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.
Olveira G.,University of Malaga |
Olveira G.,Institute Salud Carlos III |
Tapia M.J.,University of Malaga |
Ocon J.,Universitario Lozano Blesa |
And 30 more authors.
Diabetes Care | Year: 2013
OBJECTIVE-Hyperglycemia may increase mortality in patients who receive total parenteral nutrition (TPN). However, this has not been well studied in noncritically ill patients (i.e., patients in the nonintensive care unit setting). The aim of this study was to determine whether mean blood glucose level during TPN infusion is associated with increased mortality in noncritically ill hospitalized patients. RESEARCH DESIGN AND METHODS-This prospective multicenter study involved 19 Spanish hospitals. Noncritically ill patients who were prescribed TPN were included prospectively, and data were collected on demographic, clinical, and laboratory variables as well as on in-hospital mortality. RESULTS-The study included 605 patients (mean age 63.2±15.7 years). The daily mean TPN values were 1.630±323 kcal, 3.2±0.7 g carbohydrates/kg, 1.26±0.3 g amino acids/kg, and 0.9±0.2 g lipids/kg. Multiple logistic regression analysis showed that the patients who had mean blood glucose levels >180 mg/dL during the TPN infusion had a risk of mortality that was 5.6 times greater than those withmean blood glucose levels <140mg/dL (95%CI 1.47-21.4 mg/dL) after adjusting for age, sex, nutritional state, presence of diabetes or hyperglycemia before starting TPN, diagnosis, prior comorbidity, carbohydrates infused, use of steroid therapy, SD of blood glucose level, insulin units supplied, infectious complications, albumin, C-reactive protein, and HbA1c levels. CONCLUSIONS-Hyperglycemia (mean blood glucose level >180 mg/dL) in noncritically ill patients who receive TPN is associated with a higher risk of in-hospital mortality. © 2013 by the American Diabetes Association.
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.
PubMed | Hospital del Mar Barcelona, Autonomous University of Barcelona, Research and Development Unit, Hospital Benito Menni Sant Boi Of Llobregat and 2 more.
Type: | Journal: Psychiatry research | Year: 2016
This study aimed to evaluate gender differences in the deficit of insight in psychosis and determine influences of clinical, functional, and sociodemographic variables. A multicenter sample of 401 adult patients with schizophrenia and other psychotic disorders who agreed to participate was evaluated in four centers of the metropolitan area of Barcelona (Catalonia). Psychopathological assessment was performed using the Positive and Negative Syndrome Scale Lindenmayers Factors. Insight and its dimensions were assessed by means of the Scale of Unawareness of Mental Disorder. Significant differences were apparent neither between men and women in the three dimensions of insight, nor in the total awareness, nor in the total attribution subscales. However, statistically significant differences were found in awareness and attribution of particular symptoms. Women showed a worse awareness of thought disorder and alogia and a higher misattribution of apathy. Higher cognitive and positive symptoms, early stage of the illness, and having been married explained deficits of insight dimensions in women. In men, other variables such as lower functioning, higher age, other psychosis diagnosis, and, to a lower extent, higher scores in cognitive, positive, and excitative symptoms, explained deficits of insight dimensions. These data could help to design gender-specific preventive and therapeutic strategies.
PubMed | Hospital del Mar Barcelona, Institute Salud Carlos III, Hospital Universitario Central Of Asturias, Autonomous University of Barcelona and 7 more.
Type: | Journal: Thyroid : official journal of the American Thyroid Association | Year: 2016
The aim of this study was to investigate the national prevalence of thyroid dysfunction in Spain, and its association with various clinical, environmental and demographic variables.The present report includes 4554 people (42.4% men) with a mean age of 50 years (range 18-93 years) participants in a national, cross-sectional, population-based survey conducted in 2009-10. Data gathered included clinical and demographic characteristics, physical examination and blood sampling. TSH, FT4, FT3 and TPOAb concentrations were analysed by electrochemiluminescence (E170, Roche Diagnostics). UI level measurements were made in an isolated urine sample.The prevalence of treated, untreated subclinical and untreated clinical hypothyroidism was 4.2% (CI95% 3.6-4.9%), 4.6% (CI95% 4.0-5.2%) and 0.3% (CI95% 0.1-0.5%) respectively. The prevalence of total hypothyroidism (including all fractions) was 9.1% (CI95% 8.2-10.0%). The prevalence of total hyperthyroidism was 0.8% (CI95% 0.6-1.1). 7.5% (CI95% 6.7-8.3%) of the population tested positive for TPOAbs (50 U/ml). In multivariate logistic regression models, TPOAbs were strongly associated with both hypothyroidism (p<0.001) and hyperthyroidism (p= 0.005), whereas high UI levels (>200 mcgr/g creatinine), were associated with hypothyroidism (p<0.001). The positive association between UI and hypothyroidism remained for both treated (p<0.001) and untreated (p<0.05) hypothyroidism whereas it was especially significant for non-autoimmune (TPOAbs negative) forms (p<0.001). At UI levels 200 mcgr/gr there was a positive correlation between UI and TSH levels (=0,152, p<0.001) and a negative correlation between UI and FT3 levels (=-0.134, p=0.001).According to our data, a large proportion of the Spanish population (10%) has some evidence of thyroid dysfunction. High TPOAb concentrations were associated with both hypo and hyperthyroidism whereas high UI concentrations were associated with hypothyroidism.
PubMed | Hospital Del Mar Barcelona and Institute Municipal Serveis Personals Badalona
Type: Journal Article | Journal: Actas espanolas de psiquiatria | Year: 2015
To analyze factors associated with clinical observation, pharmacotherapy and referral on discharge of patients with anxiety disorder (AD) seeking care at a psychiatric emergency unit.A total of 5003 consecutive visits were reviewed over a three-year period at a psychiatric emergency service in a tertiary university hospital. Data collected included sociodemographic and clinical information as well as the Global Assessment of Functioning (GAF) and the Severity Psychiatric Illness (SPI) scale scores.Of all the visits, 992 (19.8%) were diagnosed of AD. Of these, 19.6% required clinical observation and 72.2% were referred to a psychiatrist at discharge. Regression analysis showed that referral to psychiatry was associated with being male, native, psychiatric background, greater severity, lower global functioning, and behavioral disorders. Clinical observation (in a box) was associated with being female, greater severity, and psychotic or behavioral symptoms. Prescription of benzodiazepines was associated with anxiety, no history of addiction, and lower global functioning. Antidepressants were associated with being a native, anxiety with no history of addiction, and lower functioning. Antipsychotics were associated with being native, psychiatric background (not addiction), anxiety, and lower functioning.Behavior, psychiatric background and illness severity were determinants of referral to a specialist. Besides these, psychotic symptoms and non-specific clinical symptoms were determinants of observation. Drug prescription in AD is less frequent if the main complaint is not anxiety and depends more on the level of functioning than on that of severity.
PubMed | Hospital del Mar Barcelona, University Hospital Fundacion Jimenez Diaz Madrid, Institute of Health Research INCLIVA Valencia and IIS Fundacion Jimenez Diaz
Type: Journal Article | Journal: American journal of cancer research | Year: 2016
Trastuzumab became the therapy of choice for patients with HER2-positive breast cancer in 1998, and it has provided clinical benefit ever since. However, a significant percentage of patients show primary resistance to trastuzumab at diagnosis, and most patients with metastatic disease that initially respond to trastuzumab eventually progress (acquired resistance). Consequently, there is an urgent need to improve our knowledge of the mechanisms governing resistance, so that specific therapeutic strategies can be developed to provide improved efficacy. We generated new cell lines derived from BCCL through extended exposure to trastuzumab. Drug-conditioned populations were authenticated for their molecular profile and their resistance rate was determined. Heterogeneous
PubMed | Hospital del Mar Barcelona
Type: Journal Article | Journal: Gynecological endocrinology : the official journal of the International Society of 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.
PubMed | Hospital del Mar Barcelona, University of La Laguna, University of Macedonia, Dienst Nefrologie and 13 more.
Type: Journal Article | Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association | 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.
Burillo-Putze G.,Hospital Universitario Of Canarias |
Climent B.,Hospital General Universitario |
Echarte J.L.,Hospital Del Mar Barcelona |
Puiguriguer J.,Hospital Son Espases |
Dargan P.,Guys Hospital
Anales del Sistema Sanitario de Navarra | Year: 2011
In recent years, a series of new drugs, known as smart drugs or legal highs, have gaining in popularity. They are easily obtainable through online shops. This is happening amongst younger segments of the population and is associated with recreational consumption, at weekends. In general, they are synthetic derivatives of natural products. There has been hardly any clinical research into them and they are not detectable in hospital laboratories. Three of these products, BZP (1-benzylpiperazine), mefedrone (4-methylmethcathinone) and Spice are probably the most widely used in Europe. The first two are consumed as an alternative to ecstasy and cocaine and are characterized by their producing a clinical profile of a sympathetic mimetic type; on occasion, they have serious consequences, with convulsions and even death. Spice (a mixture of herbs with synthetic cannabinoids such as JWH-018, JWH-073 and CP 47497-C8) is giving rise to profiles of dependence and schizophrenia. Although the emergent drugs have an aura of safety, there is an increasing amount of experience on their secondary effects.