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Mesial temporal sclerosis and epilepsy:a narrative review

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Acta Epileptologica 2024年第3期7卷 178-188页

作者： Daniel Villamizar-Torres Andrea Carolina Cepeda Trillos Alejandro Vargas-Moreno Member of the neurosurgery research group Pontificia Universidad JaverianaBogotá110231Colombia Radiology deparment Hospital Universitario San IgnacioBogotá110231Colombia Member of the epilepsy research group Pontificia Universidad JaverianaBogotá110231Colombia Neurosurgery department Hospital Universitario San IgnacioBogotá110231Colombia

Mesial temporal sclerosis(MTS)stands out as a prevalent etiology of medically intractable temporal lobe *** the pathological alterations,clinical manifestations and risk factors of MTS is crucial for the recognition and suspicion of this *** this paper,we provide a comprehensive narrative review on the pathophysiology,clinical manifestations,and treatment options for *** doing so,we aim to provide an up-to-date understanding of this condition.

关键词： Hippocampal sclerosis Epilepsy Temporal lobe Hippocampus

Impact of aspiration catheter size on first-pass effect in the combined use of contact aspiration and stent retriever technique

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Stroke & Vascular Neurology 2021年第4期6卷 553-560页

作者： Carlos Pérez-García Christian Maegerlein santiago Rosati Charlotte Rüther Carlos Gómez-Escalonilla Claus Zimmer Juan Arrazola Maria Teresa Berndt Manuel Moreu Interventional Neuroradiology Hospital Clinico Universitario San CarlosMadridSpain Department of Diagnostic and Interventional Neuroradiology Klinikum rechts der Isar der Technischen Universitat MunchenMunchenBayernGermany Neurology Hospital Clinico Universitario San CarlosMadridSpain Radiology Hospital Clinico Universitario San CarlosMadridSpain

Background and purpose The first-pass effect(FPE),defined as a first-pass Expanded Treatment in Cerebral Ischaemia(eTICI)2c/3 reperfusion,has emerged as a key metric of efficacy in mechanical thrombectomy(MT)for acute ischaemic *** proximal balloon occlusion together with direct thrombus aspiration during stent retriever thrombectomy(PROTECT)-PLUS technique consists in the use of a balloon guide catheter and a combined MT approach involving contact aspiration and a stent *** aim of this study is to assess the effectiveness and safety of the PROTECT-PLUS technique using distal aspiration catheters(DACs)with different inner diameters by comparing the large-bore DAC Catalyst 7 versus the use of medium-bore *** Retrospective analysis of a prospectively maintained database of patients treated with PROTECT-PLUS using Catalyst 7,Catalyst 6 or Catalyst 5 with an occlusion of either the terminal carotid artery or the M1 or M2 segments of the middle cerebral artery from 2018 to 2020 in two comprehensive stroke *** characteristics and procedural,safety and clinical outcomes were compared between *** logistic regression analysis was performed in order to find independent predictors of *** We identified 238 consecutive patients treated with PROTECT-PLUS as front-line approach using Catalyst 7(n=86),Catalyst 6(n=78)and Catalyst 5(n=76).The rate of FPE was higher with Catalyst 7(54%)than Catalyst 6(33%,p=0.009)and Catalyst 5(32%,p=0.005),in addition to higher final eTICI 2c/3 reperfusion rates,shorter procedural times,lower need of rescue therapy and fewer procedure-related *** multivariable analysis the sole independent factor associated to FPE was the use of Catalyst 7(OR 2.34;95%CI 1.19 to 4.58;p=0.014).Conclusion Further development of combined MT by incorporating larger-bore aspiration catheters is associated with higher reperfusion rates,shorter procedure times,and lower need of rescue therapy wh

关键词： shorter effect maintained

Exclusive breastfeeding greater than 50%, success of education in a university hospital in Bogotá: Case-control study

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World Journal of Clinical Pediatrics 2024年第1期13卷 23-30页

作者： Marcela Murillo Galvis Sofia Ortegon Ochoa Clara Eugenia Plata García Maria Paula Valderrama Junca Dayanna Alejandra Inga Ceballos Daniel Mauricio Mora Gómez Claudia M Granados Martin Rondón Department of Pediatrics Hospital Universitario San IgnacioBogotá110111Colombia Department of Clinical Epidemiology and Biostatistics Pontifica Universidad JaverianaBogotá110111Colombia

BACKGROUND Maintenance rates of exclusive breastfeeding(EBF)worldwide are low,thus,one of the objectives of the summary of policies on breastfeeding(BF)in world nutrition goals for 2025 are that at least 50%of infants under six months of age receive EBF that *** Objective of this study is to document the rates of EBF in children born in san ignacio University hospital(HUSI)and identify factors associated with *** To document the percentages of EBF in those that were born at HUSI and identify factors associated to their *** This is a study of cases and controls in an analytic,retrospective cohort that took children born alive between January 2016 and January 2019 at HUSI located in the city of Bogotá,*** Receiving information about BF at HUSI was able to maintain EBF up until 4 mo(OR=1.65;95%CI:1.02-2.66).The presence of gynecologic and obstetric comorbidities(OR=0.32;95%CI:0.12-0.83),having mastitis(OR=0.56;95%CI:0.33-0.94),and receiving information from mass media(OR=0.52;95%CI:0.31-0.84)are factors associated with not maintaining *** Receiving education at a Women-and Child-Friendly Institution was the only significant factor to achieve EBF until 4 mo,with a frequency greater than the one reported in the country,which matches multiple studies where counseling and individualized support on BF achieve this *** about BF and early detection of obstetric/gynecologic complications must be strengthened among the healthcare staff in charge of mothers during ***,strategies must be promoted to continue BF such as creating milk banks with the objective of increasing BF rates even when mothers return to work.

关键词： Breastfeeding Women-and Child-Friendly Institutional Strategy Strategies Adherence Education

Minimally Invasive Surgical Approach for Spinal Canal Tumors—Technique Description and Experience from a Reference Center

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Journal of Cancer Therapy 2017年第3期8卷 268-277页

作者： Miguel Berbeo Roberto Diaz Juan Carlos Perez Manuel Giraldo-Grueso santiago Gutierrez María Camila Villegas Juan Acevedo Oscar Feo Lee Oscar Zorro Juan Gomez Carlos Lindado Pablo Harker Juan Sardi hospital universitario san ignacio Pontificia Universidad Javeriana Bogotá Colombia

Background: Spinal canal tumors are difficult to diagnose and treat. The traditional surgical approaches for attempting a complete excision of these lesions frequently involve big incisions and tissue dissection with high risk of postop instability and cerebrospinal fluid leakage. Also, there is a risk of neurological worsening, sometimes irreversible. Methods: We present our experience in a patient series with spinal canal tumors and describe the surgical approach with minimally invasive techniques (MIS). All of them were performed by the Neurosurgery team of the hospital universitario san ignacio during the period of 2011-2016. Results: We reviewed forty patients with spinal canal tumors surgically treated with MIS techniques. 15 patients (37.5%) had Meningioma diagnosis (complete resection in 11 (73.3%), subtotal in 3 (20%) and biopsy in one patient), 10 patients (25%) with Schwannomas reached complete resection in 70% and subtotal in 30%. 5 patients had spinal cord metastasis, with complete resection in 4 patients (80%) and subtotal in 1 (20%). Other included ependymoma, astrocytoma, and miscellaneous. No patient has had cerebrospinal fluid leakage and no postoperative fusion has been required. Conclusions: The minimally invasive approach allowed complete tumors removal in a high number of patients and good postoperative results. These findings are similar and in some cases, better than the reported with traditional techniques. This MIS technique provides encouraging results. It requires a wide learning curve and a high degree of surgical experience.

关键词： Spinal Tumors Minimally Invasive Spine Surgery Surgical Technique

Minimally invasive nephrectomy for inflammatory renal disease

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Asian Journal of Urology 2020年第4期7卷 345-350页

作者： Paula Andrea Pena Lynda Torres-Castellanos German Patino Stefania Prada Luis Gabriel Villarraga Nicolas Fernandez Pontificia Universidad Javeriana School of MedicineBogota D.C.Colombia Department of Urology Hospital Universitario San IgnacioPontificia Universidad JaverianaSchool of MedicineBogota D.C.Colombia Division of Urology Hospital Universitario San IgnacioPontificia Universidad JaverianaBogota D.C.Colombia Division of Urology Hospital Universitario San IgnacioPontificia Universidad JaverianaSchool of MedicineBogota D.C.Colombia Department of Urology Fundacion Santa Fe de BogotaColombia Division of Urology Hospital for SickKidsUniversity of TorontoTorontoCanada

Objective:Once chronic inflammatory renal disease(IRD)develops,it creates a severe peri-fibrotic process,which makes it a relative contraindication for minimally invasive surgery(MIS).Our objective is to show that laparoscopic nephrectomy(LN)is a surgical option in IRD with fewer complications and better ***:Retrospective review of patients who underwent a modified-surgical laparoscopic transperitoneal nephrectomy was *** search included all operated patients between May 2013 and May 2018 that had a pathology result with any renal inflammatory condition(xanthogranulomatous pyelonephritis,chronic nephritis,and renal tuberculosis).We describe intra-operative variables such as operative time,blood loss,conversion rate,postoperative complications and length of hospital ***:There were 51 patients who underwent laparoscopic nephrectomy with a confirmatory pathology report for *** identified four(8%)major complications;three of them required transfusion and one conversion to open *** mean operative time was 233108 *** estimated blood loss was 206242 mL excluding the conversion cases and 281423 mL including *** mean length of hospital stay was 3.02.0 ***:Laparoscopic nephrectomy for IRD can safely be *** is a reproducible technique with low risks and complication *** experience supports that releasing the kidney first and leaving the hilum for the end is a safe approach when vascular structures are embedded into a single block of inflammatory and scar tissue.

关键词： Inflammation Kidney diseases Laparoscopy Minimally invasive surgical procedures Nephrectomy Nephritis Nephroureterectomy

Successful treatment of psychosis induced by interferon alpha and ribavirin with paliperidone:first case reported

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General Psychiatry 2019年第4期32卷 214-217页

作者： Carmen Maura Carrillo de Albornoz Calahorro Maria Isabel Navarrete Paez Margarita Guerrero Jimenez Luis Gutierrez Rojas Psychiatry Hospital Universitario Virgen de las NievesGranadaSpain hospital universitario san Cecilio University of GranadaGranadaSpain

Several clinical studies have shown a large number of mental symptoms by immunomodulatory treatment with interferon (IFN). The most frequently described symptoms are depression, suicidal behaviour, manic symptoms, anxiety, psychosis and delirium, associated with other non-specific symptoms such as fatigue, irritability, psychomotor retardation, decreased libido, insomnia, difficulty in concentration and attention. Having a history of mental disorder contraindicates the use of IFN-alpha. These adverse effects that affect the mental state appear usually at the beginning of the treatment (most after 3 weeks of treatment). The incidence of psychotic episodes is low and the episodes usually remit when treatment is interrupted;only some cases require antipsychotic treatment. We present the case of a patient affected with hepatitis C who began to present self-referential delirious symptoms after receiving the treatment with IFN and who was successfully treated with paliperidone. This patient could be classified within the group of high-risk psychiatric patients given the family history of schizophrenia and his personal history of illegal drug consumption. The pharmacological actions of paliperidone are similar to other high potency atypical antipsychotics.丁he receptorbinding profile of paliperidone most closely resembles that of risperidone and ziprasidone. Paliperidone differs from risperidone and most other antipsychotics by its relatively low extent of enzymatic hepatic metabolism. To the best of our knowledge, this is the first case described that was successfully treated with paliperidone.

关键词： psychosis interferon alpha ribavirin

Dependence of dynamic contour and Goldmann applanation tonometries on peripheral corneal thickness

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International Journal of Ophthalmology(English edition) 2017年第10期10卷 1521-1527页

作者： Federico Saenz-Frances Claudia sanz-Pozo Lara Borrego-sanz Luis Ja?ez Laura MoralesFernandez Jose Maria Martinez-de-la-Casa Julian Garcia-sanchez Julian Garcia-Feijoo Enrique santos-Bueso Ophthalmology Department Clinico Universitario San Carlos HospitalComplutense University Institute of Knowledge Technology Complutense University

AIM：To determine the effects of peripheral corneal thickness（PCT）on dynamic contour tonometry（DCT）and Goldmann applanation tonometry（GAT）.METHODS：A cross-sectional *** created a software which calculates the corneal contour（CC）as a function of the radius from the corneal apex to each pixel of the *** software generates a central circumference with a radius of 1 mm and the remainder of the cornea is segmented in 5 rings concentric with corneal apex being its diameter not constant around the corneal circumference as a consequence of the irregular CC but keeping constant the diameter of each ring in each direction of the *** was determined as the mean thickness of the most eccentric *** weighted scatterplot smoothing（LOWESS）regression was used to determine the pattern of the relationship between PCT and both DCT and GAT ***,two multivariable linear regression models were *** each of them,the dependant variable was intraocular pressure（IOP）as determined using GAT and DCT *** both of the models the predictive variable was PCT though LOWESS regression pattern was used to model the relationship between the dependant variables and the predictor *** and sex were also introduced control variables along with their first-degree interactions with *** outcome measures include amount of IOP variation explained through regression models（R2）and regression coefficients（B）.RESULTS：Subjects included 109 eyes of 109 healthy *** regression suggested that a 2nd-degree polynomial would be suitable to model the relationshipbetween both DCT and GAT with *** PCT was introduced in both models as a linear and quadratic *** age nor sex nor interactions were statistically significant in both *** GAT model,R2was 17.14%（F=9.02;P=0.0002）,PCT linear term B was-1.163（95%CI：-1.163,-0.617）.PCT quadratic term B was 0.00081（95%CI：0.00043,0.00118）.For DCT model R2was 14.28%（F=9.29;P=0.0002

关键词： Goldmann applanation tonometry dynamic contour tonometry peripheral corneal thickness corneal thickness

Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

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Journal of Geriatric Cardiology 2021年第1期18卷 20-29页

作者： Juan Martínez-Milla Marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía Marta López Castillo Ana Devesa Arbiol Ana Lucía Rivero Monteagudo María Luisa Martín Mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan Antonio Franco-Pelaéz JoséTuñón Department of Cardiology Hospital Universitario Fundación Jiménez Díaz-Quirónsalud Centro Nacional de Investigaciones Cardiovasculares MadridSpain Department of Cardiology Hospital Central de Asturias Department of Cardiology Hospital Universitario Ruber-Quirónsalud Department of Cardiology Hospital Universitario Infanta Leonor Department of Endocrinology Hospital Clínico San Carlos Universidad Autónoma de Madrid CIBERCV MadridSpain

OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 *** AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^*** analyzed the relationship between treatment with BB and mortality or cardiovascular *** mean age of our population was 82.6±4.1 *** ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,andhospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;P<0.001).Patients receiving BB consistently showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,P<0.0001),stage IIIb(GFR 30-45 m L/min per 1.73 m^2;HR=0.55,95%CI:0.26-1.06,P=0.007),and stages IV and V(GFR<30 m L/min per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).CONCLUSIONS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better *** of BB should be encouraged when possible.

关键词： CKD GFR Beta-blocker therapy in elderly patients with renal dysfunction and heart failure

Diabetes mellitus, revascularization and outcomes in elderly patients with myocardial infarction-related cardiogenic shock

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Journal of Geriatric Cardiology 2020年第10期17卷 604-611页

作者： Miquel Gual Albert Ariza-Solé María García Márquez Cristina Fernández JoséL Bernal Francesc Formiga María-Isabel Barrionuevo JoséC Sánchez-Salado Victòria Lorente Júlia Pascual Isaac Llaó Oriol Alegre Angel Cequier Javier Elola hospital Universitari de Bellvitge L’Hospitalet de LlobregatBarcelonaSpain Fundación Instituto para la Mejora de la Asistencia sanitaria MadridSpain hospital Clínico universitario san Carlos MadridSpain hospital universitario 12 de Octubre MadridSpain

Background The prognostic role of diabetes mellitus(DM)in elderly patients with myocardial infarction-related cardiogenic shock(MI-CS)remains *** information exists about the impact of intensive cardiac care unit(ICCU)and revascularization on outcomes of elderly patients with *** aimed to assess the prognostic impact of DM according to age in patients with MI-CS,and to analyze the impact ICCU management and revascularization on in-hospital mortality in MI-CS patients at older *** Discharge episodes with diagnosis of CS associated with MI were selected from the Spanish National Health System’s Basic Data *** were classified according to their availability of *** outcome measured was in-hospital *** A total of 23,590 episodes of MI-CS were identified,of whom 12,447(52.8%)were in patients aged≥75 *** impact of DM on in-hospital mortality was different among age *** in younger patients,DM was associated to a higher mortality risk(0.52 vs.0.47,OR=1.12,95%CI:1.06–1.18,χ^2hospitals with ICCU(adjusted mortality rate:74.2%vs.77.7%,P<0.001)and in patients undergoing revascularization(74.9%vs.77.3%,P<0.001).Conclusions Prognostic impact of DM in patients with MI-CS was different according to age,with a significantly lower impact at older *** availability of ICCU and revascularization were associated with better outcomes in these complex patients.

关键词： Cardiogenic shock Diabetes mellitus Myocardial infarction Revascularization The elderly