ABSTRACT
BACKGROUND: To analyze hospitalization episodes with an ICD-9 diagnosis code of influenza (codes 487 and 488) in any diagnostic position from 2009 to 2015 in the Spanish hospital surveillance system. METHODS: Information about age, length of stay in hospital, mortality, comorbidity with an influenza diagnosis code between 1 October 2009 and 30 September 2015 was obtained from the National Surveillance System for Hospital Data (Conjunto Mínimo Básico de Datos, CMBD). RESULTS: 52,884 hospital admissions were obtained. A total of 24,527 admissions corresponded to diagnoses ICD-9 code 487 (46.4%), and 28,357 (53.6%) corresponded to ICD-9 code 488. The global hospitalization rates were 8.7 and 10.6 per 100,000 people, respectively. Differences between the two diagnostic groups were found for each of the six analyzed seasons. The diagnostic ICD-9-CM 488, male gender, and high-risk patients classified by risk vaccination groups showed direct relationship with inpatient hospital death. CONCLUSIONS: Influenza diagnosis was present in a significant number of hospital admissions. The code used for diagnosis (ICD-9-CM 488), male sex, age groups and associated risk clinical conditions showed a direct relationship with inpatient hospital fatality.
Subject(s)
Hospital Mortality , Influenza, Human/diagnosis , Influenza, Human/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Hospitalization/statistics & numerical data , Humans , Infant , Influenza, Human/virology , Inpatients/statistics & numerical data , International Classification of Diseases , Male , Middle Aged , Risk Factors , Spain/epidemiology , VaccinationABSTRACT
The lack of an adequate therapy for Alzheimer's Disease (AD) contributes greatly to the continuous growing amount of papers and reviews, reflecting the important efforts made by scientists in this field. It is well known that AD is the most common cause of dementia, and up-to-date there is no prevention therapy and no cure for the disease, which contrasts with the enormous efforts put on the task. On the other hand many aspects of AD are currently debated or even unknown. This review offers a view of the current state of knowledge about AD which includes more relevant findings and processes that take part in the disease; it also shows more relevant past, present and future research on therapeutic drugs taking into account the new paradigm "Multi-Target-Directed Ligands" (MTDLs). In our opinion, this paradigm will lead from now on the research toward the discovery of better therapeutic solutions, not only in the case of AD but also in other complex diseases. This review highlights the strategies followed by now, and focuses other emerging targets that should be taken into account for the future development of new MTDLs. Thus, the path followed in this review goes from the pathology and the processes involved in AD to the strategies to consider in on-going and future researches.
ABSTRACT
Due to the growing demand of enantiomerically pure compounds, as well as the increasing strict safety, quality and environmentally requirements of industrial synthetic processes, the development of more sustainable, healthy and economically attractive strategies for the synthesis of chiral biologically active molecules is still an open challenge in the pharmaceutical industry. In this context, the biotransformations field has emerged as a real alternative to traditional synthetic routes, because of the exquisite chemo-, regio- and enantioselectivities commonly displayed by enzymes; thus, biocatalysis is becoming a widespread methodology for the synthesis of chiral compounds, not only at laboratory scale, but also at industrial scale. As hydrolases and oxido-reductases are the most employed enzymes, this review is focused on describing several industrial processes based on the use of these enzymes for obtaining chiral compounds useful for the pharmaceutical industry.
Subject(s)
Drug Industry/methods , Pharmaceutical Preparations/chemistry , Pharmaceutical Preparations/chemical synthesis , Biotransformation , Hydrolases/metabolism , Oxidation-Reduction , StereoisomerismABSTRACT
OBJECTIVES: Spanish hospital surveillance system was analyzed to estimate the burden of hospital admissions for meningococcal infection in Spain during a nine-year period (1997-2005). METHODS: Data were obtained from the national surveillance system for hospital data (Conjunto Mínimo Básico de Datos) maintained by the Ministry of Health and covering more than 95% of Spanish hospitals. RESULTS: There were 9480 hospital admissions for meningococcal infection (ICD 9 CM 036; any listed diagnosis) during the study period. Annual incidence was 2.66 cases per 100,000 population. Rate of death and case-fatality rate were 0.17 per 100,000 population and 6.45%, respectively. The average length of hospitalization was 11.2 days. Youngest age group showed the highest incidence and rate of death (43.15 and 1.17 per 100,000 population respectively in 0-4 years old group), but case-fatality rate was higher in the oldest group (12.16%; more than 30 years old group). The cost of acute hospital care is estimated to be on average 4470 euro per case, which imposes an annual direct cost of 3-5 million euro to the Spanish health system. CONCLUSIONS: Meningococcal infection is still an important cause of hospital admissions in Spain and results in large cost to the Health Care System.
Subject(s)
Hospitalization/statistics & numerical data , Meningococcal Infections/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , Hospitalization/economics , Humans , Incidence , Infant , Infant, Newborn , Length of Stay , Meningococcal Infections/economics , Meningococcal Infections/mortality , Middle Aged , Spain/epidemiology , Young AdultABSTRACT
OBJECTIVE: To evaluate the clinical and pathological characteristics and survival in patients surgically treated for renal tumours that had local recurrence or metastasis to a single site. MATERIAL AND METHODS: A retrospective study of 321 nephrectomies, evaluating the clinical and pathological variables in patients having local recurrence or metastasis to a single site, and who were treated surgically. Study and comparison of survival in the different groups. RESULTS: The only factor found to have an independent influence on local recurrence is pathological stage. Local recurrence and the presence of metastasis to a single site have similar survival rates, both being statistically worse than in patients without metastasis at diagnosis, but better than in those having metastasis at diagnosis. CONCLUSIONS: The presence of local recurrence has the same prognosis as a single excisable metastatic site, the prognosis being better than those initially with metastasis subjected to nephrectomy before receiving systemic treatment.
Subject(s)
Kidney Neoplasms/surgery , Neoplasm Recurrence, Local/epidemiology , Adult , Aged , Aged, 80 and over , Female , Humans , Kidney Neoplasms/mortality , Kidney Neoplasms/pathology , Male , Middle Aged , Neoplasm Metastasis , Nephrectomy , Retrospective Studies , Survival RateABSTRACT
OBJECTIVE: To evaluate the clinical and pathological characteristics of cystic renal tumors in our center. MATERIAL AND METHODS: A retrospective review of 239 nephrectomies is performed comparing the clinical and pathological variables of cystic tumors with those of solid renal tumors. Survival outcomes are analyzed in both groups. RESULTS: Our experience shows that cystic renal tumors behave like solid renal tumors, with no differences in survival shown. The variables studied show statistically significant differences in histological grade and number of tumors, with cystic tumors having a lower histological grade and being more often multiple in number. CONCLUSIONS: The behavior of cystic renal tumors is no different than that of solid renal tumors.
Subject(s)
Kidney Diseases, Cystic/pathology , Adult , Aged , Female , Humans , Kidney Diseases, Cystic/diagnosis , Kidney Diseases, Cystic/mortality , Kidney Diseases, Cystic/surgery , Male , Middle Aged , Neoplasm Staging , Nephrectomy , Prognosis , Retrospective Studies , Survival RateSubject(s)
Hematopoietic Stem Cell Transplantation , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Transplantation Chimera , Acute Disease , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy , Leukemia, Myeloid/epidemiology , Leukemia, Myeloid/therapy , Male , Recurrence , Retrospective Studies , Risk Factors , Transplantation, HomologousABSTRACT
OBJECTIVE: To study the clinical and pathological characteristics of incidental renal tumors treated in our center. MATERIAL AND METHODS: A retrospective review is conducted of 318 nephrectomies comparing the clinico-pathological variables of renal tumors diagnosed incidentally with those of symptomatic renal tumors. The factors influencing disease-free survival are analyzed in both groups. RESULTS: In our experience, although incidental renal tumors presented better survival than symptomatic ones owing to their better pathological state and tumor grade, incidental diagnosis was not an independent influencing factor in the multivariate study. Only when patients were studied who did not present metastases on diagnosis did incidental diagnosis become an influencing factor very close to statistical significance. CONCLUSIONS: Incidental diagnosis is not an independent prognostic factor.
Subject(s)
Kidney Neoplasms , Adult , Aged , Aged, 80 and over , Female , Humans , Incidental Findings , Kidney Neoplasms/diagnosis , Kidney Neoplasms/surgery , Male , Middle Aged , Prognosis , Retrospective StudiesABSTRACT
Metastases in the kidney are rare, evenmore if primary source is thyroid. We report the tenth case of metastases in the kidney from thyroid, and it is the first to be follicular type and absolutely asymptom. Sonography and computerized tomography with suspicion of renal tumour are showed in a asymtom female 75 years old. Left partial nephrectomy was perfomed, initially it has been pathologically diagnosed as renal clear cells tumour, however the definitive pathologic report showed follicular tumour of thyroid. Local and systemic stage was discovered with complementary techniques. Sources of metastases in kidney and diagnoses techniques are discussed.
Subject(s)
Adenocarcinoma, Follicular/secondary , Kidney Neoplasms/secondary , Thyroid Neoplasms/diagnosis , Aged , Female , Humans , Thyroid Neoplasms/pathologyABSTRACT
UNLABELLED: The aim of this study was to detect mutations in the human androgen receptor gene in radical prostatectomy specimens. MATERIAL AND METHODS: The genomic sequence was realized in 67 radical prostatectomy specimens. The mean age was 64 years old. The PSA median was 15 ng/ml. TNM 1997: 34.3% were T1 and 65.7% T2. Genomic sequence: 1. Radical prostatectomy specimens desparaffitation. 2. Extraction of the DNA 3. DNA amplification. 4. Automatic genome sequence. 5. Comparison with Gene-Bank. RESULTS: 16.7% of the specimens were mutated. The most frequent mutation was the punctual mutation. The exon most frequent mutated was exon 1.
Subject(s)
Adenocarcinoma/genetics , Mutation , Prostatic Neoplasms/genetics , Receptors, Androgen/genetics , Adenocarcinoma/pathology , Aged , Humans , Male , Middle Aged , Prostatic Neoplasms/pathologyABSTRACT
OBJECTIVE: To evaluate the functional studies in women with stress urinary incontinence. METHODS: Emphasis is placed on comprehensive understanding of stress urinary incontinence in women as well as Urodynamic techniques and findings which apply to women with this condition. RESULTS: Although prospective randomized controlled trials to evaluate the clinical efficacy, cost-effectiveness and effect on quality of life of a pre-operative Urodynamic assessment are necessary, to date only Urodynamic Investigation (Non-invasive uroflowmetry, filling cystometrogram, valsalva leak point pressure, pressure-flow studies and urethral profile) provide enough information for treatment decisions and prognosis in cases of female urinary incontinence.
Subject(s)
Urinary Incontinence/physiopathology , Urodynamics , Female , HumansABSTRACT
Prostate carcinoma is diagnosed in earlier phases of its evolution, but this carcinoma may have an unpredictible evolution. Radical treatment (surgery and radiotherapy) is the best treatment in clinically localized tumors. The biochemical failure over 5 years from the surgery is 20-50% of the patients; the biochemical failure over 10 years from the surgery is less frequent because of prognostic factors from the biologic nature of the tumor. We report a case with biochemical and clinical failure over 10 years from the surgery.
Subject(s)
Adenocarcinoma/secondary , Lung Neoplasms/secondary , Prostatectomy , Prostatic Neoplasms/surgery , Adenocarcinoma/blood , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/surgery , Aged , Biomarkers, Tumor/blood , Humans , Lung Neoplasms/blood , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Male , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Time Factors , Tomography, Emission-ComputedABSTRACT
OBJECTIVES: To identify independent predictors of progression and global survival in patients affected by pT3 renal cell carcinoma. To make risk groups by risk factors. MATERIAL AND METHODS: We evaluated 117 patients with pT3 renal cell carcinoma. 88 was M0 and 29 M1. Most frequent clinical feature: asintomatic patients. 80 males (69%) and 37 females (31%). Mean age 59 (24-82). Median follow up 34 months (mean 44 +/- 39 months). RESULTS: Pathological stage (TNM 1997) was pT3a in 52 patients (43.6%), pT3b 63 patients (53.6%) and pT3c 2 patients. HISTOLOGY: clear cell carcinoma 106 patients (90.6%), papillary 5 patients (4.3%) an dchromophobe 4 patients (3.4%). Nuclear grading according Fuhrman's classification: G1 13 patients, G2 45 patients, G3 32 and G4 12 patients. Size > 4 cm (p = 0.005/p = 0.0019), grade 3-4 (p = 0.006/p = 0.0007), N+ (p = 0.034/p = 0.009) and M+ (p = 0.035/p = 0.042) were independent prognosis factors for progression and global survival of the pT3 renal cell carcinoma. Patients M0 with 0 or 1 risk factor have better global survival tanh patients M0 with 3 or 4 risk factors and patients M1. CONCLUSIONS: Size, grade, N+ and M+ were independent prognosis factors for progression and global survival of the pT3 renal cell carcinoma. Tera are no differencies in global survival between patients M0 with 2 or 3 risk factors and patients M1.
Subject(s)
Carcinoma, Renal Cell/mortality , Carcinoma, Renal Cell/pathology , Kidney Neoplasms/mortality , Kidney Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Disease Progression , Female , Humans , Male , Middle Aged , Multivariate Analysis , Neoplasm Staging , Prognosis , Risk Factors , Survival RateABSTRACT
Primary tumors of extragonadal origin are rare, with fewer than 1000 cases described in the literature. Although the exact incidence of EGTs is unknown, clinical data suggest that roughly 3% to 5% of all germ cell tumors. We expose a case report of EGT with unusually clinic presentation. We present our diagnostic and therapeutic experience in this injuries.
Subject(s)
Germinoma/diagnostic imaging , Retroperitoneal Neoplasms/diagnostic imaging , Teratoma/diagnostic imaging , Tomography, Emission-Computed , Adult , Germinoma/drug therapy , Humans , Male , Retroperitoneal Neoplasms/drug therapy , Teratoma/drug therapyABSTRACT
Significant conceptual changes have taken place in renal tumoral diseases over the last few years. As a result of the authors' broad institutional experience, this overall revision describes the most up-to-date clinical and diagnostic aspects of this condition. Emphasis is made on molecular staging and two variables that guide the prognosis of the disease, a decisive feature to establish treatment and to contribute to change current survival rates.
Subject(s)
Carcinoma/diagnosis , Kidney Neoplasms/diagnosis , Carcinoma/genetics , Humans , Kidney Neoplasms/genetics , Neoplasm Staging , PrognosisABSTRACT
The standard therapy for renal carcinoma is radical surgery. When dealing with single, under 4 cm tumors and in the case of renal tumors in single-kidney patients, the choice therapy is nephrectomy or partial nephrectomy. Response rates in metastatic renal carcinoma using the various immune therapy approaches available range from 15 to 35%, responses being short-lasting.
Subject(s)
Kidney Neoplasms/therapy , Combined Modality Therapy , HumansABSTRACT
OBJECTIVES: To determinate whether increased expression of the p53 and Ki67 and the of the tumour suppressor gene retinoblastoma (prot Rb), in an immunohistochemistry study, were associated with relapse in invasive bladder cancer. MATERIALS AND METHODS: 47 patients with invasive bladder cancer. 42 men and 5 women. Mean age 63 years old. Relapse in 19 patients (40%). Mean time until recurrence 8.5 months. p53 and Ki67 were study in 47 patients and prot Rb in 40 patients. RESULTS: p53: Mean expression 41%. There were significant differences in the increased expression of p53 between patients with and without relapse (p = 0.03). A statistically significant association was then observed between patients with p53 > 20% (vs p53 < 20%) and adverse outcome of the disease (p = 0.04). Ki67 and prot Rb: There were no significant differences in relapse and progression free survival between Ki67 > 40% (vs Ki67 < 40%) and prot Rb < 10% (vs prot Rb > 10%). p53 expression showed a statistically significant correlation with Ki67 and prot Rb. CONCLUSION: p53 is a good prognostic marker for the relapse and progression free survival in invasive bladder cancer.
Subject(s)
Ki-67 Antigen/metabolism , Retinoblastoma Protein/metabolism , Tumor Suppressor Protein p53/metabolism , Urinary Bladder Neoplasms/metabolism , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , PrognosisABSTRACT
Adenocarcinoma of the bladder is an uncommon neoplasm corresponding as usual to a metastases and with a lower frequency to a primary vesical tumour. We present the primary adenocarcinoma treated in our hospital in the last 10 years. The moment at the diagnosis is related to the prognosis because of its tendency to muscle infiltration. The most accepted treatment is the radical cistectomy and if recurrence occurs complementary proceedings must be consider.
Subject(s)
Adenocarcinoma/surgery , Urinary Bladder Neoplasms/surgery , Adenocarcinoma/pathology , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Time Factors , Urinary Bladder Neoplasms/pathologyABSTRACT
Described here is a case of Aspergillus fumigatus cranial infection secondary to accidental cranial traumatism that occurred in an immunocompetent patient and the questions that arose concerning treatment. No reports of post-traumatic cranial osteomyelitis caused by Aspergillus spp. and the ideal treatment to be followed have yet been described in the literature. In the present case, surgical debridement of the wound followed by treatment with 1 mg/kg/iv/day of amphotericin B for 21 days and then 200 mg/vo/12 h of itraconazole for 6 months obtained good results.