5 results on '"Garcés Visier, C."'
Search Results
2. Thyroid abnormalities in patients with Hodgkin lymphoma: The importance of close surveillance.
- Author
-
Garcés-Visier C, Conejero-Gonzalez P, Andión-Catalán M, Martín-Vega A, Muñoz-Hernández D, Espinoza-Vega ML, Luis-Huertas AL, and Alonso-Calderón JL
- Subjects
- Humans, Male, Female, Retrospective Studies, Adolescent, Child, Thyroid Diseases epidemiology, Follow-Up Studies, Hypothyroidism epidemiology, Hypothyroidism etiology, Child, Preschool, Hodgkin Disease epidemiology
- Abstract
Introduction: Survival in paediatric patients with Hodgkin lymphoma (HL) has increased over the last decades. However, these patients are at increased risk of developing late thyroid sequelae due to the treatment with irradiation and alkylating agents., Methods: We conducted an observational and retrospective study in patients with a diagnosis of HL between 2007 and 2022, in a hospital that is a paediatric oncology reference centre, through the review of electronic health records. We collected data on demographic (age, sex), clinical, radiological and histopathological variables, the dosage of alkylating agents and radiotherapy (RT) and on thyroid disorders using Microsoft Excel. The data analysis was conducted with SPSS version 17, using the Fisher exact test for qualitative data, a nonparametric test for quantitative data and Kaplan-Meier curves., Results: Sixty patients received a diagnosis of HL from 2007 to 2022. The median duration of follow-up was 78.5 months. There were 4 detected cases of hypothyroidism, 5 of thyroid nodules and 1 of subclinical hyperthyroidism. Treatment with RT was significantly associated with the development of hypothyroidism (P= .026), thyroid nodules (P= .01) and thyroid disease overall (P= .003). We estimated that the risk of thyroid disease increased 8-fold with each additional Grey received (hazard ratio, 1.081; 95% CI, 1.014-1.152; P= .017)., Conclusion: Hodgkin lymphoma patients treated with RT are at increased risk of late thyroid disorders, mainly hypothyroidism and malignancy. This risk is greater the higher the RT dosage and the longer the follow-up. We did not find evidence of an association between the use of alkylating agents and an increase in the risk of thyroid disease., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
3. Pediatric perianal Crohn's disease behavior in the era of biologic therapy.
- Author
-
De La Puente S, Espinosa Góngora R, Souto Romero H, Rico Espiñeira C, Luis Huertas AL, Garcés Visier C, Ramos Rodríguez P, Muñoz Hernández D, Espinoza Vega ML, Acedo Ruiz JA, Maruszewski P, Riñón C, Morató Robert P, Palomino L, Velasco M, Martín Vega A, and Alonso Calderón JL
- Subjects
- Humans, Male, Child, Female, Retrospective Studies, Treatment Outcome, Biological Therapy, Crohn Disease drug therapy, Crohn Disease complications, Rectal Fistula therapy, Rectal Fistula complications
- Abstract
Aim of the Study: To describe perianal Crohn's disease behavior and the role of biological therapy in a sample of pediatric patients., Methods: A retrospective study of pediatric patients with Crohn's disease (CD) treated in our institution from 2017 to 2021, with a minimum follow up period of 6 months, was conducted. Patients were divided whether they had perianal disease (PD) or not. Baseline characteristics, extension of disease, growth failure rate, aggressive pattern rate, use of biological therapy and need for surgery, among other variables, were compared between both groups. Clinical and/or radiological improvement in the last 6 months of follow up was considered good control of PD., Results: Seventy eight pediatric patients with CD were included. Median age at diagnosis was 10.5 years, and median follow up time was 3.8 years. 64.1% patients were male. Of all, 15 (19.2%) had perianal disease, of which 10 had fistulizing findings and 5 had non fistulizing findings. PD was presented at diagnosis in 8 patients, and the rest developed it in a median time of 1 year from diagnosis. PD was associated with growth failure (p = 0.003), use of biological therapies (p = 0.005), and need for second line of biologics (p = 0.005). Most patients (12/15, 80%) had good control of PD with the treatment received., Conclusions: CD patients with PD seem to need a more aggressive treatment, with biological therapies playing a key role for its handling nowadays. These patients require close nutritional evaluation that ensures proper development and growth.
- Published
- 2023
- Full Text
- View/download PDF
4. Routine anti-reflux surgery combined with gastrostomy in children: is it really necessary? Our single-center experience.
- Author
-
Guillén Redondo P, Espinosa Góngora R, Luis Huertas AL, Garcés Visier C, Ramos Rodríguez P, De La Puente Pérez S, Souto Romero H, Espinoza Vega M, Rico Espiñeira C, Riñón Pastor C, and Alonso Calderón JL
- Subjects
- Child, Child, Preschool, Fundoplication, Humans, Infant, Postoperative Complications epidemiology, Retrospective Studies, Gastroesophageal Reflux epidemiology, Gastroesophageal Reflux surgery, Gastrostomy
- Abstract
Objective: To study gastroesophageal reflux (GER) in children undergoing gastrostomy in a single pediatric institution., Material and Methods: A retrospective study of patients undergoing gastrostomy from 2000 to 2017 was carried out. Demographic data, clinical data, progression, and complications were recorded. GER was considered positive in patients with clinical signs requiring antisecretory treatment, prokinetic treatment, or anti-reflux surgery to control symptoms., Results: 207 patients with a median age of 2 years [R: 0.25-18] were included. Neurological impairment was the most frequent underlying condition (74%). Swallowing difficulty and undernourishment were the main surgical indications for gastrostomy. Prior to gastrostomy, 96 out of 207 patients (46%) showed GER symptoms. Combined fundoplication and gastrostomy was performed in 41 (43%) patients with preexisting GER, 6 of whom showed GER worsening (4 required redo fundoplication). 5 complications following fundoplication were noted - gastric perforation, sustained Dumping syndrome, and gastroesophageal stenosis. 55 out of 96 (57%) patients with preexisting GER underwent gastrostomy alone. Clinical signs disappeared in 16 of them (29%) and improved or stabilized in 19 (35%). GER worsening occurred in 20 patients (36%), with subsequent fundoplication being required in 10 cases. In patients with no previous clinical signs (111 out of 207), GER symptoms occurred following gastrostomy in just 18 cases (16%), and only 2 patients required fundoplication., Conclusions: In our experience, routine anti-reflux surgery combined with gastrostomy is not justified. Individualized fundoplication should be considered in case of medical treatment failure. Further studies with an adequate design are required to establish which patients could really benefit from this procedure.
- Published
- 2021
5. Prophylactic thyroidectomy in multiple endocrine neoplasia type 2A in children: a single centre experience.
- Author
-
Garcés Visier C, Espinoza Vega M, Guillén Redondo P, Ollero Fresno JC, Souto Romero H, Luis Huertas A, Espinosa Góngora R, Rico Espiñeira C, Bautista FJ, and Alonso Calderón JL
- Subjects
- Child, Child, Preschool, Female, Follow-Up Studies, Humans, Male, Multiple Endocrine Neoplasia Type 2a pathology, Prognosis, Retrospective Studies, Multiple Endocrine Neoplasia Type 2a surgery, Thyroidectomy methods
- Abstract
Background To describe the complications and long-term results in patients with multiple endocrine neoplasia type 2A (MEN 2A) syndrome in whom a prophylactic thyroidectomy was performed, in relation to the recommendations of the American Thyroid Association (ATA). Methods A retrospective study of 14 patients with MEN 2A thyroidectomized between 2000 and 2017. We reviewed demographic, clinical, analytical and radiological data. Postoperative complications and long-term follow-up were analyzed. Results We treated eight boys and six girls with a median age of 5 years old (range 2-10). The predominant genetic mutation belonged to codon 634 (8/14, 57.14%). Total thyroidectomy (TT) without cervical lymphadenectomy was performed in all patients. A right upper parathyroidectomy was performed in one patient due to intraoperative suspicion of increased volume. Histological study revealed no alterations. Two patients presented transient hypocalcemia postoperatively and no patient had permanent hypocalcemia or nerve damage. Pathological anatomy confirmed medullary thyroid microcarcinoma in 5/14 patients: all carrying codon 634 mutation and three of them with preoperative basal calcitonin levels <20 pg/mL. No recurrences or metastases have been detected after a mean follow-up of 8 years. A patient with codon 634 mutation developed a unilateral pheochromocytoma at 25 years of age. No patient has presented hyperparathyroidism. Conclusions Prophylactic thyroidectomy without cervical lymphadenectomy is an effective and safe preventive treatment in patients with MEN 2A syndrome when it is performed by experienced surgeons in reference centers.
- Published
- 2019
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.