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Article ; Online: Sobrevida del adenocarcinoma ductal de páncreas.

Targarona, Javier / Rivero, Luis / Coayla, Guillermo / Roman, Gilbert / Rivas, Diego / Legua, Sebastián / Carrasco, Roberto

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru

2024 Volume 43, Issue 4, Page(s) 300–308

Abstract: Objective: The objective of this study is to analyze the epidemiological presentation and survival of patients with pancreatic ductal adenocarcinoma according to their clinical stage and the type of intervention performed, in a cohort of patients ... ...

Title translation	Survival of patients with pancreatic ductal adenocarcinoma.
Abstract	Objective: The objective of this study is to analyze the epidemiological presentation and survival of patients with pancreatic ductal adenocarcinoma according to their clinical stage and the type of intervention performed, in a cohort of patients treated at a clinic in Lima, Peru. Materials and methods: A retrospective cohort study evaluated patients diagnosed with pancreatic ductal adenocarcinoma from January 2015 to February 2021, considering various epidemiological factors, radiological findings, oncological staging, receipt of neoadjuvant or adjuvant chemotherapy, undergoing surgery, and post-intervention survival. Results: Out of the 249 patients analyzed, 75 of them required resective surgery. Among the main findings, it was observed that those with a CA 19-9 level below 200 U/mL had a higher median survival compared to those with a CA 19-9 level above 200 U/mL (HR: 1.96; 95% CI: 0.18-0.53; p≤0.001). Furthermore, when comparing patients according to their stage, those with resectable tumors had a median survival of 37.72 months, while those with locally advanced tumors had a median survival of 13.47 months, and those with metastatic tumors had a median survival of 7.69 months (HR: 0.87; 95% CI: 0.31-0.25; p≤0.001). Additionally, receiving neoadjuvant treatment was associated with a better prognosis of survival for patients (HR: 0.32; 95% CI: 0.19-0.53; p≤0.001). Furthermore, 5 pancreatectomies with metastatic resection were performed in oligometastatic patients treated with salvage chemotherapy, and the median survival for these patients was 22.51 months. Conclusion: Resective surgery at an early clinical stage, CA 19-9 levels below 200 U/mL, and receiving neoadjuvant chemotherapy are statistically correlated with a higher overall survival.
MeSH term(s)	Humans ; Retrospective Studies ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/therapy ; Carcinoma, Pancreatic Ductal/drug therapy ; Carcinoma, Pancreatic Ductal/pathology ; Prognosis ; Neoadjuvant Therapy
Language	Spanish
Publishing date	2024-01-14
Publishing country	Peru
Document type	English Abstract ; Journal Article
ZDB-ID	2058591-3
ISSN	1609-722X ; 1609-722X
ISSN (online)	1609-722X
ISSN	1609-722X
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Comparative Outcome Data Using Different Techniques for Posterior Lumbar Fusion: A Large Single-Center Study.

Lewis, Daniel / Marya, Shivan / Carrasco, Roberto / Sabou, Silviu / Leach, John

Asian spine journal

2023 Volume 17, Issue 5, Page(s) 807–817

Abstract: Study design: Retrospective single-center study.: Purpose: This study aims to evaluate perioperative and intermediate-term clinical outcomes of patients undergoing different lumbar fusion techniques.: Overview of literature: Various open and ... ...

Abstract	Study design: Retrospective single-center study. Purpose: This study aims to evaluate perioperative and intermediate-term clinical outcomes of patients undergoing different lumbar fusion techniques. Overview of literature: Various open and minimally invasive techniques for lumbar fusion are available, but previous studies comparing lumbar fusion techniques have heterogeneous data, making interpretation challenging. Methods: Between 2011 and 2018, data from 447 consecutive patients undergoing one/two-level lumbar fusion were analyzed. Posterior lumbar interbody fusion (PLIF) with bilateral muscle strip or Wiltse approach, open transforaminal lumbar interbody fusion (TLIF) and minimally invasive TLIF, and posterolateral fusion only were among the surgical techniques used. Core outcomes measure index (COMI) questionnaires were distributed before surgery and at 3 months, 1 year, and 2 years postoperatively to establish patient selfreported outcome measures. Demographic data (age, gender, and body mass index [BMI]) for each patient were also collected in addition to surgical indication, previous operative history, perioperative outcomes, and complications, and whether later revision surgery was required. Pearson's chi-square test, Kruskal-Wallis test, repeated measure mixed-effects models, and ordinal logistic regression were used for statistical analysis. Results: Postoperative COMI scores improved across all procedures compared with pre-surgery (p<0.001). There was no significant difference between different postoperative COMI scores. Significant predictors of higher postoperative COMI score included higher pretreatment COMI score (p≤0.001), previous surgery (p≤0.04), younger age (p≤0.05), higher BMI (p≤0.005), and the indications of lytic spondylolisthesis (p=0.02) and degenerative disc disease (p<0.001). Patients undergoing minimally invasive TLIF had a significantly shorter post-surgery stay than patients undergoing open PLIF (Kruskal-Wallis test, p=0.03). Conclusions: At 2 years postoperatively, there was no significant difference in clinical outcomes between open and minimally invasive techniques. These findings suggest that the main determinant of surgical approach should be surgeon preference and training.
Language	English
Publishing date	2023-10-04
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2559763-2
ISSN	1976-7846 ; 1976-1902
ISSN (online)	1976-7846
ISSN	1976-1902
DOI	10.31616/asj.2022.0448
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Article ; Online: Cuando la ciencia de la conducta salva vidas

Polanco Carrasco, Roberto

Cuadernos de Neuropsicología, ISSN 0718-4123, Vol. 14, Nº. 1, 2020, pags. 8-9

2020

Abstract: Si algo nos ha enseñado el coronavirus (COVID-19), una vez más, es que las políticas y sistemas de salud, y dentro de ello todo lo que involucra la precaria situación de la salud mental en general, es que las capacidades de la psicología para poder ... ...

Abstract	Si algo nos ha enseñado el coronavirus (COVID-19), una vez más, es que las políticas y sistemas de salud, y dentro de ello todo lo que involucra la precaria situación de la salud mental en general, es que las capacidades de la psicología para poder abordar esta enfermedad han sido francamente subvaloradas. En algunos casos simplemente descartados por ciertas instituciones que se vinculan a los gobiernos de turno o incluso, por qué no decirlo, hasta por los propios actores de la psicología, muchos de los cuales se han visto limitados en sus funciones. Acaso no resulta curioso que una simple búsqueda de información experta, la que debería poder hacer cualquier estudiante de último ciclo de su carrera universitaria, puede encontrar sólida y variada cantidad de conocimientos que existen desde hace años respecto a la importancia de ciertas conductas para el cuidado de la salud física y mental. Entre estos conocimientos se sabe, por ejemplo, de las consecuencias nocivas de una cuarentena prolongada, tanto en niños cuando se interrumpen la interacción con sus pares, como en adultos cuando se provoca un asilamiento afectivo obligado por la situación, temáticas ampliamente investigadas por nuestra disciplina.
Keywords	covid19
Language	Spanish
Publishing country	es
Document type	Article ; Online
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Article: The clinical and radiological outcomes of multilevel posterior lumbar interbody fusion in the treatment of degenerative scoliosis: a consecutive case series with minimum 2 years follow up.

Sabou, Silviu / Carrasco, Roberto / Verma, Rajat / Siddique, Irfan / Mohammad, Saeed

Journal of spine surgery (Hong Kong)

2020 Volume 5, Issue 4, Page(s) 520–528

Abstract: Background: Surgical treatment for adult degenerative scoliosis (ADS) is a complex undertaking and is associated with a high complication rate. Our aim was to evaluate the clinical and radiological outcomes, mortality and morbidity of multilevel ... ...

Abstract	Background: Surgical treatment for adult degenerative scoliosis (ADS) is a complex undertaking and is associated with a high complication rate. Our aim was to evaluate the clinical and radiological outcomes, mortality and morbidity of multilevel posterior lumbar interbody fusion (MPLIF) in the treatment in ADS based on the experience of a single tertiary referral center for spinal surgery. Methods: We performed a retrospective analysis of prospectively collected data of consecutive patients who had undergone multi-level posterior interbody fusion for degenerative scoliosis. We prospectively recorded patients' demographics, co-morbidities; coronal and sagittal plane deformity assessment and surgical details: number of instrumented levels, and intra-operative and postoperative complications. Functional outcomes and patient-reported complications were entered in our local spine surgery database (part of the Eurospine Spine Tango Registry) and used to collect data on functional scores and patient-reported complications preoperatively and at 6, 12 and 24 months' follow-up. Results: Our study involved 13 males and 51 females with a mean age of 70.26 (range 49-90, SD 8.9). MPLIF was performed at five levels in one patient, four levels in 29 patients, three levels in 20 patients, and two levels in 14 patients. There were a total of 14 (21.87%) major, minor and mechanical complications. There were no procedure-related mortalities. The average COMI and Eq5d scores improved significantly post-surgery, and this improvement was maintained at a mean follow-up of up to two years. Conclusions: Multilevel posterior interbody fusion is a safe procedure, and in selected cases can result in good clinical and radiological outcomes with improvement in patient quality of life.
Language	English
Publishing date	2020-01-31
Publishing country	China
Document type	Journal Article
ZDB-ID	2874556-5
ISSN	2414-4630 ; 2414-469X
ISSN (online)	2414-4630
ISSN	2414-469X
DOI	10.21037/jss.2019.12.02
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Article ; Online: Orofacial pain in 1916 patients with early or moderate Parkinson disease.

O'Neill, Francis / Kobylecki, Christopher / Carrasco, Roberto / Hu, Michele T / Grosset, Donald / Silverdale, Monty

Pain reports

2021 Volume 6, Issue 1, Page(s) e923

Abstract: Introduction: Several studies have reported that some types of orofacial pain are more common in patients with Parkinson disease (PD) than the general population.: Objectives: In this study, we aimed to investigate the prevalence of self-reported ... ...

Abstract	Introduction: Several studies have reported that some types of orofacial pain are more common in patients with Parkinson disease (PD) than the general population. Objectives: In this study, we aimed to investigate the prevalence of self-reported orofacial pain in a larger group of patients with PD than has been previously studied. Methods: We analysed data from 1916 participants with PD in a cross-sectional study recruited to the UK Parkinson's Pain Study who had detailed assessments of pain, motor, and nonmotor symptoms. The King's Parkinson's Pain scale was used to quantify different subtypes of pain. Results: A total of 139 (7.3%) patients reported the presence of some form of orofacial pain. Burning mouth syndrome was reported in 32 (1.7%), whereas chewing pain was found in 38 (2.0%) and grinding pain in 78 (4.0%). Orofacial pain was significantly more common in females (10.4%) than males (5.9%). Multiple logistic regression analysis showed a significant association between orofacial pain and pain severity, neuropathic pain, and oral motor and nonmotor dysfunction. Conclusion: In our study, population cohort of early patients with PD found prevalence of orofacial pain conditions similar to that in the general population.
Language	English
Publishing date	2021-04-13
Publishing country	United States
Document type	Journal Article
ISSN	2471-2531
ISSN (online)	2471-2531
DOI	10.1097/PR9.0000000000000923
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Article: Does Instrumentation of the Fractured Level in Thoracolumbar Fixation Affect the Functional and Radiological Outcome?

Mohammed, Riaz / Carrasco, Roberto / Verma, Rajat / Siddique, Irfan / Mohammad, Saeed / Elmalky, Mahmoud

Global spine journal

2021 , Page(s) 2192568221991106

Abstract: Study design: Retrospective comparative study.: Objectives: To compare radiological and functional outcomes of patients with fixation constructs utilizing pedicle screw stabilization at the fracture level (FL group) versus patients with non-fracture ... ...

Abstract	Study design: Retrospective comparative study. Objectives: To compare radiological and functional outcomes of patients with fixation constructs utilizing pedicle screw stabilization at the fracture level (FL group) versus patients with non-fracture level (NFL group) fixation in single level fractures of the thoracolumbar junction (T11-L1). Methods: 53 patients of whom fracture level screw was used in 34 (FL group) were compared to 19 patients in NFL group. Radiological parameters analyzed were sagittal index, bi-segmental kyphosis (Cobb) angle and degree of vertebral height restoration. Prospectively collected patient reported functional outcomes and post-operative complications were also studied. Stepwise regression analysis adjusted by age, gender and functional scores was performed to account for the small numbers and unequal sizes of the groups. Results: Back pain score was significantly lower in the FL group ( Conclusion: The inclusion of the fracture-level pedicle screws in the fixation construct significantly improves the immediate and final measured radiological parameters, with improved functional scores in single level unstable vertebral fractures of the thoracolumbar junction.
Language	English
Publishing date	2021-02-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2648287-3
ISSN	2192-5690 ; 2192-5682
ISSN (online)	2192-5690
ISSN	2192-5682
DOI	10.1177/2192568221991106
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Article ; Online: Determination of potential risk characteristics for cauda equina compression in emergency department patients presenting with atraumatic back pain: a 4-year retrospective cohort analysis within a tertiary referral neurosciences centre.

Angus, Michelle / Curtis-Lopez, Carlos M / Carrasco, Roberto / Currie, Vicki / Siddique, Irfan / Horner, Daniel E

Emergency medicine journal : EMJ

2021

Abstract: Objective: Atraumatic back pain is an increasingly common presentation to the ED. A minority of these cases will have significant structural pathology, resulting in acute cauda equina compression (CEC). Although clinicians often look for 'red flags' to ... ...

Abstract	Objective: Atraumatic back pain is an increasingly common presentation to the ED. A minority of these cases will have significant structural pathology, resulting in acute cauda equina compression (CEC). Although clinicians often look for 'red flags' to identify potential CEC, the prognostic accuracy of these presenting symptoms and clinical examination findings is unclear. We sought to evaluate the accuracy of individual clinical features in a large cohort of ED patients with atraumatic backpain and reference standard imaging, for the diagnosis of CEC. Methods: A retrospective case note review from 2014 to 2018 within an established ED atraumatic back pain pathway, undertaken at the largest tertiary spinal referral centre in the UK. We analysed routine data, collected prospectively by treating clinicians within a structured electronic health record clinical proforma. Data on signs and symptoms in 996 patients with suspected CEC referred for definitive MRI over a 4-year study period were extracted and compared against a final reference standard diagnosis. Results: We identified 111 patients with radiological evidence of CEC within the cohort referred for definitive imaging (111/996, 11.1%), of whom 109 (98.2%) underwent operative intervention. Patients with CEC were more likely to present with bilateral leg pain (OR=2.2), dermatomal sensory loss (OR 1.8) and bilateral absent ankle or ankle and knee jerks (OR=2.9). Subjective weakness was found to be associated with CEC on univariate but not multivariate analysis. We found no relationship between digital rectal examination findings and the diagnosis of CEC. Conclusions: In our cohort, factors independently associated with CEC diagnosis on MRI included bilateral leg pain, dermatomal sensory loss. Loss of lower limb reflexes was strongly suggestive of CES (likelihood ratio 3.4 on multivariate logistic regression). Our findings raise questions about the diagnostic utility of invasive digital rectal examination.
Language	English
Publishing date	2021-10-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2040124-3
ISSN	1472-0213 ; 1472-0205
ISSN (online)	1472-0213
ISSN	1472-0205
DOI	10.1136/emermed-2020-210540
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Article ; Online: Características de la infección de Helicobacter pylori en un hospital privado de Lima, experiencia del 2019 y revisión de la literatura.

Yoza, Max / Carrasco, Roberto / Li, Bruno / Bustios, Carla / Contardo, Carlos / Palacios, Fernando / Miyagui, Juan / Niebuhr, Juan / Canales, Olivia / Monge, Victor

Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru

2022 Volume 42, Issue 1, Page(s) 7–12

Abstract: Digestive diseases are the fourth leading cause of outpatient care in Peruvian healthcare centers, with gastritis and peptic ulcers being the most common. This is a retrospective, cross-sectional, descriptive study of secondary analysis of medical record ...

Title translation	Characteristics of Helicobacter pylori infection in a private hospital in Lima, 2019 experience and literature review.
Abstract	Digestive diseases are the fourth leading cause of outpatient care in Peruvian healthcare centers, with gastritis and peptic ulcers being the most common. This is a retrospective, cross-sectional, descriptive study of secondary analysis of medical record data to evaluate the prevalence of Helicobacter pylori in patients undergoing upper digestive endoscopy during 2019 at Clinica Delgado, Lima, Peru. An association between males (PRa 1.27, 95% CI 1.10-1.48, p<0.001), age categories and upper digestive endoscopy (PRa 2.53, 95% CI 2.16-2.97, p<0.001) was reported. Based on these findings, it is recommended that other causes of gastritis be identified, especially in young women with deep chronic gastritis. Furthermore, we present a review of the scientific literature of Peru on factors associated with the positivity of Helicobacter pylori in the results of superior digestive endoscopy.
MeSH term(s)	Cross-Sectional Studies ; Endoscopy, Gastrointestinal ; Female ; Gastritis/complications ; Gastritis/diagnosis ; Gastritis/epidemiology ; Helicobacter Infections/complications ; Helicobacter Infections/diagnosis ; Helicobacter Infections/epidemiology ; Helicobacter pylori ; Hospitals, Private ; Humans ; Male ; Prevalence ; Retrospective Studies
Language	Spanish
Publishing date	2022-07-27
Publishing country	Peru
Document type	Journal Article ; Review
ZDB-ID	2058591-3
ISSN	1609-722X ; 1609-722X
ISSN (online)	1609-722X
ISSN	1609-722X
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Article: Concomitant back and leg pain as predictors for trajectories of poor outcome after single level lumbar micro-decompression alone and with micro-discectomy: a study of 3,308 patients.

Carrasco, Roberto / Elmalky, Mahmoud / Sabou, Silviu / Leach, John / Verma, Rajat / Mohammad, Saeed / Siddique, Irfan

Journal of spine surgery (Hong Kong)

2020 Volume 6, Issue 4, Page(s) 688–702

Abstract: Background: Lumbar decompression is the commonest spinal intervention. One in four patients have suboptimal outcome postoperatively, however no large studies identified clear poor outcome predictors. The aim of this study was to study low back pain (LBP) ...

Abstract	Background: Lumbar decompression is the commonest spinal intervention. One in four patients have suboptimal outcome postoperatively, however no large studies identified clear poor outcome predictors. The aim of this study was to study low back pain (LBP) as a predictor of poor outcome following lumbar micro-decompression. Methods: Prospectively collected spinal registry data was analysed for patients who underwent primary, single-level, decompression with or without discectomy at single spinal centre (2011-2017). Based on the response to the Likert global outcome question, we had two outcome groups (good & poor). Percentage of achievement of minimum clinically relevant change (MCRC) for Core Outcome Measures Index (COMI) score, LBP and leg pain (LP) was examined. A two-step approach was adopted. First, COMI score, LBP and LP visual analogue scales (VAS) trajectories were modelled using a discrete mixture model. Second, multinomial logistic regression was used to determine the association between variables and trajectories. Results: We included 3,308 patients with mean follow up (1.4 y). MCRC was achieved in COMI score in 63% of cases, 42% in LBP and 62% in LP. A three-group trajectory model was identified: large-improvement (LI) (n=980), moderate-improvement (MI) (n=1,364) and no-improvement (NI) (n=966) with 99.5%, 84.5% and 31.5% of patients presenting good outcome, respectively. Higher pre-operative LBP and COMI score and smoking were strongly associated with MI and NI. In addition, higher LP, post-operative surgical complications, previous surgery at same level, conservative treatment >6 months and anxiety/depression were associated with NI. Conclusions: This is the first large-scale study reporting preoperative LBP severity, spinal stenosis and smoking as predictors for poor functional outcomes post lumbar decompression with or without discectomy. This is very useful while counselling patients for surgery to meet realistic expectations.
Language	English
Publishing date	2020-12-28
Publishing country	China
Document type	Journal Article
ZDB-ID	2874556-5
ISSN	2414-4630 ; 2414-469X
ISSN (online)	2414-4630
ISSN	2414-469X
DOI	10.21037/jss-19-462
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Article ; Online: The Cauda Scale - Validation for Clinical Practice.

Angus, Michelle / Berg, Andrew / Carrasco, Roberto / Horner, Daniel / Leach, John / Siddique, Irfan

British journal of neurosurgery

2020 Volume 34, Issue 4, Page(s) 453–456

Abstract: Purpose: ...

Abstract	Purpose:
MeSH term(s)	Cauda Equina ; Cauda Equina Syndrome ; Humans ; Magnetic Resonance Imaging ; Polyradiculopathy ; Retrospective Studies
Language	English
Publishing date	2020-04-20
Publishing country	England
Document type	Journal Article
ZDB-ID	639029-8
ISSN	1360-046X ; 0268-8697
ISSN (online)	1360-046X
ISSN	0268-8697
DOI	10.1080/02688697.2020.1754337
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