Entity

Time filter

Source Type

Barcelona, Spain

Abramowicz D.,University of Antwerp | Cochat P.,University of Lyon | Claas F.H.J.,Leiden University | Pascual J.,Hospital Del Mar Barcelona | And 15 more authors.
Nephrology Dialysis Transplantation | Year: 2015

The European Best Practice Guideline group (EBPG) issued guidelines on the evaluation and selection of kidney donor and kidney transplant candidates, as well as post-transplant recipient care, in the year 2000 and 2002. The new European Renal Best Practice board decided in 2009 that these guidelines needed updating. In order to avoid duplication of efforts with kidney disease improving global outcomes, which published in 2009 clinical practice guidelines on the post-transplant care of kidney transplant recipients, we did not address these issues in the present guidelines. The guideline was developed following a rigorous methodological approach: (i) identification of clinical questions, (ii) prioritization of questions, (iii) systematic literature review and critical appraisal of available evidence and (iv) formulation of recommendations and grading according to Grades of Recommendation Assessment, Development, and Evaluation (GRADE). The strength of each recommendation is rated 1 or 2, with 1 being a 'We recommend' statement, and 2 being a 'We suggest' statement. In addition, each statement is assigned an overall grade for the quality of evidence: A (high), B (moderate), C (low) or D (very low). The guideline makes recommendations for the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and perioperative recipient care. All together, the work group issued 112 statements. There were 51 (45%) recommendations graded '1', 18 (16%) were graded '2' and 43 (38%) statements were not graded. There were 0 (0%) recommendations graded '1A', 15 (13%) were '1B', 19 (17%) '1C' and 17 (15%) '1D'. None (0%) were graded '2A', 1 (0.9%) was '2B', 8 (7%) were '2C' and 9 (8%) '2D'. Limitations of the evidence, especially the lack of definitive clinical outcome trials, are discussed and suggestions are provided for future research. We present here the complete recommendations about the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and the perioperative recipient care. We hope that this document will help caregivers to improve the quality of care they deliver to patients. The full version with methods, rationale and references is published in Nephrol Dial Transplant (2013) 28: i1-i71; doi: 10.1093/ndt/gft218 and can be downloaded freely from http://www.oxfordjournals.org/our-journals/ndt/era-edta.html. © The Author 2014. Published by Oxford University Press.


Spasovski G.,University of Macedonia | Cochat P.,University of Lyon | Claas F.H.J.,Leiden University | Pascual J.,Hospital Del Mar Barcelona | And 15 more authors.
BANTAO Journal | Year: 2014

The Clinical Practice Guideline on evaluation of the kidney donor and transplant recipient was developed following a rigorous methodological approach aiming to provide information and aid decision-making to the transplant professionals. Thus, this document should help caregivers to improve the quality of care they deliver to patients with no intention it is defined as a standard of care. In this short version of the guidelines we present 112 statements about the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and the perioperative recipient care. The extended version of the guidelines with methods, rationale and references is published in Nephrol Dial Transplant (2013) 28: i1-i71; doi: 10.1093/ndt/gft218 and can be downloaded freely from http://www.oxfordjournals.- org/ our-journals/ndt/era-edta.html.


Nicolau P.,Hospital Del Mar Barcelona | Miralpeix E.,Hospital Del Mar Barcelona | Sola I.,Hospital Del Mar Barcelona | Sola I.,Institute of Biomedical Research Barcelona | And 4 more authors.
Gynecological Endocrinology | Year: 2014

The aim of our study is to determine whether alcohol consumption affects the results of in vitro fertilization. A review of the literature was performed to find prospective cohort studies of couples undergoing in vitro fertilization in which alcohol intake was recorded. A primary search returned 389 studies, 2 of which were finally considered eligible. A total of 2908 couples were analyzed in terms of pregnancy outcomes depending on drinking habits. The risk of IVF failure increased 4.14-fold and 2.86-fold with an increased alcohol intake of 12gr/d in women during the week and month before, respectively. The odds ratio (OR) of live birth rate in women who drank at least four drinks per week compared with women who drank fewer was 0.84; this difference was statistically significant. Paternal alcohol use levels 1 month, 1 week and during the attempts were also associated with worse reproductive effects. Our review, though including a small number of studies that were heterogeneous in design, revealed decreased rates of pregnancy and fertilization outcomes for couples who drank before or during their in vitro fertilization techniques. This suggests that couples undergoing IVF should be advised to abstain from alcohol prior to and during their procedures. © 2014 Informa UK Ltd. All rights reserved.


Luque S.,Hospital Del Mar Barcelona | Gea J.,Hospital Del Mar | Saballs P.,Hospital Del Mar | Ferrandez O.,Hospital Del Mar Barcelona | And 2 more authors.
Revista Espanola de Quimioterapia | Year: 2012

Introduction. Specific prognostic models for communityacquired pneumonia (CAP) to guide treatment decisions have been developed, such us the Pneumonia Severity Index (PSI) and the Confusion, Urea nitrogen, Respiratory rate, Blood pressure and age ≥ 65 years index (CURB-65). Additionally, general models are available such as the Mortality Probability Model (MPM-II). So far, which score performs better in CAP remains controversial. The objective was to compare PSI and CURB-65 and the general model, MPM-II, for predicting 30- day mortality in patients admitted with CAP. Methods. Prospective observational study including all consecutive patients hospitalised with a confirmed diagnosis of CAP and treated according to the hospital guidelines. Comparison of the overall discriminatory power of the models was performed by calculating the area under a receiver operator characteristic curve (AUC ROC curve) and calibration through the Goodness-of-fit test. Results. One hundred and fifty two patients were included (mean age 73.0 years; 69.1% male; 75.0% with more than one comorbid condition). Seventy-five percent of the patients were classified as high-risk subjects according to the PSI, versus 61.2% according to the CURB-65. The 30-day mortality rate was 11.8%. All three scores obtained acceptable and similar values of the AUCs of the ROC curve for predicting mortality. Despite all rules showed good calibration, this seemed to be better for CURB-65. CURB-65 also revealed the highest positive likelihood ratio. Conclusions. CURB-65 performs similar to PSI or MPMII for predicting 30-day mortality in patients with CAP. Consequently, this simple model can be regarded as a valid alternative to the more complex rules.


Torrens C.,Hospital Del Mar Barcelona | Corrales M.,Hospital Del Mar Barcelona | Vila G.,Hospital Del Mar Barcelona | Santana F.,Hospital Del Mar Barcelona | Caceres E.,Hospital Del Mar Barcelona
Journal of Orthopaedic Trauma | Year: 2011

OBJECTIVES:: Functional and quality-of-life outcomes of conservatively treated proximal humeral fractures. DESIGN:: Prospective study. SETTING:: University orthopedic department at a hospital. PATIENTS/PARTICIPANTS:: Seventy consecutive patients between the ages of 60 and 85 years. INTERVENTION:: Conservative treatment. MAIN OUTCOME MEASUREMENTS:: Functional outcome measured according to the Constant score, quality of life assessed using EuroQol-5D, and fracture pattern analyzed with x-ray and computed tomography scan. RESULTS:: All fractures consolidated uneventfully with no loss of reduction in either group. Four-part fractures obtained the worst functional results (33.66) followed by three-part fractures (54.64) and finally two-part fractures (65.88 and 71). Mild pain was expected in three- and four-part fractures, whereas two-part fractures achieved near complete pain relief. Nondisplaced fractures obtained a final Constant score of 73.58 and displaced fractures a score of 59.41 with significant differences in all Constant score items with the exception of external rotation. Although patients older than 75 years scored lower (54.63) than those younger than 75 years (70.83), there was no difference in the quality-of-life perception. CONCLUSION:: Conservative treatment of proximal humeral fractures in those patients older than age 75 years provides good pain relief with limited functional outcome. Despite limited functional outcome, this appears to have no effect on the quality-of-life perception in the population studied. Four-part fractures present the worst results and treatment options may need to be discussed with the patient to adjust treatment to patient expectations. Copyright © 2011 by Lippincott Williams & Wilkins.

Discover hidden collaborations