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Hospital de Órbigo, Spain

Oteo J.,Institute Salud Carlos III | Cercenado E.,Hospital Gregorio Maranon | Cuevas O.,Institute Salud Carlos III | Bautista V.,Institute Salud Carlos III | And 4 more authors.
Diagnostic Microbiology and Infectious Disease | Year: 2010

Cephalosporins resistance is increasing in Escherichia coli in Spain. We characterize infections by E. coli with reduced susceptibility to third-generation cephalosporins (3GCs) with the AmpC phenotype. Between January 2004 and March 2007, 121 E. coli isolates with the AmpC phenotype were collected (4.8% of all the 2538 E. coli isolates with reduced susceptibility to 3GCs). These isolates were further characterized by clinical and molecular analysis. Plasmid-encoded ampC genes were detected in 46 (38%) isolates (43 CMY-2); 75 isolates (62%) had modifications in the chromosomal ampC promoter region (c-AmpC). CMY-2 producers belonged primarily to the more virulent phylogroup D (48.4%), whereas most isolates of c-AmpC belonged to phylogroup A (56.4%). Bacteremia and infections in children were more frequently produced by CMY-2 producers. CMY-2-producing phylogroup D E. coli belonged to 8 multilocus sequence typing types. Three CMY-2 producers belonged to O25b/ST131/B2 clone. Infections caused by E. coli with the AmpC phenotype may be spreading primarily because of CMY-2-producing phylogroup D isolates, although this enzyme was also detected in the O25b/ST131/B2 clone. © 2010 Elsevier Inc. Source


Barquero-Perez O.,Rey Juan Carlos University | Goya-Esteban R.,Rey Juan Carlos University | Caamano A.,Rey Juan Carlos University | Martin-Caballero C.,Hospital Fundacion de Alcorcon | Rojo-Alvarez J.L.,Rey Juan Carlos University
Computing in Cardiology | Year: 2016

Perinatal hypoxia is a severe condition that may harm fetus organs permanently or even cause dead. When the fetus brain is partially deprived from oxygen, the control of the fetal heart rate (FHR) is affected. We hypothesize that the complex physiological mechanisms of the FHR are perturbed under perinatal hypoxia. To quantify the loss in complexity we measured Sample Entropy (SampEn), Permutation Entropy (PE), and Time Irreversibility (TI). FHR traces were preprocessed to remove artifacts. A database of 32 FHR recordings were acquired with cardiotochography, 15 controls and 16 cases. Resampling methods were used to establish the statistical differences. TI was significantly different for healthy and hypoxia fetuses (-0.38 ± 0.19 vs. -0.21±0.37, p-value=0.063). Entropy indices were higher for healthy fetuses (SampEn:0.33±0.12 vs 0.28 ± 0.09, p-value=0.11; PE:0.72±0.04 vs 0.69±0.07, p-value= 0.12). We also computed temporal and spectral indices but none of them showed significant differences. Complexity measures of the FHR were different for healthy and hypoxia fetuses. These indices may help to early detect hypoxia with less invasive methods. © 2015 CCAL. Source


Puerta-Gil P.,Tumor Markers Group | Garca-Baquero R.,Hospital Puerta Del Mar | Jia A.Y.,Columbia University | Ocaa S.,Hospital Fundacion de Alcorcon | And 5 more authors.
American Journal of Pathology | Year: 2012

Altered microRNA (miRNA) expression may occur early in bladder cancer and may play a role in carcinogenesis and tumor behavior. We evaluated whether alterations in miRNA expression could improve disease stratification and outcome prognosis in bladder tumors and noninvasive diagnosis in urinary samples. miR-143, miR-222, and miR-452 expression levels were analyzed by quantitative RT-PCR (RT-qPCR) in paired urinary and matching tumors and in two independent prospective series of tumors and urinary specimens. Differential expression of miR-143, miR-222, and miR-452 in urine were verified by in situ hybridization in matching tumors. Tumor miRNA expression by RT-qPCR correlated with tumor grade, size, and presence of carcinoma in situ for miR-222, recurrence (miR-222 and miR-143), progression (miR-222 and miR-143), disease-specific survival (miR-222), and overall survival (miR-222). Protein expression patterns of potential miRNA targets, including vascular endothelial growth factor, BCL2, v-erb-b2 erythroblastic leukemia viral oncogene (ERBB) homolog 3, and ERBB4, were evaluated by IHC in tissue arrays containing tumors for which miRNAs were assessed by RT-qPCR. Target expression correlated with expression of their predicted regulatory miRNAs, recurrence (ERBB3), progression (ERBB4), disease-specific survival (ERBB3 and ERBB4), and overall survival (ERBB3 and ERBB4). Furthermore, RT-qPCR of miR-452 (area under the curve, 0.848) and miR-222 (area under the curve, 0.718) in urine provided high accuracies for bladder cancer diagnosis. Thus, bladder tumors were characterized by changes in miRNA expression that could aid in tumor stratification and clinical outcome prognosis, and miRNAs were detected in urinary specimens for noninvasive diagnosis. © 2012 American Society for Investigative Pathology. Source


Fernandez Juarez G.,Hospital Fundacion de Alcorcon | Luno J.,Hospital General Universitario Gregorio Maranon | Barrio V.,Hospital Infanta Sofia | De Vinuesa S.G.,Hospital General Universitario Gregorio Maranon | And 7 more authors.
American Journal of Kidney Diseases | Year: 2013

Background: Blockade of the renin-angiotensin system with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers has been shown to lessen the rate of decrease in glomerular filtration rate in patients with diabetic nephropathy. Study Design: A multicenter open-label randomized controlled trial to compare the efficacy of combining the angiotensin-converting enzyme inhibitor lisinopril and the angiotensin II receptor blocker irbesartan with that of each drug in monotherapy (at both high and equipotent doses) in slowing the progression of type 2 diabetic nephropathy. Setting & Population: 133 patients with type 2 diabetic nephropathy (age, 66 ± 8 years; 76% men) from 17 centers in Spain. Intervention: Patients were randomly assigned (1:1:2) to lisinopril (n = 35), irbesartan (n = 28), or the combination of both (n = 70). Outcomes: The primary composite outcome was a >50% increase in baseline serum creatinine level, end-stage renal disease, or death. Results: Baseline values for mean estimated glomerular filtration rate and blood pressure were 49 ± 21 mL/min/1.73 m2 and 153 ± 19/81 ± 11 mm Hg. Mean geometric baseline proteinuria was protein excretion of 1.32 (95% CI, 1.10-1.62) g/g creatinine. After a median follow-up of 32 months, 21 (30%) patients in the combination group, 10 (29%) in the lisinopril group, and 8 (29%) in the irbesartan group reached the primary outcome. HRs were 0.96 (95% CI, 0.44-2.05; P = 0.9) and 0.90 (95% CI, 0.39-2.02; P = 0.8) for the combination versus the lisinopril and irbesartan groups, respectively. There were no significant differences in proteinuria reduction or blood pressure control between groups. The number of adverse events, including hyperkalemia, was similar in all 3 groups. Limitations: The study was not double blind. The sample size studied was small. Conclusions: We were unable to show a benefit of the combination of lisinopril and irbesartan compared to either agent alone at optimal high doses on the risk of progression of type 2 diabetic nephropathy. © 2013 National Kidney Foundation, Inc. Source


Montilla C.,Hospital Clinico Universitario Of Salamanca | Del Pino-Montes J.,Hospital Clinico Universitario Of Salamanca | Collantes-Estevez E.,Hospital Universitario Reina Sofia | Font P.,Hospital Clinico Universitario Of Salamanca | And 7 more authors.
Journal of Rheumatology | Year: 2012

Objective: Ankylosing spondylitis (AS) is generally observed in young patients but can occur later in life or in persons ≥ 50 years of age. Our objective was to characterize the clinical features of late-onset AS in a large multicenter national cohort. Methods: We studied late-onset AS in the National Registry of Spondyloarthritis of the Spanish Society of Rheumatology (REGISPONSER database) cohort (n = 1257), of whom 3.5% had onset at age ≥ 50 years versus a control group with onset at < 50 years. Results: There were no differences between late-onset and early-onset AS according to sex and family history of spondyloarthropathies. Patients in the late-onset group more often showed involvement of the cervical spine (22.7% vs 9.7%; p = 0.03) and arthritis of the upper (13.6% vs 3.0%; p = 0.002) and lower limbs (27.3% vs 15.2%; p = 0.03) as first manifestations than did patients in the early-onset group. A higher percentage of mixed forms (axial and peripheral joint disease) during the course of the disease was also recorded in the late-onset group (50% vs 24%; p = 0.0001). Conclusion: Our study suggests that age at onset of AS affects the patients' presenting clinical form. Arthritis of the upper limbs requires a differential diagnosis with other conditions frequent in patients over 50 years of age, such as rheumatoid arthritis or crystal-induced arthropathy. Copyright © 2012 The Journal of Rheumatology. Source

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