Hospital Universitari Of Sant Joan Of Reus

Reus, Spain

Hospital Universitari Of Sant Joan Of Reus

Reus, Spain
Time filter
Source Type

Alegret J.M.,Hospital Universitari Of Sant Joan Of Reus | Vinolas X.,Hospital Of La Santa Creu I Sant Pau | Villacastin J.,Hospital Clinico San Carlos | Martinez J.G.,Hospital General Universitario Of Alicante | And 2 more authors.
Medicina Clinica | Year: 2011

Patients and method: We studied the use of anticoagulation following cardioversion due to persistent atrial fibrillation in 422 patients with low or moderate risk of embolism, as well as its benefit during a follow-up of one year. Results: Oral anticoagulation was maintained after the first month in 80% of patients who showed sinus rhythm and in 43% after 12 months. Its maintenance in patients in sinus rhythm was related to a trend to lower incidence of embolic events (2.8% vs. 0.7%; p = 0.37). The incidence of major bleeding in patients who remained on oral anticoagulation was 4.9%, and age ≥75 years (OR 5.3; p = 0.02) was the only independently related factor. Conclusions: Anticoagulation is frequently maintained to long-term in patients without high risk of embolism but it seems that this treatment doe not have a favorable risk profile with a CHADS2 = 0 or 1 older than ≥75. © 2010 Elsevier España, S.L. All rights reserved.

Donat E.,Hospital Universitari i Politecnic la Fe | Ramos J.M.,Complejo Hospitalario Universitario Of Vigo | Sanchez-Valverde F.,Hospital Virgen Del Camino | Moreno A.,Hospital Teresa Herrrera | And 13 more authors.
Journal of Pediatric Gastroenterology and Nutrition | Year: 2016

Objectives: A large retrospective multicentre study was conducted in Spain to evaluate the efficiency of the new European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) criteria for the diagnosis of coeliac disease (CD). Methods: The study protocol was approved by the ethics committee of Hospital Universitari i Politècnic La Fe (Valencia, Spain). The present study included 2177 children (ages 0.6-15.9 years) with small bowel biopsy (SBB) performed for diagnostic purposes (from 2000 to 2009) and with a minimum 2-year follow-up after biopsy. Results: CD was diagnosed in 2126 patients (97.5%) and excluded in 51 (2.5%). Tissue transglutaminase antibodies (TG2A), anti-endomysial antibodies (EMA), and human leukocyte antigen (HLA) were reported in 751 patients, 640 symptomatic and 111 asymptomatic. TG2A levels >10 times the upper limit of normal, plus positive EMA and HLA DQ2 and/or DQ8 haplotypes, were found in 336 symptomatic patients, all of them with final diagnosis of CD. In 65 of 69 asymptomatic patients, 65 had confirmed CD and 4 did not have CD. According to the 2012 ESPGHAN guidelines, SBB may have been omitted in 52% of the symptomatic patients with CD with serologic and HLA available data. Gluten challenge was performed in 158 children, 75 of them <2 years at first biopsy. Only 1 patient in whom according to the new proposed diagnostic criteria gluten challenge would not have been mandatory did not relapse. Conclusions: Our results support the new ESPGHAN 2012 guidelines for diagnosis of CD can be safely used without the risk of overdiagnosis. A prospective multicentre study is needed to confirm our results. Copyright © 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

PubMed | University of Valladolid, Celimmune, Hospital Universitari Of Sant Joan Of Reus, Hospital Universitario Nuestra Senora Of La Candelaria and 12 more.
Type: Journal Article | Journal: The American journal of gastroenterology | Year: 2016

Treatment for celiac disease (CD) is a lifelong strict gluten-free diet (GFD). Patients should be followed-up with dietary interviews and serology as CD markers to ensure adherence to the diet. However, none of these methods offer an accurate measure of dietary compliance. Our aim was to evaluate the measurement of gluten immunogenic peptides (GIP) in stools as a marker of GFD adherence in CD patients and compare it with traditional methods of GFD monitoring.We performed a prospective, nonrandomized, multicenter study including 188 CD patients on GFD and 84 healthy controls. Subjects were given a dietary questionnaire and fecal GIP quantified by enzyme-linked immunosorbent assay (ELISA). Serological anti-tissue transglutaminase (anti-tTG) IgA and anti-deamidated gliadin peptide (anti-DGP) IgA antibodies were measured simultaneously.Of the 188 celiac patients, 56 (29.8%) had detectable GIP levels in stools. There was significant association between age and GIP in stools that revealed increasing dietary transgressions with advancing age (39.2% in subjects 13 years old) and with gender in certain age groups (60% in men 13 years old). No association was found between fecal GIP and dietary questionnaire or anti-tTG antibodies. However, association was detected between GIP and anti-DGP antibodies, although 46 of the 53 GIP stool-positive patients were negative for anti-DGP.Detection of gluten peptides in stools reveals limitations of traditional methods for monitoring GFD in celiac patients. The GIP ELISA enables direct and quantitative assessment of gluten exposure early after ingestion and could aid in the diagnosis and clinical management of nonresponsive CD and refractory CD. Trial registration number NCT02711397.

Szajewska H.,Medical University of Warsaw | Shamir R.,Tel Aviv University | Mearin L.,Leiden University | Ribes-Koninckx C.,University of Valencia | And 13 more authors.
Journal of Pediatric Gastroenterology and Nutrition | Year: 2016

Background: The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommended in 2008, based on observational data, to avoid both early (<4 months) and late (≥7 months) introduction of gluten and to introduce gluten while the infant is still being breast-fed. New evidence prompted ESPGHAN to revise these recommendations. Objective: To provide updated recommendations regarding gluten introduction in infants and the risk of developing coeliac disease (CD) during childhood. Summary: The risk of inducing CD through a gluten-containing diet exclusively applies to persons carrying at least one of the CD risk alleles. Because genetic risk alleles are generally not known in an infant at the time of solid food introduction, the following recommendations apply to all infants, although they are derived from studying families with first-degree relatives with CD. Although breast-feeding should be promoted for its other wellestablished health benefits, neither any breast-feeding nor breast-feeding during gluten introduction has been shown to reduce the risk of CD. Gluten may be introduced into the infant's diet anytime between 4 and 12 completedmonths of age. In children at high risk for CD,earlier introduction of gluten (4 vs 6months or 6 vs 12months) is associatedwith earlier development ofCDautoimmunity (defined as positive serology) and CD, but the cumulative incidence of each in later childhood is similar. Based on observational data pointing to the association between the amount of gluten intake and risk ofCD, consumption of large quantities of gluten should be avoided during the first weeks after gluten introduction and during infancy. The optimal amounts of gluten to be introduced at weaning, however, have not been established. © 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Soler N.,Hospital Universitari Of Sant Joan Of Reus | Romero-Aroca P.,Hospital Universitari Of Sant Joan Of Reus | Gris O.,Autonomous University of Barcelona | Camps J.,Hospital Universitari Sant Joan Of Reus | And 2 more authors.
Journal of Cataract and Refractive Surgery | Year: 2015

Purpose To determine whether chronic obstructive pulmonary disease (COPD) is a risk factor for a reduced corneal endothelium functional reserve after cataract surgery. Setting Department of Ophthalmology, Hospital Universitari Sant Joan, Reus, Spain. Design Prospective clinical observational cohort study. Methods Patients were assigned to 1 of the following 3 groups: mild-to-moderate COPD, severe-to-very severe COPD, and without COPD (control). Before and 3 months after phacoemulsification, specular microscopy was used to evaluate the number and morphology of endothelial cells and the central corneal thickness (CCT) was measured to evaluate corneal decompensation. Results Preoperative results were recorded for 165 eyes. The mild-to-moderate COPD group comprised 67 eyes; the severe-to-very severe COPD group, 40 eyes; and the control group, 58 eyes. Cataract surgery was performed in 112 eyes. Significant differences in nearly all preoperative and 3-month postoperative corneal endothelial parameters were observed between the COPD groups and the control group, the former having a lower cell density and percentage of hexagonal cells and a higher coefficient of variance of the mean cell area. Two weeks postoperatively, the percentage of mild central corneal edema was 0%, 36%, and 31% in the control group, mild-to-moderate COPD group, and severe-to-very severe COPD group, respectively. There was no significant difference in the preoperative or 3-month postoperative mean CCT between the groups. Conclusion Chronic obstructive pulmonary disease reduced endothelial functional reserve and increased corneal endothelial vulnerability to intraocular surgical stress. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned. © 2015 ASCRS and ESCRS.

PubMed | Complejo Hospitalario Regional Virgen Macarena, Hospital Universitario Puerta Of Hierro Majadahonda, Complejo Hospitalario Regional Y Virgen Of La Victoria, Hospital Universitari Of Sant Joan Of Reus and 6 more.
Type: Journal Article | Journal: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico | Year: 2015

Follicular non-Hodgkins lymphoma (FL) is a nodal B lymphoid malignancy that originates from the germinal center of a lymph node. FL is the second most frequent lymphoma subtype. The course of the disease is usually characterised by a typically indolent clinical course, with a median survival rate of 8-10 years, although most patients relapse after treatment. Diagnosis should always be based on a surgical specimen like an excisional node lymph biopsy. The first-line treatment of FL will depend of extension disease, tumour burden, patient symptoms, performance status and also patient decision. The addition of rituximab to conventional chemotherapy has improved ORR, PFS and OS. As first line in patients that need treatment, a combination of chemotherapy with rituximab induction followed by 2 years of rituximab maintenance is the best option. High-dose chemotherapy with autologous stem-cell transplantation in first line has not shown improvement and is not recommended as first-line therapy. Before any treatment decision in relapsed patients, a repeat biopsy is mandatory to rule out a transformation into large cell aggressive lymphoma. Standard treatment is controversial, depends on the efficacy of prior treatment, duration of the time-to-relapse, patients age and histological findings at relapse.

PubMed | Complejo Hospitalario Regional Virgen Macarena, Hospital Universitario Puerta Of Hierro Majadahonda, Complejo Hospitalario Regional Y Virgen Of La Victoria, Hospital Universitari Of Sant Joan Of Reus and 6 more.
Type: Journal Article | Journal: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico | Year: 2016

Hodgkin lymphoma (HL) is an uncommon B cell lymphoid malignancy representing approximately 10-15 % of all lymphomas. HL is composed of two distinct disease entities; the more commonly diagnosed classical HL and the rare nodular lymphocyte-predominant HL. An accurate assessment of the stage of disease and prognostic factors that identify patients at low or high risk for recurrence are used to optimize therapy. Patients with early stage disease are treated with combined modality strategies using abbreviated courses of combination chemotherapy followed by involved-field radiation therapy, while those with advanced stage disease receive a longer course of chemotherapy often without radiation therapy. High-dose chemotherapy (HDCT) followed by an autologous stem cell transplant (ASCT) is the standard of care for most patients who relapse following initial therapy. Brentuximab vedotin should be considered for patients who fail HDCT with ASCT.

PubMed | Lloret Center, Autonomous University of Barcelona, CIBER ISCIII, University Pompeu Fabra and 7 more.
Type: Journal Article | Journal: Journal of epidemiology and community health | Year: 2015

Tobacco smoke pollution (TSP) has major negative effects on infant health. Our objectives were to determine the effectiveness of a brief primary care intervention directed at parents who smoke in reducing babies TSP exposure, and to establish variables related to greater exposure.A multicentre, open, cluster-randomised clinical trial in Catalonia. The 83 participating primary health paediatric teams of the Catalan Health Service recruited 1101 babies whose parents were smokers. The intervention group (IG) received a brief TSP intervention; the control group (CG) received the usual care. Outcomes were measured by parents reported strategies to avoid TSP exposure. Baseline clinical data and characteristics of each babys TSP exposure were collected, along with infant hair samples and parents tobacco use and related attitudes/behaviours. At 3-month and 6-month follow-up, behavioural changes to avoid TSP exposure were recorded; the association between reported parental behaviours and nicotine concentration in infant hair samples was tested in a random sample of 253 babies at baseline and 6months.During follow-up, TSP-avoidance strategies improved more in the IG than in the CG: 35.4% and 26.9% ( p=0.006) at home, and 62.2% and 53.1% in cars (p=0.008). Logistic regression showed adjusted ORs for appropriate measures in the IG versus CG of 1.59 (95% CI 1.21 to 2.09) at home and 1.30 (95% CI 0.97 to 1.75) in cars. Hair samples showed that 78.7% of the babies tested were exposed. Reduced nicotine concentration was associated with improved implementation of effective strategies reported by parents at home (p=0.029) and in cars (p=0.014).The intervention produced behavioural changes to avoid TSP exposure in babies. The proportion of babies with nicotine (>=1ng/mg) in hair samples at baseline is a concern.Clinical Identifier: NCT00788996.

Background: Some patients with persistent atrial fibrillation treated pharmacologically revert to sinus rhythm prior to electrical cardioversion. Knowledge of factors predicting this effect may be clinically useful. Methodology: Data were obtained from patients enrolled in the study REgistro sobre la cardioVERSión en España (REVERSE) and treated with antiarrhythmic drugs that potentially may cause pharmacological reversal. We analized by means of logistic regression predictive factors related to reversion to sinus rhythm precardioversion. Results: Of the 752 patients treated with antiarrhythmic drugs, 160 (21%) reverted to sinus rhythm without electrical cardioversion. Amiodarone was the most widely used active compound (82%) and apparently the most effective. However, differences with other antiarrhythmic drugs were not significant (amiodarone 22% versus other antiarrhythmic drugs 17%, P =.22). Lack of obesity (body mass index < 30 kg/m2) (odds ratio [OR] = 1.9; P =.006), duration of atrial fibrillation < 1 year (OR 3.4; P =.02) and the absence of structural heart disease (OR 1,59; P =.01) were identified as independent variables with predictive value of pharmacological reversal to sinus rhythm. Among patients treated with amiodarone who met these criteria, the frequency of successful treatment increased up to 31%. Conclusion: In patients with persistent atrial fibrillation treated with anti-arrhythmic drugs, lack of obesity, duration of atrial fibrillation < 1 year and the absence of structural heart disease are predictors of reversion to sinus rhythm before electrical cardioversion. © 2012 Elsevier España, S.L. Todos los derechos reservados.

Loading Hospital Universitari Of Sant Joan Of Reus collaborators
Loading Hospital Universitari Of Sant Joan Of Reus collaborators