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Blanco JF, Caballero E, Briz D, Gómez S, Martín MD, Pablos C, González Ramírez A, da Casa C. [Ligamentum flavum hematoma: A rare cause of cauda equina syndrome in older old patient: a case report]. Rev Esp Geriatr Gerontol 2024; 59:101435. [PMID: 37983983 DOI: 10.1016/j.regg.2023.101435] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Juan F Blanco
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario de Salamanca, Salamanca, España.
| | - Eugenia Caballero
- Servicio de Hematología. Hospital Universitario de Salamanca, Salamanca, España
| | - David Briz
- Área de Enfermedades Infecciosas, Inflamatorias y Metabólicas. Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España
| | - Sonia Gómez
- Área de Enfermedades Infecciosas, Inflamatorias y Metabólicas. Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España
| | - María Dolores Martín
- Facultad de Ciencias de la Salud, Universidad Pontificia de Salamanca, Salamanca, España
| | - Carmen Pablos
- Servicio de Ortogeriatría. Hospital Universitario de Salamanca, Salamanca, España
| | | | - Carmen da Casa
- Facultad de Ciencias de la Salud, Universidad Pontificia de Salamanca, Salamanca, España
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2
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Fernández-Vigo JI, Contreras I, Crespo MJ, Beckford C, Flores-Moreno I, Cobo-Soriano R, Pareja J, Martín MD, Moreno L, Arrevola-Velasco L. Expert Panel Consensus for Addressing Anti-VEGF Treatment Challenges of Diabetic Macular Edema in Spain. Clin Ophthalmol 2022; 16:3097-3106. [PMID: 36164581 PMCID: PMC9507974 DOI: 10.2147/opth.s374763] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The treatment of diabetic macular edema (DME) has evolved rapidly in the past decade, highlighting the need to address the challenges of routine clinical practice decision-making through expert consensus agreements. Methods After a literature review and discussion of real-world experience on DME management, a group of ten retina specialists agreed on a consensus of recommendations for the most appropriate management of DME patients using vascular endothelial growth factor inhibitors (anti-VEGF) in Spain. Results The panel recommended early treatment initiation in DME patients with worse baseline visual acuity (VA) to maintain or improve outcome. For patients with good VA, an observation strategy was recommended, considering the presence of diabetic retinopathy, optical coherence tomography biomarkers, and impact on patient's quality of life. Based on the available evidence and clinical experience, the panel recommended the use of anti-VEGF intensive loading doses with the objective of achieving anatomic and visual responses as soon as possible, followed by a Treat & Extend (T&E) strategy to maintain VA improvement. Aflibercept was recommended for patients with a baseline decimal VA <0.5, followed by a T&E strategy, including the possibility to extend frequency of injections up to 16 weeks. Conclusion An expert panel proposes a consensus for the management of DME in Spain. Early treatment initiation with anti-VEGF in DME patients is recommended to maintain or improve VA; aflibercept is recommended for patients with a poor baseline VA.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Deparment of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Inés Contreras
- Deparment of Ophthalmology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS) and Clínica Rementería, Madrid, Spain
| | - María José Crespo
- Department of Ophthalmology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Carlos Beckford
- Department of Ophthalmology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | - Rosario Cobo-Soriano
- Department of Ophthalmology, Hospital Universitario Henares, Universidad Francisco de Vitoria, Madrid, Spain
| | - Jesús Pareja
- Department of Ophthalmology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Luis Moreno
- Department of Ophthalmology, Hospital 12 de Octubre, Madrid, Spain
| | - Luis Arrevola-Velasco
- Department of Ophthalmology, Clinica Baviera Instituto Oftalmológico Europeo, Madrid, Spain
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3
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Richi P, Yuste J, Navío T, González-Hombrado L, Salido M, Thuissard-Vasallo I, Jiménez-Díaz A, Llorente J, Cebrián L, Lojo L, Steiner M, Cobo T, Martín MD, García-Castro M, Castro P, Muñoz-Fernández S. Impact of Biological Therapies on the Immune Response after Pneumococcal Vaccination in Patients with Autoimmune Inflammatory Diseases. Vaccines (Basel) 2021; 9:vaccines9030203. [PMID: 33671007 PMCID: PMC7997274 DOI: 10.3390/vaccines9030203] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Patients with different autoimmune inflammatory diseases (AIID) on biological therapy are at risk of pneumococcal disease. Adults with inflammatory arthropathies, connective tissue diseases, psoriasis, or inflammatory bowel disease on biological therapy such as anti-TNFα, rituximab, tocilizumab, abatacept, or anakinra were included in this study. Patients completed a protocol combining the pneumococcal vaccines PCV13 and PPV23. Immune response against pneumococcal serotypes 1, 3, 7F, 14, 19A, and 19F were assessed evaluating functional antibodies by an opsonophagocytosis killing assay (OPKA). In this study, 182 patients with AIID completed the sequential vaccination protocol. Patients on etanercept tended to achieve OPKA titers against a larger number of serotypes than the rest of patients on other biological therapies, while adalimumab was associated to a lower number of serotypes with OPKA titers. Rituximab was not associated with a worse response when compared with the rest of biological agents. Not glucocorticoids, nor synthetic disease-modifying antirheumatic drugs, interfered with the immune response. OPKA titers against serotype 3 which is one of the most prevalent, was obtained in 44% of patients, increasing up to 58% in those on etanercept. Hence, almost 50% of patients on biological therapy achieved functional antibodies after the administration of a complete pneumococcal vaccination protocol.
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Affiliation(s)
- Patricia Richi
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
- School of Medicine, Universidad Europea, 28670 Madrid, Spain
- Correspondence: (P.R.); (J.Y.)
| | - Jose Yuste
- Spanish Pneumococcal Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, 28220 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (P.R.); (J.Y.)
| | - Teresa Navío
- Rheumatology Unit, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (T.N.); (L.C.); (L.L.)
| | | | - Marina Salido
- Rheumatology Unit, Hospital Universitario Infanta Cristina, Parla, 28981 Madrid, Spain; (M.S.); (P.C.)
| | | | - Ana Jiménez-Díaz
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
| | - Jesús Llorente
- Pharmacy Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, 28702 Madrid, Spain;
| | - Laura Cebrián
- Rheumatology Unit, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (T.N.); (L.C.); (L.L.)
| | - Leticia Lojo
- Rheumatology Unit, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (T.N.); (L.C.); (L.L.)
| | - Martina Steiner
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
- School of Medicine, Universidad Europea, 28670 Madrid, Spain
| | - Tatiana Cobo
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
- School of Medicine, Universidad Europea, 28670 Madrid, Spain
| | - María Dolores Martín
- BR Salud Laboratories, Bacteriology Department, San Sebastián de los Reyes, 28702 Madrid, Spain;
| | - Marta García-Castro
- Rheumatology Unit, Hospital del Tajo, Aranjuez, 28300 Madrid, Spain; (L.G.-H.); (M.G.-C.)
| | - Patricia Castro
- Rheumatology Unit, Hospital Universitario Infanta Cristina, Parla, 28981 Madrid, Spain; (M.S.); (P.C.)
| | - Santiago Muñoz-Fernández
- Rheumatology Unit, Hospital Universitario Infanta Sofía San Sebastián de los Reyes, 28702 Madrid, Spain; (A.J.-D.); (M.S.); (T.C.); (S.M.-F.)
- School of Medicine, Universidad Europea, 28670 Madrid, Spain
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4
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Beierlein J, Rozas E, Egorov OA, Klaas M, Yulin A, Suchomel H, Harder TH, Emmerling M, Martín MD, Shelykh IA, Schneider C, Peschel U, Viña L, Höfling S, Klembt S. Propagative Oscillations in Codirectional Polariton Waveguide Couplers. Phys Rev Lett 2021; 126:075302. [PMID: 33666454 DOI: 10.1103/physrevlett.126.075302] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 01/08/2021] [Indexed: 05/25/2023]
Abstract
We report on novel exciton-polariton routing devices created to study and purposely guide light-matter particles in their condensate phase. In a codirectional coupling device, two waveguides are connected by a partially etched section that facilitates tunable coupling of the adjacent channels. This evanescent coupling of the two macroscopic wave functions in each waveguide reveals itself in real space oscillations of the condensate. This Josephson-like oscillation has only been observed in coupled polariton traps so far. Here, we report on a similar coupling behavior in a controllable, propagative waveguide-based design. By controlling the gap width, channel length, or propagation energy, the exit port of the polariton flow can be chosen. This codirectional polariton device is a passive and scalable coupler element that can serve in compact, next generation logic architectures.
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Affiliation(s)
- J Beierlein
- Technische Physik, Wilhelm-Conrad-Röntgen Research Center for Complex Material Systems, and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany
| | - E Rozas
- Departamento de Física de Materiales, Instituto Nicolás Cabrera, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - O A Egorov
- Institute of Condensed Matter Theory and Optics, Friedrich-Schiller-Universität Jena, Max-Wien-Platz 1, D-07743 Jena, Germany
| | - M Klaas
- Technische Physik, Wilhelm-Conrad-Röntgen Research Center for Complex Material Systems, and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany
| | - A Yulin
- Faculty of Physics and Engineering, ITMO University, Saint Petersburg 197101, Russia
| | - H Suchomel
- Technische Physik, Wilhelm-Conrad-Röntgen Research Center for Complex Material Systems, and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany
| | - T H Harder
- Technische Physik, Wilhelm-Conrad-Röntgen Research Center for Complex Material Systems, and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany
| | - M Emmerling
- Technische Physik, Wilhelm-Conrad-Röntgen Research Center for Complex Material Systems, and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany
| | - M D Martín
- Departamento de Física de Materiales, Instituto Nicolás Cabrera, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - I A Shelykh
- Faculty of Physics and Engineering, ITMO University, Saint Petersburg 197101, Russia
- Science Institute, University of Iceland, IS-107 Reykjavik, Iceland
| | - C Schneider
- Technische Physik, Wilhelm-Conrad-Röntgen Research Center for Complex Material Systems, and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany
- Institute of Physics, University of Oldenburg, D-26129 Oldenburg, Germany
| | - U Peschel
- Institute of Condensed Matter Theory and Optics, Friedrich-Schiller-Universität Jena, Max-Wien-Platz 1, D-07743 Jena, Germany
| | - L Viña
- Departamento de Física de Materiales, Instituto Nicolás Cabrera, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física de la Materia Condensada, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - S Höfling
- Technische Physik, Wilhelm-Conrad-Röntgen Research Center for Complex Material Systems, and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany
- SUPA, School of Physics and Astronomy, University of St Andrews, St Andrews KY16 9SS, United Kingdom
| | - S Klembt
- Technische Physik, Wilhelm-Conrad-Röntgen Research Center for Complex Material Systems, and Würzburg-Dresden Cluster of Excellence ct.qmat, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany
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5
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Richi P, Martín MD, Andreu-Vázquez C, Jiménez-Diaz A, Steiner M, Muñoz-Fernández S. Serological response to influenza vaccine in patients with autoimmune inflammatory diseases: Results of RIER study. Med Clin (Barc) 2020; 156:118-122. [PMID: 32571618 DOI: 10.1016/j.medcli.2020.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/24/2020] [Accepted: 04/02/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Influenza vaccine is recommended for patients with autoimmune inflammatory diseases (AIID) on biological therapy. OBJECTIVE To evaluate whether serological response to Influenza vaccine obtained in patients on biological therapy is similar to that achieved in patients on synthetic disease-modifying anti-rheumatic drugs (DMARDs) and that obtained in healthy controls. METHODS We designed a cohort study in which patients with AIID, 68 on biological therapy and 46 on synthetic DMARDs, as well as 48 healthy controls, were included and vaccinated during the 2015-2016 influenza season. ELISA was used to measure Influenza antigen (Ag) A and B antibodies, before and after vaccination. RESULTS After vaccination, 88.24% of patients on biologics, 71.74% of those on synthetic DMARDs and 89.58% of healthy controls, presented detectable antibodies against antigen A, while 42.65% of subjects on biologics, 41.30% of those on DMARDs and 54.17% of healthy subjects were seropositive against Ag B. We did not find statistical differences. CONCLUSIONS In our study, biological therapy is not associated with worse serological response.
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Affiliation(s)
- Patricia Richi
- Servicio de Reumatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España; Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España.
| | - María Dolores Martín
- Departamento de Bacteriología, BR Salud Laboratorios, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Cristina Andreu-Vázquez
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| | - Ana Jiménez-Diaz
- Servicio de Reumatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
| | - Martina Steiner
- Servicio de Reumatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España; Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| | - Santiago Muñoz-Fernández
- Servicio de Reumatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España; Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
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6
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Richi P, Alonso O, Martín MD, González-Hombrado L, Navío T, Salido M, Llorente J, Andreu-Vázquez C, García-Fernández C, Jiménez-Diaz A, Lojo L, Cebrián L, Thuissard-Vasallo I, Martínez de Aramayona MJ, Cobo T, García-Castro M, Castro P, Fernández-Castro M, Illera Ó, Steiner M, Muñoz-Fernández S. Evaluation of the immune response to hepatitis B vaccine in patients on biological therapy: results of the RIER cohort study. Clin Rheumatol 2020; 39:2751-2756. [PMID: 32248433 DOI: 10.1007/s10067-020-05042-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/12/2020] [Accepted: 03/10/2020] [Indexed: 01/01/2023]
Abstract
To evaluate the response to hepatitis B virus (HBV) vaccine in patients on biological therapy. Adults with autoimmune inflammatory diseases on biological therapy such as anti-TNFα, rituximab, tocilizumab, abatacept, or anakinra were included. Hepatitis B surface antibody (anti-HBs) was measured by ELISA before and after vaccination. Seroconversion was considered when an anti-HBs titer > 10 mIU/mL was achieved. The effect of treatment on the immunoprotective state was studied. The response was compared with that obtained in patients on synthetic disease modifying anti-rheumatic drugs (DMARDs) and healthy controls. A total of 187 patients on biologicals, 48 on synthetic DMARDs, and 49 on healthy controls were analyzed. More than 80% of patients on biologics responded to the vaccine but required more boosters and second vaccine series. Patients who achieved seroconversion were younger than those who did not (47.10 ± 12.99 vs. 53.18 ± 10.54 years, p = 0.012). Being on etanercept or golimumab was associated with seroconversion, while being on rituximab was not. Seroconversion was achieved in 93.75% of patients on synthetic DMARDs and 97.96% of healthy controls. The seroconversion rate in the biologics group was lower than in the synthetic DMARD group (p = 0.043) and tended to be lower than in the healthy group (p = 0.056). In patients on biological therapy, a high rate of HBV vaccine response can be achieved when a complete vaccination schedule is administered. Vaccination while not on biological agents reduces the requirement for boosters and revaccination. Key points: • Patients on biological therapy can achieve high rates of immune response to HBV vaccine when complete vaccination schedules are administered. • However, to achieve such a high seroconversion rate, more boosters and second vaccination series are required. • This supports the proposal already made to provide HBV vaccination to all patients with an autoimmune inflammatory disease after the diagnosis is made and not when the use of a biological treatment is under consideration.
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Affiliation(s)
- Patricia Richi
- Rheumatology Unit, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain. .,Faculty of Biomedical and Health Sciences. Department of Medicine, Universidad Europea de Madrid, Madrid, Spain.
| | - Oriol Alonso
- Internal Medicine Service, Hospital Comarcal Sant Jaume de Calella, Calella, Barcelona, Spain
| | - María Dolores Martín
- Bacteriology Department, BR Salud Laboratories, San Sebastián de los Reyes, Madrid, Spain
| | | | - Teresa Navío
- Rheumatology Unit, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Marina Salido
- Rheumatology Unit, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
| | - Jesús Llorente
- Pharmacy Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Cristina Andreu-Vázquez
- Faculty of Biomedical and Health Sciences. Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - Cristina García-Fernández
- Preventive Medicine Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Ana Jiménez-Diaz
- Rheumatology Unit, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Leticia Lojo
- Rheumatology Unit, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Laura Cebrián
- Rheumatology Unit, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Israel Thuissard-Vasallo
- Faculty of Biomedical and Health Sciences. Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | | | - Tatiana Cobo
- Rheumatology Unit, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.,Faculty of Biomedical and Health Sciences. Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | | | - Patricia Castro
- Rheumatology Unit, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
| | | | - Óscar Illera
- Rheumatology Unit, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.,Faculty of Biomedical and Health Sciences. Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - Martina Steiner
- Rheumatology Unit, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.,Faculty of Biomedical and Health Sciences. Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - Santiago Muñoz-Fernández
- Rheumatology Unit, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.,Faculty of Biomedical and Health Sciences. Department of Medicine, Universidad Europea de Madrid, Madrid, Spain
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Richi P, Martín MD, de Ory F, Gutiérrez-Larraya R, Casas I, Jiménez-Díaz AM, Cava F, Muñoz-Fernandez S. Secukinumab does not impair the immunogenic response to the influenza vaccine in patients. RMD Open 2019; 5:e001018. [PMID: 31565246 PMCID: PMC6744077 DOI: 10.1136/rmdopen-2019-001018] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/21/2019] [Accepted: 08/17/2019] [Indexed: 01/01/2023] Open
Abstract
Objective To evaluate whether immunological response to influenza vaccination is impaired in patients who are receiving secukinumab. Patients and methods Subjects suffering from psoriatic arthritis or ankylosing spondylitis who were receiving treatment with secukinumab and healthy volunteers were included. All participants received seasonal inactivated trivalent influenza vaccine recommended by the WHO in the 2017–2018 northern hemisphere influenza season, which contained an A/Michigan/45/2015 (H1N1)pdm09-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus and a B/Brisbane/60/2008-like virus. Haemagglutination inhibition was used to evaluate basal antibody (Ab) titres against the three influenza vaccine virus strains just before vaccination and at least 4 weeks after the vaccine administration. Response to vaccine was considered as >4-fold increases in Ab titre. Results Thirty subjects, 17 patients and 13 healthy controls, with a follow-up duration of 33±8 days, were analysed. There were no demographic differences between groups. Patients and controls achieved a median of 4.6-fold and 4.0-fold increases, respectively, for anti H1N1 and almost 4.0 (3.7) for patients and 5.3 for controls for anti-B Ab. Both groups presented a poor response against H3N2, with <1.5-fold increase. Seroconversion rates were similar in both groups. Secukinumab did not influence the response to the influenza vaccine (relative risk: 1.09 (95% CI 0.58 to 2.07) for H1N1, RR: 1.53 (95% CI 0.15 to 15.0) for H3N2 and RR: 0.72 (95% CI 0.32 to 1.83) for B strain). Conclusion In our study, secukinumab has no effect on the immunogenic response to the influenza vaccine.
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Affiliation(s)
- Patricia Richi
- Rheumatology Department, Infanta Sofía University Hospital, San Sebastian de los Reyes, Spain.,School of Medicine, European University of Madrid, Madrid, Spain
| | - María Dolores Martín
- Bactereology Department, BR Salud Laboratories, San Sebastian de los Reyes, Spain
| | - Fernando de Ory
- National Microbiology Centre, CIBER-ESP, Instituto de Salud Carlos III, Majadahonda, Spain
| | | | - Inmaculada Casas
- National Microbiology Centre, Instituto de Salud Carlos III Campus de Majadahonda, Majadahonda, Spain
| | - Ana María Jiménez-Díaz
- Rheumatology Department, Infanta Sofía University Hospital, San Sebastian de los Reyes, Spain
| | - Fernando Cava
- BR Salud Laboratories, San Sebastian de los Reyes, Spain
| | - Santiago Muñoz-Fernandez
- Rheumatology Department, Infanta Sofía University Hospital, San Sebastian de los Reyes, Spain.,School of Medicine, European University of Madrid, Madrid, Spain
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8
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Richi P, Martín MD, Navío MT, González-Hombrado L, Salido M, Llorente J, Thuissard-Vasallo I, Alcocer P, Saa-Requejo CM, Jiménez-Diaz A, Cebrián L, Lojo L, García-Castro M, Sanz-Rosa D, Castro P, Fernández-Rodríguez S, Martínez de Aramayona MJ, Steiner M, Cobo T, García-Fernández C, Fernández-Castro M, Illera Ó, Valverde R, Muñoz-Fernández S. Antibody responses to influenza vaccine in patients on biological therapy: Results of RIER cohort study. Med Clin (Barc) 2019; 153:380-386. [PMID: 31060878 DOI: 10.1016/j.medcli.2019.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/27/2018] [Revised: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND OBJECTIVES Influenza vaccine is recommended for patients with autoimmune inflammatory rheumatic diseases who receive biological therapy. To evaluate if biological therapy impairs immunization after seasonal influenza vaccine. MATERIAL AND METHODS Patients with inflammatory arthopathies, psoriasis, inflammatory bowel disease or connective tissue diseases who were receiving or were going to initiate biological therapy were included and vaccinated during 2014-2015 influenza season. ELISA was used to measure influenza antigen A and B antibodies, before and after vaccination. Demographic parameters, diagnosis and kind of treatment were recorded and their influence on the final serological status against influenza was studied. RESULTS 253 subjects were analyzed. After vaccination, 77% of participants presented detectable antibodies against antigen A and 50.6% of them had detectable antibodies against antigen B. Final seropositivity rate against antigen B antibodies increased from baseline (50.6% vs 43.5%, p<0.001). Anti-TNF drugs were associated with better response and rituximab with the worst (79.2% vs 55.0% for final seropositivity against antigen A, p=0.020). Vaccine response in the rituximab group tended to improve when the interval between the drug administration and the vaccination was at least 12 weeks (seropositivity rate 80.0% in those with the longer interval vs 25.0% in the other group, p=0.054). CONCLUSIONS Among the patients on biological therapy vaccinated against influenza, anti-TNF therapy was identified as a predictive factor of final seropositivity. Rituximab presented a lower rate of final seropositivity, which could be increased with an accurate administration schedule.
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Affiliation(s)
- Patricia Richi
- Rheumatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain.
| | - María Dolores Martín
- Bactereology Department, BR Salud Laboratories, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - María Teresa Navío
- Rheumatology Department, Infanta Leonor University Hospital, Gran Vía del Este 80, 28031 Madrid, Spain
| | - Laura González-Hombrado
- Rheumatology Department, Tajo University Hospital, Av. Amazonas Central s/n, Aranjuez, 28300 Madrid, Spain
| | - Marina Salido
- Rheumatology Department, Infanta Cristina University Hospital, Av 9 de Junio 2, Parla, 28981 Madrid, Spain
| | - Jesús Llorente
- Pharmacy Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Israel Thuissard-Vasallo
- School of Doctoral Studies & Research, Europea University, Calle Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Patricia Alcocer
- Rheumatology Department, HM Hospital, Avenida de Manoteras n° 10, 28050 Madrid, Spain
| | - Carmen María Saa-Requejo
- Preventive Medicine Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Ana Jiménez-Diaz
- Rheumatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Laura Cebrián
- Rheumatology Department, Infanta Leonor University Hospital, Gran Vía del Este 80, 28031 Madrid, Spain
| | - Leticia Lojo
- Rheumatology Department, Infanta Leonor University Hospital, Gran Vía del Este 80, 28031 Madrid, Spain
| | - Marta García-Castro
- Rheumatology Department, Tajo University Hospital, Av. Amazonas Central s/n, Aranjuez, 28300 Madrid, Spain
| | - David Sanz-Rosa
- School of Doctoral Studies & Research, Europea University, Calle Tajo s/n, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Patricia Castro
- Rheumatology Department, Infanta Cristina University Hospital, Av 9 de Junio 2, Parla, 28981 Madrid, Spain
| | - Sandra Fernández-Rodríguez
- Occupational Medicine Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - María José Martínez de Aramayona
- Occupational Medicine Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Martina Steiner
- Rheumatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Tatiana Cobo
- Rheumatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Cristina García-Fernández
- Preventive Medicine Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Mónica Fernández-Castro
- Rheumatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Óscar Illera
- Rheumatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Ricardo Valverde
- Dermatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
| | - Santiago Muñoz-Fernández
- Rheumatology Department, Infanta Sofía University Hospital, Paseo de Europa 34, San Sebastián de los Reyes, 28702 Madrid, Spain
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Olalla J, García de Lomas JM, Márquez E, González FJ, Del Arco A, De La Torre J, Prada JL, Cantudo F, Martín MD, Nieto M, Perez Stachowski J, García-Alegría J. Experience of Using an App in HIV Patients Older Than 60 Years: Pilot Program. JMIR Mhealth Uhealth 2019; 7:e9904. [PMID: 30839281 PMCID: PMC6425307 DOI: 10.2196/mhealth.9904] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/24/2018] [Accepted: 10/12/2018] [Indexed: 02/02/2023] Open
Abstract
Background New technologies can promote knowledge of HIV infection among patients suffering from this disease. Older patients with HIV infection represent an increasingly large group that could benefit from the use of specific apps. Objective The aim of the study was to observe the acceptability and use of a mobile app on HIV infection in patients at least 60 years old and offer them the possibility of anonymously establishing contact with their peers. Methods A series of clinical and psychosocial parameters were studied in 30 HIV-infected patients of over 60 years. The patients must be at least 60 years old, with a follow-up in the outpatient clinic for at least 1 year and without pathologies that limit his or her life expectancy to less than a year. They must know how to read and write. To be part of the group assigned to the app, they had to have their own smartphone and confirm that they were connected to the internet from that device. Overall, 15 of them were randomized to use an app and 15 were in the control group. All tests were repeated after 6 months. Results The median age of patients was 66.5 years. Among them, 29 patients had an undetectable viral load at baseline. The median number of comorbid diseases was 2. Overall, 11 of them lived with their partners and 19 lived alone. They spent an average of 5 hours a day sitting down, and 56% (17/30) of them referred high physical activity. They scored 4 out of 5 for general quality of life perception. Moreover, 80% (24/30) presented high adherence to their treatment, and the average number of concomitant medications was 5. In the 6-min walking test, they covered a distance of 400 meters, and 3 of them desaturated during the test. The 15 patients made frequent use of the app, with 2407 sessions and an average of 7 min and 56 seconds time of use with a total of 13,143 screen views. During the 6 months of the trial, 3 non-AIDS events took place. There were no significant modifications to body mass index, blood pressure measurements, lipid profile, or immuno-virology information data. There were no differences in the questionnaire scores for perception of quality of life, confessed physical activity, or antiretroviral treatment (ART) and non-ART treatment adherence. Conclusions Significant differences between studied parameters were not objectified in these patients, possibly because this trial has significant limitations, such as a small sample size and only a brief follow-up period. However, patients did use the app frequently, making this a possible intervention to be proposed in future subsequent studies.
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Affiliation(s)
- Julián Olalla
- Unidad de Medicina Interna Hospital Costa del Sol, Marbella, Spain
| | | | - Efrén Márquez
- Servicio de Farmacia, Hospital Costa del Sol, Marbella, Spain
| | | | - Alfonso Del Arco
- Unidad de Medicina Interna Hospital Costa del Sol, Marbella, Spain
| | | | - Jose Luis Prada
- Unidad de Medicina Interna Hospital Costa del Sol, Marbella, Spain
| | | | | | - Miriam Nieto
- Servicio de Farmacia, Hospital Costa del Sol, Marbella, Spain
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Peg V, Sansano I, Vieites B, Bernet L, Cano R, Córdoba A, Sancho M, Martín MD, Vilardell F, Cazorla A, Espinosa-Bravo M, Pérez-García JM, Cortés J, Rubio IT, Ramón y Cajal S. Role of total tumour load of sentinel lymph node on survival in early breast cancer patients. Breast 2017; 33:8-13. [DOI: 10.1016/j.breast.2017.02.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/18/2017] [Accepted: 02/20/2017] [Indexed: 10/20/2022] Open
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11
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Otheo E, Rodríguez M, Stanescu S, Coca A, Martín MD, González-Sainz J, Galán JC, Tagarro A. Hyponatremia Is an Inflammatory Marker in Children With Community-Acquired Pneumonia. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.951] [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: 11/14/2022] Open
Affiliation(s)
- Enrique Otheo
- Pediatrics, Universitary Hospital Ramón y Cajal, Madrid, Spain
| | - Mario Rodríguez
- Microbiology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | | | - Ana Coca
- Pediatric Intensive Care Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - María Dolores Martín
- Microbiology, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | | | - Juan Carlos Galán
- Microbiology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Alfredo Tagarro
- Pediatrics, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, San Sebastian de los Reyes, Madrid, Spain
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12
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Otheo E, Rodríguez M, Tagarro A, Vázquez C, Coca A, Martín MD, González-Sainz J, Galán JC, Moreno S. Low Co-infection Rate in Children With Community-Acquired Pneumonia in Spain. Open Forum Infect Dis 2016. [PMCID: PMC7117594 DOI: 10.1093/ofid/ofw172.942] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Enrique Otheo
- Pediatrics, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
| | - Mario Rodríguez
- Microbiology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Alfredo Tagarro
- Pediatrics, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, San Sebastian de los Reyes, Madrid, Spain
| | - Carmen Vázquez
- Pediatrics, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
| | - Ana Coca
- Pediatric Intensive Care Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - María Dolores Martín
- Microbiology, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | | | - Juan Carlos Galán
- Microbiology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Santiago Moreno
- Infectious Diseases, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
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13
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Díaz FJ, de la Peña E, Hernández V, López B, de La Morena JM, Martín MD, Jiménez-Valladolid I, Llorente C. Optimization of an early discharge program after laparoscopic radical prostatectomy. Actas Urol Esp 2014; 38:355-60. [PMID: 24529540 DOI: 10.1016/j.acuro.2013.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 11/14/2013] [Accepted: 12/14/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the safety of hospital discharge 24 hours after laparoscopic radical prostatectomy and to identify possible factors associated with longer hospital stays. MATERIAL AND METHODS Retrospective study of patients diagnosed with localized prostate cancer underwent to laparoscopic radical prostatectomy consecutively between May of 2007 and December of 2010. Those patients who met the following requirements were discharged in less than 24 hours: absence of complications, drainage debit minor than 50 cc, normal oral tolerance, no significant bladder haematuria and good functional recovery. Logistic regression analysis was conducted in order to assess the possible associated variables with longer hospital stays. RESULTS A total of 266 patients were analysed. The follow-up median was 34 months. Eighty patients (30.1%) were discharged in less than 24 hours. Average stay (SD) of all series was 2.9 days (3.08). Solely HTA, neurovascular bundles sparing and the development of lymphadenectomy were statistically significant between both groups in univariate analysis (discharge<24 hours vs. discharge>24 hours). In multivariate analysis, only HTA (OR=1.98 [CI 95%:1.13-3.47], P=.016) and lymphadenectomy performance (OR=2.56 [CI 95%:1.18-5.56] P=.017) were independent predictive variables of hospital stays longer than 24 hours. CONCLUSIONS Early hospital discharge of patients underwent to LRP is feasible and safe. In our series, the lymphadenectomy performance and the HTA were associated factors to longer hospital stay.
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Affiliation(s)
- F J Díaz
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España.
| | - E de la Peña
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - V Hernández
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - B López
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - J M de La Morena
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - M D Martín
- Servicio de Medicina Preventiva, Hospital Universitario Fundación Alcorcón, Madrid, España
| | | | - C Llorente
- Servicio de Urología, Hospital Universitario Fundación Alcorcón, Madrid, España
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14
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Herreros B, Ramnath VR, Bishop L, Pintor E, Martín MD, Sánchez-González MA. Clinical ethics protocols in the clinical ethics committees of Madrid. J Med Ethics 2014; 40:205-208. [PMID: 23579231 DOI: 10.1136/medethics-2012-100791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Currently, The nature and scope of Clinical Ethics Protocols (CEPs) in Madrid (Spain) are not well understood. OBJECTIVES The main objective is to describe the features of 'guideline/recommendation' type CEPs that have been or are being developed by existing Clinical Ethics Committees (CECs) in Madrid. Secondary objectives include characterisation of those CECs that have been the most prolific in reference to CEP creation and implementation and identification of any trends in future CEP development. METHODS We collected CEPs produced and in process by CECs accredited in the public hospitals in Madrid, Spain, from 1996 to 2008. RESULTS CECs developed 30 CEPs, with 10 more in process. The most common topic is refusal of treatment (seven CEPs developed; two in process). If CEPs addressing terminal illness, Do-Not-Resuscitate orders and advance directives are placed into a separate 'ethical problems at the end of life' category, this CEP subject emerges as the most common (eight developed; four in process). There is a relationship between the age of the CEC and the development of CEPs (the oldest CECs have developed more CEPs). CECs now seem to be more likely to engage in CEP development. CONCLUSIONS The CECs in Madrid, Spain, have developed a significant number of CEPs (30 in total and 10 in process) and there is a trend towards continued development. The most frequent topics are ethical problems at the end of life and refusal of treatment by the patient.
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Affiliation(s)
- Benjamin Herreros
- Department of Biomedical Sciences, European University of Madrid, , Villaviciosa de Odon, Madrid, Spain
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15
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Chaparro M, Zanotti C, Burgueño P, Vera I, Bermejo F, Marín-Jiménez I, Yela C, López P, Martín MD, Taxonera C, Botella B, Pajares R, Ponferrada A, Calvo M, Algaba A, Pérez L, Casis B, Maté J, Orofino J, Lara N, García-Losa M, Badia X, Gisbert JP. Health care costs of complex perianal fistula in Crohn's disease. Dig Dis Sci 2013; 58:3400-6. [PMID: 24026400 DOI: 10.1007/s10620-013-2830-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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] [Received: 02/25/2013] [Accepted: 07/27/2013] [Indexed: 12/13/2022]
Abstract
AIM To evaluate the use of health care resources and the associated costs of complex perianal Crohn's disease (CD) from the National Health System perspective. METHODS We conducted a multicenter, retrospective, observational study in which gastroenterologists from 11 hospitals in the Community of Madrid took part. Data was collected on the direct healthcare resources (pharmacological treatments, surgical procedures, laboratory/diagnostic tests, visits to specialists and emergency departments, and hospitalizations) consumed by 97 adult patients with complex perianal CD which was active at some point between January 1, 2005, and case history review. RESULTS We recorded 527 treatments: 73.1% pharmacological (32.3% antibiotic, 20.5% immunomodulator, 20.3% biological) and 26.9% surgical. Mean annual global cost was €8,289/patient, 75.3% (€6,242) of which was accounted for by pharmacological treatments (€13.44 antibiotics; €1,136 immunomodulators; €5,093 biological agents), 12.4% (€1,027) by hospitalizations and surgery, 7.7% (€640) by medical visits, 4.2% (€350) by laboratory/diagnostic tests, and 0.4% (€30) by emergency department visits. CONCLUSIONS Pharmacological therapies, and in particular biological agents, are the main cost driver in complex perianal CD; costs due to surgery and hospitalizations are much lower.
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Affiliation(s)
- M Chaparro
- Servicio de Aparato Digestivo del Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Playa de Mojácar 29. Urb Bonanza, 28669, Boadilla del Monte, Madrid, Spain,
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16
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Díaz FJ, Hernández V, de la Peña E, Blázquez C, Martín MD, Llorente C. Feasibility and safety of hospital discharge 24 hours after laparoscopic radical prostatectomy. ARCH ESP UROL 2013; 66:931-938. [PMID: 24369187] [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: 06/03/2023]
Abstract
OBJECTIVES Minimally invasive techniques for the surgical treatment of prostate cancer have aimed to achieve the same functional and oncological outcomes of open surgery with a significant decrease in postoperative morbidity and a subsequent decreasing hospital stay. These improvements are important in the current economic context. Our aim was to evaluate the feasibility and safety of hospital discharge 24 h after laparoscopic radical prostatectomy (LRP). METHODS A total of 266 consecutive patients with clinical diagnosis of localized prostate cancer consecutively treated with extraperitoneal LRP between May 2007 and December 2010 were analyzed. There were no exclusion criteria for the surgical procedure. Patients were discharged in less than 24 h only in the case of absence of medical complications, with drainage of less than 50 mL allowing its removal before discharge, normal oral feeding tolerance, no significant hematuria by bladder catheter and good functional recovery of the patient. All surgery-related complications that occurred within 90 days after surgery were recorded and were classified according to the modified Clavien scale. RESULTS A total of 266 patients who underwent LRP were studied with a median follow-up of 34 months. 80 (30.1%) patients were discharged from the hospital in less than 24h. 89 (33.4%) patients were discharged within 48 h and 97 (36.5%) after 48 h.The mean hospital stay of the entire case series was 2.9 days (SD 3.08). The mean hospital stay of patients who were discharged after 48 h was 5,5 days (SD 3.94) Thirty-one patients (10.7%). experienced post-surgical complications. 25 (9.31%). of them were classified as Clavien I or II, and 6 (2.2%). Clavien III or IV. A total of 9 (3.3%) patients were readmitted. Of the group of patients who were discharged within 24h only one was readmitted due to hematuria. CONCLUSIONS Extraperitoneal LRP is the standard treatment for localized prostate cancer in our institution. This treatment reliably and safely allows a hospital stay shorter than 24 h in a significant percentage of our patients.
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Affiliation(s)
- Francisco Javier Díaz
- Servicio de Urologia y Medicina preventiva. Hospital Universitario Fundacion Alcorcon.Madrid.Spain
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17
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Palacios AI, Rodríguez M, Martín MD. [Central serous chorioretinopathy of unusual etiology: A report of 2 cases]. ACTA ACUST UNITED AC 2013; 89:275-8. [PMID: 24269442 DOI: 10.1016/j.oftal.2013.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/25/2012] [Revised: 02/21/2013] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Describe 2 rare causes of central serous chorioretinopathy. CLINICAL CASES Case 1: A 35 year old woman with loss of vision in her left eye, with a recent history of a flu vaccination. This could have been the process that triggered an immune response, with increased circulating immune complexes that favour choroidal ischemia. CASE 2 A 41 year old man with loss of vision in his left eye. As history, had consumed cocaine, which could be related to its adrenergic effect adrenergic, and earlier excimer laser refractive surgery (LASIK). CONCLUSION In both cases there was a temporal relationship between cause and effect.
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Affiliation(s)
- A I Palacios
- Servicio de Oftalmología, Hospital Universitario Infanta Cristina, Universidad Complutense de Madrid, Parla, Madrid, España.
| | - M Rodríguez
- Servicio de Oftalmología, Hospital Universitario Infanta Cristina, Universidad Complutense de Madrid, Parla, Madrid, España
| | - M D Martín
- Servicio de Oftalmología, Hospital Universitario Infanta Cristina, Universidad Complutense de Madrid, Parla, Madrid, España
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Pérez M, Herreros B, Martín MD, Molina J, Guijarro C, Velasco M. [Changes in knowledge and carrying out the advance directives of patients admitted to internal medicine]. ACTA ACUST UNITED AC 2013; 28:307-12. [PMID: 24021533 DOI: 10.1016/j.cali.2013.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 11/09/2012] [Revised: 03/10/2013] [Accepted: 03/11/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUNDS Advance directives (ADs), are documents in which patients express in advance that their wishes are fulfilled when they are unable to communicate them. It is unknown whether patients admitted to internal medicine are more aware of and make ADs. OBJECTIVE To study the changes in the level of knowledge and implementation of AD among patients admitted to an internal medicine department of a hospital in Madrid since a specific regulation to implement them was introduced. PATIENTS AND METHODS A survey was conducted among patients admitted to internal medicine in two periods: 2008 and 2010. RESULTS A total of 206 surveys were analysed (84 in 2008 and 122 in 2010). The mean age of the patients was 76.8 years, and 51.5% were women. More than two-thirds (69.4%) had a co-morbidity. and 4.4% had a terminal illness, with no statistical differences between the periods. Only 5.3% knew what ADs are, 1 had implemented ADs, and 46.1%, once informed, would like to implement them. There were no differences between 2008 and 2010 as regards knowledge and implementation of AD. In 2010 there was a greater interest to implement them (would like to implement them: 52.5 vs 36.9%), although in 2010 less respondents believe that AD would change the attitude of the doctor (not change the attitude: 92.6 vs. 69%, P<.001). CONCLUSIONS Knowledge and implementation of AD did not change significantly in the years following the regulation (from 2008-2010). In both periods, their knowledge and implementation are scarce.
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Affiliation(s)
- M Pérez
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón (HUFA), Alcorcón, Madrid, España
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Ibáñez D, Martín MD, Rubio RÁ, Muel C. [Multifocal osteonecrosis in long-term corticoid treatment secondary to panhypopituitarism: a case report]. Endocrinol Nutr 2012; 60:416-8. [PMID: 23108054 DOI: 10.1016/j.endonu.2012.07.011] [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] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 07/11/2012] [Accepted: 07/20/2012] [Indexed: 10/27/2022]
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Adrados C, Liew TCH, Amo A, Martín MD, Sanvitto D, Antón C, Giacobino E, Kavokin A, Bramati A, Viña L. Motion of spin polariton bullets in semiconductor microcavities. Phys Rev Lett 2011; 107:146402. [PMID: 22107218 DOI: 10.1103/physrevlett.107.146402] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 07/22/2011] [Indexed: 05/31/2023]
Abstract
The dynamics of optical switching in semiconductor microcavities in the strong coupling regime is studied by using time- and spatially resolved spectroscopy. The switching is triggered by polarized short pulses which create spin bullets of high polariton density. The spin packets travel with speeds of the order of 10(6) m/s due to the ballistic propagation and drift of exciton polaritons from high to low density areas. The speed is controlled by the angle of incidence of the excitation beams, which changes the polariton group velocity.
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Affiliation(s)
- C Adrados
- Laboratoire Kastler Brossel, Université Pierre et Marie Curie, École Normale Supérieure et CNRS, UPMC Case 74, 4 place Jussieu, 75252 Paris Cedex 05, France
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Sapienza R, García PD, Bertolotti J, Martín MD, Blanco A, Viña L, López C, Wiersma DS. Observation of resonant behavior in the energy velocity of diffused light. Phys Rev Lett 2007; 99:233902. [PMID: 18233364 DOI: 10.1103/physrevlett.99.233902] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Indexed: 05/25/2023]
Abstract
In this Letter we demonstrate Mie resonances mediated transport of light in randomly arranged, monodisperse dielectric spheres packed at high filling fractions. By means of both static and dynamic optical experiments we show resonant behavior in the key transport parameters and, in particular, we find that the energy transport velocity, which is lower than the group velocity, also displays a resonant behavior.
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Affiliation(s)
- R Sapienza
- Instituto de Ciencia de Materiales de Madrid , Cantoblanco 28049 Madrid España.
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22
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Martín MD, Aichmayr G, Amo A, Ballarini D, Kłopotowski L, Viña L. Polariton and spin dynamics in semiconductor microcavities under non-resonant excitation. J Phys Condens Matter 2007; 19:295204. [PMID: 21483056 DOI: 10.1088/0953-8984/19/29/295204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Semiconductor microcavities offer an ideal scenario to study strong radiation-matter interactions. In this paper we review the temporal dynamics of polaritons in II-VI and III-V based microcavities under non-resonant excitation conditions. We present evidence of final-state stimulated scattering and discuss the spin-dependent emission, which exhibits a remarkably rich behaviour.
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Affiliation(s)
- M D Martín
- SEMICUAM. Departamento de Física de Materiales, Universidad Autónoma de Madrid, E-28049 Madrid, Spain
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Larrañaga M, Martín MD, Gabilondo N, Kortaberria G, Corcuera MA, Riccardi CC, Mondragon I. Cure kinetics of epoxy systems modified with block copolymers. POLYM INT 2004. [DOI: 10.1002/pi.1574] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Froilán Torres C, Suárez JM, Martín MD, Castillo P, Hervías D, Segura JM. Silastic band migration: an unusual complication following vertical banded gastroplasty. Endoscopy 2003; 35:193. [PMID: 12561019 DOI: 10.1055/s-2003-37009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- C Froilán Torres
- Department of Gastroenterology, La Paz University Hospital, Madrid, Spain.
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Martín MD, Aichmayr G, Viña L, André R. Polarization control of the nonlinear emission of semiconductor microcavities. Phys Rev Lett 2002; 89:077402. [PMID: 12190556 DOI: 10.1103/physrevlett.89.077402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2002] [Indexed: 05/23/2023]
Abstract
The degree of circular polarization ( Weierstrass p ) of the nonlinear emission in semiconductor microcavities is controlled by changing the exciton-cavity detuning. The polariton relaxation towards K approximately 0 cavitylike states is governed by final-state stimulated scattering. The helicity of the emission is selected due to the lifting of the degeneracy of the +/-1 spin levels at K approximately 0. At short times after a pulsed excitation Weierstrass p reaches very large values, either positive or negative, as a result of stimulated scattering to the spin level of lowest energy (+1/-1 spin for positive/negative detuning).
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Affiliation(s)
- M D Martín
- Departamento de Física de Materiales C-IV, Universidad Autónoma de Madrid, Cantoblanco, Spain
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Luis Zambrana J, Fuentes F, Dolores Martín M, Díez F, Cruz G. Calidad de los informes de alta hospitalaria de los servicios de medicina interna de los hospitales públicos de Andalucía. ACTA ACUST UNITED AC 2002. [DOI: 10.1016/s1134-282x(02)77552-0] [Citation(s) in RCA: 9] [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] [Indexed: 10/27/2022]
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Jiménez RM, Martín MD, García Y, Mazas L. [Portosystemic encephalopathy: evaluation using magnetic resonance]. Rev Neurol 2001; 33:184-5. [PMID: 11700613] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- R M Jiménez
- Servicio de Radiodiagnóstico. Hospital Miguel Servet. Zaragoza. España.
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Marugán JM, Alonso-Franch M, Calvo C, Martín MD, Ochoa C. [Idiopathic perforation of the choledocus in childhood]. An Esp Pediatr 1987; 27:390-2. [PMID: 3326445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The purpose of this report is to describe a seven-years-old patient with an idiopathic perforation of the common bile duct. This disorder is more frequent in the first weeks of life, and the clinical features are not well known. Properly treated, the majority of infants survive without sequelae. Furthermore, a review of the literature is made.
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Affiliation(s)
- J M Marugán
- Departamento de Pediatría, Hospital Clínico Universitario de Valladolid
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