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Roca B, Díaz MD, Roca M. Acute prostatitis probably due to Listeria monocytogenes in an HIV-infected patient. Int J STD AIDS 2014; 26:837-8. [PMID: 25411351 DOI: 10.1177/0956462414561032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/30/2014] [Indexed: 11/16/2022]
Abstract
We report a unique case of acute bacterial prostatitis probably caused by Listeria monocytogenes in an HIV-infected patient. For the best of our knowledge, this is the first case reported of a patient with this association. Our case illustrates the protean clinical presentations that L. monocytogenes infections may adopt, particularly in immunocompromised patients.
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Roca B, Penades M, Resino E. Pandemic H1N1 influenza-associated myocarditis in a patient with Castleman’s disease. Scott Med J 2013; 58:e41-2. [DOI: 10.1177/0036933012474619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report on a patient with longstanding multicentric Castleman’s disease, hyaline-vascular type, who presented with nearly-fatal myocarditis associated with a 2009 pandemic H1N1 influenza virus infection. This is the first case of such an association described in the literature.
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Roca B, Herrero E, Resino E, Torres V, Penades M, Andreu C. Impact of education program on influenza vaccination rates in Spain. THE AMERICAN JOURNAL OF MANAGED CARE 2012; 18:e446-e452. [PMID: 23286674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To assess the impact of a simple education program on adherence to influenza vaccination. STUDY DESIGN Randomized open controlled study. METHODS The education program group (EPG) received an education program via surface mail, consisting of information regarding the effectiveness and safety of the influenza vaccine. The no-program group (NPG) received no intervention. All patients in 13 primary care practices in the city of Castellón, Spain, were included if they were 60 years or older on the first day of the 2009 seasonal influenza vaccination campaign. RESULTS There were a total of 2402 participants (mean age 70.4 [± 7.1] years); 1338 (55.7%) were women. In 2009, 950 participants (39.5%) received the vaccine, including 900 of the same participants (37.5%) who had received it in 2008 (P = .14). Of those vaccinated in 2009, 501 (52.7%) belonged to the EPG and 449 (47.3%) to the NPG (P = .01). In a logistic regression analysis we found an association between adherence to vaccination in 2009 and both vaccination in the previous year and receiving the educational intervention. Influenza-related morbidity was similar in both groups during the 7 months after vaccination. CONCLUSIONS A mailed reminder program was effective to improve influenza vaccination rate, but only to a limited extent. Vaccination the previous year was the main predictor of adherence to vaccination. More programs are needed to improve vaccination rates in the study community.
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Roca B, Resino E, Torres V, Herrero E, Penades M. Interobserver discrepancy in liver fibrosis using transient elastography. J Viral Hepat 2012; 19:711-5. [PMID: 22967102 DOI: 10.1111/j.1365-2893.2012.01608.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Transient elastography is a useful method to assess liver fibrosis, but uncertainties still exist regarding reliability and reproducibility of the technique. We aimed to improve knowledge on interobserver variability with the procedure and tried to find factors associated with such variability. This was a cross-sectional study to compare the results of transient elastography performed by two different operators, one test made just after the other. We assessed both results with correlation tests and with repeated parametric or nonparametric tests, as needed. We also carried out a multivariate analysis to find factors associated with discrepancy in the results obtained by the two operators. We included a total of 333 pairs of transient elastography tests, belonging to 274 different patients. A total of 325 pairs of tests (97.6%) were valid. Results of the first and the second tests were, respectively, median (and interquartile range) of direct measurement 6.2 (4.6-10.6) and 6.0 (4.4-10.1) kPa (P = 0.012), and mean ± standard deviation of log(10) of direct measurement 0.892 ± 0.316 and 0.871 ± 0.324 (P = 0.001). In 87 pairs of tests (26.7%), a discrepancy of at least 2 kPa between both results was found, and in 15 pairs of tests (4.6%), a discrepancy of at least 10 kPa was found. Discordance of at least one stage between both measurements was noted in 74 pairs of tests (22.8%). An association was found between higher stiffness and discrepancy between both operators (P < 0.001). Although transient elastography is a very convenient test to assess liver fibrosis in clinical practice, interobserver discrepancy in results is common and represents a significant problem with the technique. Discrepant results are more common in patients with higher values of stiffness.
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Roca B, Bennasar M, Ferrero JA, del Monte MC, Resino E. Hepatitis C virus co-infection and sexual risk behaviour are associated with a high homocysteine serum level in HIV-infected patients. Swiss Med Wkly 2012. [PMID: 22252925 DOI: 10.4414/smw.2011.13323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS A better understanding of the relationship of homocysteine with cardiovascular risk factors is needed. The objectives of this study were to assess the serum level of homocysteine in HIV-infected patients and to analyse the possible association of increased levels of the amino acid with cardiovascular risk factors, demographic and clinical characteristics of participants. METHODS Cross-sectional study carried out as a supplementary task to the usual controls necessary in HIV-infected patients in the outpatient clinic of the Hospital General of Castellon, Spain. For two consecutive visits the demographic, clinical and HIV-related characteristics and blood analyses results were obtained for each participant. Homocysteine serum level was documented and the possible association of the amino acid with all the other study variables was assessed with a multiple linear regression analysis. RESULTS A total of 145 patients were included. The mean homocysteine serum level of all participants was 11.9 ± 5.9 µmol/L. A total of 54 patients (37%) presented homocysteine serum levels higher than the upper limit of normal. An association was found between higher homocysteine serum level and the following variables: family history of early coronary disease (P = 0.027), sexual HIV risk behaviour (P = 0.016), hepatitis C virus co-infection (P = 0.002), higher height (P = 0.002), higher diastolic blood pressure (P = 0.049), lower serum level of folic acid (P <0.001), and lower serum level of vitamin B12 (P = <0.001). CONCLUSION In the HIV population, increased homocysteine serum level is associated with sexual risk behaviour and hepatitis C virus coinfection.
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Roca B, Bennasar M, Ferrero JA, del M, Resino E. Hepatitis C virus co-infection and sexual risk behaviour are associated with a high homocysteine serum level in HIV-infected patients. Swiss Med Wkly 2012; 142:w13323. [DOI: 10.4414/smw.2012.13323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Gómez Palacios A, Barrios B, Gutiérrez MT, Expósito A, Gómez Zabala J, Roca B, Pérez de Villarreal P, Ruiz S, Escobar A, Iturburu I, Méndez J. [Morbidity and costs in complete thyroidectomies. Improvement in Value of the Process by a change in the management]. ACTA ACUST UNITED AC 2011; 27:161-8. [PMID: 22137200 DOI: 10.1016/j.cali.2011.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 09/30/2011] [Accepted: 09/30/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES 1) To present the postoperative morbidity of complete thyroidectomies and the results of their clinical management and costs obtained after surgery. 2) To compare the results obtained for the morbidity and costs in the complete thyroidectomy Process, after the management changes introduced by the Endocrine Surgical Unit (ESU). 3) To define whether these changes improve the Value (benefit/cost ratio) of the Process. MATERIAL AND METHODS Prospective study of cohorts conducted on 529 complete thyroidectomies performed between 1998 and 2011. We present their clinical-pathological characteristics and we compare the clinical and management results obtained after surgery in 2 time periods: 1998-2006 without ESU (group 1, 205 patients) and 2007-2011 with ESU (group 2, 324 patients). The clinical results and the possible benefits are assessed by studying the morbimortality (recurrent lesions, hypocalcaemia [<8 mg/dl], suffocative haematomas and bleeding), and those of management, for the evaluation of the use of operating room time, the average stay and the total cost of the Process. The statistical comparison study was made using Student t test, for the comparison of means and the Chi(2) to compare percentages, accepting P<.05 as significant. RESULTS The global percentage of transient recurrent dysfunctions (TRD) was 6%, and for definitive recurrent paralysis (DRP) it was 1.5%. Hypocalcaemia, at 24 hours was 54.6%, at one month 7%, at six months 6.2% and that of definitive hypoparathyroidism 1.3%. There were 2.8% of suffocative haematomas and 2% adverse effects. The mean surgical time was 98 minutes, and the average stay was 3.66 days. In the comparison of results of the groups, the ESU improved the TRD index by nearly 7 points (10.2 vs. 3.4%, P=.002), that of DRP by 1.5 (2.4 vs. 0.4%; P=.3) until reaching under 1%. The figures on bleeding at 24 hours (53 vs. 44 cc; P=.002) and 48 hours (23 to 17 cc; P<.001), the rate of haematomas by another 6 points (6.3 vs. 0.6%; P<.001), and that of hypocalcaemia at 24 hours (P=.01). The average stay also improved (4.79 vs. 2.94 days; P<.001), the use of operating room time (reduced by 20 minutes/operation; P<.001), the total cost of the Process, decreasing by more than € 2,000/Process (P<.001), and produced a total savings for the hospital in the period of study of € 665,820. CONCLUSIONS 1) The global results (post-operative morbidity) of our total thyroidectomies are within the quality standards. 2) The surgical specialisation and the changes introduced by the ESU improved the clinical results (greater benefit) and those of management, cutting down the average stay and the operating room usage time and decreasing costs. 3) The change in management increased the Value of the Process.
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Roca B, Roca M. Nocardiosis complicated with Addison's disease. Scott Med J 2011; 56:236. [PMID: 22089052 DOI: 10.1258/smj.2011.011177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A 77-year-old woman presented with subacute respiratory symptoms which were demonstrated to be due to nocardiosis. After initial improvement with antimicrobial therapy, new symptoms appeared, consisting of persistent vomits, abdominal pain and hypotension, which led to the diagnosis of Addison's disease.
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Roca B, Reinoso I. Fiebre de origen desconocido y anemia como forma de presentación de un rabdomiosarcoma. Rev Esp Cir Ortop Traumatol (Engl Ed) 2011. [DOI: 10.1016/j.recot.2011.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Roca B, Almagro P, López F, Cabrera FJ, Montero L, Morchón D, Díez J, de la Iglesia F, Fernández M, Castiella J, Zubillaga E, Recio J, Soriano JB. Factors associated with mortality in patients with exacerbation of chronic obstructive pulmonary disease hospitalized in General Medicine departments. Intern Emerg Med 2011; 6:47-54. [PMID: 20886377 DOI: 10.1007/s11739-010-0465-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 09/14/2010] [Indexed: 11/28/2022]
Abstract
We aim to improve knowledge on risk factors that relate to mortality in subjects with exacerbation of chronic obstructive pulmonary disease (COPD) who are hospitalized in General Medicine departments. In a cross-sectional multicenter study, by means of a logistic regression analysis, we assessed the possible association of death during hospitalization with the following groups of variables of participating patients: sociodemographic features, treatment received prior to admission and during hospitalization, COPD-related clinical features recorded prior to admission, comorbidity diagnosed prior to admission, clinical data recorded during hospitalization, laboratory results recorded during hospitalization, and electrocardiographic findings recorded during hospitalization. A total of 398 patients was included; 353 (88.7%) were male, and the median age of the patients was 75 years. Of these patients, 21 (5.3%) died during hospitalization. Only 270 (67.8%) received inhaled β(2) agonists during hospitalization, while 162 (40.7%) received angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. The median of predicted FEV(1) prior to admission was 42%. A total of 350 patients (87.9%) had been diagnosed with two or more comorbid conditions prior to admission. An association was found between increased risk of death during hospitalization and the previous diagnoses of pneumonia, coronary heart disease, and stroke. In conclusion, comorbidity is an important contributor to mortality among patients hospitalized in General Medicine departments because of COPD exacerbation.
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Teira R, Suárez-Lozano I, Lozano F, Viciana P, Domingo P, Galindo P, Geijo P, Terrón A, González J, Cosín J, Ribera E, Roca B, García-Alcalde ML, Sánchez T, Muñoz-Sánchez A, Vergara A, López-Aldeguer J, Pedrol E, Vidal F, Garrido M, Santamaría JM. Characteristics and outcome of HIV infection in gypsies in the Spanish VACH Cohort. Enferm Infecc Microbiol Clin 2010; 28:266-72. [PMID: 20129716 DOI: 10.1016/j.eimc.2009.04.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2006] [Accepted: 04/22/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To study the characteristics of HIV infection in the gypsy (Roma) population in Spain, as compared with those of the Caucasian, non-gypsy majority. DESIGN Cross-sectional, historical cohort study from the Spanish VACH Cohort. METHODS Patients attending VACH clinics between 1 June 2004 and 30 November 2004 were classified according to their racial and ethnic origin as "gypsies", Caucasian non-gypsy Spanish natives (CNGN), and "other" (the last being excluded from this study). Their sociodemographic and clinico-epidemiological characteristics were compared, as well as the Kaplan-Meier curves of time to AIDS, or death, or disease progression (either of the 2 outcomes). RESULTS 4819 (48%) of 10,032 cases included in the VACH database were eligible: 210 (4.2%) were gypsies and 4252 (84.8%) were CNGN. Differences were observed in age, household, academic, inmate, marital, and employment history. Injecting drug use had been the most frequent mechanism of transmission in both groups, but to a greater extent among gypsies (72% versus 50%; P<0.000). Sex distribution, CD4 cell counts, and viral loads at the first visit were similar in the 2 groups, as was the percentage of patients with previous AIDS, percentage receiving antiretrovirals, and percentage subsequently starting antiretroviral therapy. Up to 1 April 2005, 416 new AIDS cases and 85 deaths were recorded. The percentage of these outcomes did not differ between groups, but log-rank test showed a shorter time to AIDS and disease progression among gypsies. CONCLUSIONS The sociodemographic characteristics of gypsies, the largest minority in the VACH Cohort, show differences relative to those of CNGN. HIV-related outcomes suggest that gypsies have a poorer prognosis.
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Roca B, Merino J. Nocardia brain abscess. Int J Infect Dis 2009; 14 Suppl 3:e383-4. [PMID: 19914116 DOI: 10.1016/j.ijid.2009.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Accepted: 07/13/2009] [Indexed: 11/25/2022] Open
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Suarez-Lozano I, Viciana P, Lacalle JR, Teira R, Lozano F, Lopez-Aldeguer J, Pedrol E, Domingo P, Cosin J, Roca B, Geijo P, Fuente B, Vergara A, Ribera E, Galindo MJ, Zapata A, Sanchez T, Vidal F, Munoz-Sanz A, Munoz-Sanchez J, Garrido M. The relationship between antiretroviral prescription patterns and treatment guidelines in treatment-naïve HIV-1-infected patients. HIV Med 2009; 10:573-9. [DOI: 10.1111/j.1468-1293.2009.00731.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Roca B, Resino E, Roca M, Vera JM. A dendritic cell tumor in an HIV-infected patient: case report. Ann Oncol 2009; 20:1895-6. [PMID: 19759189 DOI: 10.1093/annonc/mdp409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Roca B, Alcón L, Lucas A. Dolor en la cadera de etiología poco común. Rev Clin Esp 2009; 209:144-5. [DOI: 10.1016/s0014-2565(09)70881-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Roca B. Farmacogenómica de los antirretrovirales. Med Clin (Barc) 2009; 132:268-71. [DOI: 10.1016/j.medcli.2008.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 10/14/2008] [Indexed: 10/20/2022]
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Roca B. Adverse drug reactions to antiretroviral medication. FRONT BIOSCI-LANDMRK 2009; 14:1785-92. [DOI: 10.2741/3340] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Roca B. Castleman's Disease. A Review. AIDS Rev 2009; 11:3-7. [PMID: 19290029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Castleman's disease is characterized by a non-clonal lymph node hyperplasia. Pathologically it is classified as hyaline vascular, plasmacytic, or mixed cellularity types, and clinically it may adopt a unicentric (localized) or multicentric presentation. An association of the disease with HIV infection has been found. Many uncertainties remain concerning the etiopathogenesis and the optimal treatment of this rare condition.
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Roca B. Epistaxis and systemic disease. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2009. [DOI: 10.1016/s2173-5735(09)70175-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
We report a rare case of pyomyositis of the iliacus muscle in a 29-year-old woman. After 2 weeks of adequate treatment, secondary septic sacroiliitis occurred, a complication that had not been described previously. Pyomyositis of the iliacus muscle must be considered in the differential diagnosis of acute pain in the hip region.
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Crespo M, Ribera E, Suarez-Lozano I, Domingo P, Pedrol E, Lopez-Aldeguer J, Munoz A, Vilades C, Sanchez T, Viciana P, Teira R, Garcia-Alcalde ML, Vergara A, Lozano F, Galindo MJ, Cosin J, Roca B, Terron A, Geijo P, Vidal F, Garrido M. Effectiveness and safety of didanosine, lamivudine and efavirenz versus zidovudine, lamivudine and efavirenz for the initial treatment of HIV-infected patients from the Spanish VACH cohort. J Antimicrob Chemother 2008; 63:189-96. [DOI: 10.1093/jac/dkn450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
HIV infection is a serious but treatable disease, yet current treatment is limited by development of resistance and high rates of adverse drug reactions. Antiretroviral therapy is especially suitable for pharmacogenomic investigation as both drug exposure and treatment response can be reliably measured. Increasing knowledge about genes implicated in pharmacokinetics, mode of action, efficacy, and toxicity of drugs has already provided relevant results for clinical practice, for example: The strong association of the abacavir hypersensitivity reaction with HLA-B*5701 permits testing patients for the allele, and if present avoiding the drug and therefore preventing the reaction. Persons with the allele CYP2B6*6 present higher efavirenz "area under the curve" and have increased risk of neuropsychological toxicity. Additional gene variants are being discovered that influence the action of antiretroviral drugs. And, moreover, it is expected that larger-scale comprehensive genome approaches will profoundly improve the landscape of knowledge of HIV therapy in the future. The present article shows some recent patents related to the treatment of viral infections.
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Teira R, Geijo P, Cosín J, Muñoz-Sanz A, Viciana P, Suarez-Lozano I, López-Aldeguer J, Pedrol E, Vidal F, Sanchez T, Lozano F, Terron A, Vergara A, Galindo MJ, Domingo P, Ribera E, Roca B, Garcia-Alcalde ML, Garrido M, Muñoz-Sanchez P. Risk factors for end-stage liver disease among HIV and hepatitis C virus co-infected patients in the Spanish VACH Cohort. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
Q fever is a zoonosis caused by Coxiella burnetii. The infection is transmitted to humans mainly through aerosols generated from products of delivery of cows and other animals. Generally the disease presents acutely with fever, pneumonitis and hepatitis. But chronic endocarditis is also a possible occurrence. Diagnosis is usually made by serology. The acute form of the infection responds well to tetracyclines and other antibiotics. But endocarditis is difficult to treat, and its prognosis is grim.
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