Hospital General Universitario Gregorio Marano

Madrid, Spain

Hospital General Universitario Gregorio Marano

Madrid, Spain
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Ortiz M.,Hospital General Universitario Gregorio Marano | Martin A.,Hospital Universitario Severo Ochoa | Arribas F.,Hospital Universitario Doce Of Octubre | Del Arco C.,Hospital Universitario Of La Princesa | And 2 more authors.
European Heart Journal | Year: 2017

Aims Intravenous procainamide and amiodarone are drugs of choice for well-tolerated ventricular tachycardia. However, the choice between them, even according to Guidelines, is unclear.We performed a multicentre randomized open-labelled study to determine the safety and efficacy of intravenous procainamide and amiodarone for the acute treatment of tolerated wide QRS complex (probably ventricular) tachycardia. Methods and results Patients were randomly assigned to receive intravenous procainamide (10 mg/kg/20 min)or amiodarone (5mg/kg/20min). The primary endpoint was the incidence of major predefined cardiac adverse events within 40 min after infusion initiation. Of 74 patients included, 62 could be analysed. The primary endpoint occurred in 3 of 33 (9%) procainamide and 12 of 29 (41%) amiodarone patients (odd ratio, OR = 0.1; 95% confidence interval, CI 0.03-0.6; P = 0.006). Tachycardia terminated within 40 min in 22 (67%) procainamide and 11 (38%) amiodarone patients (OR = 3.3; 95% CI 1.2-9.3; P = 0.026). In the following 24 h, adverse events occurred in 18% procainamide and 31% amiodarone patients (OR: 0.49; 95% CI: 0.15-1.61; P: 0.24). Among 49 patients with structural heart disease, the primary endpoint was less common in procainamide patients (3 [11%] vs. 10 [43%]; OR: 0.17; 95% CI: 0.04-0.73, P = 0.017). Conclusions This study compares for the first time in a randomized design intravenous procainamide and amiodarone for the treatment of the acute episode of sustained monomorphic well-tolerated (probably) ventricular tachycardia. Procainamide therapy was associated with less major cardiac adverse events and a higher proportion of tachycardia termination within 40 min. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017.

Sancho A.M.,Hospital General Universitario Gregorio Marano | Lucena M.J.,Hospital General Universitario Gregorio Marano | Gonzalez J.A.N.,Hospital General Universitario Gregorio Marano | Gonzalez L.M.,Hospital General Universitario Gregorio Marano
Medicine (Spain) | Year: 2015

The food toxiinfections might be included within the most frequent motives of consultation in the practice of the emergencie medicine. Diverses etiologies, as well as the different needs of boarding and possible complications, it makes the standardization necessary in the actions of the professionals in the emergencies services and in the hospitalization wards.

Gomez-Gaviro M.V.,Hospital General Universitario Gregorio Maranon | Gomez-Gaviro M.V.,Hospital General Universitario Gregorio Marano | Lovell-Badge R.,UK National Institute for Medical Research | Fernandez-Aviles F.,Hospital General Universitario Gregorio Maranon | And 2 more authors.
Journal of Cardiovascular Translational Research | Year: 2012

Stem cells in adult organs reside in specialized niches that regulate their proliferation and differentiation. Investigations during the last few years have unveiled a regulatory role for blood vessels in these microenvironments. Mesenchymal stem cells (MSCs) are located surrounding capillaries in a variety of tissues and have the capacity to differentiate into different mesodermal lineages. Angiogenic progenitor cells have also been found in the adventitial layer of large vessels. In the bone marrow, endothelial cells control hematopoietic stem cell (HSC) release, and in the brain, blood vessels regulate neural stem cell (NSC) self-renewal and neurogenesis. Similarly, perivascular progenitor cells have also been found in the heart. This intimate connection between stem cells and the vasculature contributes to tissue homeostasis and repair. In this review, we focus on the regulation of stem and progenitor cells in different adult niches by blood vessels and the few mechanisms that are known to mediate this interaction. © 2012 Springer Science+Business Media, LLC.

Zuluaga M.C.,Autonomous University of Madrid | Guallar-Castillon P.,Autonomous University of Madrid | Conthe P.,Hospital General Universitario Gregorio Marano | Rodriguez-Pascual C.,Complejo Hospitalario Universitario Of Vigo | And 6 more authors.
American Heart Journal | Year: 2011

Background: Although decent housing is recognized as a prerequisite for good health, very few studies in developed countries have examined the influence of housing characteristics on disease prognosis. This work examined whether housing conditions predict mortality in older adults with heart failure (HF). Methods: This is a cohort study comprising 433 patients hospitalized for HF-related emergencies in 4 Spanish hospitals between January 1, 2000, and June 30, 2001. At baseline, patients reported whether their homes lacked an elevator (in an apartment building), hot water, heating, an indoor bathroom, a bathtub or shower, individual bedroom, automatic washing machine, and telephone and whether they frequently felt cold. Analyses included all-cause deaths identified prospectively until January 1, 2005. Results: Among study participants, 165 (38.1%) lived in a home without one of the services considered; and 111 (25.6%) lacked ≥2 services. During follow-up, 260 deaths (60%) occurred. After adjustment for the main confounders, mortality was higher in those who lived in homes without an elevator (hazard ratio [HR] 1.39, 95% CI 1.07-1.80) and in those who frequently felt cold (HR 1.39, 95% CI 1.01-1.92). In comparison with living in a home with all the services considered, mortality was higher for persons living in a home lacking 1 service (HR 1.42, 95% CI 1.10-1.93) or ≥2 services (HR 1.94, 95% CI 1.37-2.74). Patients living in homes lacking any of the services more often had poor functional status, higher comorbidity, lower educational level, and less income. Conclusion: Poor housing conditions are associated with higher mortality in HF. Patients living in these homes are especially vulnerable because they have poorer clinical situation and lower socioeconomic position. © 2011 Mosby, Inc. All rights reserved.

Resino S.,Institute Salud Carlos III | Seoane J.A.,University of La Coruña | Bellon J.M.,Hospital General Universitario Gregorio Maranon | Dorado J.,University of La Coruña | And 7 more authors.
Journal of Infection | Year: 2011

Objective: To develop an artificial neural network to predict significant fibrosis (F≥2) (ANN-SF) in HIV/Hepatitis C (HCV) coinfected patients using clinical data derived from peripheral blood. Methods: Patients were randomly divided into an estimation group (217 cases) used to generate the ANN and a test group (145 cases) used to confirm its power to predict F≥2. Liver fibrosis was estimated according to the METAVIR score. Results: The values of the area under the receiver operating characteristic curve (AUC-ROC) of the ANN-SF were 0.868 in the estimation set and 0.846 in the test set. In the estimation set, with a cut-off value of <0.35 to predict the absence of F≥2, the sensitivity (Se), specificity (Sp), and positive (PPV) and negative predictive values (NPV) were 94.1%, 41.8%, 66.3% and 85.4% respectively. Furthermore, with a cut-off value of >0.75 to predict the presence of F≥2, the ANN-SF provided Se, Sp, PPV and NPV of 53.8%, 94.9%, 92.8% and 62.8% respectively. In the test set, with a cut-off value of <0.35 to predict the absence of F≥2, the Se, Sp, PPV and NPV were 91.8%, 51.7%, 72.9% and 81.6% respectively. Furthermore, with a cut-off value of >0.75 to predict the presence of F≥2, the ANN-SF provided Se, Sp, PPV and NPV of 43.5%, 96.7%, 94.9% and 54.7% respectively. Conclusion: The ANN-SF accurately predicted significant fibrosis and outperformed other simple non-invasive indices for HIV/HCV coinfected patients. Our data suggest that ANN may be a helpful tool for guiding therapeutic decisions in clinical practice concerning HIV/HCV coinfection. © 2010 The British Infection Association.

Vaquero J.J.,Charles III University of Madrid | Sanchez J.J.,Hospital General Universitario Gregorio Marano | Udias J.M.,Complutense University of Madrid | Guerra P.,Technical University of Madrid | And 2 more authors.
IEEE Nuclear Science Symposium Conference Record | Year: 2012

PET detector modules that implement depth of interaction information reduce uncertainties about the actual line-of-response after positron annihilation. This, in turn, has an effect in the spatial resolution and uniformity across the field of view of the reconstructed image. It also has an effect on the system sensitivity since it enables the use of thicker crystal with respect to a non-DOI system without deteriorating significantly the spatial resolution. In this work we evaluate a DOI detector design based on a scintillator phoswich of two types of pixelated crystals with different time decay constants. A matrix of silicon phomultipliers (SiPM) was coupled to this crystal array without any light-guide, and its outputs were connected to an anger logic type of charge divider which outputs were buffered using a transimpedance amplifier. These position signals were digitized using charge-to-digital converters, and the time decay constant of the crystal of interaction was measured using a delayed charge method. Previous works reported in the literature have demonstrated that this scheme for DOI PET detectors produce very good results in terms of spatial and energy resolution; however, the replacement of PMT with a SiPM matrix introduces some uncertainties that required further study. SiPM have demonstrated their good imaging capabilities when used with pixelated crystal scintillators, and their good timing performance allow us to predict that the DOI resolution was not going to be a problem with this technology. In this work we present quantitative results that assess the goodness of these detectors for its use on small-animal PET scanners. © 2011 IEEE.

Garrido C.,Hospital General Universitario Gregorio Marano | Cela E.,Hospital General Universitario Gregorio Marano | Belendez C.,Hospital General Universitario Gregorio Marano | Mata C.,Hospital General Universitario Gregorio Marano | Huerta J.,Hospital General Universitario Gregorio Marano
European Journal of Pediatrics | Year: 2012

Patients with sickle cell disease have vitamin D deficiency and poor bone health which makes them prone to have an increased risk of fractures and osteoporosis in adulthood. We performed a prospective, cross-sectional study in children diagnosed with sickle cell disease living in Madrid, Spain. The purpose of this study was to evaluate the status of vitamin D of these children. Patients 0-16 years old were enrolled between 2008 and 2011. We studied demographics, calcium metabolism, and bone health, especially by measuring levels of 25-hydroxyvitamin D (25(OH)D), during different seasons of the year, and bone densitometry (beyond 4 years of age). Seventy-eight children were included in the study. Mean age was 4.8 ± 4.3 years, and mean serum 25(OH)D level was 21.50 ± 13.14 ng/ml, with no differences in 25(OH)D levels within different seasons. Fifty-six percent of children had levels of 25(OH) vitamin D of <20 ng/ml, whereas 79 and 18 % of them had levels of <30 and <11 ng/ml, respectively. Secondary hyperparathyroidism was observed in 25 % of children. Densitometry was performed in 33 children, and an abnormal z-score was seen in 15.2 % of them with no correlation with levels of 25(OH)D. Conclusions: Vitamin D deficiency is highly prevalent in children with sickle cell disease, who are residing in Madrid, Spain, and it is detected at a young age. We propose that early intervention may increase the possibility of an adequate bone density later in life. © 2012 Springer-Verlag.

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