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Burillo A.,Hospital Universitario Of Mostoles | Bouza E.,Complutense University of Madrid | Bouza E.,Hospital General Universitario Gregorio Maranon | Bouza E.,CIBER ISCIII
Infectious Disease Clinics of North America | Year: 2010

Chlamydophila pneumoniae is estimated to cause about 10% of community-acquired pneumonia (CAP) cases and 5% of bronchitis cases, although most patients with C pneumoniae infection are asymptomatic, and the course of respiratory illness is relatively mild. The incubation period of C pneumoniae infection is around 21 days, and such symptoms as cough and malaise show a gradual onset, yet may persist for several weeks or months despite appropriate antibiotic therapy. Diagnosis by nasopharyngeal specimen culture, serum antibody titers, or molecular techniques is usually delayed with respect to the onset of symptoms, antibiotic treatment, or disease resolution and there is no accurate, standardized, commercial US Food and Drug Administration-cleared diagnostic method available. Erythromycin, tetracycline, and doxycycline are used as first-line therapy, although some investigators report no clinical or survival benefits from treating CAP caused by atypical pathogens. Meanwhile, adequate prospective studies have met with ethical and logistic barriers. Despite these limitations, North American guidelines recommend the antimicrobial treatment of patients with acute C pneumoniae respiratory infection. © 2010.

Caudevilla-Galligo F.,Grupo de Intervencion en Drogas | Caudevilla-Galligo F.,University of Las Palmas de Gran Canaria | Ventura M.,University of Las Palmas de Gran Canaria | Indave Ruiz B.I.,University of Las Palmas de Gran Canaria | And 2 more authors.
Human Psychopharmacology | Year: 2013

Objective: The aim of this study was to describe the presence and composition of cathinone derivatives (CDs) in drug samples analyzed at a Drug Testing Service. Material and methods: Data provided by the Drug Testing Service at Energy Control (a Spanish organization working in risk reduction among recreational drug users) were obtained from samples delivered as, or containing CDs, between January 2010 and June 2012. Specimens were identified by combining thin layer chromatography and gas chromatography associated with mass spectrometry. Results: Two hundred and thirty-seven (3.8%) of the 6199 samples were delivered as, or contained CDs. 22 different CDs were detected, alone or in different combinations. Methylone (24.9%), mephedrone (24.5%), 4-methylethcathinone (9.28%), and methylenedioxypyrovalerone (6.8%) were the most common CDs. These substances were also found in 80 (1.3%) of 6042 samples delivered allegedly containing drugs different from CDs (such as 3,4-methylenedioxy-N-methylamphetamine (MDMA), amphetamines, ketamine⋯). Conclusions: Cathinone derivatives were markedly present in the Spanish drug market during the studied period. There is no evidence to conclude that use of CDs will become widespread or relevant for public health, but the phenomenon must be followed, as the potential risks of these new drugs of abuse are substantial. Copyright © 2013 John Wiley & Sons, Ltd.

Fernandez-Espartero M.C.,Hospital Universitario Of Mostoles | Perez-Zafrilla B.,Complejo Hospitalario Universitario Of Albacete | Naranjo A.,Hospital de Gran Canaria Dr Negrin | Esteban C.,Pharmacovigilance Center | And 3 more authors.
Seminars in Arthritis and Rheumatism | Year: 2011

Objectives: To estimate the rate of demyelinating diseases in patients with rheumatic diseases treated with tumor necrosis factor (TNF) antagonists and to describe the cases reported to 3 different pharmacovigilance sources. Methods: All confirmed cases of demyelinating disease, optic neuritis, and multiple sclerosis (MS) in patients with rheumatic diseases treated with TNF-antagonists were reviewed from 3 different sources: (1) the Spanish Registry of biological therapies in rheumatic diseases (BIOBADASER); (2) the Spanish Pharmacovigilance Database of Adverse Drug Reactions (FEDRA); and (3) a systematic review (PubMed, EMBASE, and the Cochrane Library). In BIOBADASER, the incidence rate per 1000 patients was estimated with a 95% confidence interval (95%CI). Results: In 21,425 patient-years in BIOBADASER, there were 9 patients with confirmed demyelinating disease, 4 with optic neuritis, and 1 with MS. In addition, 22 patients presented polyneuropathies, paresthesias, dysesthesias, facial palsy, or vocal cord paralysis without confirmed demyelination. The incidence rate of demyelinating disease in patients with rheumatic diseases exposed to TNF antagonists in BIOBADASER was 0.65 per 1000 patient-years (95%CI: 0.39-1.1). The incidence of MS in BIOBADASER was 0.05 (95%CI: 0.01-0.33), while the incidence in the general Spanish population was 0.02 to 0.04 cases per 1000. Compared with BIOBADASER, cases in FEDRA (n = 19) and in the literature (n = 48) tend to be younger, have shorter exposure to TNF-antagonists, and recover after discontinuation of the drug. Conclusions: It is not clear whether TNF antagonists increase the incidence of demyelinating diseases in patients with rheumatic diseases. Differences between cases depending on the pharmacovigilance source could be explained by selective reporting bias outside registries. © 2011 Elsevier Inc.

Naredo E.,Complutense University of Madrid | Naredo E.,Hospital Universitario Severo Ochoa | Uson J.,Hospital Universitario Of Mostoles | Jimenez-Palop M.,Hospital Puerta de Hierro | And 11 more authors.
Annals of the Rheumatic Diseases | Year: 2014

Objective: The primary objective of this prospective case-control study was to assess the diagnostic value of several intra-articular and periarticular ultrasound (US)- detected abnormalities in the upper and lower limbs in gout. The secondary objective was to test the concurrent validity of US abnormalities using as gold standard the microscopic demonstration of monosodium urate (MSU) crystals. Methods: Ninety-one men with gout and 42 agematched controls were prospectively recruited. All patients with gout and controls underwent US assessment of several US abnormalities in 26 joints, six bursae, eight tendons, 20 tendon compartments, four ligaments, and 18 articular cartilages by experts in US blinded to the patients' group. Patients with gout and controls with US abnormalities were asked to undergo US-guided aspiration for microscopic identification of MSU crystals. Interobserver and intraobserver reliability of the US assessment was evaluated in a web-based exercise. Results: The assessment of one joint (ie, radiocarpal joint) for hyperechoic aggregates (HAGs), two tendons (ie, patellar tendon and triceps tendon) for HAGs and three articular cartilages (ie, first metatarsal, talar and second metacarpal/femoral) for double contour sign showed the best balance between sensitivity and specificity (84.6% and 83.3%, respectively). Intraobserver reliability was good (mean κ 0.75) and interobserver reliability was moderate (κ 0.52). The aspirated material from HAGs was positive for MSU crystals in 77.6% of patients with gout and negative in all controls. Conclusions: Our results suggest that US bilateral assessment of one joint, three articular cartilages and two tendons may be valid for diagnosing gout with acceptable sensitivity and specificity.

Tejero R.,CSIC - Institute of Polymer Science and Technology | Lopez D.,CSIC - Institute of Polymer Science and Technology | Lopez-Fabal F.,Hospital Universitario Of Mostoles | Gomez-Garces J.L.,Hospital Universitario Of Mostoles | Fernandez-Garcia M.,CSIC - Institute of Polymer Science and Technology
Biomacromolecules | Year: 2015

Two series of antimicrobial polymethacrylates (PMTAs) bearing mono and bis-cationic quaternary ammonium cations (QUATs) were prepared by controlled N-alkylation of 1,3-thiazole and 1,2,3-triazole pendant groups with butyl iodide (PMTAs-BuI). The degree of quaternization (DQ) of the azole heterocycles was monitored by 1H NMR spectroscopy over a wide range of reaction times. Spectra analysis of the 1H NMR aromatic region allowed to characterize and quantify the different species involved and, therefore, to control the chemical composition distribution of the amphiphilic polycations. The polymer charge density and the hydrodynamic sizes were measured by zeta potential and dynamic light scattering (DLS), respectively. Consequently, the relationship between structure and antibacterial properties and toxicity was studied. Interestingly, these polyelectrolytes present excellent selective toxicity against bacteria being nonhemolytic even at low values of DQ. Furthermore, they were also evaluated for their microbial time-killing efficiency, presenting a 3 log-reduction in only 15 min. Additionally, the bacteria cell morphology treated with PMTAs-BuI was analyzed. © 2015 American Chemical Society.

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