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Gutiérrez A, Muñoz-Pérez R, Zapater P, Mira C, Rodríguez A, Sempere-Robles L, Torregrosa ME, Alfayate R, Moreno-Torres V, Bernal L, Belén-Galipienso O, Cameo JI, Sirera P, Herreros B, Bernabeu P, Moreno-Pérez O, Madero-Velázquez L. Inhibin B and antiMüllerian hormone as surrogate markers of fertility in male and female Crohn's disease patients: a case-control study. Front Med (Lausanne) 2024; 11:1374603. [PMID: 38725465 PMCID: PMC11080652 DOI: 10.3389/fmed.2024.1374603] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Background Several studies suggest that women with Crohn disease (CD) have reduced fertility due to decreased ovarian reserve, among other causes. On the other hand, male CD patients could have difficulties conceiving. The present study aimed to test the effect of CD on both male and female fertility potential, Sertoli cell function and ovarian reserve, assessed by inhibin-B (IB) plus IB:FSH ratio (IFR) and antiMüllerian hormone (AMH), respectively. Sexual dysfunction (SD) was studied as secondary endpoint. Methods We performed a cross-sectional, case-control study. Serum IB levels plus IFR were measured in 58 men with CD and compared to 25 age-matched healthy controls (HC). Serum AMH levels were measured in 50 women with CD and in 30 HC matched by age. SD was assessed by means of the International Index of Erectile Function (IIFE-15) in males and the Index of Female Sexual Function (IFSF) in women. Results A total of 108 CD patients and 55 HC were included. IB serum levels were significantly lower in CD men than in HC (177 ± 58 vs. 234 ± 75 pg./mL, p = 0.001). IFR was also decreased in CD patients compared to HC (58.27 ± 59.5 vs. 91.35 ± 60.04, p = 0.014). Women with CD > 30 years had lower serum AMH levels compared to HC (1.15 ± 0.74 vs. 2.14 ± 1.68 ng/mL, p = 0.033). In addition, CD women >30 years presented a serum AMH < 2 ng/mL more frequently than HC (90% vs. 40%, p = 0.004). The prevalence of SD was significantly higher among both male and female CD patients compared to HC, without association to fertility potential. Age was the only predictor of low ovarian reserve. Conclusion Testicular Sertoli cell function assessed through serum IB levels and IFR is decreased in CD male patients compared to HC, regardless of age. Age > 30 years is the single independent predictor of reduced ovarian reserve in women with CD. These results should be confirmed in further studies in order to properly counsel patients with CD and desire for offspring.
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Affiliation(s)
- Ana Gutiérrez
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Roser Muñoz-Pérez
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Pedro Zapater
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
- Department of Clinical Pharmacology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
- Universidad Miguel Hernández, Elche, Spain
| | - Cristina Mira
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Andrés Rodríguez
- Department of Gastroenterology, Hospital General Universitario Elche, Elche, Spain
| | - Laura Sempere-Robles
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - María Eugenia Torregrosa
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Clinical Analysis Department, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
| | - Rocio Alfayate
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Clinical Analysis Department, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
| | - Violeta Moreno-Torres
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
| | - Lorena Bernal
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
| | - Olivia Belén-Galipienso
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Jose Ignacio Cameo
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Paula Sirera
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Clinical Analysis Department, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
| | - Belen Herreros
- Department of Gastroenterology, Hospital Marina Baixa, Villajoyosa, Spain
| | - Puri Bernabeu
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Department of Psychology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
| | - Oscar Moreno-Pérez
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Universidad Miguel Hernández, Elche, Spain
- Department of Endocrinology and Nutrition, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
| | - Lucía Madero-Velázquez
- Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain
- Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
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Moreno-Pérez O, Reyes-García R, Modrego-Pardo I, López-Martínez M, Soler MJ. Are we ready for an adipocentric approach in people living with type 2 diabetes and chronic kidney disease? Clin Kidney J 2024; 17:sfae039. [PMID: 38572499 PMCID: PMC10986245 DOI: 10.1093/ckj/sfae039] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Indexed: 04/05/2024] Open
Abstract
We are entering a new era in the management of adiposity-based chronic disease (ABCD) with type 2 diabetes (T2D) and related chronic kidney disease (CKD). ABCD, T2D and CKD can affect almost every major organ system and have a particularly strong impact on the incidence of cardiovascular disease (CVD) and heart failure. ABCD and the associated insulin resistance are at the root of many cardiovascular, renal and metabolic (CKM) disorders, thus an integrated therapeutic framework using weight loss (WL) as a disease-modifying intervention could simplify the therapeutic approach at different stages across the lifespan. The breakthrough of highly effective WL drugs makes achieving a WL of >10% possible, which is required for a potential T2D disease remission as well as for prevention of microvascular disease, CKD, CVD events and overall mortality. The aim of this review is to discuss the link between adiposity and CKM conditions as well as placing weight management at the centre of the holistic CKM syndrome approach with a focus on CKD. We propose the clinical translation of the available evidence into a transformative Dysfunctional Adipose Tissue Approach (DATA) for people living with ABCD, T2D and CKD. This model is based on the interplay of four essential elements (i.e. adipocentric approach and target organ protection, dysfunctional adiposity, glucose homeostasis, and lifestyle intervention and de-prescription) together with a multidisciplinary person-centred care. DATA could facilitate decision-making for all clinicians involved in the management of these individuals, and if we do this in a multidisciplinary way, we are prepared to meet the adipocentric challenge.
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Affiliation(s)
- Oscar Moreno-Pérez
- Department of Endocrinology and Nutrition, General University Hospital Dr Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Alicante, Spain
- Department of Clinical Medicine, Miguel Hernández University, San Juan, Alicante, Spain
| | - Rebeca Reyes-García
- Endocrinology Unit, University Hospital of Torrecárdenas, Almería, Almería, Spain; CIBER de Fragilidad y Envejecimiento Saludable “CIBERFES”, Instituto de Salud Carlos III
| | - Inés Modrego-Pardo
- Department of Endocrinology and Nutrition, University Hospital Marina Baixa, Villajoyosa, Alicante, Spain
| | - Marina López-Martínez
- Department of Nephrology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain; Centro de Referencia en Enfermedad, Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain. GEENDIAB, RICORS2024
| | - María José Soler
- Department of Nephrology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain; Centro de Referencia en Enfermedad, Glomerular Compleja del Sistema Nacional de Salud de España (CSUR), Barcelona, Spain. GEENDIAB, RICORS2024
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3
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Moreno-Pérez O, Reyes-Garcia R, Modrego-Pardo I, Doulatram-Gamgaram VK, Cases CC, Guillen-Morote C, Mendoza NA, Tejera-Pérez C, Cárdenas-Salas J, Martínez-Fuster S, Lardiés-Sánchez B, Márquez-Pardo R, Pinés P, Fernández-García JC. Real-world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO 2 S-RWD). Diabetes Obes Metab 2024; 26:1519-1523. [PMID: 38151966 DOI: 10.1111/dom.15431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Affiliation(s)
- Oscar Moreno-Pérez
- Department of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante. Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Spain
- Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain
| | - Rebeca Reyes-Garcia
- Endocrinology Unit. University Hospital of Torrecárdenas, Almería, Spain
- CIBER de Fragilidad y Envejecimiento Saludable "CIBERFES", Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Modrego-Pardo
- Department of Endocrinology and Nutrition, Marina Baixa Hospital, Alicante, Spain
| | - Viyey Kishore Doulatram-Gamgaram
- Department of Endocrinology and Nutrition, Regional University Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Carlos Casado Cases
- Department of Endocrinology and Nutrition, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Cristina Guillen-Morote
- Department of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante. Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Spain
| | - Nieves Arias Mendoza
- Department of Endocrinology and Nutrition, General University Hospital of Elda, Alicante, Spain
| | - Cristina Tejera-Pérez
- Department of Endocrinology and Nutrition, University Hospital Complex of Ferrol, A Coruña, Spain
| | - Jersy Cárdenas-Salas
- Department of Endocrinology and Nutrition, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Sandra Martínez-Fuster
- Department of Endocrinology and Nutrition, General University Hospital of Elda, Alicante, Spain
| | | | - Rosa Márquez-Pardo
- Department of Endocrinology and Nutrition, Hospital Juan Ramón Jiménez, Huelva, Spain
| | - Pedro Pinés
- Albacete University Hospital Complex, Albacete, Spain
| | - José Carlos Fernández-García
- Department of Endocrinology and Nutrition, Regional University Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Faculty of Medicine, University of Malaga, Malaga, Spain
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Cebrián-Cuenca AM, Moreno-Pérez O, Campuzano-Ruiz R, Soler MJ, García de Lucas MD, Orozco-Beltrán D. Multidisciplinary Panel Consensus for the Management of Patients with Type 2 Diabetes: A Delphi Study. Arch Med Res 2024; 55:102923. [PMID: 38141271 DOI: 10.1016/j.arcmed.2023.102923] [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: 04/03/2023] [Revised: 09/29/2023] [Accepted: 11/16/2023] [Indexed: 12/25/2023]
Abstract
AIM To reach a multidisciplinary consensus on managing patients with type 2 diabetes among specialists in family medicine, cardiology, endocrinology, internal medicine, and nephrology. METHODS A two-round Delphi study was conducted using a questionnaire with 68 positive/negative statements distributed in four thematic blocks on diabetes management: early diagnosis and prediabetes, referral criteria, treatment and comorbidities, and clinical management. The expert panel was composed of 105 physicians from different specialties (family medicine, cardiology, endocrinology, internal medicine, and nephrology) with experience in managing patients with diabetes and who were members of a diabetes-related society. RESULTS Response rates for the first and second rounds were 86.7 and 75.2%, respectively. After both rounds, a consensus was reached on 52 (76.5%) items. The recommendations with the highest degree of consensus (median = 10, IQR = 0.00) were related to anti-smoking education, cardiovascular risk factor target control, and diabetic kidney disease. There were significant differences between family physicians and other specialties for some items. CONCLUSIONS This study provides a set of recommendations for diabetes management agreed upon by specialists from different healthcare settings.
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Affiliation(s)
- Ana M Cebrián-Cuenca
- Family Medicine Health Center of Cartagena Casco, Primary Care Research Group, Biomedical Research Institute of Murcia, Cartagena, Spain
| | - Oscar Moreno-Pérez
- Endocrinology Department, Dr. Balmis General University Hospital - Alicante Institute of Health and Biomedical Research, Alicante, Spain; Medicine Department, Miguel Hernández University, San Juan de Alicante, Spain.
| | | | - Maria Jose Soler
- Nephrology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Barcelona, Spain
| | | | - Domingo Orozco-Beltrán
- Medicine Department, Miguel Hernández University, San Juan de Alicante, Spain; Family Medicine Health Center of Cabo Huertas, Alicante, Spain
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5
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Ramos-Rincón JM, Pinargote-Celorio H, Llenas-García J, Moreno-Pérez O, González-Cuello I, Gonzalez-de-la-Aleja P, Martínez-López B, Reus S, García-López M, Rodríguez JC, Boix V, Merino E. A retrospective real-world study of early short-course remdesivir in non-hospitalized COVID-19 patients at high risk for progression: low rate of hospitalization or death, regardless of immunocompetence status. Front Pharmacol 2023; 14:1218650. [PMID: 37881188 PMCID: PMC10597661 DOI: 10.3389/fphar.2023.1218650] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/25/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction: The evidence for remdesivir therapy in immunocompromised patients is scarce. To evaluate remdesivir (RDV) effectiveness and safety in COVID-19 outpatients at high risk for progression in a real-world setting, we compare the outcome in immunocompromised (IC) patients with that in non-immunocompromised patients. Methods: Two hospitals conducted a retrospective study of all adult patients with mild-to-moderate SARS-CoV-2 infection at high risk for disease progression who were treated as outpatients with a 3-day course of RDV (1st January-30th September 2022). The primary effectiveness endpoint was a composite of any cause of hospitalization or death by day 30. A multiple logistic regression model was built to explore the association between immune status and clinical outcome, estimating adjusted odds ratios [aORs (95% CI)]. Results: We have included 211 patients, of which 57% were males, with a median age of 65 years (IQR 53-77), 70.1% were vaccinated (three or four doses), and 61.1% were IC. The median duration of symptoms before RDV treatment was 3 days (IQR 2-5). During follow-up, 14 (6.6%) patients were hospitalized, of which 6 (2.8%) were hospitalized for COVID-19 progression. No patient required mechanical ventilation, and two patients died (non-COVID-19-related). After accounting for potential confounders, only anti-CD20 treatment was associated with the composed outcome [aOR 5.35 (1.02-27.5, 95% CI)], whereas the immunocompetence status was not [aOR 1.94 (0.49-7.81, 95% CI)]. Conclusion: Early COVID-19 outpatient treatment with a 3-day course of remdesivir in vaccinated patients at high risk for disease progression during the Omicron surge had a good safety profile. It was associated with a low rate of all-cause hospitalization or death, regardless of immunocompetence status.
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Affiliation(s)
- José Manuel Ramos-Rincón
- Internal Medicine Department, Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
| | - Héctor Pinargote-Celorio
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jara Llenas-García
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Internal Medicine Service Vega Baja Hospital—Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Oscar Moreno-Pérez
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Endocrinology Department Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Inmaculada González-Cuello
- Internal Medicine Service Vega Baja Hospital—Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Pilar Gonzalez-de-la-Aleja
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Belén Martínez-López
- Internal Medicine Service Vega Baja Hospital—Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Sergio Reus
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - María García-López
- Internal Medicine Service Vega Baja Hospital—Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain
| | - Juan Carlos Rodríguez
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Microbiology Service Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Vicente Boix
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Esperanza Merino
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain
- Unit of Infectious Diseases Dr. Balmis General University Hospital—Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
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Orozco-Beltrán D, Lecumberri-Pascual E, Quesada JA, Moreno-Pérez O, Ruiz-Quintero MA, Pomares-Gómez FJ, Jodar-Gimeno E, Pardo-Ruiz C, Mascarell-Martinez I, Mirete-López RM, Morant-Bes B, Borrachero-Guijarro JM, Zapatero-Larrauri M, Aparicio-Egea MC, Paniagua-Merchán C, Requena-Ferrer RM, Caride-Miana E, Fernández-Giménez A, López-Pineda A, Nouni-García R, Carratalá-Munuera C, Cebrián-Cuenca AM. Psychometric properties of the Clarke questionnaire for hypoglycemia awareness in the Spanish population with type 2 diabetes. Postgrad Med 2023; 135:141-148. [PMID: 36475508 DOI: 10.1080/00325481.2022.2138469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The Clarke questionnaire, validated in Spanish language, assesses hypoglycemia awareness in patients with type 1 diabetes. This study aimed to analyze its psychometric properties in patients with type 2 diabetes (T2DM). METHODS This was a questionnaire validation study. Patients with T2DM and treated with insulin, sulfonylureas or glinides were consecutively recruited from six endocrinology consultations and six primary care centers. The internal structure of the 8-item Clarke questionnaire was analyzed by exploratory (training sample) and confirmatory (testing sample) factor analysis; the internal consistency using Omega's McDonald coefficient; and goodness of fit with comparative fit index (CFI, cutoff >0.9), Goodness of Fit Index (GFI, cutoff >0.9), and root mean-square error of approximation (RMSEA, cutoff <0.09), as well as unidimensionality indicators. RESULTS The 265 participants (56.8% men) had a mean age of 67.8 years. Confirmatory factor analysis for one dimension obtained poor indicators: fit test (p < 0.001); CFI = 0.748; RMSEA = 0.122 and SRMR = 0.134. Exploratory factor analysis showed 2 or 3 dimensions with poor adjustment indicators. Omega's McDonald was 0.739. CONCLUSIONS The Spanish version of the Clarke questionnaire was not valid or reliable for assessing hypoglycemia awareness in people with T2DM in Spanish population.
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Affiliation(s)
- Domingo Orozco-Beltrán
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
| | | | - Jose A Quesada
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
| | - Oscar Moreno-Pérez
- Sección de Endocrinología y Nutrición, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-FISABIO), Alicante, Spain
| | | | - Francisco J Pomares-Gómez
- Sección de Endocrinología y Nutrición, Hospital Universitario de San Juan de Alicante, Alicante, Spain
| | - Esteban Jodar-Gimeno
- Departamento de Endocrinología y Nutrición Clínica, Hospital Universitario Quirón Salud Madrid, Universidad Europea de Madrid, Madrid, Spain
| | - Carlos Pardo-Ruiz
- Sección de Endocrinología y Nutrición, Hospital Virgen de los Lirios, Alcoi, Alicante, Spain
| | | | - Rosa M Mirete-López
- Sección de Endocrinología y Nutrición, Hospital Universitario de San Juan de Alicante, Alicante, Spain
| | - Borja Morant-Bes
- Sección de Endocrinología y Nutrición, Hospital Universitario de San Juan de Alicante, Alicante, Spain
| | | | - Miriam Zapatero-Larrauri
- Departamento de Endocrinología y Nutrición Clínica, Hospital Universitario Quirón Salud Madrid, Universidad Europea de Madrid, Madrid, Spain
| | | | | | | | | | - Antonio Fernández-Giménez
- Instituto de Investigación INCLIVA, Hospital Clínico Universitario de Valencia. Universidad de Valencia, Valencia, Spain
| | - Adriana López-Pineda
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
| | - Rauf Nouni-García
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
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7
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Ramos-Rincon JM, Alenda C, García-Sevila R, Silva-Ortega S, García-Navarro M, Vidal I, Ribes I, Portilla J, Cintas A, Moreno-Pérez O, Sánchez-Martínez R, Merino E, Aranda I. Histopathological and virological features of lung, heart and liver percutaneous tissue core biopsy in patients with COVID-19: A clinicopathological case series. Malays J Pathol 2022; 44:83-92. [PMID: 35484890] [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: 06/14/2023]
Abstract
INTRODUCTION Data on pathological changes in COVID-19 are scarce. The aim of this study was to describe the histopathological and virological findings of postmortem biopsies, and the existing clinical correlations, in people who died of COVID-19. MATERIALS AND METHODS We performed postmortem needle core biopsies of the chest in 11 people who died of COVID-19 pneumonia. Tissue examination was done by light microscopy and real-time polymerase chain reaction (RTPCR). RESULTS The age of the patients were between 61 to 94 years. Of the 11 postmortem chest biopsies, lung tissue was obtained in 8, myocardium tissue in 7, and liver tissue in 5. Histologically of lung, the main findings pertaining to the lung were diffuse alveolar damage in proliferative phase (n = 4, 50%), diffuse alveolar damage in exudative and proliferative phase (n = 3, 37.5%), diffuse alveolar damage in exudative (n=1; 12.5%) and acute pneumonia (n = 2, 25%). Necrotising pneumonia, acute fibrinous and organising pneumonia, and neutrophils were detected in one sample each (12.5%). Another case presented myocarditis. RT-PCR showed RNA of SARS-CoV-2 in 7 of the 8 lung samples (87.5%), 2 of the 7 myocardial tissue samples (28.6%), and 1 of the 5 liver tissue samples (20%). CONCLUSION The postmortem examinations show diffuse alveolar damage, as well as acute or necrotising pneumonia. RT-PCR of SARS-CoV-2 was positive in most lung samples.
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Affiliation(s)
- J M Ramos-Rincon
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Internal Medicine Department, PintorBaeza, 12, 03010, Alicante, Spain.
| | - C Alenda
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Pathology Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - R García-Sevila
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Pneumology Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - S Silva-Ortega
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Pathology Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - M García-Navarro
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Internal Medicine Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - I Vidal
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Microbiology Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - I Ribes
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Internal Medicine Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - J Portilla
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Internal Medicine Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - A Cintas
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Internal Medicine Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - O Moreno-Pérez
- Miguel Hernandez University, Clinical Medicine Department, Crta n332 s/n, 03550 Sant Joan d'Alacant, Alicante, Spain
| | - R Sánchez-Martínez
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Internal Medicine Department, PintorBaeza, 12, 03010, Alicante, Spain
| | - E Merino
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Infectious Diseases Unit, PintorBaeza, 12, 03010, Alicante, Spain
| | - I Aranda
- Alicante General University Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Pathology Department, PintorBaeza, 12, 03010, Alicante, Spain
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8
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Moreno-Pérez O, Merino E, Ramos JM, Rodríguez JC, Diaz C, Mas P, Reus S, Sánchez-Martínez R, Boix V, Chico-Sánchez P, Sánchez-Payá J, Portilla J. [Valproic Acid Could Help in the Fight Against COVID-19: a case-control study]. Neurologia 2022:S0213-4853(22)00014-7. [PMID: 35185237 PMCID: PMC8841207 DOI: 10.1016/j.nrl.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/22/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE There is early evidence about Valproic acid (VPA) antiviral effect. Our aim was to investigate the incidence and severity of SARS-CoV-2 infection in VPA users as compared with the general population. MATERIAL AND METHODS A case-control study nested within a cohort, carried out between March 1 and December 17, 2020. Retrospectively, we identified confirmed SARS-CoV-2 infection patients exposed to VPA in our health department (defined as case). We ascertained VPA regimen (all the time (AT)(292 days) or at least 20% of the study period (notAT)(≥58 days) and if VPA levels were in therapeutic range (ATR) (50-100 mcg/mL) in the last 24 months. We calculated the cumulative incidence of SARS-CoV-2 infection and hospital admission in the cases, comparing it with the general unexposed VPA population (controls). RESULTS During the study period, 6183 PCR+ were detected among 281035 inhabitants, of these, 746 were hospitalized. 691 patients were on VPA notAT and 628 (90.1%) AT. The indication for VPA use was epilepsy in 54.9%. The incidence of PCR+ was 1.736 % (OR 0.785 (95%CI 0.443-1.390) and 1.910 % (OR 0.865 (95%CI 0.488-1.533), on VPA notAT and VPA AT patients, respectively vs. 2.201% in people without VPA regimen. Those patients with VPA ATR had a lower risk of PCR + (OR 0.233 (95%CI 0.057-0.951) notAT; OR 0.218 (95%CI 0.053-0.890) AT). Hospital admission incidence was lower in patient on VPA (OR was 0.543 (95% CI 0.076 to 3.871). CONCLUSION Patients with VPA within the therapeutic range had a reduction of SARS-Cov-2 infection incidence greater than 75%. There is a downward trend in the risk of COVID-19 admission by SARS-CoV-2 in patients on VPA therapy. These findings warrant further investigation.
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Affiliation(s)
- Oscar Moreno-Pérez
- Endocrinology and Nutrition department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Esperanza Merino
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jose Manuel Ramos
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Juan Carlos Rodríguez
- Microbiology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Miguel Hernández University, Elche, Spain
| | - Carmina Diaz
- Neurology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Patricio Mas
- Pharmacy department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Sergio Reus
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Rosario Sánchez-Martínez
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Vicente Boix
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
| | - Pablo Chico-Sánchez
- Preventive department, Alicante General University Hospital - - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - José Sánchez-Payá
- Preventive department, Alicante General University Hospital - - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Joaquín Portilla
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
- Clinical Medicine department, Miguel Hernández University, Elche, Spain
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9
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Llorens P, Moreno-Pérez O, Espinosa B, García T, Payá AB, Sola S, Molina F, Román F, Jiménez I, Guzman S, Gil-Rodrigo A, Peña-Pardo B, Merino E, Gil J, San-Inocencio D, Andrés M, Sánchez-Payá J. An integrated emergency department/hospital at home model in mild COVID-19 pneumonia: feasibility and outcomes after discharge from the emergency department. Intern Emerg Med 2021; 16:1673-1682. [PMID: 33625661 PMCID: PMC7903217 DOI: 10.1007/s11739-021-02661-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/02/2021] [Indexed: 01/08/2023]
Abstract
To evaluate the effectiveness of an integrated emergency department (ED)/hospital at home (HH) medical care model in mild COVID-19 pneumonia and evaluate baseline predictors of major outcomes and potential savings. Retrospective cohort study with patients evaluated for COVID-19 pneumonia in the ED, from March 3 to April 30, 2020. All of them were discharged home and controlled by HH. The main outcomes were ED revisit and the need for deferred hospital admission (protocol failure). Outcome predictors were analyzed by simple logistic regression model (OR; 95% CI). Potential savings of this medical care model were estimated. Of the 377 patients attended in the ED, 109 were identified as having mild pneumonia and were included in the ED/HH medical care model. Median age was 50.0 years, 52.3% were males and 57.8% had Charlson index ≥ 1. The median HH stay was 8 (IQR 3.7-11) days. COVID-19-related ED revisit was 19.2% (n = 21) within 6 days (IQR 3-12.5) after discharge from ED. Overall protocol failure (deferred hospital admission) was 6.4% (n = 7), without ICU admission. The ED/HH model provided potential cost savings of 77% compared to traditional stay, due to the costs of home care entails 23% of the expenses generated by a conventional hospital stay. 789 days of hospital stay were avoided by HH, rather than hospital admission. An innovative ED/HH model for selected patients with mild COVID-19 pneumonia is feasible, safe and effective. Less than 6.5% of patients requiring deferred hospital admission and potential savings were generated due to hospitalization.
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Affiliation(s)
- Pere Llorens
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
- Clinical Medicine Department, Miguel Hernandez University, Elche, Spain
| | - Oscar Moreno-Pérez
- Endocrinology and Nutrition Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, Alicante, Spain
- Clinical Medicine Department, Miguel Hernandez University, Elche, Spain
| | - Begoña Espinosa
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Tamara García
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Ana Belén Payá
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Sonia Sola
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Francisca Molina
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Francisco Román
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Inmaculada Jiménez
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Sergio Guzman
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Adriana Gil-Rodrigo
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain.
| | - Bárbara Peña-Pardo
- Emergency Department, Institute of Sanitary and Biomedical Research (ISABIAL), Alicante General University Hospital, Alicante, s/n, Maestro Alonso Street, 03010, Alicante, Spain
| | - Esperanza Merino
- Unit of Infectious Diseases, Alicante General University Hospital, Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Joan Gil
- Pneumology Department, Alicante General University Hospital, Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - David San-Inocencio
- Hospital-at-Home Unit, Department, Alicante General University Hospital, Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - Mariano Andrés
- Clinical Medicine Department, Miguel Hernandez University, Elche, Spain
- Rheumatology Department, Alicante General University Hospital, Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
| | - José Sánchez-Payá
- Preventive Department, Alicante General University Hospital, Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
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10
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García-Ayllón MS, Moreno-Pérez O, García-Arriaza J, Ramos-Rincón JM, Cortés-Gómez MÁ, Brinkmalm G, Andrés M, León-Ramírez JM, Boix V, Gil J, Zetterberg H, Esteban M, Merino E, Sáez-Valero J. Plasma ACE2 species are differentially altered in COVID-19 patients. FASEB J 2021; 35:e21745. [PMID: 34191346 PMCID: PMC8441911 DOI: 10.1096/fj.202100051r] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/24/2021] [Accepted: 06/07/2021] [Indexed: 12/20/2022]
Abstract
Studies are needed to identify useful biomarkers to assess the severity and prognosis of COVID-19 disease, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) virus. Here, we examine the levels of various plasma species of the SARS-CoV-2 host receptor, the angiotensin-converting enzyme 2 (ACE2), in patients at different phases of the infection. Human plasma ACE2 species were characterized by immunoprecipitation and western blotting employing antibodies against the ectodomain and the C-terminal domain, using a recombinant human ACE2 protein as control. In addition, changes in the cleaved and full-length ACE2 species were also examined in serum samples derived from humanized K18-hACE2 mice challenged with a lethal dose of SARS-CoV-2. ACE2 immunoreactivity was present in human plasma as several molecular mass species that probably comprise truncated (70 and 75 kDa) and full-length forms (95, 100, 130, and 170 kDa). COVID-19 patients in the acute phase of infection (n = 46) had significantly decreased levels of ACE2 full-length species, while a truncated 70-kDa form was marginally higher compared with non-disease controls (n = 26). Levels of ACE2 full-length species were in the normal range in patients after a recovery period with an interval of 58-70 days (n = 29), while the 70-kDa species decreased. Levels of the truncated ACE2 species served to discriminate between individuals infected by SARS-CoV-2 and those infected with influenza A virus (n = 17). In conclusion, specific plasma ACE2 species are altered in patients with COVID-19 and these changes normalize during the recovery phase. Alterations in ACE2 species following SARS-CoV-2 infection warrant further investigation regarding their potential usefulness as biomarkers for the disease process and to asses efficacy during vaccination.
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Affiliation(s)
- María-Salud García-Ayllón
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Unidad de Investigación, Hospital General Universitario de Elche, FISABIO, Elche, Spain
| | - Oscar Moreno-Pérez
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.,Endocrinology and Nutrition Department, Alicante General University Hospital, Alicante, Spain.,Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain
| | - Juan García-Arriaza
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - José-Manuel Ramos-Rincón
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.,Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain.,Internal Medicine Department, Alicante General University Hospital, Alicante, Spain
| | - María-Ángeles Cortés-Gómez
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Unidad de Investigación, Hospital General Universitario de Elche, FISABIO, Elche, Spain
| | - Gunnar Brinkmalm
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Mariano Andrés
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.,Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Rheumatology Department, Alicante General University Hospital Alicante, Alicante, Spain
| | - José-Manuel León-Ramírez
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.,Pneumology Department, Alicante General University Hospital, Alicante, Spain
| | - Vicente Boix
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.,Clinical Medicine Department, Universidad Miguel Hernández, Elche, Spain.,Unit of Infectious Diseases, Alicante General University Hospital, Alicante, Spain
| | - Joan Gil
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.,Pneumology Department, Alicante General University Hospital, Alicante, Spain
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Department of Neurodegenerative Disease, Institute of Neurology, University College London, London, UK.,UK Dementia Research Institute, UCL, London, UK
| | - Mariano Esteban
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología (CNB), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Esperanza Merino
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.,Unit of Infectious Diseases, Alicante General University Hospital, Alicante, Spain
| | - Javier Sáez-Valero
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, San Juan de Alicante, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
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11
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Moreno-Pérez O, Ramos JM, Gimeno A, Rodríguez JC, Andres M, Leon-Ramirez JM, Valero B, Llorens P, Boix V, Gil J, Merino E. Medium-term serostatus in Spanish case series recovered from SARS-CoV-2 infection. J Med Virol 2021; 93:6030-6039. [PMID: 34138461 PMCID: PMC8426938 DOI: 10.1002/jmv.27135] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/14/2021] [Indexed: 11/08/2022]
Abstract
The medium-term serologic response of SARS-CoV-2 infection recovered individuals is not well known. The aims were to quantify the incidence of seropositive failure in the medium term in a cohort of patients with different COVID-19 severity and to analyze its associated factors. Patients who had recovered from mild and severe forms of SARS-CoV-2 infection in an Academic Spanish hospital (March 12-May 2, 2020), were tested for total anti-SARS-CoV-2 antibodies by electrochemiluminescence immunoassay (Elecsys Anti-SARS-CoV-2 test; Roche Diagnostics GmbH). The non-seropositive status (seropositive failure) incidence (95% CI) was determined. Associations were tested by multiple logistic regression in a global cohort and severe pneumonia subpopulation. Of 435 patients with PCR-confirmed SARS-CoV-2, a serological test was carried out in 325: 210 (64.6%) had severe pneumonia (hospitalized patients), 51 (15.7%) non-severe pneumonia (managed as outpatients), and 64 (19.7%) mild cases without pneumonia. After a median (IQR) of 76 days (70-83) from symptom onset, antibody responses may not consistently develop or reach levels sufficient to be detectable by antibody tests (non-seropositive incidence) in 6.9% (95% CI, 4.4-10.6) and 20.3% (95% CI, 12.2-31.7) of patients with and without pneumonia, respectively. Baseline independent predictors of seropositive failure were higher leukocytes and fewer days of symptoms before admission, while low glomerular filtrate and fever seem associated with serologic response. Age, comorbidity or immunosuppressive therapies (corticosteroids, tocilizumab) did not influence antibody response. In the medium-term, SARS-CoV-2 seropositive failure is not infrequent in COVID-19 recovered patients. Age, comorbidity or immunosuppressive therapies did not influence antibody response.
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Affiliation(s)
- Oscar Moreno-Pérez
- Endocrinology and Nutrition Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.,Clinical Medicine Department, Miguel Hernández University, Elche, Spain
| | - Jose Manuel Ramos
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain.,Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Adelina Gimeno
- Microbiology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Juan Carlos Rodríguez
- Microbiology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.,Miguel Hernández University, Elche, Spain
| | - Mariano Andres
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain.,Rheumatology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jose-Manuel Leon-Ramirez
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Beatriz Valero
- Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Pere Llorens
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain.,Emergency Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Vicente Boix
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain.,Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Joan Gil
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Esperanza Merino
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
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12
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Moreno-Pérez O, Merino E, Chico-Sánchez P, Gras-Valentí P, Sánchez-Payá J. Effectiveness of a SARS-CoV-2 infection prevention model in elective surgery patients - a prospective study: does universal screening make sense? J Hosp Infect 2021; 115:27-31. [PMID: 33992743 PMCID: PMC8118710 DOI: 10.1016/j.jhin.2021.04.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 12/26/2022]
Abstract
This observational study included patients who underwent pre-operative coronavirus disease 2019 (COVID-19) screening in order to preserve patient safety. Reverse transcriptase polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus-2 was performed in 2292 of 8740 surgical procedures, and the incidence of a positive PCR result was 0.0022%. No healthcare-associated infections were detected. There was no difference in overall mortality or length of hospital stay compared with the same period from the previous year. A selective screening strategy to identify patients for PCR testing, based on isolation measures, presurgical clinical-epidemiological assessment and selected major surgeries susceptible to a poor COVID-19-related outcome, is effective and safe for patients and healthcare workers.
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Affiliation(s)
- O Moreno-Pérez
- Endocrinology and Nutrition Department, Alicante General University Hospital-Alicante Institute for Health and Biomedical Research, Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Elche, Spain
| | - E Merino
- Unit of Infectious Diseases, Alicante General University Hospital-Alicante Institute for Health and Biomedical Research, Alicante, Spain
| | - P Chico-Sánchez
- Preventive Department Epidemiology Unit, Preventive Medicine Department, Alicante General University Hospital-Alicante Institute for Health and Biomedical Research, Alicante, Spain
| | - P Gras-Valentí
- Preventive Department Epidemiology Unit, Preventive Medicine Department, Alicante General University Hospital-Alicante Institute for Health and Biomedical Research, Alicante, Spain
| | - J Sánchez-Payá
- Preventive Department Epidemiology Unit, Preventive Medicine Department, Alicante General University Hospital-Alicante Institute for Health and Biomedical Research, Alicante, Spain.
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13
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Moreno-Pérez O, Merino E, Leon-Ramirez JM, Andres M, Ramos JM, Arenas-Jiménez J, Asensio S, Sanchez R, Ruiz-Torregrosa P, Galan I, Scholz A, Amo A, González-delaAleja P, Boix V, Gil J. Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study. J Infect 2021; 82:378-383. [PMID: 33450302 PMCID: PMC7802523 DOI: 10.1016/j.jinf.2021.01.004] [Citation(s) in RCA: 345] [Impact Index Per Article: 115.0] [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] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/15/2020] [Accepted: 01/07/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES This study aims to analyze the incidence of Post-acute COVID-19 syndrome (PCS) and its components, and to evaluate the acute infection phase associated risk factors. METHODS A prospective cohort study of adult patients who had recovered from COVID-19 (27th February to 29th April 2020) confirmed by PCR or subsequent seroconversion, with a systematic assessment 10-14 weeks after disease onset. PCS was defined as the persistence of at least one clinically relevant symptom, or abnormalities in spirometry or chest radiology. Outcome predictors were analyzed by multiple logistic regression (OR; 95%CI). RESULTS Two hundred seventy seven patients recovered from mild (34.3%) or severe (65.7%) forms of SARS-CoV-2 infection were evaluated 77 days (IQR 72-85) after disease onset. PCS was detected in 141 patients (50.9%; 95%CI 45.0-56.7%). Symptoms were mostly mild. Alterations in spirometry were noted in 25/269 (9.3%), while in radiographs in 51/277 (18.9%). No baseline clinical features behaved as independent predictors of PCS development. CONCLUSIONS A Post-acute COVID-19 syndrome was detected in a half of COVID19 survivors. Radiological and spirometric changes were mild and observed in less than 25% of patients. No baseline clinical features behaved as independent predictors of Post-acute COVID-19 syndrome development.
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Affiliation(s)
- Oscar Moreno-Pérez
- Endocrinology and Nutrition department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain; Clinical Medicine department, Miguel Hernández University, Elche, Spain.
| | - Esperanza Merino
- Unit of Infectious Diseases, Alicante General University Hospital, Alicante Institute of Health and Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Jose-Manuel Leon-Ramirez
- Pneumology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Mariano Andres
- Clinical Medicine department, Miguel Hernández University, Elche, Spain; Rheumatology department, Alicante General University Hospital Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Jose Manuel Ramos
- Clinical Medicine department, Miguel Hernández University, Elche, Spain; Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Juan Arenas-Jiménez
- Radiology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Santos Asensio
- Pneumology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Rosa Sanchez
- Neurology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Paloma Ruiz-Torregrosa
- Pneumology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Irene Galan
- Pneumology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Alexander Scholz
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Antonio Amo
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Pilar González-delaAleja
- Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Vicente Boix
- Clinical Medicine department, Miguel Hernández University, Elche, Spain; Unit of Infectious Diseases, Alicante General University Hospital, Alicante Institute of Health and Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Joan Gil
- Pneumology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
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Arnalte-Mur L, Ortiz-Miranda D, Cerrada-Serra P, Martinez-Gómez V, Moreno-Pérez O, Barbu R, Bjorkhaug H, Czekaj M, Duckett D, Galli F, Goussios G, Grivins M, Hernández P, Prosperi P, Šūmane S. The drivers of change for the contribution of small farms to regional food security in Europe. Global Food Security 2020. [DOI: 10.1016/j.gfs.2020.100395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Moreno-Pérez O, Andres M, Leon-Ramirez JM, Sánchez-Payá J, Rodríguez JC, Sánchez R, García-Sevila R, Boix V, Gil J, Merino E. Experience with tocilizumab in severe COVID-19 pneumonia after 80 days of follow-up: A retrospective cohort study. J Autoimmun 2020; 114:102523. [PMID: 32690352 PMCID: PMC7365106 DOI: 10.1016/j.jaut.2020.102523] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To describe the clinical characteristics and predictors of major outcomes in patients treated with tocilizumab (TCZ) for severe COVID-19 pneumonia. PATIENTS AND METHODS Case series of all sequential patients with severe COVID-19 pneumonia treated with TCZ at an Academic Spanish hospital (March 12 - May 2, 2020). Clinical outcomes: death, length of hospital stay. An early clinical response to TCZ (48-72 h after the administration) was assessed by variations in respiratory function markers, Brescia COVID Respiratory Severity Scale (BCRSS), inflammatory parameters, and patients' and physicians' opinion. Associations were tested by multiple logistic regression. RESULTS From a cohort of 236 patients, 77 patients treated with TCZ were included (median age 62 years (IQR 53.0-72.0), 64.9% were males), 42.9% had Charlson index ≥3; hypertension (41.6%), obesity (34.7%), and diabetes (20.8%). Median follow-up was 83.0 days (78.0-86.5), no patient was readmitted. ICU admission was required for 42 (54.5%), invasive mechanical ventilation in 38 (49.4%) and 10 patients died (12.9% global, 23.8% at ICU admitted). After multivariate adjustment, TCZ response by BCRSS (OR 0.03 (0.01-0.68), p = 0.028), and Charlson index (OR 3.54 (1.20-10.44), p = 0.022) has been identified as independent factors associated with mortality. Median of hospital stay was 16.0 days (11.0-23.0); BCRSS, physician subjective and D-dimer response were associated with shorter hospitalization stay. CONCLUSIONS In a Mediterranean cohort, use of tocilizumab for severe COVID-19 show 12.9% of mortality. Early TCZ-response by BCRSS and low comorbidity were associated with increased survival. Early TCZ-response was related to shorter median hospital stay.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antiviral Agents/administration & dosage
- Betacoronavirus/immunology
- Betacoronavirus/pathogenicity
- COVID-19
- Coronavirus Infections/diagnosis
- Coronavirus Infections/immunology
- Coronavirus Infections/mortality
- Coronavirus Infections/therapy
- Drug Therapy, Combination
- Female
- Fibrin Fibrinogen Degradation Products/analysis
- Follow-Up Studies
- Hospital Mortality
- Humans
- Infusions, Intravenous
- Interleukin-6/immunology
- Interleukin-6/metabolism
- Length of Stay/statistics & numerical data
- Male
- Middle Aged
- Pandemics
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/immunology
- Pneumonia, Viral/mortality
- Pneumonia, Viral/therapy
- Prognosis
- Receptors, Interleukin-6/antagonists & inhibitors
- Receptors, Interleukin-6/metabolism
- Respiration, Artificial/statistics & numerical data
- Respiratory Function Tests/statistics & numerical data
- Retrospective Studies
- SARS-CoV-2
- Severity of Illness Index
- Spain/epidemiology
- Survival Analysis
- Time Factors
- Time-to-Treatment
- Treatment Outcome
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Affiliation(s)
- Oscar Moreno-Pérez
- Endocrinology and Nutrition Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain; Clinical Medicine Department, Miguel Hernández University, Elche, Spain.
| | - Mariano Andres
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain; Rheumatology Department, Alicante General University Hospital Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Jose-Manuel Leon-Ramirez
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - José Sánchez-Payá
- Preventive Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Juan Carlos Rodríguez
- Microbiology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain; Miguel Hernández University, Elche, Spain.
| | - Rosario Sánchez
- Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Raquel García-Sevila
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Vicente Boix
- Clinical Medicine Department, Miguel Hernández University, Elche, Spain; Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Joan Gil
- Pneumology Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
| | - Esperanza Merino
- Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
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16
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Moreno-Pérez O, Boix V, Merino E, Picó A, Reus S, Alfayate R, Giner L, Mirete R, Sánchez-Payá J, Portilla J. Biological markers of fertility (inhibin-B) in HIV-infected men: influence of HIV infection and antiretroviral therapy. HIV Med 2015; 17:436-44. [PMID: 26688126 DOI: 10.1111/hiv.12350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Inhibin B (IB) levels and the IB: follicle-stimulating hormone (FSH) ratio (IFR), biomarkers of global Sertoli cell function, show a strong relationship with male fertility. The aim of the study was to examine the prevalence of impaired fertility potential in HIV-infected men and the influence of antiretroviral therapy (ART) on fertility biomarkers. METHODS A cross-sectional study with sequential sampling was carried out. A total of 169 clinically stable patients in a cohort of HIV-infected men undergoing regular ambulatory assessment in a tertiary hospital were included. The mean [± standard deviation (SD)] age of the patients was 42.6 ± 8.1 years, all were clinically stable, 61.5% had disease classified as Centers for Disease Control and Prevention (CDC) stage A, and were na?ve to ART or had not had any changes to ART for 6 months (91.1%). Morning baseline IB and FSH concentrations were measured using an enzyme-linked immunosorbent assay (ELISA) and an electrochemiluminescent immunoassay (ECLIA), respectively. A multivariate logistic regression model was used to identify factors associated with impaired fertility, defined as IB < 119 pg/mL or IFR < 23.5. RESULTS The mean (± SD) IB level was 250 ± 103 pg/mL, the median [interquartile range (IQR)] FSH concentration was 5.1 (3.3-7.8) UI/L and the median (IQR) IFR was 46.1 (26.3-83.7). The prevalence of impaired fertility was 21.9% [95% confidence interval (CI) 16.3-20.7%]. Negative correlations of body mass index and waist: hip ratio with FSH and IB levels were observed (P < 0.01), while a sedentary lifestyle and previous nevirapine exposure were associated with a decreased risk of IB levels ≤ 25th percentile in multivariate analysis. Only older age, as a risk factor, and sedentary lifestyle, with a protective effect, were independently associated with impaired fertility in multivariate analysis. CONCLUSIONS Global testicular Sertoli cell function and fertility potential, assessed indirectly through serum IB levels and IB: FSH ratio, appear to be well maintained in HIV-infected men and not damaged by ART.
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Affiliation(s)
- O Moreno-Pérez
- Endocrinology and Nutrition Department, Alicante University General Hospital, Alicante, Spain.,Miguel Hernández University, San Juan de Alicante, Alicante, Spain
| | - V Boix
- Miguel Hernández University, San Juan de Alicante, Alicante, Spain.,Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain
| | - E Merino
- Miguel Hernández University, San Juan de Alicante, Alicante, Spain.,Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain
| | - A Picó
- Endocrinology and Nutrition Department, Alicante University General Hospital, Alicante, Spain.,Miguel Hernández University, San Juan de Alicante, Alicante, Spain
| | - S Reus
- Miguel Hernández University, San Juan de Alicante, Alicante, Spain.,Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain
| | - R Alfayate
- Hormone Laboratory, Alicante University General Hospital, Alicante, Spain
| | - L Giner
- Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain
| | - R Mirete
- Endocrinology and Nutrition Department, Alicante University General Hospital, Alicante, Spain
| | - J Sánchez-Payá
- Preventive Medicine Department, Alicante University General Hospital, Alicante, Spain
| | - J Portilla
- Miguel Hernández University, San Juan de Alicante, Alicante, Spain.,Infectious Diseases Unit, Alicante University General Hospital, Alicante, Spain
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17
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Esteva de Antonio I, Asenjo Araque N, Hurtado Murillo F, Fernández Rodríguez M, Vidal Hagemeijer Á, Moreno-Pérez O, Lucio Pérez MJ, López Siguero JP. Position statement: Gender dysphoria in childhood and adolescence. Working Group on Gender Identity and Sexual Development of the Spanish Society of Endocrinology and Nutrition (GIDSEEN). Endocrinol Nutr 2015; 62:380-383. [PMID: 25935352 DOI: 10.1016/j.endonu.2015.03.004] [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] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 03/06/2015] [Accepted: 03/06/2015] [Indexed: 06/04/2023]
Abstract
Gender dysphoria (GD) in childhood and adolescence is a complex condition where early detection and comprehensive treatment are essential to improve quality of life, decrease mental comorbidity, and improve GD. In this position statement, the Working Group on Gender Identity and Sexual Development of the Spanish Society of Endocrinology and Nutrition (GIDSEEN), consisting of specialists in Endocrinology, Psychology, Psychiatry, Pediatrics and Sociology, sets out recommendations for evaluation and treatment of GD in children and adolescents. Interdisciplinary management of GD should be carried out at specialized units (UTIGs), considering that any clinical intervention should follow the principles of scientific rigor, experience, ethical and deontological principles, and the necessary caution in front of chronic, aggressive, and irreversible treatments.
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Affiliation(s)
| | | | | | | | | | - Oscar Moreno-Pérez
- Endocrinología, Unidad de Identidad de Género, H.G.U. Alicante, Universidad Miguel Hernández, Alicante, España.
| | | | - Juan Pedro López Siguero
- Endocrinología Pediátrica, Unidad de Transexualidad e Identidad de Género, H.R.U Málaga (H. Materno-Infantil), Málaga, España
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18
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González-Sánchez V, Moreno-Pérez O, García de Guadiana L, Sánchez-Pellicer P, Alfayate R, Mauri M, Sánchez-Payá J, Picó A. Reference ranges for serum and salivary testosterone in young men of Mediterranean region. ACTA ACUST UNITED AC 2015; 62:4-10. [DOI: 10.1016/j.endonu.2014.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 08/28/2014] [Accepted: 09/04/2014] [Indexed: 01/17/2023]
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Moreno-Pérez O, Esteva de Antonio I. Reply to: Comments on the "Clinical practice guidelines for assessment and treatment of transsexuality" issued by the Sexual Identity and Differentiation Group of the SEEN (GIDSEEN). Endocrinol Nutr 2014; 61:118-119. [PMID: 24388415 DOI: 10.1016/j.endonu.2013.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 11/28/2013] [Indexed: 06/03/2023]
Affiliation(s)
- Oscar Moreno-Pérez
- Sección de Endocrinología y Nutrición, Unidad de Identidad de Género (UIG), Hospital General Universitario de Alicante, Universidad Miguel Hernández, Alicante, España.
| | - Isabel Esteva de Antonio
- Unidad de Transexualidad e Identidad de Género de Andalucía (UTIG), Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, España
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20
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Moreno-Pérez O, Portilla J, Escoín C, Alfayate R, Reus S, Merino E, Boix V, Bernabeu A, Giner L, Mauri M, Sánchez-Paya J, Picó A. Impact of vitamin D insufficiency on insulin homeostasis and beta cell function in nondiabetic male HIV-infected patients. HIV Med 2013; 14:540-8. [DOI: 10.1111/hiv.12042] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2013] [Indexed: 12/14/2022]
Affiliation(s)
- O Moreno-Pérez
- Endocrinology and Nutrition Department; Alicante University General Hospital; Alicante Spain
| | - J Portilla
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - C Escoín
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - R Alfayate
- Hormone Laboratory; Alicante University General Hospital; Alicante Spain
| | - S Reus
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - E Merino
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - V Boix
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - A Bernabeu
- Magnetic Resonance Unit - Inscanner S.L.; Alicante University General Hospital; Alicante Spain
| | - L Giner
- Infectious Diseases Unit; Alicante University General Hospital; Alicante Spain
| | - M Mauri
- Hormone Laboratory; Alicante University General Hospital; Alicante Spain
| | - J Sánchez-Paya
- Preventive Medicine Department; Alicante University General Hospital; Alicante Spain
| | - A Picó
- Endocrinology and Nutrition Department; Alicante University General Hospital; Alicante Spain
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21
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González-Sánchez V, Moreno-Pérez O, Sánchez-Ortiga R, Gastaldo Simeón E, Picó Alfonso AM. Neurohypophyseal germinoma: hCG in cerebrospinal fluid as a key for a diagnostic challenge. Endocrinol Nutr 2013; 60:213-6. [PMID: 22658543 DOI: 10.1016/j.endonu.2012.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 03/26/2012] [Indexed: 10/28/2022]
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22
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de-Madaria E, Abad-González A, Aparicio JR, Aparisi L, Boadas J, Boix E, de-Las-Heras G, Domínguez-Muñoz E, Farré A, Fernández-Cruz L, Gómez L, Iglesias-García J, García-Malpartida K, Guarner L, Lariño-Noia J, Lluís F, López A, Molero X, Moreno-Pérez O, Navarro S, Palazón JM, Pérez-Mateo M, Sabater L, Sastre Y, Vaquero EC, Martínez J. The Spanish Pancreatic Club's recommendations for the diagnosis and treatment of chronic pancreatitis: part 2 (treatment). Pancreatology 2012; 13:18-28. [PMID: 23395565 DOI: 10.1016/j.pan.2012.11.310] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 11/11/2012] [Accepted: 11/20/2012] [Indexed: 02/07/2023]
Abstract
Chronic pancreatitis (CP) is a complex disease with a wide range of clinical manifestations. This range comprises from asymptomatic patients to patients with disabling symptoms or complications. The management of CP is frequently different between geographic areas and even medical centers. This is due to the paucity of high quality studies and clinical practice guidelines regarding its diagnosis and treatment. The aim of the Spanish Pancreatic Club was to give current evidence-based recommendations for the management of CP. Two coordinators chose a multidisciplinary panel of 24 experts on this disease. These experts were selected according to clinical and research experience in CP. A list of questions was made and two experts reviewed each question. A draft was later produced and discussed with the entire panel of experts in a face-to-face meeting. The level of evidence was based on the ratings given by the Oxford Centre for Evidence-Based Medicine. In the second part of the consensus, recommendations were given regarding the management of pain, pseudocysts, duodenal and biliary stenosis, pancreatic fistula and ascites, left portal hypertension, diabetes mellitus, exocrine pancreatic insufficiency, and nutritional support in CP.
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Affiliation(s)
- E de-Madaria
- Pancreatic Unit, University General Hospital of Alicante, Spain.
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Martínez J, Abad-González A, Aparicio JR, Aparisi L, Boadas J, Boix E, de Las Heras G, Domínguez-Muñoz E, Farré A, Fernández-Cruz L, Gómez L, Iglesias-García J, García-Malpartida K, Guarner L, Lariño-Noia J, Lluís F, López A, Molero X, Moreno-Pérez O, Navarro S, Palazón JM, Pérez-Mateo M, Sabater L, Sastre Y, Vaquero E, de-Madaria E. The Spanish Pancreatic Club recommendations for the diagnosis and treatment of chronic pancreatitis: part 1 (diagnosis). Pancreatology 2012; 13:8-17. [PMID: 23395564 DOI: 10.1016/j.pan.2012.11.309] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Revised: 11/13/2012] [Accepted: 11/18/2012] [Indexed: 12/11/2022]
Abstract
Chronic pancreatitis (CP) is a relatively uncommon, complex and heterogeneous disease. The absence of a gold standard applicable to the initial phases of CP makes its early diagnosis difficult. Some of its complications, particularly chronic pain, can be difficult to manage. There is much variability in the diagnosis and treatment of CP and its complications amongst centers and professionals. The Spanish Pancreatic Club has developed a consensus on the management of CP. Two coordinators chose a multidisciplinary panel of 24 experts on this disease. A list of questions was drafted, and two experts reviewed each question. Then, a draft was produced and shared with the entire panel of experts and discussed in a face-to-face meeting. This first part of the consensus addresses the diagnosis of CP and its complications.
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Affiliation(s)
- J Martínez
- Pancreatic Unit, University General Hospital of Alicante, Spain.
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Sánchez-Pacheco M, Moreno-Pérez O, Sánchez-Ortiga R, Picó A, Moreno F. Hipoplasia adrenal congénita e hipogonadismo hipogonadotropo: variabilidad fenotípica de la mutación R267P del gen DAX-1. ACTA ACUST UNITED AC 2012; 59:140-2. [DOI: 10.1016/j.endonu.2011.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 05/24/2011] [Accepted: 05/25/2011] [Indexed: 11/30/2022]
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Moreno-Pérez O, Escoín C, Serna-Candel C, Portilla J, Boix V, Alfayate R, González-Sánchez V, Mauri M, Sánchez-Payá J, Picó A. The Determination of Total Testosterone and Free Testosterone (RIA) are not Applicable to the Evaluation of Gonadal Function in HIV-Infected Males. J Sex Med 2010; 7:2873-83. [DOI: 10.1111/j.1743-6109.2010.01886.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sánchez-Ortiga R, Sánchez Tejada L, Peiró Cabrera G, Moreno-Pérez O, Arias Mendoza N, Ignacio Aranda López F, Picó Alfonso A. Papel de pituitary tumour-transforming gene (PTTG) en los adenomas hipofisarios. ACTA ACUST UNITED AC 2010; 57:28-34. [DOI: 10.1016/s1575-0922(10)70006-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 12/10/2009] [Indexed: 01/23/2023]
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27
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Sánchez-Ortiga R, Moreno-Pérez O, González Sánchez V, Arias Mendoza N, Mauri Dot M, Alfayate Guerra R, López Macia A, Picó Alfonso A. Treatment of Graves' ophthalmopathy with high-dose intravenous methylprednisolone: a comparison of two dosing regimens. ACTA ACUST UNITED AC 2009; 56:118-22. [PMID: 19627724 DOI: 10.1016/s1575-0922(09)70841-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 03/03/2009] [Indexed: 11/28/2022]
Abstract
RATIONALE AND OBJECTIVE The treatment of active moderate-severe Graves' ophthalmopathy (GO) is based on the administration of highdose intravenous glucocorticoids. The present study compares the efficacy and safety of 2 different intravenous methylprednisolone (MTPiv) dosing regimens. MATERIAL AND METHODS We carry a retrospective descriptive study with sequential sampling of 24 patients (83% females) presenting moderatesevere GO (EUGOGO criteria) and receiving treatment in our center between January 2006 and June 2008. We use 2 dosing regimens: regimen A (12 weeks): 6 doses of 0.5g/week followed by 6 doses of 0.25 g/week, for a cumulative dose of 4.5 g of MTPiv (n=13); and regimen B (16 weeks): 4 cycles of 15 mg/kg, followed by 4 cycles of 7.5mg/kg, for a cumulative dose of 90 mg/kg (range, 4.9-7.4 g) (n=11). Comparisons were made for safety (fasting glucose, cytolysis-cholestasis enzymes, lipid profile) and efficacy data (clinical improvement and recurrence). RESULTS Mild-moderate liver cytolysis was recorded in four patients, one with associated moderate cholestasis and another with hyperglycemia, leading to treatment suspension - with no differences between the 2 treatment regimens. Percentage clinical improvement with regimen A was 92% (CI, 65-94%) versus 100% with regimen B (CI, 74-100%). The recurrence rate was 43% with regimen A and 63% with regimen B (p>0.05). None of the variables examined in the univariate logistic regression study were associated to a lesser treatment response or increased risk of recurrence of GO. CONCLUSIONS The treatment of GO with MTPiv is safe and effective, with a lower recurrence rate when using dosing regimen A.
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Affiliation(s)
- Ruth Sánchez-Ortiga
- Endocrinology Department, Alicante General Universitary Hospital, Alicante, Spain
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Sánchez-Ortiga R, Boix Carreño E, Moreno-Pérez O, Picó Alfonso A. [Glioblastoma multiforme and multiple endocrine neoplasic type 2 A]. Med Clin (Barc) 2009; 133:196-7. [PMID: 19268982 DOI: 10.1016/j.medcli.2008.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 06/26/2008] [Indexed: 10/20/2022]
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Moreno-Pérez O, Picó Alfonso AM, Portilla J. Hipogonadismo, disfunción eréctil y disfunción endotelial en varones con infección por el virus de la inmunodeficiencia humana. Med Clin (Barc) 2009; 132:311-21. [DOI: 10.1016/j.medcli.2008.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 07/09/2008] [Indexed: 11/29/2022]
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30
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Moreno-Pérez O, Carles Genovés C, Moreno Macián F, Rius Peris J, Albiach Mesado V. Pubertad precoz completa isosexual: hallazgos clínicos, de laboratorio y ecografía pélvica. An Pediatr (Barc) 2008; 69:413-9. [DOI: 10.1157/13127995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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