Jimenez, M. (Miguel)
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- Partial splenic embolization in a child with hereditary spherocytosis(Springer Verlag, 1995) Castro, L. (L.); Sierrasesumaga, L. (Luis); Bilbao, J.I. (José I.); Azcona-San-Julian, M.C. (María Cristina); Jimenez, M. (Miguel); Leon, P. (Pedro)
- Cost-effectiveness analysis of tropisetron vs. chlorpromazine-dexamethasone in the control of acute emesis induced by highly emetogenic chemotherapy in children(Springer, 1999) Sierrasesumaga, L. (Luis); Tejedor, I. (I.); Giraldez, J. (J.); Jimenez, M. (Miguel)To perform a cost-effectiveness analysis (CEA) between a standard antiemetic regimen-chlorpromazine + dexamethasone (CPM-DEX)- and a 5-HT3 receptor antagonist-tropisetron (TROP)--in the control of acute emesis induced by highly emetogenic chemotherapy in children, considering two analytic perspectives: hospital and patients. METHODS: The CEA was performed by constructing a decision tree, for both analytic perspectives, of the possible outcomes of treatment with TROP (single 0.2 mg/kg i.v.) or CPM (5-15 mg i.v. infusion for 3 doses) plus DEX (2 mg/m2 i.v. bolus i.v. x2). The patients were stratified by age in two groups (2-12 and 13-17). To estimate the probability of each endpoint at the decision tree we have taken as a base a trial developed in the Department of Pediatrics. Direct medical cost of primary therapy, failure, complications and side effects were included in the cost calculations. RESULTS: From patients' analytic perspective, TROP was more cost-effective than CPM-DEX for both groups of patients. Discrepancy between both analytic perspectives in 13-17 year-old patient's group was resolved in favour of the option chosen from the patients' analytic perspective (TROP). Sensitivity analysis showed the reliability of the results. CONCLUSIONS: 1. TROP was more cost-effective than CPM-DEX. 2. Taking into account the patients' analytic perspective is essential when we compare antiemetics pharmacoeconomically. 3. It seems necessary to increase the effectiveness of TROP in pediatric patients receiving highly emetogenic chemotherapy with strategies such as the addition of a steroid.
- Esclerosis tuberosa. A propósito de 22 observaciones(Universidad de Navarra, 1997) Narbona, J. (Juan); Jimenez, M. (Miguel); Leon, P. (Pedro); Dwedar, M. (M.)Realizamos una exposición de nuestra casuística, en un periodo comprendido desde 1972 hasta 1991, presentando 22 pacientes con esclerosis tuberosa. Al mismo tiempo realizamos una revisión de la literatura nacional e internacional sobre el tema, destacando sus aspectos epidemiológicos, clínicos, radiológicos, genéticos, diagnósticos, terapéuticos y pronósticos.
- Recombinant Human Erythropoietin for the Treatment of Anemia in Children With Solid Malignant Tumors(Wiley-Blackwell, 1998) Barona, P. (Pascual); Sierrasesumaga, L. (Luis); Jimenez, M. (Miguel); Leon, P. (Pedro)Cancer is often associated with chronic anemia which frequently requires blood transfusions. This study was performed to assess the efficacy and safety of r-HuEPO therapy in children with cancer. PATIENTS AND METHODS: Twenty-five patients under 18 years of age with solid malignant tumors were treated with 150 U/kg/day of r-HuEPO 5 times weekly for 12 weeks. Response was defined as an increase of the baseline hemoglobin level by at least 2 g/dl. r-HuEPO patients were compared to 25 matched historical controls. RESULTS: Response was achieved in 72% of r-HuEPO patients. Hemoglobin level increased from 9.8 +/- 0.6 g/dl at baseline to 12.4 +/- 1.7 g/dl at the end of treatment in the r-HuEPO group and increased from 9.5 +/- 0.7 g/dl to 9.6 +/- 1.4 g/dl in the control group (P < .001, Student's t-test). Only 16% of patients receiving r-HuEPO required blood transfusions vs 96% of control patients (P < .001, Student's t-test), with mean units of blood transfused per patient being 0.35 in the r-HuEPO group and 3.56 in controls (P < .001, Student's t-test). There was a statistically significance improvement in Karnofsky's index in r-HuEPO patients. No adverse reaction related to r-HuEPO therapy was observed. CONCLUSIONS: r-HuEPO is a safe and effective means of increasing hemoglobin level and reducing blood requirements in children with solid malignant tumors receiving chemotherapy.
- Correction to: Standardization and chemical characterization of intravenous therapy in adult patients: A step further in medication safety(Springer Nature, 2021) Manrique‑Rodríguez, S. (Silvia); Heras‑Hidalgo, I. (Irene); Pernia‑López, M.S. (M. Sagrario); Herranz‑Alonso, A. (Ana); Río, M.C. (M. Camino) del; Suárez‑Mier, M.B. (M. Belén); Cubero‑Pérez, M.A. (M. Antonia); Viera‑Rodríguez, V. (Verónica); Cortés‑Rey, N. (Noemí); Lafuente‑Cabrero, E. (Elizabeth); Martínez‑Ortega, M.C. (M. Carmen); Bermejo‑López, E. (Esther); Díez‑Sáenz, C. (Cristina); López‑Sánchez, P. (Piedad); Gaspar, M.L. (María Luisa); Achau‑Muñoz, R. (Rubén); Márquez‑Peiró, J.F. (Juan F.); Valera‑Rubio, M. (Marta); Domingo, E. (Esther); Aquerreta, I. (Irene); Pellín-Ariño, I. (Ignacio); Martin-Delgado, M.C. (Mari Cruz); Herrera‑Gutiérrez, M. (Manuel); Gordo, F. (Federico); Rascado, P. (Pedro); García‑Prieto, E. (Emilio); Fernández‑Sánchez, L.J. (Lucas J.); Fox‑Carpentieri, S. (Sara); Lamela‑Piteira, C. (Carlos); Guerra‑Sánchez, L. (Luis); Jimenez, M. (Miguel); Jiménez‑Aguado, M. (Miguel); Sanjurjo‑Sáez, M. (María)Background: Intravenous drug administration is associated with potential complications, such as phlebitis. The physiochemical characteristics of the infusate play a very important role in some of these problems. Aim: The aim of this study was to standardize the dilutions of intravenous drugs most commonly used in hospitalized adult patients and to characterize their pH, osmolarity and cytotoxic nature to better guide the selection of the most appropriate vascular access. Methods: The project was conducted in three phases: (i) standardization of intravenous therapy, which was conducted using a modified double-round Delphi method; (ii) characterization of the dilutions agreed on in the previous phase by means of determining the osmolarity and pH of each of the agreed concentrations, and recording the vesicant nature based on the information in literature; and (iii) algorithm proposal for selecting the most appropriate vascular access, taking into account the information gathered in the previous phases. Results: In total, 112 drugs were standardized and 307 different admixtures were assessed for pH, osmolarity and vesicant nature. Of these, 123 admixtures (40%), had osmolarity values >600 mOsm/L, pH < 4 or > 9, or were classified as vesicants. In these cases, selection of the most suitable route of infusion and vascular access device is crucial to minimize the risk of phlebitis-type complications. Conclusions: Increasing safety of intravenous therapy should be a priority in the healthcare settings. Knowing the characteristics of drugs to assess the risk involved in their administration related to their physicochemical nature may be useful to guide decision making regarding the most appropriate vascular access and devices.