Hospital Regional Universitario Carlos Haya Of Malaga

Villanueva de San Carlos, Spain

Hospital Regional Universitario Carlos Haya Of Malaga

Villanueva de San Carlos, Spain

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Vandenbroeck K.,University of the Basque Country | Vandenbroeck K.,Ikerbasque | Alvarez J.,CIC BioGUNE | Swaminathan B.,University of the Basque Country | And 17 more authors.
Genes and Immunity | Year: 2012

Cytokine and cytokine receptor genes, including IL2RA, IL7R and IL12A, are known risk factors for multiple sclerosis (MS). Excitotoxic oligodendroglial death mediated by glutamate receptors contributes to demyelinating reactions. In the present study, we screened 368 single-nucleotide polymorphisms (SNPs) in 55 genes or gene clusters coding for cytokines, cytokine receptors, suppressors of cytokine signaling (SOCS), complement factors and glutamate receptors for association with MS in a Spanish-Basque resident population. Top-scoring SNPs were found within or nearby the genes coding for SOCS-1 (P=0.0005), interleukin-28 receptor, alpha chain (P=0.0008), oncostatin M receptor (P=0.002) and interleukin-22 receptor, alpha 2 (IL22RA2; P=0.003). The SOCS1 rs243324 variant was validated as risk factor for MS in a separate cohort of 3919 MS patients and 4003 controls (combined Cochran-Mantel-Haenszel P=0.00006; odds ratio (OR)=1.13; 95% confidence interval (CI)=1.07-1.20). In addition, the T allele of rs243324 was consistently increased in relapsing-remitting/secondary progressive versus primary-progressive MS patients, in each of the six data sets used in this study (P CMH 0.0096; OR1.24; 95% CI 1.05-1.46). The association with SOCS1 appears independent from the chr16MS risk locus CLEC16A. © 2012 Macmillan Publishers Limited All rights reserved.


PubMed | Hospital Universitario Puerta Del Mar Of Cadiz, Hospital Universitario Central Of Asturias, Hospital Sant Joan Of Deu, Hospital Universitario Arnau Of Vilanova Of Lleida and 4 more.
Type: Journal Article | Journal: Enfermedades infecciosas y microbiologia clinica | Year: 2016

Nosocomial infections (NI) are a major healthcare problem. National surveillance systems enable data to be compared and to implement new measures to improve our practice.A multicentre, prospective, descriptive and observational study was conducted using the data from surveillance system for nosocomial infections created in 2007 for Spanish pediatric intensive care units. Data were collected for one month, between 01 and 31 March, for every study year (2008-2012). The objective was to report 5-years of NI surveillance data, as well as trends in infections by multidrug resistant organisms in Spanish pediatric intensive care units.A total of 3667 patients were admitted to the units during the study period. There were 90 (2.45%) patients with nosocomial infections. The mean rates during the 5 years study were: central line-associated bloodstream infection, 3.8/1000 central venous catheter-days, Ventilator-associated pneumonia 7.5/1000 endotracheal tube-days, and catheter-associated urinary tract infections 4.1/1000 urinary catheter-days. The comparison between the 2008 and 2009 rates for nosocomial infections did not show statistically significant differences. All rates homogeneously decreased from 2009 to 2012: central line-associated bloodstream infection 5.83 (95% CI 2.67-11.07) to 0.49 (95% CI 0.0125-2.76), P=0.0029; ventilator-associated pneumonia 10.44 (95% CI 5.21-18.67) to 4.04 (95% CI 1.48-8.80), P=0.0525; and Catheter-associated urinary tract infections 7.10 (95% CI 3.067-13.999) to 2.56 (95% CI 0.697-6.553), P=0.0817; respectively. The microorganism analysis: 63 of the 99 isolated bacteria (63.6%) were Gram-negative bacteria (36.5% were resistant), 19 (19.2%) Gram-positive bacteria, and 17 (17.2%) were Candida spp. infections.The local surveillance systems provide information for dealing with nosocomial infections rates.


PubMed | Autonomous University of Madrid, University of Malaga, Hospital Regional Universitario Carlos Haya Of Malaga and University of Oviedo
Type: | Journal: Neuroscience | Year: 2016

The use of more ethological animal models to study the neurobiology of anxiety has increased in recent years. We assessed the effect of an environmental enrichment (EE) protocol (24h/day over a period of two months) on anxiety-related behaviors when aged Wistar rats (21months old) were confronted with cat odor stimuli. Owing to the relationship between GABAergic interneurons and the anxiety-related neuronal network, we examined changes in the expression of Parvalbumin (PV) and 67kDa form of glutamic acid decarboxylase (GAD-67) immunoreactive cells in different brain regions involved in stress response. Behavioral results revealed that enriched rats traveled further and made more grooming behaviors during the habituation session. In the cat odor session, they traveled longer distances and they showed more active interaction with the odor stimuli and less time in freezing behavior. Zone analysis revealed that the enriched group spent more time in the intermediate zone according to the proximity of the predator odor. Regarding the neurobiological data, the EE increased the expression of PV-positive cells in some medial prefrontal regions (cingulate (Cg) and prelimbic (PL) cortices), whereas the GAD-67 expression in the basolateral amygdala was reduced in the enriched group. Our results suggest that EE is able to reduce anxiety-like behaviors in aged animals even when ethologically relevant stimuli are used. Moreover, GABAergic interneurons could be involved in mediating this resilient behavior.


Gonzalez-Molero I.,Hospital Regional Universitario Carlos Haya Of Malaga | Gonzalez-Molero I.,CIBER ISCIII | Rojo-Martinez G.,Hospital Regional Universitario Carlos Haya Of Malaga | Rojo-Martinez G.,CIBER ISCIII | And 19 more authors.
European Journal of Clinical Nutrition | Year: 2013

The aim of this study was to assess the relationship between obesity and vitamin D status cross-sectionally, the relationship between obesity and the incidence of hypovitaminosis D prospectively and inversely the relationship between vitamin D status and incidence of obesity in a population-based cohort study in Spain. At baseline (1996-1998), 1226 subjects were evaluated and follow-up assessments were performed in 2002-2004 and 2005-2007, participants undergoing an interview and clinical examination with an oral glucose tolerance test. At the second visit, 25-hydroxyvitamin D and intact parathyroid hormone concentrations were also measured. Prevalence of obesity at the three visits was 28.1, 36.2 and 39.5%, respectively. The prevalence of vitamin D deficiency (25-hydroxyvitamin D ≤20 ng/ml (≤50 nmol/l)) was 34.7%. Neither obesity at baseline (OR=0.98, 95% CI: 0.69-1.40, P=0.93) nor the development of obesity between baseline and the second evaluation (OR=0.80, 95% CI: 0.48-1.33, P=0.39) were significantly associated with vitamin D status. In subjects who were non-obese (BMI <30 kg/m 2) at the second evaluation, 25-hydroxyvitamin D values ≤17 ng/ml (≤42.5 nmol/l) were significantly associated with an increased risk of developing obesity in the next 4 years (OR=2.35, 95% CI: 1.03-5.4, P=0.040 after diverse adjustments). We conclude that vitamin D deficiency is associated with an increased risk of developing obesity. © 2013 Macmillan Publishers Limited All rights reserved.


Pozo Munoz F.,Hospital Regional Universitario Carlos Haya Of Malaga | Padilla Marin V.,Farmaceutico
Revista de Calidad Asistencial | Year: 2013

Objectives 1) To describe the frequency of positive attitudes and behaviours, in terms of patient safety, among the healthcare providers working in a healthcare district; 2) to determine whether the level of safety-related culture differs from other studies; and 3) to analyse negatively valued dimensions, and to establish areas for their improvement. Material and methods A descriptive, cross-sectional study based on the results of an evaluation of the safety-related culture was conducted on a randomly selected sample of 247 healthcare providers, by using the Spanish adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) designed by the Agency for Healthcare Research and Quality (AHRQ), as the evaluation tool. Positive and negative responses were analysed, as well as the global score. Results were compared with international and national results. Results A total of 176 completed survey questionnaires were analysed (response rate: 71.26%); 50% of responders described the safety climate as very good, 37% as acceptable, and 7% as excellent. Strong points were: «Teamwork within the units» (80.82%) and «Supervisor/ manager expectations and actions» (80.54%). Dimensions identified for potential improvement included: «Staffing» (37.93%), «Non-punitive response to error» (41.67%), and «Frequency of event reporting» (49.05%). Conclusions Strong and weak points were identified in the safety-related culture of the healthcare district studied, together with potential improvement areas. Benchmarking at the international level showed that our safety-related culture was within the average of hospitals, while at the national level, our results were above the average of hospitals. © 2012 SECA. Published by Elsevier Espana, S.L. All rights reserved.


Rodriguez M.J.,Hospital Regional Universitario Carlos Haya Of Malaga | Fernandez-Baena M.,Hospital Regional Universitario Carlos Haya Of Malaga | Barroso A.,Hospital Regional Universitario Carlos Haya Of Malaga | Yanez J.A.,Hospital Regional Universitario Carlos Haya Of Malaga
Pain Physician | Year: 2015

Background: Complex regional pain syndrome (CRPS) is a multifactorial condition with complex pathogenesis characterized by spontaneous or stimulus-induced pain that is disproportionate to the inciting event. It is also commonly accompanied by a myriad of autonomic and motor disturbances in highly variable combinations. This condition has been underreported in children until recently. Consequently, the management of CRPS in the pediatric population presents an even greater challenge than in adults, partly because there is a lack of clinical data concerning the efficacy of the diverse treatment methods available, and partly because successful treatment of CRPS involves a multidisciplinary approach. There is a variety of invasive methods to the treatment of CRPS, but scarce pediatric-focused trials have been published to date. Objective: To examine and analyze the data currently existing for the invasive management of CRPS in children. It further suggests a management algorithm based in the evidence reviewed and our team experience. Study Design: A comprehensive review of invasive management for pediatric CRPS. Setting: Academic hospital in Spain. Methods: A comprehensive review of all the evidence published to date was conducted. Four databases (PubMed, Medline, Web of Science, Embase, and Cochrane databases) were searched for articles published from 1980 to 2014. The eligibility criteria were any paper published in English or Spanish where a non-conventional approach was used to manage pediatric CRPS. Two independent reviewers extracted the data. Results: Many case series have reported the use of interventional management with positive results; however, there is not a single randomized control trial to date comparing the conservative and the invasive management in children. The largest series of pediatric cases showed that between 29% to 35% of children with CRPS needed interventional measures to manage this condition successfully. Sympathetic blocks and spinal drug infusion emerge as the most reported techniques; the spinal infusion of drugs together with the spinal cord stimulation being the most successfully employed. Based upon the available evidence with regard to effect and complications, we recommend an algorithm for the management of pediatric CRPS. Limitations: The limitations of this study include the paucity of literature, lack of randomized trials, and lack of quality evidence. Conclusions: Invasive techniques have been used to treat CRPS over the last few decades; however, the evidence for their use is still very weak. Invasive management should be contemplated only when high-standard conservative management has failed to work. © 2015, American Society of Interventional Pain Physicians. All rights reserved.


Tirado Pascual M.,Hospital Regional Universitario Carlos Haya Of Malaga
Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica | Year: 2011

Neonatal injuries produced during the childbirth or in the maneuvers of resuscitation they have a high morbidity and suppose the 8th reason of mortality in newborns. The aim of this article is to check our casuistry in the last 10 years and to present a case report of rectovaginal tear with the possible therapeutic options published in the literature. There were gathered a total of 8 perinatal neonatal injuries, being the majority of them clause-contused (5) in hairy leather, pinna and thorax. Other cases were affecting the perine: an anal tear and two rectovaginal tears; one of these patients needed colostomy and surgical repair of the perine. Only a small percentage of the perinatal neonatal injuries are valued by the paediatric surgeon. Some of them are serious and can have important consequences. The colostomy and primary or secondary closing is a therapeutic sure option in rectovaginal tears.


PubMed | Hospital Regional Universitario Carlos Haya Of Malaga
Type: Journal Article | Journal: Neuroscience research | Year: 2013

This work was aimed to assess whether voluntary exercise rescued behavioral and hippocampal alterations in mice lacking the lysophosphatidic acid LPA1 receptor (LPA1-null mice), studying the potential relationship between the amount of exercise performed and its effects. Normal and LPA1-null mice underwent 23 days of free wheel running and were tested for open-field behavior and adult hippocampal neurogenesis (cell proliferation, immature neurons, cell survival). Running decreased anxiety-like behavior in both genotypes but increased exploration only in the normal mice. While running affected all neurogenesis-related measures in normal mice (especially in the suprapyramidal blade of the dentate gyrus), only a moderate increase in cell survival was found in the mutants. Importantly, the LPA1-nulls showed notably reduced running. Analysis suggested that defective running in the LPA1-null mice could contribute to explain the scarce benefit of the voluntary exercise treatment. On the other hand, a literature review revealed that voluntary exercise is frequently used to modulate behavior and the hippocampus in transgenic mice, but half of the studies did not assess the quantity of running, overlooking any potential running impairments. This study adds evidence to the relevance of the quantity of exercise performed, emphasizing the importance of its assessment in transgenic mice research.


PubMed | Hospital Regional Universitario Carlos Haya Of Malaga
Type: Case Reports | Journal: Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica | Year: 2012

Neonatal injuries produced during the childbirth or in the maneuvers of resuscitation they have a high morbidity and suppose the 8th reason of mortality in newborns. The aim of this article is to check our casuistry in the last 10 years and to present a case report of rectovaginal tear with the possible therapeutic options published in the literature. There were gathered a total of 8 perinatal neonatal injuries, being the majority of them clause-contused (5) in hairy leather, pinna and thorax. Other cases were affecting the perine: an anal tear and two rectovaginal tears; one of these patients needed colostomy and surgical repair of the perine. Only a small percentage of the perinatal neonatal injuries are valued by the paediatric surgeon. Some of them are serious and can have important consequences. The colostomy and primary or secondary closing is a therapeutic sure option in rectovaginal tears.


PubMed | Hospital Regional Universitario Carlos Haya Of Malaga
Type: Journal Article | Journal: Revista de calidad asistencial : organo de la Sociedad Espanola de Calidad Asistencial | Year: 2013

1) To describe the frequency of positive attitudes and behaviours, in terms of patient safety, among the healthcare providers working in a healthcare district; 2) to determine whether the level of safety-related culture differs from other studies; and 3) to analyse negatively valued dimensions, and to establish areas for their improvement.A descriptive, cross-sectional study based on the results of an evaluation of the safety-related culture was conducted on a randomly selected sample of 247 healthcare providers, by using the Spanish adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) designed by the Agency for Healthcare Research and Quality (AHRQ), as the evaluation tool. Positive and negative responses were analysed, as well as the global score. Results were compared with international and national results.A total of 176 completed survey questionnaires were analysed (response rate: 71.26%); 50% of responders described the safety climate as very good, 37% as acceptable, and 7% as excellent. Strong points were: Teamwork within the units (80.82%) and Supervisor/manager expectations and actions (80.54%). Dimensions identified for potential improvement included: Staffing (37.93%), Non-punitive response to error (41.67%), and Frequency of event reporting (49.05%).Strong and weak points were identified in the safety-related culture of the healthcare district studied, together with potential improvement areas. Benchmarking at the international level showed that our safety-related culture was within the average of hospitals, while at the national level, our results were above the average of hospitals.

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