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Izquierdo-Martínez A, Civantos-Modino S, Cánovas-Molina G, Mora-Hernández B, Bernal-Bello D. An Unexpected Partner in Diabetic Ketoacidosis: Dorsal Pancreatic Agenesis. Can J Diabetes 2024; 48:141-143. [PMID: 37925052 DOI: 10.1016/j.jcjd.2023.10.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/21/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023]
Affiliation(s)
| | - Soralla Civantos-Modino
- Endocrinology and Nutrition Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Gloria Cánovas-Molina
- Endocrinology and Nutrition Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Belén Mora-Hernández
- Internal Medicine Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - David Bernal-Bello
- Internal Medicine Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Bernal-Bello D, Lara-Montes C, Jaenes-Barrios B. COVID-19? Let me see your hands. J R Coll Physicians Edinb 2023; 53:269-271. [PMID: 37850435 DOI: 10.1177/14782715231206530] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
During the first wave of the COVID�19 pandemic, a patient with anti-synthetase syndrome (ASS) was misdiagnosed as having bilateral severe acute respiratory syndrome coronavirus 2 pneumonia on admission. A comprehensive clinical evaluation would have led to the correct diagnosis earlier, as he had some data consistent with ASS on both physical examination and laboratory tests that were initially overlooked. In addition, a malignant lesion in the colon was found on screening for underlying malignancy. In this context, ASS has been considered a low-risk subgroup for cancer among idiopathic inflammatory myopathies. However, this should be interpreted cautiously and should not lead to neglect of adequate cancer screening adjusted for age, sex and other potential risk factors.
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Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Celia Lara-Montes
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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San Martín-López JV, Mesa N, Bernal-Bello D, Morales-Ortega A, Rivilla M, Guerrero M, Calderón R, Farfán AI, Rivas L, Soria G, Izquierdo A, Madroñal E, Duarte M, Piedrabuena S, Toledano-Macías M, Marrero J, de Ancos C, Frutos B, Cristóbal R, Velázquez L, Mora B, Cuenca P, Satué JÁ, Ayala-Larrañaga I, Carpintero L, Lara C, Llerena ÁR, García V, García de Viedma V, Prieto S, González-Pereira N, Bravo C, Mariño C, Lechuga LA, Tarancón J, Gonzalo S, Moreno S, Ruiz-Giardin JM. Seven Epidemic Waves of COVID-19 in a Hospital in Madrid: Analysis of Severity and Associated Factors. Viruses 2023; 15:1839. [PMID: 37766248 PMCID: PMC10538062 DOI: 10.3390/v15091839] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: COVID-19 has evolved during seven epidemic waves in Spain. Our objective was to describe changes in mortality and severity in our hospitalized patients. (2) Method: This study employed a descriptive, retrospective approach for COVID-19 patients admitted to the Hospital de Fuenlabrada (Madrid, Spain) until 31 December 2022. (3) Results: A total of 5510 admissions for COVID-19 were recorded. The first wave accounted for 1823 (33%) admissions and exhibited the highest proportion of severe patients: 65% with bilateral pneumonia and 83% with oxygen saturation under 94% during admission and elevated levels of CRP, IL-6, and D-dimer. In contrast, the seventh wave had the highest median age (79 years) and comorbidity (Charlson: 2.7), while only 3% of patients had bilateral pneumonia and 3% required intubation. The overall mortality rate was 10.3%. The first wave represented 39% of the total. The variables related to mortality were age (OR: 1.08, 1.07-1.09), cancer (OR: 1.99, 1.53-2.60), dementia (OR: 1.82, 1.20-2.75), the Charlson index (1.38, 1.31-1.47), the need for high-flow oxygen (OR: 6.10, 4.94-7.52), mechanical ventilation (OR: 11.554, 6.996-19.080), and CRP (OR: 1.04, 1.03-1.06). (4) Conclusions: The variables associated with mortality included age, comorbidity, respiratory failure, and inflammation. Differences in the baseline characteristics of admitted patients explained the differences in mortality in each wave. Differences observed between patients admitted in the latest wave and the earlier ones suggest that COVID-19 has evolved into a distinct disease, requiring a distinct approach.
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Affiliation(s)
- Juan Víctor San Martín-López
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
| | - Nieves Mesa
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - David Bernal-Bello
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Alejandro Morales-Ortega
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, 28871 Madrid, Spain
| | - Marta Rivilla
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Marta Guerrero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ruth Calderón
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ana I. Farfán
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Luis Rivas
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Guillermo Soria
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Aída Izquierdo
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Elena Madroñal
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Miguel Duarte
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Sara Piedrabuena
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - María Toledano-Macías
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Jorge Marrero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Cristina de Ancos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Begoña Frutos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Rafael Cristóbal
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Laura Velázquez
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Belén Mora
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Paula Cuenca
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - José Á. Satué
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ibone Ayala-Larrañaga
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Lorena Carpintero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Celia Lara
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Álvaro R. Llerena
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Virginia García
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Vanessa García de Viedma
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Santiago Prieto
- Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (S.P.); (N.G.-P.)
| | - Natalia González-Pereira
- Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (S.P.); (N.G.-P.)
| | - Cristina Bravo
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (C.B.); (C.M.)
| | - Carolina Mariño
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (C.B.); (C.M.)
| | - Luis Antonio Lechuga
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (L.A.L.); (J.T.)
| | - Jorge Tarancón
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (L.A.L.); (J.T.)
| | - Sonia Gonzalo
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Santiago Moreno
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, 28871 Madrid, Spain
- Servicio de Enfermedades Infecciosas, Hospital U. Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
| | - José M. Ruiz-Giardin
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
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4
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Bernal-Bello D, Rodríguez-Rodríguez J, Duarte-Millán MÁ, Frutos-Pérez B. Anti-synthetase syndrome and the risk of progressive pulmonary fibrosis: weighting of concomitant anti-Ro/SSA antibodies. Clin Rheumatol 2023; 42:2249-2250. [PMID: 37183228 DOI: 10.1007/s10067-023-06615-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/16/2023]
Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942, Fuenlabrada, Madrid, Spain.
| | - Jorge Rodríguez-Rodríguez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942, Fuenlabrada, Madrid, Spain
| | - Miguel Ángel Duarte-Millán
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942, Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942, Fuenlabrada, Madrid, Spain
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5
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Duarte-Millán MÁ, Bernal-Bello D, Frutos-Pérez B, Canora-Lebrato J. Point-of-care ultrasonography in large vessel involvement by IgG4-related disease: an opportunity for monitoring? Rheumatology (Oxford) 2023; 62:e30-e31. [PMID: 35861403 DOI: 10.1093/rheumatology/keac420] [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: 03/15/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
| | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Jesús Canora-Lebrato
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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6
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Morales-Ortega A, Farfán-Sedano AI, San Martín-López JV, Escribá-Bárcena A, Jaenes-Barrios B, Madroñal-Cerezo E, Llarena-Barroso C, Mesa-Plaza N, Frutos-Pérez B, Ruiz-Giardín JM, Duarte-Millán MÁ, Piedrabuena-García SI, Carpintero-García L, Canalejo-Castrillero E, Mora-Hernández B, García-Parra CJ, Magro-García HA, Algaba-García A, Hernández-Muniesa B, Nasarre-López B, Ontañón-Nasarre A, Domínguez-García MJ, Gómez-Santos D, Prieto-Menchero S, García de Tena J, Bermejo F, García-Gil M, Gonzalo-Pascua S, Bernal-Bello D. Baricitinib or imatinib in hospitalized COVID-19 patients: Results from COVINIB, an exploratory randomized clinical trial. J Med Virol 2023; 95:e28495. [PMID: 36639911 DOI: 10.1002/jmv.28495] [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: 11/08/2022] [Revised: 01/02/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
Baricitinib and imatinib are considered therapies for coronavirus disease 2019 (COVID-19), but their ultimate clinical impact remains to be elucidated, so our objective is to determine whether these kinase inhibitors provide benefit when added to standard care in hospitalized COVID-19 patients. Phase-2, open-label, randomized trial with a pick-the-winner design conducted from September 2020 to June 2021 in a single Spanish center. Hospitalized adults with COVID-19 pneumonia and a symptom duration ≤10 days were assigned to 3 arms: imatinib (400 mg qd, 7 days) plus standard-care, baricitinib (4 mg qd, 7 days) plus standard-care, or standard-care alone. Primary outcome was time to clinical improvement (discharge alive or a reduction of 2 points in an ordinal scale of clinical status) compared on a day-by-day basis to identify differences ≥15% between the most and least favorable groups. Secondary outcomes included oxygenation and ventilatory support requirements, additional therapies administered, all-cause mortality, and safety. One hundred and sixty-five patients analyzed. Predefined criteria for selection of the most advantageous arm were met for baricitinib, but not for imatinib. However, no statistically significant differences were observed in formal analysis, but a trend toward better results in patients receiving baricitinib was found compared to standard care alone (hazard ratio [HR] for clinical improvement: 1.41, 95% confidence intervals [CI]: 0.96-2.06; HR for discontinuing oxygen: 1.46, 95% CI: 0.94-2.28). No differences were found regarding additional therapies administered or safety. Baricitinib plus standard care showed better results for hospitalized COVID-19 patients, being the most advantageous therapeutic strategy among those proposed in this exploratory clinical trial.
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Affiliation(s)
- Alejandro Morales-Ortega
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain.,Department of Medicine, Universidad de Alcalá, Madrid, Spain
| | | | | | | | | | - Elena Madroñal-Cerezo
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Cristina Llarena-Barroso
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Nieves Mesa-Plaza
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | | | | | - Eduardo Canalejo-Castrillero
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain.,Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid, Spain
| | - Belén Mora-Hernández
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - Alicia Algaba-García
- Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Berta Nasarre-López
- Clinical Research Program, Spanish National Cancer Research Centre (CNIO)-Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Ana Ontañón-Nasarre
- Department of Hospital Pharmacy, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Dulce Gómez-Santos
- Department of Radiology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - Fernando Bermejo
- Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid, Spain.,Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Madrid, Spain.,Instituto de Investigación Sanitaria Hospital La Paz (IdiPAZ), Madrid, Spain
| | - Mario García-Gil
- Department of Hospital Pharmacy, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Sonia Gonzalo-Pascua
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain.,Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Madrid, Spain
| | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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7
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Ruiz-Giardin JM, Rivilla M, Mesa N, Morales A, Rivas L, Izquierdo A, Escribá A, San Martín JV, Bernal-Bello D, Madroñal E, Farfán AI, Guerrero M, Calderón R, Duarte MA, Piedrabuena SI, Toledano-Macías M, Satué JÁ, Marrero J, de Ancos CL, Frutos B, Cristóbal R, Soria G, Ayala-Larrañaga I, Carpintero L, de Hita M, Lara C, Llerena ÁR, García V, Jiménez R, García V, Saiz-Lou EM, Prieto S, González-Pereira N, Lechuga LA, Tarancón J, Gonzalo S. Comparative Study of Vaccinated and Unvaccinated Hospitalised Patients: A Retrospective Population Study of 500 Hospitalised Patients with SARS-CoV-2 Infection in a Spanish Population of 220,000 Inhabitants. Viruses 2022; 14:v14102284. [PMID: 36298839 PMCID: PMC9611498 DOI: 10.3390/v14102284] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives. This study aimed to compare the characteristics of fully and partially vaccinated or unvaccinated coronavirus disease 2019 (COVID-19) patients who were hospitalised in a population of 220,000 habitants. Methods: Retrospective, observational, and population studies were conducted on patients who were hospitalised due to COVID-19 from March to October 2021. We assessed the impact of vaccination and other risk factors through Cox multivariate analysis. Results: A total of 500 patients were hospitalised, among whom 77 (15.4%) were fully vaccinated, 86 (17.2%) were partially vaccinated, and 337 (67.4%) were unvaccinated. Fully vaccinated (FV) patients were older and had a higher Charlson index than those of partially vaccinated and unvaccinated patients (NFV). Bilateral pneumonia was more frequent among NFV (259/376 (68.9%)) than among FV patients (32/75 (42.7%)). The former had more intensive care unit admissions (63/423) than the latter (4/77); OR: 2.80; CI (1.07–9.47). Increasing age HZ: 1.1 (1.06–1.14)) and haematological disease at admission HZ: 2.99 (1.26–7.11)) were independent risk factors for higher mortality during the first 30 days of hospitalisation. The probability of an earlier discharge in the subgroup of 440 patients who did not die during the first 30 days of hospitalisation was related to age (older to younger: HZ: 0.98 (0.97–0.99)) and vaccination status. Conclusions: Among the patients hospitalised because of COVID-19, complete vaccination was associated with less severe forms of COVID-19, with an earlier discharge date. Age and haematological disease were related to a higher mortality rate during the first 30 days of hospitalisation.
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Affiliation(s)
- José M. Ruiz-Giardin
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- CIBERINFEC, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-916006179
| | - Marta Rivilla
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Nieves Mesa
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Alejandro Morales
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Luis Rivas
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Aída Izquierdo
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Almudena Escribá
- Oficina Regional de Coordinación de Transplante de la Comunidad de Madrid, 28046 Madrid, Spain
| | - Juan V. San Martín
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- CIBERINFEC, 28029 Madrid, Spain
| | - David Bernal-Bello
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Elena Madroñal
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Ana I. Farfán
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Marta Guerrero
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Ruth Calderón
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Miguel A. Duarte
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Sara I. Piedrabuena
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | - José Á. Satué
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Jorge Marrero
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | - Begoña Frutos
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Rafael Cristóbal
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Guillermo Soria
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | - Lorena Carpintero
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Miguel de Hita
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Celia Lara
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Álvaro R. Llerena
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Virginia García
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Raquel Jiménez
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Vanesa García
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Elena M. Saiz-Lou
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Santiago Prieto
- Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | | | - Jorge Tarancón
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Sonia Gonzalo
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
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8
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Bernal-Bello D, Serantes-Gómez D, Izquierdo-Martínez A, Morales-Ortega A, Duarte-Millán MÁ, Frutos-Pérez B. Letter to the Editor Regarding Esophageal Dysfunction and Systemic Sclerosis: Drugs Should be Kept in Mind. Rheumatol Ther 2022; 9:1237-1240. [PMID: 35716236 PMCID: PMC9314470 DOI: 10.1007/s40744-022-00459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/26/2022] [Indexed: 02/07/2023] Open
Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2. 28942, Fuenlabrada, Madrid, Spain.
| | - David Serantes-Gómez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2. 28942, Fuenlabrada, Madrid, Spain
| | - Aida Izquierdo-Martínez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2. 28942, Fuenlabrada, Madrid, Spain
| | - Alejandro Morales-Ortega
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2. 28942, Fuenlabrada, Madrid, Spain.,Department of Medicine, Universidad de Alcalá, Madrid, Spain
| | - Miguel Ángel Duarte-Millán
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2. 28942, Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2. 28942, Fuenlabrada, Madrid, Spain
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9
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Bernal-Bello D, Morales-Ortega A, Duarte-Millán MÁ, Tardío JC, Frutos-Pérez B. Lung cavitation in granulomatosis with polyangiitis: clinical implications. Clin Rheumatol 2022; 41:2915-2916. [PMID: 35705728 DOI: 10.1007/s10067-022-06243-7] [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: 02/28/2022] [Revised: 05/18/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942, Madrid, Spain.
| | - Alejandro Morales-Ortega
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942, Madrid, Spain.,Department of Medicine, Universidad de Alcalá, Madrid, Spain
| | - Miguel Ángel Duarte-Millán
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942, Madrid, Spain
| | - Juan C Tardío
- Department of Pathology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, 28942, Madrid, Spain
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10
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Morales-Ortega A, Martín-Alcalde J, Bernal-Bello D. Telangiectasias in a row. Eur J Intern Med 2022; 99:97-98. [PMID: 35123842 DOI: 10.1016/j.ejim.2022.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 01/30/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Alejandro Morales-Ortega
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, Fuenlabrada, Madrid 28942, Spain; Department of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Javier Martín-Alcalde
- Department of Dermatology, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Camino del Molino, 2, Fuenlabrada, Madrid 28942, Spain
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11
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García-Bermúdez V, Morales-Ortega A, Jaquero-Valero MI, Khedaoui R, Tardío JC, Bernal-Bello D. Primary liver lymphoma and systemic sclerosis. Rheumatology (Oxford) 2022; 61:e247-e248. [PMID: 35022683 DOI: 10.1093/rheumatology/keac026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - Radia Khedaoui
- Department of Pathology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Juan C Tardío
- Department of Pathology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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12
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Bernal-Bello D, Guerra-Pérez I, Alegre-Zahonero L. Serum CA-125 and renal impairment in patients undergoing hyperthermic intraperitoneal chemotherapy. Biomed J 2021; 45:847-848. [PMID: 34902619 PMCID: PMC9661511 DOI: 10.1016/j.bj.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine. Hospital Universitario de Fuenlabrada. Madrid, Spain.
| | - Ignacio Guerra-Pérez
- Department of Medical Specialities and Public Health. Universidad Rey Juan Carlos. Madrid. Spain
| | - Laura Alegre-Zahonero
- Department of Medical Specialities and Public Health. Universidad Rey Juan Carlos. Madrid. Spain; Department of Nephrology. Hospital Universitario de Fuenlabrada. Madrid, Spain
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13
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Duarte-Millán MA, Mesa-Plaza N, Guerrero-Santillán M, Morales-Ortega A, Bernal-Bello D, Farfán-Sedano AI, García de Viedma-García V, Velázquez-Ríos L, Frutos-Pérez B, De Ancos-Aracil CL, Soria Fernández-Llamazares G, Toledano-Macías M, Cristóbal-Bilbao R, Luquín-Ciuro N, Marrero-Francés J, Piedrabuena-García SI, Satué-Bartolomé JA, Gonzalo-Pascua S, Rivilla-Jiménez M, Carpintero-García L, Ayala-Larrañaga I, García-Bermúdez V, Lara-Montes C, Llerena-Riofrío ÁR, RIvas-Prado L, Walter S, Escriba-Barcena A, San Martín López JV, Ruíz-Giardín JM. Prognostic factors and combined use of tocilizumab and corticosteroids in a Spanish cohort of elderly COVID-19 patients. J Med Virol 2021; 94:1540-1549. [PMID: 34845754 PMCID: PMC9015514 DOI: 10.1002/jmv.27488] [Citation(s) in RCA: 6] [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: 07/15/2021] [Revised: 05/08/2021] [Accepted: 11/28/2021] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID‐19) infection in elderly patients is more aggressive and treatments have shown limited efficacy. Our objective is to describe the clinical course and to analyze the prognostic factors associated with a higher risk of mortality of a cohort of patients older than 80 years. In addition, we assess the efficacy of immunosuppressive treatments in this population. We analyzed the data from 163 patients older than 80 years admitted to our institution for COVID‐19, during March and April 2020. A Lasso regression model and subsequent multivariate Cox regression were performed to select variables predictive of death. We evaluated the efficacy of immunomodulatory therapy in three cohorts using adjusted survival analysis. The mortality rate was 43%. The mean age was 85.2 years. The disease was considered severe in 76.1% of the cases. Lasso regression and multivariate Cox regression indicated that factors correlated with hospital mortality were: age (hazard ratio [HR] 1.12, 95% confidence interval [CI]: 1.03–1.22), alcohol consumption (HR 3.15, 95% CI: 1.27–7.84), CRP > 10 mg/dL (HR 2.67, 95% CI: 1.36–5.24), and oxygen support with Venturi Mask (HR 6.37, 95% CI: 2.18–18.62) or reservoir (HR 7.87, 95% CI: 3.37–18.38). Previous treatment with antiplatelets was the only protective factor (HR 0.47, 95% CI: 0.23–0.96). In the adjusted treatment efficacy analysis, we found benefit in the combined use of tocilizumab (TCZ) and corticosteroids (CS) (HR 0.09, 95% CI: 0.01–0.74) compared to standard treatment, with no benefit of CS alone (HR 0.95, 95% CI: 0.53–1.71). Hospitalized elderly patients suffer from a severe and often fatal form of COVID‐19 disease. In this regard, several parameters might identify high‐risk patients upon admission. Combined use of TCZ and CS could improve survival. The COVID‐19 disease in the elderly population (> 80 years) is severe in most cases. We analyze which parameters at admission may be useful to better stratify the risk of mortality. Oxygen demand on admission is the most accurate parameter to determine prognosis. A combined use of corticosteroids and tocilizumab may improve overall survival versus corticosteroids alone or standard of care.
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Affiliation(s)
| | - Nieves Mesa-Plaza
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Ana I Farfán-Sedano
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Laura Velázquez-Ríos
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - María Toledano-Macías
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Nuria Luquín-Ciuro
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Jorge Marrero-Francés
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - Sonia Gonzalo-Pascua
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Marta Rivilla-Jiménez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Ibone Ayala-Larrañaga
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Celia Lara-Montes
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Luis RIvas-Prado
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Stefan Walter
- Methodological Support Unit, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - José M Ruíz-Giardín
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Bernal-Bello D, Morales-Ortega A, Isabel Farfán-Sedano A, de Tena JG, Martín-López JVS. Imatinib in COVID-19: hope and caution. The Lancet Respiratory Medicine 2021; 9:938-939. [PMID: 34147143 PMCID: PMC8409974 DOI: 10.1016/s2213-2600(21)00266-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/19/2022]
Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid 28942, Spain.
| | - Alejandro Morales-Ortega
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid 28942, Spain; Department of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
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Morales-Ortega A, Farfán-Sedano AI, Izquierdo-Martínez A, Llarena-Barroso C, Jaenes-Barrios B, Mesa-Plaza N, Toledano-Macías M, Soria Fernández-Llamazares G, Molina-Esteban L, García de Tena J, Prieto-Menchero S, Gonzalo-Pascua S, San Martín-López JV, Bernal-Bello D. Antibody formation against SARS-CoV-2 in imatinib-treated COVID-19 patients. J Infect 2021; 84:248-288. [PMID: 34437930 PMCID: PMC8381632 DOI: 10.1016/j.jinf.2021.08.034] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
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Rivas-Prado L, Morales-Ortega A, Allodi-de la Hoz S, Bernal-Bello D. Hyperparathyroidism shows its hand: findings of osteitis fibrosa cystica. Lancet 2021; 397:1914. [PMID: 34022989 DOI: 10.1016/s0140-6736(21)00796-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/26/2021] [Accepted: 03/30/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Luis Rivas-Prado
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain.
| | - Alejandro Morales-Ortega
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Sonia Allodi-de la Hoz
- Department of Radiology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
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Morales-Ortega A, Rivas-Prado L, Frutos-Pérez B, Jaenes-Barrios B, Farfán-Sedano AI, García-Parra CJ, Hernández-Muniesa B, Duarte-Millán MÁ, Madroñal-Cerezo E, Ontañón-Nasarre A, Ruiz-Giardín JM, Bermejo F, García-Gil M, Gonzalo-Pascua S, San Martín-López JV, Bernal-Bello D. Early clinical experience with imatinib in COVID-19: Searching for a dual effect. J Infect 2021; 82:186-230. [PMID: 33549625 PMCID: PMC7862035 DOI: 10.1016/j.jinf.2021.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/23/2022]
Affiliation(s)
| | - Luis Rivas-Prado
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | | | | | | | - Elena Madroñal-Cerezo
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Ana Ontañón-Nasarre
- Department of Hospital Pharmacy, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Fernando Bermejo
- Department of Gastroenterology, Hospital Universitario de Fuenlabrada. Instituto de Investigación, Sanitaria Hospital La Paz (IdiPAZ), Madrid, Spain
| | - Mario García-Gil
- Department of Hospital Pharmacy, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Sonia Gonzalo-Pascua
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Morales-Ortega A, García de Tena J, Frutos-Pérez B, Jaenes-Barrios B, Farfán-Sedano AI, Canales-Albendea MÁ, Bernal-Bello D. COVID-19 in patients with hematological malignancies: Considering the role of tyrosine kinase inhibitors. Cancer 2021; 127:1937-1938. [PMID: 33721325 PMCID: PMC8250378 DOI: 10.1002/cncr.33432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/22/2020] [Indexed: 01/09/2023]
Affiliation(s)
| | | | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | | | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Morales-Ortega A, Bernal-Bello D, Llarena-Barroso C, Frutos-Pérez B, Duarte-Millán MÁ, García de Viedma-García V, Farfán-Sedano AI, Canalejo-Castrillero E, Ruiz-Giardín JM, Ruiz-Ruiz J, San Martín-López JV. Imatinib for COVID-19: A case report. Clin Immunol 2020; 218:108518. [PMID: 32599278 PMCID: PMC7319919 DOI: 10.1016/j.clim.2020.108518] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/21/2022]
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Bernal-Bello D, Jaenes-Barrios B, Morales-Ortega A, Ruiz-Giardin JM, García-Bermúdez V, Frutos-Pérez B, Farfán-Sedano AI, de Ancos-Aracil C, Bermejo F, García-Gil M, Zapatero-Gaviria A, San Martín-López JV. Imatinib might constitute a treatment option for lung involvement in COVID-19. Autoimmun Rev 2020; 19:102565. [PMID: 32376403 PMCID: PMC7252139 DOI: 10.1016/j.autrev.2020.102565] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/26/2022]
Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain..
| | | | | | | | | | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain..
| | | | | | - Fernando Bermejo
- Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Instituto de Investigación Sanitaria Hospital La Paz (IdiPaz), Madrid, Spain..
| | - Mario García-Gil
- Department of Hospital Pharmacy, Hospital Universitario de Fuenlabrada, Madrid, Spain..
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Cristóbal-Bilbao R, Bernal-Bello D, Zapatero-Gaviria A. Signo de Hutchinson como predictor de afectación ocular en herpes zoster oftálmico. Rev Clin Esp 2019; 219:100-101. [DOI: 10.1016/j.rce.2018.06.007] [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: 05/29/2018] [Accepted: 06/09/2018] [Indexed: 10/28/2022]
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Rueda-Camino J, Bernal-Bello D, Canora-Lebrato J, Velázquez-Ríos L, García de Viedma-García V, Guerrero-Santillán M, Duarte-Millán M, Cristóbal-Bilbao R, Zapatero-Gaviria A. High doses of systemic corticosteroids in patients hospitalized for exacerbation of chronic obstructive pulmonary disease. A cohort study. Rev Clin Esp 2017. [DOI: 10.1016/j.rceng.2017.07.003] [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: 11/26/2022]
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Bernal-Bello D, Guillén-del Castillo A, Selva-O'Callaghan A, Fonollosa-Pla V, de Tena JG, Simeón-Aznar CP. Understanding the Role of Antibodies as Markers of Cancer-Associated Systemic Sclerosis: Comment on the Article by Shah et al. Arthritis Rheumatol 2017; 69:1914-1915. [DOI: 10.1002/art.40129] [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: 03/24/2017] [Accepted: 04/13/2017] [Indexed: 11/11/2022]
Affiliation(s)
- David Bernal-Bello
- Hospital Universitario de Fuenlabrada and Universidad Rey Juan Carlos; Madrid Spain
| | | | | | - Vicent Fonollosa-Pla
- Hospital Universitario Vall d'Hebron and Universidad Autónoma de Barcelona; Barcelona Spain
| | - Jaime García de Tena
- Hospital Universitario de Guadalajara, Guadalajara, Spain and Universidad de Alcalá; Alcalá de Henares Spain
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Rueda-Camino JA, Bernal-Bello D, Canora-Lebrato J, Velázquez-Ríos L, García de Viedma-García V, Guerrero-Santillán M, Duarte-Millán MA, Cristóbal-Bilbao R, Zapatero-Gaviria A. High doses of systemic corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease. A cohort study. Rev Clin Esp 2017; 217:504-509. [PMID: 28865758 DOI: 10.1016/j.rce.2017.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 05/12/2017] [Revised: 06/06/2017] [Accepted: 07/30/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the effect of high doses of corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS A prospective cohort study was conducted on patients hospitalized with COPD between January and March 2015, grouped according to the glucocorticoid dosage administered (cutoff, 40mg of prednisone/day). We compared the results of hospital stay, readmission and mortality at 3 months of discharge. RESULTS We analysed 87 patients. The median daily dose was 60mg of prednisone (interquartile range, 46.67-82.33mg/day), and the administration route was intravenous in 96.6% of the cases. We established a relative risk (RR) for hospital stays longer than 8 days of 1.095 (95% CI 0.597-2.007; P=.765) when steroid dosages greater than 40mg/day were employed. In these patients, the hazard ratio (HR) for readmission in the 3 months after discharge was 0.903 (95% CI 0.392-2.082; P=.811), and the mortality was 1.832 (95% CI 0.229-16.645; P=.568). Neither the RR nor the HR varied in a statistically significant manner after adjusting for confounding factors. CONCLUSIONS A daily dose greater than 40mg of prednisone in patients hospitalised for COPD exacerbation was not associated with a shorter hospital stay or a reduction in readmissions or mortality at 3 months.
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Affiliation(s)
- J A Rueda-Camino
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
| | - D Bernal-Bello
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - J Canora-Lebrato
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - L Velázquez-Ríos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | | | - M Guerrero-Santillán
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - M A Duarte-Millán
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - R Cristóbal-Bilbao
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - A Zapatero-Gaviria
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
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Bernal-Bello D, de Tena JG, Guillén-Del Castillo A, Selva-O'Callaghan A, Callejas-Moraga EL, Marín-Sánchez AM, Fonollosa-Pla V, Simeón-Aznar CP. Novel risk factors related to cancer in scleroderma. Autoimmun Rev 2017; 16:461-468. [PMID: 28285170 DOI: 10.1016/j.autrev.2017.03.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 02/03/2017] [Accepted: 02/09/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Emerging data have shown an increased risk of malignancy among patients diagnosed with systemic sclerosis (SSc) so identification of risk factors linking both disorders might have prognostic implications. The aim of this study was to assess the clinical and treatment-related risk factors for cancer in a single-center cohort of patients with SSc. METHODS Demographic, clinical, capillaroscopic, immunological and treatment-related data from 432 consecutive SSc patients were retrospectively analyzed. Variables that reached significant association in the univariate analysis were entered into a logistic regression in order to identify independent risk factors for cancer. RESULTS Malignancy was diagnosed in 53 patients (12.2%). Fifty-eight neoplasms were identified, among which breast (n=15), lung (n=10) and hematologic (n=9) malignancies were the most prevalent. In 19 patients the diagnosis of both scleroderma and tumour was made in <3years apart. Cancer significantly decreased the probability of survival (OR=2.61; 95%CI 1.46-4.69; p=0.001). No association with age, sex, smoking, cutaneous subset or RNA polymerase-III antibodies was found. However, risk of cancer was directly associated with the presence of anti-PM/Scl antibodies (OR=3.90; 95%CI 1.31-11.61; p=0.014), and inversely related to aspirin use (OR=0.33; 95%CI 0.12-0.90; p=0.031), which remained as independent risk factors for cancer on multivariate analysis. CONCLUSIONS PM/Scl antibodies seem to be associated with a higher risk of cancer in scleroderma. In contrast, the use of aspirin is related to a lower risk of cancer in our series. More studies are needed to ascertain the role of anti PM/Scl antibodies and aspirin in the development of malignancy among patients with SSc.
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Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, C/Camino del Molino, 2, 28942, Fuenlabrada, Madrid, Spain.
| | - Jaime García de Tena
- Department of Internal Medicine, Hospital Universitario de Guadalajara, Universidad de Alcalá, C/Donante de Sangre, s/n, 19002 Guadalajara, Spain.
| | - Alfredo Guillén-Del Castillo
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Albert Selva-O'Callaghan
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Eduardo L Callejas-Moraga
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Ana María Marín-Sánchez
- Department of Immunology, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Vicent Fonollosa-Pla
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Carmen Pilar Simeón-Aznar
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
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Bernal-Bello D, García de Tena J, Simeón-Aznar C, Fonollosa-Pla V. Systemic sclerosis, breast cancer and calcium channel blockers: A new player on the scene? Autoimmun Rev 2014; 13:880-1. [DOI: 10.1016/j.autrev.2014.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 03/08/2014] [Indexed: 01/02/2023]
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Affiliation(s)
- Jaime García de Tena
- Servicio de Medicina Interna, Hospital Universitario de Guadalajara, Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Guadalajara 19002, Spain.
| | - Laura Abejón-López
- Servicio de Medicina Interna, Hospital Universitario de Guadalajara, Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Guadalajara 19002, Spain
| | - Cristina Hernández-Gutiérrez
- Servicio de Medicina Interna, Hospital Universitario de Guadalajara, Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Guadalajara 19002, Spain
| | - David Bernal-Bello
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | - Manuel Rodríguez-Zapata
- Servicio de Medicina Interna, Hospital Universitario de Guadalajara, Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Guadalajara 19002, Spain
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Bernal-Bello D, Águila Fernández-Paniagua E, Betancort-Plata C, García de Tena J. [General Pathology training in Spain: is the resident a stone guest?]. Rev Clin Esp 2013; 214:51. [PMID: 24184037 DOI: 10.1016/j.rce.2013.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 10/01/2013] [Indexed: 11/19/2022]
Affiliation(s)
- D Bernal-Bello
- Servicio de Medicina Interna, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España.
| | | | - C Betancort-Plata
- Servicio de Medicina Interna, Hospital Universitario de Guadalajara, Guadalajara, España
| | - J García de Tena
- Servicio de Medicina Interna, Hospital Universitario de Guadalajara, Guadalajara, España; Departamento de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España
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Bernal-Bello D. El residente como docente, Quo vadis? Rev Clin Esp 2012; 212:255-8. [DOI: 10.1016/j.rce.2012.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 01/20/2012] [Accepted: 01/29/2012] [Indexed: 10/28/2022]
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Bernal-Bello D, García de Tena J, Abejón-López L, Megino-Moreno T, Barrio-Gordillo J, Rodríguez-Zapata M. Afectación atípica de palmas y plantas en la neumonía por varicela. Rev Clin Esp 2012; 212:e25-7. [DOI: 10.1016/j.rce.2011.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 10/17/2011] [Indexed: 11/15/2022]
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