Complejo Asistencial

Segovia, Spain

Complejo Asistencial

Segovia, Spain
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Vidriales M.-B.,Hospital Universitario Of Salamanca | Vidriales M.-B.,Institute Biologia Molecular y Celular del Cancer CIC CSIC | Perez-Lopez E.,Hospital Universitario Of Salamanca | Pegenaute C.,Hospital Universitario Of Salamanca | And 26 more authors.
Leukemia Research | Year: 2015

The clinical utility of minimal residual disease (MRD) analysis in acute myeloid leukaemia (AML) is not yet defined. We analysed the prognostic impact of MRD level at complete remision after induction therapy using multiparameter flow cytometry in 306 non-APL AML patients. First, we validated the prognostic value of MRD-thresholds we have previously proposed (≥0.1%; ≥0.01-0.1%; and <0.01), with a 5-year RFS of 38%, 50% and 71%, respectively (p = 0.002). Cytogenetics is the most relevant prognosis factor in AML, however intermediate risk cytogenetics represent a grey zone that require other biomarkers for risk stratification, and we show that MRD evaluation discriminate three prognostic subgroups (p = 0.03). Also, MRD assessments yielded relevant information on favourable and adverse cytogenetics, since patients with favourable cytogenetics and high MRD levels have poor prognosis and patients with adverse cytogenetics but undetectable MRD overcomes the adverse prognosis. Interestingly, in patients with intermediate or high MRD levels, intensification with transplant improved the outcome as compared with chemotherapy, while the type of intensification therapy did not influenced the outcome of patients with low MRD levels. Multivariate analysis revealed age, MRD and cytogenetics as independent variables. Moreover, a scoring system, easy in clinical practice, was generated based on MRD level and cytogenetics. © 2015 Elsevier Ltd.


Fernandez-Salazar L.,Hospital Clinico Universitario | Barrio J.,Hospital Universitario Rio Hortega | Munoz F.,Complejo Asistencial Universitario | Munoz C.,Hospital Virgen Of La Salud | And 11 more authors.
Revista Espanola de Enfermedades Digestivas | Year: 2015

Introduction: Infliximab (IFX) therapy intensification in ulcerative colitis (UC) is more common than established in pivotal studies. Objectives: To establish the frequency and form of intensification for UC in clinical practice, as well as predictors, and to compare outcomes between intensified and non-intensified treatment. Methods: A retrospective study of 10 hospitals and 144 patients with response to infliximab (IFX) induction. Predictive variables for intensification were analyzed using a Cox regression analysis. Outcome, loss of response to IFX, and colectomy were compared between intensified and non-intensified therapy. Results: Follow-up time from induction to data collection: 38 months [interquartile range (IQR), 20-62]. Time on IFX therapy: 24 months (IQR, 10-44). In all, 37% of patients required intensification. Interval was shortened for 36 patients, dose was increased for 7, and 10 subjects received both. Concurrent thiopurine immunosuppressants (IMM) and IFX initiation was an independent predictor of intensification [Hazard ratio, 0.034; p, 0.006; CI, 0.003-0.371]. In patients on intensified therapy IFX discontinuation for loss of response (30.4% vs. 10.2%; p, 0.002), steroid reintroduction (35% vs. 18%; p, 0.018), and colectomy (22% vs. 6.4%; p, 0.011) were more common. Of patients on intensification, 17% returned to receiving 5 mg/kg every 8 weeks. Conclusions: Intensification is common and occasionally reversible. IMM initiation at the time of induction with IFX predicts non-intensification. Intensification, while effective, is associated with poorer outcome. © 2015 Arán Ediciones, S. L.


PubMed | Hospital Universitario La Paz, University of Salamanca, Hospital Universitario Of San Carlos, Complejo Hospitalario Of Leon and 11 more.
Type: | Journal: Leukemia research | Year: 2016

The clinical utility of minimal residual disease (MRD) analysis in acute myeloid leukaemia (AML) is not yet defined. We analysed the prognostic impact of MRD level at complete remision after induction therapy using multiparameter flow cytometry in 306 non-APL AML patients. First, we validated the prognostic value of MRD-thresholds we have previously proposed ( 0.1%; 0.01-0.1%; and <0.01), with a 5-year RFS of 38%, 50% and 71%, respectively (p=0.002). Cytogenetics is the most relevant prognosis factor in AML, however intermediate risk cytogenetics represent a grey zone that require other biomarkers for risk stratification, and we show that MRD evaluation discriminate three prognostic subgroups (p=0.03). Also, MRD assessments yielded relevant information on favourable and adverse cytogenetics, since patients with favourable cytogenetics and high MRD levels have poor prognosis and patients with adverse cytogenetics but undetectable MRD overcomes the adverse prognosis. Interestingly, in patients with intermediate or high MRD levels, intensification with transplant improved the outcome as compared with chemotherapy, while the type of intensification therapy did not influenced the outcome of patients with low MRD levels. Multivariate analysis revealed age, MRD and cytogenetics as independent variables. Moreover, a scoring system, easy in clinical practice, was generated based on MRD level and cytogenetics.


Wanden-Berghe C.,Hospital General Universitario | Wanden-Berghe C.,University Miguel Hernández | Hernandez J.A.,Hospital Principe Of Asturias | Pelaez R.B.,Hospital Vall Dhebron | And 29 more authors.
Nutricion Hospitalaria | Year: 2015

Aim: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the year 2013. Material and methods: from January 1st to December 31st 2013 data was recorded for the HEN registry and further descriptive and analytical analysis was done. Results: in this period 3 223 patients (50.6% men) and a total of 3 272 episodes of HEN were registered in33. Spanish hospitals. The rate of prevalence was of 67,11 patients/million habitants/ year 2013. A high percentage of patients (98,24%) were older than 14 years. Adult’s mean age was 69,14 years (sd 17,64) and men were younger than women p-value <0,001. Children mean age was 2,38 years (sd 4,35). The most frequent indication for HEN was neurological disease for children (49,1%). and for adults (60,6%). Gastrostomy was the most used administration route for children (51%) while younger ones were fed with NGT (p-value 0,003) also older adults (48%) were fed with this type of tube (p-value <0,001). The most frequent reasons for cessation of treatment was death, 44,4% were children and 54,7% were adults. Conclusions: The number of patients and hospitals registered increased in the last years while the other variables maintain steady. The registry developed allowing contrasted analysis of data in order to get more information. © 2015, Nutr Hosp. All Rights Reserved.


Lopez S.A.,CS Jardinillos | Garcia I.P.,CS Jardinillos | Alonso I.C.,CS de Venta de Banos | Garcinuno A.C.,CS de Villamuriel de Cerrato | de Llano J.M.A.,Complejo Asistencial
Pediatria de Atencion Primaria | Year: 2010

Introduction: backpacks' load is worrisome because of the physical effort made by children and its potential relationship with back problems. Objectives: to know the habits of school bags' use and its relationship with back pain in the paediatric school population. Material and methods: cross-sectional observational study in three primary care centres. We analyze anthropometric and demographic variables and we fill in a questionnaire based on previous studies. Results: one hundred and fifty-nine children were included. They were 80 males y 79 females, aged 11 and 14 years, studying 5° year in primary level (EPO) and 2° year in secondary level (ESO). Sixty-nine percent of them walk to school, 80% carry the backpack in both shoulders, 59% feel tired with it, and 62.3% refer back pain. The mean score of pain is 5 (scale: 0-10). Schoolbag weight is 6.3 kg ± 2. Relative weight is 13.4% ± 5.5 of the children's body weight and it is not different neither between genders, nor in urban-rural site, but differs between ages (15.5% in 5° EPO, 11.6% in 2° ESO; p < 0.001) and type of school (public: 14.3%; concerted: 12.3%; p = 0.02). The relative weight is higher in those students who feel that the backpack is too heavy (14.2% versus 12.2%; p = 0.02), but it is not in those who refer back pain (13.8% versus 12.7%; p = 0.19). We have not found neither differences in back pain with gender and age, nor association between pain and number of TV/videogames watching hours. There is association between pain and number of extra-school sports hours (the more hours, the less pain: OR [odds ratio]: 0.23; CI [confidence interval] 95%: 0.08-0.7). There is a difference in the psychosomatic symptoms score (scale: 0-18), being higher in those who have back pain (OR 1.37; CI 95%: 1.2-1.6). Conclusions: the schoolbags' relative weight is 13.4% ± 5.5. Although we have not found association between back pain and backpack weight, it affects the feeling of discomfort in childhood and it must be considered a health problem.


Calmarza P.,Hospital Universitario Miguel Servet | Trejo J.M.,Complejo Asistencial | Lapresta C.,Hospital Universitario Miguel Servet | Fernandez M.,Hospital Santiago Apostol | Lopez P.,Complejo Asistencial
International Cardiovascular Research Journal | Year: 2015

Background: Apolipoprotein E (Apo E) is a key factor in the atherosclerosis process, but the influence of its genetic polimorphisms in southern Europe populations is not well known. Objectives: The present transversal, population-based study aimed to determine if Apo E genetic polymorphism is associated with early atherosclerosis, as assessed by carotid Intima-Media Thickness (cIMT), or with presence of carotid atherosclerotic plaques. Patients and Methods: The study sample included 171 individuals older than 40 years who were randomly selected from the population assigned to a district medical center of Burgos, Spain. The proportion of males and females in the sample and their ages matched the adult Spanish general population. cIMT and number of carotid atherosclerotic plaques were determined to assess if higher values were associated with a particular ApoE genetic polymorphism. Results: Neither cIMT nor the number of atherosclerotic plaques differed among the subjects with Apo E2, E3, and E4 genotypes. However, both total cholesterol and Low Density Lipoprotein (LDL)-cholesterol were higher in the E4 than in the E2 group. Conclusions: In this sample of adult Spanish population, no association was found between Apo E genotypes and cIMT. © 2015, Iranian Cardiovascular Research Journal. All rights reserved.


Calmarza P.,Hospital Universitario Miguel Servet | Trejo J.M.,Complejo Asistencial | Lapresta C.,Hospital Universitario Miguel Servet | Lopez P.,Complejo Asistencial
European Journal of Preventive Cardiology | Year: 2012

Background: High levels of lipoprotein(a) [Lp(a)] have been linked to an increased risk of ischaemic cardiovascular events. We examined whether Lp(a) plasma levels are associated with early arteriosclerosis by measuring intima media thickness in an asymptomatic population of Burgos, Spain. Methods: We determined lipids, lipoprotein(a) by a nephelometry method and the intima-media thickness (IMT) in the far wall of both common carotid arteries by B-mode ultrasound in a group of 172 asymptomatic subjects.Results: No association was found in the population group between Lp(a) concentrations and left, right, or overall mean IMT by univariate or multivariate regression analysis. The median IMT was not significantly different in individuals with Lp(a) levels >300 mg/l and in individuals with Lp(a) levels <300 mg/l.Conclusions: These results suggest that increased Lp(a) levels do not confer cardiovascular risk by promoting early atherogenesis, but rather increasing the susceptibility to thrombosis. © 2011 The European Society of Cardiology.


Amo A.,Complejo Asistencial | Rodriguez-Perez R.,Hospital Carlos III | Blanco J.,Complejo Asistencial | Villota J.,Hospital Carlos III | And 3 more authors.
Journal of Agricultural and Food Chemistry | Year: 2010

Only one allergen from the egg yolk, α-livetin (Gal d 5) has been described thus far. A new egg yolk allergen was detected studying 27 egg allergic patients. The study was performed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and IgE-immunoblotting and IgE-immunoblotting-inhibition assays. An egg yolk extract was fractioned by reverse-phase high-performance liquid chromatography (RP-HPLC), and the new allergen detected was characterized by N-terminal amino acid analysis. A total of 5 of the 27 patients (18%) detected a yolk allergen of an apparent molecular weight of 35 kDa by SDS-PAGE. Heating and reduction treatments did not affect its allergenicity, although digestion with simulated gastric fluid diminished the IgE-binding capacity of the allergen. The N-terminal amino acid sequence corresponded with the YGP42 protein, a fragment of the vitellogenin-1 precursor. Thus, a second egg yolk allergen has been described and designated Gal d 6 by the World Health Organization (WHO)/International Union of Immunological Societies (IUIS) Allergen Nomenclature Subcommittee. © 2010 American Chemical Society.


PubMed | Complejo Asistencial
Type: Journal Article | Journal: Journal of agricultural and food chemistry | Year: 2010

Only one allergen from the egg yolk, alpha-livetin (Gal d 5) has been described thus far. A new egg yolk allergen was detected studying 27 egg allergic patients. The study was performed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and IgE-immunoblotting and IgE-immunoblotting-inhibition assays. An egg yolk extract was fractioned by reverse-phase high-performance liquid chromatography (RP-HPLC), and the new allergen detected was characterized by N-terminal amino acid analysis. A total of 5 of the 27 patients (18%) detected a yolk allergen of an apparent molecular weight of 35 kDa by SDS-PAGE. Heating and reduction treatments did not affect its allergenicity, although digestion with simulated gastric fluid diminished the IgE-binding capacity of the allergen. The N-terminal amino acid sequence corresponded with the YGP42 protein, a fragment of the vitellogenin-1 precursor. Thus, a second egg yolk allergen has been described and designated Gal d 6 by the World Health Organization (WHO)/International Union of Immunological Societies (IUIS) Allergen Nomenclature Subcommittee.

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