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Juanes A, Ruíz J, Puig M, Blázquez M, Gilabert A, López L, Baena MI, Guiu JM, Antònia Mangues M. The Effect of the Drug-Related Problems Prevention Bundle on Early Readmissions in Patients From the Emergency Department: A Randomized Clinical Trial. Ann Pharmacother 2023; 57:1025-1035. [PMID: 36539949 DOI: 10.1177/10600280221143237] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Drug-related problems (DRPs) are prevalent and avoidable disease that patients experience due to drug use or nonuse. However, secondary prevention policies have not yet been systematized. OBJECTIVE To assess the clinical impact of a secondary prevention bundle for DRPs in patients who visited the emergency department (ED) for medicine-related problems. METHODS A single-center randomized clinical trial was conducted from August 28, 2019, to January 28, 2021, with 1-month follow-up. We included 769 adult patients who visited ED with a DRP associated with cardiovascular, alimentary tract, and metabolic system medications. For the intervention group, a DRP prevention bundle, consisting of a combined strategy initiated in the ED was applied. Patients in the control group received standard pharmaceutical care. Intervention was evaluated in terms of 30-day hospital readmission due to any cause. RESULTS Final analysis included 769 patients, of which 68 (8.8%) were readmitted within 30 days (control group, 40 of 386 [cumulative incidence: 10.4%]; intervention group, 28 of 383 [cumulative incidence, 7.3%]). After adjustment of the model for chronic heart failure, there was a lower incidence of hospital readmission among patients in the intervention group compared with those in the control group, odds ratio: 0.59 [95% confidence interval: 0.37-0.97]; number needed to treat (NNT) = 32. No significant differences in other outcomes were observed. CONCLUSION AND RELEVANCE In this clinical trial, DRP prevention bundle in adjusted analysis decreased the rate of 30-day hospital readmission for any cause in patients who visited ED for a DRP. TRIAL REGISTRATION ClinicalTrials.gov (Identifier: NCT03607097).
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Affiliation(s)
- Ana Juanes
- Department of Pharmacy, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
| | - Jesús Ruíz
- Department of Pharmacy, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
| | - Mireia Puig
- Autonomous University of Barcelona, Bellaterra, Spain
- Department of Emergency, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Marta Blázquez
- Autonomous University of Barcelona, Bellaterra, Spain
- Department of Emergency, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Antoni Gilabert
- Catalan Healthcare Consortium, Catalan Health Service, Barcelona, Spain
| | - Laia López
- Department of Pharmacy, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
| | - M Isabel Baena
- Pharmaceutical Care Research Group, University of Granada, Granada, Spain
| | - Josep M Guiu
- Catalan Healthcare Consortium, Catalan Health Service, Barcelona, Spain
| | - Maria Antònia Mangues
- Department of Pharmacy, Sant Pau Biomedical Research Institute (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
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Ruiz J, López-Vinardell L, Juanes A, Riera-Magallon A, Puig M, Mangues MA. Risk factors for emergency department revisit in elderly patients with gastrointestinal bleeding secondary to anticoagulant therapy. Eur J Hosp Pharm 2022; 29:271-274. [PMID: 33293283 PMCID: PMC9660616 DOI: 10.1136/ejhpharm-2020-002426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 11/11/2020] [Accepted: 11/17/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To evaluate the frequency of emergency department (ED) revisits among elderly patients with gastrointestinal bleeding secondary to anticoagulant treatment and identify factors associated with an increased risk of ED revisits. METHODS A 3-year retrospective observational study was designed, including elderly patients (≥65 years) with atrial fibrillation and undergoing oral anticoagulation therapy who visited the ED for gastrointestinal bleeding. To evaluate the risk factors for 30-day revisit, a multivariate analysis was designed including comorbidities, concomitant treatment, change in anticoagulant treatment and prescription of direct-acting oral anticoagulants. RESULTS 80 patients were included. At discharge, anticoagulation therapy was modified in 21 (26.2%) patients; and changed from an oral anticoagulant to heparin in 17 (21.2%) patients and to another oral anticoagulant in 4 (5.0%) patients. Anticoagulant treatment was withdrawn in 5 (6.3%) patients at discharge. Eleven (13.7%) patients revisited the ED 30 days after hospital discharge for bleeding episodes. No differences in the frequency of revisit to the ED were observed in the patients who changed their anticoagulant treatment at discharge. In the multivariate analysis, chronic kidney disease was the only factor significantly associated with revisits at 30 days. CONCLUSIONS Elderly patients who experience a first episode of gastrointestinal bleeding have a high risk of revisiting the ED for a bleeding episode, with no particular differences between the types of anticoagulant prescribed at discharge.
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Affiliation(s)
- Jesus Ruiz
- Pharmacy, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain
| | | | - Ana Juanes
- Pharmacy, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain
| | | | - Mireia Puig
- Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain
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Escalada X, Sánchez P, Hernández R, Gené E, Jacob J, Alonso G, Rimbau P, Zorrilla J, Casarramona F, Netto C, Flores S, Puig M, Villamor A, Sánchez M, Miró Ò. Prehospital emergency services in Catalonia: the SEPHCAT analysis. Emergencias 2021; 32:90-96. [PMID: 32125107] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To describe the main characteristics of all prehospital emergency services (SEPHs, the Catalan acronym) in Catalonia (the SEPHCAT study). MATERIAL AND METHODS A professional survey researcher interviewed the medical directors of all services in Catalonia, using a questionnaire prepared by the authors. Questions covered aspects related to organization, professional staffing and employment conditions, as well as the staff's training, instructional activity and research. Only closed answers were collected. The survey reflected the situation in 2015. RESULTS We identified 13 SEPHs (11 in the public health service and 2 private companies). Together they received 2 482 627 calls (16.4% to private services) and attended 943 849 emergencies (11.8% attended by private companies). Three hundred thirty-six basic life support units and 73 advanced life support units were reported. They were mostly considered to be of sufficient size and quality. The SEPHs contracted 1374845 person-hours/y (753995 physician-hours and 620 850 nurse-hours; 23.4% in private companies). These figures correspond to 815 full-time staff positions (447 for physicians and 368 for nurses). The numbers of physicians and nurses working were relatively stable during the morning, afternoon and evening shifts but decreased during the midnight-to-early-morning shift (physicians, by 31%; nurses, by 9%). A majority of the physicians employed were trained in family and community medicine (56.8%), but 21.3% had no specialized training; 6.5% had PhD degrees. SEPH physicians (61.5%) and nurses (46.2%) also taught undergraduate medical students; 46.2% of physicians and 84.6% of nurses taught postgraduate medical courses. Both undergraduate medical and nursing students were received in the same measure for practical training by 15.4% of the SEPHs; 69.2% also offered practical training for physicians at the postgraduate level and 76.9% trained postgraduate nurses. CONCLUSION SEPHs in Catalonia are very active, and private companies account for nearly 12% of the activity. Together the public and private sectors employ a large number of physicians and nurses. Staff members are involved in training others but are less involved in research.
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Affiliation(s)
- Xavier Escalada
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Pere Sánchez
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Ricard Hernández
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Emili Gené
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Javier Jacob
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Gilberto Alonso
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Pere Rimbau
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - José Zorrilla
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | | | - Cristina Netto
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Silvia Flores
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Mireia Puig
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Alberto Villamor
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Miquel Sánchez
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
| | - Òscar Miró
- Societat Catalana de Medicina d'Urgències i Emergències, Barcelona, España
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Moragas A, Garcia-Sangenís A, Prats Escudero A, Bayona Faro C, Hernández Ibáñez R, Brotons C, Vilella T, Puig M, Freixedas Casaponsa R, Cobo Guerrero S, Pera H, van der Velden AW, Butler CC, Llor C. [Prevalence of microbiologically-confirmed influenza in patients with influenza-like illness in primary care and clinical and epidemiological characteristics]. Rev Esp Quimioter 2021; 34:468-475. [PMID: 34118801 PMCID: PMC8638842 DOI: 10.37201/req/032.2021] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE We evaluated the prevalence of microbiologically-confirmed influenza infection among patients with influenza-like symptoms and compared the clinical and epidemiological characteristics of patients with and without influenza infection. METHODS Retrospective study of a cohort of patients with influenza-like symptoms from 2016 to 2018 who participated in a clinical trial in thirteen urban primary centres in Catalonia. Different epidemiological data were collected. Patients rated the different symptoms and signs on a Likert scale (absent, little problem, moderate problem and severe problem) and self-reported the measure of health status with the EuroQol visual analogue scale. A nasopharyngeal swab was taken for microbiological isolation of influenza and other microorganisms. RESULTS A total of 427 patients were included. Microbiologically confirmed influenza was found in 240 patients (56.2%). The percentage of patients with moderate-to-severe cough, muscle aches, tiredness and dizziness was greater among patients with microbiologically confirmed influenza. The self-reported health status was significantly lower among patients with true flu infection (mean of 36.3 ± 18.2 vs 41.7 ± 17.8 in patients without influenza; p<0.001). CONCLUSIONS Clinical findings are not particularly useful for confirming or excluding the diagnosis of influenza when intensity is not considered. However, the presence of moderate-to-severe cough, myalgias, tiredness and dizziness along with a poor health status is more common in patients with confirmed flu infection.
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Affiliation(s)
- A Moragas
- Ana Moragas. Centro de Salud Jaume I, Tarragona. C. Felip Pedrell, 45-47. 43005 Tarragona, Spain.
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Brotons C, Moral I, González J, Fernández D, Puig M, Vilella MT. Epidemiology of hypertriglyceridaemia. Clin Investig Arterioscler 2021; 33 Suppl 2:7-13. [PMID: 34006358 DOI: 10.1016/j.arteri.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/14/2020] [Indexed: 10/21/2022]
Abstract
Based on the most recent scientific evidence, in this chapter we describe the relation of levels of triglycerides and risk of cardiovascular diseases. Particularly, we describe the prevalence of hypertriglyceridemia based on studies published at national and international reports; the relation between hypertriglyceridemia and cardiovascular diseases according to results of cohort studies; and finally, we describe the most recent evidence from clinical trials, meta-analysis and systematic reviews that have shown data on the efficacy of lowering triglyceride levels and reducing cardiovascular diseases.
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Affiliation(s)
- Carlos Brotons
- EAP Sardenya, Instituto de Investigaciones Biomédicas Sant Pau, Barcelona, España.
| | - Irene Moral
- EAP Sardenya, Instituto de Investigaciones Biomédicas Sant Pau, Barcelona, España
| | - Jara González
- EAP Sardenya, Instituto de Investigaciones Biomédicas Sant Pau, Barcelona, España
| | - Diana Fernández
- EAP Sardenya, Instituto de Investigaciones Biomédicas Sant Pau, Barcelona, España
| | - Mireia Puig
- EAP Sardenya, Instituto de Investigaciones Biomédicas Sant Pau, Barcelona, España
| | - M Teresa Vilella
- EAP Sardenya, Instituto de Investigaciones Biomédicas Sant Pau, Barcelona, España
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Montenegro P, Brotons C, Serrano J, Fernández D, Garcia-Ramos C, Ichazo B, Lemaire J, Moral I, Wienese RP, Pitarch M, Puig M, Vilella MT, Sellarès J. Community seroprevalence of COVID-19 in probable and possible cases at primary health care centres in Spain. Fam Pract 2021; 38:154-159. [PMID: 32914857 PMCID: PMC7797756 DOI: 10.1093/fampra/cmaa096] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a scarcity of information about patients with mild or moderate symptoms during the coronavirus disease 2019 (COVID-19). This is especially true for those who attended and were followed up at primary care settings. OBJECTIVES We aim to measure the seroprevalence of antibodies against SARS-CoV-2 infection in a community sample of possible cases and among probable cases followed in primary care. METHODS We selected a random sample of 600 individuals stratified by age groups from a total population of 19 899 individuals from a community area in Barcelona. We also invited all the patients that had been followed by General Practitioners (GPs). For both populations, we used COVID-19 rapid lateral flow immunoassays, which qualitatively assess the presence of patient-generated Immunoglobulins G (IgG) and Immunoglobulin M (IgM). RESULTS Three hundred and eleven asymptomatic individuals from the randomly selected sample participated in the study. The mean age was 43.7 years [standard deviation (SD) = 21.79] and 55% were women. Seventeen individuals were seropositive for IgM and/or IgG, resulting in an overall prevalence of 5.47% (95% confidence interval = 3.44-8.58). Six hundred and thirty-four symptomatic patients were followed up by GPs. The mean age was 46.97 years (SD = 20.05) and 57.73% were women. Of these, 244 patients (38.49%) were seropositive. Results of the multivariate logistic regression analysis showed that the odds ratio for a positive test was significantly increased in patients who had fever, ageusia and contact with a patient diagnosed with COVID-19. CONCLUSIONS The seroprevalence of antibodies against SARS-CoV-2 among possible cases was lower than expected. Approximately, 40% of the symptomatic patients followed up by GPs during the peak months of the pandemic were positive.
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Affiliation(s)
- Patricia Montenegro
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
| | - Carlos Brotons
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
| | | | - Diana Fernández
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
| | | | - Begoña Ichazo
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
| | | | - Irene Moral
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
| | | | - Marc Pitarch
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
| | - Mireia Puig
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
| | - M Teresa Vilella
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
| | - Jaume Sellarès
- Research Unit, Sardenya Primary Health Care Center (EAP Sardenya), Barcelona
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona
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Corominas H, Castellví I, Pomar V, Antonijoan R, Mur I, Matas L, Gich I, de Benito N, Laiz A, Castillo D, Villamarin L, Filella D, Millán AM, Quijada MÁ, Puig M, Casademont J, Domingo P. Effectiveness and safety of intravenous tocilizumab to treat COVID-19-associated hyperinflammatory syndrome: Covizumab-6 observational cohort. Clin Immunol 2021; 223:108631. [PMID: 33189888 PMCID: PMC7658611 DOI: 10.1016/j.clim.2020.108631] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 02/05/2023]
Abstract
Although the starting event in COVID-19 is a viral infection some patients present with an over-exuberant inflammatory response, leading to acute lung injury (ALI) and adult respiratory distress syndrome (ARDS). Since IL-6 plays a critical role in the inflammatory response, we assessed the efficacy and safety of tocilizumab (TCZ) in this single-centre, observational study in all Covid-19 in-patient with a proven SARS-CoV-2 rapidly progressing infection to prevent ALI and ARDS. 104 patients with COVID-19 treated with TCZ had a lower mortality rate (5·8%) compared with the regional mortality rate (11%), hospitalized patient's mortality (10%), and slightly lower than hospitalized patients treated with our standard of care alone (6%). We found that TCZ rapidly decreased acute phase reactants, ferritin and liver release of proteins. D-Dimer decreased slowly. We did not observe specific safety concerns. Early administration of IL6-R antagonists in COVID-19 patients with impending hyperinflammatory response, may be safe and effective treatment to prevent, ICU admission and further complications.
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Affiliation(s)
- Hèctor Corominas
- Servei de Reumatologia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain.
| | - Ivan Castellví
- Servei de Reumatologia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Virginia Pomar
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Rosa Antonijoan
- Servei de Farmacología (CIBERSAM), Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Isabel Mur
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Laia Matas
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Ignasi Gich
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Natividad de Benito
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Ana Laiz
- Servei de Reumatologia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Diego Castillo
- Servei de Respiratori, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Laura Villamarin
- Servei de Farmàcia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - David Filella
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Ana Milena Millán
- Servei de Reumatologia, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - María Ángeles Quijada
- Servei de Farmacología (CIBERSAM), Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
| | - Mireia Puig
- Servei d'Urgències, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Jordi Casademont
- Servei de Medicina Interna, Barcelona, Catalonia, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain; Unitat de Malalties infeccioses, Barcelona, Catalonia, Spain
| | - Pere Domingo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Universitat Autònoma de Barcelona (UAB), Barcelona, Catalonia, Spain
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Medina‐Catalán D, Ruiz‐Ramos J, Juanes‐Borrego A, Herrera SA, Puig M, Antonia Mangues‐Bafalluy M. Factors associated with inappropriate intravenous antibiotic prescription in patients discharged from the emergency department. J Clin Pharm Ther 2020; 45:1149-1152. [DOI: 10.1111/jcpt.13198] [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] [Received: 02/21/2020] [Revised: 05/01/2020] [Accepted: 05/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Jesus Ruiz‐Ramos
- Pharmacy Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Ana Juanes‐Borrego
- Pharmacy Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Sergio A. Herrera
- Emergency Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
| | - Mireia Puig
- Emergency Department Hospital de la Santa Creu i Sant Pau Barcelona Spain
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Caballero F, Puig M, Leal J, Trejo O, Díaz I, Herrera S, Turbau M, Ris J, Benito S. Successful organ donation for transplantation: Targeted actions in the emergency department. Am J Transplant 2019; 19:2960-2961. [PMID: 31246336 DOI: 10.1111/ajt.15516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Francisco Caballero
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Puig
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesus Leal
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga Trejo
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Iván Díaz
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergio Herrera
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Turbau
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep Ris
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Salvador Benito
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Brotons C, Moral I, Fernández D, Puig M, Calvo Bonacho E, Martínez Muñoz P, Catalina Romero C, Quevedo Aguado LJ. Estimation of Lifetime Risk of Cardiovascular Disease (IBERLIFERISK): A New Tool for Cardiovascular Disease Prevention in Primary Care. Rev Esp Cardiol (Engl Ed) 2019; 72:562-568. [PMID: 30097396 DOI: 10.1016/j.rec.2018.05.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/14/2018] [Accepted: 05/04/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES To develop a predictive function of lifetime cardiovascular risk, including morbidity and mortality, in a healthy working population in Spain. METHODS Retrospective cohort study. We selected healthy workers, aged 18 to 65 years, with no history of cardiovascular disease, who underwent a health assessment between 2004 and 2007. We used 70% of the cohort to develop the risk equation, and the remaining 30% to validate the equation. Four Cox proportional hazards models were constructed using cardiovascular events and competing events as dependent variables. The same models were replicated for men and women separately. Fatal and nonfatal events were assessed until 2014. RESULTS A total of 762 054 individuals were selected. The mean age was 35.48 years and 71.14% were men. Significant risk variables in the model included manual occupations, being a smoker or exsmoker, diabetes mellitus, antihypertensive treatment, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and lipid-lowering treatment; in men, the model also included alcohol consumption, body mass index, a family history of early coronary disease in first-degree relatives, renal failure, and diastolic blood pressure. The area under the curve receiver operating characteristic was 0.84 (95%CI, 0.82-0.85) in men and 0.73 (95%CI, 0.66-0.80) in women. Calibration showed underestimation in low-risk deciles and overestimation in high-risk deciles. CONCLUSIONS The new lifetime cardiovascular risk model has satisfactory discrimination and calibration, with better results in men than in women.
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Affiliation(s)
- Carlos Brotons
- Unidad de Investigación, Equipo de Atención Primaria Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain.
| | - Irene Moral
- Unidad de Investigación, Equipo de Atención Primaria Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Diana Fernández
- Unidad de Investigación, Equipo de Atención Primaria Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Mireia Puig
- Unidad de Investigación, Equipo de Atención Primaria Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
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Brotons C, Moral I, Fernández D, Puig M, Calvo Bonacho E, Martínez Muñoz P, Catalina Romero C, Quevedo Aguado LJ. Estimación del riesgo cardiovascular de por vida (IBERLIFERISK): una herramienta nueva en prevención primaria de las enfermedades cardiovasculares. Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2018.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pujol M, Miro JM, Shaw E, Aguado JM, Garrido RSJ, Puig M, Pigrau C, Calbo E, Montejo JM, Rodriguez R, Garcia-Pais MJ, Pintado V, Escudero R, Lopez-Contreras J, Morata L, Montero M, Andres M, Pasquau J, Padilla B, Murillas J, Jover A, Lopez-Cortes LE, Garcia-Pardo G, Gasch O, Videla S, Tebe C, Pallares N, Hereu P, Sanllorente M, Dominguez MA, Camara J, Padulles A, Carratala J. LB3. Daptomycin Plus Fosfomycin vs. Daptomycin Monotherapy for Methicillin-Resistant Staphylococcus aureus Bacteremia: A Multicenter, Randomized, Clinical Trial. Open Forum Infect Dis 2018. [PMCID: PMC6253582 DOI: 10.1093/ofid/ofy229.2177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Daptomycin plus fosfomycin combination has demonstrated synergistic and bactericidal effect in animal models of methicillin-resistant Staphylococcus aureus bacteremia (MRSAB), but there is lack of data in humans.
Method
A randomized (1:1), open-label, clinical trial involving adults with MRSAB was conducted at 18 medical centers in Spain. Patients were assigned to receive daptomycin, 10 mg/kg IV daily plus fosfomycin, 2 g IV/6 hour (combination therapy) or to receive daptomycin 10 mg/kg/24 h IV (monotherapy) during 10 up to 14 days for uncomplicated bacteremia and 28 up to 42 days for complicated bacteremia. The primary efficacy endpoints were: (a) treatment success at Test-of-Cure visit (ToC: 6 weeks after end of therapy) and (b) treatment success at 7 days (defined as alive at day 7 and clearance of bacteremia without relapse from 8 to 90 days after randomization), according with the proposed primary endpoints for use in clinical trials in bloodstream infections in adults.
Result
Between December 2013 and November 2017, 674 patients with MRSAB were evaluated and 155 patients were randomized: 74 received combination therapy and 81 monotherapy. In intention-to-treat analysis, (a) at ToC visit successful outcome was achieved in 40 of 74 patients (54,1%) who received combination therapy as compared with 34 of 81 patients (42%) who were given monotherapy (54.1% vs. 42.0%; absolute difference, 12.1%; 95% confidence interval, 0%-27.0%); (b) at 7 days after starting the therapy: a successful outcome was achieved in 69 of 74 patients who received combination therapy as compared with 62 out of 81 patients who received monotherapy (93.2% vs. 76.5%; absolute difference, 16.7%; 95% confidence interval, 5.4%–27.7%). Combination therapy was associated with lower rates of microbiologic failure than monotherapy at ToC visit (0 vs. 9 patients, P = 0.009). Combination therapy, as compared with daptomycin monotherapy, was associated with a nonsignificantly higher rate of adverse events due to study medication leading to treatment failure and discontinuation of therapy: 6/74 (8.1%) vs. 3/81 (3.7%) (P = 0.31).
Conclusion
The combination of daptomycin plus fosfomycin was more effective than daptomycin alone for treating MRSAB (NCT01898338).
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
- Miquel Pujol
- Infectious Diseases Department, Hospital de Bellvitge, L’Hospitalet llobregat, Spain
| | | | - Evelyn Shaw
- Hospital de Bellvitge, L’Hospitalet llobregat, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Cristian Tebe
- Institut d’Investigacions Biomèdiques de Bellvitge (IDIBELL), L’Hospitalet llobregat, Spain
| | - Natalia Pallares
- Institud d’Investigacions Biomèdiques de Bellvitge (IDIBELL), L’Hospitalet llobregat, Spain
| | - Pilar Hereu
- Hospital de Bellvitge, L’Hospitalet llobregat, Spain
| | | | | | - Jordi Camara
- Hospital de Bellvitge, L’Hospitalet llobregat, Spain
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Martínez-González MA, Buil-Cosiales P, Corella D, Bulló M, Fitó M, Vioque J, Romaguera D, Martínez JA, Wärnberg J, López-Miranda J, Estruch R, Bueno-Cavanillas A, Arós F, Tur JA, Tinahones F, Serra-Majem L, Martín V, Lapetra J, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, Ros E, Fernández-Aranda F, Botella C, Portillo MP, Lamuela-Raventós RM, Marcos A, Sáez G, Gómez-Gracia E, Ruiz-Canela M, Toledo E, Alvarez-Alvarez I, Díez-Espino J, Sorlí JV, Basora J, Castañer O, Schröder H, Navarrete-Muñoz EM, Zulet MA, García-Rios A, Salas-Salvadó J, Corella D, Estruch R, Fitó M, Martínez-González MA, Ros E, Salas-Salvadó J, Babio N, Ros E, Sánchez-Tainta A, Martínez-González MA, Fitó M, Schröder H, Marcos A, Corella D, Wärnberg J, Martínez-González MA, Estruch R, Fernández-Aranda F, Botella C, Salas-Salvadó J, Razquin C, Bes-Rastrollo M, Sanchez Tainta A, Vázquez Z, SanJulian Aranguren B, Goñi E, Goñi L, Barrientos I, Canales M, Sayón-Orea MC, Rico A, Basterra Gortari J, Garcia Arellano A, Lecea-Juarez O, Carlos Cenoz-Osinaga J, Bartolome-Resano J, Sola-Larraza† A, Lozano-Oloriz E, Cano-Valles B, Eguaras S, Güeto V, Pascual Roquet-Jalmar E, Galilea-Zabalza I, Lancova H, Ramallal R, Garcia-Perez ML, Estremera-Urabayen V, Ariz-Arnedo MJ, Hijos-Larraz C, Fernandez Alfaro C, Iñigo-Martinez B, Villanueva Moreno R, Martin-Almendros S, Barandiaran-Bengoetxea L, Fuertes-Goñi C, Lezaun-Indurain A, Guruchaga-Arcelus MJ, Olmedo-Cruz O, Iñigo-Martínez B, Escriche-Erviti L, Ansorena-Ros R, Sanmatin-Zabaleta R, Apalategi-Lasa J, Villanueva-Telleria J, Hernández-Espinosa MM, Arroyo-Bergera I, Herrera-Valdez L, Dorronsoro-Dorronsoro L, González JI, Sorlí JV, Portolés O, Fernández-Carrión R, Ortega-Azorín C, Barragán R, Asensio EM, Coltell O, Sáiz C, Osma R, Férriz E, González-Monje I, Giménez-Fernández F, Quiles L, Carrasco P, San Onofre N, Carratalá-Calvo A, Valero-Barceló C, Antón F, Mir C, Sánchez-Navarro S, Navas J, González-Gallego I, Bort-Llorca L, Pérez-Ollero L, Giner-Valero M, Monfort-Sáez R, Nadal-Sayol J, Pascual-Fuster V, Martínez-Pérez M, Riera C, Belda MV, Medina A, Miralles E, Ramírez-Esplugues MJ, Rojo-Furió M, Mattingley G, Delgado MA, Pages MA, Riofrío Y, Abuomar L, Blasco-Lafarga N, Tosca R, Lizán L, Guillem-Saiz P, Valcarce AM, Medina MD, Monfort R, de Valcárcel S, Tormo N, Felipe-Román O, Lafuente S, Navío EI, Aldana G, Crespo JV, Llosa JL, González-García L, Raga-Marí R, Pedret Llaberia R, Gonzalez R, Sagarra Álamo R, París Palleja F, Balsells J, Roca JM, Basora Gallisa T, Vizcaino J, Llobet Alpizarte P, Anguera Perpiñá C, Llauradó Vernet M, Caballero C, Garcia Barco M, Morán Martínez MD, García Rosselló J, Del Pozo A, Poblet Calaf C, Arcelin Zabal P, Floresví X, Ciutat Benet M, Palau Galindo A, Cabré Vila JJ, Dolz Andrés F, Boj Casajuana J, Ricard M, Saiz F, Isach A, Sanchez Marin Martinez M, Bulló M, Babio N, Becerra-Tomás N, Mestres G, Basora J, Mena-Sánchez G, Barrubés Piñol L, Gil Segura M, Papandreou C, Rosique Esteban N, Chig S, Abellán Cano I, Ruiz García V, Salas-Huetos A, Hernandez P, Canudas S, Camacho-Barcia L, García-Gavilán J, Diaz A, Castañer O, Muñoz MA, Zomeño MD, Hernaéz A, Torres L, Quifer M, Llimona R, Gal LA, Pérez A, Farràs M, Elosua R, Marrugat J, Vila J, Subirana I, Pérez S, Muñoz MA, Goday A, Chillaron Jordan JJ, Flores Lerroux JA, Benaiges Boix D, Farré M, Menoyo E, Muñoz-Aguayo D, Gaixas S, Blanchart G, Sanllorente A, Soria M, Valussi J, Cuenca A, Forcano L, Pastor A, Boronat A, Tello S, Cabañero M, Franco L, Schröder H, De la Torre R, Medrano C, Bayó J, García MT, Robledo V, Babi P, Canals E, Soldevila N, Carrés L, Roca C, Comas MS, Gasulla G, Herraiz X, Martínez A, Vinyoles E, Verdú JM, Masague Aguade M, Baltasar Massip E, Lopez Grau M, Mengual M, Moldon V, Vila Vergaz M, Cabanes Gómez Ciurana R, Gili Riu M, Palomeras Vidal A, Garcia de la Hera M, González Palacios S, Torres Collado L, Valera Gran D, Compañ Gabucio L, Oncina Canovas A, Notario Barandiaran L, Orozco Beltran D, Pertusa Martínez S, Cloquell Rodrigo B, Hernándis Marsán MV, Asensio A, Altozano Rodado MC, Ballester Baixauli JJ, Fernándis Brufal N, Martínez Vergara MC, Román Maciá J, Candela García I, Pedro Cases Pérez E, Tercero Maciá C, Mira Castejón LA, de los Ángeles García García I, Zazo JM, Gisbert Sellés C, Sánchez Botella C, Fiol M, Moñino M, Colom A, Konieczna J, Morey M, Zamanillo R, Galmés AM, Pereira V, Martín MA, Yáñez A, Llobera J, Ripoll J, Prieto R, Grases F, Costa A, Fernández-Palomeque C, Fortuny E, Noris M, Munuera S, Tomás F, Fiol F, Jover A, Janer JM, Vallespir C, Mattei I, Feuerbach N, del Mar Sureda M, Vega S, Quintana L, Fiol A, Amador M, González S, Coll J, Moyá A, Abete I, Cantero I, Cristobo C, Ibero-Baraibar I, Lezáun Burgui MD, Goñi Ruiz N, Bartolomé Resano R, Cano Cáceres E, Elcarte López T, Echarte Osacain E, Pérez Sanz B, Blanco Platero I, Andueza Azcárate SA, Gimeno Aznar A, Ursúa Sesma E, Ojeda Bilbao B, Martinez Jarauta J, Ugalde Sarasa L, Rípodas Echarte B, Güeto Rubio MV, Fernández-Crehuet Navajas J, Gutiérrez Bedmar M, García Rodriguez A, Mariscal Larrubia A, Carnero Varo M, Muñoz Bravo C, Barón-López FJ, Fernández García JC, Pérez-Farinós N, Moreno-Morales N, del C Rodríguez-Martínez M, Pérez-López J, Benavente-Marín JC, Crespo Oliva E, Contreras Fernández E, Carmona González FJ, Carabaño Moral R, Torres Moreno S, Martín Ruíz MV, Alcalá Cornide M, Fuentes Gómez V, Criado García J, Jiménez Morales AI, Delgado Casado N, Ortiz Morales A, Torres Peña JD, Gómez Delgado FJ, Rodríguez Cantalejo F, Caballero Villaraso J, Alcalá JF, Peña Orihuela PJ, Quintana Navarro G, Casas R, Domenech M, Viñas C, Castro-Barquero S, Ruiz-León AM, Sadurní M, Frontana G, Villanueva P, Gual M, Soriano R, Camafort M, Sierra C, Sacanella E, Sala-Vila A, Cots JM, Sarroca I, García M, Bermúdez N, Pérez A, Duaso I, de la Arada A, Hernández R, Simón C, de la Poza MA, Gil I, Vila M, Iglesias C, Assens N, Amatller M, Rams LL, Benet T, Fernández G, Teruel J, Azorin A, Cubells M, López D, Llovet JM, Gómez ML, Climente P, de Paula L, Soto J, Carbonell C, Llor C, Abat X, Cama A, Fortuny M, Domingo C, Liberal AI, Martínez T, Yañez E, Nieto MJ, Pérez A, Lloret E, Carrazoni C, Belles AM, Olmos C, Ramentol M, Capell MJ, Casas R, Giner I, Muñoz A, Martín R, Moron E, Bonillo A, Sánchez G, Calbó C, Pous J, Massip M, García Y, Massagué MC, Ibañez R, Llaona J, Vidal T, Vizcay N, Segura E, Galindo C, Moreno M, Caubet M, Altirriba J, Fluxà G, Toribio P, Torrent E, Anton JJ, Viaplana A, Vieytes G, Duch N, Pereira A, Moreno MA, Pérez A, Sant E, Gené J, Calvillo H, Pont F, Puig M, Casasayas M, Garrich A, Senar E, Martínez A, Boix I, Sequeira E, Aragunde V, Riera S, Salgado M, Fuentes M, Martín E, Ubieto A, Pallarés F, Sala C, Abilla A, Moreno S, Mayor E, Colom T, Gaspar A, Gómez A, Palacios L, Garrigosa R, García Molina L, Riquelme Gallego B, Cano Ibañez N, Maldonado Calvo A, López Maldonado A, Garrido EM, Baena Dominguez A, García Jiménez F, Thomas Carazo E, Jesús Turnes González A, González Jiménez F, Padilla Ruiz F, Machado Santiago J, Martínez Bellón MD, Pueyos Sánchez A, Arribas Mir L, Rodríguez Tapioles R, Dorador Atienza F, Baena Camus L, Osorio Martos C, Rueda Lozano D, López Alcázar M, Ramos Díaz F, Cruz Rosales Sierra M, Alguacil Cubero P, López Rodriguez A, Guerrero García F, Tormo Molina J, Ruiz Rodríguez F, Rekondo J, Salaverria I, Alonso-Gómez A, Belló MC, Loma-Osorio A, Tojal L, Bruyel P, Goicolea L, Sorto C, Casi Casanellas A, Arnal Otero ML, Ortueta Martínez De Arbulo J, Vinagre Morgado J, Romeo Ollora J, Urraca J, Sarriegui Carrera MI, Toribio FJ, Magán E, Rodríguez A, Castro Madrid S, Gómez Merino MT, Rodríguez Jiménez M, Gutiérrez Jodra M, López Alonso B, Iturralde Iriso J, Pascual Romero C, Izquierdo De La Guerra A, Abbate M, Aguilar I, Angullo E, Arenas A, Argelich E, Bibiloni MM, Bisbal Y, Bouzas C, Busquets C, Capó X, Carreres S, De la Peña A, Gallardo L, Gámez JM, García B, García C, Julibert A, Llompart I, Mascaró CM, Mateos D, Montemayor S, Pons A, Ripoll T, Rodríguez T, Salaberry E, Sureda A, Tejada S, Ugarriza L, Valiño L, Bernal López MR, Macías González M, Ruiz Nava J, Fernández García JC, Muñoz Garach A, Vilches Pérez A, González Banderas A, Alcaide Torres J, Vargas Candela A, León Fernández M, Hernández Robles R, Santamaría Fernández S, Marín JM, Valdés Hernández S, Villalobos JC, Ortiz A, Álvarez-Pérez J, Díaz Benítez EM, Díaz-Collado F, Sánchez-Villegas A, Pérez-Cabrera J, Casañas-Quintana LT, García-Guerra RB, Bautista-Castaño I, Ruano-Rodríguez C, Sarmiento de la Fe F, García-Pastor JA, Macías-Gutiérrez B, Falcón-Sanabria I, Simón-García C, Santana-Santana AJ, Álvarez-Álvarez JB, Díaz-González BV, Castillo Anzalas JM, Sosa-Also RE, Medina-Ponce J, Abajo Olea S, Adlbi Sibai A, Aguado Arconada A, Álvarez L, Carriedo Ule E, Escobar Fernández M, Ferradal García JI, Fernández Vázquez JP, García González M, González Donquiles C, González Quintana C, González Rivero F, Lavinia Popescu M, López Gil JI, López de la Iglesia J, Marcos Delgado A, Merino Acevedo C, Reguero Celada S, Rodríguez Bul M, Vilorio-Marqués L, Santos-Lozano JM, Miró-Moriano L, Domínguez-Espinaco C, Vaquero-Díaz S, García-Corte FJ, Santos-Calonge A, Toro-Cortés C, Pelegrina-López N, Urbano-Fernández V, Ortega-Calvo M, Lozano-Rodríguez J, Rivera-Benítez I, Caballero-Valderrama M, Iglesias-Bonilla P, Román-Torres P, Corchado-Albalat Y, Mayoral-Sánchez E, de Cos AI, Gutierrez S, Artola S, Galdon A, Gonzalo I, Más S, Sierra R, Luca B, Prieto L, Galera A, Gimenez-Gracia M, Figueras R, Poch M, Freixedas R, Trias F, Sarasa I, Fanlo M, Lafuente H, Liceran M, Rodriguez-Sanchez A, Pallarols C, Monedero J, Corbella X, Corbella E, Altés A, Vinagre I, Mestres C, Viaplana J, Serra M, Vera J, Freitas T, Ortega E, Pla I, Ordovás JM, Micó V, Berninches L, Concejo MJ, Muñoz J, Adrián M, de la Fuente Y, Albertos C, Villahoz E, Cornejo ML, Gaforio JJ, Moraleda S, Liétor N, Peis JI, Ureña T, Rueda M, Ballesta MI, Moreno Lopera C, Aragoneses Isabel C, Sirur Flores MA, Ceballos de Diego M, Bescos Cáceres T, Peña Cereceda Y, Martínez Abad M, Cabrera Vela R, González Cerrajero M, Rubio Herrera MA, Torrego Ellacuría M, Barabash Bustelo A, Ortiz Ramos M, Garin Barrutia U, Baños R, García-Palacios A, Cerdá Micó C, Estañ Capell N, Iradi A, Fandos Sánchez M. Cohort Profile: Design and methods of the PREDIMED-Plus randomized trial. Int J Epidemiol 2018; 48:387-388o. [PMID: 30476123 DOI: 10.1093/ije/dyy225] [Citation(s) in RCA: 166] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2018] [Indexed: 01/04/2023] Open
Affiliation(s)
- Miguel A Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Pilar Buil-Cosiales
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Monica Bulló
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Clinical Epidemiology and Public Health Department, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - J Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Jose López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Cardiology, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Francisco Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - Lluis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Las Palmas de Gran Canaria, Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Jose Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Eating Disorders Unit, Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Hospitalet del Llobregat, Barcelona, Spain
| | - Cristina Botella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - María Puy Portillo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy and Lucio Lascaray Research Center, Universidad del País Vasco (UPV/EHU), Vitoria, Spain
| | - Rosa M Lamuela-Raventós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, -UB, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Ascensión Marcos
- Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Guillermo Sáez
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Odontology, University Hospital Dr. Peset, University of Valencia, Valencia, Spain
| | | | - Miguel Ruiz-Canela
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Estefania Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Ismael Alvarez-Alvarez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
| | - Javier Díez-Espino
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - José V Sorlí
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Josep Basora
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Olga Castañer
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Eva María Navarrete-Muñoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - Maria Angeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- University of Navarra, Department of Nutrition, Food Science and Physiology, IDISNA, Pamplona, Spain
| | - Antonio García-Rios
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Reus, Spain
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Moragrega C, Puig M, Ruz L, Montesinos E, Llorente I. Epidemiological Features and Trends of Brown Spot of Pear Disease Based on the Diversity of Pathogen Populations and Climate Change Effects. Phytopathology 2018; 108:223-233. [PMID: 28945144 DOI: 10.1094/phyto-03-17-0079-r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Brown spot of pear, caused by the fungus Stemphylium vesicarium, is an emerging disease of economic importance in several pear-growing areas in Europe. In recent years, new control strategies combining sanitation practices and fungicide applications according to developed forecasting models have been introduced to manage the disease. However, the pathogenic and saprophytic behavior of this pathogen makes it difficult to manage the disease. In addition, climate change can also result in variations in the severity and geographical distribution of the disease. In this study, ecological and epidemiological aspects of brown spot of pear disease related to inoculum characterization and climate change impact were elucidated. The pathogenic variation in S. vesicarium populations from pear orchards and its relationship to inoculum sources (air samples, leaf debris, and infected host and nonhost tissues) was determined using multivariate analysis. In total, six variables related to infection and disease development on cultivar Conference pear detached leaves of 110 S. vesicarium isolates were analyzed. A high proportion of isolates (42%) were nonpathogenic to pear; 85% of these nonpathogenic isolates were recovered from air samples. Most isolates recovered from lesions (93%) and pseudothecia (83%) were pathogenic to pear. A group of pathogenic isolates rapidly infected cultivar Conference pear leaves resulted in disease increase that followed a monomolecular model, whereas some S. vesicarium isolates required a period of time after inoculation to initiate infection and resulted in disease increase that followed a logistic model. The latter group was mainly composed of isolates recovered from pseudothecia on leaf debris, whereas the former group was mainly composed of isolates recovered from lesions on pear fruit and leaves. The relationship between the source of inoculum and pathogenic/aggressiveness profile was confirmed by principal component analysis. The effect of climate change on disease risk was analyzed in two pear-growing areas of Spain under two scenarios (A2 and B1) and for three periods (2005 to 2009, 2041 to 2060, and 2081 to 2100). Simulations showed that the level of risk predicted by BSPcast model increased to high or very high under the two scenarios and was differentially distributed in the two regions. This study is an example of how epidemiological models can be used to predict not only the onset of infections but also how climate change could affect brown spot of pear. [Formula: see text] Copyright © 2018 The Author(s). This is an open-access article distributed under the CC BY-NC-ND 4.0 International license .
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Affiliation(s)
- Concepció Moragrega
- All authors: Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, C/ Maria Aurèlia Capmany, 61, 17003 Girona Spain
| | - Mireia Puig
- All authors: Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, C/ Maria Aurèlia Capmany, 61, 17003 Girona Spain
| | - Lídia Ruz
- All authors: Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, C/ Maria Aurèlia Capmany, 61, 17003 Girona Spain
| | - Emilio Montesinos
- All authors: Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, C/ Maria Aurèlia Capmany, 61, 17003 Girona Spain
| | - Isidre Llorente
- All authors: Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, C/ Maria Aurèlia Capmany, 61, 17003 Girona Spain
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15
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Caballero F, Puig M, Leal J, Trejo O, Díaz I, Herrera S, Turbau M, Ris J, Benito S. A helpful approach to organ donation: From end-of-life care to effective organ transplantation. Am J Transplant 2018; 18:528-529. [PMID: 28891206 DOI: 10.1111/ajt.14493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- F Caballero
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Puig
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Leal
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - O Trejo
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Díaz
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Herrera
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Turbau
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Ris
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Benito
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Candel FJ, Pazos Pacheco C, Ruiz-Camps I, Maseda E, Sánchez-Benito MR, Montero A, Puig M, Gilsanz F, Aguilar J, Matesanz M. Update on management of invasive candidiasis. Rev Esp Quimioter 2017; 30:397-406. [PMID: 29115366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Given the growing incidence of invasive candidiasis in critically ill and haemato-oncological patients and its poor outcomes, an early diagnosis and treatment are need for get a better prognosis. This document reviews the current ap-proaches that help in diagnosis of invasive candidiasis based on culture-independent microbiological tests. The combination of clinical prediction scores with fungal serological markers could facilitate the approach in antifungal therapy, optimiz-ing it. This article also reviews the epidemiology and primary risk factors for invasive candidiasis in these patients, updating the therapeutic approach algorithms in both clinical contexts based on the main evidence and international guidelines.
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Affiliation(s)
- F J Candel
- Dr Francisco Javier Candel González, Department of Clinical Microbiology and Infectious Diseases. Hospital Clínico San Carlos. IDISSC. Universidad Complutense. Avda Profesor Martín Lagos s/n, 28040. Madrid, Spain.
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Caballero F, Ris J, Puig M, Leal J, Benito S. Brain-Dead Donors With Ornithine Transcarbamylase Deficiency: A Big Learning Opportunity in Clinical Evaluation. Am J Transplant 2017; 17:2229. [PMID: 28544377 DOI: 10.1111/ajt.14367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- F Caballero
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Ris
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Puig
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Leal
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Benito
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Brotons C, Moral I, Fernandez D, Puig M, Calvo E. P6232Impact of the European and American guidelines on the management and treatment of dyslipidemia in a Spanish working population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Brotons C, Moral I, Fernández D, Cuixart L, Muñoz A, Soteras A, Puig M, Joaniquet X, Casasa A. Fe de errores de «Consecuencias clínicas de la utilización de las nuevas tablas de riesgo cardiovascular SCORE OP para pacientes mayores de 65 años». Med Clin (Barc) 2017; 148:241. [DOI: 10.1016/j.medcli.2016.12.002] [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: 12/13/2016] [Accepted: 12/14/2016] [Indexed: 11/27/2022]
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Juanes A, Garin N, Mangues MA, Herrera S, Puig M, Faus MJ, Baena MI. Impact of a pharmaceutical care programme for patients with chronic disease initiated at the emergency department on drug-related negative outcomes: a randomised controlled trial. Eur J Hosp Pharm 2017; 25:274-280. [PMID: 31157039 DOI: 10.1136/ejhpharm-2016-001055] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 07/15/2016] [Revised: 01/11/2017] [Accepted: 01/23/2017] [Indexed: 11/04/2022] Open
Abstract
Background The resolution of potential drug-related problems is a priority of pharmaceutical care programmes. Objectives To assess the clinical impact on drug-related negative outcomes of a pharmaceutical care programme focusing on the resolution of potential drug-related problems, initiated in the emergency department for patients with heart failure (HF) and/or chronic obstructive pulmonary disease (COPD). Methods Controlled trials, in which older adults (≥65 years) receiving four or more medications admitted to the emergency department for ≥12 hours for worsening of HF and/or COPD were randomised (1:1) to either a pharmaceutical care programme focusing on resolving potential drug-related problems initiated at the emergency department (intervention group (IG)) or standard care (control group). Comparisons between the groups were made for the proportion of patients with drug-related negative outcomes, number of drug-related negative outcomes per patient, mean stay, patients readmitted within 180 days and 180-day mortality. Results 118 patients were included, 59 in each group. Fewer patients in the IG had drug-related negative outcomes (37 (62.7%) vs 47 (79.7%) in the control group (p=0.042)). Fewer drug-related negative outcomes per patient occurred in the IG (56 (0.95 per patient) vs 85 (1.44 per patient) in the control group (p=0.01)). The mean stay was similar between groups (194.7 hours in the IG vs 242.5 hours in the control group (p=0.186)). No difference in revisits within 180 days was found (32 (54.24%) in the IG vs 22 (37.3%) in the control group (p=0.065)). 180-Day mortality was detected in 11 (18.6%) patients in the IG compared with 13 (22%) in the control group (p=0.647). Conclusion A pharmaceutical care programme focusing on resolving potential drug-related problems initiated at the emergency department has a favourable clinical impact, as it reduces the number and prevalence of drug-related negative outcomes. No difference was found in other outcome variables.Trial registration number NCT02368548.
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Affiliation(s)
- Ana Juanes
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Noe Garin
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigacin Biomdica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Maria Antonia Mangues
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBER de Bioingeniera, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Sergio Herrera
- Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mireia Puig
- Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Maria Jose Faus
- Pharmaceutical care Research Group, Universidad de Granada, Granada, Spain
| | - Maria Isabel Baena
- Pharmaceutical care Research Group, Universidad de Granada, Granada, Spain
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Brotons C, Moral I, Fernández D, Cuixart L, Muñox A, Soteras A, Puig M, Joaniquet X, Casasa A. Consecuencias clínicas de la utilización de las nuevas tablas de riesgo cardiovascular SCORE OP para pacientes mayores de 65 años. Med Clin (Barc) 2016; 147:381-386. [DOI: 10.1016/j.medcli.2016.06.035] [Citation(s) in RCA: 11] [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] [Received: 05/05/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 11/16/2022]
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Brotons C, Moral I, Fernández D, Cuixart L, Soteras A, Puig M. Assessment of the New SCORE OP Cardiovascular Risk Charts in Patients Older Than 65 Years. Rev Esp Cardiol (Engl Ed) 2016; 69:981-983. [PMID: 27474480 DOI: 10.1016/j.rec.2016.04.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 04/25/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Carlos Brotons
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente de Medicina de Familia UDACEBA, Barcelona, Spain.
| | - Irene Moral
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente de Medicina de Familia UDACEBA, Barcelona, Spain
| | - Diana Fernández
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente de Medicina de Familia UDACEBA, Barcelona, Spain
| | - Lluís Cuixart
- Unidad Docente de Medicina de Familia UDACEBA, Barcelona, Spain; EAP Dreta de l'Eixample, Barcelona, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Anna Soteras
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente de Medicina de Familia UDACEBA, Barcelona, Spain
| | - Mireia Puig
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente de Medicina de Familia UDACEBA, Barcelona, Spain
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Brotons C, Moral I, Fernández D, Cuixart L, Soteras A, Puig M. Evaluación de las nuevas tablas de riesgo cardiovascular SCORE OP para pacientes mayores de 65 años. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.04.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Benito L, García M, Binefa G, Mila N, Vidal C, Lluch M, Puig M. Cross-sectional survey on awareness of colorectal cancer and a screening programme for primary health care professionals in Catalonia, Spain. Eur J Cancer Care (Engl) 2016; 25:992-1004. [DOI: 10.1111/ecc.12450] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2015] [Indexed: 11/29/2022]
Affiliation(s)
- L. Benito
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
- IDIBELL; Institute of Biomedical Research; Hospitalet de Llobregat (Barcelona) Spain
- Fundamental Care and Medical-Surgical Nursing Department; School of Nursing; University of Barcelona; Hospitalet de Llobregat (Barcelona) Spain
| | - M. García
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
- IDIBELL; Institute of Biomedical Research; Hospitalet de Llobregat (Barcelona) Spain
| | - G. Binefa
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
| | - N. Mila
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
| | - C. Vidal
- Cancer Prevention and Control Program; Catalan Institute of Oncology; Hospitalet de Llobregat (Barcelona) Spain
| | - M.T. Lluch
- Public Health, Mental Health and Perinatal Nursing (Barcelona); School of Nursing; University of Barcelona; Hospitalet de Llobregat (Barcelona) Spain
| | - M. Puig
- Public Health, Mental Health and Perinatal Nursing (Barcelona); School of Nursing; University of Barcelona; Hospitalet de Llobregat (Barcelona) Spain
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Puig M, Moragrega C, Ruz L, Calderón CE, Cazorla FM, Montesinos E, Llorente I. Interaction of antifungal peptide BP15 with Stemphylium vesicarium , the causal agent of brown spot of pear. Fungal Biol 2016; 120:61-71. [DOI: 10.1016/j.funbio.2015.10.007] [Citation(s) in RCA: 15] [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] [Received: 06/02/2015] [Revised: 10/13/2015] [Accepted: 10/23/2015] [Indexed: 02/08/2023]
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Puig M, Moragrega C, Ruz L, Montesinos E, Llorente I. Controlling Brown Spot of Pear by a Synthetic Antimicrobial Peptide Under Field Conditions. Plant Dis 2015; 99:1816-1822. [PMID: 30699505 DOI: 10.1094/pdis-03-15-0250-re] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Brown spot of pear, caused by Stemphylium vesicarium, is a fungal disease of increasing importance in several pear-growing areas of Europe. Disease control measures include the application of fungicides and sanitation methods. Antimicrobial peptides may be a complement or alternative to conventional fungicides used to manage brown spot disease. In a previous study, the synthetic peptide BP15 showed postinfection fungicidal activity against S. vesicarium in in vitro and detached-leaf assays. In the present study, the efficacy of BP15 (KKLFKKILKVL-NH2) in controlling brown spot of pear was evaluated under field conditions using potted plants and pear trees in orchards. In field trials, the treatments with BP15 or with the fungicide thiram were scheduled according to the infection risk predicted by the BSPcast model. Potted pear plants treated with BP15 showed a disease reduction of about 42 to 60% in five of seven trials. In three of four tree trials, the disease severity on shoots treated with BP15 was significantly lower than in the nontreated controls, with a mean efficacy of 38.2%. It was concluded that BP15 is a good candidate to be further developed as a fungicide for controlling brown spot of pear.
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Affiliation(s)
- Mireia Puig
- Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, Spain
| | - Concepció Moragrega
- Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, Spain
| | - Lídia Ruz
- Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, Spain
| | - Emilio Montesinos
- Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, Spain
| | - Isidre Llorente
- Institute of Food and Agricultural Technology-XaRTA-CIDSAV, University of Girona, Spain
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Brotons C, Calvo-Bonacho E, Moral I, Puig M, Garcia-Margallo MT, Cortés-Arcas MV, Catalina-Romero C, Quevedo-Aguado L, Ruilope LM. Comparison of application of different methods to estimate lifetime cardiovascular risk. Eur J Prev Cardiol 2015; 23:564-71. [PMID: 25827686 DOI: 10.1177/2047487315579616] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 03/10/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent guidelines recommend assessment of lifetime cardiovascular risk on the basis of traditional risk factors in adults who are not at high short-term risk. The aim of this study is to determine the implications of estimating the lifetime cardiovascular risk in individuals in a large occupational cohort in Spain. DESIGN National cross-sectional study in an occupational cohort with an in-person interview including laboratory tests. METHODS Volunteer workers who were examined between January 2011 and December 2011 were included. A total of 580,236 workers were eligible during this year and 259,834 were examined (participation rate of 44.7%). Short-term (10-year) and lifetime cardiovascular risk were estimated using the American College of Cardiology (ACC) and the American Heart Association (AHA) tool and the QRISK2 and QRISK. RESULTS Sixty-eight per cent were male, mean age was 39 years, with an age range of 16 to 75 years. Total number of individuals included in this study was 258,676. The percentage of patients at high short-term risk was 6.85% (95% confidence interval (CI) 6.75%-6.95% and 20.83% (95% CI 20.60%-21.07%) with the QRISK2, and the ACC/AHA risk equations, respectively. Of the percentage of patients classified as not at high risk with the different tools 1.61% (95% CI 1.55%-1.66%) were high lifetime risk on QRISK, and 27.41% (95% CI 27.11%-27.70%) on ACC/AHA risk. CONCLUSIONS Application of lifetime cardiovascular risk engages greater numbers of individuals at high risk with substantial differences between the different methods available. These differences can have important clinical implications specifically in the percentage of candidates for lifestyle changes and eventually lipid lowering drugs.
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Affiliation(s)
- Carlos Brotons
- Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain
| | | | - Irene Moral
- Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain
| | - Mireia Puig
- Research Unit, Sardenya Primary Health Care Centre-Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain Teaching Unit of Family Medicine ACEBA, Barcelona, Spain
| | | | | | | | | | - Luis M Ruilope
- Instituto de Investigación, Hospital Universitario Doce de Octubre, Madrid, Spain
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Pigrau C, Rodríguez-Pardo D, Fernández-Hidalgo N, Moretó L, Pellise F, Larrosa MN, Puig M, Almirante B. Health care associated hematogenous pyogenic vertebral osteomyelitis: a severe and potentially preventable infectious disease. Medicine (Baltimore) 2015; 94:e365. [PMID: 25621677 PMCID: PMC4602631 DOI: 10.1097/md.0000000000000365] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/10/2014] [Accepted: 11/14/2014] [Indexed: 12/17/2022] Open
Abstract
Although hematogenous pyogenic spinal infections have been related to hemodialysis (HD), catheter-related sepsis, and sporadically, to other nosocomial infections or procedures, in most recent studies and reviews the impact of nosocomial infection as a risk factor for vertebral osteomyelitis (VO) is not well established. The aim of our study was to describe the risk factors, infectious source, etiology, clinical features, therapy, and outcome of health care associated VO (HCAVO), and compare them with community-acquired VO (CAVO) cases.A retrospective cohort study of consecutive patients with hematogenous VO was conducted in our third-level hospital between 1987 and 2011. HCAVO was defined as onset of symptoms after 1 month of hospitalization or within 6 months after hospital discharge, or ambulatory manipulations in the 6 months before the diagnosis.Over the 25-year study period, among 163 hematogenous pyogenic VO, 41 (25%) were health care associated, a percentage that increased from 15% (9/61) in the 1987-1999 period to 31% (32/102) in the 2000-2011 period (P < 0.01). The presumed source of infection was an intravenous catheter in 14 (34%), cutaneous foci in 8 (20%), urinary tract in 7 (17%), gastrointestinal in 3 (7%), other foci in 3 (7%), and unknown in 6 (15%). Staphylococcus aureus was the most frequently isolated microorganism (14 cases, 34%), followed by coagulase-negative Staphylococci (CoNS) in 6 (15%), and Enterobacteriaceae in 6 (15%) cases.Compared with CAVO cases, patients with HCAVO were older (mean 66.0 SD 13.0 years vs 60.5 SD 15.5 years), had more underlying conditions (73% vs 50%, P < 0.05), neoplasm/immunosuppression (39% vs 7%, P < 0.005), chronic renal failure (19% vs 4%, P < 0.001), a known source of infection (85% vs 54% P < 0.05), Candida spp (7% vs 0%, P < 0.01) or CoNS infections (15% vs 2%, P < 0.05), higher mortality (15% vs 6%, P = 0.069), and a higher relapse rate in survivors (9% vs 1%, P < 0.05).Presently, in our setting, one-third of hematogenous pyogenic VO infections are health care associated, and a third of these are potentially preventable catheter-related infections. Compared with CAVO, in health care associated hematogenous VO, mortality and relapse rates are higher; hence, further prevention measures should be assessed.
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Affiliation(s)
- Carlos Pigrau
- From the Infectious Diseases Department (CP, DR-P, NF-H, LM, BA); Orthopedic Department (FP); Microbiology Department (M-NL), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona; and REIPI (Spanish Network for Research in Infectious Diseases) (CP, DR-P, NF-H, M-NL, MP, BA), Madrid, Spain
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Puig M, Moragrega C, Ruz L, Montesinos E, Llorente I. Postinfection Activity of Synthetic Antimicrobial Peptides Against Stemphylium vesicarium in Pear. Phytopathology 2014; 104:1192-200. [PMID: 24875384 DOI: 10.1094/phyto-02-14-0036-r] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Brown spot of pear is a fungal disease of economic importance caused by Stemphylium vesicarium that affects the pear crops in Europe. Due to the characteristics of this disease and the moderate efficacy of available fungicides, the effectiveness of control measures is very limited; however, synthetic antimicrobial peptides (AMPs) may be a complement to these fungicides. In the present study, 12 AMPs of the CECMEL11 library were screened for fungicidal activity against S. vesicarium. In vitro experiments showed that eight AMPs significantly reduced the germination of conidia. The most effective peptides, BP15, BP22, and BP25, reduced fungal growth and sporulation at concentrations below 50 μM. Leaf assays showed that preventive application of BP15 and BP22 did not reduce infection; however, when the peptides were applied curatively, infection was significantly reduced. The use of a BP15 fluorescein 5-isothiocyanate conjugate revealed that the peptide binds to hyphae and germ tubes and produces malformations that irreversibly stop their development.
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Brotons C, Calvo-Bonacho E, Moral I, García-Margallo MT, Cortés-Arcas MV, Puig M, Vázquez-Pirillo G, Ruilope LM. Impact of the new American and British guidelines on the management and treatment of dyslipidemia in a Spanish working population. Rev Esp Cardiol (Engl Ed) 2014; 67:906-911. [PMID: 25278212 DOI: 10.1016/j.rec.2014.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 06/25/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION AND OBJECTIVES The guidelines of the American College of Cardiology/American Heart Association and the British National Institute for Health and Clinical Excellence on the management and treatment of dyslipidemia recommend significant changes, such as the abolition of therapeutic targets and the use of new risk tables. This study aimed to evaluate the impact of the use of these new guidelines compared with the application of European guidelines. METHODS Observational study conducted among Spanish workers. We included all workers registered with the Sociedad de Prevención de Ibermutuamur in 2011 whose cardiovascular risk could be evaluated. Cardiovascular risk was calculated for each worker using the Systematic Coronary Risk Evaluation cardiovascular risk tables for low-risk countries, as well as the tables recommended by the American and British guidelines. RESULTS A total of 258,676 workers were included (68.2% men; mean age, 39.3 years). High risk was found in 3.74% of the population according to the Systematic Coronary Risk Evaluation tables and in 6.85% and 20.83% according to the British and American tables, respectively. Treatment would be needed in 20 558 workers according to the American guidelines and in 13,222 according to the British guidelines, but in only 2612 according to the European guidelines. By following the American guidelines, the cost of statins would increase by a factor of 8. CONCLUSIONS The new recommendations would result in identifying more high-risk patients and in treating a larger fraction of the population with lipid-lowering drugs than with the European recommendations, which would result in increased costs.
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Affiliation(s)
- Carlos Brotons
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain.
| | | | - Irene Moral
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | | | | | - Mireia Puig
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Gastón Vázquez-Pirillo
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Luis Miguel Ruilope
- Instituto de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain
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Brotons C, Moral I, Soriano N, Cuixart L, Osorio D, Bottaro D, Puig M, Joaniquet X, Marcos A, Casasa A. Impact of using different SCORE tables for estimating cardiovascular risk. ACTA ACUST UNITED AC 2013; 67:94-100. [PMID: 24795115 DOI: 10.1016/j.rec.2013.06.018] [Citation(s) in RCA: 3] [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: 05/09/2013] [Accepted: 06/27/2013] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES In Spain, various SCORE tables are available to estimate cardiovascular risk: tables for low-risk countries, tables calibrated for the Spanish population, and tables that include high-density lipoprotein values. The aim of this study is to assess the impact of using one or another SCORE table in clinical practice. METHODS In a cross-sectional study carried out in two primary health care centers, individuals aged 40 to 65 years in whom blood pressure and total cholesterol levels were recorded between March 2010 and March 2012 were selected. Patients with diabetes or a history of cardiovascular disease were excluded. Cardiovascular risk was calculated using SCORE for low-risk countries, SCORE with high-density lipoprotein cholesterol, and the calibrated SCORE. RESULTS Cardiovascular risk was estimated in 3716 patients. The percentage of patients at high or very high risk was 1.24% with SCORE with high-density lipoprotein cholesterol, 4.73% with the low-risk SCORE, and 15.44% with the calibrated SCORE (P<.01). Treatment with lipid-lowering drugs would be recommended in 10.23% of patients using the calibrated SCORE, 3.12% of patients using the low-risk SCORE, and 0.67% of patients using SCORE with high-density lipoprotein cholesterol. CONCLUSIONS The calibrated SCORE table classifies a larger number of patients at high or very high risk than the SCORE for low-risk countries or the SCORE with high-density lipoprotein cholesterol. Therefore, its use would imply treating more patients with lipid-lowering medication. Validation studies are needed to assess the most appropriate SCORE table for use in our setting.
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Affiliation(s)
- Carlos Brotons
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain.
| | - Irene Moral
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Núria Soriano
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain; Departamento de Pediatría, Obstetricia y Ginecología, Medicina Preventiva y Salud Pública, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lluís Cuixart
- Unidad Docente ACEBA, Barcelona, Spain; EAP Dreta de l'Eixample, Barcelona, Spain
| | - Dimelza Osorio
- Servicio de Epidemiología Clínica y Salud Pública, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - David Bottaro
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Mireia Puig
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
| | - Xavier Joaniquet
- Unidad Docente ACEBA, Barcelona, Spain; EAP Dreta de l'Eixample, Barcelona, Spain
| | - Albert Marcos
- Unidad Docente ACEBA, Barcelona, Spain; EAP Dreta de l'Eixample, Barcelona, Spain
| | - Albert Casasa
- Unidad de Investigación, Equip d'Atenció Primària Sardenya, Instituto de Investigación Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain; Unidad Docente ACEBA, Barcelona, Spain
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Hillyer P, Mane VP, Schramm LM, Puig M, Verthelyi D, Chen A, Zhao Z, Navarro MB, Kirschman KD, Bykadi S, Jubin RG, Rabin RL. Expression profiles of human interferon‐alpha and interferon‐lambda subtypes are ligand‐ and cell‐dependent. Immunol Cell Biol 2013. [PMCID: PMC4026931 DOI: 10.1038/icb.2013.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Burgos J, Luján M, Larrosa MN, Fontanals D, Bermudo G, Planes AM, Puig M, Rello J, Falcó V, Pahissa A. Risk factors for respiratory failure in pneumococcal pneumonia: the importance of pneumococcal serotypes. Eur Respir J 2013; 43:545-53. [PMID: 23845720 DOI: 10.1183/09031936.00050413] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Pneumococcal serotypes are one of the main determinants of pneumococcal disease severity; however, data about their implication in respiratory failure are scarce. We conducted an observational study of adults hospitalised with invasive pneumococcal pneumonia to describe the host- and pathogen-related factors associated with respiratory failure. Of 1258 adults with invasive pneumococcal disease, 615 (48.9%) had respiratory failure at presentation. Patients with respiratory failure were older (62.1 years versus 55.4 years, p<0.001) and had a greater proportion of comorbid conditions. They also had a greater proportion of septic shock (41.7% versus 6.1%, p<0.001), required admission to the intensive care unit more often (38.4% versus 4.2%, p<0.001) and had a higher mortality (25.5% versus 3.5%, p<0.001). After adjustment, independent risk factors for respiratory failure were: age >50 years (OR 1.63, 95% CI 1.15-2.3), chronic lung disease (OR 1.54, 95% CI 1.1-2.15), chronic heart disease (OR 1.49, 95% CI 1.01-2.22) and infection caused by serotypes 3 (OR 1.97, 95% CI 1.23-3.16), 19A (OR 2.34, 95% CI 1.14-4.42) and 19F (OR 3.55, 95% CI 1.22-10.28). In conclusion, respiratory failure is a frequent complication of pneumococcal pneumonia and causes high morbidity and mortality. Pneumococcal serotypes 3, 19A and 19F are the main risk factors for this complication.
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Affiliation(s)
- Joaquín Burgos
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona
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Barrera E, Fernandez—Galinski S, Ferrer M, Escolano F, Puig M. 662 POSTOPERATIVE ANALGESIA INDUCED BY TRANSDERMAL FENTANYL IN DORSAL AND LUMBAR SPINE ARTHRODESIS. Eur J Pain 2012. [DOI: 10.1016/s1090-3801(09)60665-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E. Barrera
- Department of Anaesthesiology/Hospital del Mar. IMAS, Barcelona, Spain
| | | | - M.D. Ferrer
- Department of Anaesthesiology/Hospital del Mar. IMAS, Barcelona, Spain
| | - F. Escolano
- Department of Anaesthesiology/Hospital del Mar. IMAS, Barcelona, Spain
| | - M. Puig
- Department of Anaesthesiology/Hospital del Mar. IMAS, Barcelona, Spain
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Zaslansky R, Chapman C, Rothaug J, Bäckström R, Brill S, Davidson E, Elessi K, Fletcher D, Fodor L, Karanja E, Konrad C, Kopf A, Leykin Y, Lipman A, Puig M, Rawal N, Schug S, Ullrich K, Volk T, Meissner W. Feasibility of international data collection and feedback on post-operative pain data: Proof of concept. Eur J Pain 2011; 16:430-8. [DOI: 10.1002/j.1532-2149.2011.00024.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2011] [Indexed: 11/05/2022]
Affiliation(s)
- R. Zaslansky
- Department of Anesthesiology and Intensive Care; Friedrich-Schiller University Hospital; Jena; Germany
| | - C.R. Chapman
- Pain Research Center; Department of Anesthesiology; University of Utah; Salt Lake City; UT; USA
| | - J. Rothaug
- Department of Anesthesiology and Intensive Care; Friedrich-Schiller University Hospital; Jena; Germany
| | - R. Bäckström
- Department of Anesthesiology and Intensive Care; University Hospital Örebro; Örebro; Sweden
| | - S. Brill
- Department of Anesthesiology and Intensive Care; Sourasky Medical Center; Tel-Aviv; Israel
| | - E. Davidson
- Department of Anesthesiology and Intensive Care; Hadassah Medical Center; Jerusalem; Israel
| | - K. Elessi
- El-Wafa Medical Rehabilitation Hospital; Gaza Strip
| | - D. Fletcher
- Department of Anesthesiology and Intensive Care; Raymond Poincaré Hospital; Garches; France
| | - L. Fodor
- Plastic and Reconstructive Surgery; Cluj University Hospital; Cluj; Romania
| | - E. Karanja
- Doctor's Service; Avenue Hospital; Nairobi; Kenya
| | - C. Konrad
- Department of Anesthesiology and Intensive Care; Kantonsspital; Lucerne; Switzerland
| | - A. Kopf
- Department of Anesthesiology and Intensive Care; Charite Medical Center; Berlin; Germany
| | - Y. Leykin
- Department of Anesthesiology and Intensive Care; Santa Maria Degli Angeli; University of Trieste and Udine; Udine; Italy
| | - A. Lipman
- Department of Pharmacotherapy; College of Pharmacy; University of Utah; Salt Lake City; UT; USA
| | - M. Puig
- Department of Anesthesiology and Intensive Care; IMIM-Hospital del Mar-UAB; Barcelona; Spain
| | - N. Rawal
- Department of Anesthesiology and Intensive Care; University Hospital Örebro; Örebro; Sweden
| | - S. Schug
- Department of Anesthesiology and Intensive Care; University of Western Australia and Royal Perth Hospital; Perth; Australia
| | - K. Ullrich
- Department of Anesthesiology and Intensive Care; Queen Mary and Westfield College; University of London; London; UK
| | - T. Volk
- Department of Anesthesiology and Intensive Care; Saarland University Hospital; Homburg; Germany
| | - W. Meissner
- Department of Anesthesiology and Intensive Care; Friedrich-Schiller University Hospital; Jena; Germany
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Burgos J, Lujan M, Falco V, Sanchez A, Puig M, Borrego A, Fontanals D, Planes AM, Pahissa A, Rello J. The Spectrum of Pneumococcal Empyema in Adults in the Early 21st Century. Clin Infect Dis 2011; 53:254-61. [DOI: 10.1093/cid/cir354] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Navia J, Monedero P, Echevarría M, Canet J, Aguilera L, Gómez-Herreras JI, Gómez-Sancho M, Puig M, Abengoechea JM, Hernández J, Romero AJ. [Health-care workload and instructional capacity of Spanish hospitals accredited to train residents in anesthesiology]. ACTA ACUST UNITED AC 2010; 57:341-50. [PMID: 20645485 DOI: 10.1016/s0034-9356(10)70246-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To describe the health-care workload and instructional capacity of Spanish hospitals accredited to train anesthesiology residents. METHODS Survey of supervisors of anesthesiology residents in 2008 to determine caseloads in surgery and obstetrics as well as in pain clinics and critical care units. The results are presented for different Spanish autonomous communities. The maximum theoretical capacity for instruction in accordance with European guidelines is calculated. RESULTS The 100 hospitals surveyed train 325 residents per year and could theoretically increase the training opportunities they offer, within certain limits. Given optimal distribution of resources, the system could train 397 residents per year in pediatric surgery in 3-month rotations, 442 residents in neurosurgery in 2-month rotations, and 479 residents in thoracic surgery in 1-month rotations. Some Spanish communities presently have problems giving training in the settings of pediatric, thoracic, and major outpatient surgery. Furthermore, even though anesthesiologists are presently responsible for 41.6% of available critical care beds, 46 hospitals do not have a sufficient number of beds to give training in this setting. This shortage may have negative repercussions on the accreditation of training programs. CONCLUSIONS Although certain limitations were found, the survey showed that the training capacity of the system is greater than accreditation suggests. It would therefore be possible to increase the number of residents.
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Affiliation(s)
- J Navia
- Miembros de la Comisión Nacional de la Especialidad de Anestesiología y Reanimación
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Sordé R, Falcó V, Lowak M, Domingo E, Ferrer A, Burgos J, Puig M, Cabral E, Len O, Pahissa A. Current and potential usefulness of pneumococcal urinary antigen detection in hospitalized patients with community-acquired pneumonia to guide antimicrobial therapy. ACTA ACUST UNITED AC 2010; 171:166-72. [PMID: 20876397 DOI: 10.1001/archinternmed.2010.347] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The role of pneumococcal urinary antigen detection in the treatment of adults with community-acquired pneumonia (CAP) is not well defined. We assessed the usefulness of pneumococcal urinary antigen detection in the diagnosis and antimicrobial guidance in patients hospitalized with CAP. METHODS A prospective study of all adults hospitalized with CAP was performed from February 2007 through January 2008. To evaluate the accuracy of the test, we calculated its sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios. The gold standard used for diagnosis of pneumococcal pneumonia was isolation in blood or pleural fluid (definite diagnosis) and isolation in sputum (probable diagnosis). Antibiotic modifications, complications, and mortality were analyzed. RESULTS A total of 474 episodes of CAP were included. Streptococcus pneumoniae was the causative pathogen in 171 cases (36.1%). It was detected exclusively by urinary antigen test in 75 cases (43.8%). Sixty-nine patients had CAP caused by a pathogen other than S pneumoniae. Specificity was 96%, positive predictive value ranged from 88.8% to 96.5%, and the positive likelihood ratio ranged from 14.6 to 19.9. The results of the test led the clinicians to reduce the spectrum of antibiotics in 41 patients. Pneumonia was cured in all of them. Potentially, this optimization would be possible in the 75 patients diagnosed exclusively by the test. CONCLUSION When its findings are positive, the pneumococcal urinary antigen test is a useful tool in the treatment of hospitalized adult patients with CAP because it may allow the clinician to optimize antimicrobial therapy with good clinical outcomes.
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Affiliation(s)
- Roger Sordé
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
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Ajenjo AC, Cabañero D, García‐Nogales P, Romero A, Puig M. 273 CHARACTERIZATION OF KAPPA OPIOD RECEPTOR AND PRODYNORPHIN/DYNORPHIN EXPRESSION IN DORSAL ROOT GANGLIA, IN A MURINE MODEL OF POSTOPERATIVE PAIN. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60276-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Campillo Ajenjo
- Pain Research Unit. IMIM‐Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D. Cabañero
- Pain Research Unit. IMIM‐Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P. García‐Nogales
- Pain Research Unit. IMIM‐Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A. Romero
- Pain Research Unit. IMIM‐Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M. Puig
- Pain Research Unit. IMIM‐Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
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Romero A, Miranda H, Dürsteler C, Puig M. 376 DEXKETOPROFEN AND TRAMADOL INTERACTION IN A MODEL OF MONOARTICULAR CHRONIC INFLAMMATORY PAIN IN MICE. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60379-7] [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: 10/20/2022]
Affiliation(s)
- A. Romero
- Pain Research Unit. Department of Anesthesiology. IMIM‐Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - H.F. Miranda
- School of Medicine, ICBM, Department of Pharmacology, Universidad de Chile, Santiago de Chile, Chile
| | - C. Dürsteler
- Pain Research Unit. Department of Anesthesiology. IMIM‐Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M. Puig
- Pain Research Unit. Department of Anesthesiology. IMIM‐Hospital del Mar. Universitat Autònoma de Barcelona, Barcelona, Spain
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Castelo-Branco C, Duran M, Puig M, Vanrell JA. Gynaecological short communication: Compliance with hormone replacement therapy at the menopause. J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443619509015501] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Martí-Fàbregas J, Bravo Y, Cocho D, Martí-Vilalta JL, Díaz-Manera J, San Román L, Puig M, Blanco M, Castellanos M, Millán M, Roquer J, Obach V, Maestre J. Frequency and Predictors of Symptomatic Intracerebral Hemorrhage in Patients with Ischemic Stroke Treated with Recombinant Tissue Plasminogen Activator outside Clinical Trials. Cerebrovasc Dis 2006; 23:85-90. [PMID: 17114877 DOI: 10.1159/000097043] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2006] [Accepted: 07/25/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To determine the frequency and predictors of symptomatic intracerebral hemorrhage (SICH) in patients treated with recombinant tissue plasminogen activator (rt-PA). METHODS We reviewed the databases of 7 tertiary hospitals that treated ischemic stroke patients with intravenous rt-PA. We recorded demographic data, vascular risk factors, time between onset and treatment, dose, the NIHSS score, body temperature, blood pressure, platelet count, blood glucose, antiplatelet treatment, and CT data. We also registered the study protocol used for treatment and deviations from the accepted protocol. A control CT was performed on all patients. SICH was diagnosed if a parenchymal hematoma was detected within the 36 h after rt-PA and was associated with an increase of > or =4 in the NIHSS score. Bivariate analyses were performed followed by a logistic regression analysis. RESULTS A total of 347 patients were studied, whose mean age was 68 +/- 10.9 years; 56% were men. Thirty-two patients (9.2%) exhibited a parenchymal hematoma, and 8 patients (2.3%) suffered a SICH. Patients with SICH had a higher frequency of previous transient ischemic attack (p = 0.04), early signs of ischemia (p = 0.003), hyperdense arterial sign (p = 0.008), and deviations (p = 0.002). Early signs of ischemia (OR 8.5, 95% CI 1.6-45.4, p = 0.01) and deviation from the protocol (OR 11.1, 95% CI 2.4-50, p = 0.002) were independent predictors of SICH. CONCLUSIONS SICH is infrequent in patients with ischemic stroke treated with rt-PA outside of a clinical trial. Its frequency increases in the presence of early signs of ischemia on the non-contrast CT scan and deviations from the recommended protocol.
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Affiliation(s)
- Joan Martí-Fàbregas
- Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
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Montserrat J, Prieto R, Puig M, Carrion M, Leon C, Hernandez L. P380 Comparison between fixed an automatic continuous positive airway pressure (CPAP) in patients with nose problems after starting treatment with CPAP. Sleep Med 2006. [DOI: 10.1016/j.sleep.2006.07.189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gómez-Garre P, Seijo M, Gutiérrez-Delicado E, Castro del Río M, de la Torre C, Gómez-Abad C, Morales-Corraliza J, Puig M, Serratosa JM. Ehlers-Danlos syndrome and periventricular nodular heterotopia in a Spanish family with a single FLNA mutation. J Med Genet 2005; 43:232-7. [PMID: 15994863 PMCID: PMC2563248 DOI: 10.1136/jmg.2004.029173] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Ehlers-Danlos syndrome (EDS) comprises a group of hereditary connective tissue disorders. Periventricular nodular heterotopia (PNH) is a human neuronal migration disorder characterised by seizures and conglomerates of neural cells around the lateral ventricles of the brain, caused by FLNA mutations. FLNA encodes filamin A, an actin binding protein involved in cytoskeletal organisation. The amino-terminal actin binding domain (ABD) of filamins contains two tandem calponin homology domains, CHD1 and CHD2. OBJECTIVE To report clinical and genetic analyses in a Spanish family affected by a connective tissue disorder suggestive of EDS type III and PNH. METHODS A clinical and molecular study was undertaken in the three affected women. Clinical histories, physical and neurological examinations, brain magnetic resonance imaging studies, and skin biopsies were done. Genetic analysis of the FLNA gene was undertaken by direct sequencing and restriction fragment length polymorphism analysis. RESULTS Mutation analysis of the FLNA gene resulted in the identification of a novel mutation in exon 3 (c.383C-->T) segregating with the combination of both syndromes. This mutation results in a substitution of an alanine residue (A128V) in CHD1. CONCLUSIONS The findings suggest that the Ala128Val mutation causes the dual EDS-PNH phenotype. This association constitutes a new variant within the EDS spectrum. This is the first description of a familial EDS-PNH association with a mutation in FLNA.
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Affiliation(s)
- P Gómez-Garre
- Laboratorio de Neurología, Fundación Jiménez Díaz, Madrid, Spain
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Belvís R, Martí-Fàbregas J, Cocho D, García-Bargo MD, Franquet E, Agudo R, Brosa V, Campreciós M, Puig M, Martí-Vilalta JL. Cerebrovascular disease as a complication of cardiac transplantation. Cerebrovasc Dis 2005; 19:267-71. [PMID: 15731558 DOI: 10.1159/000084091] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2004] [Accepted: 11/24/2004] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To characterize the frequency, risk factors, clinical presentation and etiological subtypes of cerebrovascular diseases (CVD) following cardiac transplantation (CTX). METHODS In a retrospective review of our CTX database (period 1984-2002), we assessed demographic data, vascular risk factors, surgery and donor details. We classified ischemic stroke (IS) using the clinical criteria of the Oxfordshire Community Stroke Project and the etiological criteria of the TOAST study. Logistic regression analysis and survival curves were carried out. RESULTS CTX was performed in a total of 314 patients (age 46 +/- 14 years, 78% male) and mean follow-up was 54 +/- 57 months. Twenty-two patients (7%) presented CVD: hemorrhagic stroke in 12%, transient ischemic attack in 28% and IS in 60%. CVD were early postoperative (less than 2 weeks) in 20% of patients and late in 80%. The clinical presentation in patients with IS was total anterior circulation (23.1%), partial anterior (38.4%), lacunar (15.4%) and posterior circulation (23.1%), and the etiological classification was large artery atherosclerosis (15.4%), cardioembolism (14.4%), small vessel disease (15.4%), unusual causes (15.4%) and undetermined cause (38.4%). The only independent predictor of CVD was a prior CVD event with an odds ratio of 8.2 (95% CI, 2.2-30.2, p < 0.02). The estimated risk of CVD at 5 years was greater (p < 0.02) in patients with prior CVD (4.1%) than in those without (1.1%). CONCLUSIONS CVD are a relatively frequent complication after CTX (7%) and usually occur in the late postoperative phase. CVD prior to transplantation increase the risk of CVD after this procedure.
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Affiliation(s)
- Robert Belvís
- Stroke Unit of the Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Garcia MA, Solans C, Calvo A, Hernandez E, Rey R, Bregante MA, Puig M. Determination of enro?oxacin and its primary metabolite, cipro?oxacin, in pig tissues. Application to residue studies. Biomed Chromatogr 2005; 19:27-31. [PMID: 15470686 DOI: 10.1002/bmc.411] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A simple and sensitive HPLC method has been developed for the simultaneous determination of enrofloxacin (ENR) and ciprofloxacin (CIP) in pig tissue using difloxacin (DIF) as internal standard. Tissue sample preparations were carried out by adding phosphate buffer (pH 7.4, 0.1 m), followed by extraction with trichloromethane. Fluoroquinolones were separated on a reversed-phase column and eluted with aqueous buffer solution-acetonitrile (80:20, v/v). The concentrations of CIP, ENR and DIF eluted from the column, with retention times of 2.20, 2.73 and 4.38 min, respectively, were monitored by fluorescence detection at lambda(ex) 276 and lambda(em) 442 nm. The detection and quantitation limit were 8 and 25 ng/g, respectively, for both compounds. Standard curves were linearly related to concentration in the range 25-400 ng/g. The consequences of the introduction of minor reasonable variations (ruggedness studies) have also been analysed. Finally, the measurement of the tissue levels of ENR and CIP in the pig tissues after oral administration confirmed the utility of the proposed method.
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Affiliation(s)
- M A Garcia
- Department of Analytical Chemistry, Veterinary Faculty, University of Zaragoza, Miguel Servet 177, 50013 Zaragoza, Spain
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Celada P, Puig M, Amargós-Bosch M, Adell A, Artigas F. The therapeutic role of 5-HT1A and 5-HT2A receptors in depression. J Psychiatry Neurosci 2004; 29:252-65. [PMID: 15309042 PMCID: PMC446220] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
The selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressant drugs, because they are well tolerated and have no severe side effects. They rapidly block serotonin (5-HT) reuptake, yet the onset of their therapeutic action requires weeks of treatment. This delay is the result of presynaptic and postsynaptic adaptive mechanisms secondary to reuptake inhibition. The prevention of a negative feedback mechanism operating at the 5-HT autoreceptor level enhances the neurochemical and clinical effects of SSRIs. The blockade of 5-HT2A receptors also seems to improve the clinical effects of SSRIs. These receptors are located postsynaptically to 5-HT axons, mainly in the neocortex. Pyramidal neurons in the prefrontal cortex are particularly enriched in 5-HT2A receptors. Their blockade may affect the function of prefrontal-subcortical circuits, an effect that probably underlies the beneficial effects of the addition of atypical antipsychotic drugs, which are 5-HT2A receptor antagonists, to SSRIs in treatment-resistant patients.
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MESH Headings
- Autoreceptors/antagonists & inhibitors
- Depressive Disorder, Major/drug therapy
- Depressive Disorder, Major/metabolism
- Humans
- Pindolol/pharmacology
- Pindolol/therapeutic use
- Receptor, Serotonin, 5-HT1A/drug effects
- Receptor, Serotonin, 5-HT1A/metabolism
- Receptor, Serotonin, 5-HT1A/physiology
- Receptors, Serotonin, 5-HT2/drug effects
- Receptors, Serotonin, 5-HT2/metabolism
- Receptors, Serotonin, 5-HT2/physiology
- Serotonin Antagonists/pharmacology
- Serotonin Antagonists/therapeutic use
- Selective Serotonin Reuptake Inhibitors/pharmacology
- Selective Serotonin Reuptake Inhibitors/therapeutic use
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Affiliation(s)
- Pau Celada
- Department of Neurochemistry, Institut d'Investigacions Biomèdiques de Barcelona, Consejo Superior de Investigaciones Cientificas (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
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Díaz-Corrales FJ, Colasante C, Contreras Q, Puig M, Serrano JA, Hernández L, Beaman BL. Nocardia otitidiscaviarum (GAM-5) induces parkinsonian-like alterations in mouse. Braz J Med Biol Res 2004; 37:539-48. [PMID: 15064817 DOI: 10.1590/s0100-879x2004000400011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [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: 11/21/2022] Open
Abstract
Parkinson's disease, a major neurodegenerative disorder in humans whose etiology is unknown, may be associated with some environmental factors. Nocardia otitidiscaviarum (GAM-5) isolated from a patient with an actinomycetoma produced signs similar to Parkinson's disease following iv injection into NMRI mice. NMRI mice were infected intravenously with a non-lethal dose of 5 x 10(6) colony forming units of N. otitidiscaviarum (GAM-5). Fourteen days after bacterial infection, most of the 60 mice injected exhibited parkinsonian features characterized by vertical head tremor, akinesia/bradykinesia, flexed posture and postural instability. There was a peak of nocardial growth in the brain during the first 24 h followed by a decrease, so that by 14 days nocardiae could no longer be cultured. At 24 h after infection, Gram staining showed nocardiae in neurons in the substantia nigra and occasionally in the brain parenchyma in the frontal and parietal cortex. At 21 days post-infection, tyrosine hydroxylase immunolabeling showed a 58% reduction of tyrosine hydroxylase in the substantia nigra, and a 35% reduction of tyrosine hydroxylase in the ventral tegmental region. Dopamine levels were reduced from 110 +/- 32.5 to 58 +/- 16.5 ng/mg protein (47.2% reduction) in brain from infected mice exhibiting impaired movements, whereas serotonin levels were unchanged (191 +/- 44 protein in control and 175 +/- 39 ng/mg protein in injected mice). At later times, intraneuronal inclusion bodies were observed in the substantia nigra. Our observations emphasize the need for further studies of the potential association between Parkinson's disease or parkinsonism-like disease and exposure to various nocardial species.
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Affiliation(s)
- F J Díaz-Corrales
- Laboratorio de Fisiología de la Conducta, Facultad de Medicina, Universidad de Los Andes, Merida, Venezuela
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Campo R, Brullet E, Junquera F, Puig-Diví V, Vergara M, Calvet X, Marco J, Chuecos M, Sánchez A, Alcázar A, Ruiz M, Puig M, Real J. Sedación en la endoscopia digestiva. Resultados de una encuesta hospitalaria en Cataluña. Gastroenterología y Hepatología 2004; 27:503-7. [PMID: 15544734 DOI: 10.1016/s0210-5705(03)70516-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The need for sedation is increasing in digestive endoscopy units (DEU). There are no data on the use of sedation in DEU in Catalonia (Spain). OBJECTIVE To evaluate the use of sedation in DEU in Catalonia. MATERIAL AND METHOD A questionnaire on the practice of sedation was designed and sent to the heads of medical and nursing staff of the DEU of 63 public and private hospitals in Catalonia. Two mailings were sent with an interval of three months between each. The questionnaire included 62 items on the characteristics of the hospital and the DEU, number of explorations, frequency of sedation use, drugs employed, participation of an anesthesiologist, use of monitoring, and complications. RESULTS Forty-four DEU (70%) corresponding to 31 public hospitals and 13 private hospitals completed the questionnaire. Evaluation of sedation patterns was based on 105,904 explorations performed in the various DEU (56,453 gastroscopies, 47,278 colonoscopies and 2,173 endoscopic retrograde cholangiopancreatographies (ERCP) in 2001. Sedation, sedation-analgesia or anesthesia was used in 17% of gastroscopies, 61% of colonoscopies and 100% of ERCP. Sedation was administered by an anesthesiologist in 7% of gastroscopies, 25% of colonoscopies and 38% of ERCP. Anesthesiologist administration was more frequent in private than in public centers (gastroscopies: 25% vs. 2%; colonoscopies: 57% vs. 9%, p < 0.001). No deaths associated with the use of sedation were reported. Eighty-nine percent of the DEU complied with standard recommendations for the practice of sedation. CONCLUSIONS In Catalonia, the use of sedation is highly variable, depending on the endoscopic procedure and the DEU. Use of sedation in infrequent in gastroscopy, fairly widespread in colonoscopy and routine in ERCP. Anesthesiologist administration is significantly more frequent in private hospitals. Most DEU follow standard sedation practices.
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Affiliation(s)
- R Campo
- Servicio de Aparato Digestivo, Corporació Parc Taulí, Sabadell, Barcelona, Spain.
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Iglesias X, Espuña M, Puig M, Davi E, Ribas C, Palau MJ. Pubic bone anchoring devices for the surgical treatment of urinary stress incontinence in patients with severe genital prolapse. Int Urogynecol J 2003; 13:314-8. [PMID: 12355292 DOI: 10.1007/s001920200068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to test a surgical technique for the treatment of stress urinary incontinence associated with genital prolapse through a transvaginal suspension anchored to the pubic bone. Thirty-seven patients with severe genital prolapse and urodynamically proven stress incontinence were operated on with this procedure from February 1998 to May 2000. Preoperatively a detailed history, pelvic examination and urodynamic studies were carried out. The degree of prolapse was assessed pre- and postoperatively in the lithotomy position in accordance with the classification proposed by Baden and Walker [8]. Two titanium bone screws with no. 1 polypropylene sutures attached to them and a battery-operated screw inserter are used to fix the vaginal sutures to the pubic bone bilaterally. The procedure is performed transvaginally with no abdominal or suprapubic incisions. Objective outcomes were assessed by symptom assessment, clinical examination and a full urodynamic evaluation at 6 months postoperatively, and annually by clinical evaluation. Subjective outcomes were assessed by directly interviewing the patients about their postoperative urinary symptoms and asking them to classify their level of satisfaction. An objective cure rate (no objective loss of urine during coughing in the absence of a simultaneous detrusor contraction) at the 6-month postoperative urodynamic evaluation was observed in 23 of 37 patients (62%). Recurrent anterior vaginal wall prolapse (grade 2) had developed in 7 of 37 patients (27%). Subjectively, 73% of the patients expressed satisfaction with the procedure. Early results using two bone screws into the pubis to fix the periurethral and perivesical tissues and vagina to the posterior surface of the pubic bone were disappointing. Based on our results we have abandoned the use of this procedure to correct stress incontinence associated with severe genital prolapse.
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Affiliation(s)
- X Iglesias
- Hospital Clinic, University of Barcelona, Barcelona, Spain.
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