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Estornell-Erill J.,Consorcio Hospital General Universitario Of Valencia | Igual-Munoz B.,Consorcio Hospital General Universitario Of Valencia | Monmeneu-Menadas J.V.,Consorcio Hospital General Universitario Of Valencia | Soriano-Navarro C.,Hospital Of Manises | And 8 more authors.
Revista Espanola de Cardiologia | Year: 2012

Introduction and objectives: To evaluate the capability of multidetector computed tomography to diagnose the coronary etiology of left ventricular dysfunction compared with using invasive coronary angiography and magnetic resonance. Methods: Forty consecutive patients with left ventricular dysfunction of uncertain etiology underwent invasive coronary angiography and contrast magnetic resonance. All patients were evaluated with multidetector computed tomography including coronary calcium presence and score, noninvasive coronary angiography, and myocardial tissue assessment. Results: The sensitivity and specificity of the presence of coronary calcium to identify left ventricular dysfunction was 100% and 31%, respectively. If an Agatston calcium score of >100 is taken, specificity increases to 58% with sensitivity still 100%. Sensitivity and specificity for coronary angiography by multidetector computed tomography was 100% and 96%, respectively; for identifying necrosis in contrast acquisition it was 57% and 100%, respectively; and in late acquisition, 84% and 96%, respectively. To identify coronary ventricular dysfunction with necrosis, the sensitivity and specificity was 92% and 100%, respectively. Conclusions: Of all the diagnostic tools available in multidetector computed tomography, coronary angiography is the most accurate in determining the coronary origin of left ventricular dysfunction. A combination of coronary angiography and myocardial tissue study after contrast allows a single test to obtain similar information compared with the combination of invasive coronary angiography and contrast magnetic resonance. © 2012 Sociedad Española de Cardiología. Published by Elsevier España, S.L. All rights reserved.


Moreno C.,Hospital Universitario Reina Sofia | Justicia J.L.,Stallergenes Iberica S.A. | Quiralte J.,Hospital Virgen Del Rocio | Moreno-Ancillo A.,Hospital Nuestra Senora Del Prado | And 5 more authors.
Allergy: European Journal of Allergy and Clinical Immunology | Year: 2014

Background: Grass and olive are the most frequently pollens that induce seasonal allergic rhinitis in Spain. Cross-reactivity due to panallergens shared by them and overlapping pollination complicates the recognition of allergy-causing agents, making it difficult to identify the most appropriate allergen immunotherapy (AIT) to use. The aim of this study was to determine the sensitization pattern to major grass and olive pollen allergens using component-resolved diagnostics in patients with seasonal allergic rhinitis (SAR) and positive skin prick test to grass and olive pollens and evaluate how knowledge of the sensitization patterns might influence AIT prescription.Methods: After informed written consent, a total of 1263 patients were recruited. A serum determination of specific IgE levels to Ole e 1 and Phl p 1 + 5 was performed to all patients. A comparison was made before and after obtaining the specific IgE results, and differences in diagnosis were stated.Results: At the 0.35 kU/l cut-off point, 71.2% of patients were positive to Ole e 1 and Phl p 1 + 5, 14% were positive only to Phl p 1 + 5 and 12% were positive only to Ole e 1. Based on available clinical data and skin prick test results, 922 (73%) patients would have been indicated for a mixture of grass and olive pollens for AIT. In 56.8% of patients, there was non-coincidence in the composition of AIT that would be selected before and after investigators received the in vitro data.Conclusion: The diagnostic accuracy of the recombinant allergen-specific IgE test could help to improve the selection of specific-allergen immunotherapy in polysensitized patients. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.


Fraguas D.,Hospital General Universitario Gregorio Maranon | Fraguas D.,Complejo Universitario Hospitalario Of Albacete | Gonzalez-Pinto A.,Hospital Santiago Apostol | Mico J.A.,University of Cádiz | And 11 more authors.
Schizophrenia Research | Year: 2012

Progressive loss of cortical gray matter (GM), as measured by magnetic resonance imaging, has been described early in the course of first-episode psychosis. This study aims to assess the relationship between oxidative balance and progression of cortical GM changes in a multicenter sample of first-episode early-onset psychosis (EOP) patients from baseline to two-year follow-up.A total of 48 patients (13 females, mean age 15.9. ±. 1.5. years) and 56 age- and gender-matched healthy controls (19 females, 15.3. ±. 1.5. years) were assessed. Magnetic resonance imaging (MRI) scans performed both at the time of the first psychotic episode and 2. years later were used for volumetric measurements of left and right gray matter regions (frontal, parietal, and temporal lobes) and total sulcal cerebrospinal fluid (CSF). Total glutathione (GSH) blood levels were determined at baseline.In patients, after controlling for possible confounding variables, lower baseline GSH levels were significantly associated with greater volume decrease in left frontal (B. =. 0.034, 95% confidence interval (CI): 0.011 to 0.056, r. =. 0.620, p. =. 0.006), parietal (B. =. 0.039, 95% CI: 0.020 to 0.059, r. =. 0.739, p. =. 0.001), temporal (B. =. 0.026, 95% CI: 0.016 to 0.036, r. =. 0.779, p. <. 0.001), and total (B. =. 0.022, 95% CI: 0.014 to 0.031, r. =. 0.803, p. <. 0.001) gray matter, and with greater increase in total CSF (B. =. -. 0.560, 95% CI: -. 0.270 to -. 0.850, r. =. -. 0.722, p. =. 0.001). Controls did not show significant associations between brain volume changes and GSH levels. GSH deficit during the first psychotic episode was related to greater loss of cortical GM two years later in patients with first-episode EOP, suggesting that oxidative damage may contribute to the progressive loss of cortical GM found in patients with first-episode psychosis. © 2012 Elsevier B.V.


Martinez-Martin N.,Hospital Universitario 12 Of Octubre | Fraguas D.,Complejo Universitario Hospitalario Of Albacete | Fraguas D.,Research Center Biomedica En Red Of Salud Mental Cibersam | Garcia-Portilla M.P.,University of Oviedo | And 9 more authors.
Journal of Nervous and Mental Disease | Year: 2011

This study assessed the relationship between self-perceived clinical and social needs and aggressive behavior in outpatients with schizophrenia. A total of 895 outpatients with schizophrenia were enrolled. The presence of aggressive episodes was assessed using the Modified Overt Aggression Scale. Self-perceived needs were assessed using the Camberwell Assessment of Need in six areas of needs (food, household skills, self-care, daytime activities, psychotic symptoms, satisfaction with treatment, and company). The most common areas of needs were "psychotic symptoms" (81.6%), "daytime activities" (60.6%), and "household skills" (57.5%). More needs were expressed by patients who had more severe illnesses (p < 0.001) and more aggressive behavior (p < 0.001). Multivariate analysis showed that, in schizophrenia outpatients, self-perceived needs were associated with aggressive behavior (adjusted odds ratio, 11.43; 95% confidence interval, 5.11 to 25.56). Appropriate compliance with antipsychotic treatment was related with lower aggressive behavior (p < 0.001). © 2011 by Lippincott Williams and Wilkins.


Giraldez B.G.,Neurology Laboratory and Epilepsy Unit | Giraldez B.G.,Research Center Biomedica En Red Of Enfermedades Raras Ciberer | Guerrero-Lopez R.,Neurology Laboratory and Epilepsy Unit | Guerrero-Lopez R.,Research Center Biomedica En Red Of Enfermedades Raras Ciberer | And 9 more authors.
Neuromuscular Disorders | Year: 2015

Spinal muscular atrophy and progressive myoclonic epilepsy (SMAPME, OMIM#159950) is a rare autosomal recessive disorder characterized by the combination of progressive myoclonic epilepsy and muscular weakness due to lower motor neuron disease. Mutations in ASAH1, previously associated only to Farber disease, have been recently described in seven patients with SMAPME. A homozygous c.125C>T mutation was initially found in six patients with a clinical homogeneous phenotype. A heterozygous compound mutation found in an additional patient has broadened the clinical and genetic spectrum of clinical SMAPME.We report a new case of a 13-year-old girl with SMAPME with the homozygous ASAH1 c.125C>T mutation, unique in that it is due to paternal uniparental disomy. She experienced muscle weakness from the age of three due to lower motor neuron involvement that lead to severe handicap and onset in late childhood of a progressive myoclonic epilepsy. This clinical picture fully overlaps with that of previously reported patients with this mutation and supports our view that the clinical phenotype associated with the homozygous c.125C>T mutation constitutes a clinically homogenous and recognizable disease. © 2014 Elsevier B.V.


PubMed | Grifols, Hospital Clinico Universitario Of Santiago, Hospital Sant Joan Of Deu, Complejo Universitario Hospitalario Of Albacete and 2 more.
Type: | Journal: Neuromuscular disorders : NMD | Year: 2017

We report the case of a newborn with arthrogryposis multiplex congenita and severe axial hypotonia without cardiac involvement in which, using a customized targeted next-generation sequencing assay for 64 myopathy-associated genes, we detected a novel homozygous truncating mutation, c.38661_38665del, in exon 197 of the TTN gene that is expressed only in the fetal skeletal isoform. Its pathogenicity is supported by evidence of maternal isodisomy for chromosome 2. Muscle pathology showed fibers with core-like areas devoid of oxidative staining and cytoplasmic bodies. Electron microscopy showed the replacement of the sarcomeric structure with filamentous material. Identification of this mutation expands the phenotypic spectrum of the TTN gene and shows for the first time that a mutation not found in adult TTN isoforms is involved in the development of a neuromuscular disorder. TTN mutations should be considered in all severe congenital myopathies with arthrogryposis without cardiac involvement.


Diaz Villaescusa M.J.,Seccion de Epidemiologia | Diaz Villaescusa M.J.,Complejo Universitario Hospitalario Of Albacete | Almar Marques E.,Seccion de Epidemiologia | Gomez Martinez A.,Seccion de Epidemiologia | And 6 more authors.
Gaceta Sanitaria | Year: 2010

Objective: To describe an outbreak of hepatitis A in the city of Albacete (Spain) and to assess the effectiveness of the control measures implemented. Methods: When the outbreak was noted, definitions of a case were established. Clinical and epidemiological data were collected through a survey. The temporal-spatial distribution was identified through mapping and the epidemic curve. Health education and immunoglobulin (IG) administration were conducted as immediate prevention and control measures in the population at risk. Results: From January 2005 to January 2006, 62 cases were reported. The most affected age groups were school children and young adults. Transmission was person to person. The epidemic curve was divided into two periods. Initial control measures consisted of hygiene measures and IG administration to contacts. In the second period, these measures were complemented with vaccination against hepatitis A in students of the school centers of the two neighborhoods initially involved. Due to public alarm and spread of the outbreak to adjacent neighborhoods, vaccination was extended to schools close to those where cases had been detected. No cases were notified after the last vaccination in January 2006. Conclusions: The use of vaccination after exposure to the hepatitis A virus in young adults and the school population seems to be an effective outbreak control measure. © 2009 SESPAS.

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