https://sms.carm.es/ricsmur/handle/123456789/17865 Fri, 23 Oct 2026 07:52:21 GMT 2026-10-23T07:52:21Z https://sms.carm.es/ricsmur/handle/123456789/28916 Spontaneous rupture of a liver hemangioma. A case report. Guillén-Paredes, Maria-Pilar; Martínez-Fernández, Josefa; Morales-González, Alvaro; Pardo-García, José-Luis Spontaneous rupture of a liver hemangioma is a very uncommon disease, but extremely seriousness because it is associated to a 75% of mortality caused by hipovolemic shock. A case of an spontaneous rupture of liver hemangioma, which was previously unknow, is presented. Fri, 01 Jul 2016 00:00:00 GMT https://sms.carm.es/ricsmur/handle/123456789/28916 2016-07-01T00:00:00Z https://sms.carm.es/ricsmur/handle/123456789/28850 Acute gastric volvulus. A case report Guillén-Paredes, María-Pilar; Pardo-García, José-Luis Sun, 01 Mar 2015 00:00:00 GMT https://sms.carm.es/ricsmur/handle/123456789/28850 2015-03-01T00:00:00Z https://sms.carm.es/ricsmur/handle/123456789/28157 Efficacy and safety of recombinant activated factor VII for secondary prophylaxis in patients with Glanzmann thrombasthenia García-Jaen, Pablo; Ferandez-Mosteirin, Nuria; Serrano, María-Luisa; Riesco, Susana; Aguilar, Carlos; Gabaldon, David; Kanaan-Leis, Sara; González-Prieto, Almudena; Portugal, Raquel; Mendoza, María-del-Carmen; Gilabert, Carmen; Hortal, Ana; Díaz-Ajenjo, Lorena; Lama-Villanueva, Ana; González-Galan, Alba-Mei; Sánchez-Fuentes, Ana; Benito, Rocío; Rivera, José; González-Porras, José-Ramon; Bastida, José-María BACKGROUND: Glanzmann thrombasthenia (GT) is a rare inherited platelet disorder associated with recurrent and sometimes life-threatening bleeding. Recombinant activated factor VII (rFVIIa) is approved for treatment of bleeding episodes or surgical prophylaxis in patients with GT who are refractory or alloimmunized to platelet transfusions. However, evidence for its use as secondary prophylaxis remains scarce. OBJECTIVES: This study described the efficacy and safety of rFVIIa secondary prophylaxis in patients with GT and recurrent and uncontrolled bleeding despite standard therapy. METHODS: A multicenter, retrospective study of patients with GT included in the Spanish Registry of Patients with Inherited Platelet Disorders (RETPLAC) was performed. We evaluated bleeding severity using the International Society on Thrombosis and Haemostasis (ISTH) bleeding assessment tool (BAT) and calculated the annualized bleeding rate (ABR) before and during rFVIIa prophylaxis. RESULTS: Of the 37 patients with GT included in RETPLAC, 4 patients received regular rFVIIa prophylaxis due to recurrent severe bleeding. Median baseline ISTH-BAT score was 13.5 (IQR, 9.5-18), and median preprophylaxis ABR was 3 (IQR, 3-5.25). All patients received rFVIIa of 90 ?g/kg, 3 twice weekly and 1 monthly. The median prophylaxis duration was 7.5 months (IQR, 6.75-12). Prophylaxis led to a 57.1% overall reduction in ABR, with resolution of severe bleeding in 2 patients and reduction in frequency in the remaining 2. Three patients achieved transfusion independence. All patients showed improvement in hemoglobin and iron profile. No thrombotic or adverse events occurred. CONCLUSION: Secondary prophylaxis with rFVIIa may be an effective option in patients with GT and recurrent severe bleeding unresponsive to standard therapy. Prospective studies are necessary to optimize dosing schedules and define its role in secondary prophylaxis. Fri, 01 May 2026 00:00:00 GMT https://sms.carm.es/ricsmur/handle/123456789/28157 2026-05-01T00:00:00Z https://sms.carm.es/ricsmur/handle/123456789/28122 Dosing Strategies for High-Alert Medications in Obese Pediatric Patients: A Systematic Review Hernández-Gago, Yolanda; Alcala-Minagorre, Pedro-J; Sánchez-Hernández, José-German; Rodríguez-Marrodan, Belén; Hernández-Sabater, Laura; Rodríguez-Negrín, Ana-Cristina; Rodríguez-Suárez, Claudio-Alberto Background/Objective: Childhood obesity induces physiological changes that alter drug distribution and clearance; however, these patients are often excluded from clinical trials, creating a critical safety gap for high-alert medications (HAM). The Objective was to evaluate HAM dosing strategies and pharmacokinetic (PK) alterations in overweight and obese pediatric patients. Methods: A systematic review was conducted and registered in PROSPERO (CRD42023452126). A search of MEDLINE, EMBASE, Web of Science, and Cochrane CENTRAL (1990-March 2026) identified studies reporting dosing strategies or PK of HAM in obese or overweight pediatric patients. Studies were included if they reported dosing recommendations or PK parameters. Eligible designs comprised prospective and retrospective, randomized and non-randomized, observational (cohort, case-control, and cross-sectional), case series, case reports, and narrative and systematic reviews. Study selection, data extraction, and quality assessment were conducted independently by two reviewers. Methodological quality was assessed using validated tools, and results were synthesized qualitatively. Results: Of 5801 records, 91 studies were included, providing evidence for only 27% of the evaluated HAM. Total body weight (TBW) appeared to be appropriate for insulin and vancomycin, although close monitoring was required. TBW-based dosing was associated with approximately 20% overexposure for enoxaparin, supporting the use of fat-free mass (FFM) or reduced dosing strategies. Increased clearance may justify higher doses for amlodipine and consideration of adult-equivalent dosing for metformin in adolescents. For gentamicin, FFM appeared to be the most appropriate descriptor, while adjusted body weight was used for valproic acid. In anesthetics and sedatives, reduced TBW-based dosing may be considered for propofol, whereas ideal body weight (IBW) or FFM were generally preferred for ketamine and dexmedetomidine. Analgesics such as fentanyl and morphine may require IBW- or FFM-based dosing, and maintenance dosing of paracetamol may require adjustment. Conclusions: Evidence remains limited and heterogeneous, with no standardized dosing approach. Model-informed strategies-such as population PK (PopPK) and physiologically based PK model (PBPK) approaches-may be useful for hypothesis generation and exploring PK variability; however, their clinical applicability is constrained by the limited and heterogeneous evidence base, and they should be considered exploratory. Wed, 13 May 2026 00:00:00 GMT https://sms.carm.es/ricsmur/handle/123456789/28122 2026-05-13T00:00:00Z