Pons R.,National and Kapodistrian University of Athens |
Cuenca-Leon E.,Hospital Universitari Vall dHebron |
Miravet E.,Hospital Universitari Son Dureta |
Pons M.,Hospital Universitari Son Dureta |
And 3 more authors.
European Journal of Paediatric Neurology | Year: 2012
Paroxysmal non-kinesigenic dyskinesia (PNKD) is an autosomal dominant disorder characterized by attacks of dystonic or choreathetotic movements precipitated by stress, fatigue, coffee, alcohol or menstruation. In this report we present two families with PNKD of Southern European origin carrying a PNKD recurrent mutation. Incomplete penetrance and intrafamilial variability was detected in both families. Treatment with valproic acid and levetiracetam provided favorable response. © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
Carles J.,Hospital Universitari Vall dHebron |
Chirivella I.,Hospital Clinico Universitario Of Valencia |
Climent M.A.,Fundacion Instituto Valenciano Of Oncologia |
Gallardo E.,Lhospital Of Sabadell |
And 4 more authors.
Cancer and Metastasis Reviews | Year: 2012
The approval and use of molecular targeted agents for the first-line treatment of metastatic renal cell carcinoma (mRCC) has substantially improved the clinical outcome of patients. Although eventually all patients progress, hopes have been renewed with the approval of everolimus for patients who progress on or after treatment with tyrosine kinase inhibitors. In order to improve the prognosis for these patients, it is imperative to understand the reasons why patients with mRCC fail on first-line treatment. Currently, progression is assessed on the basis of the Response Evaluation Criteria in Solid Tumors, but it is known that targeted agents tend to cause disease stabilization rather than a significant decrease in tumor mass. Therefore, it may be time to evaluate the need to incorporate additional diagnostic methods in the assessment of disease response. Equally important is the study of the factors that determine the success or failure of second-line therapy in order to increase the chances of delivering the most effective and personalized therapy possible. In this article, we review the evidence related to the evaluation of patients with mRCC who fail on first-line treatment with targeted agents, including the systems to assess response and progression, the prognostic factors, the prognostic models that have been created based on these factors, and what is known about predictive biomarkers of disease outcome. © 2012 Springer Science+Business Media, LLC.
Rius M.,Unitat de Biologia Cellular i Gentica Mdica |
Obradors A.,Autonomous University of Barcelona |
Daina G.,Unitat de Biologia Cellular i Gentica Mdica |
Ramos L.,Unitat de Biologia Cellular i Gentica Mdica |
And 7 more authors.
Fertility and Sterility | Year: 2011
Objective: To apply a comprehensive chromosomal screening through short comparative genomic hybridization (CGH) in the preimplantation genetic diagnosis (PGD) of translocations. Design: Clinical research study. Setting: A PGD laboratory and two IVF clinics. Patient(s): Three Robertsonian translocation carriers, two reciprocal translocation carriers, and a double-translocation carrier. Intervention(s): After using the short-CGH approach in the reanalysis of two unbalanced embryos, discarded from a PGD for a reciprocal translocation carrier, the same method was applied in the PGD of day-3 embryos of translocation carriers. Main Outcome Measure(s): Ability of short CGH to detect partial chromosomal abnormalities in unbalanced embryos, translocation segregation proportions, and proportion of embryos carrying chromosomal abnormalities not related to the translocations. Result(s): The short-CGH technique detected errors resulting from the meiotic segregation of the chromosomes involved in the translocations and other abnormalities affecting the remaining chromosomes. Alternate segregation was detected most frequently among Robertsonian translocation cases, whereas unbalanced chromosome segregations were found predominantly in reciprocal ones. Aneuploidy and structural chromosome errors were found more frequently in Robertsonian than in reciprocal translocation carriers. Application of short-CGH PGD achieved pregnancy in two cases. Conclusion(s): Short CGH is a reliable approach for PGD of translocations, as it is capable of detecting partial chromosome errors caused by unbalanced segregations simultaneously to the screening of all chromosomes, and it may improve the results after PGD for translocation carriers. © 2011 by American Society for Reproductive Medicine.
Gasch O.,Hospital Universitari Of Bellvitge |
Camoez M.,Hospital Universitari Of Bellvitge |
Dominguez M. A.,Hospital Universitari Of Bellvitge |
Padilla B.,Hospital Gregorio Marano n |
And 13 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2013
Objectives: A high proportion of patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia die within a few days of the onset of infection. However, predictive factors for early mortality (EM) have barely been examined. The aim of this study was to determine the predictive factors for EM in patients with MRSA bacteraemia. Methods: All episodes of MRSA bacteraemia were prospectively followed in 21 Spanish hospitals from June 2008 to December 2009. Epidemiology, clinical data, therapy and outcome were recorded. All MRSA strains were analysed in a central laboratory. Mortality was defined as death from any cause occurring in the 30 days after the onset of MRSA bacteraemia. EM was defined as patients who died within the first 2 days, and late mortality (LM) for patients who died after this period. Multivariate analyses were performed by using logistic regression models. Results: A total of 579 episodes were recorded. Mortality was observed in 179 patients (31%): it was early in 49 (8.5%) patients and late in 130 (22.5%). Independent risk factors for EM were [OR (95% CI)] initial Pitt score >3 [3.99 (1.72-3.24)], previous rapid fatal disease [3.67 (1.32-10.24)], source of infection lower respiratory tract or unknown [3.76 (1.31-10.83) and 2.83 (1.11-7.21)], non-nosocomial acquisition [2.59 (1.16-5.77)] and inappropriate initial antibiotic therapy [3.59 (1.63-7.89)]. When predictive factors for EM and LM were compared, inappropriate initial antibiotic therapy was the only distinctive predictor of EM, while endocarditis and lower respiratory tract sources both predicted LM. Conclusions: In our large cohort of patients several factors were related to EM, but the only distinctive predictor of EM was inappropriate initial antibiotic therapy©The Author 2013. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Nunez B.,Hospital Universitari Son Dureta |
Sauleda J.,Hospital Universitari Son Dureta |
Sauleda J.,Hospital Son Dureta |
Anto J.M.,Fundacio Caubet Cimera |
And 19 more authors.
American Journal of Respiratory and Critical Care Medicine | Year: 2011
Rationale: Chronic obstructive pulmonary disease (COPD) is a multicomponent disease. Autoimmunity can contribute tothe pathogenesis of COPD. Objectives: This study investigates the prevalence of circulating antinuclear antibodies (ANA) and anti-tissue (AT) antibodies, two common markers of autoimmunity, in COPD and their relationship with several components of the disease. Methods: We determined lung function, the serum titers of ANA and AT by immunofluorescence, and the serum levels of C-reactive protein (CRP) by high sensitivity nephelometry in 328 patients with clinically stable COPD and in 67 healthy controls recruited in the PAC-COPD study. Multiple linear and logistic regression analysis was used to analyze results. Measurementsand MainResults: The prevalence of abnormal ANA and AT titers was 34% and 26% in patients and 3% and 6% in controls, respectively. Levels of AT greater than or equal to 1:320 were seen in 21% of patients with COPD and were independently associated with the severity of airflow limitation and gas transfer impairment (P, 0.05). Neither ANA or AT titers was related to body mass index, current smoking status, use of inhaled steroids, the Charlson index, or serum C-reactive protein values. Conclusions: Between a quarter and a third of patients with clinically stable COPD present abnormal titersof circulating ANA and AT. The observed relationship between AT and lung function supports a role for autoimmunity in the pathogenesis of COPD.
Bonsignore M.R.,University of Palermo |
Esquinas C.,Hospital Santa Maria |
Esquinas C.,Hospital Universitario Arnau Of Vilanova |
Barcelo A.,Hospital Universitari Son Dureta |
And 7 more authors.
European Respiratory Journal | Year: 2012
Themetabolic syndrome shows a variable prevalence in obstructive sleep apnoea (OSA), and its association with insulin resistance or excessive daytime sleepiness in OSA is unclear. This study assessed the following in consecutive patients with newly diagnosed OSA: 1) the prevalence of metabolic syndrome; and 2) its association with insulin resistance and daytime sleepiness. Metabolic syndrome (National Cholesterol Education Program Adult Treatment Panel (NCEPATP) III criteria), insulin resistance (Homeostatic Model Assessment (HOMA) index, n=288) and daytime sleepiness (Epworth Sleepiness Scale) were assessed in 529 OSA patients. The prevalence of metabolic syndrome was 51.2%, which increased with OSA severity. Each metabolic syndrome component correlated with apnoea/hypopnoea index, but only blood pressure retained significance after correction for confounders. Both obesity and OSA contributed to metabolic abnormalities, with different sex-related patterns, since diagnosis of metabolic syndrome was significantly associated with neck circumference, age, body mass index and lowest arterial oxygen saturation in males, and with age and arousal index in females. The number of metabolic syndrome components increased with HOMA index (p<0.001). Prevalence of sleepiness was the same in patients with and without metabolic syndrome. The metabolic syndrome occurs in about half of "real-life" OSA patients, irrespective of daytime sleepiness, and is a reliable marker of insulin resistance. Copyright©ERS 2012.
Albacar G.,Rovira i Virgili University |
Sans T.,Hospital Verge Of La Cinta |
Martin-Santos R.,Hospital Clinic |
Garcia-Esteve L.,Hospital Clinic |
And 9 more authors.
Journal of Affective Disorders | Year: 2011
Context: Iron deficiency is the most common nutritional problem experienced by childbearing women, and postpartum depression (PPD) is the most common psychiatric disorder seen during the first year after delivery. The possible link between iron deficiency and PPD is not clear. Objective: To evaluate whether iron status 48 h after delivery was associated with PPD. Our hypothesis was that iron deficiency would be associated with PPD. Design: This was a prospective cohort study of depression-free women studied in the postpartum period. Setting: Women who give birth at obstetric units in several general hospitals in Spain. Participants: A subsample of 729 women was included in the present study after exclusion of women with high C-reactive protein (CRP) and other diseases known to interfere with iron metabolism. Main outcome measures: We evaluated depressive symptoms at 48 h, 8 weeks and 32 weeks postpartum and used a diagnostic interview to confirm the diagnosis of major depression. A blood sample obtained 48 h after delivery was used to measure the following iron storage parameters: ferritin, transferrin (Tf), free iron and transferrin saturation (TfS) and the inflammatory marker CCRP. Results: Overall, the women in the study had low iron concentrations (8.8 ± 6.9 μmol/L) and low TfS (12.6 ± 9.6%) but normal ferritin and Tf concentrations. A total of 65 women (9%) developed PPD during the 32 week postpartum period; these women also had a lower ferritin concentration (15.4 ± 12.7 μg/L vs. 21.6 ± 13.5 μg/L, P = 0.002). A strong association between ferritin and PPD was observed (odds ratio = 3.73, 95% CI: 1.84-7.56; P = 0.0001 for ferritin cutoff value of 7.26 μg/L). In our study, ferritin concentrations have a high specificity but low sensitivity in predicting PPD. Conclusions: These findings support the role of iron in the etiology of PPD and the use of ferritin as a marker of iron deficiency in the postpartum period. We believe that this topic deserves further investigation. © 2010 Elsevier B.V. All rights reserved.
Manzur A.,Hospital Universitari Of Bellvitge |
Dominguez M.A.,Hospital Universitari Of Bellvitge |
Ruiz de Gopegui E.,Hospital Universitari Son Dureta |
Mariscal D.,Microbiology Service |
And 4 more authors.
Journal of Hospital Infection | Year: 2010
The spread of meticillin-resistant Staphylococcus aureus (MRSA) is a major problem for both acute care hospitals and among residents in long term care facilities (LTCFs). We performed a cohort study to assess the natural history of MRSA colonisation in LTCF residents. Two cohorts of residents (231 MRSA carriers and 196 non-carriers) were followed up for an 18 month period, with cultures of nasal and decubitus ulcers performed every six months. In the MRSA carrier cohort, 110 (47.8%) residents had persistent MRSA colonisation for six months or longer, 44 (19.0%) had transient colonisation and nine (3.9%) were intermittently colonised. No risk factors for persistent MRSA colonisation could be determined. The annual incidence of MRSA acquisition was around 20% [95% confidence interval (CI): 14.3-25.5]. Antibiotic treatment was independently associated with MRSA acquisition (odds ratio: 2.27; 95% CI: 1.05-4.88; P=0.03). Just two clones were distinguishable by pulsed-field gel electrophoresis and multilocus sequence typing: CC5-MRSA IV, which is widely disseminated in Spanish hospitals, and ST22-MRSA IV. This study adds to the knowledge of the epidemiology of MRSA in community LTCFs, which are important components of long term care in Spain. © 2010 The Hospital Infection Society.
Raurich J.M.,Hospital Universitari Son Dureta |
Llompart-Pou J.A.,Hospital Universitari Son Dureta |
Ferreruela M.,Hospital Universitari Son Dureta |
Colomar A.,Hospital Universitari Son Dureta |
And 4 more authors.
Journal of Anesthesia | Year: 2011
Purpose: Hypoxic hepatitis may be induced by hemodynamic instability or arterial hypoxemia in critically ill patients. We investigated the incidence, etiology, association with systemic ischemic injury and risk factors for mortality in this population. Methods: Retrospective analysis of patients with hypoxic hepatitis admitted to a multidisciplinary intensive care unit (ICU) of a university hospital. Hypoxic hepatitis was defined as the existence of a compatible clinical setting (cardiocirculatory failure or arterial hypoxemia) and aminotransferase levels higher than 1000 IU/L. Results: During the 8-year study period, 182 out of the 7674 patients admitted presented hypoxic hepatitis (2.4%). The most common cause was septic shock. The rate of in-hospital mortality in hypoxic hepatitis was 61.5% (112 patients), and was higher in patients with septic shock (83.3%) and cardiac arrest (77.7%). Ischemic pancreatitis (25.6%), rhabdomyolysis (41.2%) and renal failure (67.2%) were common in these patients. Risk factors of mortality were prolonged INR (p = 0.005), need for renal replacement therapy (p = 0.001) and septic shock (p = 0.005). Conclusions: Hypoxic hepatitis was not a rare condition, and was frequently accompanied by multiorgan injury, with high mortality. Risk factors for increased mortality were prolonged INR, need for renal replacement therapy, and septic shock. © 2010 Japanese Society of Anesthesiologists.
PubMed | Hospital Universitari son Dureta
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016
15108 Background: Treatment of RC was heterogeneous before MRCC. Surgery was the standard treatment for rectal carcinoma (RC) with the help of radiochemotherapy (RCT) applied either before or after the operation. Pathologic complete responses (pCR) are 9-14% with 5FU in phase III studies.A MRCC was settled at the beginning of 2006 in our institution. With a mean follow up of 17.5 months, we report data about 53 rectal cancer patients (p) admitted to our centre between 2005 and 2007.Mean age was 67 years (range 46-84). Seventy percent were male. Performance status (PS) 0 in 30% and PS 1 57%. All had adenocarcinoma in histology, moderately differentiated in 43.4%. Pelvis MRI was performed in 56.6%, rectal USE in 54.7%, and both in 37.7%. Twenty four patients (45.3%) received no preoperative treatment, distributed as follows: cT2 2p; cT3 5p; cN+ 5p. Data about clinical stage were not recorded in 12p. Neoadjuvant RCT was administered in 29 patients (54.7%) distributed as follows cT3 2p; cT4 1p; cN+ 26p. RCT consisted in chemotherapy with 5-flurouracil (5-FU) 225 mg/mNeoadjuvant 5FU continuous infusion IV with RT seems to provide downstaging and pCR and is generally well tolerated. Multidisciplinary approach is mandatory to homogenize the clinical management of RC patients. No significant financial relationships to disclose.