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Search Results: 1 - 10 of 579634 matches for " A. Gómez Portilla "
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Pseudomixoma peritoneal: Supervivencia superior a 10 a os tras citorreducción, quimioterapia intraperitoneal e hipertermia Pseudomyxoma peritonei: Over 10 years's survival after cytoreduction, intraperitoneal chemotherapy, and hyperthermia
A. Gómez Portilla,C. Martínez de Lecea,C. Gómez,I. Cendoya
Revista Espa?ola de Enfermedades Digestivas , 2008,
Abstract:
Peritoneal carcinomatosis of colorectal origin. Current treatment: Review and update Carcinomatosis peritoneal de origen colorrectal. Estado actual del tratamiento: Revisión y puesta al día
A. Gómez Portilla,I. Cendoya,I. López de Tejada,I. Olabarría
Revista Espa?ola de Enfermedades Digestivas , 2005,
Abstract: Colorectal cancer is the most frequent tumor of the digestive tract. The high incidence of abdominal dissemination; the poor prognosis of these patients, with median survival consistently ranging from 5 to 9 months in all studies of peritoneal carcinomatosis from colorectal cancer; the failure of adjuvant systemic chemotherapy treatment with a maximal survival of 18 months despite the development of new cytostatic drugs, and new combinations of use, make it crucial to search for and develop new treatment strategies. We review the principles of Sugarbaker′s treatment protocol, which involves the combination of maximum cytoreductive radical oncological surgery for the treatment of all macroscopically disseminated disease with maximum perioperative intraperitoneal intensification chemotherapy to treat residual microscopic disease. We present the results of several scientific papers, all of them phase II studies with more than 10 patients treated, published in the medical literature by the main groups working in this line of treatment, together with the only phase III study reported and published so far, and finally the results of a recently reported retrospective international multicenter study. With this new alternative therapeutic approach, overall mean survival is 40% at 36 months, and 20% at 5 years. Based on these results, this new therapeutic approach is proposed as the treatment of choice for these unfortunate patients. El cáncer colorrectal es el tumor más frecuente del tracto digestivo. La alta incidencia de diseminación abdominal, el pobre pronóstico de estos pacientes con una mediana de supervivencia entre 5 y 9 meses demostrada repetidamente en todos los estudios de carcinomatosis peritoneal por cáncer colorrectal, el fracaso de los tratamientos sistémicos adyuvantes con quimioterapia con supervivencias máximas de 18 meses independientemente del desarrollo de nuevas drogas citostáticas y las nuevas combinaciones o formas de uso, hacen crucial la investigación y el desarrollo de nuevas estrategias de tratamiento. Revisamos los principios del protocolo del tratamiento de Sugarbaker, que contempla la combinación de la máxima cirugía radical oncológica citorreductora para el tratamiento de la enfermedad macroscópica diseminada con la máxima quimioterapia de intensificación intraperitoneal perioperatoria para el tratamiento de la enfermedad microscópica residual. Se presentan los resultados de las publicaciones científicas, de todos los estudios fase II con más de 10 pacientes tratados publicados en la literatura médica por los principales grupos de
Prevalencia y tratamiento de la patología oncológica en el anciano: El reto que se avecina Prevalence and treatment of oncologic disease in the elderly: an impeding challenge
A. Gómez Portilla,C. Martínez de Lecea,I. Cendoya,I. Olabarría
Revista Espa?ola de Enfermedades Digestivas , 2008,
Abstract: La esperanza media de vida en Espa a se ha más que duplicado a lo largo del siglo XX, llegando en la actualidad a 75 a os en el varón y 83 a os en la mujer. Las predicciones de la evolución y crecimiento poblacional a nivel mundial y nacional auguran un shock demográfico cuando en Espa a el número de mayores de 65 a os alcance el 33,5% de la población en el 2050. Es conocido que el cáncer está intrínseca y directamente relacionado con la edad, siendo una patología de personas mayores, ya que al menos el 60% de ellos aparecen en mayores de 65 a os. Los ancianos constituyen el grupo más importante de la práctica oncológica médica. Las predicciones de envejecimiento de la población espa ola, permiten intuir que el cáncer en el anciano y su tratamiento deba ser considerado un problema sanitario de primer orden. El cáncer ya no es sinónimo de muerte para la mayoría de los pacientes. Globalmente el 60% se curan o cronifican. Esta mejora pronóstico tiene un precio tanto en las expectativas de tratamiento como de posterior seguimiento y mantenimiento de las secuelas que pueden generarse. El mayor y mejor conocimiento y comprensión del proceso de envejecimiento, permitirá identificar y seleccionar aquellos pacientes mayores que pueden beneficiarse de medidas de prevención y tratamiento, y lo más importante permitirá identificar aquellos pacientes que no son candidatos de tratamientos con intención curativa por tratarse de población frágil. Los adelantos en el campo de la cirugía, especialmente en la cirugía mínimamente invasiva y su aplicación al campo de la cirugía oncológica, permiten prever que un mayor número de pacientes ancianos podrán beneficiarse de un tratamiento con intención curativa. La edad no prevendrá de tratamientos apropiados en individuos ancianos con cáncer, especialmente aquellos en los que tengan una adecuada expectativa de vida y reserva funcional. Combatir esta discriminación sanitaria constituye una de las principales prioridades en la estrategia para el mantenimiento de la salud del anciano. Presentamos y analizamos en este trabajo los cambios poblacionales que se avecinan de forma particular en Espa a, la vinculación del cáncer con la edad con sus particularidades específicas, los criterios generales de fragilidad del anciano, las limitaciones que la edad suponen para la aplicación de distintos tratamientos adyuvantes complementarios, y las nuevas alternativas quirúrgicas aplicables en pacientes oncológicos ancianos en los cánceres más frecuentes de la práctica clínica. Life expectancy in Spain has more than duplicated during the last 20
Aproximación a una ontología para lenguajes de modelado gráfico
Zapata,Carlos Mario; Giraldo,Gloria Lucía; Portilla,Byron; Gómez,Duvan; Naranjo,Marcela; Carmona,Patricia;
Revista de Ingeniería , 2009,
Abstract: uml, sysml, and webml are graphical modeling languages (gml). despite their similarities, these languages can not be jointly interpreted, since they exhibit different kinds of models and diagrams. some studies for examining the features of some gml are proposed in the state of the art, but applied to individual languages, avoiding the common features among such languages. in this paper, we propose an ontology design and implementation for summarizing gml concepts and relations. we use a methodology created in the stanford university. the developed ontology can successfully answer 35 competence questions, some of them exemplified in this paper.
Aproximación a una ontología para lenguajes de modelado gráfico
Carlos Mario Zapata,Gloria Lucía Giraldo,Byron Portilla,Duván Gómez
Revista de Ingeniería , 2009,
Abstract: UML, SysML y WebML son lenguajes de modelado gráfico (LMG) similares que no se pueden interpretar conjuntamente, pues tienen diferencias en tipos de modelos y diagramas. En la literatura se encuentran técnicas que estudian las características de algunos LMG, pero se aplican sobre lenguajes particulares, sin considerar sus características comunes. En este artículo se propone el dise o e implementación de una ontología que resuma los principales conceptos y relaciones de los LMG, utilizando una metodología creada en la Universidad de Stanford. La ontología desarrollada responde 35 preguntas de competencia, de las cuales algunas se ejemplifican en el artículo./ UML, SysML, and WebML are graphical modeling languages (GML). Despite their similarities, these languages can not be jointly interpreted, since they exhibit different kinds of models and diagrams. Some studies for examining the features of some GML are proposed in the state of the art, but applied to individual languages, avoiding the common features among such languages. In this paper, we propose an ontology design and implementation for summarizing GML concepts and relations. We use a methodology created in the Stanford University. The developed ontology can successfully answer 35 competence questions, some of them exemplified in this paper.
Lesión iatrogénica de un conducto aberrante del sectorial anterior derecho hepático (segmentos V-VIII) independiente: Dificultades en su diagnóstico y tratamiento Iatrogenic injury of an aberrant, independent, right hepatic duct (V-VIII segments): Diagnostic and therapeutic difficulties
A. Gómez Portilla,E. Romero Pujana,E. Martín,C. Martínez de Lecea
Revista Espa?ola de Enfermedades Digestivas , 2008,
Abstract:
Respuesta de autores: Réplica: Lesión iatrogénica de un conducto aberrante del sectorial anterior derecho hepático independiente. Dificultad en su diagnóstico y tratamiento Authors′response: Reply: Iatrogenic injury of an aberrrant, independent, right hepatic duct (V-VIII segments). Diagnostic and therapeutic difficulties
A. Gómez Portilla,E. Romero Pujana,E. Martín,C. Martínez de Lecea
Revista Espa?ola de Enfermedades Digestivas , 2008,
Abstract:
The European contribution to "Sugarbaker's protocol" for the treatment of colorectal peritoneal carcinomatosis Aportación europea al "protocolo de Sugarbaker" en el tratamiento de la carcinomatosis peritoneal colorrectal
A. Gómez Portilla,I. Cendoya,I. Olabarria,C. Martínez de Lecea
Revista Espa?ola de Enfermedades Digestivas , 2009,
Abstract: Introduction: in 1981, Dr. PH Sugarbaker, challenging oncological orthodoxy, considered carcinomatosis to be a locoregional stage of the disease that was still susceptible to treatment with curative intent. To this end he developed a new therapeutic alternative based on the combined treatment. The macroscopic disease treated by maximum radical oncological cytoreductive surgery (through the peritonectomies described by him), followed by treatment of the residual microscopic disease with the direct intra-abdominal application of intraoperative chemotherapy with locoregional intensification, modulated by hyperthermia and early normothermic postoperative intra-abdominal chemotherapy. Using this new therapeutic regimen, known as "Sugarbaker's Protocol", his group has reported 45% survival rates in carcinomatosis of colorectal origin at 5 years, and, in selected groups of patients, 50% survival rates at 5 years. The scientific community, however, has criticized these results considering that: it is a personal experience, with a not homogenous treatment protocol with developmental modifications over time, that it is a retrospective non-randomized study, and finally that the cytostatics used in his protocol are obsolete. Various European groups have replied to these main criticisms confirming the good results that this new therapeutic alternative offers for patients with carcinomatosis of colorectal origin. The purpose of this article is to present these contributions. Material and methods: all the articles published in the English language by European groups in the world's medical literature have been reviewed using the Pubmed-MEDLINE database to identify the relevant articles related to the treatment of carcinomatosis of colorectal origin using cytoreduction and intraperitoneal chemotherapy from January 1980 to January 2008. Results: the European contribution during these 25 years in favour of the "Sugarbaker's Protocol" has consisted fundamentally in: a) one multicenter retrospective study; b) two randomized prospective phase III studies; and c) the use of oxaliplatin and irinotecan as new cytostatic agents in the protocols for intraperitoneal chemotherapy. At the same time, two new transcendental European contributions have been made in which the possibility has been considered of combined simultaneous treatment for patients with hepatic metastases and carcinomatosis, and the introduction, as a selection factor, of patients responsive to intravenous induction chemotherapy within the regimen of sandwich treatment (with systemic neoadjuvant and adjuvant chemot
Análisis de series de tiempo univariante aplicando metodología de Box-Jenkins para la predicción de ozono en la ciudad de Cali, Colombia
Jaramillo Ayerbe,Mauricio; González Gómez,Daniel Enrique; Nú?ez Cabrera,María Eugenia; Portilla,Gloria Esperanza; Lucio García,Jesús Heriberto;
Revista Facultad de Ingeniería Universidad de Antioquia , 2007,
Abstract: the modelling results of tropospheric ozone concentration in the urban area of cali, colombia, suitable for short term forecasting, are presented. results were obtained by using an univariate time series analysis. the method was applied to a series of 2496 hourly ozone concentration data from one of the city?s air quality monitoring network stations. data were collected from april to july of 2003. a total of 104 consecutive days were covered: the first 93 days were used for model estimation, and the remaining 11 days for model validation. this technique can be used to predict (up to 8 hours) in advance high-ozone levels, allowing the environmental authorities to issue alerts to the population for possible air-quality impact on health.
Sobredosis de metformina secundaria a insuficienciarenal aguda: A propósito de 6 observaciones
Ortega Carnicer,J.; Ambrós Checa,A.; Martín Rodríguez,C.; Ruiz Lorenzo,F.; Portilla Botelhox,M.; Gómez Grande,L.;
Medicina Intensiva , 2007,
Abstract: metformin is a biguanide used in the treatment of obese adults with type 2 diabetes mellitus; metformin decreases mortality by 36% in comparison to conventional treatment. metformin administration has certain contraindications that, when ignored, especially in the case of acute renal insufficiency, leads to the accumulation of the drug and consequent lactic acidosis that can be fatal. we present 6 patients with acute renal insufficiency that experienced extreme acute metabolic acidosis (ph < 6.90 and bicarbonate < 5 meq/l) and increased anion gap while receiving metformin for the treatment of diabetes. serum lactic acid, only evaluated in the 4 patients that survived, was high. two patients died after cardiac arrest that could have been avoided. in conclusion, lactic acidosis appearing during metformin treatment for diabetes requires rapid diagnosis and treatment to enable the drug to be withdrawn and prolonged continuous hemofiltration or hemodialysis with bicarbonate to be initiated.
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