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  1. Article: Presentation of a large jejunal artery aneurysm: Management and review of the literature.

    Minaya-Bravo, Ana María / Vera-Mansilla, Cristina / Ruiz-Grande, Fernando

    International journal of surgery case reports

    2018  Volume 48, Page(s) 50–53

    Abstract: Introduction: Jejunal artery aneurysms (JAAs) constitute less than 1% of all visceral artery aneurysms. They affect mostly men in their fifth decade. In the last years, the widespread of fine cut fine image techniques has increased the number of JAAs ... ...

    Abstract Introduction: Jejunal artery aneurysms (JAAs) constitute less than 1% of all visceral artery aneurysms. They affect mostly men in their fifth decade. In the last years, the widespread of fine cut fine image techniques has increased the number of JAAs diagnosed incidentally. The first case was reported by Levine in 1944. Since then, only a half of hundred cases have been reported. There is a lack of consensus of management of intact JAAs because of the low number of cases published. We present the largest JAA reported in the English literature up to our knowledge.
    Presentation: We report a 49 year-old woman with a 4 × 5 cm. intact jejunal artery aneurysm found incidentally in a CT. It rose from the first jejunal branch of superior mesenteric artery without signs of rupture. She underwent elective surgery and the aneurysm was completely excised.
    Discussion: Causes of JAAs include congenital, atherosclerosis or degenerative process. Their rate of rupture depends on location, size and underlying disease and it reaches 10-20% for all visceral artery aneurysms. Risk factors of rupture include pregnancy, hyper-flow situations and connective diseases. Most of cases in the literature presented rupture at the time of diagnosis. JAAs are usually treated following the recommendations for visceral artery aneurysms, so intact JAAs greater than 2 cm. and those causing symptoms should be treated. Treatment includes surgery, embolisation or stent. Surgery is the preferred management for emergency settings.
    Conclusion: JAAs are extremely rare and constitute only 1% of all visceral aneurysms. They are a life-threatening condition.
    Language English
    Publishing date 2018-05-12
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2018.04.042
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Quality of Life of Patients Treated for Abdominal Aortic Aneurysm: Open Surgery and Endoprosthesis.

    Barrena-Blázquez, Silvestra / Díez-Alonso, Manuel / Riera Del Moral, Luis Felipe / Sanchez Coll, Salvador / Alvarez-Mon, Melchor / Ortega, Miguel A / Ruiz Grande, Fernando

    Journal of clinical medicine

    2022  Volume 11, Issue 8

    Abstract: Objectives: To determine the degree of long-term health-related quality of life (HRQoL) of patients undergoing surgery for abdominal aortic aneurysm (AAA) and to analyze the results according to the type of treatment, namely, open abdominal repair (OAR) ...

    Abstract Objectives: To determine the degree of long-term health-related quality of life (HRQoL) of patients undergoing surgery for abdominal aortic aneurysm (AAA) and to analyze the results according to the type of treatment, namely, open abdominal repair (OAR) or endoprosthesis (EVAR).
    Patients and methods: This was a prospective cross-sectional observational study. Patients receiving intervention for AAA between January 2013 and December 2020 were included. The Spanish version of the SF-36 questionnaire was used. A single survey was performed on all patients, and the time elapsed since the intervention was recorded.
    Results: On all health scales and in the two groups of patients, the highest scores were recorded at six months postoperatively. At that time, the EVAR and OAR groups had similar values. Between 13 and 16 months postoperatively, EVAR patients presented a transient but significant decrease in their scores for physical function (
    Conclusions: In the short term, patients treated for AAA by EVAR or OAR showed similar results on the SF-36 questionnaire. In the long term, patients treated by EVAR had lower scores on the physical function, vitality and mental health scales.
    Language English
    Publishing date 2022-04-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11082195
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Quality of Life for Patients Receiving Elective Interventions for Abdominal Aortic Aneurysms.

    Barrena-Blázquez, Silvestra / Díez-Alonso, Manuel / Riera Del Moral, Luis Felipe / Coll, Salvador Sanchez / García-Honduvilla, Natalio / Alvarez-Mon, Melchor / Ortega, Miguel A / Ruiz-Grande, Fernando

    Journal of personalized medicine

    2022  Volume 12, Issue 6

    Abstract: Objectives: ...

    Abstract Objectives:
    Language English
    Publishing date 2022-05-31
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm12060910
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Contribution of the Elastic Component and Venous Wall Arterialization in Patients with Venous Reflux.

    Ortega, Miguel A / Fraile-Martínez, Oscar / García-Montero, Cielo / Ruiz-Grande, Fernando / Álvarez-Mon, Miguel Angel / Monserrat, Jorge / Guijarro, Luis G / Coca, Santiago / Álvarez-Mon, Melchor / Bujan, Julia / García-Honduvilla, Natalio / Sáez, Miguel A

    Journal of personalized medicine

    2022  Volume 12, Issue 2

    Abstract: Chronic venous disease (CVeD) is defined as a set of disorders affecting the venous system mainly manifested in the form of varicose veins. CVeD is characterized by a sustained venous hypertension, leading to a plethora of functional and structural ... ...

    Abstract Chronic venous disease (CVeD) is defined as a set of disorders affecting the venous system mainly manifested in the form of varicose veins. CVeD is characterized by a sustained venous hypertension, leading to a plethora of functional and structural changes in the vein that may cause valve incompetence and pathologic reflux. In turn, venous reflux aggravates the venous hypertension and enhances the progression of CVeD into the most advanced stages. Previous studies have proposed that there are several alterations in the venous wall preceding the valve dysfunction and venous reflux. Besides, it has also been identified that young patients with CVeD present premature aging and changes in the venous wall composition that may be related to the presence of venous reflux. In this context, the aim of the present study is to examine the possible pathophysiological role of elastic fibers and their precursors in the venous wall of patients with reflux in comparison to those without reflux, considering the variable age in both groups (<50 years and ≥50 years). We performed immunohistochemical and quantitative polymerase chain reaction (PCR) in order to assess the protein and gene expression of tropoelastin, fibrillin-1, fibulins 4 and 5, lysyl oxidase and lysyl oxidase like 1, respectively. In parallel, we assessed the elastin content through histological techniques (orcein stain) in this group of patients. Our results show significant changes in elastic fibers and their precursors in young patients with pathologic reflux when compared with elder patients with reflux and young patients without reflux. These variations suggest that the venous system of young patients with venous reflux appears to present an enhanced dynamism and arterialization of the venous wall, which may be associated with a premature aging and pathological environment of the tissue.
    Language English
    Publishing date 2022-02-10
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm12020260
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Association of Age and Surgical Technique with the Quality of Life of Male Patients Treated for Abdominal Aorta Aneurysms: A Cross-Sectional Study.

    Barrena-Blázquez, Silvestra / Díez-Alonso, Manuel / Riera Del Moral, Luis Felipe / Sanchez-Coll, Salvador / Alvarez-Mon, Melchor / Ortega, Miguel A / Ruiz-Grande, Fernando

    International journal of environmental research and public health

    2022  Volume 19, Issue 11

    Abstract: Objectives: The achievement of a good health-related quality of life (HRQoL) has become one of the primary objectives of medical-surgical interventions. The objective of this study is to determine the HRQoL of patients who underwent abdominal aortic ... ...

    Abstract Objectives: The achievement of a good health-related quality of life (HRQoL) has become one of the primary objectives of medical-surgical interventions. The objective of this study is to determine the HRQoL of patients who underwent abdominal aortic aneurysm (AAA) surgery and to analyse the influence of age on HRQoL.
    Materials and methods: This is an observational cross-sectional study with 151 male patients who underwent an operation for AAAs between January 2013 and December 2020 in two hospital centres. HRQoL was assessed with the Spanish version of the 36-Item Short Form Survey (SF-36), starting in the month following the surgical intervention. Statistical analyses were performed using hypothesis tests and multivariate linear regression.
    Results: The mean age of the patients was 73 years (SD: 7), and the mean interval between surgery and the interview was 37 months (SD: 27). The scores of the Physical Function (
    Conclusion: Among patients who underwent an operation for an AAA, there was a negative association between the age at operation and scores on the Physical Function, Vitality, Social Function, and Mental Health dimensions of the SF-36. The type of surgical technique influences the evolution of Physical Function and Mental Health scores, regardless of age.
    MeSH term(s) Aged ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal/etiology ; Aortic Aneurysm, Abdominal/surgery ; Cross-Sectional Studies ; Endovascular Procedures/adverse effects ; Endovascular Procedures/methods ; Humans ; Male ; Quality of Life ; Treatment Outcome
    Language English
    Publishing date 2022-05-28
    Publishing country Switzerland
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph19116580
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Venous Wall of Patients with Chronic Venous Disease Exhibits a Glycolytic Phenotype.

    Fraile-Martinez, Oscar / García-Montero, Cielo / Alvarez-Mon, Miguel Ángel / Gomez-Lahoz, Ana M / Monserrat, Jorge / Llavero-Valero, Maria / Ruiz-Grande, Fernando / Coca, Santiago / Alvarez-Mon, Melchor / Buján, Julia / García-Honduvilla, Natalio / Saz, Jose V / Ortega, Miguel A

    Journal of personalized medicine

    2022  Volume 12, Issue 10

    Abstract: Chronic venous disease (CVeD) is a rising medical condition characterized by a broad spectrum of disorders in the venous system. Varicose veins (VVs) represent a frequent clinical manifestation of CVeD, particularly in the lower limbs. Prior ... ...

    Abstract Chronic venous disease (CVeD) is a rising medical condition characterized by a broad spectrum of disorders in the venous system. Varicose veins (VVs) represent a frequent clinical manifestation of CVeD, particularly in the lower limbs. Prior histopathological studies have defined a set of alterations observed in the venous wall of patients with VVs, affecting their structure and behavior. Metabolic changes in the veins appear to be a critical biological mechanism aiding our understanding of the pathogenesis of CVeD. In this sense, previous studies have identified a potential role of a glycolytic phenotype in the development of different vascular disorders; however, its precise role in CVeD remains to be fully explored. Thus, the aim of the present study was to analyze the gene and protein expression of glucose transporter 1 (GLUT-1) and the glycolytic enzymes PGK-1, ALD, GA3PDH and LDH in the VVs of patients with CVeD (
    Language English
    Publishing date 2022-10-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm12101642
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  7. Article: Understanding Chronic Venous Disease: A Critical Overview of Its Pathophysiology and Medical Management.

    Ortega, Miguel A / Fraile-Martínez, Oscar / García-Montero, Cielo / Álvarez-Mon, Miguel A / Chaowen, Chen / Ruiz-Grande, Fernando / Pekarek, Leonel / Monserrat, Jorge / Asúnsolo, Angel / García-Honduvilla, Natalio / Álvarez-Mon, Melchor / Bujan, Julia

    Journal of clinical medicine

    2021  Volume 10, Issue 15

    Abstract: Chronic venous disease (CVD) is a multifactorial condition affecting an important percentage of the global population. It ranges from mild clinical signs, such as telangiectasias or reticular veins, to severe manifestations, such as venous ulcerations. ... ...

    Abstract Chronic venous disease (CVD) is a multifactorial condition affecting an important percentage of the global population. It ranges from mild clinical signs, such as telangiectasias or reticular veins, to severe manifestations, such as venous ulcerations. However, varicose veins (VVs) are the most common manifestation of CVD. The explicit mechanisms of the disease are not well-understood. It seems that genetics and a plethora of environmental agents play an important role in the development and progression of CVD. The exposure to these factors leads to altered hemodynamics of the venous system, described as ambulatory venous hypertension, therefore promoting microcirculatory changes, inflammatory responses, hypoxia, venous wall remodeling, and epigenetic variations, even with important systemic implications. Thus, a proper clinical management of patients with CVD is essential to prevent potential harms of the disease, which also entails a significant loss of the quality of life in these individuals. Hence, the aim of the present review is to collect the current knowledge of CVD, including its epidemiology, etiology, and risk factors, but emphasizing the pathophysiology and medical care of these patients, including clinical manifestations, diagnosis, and treatments. Furthermore, future directions will also be covered in this work in order to provide potential fields to explore in the context of CVD.
    Language English
    Publishing date 2021-07-22
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm10153239
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  8. Article ; Online: Trends in the incidence of lower limb amputation after implementation of a Multidisciplinary Diabetic Foot Unit.

    Jiménez, Sara / Rubio, José Antonio / Álvarez, Julia / Ruiz-Grande, Fernando / Medina, Carlos

    Endocrinologia, diabetes y nutricion

    2017  Volume 64, Issue 4, Page(s) 188–197

    Abstract: Backgrounds and objective: Incidence of lower extremity amputations (LEA) in the population with and without diabetes mellitus (DM) was assessed after implementation of a Multidisciplinary Diabetic Foot Unit (MDFU) during 2008.: Material and methods: ...

    Title translation Tendencia de la incidencia de amputaciones de miembro inferior tras la implementación de una Unidad Multidisciplinar de Pie Diabético.
    Abstract Backgrounds and objective: Incidence of lower extremity amputations (LEA) in the population with and without diabetes mellitus (DM) was assessed after implementation of a Multidisciplinary Diabetic Foot Unit (MDFU) during 2008.
    Material and methods: Non-traumatic LEA were analyzed, and those performed before (2001-2007) and after (2008-2014) introduction of the MDFU were compared. LEA were grouped by age and sex. Their incidence was expressed as a rate per 100,000 population per year, adjusted to the standard European population.
    Results: A total of 664 LEA were performed during the 2001-2014 period, 486 (73%) of them in patients with DM. Total LEA incidence was 11.2/10
    Conclusions: Implementation of a MDFU has been shown to be associated with a significant reduction in major amputation rate in the diabetic population, although the results are not optimal yet. Both results and work at the MDFU should be improved.
    MeSH term(s) Aged ; Aged, 80 and over ; Amputation/statistics & numerical data ; Amputation/trends ; Diabetic Foot/surgery ; Diabetic Foot/therapy ; Female ; Hospital Units ; Hospitals, University ; Humans ; Interdisciplinary Communication ; Leg/surgery ; Male ; Middle Aged ; Patient Care Team ; Retrospective Studies ; Spain
    Language Spanish
    Publishing date 2017-03-30
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 2887277-0
    ISSN 2530-0172 ; 2530-0164
    ISSN (online) 2530-0172
    ISSN 2530-0164
    DOI 10.1016/j.endinu.2017.02.009
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  9. Article ; Online: Chronic venous disease patients show increased IRS-4 expression in the great saphenous vein wall.

    Ortega, Miguel A / Fraile-Martínez, Oscar / García-Montero, Cielo / Ruiz-Grande, Fernando / Barrena, Silve / Montoya, Hector / Pekarek, Leonel / Zoullas, Sofia / Alvarez-Mon, Miguel A / Sainz, Felipe / Asúnsolo, Angel / Acero, Julio / Álvarez-Mon, Melchor / Buján, Julia / García-Honduvilla, Natalio / Guijarro, Luis G

    The Journal of international medical research

    2021  Volume 49, Issue 9, Page(s) 3000605211041275

    Abstract: Objectives: Chronic venous disease (CVeD) is a multifactorial and debilitating condition that has a high prevalence in Western countries and an important associated socioeconomic burden. Varicose veins (VVs) are the most common manifestations of CVeD. ... ...

    Abstract Objectives: Chronic venous disease (CVeD) is a multifactorial and debilitating condition that has a high prevalence in Western countries and an important associated socioeconomic burden. Varicose veins (VVs) are the most common manifestations of CVeD. Pathologically, many morphological and functional changes have been described in VVs, which most notably affect venous wall integrity. Previous studies have found several molecular alterations that negatively affect normal cell signaling pathways. Insulin receptor substrate (IRS)-4 is a central adaptor protein that is closely related to insulin/insulin-like growth factor-1 signaling upstream, phosphatidylinositol 3-kinase/Akt or mitogen-activated protein kinases downstream, and other proteins. These molecular pathways have been implicated in CVeD pathogenesis. Thus, the aim of our study was to identify the role of IRS-4 in VV tissue.
    Methods: We conducted a histopathological study to analyze IRS-4 protein expression in CVeD patients compared with healthy controls.
    Results: Our results demonstrate a significant increase in IRS-4 expression in VV tissue.
    Conclusions: IRS-4 may be implicated in CVeD development and progression. Therefore, IRS-4 could be a potential diagnostic or therapeutic target for patients with this condition.
    MeSH term(s) Adaptor Proteins, Signal Transducing ; Humans ; Insulin Receptor Substrate Proteins ; Phosphatidylinositol 3-Kinases/genetics ; Phosphatidylinositol 3-Kinases/metabolism ; Phosphoproteins/metabolism ; Saphenous Vein ; Signal Transduction
    Chemical Substances Adaptor Proteins, Signal Transducing ; IRS4 protein, human ; Insulin Receptor Substrate Proteins ; Phosphoproteins
    Language English
    Publishing date 2021-09-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 184023-x
    ISSN 1473-2300 ; 0300-0605 ; 0142-2596
    ISSN (online) 1473-2300
    ISSN 0300-0605 ; 0142-2596
    DOI 10.1177/03000605211041275
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Reducing major lower extremity amputations after the introduction of a multidisciplinary team for the diabetic foot.

    Rubio, José Antonio / Aragón-Sánchez, Javier / Jiménez, Sara / Guadalix, Gregorio / Albarracín, Agustín / Salido, Carmen / Sanz-Moreno, José / Ruiz-Grande, Fernando / Gil-Fournier, Nuria / Álvarez, Julia

    The international journal of lower extremity wounds

    2014  Volume 13, Issue 1, Page(s) 22–26

    Abstract: We analyzed the incidence of lower extremity amputations (LEAs) in the 3rd Health Care Area of Madrid before and after the March 2008 introduction of a multidisciplinary team for managing diabetic foot disease. We compared the amputation rates in people ... ...

    Abstract We analyzed the incidence of lower extremity amputations (LEAs) in the 3rd Health Care Area of Madrid before and after the March 2008 introduction of a multidisciplinary team for managing diabetic foot disease. We compared the amputation rates in people with and without diabetes during 2 periods: before (2001-2007) and after (2008-2011) the introduction of a Multidisciplinary Diabetic Foot Unit (MDFU). We also analyzed the trend of the amputation rates by joinpoint regression analysis and measured the annual percentage change (APC). During the study period, 514 nontraumatic LEAs were performed, 374 (73%) in people with diabetes and 140 (27%) in people without the disease. The incidence of LEAs showed a significant reduction in major amputations in people with diabetes, from 6.1 per 100 000 per year (95% confidence interval [CI] = 4.9 to 7.2), in the 2001 to 2007 period, to 4.0 per 100 000 per year (95% CI = 2.6 to 5.5) in the 2008 to 2011 period (P = .020). There were no changes in incidence of minor or total amputations in the diabetic population or in amputations in the nondiabetic population during the study period. Joinpoint regression analysis showed a significant reduction in the incidence of major LEAs in diabetic population with an APC of -6.6% (95% CI = -10.2 to -2.8; P = .003), but there were no other significant changes. This study demonstrates that the introduction of a multidisciplinary team, coordinated by an endocrinologist and a podiatrist, for managing diabetic foot disease is associated with a reduction in the incidence of major amputations in patients with diabetes.
    MeSH term(s) Aged ; Amputation/trends ; Diabetic Foot/epidemiology ; Diabetic Foot/surgery ; Endocrinology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Interdisciplinary Communication ; Lower Extremity/surgery ; Male ; Orthopedics ; Patient Care Team ; Podiatry ; Retrospective Studies ; Spain/epidemiology
    Language English
    Publishing date 2014-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2171119-7
    ISSN 1552-6941 ; 1534-7346
    ISSN (online) 1552-6941
    ISSN 1534-7346
    DOI 10.1177/1534734614521234
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