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Borralleras C, Castrodeza Sanz J, Arrazola P, Cámara Hijón C, Eiros JM, Castrodeza Sanz J, Arrazola P, Cámara Hijón C, Fernández-Prada M, Gil de Miguel A, Mirada Masip G, Moraga-Llop F, Ocaña Rodríguez D, Puig-Barberà J, Vázquez J, Vergara-Alert J, de Cambra S. Update on Bimervax® immunogenicity amplitude. Insights on humoral response against XBB.1.5 from an extension study (NTC05142553). Rev Esp Quimioter 2023; 36:658-660. [PMID: 37675837 DOI: 10.37201/req/085.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S de Cambra
- Salomé de Cambra Florensa, HIPRA Human Health, Spain. Phone. +34 972 430 660.
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Borralleras C, Castrodeza Sanz J, Arrazola P, Cámara Hijón C, Eiros JM, Castrodeza Sanz J, Arrazola P, Cámara Hijón C, Fernández-Prada M, Gil de Miguel A, Mirada Masip G, Moraga-Llop F, Ocaña Rodríguez D, Puig-Barberà J, Vázquez J, Vergara-Alert J, de Cambra S. The PHH-1V HIPRA vaccine: a new tool in the vaccination strategy against COVID-19. Rev Esp Quimioter 2023; 36:507-515. [PMID: 37303137 PMCID: PMC10586735 DOI: 10.37201/req/046.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Vaccination against SARS-CoV-2 is essential to mitigate the personal, social and global impact of the coronavirus disease (COVID-19) as we move from a pandemic to an endemic phase. Vaccines are now required that offer broad, long-lasting immunological protection from infection in addition to protection from severe illness and hospitalisation. Here we present a review of the evidence base for a new COVID-19 vaccine, PHH-1V (Bimervax®; HIPRA HUMAN HEALTH S.L.U), and the results of an expert consensus. METHODS The expert committee consisted of Spanish experts in medicine, family medicine, paediatrics, immunology, microbiology, nursing, and veterinary medicine. Consensus was achieved using a 4-phase process consisting of a face-to-face meeting during which the scientific evidence base was reviewed, an online questionnaire to elicit opinions on the value of PHH-1V, a second face-to-face update meeting to discuss the evolution of the epidemiological situation, vaccine programmes and the scientific evidence for PHH-1V and a final face-to-face meeting at which consensus was achieved. RESULTS The experts agreed that PHH-1V constitutes a valuable novel vaccine for the development of vaccination programmes aimed towards protecting the population from SARS-CoV-2 infection and disease. Consensus was based on evidence of broad-spectrum efficacy against established and emerging SARS-CoV-2 variants, a potent immunological response, and a good safety profile. The physicochemical properties of the PHH-1V formulation facilitate handling and storage appropriate for global uptake. CONCLUSIONS The physicochemical properties, formulation, immunogenicity and low reactogenic profile of PHH-1V confirm the appropriateness of this new COVID-19 vaccine.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S de Cambra
- Salomé de Cambra Florensa, HIPRA Human Health, Spain. Phone. +34 972 430 660.
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3
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Cienfuegos-González P, Madrid-Álvarez E, Fernández-Prada M, Zapico-Baragaño M, Martín-Aragonés E, López-Fernández L. EE-7853. Campaña de captación (catch-up) con COVID-19 en pacientes hospitalizados: implementación y resultados. Vacunas 2022. [PMCID: PMC9578742 DOI: 10.1016/j.vacun.2022.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A pesar de las campañas oficiales de vacunación dirigidas a la población por parte de las autoridades sanitarias, aún se identifican personas que no han recibido ninguna dosis de vacuna o que registran pauta incompleta. El objetivo del presente trabajo es exponer la campaña de captación (catch-up) frente a COVID-19 en pacientes hospitalizados. Métodos Se revisaron los calendarios de vacunación COVID-19 de los pacientes que estaban hospitalizados entre el 08/11/2021 y el 27/06/2022 justo en el momento en que el paciente se encontraba en el centro asistencial. En aquellos que no presentaban registro de vacunación COVID-19 o que presentaban pauta incompleta se registraba en la hoja de evolución clínica ofreciendo la vacuna COVID-19 durante la estancia hospitalaria o su programación tras el alta. El facultativo y la enfermera le trasladaban esta información al paciente haciendo hincapié en esta medida preventiva. Si el paciente accedía a vacunarse, se contactaba con la Unidad de Vacunas para proceder a la vacunación. Resultados Se evaluaron un total de 2.961 pacientes. De ellos, 2.700 (91,18%) estaban correctamente vacunados según las indicaciones de vacunación vigentes. De los 261 (8,81%) restantes, 174 (66,66%) estaban pendientes de alguna dosis mientras que 87 (33,33%) habían rechazado vacunación. Tras registrar y ofrecerles la vacunación de manera oportunista a propósito de su hospitalización se consiguió que 66 (37,93%) de los que registraban vacunación incompleta continuaran con la pauta antes del alta hospitalaria y que 16 (18,39%) de los que habían rechazado previamente la vacunación, iniciaran la pauta durante su ingreso. La estrategia consiguió el catch-up frente a COVID-19 en 82 (31,41%) pacientes. Conclusiones La presente campaña de catch-up se considera efectiva. La vacunación oportunista durante la hospitalización debe tenerse en cuenta como una estrategia útil para la mejora de las coberturas de vacunación globales.
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Meca-Lallana JE, Fernández-Prada M, García Vázquez E, Moreno Guillén S, Otero Romero S, Rus Hidalgo M, Villar Guimerans LM, Eichau Madueño S, Fernández Fernández Ó, Izquierdo Ayuso G, Álvarez Cermeño JC, Arnal García C, Arroyo González R, Brieva Ruiz L, Calles Hernández C, García Merino A, González Platas M, Hernández Pérez MÁ, Moral Torres E, Olascoaga Urtaza J, Oliva-Nacarino P, Oreja-Guevara C, Ortiz Castillo R, Oterino A, Prieto González JM, Ramió-Torrentá L, Rodríguez-Antigüedad A, Saiz A, Tintoré M, Montalbán Gairin X. Consensus statement on the use of alemtuzumab in daily clinical practice in Spain. Neurologia 2022; 37:615-630. [PMID: 31987648 DOI: 10.1016/j.nrl.2019.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 11/04/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Alemtuzumab is a highly effective drug approved by the European Medicines Agency as a disease-modifying drug for the treatment of relapsing-remitting multiple sclerosis. OBJECTIVE A consensus document was drafted on the management of alemtuzumab in routine clinical practice in Spain. DEVELOPMENT A group of multiple sclerosis specialists reviewed articles addressing treatment with alemtuzumab in patients with multiple sclerosis and published before December 2017. The included studies assessed the drug's efficacy, effectiveness, and safety; screening for infections and vaccination; and administration and monitoring aspects. The initial proposed recommendations were developed by a coordinating group and based on the available evidence and their clinical experience. The consensus process was carried out in 2 stages, with the initial threshold percentage for group agreement established at 80%. The final document with all the recommendations agreed by the working group was submitted for external review and the comments received were considered by the coordinating group. CONCLUSION The present document is intended to be used as a tool for optimising the management of alemtuzumab in routine clinical practice.
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Affiliation(s)
- J E Meca-Lallana
- CSUR Esclerosis Múltiple. Servicio de Neurología. Hospital Clínico Universitario Virgen de la Arrixaca (IMIB-ARRIXACA), Cátedra de Neuroinmunología Clínica y Esclerosis Múltiple, UCAM. Universidad Católica San Antonio, Murcia, España.
| | - M Fernández-Prada
- Servicio de Medicina Preventiva y Salud Pública, Hospital Vital Álvarez-Buylla, Mieres (Asturias), España
| | - E García Vázquez
- Servicio de MI-Infecciosas. Hospital Clínico Universitario Virgen de la Arrixaca, Departamento de Medicina. Facultad de Medicina. Universidad de Murcia. IMIB-Arrixaca, Murcia, España
| | - S Moreno Guillén
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, España
| | - S Otero Romero
- Centro de Esclerosis Múltiple de Cataluña (Cemcat), Servicio de Neurología/Neuroinmunología, Hospital Universitario Vall de Hebrón, Barcelona, España
| | - M Rus Hidalgo
- Servicio de Neurología, Hospital Virgen Macarena, Sevilla, España
| | - L M Villar Guimerans
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, España
| | - S Eichau Madueño
- Servicio de Neurología, Hospital Virgen Macarena, Sevilla, España
| | - Ó Fernández Fernández
- Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Málaga, España
| | - G Izquierdo Ayuso
- Unidad de Investigación y Tratamiento de Esclerosis Múltiple, Hospital Vithas Nisa, Castilleja de la Cuesta (Sevilla), España
| | - J C Álvarez Cermeño
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, España
| | - C Arnal García
- Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Hospital General, Granada, España
| | - R Arroyo González
- Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón (Madrid), España
| | - L Brieva Ruiz
- Servicio de Neurología, Hospital Arnau de Vilanova, IRBLLEIDA, Lérida, España
| | | | - A García Merino
- Servicio de Neurología, Unidad de Neuroinmunología, Hospital Universitario Puerta de Hierro, Majadahonda (Madrid), España
| | - M González Platas
- Hospital Universitario de Canarias, La Cuesta (Santa Cruz de Tenerife), España
| | - M Á Hernández Pérez
- Servicio de Neurología, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España
| | - E Moral Torres
- Servicio de Neurología, Hospital Moisés Broggi y Hospital General de ĺHospitaletí, Sant Joan Despí (Barcelona), España
| | - J Olascoaga Urtaza
- Unidad de EM Hospital Universitario Donostia-Instituto de Investigación BIODONOSTIA, San Sebastián (Guipúzcoa), España
| | - P Oliva-Nacarino
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, España
| | - C Oreja-Guevara
- Neurología, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, España
| | | | - A Oterino
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - J M Prieto González
- Servicio de Neurología, Hospital Clínico Universitario de Santiago, Santiago de Compostela (La Coruña), España
| | - L Ramió-Torrentá
- Unidad de Neuroinmunología y Esclerosis Múltiple Territorial de Gerona, Servicio de Neurología. Hospital Universitario Doctor Josep Trueta, Grupo Neurodegeneración y Neuroinflamación. IDIBGI, Facultad de Medicina. Universidad de Gerona, Gerona, España
| | | | - A Saiz
- Servicio de Neurología, Hospital Clínico, Universidad de Barcelona, Barcelona, España
| | - M Tintoré
- Centro de Esclerosis Múltiple de Cataluña (Cemcat), Servicio de Neurología/Neuroinmunología, Hospital Universitario Vall de Hebrón, Barcelona, España
| | - X Montalbán Gairin
- Centro de Esclerosis Múltiple de Cataluña (Cemcat), Servicio de Neurología/Neuroinmunología, Hospital Universitario Vall de Hebrón, Barcelona, España
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Redondo E, Rivero-Calle I, Mascarós E, Yuste JE, Fernández-Prada M, Ocaña D, Jimeno I, Gil A, Molina J, Díaz-Maroto JL, Linares M, Martinón-Torres F. [Vaccination against community acquired pneumonia in adults. Update 2021 of the position paper by Neumoexpertos en Prevención Group]. Semergen 2021; 47:411-425. [PMID: 34332864 DOI: 10.1016/j.semerg.2021.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022]
Abstract
Community-acquired pneumonia (CAP) continues to be an important cause of morbidity and mortality in adults. The aim of this study is to update the practical prevention guide for CAP through vaccination in Spain developed in 2016 and updated in 2018, based on available vaccines and evidence through bibliographic review and expert opinion. The arrival of COVID-19 as a new cause of CAP and the recent availability of safe and effective vaccines constitutes the most significant change. Vaccines against pneumococcus, influenza, pertussis and COVID-19 can help to reduce the burden of disease from CAP and its associated complications. The available evidence supports the priority indications established in this guide, and it would be advisable to try to achieve a widespread dissemination and implementation of these recommendations in routine clinical practice.
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Affiliation(s)
- E Redondo
- Medicina de Familia, Grupo de Actividades Preventivas y Salud Pública SEMERGEN, Centro de Salud Internacional, Ayuntamiento de Madrid, Madrid, España.
| | - I Rivero-Calle
- Servicio de Pediatría, Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, España; Genética Vacunas e Infecciones Pediátricas (GENVIP), Instituto de Investigación de Santiago, Santiago de Compostela, A Coruña, España
| | - E Mascarós
- Medicina de Familia, Departamento de Salud Hospital la Fe, Consultorio Auxiliar Arquitecto Tolsá, Valencia, España
| | - J E Yuste
- Centro Nacional de Microbiología, Instituto de Salud Carlos III y CIBER de Enfermedades Respiratorias (CIBERES), Madrid, España
| | - M Fernández-Prada
- Unidad de Vacunas, Servicio Medicina Preventiva y Salud Pública, Hospital Vital Álvarez Buylla, Mieres, Asturias, España
| | - D Ocaña
- Medicina de Familia, Centro de Atención Primaria Algeciras-Norte, Algeciras, Cádiz, España
| | - I Jimeno
- Medicina de Familia, Centro de Salud Isla de Oza, Madrid, España
| | - A Gil
- Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, España
| | - J Molina
- Medicina de Familia, Centro de Atención Primaria Francia, Fuenlabrada, Madrid, España
| | - J L Díaz-Maroto
- Medicina de Familia, Centro de Atención Primaria de Guadalajara, Guadalajara, España
| | - M Linares
- Medicina de Familia, Microbiología clínica, Miembro del Grupo de Enfermedades Infecciosas de SEMERGEN. Fundación iO, España
| | - F Martinón-Torres
- Servicio de Pediatría, Sección de Pediatría Clínica, Infectológica y Traslacional, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, España; Genética Vacunas e Infecciones Pediátricas (GENVIP), Instituto de Investigación de Santiago, Santiago de Compostela, A Coruña, España
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Coto-Segura P, Fernández-Prada M, Mir-Bonafé M, García-García B, González-Iglesias I, Alonso-Penanes P, González-Guerrero M, Gutiérrez-Palacios A, Miranda-Martínez E, Martinón-Torres F. Vesiculobullous skin reactions induced by COVID-19 mRNA vaccine: report of four cases and review of the literature. Clin Exp Dermatol 2021; 47:141-143. [PMID: 34236711 PMCID: PMC8444733 DOI: 10.1111/ced.14835] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Affiliation(s)
- P Coto-Segura
- Dermatology Department, Hospital Alvarez Buylla, Mieres, Spain
| | - M Fernández-Prada
- Vaccines Unit, Preventive Medicine and Public Health Department, Hospital Alvarez Buylla, Mieres, Spain.,WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain
| | - M Mir-Bonafé
- Dermatology Department, Hospital Alvarez Buylla, Mieres, Spain
| | - B García-García
- Dermatology Department, Hospital Alvarez Buylla, Mieres, Spain
| | | | - P Alonso-Penanes
- Dermatology Department, Hospital Universitario de Cabueñes, Gijón, Spain
| | | | | | | | - F Martinón-Torres
- WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain.,Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario, Universidad de Santiago de Compostela (USC), Santiago de Compostela, Spain.,Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidad de Santiago de Compostela (USC), Santiago de Compostela, Spain
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Tornero-Molina J, Sánchez-Alonso F, Fernández-Prada M, Bris-Ochaita ML, Sifuentes-Giraldo A, Vidal-Fuentes J. Tele-Rheumatology during the COVID-19 pandemic. ACTA ACUST UNITED AC 2021; 18:157-163. [PMID: 34088655 PMCID: PMC8169323 DOI: 10.1016/j.reumae.2020.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/15/2020] [Indexed: 12/03/2022]
Abstract
Introduction During the Covid-19 pandemic strategies to prevent transmission of the viral infection obliged our hospital to promote virtual consultations. Objetive The objective of this study is to describe the results obtained with the previous strategy of transferring activity to teleconsultation during the period of maximum impact of the pandemic. Material and methods Between 16/03 and 10/05/2020 all successive consultations in our unit were performed in virtual rheumatology teleconference (RTC) format. The socio-demographic, geo-functional and clinical characteristics of all patients were collected; a numeric verbal scale (NVS) (where 0 = very dissatisfied to 10 = fully satisfied) was applied to assess the degree of satisfaction of the doctor/patient with the RTC. Results 469 TC were included. Most patients seen by RTC were women, mean age: 60,83 years. Only 16% had university education. The mean distance travelled for face-to face consultation is 33 Km with a mean total time of 2 h. Most individuals were diagnosed with osteoarthritis/soft tissue rheumatic diseases and/or osteoporosis; 21% had rheumatoid arthritis. The mean length of the TC was 9.64 min. We find more patient satisfaction with the TC when their level of education is higher (OR = 4.12); doctor satisfaction was higher when the individual was better able to manage the Internet (OR = 3.01). Conclusion It is possible to transfer rheumatological care activity to TC with a considerable degree of satisfaction for both the patient and the doctor.
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Affiliation(s)
- Jesús Tornero-Molina
- Servicio de Reumatología, Hospital Universitario General de Guadalajara, Guadalajara, Spain; Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá de Henares, Madrid, Spain.
| | | | - Manuel Fernández-Prada
- Servicio de Reumatología, Hospital Universitario General de Guadalajara, Guadalajara, Spain
| | | | | | - Javier Vidal-Fuentes
- Servicio de Reumatología, Hospital Universitario General de Guadalajara, Guadalajara, Spain
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Suárez-Ardura M, Coto-Segura P, Fernández-Prada M. [White dermographism as an atypical cutaneous manifestation of COVID-19]. Semergen 2021; 47:e55-e56. [PMID: 34020880 PMCID: PMC8078901 DOI: 10.1016/j.semerg.2021.04.004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 04/15/2021] [Indexed: 11/29/2022]
Affiliation(s)
- M Suárez-Ardura
- Área de Gestión Clínica Urgencias, Hospital Vital Álvarez Buylla, Mieres, Asturias, España
| | - P Coto-Segura
- Servicio de Dermatología, Hospital Vital Álvarez Buylla, Mieres, Asturias, España
| | - M Fernández-Prada
- Servicio de Medicina Preventiva y Salud Pública, Hospital Vital Álvarez Buylla, Mieres, Asturias, España.
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9
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Tornero-Molina J, Sánchez-Alonso F, Fernández-Prada M, Bris-Ochaita ML, Sifuentes-Giraldo A, Vidal-Fuentes J. Tele-Rheumatology During the COVID-19 Pandemic. Reumatol Clin (Engl Ed) 2020; 18:S1699-258X(20)30240-0. [PMID: 33214110 PMCID: PMC7598343 DOI: 10.1016/j.reuma.2020.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION During the COVID-19 pandemic strategies to prevent transmission of the viral infection obliged our hospital to promote virtual consultations. OBJETIVE The objective of this study is to describe the results obtained with the previous strategy of transferring activity to teleconsultation during the period of maximum impact of the pandemic. MATERIAL AND METHODS Between 16/03 and 10/05/2020 all successive consultations in our unit were performed in virtual rheumatology teleconference (RTC) format. The socio-demographic, geo-functional and clinical characteristics of all patients were collected; a numeric verbal scale (NVS) (where 0=very dissatisfied to 10=fully satisfied) was applied to assess the degree of satisfaction of the doctor/patient with the RTC. RESULTS 469 TC were included. Most patients seen by RTC were women, mean age: 60,83 years. Only 16% had university education. The mean distance travelled for face-to face consultation is 33 Km with a mean total time of 2hours. Most individuals were diagnosed with osteoarthritis/soft tissue rheumatic diseases and/or osteoporosis; 21% had rheumatoid arthritis. The mean length of the TC was 9.64minutes. We find more patient satisfaction with the TC when their level of education is higher (OR=4.12); doctor satisfaction was higher when the individual was better able to manage the Internet (OR=3.01). CONCLUSION It is possible to transfer rheumatological care activity to TC with a considerable degree of satisfaction for both the patient and the doctor.
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Affiliation(s)
- Jesús Tornero-Molina
- Servicio de Reumatología, Hospital Universitario General de Guadalajara , Guadalajara, España; Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá de Henares, Madrid, España.
| | | | - Manuel Fernández-Prada
- Servicio de Reumatología, Hospital Universitario General de Guadalajara , Guadalajara, España
| | | | | | - Javier Vidal-Fuentes
- Servicio de Reumatología, Hospital Universitario General de Guadalajara , Guadalajara, España
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Sánchez-Bilbao L, Martínez-López D, Revenga M, López-Vázquez Á, Valls-Pascual E, Atienza-Mateo B, Valls-Espinosa B, Maiz-Alonso O, Blanco A, Torre-Salaberri I, Rodríguez-Méndez V, García-Aparicio Á, Veroz-González R, Jovaní V, Peiteado D, Sánchez-Orgaz M, Tomero E, Toyos-Sáenz de Miera FJ, Pinillos V, Aurrecoechea E, Mora Á, Conesa A, Fernández-Prada M, Troyano JA, Calvo-Río V, Demetrio-Pablo R, González-Mazón Í, Hernández JL, Castañeda S, González-Gay MÁ, Blanco R. Anti-IL-6 Receptor Tocilizumab in Refractory Graves' Orbitopathy: National Multicenter Observational Study of 48 Patients. J Clin Med 2020; 9:jcm9092816. [PMID: 32878150 PMCID: PMC7563792 DOI: 10.3390/jcm9092816] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 06/21/2020] [Revised: 08/18/2020] [Accepted: 08/29/2020] [Indexed: 12/14/2022] Open
Abstract
Graves' orbitopathy (GO) is the most common extrathyroidal manifestation of Graves' disease (GD). Our aim was to assess the efficacy and safety of Tocilizumab (TCZ) in GO refractory to conventional therapy. This was an open-label multicenter study of glucocorticoid-resistant GO treated with TCZ. The main outcomes were the best-corrected visual acuity (BVCA), Clinical Activity Score (CAS) and intraocular pressure (IOP). These outcome variables were assessed at baseline, 1st, 3rd, 6th and 12th month after TCZ therapy onset. The severity of GO was assessed according to the European Group on Graves' Orbitopathy (EUGOGO). We studied 48 (38 women and 10 men) patients (95 eyes); mean age ± standard deviation 51 ± 11.8 years. Before TCZ and besides oral glucocorticoids, they had received IV methylprednisolone (n = 43), or selenium (n = 11). GO disease was moderate (n =29) or severe (n = 19) and dysthyroid optic neuropathy (DON) (n = 7). TCZ was used in monotherapy (n = 45) or combined (n = 3) at a dose of 8 mg/kg IV every four weeks (n = 43) or 162 mg/s.c. every week (n = 5). TCZ yielded a significant improvement in all of the main outcomes at the 1st month that was maintained at one year. Comparing the baseline with data at 1 year all of the variables improved; BCVA (0.78 ± 0.25 vs. 0.9 ± 0.16; p = 0.0001), CAS (4.64 ± 1.5 vs. 1.05 ± 1.27; p = 0.0001) and intraocular pressure (IOP) (19.05 ± 4.1 vs. 16.73 ± 3.4 mmHg; p = 0.007). After a mean follow-up of 16.1 ± 2.1 months, low disease activity (CAS ≤ 3), was achieved in 88 eyes (92.6%) and TCZ was withdrawn in 29 cases due to low disease activity (n = 25) or inefficacy (n = 4). No serious adverse events were observed. In conclusion, TCZ is a useful and safe therapeutic option in refractory GO treatment.
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Affiliation(s)
- Lara Sánchez-Bilbao
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
| | - David Martínez-López
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
| | - Marcelino Revenga
- Rheumatology and Ophthalmology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.R.); (Á.L.-V.)
| | - Ángel López-Vázquez
- Rheumatology and Ophthalmology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.R.); (Á.L.-V.)
| | - Elia Valls-Pascual
- Rheumatology and Ophthalmology, Hospital Universitari Doctor Peset, 46017 Valencia, Spain; (E.V.-P.); (B.V.-E.)
| | - Belén Atienza-Mateo
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
| | - Beatriz Valls-Espinosa
- Rheumatology and Ophthalmology, Hospital Universitari Doctor Peset, 46017 Valencia, Spain; (E.V.-P.); (B.V.-E.)
| | - Olga Maiz-Alonso
- Rheumatology and Ophthalmology, Hospital Universitario de Donosti, 20014 San Sebastián, Spain; (O.M.-A.); (A.B.)
| | - Ana Blanco
- Rheumatology and Ophthalmology, Hospital Universitario de Donosti, 20014 San Sebastián, Spain; (O.M.-A.); (A.B.)
| | - Ignacio Torre-Salaberri
- Rheumatology and Ophthalmology, Hospital Universitario de Basurto, 48013 Bilbao, Spain; (I.T.-S.); (V.R.-M.)
| | - Verónica Rodríguez-Méndez
- Rheumatology and Ophthalmology, Hospital Universitario de Basurto, 48013 Bilbao, Spain; (I.T.-S.); (V.R.-M.)
| | | | | | - Vega Jovaní
- Rheumatology, Hospital General Universitario de Alicante, 03010 Alicante, Spain;
| | - Diana Peiteado
- Rheumatology and Ophthalmology, Hospital Universitario La Paz, 28046 Madrid, Spain; (D.P.); (M.S.-O.)
| | - Margarita Sánchez-Orgaz
- Rheumatology and Ophthalmology, Hospital Universitario La Paz, 28046 Madrid, Spain; (D.P.); (M.S.-O.)
| | - Eva Tomero
- Rheumatology, Hospital de La Princesa, IIS-Princesa, 28006 Madrid, Spain; (E.T.); (S.C.)
| | | | | | - Elena Aurrecoechea
- Rheumatology and Ophthalmology, Hospital Sierrallana, 39300 Torrelavega, Spain; (E.A.); (Á.M.)
| | - Ángel Mora
- Rheumatology and Ophthalmology, Hospital Sierrallana, 39300 Torrelavega, Spain; (E.A.); (Á.M.)
| | - Arantxa Conesa
- Rheumatology, Hospital Clínico Universitario de Valencia, 46018 Valencia, Spain;
| | | | - Juan A. Troyano
- Ophthalmology, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain;
| | - Vanesa Calvo-Río
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
| | - Rosalía Demetrio-Pablo
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
| | - Íñigo González-Mazón
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
| | - José L. Hernández
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
| | - Santos Castañeda
- Rheumatology, Hospital de La Princesa, IIS-Princesa, 28006 Madrid, Spain; (E.T.); (S.C.)
- Cátedra UAM-Roche, EPID-Future, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
| | - Miguel Á. González-Gay
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
- Correspondence: (M.Á.G.-G.); (R.B.)
| | - Ricardo Blanco
- Rheumatology, Ophthalmology and Internal Medicine, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, 39008 Santander, Spain; (L.S.-B.); (D.M.-L.); (B.A.-M.); (V.C.-R.); (R.D.-P.); (Í.G.-M.); (J.L.H.)
- Correspondence: (M.Á.G.-G.); (R.B.)
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11
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Moraga-Llop F, Fernández-Prada M, Grande-Tejada A, Martínez-Alcorta L, Moreno-Pérez D, Pérez-Martín J. Recovering vaccine coverage lost due to the COVID-19 pandemic. Vacunas (English Edition) 2020. [PMCID: PMC7572132 DOI: 10.1016/j.vacune.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The 2019 coronavirus disease pandemic can have an alarming impact on vaccination coverage. WHO, UNICEF and Gavi warn that at least 80 million children under the age of 1 are at risk of contracting diseases such as diphtheria, measles and polio due to the interruption of routine immunization and the temporary suspension of 93 campaigns of large-scale vaccination. In Spain, a new healthcare scenario, which prioritizes telematics over in person, fear of contagion by going to health centers, and recommendations for physical distance and restricted mobility, reduce attendance at primary care centers. Despite recommendations established by the health authorities, vaccination coverage has decreased in all Autonomous Communities between 5% and 60%, depending on the age and type of vaccine. School vaccinations have been suspended and only vaccination of pregnant women against tetanus, diphtheria and pertussis has been maintained. The decrease has been more evident for non gratuity vaccines: the first dose of meningococcal vaccine B has decreased by 68.4%in the Valencian Community, and Andalusia has observed a 39% decrease in the total doses of this vaccine and of 18% for that of rotavirus. The recovering of vaccinations should be planned, organized and carried out in the shortest possible time. This article discusses some aspects of the recovery of vaccination coverage for different groups: children, adolescents and adults, and patients at risk and in special situations.
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Moraga-Llop FA, Fernández-Prada M, Grande-Tejada AM, Martínez-Alcorta LI, Moreno-Pérez D, Pérez-Martín JJ. [Recovering lost vaccine coverage due to COVID-19 pandemic]. Vacunas 2020; 21:129-135. [PMID: 32837461 PMCID: PMC7334947 DOI: 10.1016/j.vacun.2020.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 12/15/2022]
Abstract
The 2019 coronavirus disease pandemic can have an alarming impact on vaccination coverage. WHO, UNICEF and Gavi warn that at least 80 million children under the age of 1 are at risk of contracting diseases such as diphtheria, measles and polio due to the interruption of routine immunization and the temporary suspension of 93 campaigns of large-scale vaccination.In Spain, a new healthcare scenario, which prioritizes telematics over in person, fear of contagion by going to health centers, and recommendations for physical distance and restricted mobility, reduce attendance at primary care centers. Despite recommendations established by the health authorities, vaccination coverage has decreased in all Autonomous Communities between 5% and 60%, depending on the age and type of vaccine. School vaccinations have been suspended and only vaccination of pregnant women against tetanus, diphtheria and pertussis has been maintained. The decrease has been more evident for non gratuity vaccines: the first dose of meningococcal vaccine B has decreased by 68.4% in the Valencian Community, and Andalusia has observed a 39% decrease in the total doses of this vaccine and of 18% for that of rotavirus.The recovering of vaccinations should be planned, organized and carried out in the shortest possible time.This article discusses some aspects of the recovery of vaccination coverage for different groups: children, adolescents and adults, and patients at risk and in special situations.
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Affiliation(s)
- F A Moraga-Llop
- Societat Catalana de Pediatria. Asociación Española de Vacunología, Barcelona, España
| | - M Fernández-Prada
- Servicio de Medicina Preventiva y Salud Pública, Hospital Vital Álvarez Buylla, Mieres, Asturias. Asociación Española de Vacunología, Oviedo, España
| | - A M Grande-Tejada
- Servicio de Pediatría, Hospital Materno-Infantil, Universidad de Extremadura. Asociación Española de Vacunología, Badajoz, España
| | - L I Martínez-Alcorta
- Servicio de Medicina Preventiva, Hospital Universitario Donostia. Asociación Española de Vacunología, San Sebastián, España
| | - D Moreno-Pérez
- Unidad de Infectología Pediátrica, Hospital Materno-Infantil de Málaga. Grupo IBIMA. RITIP. Universidad de Málaga. Plan de Vacunaciones de Andalucía, Consejería de Salud y Familias, Málaga, España
| | - J J Pérez-Martín
- Servicio de Salud Pública de Lorca, Consejería de Salud, Región de Murcia. Asociación Española de Vacunología, Murcia, España
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13
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Meca-Lallana J, Fernández-Prada M, García Vázquez E, Moreno Guillén S, Otero Romero S, Rus Hidalgo M, Villar Guimerans L, Eichau Madueño S, Fernández Fernández Ó, Izquierdo Ayuso G, Álvarez Cermeño J, Arnal García C, Arroyo González R, Brieva Ruiz L, Calles Hernández C, García Merino A, González Plata M, Hernández Pérez M, Moral Torres E, Olascoaga Urtaza J, Oliva-Nacarino P, Oreja-Guevara C, Ortiz Castillo R, Oterino A, Prieto González J, Ramió-Torrentá L, Rodríguez-Antigüedad A, Saiz A, Tintoré M, Montalbán Gairin X. Consensus statement on the use of alemtuzumab in daily clinical practice in Spain. Neurología (English Edition) 2020; 37:615-630. [DOI: 10.1016/j.nrleng.2019.11.001] [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: 09/27/2019] [Accepted: 11/04/2019] [Indexed: 10/24/2022] Open
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14
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Fernández-Prada M, Viejo-González A, Martínez-Torrón A, Martínez-Ortega C, Ruiz-Salazar J, Huerta-González I. [Vaccine-related adverse reactions in immunocompromised patients and in special situations of a hospital Vaccine Unit]. Rev Esp Quimioter 2019; 32:432-439. [PMID: 31558008 PMCID: PMC6790885] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/04/2019] [Accepted: 05/22/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of the study was to describe the type of vaccines administered in the Vaccine Unit at a reference hospital. Calculate the overall and specific reporting rate of adverse reactions. METHODS Retrospective observational study for the period between November 2014 and November 2017, on patients who developed an adverse drug reaction (ADR) after the administration of a vaccine and who were notified to the Spanish Pharmacovigilance System. The variables analyzed were age, sex, risk group, vaccine class, co-administration and type of ADR. A univariate and bivariate analysis was performed. The global and vaccine specific rate of ADR notification was calculated. RESULTS A total of 18,123 vaccines were administered, of which 20.7% corresponded to hepatitis B virus vaccine. Fifty-three RAM suspects were reported. In 64.2% of cases only one vaccine was administered. Inactivated vaccines accounted for 88.7% of notifications. The highest number of notifications was generated by the 23 serotypes pneumococcal polysaccharide vaccine. The overall reporting rate was 0.42%. The hexavalent vaccine had the highest reporting rate (2.81%). 49.1% of the ADR were systemic. CONCLUSIONS The overall reporting rate was low but higher than that of other authors. Proper reporting of possible adverse post-vaccine reactions is essential to contribute to vaccine safety and to increase public confidence in vaccines.
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Affiliation(s)
| | | | - A Martínez-Torrón
- Alba Martínez-Torrón. Servicio de Farmacia Hospitalaria. Hospital Universitario Marqués de Valdecilla. Avda. Valdecilla 25, 39008. Santander, Cantabria, Spain.
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15
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Gómez-Romero F, Fernández-Prada M, Fernández-Suárez F, Gutiérrez-González C, Estrada-Martínez M, Cachero-Martínez D, Suárez-Fernández S, García-González N, Picatto-Hernández M, Martínez-Ortega C, Navarro-Gracia J. Intra-operative temperature monitoring with two non-invasive devices (3M Spoton® and Dräger Tcore®) in comparison with the Swan-Ganz catheter. Cirugía Cardiovascular 2019. [DOI: 10.1016/j.circv.2019.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Fernández-Prada M, Brandy-García AM, Rodríguez-Fonseca OD, Álvarez-Argüelles ME, Melón-García S. [Post-vaccination varicella in a patient receiving methotrexate]. Rev Esp Quimioter 2017; 30:236-238. [PMID: 28422472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- M Fernández-Prada
- María Fernández-Prada. Unidad de Vacunas. Servicio de Medicina Preventiva y Salud Pública del Hospital Universitario Central de Asturias. Avda Roma s/n, 33011, Oviedo, Spain.
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González-Estrada A, Fernández-Prada M, Martínez Ortega C, Lana Pérez A, López González M. Cumplimiento de las precauciones de aislamiento de contacto por microorganismos multirresistentes en un hospital de tercer nivel. ACTA ACUST UNITED AC 2016; 31:293-9. [DOI: 10.1016/j.cali.2016.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/20/2015] [Accepted: 01/08/2016] [Indexed: 12/01/2022]
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Fernández-Prada M, Martínez Bellón M, Gutiérrez Costilla E, Rodríguez Expósito A, Linares Palomino J, Guillén Solvas J. Estrategia multimodal para la prevención de la infección relacionada con la asistencia sanitaria en el Servicio de Angiología y Cirugía Vascular. Angiología 2014. [DOI: 10.1016/j.angio.2014.02.011] [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: 10/25/2022]
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Fernández-Prada M, Cabrera Castro N, Almagro López D, Almagro Nievas D. ¿Qué hacer en urgencias ante una mordedura canina con sospecha de rabia? A propósito de un caso. An Pediatr (Barc) 2014; 80:e94-5. [DOI: 10.1016/j.anpedi.2013.08.002] [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: 06/26/2013] [Accepted: 08/01/2013] [Indexed: 10/26/2022] Open
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González-Cabrera J, Fernández-Prada M, Iribar-Ibabe C, Peinado JM. Acute and chronic stress increase salivary cortisol: a study in the real-life setting of a national examination undertaken by medical graduates. Stress 2014; 17:149-56. [PMID: 24351081 DOI: 10.3109/10253890.2013.876405] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Spanish medical graduates who apply for a medical specialty training position (MIR) must take an examination that will shape their future personal and professional lives. Preparation for the test represents an important stressor that persists for several months. The aim of this study was to elucidate the stress pattern of this group and evaluate possible changes in the circadian rhythm of cortisol release in medical graduates preparing for this test. A repeated-measures longitudinal study was performed, measuring the salivary cortisol concentrations in 36 medical graduates (13 males and 23 females; mean age of 24.2 years) on five sampling days. Five cortisol samples were collected from 07:00 to 21:00 h in order to monitor changes in the circadian rhythm. On all sampling days (except on the day of the official examination), anxiety and psychological stress were evaluated with the Spanish versions of the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS). During the study period, participants showed higher levels of anxiety than the Spanish reference population as well as a progressive increase in self-perceived stress. A significant increase in salivary cortisol concentration was observed in both chronic (study and examination preparation) and acute (examinations) situations. Our results suggest that the cortisol awakening response (CAR) may be a good indicator of anticipatory stress but is unaffected by long-term examination preparation. Comparison of results between the official examination day and the mock examination days yielded evidence that learning may modulate the behavior of the hypothalamic-pituitary-adrenal axis.
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Affiliation(s)
- J González-Cabrera
- Faculty of Education, International University of Rioja (UNIR) , Logroño , Spain
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Fernández-Prada M, Martínez-Diz S, Colina López A, Almagro Nievas D, Martínez Romero B, Huertas Martínez J. [Scarlet fever outbreak in a public school in Granada in 2012]. An Pediatr (Barc) 2013; 80:249-53. [PMID: 23831204 DOI: 10.1016/j.anpedi.2013.05.020] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/17/2013] [Accepted: 05/21/2013] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Scarlet fever is a streptococcal disease characterized by a skin rash in children. It can be endemic, epidemic or sporadic. In April 2012, the headmaster of a primary school in Granada reported an outbreak of scarlet fever in the school. OBJECTIVE To describe an outbreak of scarlet fever, analyse its epidemiological and clinical characteristics, and present the preventive measures taken to control it. PATIENTS AND METHODS A case-control study was conducted using an ad hoc questionnaire, developed for this purpose. The R program, Epidat 3.1 and Microsoft Excel were used for the statistics analysis. RESULTS There were 13 cases and 30 controls. The attack rate was 3.9%. There was a statistically significant difference for the variable "relative affected". CONCLUSION There has been a confirmed outbreak of person-to-person transmitted scarlet fever, and the main risk factor was having a relative with tonsillitis.
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Affiliation(s)
- M Fernández-Prada
- Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario San Cecilio, Granada, España.
| | - S Martínez-Diz
- Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen de las Nieves, Granada, España
| | - A Colina López
- Unidad de Gestión Clínica, Churriana de la Vega, Granada, España
| | - D Almagro Nievas
- Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Distrito Sanitario Granada-Metropolitano, Granada, España
| | - B Martínez Romero
- Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen de las Nieves, Granada, España
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Richi P, Balsa A, Muñoz-Fernández S, Villaverde V, Fernández-Prada M, Vicario JL, Martín-Mola E. Factors related to radiological damage in 61 Spaniards with early rheumatoid arthritis. Ann Rheum Dis 2002; 61:270-2. [PMID: 11830438 PMCID: PMC1754021 DOI: 10.1136/ard.61.3.270] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether the presence of radiographic erosions at disease onset in patients with early rheumatoid arthritis (RA) is associated with clinical, serological, or genetic factors of poor outcome and whether patients with erosions only in the feet have a different pattern of presentation. METHODS Sixty one patients with early RA (<6 months of evolution) were studied. Clinical evaluation and serological, radiological, and genetic studies were performed at disease onset and after one year. RESULTS Forty one (67%) patients showed erosions in their hands or in their feet, or in both. Subjects with erosive RA had a higher number of swollen joints (SJN; 9 (SD 6) v. 6 (3), p=0.008), and rheumatoid factor (RF) positivity was more common (80% v. 50%, p<0.02) than those without erosions. Seven (17%) of the 41 patients in the group with erosions had erosions only in their feet. This group had a longer duration of morning stiffness (120 (60) v. 72 (52) min, p<0.005), better patient's global assessment of general health (34 (22) v. 57 (25), p< 0.05), and lower erythrocyte sedimentation rate (32 (22) v. 60 (30) mm/1st h, p <0.05) than the rest of the subjects with erosions, and none of them was in remission after one year. Remission after one year was related to a lack of cortical damage at onset and RF negativity. CONCLUSIONS Radiological damage at disease onset is associated with a worse clinical presentation and RF positivity, which are markers of poor outcome. There is a subgroup of patients, with erosions only in their feet, whose clinical presentation is less aggressive. To identify these cases of early erosive RA, radiographs of the feet should be obtained routinely.
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Affiliation(s)
- P Richi
- Rheumatology Unit, La Paz Hospital, Madrid, Spain Transfusions Centre Comunidad Autónoma de Madrid, Spain.
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Villaverde V, Balsa A, Cantalejo M, Fernández-Prada M, Madero MR, Muñoz-Fernández S, Gijón-Baños J, Martín-Mola E. Activity indices in rheumatoid arthritis. J Rheumatol 2000; 27:2576-81. [PMID: 11093436] [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: 02/18/2023]
Abstract
OBJECTIVE To determine which activity indices better correlate with assessor's (AGA) and patient's (PGA) global assessment of disease activity and to compare the improvement with American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) criteria and their association with PGA and AGA of overall improvement. METHODS Seventy-five patients with rheumatoid arthritis (RA) were studied. Swollen and tender joints, morning stiffness, grip strength, pain, AGA, PGA, Health Assessment Questionnaire (HAQ) score, erythrocyte sedimentation rate (ESR), C-reactive protein (CPR), and hemoglobin were determined before and 6 months after treatment. Several activity indices were calculated: Disease Activity Score (DAS), DAS 3, DAS 28, DAS '28,' ACR > or = 20%, Mallya, Riel, IDA, and a modification of the Stoke index. RESULTS All indices correlated with PGA and AGA before and after treatment (r > 0.38, p < 0.01), but better results were obtained with AGA than PGA. DAS, DAS 3, DAS 28, and modified Stoke had the best correlation with AGA (r > or = 0.77, p < 0.01). The indices that better detected the differences after treatment for AGA were DAS, DAS 3, DAS 28, and modified Stoke (r > or = -0.42, p < 0.01). The level of agreement between EULAR and ACR improvement classifications with both reduced and extensive joint counts was comparable and its association with PGA and AGA overall improvement was significant (p < 0.01). CONCLUSION All activity indices correlated with PGA and AGA, although the best results were obtained with AGA. Although indices' correlations were similar, the DAS group and the modified Stoke seemed to be the most useful indices to measure disease activity in RA. The discriminating potential between ACR and EULAR improvement classification was comparable, as was the association with PGA and AGA overall improvement.
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Affiliation(s)
- V Villaverde
- Rheumatology Unit, Hospital Universitario La Paz, Madrid, Spain
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Villaverde V, Balsa A, Cabezas JA, Fernández-Prada M, Torre A, Mola EM. Normotensive renal failure in a patient with systemic sclerosis and p-antineutrophil cytoplasmic autoantibodies which developed into Paget's disease of bone after immunosuppressive therapy. Rheumatology (Oxford) 1999; 38:190-1. [PMID: 10342639 DOI: 10.1093/rheumatology/38.2.190] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fernández-Prada M, Richi Alberti P, Martín-Mola E. Clinical remission in rheumatoid arthritis: efficacy of a second course of intra-muscular gold. Clin Exp Rheumatol 1998; 16:512. [PMID: 9706444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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