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Nhangave AV, Evaristo B, Osório D, Muhiwa A, Nacarapa E, Ramos JM, Munyangaju I. Knowledge about Cervical Cancer Prevention and Screening in Women with Cervical Cancer Attending Gynecological Services in Southern Mozambique. Niger J Clin Pract 2023; 26:1616-1620. [PMID: 38044763 DOI: 10.4103/njcp.njcp_893_22] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/09/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Mozambique has high rates of cervical cancer and cancer-related deaths among women. A high rate of refusal and low acceptance of treatment is observed among cervical cancer patients. The extent of their knowledge of the disease is unknown. OBJECTIVES To assess knowledge about this disease (prevention, risk factors, and the possibilities of early diagnosis) in women with cervical cancer attended in gynecological services in Gaza province, Mozambique. MATERIALS AND METHODS This cross-sectional study took place in the city of Xai-Xai at the Provincial Hospital of Xai-Xai (HPXX) in the southern province of Gaza (Mozambique). Non-probability convenience sampling was used. Eligible patients (women) aged 35-50 years, diagnosed with cervical cancer and followed at the HPXX in the second quarter of 2021 (n = 60), took part in the survey during their scheduled consultations. Descriptive statistics were calculated using SPSS statistical software (version 16). RESULTS The study included 60 women, 39 (65%) HIV positive. More than half (55.0%) believed that having a single sexual partner was an effective form of prevention; 50.0% reported that excessive alcohol consumption and having many sexual partners could cause the disease, and 46.7% affirmed that having many children increased the risk. Thirty-eight (63.3%) women reported that early diagnosis of cervical cancer was important for receiving prompt treatment, and 54 (90.0%) said regular visits to the gynecologist were important for an early diagnosis. Thirty-five (58.3%) mentioned acetic acid screening as a diagnostic test. CONCLUSIONS There are significant gaps in awareness of cervical cancer among high-risk groups.
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Affiliation(s)
- A V Nhangave
- Research Department, Gaza Provincial Research Nucleus, Provincial Health Directorate, Xai-Xai - Gaza Province, Mozambique
| | - Blc Evaristo
- Business Administration and Management, Gwaza Muthini Higher Institute of Management and Entrepreneurship, Vila de Marracuene, Maputo Province, Mozambique
| | - D Osório
- Clinical Research, Tinpswalo Association, Vincentian Association to Fight AIDS and TB, F2C3+JPR Av. De Trabalho, Chokwe, Gaza Province, Mozambique
| | - A Muhiwa
- Clinical Research, Tinpswalo Association, Vincentian Association to Fight AIDS and TB, F2C3+JPR Av. De Trabalho, Chokwe, Gaza Province, Mozambique
| | - E Nacarapa
- Clinical Research, Tinpswalo Association, Vincentian Association to Fight AIDS and TB, F2C3+JPR Av. De Trabalho, Chokwe, Gaza Province, Mozambique
| | - J M Ramos
- Department of Clinical Medicine, Alicante General University Hospital and University Miguel Hernandez de Elche, Avinguda de la Universitat d'Elx, Elche, Alicante, Spain
| | - I Munyangaju
- Clinical Research, Tinpswalo Association, Vincentian Association to Fight AIDS and TB, F2C3+JPR Av. De Trabalho, Chokwe, Gaza Province, Mozambique
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Abstract
Human immunodeficiency virus type 2 (HIV-2) was isolated in AIDS patients in 1986. Around 1-2 million people are infected worldwide. The virus is less transmissible than HIV-1, being sexual contacts the most frequent route of acquisition. In the absence of antiretroviral therapy, most HIV-2 carriers will develop AIDS; however, it takes longer than in HIV-1 infection. There is no global pandemic caused by HIV-2, as the virus is largely confined to West Africa. Due to historical ties, HIV-2 is also prevalent in Portugal and its former colonies in Brazil, India, Mozambique, and Angola. Other European countries with hundreds to thousands of HIV-2 infections are France, Belgium, and Spain. A few hundred have been reported in North America, mostly in West African foreigners. Globally, HIV-2 infections are steadily declining. Although CD4 declines occur more slowly in HIV-2 than in HIV-1 patients, the CD4 recovery with antiretroviral treatment is smaller in the former. HIV-2 is naturally resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) and some protease inhibitors. In contrast, HIV-2 is susceptible to all NRTIs and integrase inhibitors. Drug resistance in HIV-2 may develop earlier than in HIV-1 and select for mutations at distinct sites. Misdiagnosis of HIV-2 in patients wrongly considered as HIV-1 positive or in those dually infected may result in treatment failures with undetectable HIV-1RNA. Given the relatively large number of West Africans migrated to the European Union and North America, HIV-2 infection either alone or as coinfection with HIV-1 should be excluded at least once in all HIV-seroreactive persons. This should be stressed in the face of atypical HIV serological profiles, immunovirological disconnect (CD4 cell count loss despite undetectable HIV-1 viremia), and/or high epidemiological risks (birth in or sex partners from HIV-2 endemic regions). Superinfection with any HIV variant may occur in persons infected with the other, since there is no cross-protection. Thus, earlier antiretroviral therapy is warranted for either HIV-1 or HIV-2, given that it would protect from each other superinfection in persons at risk.
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Affiliation(s)
- Carmen de Mendoza
- Department of Internal Medicine, IIS Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Ana B Lozano
- Infectious Diseases Unit, Hospital de Poniente, Almería, Spain
| | | | - Teresa Cabezas
- Microbiology Unit, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | - José M Ramos
- Infectious Diseases Unit, Hospital Universitario, Alicante, Spain
| | - Vicente Soriano
- UNIR Health Sciences School and Medical Center, Madrid. Spain
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Garitano I, Linares M, Santos L, Santamaría V, Galicia F, Ramos JM. [Estimating the number of COVID-19 cases using a web-based tool: Results from the first week of the 'Covid-19 Trends' project in the Basque Country]. Semergen 2020; 46 Suppl 1:111-117. [PMID: 32513502 PMCID: PMC7241357 DOI: 10.1016/j.semerg.2020.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 04/27/2020] [Accepted: 05/17/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In the Basque Country, two cases of COVID-19 were diagnosed on February 28 2020. On March 14, the Spanish Government established a state of alarm. Only cases confirmed by molecular biology (reverse-transcriptase polymerase chain reaction [RT-PCR]) were known. We launched a web-based surveillance tool to estimate the number of symptomatic cases of COVID-19 to contribute to Public Health decision-making. MATERIAL AND METHODS We implemented an anonymous web questionnaire and disseminated it through online social media social. We collected epidemiological information about «time» (date of onset of symptoms), «place» (zip code), and «person» (gender, age). We compared cases detected by RT-PCR with the estimated cases, according to the case definition of the Ministry of Health. We calculated the questionnaire response rate and the cumulative incidence at 14days. RESULTS Between March 19 and 26, 128,009 people answered the questionnaire (5.5% of the Basque population). Of these, 26,375 met the case definition (symptom prevalence of 21.4%). The estimated cases were almost six times more than COVID-19 positive RT-PCR. The estimated 14-day cumulative incidence was 578.3 per 100,000 population compared to RT-PCR positive cases, which was 139.6 per 100,000 population. CONCLUSIONS This tool was useful in estimating the minimum number of symptomatic cases in the Basque Country, which could support Public Health actions.
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Affiliation(s)
- I Garitano
- Fundación iO, Madrid, España; Organización Sanitaria Integrada Araba, Osakidetza-Servicio Vasco de Salud, Vitoria-Gasteiz, España.
| | - M Linares
- Fundación iO, Madrid, España; Centro de Salud Buenos Aires, Servicio Madrileño de Salud, Madrid, España
| | - L Santos
- Fundación iO, Madrid, España; Centro de Salud Buenos Aires, Servicio Madrileño de Salud, Madrid, España
| | - V Santamaría
- Dirección de Business Intelligence, Telefónica, Madrid, España
| | | | - J M Ramos
- Departamento de Medicina Clínica, Facultad de Medicina, Universidad Miguel Hernández de Elche, Elche, Alicante, España
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Ramos JM, Comeche B, Tesfamariam A, Reyes F, Tiziano G, Balcha S, Edada T, Biru D, Pérez-Butragueño M, Górgolas M. Sex differences and HIV status of tuberculosis in adults at a rural hospital in southern Ethiopia: an 18-year retrospective cross-sectional study. Afr Health Sci 2020; 20:605-614. [PMID: 33163021 PMCID: PMC7609105 DOI: 10.4314/ahs.v20i2.8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the study was to compare the epidemiology, clinical characteristics and treatment outcome of tuberculosis (TB), including HIV status, in women and men in southern rural Ethiopia. Methods We conducted a register-based retrospective cohort study covering the period from September 1998 to August 2015. Result We included records of 2252 registered TB patients: 1080 (48%) women and 1172 (52%) men. Median age was similar for women and men: 27.5 years and 25.0 years, respectively. Median weight in women was 43.0 kg (interquartile range IQR: 38.0, 49.0), significantly lower than in men (50.0 kg, IQR 44.0, 55.0; p = 0.01). Extrapulmonary TB was significantly more common in women than in men (34.1% versus 28.7%; p=0.006). Treatment outcomes were similar in both sexes: in 70.3% of women and 68.9% of men, TB mortality was slightly lower in women than men (4.7% vs. 6.5%; p=0.08). In patients with TB, female sex was independently associated with low weight (adjusted aOR: 0.91; 95% CI 0.90, 0.92), less mortality (aOR: 0.54; 95% CI 0.36, 0.81), and lymph node TB (aOR: 1.57; 95% CI 1.13, 2.19) Conclusion Lymph node TB was more common in women. Treatment outcomes were similar in both sexes, but women had a lower mortality rate.
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Affiliation(s)
- José M Ramos
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
- Department of Internal Medicine. Alicante General University Hospital, ISABIAL, and Miguel Hernández University of Elche, Alicante, Spain
- Correspondence author: José Manuel Ramos, Department of Internal Medicine. Hospital General Universitario de Alicante Calle Pintor Baeza 12. Alicante 03010, Spain Tel: +34 96 593 30 00
| | - Belén Comeche
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
- National Referral Unit for Tropical Disease, Infectious Diseases Department, Ramón y Cajal University Hospital, IRICYS, Madrid, Spain
| | - Abraham Tesfamariam
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
| | - Francisco Reyes
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
| | - Gebre Tiziano
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
| | - Seble Balcha
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
| | - Tamasghen Edada
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
| | - Dejene Biru
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
| | - Mario Pérez-Butragueño
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
- Departament of Pedaitrics, Infanta Leonor University Hospital, Madrid, Spain
| | - Miguel Górgolas
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Ethiopia
- Division of Infectious Diseases, Fundación Jiménez Diaz University Hospital, and Autonomic University of Madrid, Madrid, Spain
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González-Alcaide G, Pinargote H, Ramos JM. From cut-points to key players in co-authorship networks: a case study in ventilator-associated pneumonia research. Scientometrics 2020; 123:707-733. [PMID: 32431466 PMCID: PMC7222111 DOI: 10.1007/s11192-020-03404-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/11/2019] [Indexed: 11/21/2022]
Abstract
In co-authorship networks, some nodes play the key role of cut-point, facilitating the integration of other authors and favoring connectivity among different research communities. The present study uses bibliometric and network embeddedness indicators to analyze the scientific activity on ventilator-associated pneumonia and the roles of 17 research communities and 30 cut-points therein. In addition to fostering network connectivity and cohesion, cut-points are characterized by other differential features compared to other authors, including a much higher level of productivity and greater participation in leadership positions, higher betweenness values, lower clustering coefficients and higher levels of constraint. The cut-points identified have different characteristics in terms of the connectivity they facilitate between research communities: some cut-points have established weak intercommunity ties in the form of bridges with a single author from a different community; in other cases, they serve as gatekeepers due to their connection with different authors of a community that they link with their own; cut-points may also act as structural folds, that is, actors with an overlapping role between two cohesive communities. The cut-points present very diverse connectivity degrees, with some cut-points whose elimination would provoke severe network fragmentation and others who are responsible for linking far fewer external authors to their network. The cut-points that present both the main mechanisms for obtaining social capital—that is, filling structural holes and participating in cohesive network structures—can be considered key actors/players because their participation is crucial for ensuring both integration into the main research focus of some communities with high research performance and the overall cohesion of a co-authorship network.
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Affiliation(s)
| | - Héctor Pinargote
- Department of Internal Medicine, General University Hospital of Alicante, Alicante, Spain
| | - José M Ramos
- 3Department of Clinical Medicine, Miguel Hernandez University of Elche de Elche, Alicante, Spain
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Linares M, Garitano I, Santos L, Ramos JM. [Estimation of the number of cases of COVID-19 in real time using a web form through social networks: Project COVID-19-TRENDS]. Semergen 2020; 46 Suppl 1:114-116. [PMID: 32467013 PMCID: PMC7167545 DOI: 10.1016/j.semerg.2020.04.001] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/15/2022]
Affiliation(s)
- M Linares
- Fundación iO, Madrid, España; Centro de Salud Buenos Aires, Servicio Madrileño de Salud, Madrid, España.
| | - I Garitano
- Organización Sanitaria Integrada Araba (OSI Araba), Osakidetza-Servicio Vasco de Salud, Vitoria-Gasteiz, España
| | - L Santos
- Fundación iO, Madrid, España; Centro de Salud Buenos Aires, Servicio Madrileño de Salud, Madrid, España
| | - J M Ramos
- Departamento de Medicina Clínica, Facultad de Medicina, Universidad Miguel Hernández de Elche, Alicante, España
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Mira JJ, Martin-Delgado J, Aibar C, Gómez G, Ramos JM, Aranaz J, Gómez-Muzas F, Ruguero MJ, Cobos A, Colmenero M, Gorricho J, Silvestre C, Egea-Valera MA, Marqués-Espí JA, García-Montero JI, Carrillo I. Bed 13 is not worse than any other. A retrospective cohort study. J Healthc Qual Res 2020; 35:79-85. [PMID: 32273107 DOI: 10.1016/j.jhqr.2019.11.002] [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: 09/23/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Risk management and patient safety are closely related, following this premise some industries have adopted measures to omit number 13. Healthcare is not left behind, in some hospital the day of surgery's or bed numbering avoid number 13. The objective was to assess whether it is necessary to redesign the safety policies implemented in hospitals based on avoiding 13 in the numbering of rooms/beds. METHODS A retrospective cohort study was conducted. Mortality and the number of adverse events suffered by patients admitted to rooms/beds numbering 13 (bad chance) or 7 (fair chance) over a two-year period to Intensive Care Unit, Medicine, Gastroenterology, Surgery, and Paediatric service were registered and compared. RESULTS A total of 8553 admissions were included. They had similar length-of-stay and Charlson Index scores (p-value=0.435). Mortality of bed 13 was 268 (6.2%, 95% CI 5.5-6.9) and 282 in bed 7 (6.7%, 95% CI 5.9-7.5) (p-value=0.3). A total of 422 adverse events from 4342 admissions (9.7%, 95% CI 8.9-10.6) occurred in bed 13, while in bed 7 the count of adverse events was 398 in 4211 admissions (9.4%, 95% CI 8.6-10.4) (p-value=0.6). Odds Ratio for mortality was equal to 0.9 (95% CI 0.8-1.1) and suffering adverse events when admitted to bed 13 versus bed 7 was 1.03 (95% CI 0.9-1.2). CONCLUSIONS Bed 13 is not a risk factor for patient safety. Hospitals should pay attention to causes and interventions to avoid adverse events based on evidence rather than beliefs or myths.
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Affiliation(s)
- J J Mira
- Health District Alicante-Sant Joan, Alicante, Spain; Miguel Hernández University, Elche, Spain
| | - J Martin-Delgado
- Foundation for the Promotion of Health and Biomedical Research, Sant Joan d'Alacant, Spain.
| | - C Aibar
- Aragon Health Service, Zaragoza, Spain
| | - G Gómez
- Madrid Health Service, Madrid, Spain
| | - J M Ramos
- Madrid Health Service, Madrid, Spain
| | - J Aranaz
- Preventive Medicine and Public Health Service, Ramon y Cajal University Hospital, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - F Gómez-Muzas
- Department of Universal and Public Health, Alicante, Spain
| | - M J Ruguero
- Department of Universal and Public Health, Alicante, Spain
| | - A Cobos
- Andalusian Health Service, Granada, Spain
| | | | - J Gorricho
- Navarre Health Service - Osasunbidea, Pamplona, Spain
| | - C Silvestre
- Navarre Health Service - Osasunbidea, Pamplona, Spain
| | | | | | | | - I Carrillo
- Miguel Hernández University, Elche, Spain; Foundation for the Promotion of Health and Biomedical Research, Sant Joan d'Alacant, Spain
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Ramos JM, Pérez-Butragueño M, Tesfamariam A, Reyes F, Tiziano G, Endirays J, Balcha S, Elala T, Biru D, Comeche B, Górgolas M. Comparing tuberculosis in children aged under 5 versus 5 to 14 years old in a rural hospital in southern Ethiopia: an 18-year retrospective cross-sectional study. BMC Public Health 2019; 19:856. [PMID: 31266471 PMCID: PMC6604275 DOI: 10.1186/s12889-019-7206-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 11/07/2018] [Accepted: 06/19/2019] [Indexed: 11/18/2022] Open
Abstract
Background There are few data available about childhood tuberculosis (TB) in rural hospitals in low-income countries. We assessed differences in epidemiological characteristics and treatment outcomes in children with TB aged 0–4 versus 5–14 years in rural Ethiopia. Methods For this retrospective cross-sectional study, we analyzed childhood TB registers from a rural Ethiopian hospital. We collected data on the number of cases, type of TB, and treatment outcomes using standard definitions. By means of binary and logistic regression analyses, data were compared from 1998 to 2015 in children aged under 5 versus those aged 5–14 years. Results We included 1282 TB patients: 583 (45.5%) were under 5 years old, and 699 (54.5%) were aged 5–14 years. More than half (67.2%, n = 862) had pulmonary TB (PTB), which was more common in younger children (82.5%, 481/583) than in older ones (54.5%, 381/699; p < 0.001). Most cases of PTB (87.5%, 754/862) were smear negative, including virtually all (99.6%, 479/481) younger children and most older ones (72.2%, n = 275/381; p < 0.001). The most common types of extrapulmonary TB (EPTB) were TB adenitis (54.5%, 229/420) and bone TB (20%, 84/420). Children under five showed a lower prevalence of adenitis TB (9.9% [58/583] versus 24.5% [171/699], p < 0.001), bone TB (2.9% [17/583] versus 9.6% [69/699], p < 0.001), and abdominal TB (0.9% [5/583] versus 6.3% [44/699], p < 0.001). Most diagnoses were new cases of TB (98.2%, 1259/1282). Overall, 63.5% (n = 814) of the children successfully completed treatment (< 5 years: 56.6%, 330/583; 5–14 years: 69.2%, 489/699; p < 0.001). In total, 16.3% (n = 209) transferred to another center (< 5 years: 19.4%, 113/583; 5–14 years: 13.7%, 96/699; p = 0.006). Thirteen percent of patients (n = 167) were lost to follow-up (< 5 years: 16.0%, 93/583; 5–14 years: 10.4%, 74/699; p = 0.004). Fifty-two (4.1%) children died (no age differences). Being aged 5–14 years was independently associated with successful treatment outcomes (adjusted odds ratio 1.59; 95% confidence interval: 1.16, 1.94, p = 0.002). Conclusions We observed a very low diagnostic yield for spontaneous sputum smear in children with TB. In this rural setting in Ethiopia, very young children tend to present with new cases of smear-negative PTB. They have less EPTB than older children but more TB meningitis and show lower rates of treatment success. Electronic supplementary material The online version of this article (10.1186/s12889-019-7206-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- José M Ramos
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia. .,Department of Internal Medicine, Alicante General University Hospital, ISABIAL, Calle Pintor Baeza, 12, 03010, Alicante, Spain. .,Miguel Hernández University of Elche, Alicante, Spain.
| | - Mario Pérez-Butragueño
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia.,Department of Pediatrics, Infanta Leonor University Hospital, Madrid, Spain
| | - Abraham Tesfamariam
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia
| | - Francisco Reyes
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia
| | - Gebre Tiziano
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia
| | - Jacob Endirays
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia
| | - Seble Balcha
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia
| | - Tamasghen Elala
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia
| | - Dejene Biru
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia
| | - Belén Comeche
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia.,National Referral Unit for Tropical Disease, Infectious Diseases Department, Ramón y Cajal University Hospital, IRICYS, Madrid, Spain
| | - Miguel Górgolas
- Department of Medicine and Pediatrics, Gambo Rural General Hospital, Shashamane, Ethiopia.,Division of Infectious Diseases, Jiménez Diaz University Hospital Foundation, and Autonomic University of Madrid, Madrid, Spain
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Ramos JM, García-Navarro M, Moreno V, González-de-la-Aleja P, Gimeno-Gascón A, Merino E, Portilla J. Interleukin (IL) -1 β, IL-6 and tumor necrosis factor in patients with seasonal flu. Rev Esp Quimioter 2018; 31:542-545. [PMID: 30421883 PMCID: PMC6254480] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The role of tumor necrosis factor (TNF), interleukin (IL)-1β and IL-6 in the pathogenicity of seasonal flu is unknown. METHODS We analyzed the profiles of these cytokines in 77 flu patients and 17 controls with non-flu respiratory infection, using molecular biology techniques (real-time polymerase chain reaction). RESULTS Flu patients had lower monocyte counts (p=0.029) and a slightly lower median level of IL-6 (P=0.05) than the control group. Twenty-four flu patients (31.2%) had pneumonia; this group had higher C-reactive proteins (p=0.01) and monocyte levels (p=0.009). Pro-inflammatory cytokines levels did not rise in patients with pneumonia complicating seasonal influenza. CONCLUSIONS IL-6 levels were lower in adults with influenza.
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Affiliation(s)
- José M. Ramos
- Department of Internal Medicine, Alicante University General Hospital; Department of Clinical Medicine, Miguel Hernandez University; ISABIAL - FISABIO, Alicante, Spain
| | - Mar García-Navarro
- Department of Internal Medicine, Alicante University General Hospital; Department of Clinical Medicine, Miguel Hernandez University; ISABIAL - FISABIO, Alicante, Spain
| | - Victoria Moreno
- Immunology Area, Department of Clinical Medicine, Miguel Hernández University; Alicante University General Hospital, ISABIAL - FISABIO, Alicante, Spain
| | - Pilar González-de-la-Aleja
- Department of Internal Medicine, Alicante University General Hospital; Department of Clinical Medicine, Miguel Hernandez University; ISABIAL - FISABIO, Alicante, Spain
| | - Adelina Gimeno-Gascón
- Microbiology Service, Alicante University General Hospital; ISABIAL - FISABIO, Alicante, Spain
| | - Esperanza Merino
- Infectious Diseases Unit, Alicante University General Hospital; Department of Clinical Medicine, Miguel Hernandez University; ISABIAL - FISABIO, Alicante, Spain
| | - Joaquín Portilla
- Department of Internal Medicine, Alicante University General Hospital; Department of Clinical Medicine, Miguel Hernandez University; ISABIAL - FISABIO, Alicante, Spain,Infectious Diseases Unit, Alicante University General Hospital; Department of Clinical Medicine, Miguel Hernandez University; ISABIAL - FISABIO, Alicante, Spain
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Jula J, Girones G, Edao B, Deme C, Cebrian J, Butrón L, Reyes F, Ramos JM. Seroprevalence of Toxoplasma gondii infection in pregnant women attending antenatal care in southern Ethiopia. Rev Esp Quimioter 2018; 31:363-366. [PMID: 29978983 PMCID: PMC6172689] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of the study was to assess the prevalence and possible risk factors of Toxoplasma gondii (toxoplasmosis) infection in pregnant women attending antenatal care at Gambo General Rural Hospital, southern Ethiopia. METHODS Hospital-based, prospective cross-sectional study. We collected 401 serum samples from September 1 to October 30, 2015, along with sociodemographic data and data on potential risk factors, using a simple random sampling technique. RESULTS The overall seroprevalence of T. gondii in pregnant women (mean age 23.1 years) was 23.9% (95% confidence interval [CI] 20.0, 28.3). We did not find any significant risk factors associated with seropositivity in relation with participants' level of education; occupation; contact with cats; consumption of raw or uncooked meat, vegetables, or milk; or type of flooring (soil versus cement) at home. The women who were aware of the risk of toxoplasma infection on the fetus had fewer T. gondii antibodies. Drinking unsafe water was as-sociated with a higher risk of toxoplasmosis (p = 0.08). CONCLUSIONS The seroprevalence of toxoplasmosis among pregnant women was relatively lower.
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Affiliation(s)
- Jemal Jula
- Gambo Rural General Hospital, Kore, West-Arsi, Ethiopia
| | - Guillermo Girones
- Department of Internal Medicine, Hospital General Universitario de Castellón, Castellón, Spain
| | - Beyene Edao
- Gambo Rural General Hospital, Kore, West-Arsi, Ethiopia
| | - Chala Deme
- Gambo Rural General Hospital, Kore, West-Arsi, Ethiopia
| | - Josefina Cebrian
- Microbiology Service, Hospital General Universitario de Alicante, Alicante. Spain
| | - Lidia Butrón
- Microbiology Service, Hospital General Universitario de Alicante, Alicante. Spain
| | | | - José M. Ramos
- Gambo Rural General Hospital, Kore, West-Arsi, Ethiopia,Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante. Spain,Miguel Hernández University of Elche, Alicante, Spain
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González-Alcaide G, Salinas A, Ramos JM. Scientometrics analysis of research activity and collaboration patterns in Chagas cardiomyopathy. PLoS Negl Trop Dis 2018; 12:e0006602. [PMID: 29912873 PMCID: PMC6023249 DOI: 10.1371/journal.pntd.0006602] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 02/21/2018] [Revised: 06/28/2018] [Accepted: 06/10/2018] [Indexed: 12/18/2022] Open
Abstract
Background Chagas cardiomyopathy is a serious and common complication of Chagas disease. Methods Through bibliometric and Social Network Analysis, we examined patterns of research on Chagas cardiomyopathy, identifying the main countries, authors, research clusters, and topics addressed; and measuring the contribution of different countries. Results We found 1932 documents on Chagas cardiomyopathy in the MEDLINE database. The most common document type was ‘journal article’, accounting for 79.6% of the total (n = 1538), followed by ‘review’ (n = 217, 11.2%). The number of published records increased from 156 in 1980–1984 to 311 in 2010–2014. Only 2.5% were clinical trials. Brazil and the USA dominated the research, participating in 53.1% and 25.7%, respectively, of the documents. Other Latin American countries where Chagas is endemic contributed less, with Bolivia, where Chagas disease is most prevalent, producing only 1.8% of the papers. We observed a high rate of domestic collaboration (83.1% of the documents published in 2010–2016) and a lower but significant rate of international collaboration (32.5% in the same time period). Although clinical research dominated overall, the USA, Mexico and several countries in Europe produced a considerable body of basic research on animal models. We identified four main research clusters, focused on heart failure and dysfunction (physical symptoms, imaging techniques, treatment), and on myocarditis and parasitemia in animal models. Conclusions Research on Chagas cardiomyopathy increased over the study period. There were more clinical than basic studies, though very few of the documents were clinical trials. Brazil and the USA are currently leading the research on this subject, while some highly endemic countries, such as Bolivia, have contributed very little. Different approaches could help to redress this imbalance: encouraging researchers to conduct more clinical trials, launching international collaborations to help endemic countries contribute more, and strengthening links between basic and clinical research. Scientific production on Chagas cardiomyopathy has grown considerably since the turn of the 21st century, probably reflecting the increased incidence of Chagas disease in non-endemic areas like the USA and Europe. Brazil and the USA dominate the research, but we found a very small proportion of clinical trials on Chagas cardiomyopathy and a low scientific production in several endemic countries with a high prevalence of the disease such as Colombia, Chile, Mexico and Bolivia. We observed a polarity between endemic and non-endemic countries where clinical research and basic research predominate, respectively. Different approaches could help to redress the observed imbalance of research on Chagas cardiomyopathy: encouraging researchers to conduct more clinical trials, launching international collaborations to help endemic countries contribute more, and strengthening links between basic and clinical research. It is crucial to foster translational research in order to link basic knowledge on the physiology of the disease with clinical applications in diagnosis and treatment.
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Affiliation(s)
- Gregorio González-Alcaide
- Department of History of Science and Documentation, University of Valencia, Valencia, Spain
- * E-mail:
| | | | - José M. Ramos
- Department of Clinical Medicine, Miguel Hernández University of Elche, Alicante, Spain
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
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12
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Ramos JM, Ortiz-Martínez S, Lemma D, Petros MM, Ortiz-Martínez C, Tesfamariam A, Reyes F, Belinchón I. Epidemiological and Clinical Characteristics of Children and Adolescents with Leprosy Admitted Over 16 Years at a Rural Hospital in Ethiopia: A Retrospective Analysis. J Trop Pediatr 2018. [PMID: 28645166 DOI: 10.1093/tropej/fmx048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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]
Abstract
AIM To analyse differences in children and adolescents aged ≤18 years admitted to the leprosy ward in a rural Ethiopian hospital >16 years. METHODS We retrospectively collected data from leprosy admission registry books on patients with leprosy who were admitted to a referral hospital from September 2000 to September 2016. RESULTS There were 2129 admissions for leprosy during the study period: 180 (8.4%) patients were s ≤ 18 years old. Of these, 98 (54.4%) were male and 82 (45.6%) were female. The proportion of new diagnoses in children and adolescents was 31.7%, significantly higher than in adults (11.7%; p < 0.001). There were also significant differences in the prevalence of lepromatous ulcers (46.9 vs. 61.7%), leprosy reaction (29.4 vs. 13.0%) and neuritis (16.9 vs.5.3%) between these age groups. CONCLUSIONS There were more new diagnoses, leprosy reactions and neuritis, and fewer lepromatous ulcers, in children and adolescents compared with adults, with younger patients being referred more frequently to reference centres.
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Affiliation(s)
- José M Ramos
- Department of Paediatrics and Medicine, Gambo Rural General Hospital, Shashemane, Ethiopia.,Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante 03010, Spain.,Department of Medicine, Miguel Hernández University of Elche, San Joan d'Alacant, Alicante 03550, Spain
| | - Sonia Ortiz-Martínez
- Department of Paediatrics and Medicine, Gambo Rural General Hospital, Shashemane, Ethiopia.,Primary Care Unit, El Bonillo Centro de Salud, Albacete 02610, Spain
| | - Deriba Lemma
- Department of Paediatrics and Medicine, Gambo Rural General Hospital, Shashemane, Ethiopia
| | - Matheus M Petros
- Department of Paediatrics and Medicine, Gambo Rural General Hospital, Shashemane, Ethiopia
| | - Carmen Ortiz-Martínez
- Palliative Care Unit, Hospital Nuestra Señora del Perpetuo Socorro, Albacete 02006, Spain
| | - Abraham Tesfamariam
- Department of Paediatrics and Medicine, Gambo Rural General Hospital, Shashemane, Ethiopia
| | - Francisco Reyes
- Department of Paediatrics and Medicine, Gambo Rural General Hospital, Shashemane, Ethiopia
| | - Isabel Belinchón
- Department of Medicine, Miguel Hernández University of Elche, San Joan d'Alacant, Alicante 03550, Spain.,Service of Dermatology, Hospital General Universitario de Alicante, Alicante 03010, Spain
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13
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Soriano V, Ramos JM, Barreiro P, Fernandez-Montero JV. AIDS Clinical Research in Spain-Large HIV Population, Geniality of Doctors, and Missing Opportunities. Viruses 2018; 10:v10060293. [PMID: 29848987 PMCID: PMC6024378 DOI: 10.3390/v10060293] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 05/24/2018] [Accepted: 05/25/2018] [Indexed: 02/07/2023] Open
Abstract
The first cases of AIDS in Spain were reported in 1982. Since then over 85,000 persons with AIDS have been cumulated, with 60,000 deaths. Current estimates for people living with HIV are of 145,000, of whom 20% are unaware of it. This explains the still high rate of late HIV presenters. Although the HIV epidemic in Spain was originally driven mostly by injection drug users, since the year 2000 men having sex with men (MSM) account for most new incident HIV cases. Currently, MSM represent over 80% of new yearly HIV diagnoses. In the 80s, a subset of young doctors and nurses working at Internal Medicine hospital wards became deeply engaged in attending HIV-infected persons. Before the introduction of antiretrovirals in the earlier 1990s, diagnosis and treatment of opportunistic infections was their major task. A new wave of infectious diseases specialists was born. Following the wide introduction of triple combination therapy in the late 1990s, drug side effects and antiretroviral resistance led to built a core of highly devoted HIV specialists across the country. Since then, HIV medicine has improved and currently is largely conducted by multidisciplinary teams of health care providers working at hospital-based outclinics, where HIV-positive persons are generally seen every six months. Antiretroviral therapy is currently prescribed to roughly 75,000 persons, almost all attended at clinics belonging to the government health public system. Overall, the impact of HIV/AIDS publications by Spanish teams is the third most important in Europe. HIV research in Spain has classically been funded mostly by national and European public agencies along with pharma companies. Chronologically, some of the major contributions of Spanish HIV research are being in the field of tuberculosis, toxoplasmosis, leishmaniasis, HIV variants including HIV-2, drug resistance, pharmacology, antiretroviral drug-related toxicities, coinfection with viral hepatitis, design and participation in clinical trials with antiretrovirals, immunopathogenesis, ageing, and vaccine development.
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Affiliation(s)
- Vicente Soriano
- Infectious Diseases Unit, La Paz University Hospital, 28046 Madrid, Spain.
- UNIR Health Sciences School, 28040 Madrid, Spain.
| | - José M Ramos
- Department of Internal Medicine, General University Hospital, 03010 Alicante, Spain.
| | - Pablo Barreiro
- Infectious Diseases Unit, La Paz University Hospital, 28046 Madrid, Spain.
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14
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Gómez-Hurtado I, Gimenez P, García I, Zapater P, Francés R, González-Navajas JM, Manichanh C, Ramos JM, Bellot P, Guarner F, Such J. Norfloxacin is more effective than Rifaximin in avoiding bacterial translocation in an animal model of cirrhosis. Liver Int 2018; 38:295-302. [PMID: 28834270 DOI: 10.1111/liv.13551] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/09/2017] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS Norfloxacin administration is useful in preventing bacterial infections in cirrhosis but associated to the generation of resistant species. Rifaximin is known to reach high concentrations in the intestinal lumen without generating relevant resistance in the intestinal flora. Our aim was to compare the effect of Norfloxacin and Rifaximin on intestinal flora composition, bacterial translocation and survival in cirrhotic rats. METHODS Cirrhosis was induced in rats by oral administration of CCl4 . Animals were divided into three groups: only CCl4 (group I, n = 10); CCl4 + Norfloxacin (group II, n = 17) and CCl4 + Rifaximin (group III, n = 14). Gut bacterial composition, bacterial translocation and cytokine levels were measured. RESULTS Forty-one rats were finally included. The incidence of viable and non-viable bacterial translocation was significantly reduced in animals receiving Norfloxacin; Rifaximin also decreased the incidence of viable and non-viable bacterial translocation, but did not reach statistical significance. Serum TNF-α levels were significantly lower in antibiotic groups. Norfloxacin modified intestinal microbiota, depleting significantly more pathobionts than Rifaximin. CONCLUSION Norfloxacin is more effective than Rifaximin in preventing bacterial translocation in rats with cirrhosis probably because of its capacity to reduce pathobionts from intestinal microbiota.
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Affiliation(s)
- Isabel Gómez-Hurtado
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
- Instituto Investigación Sanitaria y Biomédica Alicante (ISABIAL-FISABIO), Alicante, Spain
| | - Paula Gimenez
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
- Instituto Investigación Sanitaria y Biomédica Alicante (ISABIAL-FISABIO), Alicante, Spain
| | - Irma García
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
| | - Pedro Zapater
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
- Instituto Investigación Sanitaria y Biomédica Alicante (ISABIAL-FISABIO), Alicante, Spain
- Departamento Farmacología Clínica, UMH, Alicante, Spain
| | - Rubén Francés
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
- Instituto Investigación Sanitaria y Biomédica Alicante (ISABIAL-FISABIO), Alicante, Spain
- Departamento Medicina Clínica, UMH, Alicante, Spain
| | - José M González-Navajas
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
- Instituto Investigación Sanitaria y Biomédica Alicante (ISABIAL-FISABIO), Alicante, Spain
| | - Chaysavanh Manichanh
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
- Departamento Gastroenterología, VHIR, Barcelona, Spain
| | - José M Ramos
- Departamento Medicina Interna, HGUA, Alicante, Spain
| | - Pablo Bellot
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
- Instituto Investigación Sanitaria y Biomédica Alicante (ISABIAL-FISABIO), Alicante, Spain
| | - Francisco Guarner
- CIBERehd, Instituto Salud Carlos III, Madrid, Spain
- Departamento Gastroenterología, VHIR, Barcelona, Spain
| | - José Such
- Cleveland Clinic, Digestive Disease institute, Abu Dhabi, UAE
- Lerner School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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15
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Torres P, Pérez CI, Oyarzabal M, Ramos JM. Situación laboral de los médicos de familia formados en la Unidad Docente de Alicante. Aten Primaria 2018; 50:131-133. [PMID: 29249389 PMCID: PMC6836959 DOI: 10.1016/j.aprim.2017.10.007] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 10/08/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- Paloma Torres
- Servicio de Urgencias, Hospital General Universitario de Elda, Elda, Alicante, España; Unidad Docente Multiprofesional de Atención Familiar y Comunitaria de Alicante, Alicante, España.
| | - Clara I Pérez
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria de Alicante, Alicante, España
| | - Milagros Oyarzabal
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria de Alicante, Alicante, España
| | - José M Ramos
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Campus de Sant Joan d'Alacant, Alicante, España
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16
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Affiliation(s)
- José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain; Department of Medicine, Miguel Hernández University of Elche, San Juan Campus, Spain.
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17
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González de la Aleja P, García-Navarro M, Sánchez-Martínez R, Ramos JM. [Incomplete POEMS syndrome with multicentric Castleman's disease]. An Sist Sanit Navar 2017; 40:475-478. [PMID: 28906499 DOI: 10.23938/assn.0041] [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] [Indexed: 11/18/2022]
Abstract
Castleman's disease (CD) is an atypical lymphoproliferative disorder of unknown cause, characterized by non-clonal nodal hyperplastic growth. Two forms of clinical presentation are currently recognized, one localized and the other multicentric, and four histopathologic variants. It is characterized by generalized lymphadenopathy, hepatosplenomegaly, fever and night sweats. CD may present severe pancytopenia, multi-organ failure, lymphoma evolution and it can sometimes be associated with paraneoplastic syndromes such as POEMS syndrome. Associations of these two entities have been widely described in the current literature, although its less common association with amyloidosis is described as isolated clinical cases. We report a case with this triple association: EC, POEMS and amyloidosis.
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18
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Pérez-Tanoira R, Marín I, Berbegal L, Prieto-Pérez L, Tisiano G, Cuadros J, Górgolas M, Ramos JM. Mycological profile of tinea capitis in schoolchildren in rural southern Ethiopia. Med Mycol 2017; 55:262-268. [PMID: 27555558 DOI: 10.1093/mmy/myw061] [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: 10/08/2015] [Accepted: 06/29/2016] [Indexed: 11/14/2022] Open
Abstract
Tinea capitis is a known common infection among schoolchildren in developing countries that is still underreported in Ethiopia. The aim of this study was to examine the epidemiologic and etiologic profile of tinea capitis among school-aged children in a rural area in southern Ethiopia. We collected demographic and clinicodermatological data from school children aged 3-12 years with tinea infections. Pathologic specimens were taken for potassium hydroxide (KOH) mount and mycological culture. Dermatophyte species were identified by macroscopic examination of the colony and microscopic examination of fungal cultures. A total of 634 schoolchildren were screened in the study; 128 cases were suspected for tinea capitis based on clinical examination of which 99 patients (mean age 6.7 years within a range of 4-12 years), who were subsequently positive, either based on KOH examination or showed growth of dermatophytes on culture, were included in our study. The ratio of males to females was 3:1. A total of 88 patients (89.9%) had a culture positive for dermatophytes. The zoophilic species Trichophyton verrucosum was the most prevalent isolate (n = 29 cases), followed by the anthropophilic species T. tonsurans (n = 27). The other Trichophyton species implicated were T. mentagrophytes (n = 14), as well as T. schoenleinii, T. soudanense, and T. violaceum. Only 11 of the isolates belonged to the genus Microsporum: M. audouinii (n = 8), M. ferrugineum (n = 2), and M. gallinae (n = 1). T. verrucosum, followed by T. tonsurans were the most frequent causative agents in this study.
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Affiliation(s)
- R Pérez-Tanoira
- Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.,Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain.,Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - I Marín
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - L Berbegal
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - L Prieto-Pérez
- Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.,Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain.,Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - G Tisiano
- Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia
| | - J Cuadros
- Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.,Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Microbiology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - M Górgolas
- Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.,Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Madrid, Spain.,Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - J M Ramos
- Department of Medicine and Laboratory, Gambo Rural General Hospital, Kore, West-Arsi, Gambo, Ethiopia.,Department of Internal Medicine, Hospital General Universitario de Alicante and Universidad Miguel Hernández de Elche, Alicante, Spain
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19
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Ramos JM, León R, Merino E, Montero M, Aljibe A, Blanes M, Reus S, Boix V, Salavert M, Portilla J. Is Visceral Leishmaniasis Different in Immunocompromised Patients Without Human Immunodeficiency Virus? A Comparative, Multicenter Retrospective Cohort Analysis. Am J Trop Med Hyg 2017; 97:1127-1133. [PMID: 29016284 DOI: 10.4269/ajtmh.16-0940] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Although visceral leishmaniasis (VL) can affect immunocompromised patients, data from the human immunodeficiency virus (HIV) infection context are limited, and the characteristics of VL in other immunosuppression scenarios are not well defined. A retrospective review of all cases of VL in immunocompromised patients from January 1997 to December 2014 in two Spanish hospitals on the Mediterranean coast was performed. We included 18 transplant recipients (kidney: 7, liver: 4, lung: 3, heart: 2, and blood marrow: 2), 12 patients with other causes of immunosuppression (myasthenia gravis: 3 and rheumatoid arthritis: 2), and 73 VL HIV-positive patients. Fever was more common in transplant patients (94.4%) and patients with other types of immunosuppression (100%) than in HIV-positive individuals (73.3%). Hepatomegaly was less common in transplant recipients (27.8%) and patients with other types of immunosuppression (41.7%) compared with HIV-positive patients (69.9%) (P = 0.01; P = 0.001, respectively). Patients with other types of immunosuppression had a median leukocyte count of 1.5 × 109/L, significantly lower than HIV-positive patients (2.5 × 109/L) (P = 0.04). Serology was more commonly positive in nontransplant immunosuppressed individuals (75%) and transplant recipients (78.6%) than in HIV-patients (13.8%) (P < 0.001). Antimonial therapy was rarely used in transplant recipients (1.9%) and never in patients with other immunosuppressive conditions, whereas 34.2% of HIV-positive patients received it (P = 0.05 and P = 0.01, respectively). Mortality was 16.7% in both transplant recipients and patients with other immunosuppressive conditions and 15.1% in HIV-positive patients. The features of VL may be different in immunosuppressed patients, with more fever and less hepatomegaly and leukopenia than in HIV-infected patients.
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Affiliation(s)
- José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain.,Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain
| | - Rafael León
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain.,Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
| | - Esperanza Merino
- Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain.,Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain
| | - Marta Montero
- Unit of Infectious Diseases and Department of Internal Medicine, Hospital Universitario-Politecnico La Fe, Valencia, Spain
| | - Asunción Aljibe
- Unit of Infectious Diseases and Department of Internal Medicine, Hospital Universitario-Politecnico La Fe, Valencia, Spain
| | - Marino Blanes
- Unit of Infectious Diseases and Department of Internal Medicine, Hospital Universitario-Politecnico La Fe, Valencia, Spain
| | - Sergio Reus
- Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain.,Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain
| | - Vicente Boix
- Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain.,Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain
| | - Miguel Salavert
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain
| | - Joaquín Portilla
- Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante. Alicante, Spain.,Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of San Juan de Alicante, Alicante, Spain.,Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
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20
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González-Alcaide G, Park J, Huamaní C, Ramos JM. Dominance and leadership in research activities: Collaboration between countries of differing human development is reflected through authorship order and designation as corresponding authors in scientific publications. PLoS One 2017; 12:e0182513. [PMID: 28792519 PMCID: PMC5549749 DOI: 10.1371/journal.pone.0182513] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [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: 05/08/2017] [Accepted: 07/11/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction Scientific collaboration is an important mechanism that enables the integration of the least developed countries into research activities. In the present study, we use the order of author signatures and addresses for correspondence in scientific publications as variables to analyze the interactions between countries of very high (VHHD), high (HHD), medium (MHD), and low human development (LHD). Methodology We identified all documents published between 2011 and 2015 in journals included in the Science Citation Index-Expanded categories’ of Tropical Medicine, Infectious Diseases, Parasitology, and Pediatrics. We then classified the countries participating in the publications according to their Human Development Index (HDI), analyzing the international collaboration; positioning and influence of some countries over others in cooperative networks; their leadership; and the impact of the work based on the HDI and the type of collaboration. Results We observed a high degree of international collaboration in all the areas analyzed, in the case of both LHD and MHD countries. We identified numerous cooperative links between VHHD countries and MHD/LHD countries, reflecting the fact that cooperative links are an important mechanism for integrating research activities into the latter. The countries with large emerging economies, such as Brazil and China stand out due to the dominance they exert in the collaborations established with the United States, the UK, and other European countries. The analysis of the leadership role of the countries, measured by the frequency of lead authorships, shows limited participation by MHD/LHD countries. This reduced participation among less developed countries is further accentuated by their limited presence in the addresses for correspondence. We observed significant statistical differences in the degree of citation according to the HDI of the participating countries. Conclusions The order of signatures and the address for correspondence in scientific publications are bibliographic characteristics that facilitate a precise, in-depth analysis of cooperative practices and their associations with concepts like dominance or leadership. This is useful to monitor the existing balance in research participation in health research publications.
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Affiliation(s)
- Gregorio González-Alcaide
- Department of History of Science and Documentation, University of Valencia, Valencia, Spain
- * E-mail:
| | - Jinseo Park
- Korea Institute of Science and Technology Information (KISTI), Daejeon, South Korea
| | - Charles Huamaní
- Servicio de Neurología, Hospital Nacional Guillermo Almenara, La Victoria, Perú
| | - José M. Ramos
- Department of Clinical Medicine, Miguel Hernández University of Elche de Elche, Alicante, Spain
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
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21
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Lingscheid T, Kurth F, Clerinx J, Marocco S, Trevino B, Schunk M, Muñoz J, Gjørup IE, Jelinek T, Develoux M, Fry G, Jänisch T, Schmid ML, Bouchaud O, Puente S, Zammarchi L, Mørch K, Björkman A, Siikamäki H, Neumayr A, Nielsen H, Hellgren U, Paul M, Calleri G, Kosina P, Myrvang B, Ramos JM, Just-Nübling G, Beltrame A, Saraiva da Cunha J, Kern P, Rochat L, Stich A, Pongratz P, Grobusch MP, Suttorp N, Witzenrath M, Hatz C, Zoller T. Schistosomiasis in European Travelers and Migrants: Analysis of 14 Years TropNet Surveillance Data. Am J Trop Med Hyg 2017; 97:567-574. [PMID: 28722637 PMCID: PMC5544096 DOI: 10.4269/ajtmh.17-0034] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 01/14/2017] [Accepted: 03/30/2017] [Indexed: 02/05/2023] Open
Abstract
Schistosomiasis remains one of the most prevalent parasitic diseases worldwide and the infection is frequently found in travelers and migrants. The European Network for Tropical Medicine and Travel Health conducted a sentinel surveillance study on imported schistosomiasis between 1997 and 2010. This report summarizes epidemiological and clinical data from 1,465 cases of imported schistosomiasis. Direct pathogen detection and serology were the main diagnostic tools applied. Of these, 486 (33%) cases were identified among European travelers, 231 (16%) among long-term expatriates, and 748 (51%) among non-European immigrants. Overall, only 18.6% of travelers had received pretravel advice; 95% of infections were acquired in the African region. On species level, Schistosoma mansoni was identified in 570 (39%) and Schistosoma haematobium in 318 (22%) cases; 57.5% of patients were symptomatic. Acute symptoms were reported in 27% of patients leading to earlier presentation within 3 months. Praziquantel was used in all patients to treat schistosomiasis. Many infections were detected in asymptomatic patients. In 47.4% of asymptomatic patients infection was detected by microscopy and in 39% by serology or antigen testing. Schistosomiasis remains a frequent infection in travelers and migrants to Europe. Travelers should be made aware of the risk of schistosomiasis infection when traveling to sub-Saharan Africa. Posttravel consultations particularly for returning expatriates are useful given the high potential for detecting asymptomatic infections.
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Affiliation(s)
- Tilman Lingscheid
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Florian Kurth
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Clerinx
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Stefania Marocco
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
| | - Begoña Trevino
- Tropical Medicine and International Health Unit, Hospital Vall d’Hebron Drassanes, PROSICS Barcelona, Barcelona, Spain
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the Ludwig-Maximilians-University (LMU), Munich, Germany
| | - José Muñoz
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Ida E. Gjørup
- Infectious Diseases Unit, Herlev University Hospital, Copenhagen, Denmark
| | - Tomas Jelinek
- Berlin Centre for Travel and Tropical Medicine, Berlin, Germany
| | - Michel Develoux
- Service de Parasitologie, Hôpital Saint-Antoine, Paris, France
| | - Graham Fry
- Tropical Medical Bureau, Dublin, Ireland
| | - Thomas Jänisch
- Department of Infectious Diseases, University Hospital Heideberg, Heidelberg, Germany
| | - Matthias L. Schmid
- Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Olivier Bouchaud
- Consultation de médecine tropicale, Hôpital Avicenne, Bobigny, France
| | | | - Lorenzo Zammarchi
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Kristine Mørch
- Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
| | - Anders Björkman
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Heli Siikamäki
- Inflammation Centre, Clinic of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Urban Hellgren
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Malgorzata Paul
- Department and Clinic of Tropical and Parasitic Diseases, Karol Marcinkowski University of Medical Sciences, Poznan, Poland
| | - Guido Calleri
- Travel Medicine Unit, Department of Infectious Diseases, Amedeo di Savoia Hospital-ASLTO2, Turin, Italy
| | - Pavel Kosina
- Department of Infectious Diseases, University Hospital, Hradec Králové, Czech Republic
| | | | - José M. Ramos
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
| | - Gudrun Just-Nübling
- Department of Internal Medicine II, Section Infectious Diseases and Tropical Medicine, University Hospital Frankfurt, Main, Germany
| | - Anna Beltrame
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
- Clinic of Infectious Diseases, University of Udine, Udine, Italy
| | | | - Peter Kern
- Department of Internal Medicine III, Comprehensive Infectious Diseases Center, Ulm University Hospital, Ulm, Germany
| | - Laurence Rochat
- Department of Ambulatory Care and Community Medicine, Travel Clinic, University Hospital, Lausanne, Switzerland
| | - August Stich
- Abteilung Tropenmedizin, Missionsärztliche Klinik, Würzburg, Germany
| | - Peter Pongratz
- Division of Tropical Medicine and Infectious Diseases, Rostock University Medical Center, Germany
| | - Martin P. Grobusch
- Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Norbert Suttorp
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Witzenrath
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Christoph Hatz
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Thomas Zoller
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - TropNet Schistosomiasis Investigator Group
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute of Tropical Medicine, Antwerp, Belgium
- Centro per le Malattie Tropicali, Ospedale S. Cuore, Negrar, Verona, Italy
- Tropical Medicine and International Health Unit, Hospital Vall d’Hebron Drassanes, PROSICS Barcelona, Barcelona, Spain
- Division of Infectious Diseases and Tropical Medicine, Medical Centre of the Ludwig-Maximilians-University (LMU), Munich, Germany
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Infectious Diseases Unit, Herlev University Hospital, Copenhagen, Denmark
- Berlin Centre for Travel and Tropical Medicine, Berlin, Germany
- Service de Parasitologie, Hôpital Saint-Antoine, Paris, France
- Tropical Medical Bureau, Dublin, Ireland
- Department of Infectious Diseases, University Hospital Heideberg, Heidelberg, Germany
- Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
- Consultation de médecine tropicale, Hôpital Avicenne, Bobigny, France
- Hospital Carlos III, Madrid, Spain
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Inflammation Centre, Clinic of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department and Clinic of Tropical and Parasitic Diseases, Karol Marcinkowski University of Medical Sciences, Poznan, Poland
- Travel Medicine Unit, Department of Infectious Diseases, Amedeo di Savoia Hospital-ASLTO2, Turin, Italy
- Department of Infectious Diseases, University Hospital, Hradec Králové, Czech Republic
- Oslo University Hospital, Ullevål, Norway
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
- Department of Internal Medicine II, Section Infectious Diseases and Tropical Medicine, University Hospital Frankfurt, Main, Germany
- Clinic of Infectious Diseases, University of Udine, Udine, Italy
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Department of Internal Medicine III, Comprehensive Infectious Diseases Center, Ulm University Hospital, Ulm, Germany
- Department of Ambulatory Care and Community Medicine, Travel Clinic, University Hospital, Lausanne, Switzerland
- Abteilung Tropenmedizin, Missionsärztliche Klinik, Würzburg, Germany
- Division of Tropical Medicine and Infectious Diseases, Rostock University Medical Center, Germany
- Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Mendoza CD, Requena S, Caballero E, Cabezas T, Peñaranda M, Amengual MJ, Sáez A, Lozano AB, Ramos JM, Soriano V. Antiretroviral treatment of HIV-2 infection. Future Virol 2017. [DOI: 10.2217/fvl-2017-0037] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
HIV-2 is a neglected virus despite estimates of 1–2 million people being infected worldwide. AIDS develops more slowly in HIV-2 than HIV-1. Outside endemic regions, HIV-2 is mostly found in immigrants from west Africa or their sex partners. There are four major caveats when treating HIV-2. First, some antiretrovirals are not or only partially active against HIV-2. Second, CD4 declines in HIV-2 occur slowly, but CD4 recovery is smaller with antiretroviral treatment. Third, both virological failure and rapid emergence of drug resistance occur more frequently in HIV-2 than HIV-1. Finally, misdiagnosis of HIV-2 in patients wrongly considered as infected with HIV-1 or in those dually infected may result in treatment failures with undetectable HIV-1 RNA. Integrase inhibitors, and especially dolutegravir, should be part of any preferred HIV-2 antiretroviral combination nowadays.
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Affiliation(s)
- Carmen de Mendoza
- Laboratory of Internal Medicine, Puerta de Hierro Research Institute, Majadahonda, Spain
| | - Silvia Requena
- Laboratory of Internal Medicine, Puerta de Hierro Research Institute, Majadahonda, Spain
| | | | | | - María Peñaranda
- Microbiology Unit, Son Espases Hospital, Palma de Mallorca, Spain
| | | | - Ana Sáez
- Microbiology Unit, Hospital Marqués de Valdecilla, Santander, Spain
| | | | - José M Ramos
- Infectious Diseases Unit, General Hospital, Alicante, Spain
| | - Vincent Soriano
- Infectious Diseases Unit, La Paz University Hospital & Autonomous University, Madrid, Spain
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Peris J, Bellot P, Roig P, Reus S, Carrascosa S, González-Alcaide G, Palazón JM, Ramos JM. Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study. BMC Geriatr 2017; 17:161. [PMID: 28732474 PMCID: PMC5521099 DOI: 10.1186/s12877-017-0545-x] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 07/11/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To analyse the clinical, epidemiological, microbiological and prognostic differences of pyogenic liver abscess (PLA) in older (≥ 65 years of age) versus younger patients (< 65 years). METHODS Multicentre, retrospective cohort study in all patients with PLA admitted to two Spanish hospitals from January 2000 to January 2014. Cases were divided into two age groups (< 65 years and ≥65 years) for comparison of clinical, epidemiological and microbiological characteristics as well as treatment. RESULTS Of 98 patients analysed, 40 patients were younger than 65, and 58 were aged 65 or older. Significant associations in the older group were found with female sex (adjusted odds ratio [ORa] 9.0; 95% CI 1.4, 56), non-cryptogenic origin (ORa 14.5; 95% CI 1.6, 129), absence of chronic liver disease (ORa 14; 95% CI 1.3, 155), Escherichia coli infection (ORa 7.7; 95% CI 1.03, 58), and incidence of complications (ORa 2.3; 95% CI 1.04, 5.4). Mortality was 8.2% overall, although all deaths occurred in the older group (8/58; 13.8%) (p = 0.02). DISCUSSION Our results are in consonance with other published studies. Older patients with PLA tend to present more anomalies in the biliary tract (Kai et. al, World J Gastroenterol 18: 2948-295, 2012, Rahimian et. al, Clin Infect Dis 39:1654-9, 2004, Seeto, Medicine (Baltimore) 75:99-113, 1996, Kao et.al, Aliment Pharmacol Ther 36:467-76, 2012, Lai et. al, Gastroenterology 146:129-37, 2014), while younger patients are more often male and present more commonly with previous liver disease (especially related to alcohol) and cryptogenic PLA. CONCLUSION In patients aged 65 or older, PLA was more common in women and in those with a history of biliary disease, and E. coli was the most frequent bacterium. Mortality was also higher in the older group.
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Affiliation(s)
- Jorge Peris
- Deparment of Internal Medicine, Hospital Universitario Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain
| | - Pablo Bellot
- Gastroenterology and Hepatology Service, Hospital General Universitario de Alicante, Alicante, Alicante, Spain
| | - Pablo Roig
- Deparment of Internal Medicine, Hospital Universitario Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain
| | - Sergio Reus
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain
- Unit of Infectious Diseases, Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Alicante, Spain
| | - Sara Carrascosa
- Family Medicine Department, Campello Health Centre, El Campello, Alicante, Spain
| | - Gregorio González-Alcaide
- Department of History of Science and Documentation, University of Valencia, Valencia, Valencia, Spain
| | - José M Palazón
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain
- Gastroenterology and Hepatology Service, Hospital General Universitario de Alicante, Alicante, Alicante, Spain
| | - José M Ramos
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Campus of Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain.
- Department of Internal Medicine, Hospital General Universitario de Alicante Alicante, Alicante, Alicante, Spain.
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Llorente Nieto P, González-Alcaide G, Ramos JM. [Mass gatherings: a systematic review of the literature on large events]. Emergencias 2017; 29:257-265. [PMID: 28825282] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We reviewed the literature on mass gatherings published worldwide to determine event types and topics or epidemiologic aspects covered. Articles using the term mass gatherings indexed in the Scopus database between 2000 and 2015 were reviewed. Of the 518 returned, we selected 96 with relevant information. The main event types studied were related to sports (46%), music (25%) or religious/social content (23%), and the most commonly studied locations were the United States (n=21), the Kingdom of Saudi Arabia (n=17), Australia (n=11), and the United Kingdom (n=10). The four most often studied events were the Hajj (n=17), the Olympic games (n=13), World Youth Day (n=8), and the FIFA World Cup (n=6). The main topics studied were models of health care (n=55), health care evaluation by means of rates of patients presenting for care or transferred to hospitals (n=21), respiratory pathogens (n=18), syndromic surveillance (n=10), and the global spread of diseases (n=10). Mass gatherings are an emerging area of study addressed by various medical specialties that have focused on studying the health care models used at such events. Emergency medicine is particularly involved with this research topic.
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Affiliation(s)
- Pedro Llorente Nieto
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Alicante, España. Servicio de Medicina Interna, Hospital General Universitario de Alicante, España
| | | | - José M Ramos
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Alicante, España. Servicio de Medicina Interna, Hospital General Universitario de Alicante, España
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de Mendoza C, Cabezas T, Caballero E, Requena S, Amengual MJ, Peñaranda M, Sáez A, Tellez R, Lozano AB, Treviño A, Ramos JM, Pérez JL, Barreiro P, Soriano V. HIV type 2 epidemic in Spain: challenges and missing opportunities. AIDS 2017; 31:1353-1364. [PMID: 28358736 DOI: 10.1097/qad.0000000000001485] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
: HIV type 2 (HIV-2) is a neglected virus despite estimates of 1-2 million people infected worldwide. HIV-2 is less efficiently transmitted than HIV-1 by sex and from mother to child. Although AIDS may develop in HIV-2 carriers, it takes longer than in HIV-1-infected patients. In contrast with HIV-1 infection, there is no global pandemic caused by HIV-2, as the virus is largely confined to West Africa. In a less extent and due to socioeconomic ties and wars, HIV-2 is prevalent in Portugal and its former colonies in Brazil, India, Mozambique and Angola. Globally, HIV-2 infections are steadily declining over time. A total of 338 cases of HIV-2 infection had been reported at the Spanish HIV-2 registry until December 2016, of whom 63% were men. Overall 72% were sub-Saharan Africans, whereas 16% were native Spaniards. Dual HIV-1 and HIV-2 coinfection was found in 9% of patients. Heterosexual contact was the most likely route of HIV-2 acquisition in more than 90% of cases. Roughly one-third presented with CD4 cell counts less than 200 cells/μl and/or AIDS clinical events. Plasma HIV-2 RNA was undetectable at baseline in 40% of patients. To date, one-third of HIV-2 carriers have received antiretroviral therapy, using integrase inhibitors 32 individuals. New diagnoses of HIV-2 in Spain have remained stable since 2010 with an average of 15 cases yearly. Illegal immigration from Northwestern African borders accounts for over 75% of new HIV-2 diagnoses. Given the relatively large community of West Africans already living in Spain and the continuous flux of immigration from endemic regions, HIV-2 infection either alone or as coinfection with HIV-1 should be excluded once in all HIV-seroreactive persons, especially when showing atypical HIV serological profiles, immunovirological disconnect (CD4 cell count loss despite undetectable HIV-1 viremia) and/or high epidemiological risks (birth in or sex partners from endemic regions).
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26
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Barreiro P, Tiziano G, Fano H, Yohannes T, Gosa A, Reyes F, Tesfamariam A, Górgolas M, Ramos JM. Malaria and severe anemia over eight years at Gambo Rural Hospital, southern Ethiopia. Pathog Glob Health 2017; 111:195-199. [PMID: 28502227 DOI: 10.1080/20477724.2017.1322262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Evolution of incident malaria and frequency of anemia were analyzed over eight years in a rural hospital in southern Ethiopia. Capillary blood samples were tested for hemoglobin concentration, and in some instances for malaria parasites, at Gambo Rural General Hospital between January 2007 and September 2014, and the results recorded. Main demographic data were also recorded in subjects with Plasmodium sp. infections. Of a total of 54,493 blood samples taken from 45,096 different patients, 21,723 (39.9%) samples from 19,173 (42.5%) patients were tested for malaria parasites. Malaria was diagnosed in 825 (3.79%, 95% CI 3.55%, 4.06%) instances (58.3% P. vivax and 41.7% P. falciparum; one episode in 575 patients and two episodes in 125 patients). A sustained decrease in yearly incidence of malaria was observed between 2011 (6.1%) and 2014 (2.4%) (p < 0.01). Of all the malaria patients, those with hemoglobin levels less than 8 g/dL, were younger compared to those with levels of 8 g/dL or more (median age of 5 years vs. 18 years; p < 0.01) and more commonly infected with P. falciparum (57.1% vs. 34.8%; p < 0.001). In multivariate analysis, severe anemia (hemoglobin <8 g/dL) in the context of anemia was associated with P falciparum infection (adjusted odd ratio [OR] 2.48, 95% confidence interval [CI] 1.68, 3.65) and younger age (OR 1.06, 95% CI 1.04, 1.07).
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Affiliation(s)
- Pablo Barreiro
- a Tropical and Travel Medicine Unit , Hospital Carlos III - La Paz , Madrid , Spain
| | | | - Haji Fano
- b Gambo Rural General Hospital , Gambo , Ethiopia
| | | | | | | | | | - Miguel Górgolas
- c Division of Infectious Diseases, Fundación Jiménez-Díaz , Universidad Autonoma de Madrid , Madrid , Spain
| | - José M Ramos
- b Gambo Rural General Hospital , Gambo , Ethiopia.,d Department of Internal Medicine , Hospital General Universitario de Alicante, Universidad Miguel Hernández de Elche , Alicante , Spain
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da Silva RP, Piccin CF, Martins EF, Kaminski RS, Fischer MK, Zibetti MR, Giordani JN, Ramos JM, Oliveira PG, dos Santos KC, Rodrigues LD, Costa LS, da Silva LM, Bueno KS, Martinez D. 0503 EXERCISE PRACTICE IS INDEPENDENTLY ASSOCIATED WITH PERCEIVED SLEEP QUALITY, BUT NOT SLEEPINESS IN SEVERE OBSTRUCTIVE SLEEP APNEA PATIENTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.502] [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: 11/13/2022] Open
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28
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González I, Pascual JC, Corona D, Hispán P, Ramos JM, Sánchez-Paya J, Jemec GB. Assessment of subclinical atherosclerosis in hidradenitis suppurativa: Reply to Dr Vinkel's letter. J Eur Acad Dermatol Venereol 2017; 31:e413-e414. [PMID: 28300331 DOI: 10.1111/jdv.14226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I González
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - J C Pascual
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - D Corona
- Department of Neurology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - P Hispán
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - J M Ramos
- Department of Internal Medicine, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - J Sánchez-Paya
- Epidemiology Unit, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital Roskilde, Copenhagen, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
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Ramos JM, Mula P, de Lucio A, Reyes F, González V, García L, Benito A, Berzosa P. Improved detection of mixed P. falciparum-P. vivax infection at a rural health centre in Ethiopia using PCR. Trop Biomed 2017; 34:150-156. [PMID: 33592993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study aims to this study is to compare the co-infection Plasmodium falciparum + Plasmodium vivax and compare the detection of cases of mixed-species malaria using light microscopy versus semi-nested multiplex PCR (sPCR). Investigators collected 3060 samples at a rural health centre in Ethiopia from December 2010 to October 2011. Two capillary blood specimens were taken from each patient, one for diagnosis of Plasmodium infection by light microscopy and the other for sPCR-based diagnosis. LM detected 627 positive cases; these samples, together with 582 negatives by LM, were also subjected to sPCR testing. Of the 627 positive samples by LM, 68.4% were positive for P. vivax, 30.5% for P. falciparum, and 1.1% for P. falciparum + P. vivax co-infection. Using the sPCR technique, we identified 788 samples positive for Plasmodium: 33.0% for P. vivax, 26.5% for P. falciparum, 3.7% for P. falciparum + P. vivax co-infection, 2.0% for P. ovale and 0.8% for P. vivax + P. ovale co-infection. In the case of P. falciparum + P. vivax co-infection, light microscopy diagnosis showed a sensitivity of 11.1%, a specificity of 99.8%, a positive predictive value of 71.4% and a negative predictive value of 96.6%. The concordance rate for identifying P. falciparum + P. vivax co-infection (kappa statistic) with microscopy and sPCR was 0.184. The LM approach has low sensitivity for the detection of mixed-species infections, while sPCR is more useful.
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Affiliation(s)
- J M Ramos
- Gambo General Rural Hospital, Shashemane, Ethiopia
- Department of Internal Medicine, Hospital General Universitario de Alicante Alicante, Spain
| | - P Mula
- Gambo General Rural Hospital, Shashemane, Ethiopia
| | - A de Lucio
- National Centre for Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain
| | - F Reyes
- Gambo General Rural Hospital, Shashemane, Ethiopia
| | - V González
- National Centre for Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain
| | - L García
- National Centre for Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain
| | - A Benito
- National Centre for Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain
| | - P Berzosa
- National Centre for Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain
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Olaso A, Ramos JM, López-Ballero MF, Olaso I. Malaria in Europe: Follow-up of autochthonous malaria in Greece and new risks. Enferm Infecc Microbiol Clin 2016; 35:543-544. [PMID: 27979435 DOI: 10.1016/j.eimc.2016.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/03/2016] [Accepted: 11/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | - José M Ramos
- Servicio de Medicina Interna, Hospital General Universitario de Alicante y Universidad Miguel Hernández de Elche, Alicante, Spain; Máster de Medicina Tropical y Salud Internacional, Universidad Autónoma de Madrid, Madrid, Spain
| | - María F López-Ballero
- Especialidad en Medicina Física y Rehabilitación, Hospital de Fuenlabrada, Madrid, Spain
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Ramos JM, García-Navarro MM, González de la Aleja MP, Sánchez-Martínez R, Gimeno-Gascón A, Reus S, Merino E, Rodríguez-Díaz JC, Portilla J. Seasonal influenza in octogenarians and nonagenarians admitted to a general hospital: epidemiology, clinical presentation and prognostic factors. Rev Esp Quimioter 2016; 29:296-301. [PMID: 27714398] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Seasonal influenza is responsible for high annual morbidity and mortality worldwide, especially in elderly patients. The aim of the study was to analyse the epidemiological, clinical and prognostic features of influenza in octogenarians and nonagenarians admitted to a general hospital, as well as risk factors associated with mortality. METHODS Retrospective, cross-sectional, descriptive study in patients admitted and diagnosed with influenza by molecular biology in the General University Hospital of Alicante from 1 January to 31 April 2015. RESULTS A total of 219 patients were diagnosed with influenza in the study period: 55 (25.1%) were ≤64 years-old; 77 (35.2%) were aged 65-79; 67 (30.6%) were aged 80-89 years; and 20 (9.1%) were aged ≥90 years. Most flu episodes were caused by influenza A (n=181, 82.6%). Patients aged 80 years or older had lower glomerular filtration rate (mean: 49.7 mL/min vs. 62.2 mL/min; p=0.006), a greater need for non-invasive mechanical ventilation (22% vs 9.3%; p=0.02), greater co-morbidity due to cardiac insufficiency (40.5% vs. 16.4%; p<0.001) and chronic renal disease (32.9 vs. 20%, p=0.03), and greater mortality (19% vs. 2.9%; p<0.001). In a multivariate analysis, mortality was higher in those aged 80 or over (adjusted odds ratio [ORa] 9.2, 95% confidence interval [CI] 1.65-51.1), those who had acquired the flu in a long-term care facility (ORa 11.9, 95% CI 1.06-134), and those with hyperlactataemia (ORa 1.89, 95% CI 1.20-3.00). CONCLUSIONS Seasonal influenza is a serious problem leading to elevated mortality in octogenarian and nonagenarian patients admitted to a general hospital.
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Affiliation(s)
- J M Ramos
- José Manuel Ramos, Servicio de Medicina Interna. Hospital General Universitario de Alicante. C/ Pintor Baeza 12, 03010 Alicante, Spain.
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Affiliation(s)
- D Romero-Pérez
- Department of Dermatology, Hospital General Universitario de Alicante, Calle Pintor Baeza, 12, 03010, Alicante, Spain
| | - J M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Calle Pintor Baeza, 12, 03010, Alicante, Spain.,Department of Clinical Medicine, Miguel Hernández University of Elche, Sant Joan d'Alacant Campus, Alicante, Spain
| | - B Encabo
- Department of Dermatology, Hospital General Universitario de Alicante, Calle Pintor Baeza, 12, 03010, Alicante, Spain
| | - I Belinchón
- Department of Dermatology, Hospital General Universitario de Alicante, Calle Pintor Baeza, 12, 03010, Alicante, Spain. .,Department of Clinical Medicine, Miguel Hernández University of Elche, Sant Joan d'Alacant Campus, Alicante, Spain.
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Deme C, Edao B, Jaya G, Tisiano G, Fano H, Alegria I, Reyes F, Gorgolas M, Ramos JM. PREVALENCE OF HYPERTENSION, ANEMIA, ASYMPTOMATIC URINARY TRACT INFECTION, SYPHILIS, HIV AND HEPATITIS B VIRUS INFECTION AMONG PREGNANT WOMEN ATTENDING AN ANTENATAL CLINIC AT A RURAL HOSPITAL IN SOUTHERN ETHIOPIA. Southeast Asian J Trop Med Public Health 2016; 47:1032-1039. [PMID: 29620811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Antenatal care (ANC) is provided to prevent, diagnose early and treat pregnant women for a variety of diseases. The objective of this study was to determine the seroprevalences of syphilis, human immunodeficiency virus (HIV) and hepatitis B virus (HVB) and asymptomatic urinary tract infections and the prevalence of hypertension and anemia among pregnant women attending the antenatal clinic at Gambo Rural Hospital in southern Ethiopia. The following tests were conducted among study subjects: hemoglobin (Hgb) level, rapid plasma reagin (RPR) for syphilis, anti-HIV antibodies, hepatitis B surface antigen (HBsAg) and urine analysis. A total of 574 pregnant women were included in this study. The mean age of the participants was 25.7 (SD: 4.8) years old; 88.2% were living in urban areas and 11.8% in rural areas. Sixty-seven point two percent of participants began their attended care during the second trimester of their pregnancy. Overall, anemia (Hgb < 11 mg/dl) was present in 8.9% (95% CI: 6.9-11.6): severe anemia (Hgb < 7 mg/dl), moderate anemia (Hgb 7-8.9 mg/dl) and mild anemia (Hgb 9-10.9 mg/dl) were found in 0.5% (95% CI: 0.2-1.5), 0.2% (95% CI: 0.03-0.9) and 8.2% (95% CI: 6.2-10.8). The overall prevalence of hypertension was 1.2% (95% CI: 0.06-2.6). This was significantly higher (p=0.01) in the third trimester (3.2%) than in the second (0.5%) and first (0%) trimesters. The prevalence of preeclampsia, defined by have hypertension and proteinuria, was 0.7% (95% CI: 0.3-1.8). Asymptomatic urinary tract infection (having ≥10 white blood cells /high power field in the urine) was present in 12.7% of participants (95% CI: 10.0-15.5). The RPR test was positive in two patients (0.3%; 95% CI: 0.1-1.3). The prevalences of positive test for HBsAg and HIV-1 were 2.3% (95% CI: 1.3-3.8) and 0.2% (95% CI: 0.03-0.9), respectively. No HIV-2 cases were detected. Our data show relatively low prevalences of anemia, hypertension, urinary tract infection, syphilis, HIV, and hepatitis B virus infections among study subjects at a rural antenatal clinic in southern Ethiopia.
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Ramos JM, Pinargote H, Navarrete-Muñoz EM, Salinas A, Sastre J. Hospital admissions among immigrants from low-income and foreign citizens from high-income countries in Spain in 2000-2012. J Epidemiol Glob Health 2016; 6:295-302. [PMID: 27546833 PMCID: PMC7320467 DOI: 10.1016/j.jegh.2016.07.002] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 07/05/2016] [Accepted: 07/29/2016] [Indexed: 11/18/2022] Open
Abstract
Over the last decade, the number of foreign nationals in Spain has increased. Our aim was to report the trends in hospital admissions, differentiating between foreign nationals from high-income countries (HICs) and from low- and middle-income countries (LMICs) in a public hospital. A retrospective analysis of hospital admissions in patients aged ⩾15 years between 2000 and 2012 was performed by means of hospital information systems at a public hospital in the city of Alicante, Spain. During the period of the study, 387,862 patients were admitted: 32,020 (8.3%) were foreign, 22,446 (5.8%) were from LMICs, and 9574 (2.5%) were from HICs. The number of foreign nationals, foreign nationals from LMICs, and foreign nationals from HICs admitted increased from 1019, 530, and 489 in 2000 to 2925, 2097, and 828, respectively in 2012. A total of 27.5% of patients were admitted for pregnancy, childbirth, and puerperium, especially foreign nationals from LMICs (34.3%), and 14.1% of foreign nationals were admitted for cardiovascular diseases (14.1%), which were more common in those from HICs (26.3%). The number of admissions among foreign nationals from LMICs increased significantly in all the diagnoses, but in pregnancy, childbirth, and puerperium, the increase was higher. In conclusion, nearly one out of 10 adult patients admitted to our hospital was foreign, mainly from LMICs, and the main reason for admission was diagnoses related to pregnancy, childbirth, and puerperium.
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Affiliation(s)
- José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain; Department of Clinical Medicine, Miguel Hernández University of Elche, Alicante, Spain.
| | - Héctor Pinargote
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
| | - Eva M Navarrete-Muñoz
- Department of Public Health, Miguel Hernández University of Elche, Alicante, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Alejando Salinas
- Department of Internal Medicine, Hospital de Denia, Alicante, Spain
| | - Jaume Sastre
- Department of Admission and Documentation, Hospital General Universitario de Alicante, Alicante, Spain
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Salinas A, Ramos JM, Górgolas M. Immigration, tourism and the heart: a descriptive analysis of cardiovascular diseases in different populations. Gac Sanit 2016; 30:483-484. [PMID: 27381426 DOI: 10.1016/j.gaceta.2016.05.009] [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] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 05/13/2016] [Accepted: 05/19/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Alejandro Salinas
- Department of Internal Medicine, Hospital de Denia, Alicante, Spain.
| | - José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Miguel Górgolas
- Division of Infectious Diseases, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
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Martínez-Alonso E, Ramos JM. A systematic review of randomized clinical trials published in Malaria Journal between 2008 and 2013. Rev Esp Quimioter 2016; 29:130-145. [PMID: 27092770] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Randomized controlled trials (RCT) are a key component in clinical research and they provide the highest quality clinical results. The objective of this study was to describe the main characteristics of RCTs published in Malaria Journal, including research topics, study population and design, funding sources and collaboration between institutions. This may help researchers and funders define future research priorities in this field. METHODS A retrospective analysis was performed on the RCTs published in Malaria Journal between January 1, 2008 and December 31, 2013. A key-word search by "Randomized controlled trial" or "Random*" was carried out in PubMed. RCT indexed to MEDLINE were selected for the analysis. RESULTS A total of 108 published articles containing RCTs were analysed. Treatment of uncomplicated Plasmodium falciparum malaria (n=45, 41.6%), especially the efficacy and safety of antimalarial drugs, and malaria prevention (n=34, 31.5%) were the two main research topics. The majority of trials were conducted in Africa (62.2%) and Asia (27%) and received external funding (private, 42.3% and/or public, 38.6%). Paediatric population was the primary study group (n=63, 58.3%), followed by adults (n=29, 26.9%). Pregnant women (n=7) and geriatric population (n=1) remain underrepresented. Nearly 75% of trials were conducted in individual subjects and 25% in groups of subjects (cluster RCTs). A considerable collaboration between researchers and institutions is noteworthy. CONCLUSIONS RCTs published in Malaria Journal address a wide range of research topics. Paediatric trials conducted in Africa and Asia are frequently performed, and a significant worldwide collaboration to fight against malaria has been identified.
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Affiliation(s)
- E Martínez-Alonso
- Elena Martínez-Alonso. Pharmacology and Clinical Assessment Division. Spanish Agency for Medicines and Medical Devices. Calle Campezo, 1, Edificio 8, 28022 Madrid, Spain.
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Ramos JM, Picasso MC, Lo JA, Hernandez AV. Letter to the editor about “Effects of fruit and vegetables on metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials” by Shin JY, Kim JY, Kang HT, Han KH, Shim JY published online in 2015 May 6. Int J Food Sci Nutr 2016; 67:353. [DOI: 10.3109/09637486.2016.1158243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- JM Ramos
- School of Nutrition, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - MC Picasso
- School of Nutrition, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - JA Lo
- School of Nutrition, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - AV Hernandez
- School of Nutrition, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
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Ramos JM, Romero D, Belinchón I. Epidemiology of Leprosy in Spain: The Role of the International Migration. PLoS Negl Trop Dis 2016; 10:e0004321. [PMID: 26939132 PMCID: PMC4777425 DOI: 10.1371/journal.pntd.0004321] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/02/2015] [Indexed: 11/22/2022] Open
Abstract
Background Although incidence of leprosy in Spain has declined steadily over the years, the fivefold increase in immigration since the turn of the century—much of it from countries where leprosy is still prevalent—has been linked to an uptick in registered cases. Objective To describe the epidemiologic trends of incident leprosy cases detected in Spain among Spanish- and foreign-born population groups. Methods Observational, retrospective study of suspected leprosy cases in Spain, as reported through the System of Compulsory Notification of Diseases from 2003 to 2013, with results disaggregated by country of birth. We collected statistical data on leprosy burden for other countries from WHO to estimate the expected number of imported cases. Results Of the 168 leprosy cases registered during the study period, 40 (24.6%) were in Spanish patients, while 128 (76.2%) were detected in legally resident immigrants. We identified a significantly higher number of imported leprosy cases during the 2008–2010 and 2011–2013 trienniums compared to the reference biennium 2003–2004 (OR 5.38, 95% CI 1.83–14.88 and OR 4.80, 95% CI 1.41–16.33, respectively). Most imported cases were diagnosed in Latin American immigrants (71.9%), especially Brazilians, but also Paraguayans, Bolivians and other nationalities from South and Central America. However, registered incidence was lower than expected for each year. For example, in 2003, the expected new cases in immigrants was 47.12, compared to only four cases that were actually detected (a 91% difference). Likewise, we expected to find 49.6 incident cases among immigrants in 2009, but only 15 new cases were reported (60% fewer than expected). Conclusion Imported cases of leprosy are responsible for most leprosy incidence in Spain, and we cannot rule out some under-diagnosis. Clinicians should be made more aware of the potential for leprosy incidence among patients from countries where the disease is endemic. Most of cases of leprosy that are diagnosed in Europe come from other parts of the world. This study describes the epidemiologic trends of incident leprosy cases detected in Spain among Spanish- and foreign-born population groups from 2003 to 2013. We show that new cases of leprosy will continue to appear in the country regardless of the control measures taken at a domestic level, as people from leprosy-endemic areas will continue to migrate. That said, we also found that the actual number of incident cases registered through the national reporting system was far below the expected cases estimated from WHO statistical data on countries of origin. Nevertheless, leprosy should be considered among the differential diagnoses in patients presenting in Spanish health centres with suspected cutaneous and neurological signs and symptoms, especially if they are from Brazil, Paraguay, Bolivia or other areas where leprosy is prevalent. Given the high proportion of Latin American immigrants in Spain, our findings are very relevant, and it is advisable that the Spanish Medical University Programme reinstate the inclusion of leprosy in training for junior doctors.
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Affiliation(s)
- José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain.,Department of Medicine, Miguel Hernández University of Elche, Alicante, Spain
| | - David Romero
- Service of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - Isabel Belinchón
- Department of Medicine, Miguel Hernández University of Elche, Alicante, Spain.,Service of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
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Llorente P, Ramos JM. «Mass gathering» o reuniones masivas de personas: un nuevo reto para la salud pública en España. Enfermería Clínica 2016; 26:153-4. [DOI: 10.1016/j.enfcli.2015.09.008] [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: 09/04/2015] [Revised: 09/14/2015] [Accepted: 09/17/2015] [Indexed: 11/28/2022]
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Ramos JM, León R, Andreu M, de las Parras ER, Rodríguez-Díaz JC, Esteban Á, Saugar JM, Torrús D. Serological study of Trypanosoma cruzi, Strongyloides stercoralis, HIV, human T cell lymphotropic virus (HTLV) and syphilis infections in asymptomatic Latin-American immigrants in Spain. Trans R Soc Trop Med Hyg 2016; 109:447-53. [PMID: 26065661 DOI: 10.1093/trstmh/trv043] [Citation(s) in RCA: 16] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE We aimed to perform a serological screening for T. cruzi, Strongyloides stercoralis, HIV, human T cell lymphotropic virus (HTLV) and syphilis in Latin American immigrants admitted to hospital in Spain. METHODS We have carried out a cross-sectional study of Latin American immigrants admitted to the Hospital General Universitario Alicante (Spain) from June 2012 to May 2014, where screening of Chagas disease, strongyloidiasis, HTLV, HIV and syphilis was performed by serology. RESULTS A total 180 patients were included in the study. Patients' median age was 38 years old, 123 (68.3%; 123/180) were female and 57 (31.7%; 57/180) male. Five of the 180 (2.5%) patients were positive for Chagas disease; associated with knowledge about Chagas disease (p=0.005), previous contact with patients with Chagas disease (p=0.04) and being Bolivian (p<0.001). Forty-two of the 157 (26.8%) patients were positive for Strongyloides serology; associated positively with being male (p<0.001), eosinophilia (p=0.001), hyper-IgE (p<0.001) and being Ecuadorian (p=0.001), and negatively associated with being Colombian (p=0.03). Positive serology of latent syphilis was found in 1.8% (3/171) of patients. Serology of HTLV was negative in all cases. No new cases of HIV infection were diagnosed. CONCLUSIONS We propose that Latin American immigrant patients admitted to hospital in Spain be screened for strongyloidiasis, Chagas disease and syphilis by serology.
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Affiliation(s)
- José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante Spain Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Spain
| | - Rafael León
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante Spain
| | - Mariano Andreu
- Division of Microbiology, Hospital General Universitario de Alicante, Alicante, Spain Department of Microbiology, Universidad de Alicante, Alicante, Spain
| | | | - Juan C Rodríguez-Díaz
- Division of Microbiology, Hospital General Universitario de Alicante, Alicante, Spain Department of Microbiology, Universidad Miguel Hernandez de Elche, Spain
| | - Ángel Esteban
- Department of Clinical Laboratory, Hospital General Universitario de Alicante, Alicante, Spain
| | - José M Saugar
- Service of Parasitology, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Diego Torrús
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante Spain
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Ramos JM, Tissiano G, Fano H, Yohannes T, Gosa A, Reyes F, Górgolas M, Barreiro P. Prevalence of positive HIV, HBV, HCV and treponemal tests in blood donors in a rural hospital in southern Ethiopia. J Clin Virol 2016; 77:60-2. [PMID: 26896875 DOI: 10.1016/j.jcv.2016.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 10/22/2022]
Affiliation(s)
- José M Ramos
- Laboratory of Microbiology and Department of Medicine, Gambo Rural General Hospital, Shashemane (PO Box 121), Ethiopia; Department of Internal Medicine, Hospital General Universitario de Alicante, Calle de Pintor Baeza, 12, 03010 Alicante, Spain.
| | - Gabre Tissiano
- Laboratory of Microbiology and Department of Medicine, Gambo Rural General Hospital, Shashemane (PO Box 121), Ethiopia.
| | - Haji Fano
- Laboratory of Microbiology and Department of Medicine, Gambo Rural General Hospital, Shashemane (PO Box 121), Ethiopia.
| | - Tafese Yohannes
- Laboratory of Microbiology and Department of Medicine, Gambo Rural General Hospital, Shashemane (PO Box 121), Ethiopia.
| | - Ashenafi Gosa
- Laboratory of Microbiology and Department of Medicine, Gambo Rural General Hospital, Shashemane (PO Box 121), Ethiopia.
| | - Francisco Reyes
- Laboratory of Microbiology and Department of Medicine, Gambo Rural General Hospital, Shashemane (PO Box 121), Ethiopia.
| | - Miguel Górgolas
- Division of Infectious Diseases, Fundación Jiménez Díaz, Avenida de Reyes Catolico s/n, 28003 Madrid, Spain.
| | - Pablo Barreiro
- Section of Infectious Diseases, Hospital Carlos III-La Paz, Calle de Sinesio Delgado, 10, 28029 Madrid, Spain.
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Ramos JM, Vidal I, Bellot P, Gómez-Hurtado I, Zapater P, Such J. Comparison of the in vitro susceptibility of rifaximin versus norfloxacin against multidrug resistant bacteria in a hospital setting. A proof-of-concept study for use in advanced cirrhosis. Gut 2016; 65:182-3. [PMID: 25832107 DOI: 10.1136/gutjnl-2015-309421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 03/07/2015] [Indexed: 12/08/2022]
Affiliation(s)
- J M Ramos
- Department of Clinical Medicine, Miguel Hernández University, Elche, Alicante, Spain Departments of Internal Medicine, Hospital General Universitario, Alicante, Spain
| | - I Vidal
- Departments of Microbiology, Hospital General Universitario, Alicante, Spain
| | - P Bellot
- Liver Unit, Hospital General Universitario, Alicante, Spain CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
| | | | - P Zapater
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain Department of Clinical Pharmacology, Hospital General Universitario, Alicante, Spain
| | - J Such
- CIBERehd, Instituto de Salud Carlos III, Madrid, Spain Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
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León R, Sánchez-Martínez R, Palazón JM, Payá A, Ramos JM, Pinargote H. [Nodular regenerative hyperplasia associated with common variable immunodeficiency and other comorbidities]. Med Clin (Barc) 2015; 146:263-6. [PMID: 26723943 DOI: 10.1016/j.medcli.2015.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 09/01/2015] [Accepted: 11/05/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVE Currently, there are not many data on the evolution of nodular regenerative hyperplasia (NRH) associated or not with underlying diseases and in particular that associated with common variable inmunodeficiency (CVID). Twenty cases of NRH are presented, and the differences between the cases associated with CVID and those related to other diseases are analysed. METHODS Retrospective and descriptive study over a period of 14 years. RESULTS Twelve out of the 20 patients were men; the median age was 51 years. CVID was the main illness associated with NRH. In patients with CVID and NRH, gastrointestinal haemorrhage was more common, all the patients had high gamma glutamyl transferase and alkaline phosphatase and none had altered albumin and bilirubin levels compared to the patients without CVID. On follow-up, 50% of patients with CVID (2/4) had died compared to 33.3% (5/15) without CVID. CONCLUSIONS NRH in patients with CVID seems to have more biochemical data of anicteric cholestasis and portal hypertension and could be associated with lower survival.
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Affiliation(s)
- Rafael León
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España.
| | | | - José M Palazón
- Servicio de Medicina Digestiva, Hospital General Universitario de Alicante, Alicante, España; Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Alicante, España
| | - Artemio Payá
- Servicio de Anatomía Patológica, Hospital General Universitario de Alicante, Alicante, España
| | - José M Ramos
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España; Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Alicante, España
| | - Héctor Pinargote
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España
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González-Alcaide G, Park J, Huamaní C, Belinchón I, Ramos JM. Evolution of Cooperation Patterns in Psoriasis Research: Co-Authorship Network Analysis of Papers in Medline (1942-2013). PLoS One 2015; 10:e0144837. [PMID: 26658481 PMCID: PMC4676628 DOI: 10.1371/journal.pone.0144837] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 07/16/2015] [Accepted: 11/23/2015] [Indexed: 12/15/2022] Open
Abstract
Background Although researchers have worked in collaboration since the origins of modern science and the publication of the first scientific journals in the eighteenth century, this phenomenon has acquired exceptional importance in the last several decades. Since the mid-twentieth century, new knowledge has been generated from within an ever-growing network of investigators, working cooperatively in research groups across countries and institutions. Cooperation is a crucial determinant of academic success. Objective The aim of the present paper is to analyze the evolution of scientific collaboration at the micro level, with regard to the scientific production generated on psoriasis research. Methods A bibliographic search in the Medline database containing the MeSH terms “psoriasis” or “psoriatic arthritis” was carried out. The search results were limited to articles, reviews and letters. After identifying the co-authorships of documents on psoriasis indexed in the Medline database (1942–2013), various bibliometric indicators were obtained, including the average number of authors per document and degree of multi-authorship over time. In addition, we performed a network analysis to study the evolution of certain features of the co-authorship network as a whole: average degree, size of the largest component, clustering coefficient, density and average distance. We also analyzed the evolution of the giant component to characterize the changing research patterns in the field, and we calculated social network indicators for the nodes, namely betweenness and closeness. Results The main active research clusters in the area were identified, along with their authors of reference. Our analysis of 28,670 documents sheds light on different aspects related to the evolution of scientific collaboration in the field, including the progressive increase in the mean number of co-authors (which stood at 5.17 in the 2004–2013 decade), and the rise in multi-authored papers signed by many different authors (in the same decade, 25.77% of the documents had between 6 and 9 co-authors, and 10.28% had 10 or more). With regard to the network indicators, the average degree gradually increased up to 10.97 in the study period. The percentage of authors pertaining to the largest component also rose to 73.02% of the authors. The clustering coefficient, on the other hand, remained stable throughout the entire 70-year period, with values hovering around 0.9. Finally, the average distance peaked in the decades 1974–1983 (8.29) and 1984–2003 (8.12) then fell over the next two decades, down to 5.25 in 2004–2013. The construction of the co-authorship network (threshold of collaboration ≥ 10 co-authored works) revealed a giant component of 161 researchers, containing 6 highly cohesive sub-components. Conclusions Our study reveals the existence of a growing research community in which collaboration is increasingly important. We can highlight an essential feature associated with scientific collaboration: multi-authored papers, with growing numbers of collaborators contributing to them, are becoming more and more common, therefore the formation of research groups of increasing depth (specialization) and breadth (multidisciplinarity) is now a cornerstone of research success.
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Affiliation(s)
- Gregorio González-Alcaide
- Department of History of Science and Documentation, Universitat de València, Valencia, Spain
- * E-mail:
| | - Jinseo Park
- Korea Institute of Science and Technology Information (KISTI), Deajeon, South Korea
| | | | - Isabel Belinchón
- Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain
| | - José M. Ramos
- Department of Medicine, Universidad Miguel Hernández de Elche, Alicante, Spain
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
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Jimenez-Jorge S, de Mateo S, Delgado-Sanz C, Pozo F, Casas I, Garcia-Cenoz M, Castilla J, Rodriguez C, Vega T, Quinones C, Martinez E, Vanrell JM, Gimenez J, Castrillejo D, Altzibar JM, Carril F, Ramos JM, Serrano MC, Martinez A, Torner N, Perez E, Gallardo V, Larrauri A. Estimating influenza vaccine effectiveness in Spain using sentinel surveillance data. ACTA ACUST UNITED AC 2015. [PMID: 26212144 DOI: 10.2807/1560-7917.es2015.20.28.21187] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We aimed to estimate influenza vaccine effectiveness (VE) against laboratory-confirmed influenza during three influenza seasons (2010/11 to 2012/2013) in Spain using surveillance data and to compare the results with data obtained by the cycEVA study, the Spanish component of the Influenza Monitoring Vaccine Effectiveness (I-MOVE) network. We used the test-negative case–control design, with data from the Spanish Influenza Sentinel Surveillance System (SISS) or from the cycEVA study. Cases were laboratory-confirmed influenza patients with the predominant influenza virus of each season, and controls were those testing negative for any influenza virus. We calculated the overall and age-specific adjusted VE. Although the number of patients recorded in the SISS was three times higher than that in the cycEVA study, the quality of information for important variables, i.e. vaccination status and laboratory results, was high in both studies. Overall, the SISS and cycEVA influenza VE estimates were largely similar during the study period. For elderly patients (> 59 years), the SISS estimates were slightly lower than those of cycEVA, and estimates for children (0–14 years) were higher using SISS in two of the three seasons studied. Enhancing the SISS by collecting the date of influenza vaccination and reducing the percentage of patients with incomplete information would optimise the system to provide reliable annual influenza VE estimates to guide influenza vaccination policies.
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Affiliation(s)
- S Jimenez-Jorge
- National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain
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Gironé G, Mateo C, Gaya V, Usó J, Mínguez C, Roca B, Ramos JM. Admissions for imported and non-imported parasitic diseases at a General Hospital in Spain: A retrospective analysis. Travel Med Infect Dis 2015; 13:322-8. [PMID: 26003567 DOI: 10.1016/j.tmaid.2015.04.008] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To analyze imported and non-imported parasitic diseases as a cause of admission to a general hospital. METHODS A retrospective analysis of hospital admissions for parasitic diseases between 2004 and 2013 performed by means of hospital information systems at a public hospital in the city of Castellón (Spain). RESULTS During the period covered in this study, there were 204,349 admissions, 213 of which were for parasitic diseases (prevalence: 1.04/1000 admission). 129 were neglected parasitic tropical diseases and 61 were imported parasitic diseases. The main parasitic diseases were hydatidosis (24.9%), visceral leishmaniasis (22.5%) and malaria (12.2%). There was a decrease in admissions for visceral leishmaniasis in the 2004-2008 period from 27.7% to 15.9% in the 2009-2013 period (p < 0.001), and an increase in admissions for malaria from 5.0% to 21.3% (p < 0.001). 38 (20.3%) of the 187 patients with parasitic diseases were HIV infected. HIV infection was more common in patients with toxoplasmosis (94.1%; p < 0.001), cryptosporidiosis (66.7%; p < 0.02) and visceral leishmaniasis (46.4%; p = 0.003). There were 34 (18.2%) children with parasitic diseases. Twelve of the 28 patients with visceral leishmaniasis (42.9%; p < 0.001), and 11 of the 17 patients with soil-transmitted diseases were children (64.7%; p < 0.001). The cause of death in eight patients was parasitic disease related (mortality rate: 4.3%). The mortality rate for visceral leishmaniasis was significantly higher (14.3%; p = 0.01). CONCLUSION The main cause is endemic parasitic diseases such as hydatidosis. Visceral leishmaniasis decreased during the period covered by the study, but malaria increased.
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Affiliation(s)
- Guillermo Gironé
- Department of Internal Medicine, Hospital Universitari General de Castelló, Catelló, Spain
| | - Claudia Mateo
- Department of Internal Medicine, Hospital Universitari General de Castelló, Catelló, Spain
| | - Víctor Gaya
- Department of Internal Medicine, Hospital Universitari General de Castelló, Catelló, Spain
| | - Jordi Usó
- Department of Internal Medicine, Hospital Universitari General de Castelló, Catelló, Spain
| | - Carlos Mínguez
- Department of Internal Medicine, Hospital Universitari General de Castelló, Catelló, Spain
| | - Bernardino Roca
- Department of Internal Medicine, Hospital Universitari General de Castelló, Catelló, Spain
| | - José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain; Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Alicante, Spain.
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Ramos JM, Alegria I, Tessema D, Mohamed N, Tissiano G, Fano H, Yohannes T, Gosa A, Tesfamariam A, Reyes F. EPIDEMIOLOGY OF ROTAVIRUS DIARRHEA AMONG CHILDREN AGED LESS THAN 5 YEARS IN RURAL SOUTHERN ETHIOPIA. Southeast Asian J Trop Med Public Health 2015; 46:434-443. [PMID: 26521516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of this study was to determine the epidemiological and clinical features of rotavirus infection among children aged less than 5 years in rural southern Ethiopia. We conducted a hospital-based, prospective study among children aged less than 5 years with acute diarrhea and moderate to severe dehydration attending the outpatient department of Gambo Rural Hospital, Ethiopia during September-November 2012. Three hundred fourteen children were included in the study, of whom 137 (43.6%) had rotavirus infection. The average age of children with rotavirus infection was lower than those without it [odds ratio (OR): 0.94]. Finding severe dehydration on skin pinch test (adjusted OR: 3.76) and having diarrhea for !3 days (adjusted OR: 2.50) were associated with rotavirus infection. The mortality rate was 4.4% among rotavirus infection children and 0% among non-rotavirus diarrhea cases (p=0.006). Rotavirus infection should be suspected in children with severe dehydration on a skin pinch test and among those presenting with diarrhea for 3 days in rural southern Ethiopia.
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Pascual JC, Belinchón I, Ramos JM. Cutaneous surgery complications in individuals aged 80 and older versus younger than 80 after excision of nonmelanoma skin cancer. J Am Geriatr Soc 2015; 63:188-90. [PMID: 25597576 DOI: 10.1111/jgs.13226] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- José C Pascual
- Department of Dermatology, Hospital General Universitario, Alicante, Spain
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León R, Sánchez-Sánchez G, Sánchez-Martínez R, Ramos JM. Senile cardiac amyloidosis in 68 years-old male with ascites. Rev Clin Esp 2015; 215:346-8. [PMID: 25796469 DOI: 10.1016/j.rce.2015.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 01/19/2015] [Accepted: 02/09/2015] [Indexed: 01/01/2023]
Affiliation(s)
- R León
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España.
| | - G Sánchez-Sánchez
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España
| | - R Sánchez-Martínez
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España
| | - J M Ramos
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Alicante, España
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