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Calmarza P, Lapresta C, Martínez García M, Ochoa J, Sienes Bailo P, Acha Pérez J, Beltrán Audera J, González-Roca E. Musculoskeletal pain and muscular weakness as the main symptoms of adult hypophosphatasia in a Spanish cohort: clinical characterization and identification of a new ALPL gene variant. J Bone Miner Metab 2023; 41:654-665. [PMID: 37351650 DOI: 10.1007/s00774-023-01440-z] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/15/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION Hypophosphatasia (HPP) is a rare inherited disorder, caused by mutations in the alkaline phosphatase (ALPL) gene, which encodes for the tissue non-specific alkaline phosphatase (TNSALP) isoform of alkaline phosphatase (ALP). Adult HPP is one of the mild forms that presents with unspecific signs such as osteopenia, osteomalacia and muscle involvement. Our purpose was to identify and characterize possibly misdiagnosed adult HPP patients at a clinical and biochemical level. MATERIAL AND METHODS At the laboratory of Miguel Servet University Hospital we retrospectively reviewed serum ALP levels in adults over a 48-month period. The clinical records of individuals with consistently low ALP levels were reviewed to exclude secondary causes. Those with persistent hypophosphatasemia were screened for symptoms of HPP. The study participants were evaluated at biochemical and genetic levels. RESULTS We identified 705 ALP determinations (out of 384,000 processed) in 589 patients below the reference range (30 U/l). Only 21 patients with clinical signs and symptoms of HPP were selected for genetic testing. Finally, only 12 patients participated in the study, 83.3% of whom (10/12) harbored a pathogenic or likely pathogenic variant in a heterozygous state. The major symptoms of our cohort were the presence of musculoskeletal pain (100% of patients) and muscular weakness (83.3% patients). CONCLUSION Mild HPP patients presenting with diffuse symptoms such as musculoskeletal pain may be undiagnosed or misdiagnosed as osteoporosis patients by routine diagnosis. It is important to identify these individuals, to avoid inappropriate treatment with antiresorptive drugs.
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Affiliation(s)
- Pilar Calmarza
- Clinical Biochemistry Department, IIS Aragón, Miguel Servet University Hospital, Network Research Center in Cardiovascular Diseases (CIBERCV), University of Zaragoza, 50009, Zaragoza, Spain.
| | - Carlos Lapresta
- Preventive Medicine Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain
| | | | - José Ochoa
- Occupational Risk Prevention Service, MAS Prevention, Zaragoza, Spain
| | - Paula Sienes Bailo
- Clinical Biochemistry Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain
| | - Javier Acha Pérez
- Endocrinology Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain
| | - Jesús Beltrán Audera
- Rheumatology department, Miguel Servet University Hospital, 50009, Zaragoza, Spain
| | - Eva González-Roca
- Molecular Biology Core Lab/Immunology Department, CDB. Hospital Clínic, Barcelona, Spain
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Millán-Lou MI, López C, Bueno J, Pérez-Laguna V, Lapresta C, Fuertes ME, Rite S, Santiago M, Romo M, Samper S, Cebollada A, Oteo-Iglesias J, Rezusta A. Successful control of Serratia marcescens outbreak in a neonatal unit of a tertiary-care hospital in Spain. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:248-254. [PMID: 35577443 DOI: 10.1016/j.eimce.2021.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/06/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Serratia marcescens is a Gram-negative bacterium that is found in hospital environments and commonly associated with outbreaks in neonatal units. One S. marcescens isolate was detected from a bloodstream culture from a neonate in our hospital that was followed by an outbreak. The aim of this study was to describe the molecular epidemiology of a S. marcescens outbreak in the neonatal unit. METHODS In order to investigate the outbreak, weekly surveillance rectal swabs were submitted for culture from all patients admitted in this unit from August to September 2018. Environmental samples were obtained from potential sources in September 2018. Typing of isolates was performed by pulsed field gel electrophoresis (PFGE). In addition, we studied the in vitro activity of chlorhexidine against S. marcescens. RESULTS During this period, 146 infants were hospitalised in our neonatal unit, of which 16 patients had a S. marcescens-positive sample. A total of 36 environmental surveillance samples were collected, and one sample from a stethoscope from an incubator of a colonized baby was positive for S. marcescens. All the 18 isolates, including the isolate from the stethoscope, belonged to a single PFGE cluster. We found that very low concentrations of chlorhexidine, even with application times close to 0 achieved significant reductions in the amount of S. marcescens. CONCLUSION A unique clone of S. marcescens caused this outbreak, including isolates from patients and from one stethoscope. The outbreak was controlled with the early implementation of specific control measures.
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Affiliation(s)
- María Isabel Millán-Lou
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - Concepción López
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - Jessica Bueno
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Vanesa Pérez-Laguna
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - Carlos Lapresta
- Servicio de Medicina Preventiva, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - María Elena Fuertes
- Unidad de neonatología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - Segundo Rite
- Unidad de neonatología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - Mónica Santiago
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - María Romo
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - Sofia Samper
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Alberto Cebollada
- CIBERES, ISCIII, Madrid, Spain; Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; Unidad de Biocomputación, Instituto Aragonés de Ciencias de la Salud (IACS/IIS Aragón), Zaragoza, Spain
| | - Jesús Oteo-Iglesias
- Laboratorio de Referencia e Investigación en Resistencia a Antibióticos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Rezusta
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain; Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain
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3
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Millán-Lou MI, López C, Bueno J, Pérez-Laguna V, Lapresta C, Fuertes ME, Rite S, Santiago M, Romo M, Samper S, Cebollada A, Oteo-Iglesias J, Rezusta A. Successful control of Serratia marcescens outbreak in a neonatal unit of a tertiary-care hospital in Spain. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00186-5. [PMID: 34144851 DOI: 10.1016/j.eimc.2021.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 02/06/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Serratia marcescens is a Gram-negative bacterium that is found in hospital environments and commonly associated with outbreaks in neonatal units. One S. marcescens isolate was detected from a bloodstream culture from a neonate in our hospital that was followed by an outbreak. The aim of this study was to describe the molecular epidemiology of a S. marcescens outbreak in the neonatal unit. METHODS In order to investigate the outbreak, weekly surveillance rectal swabs were submitted for culture from all patients admitted in this unit from August to September 2018. Environmental samples were obtained from potential sources in September 2018. Typing of isolates was performed by pulsed field gel electrophoresis (PFGE). In addition, we studied the in vitro activity of chlorhexidine against S. marcescens. RESULTS During this period, 146 infants were hospitalised in our neonatal unit, of which 16 patients had a S. marcescens-positive sample. A total of 36 environmental surveillance samples were collected, and one sample from a stethoscope from an incubator of a colonized baby was positive for S. marcescens. All the 18 isolates, including the isolate from the stethoscope, belonged to a single PFGE cluster. We found that very low concentrations of chlorhexidine, even with application times close to 0 achieved significant reductions in the amount of S. marcescens. CONCLUSION A unique clone of S. marcescens caused this outbreak, including isolates from patients and from one stethoscope. The outbreak was controlled with the early implementation of specific control measures.
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Affiliation(s)
- María Isabel Millán-Lou
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - Concepción López
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - Jessica Bueno
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Vanesa Pérez-Laguna
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
| | - Carlos Lapresta
- Servicio de Medicina Preventiva, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - María Elena Fuertes
- Unidad de neonatología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - Segundo Rite
- Unidad de neonatología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - Mónica Santiago
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - María Romo
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain
| | - Sofia Samper
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Alberto Cebollada
- CIBERES, ISCIII, Madrid, Spain; Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain; Unidad de Biocomputación, Instituto Aragonés de Ciencias de la Salud (IACS/IIS Aragón), Zaragoza, Spain
| | - Jesús Oteo-Iglesias
- Laboratorio de Referencia e Investigación en Resistencia a Antibióticos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Rezusta
- Servicio de Microbiología, Hospital Universitario Miguel-Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain; Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain
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Calmarza P, Lapresta C, Martínez M, Lahoz R, Povar J. Utility of myeloperoxidase in the differential diagnosis of acute coronary syndrome. Arch Cardiol Mex 2017; 88:391-396. [PMID: 29233491 DOI: 10.1016/j.acmx.2017.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 07/19/2017] [Revised: 10/31/2017] [Accepted: 11/06/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES To determine the usefulness of myeloperoxidase in discriminating between patients with acute coronary syndrome and patients with chest pain by other causes. METHODS The study included all patients over 18 years of age who come consecutively to the emergency department from September 2015 to December 2015 with chest pain of non-traumatic origin. The initial patient evaluation was performed according to the study protocol for patients with suspected acute coronary syndrome (ACS) in our Emergency Department. This included the serial measurement of troponin, and in this case myeloperoxidase, with serialization on admission and at 6h. For the determination of myeloperoxidase (MPO), a single step sandwich enzyme immunoassay by Siemens, automated on a Dimension analyser, was used. RESULTS Statistically significant differences were observed in the concentration of myeloperoxidase at time 0 among patients diagnosed with ACS: 505 (413)pmol/L, and non-ACS patients: 388 (195)pmol/L (p<.001), as well as at 6h (p<.001). An area under the curve ROC of 0.824 was obtained at 6h for ACS patients, with a confidence interval of 95% from 0.715 to 0.933 and a level of significance of p<.001. Statistically significant differences were also found in the concentration of myeloperoxidase at time 0 and at 6h among patients with ACS and patients with heart disease other than coronary artery disease. CONCLUSIONS The concentration of MPO helps to differentiate between ACS and non-ACS patients, as well as between ACS patients and patients with heart diseases other than coronary artery disease.
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Affiliation(s)
- Pilar Calmarza
- Department of Clinical Biochemistry, Universitary Hospital Miguel Servet, Zaragoza, Spain.
| | - Carlos Lapresta
- Department of Preventive Medicine, Barbastro Hospital, Huesca, Spain
| | - María Martínez
- Department of Endocrinology, University Hospital Miguel Servet, Zaragoza, Spain
| | - Raquel Lahoz
- Department of Clinical Biochemistry, Universitary Hospital Miguel Servet, Zaragoza, Spain
| | - Javier Povar
- Department of Urgences, University Hospital Miguel Servet, Zaragoza, Spain
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Calmarza P, Lapresta C, García-Castañón S, López-Perales C, Pérez-Guerrero A, Portolés A. [Usefulness of copeptin in the diagnosis of acute coronary syndrome in the emergency department of a tertiary hospital]. Clin Investig Arterioscler 2016; 28:209-215. [PMID: 27650658 DOI: 10.1016/j.arteri.2016.07.001] [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] [Received: 04/24/2016] [Revised: 06/27/2016] [Accepted: 07/03/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES This study was conducted in order to evaluate the usefulness of copeptin (a stable fragment of the precursor of arginine vasopressin) in the differential diagnosis of acute chest pain of probable coronary origin. MATERIAL AND METHODS The study includes 82 patients who were initially evaluated according to the protocol of a patient with suspected acute coronary syndrome (ACS) in our Emergency Department, including the determination of troponin and copeptin with specimens taken on admission (time 0) and at 6h. RESULTS Statistically significant differences were observed in copeptin concentrations at time 0 among patients diagnosed with non-ST-segment elevation (NTEACS): 42.1±38.7pmol/L and non-NSTEACS patients: 15.6±21.2pmol/L (P<. 01). However, the differences did not reach statistical significance at 6h (P=.093). The analysis of the area under the ROC curve for Copeptin in NSTEACS patients at time 0 was 0.713, with a confidence interval of 95% from 0.592 to 0.834 and a significance level of P=.001. CONCLUSIONS The concentration of copeptin represents an additional value in the differentiation between NSTEACS patients and non-NSTEACS patients, as well as between ACS patients and patients with stable angina. The cut-off point of 10pmol/L provides the best values for sensitivity, negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) in the diagnosis of NSTEACS patients.
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Affiliation(s)
- Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - Carlos Lapresta
- Servicio de Medicina Preventiva, Hospital de Barbastro, Zaragoza, España
| | | | | | | | - Ana Portolés
- Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, España
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Calmarza P, Trejo JM, Lapresta C, López P. [Intima-media thickness in a middle-old age sample of the Spanish general population]. Clin Investig Arterioscler 2014; 27:111-7. [PMID: 25542632 DOI: 10.1016/j.arteri.2014.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 09/28/2014] [Accepted: 09/29/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To ascertain reference values of carotid intima-media thickness (cIMT) in a middle and old-aged sample of the Spanish general population and to establish the 75(th) percentile above which it is necessary to control more strictly other cardiovascular risk factors. To determine cIMT values and the number of carotid plaques in age and sex subgroups, and whether there are differences between them. MATERIAL AND METHODS Lipids, apolipoproteins, number of carotid atherosclerotic plaques if any, and cIMT of both common carotid arteries were determined in 171 individuals, representative of the adult general population of Burgos (Spain). RESULTS The median age of the patients was 63 years (interquartile range = 20) and the 75th percentile of carotid IMT was 0,88 mm and 0,81 mm in men and women, respectively. This study shows that the values of cIMT median increase with age and are higher in men than in women in all age groups, except in individuals over 74 years where cIMT median values are similar. The presence or absence of atherosclerotic plaques was not statistically different between men and women at different ages. CONCLUSIONS This population study shows the reference values of cIMT in a middle and old-aged sample of the Spanish population and shows that age, male gender, systolic blood pressure (SBP) and personal history of coronary heart disease are the main determinants of increased cIMT.
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Affiliation(s)
- Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - José María Trejo
- Servicio de Neurología, Complejo Hospitalario de Burgos, Burgos, España
| | - Carlos Lapresta
- Servicio de Medicina Preventiva, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Pilar López
- Servicio de Urgencias, Complejo Hospitalario de Burgos, Burgos, España
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Bello S, Mincholé E, Fandos S, Lasierra AB, Ruiz MA, Simon AL, Panadero C, Lapresta C, Menendez R, Torres A. Inflammatory response in mixed viral-bacterial community-acquired pneumonia. BMC Pulm Med 2014; 14:123. [PMID: 25073709 PMCID: PMC4118651 DOI: 10.1186/1471-2466-14-123] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 07/23/2014] [Indexed: 11/20/2022] Open
Abstract
Background The role of mixed pneumonia (virus + bacteria) in community-acquired pneumonia (CAP) has been described in recent years. However, it is not known whether the systemic inflammatory profile is different compared to monomicrobial CAP. We wanted to investigate this profile of mixed viral-bacterial infection and to compare it to monomicrobial bacterial or viral CAP. Methods We measured baseline serum procalcitonin (PCT), C reactive protein (CRP), and white blood cell (WBC) count in 171 patients with CAP with definite etiology admitted to a tertiary hospital: 59 (34.5%) bacterial, 66 (39.%) viral and 46 (27%) mixed (viral-bacterial). Results Serum PCT levels were higher in mixed and bacterial CAP compared to viral CAP. CRP levels were higher in mixed CAP compared to the other groups. CRP was independently associated with mixed CAP. CRP levels below 26 mg/dL were indicative of an etiology other than mixed in 83% of cases, but the positive predictive value was 45%. PCT levels over 2.10 ng/mL had a positive predictive value for bacterial-involved CAP versus viral CAP of 78%, but the negative predictive value was 48%. Conclusions Mixed CAP has a different inflammatory pattern compared to bacterial or viral CAP. High CRP levels may be useful for clinicians to suspect mixed CAP.
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Affiliation(s)
- Salvador Bello
- Servicio de Neumologia, Hospital Universitario Miguel Servet, Paseo Isabel La Católica, 1-3, 50009 Zaragoza, Spain.
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Calmarza P, Bajador E, Lapresta C, García Castañón S, de Castro I, Civeira F. [Effect of biliary obstruction on lipoprotein(a) concentration]. Clin Investig Arterioscler 2014; 26:218-23. [PMID: 24629889 DOI: 10.1016/j.arteri.2014.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 01/29/2014] [Accepted: 01/30/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This study was appointed to determine the correlation between the concentration of lipoprotein(a) [Lp(a)], apolipoproteins and lipids with biochemical parameters of liver function in a group of patients with reversible cholestasis. We have also determined the concentration of these parameters once solved the biliary obstruction process. MATERIAL AND METHODS Eighteen adults over 17 years with extrahepatic cholestasis were included in the study on a prospective basis, and we determined in them biochemical liver function parameters and lipoprotein metabolism parameters, particularly Lp(a) before and after unblocking. RESULTS The concentration of Lp(a) prior to desobstruction was inverse and statistically significantly correlated with the concentration of gamma glutamyl transpeptidase (correlation coefficient [r] = -0.757, P = .018). The concentration of Lp(a) (median = 2.66 mg/dL, interquartile range = 5,62) showed a statistically significant increase (median = 9.72 mg/dL, interquartile range = 28.76, P < .001), once the unblocking was performed. Concentrations of total cholesterol and triglycerides had a statistically significant decrease, and HDL cholesterol and apolipoprotein A-1 showed a statistically significant increase once the unblocking was carried out. CONCLUSIONS The concentration of Lp(a) is decreased during cholestasis, although there is a significant simultaneous hypercholesterolemia. Cholestasis has a causal role in lowering Lp(a), because the unblocking of bile duct recovers Lp(a) concentration. Our study supports the concept that bile acids exert a controlling effect on the synthesis of Lp(a) and open a mechanism for the treatment of hyper Lp(a).
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Affiliation(s)
- Pilar Calmarza
- Servicio de Bioquímica Clínica, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - Eduardo Bajador
- Servicio de Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Carlos Lapresta
- Servicio de Medicina Preventiva, Hospital Universitario Miguel Servet, Zaragoza, España
| | | | - Isabel de Castro
- Unidad de Lípidos y Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Fernando Civeira
- Unidad de Lípidos y Laboratorio de Investigación Molecular, Hospital Universitario Miguel Servet, Zaragoza, España
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Calmarza P, Trejo JM, Lapresta C, López P. LDL Oxidation and Its Association With Carotid Artery Intima-Media Thickness and Other Cardiovascular Risk Factors in a Sample of Spanish General Population. Angiology 2013; 65:357-62. [DOI: 10.1177/0003319713488639] [Citation(s) in RCA: 9] [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: 11/16/2022]
Abstract
We studied the association between oxidized low-density lipoproteins (OxLDLs) and early atherosclerosis, assessed by carotid artery intima-media thickness (cIMT), as well as with other known atherosclerosis risk factors in a sample of the general middle- and old-age population of Burgos (Spain). Circulating OxLDL showed a significant and independent association with the average cIMT of both carotid arteries but not with the absence or presence of ≥1 carotid atheroma plaques. Plasma OxLDL concentrations were associated with age, smoking, low-density lipoprotein-cholesterol, and triglycerides, independently of other variables. Our findings in an asymptomatic sample representative of the Spanish middle- and old-age population underscore the role of OxLDL in early atherosclerosis represented by the cIMT especially in older asymptomatic individuals, but this cannot be extended to more advanced atherosclerosis, represented by carotid plaques.
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Affiliation(s)
- Pilar Calmarza
- Service of Clinical Biochemistry, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - José María Trejo
- Service of Neurology, Research Unit, Complejo Asistencial, Burgos, Spain
| | - Carlos Lapresta
- Service of Preventive Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Pilar López
- Service of Urgences, Research Unit, Complejo Asistencial, Burgos, Spain
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10
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Calmarza P, Trejo JM, Lapresta C, Lopez P. Lack of association between carotid intima-media thickness and apolipoprotein (a) isoforms in a sample of Spanish general population. J Cardiol 2013; 61:372-7. [DOI: 10.1016/j.jjcc.2013.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 12/05/2012] [Accepted: 01/10/2013] [Indexed: 11/30/2022]
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Calmarza P, Trejo JM, Lapresta C, Lopez P. Relationship between lipoprotein(a) concentrations and intima-media thickness: a healthy population study. Eur J Prev Cardiol 2011; 19:1290-5. [DOI: 10.1177/1741826711423216] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- P Calmarza
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - JM Trejo
- Complejo Asistencial, Burgos, Spain
| | - C Lapresta
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - P Lopez
- Complejo Asistencial, Burgos, Spain
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Crespo R, Lapresta C, Castán S, Campillos J, Rodríguez-Solanilla B, Tobajas J. Análisis de la finalización de la gestación y morbilidad materna en las gestaciones de 41 semanas. Clínica e Investigación en Ginecología y Obstetricia 2011. [DOI: 10.1016/j.gine.2010.10.004] [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: 10/18/2022]
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Moros ML, Rodrigo C, Villacampa A, Ruiz J, Lapresta C. Septic shock in pregnancy due to pyogenic sacroiliitis: a case report. J Med Case Rep 2009; 3:6505. [PMID: 19830110 PMCID: PMC2726500 DOI: 10.1186/1752-1947-3-6505] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Accepted: 01/22/2009] [Indexed: 11/16/2022] Open
Abstract
Introduction Lower back pain due to sacroiliac joint dysfunction is a common symptom during pregnancy. However, infection of the sacroiliac joint is rare, even more so if no predisposing factors are present. Case presentation After the onset of unspecific acute pain in the left buttock region, a 31-year-old pregnant woman developed septic shock due to pyogenic sacroiliitis. The medical and obstetric management, treatment applied and patient's experience are described. Conclusion The correct diagnosis and treatment of pyogenic sacroiliitis during pregnancy may avoid joint and bone destruction in addition to maternal and fetal complications.
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Hernández M, Lapresta C, Montaño C, Giménez-Julvez T, Arribas J. P3.12 Antimicrobial Susceptibility of Nosocomial Infections in a Tertiary Hospital over the Period from January 1995 to December 2005. J Hosp Infect 2006. [DOI: 10.1016/s0195-6701(06)60055-8] [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: 10/23/2022]
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Hernandez-Navarrete M, Montaño-Remacha M, Lapresta C, Gimenez-Julvez M, Pastor-Eixarch S, Arribas-Llorente J. P4.17 Methicillin Resistant Staphylococcus aureus (MRSA) in a tertiary centre in 5 years time (2001-2005). J Hosp Infect 2006. [DOI: 10.1016/s0195-6701(06)60079-0] [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: 11/25/2022]
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