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1.
Eur J Public Health ; 33(4): 675-681, 2023 08 01.
Article in English | MEDLINE | ID: mdl-37087109

ABSTRACT

BACKGROUND: We performed a nationwide population-based retrospective study to describe the epidemiology of bacterial co-infections in coronavirus disease 2019 (COVID-19)-hospitalized patients in Spain in 2020. We also analyzed the risk factors for co-infection, the etiology and the impact in the outcome. METHODS: Data were obtained from records in the Minimum Basic Data Set (MBDS) of the National Surveillance System for Hospital Data in Spain, provided by the Ministry of Health and annually published with 2 years lag. COVID-19 circulated in two waves in 2020: from its introduction to 31st June and from 1st July to 31st December. The risk of developing a healthcare-associated bacterial co-infection and the risk for in-hospital and intensive care unit (ICU) mortality in co-infected patients was assessed using an adjusted logistic regression model. RESULTS: The incidence of bacterial co-infection in COVID-19 hospitalized patients was 2.3%. The main risk factors associated with bacterial co-infection were organ failure, obesity and male sex. Co-infection was associated with worse outcomes including higher in-hospital, in-ICU mortality and higher length of stay. Gram-negative bacteria caused most infections. Causative agents were similar between waves, although higher co-infections with Pseudomonas spp. were detected in the first wave and with Haemophilus influenzae and Streptococcus pneumoniae in the second. CONCLUSIONS: Co-infections are not as common as those found in other viral respiratory infections; therefore, antibiotics should be used carefully. Screening for actual co-infection to prescribe antibiotic therapy when required should be performed.


Subject(s)
Bacterial Infections , COVID-19 , Coinfection , Humans , Male , COVID-19/epidemiology , Coinfection/epidemiology , Coinfection/drug therapy , Spain/epidemiology , Retrospective Studies , Bacterial Infections/epidemiology , Bacterial Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Risk Factors
2.
Ann Hematol ; 101(10): 2263-2270, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35997804

ABSTRACT

Failure of second-generation tyrosine kinase inhibitors (2GTKI) is a challenging situation in patients with chronic myeloid leukemia (CML). Asciminib, recently approved by the US Federal Drug Administration, has demonstrated in clinical trials a good efficacy and safety profile after failure of 2GTKI. However, no study has specifically addressed response rates to asciminib in ponatinib pretreated patients (PPT). Here, we present data on responses to asciminib from 52 patients in clinical practice, 20 of them (38%) with prior ponatinib exposure. We analyzed retrospectively responses and toxicities under asciminib and compared results between PPT and non-PPT patients.After a median follow-up of 30 months, 34 patients (65%) switched to asciminib due to intolerance and 18 (35%) due to resistance to prior TKIs. Forty-six patients (88%) had received at least 3 prior TKIs. Regarding responses, complete cytogenetic response was achieved or maintained in 74% and 53% for non-PPT and PPT patients, respectively. Deeper responses such as major molecular response and molecular response 4.5 were achieved in 65% and 19% in non-PPT versus 32% and 11% in PPT, respectively. Two patients (4%) harbored the T315I mutation, both PPT.In terms of toxicities, non-PPT displayed 22% grade 3-4 TEAE versus 20% in PPT. Four patients (20% of PPT) suffered from cross-intolerance with asciminib as they did under ponatinib.Our data supports asciminib as a promising alternative in resistant and intolerant non-PPT patients, as well as in intolerant PPT patients; the resistant PPT subset remains as a challenging group in need of further therapeutic options.


Subject(s)
Antineoplastic Agents , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Pyridazines , Antineoplastic Agents/adverse effects , Drug Resistance, Neoplasm , Fusion Proteins, bcr-abl/genetics , Humans , Imidazoles , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Niacinamide/analogs & derivatives , Protein Kinase Inhibitors/adverse effects , Pyrazoles , Pyridazines/adverse effects , Retrospective Studies
3.
BMC Pediatr ; 22(1): 136, 2022 03 15.
Article in English | MEDLINE | ID: mdl-35287608

ABSTRACT

BACKGROUND: Neonatal acute kidney injury (AKI) has been associated with unfavorable outcomes, including increased mortality. We aimed to describe the clinical course and outcomes during the first 7 days after diagnosis in newborns with AKI in three neonatal intensive care units in Popayán-Colombia. METHODS: Multi-center prospective cohort study conducted between June 2019 and December 2020 in three NICUs after ethical approval. We included newborns between 2 and 28 days of life, first diagnosed with AKI using the KDIGO classification modified for newborns which consider increased serum creatinine values over baseline values as well as urine output over time in hours or both. Patients with chromosomal abnormalities, major kidney malformations, and complex congenital heart disease were excluded. Patients were followed for up to 7 days after diagnosis and the maximum KDIGO stage, recovery of kidney function, need for renal replacement therapy and cumulative incidence of death were evaluated. RESULTS: Over the 18 months of the study, 4132 newborns were admitted to the NICUs, and 93 patients (2.25, 95% CI 1.82-2.75%) developed neonatal AKI. 59.1% of the newborns were premature and there were no differences in severity according to gestational age. During follow-up, the maximum KDIGO was 64.5% for AKI-stage 1, 11.8% for AKI-stage 2, and 23.7% for AKI-stage 3. Kidney function recovery was higher in AKI-stage 1 patients vs. AKI-severe (AKI-stage 2 and 3) (95% vs. 48.5%). Five patients (5.4%) received renal replacement therapy and 15 died (16.1%), four in AKI-stage 1 vs. 11 in AKI-severe (6.7% vs 33.3%). CONCLUSIONS: Newborns admitted to the NICUs can develop AKI regardless of gestational age, and it is more frequent between the second and ninth days of life. More patients whit AKI-stage 1 recover and die less than those in a severe stage.


Subject(s)
Acute Kidney Injury , Acute Kidney Injury/diagnosis , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Humans , Incidence , Infant, Newborn , Intensive Care Units, Neonatal , Prospective Studies , Renal Replacement Therapy , Retrospective Studies , Risk Factors
4.
Ann Oncol ; 32(4): 533-541, 2021 04.
Article in English | MEDLINE | ID: mdl-33482247

ABSTRACT

BACKGROUND: In 2004, we started an intergroup randomized trial of adjuvant imatinib versus no further therapy after R0-R1 surgery in localized, high/intermediate-risk gastrointestinal stromal tumors (GIST) patients. Interim analysis results were published in 2015 upon recommendation from an independent data review committee. We report the final outcome of the study. PATIENTS AND METHODS: This was a randomized, open-label, multicenter phase III trial carried out at 112 hospitals in 12 countries. Patients were randomized to 2 years of imatinib, 400 mg daily, or no further therapy after surgery. The primary endpoint was imatinib failure-free survival (IFFS), while relapse-free survival (RFS), relapse-free interval (RFI), overall survival (OS) and toxicity were secondary endpoints. Adjusting for the interim analyses, results on IFFS were assessed on a 4.3% significance level; for the other endpoints, 5% was used. RESULTS: Nine hundred and eight patients were randomized between January 2005 and October 2008: 454 to imatinib and 454 to observation; 835 patients were eligible. With a median follow-up of 9.1 years, 5 (10)-year IFFS was 87% (75%) in the imatinib arm versus 83% (74%) in the control arm [hazard ratio (HR) = 0.87, 95.7% confidence interval (CI) (0.65; 1.15), P = 0.31]; RFS was 70% versus 63% at 5 years and 63% versus 61% at 10 years, [HR = 0.71, 95% CI (0.57; 0.89), P = 0.002]; OS was 93% versus 92% at 5 years and 80% versus 78% at 10 years [HR = 0.88, 95% CI (0.65; 1.21), P = 0.43]. Among 526 patients with high-risk GIST by local pathology, 10-year IFFS and RFS were 69% versus 61%, and 48% versus 43%, respectively. CONCLUSIONS: With 9.1 years of follow-up, a trend toward better long-term IFFS in imatinib-treated patients was observed in the high-risk subgroup. Although the difference was not statistically significant and the surrogacy value of such an endpoint is not validated, this may be seen as supporting the results reported by the Scandinavian/German trial, showing a sustained small but significant long-term OS benefit in high-risk GIST patients treated with 3 years of adjuvant imatinib.


Subject(s)
Antineoplastic Agents , Gastrointestinal Neoplasms , Gastrointestinal Stromal Tumors , Sarcoma , Antineoplastic Agents/therapeutic use , Chemotherapy, Adjuvant , Gastrointestinal Neoplasms/drug therapy , Gastrointestinal Stromal Tumors/drug therapy , Humans , Imatinib Mesylate/therapeutic use , Italy , Neoplasm Recurrence, Local/drug therapy , Sarcoma/drug therapy
5.
BMC Oral Health ; 21(1): 329, 2021 07 01.
Article in English | MEDLINE | ID: mdl-34210281

ABSTRACT

BACKGROUND: Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this "Caries OUT" study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time. METHODS: In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children's oral-health behaviour change, parents' and dentists' process acceptability, and costs exploration. A sample size of 258 3-5 and 6-8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments' time. A trained examiner per centre will conduct examinations at baseline, at 5-5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child's CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents' and dentists' process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. DISCUSSION: The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. TRIAL REGISTRATION: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h . Protocol-version 2: 27/01/2021.


Subject(s)
COVID-19 , Dental Caries , Adolescent , Adult , Aged , Child , Child, Preschool , Dental Caries/epidemiology , Dental Caries/prevention & control , Dental Caries Susceptibility , Dentists , Humans , Middle Aged , Multicenter Studies as Topic , Pandemics/prevention & control , Professional Role , Retrospective Studies , SARS-CoV-2 , Young Adult
6.
Nanotechnology ; 31(20): 205601, 2020 May 15.
Article in English | MEDLINE | ID: mdl-31978898

ABSTRACT

Zinc oxide nanostructures such as nanosheets (NS) and nanoflowers (NF) were obtained by a facile hydrothermal synthesis using zinc chloride (ZnCl2) as precursor with low molar concentrations and a short synthesis time (2 h) at 200 °C. By means of X-ray diffraction and Raman spectroscopy measurements, the wurtzite-type ZnO structure was confirmed with high crystalline quality. SEM micrographs showed the influence of ZnCl2 concentration on ZnO morphology; ZnO NF were obtained at low concentrations (0.02 and 0.05 M), while ZnO NS were seen for higher concentrations (0.2-0.6 M) and their thicknesses can be estimated from 15 to 60 nm. In addition, TEM images showed a large number of pores with sizes below 15 nm in both ZnO nanostructures. Raman and photoluminescence displayed the surface defects density for ZnO nanostructures. Raman spectra showed the E1(LO) mode localized at ∼581 cm-1, associated with oxygen vacancies and zinc interstitials, being more intense for ZnO NF, while photoluminescence results showed a strong yellow-orange emission (centered from 587 to 618 nm) relative to UV emission, being more intense for ZnO NF. These properties reveal further potential for high performance luminescent devices based on ZnO NF and NS.

7.
Clin Lab ; 66(1)2020 Jan 01.
Article in English | MEDLINE | ID: mdl-32013367

ABSTRACT

BACKGROUND: Most laboratory errors occur in the preanalytical phase. Among the most common preanalytical errors are interferences due to hemolysis, lipemia, and icterus. Our objective was to evaluate a serum interference estimation methodology by the RSD classifier, to identify other biochemical parameters affected by preanalytical interferences, and to determine the economic impact of its implementation. METHODS: The serum indices of 65,529 requests measured by the RSD system and by the analytical determination on the Cobas 711 or Cobas 8000 platforms were collected. We proceeded to the search for association patterns between the serum indices and laboratory analytical tests using data mining techniques. The influence of the preanalytical interferences was evaluated in 91 laboratory tests that include biochemistry, immunoassay, and coagulation. The savings estimation after the implementation of this methodology was made by time series models. RESULTS: The evaluation of the generated model showed compatibilities between the methods used (94.4% accuracy). The implementation of a protocol for serum indices estimation by the RSD would avoid the unnecessary analysis of the tests which are affected by interferences, achieving an estimated annual savings of €10,561. In addition, it allowed the estimation of bilirubin values which would add an annual savings of €4,900 in our laboratory. On the other hand, data mining techniques have allowed us to identify the following laboratory tests affected by hemolysis which are not usually considered in laboratories: iron, transferrin, fibrinogen, and alkaline phosphatase. CONCLUSIONS: The RSD classifier is an efficient estimation method of serum indices and it allows the estimation of bilirubin values. The implementation of this methodology in our laboratory could lead to an estimated annual savings of more than €15,000 without increasing response times. Iron, alkaline phosphatase, transferrin, and fibrinogen should be included in the evaluated procedure.


Subject(s)
Blood Chemical Analysis/standards , Pre-Analytical Phase/standards , Algorithms , Blood Chemical Analysis/methods , Data Mining , Hemolysis , Humans , Hyperlipidemias , Jaundice , Pre-Analytical Phase/methods , Reference Values , Reproducibility of Results
8.
Epidemiol Infect ; 147: e71, 2019 01.
Article in English | MEDLINE | ID: mdl-30869023

ABSTRACT

We investigated the distribution of comorbidities among adult tuberculosis (TB) patients in Chiapas, the poorest Mexican state, with a high presence of indigenous population, and a corridor for migrants from Latin America. Secondary analysis on 5508 new adult TB patients diagnosed between 2010 and 2014 revealed that the most prevalent comorbidities were diabetes mellitus (DM; 19.1%) and undernutrition (14.4%). The prevalence of DM in these TB patients was significantly higher among middle aged (41-64 years) compared with older adults (⩾65 years) (38.6% vs. 23.2%; P < 0.0001). The prevalence of undernutrition was lower among those with DM, and higher in communities with high indigenous presence. Immigrants only comprised 2% of all TB cases, but were more likely to have unfavourable TB treatment outcomes (treatment failure, death and default) when compared with those born in Chiapas (29.5% vs. 11.1%; P < 0.05). Unfavourable TB outcomes were also more prevalent among the TB patients with undernutrition, HIV or older age, but not DM (P < 0.05). Our study in Chiapas illustrates the challenges of other regions worldwide where social (e.g. indigenous origin, poverty, migration) and host factors (DM, undernutrition, HIV, older age) are associated with TB. Further understanding of these critical factors will guide local policy makers and health providers to improve TB management.


Subject(s)
Diabetes Mellitus/epidemiology , Human Migration/statistics & numerical data , Indians, North American/statistics & numerical data , Indigenous Peoples/statistics & numerical data , Malnutrition/epidemiology , Tuberculosis/epidemiology , Adult , Aged , Aged, 80 and over , Alcoholism/epidemiology , Alcoholism/etiology , Comorbidity , Cross-Sectional Studies , Diabetes Mellitus/etiology , Female , HIV Infections/epidemiology , HIV Infections/virology , Humans , Male , Malnutrition/etiology , Mexico/epidemiology , Middle Aged , Prevalence , Risk Factors , Tuberculosis/microbiology , Young Adult
9.
Encephale ; 45(1): 95-97, 2019 Feb.
Article in French | MEDLINE | ID: mdl-29402385

ABSTRACT

Psychiatric care has always included patients in crisis who are potentially dangerous or agitated. Faced with the many issues they may encounter, the therapeutic relationship has always been prioritized over all other considerations. However, the practice of seclusion and restraint has been steadily increasing in the past few decades. Their use is becoming customary rather than exceptional and consequently fosters less thought by the care teams. In the Healthcare System Modernization Act of January 26th, 2016, the lawmakers sought to underline the freedom-destroying nature of these practices and the necessity of their regulation. This law represents a fundamental change in the nature of seclusion and restraint. What was but a simple prescription becomes a conscious decision of depriving someone of her or his freedom and must only be considered as a last resort. The changes in the Law and the recent changes in the recommendations for clinical practice by the French National Institute of Health invite reflection. Many questions remain about the origins of violence, the reasons for the increasing use of seclusion and restraint measures, and the alternatives that have been developed. Many theories suggest that the less stressful and constrained an environment is, the more empowered the patient will be. He is an actor in his own care and is considered a full active participant. The Law is reconciled with caregivers initiating a reflection on the benefits of these measures regarding the violation of fundamental freedoms. Reflection on psychiatric care and the quality of its management must be the focus when caring for patients in crisis.


Subject(s)
Clinical Decision-Making , Mental Disorders/psychology , Mental Disorders/therapy , Patient Isolation/psychology , Psychiatry/legislation & jurisprudence , Psychiatry/trends , Restraint, Physical/legislation & jurisprudence , Restraint, Physical/standards , Commitment of Mentally Ill , France , Humans
10.
Nutr Metab Cardiovasc Dis ; 27(2): 129-137, 2017 02.
Article in English | MEDLINE | ID: mdl-28077257

ABSTRACT

BACKGROUND AND AIM: To evaluate the effectiveness and safety of a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, dapagliflozin, in patients with type 2 diabetes mellitus (T2DM) and background glucagon-like peptide-1 receptor agonist (GLP1-RA) therapy. METHODS AND RESULTS: This is a 12-month, real-world observational study, which assessed the effectiveness and safety of dapagliflozin in patients with T2DM and background GLP1-RA therapy. The main outcome measures were changes in A1C and weight at 6 and 12 months from baseline. Secondary outcomes were differences in A1C and weight reduction between this cohort and another group of patients with T2DM treated with dapagliflozin but without background GLP1-RA therapy. In total, 109 patients with GLP1-RA and 104 patients without GLP1-RA were included. Baseline mean A1C and weight in the GLP1-RA and non-GLP1-RA groups were 7.4% vs. 7.3% and 96.2 kg vs. 95.1 kg, respectively. A significant reduction in A1C was seen with dapagliflozin in both cohorts at 6 and 12 months (GLP1-RA: -0.51% and -0.34%, non-GLP1-RA: -0.69% and -0.62%, respectively, p < 0.0001 in all analyses). Weight was significantly reduced in both groups at 6 and 12 months (GLP1-RA: -2.3 kg and -2.4 kg, non-GLP1-RA: -3.9 kg and -4.8 kg, respectively, p < 0.0001 in all analyses). A1C reduction and weight loss were significantly lower in patients with GLP1-RA than in patients without GLP1-RAs. Drug discontinuation rates were similar in both cohorts. CONCLUSIONS: Dapagliflozin, when added in real life to patients with T2DM treated with GLP1-RAs, induced a further significant, albeit modest improvement in A1C and a further weight loss.


Subject(s)
Benzhydryl Compounds/therapeutic use , Blood Glucose/drug effects , Diabetes Mellitus, Type 2/drug therapy , Glucagon-Like Peptide-1 Receptor/agonists , Glucosides/therapeutic use , Hypoglycemic Agents/therapeutic use , Incretins/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors , Aged , Benzhydryl Compounds/adverse effects , Biomarkers/blood , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diagnosis , Drug Therapy, Combination , Female , Glucagon-Like Peptide-1 Receptor/metabolism , Glucosides/adverse effects , Glycated Hemoglobin/metabolism , Humans , Hypoglycemic Agents/adverse effects , Incretins/adverse effects , Male , Middle Aged , Retrospective Studies , Sodium-Glucose Transporter 2/metabolism , Spain , Time Factors , Treatment Outcome , Weight Loss/drug effects
11.
Rev Gastroenterol Mex ; 82(2): 123-128, 2017.
Article in English, Spanish | MEDLINE | ID: mdl-28283314

ABSTRACT

BACKGROUND: The predictive scale for mortality risk in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) proposed by Italy's PNED (Progetto Nazionale Emorragia Digestiva) group has not been validated in Latin America since its original publication. AIM: To compare the PNED system and the Rockall score as mortality predictors in patients hospitalized for NVUGIB. MATERIAL AND METHODS: A multicenter, prospective, cross-sectional, analytic study was conducted that recruited patients diagnosed with nonvariceal upper gastrointestinal bleeding within the time frame of 2011 to 2015. Six Mexican hospital centers participated in the study. The Rockall and PNED system scores were calculated, classifying the patients as having mild, moderate, or severe disease. The association between mortality and risk was determined through the chi-square test and relative risk (RR) calculation. Statistical significance was set at a P<.05. RESULTS: Information on 198 patients was collected. Only 8 patients (4%) died from causes directly associated with bleeding. According to the Rockall score, 46 patients had severe disease (23.2%), 5 of whom died, with a RR of 5.5 (CI 1.35-22.02, P=.006). In relation to the PNED, only 8 patients had severe disease (4%), 5 of whom died, with a RR of 38.7 (CI 11.4-137.3, P=.001). CONCLUSIONS: The PNED system was more selective for classifying a case as severe, but it had a greater predictive capacity for mortality, compared with the Rockall score.


Subject(s)
Algorithms , Gastrointestinal Hemorrhage/mortality , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Mexico/epidemiology , Middle Aged , Predictive Value of Tests , Prospective Studies , Risk Assessment
12.
Clin Genet ; 90(4): 361-5, 2016 10.
Article in English | MEDLINE | ID: mdl-26864382

ABSTRACT

Breast cancer (BC) is the most frequent cancer among women in Morocco. However, the role of the most prevalent BC-predisposing genes, BRCA1 and BRCA2, has been largely unexplored. To help define the role of BRCA1 in BC in Morocco, we characterized the first potential BRCA1 founder mutation in this population. Genetic testing of BRCA1 and BRCA2 in BC high-risk families identified mutation BRCA1 c.5309G>T, p.(Gly1770Val) or G1770V in five independent families from Morocco, suggesting a founder effect. To confirm this hypothesis, haplotype construction was performed using seven intragenic and flanking BRCA1 microsatellite markers. Clinical data were also compiled. Clinical data from carriers of mutation G1770V correspond to data from carriers of BRCA1 pathogenic mutations. Microsatellite analysis showed a common haplotype for the five families in a region comprising 1.54 Mb, confirming G1770V as the first specific founder BRCA1 mutation in the Moroccan population. Our findings contribute to a better understanding of BC genetics in the Moroccan population. Nevertheless, comprehensive studies of mutation G1770V in large series of BC patients from Morocco are needed to assess the real prevalence of this mutation and to improve genetic testing and risk assessment in this population.


Subject(s)
BRCA1 Protein/genetics , Founder Effect , Mutation , Adult , BRCA1 Protein/chemistry , Female , Genetic Predisposition to Disease , Haplotypes , Humans , Microsatellite Repeats , Middle Aged , Morocco , Pedigree
13.
Ann Hematol ; 95(5): 719-32, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26898207

ABSTRACT

The current consensus on the diagnosis, prognosis, and treatment of essential thrombocythemia (ET) is based on experts' recommendations. However, several aspects of the diagnosis of, prognosis of, and therapy for ET are still controversial. The Delphi method was employed with an expert panel of members of the Spanish Group of Ph-negative Myeloproliferative Neoplasms in order to identify the degree of agreement on the diagnosis, prognosis, and treatment of ET. Nine leading experts selected a total of 41 clinical hematologists with well-known expertise in ET. An electronic questionnaire was used to collect the questions rated in a four-step scale. The questions were grouped into four blocks: diagnosis, risk stratification, goals of therapy, and treatment strategy. After the first round consisting of 80 questions, a second round including 14 additional questions focused on the recommendations advocated by experts of the European LeukemiaNet in 2011 was analyzed. The median and mean values for the first and second rounds were calculated. A summary of the conclusions considered as the most representative of each block of questions is presented. The Delphi method is a powerful instrument to address the current approaches and controversies surrounding ET.


Subject(s)
Thrombocythemia, Essential/diagnosis , Thrombocythemia, Essential/therapy , Bone Marrow Examination/standards , Bone Marrow Examination/statistics & numerical data , DNA Mutational Analysis/statistics & numerical data , Delphi Technique , Diagnosis, Differential , Disease Management , Humans , Hydroxyurea/therapeutic use , Janus Kinase 2/genetics , Mutation, Missense , Platelet Count , Polycythemia Vera/diagnosis , Prognosis , Quinazolines/therapeutic use , Receptors, Thrombopoietin/genetics , Risk Assessment , Surveys and Questionnaires , Thrombocythemia, Essential/mortality , Thrombophilia/diagnosis , Thrombophilia/drug therapy , Thrombophilia/etiology
14.
Rev Clin Esp ; 2020 Mar 02.
Article in English, Spanish | MEDLINE | ID: mdl-32139075
15.
J Chem Phys ; 141(7): 074308, 2014 Aug 21.
Article in English | MEDLINE | ID: mdl-25149787

ABSTRACT

Vertical excitation energies of the methyl and silyl radicals were inferred from ab initio electron propagator calculations on the electron affinities of CH3(+) and SiH3(+). Photoionization cross sections and angular distribution of photoelectrons for the outermost orbitals of both CH3 and SiH3 radicals have been obtained with the Molecular Quantum Defect Orbital method. The individual ionization cross sections corresponding to the Rydberg channels to which the excitation of the ground state's outermost electron gives rise are reported. Despite the relevance of methyl radical in atmospheric chemistry and combustion processes, only data for the photon energy range of 10-11 eV seem to be available. Good agreement has been found with experiment for photoionization cross section of this radical. To our knowledge, predictions of the above mentioned photoionization parameters on silyl radical are made here for the first time, and we are not aware of any reported experimental measurements. An analysis of our results reveals the presence of a Cooper minimum in the photoionization of the silyl radical. The adequacy of the two theoretical procedures employed in the present work is discussed.

16.
Neurologia ; 29(8): 497-503, 2014 Oct.
Article in English, Spanish | MEDLINE | ID: mdl-23433740

ABSTRACT

INTRODUCTION: The cholinergic system includes neurons located in the basal forebrain and their long axons that reach the cerebral cortex and the hippocampus. This system modulates cognitive function. In Alzheimer's disease (AD) and ageing, cognitive impairment is associated with progressive damage to cholinergic fibres, which leads us to the cholinergic hypothesis for AD. DEVELOPMENT: The AD produces alterations in the expression and activity of acetyltransferase (ChAT) and acetyl cholinesterase (AChE), enzymes specifically related to cholinergic system function. Both proteins play a role in cholinergic transmission, which is altered in both the cerebral cortex and the hippocampus due to ageing and AD. Dementia disorders are associated with the severe destruction and disorganisation of the cholinergic projections extending to both structures. Specific markers, such as anti-ChAT and anti-AChE antibodies, have been used in light immunohistochemistry and electron microscopy assays to study this system in adult members of certain animal species. CONCLUSIONS: This paper reviews the main immunomorphological studies of the cerebral cortex and hippocampus in some animal species with particular emphasis on the cholinergic system and its relationship with the AD.


Subject(s)
Acetylcholinesterase/metabolism , Alzheimer Disease/metabolism , Cerebral Cortex/metabolism , Choline O-Acetyltransferase/metabolism , Hippocampus/metabolism , Aging/physiology , Animals , Biomarkers/metabolism , Cholinergic Fibers/metabolism , Disease Models, Animal , Humans , Neurons/metabolism
17.
Sci Rep ; 14(1): 5203, 2024 03 03.
Article in English | MEDLINE | ID: mdl-38433130

ABSTRACT

We realize a nationwide population-based retrospective study to analyze the characteristics and risk factors of fungal co-infections in COVID-19 hospitalized patients as well as describe their causative agents in the Spanish population in 2020 and 2021. Data were obtained from records in the Minimum Basic Data Set of the National Surveillance System for Hospital Data in Spain, provided by the Ministry of Health, and annually published with two years lag. The assessment of the risk associated with the development of healthcare-associated fungal co-infections was assessed using an adjusted logistic regression model. The incidence of fungal co-infection in COVID-19 hospitalized patients was 1.41%. The main risk factors associated were surgery, sepsis, age, male gender, obesity, and COPD. Co-infection was associated with worse outcomes including higher in-hospital and in ICU mortality, and higher length of stay. Candida spp. and Aspergillus spp. were the microorganisms more frequent. This is the first study analyzing fungal coinfection at a national level in hospitalized patients with COVID-19 in Spanish population and one of the few studies available that demonstrate that surgery was an independent risk factor of Aspergillosis coinfection in COVID-19 patients.


Subject(s)
COVID-19 , Coinfection , Cross Infection , Mycoses , Humans , Male , Spain/epidemiology , Coinfection/epidemiology , Retrospective Studies , COVID-19/epidemiology , Mycoses/complications , Mycoses/epidemiology
19.
Neurologia ; 28(4): 212-8, 2013 May.
Article in English, Spanish | MEDLINE | ID: mdl-22703630

ABSTRACT

INTRODUCTION: Nicotinic acetylcholine receptors (nAChRs) are widely expressed throughout several brain regions. Formation of the α4ß2 and α7 subtypes in particular is involved in the organisation of different types of memory. Furthermore, due to their location, these receptors can control the release of various types of neurotransmitters and contribute to synaptic plasticity. METHODS: Rats were divided into three groups, an experimental group (E), a sham-operated group, (S) and an intact group (T). In group E, stereotactic guidance was used to induce a chemical lesion with 1 µ/µL of 5,7-dihydroxytryptamine (5,7-DHT) in the anteroventral part of the dorsal raphe nucleus (DRN). In the sham-operated group (S), animals underwent surgery including delivery of the same excipient solution to the same site. The intact group (T) received no treatment whatsoever. Twenty days after surgery, animals in all groups were euthanised by decapitation to evaluate the expression of α4 and α7 nAChRs by means of molecular biology techniques. RESULTS: 5-HT denervation of the rat PFC differentially modified the expression of α4 and α7 receptors: while α4 receptor expression increased, α7 expression decreased. CONCLUSION: Expression differences observed between the two subtypes may be due to their separate locations. The α4 subtype is found in postsynaptic locations and may be related to adaptive changes in postsynaptic cells, while the location of α7 is presynaptic. This explains why the lesion and the elimination of 5-HT fibres in the CPF would cause a decrease in α7 expression.


Subject(s)
Prefrontal Cortex/physiology , Receptors, Nicotinic/biosynthesis , Serotonergic Neurons/physiology , alpha7 Nicotinic Acetylcholine Receptor/biosynthesis , 5,7-Dihydroxytryptamine/toxicity , Animals , Denervation , Female , Memory/physiology , Neuronal Plasticity/drug effects , Polymerase Chain Reaction , Prefrontal Cortex/drug effects , RNA/biosynthesis , RNA/genetics , Rats , Rats, Sprague-Dawley , Receptors, Nicotinic/drug effects , Serotonergic Neurons/drug effects , Serotonin Agents/toxicity , alpha7 Nicotinic Acetylcholine Receptor/drug effects
20.
Neurologia ; 28(8): 497-502, 2013 Oct.
Article in Spanish | MEDLINE | ID: mdl-23972735

ABSTRACT

INTRODUCTION: Different animal models for Alzheimer disease (AD) have been designed to support the hypothesis that the neurodegeneration (loss of neurons and synapses with reactive gliosis) associated with Aß and tau deposition in these models is similar to that in the human brain. These alterations produce functional changes beginning with decreased ability to carry out daily and social life activities, memory loss, and neuropsychiatric disorders in general. Neuronal alteration plays an important role in early stages of the disease, especially in the CA1 area of hippocampus in both human and animal models. METHODS: Two groups (WT and 3xTg-AD) of 11-month-old female mice were used in a behavioural analysis (nest building) and a morphometric analysis of the CA1 region of the dorsal hippocampus. RESULTS: The 3xTg-AD mice showed a 50% reduction in nest quality associated with a significant increase in damaged neurons in the CA1 hippocampal area (26%±6%, P<.05) compared to the WT group. CONCLUSIONS: The decreased ability to carry out activities of daily living (humans) or nest building (3xTg-AD mice) is related to the neuronal alterations observed in AD. These alterations are controlled by the hippocampus. Post-mortem analyses of the human hippocampus, and the CA1 region in 3xTg-AD mice, show that these areas are associated with alterations in the deposition of Aß and tau proteins, which start accumulating in the early stages of AD.


Subject(s)
Alzheimer Disease/pathology , Alzheimer Disease/psychology , Hippocampus/pathology , Instinct , Alzheimer Disease/genetics , Animals , CA1 Region, Hippocampal/pathology , Female , Genotype , Humans , Mice , Mice, Transgenic , Nesting Behavior , Psychomotor Performance/physiology
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