Complejo Hospitalario Universitario Of Cartagena

Murcia, Spain

Complejo Hospitalario Universitario Of Cartagena

Murcia, Spain
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Carnes J.,Laboratorios LETI S.L. | De Larramendi C.H.,Hospital Marina Baixa | Ferrer A.,Hospital Vega Baja | Huertas A.J.,Complejo Hospitalario Universitario Of Cartagena | And 5 more authors.
Food Chemistry | Year: 2013

Goji berries (GB) have been introduced in Western diet. Preliminary reports have demonstrated its allergenic capacity. The objectives of the study were to investigate the frequency of sensitisation and the allergens involved. 566 individuals, with respiratory or cutaneous symptoms were skin-prick tested with GB extract. Thirty three were positive (5.8%). 94% were sensitised to other allergens. Specific IgE to GB, peach, tomato and nut-mix was measured. Thirteen individuals from 24 available sera (54.2%) had positive specific IgE. 92.3% of GB positive patients were positive to peach. Seven individuals recognised 8 bands and six recognised a 7 kDa band. This band was identified as a LTP by MS/MS. Cross-reactivity was demonstrated with tomato, tobacco, nutmix, Artemisia pollen and purified Lyc e 3 and Pru p 3. GB are a new allergenic source with high prevalence of sensitisation. LTP seems to be the major allergen involved in sensitisation and cross-reactivity. © 2012 Elsevier Ltd. All rights reserved.

Larramendi C.H.,Hospital Marina Baixa | Lopez-Matas M.A.,Laboratorios LETI S.L. | Ferrer A.,Hospital Of La Vega Baja | Huertas A.J.,Complejo Hospitalario Universitario Of Cartagena | And 5 more authors.
International Archives of Allergy and Immunology | Year: 2013

Background: Although allergy to Cannabis sativa was first reported over 40 years ago, the allergenicity has scarcely been studied. The objectives of this study were to investigate the frequency of sensitization to this plant, to analyze the clinical characteristics and allergenic profile of sensitized individuals and to identify the allergens involved. Methods: Five hundred and forty-five individuals in Spain attending allergy clinics with respiratory or cutaneous symptoms underwent a skin-prick test (SPT) with C. sativa leaf extract. The extract was characterized by SDS-PAGE and 2-dimensional electrophoresis. Specific IgE to C. sativa was measured in positive SPT individuals. The clinical and allergenic profiles of sensitized individuals were investigated and the most-recognized allergens sequenced and characterized by liquid chromatography-mass spectrometry/mass spectrometry. Results: Of this preselected population, 44 individuals had positive SPT to C. sativa (prevalence 8.1%). Prevalence was higher in individuals who were C. sativa smokers (14.6%). Two individuals reported mild symptoms with C. sativa. Twenty-one individuals from 32 available sera (65.6%) had positive specific IgE to C. sativa. Twelve sera recognized at least 6 different bands in a molecular-weight range of between 10 and 60 kDa. Six of them recognized a 10-kDa band, identified as a lipid transfer protein (LTP) and 8 recognized a 38-kDa band, identified as a thaumatin-like protein. Conclusions: There is a high prevalence of sensitization to C. sativa leaves. The clinical symptoms directly attributed to C. sativa were uncommon and mild. The sensitization profile observed suggests that C. sativa sensitization may be mediated by two mechanisms, i.e. cross-reactivity, mainly with LTP and thaumatin-like protein, and exposure-related 'de novo' sensitization. Copyright © 2013 S. Karger AG, Basel.

Trujillo-Santos J.,Complejo Hospitalario Universitario Of Cartagena | Barron M.,Hospital San Pedro | Gallego P.,Hospital Sas Of Jerez | Babalis D.,Kat General Hospital | And 3 more authors.
Journal of Vascular Surgery | Year: 2014

Background Some physicians are still concerned about the safety of treatment at home of patients with acute deep venous thrombosis (DVT). Methods We used data from the RIETE (Registro Informatizado de la Enfermedad TromboEmbólica) registry to compare the outcomes in consecutive outpatients with acute lower limb DVT according to initial treatment at home or in the hospital. A propensity score-matching analysis was carried out with a logistic regression model. Results As of December 2012, 13,493 patients had been enrolled. Of these, 4456 (31%) were treated at home. Patients treated at home were more likely to be male and younger and to weigh more; they were less likely than those treated in the hospital to have chronic heart failure, lung disease, renal insufficiency, anemia, recent bleeding, immobilization, or cancer. During the first week of anticoagulation, 27 patients (0.20%) suffered pulmonary embolism (PE), 12 (0.09%) recurrent DVT, and 51 (0.38%) major bleeding; 80 (0.59%) died. When only patients treated at home were considered, 12 (0.27%) had PE, 4 (0.09%) had recurrent DVT, 6 (0.13%) bled, and 4 (0.09%) died (no fatal PE, 3 fatal bleeds). After propensity analysis, patients treated at home had a similar rate of venous thromboembolism recurrences and a lower rate of major bleeding (odds ratio, 0.4; 95% confidence interval, 0.1-1.0) or death (odds ratio, 0.2; 95% confidence interval, 0.1-0.7) within the first week compared with those treated in the hospital. Conclusions In outpatients with DVT, home treatment was associated with a better outcome than treatment in the hospital. These data may help safely treat more DVT patients at home. Copyright © 2014 by the Society for Vascular Surgery.

PubMed | Hospital Marina Baixa, Complejo Hospitalario Universitario Of Cartagena, Hospital Of La Vega Baja, Allergy Unit and 3 more.
Type: Journal Article | Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology | Year: 2016

Tropomyosin is the most studied shellfish allergen and has been involved in cross-reactivity among different invertebrates (crustacean, mollusks, mites, insects, and nematodes).To determine the relevance of tropomyosin in mite- and shellfish-sensitized patients using tropomyosin skin testing.Patients were divided into 3 groups: group M included mite allergic patients (ie, individuals with respiratory symptoms and a positive result on skin prick testing [SPT] to house dust mites), group S included shellfish allergic patients (ie, individuals who reported symptoms with shellfish), and group MS included mite- and shellfish allergic patients (ie, individuals who simultaneously fulfilled the inclusion criteria for groups M and S). Tropomyosin was purified from shrimp, characterized, and used in SPT for diagnosis in the patient population.Eight hundred fifty patients were included in the study: 790 (92.9%) in group M, 21 (2.5%) in group S, and 39 (4.6%) in group MS. Tropomyosin was purified from shrimp with a purity higher than 95%. Forty-two individuals tested positive to tropomyosin: the prevalence was 2.7% in group M, 28.6% in group S, and 38.5% in patients of group MS. Twenty-one (50%) of the tropomyosin-positive individuals had symptoms with shellfish, and 3 (14.3%) reported anaphylaxis.The prevalence of tropomyosin was low in mite-sensitized patients (2.7 %) and high in shellfish allergic patients (28.6%). The higher prevalence of tropomyosin was found in patients sensitized to both mite and shellfish (38.5%). The selection of tropomyosin-sensitized patients by SPT might help in the choice of appropriate treatments or management for these patients.

Maestre A.,Hospital Vinalopo Salud | Trujillo-Santos J.,Complejo Hospitalario Universitario Of Cartagena | Visona A.,Vascular Medicine | Lobo J.L.,Hospital Of Txagorritxu | And 4 more authors.
Thrombosis Research | Year: 2014

Background The prognostic value of D-dimer testing in patients with acute pulmonary embolism (PE) has not been thoroughly studied. Methods We used the RIETE Registry data to assess the 90-day prognostic value of increased IL Test D-dimer® levels at baseline in patients with PE, according to the presence or absence of cancer. Results As of May 2013, 3,283 patients with acute PE underwent D-dimer testing using IL Test D-dimer®. Among 2,588 patients without cancer, those with D-dimer levels in the highest quartile had a higher rate of fatal PE (2.6% vs. 0.9%; p = 0.002), fatal bleeding (1.1% vs. 0.3%; p = 0.017) and all-cause death (9.1% vs. 4.4%; p < 0.001) at 90 days compared with those with levels in the lowest quartiles. Among 695 patients with cancer, those with levels in the highest quartile had a similar rate of fatal PE or fatal bleeding but higher mortality (35% vs. 24%; p < 0.01). On multivariate analysis, non-cancer patients with D-dimer levels in the highest quartile had an increased risk for fatal PE (odds ratio [OR]: 3.3; 95% CI: 1.6-6.6), fatal bleeding (OR: 4.3; 95% CI: 1.4-13.7) and all-cause death (OR: 2.1; 95% CI: 1.4-3.1) compared with patients with levels in the lowest quartiles. Conclusions Non-cancer patients with acute PE and IL Test D-dimer® levels in the highest quartile had an independently higher risk for fatal PE, fatal bleeding and all-cause death at 90 days than those with levels in the lowest quartiles. In patients with cancer, D-dimer levels failed to predict fatal PE or fatal bleeding. © 2014 Elsevier Ltd.

PubMed | French Clinical Research Infrastructure Network F CRIN, Complejo Hospitalario Universitario Of Cartagena, Hospital Universitario Doctor Peset, University of Murcia and 5 more.
Type: | Journal: The American journal of medicine | Year: 2016

We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site.We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer).As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years).Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.

Huertas A.J.,Complejo Hospitalario Universitario Of Cartagena | Carreno A.,Complejo Hospitalario Universitario Of Cartagena | Merida C.,Complejo Hospitalario Universitario Of Cartagena | Pajaron-Fernandez M.J.,Complejo Hospitalario Universitario Of Cartagena | And 2 more authors.
Allergologia et Immunopathologia | Year: 2014

Background: Sensitisation to pan-allergens has become an interesting tool for the study of the allergenic profile of different populations. Profilins are one of the most common pan-allergens to be studied because they are responsible for a large number of sensitisations and are clearly related to cross-reactivity and co-sensitisation. Objectives: The objective of this study was to investigate the profile of sensitisation to profilins and to correlate it with sensitisation to foods and pollens. Methods: Six hundred and fifty-four consecutive patients were skin-prick tested with a battery of common allergens including pollens, epithelia, mites and moulds and profilin and divided into three groups depending on their sensitisation profile (non-atopic, atopic with pollinosis and atopic without pollinosis). Patients with symptoms were challenged and diagnosed with the offending food extracts. Profilin sensitisation was identified and analysed in detail. Results: According to the classification of the population, the prevalence of profilin sensitisation was estimated at 2.9% in patients suffering respiratory allergy, 4.2% in atopic patients, and 5.9% in pollen-sensitised individuals. Positive association was observed between pollen (except Cupressus and olive) and profilin but not with moulds, mites or epithelia. With respect to foods, positive association was only observed between profilin and melon sensitisation. Lastly, in terms of symptoms, positive association was only observed between profilin sensitisation and OAS. Conclusion: Profilin sensitisation seems to be a marker of pollen-related poly-sensitisation in our area. Pan-allergen diagnosis seems to be an essential tool for developing and improving selection of the correct treatment for allergic patients. © 2013 SEICAP.

Lopez J.F.,Complejo Hospitalario Universitario Of Cartagena | Arana C.A.C.,Complejo Hospitalario Universitario Of Cartagena | Monzon C.G.C.,Complejo Hospitalario Universitario Of Cartagena
Revista Colombiana de Anestesiologia | Year: 2012

Introduction: The incorporation of new guidelines or strategies as part of good practices in the use of muscle relaxants is not a requirement at present in the practice of anesthesia. There are only action recommendations designed to persuade clinicians of the fact that neuromuscular monitoring is a very useful tool for the rational use of muscle relaxants. Methodology: Complications occur, and residual paralysis is a significant event. For this reason, the authors advocate that monitoring neuromuscular blockmay be a determining factor in improving patient care and reducing morbidity and mortality. This reviewand its methodology based on the experience of the authors is designed to present, in a simple format, the knowledge that is considered fundamental for the systematic use of neuromuscular monitoring in every day practice. Results and conclusions: This update describes the fundamental principles of the methods available at present, emphasizing quantitative recording measurements. It then describes the different ways in which muscles respond to the effect of neuromuscular blockade, as these are critical fundamental principles that have to be known. Neuromuscular monitoring is a practice that should be implemented every time a neuromuscular block is required. We are aware of the difficulty of generating an explicit recommendation, but our enthusiasm is derived from the benefits we have personally experienced when applying these methods that have been knownfor a long time. Due to the potential morbidity associated with residual muscle relaxation, perioperative monitoring of neuromuscular function is essential. © 2012 Published by Elsevier España.

PubMed | Complejo Hospitalario Universitario Of Cartagena
Type: Journal Article | Journal: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva | Year: 2016

Gastric involvement with the varicella-zoster virus is an uncommon clinical condition where early suspicion and diagnosis are important to prevent the consequences deriving from its high morbidity and mortality, which in immunocompromised patients oscillate between 9% and 41% according to the various series. Two cases of gastric involvement with the varicella-zoster virus (VZV) in two patients with blood cancer are reported below. Gastric lesions are usually preceded by typical papulovesicular skin lesions. When gastric involvement is the first symptom of the disease its diagnosis and management may be delayed, which may entail severe consequences for immunocompromised patients. It is therefore that we suggest its inclusion in the algorithm for immunocompromised patients with abdominal pain and ulcer-like endoscopic lesions.

PubMed | Complejo Hospitalario Universitario Of Cartagena, Hospital Universitario Nuestra Senora Of Valme, Hospital Moncloa, Hospital General Of Castello and 4 more.
Type: Journal Article | Journal: Medicina intensiva | Year: 2016

To evaluate the use and effectiveness of a routine invasive strategy (RIS) in patients with acute coronary syndrome without persistent ST-segment elevation with renal dysfunction in the real world scenario.A retrospective cohort study based on the ARIAM-SEMICYUC Registry (2011-2014) was carried out. Renal dysfunction was defined as GFR (Cockroft-Gault)<60ml/min (moderate dysfunction) or<30ml/min (severe dysfunction). Patients in which early angiography (<72h) was performed due to cardiogenic shock or recurrent myocardial ischemia were excluded. The primary endpoint was hospital mortality. Confounding factors were controlled using propensity score analysis.A total of 4,279 patients were analyzed, of which 26% had moderate renal dysfunction and 5% severe dysfunction. Patients with renal dysfunction had greater severity and comorbidity, higher hospital mortality (8.6 vs. 1.8%), and lesser use of the RIS (40 vs. 52%). The adjusted OR for mortality in patients without/with renal dysfunction were 0.38 (95% confidence interval [95%CI] 0.17 to 0.81) and 0.52 (95%CI 0.32 to 0.87), respectively (interaction P-value=.4779). The impact (adjusted risk difference) of RIS was higher in the group with renal dysfunction (-5.1%, 95%CI -8.1 to -2.1 vs. -1.6%, 95%CI -2.6 to -0.6; interaction P-value=.0335). No significant interaction was detected for the other endpoints considered (ICU mortality, 30-day mortality, myocardial infarction, acute renal failure or moderate/severe bleeding).The results suggest that the effectiveness of IRS is similar in patients with normal or abnormal renal function, and alert to the under-utilization of this strategy in such patients.

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