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Rispoil L.T.,Hospital General Universitario Of Valencia | Tarragon A.V.,Hospital Universitario Doctor Peset Of Valencia | Prado A.V.,Hospital General Universitario Of Valencia | Tormo G.S.,Hospital General Universitario | And 4 more authors.
Nutricion Hospitalaria

Introduction: Oxidative stress (OS), which is overtly present in morbid obesity, is an indicator of a chronic inflammatory state associated to obesity and possibly related with the associated comorbidities, some of which represent an important risk factor for the occurrence of cardiovascular diseases, so that decreasing its intensity has become a treatment priority. Materials and methods: he have consecutively performed the duodenal crossing surgical technique in 28 patients suffering from morbid obesity, assessing the level of oxidative stress by the determination of the products of molecular oxidation and antioxidants before the surgery and throughout one year after the surgery. Weight evolution and the progression of the comorbidities already present were assessed. Results: the mean age of the patients in this series was 43 ± 1 years and the mean BMI 50.3. 82% had associated comorbidities. After the surgery, all the patients progressively lost weight throughout the study period, with a parallel improvement of the comorbidities and a progressive decrease in OS values and improvement of the antioxidant systems, the OS values being similar to those of a normal population at the end of the study. Conclusion: The weight loss achieved allows improving the comorbidities and the oxidative stress values so that at the end of the study the results obtained are similar to those of a normal population. Source

Calvo-Rio V.,Hospital Universitario Marques Of Valdecilla | de la Hera D.,Hospital Universitario Marques Of Valdecilla | Beltran-Catalan E.,Hospital General Universitario Of Valencia | Blanco R.,Hospital Universitario Marques Of Valdecilla | And 10 more authors.
Clinical and Experimental Rheumatology

Objective: To evaluate the clinical response to Tocilizumab (TCZ) in three patients with non-infectious uveitis refractory to anti-TNF-α drugs. Methods: Assessment of TCZ-treated patients with immune-mediated uveitis from two Spanish medical referral centres. Uveitis had been refractory to previous standard synthetic immunosuppressive drugs and at least one TNF-α inhibitor. A literature review of patients with immune-mediated uveitis treated with TCZ therapy was also conducted. Results: 3 women (5 eyes) with uveitis refractory to conventional immunosuppressive therapy and at least one anti-TNF-α drug were treated with TCZ. The mean age of the patients was 48.6±16.1 (range 37-67) years. In two cases uveitis was bilateral and in the other unilateral. The underlying diseases were rheumatoid arthritis in one case and Behçet's disease in the other two cases. After a mean follow-up of 7.3±5.7 (range 1-12) months using TCZ therapy, all patients experienced ocular improvement. Also, in 3 eyes inactive intraocular inflammation was achieved. None of the patients had side effects during the period of treatment with this drug. A literature review disclosed that our observations are in keeping with other reports that showed good response to TCZ in 11 of 12 patients with immune-mediated uveitis refractory to other biologic agents. Conclusion: TCZ appears to be an effective and safe therapy for the management of patients with uveitis refractory to other biologic drugs. © Clinical and Experimental Rrheumatology 2014. Source

Sanz F.,Universitari Of Valencia | Restrepo M.I.,University of Texas Health Science Center at San Antonio | Fernandez E.,Veterans Evidence Based Research Dissemination and Implementation Center | Fernandez E.,Hospital Universitario Doctor Peset Of Valencia | And 5 more authors.
Respiratory Care

BACKGROUND: Hypoxemia may influence the prognosis of patients with mild pneumonia, regardless of the initial CURB-65 score (confusion, blood urea nitrogen > 20 mg/dL, respiratory rate > 30 breaths/min, blood pressure < 90/60 mm Hg, and age ≥ 65 y). OBJECTIVE: To determine the risk factors associated with hypoxemia and the influence of hypoxemia on clinical outcomes in hospitalized patients with mild pneumonia. METHODS: We performed a multicenter prospective cohort study of 585 consecutive hospitalized patients with mild pneumonia (CURB-65 groups 0 and 1). We stratified the patients according to the presence of hypoxemia, defined as a PaO2/FIO2 < 300 mm Hg on admission. We assessed the risk factors associated with hypoxemia, hypoxemia's influence on the course of pneumonia, and clinical outcomes (mortality, hospital stay, and need for intensive care unit admission), with multivariable regression. RESULTS: Fifty percent of the patients (294 cases) had hypoxemia on admission. The risk factors independently associated with hypoxemia were: bilateral radiological involvement (odds ratio 2.8, 95% CI 1.1-7.5), history of COPD (odds ratio 2.5, 95% CI 1.4-4.3), and hypoalbuminemia (odds ratio 2.0, 95% CI.1-3.5). The hypoxemic patients had longer hospital stay, higher intensive care unit admission rate, higher rate of severe sepsis, and higher mortality than the non-hypoxemic patients. CONCLUSIONS: Hypoxemia in patients with mild pneumonia is independently associated with several adverse clinical and radiological variables, and the hypoxemic patients had worse clinical outcomes than the non-hypoxemic patients. Therefore, additional attention should be paid to the presence of hypoxemia, regardless of a low CURB-65 score. © 2011 Daedalus Enterprises. Source

Martinez-Moreno J.,Polytechnic University of Valencia | Martinez-Moreno J.,Hospital Universitario Doctor Peset Of Valencia | Mura C.,Polytechnic University of Valencia | Merino V.,Polytechnic University of Valencia | And 3 more authors.
Journal of Arthroplasty

The objectives of this study were to examine ciprofloxacin release from three trademarks of bone cements (Simplex®, Lima® and Palacos®) and its bioactivity using as variables, the mixing method, the chemical form of the antibiotic and the antibiotic combination. The antibiotic amount released in base form represents 35% of antibiotic amount released when hydrochloride form is incorporated. Moreover, the combination (vancomycin and ciprofloxacin) shows a stronger release (132%) than hydrochloride ciprofloxacin alone. Three cements show equal drug release profile (P > 0.05). A bioactivity simulation exercise showed that until 72 hours post-surgery, ciprofloxacin concentrations in the implant would be higher than 0.1 μg/mL in 100% of the patients. After drain removal, it is expected that bioactivity would increase since drug clearance from implant would decrease. © 2015 Elsevier Inc.. Source

Moro-Valdezate D.,Hospital Clinico Universitario Of Valencia | Moro-Valdezate D.,National University of General San Martin | Buch-Villa E.,Hospital de Sagunto | Peiro S.,Superior Services | And 5 more authors.
Breast Cancer

Background: Several factors can modify health-related quality of life (HRQOL) of breast cancer survivors. The objective of the current study was to analyse the associations between HRQOL scores 1 year after breast cancer surgery and sociodemographic and clinical factors. Methods: This was an observational, multicentre and prospective study of a cohort of patients who underwent oncological breast cancer surgery and which was followed up for 1 year. The HRQOL was assessed at 1 year after surgery using three questionnaires: EuroQol-5D, EORTC QLQ-C30 and its breast-specific module BR-23. Results: A total of 364 patients participated in the study. Some factors were associated with better HRQOL 1 year after surgery: age between 60 and 69 years and under 50 years, being single or a housewife, stage I-II, invasive papillary carcinoma, breast-conserving surgery (BCS) or lack of axillary dissection. However, only the following were independent predictive factors: being single or a housewife, BCS, invasive papillary carcinoma, coming from an outpatient clinic or not receiving radiotherapy. Further, some factors were independent predictors of a worse HRQOL: age over 70 years, being married, separated or widowed, stage III or not receiving adjuvant chemotherapy. Conclusions: Demographic and clinical factors can influence HRQOL, some of them independently. © 2012 The Japanese Breast Cancer Society. Source

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