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Cediel Calderon G, Lopez H, Domingo M, Codina P, Santiago E, Borrellas A, Gonzalez B, Rivas C, Crespo E, Pulido A, Velayos P, Barcelo E, Lupon J, Bayes-Genis A. Alcohol abstinence vs. persistent alcohol consumption in alcoholic cardiomyopathy: impact on long-term prognosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Alcoholic Cardiomyopathy (ACM) remains a prevalent form of toxic-induced heart damage. Whether ACM prognosis depends on the persistence of alcohol consumption is a matter of debate.
Purpose
We sought to determine predictors of adverse events during long-term follow-up and left ventricular ejection fraction (LVEF) changes between abstainers and non-abstainers.
Methods
Consecutive patients admitted to a HF clinic from 2001 to 2020 with ACM were included. The primary endpoint was the composite of all-cause death or HF hospitalization. HF hospitalization was analyzed as a secondary outcome. Changes in LVEF at 1- and 3-years follow-up according to discontinuation of alcohol consumption was also analyzed. Multivariable Cox regression analyses were performed using the competing risk strategy for the secondary endpoint.
Results
A total of 122 patients were included with a mean age of 57.8±10.0 years and 95.1% (n=116) of males. The mean LVEF was 27.5% ± 10.6 and 11.5% (n=14) exhibited NYHA functional class 3. A total of 92 (75.4%) patients remained abstinent during follow-up; the rest continued with at least moderate alcohol intake. After a median follow-up of 6.8 years (interquartile range: 3.2 to 11.3 years), 59 (48.4%) presented the primary endpoint (45 [36.9%] died and 34 [27.9%] experienced HF readmission). Independent predictors of the primary outcome were age (hazard ratio [HR]: 1.03; 95% confidence interval [CI]: 1.00–1.06; p=0.042), hemoglobin (HR: 0.68; 95% CI: 0.56–0.82; p<0.001) and alcohol abstinence (HR: 0.35; 95% CI: 0.20–0.61; p<0.001). Predictors of HF readmission were hemoglobin (HR: 0.65; 95% CI: 0.50–0.83; p=0.001) and alcohol abstinence (HR: 0.39; 95% CI: 0.17–0.92; p=0.032). Improvement in LVEF was higher in abstainers (27.5±10.6% from baseline to 46.7±13.1% and 49.1±14.3% at 1- and 3-years respectively) than in non-abstainers (27.8±10.3% to 40.3±14.0% and 39.2±16.3% at 1- and 3-years respectively), being these changes in LVEF significantly different between both groups (p=0.004).
Conclusions
Patients with ACM and who remain abstainers during follow-up exhibit better outcomes and higher LVEF improvement in comparison to non-abstainers. These findings should help to inform lifestyle modification for patients with ACM.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Cediel Calderon
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - H Lopez
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - M Domingo
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - P Codina
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Santiago
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - A Borrellas
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - B Gonzalez
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - C Rivas
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Crespo
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - A Pulido
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - P Velayos
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Barcelo
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - J Lupon
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - A Bayes-Genis
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
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2
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Gonzalez B, Zamora E, Rivas C, Pulido A, Crespo E, Velayos P, Diaz V, Altabella M, Bares D, Codina P, Domingo M, Santiago-Vacas E, Cediel G, Lupon J, Bayes-Genis A. Quality of life in patients with heart failure and improved ejection fraction: one year changes and prognostic implication. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Inconsistent and controversial results have been reported about the association of quality of life (QoL) and left ventricular ejection fraction (LVEF) in patients with heart failure (HF). The 2021 universal definition of HF specifically describes the criteria for the patients with HF and improved LVEF (HFimpEF): HF with a baseline LVEF ≤40%, a ≥10 point increase from baseline LVEF, and a second measurement of LVEF >40%.
Purpose
1) To assess whether patients with HF and reduced LVEF (HFrEF) at first visit in an outpatient HF Clinic that fulfil the HFimpEF criteria one year later presented a higher improvement in QoL assessed by the Minnesota Living With Heart Failure Questionnaire (MLWHFQ) than those patients that did not fulfil HFimpEF criteria. 2) To assess the prognostic role of QoL on outcomes in HFimpEF patients.
Methods
In a prospective registry of real-life HF outpatients LVEF and QoL evaluated by MLWHFQ were assessed at first visit at the HF Clinic and at one year of follow-up.
Results
From August 2001 to August 2021, baseline and one year LVEF and MLWFQ scores were available in 1040 patients with an initial LVEF ≤40%. Table 1 shows baseline demographic and clinical characteristics of patients. In summary, mean age was 65.2±11.7 years, 75.9% of the patients were men, the main aetiology was ischaemic heart disease (52.9%) and patients were mostly in New York heart Association (NHYA) class II (71.1%) and III (21.6%). Baseline LVEF was 28.5% ± 7.3 and baseline MLWHFQ score was 30.2±19.5. At one year, mean LVEF increased to 38.0±12.2 while MLWHFQ scores improved to 17.4±16.0. There were 361 patients that fulfilled the HFimpEF criteria (34.7%). These patients significantly and markedly improved both LVEF (from 28.7±6.6 to 50.9±7.6, p<0.001) and QoL (from 32.9±20.6 to 16.9±16.0, p<0.001). Although in patients that did not fulfil the criteria of HFimpEF both LVEF (from 28.4±7.6 to 31.1±7.9, p<0.001) and QoL (from 28.7±18.8 to 17.6±15.9, p<0.001) also significantly improved, the improvement in QoL was significantly higher in HFimpEF patients (−16.0±23.8 vs. −11.1±20.3, p=0.001), taking into account that baseline MLWHFQ score was worse in HFimpEF patients (p=0.001). However, at one year QoL was similar when both groups were compared (p=0.50). MLWHFQ score at one year proved to be superior to QoL improvement (using a cut-off of at least 5 points) from the prognostic point of view.
Conclusions
QoL improved both in patients with and without HFimpEF criteria, and QoL perception at one year was similar in both groups, suggesting the influence of other factors other than LVEF in QoL perception. QoL at one year revealed to be superior to QoL changes from baseline from the prognostic point of view.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B Gonzalez
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - E Zamora
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - C Rivas
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - A Pulido
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - E Crespo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - P Velayos
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - V Diaz
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - M Altabella
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - D Bares
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - P Codina
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - M Domingo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | | | - G Cediel
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - J Lupon
- Germans Trias i Pujol Hospital , Badalona , Spain
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Roig T, Gonzalez B, Lopez Y, Rivas C, Arderiu A, Pulido A, Crespo E, Velayos P, Diaz V, Altabella M, Bares D, Barcelo E, Domingo M, Lupon J, Bayes-Genis A. How to screen frailty in outpatients with heart failure: multimodality assessment vs. the Vulnerable Elderly Survey 13 (VES-13) scale. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
During two decades we have been screening fragility in outpatients with heart failure (HF) with a multimodality assessment using several geriatric scales, showing that frailty or fragility is frequent in HF patients, even in young patients, and we demonstrated that this identified fragility played an important prognostic role. Frailty is a medical syndrome with multiple causes and contributors that increases outpatients' vulnerability so a minimal stress can cause functional impairment, with a major risk of dependency, even death. Frailty can be reversible or attenuated by interventions. Nowadays several specific scales for fragility or frailty detection are widely available. One of them, the Vulnerable Elderly Survey 13 (VES-13) has scarcely been used in HF.
Purpose
To assess the prevalence of fragility in an outpatient HF Clinic at first visit using both the VES-13 scale and a multimodality assessment that includes Barthel index, OARS scale, Pfeiffer test, and abbreviated Yesavage Geriatric Depression Scale of 4 items (GDS), and compare the two approaches
Methods
Nurses fulfilled the scales with the patients at their first visit. An scoring ≥3 in the VES-13 scale and the presence of one of the predefined criteria in the multimodality assessment (Barthel <90; OARS score <10 in women and <6 in men; Pfeiffer Test score >3±1, depending on educational level; one positive depression response in abbreviated GDS; and age >85 years or nobody to turn to for help) were considered to have fragility for the purpose of the study.
Results
From March 2021 to December 2021, 136 patients were evaluated with the two fragility screening modalities (mean age 68.8±10.8 years, 64% men, 46% from ischaemic aetiology, 65.4%/27.9% in NYHA class II/III, LVEF 39.5% ± 13.4). VES-13 identified 51 (37.5%) patients with fragility, while the multimodality assessment detected 45 (33.6%) patients. Barthel index and depressive symptoms in the GDS were the most altered items (19 and 20 patients respectively) in the multimodality assessment. Concordance between VES-13 and multimodality assessment was 83.8%, but Cohen's Kappa was 0.65, not reaching the suitable level of 0.70.
Conclusions
VES-13 was capable of identifying a higher number of patients with fragility at first visit in the routine screening performed in an outpatient HF clinic, than the multimodality assessment used in the last decades. Follow-up of patients and further analysis will allow evaluating which of these two approaches adds more value for outcomes prediction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Roig
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - B Gonzalez
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - Y Lopez
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - C Rivas
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - A Arderiu
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - A Pulido
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - E Crespo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - P Velayos
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - V Diaz
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - M Altabella
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - D Bares
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - E Barcelo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - M Domingo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - J Lupon
- Germans Trias i Pujol Hospital , Badalona , Spain
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Zamora E, González B, Lupón J, Borrellas A, Domingo M, Santiago‐Vacas E, Cediel G, Codina P, Rivas C, Pulido A, Crespo E, Velayos P, Diaz V, Bayes‐Genis A. Quality of life in patients with heart failure and improved ejection fraction: one-year changes and prognosis. ESC Heart Fail 2022; 9:3804-3813. [PMID: 35916351 PMCID: PMC9773756 DOI: 10.1002/ehf2.14098] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/16/2022] [Accepted: 07/20/2022] [Indexed: 01/19/2023] Open
Abstract
AIMS The criteria for patients with heart failure (HF) and improved ejection fraction (HFimpEF) are a baseline left ventricular ejection fraction (LVEF) ≤40%, a ≥10-point increase from baseline LVEF, and a second LVEF measurement >40%. We aimed to (i) assess patients with HF and reduced LVEF (HFrEF) at baseline and compare quality of life (QoL) changes between those that fulfilled and those that did not fulfil the HFimpEF criteria 1 year later and (ii) assess the prognostic role of QoL in patients with HFimpEF. METHODS We reviewed data from a prospective registry of real-world outpatients with HF that were assessed for LVEF and QoL at a first visit to the HF clinic and 1 year later. QoL was evaluated with the Minnesota Living with Heart Failure Questionnaire (MLWHFQ). The primary prognostic endpoint was the composite of all-cause death or HF hospitalization. RESULTS Baseline and 1-year LVEF and MLWFQ scores were available for 1040 patients with an initial LVEF ≤40% (mean age, 65.2 ± 11.7 years; 75.9% men). The main aetiology was ischaemic heart disease (52.9%), and patients were mostly in New York heart Association Classes II (71.1%) and III (21.6%). At baseline, the mean LVEF was 28.5% ± 7.3, and the mean MLWHFQ score was 30.2 ± 19.5. After 1 year, the mean LVEF increased to 38.0% ± 12.2, and the MLWHFQ scores improved to 17.4 ± 16.0. In 361 patients that fulfilled the HFimpEF criteria (34.7%), significant improvements were observed in both LVEF (from 28.7% ± 6.6 to 50.9% ± 7.6, P < 0.001) and QoL (from 32.9 ± 20.6 to 16.9 ± 16.0, P < 0.001). Patients that did not fulfil the HFimpEF criteria also showed significant improvements in LVEF (from 28.4% ± 7.6 to 31.1% ± 7.9, P < 0.001) and QoL (from 28.7 ± 18.8 to 17.6 ± 15.9, P < 0.001). However, the QoL improvement was significantly higher in the HFimpEF group (-16.0 ± 23.8 vs. -11.1 ± 20.3, P = 0.001), despite the worse mean baseline MLWHFQ score, compared with the non-HFimpEF group (P = 0.001). The 1-year QoL was similar between groups (P = 0.50). The 1-year MLWHFQ score was independently associated with outcomes; the hazard ratio for the composite endpoint was 1.02 (95% CI: 1.01-1.03, P = 0.006). In contrast, the QoL improvement (with a cut-off ≥5 points) was not independently associated with the composite outcome. CONCLUSIONS Patients with HFrEF showed improved QoL after 1 year, regardless of whether they met the HFimpEF criteria. The similar 1-year QoL perception between groups suggested that factors other than LVEF influenced QoL perception. The 1-year QoL was superior to the QoL change from baseline for predicting prognosis in patients with HFimpEF.
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Affiliation(s)
- Elisabet Zamora
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain,Department of MedicineUniversitat Autonoma de BarcelonaBarcelonaSpain,CIBERCVInstituto de Salud Carlos IIIMadridSpain
| | - Beatriz González
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Josep Lupón
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain,Department of MedicineUniversitat Autonoma de BarcelonaBarcelonaSpain,CIBERCVInstituto de Salud Carlos IIIMadridSpain
| | - Andrea Borrellas
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Mar Domingo
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Evelyn Santiago‐Vacas
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Germán Cediel
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Pau Codina
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain,Department of MedicineUniversitat Autonoma de BarcelonaBarcelonaSpain
| | - Carmen Rivas
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Ana Pulido
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Eva Crespo
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Patricia Velayos
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Violeta Diaz
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain
| | - Antoni Bayes‐Genis
- Heart Failure Clinic and Cardiology ServiceUniversity Hospital Germans Trias i PujolBarcelonaSpain,Department of MedicineUniversitat Autonoma de BarcelonaBarcelonaSpain,CIBERCVInstituto de Salud Carlos IIIMadridSpain
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5
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Casas I, Castellà L, Gimenez M, Pulido A, Sopena N, Ciércoles A, Mena G, Reina D, López R, Garcia-Quesada MJ. Impact of a multimodal intervention on compliance with hand hygiene among health care workers of a tertiary hospital. Med Clin (Barc) 2022; 159:426-431. [PMID: 35210097 DOI: 10.1016/j.medcli.2021.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/19/2021] [Accepted: 12/27/2021] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND OBJECTIVE Hand hygiene (HH) is the simplest and most effective measure for the prevention of infection related to healthcare. Despite this, compliance in healthcare professionals continues to be suboptimal. The aim of this study is to assess the impact of an expanded World Health Organization (WHO) multimodal strategy on HH compliance in healthcare personnel. MATERIAL AND METHODS A quasi-experimental before-after study was designed, carrying out the expanded WHO multimodal strategy in 2018, aimed at professionals in a tertiary hospital. In this strategy, apart from applying the 5 pillars of the WHO, a video was made, the administration of the WHO perceptions questionnaire and an incentive to the service/unit with better compliance, adding to the training a modality of practical workshops. The compliance percentages for 2017 and 2018 were compared. RESULTS In 2017, 1056 opportunities were observed, registering 631 HH actions, with global compliance of 60% (95% CI 56.7-62.7). In 2018, with 1481 opportunities observed and 1111 HH actions, compliance was 75% (95% CI 72.7-77.2) (P<.001). This compliance increased in all professional categories and in all indications. CONCLUSIONS The application of an expanded multimodal strategy has a positive impact on HH compliance. Strategies should be directed to the categories with the worst compliance and continuously over time.
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Affiliation(s)
- Irma Casas
- Servicio de Medicina Preventiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, España; Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Barcelona, España
| | - Laia Castellà
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
| | - Montse Gimenez
- Servicio de Microbiología, Laboratorio Clínico Metropolitana Norte, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Ana Pulido
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Nieves Sopena
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, España; Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Barcelona, España; Servicio de Enfermedades Infecciosas, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Anna Ciércoles
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Guillermo Mena
- Servicio de Medicina Preventiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, España; Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Barcelona, España
| | - Dina Reina
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Raúl López
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Maria-José Garcia-Quesada
- Enfermería de Control de Infección, Dirección Enfermera, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
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Santiago-Vacas E, Domingo M, Codina P, Cediel G, Spitaleri G, Zamora E, Gual F, Teis A, Santesmases J, Velayos P, Pulido A, Crespo E, Nunez J, Lupon J, Bayes-Genis A. How predict right ventricular-pulmonary circulation coupling improvement in chronic heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Right ventricular-pulmonary circulation coupling (RVPAC), which can be measured by the relation between tricuspid annular plane systolic excursion (TAPSE) and systolic pulmonary artery pressure (SPAP) by echocardiography, has been postulated as an independent prognostic factor of hospitalizations and mortality in heart failure (HF) patients.
Purpose
Our aim was to know the predictors of RVPAC improvement in a chronic HF cohort.
Methods
Retrospective analysis of a prospectively studied cohort of HF outpatients of different aetiologies attended in a multidisciplinary HF Unit. Prospectively scheduled echo-Doppler studies were performed at first visit and 1 year. A TAPSE/SPAP ratio <0.36 mm/mmHg was identified as the most deleterious. Significant RVPAC improvement at 1 year was defined as TAPSE/SPAP ratio ≥0.36 mm/mmHg together with a ≥10% improvement from baseline RVPAC. Multivariable logistic regression analysis (conditional backward stepwise) was performed to select variables independently associated with significant RVPAC improvement. A predictive model including age and the previously selected variables was created.
Results
From August 2001 to July 2017, 554 patients with TAPSE and SPAP data in the initial visit were included. Mean follow-up time was 4.6±3.7 years. At first visit 252 (45.5%) patients had RVPAC <0.36 mm/mmHg. Out of them, RVPAC at 1 year improved in 55 (21.8%). In multivariable analysis, the presence of baseline atrial fibrillation/flutter (OR 0.12 [95% CI 0.05–0.28], p<0.001), SPAP (OR 0.96 [95% CI 0.92–0.99], p=0.014) and female gender (OR 0.34 [95% CI 0.12–0.91], p=0.03) were related to lesser probability of RVPAC improvement at 1 year. A model with such variables, together with age, showed an AUC of 0.824 to predict significant RVPAC improvement.
Conclusions
Atrial fibrillation/flutter, increasing SPAP and female gender hamper RVPAC improvement at 1 year in HF patients with baseline TAPSE/SPAP ratio <0.36.
Funding Acknowledgement
Type of funding sources: None. Multivariate regression analysis
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Affiliation(s)
| | - M Domingo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - P Codina
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - G Cediel
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - G Spitaleri
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - F Gual
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - A Teis
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - P Velayos
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - A Pulido
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - E Crespo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - J Nunez
- Research Foundation Hospital of Valencia (INCLIVA), Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Badalona, Spain
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7
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Casquete D, Codina P, Domingo M, Santiago E, Cediel G, Spitaleri G, Zamora E, Santesmases J, Boldo M, Rivas C, Gonzalez B, Velayos P, Pulido A, Lupon J, Bayes-Genis A. Natriuretic peptide dynamics with remote pulmonary artery pressure monitoring. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Real-life clinical practice has confirmed the value of pulmonary artery (PA) pressure-guided therapy in patients with heart failure (HF) and history of repeated HF hospitalizations (HFH), to greater extent to that reported in the pivotal clinical trial CHAMPION-HF. The value of hemodynamic monitoring in a population of patients with HF and elevated natriuretic peptides, but without recent HFH, is unknown.
Objective
To assess N-terminal-pro-brain natriuretic peptide (NTproBNP) dynamics before and 6 months after PA pressure sensor implantation.
Methods
Ten patients managed in a multidisciplinary HF clinic implanted with the CardioMEMS PA pressure sensor were consecutively included from June 2019 to July 2020. Mean age was 63.1±23.5 years, 30% were women, 40% had HF with reduced EF (EF <40%). NTproBNP was measured at baseline and six months after sensor implantation. Wilcoxon matched-pairs signed-rank test was used to compare NTproBNP values at baseline and at 6 months. Fractional polynomial fit plot was used to represent changes in mean PA pressure over time. Linear regression was used to predict the change in NTproBNP based on the change in PA pressures.
Results
Mean daily pressure transmission rate was 92.4±5.1%. During the six-month study period 90% of patients had a change in medication related to PA pressure, with an average of 0.21 [0.17–0.66] changes per patient per month. Mean PA pressure at baseline was 28.5±9.5 mmHg, and decreased by 5.5 mmHg at 6 months (p=0.01) (Figure 1). NTproBNP was also significantly lower six months post CardioMEMS implantation; decreasing from 1696 pg/ml [976–2930] at baseline to 1046 pg/ml [616–2076] after six months (p=0.04) (Figure 2). There was a weak correlation between the change in NTproBNP and the change in mean PA pressure (R2=0.22, p=0.17).
Conclusions
NTproBNP values were significantly lower 6-months following implantation of a PA pressure sensor to guide HF management. Mean PA pressures were also significantly reduced.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Hospital Universitari Germans Trias i Pujol Figure 1. Change in mean PA pressure over time.Figure 2. Change in NTproBNP after PAP monitoring.
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Affiliation(s)
- D Casquete
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - P Codina
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - E Santiago
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - G Cediel
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - G Spitaleri
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - J Santesmases
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - M Boldo
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - B Gonzalez
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - A Pulido
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
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8
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Domingo M, Conangla L, Lupón J, de Antonio M, Moliner P, Santiago-Vacas E, Codina P, Zamora E, Cediel G, González B, Díaz V, Rivas C, Velayos P, Santesmases J, Pulido A, Crespo E, Bayés-Genís A. Valor pronóstico de la ecografía de pulmón en pacientes ambulatorios con insuficiencia cardiaca crónica estable. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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9
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Codina P, De Antonio M, Santiago-Vacas E, Domingo M, Zamora E, Santesmases J, Subirana I, Buchaca D, Alonso N, Troya M, Velayos P, Pulido A, Nunez J, Lupon J, Bayes-Genis A. How mortality risk estimated by MAGGIC-HF, SHFM and BCN-Bio HF scores is modified after 12-month management in a multidisciplinary HF Clinic. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Heart failure (HF) contemporary management has significantly improved over the past two decades leading to better survival. How application of the contemporary HF management guidelines affects the risk of death estimated by available web-based risk scores is not elucidated.
Objective
To assess changes in mortality risk prediction after a after a 12-month management period in a multidisciplinary HF Clinic.
Methods
Out of 1,689 consecutive patients with HF admitted at our ambulatory HF Clinic from May 2006 to November 2018, those who completed one year follow-up were considered for the study. Patients without NTproBNP measurement or with more than 3 missing variables for risk estimation were excluded. Three contemporary web-based HF risk scores were evaluated: MAGGIC-HF, Seattle HF Model (SHFM) and the Barcelona Bio-HF Calculator containing NTproBNP (BCN Bio-HF). Risk of all-cause death at one year and at 3 years were calculated at baseline and re-evaluated after 12-month management in a multidsisciplinary HF Clinic. Wilcoxon paired data test was used to compare changes in mortality risk estimation over time and test equality of matched pairs for comparing estimated change among tools. 442 patients used to derive the Barcelona Bio-HF Calculator were excluded for discrimination purposes.
Results
1,157 patients were included (age 65.7±12.7 years, 70.4% men). A significant reduction in mortality risk estimation was observed with the three HF risk scores evaluated at 12-months (Table). The BCN Bio-HF model showed significantly different changes in risk estimation, fact that indeed was partnered with numerically better discrimination. AUC at 1 and 3 years, respectively, were: BCN Bio-HF (0.773 and 0.775), MAGGIC HF (0.686 and 0.748) and SHFM (0.773 and 0.739).
Conclusions
The three web-based risk scores evaluated showed a significant reduction in mortality risk estimation after 12 month management in a multidisciplinary HF Clinic. The BCN Bio-HF score showed higher reduction in estimated risk, together with better discrimination, likely because it incorporates contemporary treatment and use of biomarkers.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Codina
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | | | - M Domingo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - I Subirana
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - D Buchaca
- Barcelona Supercomputing Center, Barcelona, Spain
| | - N Alonso
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - M.I Troya
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - A Pulido
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - J Nunez
- Hospital General Universitario de Valencia, Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Badalona, Spain
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10
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Domingo M, Conangla L, Lupón J, de Antonio M, Moliner P, Santiago-Vacas E, Codina P, Zamora E, Cediel G, González B, Díaz V, Rivas C, Velayos P, Santesmases J, Pulido A, Crespo E, Bayés-Genís A. Prognostic value of lung ultrasound in chronic stable ambulatory heart failure patients. Rev Esp Cardiol (Engl Ed) 2020; 74:862-869. [PMID: 32861606 DOI: 10.1016/j.rec.2020.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/13/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION AND OBJECTIVES The role of lung ultrasound (LUS) in acute heart failure (HF) has been widely studied, but little is known about its usefulness in chronic HF. This study assessed the prognostic value of LUS in a cohort of chronic HF stable ambulatory patients. METHODS We included consecutive outpatients who attended a scheduled follow-up visit in a HF clinic. LUS was performed in situ. The operators were blinded to clinical data and examined 8 thoracic areas. The sum of B-lines across all lung zones and the quartiles of this addition were used for the analyses. Linear regression and Cox regression analyses were performed. The main clinical outcomes were a composite of all-cause death or hospitalization for HF and mortality from any cause. RESULTS A total of 577 individuals were included (72% men; 69± 12 years). The mean number of B-lines was 5±6. During a mean follow-up of 31±7 months, 157 patients experienced the main clinical outcome and 111 died. Having ≥ 8 B-lines (Q4) doubled the risk of experiencing the composite primary event (P <.001) and increased the risk of death from any cause by 2.6-fold (P <.001). On multivariate analysis, the total sum of B-lines remained independent predictive factor of the composite endpoint (HR, 1.04; 95%CI, 1.02-1.06; P=.002) and of all-cause death (HR, 1.04; 95%CI, 1.02-1.07; P=.001), independently of whether or not N-terminal pro-B-type natriuretic peptide (NT-proBNP) was included in the model (P=.01 and P=.008, respectively), with a 3% to 4% increased risk for each 1-line addition. CONCLUSIONS LUS identified patients with stable chronic HF at high risk of death or HF hospitalization.
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Affiliation(s)
- Mar Domingo
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Laura Conangla
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Josep Lupón
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta de Antonio
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Pedro Moliner
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Evelyn Santiago-Vacas
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Pau Codina
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Elisabet Zamora
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain
| | - Germán Cediel
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Beatriz González
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Violeta Díaz
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Carmen Rivas
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Patricia Velayos
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Javier Santesmases
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Ana Pulido
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Eva Crespo
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Antoni Bayés-Genís
- Servei de Cardiologia, Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBERCV, Instituto de Salud Carlos III, Madrid, Spain.
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11
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Castellà L, Sopena N, Rodriguez-Montserrat D, Alonso-Fernández S, Cavanilles JM, Iborra M, Ciercoles A, Pulido A, Gimenez M, Hernandez Hermoso JA, Casas I. Intervention to reduce the incidence of surgical site infection in spine surgery. Am J Infect Control 2020; 48:550-554. [PMID: 31706545 DOI: 10.1016/j.ajic.2019.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND This study examines the incidence, characteristics, and risk factors of surgical site infections (SSIs) after spine surgery and evaluates the efficacy of a preventive intervention. METHODS This was a quasi-experimental pretest/posttest study in patients undergoing spinal surgery in an orthopedic surgery department from December 2014 to November 2016. Based on the results of the study, we revised the preventive protocol with modification of wound dressing, staff training, and feedback. SSI rates were compared between the pre-intervention (December 2014 to November 2015) and post-intervention (December 2015 to November 2016) periods. The risk factors were analyzed using univariate and multivariate analyses. RESULTS Of the 139 patients included, 14 cases of SSI were diagnosed, with a significant decrease in the incidence of SSIs from the pre-intervention period to the post-intervention period (19.4% vs 2.6%; P = .001). The etiology was known in 13 cases, with enteric flora being predominant in the pre-intervention group. Univariate analysis showed that age, body mass index, days until sitting and ambulation, and incontinence were statistically significant risk factors. After multivariate analysis, only body mass index and days until ambulation remained significant. When the effect of intervention was adjusted with other risk factors, this variable remained statistically significant. CONCLUSIONS An intervention that includes modification of wound dressing and early mobilization, as well as staff awareness training, monitoring, and feedback, allowed a significant reduction in the incidence of SSI following spinal surgery, particularly infections caused by enteric flora.
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Affiliation(s)
- Laia Castellà
- Germans Trias i Pujol University Hospital, Badalona, Spain; IGTP Health Sciences Research Institute, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Nieves Sopena
- IGTP Health Sciences Research Institute, Germans Trias i Pujol University Hospital, Badalona, Spain; Infectious Diseases Department, Germans Trias i Pujol University Hospital, Badalona, Spain; Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain.
| | | | - Sergio Alonso-Fernández
- Germans Trias i Pujol University Hospital, Badalona, Spain; IGTP Health Sciences Research Institute, Germans Trias i Pujol University Hospital, Badalona, Spain; Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain; Fundamental Care and Medical-Surgical Nursing Department, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Jose María Cavanilles
- Orthopedic Surgery Department, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Miquel Iborra
- Orthopedic Surgery Department, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Ana Ciercoles
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Ana Pulido
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Montserrat Gimenez
- Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Microbiology Department, North Metropolitan Clinical Laboratory, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Jose Antonio Hernandez Hermoso
- Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Orthopedic Surgery Department, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Irma Casas
- Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Preventive Medicine Department, Germans Trias i Pujol University Hospital, Badalona, Spain
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12
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Fernández-Cruz A, Kwon M, Guinea J, Escribano P, Jiménez MDCM, Pulido A, Parra V, Serrano D, Gayoso J, Martín JLD, Bouza E. Inonotosis in Patient with Hematologic Malignancy. Emerg Infect Dis 2018; 24:180-182. [PMID: 29260664 PMCID: PMC5749471 DOI: 10.3201/eid2401.171265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a lung-invasive fungal disease with possible cutaneous needle tract seeding in a patient with a febrile neutropenia caused by the Basidiomycetes mold Inonotus spp. Although rare, Inonotus spp. should be added to the list of microorganisms causing invasive fungal disease in neutropenic patients with hematologic malignancies.
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13
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Oliver-Tomas B, Gonell F, Pulido A, Renz M, Boronat M. Effect of the Cα substitution on the ketonic decarboxylation of carboxylic acids over m-ZrO2: the role of entropy. Catal Sci Technol 2016. [DOI: 10.1039/c6cy00395h] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Entropy effects and not activation energies are responsible for the lower reactivity of branched acids towards ZrO2-catalyzed ketonic decarboxylation.
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Affiliation(s)
- B. Oliver-Tomas
- Instituto Tecnología Química
- Universidad Politécnica de Valencia–Consejo Superior de Investigaciones Científicas
- 46022 Valencia
- Spain
| | - F. Gonell
- Instituto Tecnología Química
- Universidad Politécnica de Valencia–Consejo Superior de Investigaciones Científicas
- 46022 Valencia
- Spain
- Departamento de Química Inorgánica y Orgánica
| | - A. Pulido
- Instituto Tecnología Química
- Universidad Politécnica de Valencia–Consejo Superior de Investigaciones Científicas
- 46022 Valencia
- Spain
| | - M. Renz
- Instituto Tecnología Química
- Universidad Politécnica de Valencia–Consejo Superior de Investigaciones Científicas
- 46022 Valencia
- Spain
| | - M. Boronat
- Instituto Tecnología Química
- Universidad Politécnica de Valencia–Consejo Superior de Investigaciones Científicas
- 46022 Valencia
- Spain
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14
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Boronat M, Pulido A, Concepción P, Corma A. Propene epoxidation with O2or H2–O2mixtures over silver catalysts: theoretical insights into the role of the particle size. Phys Chem Chem Phys 2014; 16:26600-12. [DOI: 10.1039/c4cp02198c] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Fuentelsaz-del Barrio V, Pulido A, Parra V. Asymptomatic Lesion on the Forehead. Actas Dermo-Sifiliográficas (English Edition) 2011. [DOI: 10.1016/j.adengl.2011.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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16
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Fuentelsaz-del Barrio V, Pulido A, Parra V. [Asymptomatic lesion on the forehead]. Actas Dermosifiliogr 2011; 102:731-2. [PMID: 21925634 DOI: 10.1016/j.ad.2011.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Revised: 02/02/2011] [Accepted: 02/09/2011] [Indexed: 10/17/2022] Open
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17
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Pulido A, Baniandrés O, Borregón P, Cano N, Parra V, Suárez R, Lázaro P. [Extramammary Paget's disease as the form of presentation of anal canal adenocarcinoma]. Gastroenterol Hepatol 2011; 34:376-7. [PMID: 21481975 DOI: 10.1016/j.gastrohep.2011.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 01/09/2011] [Accepted: 01/18/2011] [Indexed: 11/17/2022]
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18
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Pulido A, Carretero F, Avilés J. Exantema febril en un paciente procedente de Centroamérica. Actas Dermo-Sifiliográficas 2011; 102:149-50. [DOI: 10.1016/j.ad.2010.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 12/09/2010] [Accepted: 12/17/2010] [Indexed: 10/18/2022] Open
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Baniandrés O, Pulido A, Silvente C, Suárez R, Lázaro P. Clinical Outcomes in Patients With Psoriasis Following Discontinuation of Efalizumab Due to Suspension of Marketing Authorization. Actas Dermo-Sifiliográficas (English Edition) 2010. [DOI: 10.1016/s1578-2190(10)70665-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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20
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Grajciar L, Areán CO, Pulido A, Nachtigall P. Periodic DFT investigation of the effect of aluminium content on the properties of the acid zeolite H-FER. Phys Chem Chem Phys 2010; 12:1497-506. [DOI: 10.1039/b917969k] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Areán CO, Palomino GT, Carayol ML, Pulido A, Rubeš M, Bludský O, Nachtigall P. Hydrogen adsorption on the zeolite Ca-A: DFT and FT-IR investigation. Chem Phys Lett 2009. [DOI: 10.1016/j.cplett.2009.06.058] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Maquivar M, Verduzco A, Galina CS, Pulido A, Rojas S, Forster K, Van der Laan G, Arnoni R. Relationship Among Follicular Growth, Oestrus, Time of Ovulation, Endogenous Estradiol 17β and Luteinizing Hormone in Bos Indicus Cows After a Synchronization Program. Reprod Domest Anim 2007; 42:571-6. [DOI: 10.1111/j.1439-0531.2006.00821.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Pulido A, Bakos F, Castillo A, Vallés MP, Barnabás B, Olmedilla A. Influence of Fe concentration in the medium on multicellular pollen grains and haploid plants induced by mannitol pretreatment in barley (Hordeum vulgare L.). Protoplasma 2006; 228:101-6. [PMID: 16937061 DOI: 10.1007/s00709-006-0178-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Accepted: 06/08/2005] [Indexed: 05/11/2023]
Abstract
This study aims to clarify the short- and long-term effects of the iron concentration in the medium on androgenesis induced in barley by isolated microspore culture. The ultrastructural features and pectin composition of the intine wall were studied in the initial stages of androgenesis. The evolution of electron-dense iron deposits on the intine was analysed in multicellular pollen grains obtained by isolated microspore culture performed for 3, 6, and 9 days using various concentrations of FeNa(2) EDTA. Finally, the number of embryo-like structures and green plants obtained by microspore culture using different Fe concentrations was evaluated in order to estimate the optimum concentration for isolated microspore culture.
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Affiliation(s)
- A Pulido
- Departamento de Bioquímica, Biología Celular y Molecular de Plantas, Estación Experimental del Zaidin, Consejo Superior de Investigaciones Científicas, Granada, Spain
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Pulido A, Bakos F, Castillo A, Vallés MP, Barnabas B, Olmedilla A. Cytological and ultrastructural changes induced in anther and isolated-microspore cultures in barley: Fe deposits in isolated-microspore cultures. J Struct Biol 2005; 149:170-81. [PMID: 15681233 DOI: 10.1016/j.jsb.2004.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2004] [Revised: 09/06/2004] [Indexed: 10/26/2022]
Abstract
To gain further insight into the role played by sporophytic anther tissues in the early stages of the androgenic process, we have compared the cytology and ultrastructure of barley embryogenic pollen grains obtained by anther culture with those obtained by isolated-microspore culture. The microspores behaved similarly in both culture systems but ultrastructural studies detected a significant difference: the presence of electron-dense deposits on the intine of embryogenic pollen grains generated by isolated-microspore culture compared to their absence in grains generated by anther culture. To discover the nature of these deposits, we applied proteinase K and EDTA treatments to ultrathin sections. We also subjected the deposits to X-ray microanalysis and found that they contained iron. Anthers and isolated microspores were cultured in media containing different concentrations of iron so as to evaluate the presence of these deposits on the intine. Deposits were not found in anther cultures at any iron concentration used or in microspore cultures when concentrations were lower than 40 mg/L. The Fe deposits on the intine appear to derive from an excess of Fe in the isolated-microspore culture medium which, if allowed to pass through the cell wall, could well be toxic to the embryogenic development of the microspores.
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Affiliation(s)
- A Pulido
- Department of Plant Biochemistry, Cell and Molecular Biology, EEZ (CSIC), Professor Albareda 1, E-18008 Granada, Spain
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Albalate M, Fernández C, López MD, Gago C, Jarraiz A, Pulido A, González A, Santana H, Hernando P, Gazapo RM, Caramelo C. [Can we increase phosphate removal with conventional hemodialysis?]. Nefrologia 2003; 23:520-7. [PMID: 15002787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The aim of the present study was to investigate the effect of different dialysate buffer and glucose concentrations, membrane surface (S) bigger than 2 m2 and increased dialysate flow (Qd) in phosphate (P) removal. METHODS A. First phase (5 patients): the following variations in dialysate composition were introduced. A: glucose 1.60 g/L, bicarbonate: 39 mEq/L, acetate 4 mEq/L, B: glucose 1.5 g/L bicarbonate 17 mEq/L, acetate 10 mEq/L; C: glucose 0, bicarbonate: 39 mEq/L, acetate 4 mEq/L; and D: glucose 0, bicarbonate 17 mEq/L, acetate 10 mEq/L. B. Second phase (14 patients): variations in S and Qd were: 1. Qd: 500 mL/min + Hemophan 2 m2, 2. Qd: 500 mL/min + Hemophan 2.6 m2, 3. Qd: 750 mL/min + Hemophan 2 m2, 4. Qd: 750 mL/min + Hemophan 2.6 m2. RESULTS Comparing HDs performed with low bicarbonate (B and D) respect to current buffer formulations (A and C), total P removal was 997.3 (+/- 237.3) vs 882 (+/- 216.1) mg (p NS). No differences were found by grouping the sessions according to glucose concentration. There were no significant differences in total phosphate removal between the two different S or Qd. The most important predictive factor of total P removal was the initial P and 2 hours serum P concentration, and PTH concentration. CONCLUSIONS i) Removal of P is better predicted by pre-dialysis P serum concentration; ii) P removal was not affected by the changes in bicarbonate and glucose concentration in the dialysate; iii) the increase of the dialyzer area between 2 and 2.6 m2 augments Kt/V, but without influencing P elimination; iv) a higher Qd does not determine significant differences in P removal and v) higher PTH is associated with a higher P elimination.
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Affiliation(s)
- M Albalate
- Servicio de Nefrología, Fundación Jiménez Díaz, Madrid, España
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Pulido A, Ruisánchez I, Boqué R, Rius F. Estimating the uncertainty of binary test results to assess their compliance with regulatory limits. Anal Chim Acta 2002. [DOI: 10.1016/s0003-2670(01)01604-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dominguez MA, Liñares J, Pulido A, Perez JL, de Lencastre H. Molecular tracking of coagulase-negative staphylococcal isolates from catheter-related infections. Microb Drug Resist 2000; 2:423-9. [PMID: 9158813 DOI: 10.1089/mdr.1996.2.423] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Three molecular typing methods (pulsed-field electrophoresis, localization of the mecA gene, and probing the vicinity of mec) have been used for the characterization of 40 catheter-related isolates of coagulase-negative staphylococci (CNS) in 14 patients admitted to the same hospital. The 40 isolates yielded 14 different SmaI banding patterns and corresponding unique localizations of mecA, each associated with a unique ClaI mecA polymorph. In 6 of the 14 patients the contaminated skin at the catheter entry site was the source of 4 local infections and 2 cases of bacteremia. A contaminated hub was the origin of 2 local infections and 4 cases of bacteremia in 6 more patients. The remaining 2 patients had positive cultures from both skin and catheter hub. In each bacteremic patient, the CNS recovered from catheter-related sites (tip, skin, and/or hub) and the CNS recovered from blood were identical, but each of these matching isolates was unique to the particular patients, indicating a low rate of cross-infection from patient to patient. Although classical methods for typing CNS (e.g., biotype and antibiotype) are readily available for most hospital laboratories, they have limitations concerning reproducibility and discriminatory power. Molecular epidemiologic techniques can provide powerful support to traditional techniques in determining the etiologic role of CNS in the disease process.
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Affiliation(s)
- M A Dominguez
- Microbiology Department, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona, Spain
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García A, Pérez JL, Pulido A, Niubó J, Pérez P, Martín R. [Evaluation of four rapid methods for the investigation of the toxigenic capacity of Clostridium difficile strains isolated in a selective medium]. Enferm Infecc Microbiol Clin 2000; 18:109-12. [PMID: 10905010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND Use of selective Clostridium difficile culture as a diagnostic method for C. difficile associated disease requires to prove the toxigenic ability of the isolates. Toxin B detection by cell culture assay after growing the microorganism in enriched broth is the standard method, but it delays the final diagnosis for 3-5 days. This study compares retrospectively four rapid techniques for detecting these toxigenic C. difficile strains. METHODS 106 clinical isolates of C. difficile (72 toxigenic and 34 non-toxigenic), these and 16 clinical strains of other species of Clostridium were investigated. The four methods were performed directly from colonies growing on solid agar. They were: a) cytotoxin detection in cell culture; b) two PCR amplifications of toxin A and toxin B, respectively, and c) toxin A detection by an immunoenzymatic method (VIDAS CDA2). All these procedures were completed within a normal working day. RESULTS Only the 72 toxigenic C. difficile strains gave positive results by cell culture and PCR techniques (sensitivity and specificity: 100%). A total of 14 out of 49 toxigenic C. difficile strains showed negative results by the VIDAS assay in the first run, but all them were positive in repeated tests. CONCLUSIONS Although all methods performed well, the cytotoxicity assay done directly on colonies growing in CCFA is a simple and rapid technique, and appears to be well-suited for use in laboratories with access to cell cultures.
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Affiliation(s)
- A García
- Servicio de Microbiología, Ciutat Sanitària i Universitària de Bellvitge, L'Hospitalet de Llobregat, Barcelona
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León-S FE, Vera LM, Pulido A. Born in tropical countries. Arch Med Res 1999; 30:412. [PMID: 11676436 DOI: 10.1016/s0188-4409(99)00066-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pulido A, Ruisánchez I, Rius F. Radial basis functions applied to the classification of UV–visible spectra1This paper is dedicated to the memory of Prof. Jean Thomas Clerc, to honor his contributions to the field of chemometrics and to Analytica Chimica Acta.1. Anal Chim Acta 1999. [DOI: 10.1016/s0003-2670(99)00082-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
A patient with a total hip arthroplasty developed an aggressive infection with group G Streptococcus. Very few similar cases have been reported, but they all resolved with antibiotics or drainage. A Girdlestone resection was necessary in our case because of loosening and extensive bony destruction. The true incidence may be greater than that reported and the prognosis may be worse.
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Affiliation(s)
- M Pons
- Servei de Cirurgia de l'Aparell Locomotor, Hospital San Raphael, Barcelona, Spain
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Domínguez A, Alcaide F, Pulido A, Ayats J, Pérez JL, Martín R. Use of a commercial double-test tablet (Rosco PGUA/indole) for screening of Escherichia coli. Diagn Microbiol Infect Dis 1992; 15:291-4. [PMID: 1611844 DOI: 10.1016/0732-8893(92)90013-j] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A commercial double-test tablet (Rosco PGUA/indole) for detection of beta-glucuronidase (beta-GUR) activity and indole production was evaluated on a collection of 393 isolates of Enterobacteria. Both beta-GUR and indole were positive on 96.6% of Escherichia coli strains. beta-GUR, only, was also detected in 25 Shigella spp., four Enterobacter cloacae, eight Citrobacter freundii, and five Salmonella enteritidis strains, none of which were indole producers. An additional 261 consecutive clinical isolates of oxidase-negative nonswarming Gram-negative bacilli were studied in a parallel comparative field trial against conventional identification methods. For 200 strains, the standard method and PGUA/indole test were performed from the primary culture plate. The remaining 61 (23.4%) required subculture before testing. Sensitivity, specificity, positive predictive value, and negative predictive value of PGUA/indole test in the screening for E. coli were, respectively, 94.1%, 100%, 100%, and 87.1%. In our experience, PGUA/indole test is a rapid, precise, simple-to-perform, and economical method for screening E. coli. However, the need for a large inoculum may limit its application on primary cultures.
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Affiliation(s)
- A Domínguez
- Service of Microbiology, Hospital de Bellvitge Príncipes de España, Barcelona, Spain
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Pulido A, Liñares J, Escribano E, Alonso T, Ariza J. [Evolution of antibiotic sensitivity in Brucella melitensis]. Enferm Infecc Microbiol Clin 1992; 10:56-7. [PMID: 1498179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Pulido A, Zarco L, Galina CS, Murcia C, Flores G, Posadas E. Progesterone metabolism during storage of blood samples from Gyr cattle: Effects of anticoagulant, time and temperature of incubation. Theriogenology 1991; 35:965-75. [PMID: 16726964 DOI: 10.1016/0093-691x(91)90307-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/1990] [Accepted: 03/15/1991] [Indexed: 11/22/2022]
Abstract
Ten Gyr cows with a functional corpus luteum were used to evaluate the effects of time and temperature of incubation of blood samples on progesterone (P4) concentrations detected in plasma or serum. From each cow, a blood sample was collected into a flask containing no anticoagulant, another into an heparinized flask and a third into a flask containing sodium fluoride. The blood from each flask was divided into 46 aliquots. One of them was centrifuged within 5 min of collection. The remaining 45 aliquots were divided into three groups and kept at three different temperatures: 4 degrees C, 17 degrees C, or 37 degrees C. For each anticoagulant, aliquots from every cow and incubation temperature were centrifuged every 30 min for 6 h, and then at 8, 12 and 24 h. Plasma or serum were separated immediately after centrifugation and were kept frozen at -20 degrees C until assayed for progesterone. The mean initial concentration of P4 in serum (8.3 ng/ml) significantly diminished (P<0.05) to 6.7 ng/ml after 5 h of incubation at 4 degrees C, 3 h at 17 degrees C, or 2 h at 37 degrees C. In plasma from heparinized blood the initial concentration (7.8 ng/ml) declined significantly after 6 h of incubation at 4 degrees C, 2 h at 17 degrees C, or 1 h at 37 degrees C. Sodium fluoride used as anticoagulant prevented the degradation of P4 since the initial concentration of P4 (6.7 ng/ml) never declined during incubation at either 4 degrees C or 37 degrees C; the only significant reduction occurred after 24 h of incubation at 17 degrees C.
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Affiliation(s)
- A Pulido
- Departamento de Reproducción, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Apartado postal 22-256, México, DF, 14000 México
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Pérez JL, Sauca G, Pulido A, Murgui L, García D, Bosch J. [Multicenter study of the Rosco-Neisseria system for the identification of pathogenic neisserias and Branhamella catarrhalis]. Enferm Infecc Microbiol Clin 1991; 9:95-7. [PMID: 1677275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The commercial Rosco-Neisseria system was evaluated in the identification of 228 oxidase-positive Gram-negative diplococci and it was compared with conventional tests. The procedure detects gamma-glutamyl aminopeptidase, ONPG, tributyrin hydrolysis, and sensitivity to the disk of 10 micrograms of colistin. A correct identification was obtained in the 65 strains of Neisseria gonorrhoeae, the 33 of N. meningitidis, the 12 of N. lactamica, and the 56 of B. catarrhalis. The method was also able to discriminate 54 out of the 62 strains of nonpathogenic Neisseria. However, the 7 strains of Neisseria polysaccharea and one strain of N. subflava biovar perflava were erroneously identified as N. gonorrhoeae. None of the latter was superoxol positive in contrast with the 100% of cases of gonococcal strains. The Rosco-Neisseria system is simple and inexpensive but it should be applied on specimens that grow on selective media for gonococci (such as Thayer-Martin and others) and it should be complemented by superoxol test.
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Affiliation(s)
- J L Pérez
- Servicio de Microbiología, Hospital de Bellvitge-Prínceps d'Espanya, Universidad de Barcelona
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Abstract
A series of 23 patients with chronic pilonidal disease have been treated by excision and transposition rhomboid flap. Full primary healing was obtained in all patients, with only two cases of wound seroma. The average hospital stay was 9 days. The mean follow-up period was 12 months, and no late recurrences have occurred.
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Affiliation(s)
- C Jiménez Romero
- Service of General and Digestive Surgery, Hospital 12 de Octubre, Madrid, Spain
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Pérez JL, Pulido A, Pantozzi F, Martin R. Butyrate esterase (4-methylumbelliferyl butyrate) spot test, a simple method for immediate identification of Moraxella (Branhamella) catarrhalis [corrected]. J Clin Microbiol 1990; 28:2347-8. [PMID: 2121784 PMCID: PMC268174 DOI: 10.1128/jcm.28.10.2347-2348.1990] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A total of 47 Moraxella (Branhamella) catarrhalis strains, 89 strains of Neisseria spp., and 82 strains of miscellaneous bacteria and yeasts were studied by using a fluorogenic spot method which detects butyrate esterase. A positive butyrate esterase spot test correctly differentiated M. catarrhalis from Neisseria spp., which had a negative butyrate esterase spot test reaction. The test is rapid, simple, and easy to perform. The butyrate esterase spot test was useful for direct identification of M. catarrhalis from primary cultures. However, false-positive reactions may occur with mixed cultures.
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Affiliation(s)
- J L Pérez
- Service of Microbiology, Hospital de Bellvitge Principes de España, Universidad de Barcelona, Spain
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