared with pathologic classifications obtained after surgery. Of the 37 tumors, 15 were found at surgery to be in the antrum, 10 were in the gastric body, 5 were proximal, and 7 were diffuse. After surgery, tumors were classified as follows: 2 (5%) T1, 4 (11%) T2, 15 (41%) T3, and 16 (43%) T4. Hydrogastric sonography correctly classified 30 (81%) of the 37 tumors. Sonography was correct for 2 (100%) of the 2 T1 tumors, 2 (50%) of the 4 T2 tumors, 13 (87%) of the 15 T3 tumors, and 13 (81%) of the 16 T4 tumors. Five sonographic errors were due to understaging and 4 to overstaging. With regard to tumor site, sonographic results were correct for 4 (57%) of the 7 diffuse tumors, 3 (60%) of the 5 proximal tumors, 9 (90%) of the 10 gastric body tumors, and 14 (93%) of the 15 antral tumors. Hydrogastric sonography is useful for preoperative evaluation of transmural infiltration by gastric cancers, particularly tumors in the antrum or gastric body.Journal of Clinical Ultrasound 27(9):499-504. · 0.81 Impact Factor
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2007
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Hospital Universitario La Paz
Madrid, Madrid, Spain
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