Hospital Universitario Doctor Peset Of Valencia

Valencia de Alcántara, Spain

Hospital Universitario Doctor Peset Of Valencia

Valencia de Alcántara, Spain

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Martinez-Moreno J.,Polytechnic University of Valencia | Martinez-Moreno J.,Hospital Universitario Doctor Peset Of Valencia | Merino V.,Polytechnic University of Valencia | Nacher A.,Polytechnic University of Valencia | And 3 more authors.
Anales de la Real Academia Nacional de Farmacia | Year: 2015

Antibiotic loaded bone cement used in prosthesis fixing, is a local release form that minimizes the prevalence and the complications that the antibiotics would unleash when administered intravenously. The aim of this work is to study in vitro release kinetics of ciprofloxacin and vancomycin loaded in different commercial cements and evaluate the bioactivity through a simulation exercise pharmacokinetics. Samples were prepared with commercial bone cement and ciprofloxacin and vancomycin hydrochloride (40:0,5:0,5). Release study were carried out under stirring in phosphate buffer, pH=7,4, for two months at 37°C. The antibiotic amount and elution rate, were compared using ANOVA. In order to study the bioactivity, Monte Carlo simulation was performed. The ciprofloxacin released from samples for 8 weeks was 0.29±0.06 mg from the Palacos® cements, 0.44±0.06 mg from LimaCMT1® and 0.18±0.04 mg from Simplex®. The vancomycin released for 24 hours was 0.34±0.17 mg from Palacos® cement, 0.68±0.16 mg from LimaCMT1® and 0.17±0.02 mg from Simplex®. After this time the release stopped. The simulation study shows that during the first 72 hours, the antibiotic coverage would depends on the bone cement, the sensitivity of the microorganism and postoperative day. At subsequence times, it is expected that local bioactivity increases.


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 | Year: 2015

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..


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 | Year: 2011

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.


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 | Year: 2014

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.


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 | Year: 2013

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.


Moro-Valdezate D.,Hospital Clinico Universitario Of Valencia | Peiro S.,Superior Services | Buch-Villa E.,Hospital Of Sagunto | Caballero-Garate A.,Hospital Clinico Universitario Of Valencia | And 4 more authors.
Journal of Breast Cancer | Year: 2013

Purpose: The objective of this study was to describe the evolution of health-related quality of life (HRQOL) in a cohort of breast cancer patients over 1 year after surgery and to analyse the predictive ability of HRQOL measurement instruments. Methods: Observational, multicenter and prospective study of a cohort of breast cancer patients, assessing HRQOL at 1, 6, and 12 months after surgery using three questionnaires: EuroQol-5D-3L, EORTC QLQ-C30, and EORTC QLQ-BR23. Results: A total of 364 women participated in the study. Visual Analogue Scale (VAS) scores from the EuroQol improved (1 month vs. 1 year: 70 vs. 80; p<0.0001); however, the EuroQol score showed no significant change (0.81 vs. 0.83; p=0.1323). In contrast, Global Health Status on the EORTC QLQ-C30 improved (66.67 vs. 100.00; p<0.0001), as did all of this instrument ́s scales and most of its independent items. The EORTC QLQ-BR23 dimensions showed improvement, except for sexual functioning (100.00 vs. 86.67; p=0.0030) and future perspective (33.33 vs. 66.67; p<0.0001). Patients with good HRQOL outcomes at 1 month showed improved levels of HRQOL at 1 year; HRQOL measured at 1 month was predictive of HRQOL at 1 year. Conclusion: HRQOL improved during the follow-up period. Likewise, HRQOL measu- rement instruments can predict early HRQOL. © 2013 Korean Breast Cancer Society. All rights reserved.


Moro-Valdezate D.,Hospital Clinico Universitario Of Valencia | Moro-Valdezate D.,National University of General San Martín | Buch-Villa E.,Hospital Of Sagunto | Peiro S.,Superior Services | And 5 more authors.
Breast Cancer | Year: 2014

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.


Bernat Garcia J.,Hospital Universitario Doctor Peset Of Valencia | Fuertes Prosper A.,Hospital Universitario Doctor Peset Of Valencia | Marti Ibor E.,Hospital Universitario Doctor Peset Of Valencia | Marquina Vila A.,Hospital Universitario Doctor Peset Of Valencia
Dermatology Online Journal | Year: 2014

Infantile digital fibromatosis is a rare benign fibro/myofibroblastic proliferation that almost only occurs on the fingers and toes. It is characterized by bright, round, intracytoplasmic, eosinophilic inclusions. We present a case of infantile digital fibromatosis in a 6-years-old child. © 2014 by the article author(s).


PubMed | Polytechnic University of Valencia and Hospital Universitario Doctor Peset Of Valencia
Type: Journal Article | Journal: The Journal of arthroplasty | Year: 2015

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 g/mL in 100% of the patients. After drain removal, it is expected that bioactivity would increase since drug clearance from implant would decrease.

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