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Meurice A, Pujol R, De Fourmestraux C, Coquillon M, Tessier C. Retroperitoneoscopy of the presacral space in horses: Surgical access and anatomy. Equine Vet J 2024; 56:607-616. [PMID: 37654189 DOI: 10.1111/evj.13994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Surgical approaches to the equine rectum and perirectal area are described in the literature. However, surgeries in this region can be challenging. OBJECTIVE To describe the surgical anatomy of the presacral space and to evaluate its access using a retroperitoneoscopic approach. STUDY DESIGN Ex vivo experiment. METHODS Preliminary dissections were performed in two cadavers to define the boundaries of the presacral space and to determine portal locations for the surgical approach. After that, nine cadavers were used for experimental presacral retroperitoneoscopic procedure in a standing position. Following retroperitoneoscopy, cadavers were dissected to confirm the anatomical structures observed during the endoscopic procedures, to control the location of each portal and to record iatrogenic trauma. RESULTS The presacral space was bordered by the vertebral column from the ventral aspect of lumbosacral promontorium to the first coccygeal vertebra dorsally and by the presacral fascia and peritoneum ventrally. Lateral limits were composed of the sacrosciatic ligament and transversalis fascia. Cranial and caudal borders were composed of the peritoneum and coccygeal and levator ani muscles respectively. Retroperitoneoscopic portals were placed between the external anal sphincter and semimembranosus muscles and between the base of the tail and the external anal sphincter muscle through the anococcygeal fascia to enter the space by its caudal border. The retroperitoneal space was reached in all cases and the dorsal and lateral aspects of the rectum were visualised after creation of a working space. MAIN LIMITATIONS Use of cadaver specimens do not permit to evaluate the tolerance in living animals and the surgical complications such as rectal damage, haemorrhage and infection. CONCLUSION This study provides an anatomical description and surgical access of the presacral space with a minimal invasive approach. Retroperitoneoscopy allows access to the rectum and the dorsal aspect of the pelvis.
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Affiliation(s)
- Antoine Meurice
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
| | | | - Claire De Fourmestraux
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
| | - Morgane Coquillon
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
| | - Caroline Tessier
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
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Laguna G, Suárez-Sipmann F, Tusman G, Ripollés J, Díaz-Cambronero O, Pujol R, Rivas E, Garutti I, Mellado R, Vallverdú J, Jacas A, Fervienza A, Marrero R, Librero J, Villar J, Ferrando C. Rationale and study design for an Individualized PeriopeRative Open lung VEntilatory approach in Emergency Abdominal Laparotomy/scopy: study protocol for a prospective international randomized controlled trial. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00075-1. [PMID: 38636796 DOI: 10.1016/j.redare.2024.04.007] [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] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/16/2023] [Indexed: 04/20/2024]
Abstract
BACKGROUND Postoperative pulmonary complications (PPC) are the most frequent postoperative complications, with an estimated prevalence in elective surgery ranging from 20% in observational cohort studies to 40% in randomized clinical trials. However, the prevalence of PPCs in patients undergoing emergency abdominal surgery is not well defined. Lung-protective ventilation aims to minimize ventilator-induced lung injury and reduce PPCs. The open lung approach (OLA), which combines recruitment manoeuvres (RM) and positive end-expiratory pressure (PEEP) titration, aims to minimize areas of atelectasis and the development of PPCs; however, there is no conclusive evidence in the literature that OLA can prevent PPCs. The purpose of this study is to compare an individualized perioperative OLA with conventional standardized lung-protective ventilation in patients undergoing emergency abdominal surgery with clinical signs of intraoperative lung collapse. METHODS Randomized international clinical trial to compare an individualized perioperative OLA (RM plus individualized PEEP and individualized postoperative respiratory support) with conventional lung-protective ventilation (standard PEEP of 5 cmH2O and conventional postoperative oxygen therapy) in patients undergoing emergency abdominal surgery with clinical signs of lung collapse. Patients will be randomised to open-label parallel groups. The primary outcome is any severe PPC during the first 7 postoperative days, including: acute respiratory failure, pneumothorax, weaning failure, acute respiratory distress syndrome, and pulmonary infection. The estimated sample size is 732 patients (366 per group). The final sample size will be readjusted during the interim analysis. DISCUSSION The Individualized Perioperative Open-lung Ventilatory Strategy in emergency abdominal laparotomy (iPROVE-EAL) is the first multicentre, randomized, controlled trial to investigate whether an individualized perioperative approach prevents PPCs in patients undergoing emergency surgery.
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Affiliation(s)
- G Laguna
- Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Barcelona, España.
| | - F Suárez-Sipmann
- Unidad de Cuidados Intensivos, Hospital Universitario La Princesa, Madrid, España; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España
| | - G Tusman
- Departamento de Anestesia, Hospital Privado de Comunidad, Mar de Plata, Argentina
| | - J Ripollés
- Departamento de Anestesia, Hospital Infanta Leonor, Madrid, España
| | | | - R Pujol
- Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Barcelona, España
| | - E Rivas
- Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Barcelona, España
| | - I Garutti
- Departamento de Anestesia, Hospital Universitario Gregorio Marañón, Madrid, España
| | - R Mellado
- Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Barcelona, España
| | - J Vallverdú
- Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Barcelona, España
| | - A Jacas
- Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Barcelona, España
| | - A Fervienza
- Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Barcelona, España
| | - R Marrero
- Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Barcelona, España
| | - J Librero
- Navarrabiomed-Fundación Miguel Servet, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, España
| | - J Villar
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España; Red Multidisciplinar de Investigación en Evaluación de Disfunción de Órganos, Unidad de Investigación, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, España
| | - C Ferrando
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España; Departamento de Anestesia y Cuidados Críticos, Hospital Clínic, Institut D'Investigació August Pi i Sunyer, Barcelona, España
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Najidh S, Van der Sluijs Gelling AJ, Cozzio A, Dobos G, Bagot M, Beylot-Barry M, Guenova E, Nicolay J, Lima M, Ortiz-Romero PL, Papadavid E, Pujol R, Quaglino P, Stadler R, Wehkamp U, Whittaker S, Van Dongen JJM, Montero JF, Almeida J, Vermeer MH. Immunophenotypic identification and characterization of CTCL tumor cells in blood using standardized flow cytometry: a European multicenter study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00548-2] [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: 11/27/2022]
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Meurice A, Pujol R, Albaric O, De Fourmestraux C, Tessier C. Tracheal obstructive mastocytoma in a pony. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Antoine Meurice
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine Food Science and Engineering Nantes France
| | - Raymond Pujol
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine Food Science and Engineering Nantes France
| | - Olivier Albaric
- LabOniris, ONIRIS, National College of Veterinary Medicine Food Science and Engineering Nantes France
| | - Claire De Fourmestraux
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine Food Science and Engineering Nantes France
| | - Caroline Tessier
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine Food Science and Engineering Nantes France
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Ambroa Rey E, Valdivielso T, García-Miguel J, Lizondo M, Ramírez T, Infestas Á, Navarro D, Lorenzo Á, Parcerisa M, Pujol R, Gallardo Ú, Peralta A, López A, Amat D, Frontera G, Colomer M. PO-1466 On how treatment over weekends palliate scheduled and unscheduled interruptions. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03430-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lizondo M, Gonzalez Lao E, Oraa López L, Parra Prieto B, Fabres Martín C, Ramírez T, Navarro D, García-Miguel J, Ambroa E, Valdivielso T, Infiestas Á, Lorenzo Á, Gallardo U, Peralta A, Frontera G, Amat D, López A, Almendros S, Ballesteros M, Parcerisa M, Pujol R, Colomer M. PO-1667 Risk management plan for the 3D printed bolus in radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03631-3] [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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Ambroa E, Valdivielso T, Lizondo M, Navarro D, Infestas A, Ramírez T, García-Miguel J, López A, Amat D, Frontera G, Parcerisa M, Pujol R, Gallardo U, Peralta A, Colomer M. Influence of using unflattened photon beams in VMAT prostate treatments. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00413-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Pujol R, Tessier C, Manneveau G, De Fourmestraux C. Suspected primary mycotic rhinitis and paranasal sinusitis in seven horses (2013–2019). EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Pujol
- Department of Surgery Equine Clinic ONIRIS National College of Veterinary Medicine Food Science and Engineering Nantes France
| | - C. Tessier
- Department of Surgery Equine Clinic ONIRIS National College of Veterinary Medicine Food Science and Engineering Nantes France
| | - G. Manneveau
- Department of Surgery Equine Clinic ONIRIS National College of Veterinary Medicine Food Science and Engineering Nantes France
- Clinique Équine de Provence Saint‐Cannat France
| | - C. De Fourmestraux
- Department of Surgery Equine Clinic ONIRIS National College of Veterinary Medicine Food Science and Engineering Nantes France
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Pujol R, De Fourmestraux C, Symoens A, Branchereau J, Tessier C. Retroperitoneoscopy in the horse: Anatomical study of the retroperitoneal perirenal space and description of a surgical approach. Equine Vet J 2020; 53:364-372. [PMID: 32473613 DOI: 10.1111/evj.13293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 10/11/2019] [Revised: 03/21/2020] [Accepted: 05/10/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Surgical approaches to the kidneys and perirenal structures are uncommonly performed in horses and several complications have been described with the current procedures. OBJECTIVE To describe the anatomy of the retroperitoneal perirenal space and investigate a retroperitoneal minimally invasive approach to access the kidney and perirenal structures in horses. STUDY DESIGN Descriptive, cadaveric study. METHODS Anatomical description of the retroperitoneal space was performed on three equine cadavers and the surgical approach was developed based on these dissections. Ten cadaveric horses underwent a retroperitoneoscopy. Five horses were placed in a right lateral recumbency position to explore the left retroperitoneal space and five horses were placed in a standing position to explore both left and right sides. Anatomical landmarks, working space and access to the renal hilus and perirenal structures were evaluated. RESULTS Dissections revealed that kidneys are surrounded by a renal fascia which delimits two spaces: a perirenal space between the kidney and the renal fascia, and a pararenal space between the renal fascia and psoas muscles or peritoneum. The retroperitoneoscopic portal was placed at the level of the dorsal aspect of the tuber coxae, 3 cm caudal to the last rib for the left side and 2 cm caudal to the last rib for the right side. Retroperitoneal access and working space were successfully established in all horses. The standing position allowed an easier dissection than lateral recumbency. Division of the perirenal fat allowed access to the kidney and adrenal glands as well as individualisation of renal vessels and ureter in the renal hilus. MAIN LIMITATIONS Study of cadavers precluded appreciation of haemorrhage or use the pulsating vessels as landmarks. CONCLUSIONS This study provides a description of the retroperitoneal perirenal space and describes a new surgical approach to access kidneys and perirenal structures in horses.
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Affiliation(s)
- Raymond Pujol
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
| | - Claire De Fourmestraux
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
| | - Antoine Symoens
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
| | - Julien Branchereau
- Institut de Transplantation Urologie Nephrologie (ITUN), CHU Nantes, Nantes, France.,CRTI Centre de Recherche en Transplantation et Immunologie (CRTI), UMR1064, INSERM, Université de Nantes, Nantes, France
| | - Caroline Tessier
- Department of Surgery, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
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De Jesús-Gil C, Sans-de San Nicolás L, Ferran M, Chiriac A, Pujol R, Celada A, Santamaria-Babi L. 066 Streptococcus pyogenes specific IgG, but not IgA, identifies guttate psoriasis patients with increased CLA+ T cells IL17A, IL17F and IL9 producters. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.069] [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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De Jesús-Gil C, Sans-de San Nicolás L, Ferran M, Chiriac A, Celada A, Pujol R, Santamaria-Babi L. 027 IgA plasma levels, but not IgG, against Streptococcus pyogenes identifies Anti-Streptolysin O negative chronic plaque psoriasis patients with increased specific CLA+ T cells IL17A and IL17F producers. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.030] [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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Scarisbrick JJ, Quaglino P, Prince HM, Papadavid E, Hodak E, Bagot M, Servitje O, Berti E, Ortiz-Romero P, Stadler R, Patsatsi A, Knobler R, Guenova E, Child F, Whittaker S, Nikolaou V, Tomasini C, Amitay I, Prag Naveh H, Ram-Wolff C, Battistella M, Alberti-Violetti S, Stranzenbach R, Gargallo V, Muniesa C, Koletsa T, Jonak C, Porkert S, Mitteldorf C, Estrach T, Combalia A, Marschalko M, Csomor J, Szepesi A, Cozzio A, Dummer R, Pimpinelli N, Grandi V, Beylot-Barry M, Pham-Ledard A, Wobser M, Geissinger E, Wehkamp U, Weichenthal M, Cowan R, Parry E, Harris J, Wachsmuth R, Turner D, Bates A, Healy E, Trautinger F, Latzka J, Yoo J, Vydianath B, Amel-Kashipaz R, Marinos L, Oikonomidi A, Stratigos A, Vignon-Pennamen MD, Battistella M, Climent F, Gonzalez-Barca E, Georgiou E, Senetta R, Zinzani P, Vakeva L, Ranki A, Busschots AM, Hauben E, Bervoets A, Woei-A-Jin FJSH, Matin R, Collins G, Weatherhead S, Frew J, Bayne M, Dunnill G, McKay P, Arumainathan A, Azurdia R, Benstead K, Twigger R, Rieger K, Brown R, Sanches JA, Miyashiro D, Akilov O, McCann S, Sahi H, Damasco FM, Querfeld C, Folkes A, Bur C, Klemke CD, Enz P, Pujol R, Quint K, Geskin L, Hong E, Evison F, Vermeer M, Cerroni L, Kempf W, Kim Y, Willemze R. The PROCLIPI international registry of early-stage mycosis fungoides identifies substantial diagnostic delay in most patients. Br J Dermatol 2019; 181:350-357. [PMID: 30267549 DOI: 10.1111/bjd.17258] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Survival in mycosis fungoides (MF) is varied and may be poor. The PROCLIPI (PROspective Cutaneous Lymphoma International Prognostic Index) study is a web-based data collection system for early-stage MF with legal data-sharing agreements permitting international collaboration in a rare cancer with complex pathology. Clinicopathological data must be 100% complete and in-built intelligence in the database system ensures accurate staging. OBJECTIVES To develop a prognostic index for MF. METHODS Predefined datasets for clinical, haematological, radiological, immunohistochemical, genotypic, treatment and quality of life are collected at first diagnosis of MF and annually to test against survival. Biobanked tissue samples are recorded within a Federated Biobank for translational studies. RESULTS In total, 430 patients were enrolled from 29 centres in 15 countries spanning five continents. Altogether, 348 were confirmed as having early-stage MF at central review. The majority had classical MF (81·6%) with a CD4 phenotype (88·2%). Folliculotropic MF was diagnosed in 17·8%. Most presented with stage I (IA: 49·4%; IB: 42·8%), but 7·8% presented with enlarged lymph nodes (stage IIA). A diagnostic delay between first symptom development and initial diagnosis was frequent [85·6%; median delay 36 months (interquartile range 12-90)]. This highlights the difficulties in accurate diagnosis, which includes lack of a singular diagnostic test for MF. CONCLUSIONS This confirmed early-stage MF cohort is being followed-up to identify prognostic factors, which may allow better management and improve survival by identifying patients at risk of disease progression. This study design is a useful model for collaboration in other rare diseases, especially where pathological diagnosis can be complex.
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Affiliation(s)
- J J Scarisbrick
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - P Quaglino
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H M Prince
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Papadavid
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hodak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Bagot
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Servitje
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Berti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - P Ortiz-Romero
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Stadler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Patsatsi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Knobler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Guenova
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Child
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - S Whittaker
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - V Nikolaou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Tomasini
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - I Amitay
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Prag Naveh
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Ram-Wolff
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Alberti-Violetti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Stranzenbach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - V Gargallo
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Muniesa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Koletsa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Jonak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Porkert
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Mitteldorf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Estrach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Combalia
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Marschalko
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Csomor
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Szepesi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Cozzio
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Dummer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - N Pimpinelli
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - V Grandi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Beylot-Barry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Pham-Ledard
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Wobser
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Geissinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - U Wehkamp
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Weichenthal
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Cowan
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - E Parry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - J Harris
- Member of the UK Cutaneous Lymphoma Group
| | - R Wachsmuth
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - D Turner
- Member of the UK Cutaneous Lymphoma Group
| | - A Bates
- Member of the UK Cutaneous Lymphoma Group
| | - E Healy
- Member of the UK Cutaneous Lymphoma Group
| | - F Trautinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J Latzka
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Yoo
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - B Vydianath
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - R Amel-Kashipaz
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - L Marinos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Oikonomidi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Stratigos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M-D Vignon-Pennamen
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F Climent
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Gonzalez-Barca
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Georgiou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Senetta
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Zinzani
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Vakeva
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Ranki
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A-M Busschots
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Hauben
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Bervoets
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F J S H Woei-A-Jin
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Matin
- Member of the UK Cutaneous Lymphoma Group
| | - G Collins
- Member of the UK Cutaneous Lymphoma Group
| | | | - J Frew
- Member of the UK Cutaneous Lymphoma Group
| | - M Bayne
- Member of the UK Cutaneous Lymphoma Group
| | - G Dunnill
- Member of the UK Cutaneous Lymphoma Group
| | - P McKay
- Member of the UK Cutaneous Lymphoma Group
| | | | - R Azurdia
- Member of the UK Cutaneous Lymphoma Group
| | - K Benstead
- Member of the UK Cutaneous Lymphoma Group
| | - R Twigger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Rieger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Brown
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J A Sanches
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - D Miyashiro
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Akilov
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S McCann
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Sahi
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F M Damasco
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Querfeld
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Folkes
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Bur
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C-D Klemke
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Enz
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Pujol
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Quint
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Geskin
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hong
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Evison
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - M Vermeer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - L Cerroni
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - W Kempf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - Y Kim
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Willemze
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
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Yoo J, Bagot M, Hodak E, Servitige O, Pujol R, Marschalko M, Papadavid E, Cowan R, Mitteldorf C, Jonak C, Querfeld C, Busschots A, Matin R, Wehkemp U, Ma Y, Wong E, Battistella M, Evison F, Kim Y, Scarisbrick J. Lymph node imaging and correlation with histological N-class: results from the PROCLIPI study show sum of the product of dimensions is the better predictor than single axis measurements. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Wehkamp U, Whittaker S, Servitje O, Berti E, Querfeld C, Bagot M, Stadler R, Stranzenbach R, Marschalko M, Busschots AM, Jost M, Sanches J, Ortiz-Romero P, Estrach T, Vakeva L, Jonak C, Akilov O, Hodak E, Mitteldorf C, Bates A, Beylot-Barry M, Cowan R, Pujol R, Matin R, Papadavid E, Quaglino P, Vermeer M, Kempf W, Kim Y, Scarisbrick J. T-cell receptor rearrangements in the skin and blood of patients in the PROCLIPI study: detection of clonal rearrangements in the skin (and blood) correlates with the B-class of MF and SS patients. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30580-5] [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: 10/26/2022]
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Abstract
OBJECTIVE The number of older people with functional or other problems that prevent them from going out of doors is unknown. The objective of this study was to estimate the prevalence of homebound status in Spain and to determine their main characteristics. MATERIAL AND METHODS The Classification of Functioning, Disability and Health was used. Homebound status was defined according to the declared difficulty with regard to mobility outside the home: completely homebound (not able to leave home), semi-homebound (have serious difficulties but can leave with help), and the individuals without problems that were not homebound. Capacity and performance qualifiers were used to assess the final impact of technical or personal help. Prevalences were calculated, and sociodemographic and health characteristics were compared for the different groups. RESULTS Out of a total of 2,146,362 older people with disabilities, 8.1% (95% CI: 8.1-8.2) and 16.0% (95% CI: 15.9-16.0) were (complete) homebound, and semi-homebound, respectively. The homebound elderly were mostly women, had a higher mean age and low education level. They also declared they had more difficulty for the environmental barriers, had worse perceived health, a greater number of disabilities, chronic health conditions, and more functional problems. CONCLUSIONS The prevalence of older disabled people with a homebound status was 24.1%. The social, health, and functional characteristics suggest situations of vulnerability. The information on homebound individuals could contribute to enhance social and health plans, and to raise the visibility of this problem.
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Affiliation(s)
- A Ayala
- Instituto de Economía, Geografía y Demografía (IEGD), Centro de Ciencias Humanas y Sociales (CCHS-CSIC), Madrid, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC).
| | - R Pujol
- Instituto Nacional de Estadística (INE), Madrid, España
| | - A Abellán
- Instituto de Economía, Geografía y Demografía (IEGD), Centro de Ciencias Humanas y Sociales (CCHS-CSIC), Madrid, España
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Pujol R, Girard CA, Richard H, Hassanpour I, Binette MP, Beauchamp G, McDougall JJ, Laverty S. Synovial nerve fiber density decreases with naturally-occurring osteoarthritis in horses. Osteoarthritis Cartilage 2018; 26:1379-1388. [PMID: 29958917 DOI: 10.1016/j.joca.2018.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 12/23/2017] [Revised: 05/10/2018] [Accepted: 06/07/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To measure the nerve fiber density in synovial membranes from healthy and OA equine joints and to investigate the relationship between synovial innervation and OA severity, synovial vascularity and synovitis. DESIGN Twenty-five equine metacarpophalangeal joints were collected post-mortem. The joints were dissected and the macroscopic lesions of the articular cartilage were scored. Synovial membrane specimens (n = 50) were harvested, fixed, sectioned and scored histologically. Immunohistochemical staining and immunofluorescence with S-100 protein, that identifies nerve fibers, and ⍺-actin, that stains vascular smooth muscle, were also performed on site-matched specimens and the relationships between these tissues was interrogated. RESULTS The nerve fiber density was higher in the superficial layer (≤200 μm) of the synovium when compared to the deeper layer in control equine joints (mean difference (95% C.I.): 0.054% (0.018%, 0.11%)). In osteoarthritic joints, synovial innervation decreased in the superficial layer with increasing macroscopic OA score (β (SEM), 95% C.I.: -0.0061 (0.00021), -0.0011, -0.00017). The blood vessel density was also higher in the superficial layer of the synovium compared to the deep layer in the control (mean difference (95% C.I.): 1.1% (0.36%, 2.3%)) and OA (mean difference (95% C.I.): 0.60% (0.22%, 1.2%)) equine joints. Moreover, considering all synovial specimens, higher nerve fiber density in the deep layer positively correlated with blood vessel density (β (SEM), 95% C.I.: 0.11 (0.036), 0.035, 0.18). CONCLUSION The reduction in nerve fiber density with advanced cartilage degeneration suggests that peripheral neuropathy is associated with equine OA. Whether this link is associated with neuropathic pain, requires further investigation.
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Affiliation(s)
- R Pujol
- Comparative Orthopedic Research Laboratory, Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Québec, J2S 7C6, Canada
| | - C A Girard
- Comparative Orthopedic Research Laboratory, Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Québec, J2S 7C6, Canada
| | - H Richard
- Comparative Orthopedic Research Laboratory, Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Québec, J2S 7C6, Canada
| | - I Hassanpour
- Comparative Orthopedic Research Laboratory, Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Québec, J2S 7C6, Canada
| | - M P Binette
- Comparative Orthopedic Research Laboratory, Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Québec, J2S 7C6, Canada
| | - G Beauchamp
- Comparative Orthopedic Research Laboratory, Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Québec, J2S 7C6, Canada
| | - J J McDougall
- Department of Pharmacology, Dalhousie University, 5850 College Street, Halifax, Nova Scotia, B3H 4R2, Canada; Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, 5850 College Street, Halifax, Nova Scotia, B3H 4R2, Canada
| | - S Laverty
- Comparative Orthopedic Research Laboratory, Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Québec, J2S 7C6, Canada.
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Colomer M, Amat D, López A, Frontera G, Navarro D, Gómez R, Ambroa E, García-Miguel J, Parceisa M, Pujol R, Ramírez T. EP-1903: Is it always possible to boost breast tumour bed with conformal photon beams? Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32212-6] [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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Alvarado-Cardenas M, Marin A, Martinez M, Pinal-Fernandez I, Labrador-Horrillo M, Moreno P, Millisenda J, Grau J, Pujol R, Juárez C, Selva-O'Callaghan A. OP0009 Distinctive Immunofluorescence Pattern in Statin-Associated Autoimmune Myopathy with Anti-HMGCR Autoantibodies. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2836] [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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Draibe J, Poveda R, Fulladosa X, Vidaller A, Zulberti C, Gomà M, Pujol R, Ripoll È, Torras J, Grinyó JM. Use of mycophenolate in ANCA-associated renal vasculitis: 13 years of experience at a university hospital. Nephrol Dial Transplant 2015; 30 Suppl 1:i132-7. [PMID: 25805744 DOI: 10.1093/ndt/gfv061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Standard therapy with corticosteroids (CS) and cyclophosphamide (CYC) followed by azathioprine has been shown to improve renal and patient survival in ANCA-associated renal vasculitis (rAAV). Mycophenolate mofetil (MF) has been progressively introduced for the treatment of rAAV in the last years because of its immunosuppressive efficacy combined with a lower toxicity profile. In this study, we retrospectively analyse the results of the introduction of MF for maintenance and induction therapy in rAAV in our institution from 2001 to 2013. RESULTS We reported 67 patients treated with MF as a maintenance treatment, divided by baseline serum creatinine (>500 µmol/L: Group 1 and <500 µmol/L: Group 2) and treatment schedule. Twenty-nine of the 67 patients were also treated with MF as induction treatment, mostly in Group 2. During the follow-up (2 years after the diagnosis) creatinine levels for serum glomerular filtration rate, ANCA titres, C-reactive protein and percentage of haematuria decreased in all groups. In Group 2, parameters and also relapse rates were similar at 24 months in patients treated with CYC or MF as an induction treatment (Subgroups 2a and 2b, respectively). Median dose of MF in maintenance treatment was 1000 mg daily and prednisone dose was tapered to 10 mg daily from Month 3. After 24 months, 82% of patients remained on MF therapy, 18% had discontinued the treatment, seven of them due to medical indication and two because of gastrointestinal intolerance. The percentage of patients that started renal replacement therapy was irregular in Group 1 depending on the subgroup (25-100%), and 10% in Group 2. Adverse effects, such as neutropenia, infections and neoplasia, were more prevalent in groups treated with CYC. CONCLUSION In conclusion, in our patients with rAAV, MF demonstrated to be an effective and well-tolerated option for maintenance treatment. As an induction treatment, MF seems to be similar to CYC for patients with moderate renal failure in the diagnosis.
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Affiliation(s)
- J Draibe
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - R Poveda
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - X Fulladosa
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - A Vidaller
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - C Zulberti
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - M Gomà
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - R Pujol
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - È Ripoll
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - J Torras
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - J M Grinyó
- Nephrology Department, Internal Medicine Department, Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
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Pujol R, Conthe P, Garcia Alegría J. Reorganización de la especialización médica. Más allá de la Ley de Ordenación de Profesiones Sanitarias. Rev Clin Esp 2014; 214:529-33. [DOI: 10.1016/j.rce.2014.08.014] [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] [Received: 06/02/2014] [Revised: 08/27/2014] [Accepted: 08/31/2014] [Indexed: 12/01/2022]
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Casanova J, Sanmartín V, Martí R, Morales J, Soler J, Purroy F, Pujol R. Evaluating Clinical Dermatology Practice in Medical Undergraduates. Actas Dermo-Sifiliográficas (English Edition) 2014. [DOI: 10.1016/j.adengl.2014.04.017] [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: 11/26/2022] Open
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22
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Casanova JM, Sanmartín V, Martí RM, Morales JL, Soler J, Purroy F, Pujol R. Evaluación de las prácticas clínicas de Dermatología en el grado de Medicina. Actas Dermo-Sifiliográficas 2014; 105:459-68. [PMID: 23664251 DOI: 10.1016/j.ad.2012.12.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 11/11/2012] [Accepted: 12/16/2012] [Indexed: 11/16/2022] Open
Affiliation(s)
- J M Casanova
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Universitat de Lleida, Lleida, España.
| | - V Sanmartín
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Universitat de Lleida, Lleida, España
| | - R M Martí
- Servicio de Dermatología, Hospital Universitario Arnau de Vilanova, Universitat de Lleida, Lleida, España
| | - J L Morales
- Servicio de Medicina Interna, Hospital Universitari Arnau de Vilanova, Lleida, España
| | - J Soler
- Médico de Familia, Lleida, España
| | - F Purroy
- Servicio de Neurología, Hospital Universitario Arnau de Vilanova, Lleida, España
| | - R Pujol
- Servicio de Dermatología, Hospital Universitari del Mar, Barcelona, España
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Formiga F, Ferrer A, Padros G, Cintra A, Pujol R. Inverted CD4:CD8 ratio is not associated with three-year mortality in a sample of community-dwelling oldest old: the OCTABAIX immune study. J Nutr Health Aging 2014; 18:425-8. [PMID: 24676325 DOI: 10.1007/s12603-013-0403-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 11/30/2022]
Abstract
BACKGROUND The presence of an immune risk phenotype (IRP) has been correlated with survival rates in elderly people. OBJECTIVE To determine whether an inverted CD4:CD8 ratio might be a marker of IRP in a sample of oldest old by assessing its relationship with mortality. DESIGN Prospective cohort study. SETTING Community-based survey study of seven primary healthcare centres. PARTICIPANTS 328 people born in 1924 and registered with primary healthcare centres. MEASUREMENTS Chronic drug prescription, functional status (Barthel and Lawton indexes) and cognitive status (Spanish version of the Mini-Mental State Examination) were recorded. CD4:CD8 ratios were determined, with a ratio of 1.00 or less being used to define IRP. RESULTS The CD4:CD8 ratio was 1.00 or less in 47 subjects (15.6%). After three years, 51 subjects had died (16.3%); 9 were from among the 47 (19.1%) with an inverted CD4:CD8 ratio and 42 (15.8%) from the remainder (P=0.52). Multivariate analysis identified two significant clinical variables (Lawton Index scores and the number of chronic drugs prescribed) as being independent predictors of three-year mortality risk in this cohort of octogenarians. This risk profile did not change when introducing the CD4:CD8 ratio into the calculation. CONCLUSION In this community-dwelling population of oldest old (85 years old at baseline) an inverted CD4:CD8 ratio was not associated with three-year mortality.
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Affiliation(s)
- F Formiga
- F. Formiga, MD, PhD, Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat 08907, Barcelona, Spain. E-mail: , Phone: (+34) 93 260 74 19; Fax: (+34) 93 260 74 20
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Bouza E, Giannella M, Pinilla B, Pujol R, Capdevila J, Muñoz P. The management of pneumonia in internal medicine. Rev Clin Esp 2013. [DOI: 10.1016/j.rceng.2013.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bouza E, Giannella M, Pinilla B, Pujol R, Capdevila JA, Muñoz P. The management of pneumonia in internal medicine. Rev Clin Esp 2013; 213:298-305. [PMID: 23664752 DOI: 10.1016/j.rce.2013.03.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 02/19/2013] [Accepted: 03/06/2013] [Indexed: 10/26/2022]
Abstract
Pneumonia generates a high workload for internal medicine departments. Management of this disease is challenging, because patients are usually elderly and have multiple comorbid conditions. Furthermore, the interpretation and adherence to guidelines are far from clear in this setting. We report the opinion of 43 internists especially interested in infectious diseases that were questioned at the 2011 XXXII National Conference of Spanish Society of Internal Medicine about the main issues involved in the management of pneumonia in the internal medicine departments, namely, classification, admission criteria, microbiological workup, therapeutic management, discharge policy, and prevention of future episodes. Participants were asked to choose between 2 options for each statement by 4 investigators. Consensus could not be reached in many cases. The most controversial issues concerned recognition and management of healthcare-associated pneumonia (HCAP). Most participants were aware of the differences in terms of underlying diseases, etiological distribution, and outcome of HCAP compared with community-acquired pneumonia, but only a minority agreed to manage HCAP as hospital-acquired pneumonia, as suggested by some guidelines. A clinical patient-to-patient approach proved to be the option preferred by internists in the management of HCAP.
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Affiliation(s)
- E Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Gómez de Carvallo M, Calvo B, Benach J, Pujol R, Giménez-Arnau A. Evaluación de los criterios de imputabilidad de dermatosis profesional definidos por Mathias. Actas Dermo-Sifiliográficas 2012; 103:411-21. [DOI: 10.1016/j.ad.2011.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Revised: 12/04/2011] [Accepted: 12/09/2011] [Indexed: 11/16/2022] Open
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Formiga F, Ferrer A, Chivite D, Pinto X, Badia T, Padrós G, Pujol R. Serum high-density lipoprotein cholesterol levels correlate well with functional but not with cognitive status in 85-year-old subjects. J Nutr Health Aging 2012; 16:449-53. [PMID: 22555789 DOI: 10.1007/s12603-012-0018-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We evaluate the association between high-density lipoprotein cholesterol (HDL-C) levels and physical and cognitive performance indicators in 85-year-old subjects. DESIGN Prospective cohort study. SETTING A community-based study. PARTICIPANTS 321 subjects enrolled in the Octabaix Study. METHODS Functional status was determined using the Lawton-Brody Index (LI) and the Barthel Index (BI). Cognition was assessed using the modified Spanish version of the Mini-Mental State Examination (MEC). We also measured risks related to nutrition and falls, as well as comorbidity and chronic drug prescription. HDL-C serum concentrations <40 mg/dl for men and <46 mg/dl for women were used as cut-off values to discriminate between normal and low HDL-C concentrations. RESULTS The sample consisted of 197 women (61%) and 124 men. Mean HDL-C levels were 56.5 ± 15 mg/dl, with gender differences being found (59.3 ± 15 mg/dl in women vs. 52.1 ± 13 mg/dl in men; p<0.0001). Sixty-one subjects (19%) had low HDL-C values. HDL-C levels correlated with BI (r=0.11, p=0.04) and LI (r=0.17, p=0.002) scores, but not with MEC scores (r=0.08, p=0.13). Poor BI and LI scores, lower MEC scores, a risk of falls and malnutrition, and polypharmacy were all associated with lower HDL-C values in the bivariate analysis. Multiple logistic regression analysis showed only a significant association between normal HDL-C serum values and better BI scores (p<0.001, OR 1.02, 95% CI 1.01-1.04). CONCLUSIONS Individuals with higher levels of HDL-C had better functional and cognitive status, but after multivariate analysis this relationship only remained significant for functional status.
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Affiliation(s)
- F Formiga
- Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain.
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Alliez J, Baudry M, Pujol R. Un nouveau messie. Encephale 2011; 37:51-61. [DOI: 10.1016/s0013-7006(11)70064-1] [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: 10/14/2022]
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Martínez Palli G, Ubré M, Rivas E, Blasi A, Borrat X, Pujol R, Taurà RP, Balust J. [An established anesthesia team-care model: over 12000 cases in a digestive endoscopy unit]. Rev Esp Anestesiol Reanim 2011; 58:406-411. [PMID: 22046861 DOI: 10.1016/s0034-9356(11)70103-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVE The growing demand for digestive and other endoscopic procedures outside the operating room, both in terms of type of endoscopy and number of patients, requires reorganization of the anesthesiology department's workload. We describe 2 years of our hospital digestive endoscopy unit's experience with a now well-established care model involving both anesthesiologists and nurse anesthetists. MATERIAL AND METHODS After previously reviewing the medical records of outpatients and conducting a telephone interview about state of health, nurse anesthetists administered a combination of propofol and remifentanil through a target-controlled infusion system under an anesthesiologist's direct supervision. RESULTS The ratio of anesthesiologists to nurses ranged from 1:2 to 1:3 according to the complexity of the examination procedure. Over 12000 endoscopies (simple to advanced) in a total of 11853 patients were performed under anesthesia during the study period. Airway management maneuvers were required by 4.9% of the patients; 0.18% required bag ventilation for respiratory depression, and 0.084% required bolus doses of a vasopressor to treat hypotension or atropine to treat bradycardia. The procedure had to be halted early in 9 patients (0.07%). No patient required orotracheal intubation and none died. Nor were any complications related to sedation recorded. CONCLUSION The results suggest that this care model can safely accommodate a large caseload in anesthesia at an optimum level of quality.
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Affiliation(s)
- G Martínez Palli
- Servicio de Anestesiología y Reanimación, Sección del Instituto de Enfermedades Digestivas, Hospital Clinic de Barcelona.
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Porcel J, Casademont J, Conthe P, Pinilla B, Pujol R, García-Alegría J. Competencias básicas de la medicina interna. Rev Clin Esp 2011; 211:307-11. [DOI: 10.1016/j.rce.2011.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Accepted: 03/21/2011] [Indexed: 11/28/2022]
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Gabarrós A, Martino J, Juncadella M, Plans G, Pujol R, Deus J, Godino O, Torres A, Aparicio A, Conesa G, Acebes JJ. [Intraoperative identification of the supplementary motor area in neurooncological surgery]. Neurocirugia (Astur) 2011; 22:123-132. [PMID: 21597653] [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: 05/30/2023]
Abstract
OBJECTIVES The main objective of the present work was to identify, by means of intraoperative electrical stimulation, the supplementary motor area (SMA) region which is implicated in complex motor function. The functional prognostic relevance of the surgical preservation of this area was also analyzed. METHOD Fifteen patients with tumors infiltrating the premotor cortex were selected. All patients were operated under awake conditions. Primary motor cortex was identified with intraoperative electrical stimulation (IES). To identify the SMA, patients were asked to do a finger opposition motor task with their hand contralateral to the lesion, that was blocked by electrically stimulating the premotor cerebral cortex. RESULTS SMA was identified in all patients with IES. Complete surgical resection was achieved in 13 patients (86.6%) and subtotal in 2 patients (13.3%). SMA function was preserved in 14 patients (93.3%). In only one patient the SMA was partially resected because of tumor infiltration (6.6%). In the immediate postoperative period, 8 patients (53.3%) did not show changes in comparison to their preoperative clinical status, and 2 patients improved. At 6 months follow up, 5 patients (33.3%) were asymptomatic and 10 patients showed permanent deficits. In this last group, five patients (33.3%) showed mild deficits that did not interfere with a normal life. In the other 5 patients (33.3%), permanent deficits interfered with daily life activities: two patients presented severe hemiparesis 3/5 (same similar to their preoperative status with no improvement), one patient had motor aphasia, and two other patients (13.3%) showed permanent left SMA syndrome. In two patients with severe postoperative hemiparesis, tumor infiltration of primary motor cortex and piramidal pathway was observed; severe preoperative motor deficit (KPS <70) was associated with poor functional outcome. CONCLUSIONS Intraoperative electrical cortical stimulation is useful to identify the SMA. Once identified, SMA preservation decreases the risk of postoperative symptoms and permanent SMA syndrome. When SMA is infiltrated by the tumor, radical resection may cause permanent neurological deficits, specially in the dominant hemisphere. Severe preoperative motor deficit was associated with poor outcome.
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Affiliation(s)
- A Gabarrós
- Servicios de Neurocirugía, Hospital Universitari de Bellvitge (Barcelona).
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Gabarrós A, Martino J, Juncadella M, Plans G, Pujol R, Deus J, Godino O, Torres A, Aparicio A, Conesa G, Acebes J. Identificación intraoperatoria del área motora suplementaria en cirugía neurooncológica. Neurocirugia (Astur) 2011. [DOI: 10.4321/s1130-14732011000200003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Casanova JM, Soria X, Borrego L, de Argila D, Ribera M, Pujol R. [Portfolios: a tool for the training and assessment of residents in dermatology, part 1]. Actas Dermosifiliogr 2011; 102:244-54. [PMID: 21306691 DOI: 10.1016/j.ad.2010.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 11/07/2010] [Accepted: 11/08/2010] [Indexed: 11/26/2022] Open
Abstract
The medical resident's portfolio is a collection of materials that show reflective learning in the context of clinical practice. A portfolio contains documents (such as case histories and questionnaires the resident has used), images, and video recordings that reveal that an individual has acquired the competencies needed for professional practice. A portfolio is an assessment tool that simultaneously supports learning and gives evidence for certifying competence. It encourages independent continuing professional development that is incremental and centered on answering questions about what one has learned, how it might be applied, what still needs to be learned, and what must be done to reach one's goal. Answering such questions provides evidence of competencies that have been acquired and what is still lacking, allowing the trainee to develop a plan for personal improvement and evaluate subsequent achievements. The first step in creating a portfolio is to list required skills and abilities, along with the actions that will allow the resident to acquire them during each year of residency training. The ultimate goal is to define the resident's professional competence. We describe a model on which to base a training and assessment portfolio for residents in dermatology.
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Affiliation(s)
- J M Casanova
- Servicio de Dermatología, Hospital Universitari Arnau de Vilanova, Lleida, España.
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Formiga F, Ferrer A, Rodriguez Molinero A, Fraga A, Cuerpo S, Pujol R. Vital status after five-year follow-up of nonagenarians with functional and/or cognitive impairment at baseline: the NonaSantfeliu study. J Nutr Health Aging 2011; 15:121-5. [PMID: 21365165 DOI: 10.1007/s12603-011-0024-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/25/2022]
Abstract
OBJECTIVES To evaluate vital status after five years of follow-up in a cohort of nonagenarians with functional and/or cognitive impairment at baseline. DESIGN Prospective cohort study. SETTING A community-based study. PARTICIPANTS Nonagenarians enrolled in the NonaSantfeliu study. MEASUREMENTS Functional status was determined by the Lawton-Brody and Barthel indexes (BI), while cognition was assessed using the Spanish version of the Mini-Mental State Examination (MEC). Nonagenarians scoring up to 59 points on the BI were defined as individuals with significant functional impairment. Nonagenarians with cognitive decline were defined as those individuals with a score of 23 or less on the MEC. Subjects scoring < 60 on the BI and < 24 on the MEC were considered to show combined impairment (both functional and cognitive). RESULTS Sixty-three of 71 (88.8%) subjects with a BI < 60 and 73 of 84 (86.9%) with a MEC score < 24 had died after five years. Forty-eight of 53 nonagenarians (90%) with combined impairment died during the same follow-up period. A prior diagnosis of heart failure was the only variable associated with higher mortality in the three groups of subjects. CONCLUSION Most of the nonagenarian subjects with functional and/or cognitive impairment at baseline had died at five-year follow-up.
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Affiliation(s)
- F Formiga
- Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Barcelona, Spain.
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Formiga F, Ferrer A, Almeda J, San Jose A, Gil A, Pujol R. Utility of geriatric assessment tools to identify 85-years old subjects with vitamin D deficiency. J Nutr Health Aging 2011; 15:110-4. [PMID: 21365163 DOI: 10.1007/s12603-011-0022-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To calculate the prevalence of hypovitaminosis D in subjects aged 85 years old and to study the relationship between some common geriatric evaluation scales and vitamin D status. DESIGN Prospective cohort study. SETTING A community-based study. PARTICIPANTS 312 subjects aged 85 years old. MEASUREMENTS Geriatric assessment was based on comorbidity, functional status according to the Barthel Index (BI) and Lawton Index (LI), cognitive status measured by the Spanish version of the Mini-Mental State Examination (MEC), nutritional risk according to the Mini Nutritional Assessment (MNA), and gait using the Tinetti Gait Scale. Serum 25(OH)D concentrations were used to assess vitamin D status. Hypovitaminosis D was considered as < 25 ng/ml and deficiency < 11 ng/ml. RESULTS Mean serum 25(OH)D level was 28 ± 30 ng/ml. The prevalence of hypovitaminosis D was 52.5% (38.1% insufficiency and 14.4% deficiency). Men had higher levels than women (32.2 ± 44 vs. 25.2 ± 25 ng/ml; p=0.04). The bivariate analyses identified an association between MNA scores and hypovitaminosis D, and showed that females ande participants with poor BI, Tinetti and MNA scores were associated with deficiency. Logistic regression analysis confirmed a significant association between poor MNA scores and both hypovitaminosis D (p < 0.04, OR 1.066, 95% CI 1.002-1.135) and vitamin D deficiency (p < 0.0001, OR 1.192, 95% CI 1.099-1.293). CONCLUSIONS More than half the population aged 85 years has a vitamin D deficit and 14.4% show a deficiency. A lower score on the MNA scale is associated with a greater likelihood of having lower vitamin D serum values.
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Affiliation(s)
- F Formiga
- Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Barcelona, Spain.
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Casanova J, Soria X, Borrego L, de Argila D, Ribera M, Pujol R. Portfolios: A Tool for the Training and Assessment of Residents in Dermatology, Part 1. Actas Dermo-Sifiliográficas (English Edition) 2011. [DOI: 10.1016/s1578-2190(11)70799-5] [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: 10/17/2022] Open
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Riera-Mestre A, Martínez-Yelamos S, Martínez-Yelamos A, Ferrer I, Pujol R, Vidaller A. Clinicopathologic features and outcomes of neuro-Behçet disease in Spain: a study of 20 patients. Eur J Intern Med 2010; 21:536-41. [PMID: 21111940 DOI: 10.1016/j.ejim.2010.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 07/27/2010] [Accepted: 08/10/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND To describe the clinical characteristics and evolution of a series of adult patients hospitalized for neuro-Behçet disease (NBD). METHODS Consecutive patients admitted for NBD in a teaching hospital were retrospectively selected. Disability at discharge and during follow-up was graded with the modified Rankin Scale, and outcome classified as good or poor (grades 3-6). RESULTS Twenty patients were included (M/F, 13/7). Mean age at NBD diagnosis was 36.3 years. Nineteen patients had other manifestations of Behçet disease (BD) before NBD developed, but only 7 met the complete diagnostic criteria for BD. Fever, headache, motor weakness, and cranial nerve palsy were each present in approximately 60% of patients. There was a low prevalence of behavioral changes (5%), seizures (5%), and sphincter incontinence (0%), and a relatively high prevalence of meningism (25%). Non-neurologic manifestations of BD were concurrently detected in 15 patients (75%). 80% had parenchymal involvement. Brain biopsies during 5 attacks showed perivascular lymphocytic infiltration with reactive astrocytosis, but no frank vasculitis. During a mean follow-up of 6.3 years per patient, 12 had at least one relapse. In total, there were 22 relapses; all but two were in the same location and were symptomatically similar in each patient. At the end of follow-up, 7 patients (35%) had a poor outcome, including 4 who died. CONCLUSION Recording of previous manifestations of BD and a physical examination to detect concomitant systemic manifestations of BD may help establish an early diagnosis of NBD. Relapses frequently occurred in the same location. No frank vasculitis was present in brain biopsies.
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Affiliation(s)
- A Riera-Mestre
- Department of Internal Medicine, Hospital Universitari de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
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Abstract
OBJECTIVES To examine the survival rates of subjects aged 95 or over after a follow-up period of 3 years, and to determine predictive factors for mortality risk. DESIGN A prospective cohort study. SETTING A community-based study. PARTICIPANTS Forty-eight subjects aged 95 or over. MEASUREMENTS Sociodemographic data, Barthel Index, Lawton-Brody Index, Spanish version of the Mini-Mental State Examination, short version of the Mini Nutritional Assessment, comorbidity (Charlson Index), and prevalent chronic diseases were evaluated. Patients who died were compared with the rest. RESULTS Thirty-six deaths (75%) were recorded during follow-up. The Cox multivariate analysis showed that lower Barthel Index scores and a history of heart failure were independently associated with long-term mortality. CONCLUSIONS In subjects aged 95 or over, poor functional status and history of heart failure were the two independent risk factors for 3-year mortality.
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Affiliation(s)
- F Formiga
- Geriatric Unit, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat 08907, Barcelona, Spain.
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Sala-Sastre N, Herdman M, Navarro L, de la Prada M, Pujol R, Serra C, Alonso J, Flyvholm MA, Giménez-Arnau AM. [Occupational dermatoses. Cross-cultural adaptation of the Nordic Occupational Skin Questionnaire (NOSQ-2002) from English to Spanish and Catalan]. Actas Dermosifiliogr 2009; 100:685-692. [PMID: 19775546] [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: 05/28/2023] Open
Abstract
BACKGROUND Eczema of the hands and urticaria are very common occupational dermatoses. The Nordic Occupational Skin Questionnaire (NOSQ-2002), developed in English, is an essential tool for the study of occupational skin diseases. The short version of the questionnaire is useful for screening and the long version is used to study risk factors. OBJECTIVE. The aim of this study was to culturally adapt the long version of the NOSQ to Spanish and Catalan and to ensure comprehension, semantic validity, and equivalence with the original. METHODS The principles of the International Society for Pharmacoeconomics and Outcomes Research for good research practices were applied. A 4-phase method was used, with direct, revised translation, back translation, and cognitive interviews. RESULTS After direct translation, a first version was issued by the Spanish Working Group. This version was evaluated in cognitive interviews. Modifications were made to 39 questions (68 %) in the Spanish version and 27 questions (47 %) in the Catalan version. Changes included addition of examples to improve understanding, reformulation of instructions, change to use of a direct question format, and addition of certain definitions. The back translation was evaluated by the original authors, leading to a further 7 changes in the Spanish version and 2 in the Catalan version. The third consensus version underwent a second round of cognitive interviews, after which the definitive version in each language was issued. CONCLUSION. Spanish and Catalan versions of the NOSQ-2002 questionnaire are available at www.ami.dk/NOSQ and www.arbejdsmiljoforskning.dk.
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Affiliation(s)
- N Sala-Sastre
- Mateu Orfila de Salut Laboral, Universitat Pompeu Fabra, Barcelona, España
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Sala-Sastre N, Herdman M, Navarro L, de la Prada M, Pujol R, Serra C, Alonso J, Flyvholm M, Giménez-Arnau A. Dermatosis profesionales. Adaptación transcultural del cuestionario Nordic Occupational Skin Questionnaire (NOSQ-2002) del inglés al castellano y al catalán. Actas Dermo-Sifiliográficas 2009. [DOI: 10.1016/s0001-7310(09)72281-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Uziel A, Pujol R, Bock GR. Foreword. Acta Otolaryngol 2009. [DOI: 10.3109/00016489109128022] [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: 11/13/2022]
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Formiga F, Ferrer A, Pérez-Castejón J, Riera-Mestre A, Chivite D, Pujol R. Factores asociados a mortalidad en nonagenarios. Estudio NonaSantfeliu. Seguimiento a los dos años. Rev Clin Esp 2009; 209:9-14. [DOI: 10.1016/s0014-2565(09)70352-2] [Citation(s) in RCA: 15] [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] [Indexed: 11/27/2022]
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Formiga F, Lopez-Soto A, Duaso E, Chivite D, Ruiz D, Perez-Castejon JM, Navarro M, Pujol R. Characteristics of falls producing hip fractures in nonagenarians. J Nutr Health Aging 2008; 12:664-7. [PMID: 18953466 DOI: 10.1007/bf03008279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
OBJECTIVES To evaluate the characteristics associated with falls causing hip fracture in patients 90 years of age or older (nonagenarians). A second objective was to compare these characteristics with those present in younger patients (65-79 year-olds). DESIGN Prospective, observational study. SETTING Six hospitals in Barcelona (Spain) and its surrounding area. PARTICIPANTS 105 nonagenarians diagnosed with hip fracture after a fall. Most patients were women (78; 74%), with a mean age of 92.2+/-2 years. All of them were living in the community, except for eight institutionalized patients. 221 patients aged 65 to 79 composed the younger patient's comparison group. MEASUREMENTS Characteristics of falls causing hip fracture were analyzed: location, time and the risk factor for the fall, classified as intrinsic, extrinsic or combined. RESULTS The mean number of falls in the previous year was 1.5 - 22% of the patients reported having fallen two or more times. Falls usually happened while at home (70%) and during the day (64%). An intrinsic risk factor was considered the most likely cause in 37% of the cases, an extrinsic risk factor in 35%, and a combination in 28%. Multiple stepwise logistic regression analysis showed that nonagenarians were characterized by lower BI scores, more falls happening during night time, a higher use of, benzodiazepines and diuretics, and a lower use of non-benzodiazepinic hypnotics. CONCLUSIONS Most falls causing hip fracture in nonagenarians happen during the day and at home. Falls in nonagenarians happening more frequently during nighttime, and these oldest subjects had lower BI scores, and a higher use of benzodiazepines and diuretics and less use of non-benzodiazepines hypnotics compared with the younger patients.
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Affiliation(s)
- F Formiga
- Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, L Hospitalet de Llobregat, Barcelona, Spain.
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Pujol R, Forteza-Rey J. La Educación Médica está de luto. Rev Clin Esp 2008. [DOI: 10.1157/13127617] [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: 11/21/2022]
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Pujol R, Gracia I, Valero R, Fàbregas N. [Low bispectral index values in an awake patient: an artifact to take into consideration]. Rev Esp Anestesiol Reanim 2008; 55:455-456. [PMID: 18853692 DOI: 10.1016/s0034-9356(08)70625-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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Formiga F, Ferrer A, Pujol R. Morbimortalidad en nonagenarios con antecedentes de accidente vascular cerebral o fractura de fémur. Estudio NonaSantfeliu. Rev Clin Esp 2008; 208:353-5. [DOI: 10.1157/13124315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Riera-Mestre A, Martínez-Yélamos S, Martínez-Yélamos A, Vidaller A, Pujol R. [Neuro-Behçet and neurotoxicity due to cyclosporine]. Rev Clin Esp 2008; 208:205-6; author reply 206. [PMID: 18381009 DOI: 10.1157/13117047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
OBJECTIVES To evaluate the prevalence of falls and their circumstances in non-institutionalized people older than 89 years and living in an urban community. DESIGN Cross-sectional cohort study. SETTING Community-based study. PARTICIPANTS 137 nonagenarians living at home. MEASUREMENTS We evaluated sociodemographic data, capacity to perform basic activities according to the Barthel Index (BI) and instrumental activities on the Lawton-Brody Index (LI), cognition with the Spanish version of the Mini-Mental State Examination (MEC), near visual acuity by the Snellen test, and auditory acuity with the whisper test. RESULTS Ninety-nine women (72%) and 38 men with an average age of 93.07 years (0.7) were included. 48.1% of them had suffered a fall during the last year, and in 20% of cases this had happened on more than one occasion. In 5.7% of cases, falls led to fractures. Factors associated with falls were a lower LI and a greater number of prescribed drugs. In the multivariate analysis the only factor related to falls was the number of drugs taken (p>0.001, odds ratio 0.785, 95% confidence interval 0.676-0.912). CONCLUSIONS Measures to prevent falls among nonagenarians should be intensified due to their high frequency. In this age group the increase in the percentage of falls is mainly related to the higher number of drugs taken.
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Affiliation(s)
- F Formiga
- Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
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Ferrer A, Formiga F, Ruiz D, Mascaro J, Olmedo C, Pujol R. Predictive items of functional decline and 2-year mortality in nonagenarians--the NonaSantfeliu study. Eur J Public Health 2008; 18:406-9. [DOI: 10.1093/eurpub/ckn020] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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