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Ruiz-Algueró M, Alejos B, García Yubero C, Riera Jaume M, Antonio Iribarren J, Asensi V, Pasquau F, Galera CE, Pascual-Carrasco M, Muñoz A, Jarrín I, Suárez-García I, Moreno S, Jarrín I, Dalmau D, Navarro ML, González MI, Blanco JL, Garcia F, Rubio R, Iribarren JA, Gutiérrez F, Vidal F, Berenguer J, González J, Alejos B, Hernando V, Moreno C, Iniesta C, Garcia Sousa LM, Perez NS, Muñoz-Fernández MÁ, García-Merino IM, Fernández IC, Rico CG, de la Fuente JG, Concejo PP, Portilla J, Merino E, Reus S, Boix V, Giner L, Gadea C, Portilla I, Pampliega M, Díez M, Rodríguez JC, Sánchez-Payá J, Gómez JL, Hernández J, Alemán MR, del Mar Alonso M, Inmaculada Hernández M, Díaz-Flores F, García D, Pelazas R, Lirola AL, Moreno JS, Caso AA, Hernández Gutiérrez C, Novella Mena M, Rubio R, Pulido F, Bisbal O, Hernando A, Domínguez L, Crestelo DR, Bermejo L, Santacreu M, Antonio Iribarren J, Arrizabalaga J, Aramburu MJ, Camino X, Rodríguez-Arrondo F, von Wichmann MÁ, Tomé LP, Goenaga MÁ, Bustinduy MJ, Azkune H, Ibarguren M, Lizardi A, Kortajarena X, Gutiérrez F, Masiá M, Padilla S, Navarro A, Montolio F, Robledano C, Gregori Colomé J, Adsuar A, Pascual R, Fernández M, García E, García JA, Barber X, Muga R, Sanvisens A, Fuster D, Berenguer J, de Quirós JCLB, Gutiérrez I, Ramírez M, Padilla B, Gijón P, Aldamiz-Echevarría T, Tejerina F, José Parras F, Balsalobre P, Diez C, Latorre LP, Vidal F, Peraire J, Viladés C, Veloso S, Vargas M, López-Dupla M, Olona M, Rull A, Rodríguez-Gallego E, Alba V, Montero Alonso M, López Aldeguer J, Blanes Juliá M, Tasias Pitarch M, Hernández IC, Calabuig Muñoz E, Cuéllar Tovar S, Salavert Lletí M, Navarro JF, González-Garcia J, Arnalich F, Arribas JR, de la Serna JIB, Castro JM, Escosa L, Herranz P, Hontañón V, García-Bujalance S, López-Hortelano MG, González-Baeza A, Martín-Carbonero ML, Mayoral M, Mellado MJ, Micán RE, Montejano R, Luisa Montes M, Moreno V, Pérez-Valero I, Rodés B, Sainz T, Sendagorta E, Stella Alcáriz N, Valencia E, Ramón Blanco J, Antonio Oteo J, Ibarra V, Metola L, Sanz M, Pérez-Martínez L, Arazo P, Sampériz G, Dalmau D, Jaén A, Sanmartí M, Cairó M, Martinez-Lacasa J, Velli P, Font R, Xercavins M, Alonso N, Repáraz J, de Alda MGR, de León Cano MT, de Galarreta BPR, Segura F, José Amengual M, Navarro G, Sala M, Cervantes M, Pineda V, Calzado S, Navarro M, de los Santos I, Sanz Sanz J, Aparicio AS, Sarriá Cepeda C, Garcia-Fraile Fraile L, Martín Gayo E, Moreno S, Luis Casado J, Dronda F, Moreno A, Jesús Pérez Elías M, Gómez Ayerbe C, Gutiérrez C, Madrid N, del Campo Terrón S, Martí P, Ansa U, Serrano S, Jesús Vivancos M, Cano A, García AA, Bravo Urbieta J, Muñoz Á, Jose Alcaraz M, Villalba MDC, García F, Hernández J, Peña A, Muñoz L, Casas P, Alvarez M, Chueca N, Vinuesa D, Martinez-Montes C, Romero JD, Rodríguez C, Puerta T, Carlos Carrió J, Vera M, Ballesteros J, Ayerdi O, Antela A, Losada E, Riera M, Peñaranda M, Leyes M, Ribas MA, Campins AA, Vidal C, Fanjul F, Murillas J, Homar F, Santos J, Ayerbe CG, Viciana I, Palacios R, González CM, Viciana P, Espinosa N, López-Cortés LF, Podzamczer D, Ferrer E, Imaz A, Tiraboschi J, Silva A, Saumoy M, Ribera E, Curran A, Olalla J, del Arco A, de la torre J, Prada JL, de Lomas Guerrero JMG, Stachowski JP, Martínez OJ, Vera FJ, Martínez L, García J, Alcaraz B, Jimeno A, Iglesias AC, Souto BP, de Cea AM, Muñoz J, Zubero MZ, Baraia-Etxaburu JM, Ugarte SI, Beneitez OLF, de Munain JL, López MMC, de la Peña M, Lopez M, Galera C, Albendin H, Pérez A, Iborra A, Moreno A, Merlos MA, Vidal A, Amador C, Pasquau F, Ena J, Benito C, Fenoll V, Anguita CG, Rabasa JTA, Suárez-García I, Malmierca E, González-Ruano P, Rodrigo DM, Seco MPR, Vidal MAG, de Zarraga MA, Pérez VE, Molina MJT, García JV, Moreno JPS, Górgolas M, Cabello A, Álvarez B, Prieto L, Sanz Moreno J, Arranz Caso A, Gutiérrez CH, Novella Mena M, Galindo Puerto MJ, Fernando Vilalta R, Ferrer Ribera A, Román AR, Brieva Herrero MT, Juárez AR, López PL, Sánchez IM, Martínez JP, Jiménez MC, Perea RT, Ruiz-Capillas JJJ, Pineda JA. Use of Generic Antiretroviral Drugs and Single-Tablet Regimen De-Simplification for the Treatment of HIV Infection in Spain. AIDS Res Hum Retroviruses 2022; 38:433-440. [PMID: 35357907 DOI: 10.1089/aid.2021.0122] [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] [Indexed: 11/13/2022] Open
Abstract
The present study sought to describe the use of generic drugs and single-tablet regimen (STR) de-simplification for the treatment of human immunodeficiency virus (HIV) infection among 41 hospitals from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). In June 2018, we collected information on when generic antiretroviral drugs (ARVs) were introduced in the different hospitals, how the decisions to use them were made, and how the information was provided to the patients. Most of the nine available generic ARVs in Spain by June 2018 had been introduced in at least 85% of the participating hospitals, except for zidovudine (AZT)/lamivudine (3TC) and AZT. The time difference between the effective marketing date of each generic ARV and its first dispensing date in the hospitals was much shorter for the more recently approved generic ARV since the year 2017. However, only up to 20% of the hospitals de-simplified efavirenz (EFV)/tenofovir disoproxil (TDF)/emtricitabine (FTC), dolutegravir (DTG)/abacavir (ABC)/3TC, and rilpivirine (RPV)/TDF/FTC (to generic EFV+TDF/FTC, DTG+generic ABC/3TC, and RPV+generic TDF/FTC, respectively), whereas the generic STR EFV/TDF/FTC was introduced in 87.8% of the centers. The median times between the date of effective marketing of generic TDF/FTC and the date of de-simplification of EFV/TDF/FTC and RPV/TDF/FTC were 723 [interquartile range (IQR): 369-1,119] and 234 (IQR: 142-264) days, respectively; this time was 155 (IQR: 28-287) days for de-simplification of DTG/ABC/3TC. In conclusion, despite the widespread use of generic ARVs, STRs de-simplification was only undertaken in <20% of the hospitals. There was wide variability in the timing of the introduction of each generic ARV after they were available in the market.
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Affiliation(s)
- Marta Ruiz-Algueró
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
| | - Belén Alejos
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
| | | | | | - José Antonio Iribarren
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, Instituto de Investigación BioDonostia, San Sebastián, Spain
| | - Víctor Asensi
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Mario Pascual-Carrasco
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Unidad de Investigación en Telemedicina y Salud Digital (UITes), Instituto de Salud Carlos III, Madrid, Spain
| | - Adolfo Muñoz
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Unidad de Investigación en Telemedicina y Salud Digital (UITes), Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Jarrín
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
| | - Inés Suárez-García
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain
- Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, Spain
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Ferrando C, Mellado-Artigas R, Gea A, Arruti E, Aldecoa C, Bordell A, Adalia R, Zattera L, Ramasco F, Monedero P, Maseda E, Martínez A, Tamayo G, Mercadal J, Muñoz G, Jacas A, Ángeles G, Castro P, Hernández-Tejero M, Fernandez J, Gómez-Rojo M, Candela Á, Ripollés J, Nieto A, Bassas E, Deiros C, Margarit A, Redondo F, Martín A, García N, Casas P, Morcillo C, Hernández-Sanz M. Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: A prospective, cohort, multicentre study. Revista Española de Anestesiología y Reanimación (English Edition) 2020. [PMCID: PMC7833676 DOI: 10.1016/j.redare.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background The clinical course of COVID-19 critically ill patients, during their admission in the intensive care unit (UCI), including medical and infectious complications and support therapies, as well as their association with in-ICU mortality has not been fully reported. Objective This study aimed to describe clinical characteristics and clinical course of ICU COVID-19 patients, and to determine risk factors for ICU mortality of COVID-19 patients. Methods Prospective, multicentre, cohort study that enrolled critically ill COVID-19 patients admitted into 30 ICUs from Spain and Andorra. Consecutive patients from March 12th to May 26th, 2020 were enrolled if they had died or were discharged from ICU during the study period. Demographics, symptoms, vital signs, laboratory markers, supportive therapies, pharmacological treatments, medical and infectious complications were reported and compared between deceased and discharged patients. Results A total of 663 patients were included. Overall ICU mortality was 31% (203 patients). At ICU admission non-survivors were more hypoxemic [SpO2 with non-rebreather mask, 90 (IQR 83–93) vs 91 (IQR 87–94); p < 0.001] and with higher sequential organ failure assessment score [SOFA, 7 (IQR 5–9) vs 4 (IQR 3–7); p < 0.001]. Complications were more frequent in non-survivors: acute respiratory distress syndrome (ARDS) (95% vs 89%; p = 0.009), acute kidney injury (AKI) (58% vs 24%; p < 10−16), shock (42% vs 14%; p < 10−13), and arrhythmias (24% vs 11%; p < 10−4). Respiratory super-infection, bloodstream infection and septic shock were higher in non-survivors (33% vs 25%; p = 0.03, 33% vs 23%; p = 0.01 and 15% vs 3%, p = 10−7), respectively. The multivariable regression model showed that age was associated with mortality, with every year increasing risk-of-death by 1% (95%CI: 1–10, p = 0.014). Each 5-point increase in APACHE II independently predicted mortality [OR: 1.508 (1.081, 2.104), p = 0.015]. Patients with AKI [OR: 2.468 (1.628, 3.741), p < 10−4)], cardiac arrest [OR: 11.099 (3.389, 36.353), p = 0.0001], and septic shock [OR: 3.224 (1.486, 6.994), p = 0.002] had an increased risk-of-death. Conclusions Older COVID-19 patients with higher APACHE II scores on admission, those who developed AKI grades II or III and/or septic shock during ICU stay had an increased risk-of-death. ICU mortality was 31%.
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Ferrando C, Mellado-Artigas R, Gea A, Arruti E, Aldecoa C, Bordell A, Adalia R, Zattera L, Ramasco F, Monedero P, Maseda E, Martínez A, Tamayo G, Mercadal J, Muñoz G, Jacas A, Ángeles G, Castro P, Hernández-Tejero M, Fernandez J, Gómez-Rojo M, Candela Á, Ripollés J, Nieto A, Bassas E, Deiros C, Margarit A, Redondo FJ, Martín A, García N, Casas P, Morcillo C, Hernández-Sanz ML. Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: A prospective, cohort, multicentre study. ACTA ACUST UNITED AC 2020; 67:425-437. [PMID: 32800622 PMCID: PMC7357496 DOI: 10.1016/j.redar.2020.07.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Antecedentes No se ha reportado plenamente la evolución clínica de los pacientes críticos de COVID-19 durante su ingreso en la unidad de cuidados intensivos (UCI), incluyendo las complicaciones médicas e infecciosas y terapias de soporte, así como su asociación con la mortalidad en UCI. Objetivo El objetivo de este estudio es describir las características clínicas y la evolución de los pacientes ingresados en UCI por COVID-19 y determinar los factores de riesgo de la mortalidad en UCI de dichos pacientes. Métodos Estudio prospectivo, multicéntrico y de cohorte, que incluyó a los pacientes críticos de COVID-19 ingresados en 30 UCI de España y Andorra. Se incluyó a los pacientes consecutivos del 12 de marzo al 26 de mayo del 2020 si habían fallecido o habían recibido el alta de la UCI durante el periodo de estudio. Se reportaron los datos demográficos, los síntomas, los signos vitales, los marcadores de laboratorio, las terapias de soporte, terapias farmacológicas y las complicaciones médicas e infecciosas, realizándose una comparación entre los pacientes fallecidos y los pacientes dados de alta. Resultados Se incluyó a un total de 663 pacientes. La mortalidad general en UCI fue del 31% (203 pacientes). Al ingreso en UCI los no supervivientes eran más hipoxémicos (SpO2 con mascarilla de no reinhalación, de 90 [RIC 83-93] vs. 91 [RIC 87-94]; p < 0,001] y con mayor puntuación en la escala SOFA-Evaluación de daño orgánico secuencial (SOFA, 7 [RIC 5-9] vs. 4 [RIC 3-7]; p <0,001]). Las complicaciones fueron más frecuentes en los no supervivientes: síndrome de distrés respiratorio agudo (SDRA) (95% vs. 89%; p = 0,009), insuficiencia renal aguda (IRA) (58% vs. 24%; p < 10–6), shock (42% vs. 14%; p < 10–13) y arritmias (24% vs. 11%; p < 10–4). Las superinfecciones respiratorias, infecciones del torrente sanguíneo y los shock sépticos fueron más frecuentes en los no supervivientes (33% vs. 25%; p = 0,03, 33% vs. 23%; p = 0,01 y 15% vs. 3%, p = 10–7, respectivamente). El modelo de regresión multivariable reflejó que la edad estaba asociada a la mortalidad y que cada año incrementaba el riesgo de muerte en un 1% (IC del 95%: 1-10, p = 0,014). Cada incremento de 5 puntos en la escala APACHE II predijo de manera independiente la mortalidad (odds ratio [OR]: 1,508 [1,081, 2,104], p = 0,015). Los pacientes con IRA (OR: 2,468 [1,628, 3,741], p < 10–4)], paro cardiaco (OR: 11,099 [3,389, 36,353], p = 0,0001] y shock séptico [OR: 3,224 [1,486, 6,994], p= 0,002) tuvieron un riesgo de muerte incrementado. Conclusiones Los pacientes mayores de COVID-19 con puntuaciones APACHE II más altas al ingreso, que desarrollaron IRA en grados ii o iii o shock séptico durante la estancia en UCI tuvieron un riesgo de muerte incrementado. La mortalidad en UCI fue del 31%.
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Affiliation(s)
- C Ferrando
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España.
| | - R Mellado-Artigas
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - A Gea
- Departamento de Medicina Preventiva y Salud Pública, Escuela Médica, Universidad de Navarra, Pamplona, España
| | - E Arruti
- Tecnología Ubikare, Bilbao, Vizcaya, España
| | - C Aldecoa
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario Río Hortega, Valladolid, España
| | - A Bordell
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario Río Hortega, Valladolid, España
| | - R Adalia
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - L Zattera
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - F Ramasco
- Departamento de Anestesiología y Cuidados Críticos, Hospital La Princesa, Madrid, España
| | - P Monedero
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - E Maseda
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario La Paz, Madrid, España
| | - A Martínez
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Cruces, Barakaldo, Vizcaya, España
| | - G Tamayo
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Cruces, Barakaldo, Vizcaya, España
| | - J Mercadal
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - G Muñoz
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - A Jacas
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - G Ángeles
- Departamento de Anestesiología y Cuidados Críticos, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, España
| | - P Castro
- Unidad de Cuidados Intensivos Médicos, Hospital Clínic, Institut D'investigació August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, España
| | - M Hernández-Tejero
- Unidad Hepática, Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - J Fernandez
- Unidad Hepática, Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - M Gómez-Rojo
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Ramón y Cajal, Madrid, España
| | - Á Candela
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Ramón y Cajal, Madrid, España
| | - J Ripollés
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Universitario Infanta Leonor, Madrid, España
| | - A Nieto
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Universitario Infanta Leonor, Madrid, España
| | - E Bassas
- Departamento de Anestesiología y Cuidados Críticos, Hospital San Joan Despí Moises Broggi, Barcelona, España
| | - C Deiros
- Departamento de Anestesiología y Cuidados Críticos, Hospital San Joan Despí Moises Broggi, Barcelona, España
| | - A Margarit
- Departamento de Anestesiología y Cuidados Críticos, Hospital del Mar, Barcelona, España
| | - F J Redondo
- Departamento de Anestesiología y Cuidados Críticos, Hospital Nostra Senyora de Meritxell SAAS, Andorra, Andorra
| | - A Martín
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Ciudad Real, Ciudad Real, España
| | - N García
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Urdúliz, Urdúliz, Vizcaya, España
| | - P Casas
- Departamento de Anestesiología y Cuidados Críticos, Hospital de Terrasa, Terrasa, Barcelona, España
| | - C Morcillo
- Departamento de Anestesiología y Cuidados Críticos, Hospital Universitario a Coruña, A Coruña, España
| | - M L Hernández-Sanz
- Departamento de Anestesiología y Cuidados Críticos, Hospital Sanitas CIMA, Barcelona, España
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Casas P, Navarro D, Aguilera A, García F. Diagnóstico tradicional versus diagnóstico en un solo paso del virus de la hepatitis C. Estudio piloto en 2 centros asistenciales. Enferm Infecc Microbiol Clin 2019; 37:348-349. [DOI: 10.1016/j.eimc.2018.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/06/2018] [Accepted: 05/12/2018] [Indexed: 12/09/2022]
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Kostaki EG, Flampouris A, Karamitros T, Chueca N, Alvarez M, Casas P, Alejos B, Hatzakis A, Garcia F, Paraskevis D. Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions. Front Microbiol 2019; 10:370. [PMID: 30915040 PMCID: PMC6421502 DOI: 10.3389/fmicb.2019.00370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/12/2019] [Indexed: 01/25/2023] Open
Abstract
Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain. Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively. Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p < 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin. Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics.
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Affiliation(s)
- Evangelia-Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Flampouris
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Timokratis Karamitros
- Department of Zoology, University of Oxford, Oxford, United Kingdom.,Public Health Laboratories, Department of Microbiology, Hellenic Pasteur Institute, Athens, Greece
| | - Natalia Chueca
- Department of Clinical Microbiology, Hospital Universitario San Cecilio, Instituto de Investigación Ibs, Granada, Spain
| | - Marta Alvarez
- Department of Clinical Microbiology, Hospital Universitario San Cecilio, Instituto de Investigación Ibs, Granada, Spain
| | - Paz Casas
- Department of Clinical Microbiology, Hospital Universitario San Cecilio, Instituto de Investigación Ibs, Granada, Spain
| | - Belen Alejos
- Centro Nacional de Epidemiología, Universidad de Alcalá de Henares, Madrid, Spain
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Federico Garcia
- Department of Clinical Microbiology, Hospital Universitario San Cecilio, Instituto de Investigación Ibs, Granada, Spain
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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6
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Alvarez M, Casas P, de Salazar A, Chueca N, Guerrero-Beltran C, Rodríguez C, Imaz A, Espinosa N, García-Bujalance S, Pérez-Elías MJ, García-Alvarez M, Iribarren JA, Santos J, Dalmau D, Aguilera A, Vinuesa D, Gutiérrez F, Piérola B, Molina JM, Peraire J, Portilla I, Gómez-Sirvent JL, Olalla J, Galera C, Blanco JR, Riera M, García-Fraile L, Navarro G, Curran A, Poveda E, García F, Moreno S, Jarrín I, Dalmau D, Navarro ML, González MI, Blanco JL, Garcia F, Rubio R, Iribarren JA, Gutiérrez F, Vidal F, Berenguer J, González J, Alejos B, Hernando V, Moreno C, Iniesta C, Sousa LMG, Perez NS, Muñoz-Fernández MÁ, García-Merino IM, Fernández IC, Rico CG, de la Fuente JG, Concejo PP. Surveillance of transmitted drug resistance to integrase inhibitors in Spain: implications for clinical practice. J Antimicrob Chemother 2019; 74:1693-1700. [DOI: 10.1093/jac/dkz067] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 01/17/2019] [Accepted: 01/24/2019] [Indexed: 12/20/2022] Open
Affiliation(s)
- Marta Alvarez
- Unidad de Microbiología Clínica, Hospital Universitario San Cecilio, Granada, Instituto de Investigacion Ibs., Granada, Spain
| | - Paz Casas
- Unidad de Microbiología Clínica, Hospital Universitario San Cecilio, Granada, Instituto de Investigacion Ibs., Granada, Spain
| | - Adolfo de Salazar
- Unidad de Microbiología Clínica, Hospital Universitario San Cecilio, Granada, Instituto de Investigacion Ibs., Granada, Spain
| | - Natalia Chueca
- Unidad de Microbiología Clínica, Hospital Universitario San Cecilio, Granada, Instituto de Investigacion Ibs., Granada, Spain
| | - Carlos Guerrero-Beltran
- Unidad de Microbiología Clínica, Hospital Universitario San Cecilio, Granada, Instituto de Investigacion Ibs., Granada, Spain
| | | | - Arkaitz Imaz
- Unidad de VIH e ITS, Departamento de Enfermedades Infecciosas, Hospital Universitari de Bellvitge-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Nuria Espinosa
- Unidad de Enfermedades Infecciosas, Hospital Virgen del Rocio, Sevilla, Spain
| | | | | | - Mónica García-Alvarez
- Unidad de Microbiología Clínica, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - Jose Antonio Iribarren
- Unidad de Enfermedades Infecciosas, Hospital Universitario Donostia, Instituto BioDonostia, Donostia, Spain
| | - Jesús Santos
- Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - David Dalmau
- Unidad de Enfermedades Infecciosas, Hospital Universitario Mutua Terrasa, Terrasa, Spain
| | - Antonio Aguilera
- Servicio y Departamento de Microbiología, Complejo Hospitalario Universitario de Santiago y Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - David Vinuesa
- Unidad de Enfermedades Infecciosas, Hospital Universitario, Universitario San Cecilio, Granada, Spain
| | - Félix Gutiérrez
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Elche & Universidad Miguel Hernández, Alicante, Spain
| | - Beatriz Piérola
- Unidad de Enfermedades Infecciosas, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - José Miguel Molina
- Unidad de Microbiología Clínica, Hospital Universitario La Fe, Valencia, Spain
| | - Joaquim Peraire
- Unidad de Enfermedades Infecciosas, Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
| | - Irene Portilla
- Unidad de Enfermedades Infecciosas, Hospital Universitario Alicante, Alicante, Spain
| | - Juan Luis Gómez-Sirvent
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Julián Olalla
- Unidad de Enfermedades Infecciosas, Hospital Costa del Sol, Marbella, Spain
| | - Carlos Galera
- Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - José Ramón Blanco
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Pedro, Logroño, Spain
| | - Melchor Riera
- Unidad de Enfermedades Infecciosas, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Lucio García-Fraile
- Unidad de Enfermedades Infecciosas, Hospital Universitario La Princesa, Madrid, Spain
| | - Gemma Navarro
- Unidad de Enfermedades Infecciosas, Hospital Universitario Parc Taulí, Sabadell, Spain
| | - Adrían Curran
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d´Hebron, Barcelona, Spain
| | - Eva Poveda
- Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur)-Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, Spain
| | - Federico García
- Unidad de Microbiología Clínica, Hospital Universitario San Cecilio, Granada, Instituto de Investigacion Ibs., Granada, Spain
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7
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Aguilera A, Navarro D, Rodríguez-Frias F, Viciana I, Martínez-Sapiña AM, Rodríguez MJ, Martró E, Lozano MC, Coletta E, Cardeñoso L, Suárez A, Trigo M, Rodríguez-Granjer J, Montiel N, de la Iglesia A, Alados JC, Vegas C, Bernal S, Fernández-Cuenca F, Pena MJ, Reina G, García-Bujalance S, Echevarria MJ, Benítez L, Pérez-Castro S, Ocete D, García-Arata I, Guerrero C, Rodríguez-Iglesias M, Casas P, García F. Prevalence and distribution of hepatitis C virus genotypes in Spain during the 2000-2015 period (the GEHEP 005 study). J Viral Hepat 2017; 24:725-732. [PMID: 28248445 DOI: 10.1111/jvh.12700] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/09/2017] [Indexed: 12/11/2022]
Abstract
We report the largest study on the prevalence and distribution of HCV genotypes in Spain (2000-2015), and we relate them with clinical, epidemiological and virological factors. Patients from 29 hospitals in 10 autonomous communities (Andalusia, Aragon, Castilla-Leon, Catalonia, Galicia, Canary Islands, Madrid Community, Valencian Community, Murcia Region and Basque Country) have been studied. Annual distribution of HCV genotypes and subtypes, as well as gender, age, transmission route, HIV and/or HBV coinfection, and treatment details were recorded. We included 48595 chronically HCV-infected patients with the following characteristics: median age 51 years (IQR, 44-58), 67.9% male, 19.1% HIV-coinfected, 23.5% HBV-coinfected. Parenteral transmission route was the most frequent (58.7%). Genotype distribution was 66.9% GT1 (24.9% subtype 1a and 37.9% subtype 1b), 2.8% GT2, 17.3% GT3, 11.4% GT4 and 0.1% GT5 and 0.02% GT6. LiPA was the most widely HCV genotyping test used (52.4%). HCV subtype 1a and genotypes 3 and 4 were closely associated with male gender, parenteral route of infection and HIV and HBV coinfection; in contrast, subtype 1b and genotype 2 were associated with female gender, nonparenteral route and mono-infection. Age was related to genotype distribution, and different patterns of distribution and biodiversity index were observed between different geographical areas. Finally, we describe how treatment and changes in transmission routes may have affected HCV genotype prevalence and distribution patterns. We present the most recent data on molecular epidemiology of hepatitis C virus in Spain. This study confirms that genotype distributions vary with age, sex, HIV and HBV coinfection and within geographical areas and epidemiological groups.
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Affiliation(s)
- A Aguilera
- Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | - D Navarro
- Complexo Hospitalario Universitario de Santiago de Compostela, A Coruña, Spain
| | | | - I Viciana
- Hospital Clínico Universitario Virgen de la Victoria, Malaga, Spain
| | | | | | - E Martró
- Hospital Universitari Germans Trías i Pujol, Badalona, CIBER en Epidemiología y Salud Pública, Barcelona, Spain
| | - M C Lozano
- Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - E Coletta
- Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | - L Cardeñoso
- Hospital Universitario de la Princesa, Madrid, Spain
| | - A Suárez
- Hospital Clínico San Carlos, Madrid, Spain
| | - M Trigo
- Complexo Hospitalario de Pontevedra, Pontevedra, Spain
| | | | - N Montiel
- Hospital Costa del Sol, Marbella, Spain
| | - A de la Iglesia
- Complejo Hospitalario Universitario de Huelva, Huelva, Spain
| | - J C Alados
- Hospital del SAS de Jerez de la Frontera, Sevilla, Spain
| | - C Vegas
- Fundación Jiménez Díaz, Madrid, Spain
| | - S Bernal
- Hospital Universitario Virgen de Valme, Sevilla, Spain
| | | | - M J Pena
- Hospital Doctor Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - G Reina
- Clínica Universitaria de Navarra, Pamplona, Spain
| | | | | | - L Benítez
- Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | - D Ocete
- Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - I García-Arata
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - C Guerrero
- Hospital General Universitario Morales Meseguer, Murcia, Spain
| | | | - P Casas
- Hospital Universitario San Cecilio, Instituto de Investigación Ibs-Granada, Granada, Spain
| | - F García
- Hospital Universitario San Cecilio, Instituto de Investigación Ibs-Granada, Granada, Spain
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8
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Del Buey M, Esteban O, Lanchares E, Martinez M, Casas P, Ascaso F, Cristobal J. Regression of corneal neovascularization associated with corneal epithelial defect after treatment with regenerating agents (Cacicol ®
). Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0674] [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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9
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Kartashev V, Döring M, Nieto L, Coletta E, Kaiser R, Sierra S, Guerrero A, Stoiber H, Paar C, Vandamme A, Nevens F, Ranst MV, Cuypers L, Braun P, Ehret R, Obermeier M, Schneeweiss S, Scholten S, Römer K, Isernhagen K, Qurashi N, Heger E, Knops E, Neumann-Fraune M, Timm J, Walker A, Lübke N, Wedemeyer H, Wiesch JSZ, Lütgehetmann M, Polywka S, Däumer M, Hoffmann D, Protzer U, Marascio N, Foca A, Liberto M, Barreca G, Galati L, Torti C, Pisani V, Perno C, Ceccherini-Silberstein F, Cento V, Ciotti M, Zazzi M, Rossetti B, Luca A, Caudai C, Mor O, Devaux C, Staub T, Araujo F, Gomes P, Cabanas J, Markin N, Khomenko I, Govorukhina M, Lugovskaya G, Dontsov D, Mas A, Martró E, Saludes V, Rodríguez-Frías F, García F, Casas P, Iglesia ADL, Alados J, Pena-López M, Rodríguez M, Galán J, Suárez A, Cardeñoso L, Guerrero M, Vegas-Dominguez C, Blas-Espada J, García R, García-Bujalance S, Benítez-Gutiérrez L, Mendoza CD, Montiel N, Santos J, Viciana I, Delgado A, Martínez-Sanchez P, Fernández-Alonso M, Reina G, Trigo M, Echeverría M, Aguilera A, Navarro D, Bernal S, Lozano M, Fernández-Cuenca F, Orduña A, Eiros J, Lejarazu ROD, Martínez-Sapiña A, García-Díaz A, Haque T. New findings in HCV genotype distribution in selected West European, Russian and Israeli regions. J Clin Virol 2016; 81:82-9. [DOI: 10.1016/j.jcv.2016.05.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/17/2016] [Accepted: 05/19/2016] [Indexed: 02/06/2023]
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10
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Diéguez P, Casas P, López S, Fajardo M. Ultrasound guided nerve block for breast surgery. ACTA ACUST UNITED AC 2016; 63:159-67. [PMID: 26776926 DOI: 10.1016/j.redar.2015.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 07/26/2015] [Revised: 11/06/2015] [Accepted: 11/09/2015] [Indexed: 12/17/2022]
Abstract
The breast surgery has undergone changes in recent years, encouraging new initiatives for the anaesthetic management of these patients in order to achieve maximum quality and rapid recovery. The fundamental tool that has allowed a significant improvement in the progress of regional anaesthesia for breast disease has been ultrasound, boosting the description and introduction into clinical practice of interfascial chest wall blocks, although the reference standard is still the paravertebral block. It is very likely that these blocks will change the protocols in the coming years. A review is presented of the anatomy of the breast region, description of nerve blocks and techniques, as well as their indications, all according to published articles and the opinion of the authors based on their experience.
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Affiliation(s)
- P Diéguez
- Servicio de Anestesiología, Hospital Abente y Lago, Complexo Hospitalario Universitario de A Coruña, A Coruña, España.
| | - P Casas
- Servicio de Anestesiología, Hospital Abente y Lago, Complexo Hospitalario Universitario de A Coruña, A Coruña, España
| | - S López
- Servicio de Anestesiología, Hospital Abente y Lago, Complexo Hospitalario Universitario de A Coruña, A Coruña, España
| | - M Fajardo
- Servicio de Anestesiología, Hospital Universitario de Móstoles, Madrid, España
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11
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Caramello C, Del Buey M, Cristobal J, Mateo Orobia A, Martinez Velez M, Sanchez Marin J, Idoate A, Pinilla I, Casas P. Small pupil and pupil dilatation methods. Comparative study in cataract surgery. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- C.M. Caramello
- Hospital Clinico Universitario Lozano Blesa; Oftalmología; Zaragoza Spain
| | - M. Del Buey
- Hospital Clinico Universitario Lozano Blesa; Oftalmología; Zaragoza Spain
| | - J. Cristobal
- Hospital Clinico Universitario Lozano Blesa; Oftalmología; Zaragoza Spain
| | | | - M. Martinez Velez
- Hospital Clinico Universitario Lozano Blesa; Oftalmología; Zaragoza Spain
| | - J.I. Sanchez Marin
- Hospital Clinico Universitario Lozano Blesa; Oftalmología; Zaragoza Spain
| | - A. Idoate
- Hospital Clinico Universitario Lozano Blesa; Oftalmología; Zaragoza Spain
| | - I. Pinilla
- Hospital Clinico Universitario Lozano Blesa; Oftalmología; Zaragoza Spain
| | - P. Casas
- Hospital Clinico Universitario Lozano Blesa; Oftalmología; Zaragoza Spain
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12
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Del Buey M, Casas P, Caramello C, Esteban O, Martinez M, Sánchez N, Pinilla I, Lanchares E. Analysis of the efficacy of the tissue regenerating agent (RGTA) 0.01% poly-carboxymethylglucose sulfate in the treatment of neurotrophic corneal ulcers and persistent epithelial defects. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M.A. Del Buey
- Ophthalmology; “Lozano Blesa” Clinical University Hospital; Zaragoza Spain
| | - P. Casas
- Ophthalmology; “Lozano Blesa” Clinical University Hospital; Zaragoza Spain
| | - C.M. Caramello
- Ophthalmology; “Lozano Blesa” Clinical University Hospital; Zaragoza Spain
| | - O. Esteban
- Ophthalmology; “Lozano Blesa” Clinical University Hospital; Zaragoza Spain
| | - M. Martinez
- Ophthalmology; “Lozano Blesa” Clinical University Hospital; Zaragoza Spain
| | - N. Sánchez
- Ophthalmology; “Lozano Blesa” Clinical University Hospital; Zaragoza Spain
| | - I. Pinilla
- Ophthalmology; “Lozano Blesa” Clinical University Hospital; Zaragoza Spain
| | - E. Lanchares
- Engeniering; Universidad de Zaragoza; Zaragoza Spain
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13
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Gomez Veiga F, Ponce J, Pertega J, Romero E, Casas P, Janeiro J, Zarraonandia A, Gómez Rodríguez I, Alvarez A, Martul E, González-Martín M. MP-4.04: Results in Patients with PSA of 2.5-4ng/ml and 4-10ng/ml Candidates for Prostate Biopsy. Urology 2008. [DOI: 10.1016/j.urology.2008.08.246] [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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14
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Ruibal M, Zarraonandia A, Casas P, Janeiro J, Alonso A, González-Martín M. MP-5.13: Nephron-sparing Surgery for Renal Tumor in Allograft Kidney. Urology 2008. [DOI: 10.1016/j.urology.2008.08.277] [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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15
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Romero Selas E, Álvarez Castelo L, Ponce J, Sánchez J, Casas P, Janeiro J, López D, Martínez S, Chantada V, González Martín M. Divertículo de uretra habitado por litiasis. ARCH ESP UROL 2008; 61:449. [DOI: 10.4321/s0004-06142008000300016] [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: 11/11/2022]
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16
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Ponce J, Veiga F, Romero E, Pértega S, Casas P, Janeiro J, Loópez D, Martínez S, Rosado E, Goómez I, González Martín M. MP-11.16: Prostate cancer predictive model for patients candidates to first extended prostate biopsy with PSA 2.5 - 10 ng/ml. Urology 2007. [DOI: 10.1016/j.urology.2007.06.399] [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: 11/16/2022]
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17
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Romero Selas E, Veiga G, Ponce D, Pertega S, Castelo A, Janeiro J, Casas P, Martín G. MP-11.07: Results in patients who underwent prostate biopsy with PSA values 2,5 - 4 ng/ml. Urology 2007. [DOI: 10.1016/j.urology.2007.06.390] [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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18
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Ponce J, Veiga F, Romero E, Pértega S, Janeiro J, Casas P, Martínez S, Lopez D, Rodríguez I, Fernández E, González Martín M. MP-11.15: Comparison study between ten core extended and saturation prostate biopsy in a repeat prostate biopsy population. Urology 2007. [DOI: 10.1016/j.urology.2007.06.398] [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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Barbagelata A, Gómez Veiga F, Ponce Dı́az Reixa J, Alvarez Castelo L, Romero Selas E, Pertega S, Janeiro J, Casas P, Gonzalez-Martin M. UP-02.61. Urology 2006. [DOI: 10.1016/j.urology.2006.08.804] [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: 10/24/2022]
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Affiliation(s)
- E Romero Selas
- Servicio de Urología, Hospital Juan Canalejo, La Coruña, España.
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21
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lasdica S, Fainstein D, Casas P, Frizza I, Montivero M, Giussani J, Urizar R. Ventilación mecánica no invasiva en la lesión pulmonar aguda hipoxémica. Med Intensiva 2001. [DOI: 10.1016/s0210-5691(01)79709-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lasdica S, Fainstein D, Casas P, Maurizi D, Gertiser M, Czerniecki A. Botulismo por herida: una causa de parálisis muscular generalizada. Med Intensiva 2000. [DOI: 10.1016/s0210-5691(00)79604-5] [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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López Gil M, Arribas F, Velázquez MT, Casas P. [Hypertensive cardiopathy and arrhythmias]. Rev Esp Cardiol 1997; 50 Suppl 4:68-73. [PMID: 9411591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The anatomical and tissue changes caused by hypertension are responsible of the higher incidence of atrial and ventricular arrhythmias as compared to normal population. Hypertension, when associated with atrial fibrillation, becomes an important risk factor for systemic embolism. Atrial dilatation and/or fibrosis because of haemodynamic overload due to left ventricular hypertrophy are the arrhythmic substrate. The higher incidence of ventricular arrhythmias is related to left ventricular hypertrophy. Ventricular premature beats, frequent and/or polymorphic in most of the cases, and short runs are the usual picture. Sustained ventricular tachycardia is seldom documented. The substrate is created by hypertrophy itself, resulting in conduction disturbances favoring reentry. Associated myocardial ischemia plays an important role in the genesis of ventricular arrhythmias. Left ventricular hypertrophy is associated with an increased incidence of total cardiac death and sudden death. Ventricular arrhythmias are suggested to be a poor prognostic factor. The aim of this article is to offer a simplified review of the meaning of cardiac arrhythmias in the hypertensive patient, and to give some clues to the practical approach in the clinical setting.
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Affiliation(s)
- M López Gil
- Servicio de Cardiología, Hospital 12 de Octubre, Madrid
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Ramos Seisdedos G, Casas P, Beltrán de Heredia J. [Peripheral nerve injury and its muscular repercussions. Experimental study of various therapeutic methods]. Int Surg 1970; 53:450-61. [PMID: 4193406] [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: 01/09/2023] Open
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