29 results on '"Sarbelio Rodríguez"'
Search Results
2. Switching from endoscopic submucosal dissection to salvage piecemeal knife-assisted snare resection to remove a lesion: a preoperative risk score from the beginning
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José-C. Marín-Gabriel, David Lora-Pablos, José Díaz-Tasende, Pilar Cancelas-Navia, Sarbelio Rodríguez-Muñoz, Andrés-J. del-Pozo-García, Marina Alonso-Riaño, Yolanda Rodríguez-Gil, Carolina Ibarrola-Andrés, and Gregorio Castellano-Tortajada
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Endoscopic submucosal dissection ,Endoscopic mucosal resection ,Predictive value ,Sensitivity and specificity ,ROC curve ,Area under curve ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
ABSTRACT Background and aims: endoscopic submucosal dissection (ESD) in the Western setting remains a challenge. Therefore, other simplified techniques such as knife-assisted snare resection (KAR) have been reported to overcome this issue. Methods: patients who underwent an ESD for the treatment of gastrointestinal neoplasms were included in a retrospective cross-sectional observational study. Factors associated with the end of ESD as a salvage p-KAR were identified and a logistic regression model was developed. Results: a total of 136 lesions in 133 patients were analyzed. Operator experience of under 50 cases and the combination of lesion size > 30 mm and colorectal location were independent predictive factors for switching to a salvage p-KAR according to the multivariate logistic regression analysis. We developed a risk scoring system based on these four variables (experience, size, location and the combination of size and location) with a receiver operating characteristic curve of 0.81 (95% CI: 0.74-0.89). The diagnostic accuracy of the score for a cut-off point ≥ 5 had a sensitivity of 0.79 (95% CI: 0.66-0.93) and a specificity of 0.71 (95% CI: 0.61-0.80). Conclusion: a simple predictive score system that includes four preoperative factors accurately predicts ESD to finish as a p-KAR. A careful selection of cases considering these variables could be useful to achieve better outcomes in the Western setting.
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- 2018
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3. Colangioscopia: ver para creer, ver para saber, ver para curar
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Sarbelio Rodríguez-Muñoz
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2018
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4. Endoscopic submucosal dissection (ESD) of antral subepithelial lesion suspected of malignancy
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José Carlos Marín-Gabriel, Esperanza Martos-Vizcaíno, José Díaz-Tasende, Marina Alonso-Riaño, Mercedes Pérez-Carreras, Sarbelio Rodríguez-Muñoz, Andrés J. del-Pozo-García, Francisco Colina-Ruizdelgado, and Gregorio Castellano-Tortajada
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Endoscopic submucosal dissection ,Subepithelial tumor ,Inflammatory fibroid polyp ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Subepithelial gastric tumours comprise a heterogeneous group of lesions. Endoscopic ultrasonography with fine-needle aspiration (EUS-FNA) is a useful approach but cannot always offer a definitive diagnosis to guide future therapeutic decisions. In the case we describe, biopsy samples of an antral subepithelial lesion and cytological analysis obtained with an EUS-FNA suggested the diagnosis of an adenocarcinoma. Endoscopic submucosal dissection (ESD) allowed en bloc resection of the tumour ensuring diagnosis and providing a definitive treatment.
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- 2015
5. Endoscopic submucosal dissection: Sociedad Española de Endoscopia Digestiva (SEED) clinical guideline
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Gloria Fernández-Esparrach, Ángel Calderón, Joaquín de-la Peña, José B. Díaz-Tasende, José Miguel Esteban, Antonio Gimeno-García, Alberto Herreros-de-Tejada, David Martínez-Ares, David Nicolás-Pérez, Óscar Nogales, Akiko Ono, Aitor Orive-Calzada, Adolfo Parra-Blanco, Sarbelio Rodríguez-Muñoz, Eloy Sánchez-Hernández, Andrés Sánchez-Yagüe, Enrique Vázquez-Sequeiros, Juan Vila, and Leopoldo López-Rosés
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2014
6. Experimental study of hybrid-knife endoscopic submucosal dissection (ESD) versus standard ESD in a Western country
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Joaquín de-la Peña, Ángel Calderón, José Miguel Esteban, Leopoldo López-Rosés, David Martínez-Ares, Óscar Nogales, Aitor Orive-Calzada, Sarbelio Rodríguez, Eloy Sánchez-Hernández, Juan Vila, and Gloria Fernández-Esparrach
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Endoscopic submucosal dissection ,ESD ,Hybrid-knife ESD ,Water-jet assisted ESD ,Experimental endoscopy ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background: Endoscopic submucosal dissection (ESD) is an effective but time-consuming treatment for early neoplasia that requires a high level of expertise. Objective: The objective of this study was to assess the efficacy and learning curve of gastric ESD with a hybrid knife with high-pressure water jet and to compare with standard ESD. Material and methods: We performed a prospective non-survival animal study comparing hybrid-knife and standard gastric ESD. Variables recorded were: Number of en-bloc ESD, number of ESD with all marks included (R0), size of specimens, time and speed of dissection and adverse events. Ten endoscopists performed a total of 50 gastric ESD (30 hybrid-knife and 20 standard). Results: Forty-six (92%) ESD were en-bloc and 25 (50%) R0 (hybrid-knife: n = 13, 44%; standard: n = 16, 80%; p = 0.04). Hybrid-knife ESD was faster than standard (time: 44.6 ± 21.4 minutes vs. 68.7 ± 33.5 minutes; p = 0.009 and velocity: 20.8 ± 9.2 mm²/min vs. 14.3 ± 9.3 mm²/min (p = 0.079). Adverse events were not different. There was no change in speed with any of two techniques (hybrid-knife: From 20.33 ± 15.68 to 28.18 ± 20.07 mm²/min; p = 0.615 and standard: From 6.4 ± 0.3 to 19.48 ± 19.21 mm²/min; p = 0.607). The learning curve showed a significant improvement in R0 rate in the hybrid-knife group (from 30% to 100%). Conclusion: despite the initial performance of hybrid-knife ESD is worse than standard ESD, the learning curve with hybrid-knife ESD is short and is associated with a rapid improvement. The introduction of new tools to facilitate ESD should be implemented with caution in order to avoid a negative impact on the results.
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- 2014
7. Endoscopic submucosal dissection in Spain: outcomes and development possibilities
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Juan J. Vila, Marcos Kutz, Gloria Fernández-Esparrach, Leopoldo López-Rosés, Sarbelio Rodríguez, and Andrés Sánchez-Yague
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Disección submucosa endoscópica ,Cáncer gástrico precoz ,Neoplasias gástricas ,Endoscopia ,Curva de aprendizaje ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Endoscopic submucosal dissection (ESD) allows endoscopic, curative, en-bloc resection of superficial malignant or premalignant lesions. This procedure was conceived over 10 years ago in Japan, but has not experienced great expansion in Western countries for different reasons. This article reviews ESD indications and outcomes, and reflects on the reasons that prevent ESD from becoming common clinical practice in Western hospitals. Finally, recommendations on ESD training in our setting are made.
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- 2013
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8. ERCP in a low-volume hospital: Arguments 'for' and 'against' this type of practice CPRE en un hospital con bajo volumen: argumentos 'a favor' y 'en contra' de este tipo de práctica
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Leopoldo López-Rosés, Sarbelio Rodríguez-Muñoz, Enrique Vázquez-Sequeiros, and J. Enrique Domínguez-Muñoz
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2013
9. Relevant phosphoproteomic and mass spectrometry: approaches useful in clinical research
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Elena López, Sarbelio Rodríguez Muñoz, Juan López Pascual, and Luis Madero
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Phosphoproteomics ,Mass spectrometry ,Clinical research ,Medicine (General) ,R5-920 - Abstract
Abstract Background “It's not what we do, it's the way that we do it”. Never has this maxim been truer in proteomics than now. Mass Spectrometry‐based proteomics/phosphoproteomics tools are critical to understand the structure and dynamics (spatial and temporal) of signalling that engages and migrates through the entire proteome. Approaches such as affinity purification followed by Mass Spectrometry (MS) have been used to elucidate relevant biological questions disease vs. health. Thousands of proteins interact via physical and chemical association. Moreover, certain proteins can covalently modify other proteins post‐translationally. These post‐translational modifications (PTMs) ultimately give rise to the emergent functions of cells in sequence, space and time. Findings Understanding the functions of phosphorylated proteins thus requires one to study proteomes as linked‐systems rather than collections of individual protein molecules. Indeed, the interacting proteome or protein‐network knowledge has recently received much attention, as network‐systems (signalling pathways) are effective snapshots in time, of the proteome as a whole. MS approaches are clearly essential, in spite of the difficulties of some low abundance proteins for future clinical advances. Conclusion Clinical proteomics‐MS has come a long way in the past decade in terms of technology/platform development, protein chemistry, and together with bioinformatics and other OMICS tools to identify molecular signatures of diseases based on protein pathways and signalling cascades. Hence, there is great promise for disease diagnosis, prognosis, and prediction of therapeutic outcome on an individualized basis. However, and as a general rule, without correct study design, strategy and implementation of robust analytical methodologies, the efforts, efficiency and expectations to make biomarkers (especially phosphorylated kinases) a useful reality in the near future, can easily be hampered.
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- 2012
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10. Complications of percutaneous endoscopic gastrostomy-jejunostomy for levodopa/carbidopa infusion in advanced Parkinson's disease
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Ana Olivares, David Collado, Miguel Muñoz-Navas, Marta Calvo, Eduardo Olivo, Inmaculada Chico, Carlos Marra, Rafael Sánchez-Estella, Sarbelio Rodríguez, Josè Carlos Subtil, and Luis Ramon Rábago
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percutaneous endoscopic gastrostomy-tube, levodopa/carbidopa infusion in duodenum, intestinal obstruction, intestinal perforation, endoscopic extraction ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Continuous infusions of levodopa directly into the duodenum-yeyunum is an effective therapy to reduce daily off time in an advanced stage of Parkinson's disease, but it is not without complications, particularly device related problems. We present our experience in three Spanish hospitals with these complications, including a severe case with migration, several decubitus ulcers, and one case of perforation of the bowel and finally death.
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- 2012
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11. Therapeutic impact of colon capsule endoscopy with PillCam™ COLON 2 after incomplete standard colonoscopy: a Spanish multicenter study
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Óscar Nogales, Javier García-Lledó, Marisol Luján, David Nicolás, José Francisco Juanmartiñena, Begoña González-Suárez, Francisco Sánchez-Ceballos, Ignacio Couto, José Olmedo, Cristina Garfia, Cristina Carretero, Ignacio Fernández-Urién, Sarbelio Rodríguez, Matilde Asteinza, Pilar Olivencia, Ángeles Masedo, Miguel Muñoz-Navas, Beatriz Merino, and Cecilia González-Asanza
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Capsule endoscopy ,Colonoscopy ,Colonic polyps ,Colonic neoplasms ,Colonic diverticulosis ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Introduction: Colon capsule endoscopy (CCE) is an alternative approach for the examination of the colon in patients who refuse colonoscopy or after incomplete colonoscopy (IC). We conducted a study to determine the frequency of complete colonoscopy after IC, the diagnostic yield of CCE, the therapeutic impact of lesions found in CCE, the level of colon cleanliness and the safety of the procedure. Methods: We performed a prospective, multicenter study involving ten Spanish hospitals. Consecutive outpatients aged ≥ 18 years with previous IC were invited to participate. The latest version of the CCE device, PillCam™ COLON 2 (CCE-2), was administered to all patients according to the protocol. Results: The study population comprised 96 patients. The most frequent cause of IC was the inability to move past a loop using standard maneuvers (75/96 patients, 78%). Complete visualization of the colon was obtained with CCE-2 in 69 patients (71.9%). Of the 27 patients in whom the CCE-2 did not reach the hemorrhoidal plexus, it passed the colonic segment explored with the previous colonoscopy in 20 cases; therefore, it could be inferred that a combined approach (CCE-2 plus colonoscopy) enabled complete visualization of the colonic mucosa in 92.7% of patients. CCE-2 revealed new lesions in 58 patients (60.4%). Polyps were the most frequent finding (41 patients; 42.7% of the total number of patients). In 43 of the 58 patients (44.8% of the total number of patients), the new lesions observed led to modification of therapy, which included a new colonoscopy for polyp resection or surgery in patients with colonic neoplasm. Conclusions: CCE-2 is a suitable diagnostic procedure that can lead to more frequent diagnosis of significant colonic lesions after IC.
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12. Colonic endoscopic full-thickness resection (EFTR) with the over-the-scope device (FTRD): a short case series
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José Carlos Marín-Gabriel, José Díaz-Tasende, Sarbelio Rodríguez-Muñoz, Andrés J. del-Pozo-García, and Carolina Ibarrola-Andrés
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Colonic neoplasms ,Colonic subepithelial tumor ,Granular cell tumor ,Endoscopic full-thickness resection ,Full-thickness resection device ,Over-the-scope clip ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
The endoscopic treatment of early gastrointestinal neoplasms usually involves the resection of the superficial layers, mucosa and submucosa, of the wall. However, in some circumstances, a full-thickness resection may be necessary. Endoscopic full-thickness resection (EFTR) may be an adequate approach in challenging lesions such as adenomas or early cancers with severe submucosal fibrosis or small sub-epithelial lesions in the lower GI tract. Furthermore, this novel technique has the potential to spare surgical therapy in a subset of cases. In this paper, we describe our results with the full-thickness resection device (FTRD) in three different situations.
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13. Me, the intruder: revisited and rethought
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Sarbelio Rodríguez-Muñoz, María Ataz-Orihuela, and Beatriz Arberas-Díez
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ERCP ,Sedation ,Propofol ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Full Text
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14. Relevant phosphoproteomic and mass spectrometry: approaches useful in clinical research
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López, Elena, Muñoz, Sarbelio Rodríguez, Pascual, Juan López, and Madero, Luis
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- 2012
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15. Long-term follow-up after endoscopic submucosal dissection of colorectal lesions in a Spanish cohort
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José Díaz-Tasende, Julia Arribas Anta, Sarbelio Rodríguez Muñoz, Carlos Piedracoba-Cadahia, Esteban Romero Romero, José Carlos Marín-Gabriel, Teresa Álvarez-Nava Torrego, Marta Rodríguez Carrasco, Andrés J. Del Pozo-García, David Rafael de la Cruz Esteban, and Ángel Cañete Ruiz
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Gynecology ,medicine.medical_specialty ,Endoscopic Mucosal Resection ,Long term follow up ,business.industry ,Gastroenterology ,General Medicine ,Endoscopic submucosal dissection ,Treatment Outcome ,medicine ,Humans ,Neoplasm Recurrence, Local ,business ,Colorectal Neoplasms ,Follow-Up Studies ,Retrospective Studies - Abstract
Introduccion: la diseccion submucosa endoscopica (DSE) en colon es una tecnica en expansion en paises occidentales. Existen pocos estudios con seguimiento a largo plazo. Objetivo: analizar supervivencia libre de enfermedad a largo plazo tras DSE y comparar las tasas de recidiva en funcion de diferentes factores. Material y metodos: cohorte prospectiva de pacientes con DSE planeada entre septiembre de 2008 y diciembre de 2015. Cuando no fue posible tecnicamente completar DSE se realizo diseccion hibrida en bloque o fragmentada. Se analizo la tasa de recurrencia a cinco anos mediante curvas de Kaplan-Meier y se compararon en funcion de diferentes factores usando test de log-rank. Resultados: se incluyo una cohorte inicial de 89 pacientes en los que se consiguio seguimiento en 69. De los 69 pacientes, en 31 (45%) se realizo DSE; en once (16%), DSE hibrida; y en 27 (39%), DSE hibrida fragmentada. La mediana de seguimiento fue de 27 meses. La supervivencia libre de enfermedad a cinco anos fue del 81%. La media de endoscopias para eliminar la recurrencia fueron dos (rango 1-7) y ninguna requirio cirugia. La tasa de recidiva fue significativamente menor tras DSE “en bloque” respecto a fragmentada (15% vs. 27%, p = 0,036) y en resecciones R0 respecto a R1 (0% vs. 26%, p = 0,034). Las resecciones con margenes laterales negativos en lesiones resecadas en bloque presentaron menor tasa de recidiva respecto a aquellas con margenes afectos/desconocidos, que no alcanzaron la significacion estadistica (0% vs. 28%, p = 0,09). Conclusiones: en nuestro estudio, la supervivencia libre de enfermedad a cinco anos fue del 81% y ningun paciente requirio cirugia durante el seguimiento. Las resecciones fragmentadas y R1 se asociaron de forma significativa con mayor tasa de recurrencia.
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- 2020
16. Endoscopic submucosal dissection for gastric epithelial lesions: long-term results in a Spanish cohort
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Carlos Piedracoba-Cadahia, Julia Arribas Anta, José Díaz-Tasende, Sarbelio Rodríguez Muñoz, Teresa Álvarez-Nava Torrego, Marta Rodríguez Carrasco, José Carlos Marín-Gabriel, David Rafael de la Cruz Esteban, Esteban Romero Romero, Andrés J. Del Pozo-García, and Ángel Cañete Ruiz
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Gynecology ,medicine.medical_specialty ,Endoscopic Mucosal Resection ,business.industry ,Dissection ,Treatment outcome ,Gastroenterology ,General Medicine ,Long term results ,Endoscopic submucosal dissection ,Neoplasm Recurrence ,Treatment Outcome ,Gastric Mucosa ,Stomach Neoplasms ,medicine ,Humans ,Neoplasm Recurrence, Local ,business ,Retrospective Studies - Abstract
Introduccion: la diseccion submucosa endoscopica sobre lesiones gastricas (DSE-G) es una tecnica que permite la reseccion de tumores gastricos precoces en bloque, con una tasa de curacion similar a la cirugia y una morbimortalidad menor. Objetivo: analizar la supervivencia total, la supervivencia libre de enfermedad y la tasa de recidiva en pacientes sometidos a DSE-G en una cohorte espanola a lo largo de su evolucion clinica. Material y metodos: estudio observacional prospectivo. Inclusion de pacientes sometidos a DSE-G de 2008 a 2015, con seguimiento entre seis y 60 meses. Se analizo la recurrencia a cinco anos mediante curvas de Kaplan-Meier y los resultados fueron comparados entre diferentes factores (en bloque vs. reseccion fragmentada, resecciones curativas R0 vs. margen lateral afecto ML+) usando test log-rank. Resultados: se analizaron 35 pacientes sometidos a DSE-G, con una mediana de seguimiento de 33,62 meses. Se identificaron cuatro recidivas en este periodo (11,4%), tres de ellas tratadas mediante nueva DSE-G. La presencia de ML+ en la pieza histologica se relaciono con mayor tasa de recidiva local durante el seguimiento (p = 0,06). Las resecciones fragmentadas presentaron un mayor riesgo de recidiva pero sin detectarse diferencias estadisticamente significativas (p = 0,49). No se registraron fallecimientos por neoplasia gastrica ni gastrectomia por persistencia de enfermedad en este periodo. La tasa de supervivencia global en nuestra serie fue de 94,3%. Conclusiones: la DSE-G realizada en nuestro medio permite una tasa elevada de curacion a largo plazo evitando la cirugia. Estos resultados se asemejan a las series europeas publicadas y aun se encuentran lejos de las tasas de curacion y recidiva de las cohortes asiaticas. Los casos de recidiva local pueden ser controlados mediante endoscopia.
- Published
- 2020
17. COMPLICACIONES DE LAS PRÓTESIS AUTOEXPANDIBLES ANTE OBSTRUCCIÓN TUMORAL COLORRECTAL Y ADYUVANCIA CON BEVACIZUMAB
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Fernando Sánchez Gómez, Sarbelio Rodríguez Muñoz, Inmaculada Salces Franco, José Carlos Marín Gabriel, José Manuel Dutari Valdés, and Andrés del Pozo García
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- 2019
18. EFICACIA DE LA CPRE EN PACIENTES CON CIRROSIS HEPÁTICA FRENTE A PACIENTES CON FUNCIÓN HEPÁTICA CONSERVADA
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Laura López Couceiro, José Carlos Marín Gabriel, Sarbelio Rodríguez Muñoz, José Díaz Tasende, Andrés del Pozo García, Gregorio Castellano Tortajada, Fernando Sánchez Gómez, Elena Gómez Domínguez, and Inmaculada Fernández Vázquez
- Published
- 2019
19. Me, the intruder: revisited and rethought
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Maria Ataz Orihuela, Sarbelio Rodríguez Muñoz, and Beatriz Arberas Díez
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Medical education ,business.industry ,Sedation ,Gastroenterology ,General Medicine ,ERCP ,Ask price ,Medicine ,lcsh:Diseases of the digestive system. Gastroenterology ,Obligation ,lcsh:RC799-869 ,medicine.symptom ,business ,Propofol - Abstract
I have read Dr. Luzon's article (1) and have shared his opinions for a long time. As I indicated in my letter 13 years ago (2), all of our patients need to receive adequate sedation in endoscopic explorations, including ERCP. It is also our obligation as the person responsible for the procedure, to ensure that this is so. At present and without renouncing any of my beliefs, I think it is necessary to ask ourselves several questions: .
- Published
- 2018
20. EFICACIA Y SEGURIDAD DE LA CPRE EN PACIENTES CON CIRROSIS HEPÁTICA
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Fernando Sánchez Gómez, Sarbelio Rodríguez Muñoz, Inmaculada Fernández Vázquez, Andrés del Pozo García, Gregorio Castellano Tortajada, José Díaz Tasende, Laura López Couceiro, Elena Gómez Domínguez, and José Carlos Marín Gabriel
- Published
- 2018
21. Bowel cleansing effectiveness and safety of 1L PEG + Asc in the real-world setting: Observational, retrospective, multicenter study of over 13000 patients
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José Miguel Esteban López-Jamar, Ricardo Gorjão, José Cotter, Vicente Lorenzo-Zúñiga García, Miguel Angel Pantaleón Sánchez, David Carral Martínez, Fernando Sábado, Elena Pérez Arellano, Blas José Gómez Rodríguez, Antonio López Cano, Salvador Machlab, Cátia Arieira, Fatma Akriche, Carmen Turbí Disla, and Sarbelio Rodriguez Muñoz
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Colonoscopy ,NER1006 ,Plenvu ,Polyethylene glycol ,bowel preparation ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2023
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22. Therapeutic impact of colon capsule endoscopy with PillCam COLON 2 after incomplete standard colonoscopy: a Spanish multicenter study
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Ignacio Couto, Ángeles Masedo, Begoña González-Suárez, Miguel Muñoz-Navas, Pilar Olivencia, José Olmedo, Francisco Sánchez Ceballos, Sarbelio Rodríguez, Matilde Asteinza, David Nicolás, Óscar Nogales, Ignacio Fernández Urién, Cristina Carretero, Cecilia González Asanza, Beatriz Merino, Cristina Garfia, Marisol Luján, Javier García-Lledó, and José Francisco Juanmartiñena
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Adult ,Male ,Colonic diverticulosis ,medicine.medical_specialty ,Colon ,Colonic neoplasms ,Colonoscopy ,Colonic polyps ,Gastroenterology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Capsule endoscopy ,law ,Internal medicine ,Diverticulosis, Colonic ,medicine ,Humans ,Prospective Studies ,Intestinal Mucosa ,lcsh:RC799-869 ,Prospective cohort study ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Combined approach ,Diverticulosis ,Clinical trial ,Multicenter study ,Spain ,030220 oncology & carcinogenesis ,Population study ,Female ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,business - Abstract
Introduction: Colon capsule endoscopy (CCE) is an alternative approach for the examination of the colon in patients who refuse colonoscopy or after incomplete colonoscopy (IC). We conducted a study to determine the frequency of complete colonoscopy after IC, the diagnostic yield of CCE, the therapeutic impact of lesions found in CCE, the level of colon cleanliness and the safety of the procedure. Methods: We performed a prospective, multicenter study involving ten Spanish hospitals. Consecutive outpatients aged ≥ 18 years with previous IC were invited to participate. The latest version of the CCE device, PillCam™ COLON 2 (CCE-2), was administered to all patients according to the protocol. Results: The study population comprised 96 patients. The most frequent cause of IC was the inability to move past a loop using standard maneuvers (75/96 patients, 78%). Complete visualization of the colon was obtained with CCE-2 in 69 patients (71.9%). Of the 27 patients in whom the CCE-2 did not reach the hemorrhoidal plexus, it passed the colonic segment explored with the previous colonoscopy in 20 cases; therefore, it could be inferred that a combined approach (CCE-2 plus colonoscopy) enabled complete visualization of the colonic mucosa in 92.7% of patients. CCE-2 revealed new lesions in 58 patients (60.4%). Polyps were the most frequent finding (41 patients; 42.7% of the total number of patients). In 43 of the 58 patients (44.8% of the total number of patients), the new lesions observed led to modification of therapy, which included a new colonoscopy for polyp resection or surgery in patients with colonic neoplasm. Conclusions: CCE-2 is a suitable diagnostic procedure that can lead to more frequent diagnosis of significant colonic lesions after IC.
- Published
- 2017
23. Innate Lymphoid Cells Groups 1 and 3 in the Epithelial Compartment of Functional Human Intestinal Allografts
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Rocío Laguna-Goya, C. Jimenez, Iván Bernardo, Paloma Talayero, Esther Mancebo, Estela Paz-Artal, Francisco Cano-Romero, Iago Justo, Jorge Calvo-Pulido, Carmelo Loinaz, Álvaro García-Sesma, and Sarbelio Rodríguez-Muñoz
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0301 basic medicine ,Adult ,Male ,CD3 Complex ,CD3 ,Population ,chemical and pharmacologic phenomena ,Biology ,Lymphocyte Activation ,digestive system ,03 medical and health sciences ,Young Adult ,RAR-related orphan receptor gamma ,Antigens, CD ,T-Lymphocyte Subsets ,Immunology and Allergy ,Cytotoxic T cell ,Humans ,Pharmacology (medical) ,education ,Interleukin-7 receptor ,Aged ,Transplantation ,education.field_of_study ,hemic and immune systems ,Epithelial Cells ,Middle Aged ,Allografts ,Molecular biology ,Granzyme B ,Intestines ,Killer Cells, Natural ,Intestinal Diseases ,030104 developmental biology ,Case-Control Studies ,Immunology ,biology.protein ,Intraepithelial lymphocyte ,Cytokines ,Female ,Integrin alpha Chains ,CD8 - Abstract
We examined intraepithelial lymphocytes (IELs) in 213 ileal biopsies from 16 bowel grafts and compared them with 32 biopsies from native intestines. During the first year posttransplantation, grafts exhibited low levels of IELs (percentage of CD103(+) cells) principally due to reduced CD3(+) CD8(+) cells, while CD103(+) CD3(-) cell numbers became significantly higher. Changes in IEL subsets did not correlate with histology results, isolated intestine, or multivisceral transplants, but CD3(-) IELs were significantly higher in patients receiving corticosteroids. Compared with controls, more CD3(-) IELs of the grafts expressed CD56, NKp44, interleukin (IL)-23 receptor, retinoid-related orphan receptor gamma t (RORγt), and CCR6. No difference was observed in granzyme B, and CD3(-) CD127(+) cells were more abundant in native intestines. Ex vivo, and after in vitro activation, CD3(-) IELs in grafts produced significantly more interferon (IFN)-γ and IL-22, and a double IFNγ(+) IL-22(+) population was observed. Epithelial cell-depleted grafts IELs were cytotoxic, whereas this was not observed in controls. In conclusion, different from native intestines, a CD3(-) IEL subset predominates in grafts, showing features of natural killer cells and intraepithelial ILC1 (CD56(+) , NKp44(+) , CCR6(+) , CD127(-) , cytotoxicity, and IFNγ secretion), ILC3 (CD56(+) , NKp44(+) , IL-23R(+) , CCR6(+) , RORγt(+) , and IL-22 secretion), and intermediate ILC1-ILC3 phenotypes (IFNγ(+) IL-22(+) ). Viability of intestinal grafts may depend on the balance among proinflammatory and homeostatic roles of ILC subsets.
- Published
- 2015
24. Endoscopic submucosal dissection. Sociedad Española de Endoscopia Digestiva (SEED) clinical guideline
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José Díaz Tasende, José Miguel Esteban, Enrique Vazquez-Sequeiros, David Nicolás-Pérez, Antonio Z. Gimeno-García, Sarbelio Rodríguez Muñoz, Leopoldo López Rosés, Ángel Calderón, Óscar Nogales, Juan J. Vila, Joaquín de la Peña, David Martínez-Ares, Eloy Sánchez Hernández, Alberto Herreros de Tejada, Gloria Fernández-Esparrach, Adolfo Parra-Blanco, Andres Sanchez-Yague, Aitor Orive-Calzada, Akiko Ono, and Universitat de Barcelona
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,Gastroenterology ,Mucosa gastrointestinal ,Endoscopy ,General Medicine ,Endoscopic submucosal dissection ,Guideline ,Endoscopy, Gastrointestinal ,Surgery ,Stomach Neoplasms ,Gastrointestinal mucosa ,Medicine ,Humans ,lcsh:Diseases of the digestive system. Gastroenterology ,Endoscòpia ,lcsh:RC799-869 ,Intestinal Mucosa ,Càncer ,business ,Cancer - Abstract
Gloria Fernandez-Esparrach, Angel Calderon, Joaquin de-la-Pena, Jose B. Diaz-Tasende, Jose Miguel Esteban, Antonio Zebenzuy Gimeno-Garcia, Alberto Herreros-de-Tejada, David Martinez-Ares, David Nicolas-Perez, Oscar Nogales, Akiko Ono, Aitor Orive-Calzada, Adolfo Parra-Blanco, Sarbelio Rodriguez-Munoz, Eloy Sanchez-Hernandez, Andres Sanchez-Yague, Enrique Vazquez-Sequeiros, Juan Vila and Leopoldo Lopez-Roses; on behalf of the Sociedad Espanola de Endoscopia Digestiva (SEED)
- Published
- 2014
25. Technical Phosphoproteomic and Bioinformatic Tools useful in Cancer Research
- Author
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Jesús Mendieta, Isabel López, Sarbelio Rodríguez Muñoz, Jan-Jaap Wesselink, Elena López, Paulino Gómez-Puertas, Ministerio de Ciencia e Innovación (España), European Commission, and Fundación Ramón Areces
- Subjects
0303 health sciences ,business.industry ,Phosphopeptide ,Kinase ,Cancer ,Health Informatics ,Review ,medicine.disease ,Proteomics ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Cancer research ,Medicine ,Protein phosphorylation ,Identification (biology) ,Signal transduction ,business ,Human cancer ,030304 developmental biology - Abstract
Reversible protein phosphorylation is one of the most important forms of cellular regulation. Thus, phosphoproteomic analysis of protein phosphorylation in cells is a powerful tool to evaluate cell functional status. The importance of protein kinase-regulated signal transduction pathways in human cancer has led to the development of drugs that inhibit protein kinases at the apex or intermediary levels of these pathways. Phosphoproteomic analysis of these signalling pathways will provide important insights for operation and connectivity of these pathways to facilitate identification of the best targets for cancer therapies. Enrichment of phosphorylated proteins or peptides from tissue or bodily fluid samples is required. The application of technologies such as phosphoenrichments, mass spectrometry (MS) coupled to bioinformatics tools is crucial for the identification and quantification of protein phosphorylation sites for advancing in such relevant clinical research. A combination of different phosphopeptide enrichments, quantitative techniques and bioinformatic tools is necessary to achieve good phospho-regulation data and good structural analysis of protein studies. The current and most useful proteomics and bioinformatics techniques will be explained with research examples. Our aim in this article is to be helpful for cancer research via detailing proteomics and bioinformatic tools., This study was supported by: the Spanish Ministerio de Ciencia e Innovación through grants SAF2007-61926 (to PGP) and the European Commission through grant FP7 HEALTH-F3-2009-223431 (to PGP). Biomol-Informatics was financed by the European Social Fund. Support from the "Fundación Ramón Areces" is acknowledged. We also thank the Centro de Computación Científica-UAM for computational support. Special thanks Prof. Ernest Feytmans (Honorary Director at Swiss Institute of Bioinformatics -Location Geneva Area, Switzerland) and Prof. Shabaz Mohammed (Theme Leader at the Netherlands Proteomics Centre, Lecturer Utrecht University) who contributed to the publication of this article.
- Published
- 2011
26. Complications of percutaneous endoscopic gastrostomy-jejunostomy for levodopa/carbidopa infusion in advanced Parkinson's disease
- Author
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David Collado, Sarbelio Rodríguez, Inmaculada Chico, Rafael Sánchez-Estella, Ana Olivares, Marta Calvo, Carlos Marra, Eduardo Olivo, L. R. Rábago, Miguel Muñoz-Navas, and Jose Carlos Subtil
- Subjects
Levodopa ,medicine.medical_specialty ,Parkinson's disease ,medicine.medical_treatment ,Perforation (oil well) ,levodopa/carbidopa infusion in duodenum ,RC799-869 ,percutaneous endoscopic gastrostomy-tube, levodopa/carbidopa infusion in duodenum, intestinal obstruction, intestinal perforation, endoscopic extraction ,percutaneous endoscopic gastrostomy-tube ,Percutaneous endoscopic gastrostomy ,Medicine ,Off time ,intestinal perforation ,Hepatology ,business.industry ,digestive, oral, and skin physiology ,Advanced stage ,Gastroenterology ,Diseases of the digestive system. Gastroenterology ,intestinal obstruction ,medicine.disease ,Surgery ,endoscopic extraction ,Anesthesia ,Jejunostomy ,Levodopa carbidopa ,business ,medicine.drug - Abstract
Continuous infusions of levodopa directly into the duodenum-yeyunum is an effective therapy to reduce daily off time in an advanced stage of Parkinson's disease, but it is not without complications, particularly device related problems. We present our experience in three Spanish hospitals with these complications, including a severe case with migration, several decubitus ulcers, and one case of perforation of the bowel and finally death.
- Published
- 2012
27. Experimental study of hybrid-knife endoscopic submucosal dissection (ESD) versus standard ESD in a Western country
- Author
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Joaquín De-la-Peña, Eloy Sánchez-Hernández, Gloria Fernández-Esparrach, David Martínez-Ares, José Miguel Esteban, Óscar Nogales, Aitor Orive-Calzada, Sarbelio Rodríguez, Leopoldo López-Rosés, Juan J. Vila, Ángel Calderón, and Universitat de Barcelona
- Subjects
Male ,medicine.medical_specialty ,Swine ,ESD ,Endoscopy, Gastrointestinal ,Experimental endoscopy ,Cirurgia digestiva ,Stomach Neoplasms ,Gastrointestinal mucosa ,Hybrid-knife ESD ,medicine ,Animals ,Animal study ,lcsh:RC799-869 ,Endoscòpia ,High pressure water ,business.industry ,Gastroenterology ,Mucosa gastrointestinal ,Endoscopy ,General Medicine ,Endoscopic submucosal dissection ,Surgical Instruments ,Gastrointestinal surgery ,Surgery ,Water-jet assisted ESD ,lcsh:Diseases of the digestive system. Gastroenterology ,Nuclear medicine ,business ,Learning Curve - Abstract
Background Endoscopic submucosal dissection (ESD) is an effective but time-consuming treatment for early neoplasia that requires a high level of expertise. Objective The objective of this study was to assess the efficacy and learning curve of gastric ESD with a hybrid knife with high pressure water jet and to compare with standard ESD. Material and methods We performed a prospective non survival animal study comparing hybrid-knife and standard gastric ESD. Variables recorded were: Number of en-bloc ESD, number of ESD with all marks included (R0), size of specimens, time and speed of dissection and adverse events. Ten endoscopists performed a total of 50 gastric ESD (30 hybrid-knife and 20 standard). Results Forty-six (92 %) ESD were en-bloc and 25 (50 %) R0 (hybrid-knife: n = 13, 44 %; standard: n = 16, 80 %; p = 0.04). Hybrid-knife ESD was faster than standard (time: 44.6 +/- 21.4 minutes vs. 68.7 +/- 33.5 minutes; p = 0.009 and velocity: 20.8 +/- 9.2 mm(2)/min vs. 14.3 +/- 9.3 mm(2)/min (p = 0.079). Adverse events were not different. There was no change in speed with any of two techniques (hybrid-knife: From 20.33 +/- 15.68 to 28.18 +/- 20.07 mm(2)/min; p = 0.615 and standard: From 6.4 +/- 0.3 to 19.48 +/- 19.21 mm(2)/min; p = 0.607). The learning curve showed a significant improvement in R0 rate in the hybrid-knife group (from 30 % to 100 %). Conclusion despite the initial performance of hybrid-knife ESD is worse than standard ESD, the learning curve with hybrid knife ESD is short and is associated with a rapid improvement. The introduction of new tools to facilitate ESD should be implemented with caution in order to avoid a negative impact on the results.
28. Relevant phosphoproteomic and mass spectrometry: approaches useful in clinical research
- Author
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Elena López, Sarbelio Rodríguez Muñoz, Juan López Pascual, and Luis Madero
- Subjects
lcsh:R5-920 ,Phosphoproteomics ,Mass spectrometry ,Chemical Association ,Chemistry ,Short Report ,Medicine (miscellaneous) ,Sequence (biology) ,Computational biology ,Bioinformatics ,Proteomics ,Clinical research ,Medicine public health ,Proteome ,Molecular Medicine ,lcsh:Medicine (General) - Abstract
Background “It's not what we do, it's the way that we do it”. Never has this maxim been truer in proteomics than now. Mass Spectrometry‐based proteomics/phosphoproteomics tools are critical to understand the structure and dynamics (spatial and temporal) of signalling that engages and migrates through the entire proteome. Approaches such as affinity purification followed by Mass Spectrometry (MS) have been used to elucidate relevant biological questions disease vs. health. Thousands of proteins interact via physical and chemical association. Moreover, certain proteins can covalently modify other proteins post‐translationally. These post‐translational modifications (PTMs) ultimately give rise to the emergent functions of cells in sequence, space and time. Findings Understanding the functions of phosphorylated proteins thus requires one to study proteomes as linked‐systems rather than collections of individual protein molecules. Indeed, the interacting proteome or protein‐network knowledge has recently received much attention, as network‐systems (signalling pathways) are effective snapshots in time, of the proteome as a whole. MS approaches are clearly essential, in spite of the difficulties of some low abundance proteins for future clinical advances. Conclusion Clinical proteomics‐MS has come a long way in the past decade in terms of technology/platform development, protein chemistry, and together with bioinformatics and other OMICS tools to identify molecular signatures of diseases based on protein pathways and signalling cascades. Hence, there is great promise for disease diagnosis, prognosis, and prediction of therapeutic outcome on an individualized basis. However, and as a general rule, without correct study design, strategy and implementation of robust analytical methodologies, the efforts, efficiency and expectations to make biomarkers (especially phosphorylated kinases) a useful reality in the near future, can easily be hampered.
- Full Text
- View/download PDF
29. Technical phosphoproteomic and bioinformatic tools useful in cancer research.
- Author
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López E, Wesselink JJ, López I, Mendieta J, Gómez-Puertas P, and Muñoz SR
- Abstract
Reversible protein phosphorylation is one of the most important forms of cellular regulation. Thus, phosphoproteomic analysis of protein phosphorylation in cells is a powerful tool to evaluate cell functional status. The importance of protein kinase-regulated signal transduction pathways in human cancer has led to the development of drugs that inhibit protein kinases at the apex or intermediary levels of these pathways. Phosphoproteomic analysis of these signalling pathways will provide important insights for operation and connectivity of these pathways to facilitate identification of the best targets for cancer therapies. Enrichment of phosphorylated proteins or peptides from tissue or bodily fluid samples is required. The application of technologies such as phosphoenrichments, mass spectrometry (MS) coupled to bioinformatics tools is crucial for the identification and quantification of protein phosphorylation sites for advancing in such relevant clinical research. A combination of different phosphopeptide enrichments, quantitative techniques and bioinformatic tools is necessary to achieve good phospho-regulation data and good structural analysis of protein studies. The current and most useful proteomics and bioinformatics techniques will be explained with research examples. Our aim in this article is to be helpful for cancer research via detailing proteomics and bioinformatic tools.
- Published
- 2011
- Full Text
- View/download PDF
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