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Hospital de Órbigo, Spain

Ochoa E.M.,Regional Ministry of Health | Gomez-Acebo I.,University of Cantabria | Rodriguez-Cundin P.,Sierrallana Hospital | Navarro-Cordoba M.,Marques de Valdecilla Hospital | And 2 more authors.
Behavioral Medicine | Year: 2010

This article explores the relationship between family history of breast cancer (FHBC) and health-related behavior and medical management, using a cross-sectional analysis of 685 women, based on self-report. The influence of FHBC on lifestyle (alcohol use, physical activity, weight and diet) and medical management decisions (screening for chronic diseases) was assessed using odds ratios (OR) and 95% confidence interval (CI). Adjustment for confounders was performed using unconditional logistic regression. Sixty five women (9.5%) reported relatives with breast cancer. Women with FHBC are more likely to have had a mammography and colonoscopy or sigmoidoscopy. These women have about twice the probability of performing more intense physical exercise, contrasting with high-risk women whose consumption of fibre is lower and sweets is higher. No significant association was found between alcohol consumption or Body Mass Index and family history. Spontaneous behavioral change to a more preventive lifestyle in relatives of cancer patients is very low. © Taylor & Francis Group, LLC.

Galindo-Izquierdo M.,Rheumatology Unit Hospital Universitario 12 Of Octubre | Rodriguez-Almaraz E.,Rheumatology Unit Hospital Universitario 12 Of Octubre | Pego-Reigosa J.M.,University of Vigo | Lopez-Longo F.J.,Gregorio Maranon University Hospital | And 41 more authors.
Medicine (United States) | Year: 2016

The aim of the study was to profile those patients included in the RELESSER registry with histologically proven renal involvement in order to better understand the current state of lupus nephritis (LN) in Spain. RELESSER-TRANS is a multicenter cross-sectional registry with an analytical component. Information was collected from the medical records of patients with systemic lupus erythematosus who were followed at participating rheumatology units. A total of 359 variables including demographic data, clinical manifestations, disease activity, severity, comorbidities, LN outcome, treatments, and mortality were recorded. Only patients with a histological confirmation of LN were included.We performed a descriptive analysis, chi-square or Student's t tests according to the type of variable and its relationship with LN. Odds ratio and confidence intervals were calculated by using simple logistic regression. LN was histologically confirmed in 1092/3575 patients (30.5%). Most patients were female (85.7%), Caucasian (90.2%), and the mean age at LN diagnosis was 28.4-12.7 years. The risk for LN development was higher in men (M/F:47.85/30.91%, P<0.001), in younger individuals (P<0.001), and in Hispanics (P=0.03). Complete response to treatment was achieved in 68.3% of patients; 10.35% developed ESRD, which required a kidney transplant in 45% of such cases. The older the patient, the greater was the likelihood of complete response (P<0.001). Recurrences were associated with persistent lupus activity at the time of the last visit (P<0.001) and with ESRD (P<0.001). Thrombotic microangiopathy was a risk factor for ESRD (P=0.04), as for the necessity of dialysis (P=0.01) or renal transplantation (P=0.03). LN itself was a poor prognostic risk factor of mortality (OR 2.4 [1.81-3.22], P<0.001). Patients receiving antimalarials had a significantly lower risk of developing LN (P<0.001) and ESRD (P<0.001), and responded better to specific treatments for LN (P=0.014). More than two-thirds of the patients with LN from a wide European cohort achieved a complete response to treatment. The presence of positive anti-Sm antibodies was associated with a higher frequency of LN and a decreased rate of complete response to treatment. The use of antimalarials reduced both the risk of developing renal disease and its severity, and contributed to attaining a complete renal response. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Martinez-Garcia M.A.,Polytechnic University of Valencia | Martinez-Garcia M.A.,CIBER ISCIII | Campos-Rodriguez F.,University of Seville | Duran-Cantolla J.,Alava University Hospital | And 20 more authors.
Sleep Medicine | Year: 2014

Objective: The association between obstructive sleep apnea (OSA) and cancer mortality has scarcely been studied. The objective of this study was to investigate whether OSA is associated with increased cancer mortality in a large cohort of patients with OSA suspicion. Methods: This was a multicenter study in consecutive patients investigated for suspected OSA. OSA severity was measured by the apnea-hypopnea index (AHI) and the hypoxemia index (% night-time spent with oxygen saturation <90%, TSat90). The association between OSA severity and cancer mortality was assessed using Cox's proportional regression analyses after adjusting for relevant confounders. Results: In all, 5427 patients with median follow-up of 4.5years were included. Of these, 527 (9.7%) were diagnosed with cancer. Log-transformed TSat90 was independently associated with increased cancer mortality in the entire cohort (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.03-1.42), as well as in the group of patients with cancer (HR, 1.19; 95% CI, 1.02-1.41). The closest association was shown in patients <65years in both the AHI (continuous log-transformed AHI: HR, 1.87; 95% CI, 1.1-3.2; upper vs lower AHI tertile: HR, 3.98; 95% CI, 1.14-3.64) and the TSat90 (continuous log-transformed TSat90: HR, 1.73; 95% CI, 1.23-2.4; upper vs lower TSat90 tertile: HR, 14.4; 95% CI, 1.85-111.6). Conclusions: OSA severity was associated with increased cancer mortality, particularly in patients aged <65. years. © 2014 Elsevier B.V..

Rello J.,Hospital Universitari Vall dHebron | Rello J.,Ciberes Research Center Biomedica En Red Of Enfermedades Respiratorias | Rello J.,Autonomous University of Barcelona | Gattarello S.,Hospital Universitari Vall dHebron | And 63 more authors.
Medicina Intensiva | Year: 2013

Objectives: To compare intensive care unit (ICU) mortality in patients with severe community-acquired pneumonia (SCAP) caused by Legionella pneumophila receiving combined therapy or monotherapy. Methods: A prospective multicenter study was made, including all patients with sporadic, community-acquired Legionnaires' disease (LD) admitted to the ICU. Admission data and information on the course of the disease were recorded. Antibiotic prescriptions were left to the discretion of the attending physician and were not standardized. Results: Twenty-five cases of SCAP due to L. pneumophila were included, and 7 patients (28%) out of 25 died after a median of 7 days of mechanical ventilation. Fifteen patients (60%) presented shock. Levofloxacin and clarithromycin were the antibiotics most commonly used in monotherapy, while the most frequent combination was rifampicin plus clarithromycin. Patients subjected to combination therapy presented a lower mortality rate versus patients subjected to monotherapy (odds ratio for death [OR] 0.15; 95%CI 0.02-1.04; p=. 0.08). In patients with shock, this association was stronger and proved statistically significant (OR for death 0.06; 95%CI 0.004-0.86; p=. 0.04). Conclusions: Combined antibiotic therapy decreases mortality in patients with SCAP and shock caused by L. pneumophila. © 2012 Elsevier España, S.L. and SEMICYUC.

Llorenc V.,Clinic Institute of Ophthalmology ICOF | Mesquida M.,Clinic Institute of Ophthalmology ICOF | Sainz De La Maza M.,Clinic Institute of Ophthalmology ICOF | Blanco R.,Marques de Valdecilla Hospital | And 5 more authors.
Ocular Immunology and Inflammation | Year: 2016

Purpose: To study the efficacy and tolerance of certolizumab pegol (CZP) in active uveitis.Methods: Retrospective case series at 4 referral centers. Patients treated with CZP for active uveitis during at least 6 months were eligible. Inflammation by SUN scores, visual acuity (VA) (logMAR), and central macular thickness (CMT) were compared from baseline until final follow-up. Quiescence was defined as 0+ to 0.5+ in anterior chamber and vitreous haze scores and no CMT increase.Results: Four males and 3 females (14 eyes) were included, mean age 42.4 ± 8.8 years. All were long-lasting chronic-relapsing uveitis with prior failure to other anti-TNF-α. After a mean follow-up of 10.4 ± 4.8 months, 5/7 patients (71.4%) achieved quiescence with CZP. VA improved significantly from +0.52 ± 0.68 to +0.45 ± 0.68 (p = 0.032) at 1 month and to +0.44 ± 0.64 (p = 0.035) at 6 months. No adverse events were found.Conclusion: CZP can be an effective alternative in refractory uveitis. © 2016 Taylor & Francis Group, LLC.

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