Hospital de Órbigo, Spain
Hospital de Órbigo, Spain

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Figa R.,University of Barcelona | Muneton D.,Autonomous University of Barcelona | Gomez L.,Mutua Of Terrassa University Hospital | Matamala A.,University of Barcelona | And 3 more authors.
Anaerobe | Year: 2017

Objective To compare a series of monomicrobial Propionibacterium acnes (P. acnes) knee and hip periprosthetic joint infection (PJI) cases with cases of polymicrobial PJI which included P. acnes. We hypothesized that the presence of a polymicrobial P. acnes infection would lead to worse outcomes than those in cases of monomicrobial P. acnes PJI. Methods Retrospective multicentre study. All patients with hip or knee PJIs including P. acnes diagnosed from August-2002 to July-2013 in two university hospitals were included. We collected demographic data, McPherson classification, local signs of infection (swelling or wound drainage), laboratory and histological data, surgical management, antibiotic treatment and outcomes. Data were compared between two groups: cases of monomicrobial P. acnes PJI, and cases of polymicrobial PJI involving P. acnes. Results Thirty-eight patients who presented with 38 PJIs were included; median age was 71 (IQR:62.5–79); 21 were men (55%); median follow-up was 42 months (IQR:17.5–58). Local signs of infection were present in 14 patients (36.8%); ESR>30 mm/h in 14 patients (36.8%); CRP>1 mg/dl in 15 patients (39.5%); 11 out of 25 patients (44%) had positive preoperative cultures from joint aspiration. Positive histologic studies (Feldman's criteria) were found in 5 out of 28 patients (17.8%). Twenty-four patients (63%) had monomicrobial PJIs; 14 patients (37%) had polymicrobial PJIs. There were no significant outcome differences between monomicrobial and polymicrobial PJIs cases; overall, the success rates were 79.2% and 85.7% respectively (P > 0.05). Conclusions We did not find any significant differences between monomicrobial and polymicrobial P. acnes PJI outcomes. ESR, CRP and histologic study are established parameters for diagnosing PJI which did not prove useful in P. acnes PJI. © 2017 Elsevier Ltd


Lapuente A.,Mutua Of Terrassa University Hospital | Garcia M.E.,Menarini Pharmaceutical | Padilla F.,Mutua Of Terrassa University Hospital | Heredia J.L.,Mutua Of Terrassa University Hospital | Soriano J.B.,Autonomous University of Madrid
International Journal of COPD | Year: 2015

Background: Retrospective studies based on clinical data and without spirometric confirmation suggest a poorer prognosis of patients with ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) following percutaneous coronary intervention (PCI). The impact of undiagnosed COPD in these patients is unknown. We aimed to evaluate the prognostic impact of COPD – previously or newly diagnosed – in patients with IHD treated with PCI. Methods: Patients with IHD confirmed by PCI were consecutively included. After PCI they underwent forced spirometry and evaluation for cardiovascular risk factors. All-cause mortality, new cardiovascular events, and their combined endpoint were analyzed. Results: A total of 133 patients (78%) male, with a mean (SD) age of 63 (10.12) years were included. Of these, 33 (24.8%) met the spirometric criteria for COPD, of whom 81.8% were undiagnosed. IHD patients with COPD were older, had more coronary vessels affected, and a greater history of previous myocardial infarction. Median follow-up was 934 days (interquartile range [25%–75%]: 546–1,160). COPD patients had greater mortality (P=0.008; hazard ratio [HR]: 8.85; 95% confidence interval [CI]: 1.76–44.47) and number of cardiovascular events (P=0.024; HR: 1.87; 95% CI: 1.04–3.33), even those without a previous diagnosis of COPD (P=0.01; HR: 1.78; 95% CI: 1.12–2.83). These differences remained after adjustment for sex, age, number of coronary vessels affected, and previous myocardial infarction (P=0.025; HR: 1.83; 95% CI: 1.08–3.1). Conclusion: Prevalence and underdiagnosis of COPD in patients with IHD who undergo PCI are both high. These patients have an independent greater mortality and a higher number of cardiovascular events during follow-up. © 2015, Almagro et al.


Camacho-Garcia R.J.,University of Seville | Hervas A.,Mutua Of Terrassa University Hospital | Toma C.,University of Barcelona | Toma C.,Biomedical Network Research Center on Rare Diseases | And 5 more authors.
Psychiatric Genetics | Year: 2013

Neurexins are synaptic plasma membrane proteins encoded by three genes (NRXN1, -2, -3) with alternative promoters. Mutations in neurexin genes have been identified in different neurodevelopmental disorders, including autism. Recently, two point mutations altering the translation initiation site of NRXN1β (c.-3G>T and c.3G>T) have been described in patients with autism and mental retardation. In this study, we analyzed the NRXN1β gene in a sample of 153 patients with autism. We report the identification of a novel mutation, c.3G>A (p.Met1), affecting the translation initiation site. Expression analysis showed that the c.3G>A mutation switches the translation start site of NRXN1β to an in-frame downstream methionine and decreases synaptic levels of the mutant protein in cultured neurons. These data reinforce a role for synaptic defects of NRXN1β in neurodevelopmental disorders. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


PubMed | Autonomous University of Madrid, Mutua Of Terrassa University Hospital and Menarini Pharmaceutical
Type: | Journal: International journal of chronic obstructive pulmonary disease | Year: 2015

Retrospective studies based on clinical data and without spirometric confirmation suggest a poorer prognosis of patients with ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) following percutaneous coronary intervention (PCI). The impact of undiagnosed COPD in these patients is unknown. We aimed to evaluate the prognostic impact of COPD - previously or newly diagnosed - in patients with IHD treated with PCI.Patients with IHD confirmed by PCI were consecutively included. After PCI they underwent forced spirometry and evaluation for cardiovascular risk factors. All-cause mortality, new cardiovascular events, and their combined endpoint were analyzed.A total of 133 patients (78%) male, with a mean (SD) age of 63 (10.12) years were included. Of these, 33 (24.8%) met the spirometric criteria for COPD, of whom 81.8% were undiagnosed. IHD patients with COPD were older, had more coronary vessels affected, and a greater history of previous myocardial infarction. Median follow-up was 934 days (interquartile range [25%-75%]: 546-1,160). COPD patients had greater mortality (P=0.008; hazard ratio [HR]: 8.85; 95% confidence interval [CI]: 1.76-44.47) and number of cardiovascular events (P=0.024; HR: 1.87; 95% CI: 1.04-3.33), even those without a previous diagnosis of COPD (P=0.01; HR: 1.78; 95% CI: 1.12-2.83). These differences remained after adjustment for sex, age, number of coronary vessels affected, and previous myocardial infarction (P=0.025; HR: 1.83; 95% CI: 1.08-3.1).Prevalence and underdiagnosis of COPD in patients with IHD who undergo PCI are both high. These patients have an independent greater mortality and a higher number of cardiovascular events during follow-up.


Abad-Corpa E.,Zone VI Management Vega Media Del Segura | Abad-Corpa E.,Carlos III Health Institute | Gonzalez-Gil T.,Rey Juan Carlos University | Barderas-Manchado A.M.,Carlos III Health Institute | And 4 more authors.
BMC Geriatrics | Year: 2010

Background: Dealing with dependency in the elderly and their families leads us to explore the life experience of those involved together with the processes of adaptation to this condition. A number of original studies have been published which, following a qualitative methodology, have dealt with both dimensions. Methods/Design: Objectives: 1) To present a synthesis of the qualitative evidence available on the process of adaptation to dependency in elderly persons and their families; 2) to conduct an in-depth study into the experiences and strategies developed by both to optimise their living conditions; 3) to enable standards of action/intervention to be developed in the caregiving environment. A synthesis of qualitative studies is projected with an extensive and inclusive bibliography search strategy. The primary search will focus on the major databases (CINAHL, MEDLINE, EMBASE, PsycInfo, PSICODOC, Cochrane Library, JBI, EMBASE, LILACS, CUIDEN, CUIDEN qualitative, CUIDATGE, British Nursing Index, SSCI). The secondary search will be conducted in articles taken from the references to studies identified in the articles and reports and the manual search in congresses and foundation papers. Article quality will be assessed by the guide proposed by Sandelowski & Barroso and data extraction done using the QARI data extraction form proposed by the Joanna Briggs Institute for Evidence-Based Practice. The synthesis of the findings will be based on the principles and procedures of grounded theory: coding, identification and relationship between categories, and synthesis using constant comparison as a strategy. Discussion: This synthesis of qualitative evidence will enable us to detect health needs as perceived by the receivers in their own interaction contexts. © 2010 Abad-Corpa et al; licensee BioMed Central Ltd.

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