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Pascual-Saldaña H, Masip-Bruin X, Asensio A, Alonso A, Blanco I. Innovative Predictive Approach towards a Personalized Oxygen Dosing System. Sensors (Basel) 2024; 24:764. [PMID: 38339481 PMCID: PMC10857553 DOI: 10.3390/s24030764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/21/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
Despite the large impact chronic obstructive pulmonary disease (COPD) that has on the population, the implementation of new technologies for diagnosis and treatment remains limited. Current practices in ambulatory oxygen therapy used in COPD rely on fixed doses overlooking the diverse activities which patients engage in. To address this challenge, we propose a software architecture aimed at delivering patient-personalized edge-based artificial intelligence (AI)-assisted models that are built upon data collected from patients' previous experiences along with an evaluation function. The main objectives reside in proactively administering precise oxygen dosages in real time to the patient (the edge), leveraging individual patient data, previous experiences, and actual activity levels, thereby representing a substantial advancement over conventional oxygen dosing. Through a pilot test using vital sign data from a cohort of five patients, the limitations of a one-size-fits-all approach are demonstrated, thus highlighting the need for personalized treatment strategies. This study underscores the importance of adopting advanced technological approaches for ambulatory oxygen therapy.
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Affiliation(s)
- Heribert Pascual-Saldaña
- Advanced Network Architectures Lab (CRAAX), Universitat Politècnica de Catalunya, 08800 Vilanova i la Geltrú, Spain;
| | - Xavi Masip-Bruin
- Advanced Network Architectures Lab (CRAAX), Universitat Politècnica de Catalunya, 08800 Vilanova i la Geltrú, Spain;
| | - Adrián Asensio
- Advanced Network Architectures Lab (CRAAX), Universitat Politècnica de Catalunya, 08800 Vilanova i la Geltrú, Spain;
| | - Albert Alonso
- Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain;
| | - Isabel Blanco
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
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Bouza E, Asensio A, García Navarro JA, González P, Costa Benito MA, Aguilar J, Barberán J, Cabrera J, Díez-Manglano J, Fernández C, Fernandez-Prada M, Fontán G, Cisneros JM, Lorenzo-Vidal B, Martín Oliveros A, Navas P, Palomo E, Kestler M. Recommendations for the prevention of healthcare-associated infections in nursing homes. Rev Esp Quimioter 2023; 36:552-561. [PMID: 37465867 DOI: 10.37201/req/078.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Nursing homes (NH) conceptually should look as much like a home as possible. However NH have unquestionable similarities with a nosocomium as they are places where many patients with underlying diseases and comorbidities accumulate. There is evidence of transmission of microorganisms between residents and between residents and caregivers. We have not found any recommendations specifically aimed at the prevention of nosocomial infections in NH by the major Public Health Agencies and, therefore, the Health Sciences Foundation (Fundación de Ciencias de la Salud) has convened a series of experts and 14 Spanish scientific societies to discuss recommendations that could guide NH personnel in establishing written programs for the control and reduction of these infections. The present document is the result of these deliberations and contains suggestions for establishing such control programs on a voluntary and flexible basis in NH. We also hope that the document can help the health authorities to encourage this control activity in the different territorial areas of Spain. In our opinion, it is necessary to draw up a written plan and establish the figure of a coordinator or person responsible for implementing these projects. The document includes measures to be implemented and ways of quantifying the reality of different problems and of monitoring the impact of the measures established.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - M Kestler
- Martha Kestler, General University Hospital Gregorio Marañón, C/ Dr. Esquerdo, 46, 28007 Madrid, Spain.
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Bouza E, Vargas F, Alcázar B, Álvarez T, Asensio A, Cruceta G, Gracia D, Guinea J, Gil MA, Linares C, Muñoz P, Pastor P, Pedro-Botet ML, Querol X, Tovar J, Urrutia I, Villar F, Palomo E. Air pollution and health prevention: A document of reflection. Rev Esp Quimioter 2022; 35:307-332. [PMID: 35277084 PMCID: PMC9333116 DOI: 10.37201/req/171.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Ambient air quality, pollution and its implication on health is a topic of enormous importance that is normally dealt with by major specialists in their particular areas of interest. In general, it is not discussed from multidisciplinary approaches or with a language that can reach everyone. For this reason, the Health Sciences Foundation, from its prevention area, has formulated a series of questions to people with very varied competences in the area of ambient air quality in order to obtain a global panorama of the problem and its elements of measurement and control. The answers have been produced by specialists in each subject and have been subjected to a general discussion that has allowed conclusions to be reached on each point. The subject was divided into three main blocks: external ambient air, internal ambient air, mainly in the work-place, and hospital ambient air and the consequences of its poor control. Along with the definitions of each area and the indicators of good and bad quality, some necessary solutions have been pointed out. We have tried to know the current legislation on this problem and the competences of the different administrations on it. Despite its enormous importance, ambient air quality and health is not usually a topic of frequent presence in the general media and we have asked about the causes of this. Finally, the paper addresses a series of reflections from the perspective of ethics and very particularly in the light of the events that the present pandemic raises. This work aims to provide objective data and opinions that will enable non-specialists in the field to gain a better understanding of this worrying reality.
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Affiliation(s)
- E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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Assadian O, Harbarth S, Vos M, Knobloch JK, Asensio A, Widmer AF. Practical recommendations for routine cleaning and disinfection procedures in healthcare institutions: a narrative review. J Hosp Infect 2021; 113:104-114. [PMID: 33744383 DOI: 10.1016/j.jhin.2021.03.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/12/2022]
Abstract
Healthcare-associated infections (HAIs) are the most common adverse outcomes due to delivery of medical care. HAIs increase morbidity and mortality, prolong hospital stay, and are associated with additional healthcare costs. Contaminated surfaces, particularly those that are touched frequently, act as reservoirs for pathogens and contribute towards pathogen transmission. Therefore, healthcare hygiene requires a comprehensive approach whereby different strategies may be implemented together, next to targeted, risk-based approaches, in order to reduce the risk of HAIs for patients. This approach includes hand hygiene in conjunction with environmental cleaning and disinfection of surfaces and clinical equipment. This review focuses on routine environmental cleaning and disinfection including areas with a moderate risk of contamination, such as general wards. As scientific evidence has not yet resulted in universally accepted guidelines nor led to universally accepted practical recommendations pertaining to surface cleaning and disinfection, this review provides expert guidance for healthcare workers in their daily practice. It also covers outbreak situations and suggests practical guidance for clinically relevant pathogens. Key elements of environmental cleaning and disinfection, including a fundamental clinical risk assessment, choice of appropriate disinfectants and cleaning equipment, definitions for standardized cleaning processes and the relevance of structured training, are reviewed in detail with a focus on practical topics and implementation.
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Affiliation(s)
- O Assadian
- Regional Hospital Wiener Neustadt, Wiener Neustadt, Austria; Institute for Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK.
| | - S Harbarth
- Infection Control Programme and Division of Infectious Diseases, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - M Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - J K Knobloch
- Institute for Medical Microbiology, Virology and Hygiene, Department for Infection Prevention and Control, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - A Asensio
- Preventive Medicine Department, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - A F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
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Meijs AP, Prantner I, Kärki T, Ferreira JA, Kinross P, Presterl E, Märtin P, Lyytikäinen O, Hansen S, Szőnyi A, Ricchizzi E, Valinteliėnė R, Zerafa S, de Greeff SC, Berg TC, Fernandes PA, Štefkovičová M, Asensio A, Lamagni T, Sartaj M, Reilly J, Harrison W, Suetens C, Koek MBG. Prevalence and incidence of surgical site infections in the European Union/European Economic Area: how do these measures relate? J Hosp Infect 2019; 103:404-411. [PMID: 31265856 DOI: 10.1016/j.jhin.2019.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND In 2011-2012, the European Centre for Disease Prevention and Control (ECDC) initiated the first European point prevalence survey (PPS) of healthcare-associated infections (HCAIs) in addition to targeted surveillance of the incidence of specific types of HCAI such as surgical site infections (SSIs). AIM To investigate whether national and multi-country SSI incidence can be estimated from ECDC PPS data. METHODS In all, 159 hospitals were included from 15 countries that participated in both ECDC surveillance modules, aligning surgical procedures in the incidence surveillance to corresponding specialties from the PPS. National daily prevalence of SSIs was simulated from the incidence surveillance data, the Rhame and Sudderth (R&S) formula was used to estimate national and multi-country SSI incidence from the PPS data, and national incidence per specialty was predicted using a linear model including data from the PPS. FINDINGS The simulation of daily SSI prevalence from incidence surveillance of SSIs showed that prevalence fluctuated randomly depending on the day of measurement. The correlation between the national aggregated incidence estimated with R&S formula and observed SSI incidence was low (correlation coefficient = 0.24), but specialty-specific incidence results were more reliable, especially when the number of included patients was large (correlation coefficients ranging from 0.40 to 1.00). The linear prediction model including PPS data had low proportion of explained variance (0.40). CONCLUSION Due to a lack of accuracy, use of PPS data to estimate SSI incidence is recommended only in situations where incidence surveillance of SSIs is not performed, and where sufficiently large samples of PPS data are available.
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Affiliation(s)
- A P Meijs
- Centre for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - I Prantner
- National Center for Epidemiology, Department of Hospital Epidemiology and Hygiene, Budapest, Hungary; National Public Health Center, Budapest, Hungary
| | - T Kärki
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - J A Ferreira
- Department of Statistics, Informatics and Modelling, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - P Kinross
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - E Presterl
- Medical University Vienna, Vienna, Austria
| | - P Märtin
- West Tallinn Central Hospital, Health Board, Tallinn, Estonia
| | - O Lyytikäinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - S Hansen
- Institute of Hygiene and Environmental Health Charité, University Medicine Berlin, Berlin, Germany
| | - A Szőnyi
- National Center for Epidemiology, Department of Hospital Epidemiology and Hygiene, Budapest, Hungary; National Public Health Center, Budapest, Hungary
| | - E Ricchizzi
- Agenzia sanitaria e sociale regionale - Regione Emilia Romagna, Bologna, Italy
| | | | - S Zerafa
- Mater Dei Hospital, Msida, Malta
| | - S C de Greeff
- Centre for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - T C Berg
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - M Štefkovičová
- Alexander Dubcek University in Trenčín and Regional Public Health Authority in Trenčín, Slovakia
| | - A Asensio
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - T Lamagni
- Public Health England, London, England, UK
| | - M Sartaj
- HSC Public Health Agency, Belfast, Northern Ireland, UK
| | - J Reilly
- Health Protection Scotland National Services Scotland and Glasgow Caledonian University, Glasgow, Scotland, UK
| | | | - C Suetens
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - M B G Koek
- Centre for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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6
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Martínez-González MA, Buil-Cosiales P, Corella D, Bulló M, Fitó M, Vioque J, Romaguera D, Martínez JA, Wärnberg J, López-Miranda J, Estruch R, Bueno-Cavanillas A, Arós F, Tur JA, Tinahones F, Serra-Majem L, Martín V, Lapetra J, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, Ros E, Fernández-Aranda F, Botella C, Portillo MP, Lamuela-Raventós RM, Marcos A, Sáez G, Gómez-Gracia E, Ruiz-Canela M, Toledo E, Alvarez-Alvarez I, Díez-Espino J, Sorlí JV, Basora J, Castañer O, Schröder H, Navarrete-Muñoz EM, Zulet MA, García-Rios A, Salas-Salvadó J, Corella D, Estruch R, Fitó M, Martínez-González MA, Ros E, Salas-Salvadó J, Babio N, Ros E, Sánchez-Tainta A, Martínez-González MA, Fitó M, Schröder H, Marcos A, Corella D, Wärnberg J, Martínez-González MA, Estruch R, Fernández-Aranda F, Botella C, Salas-Salvadó J, Razquin C, Bes-Rastrollo M, Sanchez Tainta A, Vázquez Z, SanJulian Aranguren B, Goñi E, Goñi L, Barrientos I, Canales M, Sayón-Orea MC, Rico A, Basterra Gortari J, Garcia Arellano A, Lecea-Juarez O, Carlos Cenoz-Osinaga J, Bartolome-Resano J, Sola-Larraza† A, Lozano-Oloriz E, Cano-Valles B, Eguaras S, Güeto V, Pascual Roquet-Jalmar E, Galilea-Zabalza I, Lancova H, Ramallal R, Garcia-Perez ML, Estremera-Urabayen V, Ariz-Arnedo MJ, Hijos-Larraz C, Fernandez Alfaro C, Iñigo-Martinez B, Villanueva Moreno R, Martin-Almendros S, Barandiaran-Bengoetxea L, Fuertes-Goñi C, Lezaun-Indurain A, Guruchaga-Arcelus MJ, Olmedo-Cruz O, Iñigo-Martínez B, Escriche-Erviti L, Ansorena-Ros R, Sanmatin-Zabaleta R, Apalategi-Lasa J, Villanueva-Telleria J, Hernández-Espinosa MM, Arroyo-Bergera I, Herrera-Valdez L, Dorronsoro-Dorronsoro L, González JI, Sorlí JV, Portolés O, Fernández-Carrión R, Ortega-Azorín C, Barragán R, Asensio EM, Coltell O, Sáiz C, Osma R, Férriz E, González-Monje I, Giménez-Fernández F, Quiles L, Carrasco P, San Onofre N, Carratalá-Calvo A, Valero-Barceló C, Antón F, Mir C, Sánchez-Navarro S, Navas J, González-Gallego I, Bort-Llorca L, Pérez-Ollero L, Giner-Valero M, Monfort-Sáez R, Nadal-Sayol J, Pascual-Fuster V, Martínez-Pérez M, Riera C, Belda MV, Medina A, Miralles E, Ramírez-Esplugues MJ, Rojo-Furió M, Mattingley G, Delgado MA, Pages MA, Riofrío Y, Abuomar L, Blasco-Lafarga N, Tosca R, Lizán L, Guillem-Saiz P, Valcarce AM, Medina MD, Monfort R, de Valcárcel S, Tormo N, Felipe-Román O, Lafuente S, Navío EI, Aldana G, Crespo JV, Llosa JL, González-García L, Raga-Marí R, Pedret Llaberia R, Gonzalez R, Sagarra Álamo R, París Palleja F, Balsells J, Roca JM, Basora Gallisa T, Vizcaino J, Llobet Alpizarte P, Anguera Perpiñá C, Llauradó Vernet M, Caballero C, Garcia Barco M, Morán Martínez MD, García Rosselló J, Del Pozo A, Poblet Calaf C, Arcelin Zabal P, Floresví X, Ciutat Benet M, Palau Galindo A, Cabré Vila JJ, Dolz Andrés F, Boj Casajuana J, Ricard M, Saiz F, Isach A, Sanchez Marin Martinez M, Bulló M, Babio N, Becerra-Tomás N, Mestres G, Basora J, Mena-Sánchez G, Barrubés Piñol L, Gil Segura M, Papandreou C, Rosique Esteban N, Chig S, Abellán Cano I, Ruiz García V, Salas-Huetos A, Hernandez P, Canudas S, Camacho-Barcia L, García-Gavilán J, Diaz A, Castañer O, Muñoz MA, Zomeño MD, Hernaéz A, Torres L, Quifer M, Llimona R, Gal LA, Pérez A, Farràs M, Elosua R, Marrugat J, Vila J, Subirana I, Pérez S, Muñoz MA, Goday A, Chillaron Jordan JJ, Flores Lerroux JA, Benaiges Boix D, Farré M, Menoyo E, Muñoz-Aguayo D, Gaixas S, Blanchart G, Sanllorente A, Soria M, Valussi J, Cuenca A, Forcano L, Pastor A, Boronat A, Tello S, Cabañero M, Franco L, Schröder H, De la Torre R, Medrano C, Bayó J, García MT, Robledo V, Babi P, Canals E, Soldevila N, Carrés L, Roca C, Comas MS, Gasulla G, Herraiz X, Martínez A, Vinyoles E, Verdú JM, Masague Aguade M, Baltasar Massip E, Lopez Grau M, Mengual M, Moldon V, Vila Vergaz M, Cabanes Gómez Ciurana R, Gili Riu M, Palomeras Vidal A, Garcia de la Hera M, González Palacios S, Torres Collado L, Valera Gran D, Compañ Gabucio L, Oncina Canovas A, Notario Barandiaran L, Orozco Beltran D, Pertusa Martínez S, Cloquell Rodrigo B, Hernándis Marsán MV, Asensio A, Altozano Rodado MC, Ballester Baixauli JJ, Fernándis Brufal N, Martínez Vergara MC, Román Maciá J, Candela García I, Pedro Cases Pérez E, Tercero Maciá C, Mira Castejón LA, de los Ángeles García García I, Zazo JM, Gisbert Sellés C, Sánchez Botella C, Fiol M, Moñino M, Colom A, Konieczna J, Morey M, Zamanillo R, Galmés AM, Pereira V, Martín MA, Yáñez A, Llobera J, Ripoll J, Prieto R, Grases F, Costa A, Fernández-Palomeque C, Fortuny E, Noris M, Munuera S, Tomás F, Fiol F, Jover A, Janer JM, Vallespir C, Mattei I, Feuerbach N, del Mar Sureda M, Vega S, Quintana L, Fiol A, Amador M, González S, Coll J, Moyá A, Abete I, Cantero I, Cristobo C, Ibero-Baraibar I, Lezáun Burgui MD, Goñi Ruiz N, Bartolomé Resano R, Cano Cáceres E, Elcarte López T, Echarte Osacain E, Pérez Sanz B, Blanco Platero I, Andueza Azcárate SA, Gimeno Aznar A, Ursúa Sesma E, Ojeda Bilbao B, Martinez Jarauta J, Ugalde Sarasa L, Rípodas Echarte B, Güeto Rubio MV, Fernández-Crehuet Navajas J, Gutiérrez Bedmar M, García Rodriguez A, Mariscal Larrubia A, Carnero Varo M, Muñoz Bravo C, Barón-López FJ, Fernández García JC, Pérez-Farinós N, Moreno-Morales N, del C Rodríguez-Martínez M, Pérez-López J, Benavente-Marín JC, Crespo Oliva E, Contreras Fernández E, Carmona González FJ, Carabaño Moral R, Torres Moreno S, Martín Ruíz MV, Alcalá Cornide M, Fuentes Gómez V, Criado García J, Jiménez Morales AI, Delgado Casado N, Ortiz Morales A, Torres Peña JD, Gómez Delgado FJ, Rodríguez Cantalejo F, Caballero Villaraso J, Alcalá JF, Peña Orihuela PJ, Quintana Navarro G, Casas R, Domenech M, Viñas C, Castro-Barquero S, Ruiz-León AM, Sadurní M, Frontana G, Villanueva P, Gual M, Soriano R, Camafort M, Sierra C, Sacanella E, Sala-Vila A, Cots JM, Sarroca I, García M, Bermúdez N, Pérez A, Duaso I, de la Arada A, Hernández R, Simón C, de la Poza MA, Gil I, Vila M, Iglesias C, Assens N, Amatller M, Rams LL, Benet T, Fernández G, Teruel J, Azorin A, Cubells M, López D, Llovet JM, Gómez ML, Climente P, de Paula L, Soto J, Carbonell C, Llor C, Abat X, Cama A, Fortuny M, Domingo C, Liberal AI, Martínez T, Yañez E, Nieto MJ, Pérez A, Lloret E, Carrazoni C, Belles AM, Olmos C, Ramentol M, Capell MJ, Casas R, Giner I, Muñoz A, Martín R, Moron E, Bonillo A, Sánchez G, Calbó C, Pous J, Massip M, García Y, Massagué MC, Ibañez R, Llaona J, Vidal T, Vizcay N, Segura E, Galindo C, Moreno M, Caubet M, Altirriba J, Fluxà G, Toribio P, Torrent E, Anton JJ, Viaplana A, Vieytes G, Duch N, Pereira A, Moreno MA, Pérez A, Sant E, Gené J, Calvillo H, Pont F, Puig M, Casasayas M, Garrich A, Senar E, Martínez A, Boix I, Sequeira E, Aragunde V, Riera S, Salgado M, Fuentes M, Martín E, Ubieto A, Pallarés F, Sala C, Abilla A, Moreno S, Mayor E, Colom T, Gaspar A, Gómez A, Palacios L, Garrigosa R, García Molina L, Riquelme Gallego B, Cano Ibañez N, Maldonado Calvo A, López Maldonado A, Garrido EM, Baena Dominguez A, García Jiménez F, Thomas Carazo E, Jesús Turnes González A, González Jiménez F, Padilla Ruiz F, Machado Santiago J, Martínez Bellón MD, Pueyos Sánchez A, Arribas Mir L, Rodríguez Tapioles R, Dorador Atienza F, Baena Camus L, Osorio Martos C, Rueda Lozano D, López Alcázar M, Ramos Díaz F, Cruz Rosales Sierra M, Alguacil Cubero P, López Rodriguez A, Guerrero García F, Tormo Molina J, Ruiz Rodríguez F, Rekondo J, Salaverria I, Alonso-Gómez A, Belló MC, Loma-Osorio A, Tojal L, Bruyel P, Goicolea L, Sorto C, Casi Casanellas A, Arnal Otero ML, Ortueta Martínez De Arbulo J, Vinagre Morgado J, Romeo Ollora J, Urraca J, Sarriegui Carrera MI, Toribio FJ, Magán E, Rodríguez A, Castro Madrid S, Gómez Merino MT, Rodríguez Jiménez M, Gutiérrez Jodra M, López Alonso B, Iturralde Iriso J, Pascual Romero C, Izquierdo De La Guerra A, Abbate M, Aguilar I, Angullo E, Arenas A, Argelich E, Bibiloni MM, Bisbal Y, Bouzas C, Busquets C, Capó X, Carreres S, De la Peña A, Gallardo L, Gámez JM, García B, García C, Julibert A, Llompart I, Mascaró CM, Mateos D, Montemayor S, Pons A, Ripoll T, Rodríguez T, Salaberry E, Sureda A, Tejada S, Ugarriza L, Valiño L, Bernal López MR, Macías González M, Ruiz Nava J, Fernández García JC, Muñoz Garach A, Vilches Pérez A, González Banderas A, Alcaide Torres J, Vargas Candela A, León Fernández M, Hernández Robles R, Santamaría Fernández S, Marín JM, Valdés Hernández S, Villalobos JC, Ortiz A, Álvarez-Pérez J, Díaz Benítez EM, Díaz-Collado F, Sánchez-Villegas A, Pérez-Cabrera J, Casañas-Quintana LT, García-Guerra RB, Bautista-Castaño I, Ruano-Rodríguez C, Sarmiento de la Fe F, García-Pastor JA, Macías-Gutiérrez B, Falcón-Sanabria I, Simón-García C, Santana-Santana AJ, Álvarez-Álvarez JB, Díaz-González BV, Castillo Anzalas JM, Sosa-Also RE, Medina-Ponce J, Abajo Olea S, Adlbi Sibai A, Aguado Arconada A, Álvarez L, Carriedo Ule E, Escobar Fernández M, Ferradal García JI, Fernández Vázquez JP, García González M, González Donquiles C, González Quintana C, González Rivero F, Lavinia Popescu M, López Gil JI, López de la Iglesia J, Marcos Delgado A, Merino Acevedo C, Reguero Celada S, Rodríguez Bul M, Vilorio-Marqués L, Santos-Lozano JM, Miró-Moriano L, Domínguez-Espinaco C, Vaquero-Díaz S, García-Corte FJ, Santos-Calonge A, Toro-Cortés C, Pelegrina-López N, Urbano-Fernández V, Ortega-Calvo M, Lozano-Rodríguez J, Rivera-Benítez I, Caballero-Valderrama M, Iglesias-Bonilla P, Román-Torres P, Corchado-Albalat Y, Mayoral-Sánchez E, de Cos AI, Gutierrez S, Artola S, Galdon A, Gonzalo I, Más S, Sierra R, Luca B, Prieto L, Galera A, Gimenez-Gracia M, Figueras R, Poch M, Freixedas R, Trias F, Sarasa I, Fanlo M, Lafuente H, Liceran M, Rodriguez-Sanchez A, Pallarols C, Monedero J, Corbella X, Corbella E, Altés A, Vinagre I, Mestres C, Viaplana J, Serra M, Vera J, Freitas T, Ortega E, Pla I, Ordovás JM, Micó V, Berninches L, Concejo MJ, Muñoz J, Adrián M, de la Fuente Y, Albertos C, Villahoz E, Cornejo ML, Gaforio JJ, Moraleda S, Liétor N, Peis JI, Ureña T, Rueda M, Ballesta MI, Moreno Lopera C, Aragoneses Isabel C, Sirur Flores MA, Ceballos de Diego M, Bescos Cáceres T, Peña Cereceda Y, Martínez Abad M, Cabrera Vela R, González Cerrajero M, Rubio Herrera MA, Torrego Ellacuría M, Barabash Bustelo A, Ortiz Ramos M, Garin Barrutia U, Baños R, García-Palacios A, Cerdá Micó C, Estañ Capell N, Iradi A, Fandos Sánchez M. Cohort Profile: Design and methods of the PREDIMED-Plus randomized trial. Int J Epidemiol 2018; 48:387-388o. [PMID: 30476123 DOI: 10.1093/ije/dyy225] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 01/04/2023] Open
Affiliation(s)
- Miguel A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Pilar Buil-Cosiales
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Monica Bulló
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Clinical Epidemiology and Public Health Department, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Jose López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Cardiology, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Francisco Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Las Palmas de Gran Canaria, Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Jose Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Eating Disorders Unit, Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain
| | - Cristina Botella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - María Puy Portillo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy and Lucio Lascaray Research Center, Universidad del País Vasco (UPV/EHU), Vitoria, Spain
| | - Rosa M Lamuela-Raventós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, -UB, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Ascensión Marcos
- Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Guillermo Sáez
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Odontology, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
| | | | - Miguel Ruiz-Canela
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Estefania Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Ismael Alvarez-Alvarez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Javier Díez-Espino
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - José V Sorlí
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Josep Basora
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Olga Castañer
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Eva María Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Maria Angeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Antonio García-Rios
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
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Asensio A, Marques S, Ferragut J, Alvarez L, Picornell A. Ibermitobase: A search tool for mtDNA population data in the Iberian Peninsula. Forensic Science International: Genetics Supplement Series 2015. [DOI: 10.1016/j.fsigss.2015.09.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ramos A, Benitez-Gutierrez L, Asensio A, Ruiz-Antorán B, Folguera C, Sanchez-Romero I, Muñez E. Correction: Antimicrobial stewardship in patients recently transferred to a ward from the ICU. Rev Esp Quimioter 2014; 27:134-139. [PMID: 24940898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED This paper is a corrigendum to the previously published paper: "Antimicrobial stewardship in patients recently transferred to a ward from the ICU" [Rev Esp Quimioter. 2014 Mar;27(1):46-50.] This corrigendum was prepared in order to correct some erroneous comments included in the discussion section. First, it should be pointed out that there could have been several suitable options for treating many infections and that, therefore, the word "inadequate" was not the most appropriate in this situation. In addition, some comments about the interpretation of microbiological results made by ICU physicians have been removed from the first article because this variable was not included in the study. Finally, another change made to the discussion was to clarify the ICU physicians' alleged low level of compliance with advice given by infectious disease specialists. This has been suggested in previous studies it cannot be substantiated when analyzing the results of the study. PURPOSE Inappropriate use of antibiotics is an important health problem that is related to increasing bacterial resistance. Despite its relevance, many health institutions assign very limited resources to improving prescribing practices. An antimicrobial stewardship programme (APS) centred on patients discharged from the ICU could efficiently undertake this task. METHODS During this six month study the main activity was performing a programmed review of antimicrobial prescriptions in patients transferred to the ward from the ICU. In the case of amendable antimicrobial treatment, a recommendation was included in the medical record. RESULTS A total of 437 antimicrobial prescriptions for 286 patients were revised during a six month period and a total of 271 prescriptions (62%) in 183 patients were considered to be amendable. In most of these cases, treatment could have been reduced taking into consideration each patient's clinical improvement and their location in a hospital area with a lower risk of infection due to resistant bacteria. The most common advice was antimicrobial withdrawal (64%), antimicrobial change (20%) and switching to oral route (12%). Proposed recommendations were addressed in 212 cases (78%). There was no significant difference in adherence with respect to the type of recommendation (p=0.417). There was a 5% lower use of antibiotics during the year the study was conducted compared to the previous one. CONCLUSIONS ASPs centred on patients discharged from the ICU may be an efficient strategy to ameliorate antimicrobial use in hospitals.
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Affiliation(s)
- A Ramos
- Antonio Ramos, Department of Internal Medicine (Infectious Diseases Unit). Hospital Universitario Puerta de Hierro. Universidad Autónoma de Madrid, Maestro Rodrigo nº 2. 28222 Majadahonda, Madrid. Spain.
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Ramos A, Benítez-Gutierrez L, Asensio A, Ruiz-Antorán B, Folguera C, Sánchez-Romero I, Muñez E. Antimicrobial stewardship in patients recently transferred to a ward from the ICU. Rev Esp Quimioter 2014; 27:46-50. [PMID: 24676242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Inappropriate use of antibiotics is an important health problem that is related to increasing bacterial resistance. Despite its relevance, many health institutions assign very limited resources to improving prescribing practices. An antimicrobial stewardship programme (APS) centred on patients discharged from the ICU could efficiently undertake this task. METHODS During this six month study the main activity was performing a programmed review of antimicrobial prescriptions in patients transferred to the ward from the ICU. In the case of inadequate antimicrobial treatment, a recommendation was included in the medical record. RESULTS A total of 437 antimicrobial prescriptions for 286 patients were revised during a six month period. In all, 271 prescriptions (62%) were considered inappropriate in 183 patients. The most common reasons for inappropriateness were treating unconfirmed infection (43%), inadequate antimicrobial coverage (34%) and intravenous administration when the oral route was feasible (11%). Proposed recommendations were addressed in 212 cases (78%). There was no significant difference in adherence with respect to the type of recommendation (p=0.417). There was a 5% lower use of antibiotics during the year the study was conducted compared to the previous one. CONCLUSIONS ASPs centred on patients discharged from the ICU may be an efficient strategy to ameliorate antimicrobial use in hospitals.
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Affiliation(s)
- A Ramos
- Antonio Ramos,Department of Internal Medicine (Infectious Diseases Unit). Hospital Universitario Puerta de Hierro. Universidad Autónoma de Madrid, Maestro Rodrigo nº 2. 28220 Majadahonda. Madrid. Spain.
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Velasco L, Asensio A, Berral JL, Castro A, López V. Towards a carrier SDN: an example for elastic inter-datacenter connectivity. Opt Express 2014; 22:55-61. [PMID: 24514965 DOI: 10.1364/oe.22.000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We propose a network-driven transfer mode for cloud operations in a step towards a carrier SDN. Inter-datacenter connectivity is requested in terms of volume of data and completion time. The SDN controller translates and forwards requests to an ABNO controller in charge of a flexgrid network.
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Castillo I, Ojea MA, Boqué C, Asensio A, Hermosilla MM, Blanes M. [Effectiveness and safety of lenalidomide in myelofibrosis patients: a case series from the Spanish compassionate use program]. Farm Hosp 2013; 37:135-42. [PMID: 23789757 DOI: 10.7399/fh.2013.37.2.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Myelofibrosis (MF) is a chronic myeloproliferative neoplasm (CMPN) characterized by clonal proliferation of the pluripotent hematopoietic germinal cell, fibrosis, and bone marrow angiogenesis, and with extra medullary hematopoiesis. Lenalidomide is an immunomodulatory and antiangiogenic agent that has shown clinical benefit in MF patients in several phase II clinical trials. In this work, we present the results of the retrospective assessment of a series of 32 patients diagnosed with MF that received treatment with lenalidomide within the Spanish program of hospital compassionate use. METHOD Multicenter, retrospective study of a case series of MF patients receiving compassionate treatment with lenalidomide. RESULTS We gathered information on 32 MF patients that were treated with lenalidomide at 17 Spanish hospitals. The mean age was 68 years (range, 50-83), 72% males. Twenty-six (81%) patients had intermediate-high risk according to Dupriez prognostic score. In 16 patients, the daily dose scheduled was 10 mg/day for 21 days in 28-day cycles; the remaining patients received lower doses or other regimes. In 29 out of 32 patients, response assessment was available. Two patients had complete clinical and hematologic response and 14 had partial response. The most common adverse events observed were neutropenia (56%), thrombocytopenia (50%), and anemia (40%). CONCLUSIONS Continuous treatment with lenalidomide is active in MF patients pretreated heavily. Lenalidomide-induced myelosuppression and other associated toxicities are manageable with dose adjustments.
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Fernandez C, Santos-Silva MC, López A, Matarraz S, Jara-Acevedo M, Ciudad J, Gutierrez ML, Sánchez ML, Salvador-Osuna C, Berruezo MJ, Díaz-Arias JÁ, Palomo-Hernández AM, Colado E, González N, Gallardo D, Asensio A, García-Sánchez R, Saldaña R, Cerveró C, Carboné-Bañeres A, Gutierrez O, Orfao A. Newly diagnosed adult AML and MPAL patients frequently show clonal residual hematopoiesis. Leukemia 2013; 27:2149-56. [DOI: 10.1038/leu.2013.109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/02/2013] [Accepted: 04/05/2013] [Indexed: 11/09/2022]
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Pascual P, Carmona P, Barral J, Umerez M, Irastorza B, Aranguren A, Lizeaga G, Asensio A, Esnaola E, Andueza K. GRP-166 Safety Evaluation of Rituximab Off-Label Use For Systemic Autoimmune Rheumatic Diseases. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Alonso Villán E, Pérez Rodríguez J, Rodríguez J, Ruiz J, del Cerro M, Hierro L, García Pose A, Aroca A, Asensio A, García-Miguel P, Soto C, del Diego J, Díaz C, Iglesias A, Lahoz A, Rodríguez I. Mortalidad infantil en un hospital de nivel terciario. Limitación de esfuerzo terapéutico, correspondencia clínico–patológica y precisión diagnóstica. An Pediatr (Barc) 2012; 76:343-9. [DOI: 10.1016/j.anpedi.2011.09.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 09/08/2011] [Accepted: 09/19/2011] [Indexed: 10/15/2022] Open
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Gonzalez PP, Asensio A, Carmona P, Barral J, Lizeaga G, Fernandez I, Esnaola E, Irastorza B, Valbuena O, Bachiller M. Pharmaceutical intervention for Vitamin D level: CPC105 table 1. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Asensio A, Lizeaga G, Fernandez I, Pascual P, Carmona P, Barral J, Irastorza B, Andueza K, Esnaola E, Valbuena O. Development of a pharmaceutical care programme in a bone marrow transplantation unit. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Asensio A, Alvarez-Espejo T, Fernandez-Crehuet J, Ramos A, Vaque-Rafart J, Bishopberger C, Hernández Navarrete MJ, Calbo-Torrecillas F, Campayo J, Cantón R, on behalf of the Estudio de Prevale C. Trends in yearly prevalence of third-generation cephalosporin and fluoroquinolone resistant Enterobacteriaceae infections and antimicrobial use in Spanish hospitals, Spain, 1999 to 2010. Euro Surveill 2011; 16. [DOI: 10.2807/ese.16.40.19983-en] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lázaro M, Ramos A, Ussetti P, Asensio A, Laporta R, Muñez E, Sánchez-Romero I, Tejerina E, Burgos R, Moñivas V, Varela A. Aspergillus endocarditis in lung transplant recipients: case report and literature review. Transpl Infect Dis 2011; 13:186-91. [DOI: 10.1111/j.1399-3062.2010.00589.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Adams NG, Adekambi T, Afeltra J, Aguado J, Aires de Sousa M, Akiyoshi K, Al Hasan M, Ala-Kokko T, Albert M, Alfandari S, Allen D, Allerberger F, Almyroudis N, Alp E, Amin R, Anderson-Berry A, Andes DR, Andremont A, Andreu A, Angelakis M, Antachopoulos C, Antoniadou A, Arabatzis M, Arlet G, Arnez M, Arnold C, Asensio A, Asseray N, Ausiello C, Avni T, Ayling R, Baddour L, Baguelin M, Bányai K, Barbour A, Basco LK, Bauer D, Bayston R, Beall B, Becker K, Behr M, Bejon P, Belliot G, Benito-Fernandez J, Benjamin D, Benschop K, Berencsi G, Bergeron MG, Bernard K, Berner R, Beyersmann J, Bille J, Bizzini A, Bjarnsholt T, Blanc D, Blanco J, Blot S, Bohnert J, Boillat N, Bonomo R, Bonten M, Bordon JM, Borel N, Boschiroli ML, Bosilkovski M, Bosso JA, Botelho-Nevers E, Bou G, Bretagne S, Brouqui P, Brun-Buisson C, Brunetto M, Bucher H, Buchheidt D, Buckling A, Bulpa P, Cambau E, Canducci F, Cantón R, Capobianchi M, Carattoli A, Carcopino X, Cardona-Castro N, Carling PC, Carrat F, Castilla J, Castilletti C, Cavaco L, Cavallo R, Ceccherini-Silberstein F, Centrón D, Chappuis F, Charrel R, Chen M, Chevaliez S, Chezzi C, Chomel B, Chowers M, Chryssanthou E, Ciammaruconi A, Ciccozzi M, Cid J, Ciofu O, Cisneros D, Ciufolini MG, Clark C, Clarke SC, Clayton R, Clementi M, Clemons K, Cloeckaert A, Cloud J, Coenye T, Cohen Bacri S, Cohen R, Coia J, Colombo A, Colson P, Concerse P, Cordonnier C, Cormican M, Cornaglia G, Cornely O, Costa S, Cots F, Craxi A, Creti R, Crnich C, Cuenca Estrella M, Cusi MG, d'Ettorre G, da Cruz Lamas C, Daikos G, Dannaoui E, De Barbeyrac B, De Grazia S, de Jager C, de Lamballerie X, de Marco F, del Palacio A, Delpeyroux F, Denamur E, Denis O, Depaquit J, Deplano A, Desenclos JC, Desjeux P, Deutch S, Di Luca D, Dianzani F, Diep B, Diestra K, Dignani C, Dimopoulos G, Divizia M, Doi Y, Dornbusch HJ, Dotis J, Drancourt M, Drevinek P, Dromer F, Dryden M, Dubreuil L, Dubus JC, Dumitrescu O, Dumke R, DuPont H, Edelstein M, Eggimann P, Eis-Huebinger AM, El Atrouni WI, Entenza J, Ergonul O, Espinel-Ingroff A, Esteban J, Etienne J, Fan XG, Fenollar F, Ferrante P, Ferrieri P, Ferry T, Feuchtinger T, Finegold S, Fingerle V, Fitch M, Fitzgerald R, Flori P, Fluit A, Fontana R, Fournier PE, François M, Francois P, Freedman DO, Friedrich A, Gallego L, Gallinella G, Gangneux JP, Gannon V, Garbarg-Chenon A, Garbino J, Garnacho-Montero J, Gatermann S, Gautret P, Gentile G, Gerlich W, Ghannoum M, Ghebremedhin B, Ghigo E, Giamarellos-Bourboulis E, Girgis R, Giske C, Glupczynski Y, Gnarpe J, Gomez-Barrena E, Gorwitz RJ, Gosselin R, Goubau P, Gould E, Gradel K, Gray J, Gregson D, Greub G, Grijalva CG, Groll A, Groschup M, Gutiérrez J, Hackam DG, Hall WA, Hallett R, Hansen S, Harbarth S, Harf-Monteil C, Hasanjani RMR, Hasler P, Hatchette T, Hauser P, He Q, Hedges A, Helbig J, Hennequin C, Herrmann B, Hezode C, Higgins P, Hoesli I, Hoiby N, Hope W, Houvinen P, Hsu LY, Huard R, Humphreys H, Icardi M, Imoehl M, Ivanova K, Iwamoto T, Izopet J, Jackson Y, Jacobsen K, Jang TN, Jasir A, Jaulhac B, Jaureguy F, Jefferies JM, Jehl F, Johnstone J, Joly-Guillou ML, Jonas M, Jones M, Joukhadar C, Kahl B, Kaier K, Kaiser L, Kato H, Katragkou A, Kearns A, Kern W, Kerr K, Kessin R, Kibbler C, Kimberlin D, Kittang B, Klaassen C, Kluytmans J, Ko WC, Koh WJ, Kostrzewa M, Kourbeti I, Krause R, Krcmery V, Krizova P, Kuijper E, Kullberg BJ, Kumar G, Kunin CM, La Scola B, Lagging M, Lagrou K, Lamagni T, Landini P, Landman D, Larsen A, Lass-Floerl C, Laupland K, Lavigne JP, Leblebicioglu H, Lee B, Lee CH, Leggat P, Lehours P, Leibovici L, Leon L, Leonard N, Leone M, Lescure X, Lesprit P, Levy PY, Lew D, Lexau CA, Li SY, Li W, Lieberman D, Lina B, Lina G, Lindsay JA, Livermore D, Lorente L, Lortholary O, Lucet JC, Lund B, Lütticken R, MacLeod C, Madhi S, Maertens J, Maggi F, Maiden M, Maillard JY, Maira-Litran T, Maltezou H, Manian FA, Mantadakis E, Maragakis L, Marcelin AG, Marchaim D, Marchetti O, Marcos M, Markotic A, Martina B, Martínez J, Martinez JL, Marty F, Maurin M, McGee L, Mediannikov O, Meersseman W, Megraud F, Meletiadis J, Mellmann A, Meyer E, Meyer W, Meylan P, Michalopoulos A, Micol R, Midulla F, Mikami Y, Miller RF, Miragaia M, Miriagou V, Mitchell TJ, Miyakis S, Mokrousov I, Monecke S, Mönkemüller K, Monno L, Monod M, Morales G, Moriarty F, Morosini I, Mortensen E, Mubarak K, Mueller B, Mühlemann K, Muñoz Bellido JL, Murray P, Muscillo M, Mylotte J, Naessens A, Nagy E, Nahm MH, Nassif X, Navarro D, Navarro F, Neofytos D, Nes I, Ní Eidhin D, Nicolle L, Niederman MS, Nigro G, Nimmo G, Nordmann P, Nougairède A, Novais A, Nygard K, Oliveira D, Orth D, Ortiz JR, Osherov N, Österblad M, Ostrosky-Zeichner L, Pagano L, Palamara AT, Pallares R, Panagopoulou P, Pandey P, Panepinto J, Pappas G, Parkins M, Parola P, Pasqualotto A, Pasteran F, Paul M, Pawlotsky JM, Peeters M, Peixe L, Pepin J, Peralta G, Pereyre S, Perfect JR, Petinaki E, Petric M, Pettigrew M, Pfaller M, Philipp M, Phillips G, Pichichero M, Pierangeli A, Pierard D, Pigrau C, Pilishvili T, Pinto F, Pistello M, Pitout J, Poirel L, Poli G, Poppert S, Posfay-Barbe K, Pothier P, Poxton I, Poyart C, Pozzetto B, Pujol M, Pulcini C, Punyadeera C, Ramirez M, Ranque S, Raoult D, Rasigade JP, Re MC, Reilly JS, Reinert R, Renaud B, Rice L, Rich S, Richet H, Rigouts L, Riva E, Rizzo C, Robotham J, Rodicio MR, Rodriguez J, Rodriguez-Bano J, Rogier C, Roilides E, Rolain JM, Rooijakkers S, Rooney P, Rossi F, Rotimi V, Rottman M, Roux V, Ruhe J, Russo G, Sadowy E, Sagel U, Said SI, Saijo M, Sak B, Sa-Leao R, Sanders EAM, Sanguinetti M, Sarrazin C, Savelkoul P, Scheifele D, Schmidt WP, Schønheyder H, Schönrich G, Schrenzel J, Schubert S, Schwarz K, Schwarz S, Sefton A, Segondy M, Seifert H, Seng P, Senneville E, Sexton D, Shafer RW, Shalit I, Shankar N, Shata TM, Shields J, Sibley C, Sicinschi L, Siljander T, Simitsopoulou M, Simoons-Smit AM, Sissoko D, Sjögren J, Skiada A, Skoczynska A, Skov R, Slack M, Sogaard M, Sola C, Soriano A, Sotto A, Sougakoff W, Sougakoff W, Souli M, Spelberg B, Spelman D, Spiliopoulou I, Springer B, Stefani S, Stein A, Steinbach WJ, Steinbakk M, Strakova L, Strenger V, Sturm P, Sullivan P, Sutton D, Symmons D, Tacconelli E, Tamalet C, Tang JW, Tang YW, Tattevin P, Thibault V, Thomsen RW, Thuny F, Tong S, Torres C, Townsend R, Tristan A, Trouillet JL, Tsai HC, Tsitsopoulos P, Tuerlinckx D, Tulkens P, Tumbarello M, Tureen J, Turnidge JD, Turriziani O, Tutuian R, Uçkay I, Upton M, Vabret A, Vamvakas EC, van den Boom D, Van Eldere J, van Leeuwen W, van Strijp J, Van Veen S, Vandamme P, Vandenesch F, Vayssier M, Velin D, Venditti M, Venter M, Venuti A, Vergnaud G, Verheij T, Verhofstede C, Viscoli C, Vizza CD, Vogel U, Waller A, Wang YF, Warn P, Warris A, Wauters G, Weidmann M, Weill FX, Weinberger M, Welch D, Wellinghausen N, Wheat J, Widmer A, Wild F, Willems R, Willinger B, Winstanley C, Witte W, Wolff M, Wong F, Wootton M, Wyllie D, Xu W, Yamamoto S, Yaron S, Yildirim I, Zaoutis T, Zazzi M, Zbinden R, Zehender GG, Zemlickova H, Zerbini ML, Zhang L, Zhang Y, Zhao YD, Zhu Z, Zimmerli W. ACKNOWLEDGEMENT OF REVIEWERS. Clin Microbiol Infect 2011. [DOI: 10.1111/j.1469-0691.2010.03428.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Perez-Piaya M, Abarca E, Soler V, Coca A, Cruz M, Villagra F, Giannivelli S, Asensio A. Levels of N-terminal-pro-brain natriuretic peptide in congenital heart disease surgery and its value as a predictive biomarker. Interact Cardiovasc Thorac Surg 2010; 12:461-6. [DOI: 10.1510/icvts.2010.245803] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Asensio A, Alvarez-Espejo T, Cantón R, Ramos A, Muñez E, Molina J, Monge D, Vaqué J. P24.05 Time trends and associated factors to antimicrobial resistance of Escherichia coli infections in hospitalized patients. Spain, 1999–2009. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60230-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Asensio A, Alvarez-Espejo T, Sánchez-Payá J, Ramos A, Muñez E, Dominguez V, Pastor V, Vaqué J. P24.04 Time trends and associated factors to antimicrobial resistance of Klebsiella pneumoniae infections in hospitalized patients. Spain 1999–2009. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60229-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Goicoechea M, Cía F, San José C, Asensio A, Emparanza JI, Gil AG, López de Cerain A, Aldazabal P, Azpitarte M, Otaegui D, López de Munain A. Minimizing creatine kinase variability in rats for neuromuscular research purposes. Lab Anim 2008; 42:19-25. [PMID: 18348763 DOI: 10.1258/la.2007.06006e] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Rat serum or plasma creatine kinase (CK) activity is widely used to evaluate myopathic processes, to test the myotoxicity of different drugs, or to analyse the benefits of emerging gene therapies in some neuromuscular disorders. However, great variability is found in this determination. The aim of this study has been to control some factors of variation in order to reduce variability and increase the reproducibility of analytical data. 8-10-week-old Wistar-Han rats were used. The study consisted of four sequential phases. Phase I aimed to analyse the effect of ether and isoflurane as anaesthetic drugs. The objective of Phase II was to evaluate bleeding rats via retro-orbital sinus vs. tail vein. Phases III and IV were designed as two separate, repeated measure experiments on two factors: habituation to laboratory handling procedures in Phase III and gender in Phase IV. The repeated factor was the storage temperature of blood sample prior to centrifugation. Ether did not significantly increased the CK value. Using isoflurane, getting rats accustomed to laboratory handling procedures and whole blood refrigeration prior to centrifugation and serum separation resulted in statistically significant reduction in CK value and variability. Male rats showed significantly higher values than female rats. In the light of our findings, CK value and variability in rats may be minimized by choosing tail vein as site of bleeding, getting rats accustomed to laboratory handling procedures and maintaining whole blood refrigerated until centrifugation and serum separation.
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Affiliation(s)
- M Goicoechea
- Unidad Experimental, Laboratorio Unificado, Hospital Donostia, San Sebastián, Spain.
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Ramos A, Asensio A, Muñez E, Torre-Cisneros J, Blanes M, Carratalá J, Segovia J, Munoz P, Cisneros J, Bou G, Aguado J, Cervera C, Gurgui M. Incisional surgical infection in heart transplantation. Transpl Infect Dis 2008; 10:298-302. [DOI: 10.1111/j.1399-3062.2008.00316.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Asensio A, Vaque-Rafart J, Calbo-Torrecillas F, Gestal-Otero JJ, López-Fernández F, Trilla-Garcia A, Cantón R. Increasing rates in Clostridium difficile infection (CDI) among hospitalised patients, Spain 1999-2007. Euro Surveill 2008. [DOI: 10.2807/ese.13.31.18943-en] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- A Asensio
- Department of Preventive Medicine, Hospital Universitario Puerta de Hierro. Madrid, Spain
| | - J Vaque-Rafart
- Department of Preventive Medicine, Hospital Vall d´Hebron. Barcelona, Spain
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- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
| | - F López-Fernández
- Department of Preventive Medicine, Hospital Universitario Puerto del Mar, Cádiz, Spain
| | | | - R Cantón
- Department of Microbiology. Hospital Universitario Ramón y Cajal. Madrid, Spain
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Asensio A, Vaque-Rafart J, Calbo-Torrecillas F, Gestal-Otero JJ, López-Fernández F, Trilla-Garcia A, Canton R. Increasing rates in Clostridium difficile infection (CDI) among hospitalised patients, Spain 1999-2007. Euro Surveill 2008; 13:18943. [PMID: 18761902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Limited information is available on the burden and epidemiology of Clostridium difficile infection (CDI) in Spain. The present report communicates the secular trends in prevalence of CDI among hospitalised patients in Spain from 1999 through 2007. Data were obtained through the EPINE study (Estudio de prevalencia de las infecciones nosocomiales en los hospitales españoles), a point prevalence study series of nosocomial infections among patients admitted to hospital in Spain. A total of 378 cases with CDI were identified. Median age was 74 years. Prevalence rates of CDI increased from 3.9 to 12.2 cases per 10,000 hospitalised patients and showed a significantly increasing secular trend from 1999 through 2007 (prevalence rate ratio per each year increment 1.09; 95% CI 1.05 - 1.14). Percentage of hospitalised patients receiving antimicrobials increased linearly from 36.0% in 1999 to 40.7% in 2007 (p <0.001) and was strongly correlated to CDI prevalence (R square = 0.73; regression coefficient =1.194, 95% CI= 1.192 - 1.196).
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Affiliation(s)
- A Asensio
- Department of Preventive Medicine, Hospital Universitario Puerta de Hierro. Madrid, Spain.
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Montoto S, Moreno C, Domingo-Domenech E, Estany C, Oriol A, Altes A, Besalduch J, Pedro C, Gardella S, Escoda L, Asensio A, Vivancos P, Galan P, de Sevilla AF, Ribera JM, Briones J, Colomer D, Campo E, Montserrat E, Lopez-Guillermo A. High clinical and molecular response rates with fludarabine, cyclophosphamide and mitoxantrone in previously untreated patients with advanced stage follicular lymphoma. Haematologica 2008; 93:207-14. [DOI: 10.3324/haematol.11671] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Camarero C, Eiras P, Asensio A, Leon F, Olivares F, Escobar H, Roy G. Intraepithelial lymphocytes and coeliac disease: permanent changes in CD3−/CD7+ and T cell receptor γβ subsets studied by flow cytometry. Acta Paediatr 2007. [DOI: 10.1111/j.1651-2227.2000.tb01330.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Asensio A, Cantón R, Vaqué J, Rosselló J, Calbo F, García-Caballero J, Domínguez V, Hernández A, Trilla A. Nosocomial and community-acquired meticillin-resistant Staphylococcus aureus infections in hospitalized patients (Spain, 1993–2003). J Hosp Infect 2006; 63:465-71. [PMID: 16781015 DOI: 10.1016/j.jhin.2006.03.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2005] [Accepted: 03/08/2006] [Indexed: 11/27/2022]
Abstract
A series of annual surveys on the prevalence of infections in hospitalized patients in Spain was undertaken from 1993 to 2003 to describe clinical and demographic characteristics, trends and geographical variations in the proportion of meticillin-resistant Staphylococcus aureus (MRSA). A total of 8312 S. aureus infections in patients from 296 acute care hospitals pertaining to 17 regions in Spain were observed during the study period. Overall, 23.8% of these organisms were reported as meticillin resistant. The proportion of MRSA varied widely across regions and during the study period. Patients with nosocomial infections (NIs) had a two-fold higher prevalence of MRSA (31%) than patients with community-acquired infections (CAIs) (14%; P<0.001). Nevertheless, there was an increasing trend in the prevalence of MRSA isolates, both in patients with NI (from 22% to 41%; P<0.001) and with CAI (from 7% to 28%; P<0.001) throughout the 11-year period. Geographical variations over the last three years (2001-2003) show a centripetal gradient, with the lowest MRSA prevalence in south-west Spain and the highest MRSA prevalence in the central regions. Almost five-fold differences in MRSA proportions were seen between regions (range 10.3-54.5%). Compared with bloodstream infections, infections in other sites were more likely to be caused by MRSA (adjusted odds ratios for surgical site, urinary tract, skin and respiratory infections of 1.2, 1.2, 1.5 and 2.1, respectively).
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Affiliation(s)
- A Asensio
- Hospital Universitario Puerta de Hierro, Madrid, Spain.
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Abadias M, Cañamás TP, Asensio A, Anguera M, Viñas I. Microbial quality of commercial 'Golden Delicious' apples throughout production and shelf-life in Lleida (Catalonia, Spain). Int J Food Microbiol 2006; 108:404-9. [PMID: 16488042 DOI: 10.1016/j.ijfoodmicro.2005.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Revised: 09/05/2005] [Accepted: 12/02/2005] [Indexed: 11/28/2022]
Abstract
'Golden Delicious' apples taken from different points throughout the production chain and shelf-life were analysed for Enterobacteriaceae, thermotolerant coliforms, E. coli, E. coli O157:H7 and Salmonella spp. A total of 36 samples picked up in the orchard, 36 after storage and handling in the packinghouses and 144 from different retail stores were analysed using standardised techniques. Enterobacteriaceae counts were very variable. Pantoea spp. was the main genera isolated. The percentage of samples with thermotolerant coliforms was 16.6%, 22.2% and 10.4% after harvest, after handling in the packinghouse and in the stores, respectively. Strains belonging to Citrobacter, Enterobacter, Klebsiella and Escherichia were isolated. Three samples coming from orchards, five from the packinghouse and two from retailers harboured E. coli. However, none of the E. coli strains isolated had the virulence genes that are pathogenic for humans. None of the samples was Salmonella positive. This is the first study regarding microbial safety of fresh apples in the European Union (EU).
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Affiliation(s)
- M Abadias
- Postharvest Unit. CeRTA. Centre UdL-IRTA. 191 Rovira Roure Avenue, 25198, Lleida, Catalonia, Spain.
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Ramos A, Asensio A, Perales I, Montero MC, Martín T. Prolonged paradoxical reaction of tuberculosis in an HIV-infected patient after initiation of highly active antiretroviral therapy. Eur J Clin Microbiol Infect Dis 2003; 22:374-6. [PMID: 12774198 DOI: 10.1007/s10096-003-0940-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- A Ramos
- Department of Internal Medicine III, Hospital Universitario Clínica Puerta de Hierro, Universidad Autónoma de Madrid, San Martín de Porres n 4, 28035 Madrid, Spain.
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León F, Eiras P, Camarero C, Roldán E, Sánchez L, R-Pena R, Asensio A, Bootello A, Roy G. [Advances in the diagnosis of celiac disease: anti-transglutaminase antibodies and intestinal intraepithelial lymphocytes]. Gastroenterol Hepatol 2002; 25:416-22. [PMID: 12069705 DOI: 10.1016/s0210-5705(02)70276-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- F León
- Servicio de Inmunología, Hospital Ramón y Cajal, Madrid, Spain
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34
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Cobo J, Oliva J, Asensio A, Navas E, Cobo ME, Sánchez-García MD, Dronda F, Gómez-Mampaso E, Guerrero A, Moreno S. Predicting tuberculosis among HIV-infected patients admitted to hospital: comparison of a model with clinical judgment of infectious disease specialists. Eur J Clin Microbiol Infect Dis 2001; 20:779-84. [PMID: 11783693 DOI: 10.1007/s100960100591] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this prospective study was to compare a model based on clinical variables with the clinical judgment of infectious disease specialists to identify HIV-infected patients requiring isolation at admission in order to prevent the nosocomial transmission of tuberculosis. Clinical, epidemiological and radiological variables available at admission were recorded for 362 admissions of 274 HIV-infected patients. Using multiple logistic regression analysis, a model to identify patients with tuberculosis was developed based on four clinical variables (node enlargement, constitutional symptoms, intravenous drug use, history of previous correct therapy for tuberculosis) and a positive auramine sputum stain. This model was applied to each of the 362 admissions studied. The decision made by the infectious disease specialist at admission was also recorded. The results indicate that application of the model would have allowed physicians to correctly identify and isolate 24 of 27 patients with tuberculosis, while 5.4 patients without tuberculosis would have been unnecessarily isolated for every patient with tuberculosis. The results for the infectious disease specialists were slightly better, with 26 of 27 patients with tuberculosis being identified and isolated correctly and only 3.2 patients being isolated unnecessarily for every patient with tuberculosis. Thus, a simple model based on clinical variables may be useful in helping physicians identify tuberculosis carriers among HIV-infected patients, but infectious disease specialists are able to identify them more efficiently.
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Affiliation(s)
- J Cobo
- Servicio de Enfermedades Infecciosas, Hospital Ramĵn y Cajal, Carretera de Colmenar Viejo, Madrid, Spain.
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Abstract
Density functional theory at the UB3PW91/6-31G(d.p) level on the open and bridged forms of the 2-phenylethyl radical are reported here together with activation energies and calculated rate constants for rearrangement of the bridged to the open radical. In addition, the effect of substituents on the aryl ring upon the relative energies, activation energies, and rate constants for rearrangement from the bridged to open forms are presented. Para-substituents include CH3, CF3.CN, CHO.OH, SH, O-, S-, and NO. The parent bridged radical is found to be 10.1 kcal/mol higher in enthalpy than the open form. The activation energy for conversion of the bridged to open radical is 3.96 kcal/mol. Para-substitution by CN or CHO significantly lowers the difference in energy between the species, while substitution by NO renders the bridged form more stable. Para-substitution by CN or CHO coupled with substitution with CN in the ortho-positions makes the open and bridged radical approximately equivalent in energy.
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Affiliation(s)
- A Asensio
- Department of Chemistry, City University of New York, Hunter College and the Graduate School, 695 Park Avenue, New York, New York 10021, USA
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Fustero S, Navarro A, Pina B, Soler JG, Bartolomé A, Asensio A, Simón A, Bravo P, Fronza G, Volonterio A, Zanda M. Enantioselective synthesis of fluorinated alpha-amino acids and derivatives in combination with ring-closing metathesis: intramolecular pi-stacking interactions as a source of stereocontrol. Org Lett 2001; 3:2621-4. [PMID: 11506593 DOI: 10.1021/ol016087q] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
[reaction: see text]. Hydride reduction of C=N bonds stereocontrolled by intramolecular pi-stacking interactions of 1-naphthylsulfinyl and N-aryl groups, nonoxidative Pummerer rearrangement, and ring-closing metathesis are efficiently combined in a highly stereoselective entry to enantiomerically pure cyclic and acyclic fluorinated beta-amino alcohols and alpha-amino acid derivatives, respectively.
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Affiliation(s)
- S Fustero
- Departamento de Química Orgánica, Facultad de Farmacia, Universidad de Valencia, E-46100 Burjassot, Valencia, Spain.
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Cobo J, Asensio A, Moreno S, Navas E, Pintado V, Oliva J, Gómez-Mampaso E, Guerrero A. Risk factors for nosocomial transmission of multidrug-resistant tuberculosis due to Mycobacterium bovis among HIV-infected patients. Int J Tuberc Lung Dis 2001; 5:413-8. [PMID: 11336271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
OBJECTIVE To identify risk factors for transmission of multidrug-resistant tuberculosis (MDR-TB) among hospitalized human immunodeficiency virus (HIV) infected patients exposed during a nosocomial outbreak. DESIGN Case control study. Cases were HIV-infected patients with MDR-TB due to Mycobacterium bovis (MDR-TBMb) who acquired the disease after exposure to an MDR-TBMb patient in an hospital ward. Controls were HIV-infected patients exposed to a case of MDR-TBMb in an hospital ward but who did not develop MDR-TBMb during the follow-up. RESULTS Nineteen cases and 31 controls were included. CD4 cell counts were significantly lower among cases. Exposure in the infectious diseases ward or exposure to the index patient were associated with development of MDR-TBMb, while exposure during a single-room hospital stay and exposure in the respiratory isolation ward were associated with non-development of MDR-TBMb. A multiple regression logistic model showed that only a CD4 cell count below 50/microL and exposure to the index patient increased the risk of developing MDR-TBMb (P < 0.05). Hospitalization in a single room seemed to protect HIV-infected patients from developing nosocomial MDR-TBMb (P = 0.052). CONCLUSIONS Over classic risk factors, such as length of exposure or sharing a room with a case, severe immunosuppression independently increases the risk of MDR-TB transmission in the context of a nosocomial MDR-TB outbreak among HIV-infected patients. This information must be considered in the management of tuberculosis outbreaks. Patients with CD4 cell counts below 50/microL should be the principal group targeted for prevention strategies in nosocomial outbreaks.
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Affiliation(s)
- J Cobo
- Department of Infectious Diseases, Ramón y Cajal Hospital, University of Alcalá, Madrid, Spain.
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Cebolla VL, Gálvez EM, Membrado L, Domingo MP, Asensio A, Vela J. Improved analysis of a gas oil using a high-performance thin-layer chromatographic system. J Chromatogr Sci 2000; 38:512-4. [PMID: 11105775 DOI: 10.1093/chromsci/38.11.512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- V L Cebolla
- Departamento de Procesos Químicos, Instituto de Carboquímica, Zaragoza, Spain
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39
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Fortun J, Perez-Molina JA, Asensio A, Calderon C, Casado JL, Mir N. Semiquantitative culture of IV catheter without removal. Infect Control Hosp Epidemiol 2000; 21:618-9. [PMID: 11001273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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40
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Lloveras E, Solé F, Espinet B, Besses C, Asensio A, Abella E, Woessner S, Florensa L. Cytogenetic and fluorescence in situ hybridization studies in four cases of plasma cell leukemia. Cancer Genet Cytogenet 2000; 121:163-6. [PMID: 11063801 DOI: 10.1016/s0165-4608(00)00243-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We present a cytogenetic and fluorescence in situ hybridization (FISH) study, using centromeric probes for chromosomes 3, 7, 11, and 18, TP53 gene (17p13), and RB-1 locus (13q14) DNA probes, in four cases of plasma cell leukemia (PCL). Among the four cases, three presented monosomy of the RB-1 locus and one monoallelic deletion of the TP53 gene. The present report shows the usefulness of the FISH technique to detect abnormalities not previously observed by conventional cytogenetics.
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Affiliation(s)
- E Lloveras
- Laboratori de Citologia Hematològica/Laboratori de Referència de Catalunya, Unitat d'Hematologia, Hospital del Mar, Barcelona, Spain
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41
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Fortún J, Perez-Molina JA, Asensio A, Calderón C, Casado JL, Mir N, Moreno A, Guerrero A. Semiquantitative culture of subcutaneous segment for conservative diagnosis of intravascular catheter-related infection. JPEN J Parenter Enteral Nutr 2000; 24:210-4. [PMID: 10885714 DOI: 10.1177/0148607100024004210] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sensitivity and negative predictive values of combined surface cultures (skin and hub) are high in the presumptive diagnosis of catheter-related infection, but specificity and PPVs are poor. The purpose of the study was to evaluate the yield of the semiquantitative culture of the subcutaneous segment in the diagnosis of colonization of the catheter tip without removal of the catheter. METHODS A prospective study was performed in 124 nontunneled central venous catheters that were removed because of suspected infection or the end of therapy. Catheter colonization was considered if >15 colony-forming units (CFU) in the roll procedure or > 1,000 CFU in the quantitative Cleri procedure were recovered from the tip cultures ("gold standard"). Before removing the catheter, a semiquantitative culture of skin surrounding the point of insertion, a semiquantitative culture of the subcutaneous segment (after removing the catheter only 2 cm), a semiquantitative cultures of the hub, and a pareated quantitative blood culture were performed. Receiver operating characteristic curves were calculated to estimate the cutoff points, and a culture was considered positive when CFUs were > or =15, > or =15, and > or =5 for skin, hub, and subcutaneous segment cultures, respectively. RESULTS Catheter colonization was detected in 51 catheters. The mean duration of catheterization was 14 +/- 8 days, and the rates of incidence of tip colonization and bacteremia were 2.9 per 100 catheter days and 1.2 per 100 catheter days, respectively. Sensitivity of skin, subcutaneous, and hub cultures analyzed individually were < or =61%; however, specificity and positive predictive values (PPVs) of subcutaneous segment cultures were significantly higher than skin cultures (94% and 88.5% vs 71.6% (p = .001) and 62% (p = .014), respectively). Sensitivity of the combined skin and hub cultures and of the combined subcutaneous segment and hub cultures were similar: 86.2% and 84.3%, respectively; however, specificity and PPVs of this latter combination were significantly higher than former: 82% and 78.1% vs 59.7% (p = .008) and 61.9% (p = .07), respectively. The likelihood ratio of a positive test for the combined subcutaneous segment and hub culture was 4.68, and only 2.13 for the combined skin and hub culture. CONCLUSIONS These results indicate that the combined subcutaneous segment and hub culture constitutes an easy, effective procedure for the conservative diagnosis of catheter colonization.
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Affiliation(s)
- J Fortún
- Infectious Diseases and Clinical Microbiology Department, Alcalá de Henares University, Ramón y Cajal Hospital, Madrid, Spain.
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42
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Solé F, Espinet B, Salido M, Lloveras E, Fernández C, Cigudosa JC, Asensio A, Woessner S, Florensa L. Translocation t(6;14)(p12;q32): a novel cytogenetic abnormality in splenic lymphoma with villous lymphocytes. Br J Haematol 2000; 110:241-3. [PMID: 10931012 DOI: 10.1046/j.1365-2141.2000.02072-7.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Alvarez M, Alvarez ME, Máiz L, Asensio A, Baquero F, Canton R. Antimicrobial susceptibility profiles of oropharyngeal viridans group streptococci isolates from cystic fibrosis and non-cystic fibrosis patients. Microb Drug Resist 2000; 4:123-8. [PMID: 9650999 DOI: 10.1089/mdr.1998.4.123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The antimicrobial susceptibility profile of 77 oropharyngeal viridans streptococci isolates from 34 cystic fibrosis (CF) patients and 58 isolates from 43 healthy non-CF patients were studied by the E-test and the standard disk diffusion methods. Overall penicillin and cefotaxime resistances (intermediate plus resistant isolates) were significantly higher (p < 0.05) among CF isolates (72.7% and 45.5%, respectively) than among non-CF isolates (51.7% and 15.5%, respectively). No significant difference was observed in overall (intermediate plus resistant) erythromycin resistance rates, although high-level erythromycin resistance (> or =32 microg/mL) was more frequently found in CF isolates (24.6%) than in non-CF isolates (12.1%). An unexpected high percentage of isolates showed low level erythromycin resistance (MIC range, 0.5-15 microg/mL): 41.5% in cystic fibrosis and 46.5% in non-CF isolates. No significant differences were observed regarding the percentage of colonized patients with at least one penicillin-resistant isolate. On the contrary, colonization with cefotaxime (p < 0.001) or erythromycin (p = 0.014) resistant isolates were significantly more prevalent in CF patients. Similar tetracycline and chloramphenicol resistance rates were observed for both groups. Viridans isolates resistant to a single antibiotic were more prevalent among non-CF patients and multiple resistance was higher among CF patients. Prior antibiotic exposure could result in differences in beta-lactam resistance and colonization rates with resistant isolates between both groups. None of the non-CF patients was previously treated with antimicrobials for a period of three months before sampling. In contrast, 94.1% of CF patients were treated with antimicrobials within the same period; 65.6% with beta-lactam antibiotics. Patients with CF disease, frequently exposed to antimicrobials, may be a reservoir of viridans streptococci isolates with resistance determinants, particularly to beta-lactam antibiotics.
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Affiliation(s)
- M Alvarez
- Servicio de Microbiología, Hospital Ramón y Cajal, Madrid, Spain
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Camarero C, Eiras P, Asensio A, Leon F, Olivares F, Escobar H, Roy G. Intraepithelial lymphocytes and coeliac disease: permanent changes in CD3-/CD7+ and T cell receptor gammadelta subsets studied by flow cytometry. Acta Paediatr 2000; 89:285-90. [PMID: 10772275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
UNLABELLED Permanent changes in intestinal intraepithelial lymphocytes have been observed in coeliac patients. The aim of this investigation was to study small intestinal intraepithelial lymphocytes by using flow cytometry and to evaluate its diagnostic value in coeliac disease. Three-colour flow cytometry analyses were performed on isolated epithelial cells of 117 intestinal biopsies obtained from 113 children (54 coeliac disease, 4 other enteropathies, 18 Helicobacter pylori associated gastritis and 37 normal controls). A multiple logistic regression model was developed to select the best intraepithelial lymphocytes subset predictor of coeliac disease. Coeliac patients had significant higher levels of T cell receptor gammadelta intraepithelial lymphocytes than control patients (p < 0.01), H. pylori patients (p < 0.01) and other enteropathies (p < 0.05). The density of CD3-/CD7+ intraepithelial lymphocytes, a intraepithelial lymphocyte subset poorly characterized by immunohistochemical methods, was significantly lower in coeliac patients than in the control group (p < 0.01). H. pylori group (p < 0.01) and other enteropathies (p < 0.01). Both changes remained altered independent of the coeliac patient's diet. The data were used on a logistic regression analysis in order to calculate sensitivity [94.4%; 95% confidence interval (CI) 83.7-98.6%], specificity (94.9%; 95% CI 84.9-98.7%) and likelihood ratio for a positive test 18.5 (95% CI 6.1-55.8) in the diagnosis of coeliac disease. CONCLUSION Changes in T cell receptor gammadelta and CD3-/CD7+ intraepithelial lymphocytes subsets are permanently observed in paediatric coeliac disease. Their assessment, by three-colour flow cytometry on routine diagnostic biopsies, permits a better characterization of coeliac enteropathy and represents a valuable procedure to identify coeliac patients with different clinical presentations.
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Affiliation(s)
- C Camarero
- Department of Paediatric Gastroenterology, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
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Asensio A, Oliver A, González-Diego P, Baquero F, Pérez-Díaz JC, Ros P, Cobo J, Palacios M, Lasheras D, Cantón R. Outbreak of a multiresistant Klebsiella pneumoniae strain in an intensive care unit: antibiotic use as risk factor for colonization and infection. Clin Infect Dis 2000; 30:55-60. [PMID: 10619733 DOI: 10.1086/313590] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An observational study was undertaken to describe a nosocomial outbreak caused by multiresistant Klebsiella pneumoniae (MRKP). Ten patients in the pediatric intensive care unit (ICU) at a hospital in Madrid were colonized by or infected with MRKP from October 1997 to April 1998. Thirty-two patients with MRKP-negative surveillance cultures who were admitted to the ICU during the outbreak period were selected as control patients. Random amplified polymorphic DNA analysis of MRKP isolates revealed patterns that were indistinguishable from each other. After identification of colonized patients by surveillance cultures and implementation of standard and contact precautions, the outbreak was controlled. An age <12 weeks (odds ratio [OR], 13.1) and previous treatment with third-generation cephalosporins and aminoglycosides (OR, 31.2) were independently associated with MRKP colonization and/or infection. Individual exposure to antibiotics, irrespective of other clinical determinants, is a risk factor for MRKP acquisition. Screening high-risk patients during outbreaks and reducing the use of third-generation cephalosporins and aminoglycosides contribute to the control of these epidemics.
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Affiliation(s)
- A Asensio
- Servicio de Medicina Preventiva, Hospital Ramón y Cajal, Madrid, Spain.
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Abstract
To quantify the net effect of deep surgical site infection (DSSI) on postoperative stay (POS) among patients who had undergone open heart surgery, and to assess the comparability of two methods, two observational studies were conducted: one on a retrospective cohort of 701 operated patients, and the other on a cohort of 31 infected patients versus a cohort of uninfected patients, with 1:1 matching. In addition to DSSI, a further three factors were identified by multivariate analysis as independent POS-related predictor variables. After internal validation of the multivariate model, excess POS attributable to DSSI amounted to 20.7 days (95% confidence interval [CI] 16.7-24.9). In contrast, excess length of stay attributable to DSSI among the matched pairs who survived infection (22) totaled 14.3 days (95% CI 3.2-25.4) and 26.5 days (mean and median differences). Multivariate techniques may prove a more appropriate and reliable analysis than matched-pair comparisons for the purpose of evaluating the extra stay and cost attributable to the nosocomial infections.
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Affiliation(s)
- A Asensio
- Ramón y Cajal Hospital, Department of Preventive Medicine, University of Alcalá, Madrid, Spain
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Guerrero A, Cobo J, Fortún J, Navas E, Quereda C, Asensio A, Cañón J, Blazquez J, Gómez-Mampaso E. Nosocomial transmission of Mycobacterium bovis resistant to 11 drugs in people with advanced HIV-1 infection. Lancet 1997; 350:1738-42. [PMID: 9413465 DOI: 10.1016/s0140-6736(97)07567-3] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Since 1990, several nosocomial outbreaks of multidrug-resistant (MDR) tuberculosis have occurred, none of which have involved Mycobacterium bovis. We describe an epidemic of nosocomial and primary MDR M bovis tuberculosis from December, 1993, to February, 1995, among HIV-1-infected patients in a district of Madrid. METHODS We undertook genetic characterisation of the M bovis strain and investigated its presence in a tuberculosis epidemic in a Madrid hospital in a case-controlled study. We assessed 19 cases diagnosed with MDR tuberculosis due to M bovis during the study period. For the control group, we randomly selected 33 patients with HIV-1 infection and isolation of a strain of M tuberculosis susceptible to isoniazid, rifampicin, or both, who were treated in Ramón y Cajal Hospital. Infection-control policies and practices were implemented. FINDINGS We detected 19 cases in HIV-1-infected patients of primary MDR tuberculosis produced by M bovis resistant to 11 antituberculosis drugs. We found phenotypic and genotypic similarities in the strains of M bovis. In the case group, the index case and two other cases had had previous contact with another hospital that had had an MDR tuberculosis outbreak. All patients died after a mean of 44 days (range 2-116), despite multidrug treatment with first-line and second-line antituberculosis drugs. The cases with M bovis MDR tuberculosis were significantly more likely than controls to have been admitted to a hospital ward at the same time as patients already infected with MDR tuberculosis during the 10 months before their diagnosis (adjusted odds ratio 94.6 [95% CI 9.4-956.3], p < 0.0001). Advanced HIV-1 immunosuppression was associated with the development of MDR tuberculosis. Implementation of control measures stopped the epidemic. INTERPRETATION An M bovis primary MDR tuberculosis epidemic that cannot be treated effectively and with high mortality has emerged in Europe and has been transmitted between hospitals.
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Affiliation(s)
- A Guerrero
- Infectious Disease and Clinical Microbiology Department, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
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Solé F, Woessner S, Pérez-Losada A, Florensa L, Montero S, Asensio A, Besses C, Sans-Sabrafen J. Cytogenetic studies in seventy-six cases of B-chronic lymphoproliferative disorders. Cancer Genet Cytogenet 1997; 93:160-6. [PMID: 9078302 DOI: 10.1016/s0165-4608(96)00191-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The results of cytogenetic studies are reported in 76 patients with B-chronic lymphoproliferative disorders (B-CLPD): 60 patients with chronic lymphocytic leukemia (CLL), six with follicular lymphoma in leukemic phase (FLLP), five with splenic B-cell lymphoma with villous lymphocytes (SLVL), two with chronic prolymphocytic leukemia (CPL), two with hairy cell leukemia (HCL), and one with plasma cell leukemia (PCL). PHA (phytohemagglutinin), PWM (pokeweed mitogen), LPS (lipopolysaccharide from Escherichia Coli), TPA (phorbol 12-myristate acetate), IL6 (interleukin 6), and DxS (dextran sulfate) were used as mitogens. Mitoses were obtained in 75 cases. Clonal aberrations could be demonstrated in 34 cases (44%). In CLL, classical type, chromosomes 6, 11, and 13 were more frequently involved, whereas trisomy 12 was frequently found in CLL mixed-cell type, in FLLP, and CPL. In SLVL the deletion del(7)(q32) is noteworthy and miscellaneous chromosome abnormalities in the remaining patients were observed. Regarding the efficiency of mitogens, PHA turned to be the most effective in obtaining metaphases and in detecting clonal chromosomal aberrations.
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Affiliation(s)
- F Solé
- Laboratori de Citologia Hematológica, Hospital Central L' Aliança, Barcelona, Spain
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Salinas R, Asensio A, Tuset E, Abella E, Bosch A, Las Heras G, Escoda L, Farré V, García M, García M, Jiménez C, Kian C, Martín E, Oriol A, Orriols J, Panadés M, Pero A, Prat M, Ramón O, Revilla E, Segalés JM, Vallés A. [Organizational models for the hematology areas of the district hospitals of Catalonia]. Sangre (Barc) 1996; 41:211-20. [PMID: 8755209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE The haematological assistance in Catalonia is based upon the district hospitals, in the first step, and the stage III hospitals located usually in higher population nuclei, in the second step. The purpose of this work was to analyse the resources of the "primary haematological assistance" network provided by the district hospitals, to evaluate them and to propose a model for their organisation. MATERIAL AND METHODS An enquiry was carried out to all members of the Grup de Treball d'Hospitals Comarcals de Catalunya (Catalonia's District Hospitals Task Force). The evaluable data included demographic figures of the population assisted, personnel of each haematological area, organising structure, clinical activity, cytomorphology, blood banks, laboratories and continuous formation activities. RESULTS The enquiry was answered by 15 of the 21 district hospitals (71.4%) with haematologists in Catalonia. The population assisted in those hospitals is 2,100,000 (ranging between 55,000 an 450,000). All centres are integrated in the National Health network. Eleven of the hospitals analysed have only one haematologist (73.3%). If his dedication is 100% of the time, this would represent a doctor for 105,000 people. The time devoted to work is 690 hours a week for all the population, with a mean of 3,043. Four patients assisted per hour. The total number of hospital beds is 3,353 (50-450), with a mean number of 1 haematologist for every 167.6 beds. The number of patients hospitalized due to blood diseases ranges between 3 and 13 per month. Six of the 15 centres are adjunct to the outpatient clinic. Two centres have a blood bank and 7 have developed an autotransfusion programme. All the centres but one perform oral anticoagulant treatment follow-up, the number of patients assisted ranging from 20 to 210 per week. None of the hospitals has a separate Haematology Service; in most of them haematology is structurally and functionally dependent from Laboratories and in some there is a mixed Laboratory/Internal Medicine functional organisation, depending of the Medical Direction. No haematologist is ever on call specifically for his specialty. Continuous formation activities are carried out in 9 of the 15 centres (60%). COMMENT Several measures are proposed to improve the haematological assistance, acting on different levels: continuous formation, patient flows and circuits, resident doctors training, anticoagulant treatment network, organisation models, credit cards from the Spanish Association of Haematology.
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Affiliation(s)
- R Salinas
- Hospital General de Manresa, Barcelona
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Asensio A, Torres J. Proportion of mortality caused by severe hospital-acquired infection in open-heart surgery. Clin Perform Qual Health Care 1996; 4:67-73. [PMID: 10172624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To investigate severe hospital-acquired infection as an independent risk factor for in-hospital mortality and the proportion of mortality caused by severe hospital-acquired infections in patients under going open-heart surgery. SETTING A 1,300-bed teaching hospital in Spain. METHODS A retrospective cohort study of 702 patients who underwent open-heart surgery procedures between January 1989 and December 1991. The mean age was 57 years, and 68% of the subjects were men. Of the 702 patients, 42% underwent a valve operation, 41% had coronary artery bypass grafting, 4% had both a valve operation and coronary artery bypass grafting, 5% underwent repair of congenital heart disease, and 8% had other surgical procedures. RESULTS The cumulative incidence of severe hospital infection was 16.8%. The overall mortality rate was 5.4%. The mortality risk was 5.15 times higher in nosocomially infected patients than in uninfected patients. In addition, univariate analysis revealed up to 18 perioperative variables associated with in-hospital mortality. By multiple logistic regression, we identified four factors that independently predicted increased risk of mortality: preoperative New York Heart Association functional class level IV; long duration of cardiopulmonary bypass; low cardiac output syndrome; and severe hospital-acquired infection. The proportion of mortality caused by severe hospital-acquired infection in the cohort was 31.1%. CONCLUSIONS Severe hospital-acquired infection is a principal factor in in-hospital mortality. One third of all deaths are caused by infection. Major efforts should be devoted to the prevention and control of severe nosocomial infections in open-heart surgery patients to prevent mortality.
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Affiliation(s)
- A Asensio
- Ramón y Cajal Hospital, University of Alcalá de Henares, Madrid, Spain
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