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8.
PLoS One ; 16(6): e0253465, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34161387

RESUMEN

INTRODUCTION: This study was aimed to identify risk factors associated with unfavorable outcomes (composite outcome variable: mortality and need for mechanical ventilation) in patients hospitalized in Galicia with COVID-19 pneumonia. METHODS: Retrospective, multicenter, observational study carried out in the 8 Galician tertiary hospitals. All Patients admitted with confirmed COVID-19 pneumonia from 1st of March to April 24th, 2020 were included. A multivariable logistic regression analysis was performed in order to identify the relationship between risk factors, therapeutic interventions and the composite outcome variable. RESULTS: A total of 1292 patients (56.1% male) were included. Two hundred and twenty-five (17.4%) died and 327 (25.3%) reached the main outcome variable. Age [odds ratio (OR) = 1.03 (95% confidence interval (CI): 1.01-1.04)], CRP quartiles 3 and 4 [OR = 2.24 (95% CI: 1.39-3.63)] and [OR = 3.04 (95% CI: 1.88-4.92)], respectively, Charlson index [OR = 1.16 (95%CI: 1.06-1.26)], SaO2 upon admission [OR = 0.93 (95% CI: 0.91-0.95)], hydroxychloroquine prescription [OR = 0.22 (95%CI: 0.12-0.37)], systemic corticosteroids prescription [OR = 1.99 (95%CI: 1.45-2.75)], and tocilizumab prescription [OR = 3.39 (95%CI: 2.15-5.36)], significantly impacted the outcome. Sensitivity analysis using different alternative logistic regression models identified consistently the ratio admissions/hospital beds as a predictor of the outcome [OR = 1.06 (95% CI: 1.02-1.11)]. CONCLUSION: These findings may help to identify patients at hospital admission with a higher risk of death and may urge healthcare authorities to implement policies aimed at reducing deaths by increasing the availability of hospital beds.


Asunto(s)
Antivirales/uso terapéutico , COVID-19/mortalidad , COVID-19/terapia , Corticoesteroides/uso terapéutico , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , Comorbilidad , Femenino , Hospitales/estadística & datos numéricos , Humanos , Hidroxicloroquina/uso terapéutico , Masculino , Persona de Mediana Edad , Respiración Artificial , Estudios Retrospectivos , Factores de Riesgo , España/epidemiología , Resultado del Tratamiento
11.
Arch Bronconeumol (Engl Ed) ; 56(5): 275-276, 2020 May.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31668769
12.
Arch. bronconeumol. (Ed. impr.) ; 53(8): 437-442, ago. 2017. tab, graf
Artículo en Español | IBECS | ID: ibc-166017

RESUMEN

Asbesto, también conocido en España como amianto, es el término utilizado para nombrar a un conjunto de silicatos minerales que suelen romperse en fibras. Su uso ha comportado la aparición de numerosas enfermedades, especialmente pleuropulmonares, todas ellas caracterizadas por su prolongada latencia. El asbesto es, además, un carcinógeno del grupo IA reconocido por la OMS desde 1987. En España está prohibido desde 2002. La publicación en 2013 de la 3.a edición del protocolo de vigilancia sanitaria específica del amianto junto con la aparición de nuevas técnicas diagnósticas han motivado al grupo EROM de SEPAR a promover la elaboración de esta normativa que revisa aspectos clínicos, radiológicos y funcionales de las diferentes enfermedades relacionadas. También establece recomendaciones para el diagnóstico y seguimiento de los pacientes expuestos. Dichas recomendaciones han sido establecidas mediante sistema GRADE (AU)


Asbestos is the term used for a set of mineral silicates that tend to break up into fibers. Its use has been associated with numerous diseases affecting the lung and pleura in particular, all of which are characterized by their long period of latency. Asbestos, moreover, has been recognized by the WHO as a Group IA carcinogen since 1987 and its use was banned in Spain in 2002. The publication in 2013 of the 3rd edition of the specific asbestos health monitoring protocol, together with the development of new diagnostic techniques, prompted the SEPAR EROM group to sponsor publication of guidelines, which review the clinical, radiological and functional aspects of the different asbestos-related diseases. Recommendations have also been made for the diagnosis and follow-up of exposed patients. These recommendations were drawn up in accordance with the GRADE classification system (AU)


Asunto(s)
Humanos , Asbestosis/diagnóstico , Asbestosis/terapia , Neoplasias Pulmonares/epidemiología , Neoplasias Pleurales/epidemiología , Pautas de la Práctica en Medicina , Mesotelioma/patología , Amianto/efectos adversos , Pruebas de Función Respiratoria
13.
Arch Bronconeumol ; 53(8): 437-442, 2017 Aug.
Artículo en Inglés, Español | MEDLINE | ID: mdl-28279517

RESUMEN

Asbestos is the term used for a set of mineral silicates that tend to break up into fibers. Its use has been associated with numerous diseases affecting the lung and pleura in particular, all of which are characterized by their long period of latency. Asbestos, moreover, has been recognized by the WHO as a Group IA carcinogen since 1987 and its use was banned in Spain in 2002. The publication in 2013 of the 3rd edition of the specific asbestos health monitoring protocol, together with the development of new diagnostic techniques, prompted the SEPAR EROM group to sponsor publication of guidelines, which review the clinical, radiological and functional aspects of the different asbestos-related diseases. Recommendations have also been made for the diagnosis and follow-up of exposed patients. These recommendations were drawn up in accordance with the GRADE classification system.


Asunto(s)
Asbestosis/diagnóstico , Asbestosis/terapia , Amianto/clasificación , Amianto/toxicidad , Asbestosis/diagnóstico por imagen , Asbestosis/prevención & control , Biomarcadores de Tumor , Carcinoma Broncogénico/diagnóstico , Carcinoma Broncogénico/etiología , Carcinoma Broncogénico/terapia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/terapia , Tamizaje Masivo , Mesotelioma/diagnóstico , Mesotelioma/etiología , Mesotelioma/terapia , Fibras Minerales/análisis , Fibras Minerales/toxicidad , Exposición Profesional , Salud Laboral/legislación & jurisprudencia , Enfermedades Pleurales/diagnóstico , Enfermedades Pleurales/diagnóstico por imagen , Enfermedades Pleurales/terapia , Neoplasias Pleurales/diagnóstico , Neoplasias Pleurales/etiología , Neoplasias Pleurales/terapia , Tomografía Computarizada por Tomografía de Emisión de Positrones , Pruebas de Función Respiratoria , Fumar/epidemiología , España
16.
Cancer Epidemiol Biomarkers Prev ; 18(2): 646-50, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19190155

RESUMEN

BACKGROUND: Malignant pleural mesothelioma (MPM) results from malignant transformation of mesothelial cells. Past asbestos exposure represents a major risk factor for MPM and other benign pleural disease. Soluble mesothelin-related peptides (SMRP) have been regarded as a promising serum biomarker for MPM. The aim of this study was to investigate serum levels of SMRP in malignant and nonmalignant asbestos-related pleural disease. PATIENTS: Four groups of patients were investigated: group 1 composed of 48 healthy subjects, group 2 composed of 177 patients with previous asbestos exposure and no pleural disease, group 3 composed of 36 patients with MPM, and group 4 composed of 101 patients with previous asbestos exposure and benign pleural disease. Serum SMRP levels were determined by ELISA. RESULTS: Serum SMRP levels were significantly higher among group 3 than the other three groups. There were no differences in SMRP concentrations between groups 2 and 4. Subjects exposed to asbestos had higher SMRP concentrations than normal control subjects regardless of the presence of pleural disease. The area under the receiver operating characteristic curve for SMRP values was 0.75 (95% confidence interval, 0.68-0.83). The SMRP level at 0.55 nmol/L/L was determined as the most optimal cutoff value with resulting sensitivity and specificity of 72% and 72% for the diagnosis of MPM. CONCLUSIONS: These data attest to good diagnostic sensitivity and specificity of SMRP for the diagnosis of malignant mesothelioma. We have also shown that serum SMRP levels might serve as a marker of asbestos exposure.


Asunto(s)
Asbestosis/sangre , Biomarcadores de Tumor/sangre , Glicoproteínas de Membrana/sangre , Mesotelioma/sangre , Neoplasias Pleurales/sangre , Adulto , Área Bajo la Curva , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Proteínas Ligadas a GPI , Humanos , Masculino , Mesotelina , Mesotelioma/inducido químicamente , Persona de Mediana Edad , Neoplasias Pleurales/inducido químicamente , Estudios Prospectivos , Curva ROC , Estadísticas no Paramétricas
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