Joan XXIII Hospital

Tarragona, Spain

Joan XXIII Hospital

Tarragona, Spain

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Casellas F.,University of Barcelona | Barreiro De Acosta M.,Santiago Of Compostela Clinic Hospital | Iglesias M.,Santiago Of Compostela Clinic Hospital | Robles V.,University of Barcelona | And 6 more authors.
European Journal of Gastroenterology and Hepatology | Year: 2012

Background: Inflammatory bowel disease (IBD) is a debilitating immune disorder that impairs function and health-related quality of life (HRQOL). A goal of IBD treatment is mucosal healing, but it is not known whether it achieves normalization of the patients' perception of health. This can be assessed by using a cut-off scoring threshold of the Inflammatory Bowel Disease Questonnaire-36 (IBDQ-36). AIMS: To determine whether patients with Crohn's disease (CD) and ulcerative colitis (UC) in clinical remission and with mucosal healing normalize their HRQOL. Methods: This is a multicentric, prospective, observational, cross-sectional study of patients who are in stable clinical remission and having mucosal healing. Patients completed the IBDQ-36, the EuroQol-5D, and the Daily Fatigue Impact Scale fatigue questionnaires. Complete restoration of health was believed to have occurred when the global score in the IBDQ-36 was at least 209 points. Results: A total of 115 patients (48 with CD, 67 with UC) were included. The median activity index (the Harvey-Bradshaw or the colitis activity index) was 1.0 and the median endoscopic index (Simple Endoscopic Score for Crohn's disease or Mayo) was 0. Eighty percent of the patients (79% in CD and 82% in UC patients, P=NS) normalized their HRQOL. Type of treatment was not related to normalization of HRQOL. The lack of restoration of health was significantly related to fatigue and anxiety/depression. Conclusion: Mucosal healing is associated with a normalization of the perception of health by most IBD patients independently of treatment. However, a significant group of patients do not achieve restoration of HRQOL, which reinforces the necessity of a global care addressed to all patient concerns to achieve patients' complete health restoration. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Ochoa-Gondar O.,Institute Catala Of La Salut | Figuerola-Massana E.,Joan XXIII Hospital | Vila-Corcoles A.,Institute Catala Of La Salut | Aguirre C.A.,Institute Catala Of La Salut | And 4 more authors.
International Journal of Pediatric Otorhinolaryngology | Year: 2015

Objective: This study investigated incidence and serotype distribution of Streptococcus pneumoniae causing acute otitis media (AOM) in Catalonian children, evaluating vaccination effectiveness in the current era of extended valency pneumococcal conjugate vaccines (PCVs). Methods: Population-based surveillance study that included all AOM cases with isolation of pneumococcus (from otic fluids/otorrea) identified among children ≤14 years in the region of Tarragona (Southern Catalonia, Spain) from 01/01/2007 to 31/12/2013. Prevalence of infections caused by serotypes covered by the different PCVs formulations were calculated for the periods before and after 30/06/2010 (date of PCV7/PCV13 replacement). The indirect cohort method was used to estimate PCV7/13 effectiveness against vaccine-type infections. Results: A total of 78 children with a pneumococcal AOM were identified across study period, which meant an incidence rate of 23 cases per 100,000 population-year. Thirty-six cases (46.2%) occurred within the late PCV7 era and 42 cases (53.8%) during the early PCV13 era. Overall, the most common serotypes were type 19. A (21.7%), type 3 (13.3%) and type 15B (6.7%). Prevalence of cases caused by serotypes included in PCV7 did not substantially change between the first and the second study period (from 10.3% to 12.9%), whereas prevalence of cases caused by PCV13 serotypes showed a decreasing trend between both periods (from 65.5% to 48.4%). The aggregate PCV7/13 effectiveness against vaccine-type infections was 72% (95% confidence interval: -26 to 94). Conclusion: Pneumococcal conjugate vaccination appears an acceptable preventive option to prevent pneumococcal AOM in infants. However, its serotype coverage and clinical effectiveness are not optimal. © 2015 Elsevier Ireland Ltd.


Ochoa-Gondar O.,Institute Catala Of La Salut | Vila-Corcoles A.,Institute Catala Of La Salut | Rodriguez-Blanco T.,Autonomous University of Barcelona | de Diego-Cabanes C.,Institute Catala Of La Salut | And 2 more authors.
Vaccine | Year: 2014

Background: Cardiovascular benefits using the 23-valent pneumococcal polysaccharide vaccine (PPV23) are controversial. This study assessed clinical effectiveness of PPV23 in preventing acute myocardial infarction in people over 60-years. Methodology: We conducted a population-based cohort study involving 27,204 individuals ≥60 years-old in Tarragona, Spain, who were prospectively followed from 01/12/2008 until 30/11/2011. Outcomes were hospitalization for AMI, 30-day mortality from AMI and all-cause death. Cox regression was used to evaluate the association between pneumococcal vaccination and the risk of each outcome. Results: Cohort members were followed for a total of 76,033 person-years, of which 29,065 were for vaccinated subjects. Overall, 359 cases of AMI, 55 deaths from AMI and 2465 all-cause deaths were observed. Pneumococcal vaccination did not alter the risk of AMI (multivariable hazard ratio [HR]: 0.95; 95% confidence interval [CI]: 0.76-1.18; p= 0.630), death from AMI (HR: 1.32; 95% CI: 0.76-2.28; p= 0.321) and all-cause death (HR: 0.97; 95% CI: 0.89-1.05; p= 0.448). In analyses focused on people with and without history of prior coronary artery disease, pneumococcal vaccination did not emerge effective in preventing any analyzed event. Conclusions: This study supports that PPV23 does not provide any relevant benefit against AMI in the general population over 60 years, as in primary as well as in secondary prevention, although it is underpowered to exclude a small benefit of vaccination against rare outcomes. © 2013 Elsevier Ltd.


Vazquez Bouso O.,Joan XXIII Hospital | Forteza Gonzalez G.,Joan XXIII Hospital | Mommsen J.,Joan XXIII Hospital | Grau V.G.,Joan XXIII Hospital | And 2 more authors.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology | Year: 2010

Many patients suffer recurrent episodes of temporomandibular joint (TMJ) dislocation due to an excess of muscle contraction or spasticity in the depressor muscles of the jaw. The manual repositioning using the Nelaton maneuver is the first treatment. Occasionally, it may be necessary to use sedation or general anesthesia to achieve the desired muscle relaxation. In case of recurrence, surgical treatment is indicated. One nonsurgical method of treatment is the local infiltration of botulinum toxin type A. We present 4 cases of recurrent TMJ dislocation in patients suffering from conditions of neurologic origin, with considerable motor deterioration, treated with local infiltration of botulinum toxin type A. In conclusion, the injection of botulinum toxin type A is an effective method in cases of neurogenic TMJ dislocation, with low morbididty and side effects, improving patients' quality of life. © 2010 Mosby, Inc. All rights reserved.


Stern A.,Grunenthal Pharma SA | Sanchez-Magro I.,Grunenthal Pharma SA | Rull M.,Joan XXIII Hospital
Journal of Medical Economics | Year: 2011

Objective: The relationship between chronic noncancer pain (CNCP) control and pain medication (analgesic) adherence has not been widely documented. The primary aim of this study was to evaluate the relationship between pain intensity and the degree of adherence to analgesic medication prescribed in pain clinics. There was also a special emphasis on the influence of polypharmacy on adherence. Methods: A cross-sectional clinical survey was carried out in pain clinics across Spain. Demographic and clinical data were collected from patients: pain intensity, analgesic prescription and adherence, and the presence of concomitant medical conditions and treatments. The relationship between analgesic adherence and pain intensity was analyzed using correlations and propensity scores based on ordinal logistic regression. Correlates of pain intensity were explored using multiple linear regression. Results: Data was gathered from 1407 patients; 1321 were eligible for analysis. Their mean (standard deviation) age was 61.6 (14.7) years and the majority (67.3%) were women. More than half (57.9%) received step 3 analgesics. Pain intensity was scored 5 out of 10 on average. Just 65.9% of patients were reported to not have missed any analgesic dose during the previous week. Pain intensity correlated negatively with analgesic adherence (r s=-0.151, p<0.001). Moderate versus very intense pain was predicted in patients with 'good' and 'very poor' adherence, respectively. The presence of concomitant medications also correlated negatively with analgesic adherence (r s=-0.074, p=0.007). However, few investigators reported such a negative effect of polypharmacy. Limitations: Key limitations of this research are its cross-sectional design and the absence of an objective means of measuring medication adherence. Conclusions: This study has shown that there is a small but significant inverse relationship between analgesic adherence and CNCP control, which has remained elusive to date and should be further evaluated. Polypharmacy also had a negative influence on adherence, although this was not acknowledged by all investigators. © 2011 Informa UK Ltd All rights reserved.


Vila-Corcoles A.,Institute Catala Of La Salut | Ochoa-Gondar O.,Institute Catala Of La Salut | Gomez-Bertomeu F.,Joan XXIII Hospital | Raga-Luria X.,Santa Tecla Hospital
Vaccine | Year: 2011

Population-based surveillance study conducted among persons 65 years or older from the region of Tarragona (Southern Catalonia, Spain) during 2002-2009. All cases with isolation of pneumococcus from normally sterile bodily fluids were included. Incidence rates of invasive pneumococcal disease (IPD) and prevalence of infections caused by serotypes included in different pneumococcal conjugate vaccines (PCVs) and the 23-valent pneumococcal polysaccharide vaccine (PPV-23) were calculated. Overall, 176 IPD cases were observed, which means an incidence of 48 episodes per 100,000 person-year throughout the study period. The most dominant serotypes were 7F (10.1%), 14 (9.4%), 19A (9.4%), 3 (8.6%), 6A (7.9%) and 1 (7.2%). IPD cases due to PCV-7 types (from 37.2% to 14.6%; p=0.003) and PCV-10 types (from 60.5% to 32.3%; p=0.002) considerably decreased between 2002-2005 and 2006-2009 periods. Percentage of cases due to PCV-13 types (76.7% vs 62.5%; p=0.099) and PPV-23 types (81.4% vs 68.8%; p=0.122) did not significantly change between both periods. As main conclusion, in our setting, the PCV-13 has almost similar serotype coverage to the PPV-23 in preventing IPD among the elderly population, which suggests a possible future use of the conjugate vaccine in all age groups. © 2011 Elsevier Ltd.


PubMed | University of Verona, Institute of Histopathology and Diagnostic Cytopathology, University of Foggia and Joan XXIII Hospital
Type: Journal Article | Journal: International journal of surgical pathology | Year: 2016

Basosquamous carcinoma is a rare cutaneous tumor considered by some authors as an aggressive type of basal cell carcinoma having a propensity for local recurrence and a potential risk for regional and distant metastatic spread. Herein we present 2 cases of basosquamous carcinoma of head and neck region, with metastatic spread to parotid gland (case 1) and to cervical nodes (case 2). Both patients had recurrence 2 years after initial treatment of the primary lesion (first patient: surgery; second patient: radiotherapy) and at the same time developed regional metastases. We conclude that basosquamous carcinoma must be considered as an aggressive variant of basal cell carcinoma having a great propensity to metastasize even at an early tumor stage. The clinical features, the morphologic aspects, and the treatment of this rare entity are discussed in this article.


PubMed | Santa Tecla Hospital, Joan XXIII Hospital and Institute Catala Of La Salut
Type: Journal Article | Journal: International journal of pediatric otorhinolaryngology | Year: 2015

This study investigated incidence and serotype distribution of Streptococcus pneumoniae causing acute otitis media (AOM) in Catalonian children, evaluating vaccination effectiveness in the current era of extended valency pneumococcal conjugate vaccines (PCVs).Population-based surveillance study that included all AOM cases with isolation of pneumococcus (from otic fluids/otorrea) identified among children 14 years in the region of Tarragona (Southern Catalonia, Spain) from 01/01/2007 to 31/12/2013. Prevalence of infections caused by serotypes covered by the different PCVs formulations were calculated for the periods before and after 30/06/2010 (date of PCV7/PCV13 replacement). The indirect cohort method was used to estimate PCV7/13 effectiveness against vaccine-type infections.A total of 78 children with a pneumococcal AOM were identified across study period, which meant an incidence rate of 23 cases per 100,000 population-year. Thirty-six cases (46.2%) occurred within the late PCV7 era and 42 cases (53.8%) during the early PCV13 era. Overall, the most common serotypes were type 19A (21.7%), type 3 (13.3%) and type 15B (6.7%). Prevalence of cases caused by serotypes included in PCV7 did not substantially change between the first and the second study period (from 10.3% to 12.9%), whereas prevalence of cases caused by PCV13 serotypes showed a decreasing trend between both periods (from 65.5% to 48.4%). The aggregate PCV7/13 effectiveness against vaccine-type infections was 72% (95% confidence interval: -26 to 94).Pneumococcal conjugate vaccination appears an acceptable preventive option to prevent pneumococcal AOM in infants. However, its serotype coverage and clinical effectiveness are not optimal.


PubMed | Joan XXIII Hospital, Sant Pau i Santa Tecla Hospital, Idiap Research Institute and Institute Catala Of La Salut
Type: Journal Article | Journal: Acta neurologica Scandinavica | Year: 2016

The objective of this study was to investigate incidence and mortality from ischemic stroke in older adults with specific underlying chronic conditions, evaluating the influence of these conditions in developing stroke.Population-based cohort study involving 27,204 individuals 60 years old in Southern Catalonia, Spain. All cases of hospitalization from ischemic stroke (confirmed by neuro-imaging) were collected from 01/12/2008 until 30/11/2011. Incidence rates and 30-day mortality were estimated according to age, sex, chronic illnesses, and underlying conditions. Multivariable Cox regression analysis was used to calculate Hazards Ratio (HR) and estimate the association between baseline conditions and risk of developing stroke.Mean incidence rate reached 453 cases per 100,000 person-years. Maximum rates appeared among individuals with history of prior stroke (2926 per 100,000), atrial fibrillation (1815 per 100,000), coronary artery disease (1104 per 100,000), nursing-home residence (1014 per 100,000), and advanced age 80 years (1006 per 100,000). Thirty-day mortality was 13% overall, reaching 21% among patients over 80 years. Age [HR: 1.06; 95% confidence interval (CI): 1.04-1.07], history of prior stroke (HR: 5.08; 95% CI: 3.96-6.51), history of coronary artery disease (HR: 1.65; 95% CI: 1.21-2.25), atrial fibrillation (HR: 2.96; 95% CI: 2.30-3.81), diabetes mellitus (HR: 1.55; 95% CI: 1.23-1.95), and smoking (HR: 1.64; 95% CI: 1.15-2.34) emerged independently associated with an increased risk of ischemic stroke.Incidence and mortality from ischemic stroke remains considerable. Apart from age and history of atherosclerosis (prior stroke or coronary artery disease), atrial fibrillation, diabetes, and smoking were the underlying conditions most strongly associated with an increased risk.


PubMed | Santa Tecla Hospital, Joan XXIII Hospital, Institute Catala Of La Salut and Autonomous University of Barcelona
Type: Journal Article | Journal: Infection | Year: 2015

To investigate hospitalizations from pneumococcal pneumonia in older adults with specific underlying chronic conditions, evaluating the influence of these conditions in developing pneumonia.Population-based cohort study involving 27,204 individuals 60 years old in Southern Catalonia, Spain. All cases of hospitalization from pneumococcal pneumonia (bacteremic and nonbacteremic) were collected since 01/12/2008 until 30/11/2011. Cox regression was used to calculate hazards ratio (HR) and estimate the association between baseline conditions and the risk of developing pneumococcal pneumonia.Maximum incidences (per 1000 person-years) appeared among patients with history of prior pneumonia (14.6), nursing home residents (12.8), persons with immunodeficiency/asplenia (7.7) and patients with chronic pulmonary disease (7.6). In multivariable analysis, age (HR: 1.05), nursing home residence (HR: 4.59), history of prior pneumonia (HR: 3.58), stroke (HR: 2.50), chronic heart disease (HR: 1.53), chronic pulmonary disease (HR: 4.09), diabetes mellitus (HR: 1.66), smoking (HR: 1.69) and immunosuppressive medication (HR: 1.87) appeared significantly associated with an increased risk of pneumococcal pneumonia.Our data support that nursing home residence, chronic pulmonary disease and immunocompromising conditions are the underlying conditions most strongly associated with an increasing risk of pneumococcal pneumonia in older adults. This data underline the need for better prevention strategies among these persons.

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