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Garcia-Guasch R.,Hospital Universitari Germans Trias i Pujol | Garcia-Guasch R.,Autonomous University of Barcelona | Roige J.,Autonomous University of Barcelona | Roige J.,Hospital Universitari Of La Vall Dhebron | Padros J.,Catalonia Geriatric Assessment Unit
Current Opinion in Anaesthesiology | Year: 2012

Purpose of review: Anaesthesiologists have a significantly higher frequency of substance abuse by a factor of nearly 3 when compared with other physicians. This is still a current problem that must be reviewed. Recent findings: Many hypotheses have been formulated to explain why anaesthesiologists appear to be more susceptible to substance abuse than other medical professionals (genetic differences in sensitivity to opioids, stress, the association between chemical dependence and other psychopathology or the second-hand exposure hypothesis). Environmental exposure and sensitization may be an important risk factor in physician addiction. There is a long debate about returning to work for an anaesthetist who has been depending on opioid drugs, and recent debates are discussed. Institutional efforts have been made in many countries and physician health programmes have been developed. Summary: As drug abuse among anaesthesiologists has continued, new studies have been conducted to know the theories about susceptibility. Written substance abuse policies and controls must be taken in place and in all countries. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

Jauregui Presa I.,Hospital Universitario Basurto | Ortiz de Frutos F.J.,Dermatology Unit | Ferrer M.,University of Navarra | Gimenez-Arnau A.,University of the Sea | And 5 more authors.
Journal of Investigational Allergology and Clinical Immunology | Year: 2014

Chronic urticaria (CU) is very prevalent in the general population and, despite its low mortality, can have devastating effects on the quality of life (QoL) of those who experience it. Therefore, consensus documents on its classification, diagnosis, and treatment have become a necessity. The intensity of urticaria is currently evaluated using indices such as the Urticaria Activity Score and visual analog scales to assess itch or the degree of itch associated with the use of antihistamines. QoL is evaluated using various generic questionnaires and specific tools for skin disease and for CU. In recent years, attempts have been made to combine these evaluations to create a specific tool that would enable us to simultaneously evaluate the severity of the condition and the impact of symptoms on QoL. One such tool is the Urticaria Severity Score, which also allows us to compare global changes brought about by different treatments. © 2014 Esmon Publicidad. Source

Prat A.,Vall dHebron Institute of Oncology VHIO | Cruz C.,Vall dHebron Institute of Oncology VHIO | Hoadley K.A.,University of North Carolina at Chapel Hill | Diez O.,Hospital Universitari Of La Vall Dhebron | And 2 more authors.
Breast Cancer Research and Treatment | Year: 2014

BRCA1-mutated breast cancer is associated with basal-like disease; however, it is currently unclear if the presence of a BRCA1 mutation depicts a different entity within this subgroup. In this study, we compared the molecular features among basal-like tumors with and without BRCA1 mutations. Fourteen patients with BRCA1-mutated (nine germline and five somatic) tumors and basal-like disease, and 79 patients with BRCA1 non-mutated tumors and basal-like disease, were identified from the cancer genome atlas dataset. The following molecular data types were evaluated: global gene expression, selected protein and phospho-protein expression, global miRNA expression, global DNA methylation, total number of somatic mutations, TP53 and PIK3CA somatic mutations, and global DNA copy-number aberrations. For intrinsic subtype identification, we used the PAM50 subtype predictor. Within the basal-like disease, we observed minor molecular differences in terms of gene, protein, and miRNA expression, and DNA methylation variation, according to BRCA1 status (either germinal or somatic). However, there were significant differences according to average number of mutations and DNA copy-number aberrations, and four amplified regions (2q32.2, 3q29, 6p22.3, and 22q12.2), which are characteristic in high-grade serous ovarian carcinomas, were observed in both germline and somatic BRCA1-mutated breast tumors. These results suggest that minor, but potentially relevant, baseline molecular features exist among basal-like tumors according to BRCA1 status. Additional studies are needed to better clarify if BRCA1 genetic status is an independent prognostic feature, and more importantly, if BRCA1 mutation status is a predictive biomarker of benefit from DNA-damaging agents among basal-like disease. © 2014 The Author(s). Source

Cordero A.,Hospital Universitario Of San Juan | Masia M.D.,Hospital Universitario Of San Juan | Galve E.,Hospital Universitari Of La Vall Dhebron
Revista Espanola de Cardiologia | Year: 2014

Regular physical exercise is an established recommendation for preventing and treating the main modifiable cardiovascular risk factors, such as diabetes mellitus, hypertension, and dyslipidemia. Performing physical activity of moderate intensity for a minimum of 30 minutes 5 days a week or of high intensity for a minimum of 20 minutes 3 days a week improves functional capacity and is associated with reductions in the incidence of cardiovascular disease and mortality. Physical exercise induces physiological cardiovascular adaptations that improve physical performance, and only in extreme cases can these adaptations lead to an increased risk of physical exercise-associated complications. The incidence of sudden death or serious complications during physical exercise is very low and is concentrated in people with heart diseases or with pathological cardiac adaptation to exercise. Most of these cases can be detected by cardiology units or well-trained professionals. © 2014 Sociedad Espanõla de Cardiología. Published by Elsevier España, S.L.U. All rights. Source

Allepuz A.,Catalan Agency for Quality and Healthcare Assessment | Martinez O.,Catalan Agency for Quality and Healthcare Assessment | Tebe C.,Catalan Agency for Quality and Healthcare Assessment | Nardi J.,Hospital Universitari Of La Vall Dhebron | And 2 more authors.
Journal of Arthroplasty | Year: 2014

The aim was to present results on prosthesis performance in Catalonia for the period 2005-2010. All publicly funded hospitals submit in an electronic format data on hip and knee arthroplasties: patients' insurance identification number, hospital, joint (hip/knee), type of arthroplasty (primary/revision), side (right/left), date of surgery and prosthesis (manufacturer name and catalogue number). A standard survival analysis based on Kaplan-Meier estimation was carried out. Fifty-two hospitals have sent information to the RACat which has data on 36,951 knee and 26,477 hip arthroplasties. Cumulative prostheses revision risks at 3. years were 3.3% (95% CI: 3.1-3.6) for knee, 2.9% (95% CI: 2.5-3.3) for total hip and 2.5% (95% CI: 2.0-3.1) for partial hip. When compared to other registries a higher risk of revision was observed. © 2014 Elsevier Inc. Source

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