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Hospital de Órbigo, Spain

Viasus D.,Hospital Universitari Of Bellvitge Idibell
Expert review of anti-infective therapy

Early identification of patients with community-acquired pneumonia (CAP) at risk of poor outcome is critical for defining site of care and may impact on hospital resource consumption and prognosis. The Pneumonia Severity Index and CURB-65 are clinical rules that accurately identify individuals at risk of death. However, these scores have some limitations. Therefore in recent years, increasing attention has been being paid to research on biomarkers, since they have the potential to resolve fundamental issues regarding prognostic prediction that cannot be readily addressed using CAP-specific scores. Nevertheless, the use of biomarkers in this context needs to be validated in prospective trials so as to elucidate how they can best be applied in practice. This review examines the usefulness of biomarkers, whether used alone or in conjunction with other clinical severity of illness scores, for identifying CAP patients at risk of short- and long-term mortality and for predicting both the need for intensive care unit admission and the potential for treatment failure. Source

Felipe A.,University of Barcelona | Bielanska J.,University of Barcelona | Comes N.,University of Barcelona | Vallejo A.,University of Barcelona | And 5 more authors.
Current Medicinal Chemistry

Potassium channels (KCh) are a diverse group of membrane proteins that participate in the control of the membrane potential. More than eighty different KCh genes have been identified, which are expressed in virtually all living cells. In addition to nerve and cardiac action potentials, these proteins are involved in a number of physiological processes, including cell volume regulation, apoptosis, immunomodulation and differentiation. Furthermore, many KCh have been reported to play a role in proliferation and cell cycle progression in mammalian cells, and an important number of studies report the involvement of KCh in cancer progression. The voltagedependent potassium (Kv) channels, in turn, form the largest family of human KCh, which comprises about 40 genes. Because Kv1.3 and Kv1.5 channels modulate proliferation of different mammalian cells, these proteins have been analyzed in a number of tumors and cancer cells. In most cancers, the expression patterns of Kv1.3 and Kv1.5 are remodeled, and in some cases, a correlation has been established between protein abundance and grade of tumor malignancy. The list of cancers evaluated is constantly growing, indicating that these proteins may be future targets for treatment. The aim of this review is to provide an updated overview of Kv1.3 and Kv1.5 channels during cancer development. Unlike Kv1.5, Kv1.3 is characterized by a very selective and potent pharmacology, which could lead to specific pharmacological targeting. Because potassium channels may play a pivotal role in tumor cell proliferation, these proteins should be taken into account when designing new cancer treatment strategies. © 2012 Bentham Science Publishers. Source

Ferreiro J.L.,Jacksonville University | Ferreiro J.L.,Hospital Universitari Of Bellvitge Idibell | Bhatt D.L.,Harvard University | Ueno M.,Jacksonville University | And 2 more authors.
Journal of the American College of Cardiology

Objectives: The goal of this study was to investigate the differential efficacy of clopidogrel or aspirin monotherapy according to smoking status in patients with atherosclerotic vascular disease. Background: Smoking enhances clopidogrel-induced platelet inhibition, which may explain the higher relative benefit among smokers observed in trials evaluating dual antiplatelet therapy. Whether smoking has an impact on clinical outcomes in patients requiring a single antiplatelet agent remains unknown. Methods: This was a post-hoc analysis of the CAPRIE (Clopidogrel Versus Aspirin in Patients at Risk of Ischemic Events) trial that compared clopidogrel and aspirin monotherapy in patients (N = 19,184) with atherosclerotic vascular disease. Results: Current smokers (n = 5,688) had an increased risk of ischemic events compared with never smokers (n = 4,135; hazard ratio [HR]: 1.24 [95% confidence interval (CI): 1.08 to 1.42]) and ex-smokers (n = 9,381; HR: 1.32 [95% CI: 1.18 to 1.47]) (p < 0.001). Clopidogrel was associated with a reduction in ischemic events among current smokers (8.3% vs. 10.8%; HR: 0.76 [95% CI: 0.64 to 0.90]), whereas no benefit over aspirin was seen in the combined group of ex-smokers/never-smoked patients (10.4% vs. 10.6%; HR: 0.99 [95% CI: 0.89 to 1.10]; p = 0.01 for interaction). Among current smokers, clopidogrel also reduced myocardial infarction, vascular death, and death from any cause compared with aspirin. No interaction between smoking status and study treatment was observed for bleeding events. Conclusions: In a post-hoc analysis of the CAPRIE population, current smokers appeared to have enhanced benefit with clopidogrel therapy for secondary prevention compared with aspirin. These results should be considered hypothesis generating for future prospective studies assessing the impact of specific platelet-inhibiting strategies according to smoking status. © 2014 by the American College of Cardiology Foundation Published by Elsevier Inc. Source

Corominas M.,Hospital Universitari Of Bellvitge Idibell | Gastaminza G.,University of Navarra | Lobera T.,Hospital San Pedro San Millan
Journal of Investigational Allergology and Clinical Immunology

Strictly speaking, biological drugs are defined as drugs obtained using biotechnology that act on the immune system. They encompass monoclonal antibodies, fusion proteins, and cytokines. Although they are restricted to specific diseases, they have been increasingly used in recent years, with the consequent reporting of adverse reactions, many of which occur during the postmarketing phase. Because of the characteristics of adverse reactions, a new classification has been proposed. Hypersensitivity reactions are beta-type reactions and include infusion reactions and injection site reactions. In some cases, an immune mechanism mediated by IgE, IgG, or T cells is involved. Clinical symptoms vary widely, from skin reactions to anaphylaxis. Diagnostic studies are based on skin tests and in vitro tests (specific IgE, basophil activation test). Most are not standardized and are conducted in small groups of patients, thus making it impossible to obtain sensitivity and specificity values. With some biological drugs, desensitization protocols have proven successful. In this review, we discuss hypersensitivity reactions to biological drugs and the diagnostic tests used to assess these reactions. © 2014 Esmon Publicidad. Source

Espinal P.,University of Barcelona | Marti S.,Hospital Universitari Of Bellvitge Idibell | Vila J.,University of Barcelona
Journal of Hospital Infection

Background: Acinetobacter baumannii is emerging as an important hospital pathogen, which can persist in the environment for extended periods of time. It is known to produce biofilms, a community of bacteria enclosed within a protective polymeric matrix. Aim: To establish whether the effect of biofilm formation by Acinetobacter baumannii may be associated with persistence in the hospital environment. Methods: The effect of biofilm formation on the survival of A. baumannii on dry surfaces was investigated in biofilm-forming compared to non-biofilm-forming strains. Survival assays were determined by viable counts of the cells inoculated on to glass cover slips and stored under controlled conditions of temperature and relative humidity. Findings: The survival times for the biofilm-forming strains were longer than for the non-biofilm-forming ones (36 vs 15 days, respectively, P< 0.001). Scanning and transmission electron microscopy studies showed a polysaccharide layer and appendages in the biofilm-forming strains, not in the non-biofilm forming ones. Conclusion: Biofilm formation increases the survival rate of A. baumannii on dry surfaces and may contribute to its persistence in the hospital environment, increasing the probability of causing nosocomial infections and outbreaks. © 2011 The Healthcare Infection Society. Source

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