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Redondo S, De Dios A, Gomis-Pastor M, Esquirol A, Aso O, Triquell M, Moreno ME, Riba M, Ruiz J, Blasco A, Tobajas E, González I, Sierra J, Martino R, García-Cadenas I. Feasibility of a new model of care for allogeneic stem cell transplantation recipients facilitated by eHealth: The MY-Medula pilot study. Transplant Cell Ther 2023:S2666-6367(23)01175-2. [PMID: 36948273 DOI: 10.1016/j.jtct.2023.03.016] [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: 02/03/2023] [Revised: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND The use of allogeneic stem cell transplantation (allo-SCT) for the treatment of hematologic diseases is steadily increasing. However, allo-SCT has the downside of causing considerable treatment-related morbidity and mortality. Mobile technology applied to healthcare (mHealth) has proven to be a cost-effective strategy to improve care and offer new services to people with multimorbidity, but there are few data on its usefulness in allo-SCT recipients. OBJECTIVE The aim of this report was to describe a new integrated healthcare model facilitated by an mHealth platform, named EMMASalud-MY-Medula, and to report the results of a le. STUDY DESIGN The MY-Medula platform development approach consisted of 4 phases. Firstly, patient and healthcare professional needs were identified and technological development and pre-testing tests were conducted (phases 1-3, January 2016-March 2021). Then, a non-randomized, prospective, observational, single-center pilot study was conducted (October 2021-January 2022) at the adult Stem Cell Transplant Unit of a tertiary university hospital. RESULTS Twenty-eight volunteer allo-SCT recipients were included in the pilot study. Fifty percent were outpatients in the first-year post-SCT and the remaining 50% were affected by steroid-dependent graft-versus-host disease (SR-GVHD). All patients used MY-Medula application during the two-month follow-up period with a median number of visits to the application of 143 (range 6-477). A total of 2067 self-monitoring records were made, and 205 text messages were received, most of them related to symptoms description (47%) and doubts about medication (21%). In 3.4% of the cases drug dose adjustments were performed by the pharmacist because of dosing errors or interactions. At the end of the study, a 6-question Likert-type questionnaire for patients and a 22-question test for healthcare professionals showed a high degree of satisfaction (95% and 100% respectively) with the new healthcare pathway. CONCLUSIONS Re-engineering allo-SCT recipients follow-up into an integrated, multidisciplinary model of care facilitated by mHealth tools is feasible and has been associated with a high usability and degree of satisfaction by patients and healthcare professionals. A randomized trial aiming to determine the cost-effectiveness of MY-Medula-based follow-up post-SCT is currently enrolling participants.
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Affiliation(s)
- S Redondo
- Hematology Department, Hospital de la Santa Creu i Sant Pau. IIB-Sant Pau and José Carreras Leukemia Research Institutes. Departamento de Medicina, Universitat Autónoma de Barcelona, Spain.
| | - A De Dios
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau.; Digital Health Department, Hospital de la Santa Creu i Sant Pau
| | - M Gomis-Pastor
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau.; Digital Health Department, Hospital de la Santa Creu i Sant Pau
| | - A Esquirol
- Hematology Department, Hospital de la Santa Creu i Sant Pau. IIB-Sant Pau and José Carreras Leukemia Research Institutes. Departamento de Medicina, Universitat Autónoma de Barcelona, Spain
| | - O Aso
- Hematology Nursing Department, Hospital de la Santa Creu i Sant Pau
| | - M Triquell
- Hematology Nursing Department, Hospital de la Santa Creu i Sant Pau
| | - M E Moreno
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau
| | - M Riba
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau
| | - J Ruiz
- Nutrition and Dietetics Department, Hospital de la Santa Creu i Sant Pau
| | - A Blasco
- Nutrition and Dietetics Department, Hospital de la Santa Creu i Sant Pau
| | - E Tobajas
- Psycho-Oncology Department, Hospital de la Santa Creu i Sant Pau
| | - I González
- Hematology Nursing Department, Hospital de la Santa Creu i Sant Pau
| | - J Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau. IIB-Sant Pau and José Carreras Leukemia Research Institutes. Departamento de Medicina, Universitat Autónoma de Barcelona, Spain
| | - R Martino
- Hematology Department, Hospital de la Santa Creu i Sant Pau. IIB-Sant Pau and José Carreras Leukemia Research Institutes. Departamento de Medicina, Universitat Autónoma de Barcelona, Spain
| | - I García-Cadenas
- Hematology Department, Hospital de la Santa Creu i Sant Pau. IIB-Sant Pau and José Carreras Leukemia Research Institutes. Departamento de Medicina, Universitat Autónoma de Barcelona, Spain
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Arias-de la Torre J, Fernández-Villa T, Molina AJ, Amezcua-Prieto C, Mateos R, Cancela JM, Delgado-Rodríguez M, Ortíz-Moncada R, Alguacil J, Redondo S, Gómez-Acebo I, Morales-Suárez-Varela M, Blázquez Abellán G, Jiménez Mejías E, Valero LF, Ayán C, Vilorio-Marqués L, Olmedo-Requena R, Martín V. Psychological Distress, Family Support and Employment Status in First-Year University Students in Spain. Int J Environ Res Public Health 2019; 16:ijerph16071209. [PMID: 30987309 PMCID: PMC6480047 DOI: 10.3390/ijerph16071209] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 01/04/2023]
Abstract
Mental disorders are consistently and closely related to psychological distress. At the start of the university period, the relationship between a student's psychological distress, family support, and employment status is not well-known. The aims of this study were: To determine the prevalence of psychological distress in first-year university students and to analyze its relationship with family support and the student's employment status. Data from 4166 first-year university students from nine universities across Spain were considered. The prevalence of psychological distress was obtained using the GHQ-12, a valid and reliable screening tool to detect poor mental health. To analyze the relationship between psychological distress, family support, and employment status, logistic regression models were fitted. Regarding the prevalence found, 46.9% of men and 54.2% of women had psychological distress. In both genders, psychological distress levels increased as family support decreased. Among women, psychological distress was associated with their employment status. The prevalence of psychological distress among first-year university students in Spain is high. In addition, family support, and employment status for women, could be factors to take into account when developing psychological distress prevention strategies at the beginning of the university period.
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Affiliation(s)
- Jorge Arias-de la Torre
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, 08005 Barcelona, Spain.
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain.
| | - Tania Fernández-Villa
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain.
| | - Antonio José Molina
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain.
| | - Carmen Amezcua-Prieto
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
- Biosanitary Research Institute of Granada (ibs.GRANADA), University Hospitals of Granada-University of Granada, 18071 Granada, Spain.
| | - Ramona Mateos
- Department of Preventive Medicine and Public Health, University of Salamanca, 37007 Salamanca, Spain.
| | - José María Cancela
- Faculty of Education Sciences & Sports, University of Vigo, HealthyFit Research Group Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, 36005 Pontevedra, Spain.
| | - Miguel Delgado-Rodríguez
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Division of Preventive Medicine and Public Health, University of Jaén, 23071 Jaén, Spain.
| | - Rocío Ortíz-Moncada
- Departments of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain.
- Research group on Food and Nutrition-Research group of Public Health, University of Alicante, 03690 Alicante, Spain.
| | - Juan Alguacil
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Research Center on Natural Resources, Health, and Environment (RENSMA), University of Huelva, 21071 Huelva, Spain.
| | - Susana Redondo
- Gerencia de Servicios Sociales, Comisionado Regional para la Droga, 47009 Valladolid, Spain.
| | - Inés Gómez-Acebo
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- IDIVAL, University of Cantabria, 39011 Santander, Spain.
| | - María Morales-Suárez-Varela
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of Valencia, 46100 Burjassot, Spain.
| | - Gemma Blázquez Abellán
- Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, University of Castilla-La Mancha, 13071 Albacete, Spain.
| | - Eladio Jiménez Mejías
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
- Biosanitary Research Institute of Granada (ibs.GRANADA), University Hospitals of Granada-University of Granada, 18071 Granada, Spain.
| | - Luis Félix Valero
- Department of Preventive Medicine and Public Health, University of Salamanca, 37007 Salamanca, Spain.
| | - Carlos Ayán
- Faculty of Education Sciences & Sports, University of Vigo, HealthyFit Research Group Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, 36005 Pontevedra, Spain.
| | - Laura Vilorio-Marqués
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain.
| | - Rocío Olmedo-Requena
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18071 Granada, Spain.
- Biosanitary Research Institute of Granada (ibs.GRANADA), University Hospitals of Granada-University of Granada, 18071 Granada, Spain.
| | - Vicente Martín
- The Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS)/Instituto de Biomedicina (IBIOMED), Universidad de León, 24071 León, Spain.
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Affiliation(s)
- Nuria Giménez
- Unidad de Investigación, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Comité Ético de Investigación Clínica, Hospital Universitario Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Laboratorio de Toxicología, Universitat Autònoma de Barcelona, Barcelona, España.
| | - David Pedrazas
- Unidad de Investigación, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España; ABS Abrera, Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona, España; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Susana Redondo
- Comité Ético de Investigación Clínica, Hospital Universitario Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Servicio de Farmacia, Hospital Universitario Mútua Terrassa, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España
| | - Salvador Quintana
- Comité Ético de Investigación Clínica, Hospital Universitario Mútua Terrassa, Universitat de Barcelona, Barcelona, España
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Dalmau A, Fustran N, Camprubi I, Sanzol R, Redondo S, Ramos E, Torras J, Sabaté A. Analgesia with continuous wound infusion of local anesthetic versus saline: Double-blind randomized, controlled trial in hepatectomy. Am J Surg 2017; 215:138-143. [PMID: 28958651 DOI: 10.1016/j.amjsurg.2017.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 04/03/2017] [Accepted: 09/15/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Surgical wound is source of pain in hepatectomy with laparotomy. Continuous wound infusion of ropivacaine may provide effective analgesia. METHODS This prospective, randomized trial, patients scheduled for hepatectomy received a 48-h preperitoneal continuous wound infusion of either 0.23% ropivacaine or 0.9% saline at 5 ml/h. Primary endpoint was 48 h morphine consumption. RESULTS 53 patients included in the ropivacaine group and 46 in the saline group. Morphine consumption was 24.63 mg in the ropivacaine group, and 26.78 mg (p = 0.669) in the saline group. Pain was comparable between groups and there were no differences in solid food intake, ambulation, or length of hospital stay. No local or systemic complications were recorded. CONCLUSIONS Continuous wound infusion with ropivacaine is safe, but it neither reduced morphine consumption nor enhanced recovery in patients undergoing hepatectomy. Success of enhanced recovery in hepatectomy is not influenced by the analgesic regimen if pain is well controlled.
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Affiliation(s)
- Antònia Dalmau
- Acute Pain Clinic Division, Department of Anesthesia, Reanimation and Pain Clinic, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain.
| | - Noelia Fustran
- Department of Anesthesia, Reanimation and Pain Clinic, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain
| | - Imma Camprubi
- Anesthesia Divison General Surgery, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain
| | - Resurrección Sanzol
- Anesthesia Divison Ambulatory Surgery, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain
| | - Susana Redondo
- Department of Anesthesia, Reanimation and Pain Clinic, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain
| | - Emilio Ramos
- Hepatic Surgery Unit, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain
| | - Jaume Torras
- Department of Hepatic Surgery, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain
| | - Antoni Sabaté
- Department of Anesthesia, Reanimation and Pain Clinic, Hospital Universitari de Bellvitge, Universitat de Barcelona Health Campus, IDIBELL, Barcelona, Spain
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Gornals JB, Consiglieri C, Redondo S. SpyGlass DS-guided conversion of transmural pancreaticogastrostomy drainage to transpapillary drainage by rendezvous via a lumen-apposing metal stent. Endoscopy 2017; 49:E97-E98. [PMID: 28192806 DOI: 10.1055/s-0043-100216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Joan B Gornals
- Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Catalonia, Spain
| | - Claudia Consiglieri
- Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Catalonia, Spain
| | - Susana Redondo
- Department of Anaesthesiology, Hospital Universitari de Bellvitge-IDIBELL Catalonia, Spain
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Osorio S, Casado L, Giraldo P, Maestro B, Andrade M, Redondo S, García-Gutiérrez V, Ayala R, Garcia N, Steegmann J. Leucemia mieloide crónica en España: sus características de presentación han cambiado. Sección española del registro poblacional EUTOS. Rev Clin Esp 2016; 216:293-300. [DOI: 10.1016/j.rce.2016.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 01/19/2016] [Accepted: 03/02/2016] [Indexed: 11/27/2022]
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Osorio S, Casado L, Giraldo P, Maestro B, Andrade M, Redondo S, García-Gutiérrez V, Ayala R, Garcia N, Steegmann J. Chronic myeloid leukaemia in Spain: Its presentation characteristics have changed. Spanish section of the EUTOS population-based registry. Rev Clin Esp 2016. [DOI: 10.1016/j.rceng.2016.04.002] [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: 10/21/2022]
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Giménez N, Pedrazas D, Redondo S, Quintana S. [Informed consent process in clinical trials: Insights of researchers, patients and general practitioners]. Aten Primaria 2016; 48:518-526. [PMID: 26777978 PMCID: PMC6877861 DOI: 10.1016/j.aprim.2015.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Adequate information for patients and respect for their autonomy are mandatory in research. This article examined insights of researchers, patients and general practitioners (GPs) on the informed consent process in clinical trials, and the role of the GP. DESIGN A cross-sectional study using three questionnaires, informed consent reviews, medical records, and hospital discharge reports. SETTING GPs, researchers and patients involved in clinical trials. PARTICIPANTS Included, 504 GPs, 108 researchers, and 71 patients. RESULTS Consulting the GP was recommended in 50% of the informed consents. Participation in clinical trials was shown in 33% of the medical records and 3% of the hospital discharge reports. GPs scored 3.54 points (on a 1-10 scale) on the assessment of the information received by the principal investigator. The readability of the informed consent sheet was rated 8.03 points by researchers, and the understanding was rated 7.68 points by patients. Patient satisfaction was positively associated with more time for reflection. CONCLUSIONS GPs were not satisfied with the information received on the participation of patients under their in clinical trials. Researchers were satisfied with the information they offered to patients, and were aware of the need to improve the information GPs received. Patients collaborated greatly towards biomedical research, expressed satisfaction with the overall process, and minimised the difficulties associated with participation.
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Affiliation(s)
- Nuria Giménez
- Unidad de Investigación, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Comité Ético de Investigación Clínica, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Laboratorio de Toxicología, Universitat Autònoma de Barcelona, España.
| | - David Pedrazas
- Unidad de Investigación, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España; ABS Abrera, Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona, España; Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Susana Redondo
- Comité Ético de Investigación Clínica, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, España; Servicio de Farmacia, Hospital Universitari Mútua Terrassa, Fundación para la Investigación Mútua Terrassa, Universitat de Barcelona, Barcelona, España
| | - Salvador Quintana
- Comité Ético de Investigación Clínica, Hospital Universitari Mútua Terrassa, Universitat de Barcelona, Barcelona, España
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Gornals JB, Consiglieri CF, Busquets J, Salord S, de-la-Hera M, Secanella L, Redondo S, Pelaez N, Fabregat J. Endoscopic necrosectomy of walled-off pancreatic necrosis using a lumen-apposing metal stent and irrigation technique. Surg Endosc 2015; 30:2592-602. [PMID: 26335077 DOI: 10.1007/s00464-015-4505-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 12/26/2014] [Accepted: 08/03/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND Endoscopic management of walled-off pancreatic necrosis (WOPN) is an area of great interest with many still unanswered questions, including the role of mechanical necrosectomy versus irrigation. The aim of this study was to evaluate a new method of endoscopic transmural necrosectomy. METHODS Patients with WOPN after necrotizing pancreatitis, who underwent endoscopic transmural necrosectomy using a lumen-apposing metal stent with vigorous irrigation sessions, were prospectively recruited between September 2011 and August 2014. Initial endoscopic session was performed by EUS-guided drainage and lavage sessions by flushing saline through the stent. Technical and clinical success rates, number of repeat interventions, and adverse events were analyzed. RESULTS Twelve patients with 13 WOPN collections (median size 12.4 ± 2.94 cm) underwent endoscopic treatment. Clinical success was achieved in 100 % of cases after a median of three sessions per patient (range 2-8). The median length of hospitalization was 15.9 days. Median procedure time of the access session was 31 ± 10.16 min. No adverse events (AE) were described during the procedures or 24 h after. There were four AE (two infections and two bleedings) between sessions, but only two were severe (16.6 %). There was no need for surgery, and no mortalities occurred. Mean time to stent retrieval was 9 ± 3.4 weeks. Mean follow-up was 13 months with only one recurrence at 12 months after stent removal. CONCLUSIONS This new variant of irrigation endoscopic transmural necrosectomy without mechanical debridement helps to simplify the technique, is feasible, and has excellent outcomes in WOPN treatment.
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Affiliation(s)
- Joan B Gornals
- Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari de Bellvitge-IDIBELL (Bellvitge Biomedical Research Institute), Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Catalonia, Spain.
| | - Claudia F Consiglieri
- Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari de Bellvitge-IDIBELL (Bellvitge Biomedical Research Institute), Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Catalonia, Spain
| | - Juli Busquets
- Department of Surgery, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain
| | - Silvia Salord
- Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari de Bellvitge-IDIBELL (Bellvitge Biomedical Research Institute), Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Catalonia, Spain
| | - Meritxell de-la-Hera
- Endoscopy Unit, Department of Digestive Diseases, Hospital Universitari de Bellvitge-IDIBELL (Bellvitge Biomedical Research Institute), Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Catalonia, Spain
| | - Lluis Secanella
- Department of Surgery, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain
| | - Susana Redondo
- Department of Anesthesiology, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain
| | - Nuria Pelaez
- Department of Surgery, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain
| | - Joan Fabregat
- Department of Surgery, Hospital Universitari de Bellvitge-IDIBELL, Barcelona, Spain
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Fustran N, Dalmau A, Ferreres E, Camprubí I, Sanzol R, Redondo S, Kreisler E, Biondo S, Sabaté A. Postoperative analgesia with continuous wound infusion of local anaesthesia vs saline: a double-blind randomized, controlled trial in colorectal surgery. Colorectal Dis 2015; 17:342-50. [PMID: 25580989 DOI: 10.1111/codi.12893] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 08/18/2014] [Indexed: 01/10/2023]
Abstract
AIM The aim of this prospective double-blind randomized clinical trial was to determine whether preperitoneal continuous wound infusion (CWI) of the local anaesthetic ropivacaine after either laparotomy or video-assisted laparoscopy for colorectal surgery would reduce patient consumption of morphine. METHOD Patients scheduled for colorectal surgery randomly received a 48-h preperitoneal CWI of either 0.38% ropivacaine or 0.9% saline at rates of 5 ml/h after laparotomy or 2 ml/h after laparoscopy. The primary end-point was total morphine consumption in surgery and afterwards through a patient-controlled analgesia device. Results in the laparotomy and laparoscopy subgroups were also compared. RESULTS Sixty-seven patients were included, 33 in the ropivacaine CWI group and 34 in the saline group. Median [interquartile range (IQR)] morphine consumption was lower in the ropivacaine group [23.5 mg (11.25-42.75)] than in the saline group [52 mg (24.5-64)] (P = 0.010). Morphine consumption was also lower in the laparotomy subgroup receiving ropivacaine [21.5 (15.6-34.7)] than in the saline group [52.5 (22.5-65) ml] (P = 0.041). Consumption was statistically similar in laparoscopy patients on ropivacaine or saline. No side effects were observed. Sixteen patients had a surgical wound infection (23.9%); 11 (16.4%) presented wound infection and five (7.5%) organ space infection. Forty-six catheter cultures were obtained; 10 (21.7%) were positive, assessed to be due to contamination. CONCLUSION Preperitoneal CWI of ropivacaine is a good, safe addition to a multimodal analgesia regimen for colorectal surgery. CWI can reduce morphine consumption without increasing adverse effects.
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Affiliation(s)
- N Fustran
- Department of Anaesthesia, Reanimation and Pain Clinic, Bellvitge University Hospital, University of Barcelona, Barcelona, Spain
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Tejerina T, Ramajo M, Navarro-Dorado J, Ostos F, Urraca C, Garcés Z, Reguillo F, Redondo S, Medina-Moreno U. Role of transcription factors on the release and functionality of endothelial progenitor cells of patients undergoing cardiac surgery. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.340] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Medina U, Navarro-Dorado J, Ramajo M, Ostos F, Urraca C, Garces Z, Reguillo F, Redondo S, Tejerina T. Role of endoglin and its association with adhesion molecules in patients with hypercholesterolemia or hypertension. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.332] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Soriano L, Redondo S, Arcenillas P, March P, Garriga R, Pla R. DGI-059 Safety of Anti-Epidermal Growth Factor Receptor Agents: Cetuximab and Panitumumab: Abstract DGI-059 Table 1. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.325] [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: 11/04/2022] Open
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Arcenillas P, Redondo S, Giménez N, March P, Soriano L, Pla R, Quintana S. OHP-047 Impact of the Economic Crisis on Biomedical Research: Analysis of the Work of a Clinical Research Ethics Committee: Abstract OHP-047 Table 1. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.421] [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: 11/04/2022] Open
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Vilardell N, Redondo S, Giménez N, Soriano L, Pla R, Quintana S. Investigator perception of trial presentation to the clinical research ethics committee. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.410] [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: 11/03/2022] Open
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Redondo S, Garcés Z, Reguillo F, Carnero M, Navarro-Dorado J, Ramajo M, Rodríguez J, Tejerina T. 319. Señalización alterada de factor de crecimiento transformante SS en células de músculo liso vascular humanas y en arterias mamarias internas de pacientes sometidos a revascularización miocárdica. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70407-2] [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: 11/16/2022] Open
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Redondo S, Ruiz E, Gordillo-Moscoso A, Navarro-Dorado J, Ramajo M, Rodríguez E, Reguillo F, Carnero M, Casado M, Tejerina T. Overproduction of cyclo-oxygenase-2 (COX-2) is involved in the resistance to apoptosis in vascular smooth muscle cells from diabetic patients: a link between inflammation and apoptosis. Diabetologia 2011; 54:190-9. [PMID: 20957341 DOI: 10.1007/s00125-010-1947-x] [Citation(s) in RCA: 13] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 09/27/2010] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS Inflammation is a common feature in cardiovascular diseases, including diabetes mellitus. In addition to the well-known inflammatory role of cyclo-oxygenase-2 (COX-2), this protein has also been implicated in apoptosis resistance in tumour cells. Vascular smooth muscle cells (VSMC) from diabetic patients are also resistant to apoptosis because of an increased abundance of B cell lymphoma 2 protein (BCL2). In this work, we investigated whether overproduction of COX-2 was involved in the resistance to apoptosis in VSMC from diabetic patients. METHODS VSMC were obtained from internal mammary arteries from patients who had undergone coronary artery bypass graft surgery. Apoptosis was measured by DNA fragmentation, BCL2 degradation and cytochrome c release. RESULTS Apoptosis induced by C-reactive protein in cells from non-diabetic patients was mediated by COX-2. VSMC from diabetic patients showed higher basal levels of COX-2 compared with those from non-diabetic patients. Transfection of VSMC from non-diabetic patients with a plasmid containing COX-2 (also known as PTGS2) increased basal production of COX-2 and BCL2 and mimicked the resistance to apoptosis that occurs in diabetic patients. We also found a significant correlation (R = 0.846, p = 0.016) between COX-2 and BCL2 production in arterial rings from diabetic patients measured by confocal microscopy. However, inhibition of COX-2 production by small interfering RNA proved unable to reverse BCL2 production in diabetic VSMC. CONCLUSIONS/INTERPRETATION These results suggest a link between inflammation (COX-2) and apoptosis resistance (BCL2) in the arteries of diabetic patients. This relationship is not causative and the common production of these two proteins may be co-regulated by shared regulatory elements in diabetes.
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Affiliation(s)
- S Redondo
- Department of Pharmacology, Universidad Complutense, Madrid, Spain.
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Carmero Alcázar M, Tejerina Sánchez M, Reguillo Lacruz F, Redondo S, Rodríguez Hernández J, Correa J. 83. La cirugía de reva scularizac ión miocárdica ag rava el estrés oxidativo en pac ientes con enfermedad coronaria. Cirugía Cardiovascular 2010. [DOI: 10.1016/s1134-0096(10)70757-9] [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: 11/24/2022] Open
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Fabregate M, Redondo S, Garcia-Prieto V, Marin E, Fabregate R, De La Torre N, Saban-Ruiz J. BIOELECTRICAL IMPEDANCE ANALYSIS AND ORAL GLUCOSE TOLERANCE TEST. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70307-6] [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: 11/26/2022]
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Saban-Ruiz J, Fabregate R, Fabregate M, Redondo S, Marin E, Garcia-Prieto V, De La Torre N. TRYGLYCERIDES AND GLYCEMIC CONTROL HAVE INFLUCENCE ON SMALL ARTERY ELASTICITY IN DIABETIC PATIENTS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70294-0] [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: 11/26/2022]
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Valenzuela P, Ramos P, Redondo S, Cabrera Y, Alvarez I, Ruiz A. Endometrioid adenocarcinoma of the ovary and endometriosis. Eur J Obstet Gynecol Reprod Biol 2007; 134:83-6. [PMID: 16844279 DOI: 10.1016/j.ejogrb.2006.06.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [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: 07/25/2005] [Revised: 05/08/2006] [Accepted: 06/13/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We present a retrospective analysis of 22 cases of endometrioid ovarian carcinoma, reviewed to identify endometriosis and its malignant transformation. STUDY DESIGN Twenty-two patients with endometrioid ovarian cancer were included in the review. Their clinical and histological data were retrospectively reviewed. The origin of the tumours was considered endometriosis-related when the presence of malignant changes in endometriosis glands leading to endometrioid carcinoma were found. RESULTS Endometriosis was detected in three cases (3/22=14%). One of them presented a clearly benign to malignant transformation area. In another patient, the transition zone was abrupt and present in both ovaries. In the third, a pre-menopausal woman, ovarian endometriosis with only focal endometrioid carcinoma was observed. The three of them had a clear-cell carcinoma component. The presence of a clear-cell component was significantly greater in patients with endometriosis than in patients without endometriosis Each patient had a different clinical presentation: increase in abdominal perimeter, post-menopausal vaginal haemorrhage and hypermenorrhea. Preoperative CA 125 levels were avalaible in 15 of the patients (15/22=68%). Endometriosis was found in two of these 15 patients, both with the highest CA 125 measured levels, exceeding 1700 U/ml. In the remaining of the patients, CA 125 value did not exceed 35 U/ml. CONCLUSION Although this association is not very frequent, patients with ovarian endometriosis and a high CA 125 serum level should be managed with special care, regardless of their pre-menopausal or post-menopausal status.
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Affiliation(s)
- P Valenzuela
- Obstetrics and Gynaecology Department, Principe de Asturias Hospital, Alcalá de Henares University, Alcalá de Henares, Madrid, Spain.
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Redondo S, Fabregate M, Sanchez O, Masjuan J, Fabregate R, Alonso De Lecinana M, Saban-Ruiz J. PO17-490 INTIMA-MEDIA THICKNESS, ANKLE-BRACHIAL PRESSURE INDEX AND TRANSCRANIAL DOPPLER SONOGRAPHY IN HYPERTENSIVE PATIENTS. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71500-3] [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: 11/27/2022]
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De La Torre N, Coca-Robinot D, Fabregate R, Sanchez O, Redondo S, Fabregate M, Saban-Ruiz J. PO9-262 CHANGES IN MICROCIRCULATION IN PATIENTS WITH HIGH SENSITIVITY C-REACTIVE PROTEIN. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71272-2] [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: 11/16/2022]
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Saban-Ruiz J, Fabregate R, Fabregate M, Sanchez O, Redondo S, De LaTorre N, Campoy J. PO14-379 RELATION BETWEEN THE STIFFNESS OF LARGE/SMALL ARTERIES AND ENDOTHELIUM-DEPENDENT AND NON-ENDOTHELIUM DEPENDENT VASODILATION. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71389-2] [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: 10/23/2022]
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Redondo S, Fabregate R, Sanchez O, De La Torre N, Saban-Ruiz J. PO15-413 ALTERED FLOW-MEDIATED BRACHIAL ARTERY DILATATION. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71423-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: 11/16/2022]
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Redondo S, Ruiz E, Gordillo-Moscoso A, Tejerina T. Tu-P8:292 How aspirin modulates the TGF-B pathway in human vascular smooth muscle cells. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80995-5] [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: 11/24/2022]
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Ruiz E, Gordillo-Moscoso A, Redondo S, Tejerina T. We-P11:118 Pioglitazone induces apoptosis in human vascular smooth muscle cells from hypercholesterolemic patients by involving the TGF-B pathway. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81472-8] [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: 11/28/2022]
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Castillo JM, Redondo S, Wharmby C, Figueroa ME, Luque T, Castellanos EM, Davy AJ. Environmental determination of shoot height in populations of the cordgrassSpartina maritima. ACTA ACUST UNITED AC 2005. [DOI: 10.1007/bf02732913] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Llop J, Sabin P, Garau M, Burgos R, Pérez M, Massó J, Cardona D, Sánchez Segura JM, Garriga R, Redondo S, Sagalés M, Ferrer D, Pons M, Vuelta M, Fàbregas X, Vitales M, Casasín T, Martínez J, Morató L, Soler M. The importance of clinical factors in parenteral nutrition-associated hypertriglyceridemia. Clin Nutr 2003; 22:577-83. [PMID: 14613761 DOI: 10.1016/s0261-5614(03)00082-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [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: 01/26/2023]
Abstract
AIMS The purpose of this study was to establish the relevance of several clinical factors associated with parenteral nutrition (PN) hypertriglyceridemia and to construct a predictive model for this complication. METHOD This multicenter study included all patients with initial serum triglyceridemia <3 mmol and receiving a minimum of 7 days' PN therapy. The study ended for each patient when hypertriglyceridemia developed or PN was terminated. Two multivariate models were constructed, one to study the clinical factors and the second to predict plasma triglyceridemia. A total of 22 clinical factors studied as independent variables were included in the multiple-step regression models only when they showed a P-value over 0.1. Statistical significance was determined by the confidence interval of the odds ratio (OR) and the partial regression coefficient (b). RESULTS The study included 260 patients from 14 hospitals. Lipid administration was 0.83+/-0.37 g/kg/day. Among the total, 68 patients (26.2%) showed hypertriglyceridemia. Variables included in both models were serum glucose (OR, 2.63; b, 0.06), renal failure (OR, 10.56; b, 1.70), corticoid administration >0.5 mg/kg (OR, 7.98; b, 0.97), pancreatitis (OR, 4.38; b, 0.64), sepsis (OR, 4.48; b, 0.24), lipids infused (OR, 3.03; b, 0.24) and heparin administration >3 mg/kg/day (OR, 0.11; b, -1.21). CONCLUSION Although the rate of lipid infusion was low, certain clinical factors modified triglyceridemia. Nevertheless, relatively fast plasma clearance of lipids infused indicates that a reduction in lipid supply could be a quick, effective measure for controlling hypertriglyceridemia. Thus, careful monitoring of patients with clinical factors predicting risk in the model studied, with adjustment of lipid perfusion rates accordingly, is suggested to avoid hypertriglyceridemia.
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Affiliation(s)
- J Llop
- Hospital Universitari de Bellvitge, Spain
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Peiró E, Valenzuela P, Medina L, Cámara M, Cabrera Y, Redondo S. Diagnóstico de la amenaza de parto prematuro. Clínica e Investigación en Ginecología y Obstetricia 2003. [DOI: 10.1016/s0210-573x(03)77285-2] [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: 11/27/2022]
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