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Escudero D, Astola I, Balboa S, Leoz B, Meilan Á, Del Busto C, Quindós B, Forcelledo L, Vizcaino D, Martín L, Salgado E, Viña L. Clinico-radiological related to early brain death factors. Med Intensiva 2021; 46:1-7. [PMID: 34802992 DOI: 10.1016/j.medine.2021.11.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 06/09/2020] [Accepted: 06/28/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify clinical and radiological factors associated to early evolution to brain death (BD), defined as occurring within the first 24 h. DESIGN A retrospective cohort study was made covering the period 2015-2017. SETTING An adult Intensive Care Unit (ICU). PATIENTS/METHODS Epidemiological, clinical and imaging (CT scan) parameters upon admission to the ICU in patients evolving to BD. RESULTS A total of 166 patients with BD (86 males, mean age 62.7 years) were analyzed. Primary cause: intracerebral hemorrhage 42.8%, subarachnoid hemorrhage 18.7%, traumatic brain injury 17.5%, anoxia 9%, stroke 7.8%, other causes 4.2%. Epidemiological data: arterial hypertension 50%, dyslipidemia 34%, smoking 33%, antiplatelet medication 21%, alcoholism 19%, anticoagulant therapy 15%, diabetes 15%. The Glasgow Coma Score (GCS) upon admission was 3 in 68.8% of the cases in early BD versus in 38.2% of the cases in BD occurring after 24 h (p = 0.0001). Eighty-five patients presented supratentorial hematomas with a volume of 90.9 ml in early BD versus 82.7 ml in BD > 24 h (p = 0.54). The mean midline shift was 10.7 mm in early BD versus 7.8 mm in BD > 24 h (p = 0.045). Ninety-one patients presented ventriculomegaly and 38 additionally ependymal transudation (p = 0.021). Thirty-six patients with early BD versus 24 with BD > 24 h presented complete effacement of basal cisterns (p = 0.005), sulcular effacement (p = 0.013), loss of cortico-subcortical differentiation (p = 0.0001) and effacement of the suprasellar cistern (p = 0.005). The optic nerve sheath measurements showed no significant differences between groups. CONCLUSIONS Early BD (>24 h) was associated to GCS < 5, midline shift, effacement of the basal cisterns, cerebral sulci and suprasellar cistern, and ependymal transudation.
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Affiliation(s)
- D Escudero
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - I Astola
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - S Balboa
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - B Leoz
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Á Meilan
- Sección de Neurorradiología, Servicio de Radiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - C Del Busto
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - B Quindós
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - L Forcelledo
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - D Vizcaino
- Sección de Neurorradiología, Servicio de Radiología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - L Martín
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - E Salgado
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - L Viña
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain
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Martínez-Sánchez L, López-Ávila J, Barasoain-Millán A, Angelats-Romero CM, Azkunaga-Santibañez B, Molina-Cabañero JC, Alday A, Andrés A, Angelats C, Aquino E, Astete J, Baena I, Barasoain A, Bello P, Benito C, Benito H, Botifoll E, Burguera B, Campos C, Canduela V, Clerigué N, Comalrena C, Del Campo T, De Miguel B, Fernández R, Fernández B, García E, García M, García M, García M, García-Vao C, Herrero L, Huerta P, Humayor J, Hurtado P, Iturralde I, Jordá A, Khodayar P, Lalinde M, Lobato Z, López J, López V, Luaces C, Mangione L, Martín L, Martínez S. L, Martínez L, Martorell J, May M, Melguizo M, Mesa S, Molina J, Muñiz M, Muñoz J, Muñoz N, Oliva S, Palacios M, Pérez A, Pérez C, Pinyot M, Peñalba A, Pociello N, Rodríguez A, Rodríguez M, Señer R, Serrano I, Vázquez P, Vidal C. Actions that should not be taken with a paediatric patient who has been exposed to a potentially toxic substance. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpede.2020.07.016] [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: 10/21/2022] Open
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Martín L, Benlliure J, Cortina-Gil D, Haruna A, Ruiz C. Validation of a laser driven plasma X-ray microfocus source for high resolution radiography imaging. Phys Med 2021; 82:163-170. [PMID: 33640836 DOI: 10.1016/j.ejmp.2020.12.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/31/2020] [Revised: 11/04/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022] Open
Abstract
Hard X-ray radiation with high brightness and high fluxes is nowadays available on the fourth generation of synchrotrons and X-FELs, but the large size and complexity of these sources makes its use difficult for widespread applications. New table top X-ray sources driven by ultrashort high power lasers offer a compelling route to expand the availability of hard X-ray sources. They can be used for advanced imaging techniques, due to its small source size and spatial coherence. We present in this paper the validation of a compact laser-driven X-ray microfocus source for high-resolution radiography imaging. This novel device was built at the Laser Laboratory for Acceleration and Applications (L2A2) at the University of Santiago de Compostela. This paper describes the laser-plasma X-ray source with improved stability and characterize some of its properties. We demonstrate the high-contrast and resolution of the images obtained with this source by using masks with well known geometries, and detailed analysis by using the modulation transfer function. Finally, we discuss the properties of this source in comparison to other compact microfocus X-ray sources.
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Affiliation(s)
- L Martín
- IGFAE, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
| | - J Benlliure
- IGFAE, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - D Cortina-Gil
- IGFAE, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - A Haruna
- IGFAE, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - C Ruiz
- Instituto de Física Fundamental y Matemáticas, Universidad de Salamanca, Spain
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Escudero D, Astola I, Balboa S, Leoz B, Meilan Á, Del Busto C, Quindós B, Forcelledo L, Vizcaino D, Martín L, Salgado E, Viña L. Clinico-radiological related to early brain death factors. Med Intensiva 2020; 46:S0210-5691(20)30249-7. [PMID: 32873408 DOI: 10.1016/j.medin.2020.06.019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 06/09/2020] [Accepted: 06/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To identify clinical and radiological factors associated to early evolution to brain death (BD), defined as occurring within the first 24 hours. DESIGN A retrospective cohort study was made covering the period 2015-2017. SETTING An adult Intensive Care Unit (ICU). PATIENTS/METHODS Epidemiological, clinical and imaging (CT scan) parameters upon admission to the ICU in patients evolving to BD. RESULTS A total of 166 patients with BD (86 males, mean age 62.7 years) were analyzed. Primary cause: intracerebral hemorrhage 42.8%, subarachnoid hemorrhage 18.7%, traumatic brain injury 17.5%, anoxia 9%, stroke 7.8%, other causes 4.2%. Epidemiological data: arterial hypertension 50%, dyslipidemia 34%, smoking 33%, antiplatelet medication 21%, alcoholism 19%, anticoagulant therapy 15%, diabetes 15%. The Glasgow Coma Score (GCS) upon admission was 3 in 68.8% of the cases in early BD versus in 38.2% of the cases in BD occurring after 24 h (p = 0.0001). Eighty-five patients presented supratentorial hematomas with a volume of 90.9 ml in early BD versus 82.7 ml in BD >24 h (p = 0.54). The mean midline shift was 10.7 mm in early BD versus 7.8 mm in BD >24 h (p = 0.045). Ninety-one patients presented ventriculomegaly and 38 additionally ependymal transudation (p = 0.021). Thirty-six patients with early BD versus 24 with BD >24 h presented complete effacement of basal cisterns (p = 0.005), sulcular effacement (p = 0.013), loss of cortico-subcortical differentiation (p = 0.0001) and effacement of the suprasellar cistern (p = 0.005). The optic nerve sheath measurements showed no significant differences between groups. CONCLUSIONS Early BD (>24 h) was associated to GCS < 5, midline shift, effacement of the basal cisterns, cerebral sulci and suprasellar cistern, and ependymal transudation.
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Affiliation(s)
- D Escudero
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España.
| | - I Astola
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
| | - S Balboa
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
| | - B Leoz
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
| | - Á Meilan
- Sección de Neurorradiología, Servicio de Radiología. Hospital Universitario Central de Asturias, Oviedo, España
| | - C Del Busto
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
| | - B Quindós
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
| | - L Forcelledo
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
| | - D Vizcaino
- Sección de Neurorradiología, Servicio de Radiología. Hospital Universitario Central de Asturias, Oviedo, España
| | - L Martín
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
| | - E Salgado
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
| | - L Viña
- Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias, Oviedo, España
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Asencio JM, Cortese S, López Baena JA, Olmedilla L, Pérez Peña JM, Salcedo MM, Matilla A, Martín L, Martínez C, Orue-Echebarria MI, Lozano P. Evaluation of Plasma Disappearance Rate Indocyanine Green Clearance as a Predictor of Liver Graft Rejection in Donor Brain Death. Transplant Proc 2020; 52:1472-1476. [PMID: 32217011 DOI: 10.1016/j.transproceed.2020.01.084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/02/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION There currently exist no quantitative methods to assess graft viability before the donor procurement procedure. In Europe, around 20% of liver grafts evaluated "in situ" by an experienced surgeon are discarded. The aim of this study is to evaluate the use of the plasma disappearance rate indocyanine green (PDR-ICG) clearance in predicting liver graft rejection to avoid this 20% of futile surgeries. OBJECTIVES To evaluate PDR-ICG as a predictor of liver graft rejection in death brain donors compared with the gold standard evaluation by an experienced surgeon. MATERIAL AND METHODS Prospective observational single center study. From March 2017 to July 2019, 29 donors were included in the study, 17 were men and 12 women with a median age of 68 years ± 16.9 years. Donors had an intensive care unit stay of 2 days ± 4 days. PDR-ICG was measured with PICCO2 monitor. Indocyanine green clearance dose was 0.25 mg/kg injected intravenously in the operating room just before donor procurement procedure is initiated. The surgeon was unaware of the PDR-ICG measure until the decision of graft acceptance was taken. Data regarding the donors and biopsy results were included in a prospective database. RESULTS PDR-ICG measure could be obtained in 10 minutes in all of the cases included. The median PDR-ICG obtained was 18%/min (range, 2.4-31%/min). Graft rejection took place in 15 out of the 29 donors. PDR-ICG value was less than 10%/min in 6 of these rejected grafts and less than 15%/min in 10 donors. All donor grafts with PDR-ICG <15% were discarded. The graft had been discarded in 5 donors with a PDR-ICG >15%. CONCLUSIONS In our study a plasma disappearance rate <10 would have identified the grafts that would be rejected, thus avoiding the displacement work and expense of the surgical team. These results should be confirmed in a multicentric study.
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Affiliation(s)
- J M Asencio
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - S Cortese
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - J A López Baena
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - L Olmedilla
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - J M Pérez Peña
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - M M Salcedo
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - A Matilla
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - L Martín
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - C Martínez
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - M I Orue-Echebarria
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - P Lozano
- Liver Transplant Unit, Hospital Universitario Gregorio Marañón de Madrid, Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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Millán-Callado M, Guerrero C, Quesada J, Gómez J, Fernández B, Lerendegui-Marco J, Rodríguez-González T, Domingo-Pardo C, Tarifeño-Saldivia A, Benlliure J, Cortina D, Martín L, Peñas J, Cano-Ott D, Martínez T. Laser-driven neutrons for time-of-flight experiments? EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202023917012] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Neutron beams, both pulsed and continuous, are a powerful tool in a wide variety of research fields and applications. Nowadays, pulsed neutron beams are produced in conventional accelerator facilities in which the time-of-fight technique is used to determine the kinetic energy of the neutrons inducing the reactions of interest.
In the last decades, the development of ultra-short (femtosecond) and ultra-high power (> 1018 W/cm2) lasers has opened the door to a vast number of new applications, including the production and acceleration of pulsed ion beams. These have been recently used to produce pulsed neutron beams, reaching fluxes per pulse similar and even higher than those of conventional neutron beams, hence becoming an alternative for the pulsed neutron beam users community. Nevertheless, these laser-driven neutrons have not been exploited in nuclear physics experiments so far.
Our main goal is to produce and characterize laser-driven neutrons but optimizing the analysis, diagnostic and detection techniques currently used in conventional neutron sources to implement them in this new environment. As a result, we would lay down the viability of carrying out nuclear physics experiments using this kind of sources by identifying the advantages and limitations of this production method.
To achieve this purpose, we plan to perform experiments in both medium (50TW@L2A2, in Santiago de Com-postela) and high (1PW@APOLLON, in Paris) power laser facilities.
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López A, García B, Gómez A, González L, González N, Martín L, Jaime G. Concordance of the ions and GAP anion obtained by gasometry vs standard laboratory in critical care. Med Intensiva 2018; 43:521-527. [PMID: 30193741 DOI: 10.1016/j.medin.2018.06.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the differences observed in ion and GAP anion determinations obtained by point-of-care (POC) blood gas versus laboratory biochemical testing, and to analyze the possible errors according to the limits of normality. MATERIAL AND METHODS A descriptive, cross-sectional retrospective study was made to assess concordance between two diagnostic tests in patients admitted to the Critical Care Unit of Ourense University Hospital Complex (Spain), between July and November 2015, involving at least one coinciding biochemical test and POC determination. Patients under 18years of age were excluded. RESULTS A total of 1,073 samples were analyzed. Lin's concordance correlation coefficients for sodium, potassium and chlorine were 0.87, 0.84 and 0.72, respectively. Kappa concordance of the normality limits for sodium, potassium and chlorine was 0.63, 0.74 and 0.32. The results indicated poor correlation of the anion GAP and null concordance between POC and biochemical testing, including the value corrected for albumin. CONCLUSIONS Poor concordance was observed between the ion values as determined by biochemistry and blood gases; the two methods are therefore not interchangeable. Kappa agreement with normality limits was good for sodium and potassium, and weak for chlorine. Possible validity was noted in orienting the classification within the ion limits, with the exception of chlorine. No agreement was recorded in relation to the anion GAP, even that corrected for albumin.
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Affiliation(s)
- A López
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur), SERGAS-UVIGO, Vigo, Pontevedra, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), SERGAS, Ourense, España.
| | - B García
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur), SERGAS-UVIGO, Vigo, Pontevedra, España; Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Costa del Sol, Marbella, Málaga, España
| | - A Gómez
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur), SERGAS-UVIGO, Vigo, Pontevedra, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), SERGAS, Ourense, España
| | - L González
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur), SERGAS-UVIGO, Vigo, Pontevedra, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), SERGAS, Ourense, España
| | - N González
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur), SERGAS-UVIGO, Vigo, Pontevedra, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), SERGAS, Ourense, España
| | - L Martín
- Grupo de Investigación en Anestesia y Cuidados Críticos, Instituto de Investigación Sanitaria Galicia SUR (ISS Galicia Sur), SERGAS-UVIGO, Vigo, Pontevedra, España; Servicio de Anestesia y Reanimación, Complexo Hospitalario Universitario de Ourense (CHUO), SERGAS, Ourense, España
| | - G Jaime
- Servicio de Análisis Clínicos, Complexo Hospitalario Universitario de Ourense (CHUO), SERGAS, Ourense, España
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Eceiza I, Barrio A, Martín L, Veganzones MA, Fernández-Berridi MJ, Irusta L. Thermal and fire behavior of isophorone diisocyanate based polyurethane foams containing conventional flame retardants. J Appl Polym Sci 2017. [DOI: 10.1002/app.45944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- I. Eceiza
- Department of Polymer Science and Technology; POLYMAT, University of the Basque Country UPV-EHU, P.O. Box 1072; Donostia San Sebastian 20080 Spain
| | - A. Barrio
- TECNALIA, Construction Division, Area Anardi 5; Azpeitia E-20730 Spain
| | - L. Martín
- Macrobehaviour-Mesostructure-Nanotechnology SGIker Service, Polytechnic School; University of the Basque Country UPV-EHU, Plaza Europa 1; Donostia San Sebastian 20018 Spain
| | - M. A. Veganzones
- GIPSA-Lab, CNRS, 11 rue des Mathématiques, Grenoble Campus, BP.46; F-38402 St. Martin d'Hères Cedex France
- NEM Solutions; Paseo Mikeletegi 54 San Sebastian 20009 Spain
| | - M. J. Fernández-Berridi
- Department of Polymer Science and Technology; POLYMAT, University of the Basque Country UPV-EHU, P.O. Box 1072; Donostia San Sebastian 20080 Spain
| | - L. Irusta
- Department of Polymer Science and Technology; POLYMAT, University of the Basque Country UPV-EHU, P.O. Box 1072; Donostia San Sebastian 20080 Spain
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Escudero D, Cofiño L, Forcelledo L, Quindós B, Calleja C, Martín L. Control de una endemia de Acinetobacter baumannii multirresistente en la UCI. Recordando lo obvio. Med Intensiva 2017; 41:497-499. [DOI: 10.1016/j.medin.2016.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/01/2016] [Accepted: 11/05/2016] [Indexed: 11/24/2022]
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López-Amor L, Viña L, Martín L, Calleja C, Rodríguez-García R, Astola I, Forcelledo L, Álvarez-García L, Díaz-Gómez C, Fernández-Domínguez J, Vázquez F, Escudero D. Infectious complications related to external ventricular shunt. Incidence and risk factors. Rev Esp Quimioter 2017; 30:327-333. [PMID: 28749123] [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: 06/07/2023]
Abstract
OBJECTIVE Infectious complications related to external ventricular shunt (ICREVS) are a main problem in neurocritical intensive care units (ICU). The aim of the review is to assess the incidence of ICREVS and to analyse factors involved. METHODS Retrospective analysis, adult polyvalent ICU in a third level reference hospital. Patients carrying external ventricular shunt (DVE) were included. Those patients with central nervous system infection diagnosed prior DVE placement were excluded. RESULTS 87 patients were included with 106 DVE. Most common admittance diagnosis was subarachnoid haemorrhage (49.4%). 31 patients with 32 DVE developed an ICREVS. Infection rate is 19.5 per 1000 days of shunt for ICREVS and 14 per 1000 days for ventriculitis. 31.6% of the patients developed ICREVS and 25.3% ventriculitis. Patients who developed ICREVS presented higher shunt manipulations (2.0 ± 0.6 vs. 3.26 ± 1.02, p=0.02), shunt repositioning (0.1 ± 0.1 vs. 0.2 ± 0.1) and ICU and hospital stay (29.8 ± 4.9 vs 49.8 ± 5.2, p<0.01 y 67.4 ± 18.8 vs. 108.9 ± 30.2, p=0.02. Those DVE with ICREVS were placed for longer not only at infection diagnosis but also at removal (12.6 ± 2.1 vs. 18.3 ± 3.6 and 12.6 ± 2.1 vs. 30.4 ± 7.3 days, p<0.01). No difference in mortality was found. CONCLUSIONS One out of three patients with a DVE develops an infection. The risk factors are the number of manipulations, repositioning and the permanency days. Patients with ICREVS had a longer ICU and hospital average stay without an increase in mortality.
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Affiliation(s)
- L López-Amor
- Lucía López Amor, Servicio de Medicina Intensiva. Hospital Universitario Central de Asturias Avenida de Roma s/n 33011 Oviedo. Asturias, Spain.
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Fernández J, Cunningham SA, Fernández-Verdugo A, Viña-Soria L, Martín L, Rodicio MR, Escudero D, Vazquez F, Mandrekar JN, Patel R. Evaluation of a real-time PCR assay for rectal screening of OXA-48-producing Enterobacteriaceae in a general intensive care unit of an endemic hospital. Diagn Microbiol Infect Dis 2017; 88:252-258. [PMID: 28442306 DOI: 10.1016/j.diagmicrobio.2017.04.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/31/2017] [Accepted: 04/02/2017] [Indexed: 11/19/2022]
Abstract
Carbapenemase-producing Enterobacteriaceae are increasing worldwide. Rectal screening for these bacteria can inform the management of infected and colonized patients, especially those admitted to intensive care units (ICUs). A laboratory developed, qualitative duplex real-time polymerase chain reaction assay for rapid detection of OXA-48-like and VIM producing Enterobacteriaceae, performed on rectal swabs, was designed and evaluated in an intensive care unit with endemic presence of OXA-48. During analytical assay validation, no cross-reactivity was observed and 100% sensitivity and specificity were obtained for both blaOXA-48-like and blaVIM in all spiked clinical samples. During the clinical part of the study, the global sensitivity and specificity of the real-time PCR assay for OXA-48 detection were 95.7% and 100% (P=0.1250), respectively, in comparison with culture; no VIM-producing Enterobacteriaceae were detected. Clinical features of patients in the ICU who were colonized or infected with OXA-48 producing Enterobacteriaceae, including outcome, were analyzed. Most had severe underlying conditions, and had risk factors for colonization with carbapenemase-producing Enterobacteriaceae before or during ICU admission, such as receiving previous antimicrobial therapy, prior healthcare exposure (including long-term care), chronic disease, immunosuppression and/or the presence of an intravascular catheter and/or mechanical ventilation device. The described real-time PCR assay is fast (~2-3hours, if DNA extraction is included), simple to perform and results are easy to interpret, features which make it applicable in the routine of clinical microbiology laboratories. Implementation in endemic hospitals could contribute to early detection of patients colonized by OXA-48 producing Enterobacteriaceae and prevention of their spread.
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Affiliation(s)
- J Fernández
- Service of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain; Department of Functional Biology, Section of Microbiology, University of Oviedo, Oviedo, Spain
| | - S A Cunningham
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - A Fernández-Verdugo
- Service of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - L Viña-Soria
- Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - L Martín
- Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - M R Rodicio
- Department of Functional Biology, Section of Microbiology, University of Oviedo, Oviedo, Spain
| | - D Escudero
- Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - F Vazquez
- Service of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain; Department of Functional Biology, Section of Microbiology, University of Oviedo, Oviedo, Spain; Fundación de Investigación Oftalmológica. Instituto Universitario Oftalmológico, Fernández-Vega
| | - J N Mandrekar
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - R Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN; Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN.
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Martín L, Antequera T, Ruiz J, Cava R, Tejeda J, Córdoba J. Influencia de las condiciones de elaboración sobre la proteolisis durante la maduración del jamón ibérico Influence of the processing conditions of Iberian ham on proteolysis during ripening. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201329800400103] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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
Non-protein nitrogen and its fractions (peptides, amino acids and volatile basic nitrogen) were determined in biceps femoris and semimembranosus muscles of two homogeneous groups of Iberian dry-cured ham in different stages of maturation, and ripened in two different factories under different environmental conditions. A progressive increase in non-protein nitrogen was observed during ripening in all groups, being especially intense during the drying stage, when the temperature was the highest during maturation. During the first stages of processing, the proportion of peptides and free amino acids remained similar while free amino acids increased more markedly from the drying stage, representing the largest fraction at the end of the process. Volatile basic nitrogen was the least abundant fraction of non-protein nitrogen during ripening. Hams kept at higher temperature during longer periods, and with lower salt content, produced larger amounts of all three fractions of non-protein nitrogen in fully ripened dry-cured Iberian ham.
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Affiliation(s)
- L. Martín
- Tecnología e Higiene de los Alimentos. Facultad de Veterinaria. Universidad de Extremadura. 10071 Cáceres. Spain
| | - T. Antequera
- Tecnología e Higiene de los Alimentos. Facultad de Veterinaria. Universidad de Extremadura. 10071 Cáceres. Spain
| | - J. Ruiz
- Tecnología e Higiene de los Alimentos. Facultad de Veterinaria. Universidad de Extremadura. 10071 Cáceres. Spain
| | - R. Cava
- Tecnología e Higiene de los Alimentos. Facultad de Veterinaria. Universidad de Extremadura. 10071 Cáceres. Spain
| | - J.F. Tejeda
- Tecnología e Higiene de los Alimentos. Facultad de Veterinaria. Universidad de Extremadura. 10071 Cáceres. Spain
| | - J.J. Córdoba
- Tecnología e Higiene de los Alimentos. Facultad de Veterinaria. Universidad de Extremadura. 10071 Cáceres. Spain
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Escudero D, Martín L, Viña L, Forcelledo L, García-Arias B, López-Amor L. Abrir las puertas de la UCI. Una necesidad inexcusable. Med Intensiva 2015; 39:522-3. [DOI: 10.1016/j.medin.2015.07.004] [Citation(s) in RCA: 11] [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] [Received: 06/25/2015] [Accepted: 07/07/2015] [Indexed: 11/28/2022]
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Escudero D, Martín L, Viña L, Quindós B, Espina MJ, Forcelledo L, López-Amor L, García-Arias B, del Busto C, de Cima S, Fernández-Rey E. [Visitation policy, design and comfort in Spanish intensive care units]. ACTA ACUST UNITED AC 2015; 30:243-50. [PMID: 26346582 DOI: 10.1016/j.cali.2015.06.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 06/04/2015] [Accepted: 06/29/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the design and comfort in the Intensive Care Units (ICUs), by analysing visiting hours, information, and family participation in patient care. DESIGN Descriptive, multicentre study. SETTING Spanish ICUs. METHODS A questionnaire e-mailed to members of the Spanish Society of Intensive Care Medicine, Critical and Coronary Units (SEMICYUC), subscribers of the Electronic Journal Intensive Care Medicine, and disseminated through the blog Proyecto HU-CI. RESULTS A total of 135 questionnaires from 131 hospitals were analysed. Visiting hours: 3.8% open 24h, 9.8% open daytime, and 67.7% have 2 visits a day. Information: given only by the doctor in 75.2% of the cases, doctor and nurse together in 4.5%, with a frequency of once a day in 79.7%. During weekends, information is given in 95.5% of the cases. Information given over the phone 74.4%. Family participation in patient care: hygiene 11%, feeding 80.5%, physiotherapy 17%. Personal objects allowed: mobile phone 41%, computer 55%, sound system 77%, and television 30%. Architecture and comfort: all individual cubicles 60.2%, natural light 54.9%, television 7.5%, ambient music 12%, clock in the cubicle 15.8%, environmental noise meter 3.8%, and a waiting room near the ICU 68.4%. CONCLUSIONS Visiting policy is restrictive, with a closed ICU being the predominating culture. On average, technological communication devices are not allowed. Family participation in patient care is low. The ICU design does not guarantee privacy or provide a desirable level of comfort.
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Affiliation(s)
- D Escudero
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España.
| | - L Martín
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - L Viña
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - B Quindós
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - M J Espina
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - L Forcelledo
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - L López-Amor
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - B García-Arias
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - C del Busto
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - S de Cima
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - E Fernández-Rey
- Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España
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Palmou N, Calvo-Río V, Loricera J, Hernández J, Mata C, Martín L, Ortíz-Sanjuán F, Άlvarez L, González-Vela M, González-Lamuño D, Fernández-Llaca H, González-Lόpez M, Armesto S, Arias M, González-Gay M, Blanco R. FRI0246 Relapses and Predictive Factors in Henoch-Schönlein Purpura. Study of 417 Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5595] [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: 11/04/2022]
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16
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Garre P, Martín L, Sanz J, Romero A, Tosar A, Bando I, Llovet P, Diaque P, García-Paredes B, Díaz-Rubio E, de la Hoya M, Caldés T. BRCA2 gene: a candidate for clinical testing in familial colorectal cancer type X. Clin Genet 2014; 87:582-7. [PMID: 24814045 DOI: 10.1111/cge.12427] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/09/2014] [Accepted: 05/09/2014] [Indexed: 01/19/2023]
Abstract
Familial colorectal cancer type X (FCCX) encompasses a group of families with dominant inheritance pattern of colorectal cancer (CRC) but no alteration in any known CRC susceptibility gene. Therefore, the explanation of their susceptibility is a priority to offer an accurate genetic counseling. We screened the 27 coding exons and exon-intron boundaries of BRCA2 in 48 FCCX probands. We identified 29 variants including a frameshift mutation. Deleterious variant c.3847_3848delGT p.(Val1283Lysfs*2) showed cosegregation with disease as well as loss of heterozygosity (LOH) in CRC tumor DNA. This is the first evidence of germline BRCA2 pathogenic mutation associated with CRC risk. Furthermore, missense variants c.502C>A p.(Pro168Thr), c.5744C>T p.(Thr1915Met) and c.7759C>T p.(Leu2587Phe) were proposed as candidate risk alleles based on cosegregation, LOH tumor analysis and in silico testing.
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Affiliation(s)
- P Garre
- Laboratorio de Oncología Molecular, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
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Loricera J, Calvo-Río V, Mata C, Martín L, Ortiz-Sanjuán F, Santos-Gόmez M, Άlvarez L, González-Vela M, González-Lamuño D, Rueda-Gotor J, Fernández-Llaca H, González-Lόpez M, Armesto S, Peirό E, Arias M, González-Gay M, Blanco R. AB0584 Clinical Features of Patients with Henoch-SchÖNlein Purpura. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4358] [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: 11/04/2022]
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18
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Ortiz-Sanjuán F, Blanco R, Pina T, Calvo-Río V, Loricera J, Martín L, Άlvarez L, González-Vela M, Rueda-Gotor J, González-Lόpez M, Peirό M, Santos-Gόmez M, Arias M, González-Gay M. AB0587 Limitations of the 1990 American College of Rheumatology Criteria in the Classification of Cutaneous Vasculitis. Study of 773 Cutaneous Vasculitis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3111] [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]
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Loricera J, Calvo-Río V, Ortiz-Sanjuán F, Santos-Gόmez M, Mata C, Martín L, Άlvarez L, González-Vela M, Rueda-Gotor J, González-Lόpez M, Armesto S, Peirό E, Arias M, Pina T, González-Gay M, Blanco R. AB0583 Revisiting Clinical Differences between Hipersensitivity Vasculitis and Henoch-SchÖNlein Purpura in Adults from A Defined Population. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3002] [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]
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Muñoz M, Calvo F, Serrano J, Calles C, Laureiro J, Martín L, Gómez-Espí M, Del Valle E. PO-0715: Post-neoadjuvant presacral radiological abnormalities in rectal cancer: Long-term risk factors analysis. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30833-1] [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: 12/01/2022]
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Petrón M, Broncano J, Otte J, Martín L, Timón M. Effect of commercial proteases on shelf-life extension of Iberian dry-cured sausage. Lebensm Wiss Technol 2013. [DOI: 10.1016/j.lwt.2013.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Holguín Á, Yebra G, Martín L, de Pineda AT, Ruiz LE, Quezada AY, Nieto AI, Escobar G. Transmitted drug-resistance in human immunodeficiency virus-infected adult population in El Salvador, Central America. Clin Microbiol Infect 2013; 19:E523-32. [PMID: 23782115 DOI: 10.1111/1469-0691.12264] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 02/06/2013] [Revised: 04/22/2013] [Accepted: 05/09/2013] [Indexed: 11/26/2022]
Abstract
El Salvador harbours one of the largest Central American human immunodeficiency virus (HIV) epidemics, but few studies have analysed it in depth. Here, we describe the presence of transmitted drug resistance (TDR) and HIV variants in the HIV-infected adult population in El Salvador. Dried blood spots from 119 HIV-infected antiretroviral-naive adults attended in El Salvador were collected in 2011. The TDR was assessed according to the list recommended by the WHO. HIV-1 variants were described using phylogeny. Pol sequences could be amplified in 88 patients (50.6% men), with a mean age of 35 years. Almost all (96.7%) were infected with HIV through sexual practice and 58.7% were recently diagnosed. The mean CD4(+) count was 474 cells/mm(3) and 43.1% and 15.5% of patients showed moderate (<500 CD4 cells) or severe (<200) immune suppression, respectively. HIV-1 viral load was >100 000 copies/mL in 24.7% of patients and <2000 copies/mL in 9.1%. Five samples (5.7%) harboured any TDR mutation: 2.3% for nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI), and 1.4% for protease inhibitor (PI). All showed only one TDR single-class resistance mutation: M184I (two cases) for NRTI, K101E and K103N for NNRTI and L23I for PI. All viruses excepting one (URF_BG) belonged to subtype B. No phylogenetic TDR networks were found. In conclusion, we report a TDR prevalence of 5.7% in El Salvador, lower than in other Central American studies. Periodical studies are essential to monitor and prevent TDR emergence in low-income and middle-income regions. Also, more efforts are needed to promote early diagnosis and prevention of infection in El Salvador.
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Affiliation(s)
- Á Holguín
- HIV-1 Molecular Epidemiology Laboratory, Microbiology Department, Hospital Ramón y Cajal-IRYCIS, Madrid, Spain
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Calvo-Río V, Loricera J, Martín L, Ortiz-Sanjuán F, Alvarez L, González-Vela MC, González-Lamuño D, Mata C, Gortázar P, Rueda-Gotor J, Arias M, Martínez-Taboada V, González-Gay MA, Blanco R. SAT0157 Nephropathy in Henoch-SchÖNlein Purpura: Study of 142 Patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1883] [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: 11/04/2022]
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Rueda-Gotor J, Calvo-Río V, Martín L, Loricera J, Ortiz-Sanjuán F, Lamuño D, González-Lόpez M, Fernández-Llaca H, González-Vela M, Arias M, Peirό E, González-Gay M, Blanco R. FRI0229 Henoch-schoenlein purpura nephritis and IGA nephropaty: A comparative clinical study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2686] [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: 11/04/2022]
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Rueda-Gotor J, Calvo-Río V, Loricera J, Ortiz-Sanjuán F, Lamuño D, Martín L, González-Lόpez M, Fernández-Llaca H, González-Vela M, Arias M, Mata-Arnáiz C, Peirό E, González-Gay M, Blanco R. AB1166 Henoch-schoenlein purpura: Clinical study of 340 patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1164] [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]
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26
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Calvo-Río V, Loricera J, Martín L, Ortiz-Sanjuán F, Alvarez L, González-Vela MC, González-Lamuño D, Mata C, Gortázar P, Rueda-Gotor J, Arias M, Peiró E, Martínez-Taboada VM, González-Gay MA, Blanco R. Henoch-Schönlein purpura nephritis and IgA nephropathy: a comparative clinical study. Clin Exp Rheumatol 2013; 31:S45-S51. [PMID: 23663681] [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] [Received: 02/26/2013] [Accepted: 03/15/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Henoch-Schönlein purpura nephritis (HSPN) and IgA nephropathy (IgAN) are related syndromes. In the present study we aimed to compare the clinical characteristics and outcome of a large and unselected series of patients diagnosed as having HSPN and IgAN. METHODS Comparative study of a wide and unselected population of HSPN (142 patient) and IgAN (61 patients) from a teaching hospital of Northern Spain. RESULTS All of the following comparisons were expressed between HSPN vs. IgAN, respectively. HSPN patients were younger (30.6±26.4 vs. 37.1±16.5 years, p<0.001). Precipitating events, usually an upper respiratory tract infection and/or drug intake, were more frequently observed in HSPN (38% vs. 23%, p=0.03). Extra-renal manifestations were also more common in HSPN than in IgAN; skin lesions (100% vs. 1.8%; p<0.001), gastrointestinal (62% vs. 7.4%; p<0.001), and joint involvement (61.3% vs. 3.6%; p<0.001). However, nephritis was less severe in HSPN, renal insufficiency (25% in HSPN vs. 63.4% in IgAN; p<0.001), nephrotic syndrome (12.5%, vs. 43.7%; p<0.001), and nephritic syndrome (6.8% vs. 10.7%; NS). Leukocytosis was more frequent in HSPN (22.5% vs. 8.2%; p=0.015) and anaemia in IgAN (12.7% in HSPN vs. 36% in IgAN, p<0.001). The frequency of corticosteroid (79.6% vs. 69%; NS) and cytotoxic drug (19% vs. 16.5%, NS) use was similar. The frequency of relapses was similar (38.6% in HSPN vs. 36.3% in IgAN). After a median follow-up of 120.8 (IQR; 110-132) months in HSPN and 138.6 (IQR; 117-156) in IgAN, requirement for dialysis (2.9% vs. 43.5%; p<0.001), renal transplant (0% vs. 36%, p<0.001) and residual chronic renal insufficiency (4.9% vs. 63.8%; p<0.001) was more frequently observed in patients with in IgAN. CONCLUSIONS HSPN and IgAN represent different syndromes. IgAN has more severe renal involvement while HSPN is associated with more extra-renal manifestations.
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Affiliation(s)
- V Calvo-Río
- Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain
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Martín L, González-Coloma A, Díaz C, Mainar A, Urieta J. Supercritical CO2 extraction of Persea indica: Effect of extraction parameters, modelling and bioactivity of its extracts. J Supercrit Fluids 2011. [DOI: 10.1016/j.supflu.2011.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [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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Martos M, Cosme A, Bujanda L, Múgica F, Martín L, Iribarren A. Obstructive jaundice for biliary mold due to foreign body. Rev Esp Enferm Dig 2011; 103:36-37. [PMID: 21341936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- M Martos
- Department of Gastroenterology, Donostia Hospital, San Sebastián, Guipúzcoa, Spain
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San Martín GG, Górriz C, Martín L, Escamilla C, López-Lozano JJ, Vargas JA, Ruiz G, Cabello A. [Dysphonia as a first symptom in several neuromuscular diseases. Laryngeal electroneuromyography diagnostic utility]. Neurologia 2009; 24:819-821. [PMID: 21476234] [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: 05/30/2023] Open
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González-Guerra E, Haro MR, Fariña MC, Martín L, Manzarbeitia L, Requena L. Glomeruloid haemangioma is not always associated with POEMS syndrome. Clin Exp Dermatol 2009; 34:800-3. [DOI: 10.1111/j.1365-2230.2008.02997.x] [Citation(s) in RCA: 12] [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: 12/26/2022]
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Jiménez M, Esteban L, Robles A, Hita E, Martín L, Rodriguez A, González P, Molina E. Enzymatic synthesis of structured triacylglycerols (sTAGs) highly rich in palmitic acid at position 2 and caprylic acid at positions 1 and 3. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.507] [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: 10/20/2022]
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Martín L, González P, Robles A, Rodríguez A, Jiménez M, Hita E, Esteban L, Molina E. Concentration of docosahexaenoic acid (DHA) by selective alcoholysis catalyzed by lipases. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.503] [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: 11/30/2022]
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Rodríguez A, Esteban L, Robles A, Martín L, Jiménez M, Hita E, González P, Molina E. Synthesis of structured triacylglycerols by two enzymatic steps: ethanolysis of cold liver oil and esterification of 2-monoacylglycerols. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.502] [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: 10/20/2022]
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Martín L, González P, Robles A, Rodríguez A, Hita E, Jiménez M, Esteban L, Molina E. Concentration of docosahexaenoic acid (DHA) by kinetic resolution by a Thermomyces lanuginosus lipase. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.506] [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: 11/15/2022]
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Córdoba S, Martínez D, Martín L, Borbujo JM. [Tongue ulcer as a manifestation of temporal arteritis]. Actas Dermosifiliogr 2009; 100:237-238. [PMID: 19457313] [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: 05/27/2023] Open
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Córdoba S, Martínez D, Martín L, Borbujo J. Tongue Ulcer as a Manifestation of Temporal Arteritis. Actas Dermo-Sifiliográficas (English Edition) 2009. [DOI: 10.1016/s1578-2190(09)70053-8] [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: 10/19/2022] Open
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Martín D, Paniagua J, Martín L. Casos en imagen 2.—Vólvulo de ciego. Radiología 2008; 50:238; discussion 252. [DOI: 10.1016/s0033-8338(08)71974-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: 11/29/2022]
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González-Guerra E, Haro MR, Angulo J, Fariña MC, Martín L, Requena L. [Superficial spreading capillary hemangioma: case report]. Actas Dermosifiliogr 2007; 98:430-2. [PMID: 17663934] [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: 05/16/2023] Open
Abstract
Superficial spreading capillary hemangioma has been described for the first and sole time by Mihara and collaborators in 1986, as a proliferation of capillaries in the dermal papillae, separated by thin elongated rete ridges. Clinically it appeared as an asymptomatic, isolated, small and long-standing red plaque of slow growth located in the plantar surface of a 57-year-old Japanese woman. We report a 23-year-old Caucasian woman with an asymptomatic, long-standing, brownish plantar lesion of stable size. In the pathological study we observed a capillary proliferation in tangles with slack stroma located in the papillary dermis. We report, therefore, the second case of superficial spreading capillary hemangioma published in the literature.
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Abstract
OBJECTIVES Sudden death constitutes a major sanitary problem with high mortality and serious neurological complications. The objective of this study was to analyze the prognosis and the characteristics of patients who initially recovered after an episode of cardiac arrest and who were admitted to the intensive care unit (ICU). METHOD We retrospectively studied the clinical characteristics and outcome of 65 patients admitted to the Intensive Care Unit during a 3 years period with aborted sudden death. RESULTS 65 patients, 44 (67.7%) men and 21 (32.3%) women. Middle ages 69.1 +/- 13.9. 29 (44.6%) out of hospital and 36 (55.4%) into hospital sudden death. Cardiopulmonary resuscitation was <10 minutes in 28 cases (43.1%), and > 10 minutes in 37 (56.9%). 36 (55.4%) of all sudden deaths were of cardiac origin. 37 patients (56.9%) died and 28 (43.1%) survived the episode. It was LET in 11 cases (16.9%). 29 (44.6%) of all had post- anoxic encephalopathy and most died before discharge from ICU. Of 28 survivors, 5 patients were discharged alive with post-anoxic encephalopathy (17.8%) and 23 were discharged without neurological disturbances (82.2%). This was more frequent when sudden death was into hospital (p 0.009) and cardiopulmonary resuscitation was < 10 minutes (p 0.045). CONCLUSIONS High number of the patients admitted to a Intensive Care unit with aborted sudden death died during ICU stay. Many patients had post-anoxic encephalopathy and most of these died. So, up to 35% of the patients admitted after an episode of cardiac arrest were discharged alive and without severe neurological damage.
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Affiliation(s)
- R Ridruejo
- Servicio de Medicina Intensiva, Hospital Clínico Universitario, Lozano Blesa, Zaragoza, Spain.
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De la Morena F, Martín L, Gisbert JP, Fernández Herrera J, Goiriz R. Refractory and infected pyoderma gangrenosum in a patient with ulcerative colitis: response to infliximab. Inflamm Bowel Dis 2007; 13:509-10. [PMID: 17206663 DOI: 10.1002/ibd.20081] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Gamo R, Aguilar A, Gónzalez-Valle O, Houmani M, Martín L, Gallego MA. Localized linear IgA disease associated with monoclonal gammapathy of undetermined significance. J Eur Acad Dermatol Venereol 2007; 21:544-5. [PMID: 17373989 DOI: 10.1111/j.1468-3083.2006.01943.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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González-Guerra E, Haro M, Ángulo J, Fariña M, Martín L, Requena L. Superficial Spreading Capillary Hemangioma: Case Report. Actas Dermo-Sifiliográficas (English Edition) 2007. [DOI: 10.1016/s1578-2190(07)70477-8] [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: 10/19/2022] Open
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Romero A, Martín L, Hernández-Núñez A, Arias D, Castaño E, Borbujo J. Eruptive Pseudoangiomatosis. Actas Dermo-Sifiliográficas (English Edition) 2007. [DOI: 10.1016/s1578-2190(07)70417-1] [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] Open
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Diego L, Martín-Vivaldi J, Ramírez F, Soria MJ, Martín L. Peritonitis bacteriana espontánea por Listeria monocytogenes en paciente con cirrosis hepática. Rev esp enferm dig 2005; 97:603-4. [PMID: 16266228 DOI: 10.4321/s1130-01082005000800010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ruiz-Mesa JD, Sánchez-Gonzalez J, Reguera JM, Martín L, Lopez-Palmero S, Colmenero JD. Rose Bengal test: diagnostic yield and use for the rapid diagnosis of human brucellosis in emergency departments in endemic areas. Clin Microbiol Infect 2005; 11:221-5. [PMID: 15715720 DOI: 10.1111/j.1469-0691.2004.01063.x] [Citation(s) in RCA: 61] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of the present study was to analyse the diagnostic yield of the rose Bengal test for the rapid diagnosis of human brucellosis in an emergency department in an area where the disease is endemic. The study included 711 patients diagnosed initially with brucellosis and 270 controls. Brucellosis patients were divided into three groups: group I, individuals with no regular exposure to or history of brucellosis; group II, individuals exposed repeatedly to Brucella infection; and group III, individuals infected with Brucella who had received appropriate treatment during the previous 12 months. Blood cultures were positive for 445 (62.6%) brucellosis patients, while the remaining 266 (37.4%) patients were diagnosed according to clinical and serological criteria. The overall sensitivity of the rose Bengal test was 92.9%. The specificities for groups I, II and III were 94.3%, 91.7% and 76.9%, respectively, with positive likelihood ratios of 16.5, 10.4 and 4.2, respectively. The diagnostic gain after the performance of the rose Bengal test was good or very good in patients with no previous exposure to Brucella or history of brucellosis, but poor in patients who were exposed repeatedly to Brucella or had a history of brucellosis and a low pre-test probability. Use of the rose Bengal test as the sole technique for the diagnosis of brucellosis in endemic areas should be considered very carefully in the context of patients who are exposed repeatedly to Brucella or have a history of brucellosis.
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Affiliation(s)
- J D Ruiz-Mesa
- Infectious Diseases Unit, Internal Medicine Department, Carlos Haya University, 29010 Malaga, Spain
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