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Pimentel-Ponce M, Romero-Galisteo RP, Palomo-Carrión R, Pinero-Pinto E, Antonio Merchán-Baeza J, Ruiz-Muñoz M, Oliver-Pece J, González-Sánchez M. Gamification and neurological motor rehabilitation in children and adolescents: a systematic review. Neurologia 2024; 39:63-83. [PMID: 38065433 DOI: 10.1016/j.nrleng.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/07/2021] [Indexed: 12/25/2023] Open
Abstract
INTRODUCTION Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. METHODS We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. RESULTS From a total of 469 studies, 11 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), neurological gait disorders (1), and neurological impairment of balance and coordination (1). CONCLUSION The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.
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Affiliation(s)
| | - R P Romero-Galisteo
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - R Palomo-Carrión
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia, Universidad de Castilla la Mancha, Toledo, Spain
| | - E Pinero-Pinto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - J Antonio Merchán-Baeza
- Grupo de investigación Methodology, Methods, Models and Outcomes of Health and Social Sciences (M30), Facultad de Cienciasde la Salud y Bienestar, Universidad de Vic-Universidad Central de Cataluña (UVIC-UCC), Vic, Barcelona, Spain
| | - M Ruiz-Muñoz
- Departamento de Enfermería y Podología, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - J Oliver-Pece
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Málaga, Spain
| | - M González-Sánchez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica deMálaga (IBIMA), Málaga, Spain
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Tolosa-Vilella C, Del Mar Rodero-Roldán M, Guillen-Del-Castillo A, Marín-Ballvé A, Boldova-Aguar R, Marí-Alfonso B, Feijoo-Massó C, Colunga-Argüelles D, Rubio-Rivas M, Trapiella-Martínez L, Iniesta-Arandia N, Callejas-Moraga E, García-Hernández FJ, Sáez-Comet L, González-Echávarri C, Ortego-Centeno N, Freire M, Vargas-Hitos JA, Ríos-Blanco JJ, Todolí-Parra JA, Rodríguez-Pintó I, Chamorro AJ, Pla-Salas X, Madroñero-Vuelta AB, Ruiz-Muñoz M, Fonollosa-Pla V, Simeón-Aznar CP. Nailfold videocapillaroscopy patterns in systemic sclerosis: implications for cutaneous subsets, disease features and prognostic value for survival. Clin Exp Rheumatol 2023; 41:1695-1703. [PMID: 37534953 DOI: 10.55563/clinexprheumatol/8lrofr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES To assess the associations and prognostic value of scleroderma patterns by nailfold videocapillaroscopy (NVC) in patients with systemic sclerosis (SSc) and cutaneous subsets. METHODS At baseline, 1356 SSc patients from the RESCLE registry were compared according to the scleroderma pattern as Late pattern and non-Late pattern, which included Early and Active patterns. Patient characteristics, disease features, survival time and causes of death were analysed. RESULTS Late pattern was identified in 540 (39.8%), and non-Late pattern in 816 (60.2%) patients (88% women; 987 lcSSc/251 dcSSc). Late pattern was associated to dcSSc (OR=1.96; p<0.001), interstitial lung disease (ILD) (OR=1.29; p=0.031), and scleroderma renal crisis (OR=3.46; p<0.001). Once the cutaneous subset was disregarded in an alternative analysis, both digital ulcers (DU) (OR=1.29; p<0.037) and anti-topoisomerase I antibodies (OR=1.39; p< 0.036) emerged associated with the Late pattern. By cutaneous subsets, associations with Late pattern were: (1) in dcSSc, acro-osteolysis (OR=2.13; p=0.022), and systolic pulmonary artery pressure >40 mmHg by Doppler echocardiogram (OR=2.24; p<0.001); and (2) in lcSSc, ILD (OR=1.38; p=0.028). Survival was reduced in dcSSc with Late pattern compared to non-Late pattern (p=0.049). Risk factors for SSc mortality in multivariate regression Cox analysis were age at diagnosis (HR=1.03; p<0.001), dcSSc (HR=2.48; p<0.001), DU (HR=1.38; p=0.046), ILD (HR=2.81; p<0.001), and pulmonary arterial hypertension (HR=1.99; p<0.001). CONCLUSIONS SSc patients with Late pattern more frequently present dcSSc and develop more fibrotic and vascular manifestations. Advanced microangiopathy by NVC identifies dcSSc patients at risk of reduced survival due to SSc-related causes.
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Affiliation(s)
- Carles Tolosa-Vilella
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Parc Taulí, Hospital Universitari, Sabadell, Barcelona, and Universitat Autònoma de Barcelona, Spain
| | - Maria Del Mar Rodero-Roldán
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Alfredo Guillen-Del-Castillo
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, and Universitat Autònoma de Barcelona, Spain.
| | - Adela Marín-Ballvé
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Rafael Boldova-Aguar
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Begoña Marí-Alfonso
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Parc Taulí, Hospital Universitari, Sabadell, Barcelona, and Universitat Autònoma de Barcelona, Spain
| | - Carlos Feijoo-Massó
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Parc Taulí, Hospital Universitari, Sabadell, Barcelona, and Universitat Autònoma de Barcelona, Spain
| | | | - Manuel Rubio-Rivas
- Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Luis Trapiella-Martínez
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario de Cabueñes, Gijón, Spain
| | - Nerea Iniesta-Arandia
- Department of Systemic Autoimmune Diseases, Institut Clinic de Medicina i Dermatología, Hospital Universitario Clínic, Barcelona, Spain
| | - Eduardo Callejas-Moraga
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Parc Taulí, Hospital Universitari, Sabadell, Barcelona, and Universitat Autònoma de Barcelona, Spain
| | | | - Luis Sáez-Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Cristina González-Echávarri
- Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain
| | - Norberto Ortego-Centeno
- Department of Internal Medicine, Unit of Systemic Autoimmune Diseases, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria Ibs Granada, Facultad de Medicina Granada, Spain
| | - Mayka Freire
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | | | - Juan J Ríos-Blanco
- Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Antonio-J Chamorro
- Department of Internal Medicine, Hospital Clínico Universitario de Salamanca, Universidad de Salamanca-IBSAL, Salamanca, Spain
| | - Xavier Pla-Salas
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Consorci Hospitalari de Vic, Vic, Barcelona, Spain
| | | | - Manuel Ruiz-Muñoz
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Vicent Fonollosa-Pla
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, and Universitat Autònoma de Barcelona, Spain
| | - Carmen Pilar Simeón-Aznar
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, and Universitat Autònoma de Barcelona, Spain
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Carbonell C, Marcos M, Guillén-Del-Castillo A, Rubio-Rivas M, Argibay A, Marín-Ballvé A, Rodríguez-Pintó I, Baldà-Masmiquel M, Callejas-Moraga E, Colunga D, Sáez-Comet L, González-Echávarri C, Ortego-Centeno N, Marí-Alfonso B, Vargas-Hitos JA, Todolí-Parra JA, Trapiella L, Herranz-Marín MT, Freire M, Castro-Salomó A, Perales-Fraile I, Madroñero-Vuelta AB, Sánchez-García ME, Ruiz-Muñoz M, González-García A, Sánchez-Redondo J, de-la-Red-Bellvis G, Fernández-Luque A, Muela-Molinero A, Lledó GM, Tolosa-Vilella C, Fonollosa-Pla V, Chamorro AJ, Simeón-Aznar CP. Standardized incidence ratios and risk factors for cancer in patients with systemic sclerosis: Data from the Spanish Scleroderma Registry (RESCLE). Autoimmun Rev 2022; 21:103167. [PMID: 35931315 DOI: 10.1016/j.autrev.2022.103167] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 11/24/2022]
Abstract
AIM Patients with systemic sclerosis (SSc) are at increased risk of cancer, a growing cause of non-SSc-related death among these patients. We analyzed the increased cancer risk among Spanish patients with SSc using standardized incidence ratios (SIRs) and identified independent cancer risk factors in this population. MATERIAL AND METHODS Spanish Scleroderma Registry data were analyzed to determine the demographic characteristics of patients with SSc, and logistic regression was used to identify cancer risk factors. SIRs with 95% confidence intervals (CIs) relative to the general Spanish population were calculated. RESULTS Of 1930 patients with SSc, 206 had cancer, most commonly breast, lung, hematological, and colorectal cancers. Patients with SSc had increased risks of overall cancer (SIR 1.48, 95% CI 1.36-1.60; P < 0.001), and of lung (SIR 2.22, 95% CI 1.77-2.73; P < 0.001), breast (SIR 1.31, 95% CI 1.10-1.54; P = 0.003), and hematological (SIR 2.03, 95% CI 1.52-2.62; P < 0.001) cancers. Cancer was associated with older age at SSc onset (odds ratio [OR] 1.22, 95% CI 1.01-1.03; P < 0.001), the presence of primary biliary cholangitis (OR 2.35, 95% CI 1.18-4.68; P = 0.015) and forced vital capacity <70% (OR 1.8, 95% CI 1.24-2.70; P = 0.002). The presence of anticentromere antibodies lowered the risk of cancer (OR 0.66, 95% CI 0.45-0.97; P = 0.036). CONCLUSIONS Spanish patients with SSc had an increased cancer risk compared with the general population. Some characteristics, including specific autoantibodies, may be related to this increased risk.
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Affiliation(s)
- Cristina Carbonell
- Department of Internal Medicine, Hospital Universitario de Salamanca, Universidad de Salamanca-IBSAL, Salamanca, Spain
| | - Miguel Marcos
- Department of Internal Medicine, Hospital Universitario de Salamanca, Universidad de Salamanca-IBSAL, Salamanca, Spain.
| | - Alfredo Guillén-Del-Castillo
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Manuel Rubio-Rivas
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ana Argibay
- Unit of Systemic Autoimmune Diseases and Thrombosis, Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo. Vigo, Pontevedra, Spain
| | - Adela Marín-Ballvé
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, IIS Aragón. Zaragoza, Spain
| | - Ignasi Rodríguez-Pintó
- Department of Internal Medicine, Hospital Universitario Mútua Terrassa, Terrassa, Barcelona, Spain
| | - Maria Baldà-Masmiquel
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine, Consorci Hospitalari de Vic. Vic, Barcelona, Spain
| | - Eduardo Callejas-Moraga
- Department of Internal Medicine, Parc Taulí, Hospital Universitario, Sabadell, Barcelona, Spain
| | - Dolores Colunga
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Luis Sáez-Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Cristina González-Echávarri
- Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain
| | - Norberto Ortego-Centeno
- Inst Invest Biosanitaria Ibs Granada. Department of Internal Medicine, Unit of Systemic Autoimmune Diseases. Department of Medicine, Facultad de Medicina. Hospital Universitario San Cecilio. Granada. Spain
| | - Begoña Marí-Alfonso
- Department of Internal Medicine, Parc Taulí, Hospital Universitario, Sabadell, Barcelona, Spain
| | | | | | - Luis Trapiella
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | - Mayka Freire
- Unit of Autoimmune Diseases, Department of Internal Medicine. Hospital Clínico Universitario de Santiago. Santiago de Compostela, A Coruña, Spain
| | - Antoni Castro-Salomó
- Department of Internal Medicine. Hospital Universitario Sant Joan. Reus, Tarragona, Spain
| | - Isabel Perales-Fraile
- Department of Internal Medicine. Hospital Universitario Rey Juan Carlos. Móstoles, Madrid, Spain
| | | | | | - Manuel Ruiz-Muñoz
- Department of Internal Medicine. Hospital Universitario Fundación Alcorcón. Alcorcón, Madrid, Spain
| | | | - Jorge Sánchez-Redondo
- Department of Internal Medicine. Hospital Universitario de Móstoles. Móstoles, Madrid, Spain
| | - Gloria de-la-Red-Bellvis
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine. Fundació Hospital de l'Esperit Sant. Santa Coloma de Gramenet, Barcelona, Spain
| | | | - Alberto Muela-Molinero
- Department of Internal Medicine. Complejo Asistencial Universitario de León. León, Spain
| | - Gema-María Lledó
- Department of Autoimmune Diseases. Hospital Clinic. Barcelona, Spain
| | - Carles Tolosa-Vilella
- Department of Internal Medicine, Parc Taulí, Hospital Universitario, Sabadell, Barcelona, Spain
| | - Vicent Fonollosa-Pla
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Antonio-Javier Chamorro
- Department of Internal Medicine, Hospital Universitario de Salamanca, Universidad de Salamanca-IBSAL, Salamanca, Spain
| | - Carmen-Pilar Simeón-Aznar
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Montejano R, de la Calle-Prieto F, Velasco M, Guijarro C, Queiruga-Parada J, Jiménez-González M, González-Ruano P, Martínez P, Goikoetxea AJ, Ibarrola M, Ciudad M, Gutiérrez Á, Torralba M, Díaz-Brasero A, Ryan P, Marcelo C, Díez C, Ibarra S, Merino E, Estrada V, Marcos J, Novella M, Rivera MA, Ruiz-Muñoz M, de Miguel M, Soler L, del Álamo M, Moreno S, Carcas AJ, Borobia AM, Arribas JR. Tenofovir Disoproxil Fumarate/Emtricitabine and Baricitinib for Patients at High Risk of Severe Coronavirus Disease 2019: The PANCOVID Randomized Clinical Trial. Clin Infect Dis 2022; 76:e116-e125. [PMID: 35906838 PMCID: PMC9384601 DOI: 10.1093/cid/ciac628] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/15/2022] [Accepted: 07/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study was designed to evaluate if patients with high risk for severe coronavirus disease 2019 (COVID-19) would benefit from treatment with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) followed by baricitinib in case of hypoxemia and systemic inflammation. METHODS PANCOVID is an open-label, double-randomized, phase 3 pragmatic clinical trial including adults with symptomatic COVID-19 with ≥2 comorbidities or aged ≥60 years and was conducted between 10 October 2020 and 23 September 2021. In the first randomization, patients received TDF/FTC or no TDF/FTC. In the second randomization, patients with room air oxygen saturation <95% and at least 1 increased inflammatory biomarker received baricitinib plus dexamethasone or dexamethasone alone. The primary endpoint was 28-day mortality. Main secondary endpoint was 28-day disease progression or critical care unit admission or mortality. The trial was stopped before reaching planned sample size due to the decrease in the number of cases and a mortality rate substantially lower than expected. RESULTS Of the 355 included participants, 97% were hospitalized at baseline. Overall, 28-day mortality was 3.1%. The 28-day mortality relative risk (RR) for participants treated with TDF/FTC was 1.76 (95% confidence interval [CI], .52-5.91; P = .379); it was 0.42 (95% CI, .11-1.59; P = .201) for those treated with baricitinib. The 28-day RR for the main secondary combined endpoint for participants treated with TDF/FTC was 0.95 (95% CI, .66-1.40; P = .774); it was 0.90 (95% CI, .61-1.33; P = .687) for those treated with baricitinib. CONCLUSIONS Our results do not suggest a beneficial effect of TDF/FTC; nevertheless, they are compatible with the beneficial effect of baricitinib already established by other clinical trials. CLINICAL TRIALS REGISTRATION EudraCT: 2020-001156-18.
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Affiliation(s)
| | | | - María Velasco
- Infectious Diseases. Research Unit. University Hospital Fundación Alcorcón. Madrid. Spain
| | - Carlos Guijarro
- Internal Medicine Unit. University Hospital Fundación Alcorcón. Rey Juan Carlos University. Madrid. Spain
| | - Javier Queiruga-Parada
- Clinical Pharmacology Department, La Paz University Hospital, IdiPAZ. Infectious Diseases Unit. La Paz University Hospital. IdiPAZ. Madrid. Spain
| | - María Jiménez-González
- Clinical Pharmacology Department, La Paz University Hospital, IdiPAZ. La Paz University Hospital. IdiPAZ. Spanish Clinical Research Network – SCReN. Madrid. Spain
| | | | - Patricia Martínez
- Internal Medicine Department. University Hospital Infanta Sofía. Madrid. Spain
| | | | - Marta Ibarrola
- Infectious Diseases Unit. Cruces University Hospital. Barakaldo. Spain
| | - Marianela Ciudad
- Infectious Diseases Unit. Internal Medicine Department. La Princesa University Hospital, Madrid, Spain
| | - Ángela Gutiérrez
- Infectious Diseases Unit. Internal Medicine Department. La Princesa University Hospital, Madrid, Spain
| | - Miguel Torralba
- Internal Medicine Department. Guadalajara University Hospital. University of Alcalá. Spain
| | - Ana Díaz-Brasero
- Internal Medicine Department. Guadalajara University Hospital. University of Alcalá. Spain
| | - Pablo Ryan
- Infanta Leonor University Hospital. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC). School of Medicine, Complutense University. Madrid, Spain
| | | | - Cristina Díez
- Clinical Microbiology and Infectious Diseases Department. Gregorio Marañon University Hospital. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid, Spain
| | - Sofía Ibarra
- Infectious Diseases Department. Basurto University Hospital. Basurto. Spain
| | - Esperanza Merino
- Infectious Diseases Unit. Alicante General University Hospital. Alicante Institute of Health and Biomedical Research (ISABIAL). Alicante, Spain
| | - Vicente Estrada
- Infectious Diseases Unit. Internal Medicine Department. Clínico San Carlos University Hospital. IdiSSC. Madrid, Spain
| | - Javier Marcos
- Internal Medicine Department. University Hospital Fundación Alcorcón. Madrid, Spain
| | - María Novella
- Internal Medicine Department. Príncipe de Asturias University Hospital. Alcalá de Henares, Spain
| | - María A Rivera
- Emergency Department. La Paz University Hospital. Madrid, Spain
| | - Manuel Ruiz-Muñoz
- Internal Medicine Department. University Hospital Fundación Alcorcón. Madrid, Spain
| | | | - Llanos Soler
- Internal Medicine Department. University Hospital Infanta Sofía. Madrid. Spain
| | - Mikel del Álamo
- Infectious Diseases Unit. Cruces University Hospital. Barakaldo. Spain
| | - Santiago Moreno
- Infectious Diseases Department. Ramón y Cajal University Hospital. IRYCIS. University of Alcalá School of Medicine. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC). Madrid, Spain
| | | | | | - José R Arribas
- Corresponding author: José R. Arribas, MD Unidad de Enfermedades Infecciosas. Hospital Universitario La Paz. IdiPAZ. Paseo de la Castellana 261, Madrid 28046, Spain. E-mail:
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5
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Morata A, Arroyo T, Bañuelos MA, Blanco P, Briones A, Cantoral JM, Castrillo D, Cordero-Bueso G, Del Fresno JM, Escott C, Escribano-Viana R, Fernández-González M, Ferrer S, García M, González C, Gutiérrez AR, Loira I, Malfeito-Ferreira M, Martínez A, Pardo I, Ramírez M, Ruiz-Muñoz M, Santamaría P, Suárez-Lepe JA, Vilela A, Capozzi V. Wine yeast selection in the Iberian Peninsula: Saccharomyces and non- Saccharomyces as drivers of innovation in Spanish and Portuguese wine industries. Crit Rev Food Sci Nutr 2022; 63:10899-10927. [PMID: 35687346 DOI: 10.1080/10408398.2022.2083574] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Yeast selection for the wine industry in Spain started in 1950 for the understanding of the microbial ecology, and for the selection of optimal strains to improve the performance of alcoholic fermentation and the overall wine quality. This process has been strongly developed over the last 30 years, firstly on Saccharomyces cerevisiae, and, lately, with intense activity on non-Saccharomyces. Several thousand yeast strains have been isolated, identified and tested to select those with better performance and/or specific technological properties. The present review proposes a global survey of this massive ex-situ preservation of eukaryotic microorganisms, a reservoir of biotechnological solutions for the wine sector, overviewing relevant screenings that led to the selection of strains from 12 genera and 22 species of oenological significance. In the first part, the attention goes to the selection programmes related to relevant wine-producing areas (i.e. Douro, Extremadura, Galicia, La Mancha and Uclés, Ribera del Duero, Rioja, Sherry area, and Valencia). In the second part, the focus shifted on specific non-Saccharomyces genera/species selected from different Spanish and Portuguese regions, exploited to enhance particular attributes of the wines. A fil rouge of the dissertation is the design of tailored biotechnological solutions for wines typical of given geographic areas.
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Affiliation(s)
- A Morata
- EnotecUPM, ETSIAAB, Universidad Politécnica de Madrid, Madrid, Spain
| | - T Arroyo
- Departamento de Investigación Agroalimentaria, IMIDRA, Finca El Encín, Madrid, Spain
| | - M A Bañuelos
- EnotecUPM, ETSIAAB, Universidad Politécnica de Madrid, Madrid, Spain
| | - P Blanco
- Estación de Viticultura e Enoloxía de Galicia (EVEGA-AGACAL), Leiro, Ourense, Spain
| | - A Briones
- Tecnología de alimentos, Facultad de Ciencias y Tecnologías Químicas, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - J M Cantoral
- Laboratorio de Microbiología. Dept. de Biomedicina, Biotecnología y Salud Pública. Facultad de Ciencias del Mar y Ambientales, Universidad de Cádiz, Puerto Real, Cádiz, Spain
| | - D Castrillo
- Estación de Viticultura e Enoloxía de Galicia (EVEGA-AGACAL), Leiro, Ourense, Spain
| | - G Cordero-Bueso
- Laboratorio de Microbiología. Dept. de Biomedicina, Biotecnología y Salud Pública. Facultad de Ciencias del Mar y Ambientales, Universidad de Cádiz, Puerto Real, Cádiz, Spain
| | - J M Del Fresno
- EnotecUPM, ETSIAAB, Universidad Politécnica de Madrid, Madrid, Spain
| | - C Escott
- EnotecUPM, ETSIAAB, Universidad Politécnica de Madrid, Madrid, Spain
| | - R Escribano-Viana
- Finca La Grajera, Instituto de Ciencias de la Vid y el Vino (Universidad de La Rioja, Gobierno de La Rioja, CSIC), Logroño, Spain
| | - M Fernández-González
- Tecnología de alimentos, Facultad de Ciencias y Tecnologías Químicas, Universidad de Castilla-La Mancha, Ciudad Real, Spain
| | - S Ferrer
- ENOLAB, Institut de Biotecnologia i Biomedicina (BioTecMed), Universitat de València, Valencia, Spain
| | - M García
- Departamento de Investigación Agroalimentaria, IMIDRA, Finca El Encín, Madrid, Spain
| | - C González
- EnotecUPM, ETSIAAB, Universidad Politécnica de Madrid, Madrid, Spain
| | - A R Gutiérrez
- Finca La Grajera, Instituto de Ciencias de la Vid y el Vino (Universidad de La Rioja, Gobierno de La Rioja, CSIC), Logroño, Spain
| | - I Loira
- EnotecUPM, ETSIAAB, Universidad Politécnica de Madrid, Madrid, Spain
| | - M Malfeito-Ferreira
- Departamento Recursos Naturais Ambiente e Território (DRAT), Linking Landscape Environment Agriculture and Food Research Centre (LEAF), Instituto Superior de Agronomía, Tapada da Ajuda, Lisboa, Portugal
| | - A Martínez
- Departamento de Ciencias Biomédicas, Facultad de Ciencias (Edificio Antiguo Rectorado), Universidad de Extremadura, Badajoz, Spain
| | - I Pardo
- ENOLAB, Institut de Biotecnologia i Biomedicina (BioTecMed), Universitat de València, Valencia, Spain
| | - M Ramírez
- Departamento de Ciencias Biomédicas, Facultad de Ciencias (Edificio Antiguo Rectorado), Universidad de Extremadura, Badajoz, Spain
| | - M Ruiz-Muñoz
- Laboratorio de Microbiología. Dept. de Biomedicina, Biotecnología y Salud Pública. Facultad de Ciencias del Mar y Ambientales, Universidad de Cádiz, Puerto Real, Cádiz, Spain
| | - P Santamaría
- Finca La Grajera, Instituto de Ciencias de la Vid y el Vino (Universidad de La Rioja, Gobierno de La Rioja, CSIC), Logroño, Spain
| | - J A Suárez-Lepe
- EnotecUPM, ETSIAAB, Universidad Politécnica de Madrid, Madrid, Spain
| | - A Vilela
- CQ-VR, Chemistry Research Centre, School of Life and Environmental Sciences (ECVA), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - V Capozzi
- National Research Council (CNR) of Italy, c/o CS-DAT, Institute of Sciences of Food Production, Foggia, Italy
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6
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Pimentel-Ponce M, Romero-Galisteo RP, Palomo-Carrión R, Pinero-Pinto E, Merchán-Baeza JA, Ruiz-Muñoz M, Oliver-Pece J, González-Sánchez M. Gamification and neurological motor rehabilitation in children and adolescents: A systematic review. Neurologia 2021; 39:S0213-4853(21)00049-9. [PMID: 33867183 DOI: 10.1016/j.nrl.2021.02.011] [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: 09/04/2020] [Revised: 12/30/2020] [Accepted: 02/07/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. METHODS We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. RESULTS From a total of 469 studies, 10 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6studies), followed by developmental coordination disorder (3), and neurological impairment of balance and coordination (1). CONCLUSION The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.
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Affiliation(s)
| | - R P Romero-Galisteo
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España.
| | - R Palomo-Carrión
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia, Universidad de Castilla la Mancha, Toledo, España
| | - E Pinero-Pinto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, España
| | - J A Merchán-Baeza
- Grupo de investigación Methodlogy, Methods, Models and Outcomes of Health and Social Sciences (M30), Facultad de Ciencias de la Salud y Bienestar, Universidad de Vic-Universidad Central de Cataluña (UVIC-UCC), Vic, Barcelona, España
| | - M Ruiz-Muñoz
- Departamento de Enfermería y Podología, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
| | - J Oliver-Pece
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Málaga, España
| | - M González-Sánchez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
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7
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Cordero-Bueso G, Moraga J, Rios-Carrasco M, Ruiz-Muñoz M, Manuel Cantoral J. Isolation of bacteriophages from must and wine for the elimination of contaminating bacteria as an alternative to the use of sulfurous. BIO Web Conf 2019. [DOI: 10.1051/bioconf/20191502011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Acetic and some lactic acid bacteria are the main reason for the loss of quality of musts and wines, giving rise to defects such as “vinegary”, “chopped” or preventing alcoholic and / or malolactic fermentation. The solution to this problem consists in the application of authorized bactericidal agents, such as sulfurous. The aim of this work is to isolate bacteriophages from musts and wines of different grape varieties, able to eliminate lactic and acetic acid bacteria spoilages. Musts obtained from grape-berries of Vitis vinifera cv. Chardonnay and Moscatel and a red wine made with the Tintilla de Rota variety were used to isolate bacteriophages. It were isolated by classical virology methods and identified by electron microscopy. Host bacteria used in the study were the lactic acid bacteria of the species Lactobacillus hilgardii, L. plantarum and Oenococcus oeni and the acetic bacteria Acetobacter aceti. A comparative study was performed on musts and wines, previously inoculated with bacteria, by phage titration and SO2 addition to study the effectiveness of bacteriophages against bacteria. Bacteriophages were obtained from all musts and wine, belonging to the order of Caudovirals and Tectivirals. The comparative study showed that a cocktail of bacteriophages at low concentration is as effective as sulfur.
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8
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Ruiz-Muñoz M, Cordero-Bueso G, Martínez S, Pérez F, Hughes-Herrera D, Izquierdo-Bueno I, Cantoral J. The veil of flor's structure, composition and interactions in biological ageing wines. BIO Web Conf 2019. [DOI: 10.1051/bioconf/20191502018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Biological ageing occurs after fermentation of the grape must and it is due to the appearance of a biofilm on the surface of the wine called “veil of flor”. Yeast involved in veil formation are mainly Saccharomyces cerevisiae and they have traditionally been divided into four races according to their ability to metabolize different sugars. The growth of flor yeasts depends on different factors, such as the aerobic assimilation of the wine ethanol, since the medium is deficient in both sugars and nitrogen. Actually, flor yeast metabolism is different from wine S. cerevisiaeyeast, but it hasn't been analysed yet. Thus, the aim of this work is to study the diversity of flor yeast strains and to analyse the composition and the structure of the veil of flor in Jerez-Xérés-Sherry D.O. The results of this work revealed 14 different genotypes of S. cerevisiaestrains using multiplex-microsatellite PCR and these strains showed 8 different biochemical profiles using a similar procedure than traditionally. In addition, mannose and glucose were found in veil of flor complex using UHPLC-MS.
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9
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Brito-Zerón P, Kostov B, Moral-Moral P, Martínez-Zapico A, Díaz-Pedroche C, Fraile G, Pérez-Guerrero P, Fonseca E, Robles A, Vaquero-Herrero MP, Calvo MA, Forner MJ, Morcillo C, Larrañaga J, Rodriguez-Carballeira M, Ruiz-Muñoz M, Hurtado-García R, Prieto-González S, Aguilar AA, Caminal-Montero L, Hernández-Jiménez P, Fernández-Viagas CR, Castro P, Massó VM, Flores-Chavez A, Ramos-Casals M. Prognostic Factors of Death in 151 Adults With Hemophagocytic Syndrome: Etiopathogenically Driven Analysis. Mayo Clin Proc Innov Qual Outcomes 2018; 2:267-276. [PMID: 30225460 PMCID: PMC6132215 DOI: 10.1016/j.mayocpiqo.2018.06.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 06/24/2018] [Accepted: 06/27/2018] [Indexed: 01/09/2023] Open
Abstract
Objective To characterize the etiologies and clinical features at diagnosis of patients with hemophagocytic lymphohistiocytosis (HLH) and correlate these baseline features with survival using an etiopathogenically guided multivariable model. Patients and Methods The Spanish Group of Autoimmune Diseases HLH Study Group, formed in 2013, is aimed at collecting adult patients with HLH diagnosed in internal medicine departments between January 3, 2013, and October 28, 2017. Results The cohort consisted of 151 patients (91 men; mean age, 51.4 years). After a mean follow-up of 17 months (range, 1-142 months), 80 patients died. Time-to-event analyses for death identified a worse survival curve for patients with neoplasia (P<.001), mixed microbiological infections (P=.02), and more than 1 infection (P=.01) and glucocorticoid monotherapy (P=.02). According to univariate analyses, platelets of less than 100,000/mm3 (hazard ratio [HR], 3.39; 95% CI, 1.37-8.40), leukopenia (HR, 1.81; 95% CI, 1.01-3.23), severe hyponatremia (HR, 1.61; 95% CI, 1.02-2.54), disseminated intravascular coagulation (HR, 1.87; 95% CI, 1.05-3.34), bacterial infection (HR, 1.99; 95% CI, 1.09-3.63), mixed microbiological infections (HR, 3.42; 95% CI, 1.38-8.46), and 2 or more infectious triggers (HR, 2.95; 95% CI, 1.43-6.08) were significantly associated with death. In contrast, peripheral adenopathies (HR, 0.63; 95% CI, 0.40-0.98) and the immunosuppressive drug/intravenous immunoglobulin/biological therapies (HR, 0.44; 95% CI, 0.20-0.96) were protective against all-cause mortality. Multivariable Cox proportional hazards regression analysis identified 2 or more infectious triggers (HR, 3.14; 95% CI, 1.28-7.68) as the only variable independently associated with death. Conclusion The mortality rate of adult patients diagnosed with HLH exceeds 50%. Infection with more than 1 microbiological agent was the only independent variable associated with mortality irrespective of the underlying disease, epidemiological profile, clinical presentation, and therapeutic management.
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Affiliation(s)
- Pilar Brito-Zerón
- Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA-Sanitas, Barcelona, Spain
| | - Belchin Kostov
- Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.,Primary Healthcare Transversal Research Group, IDIBAPS, Barcelona, Spain
| | - Pedro Moral-Moral
- Immunopathology Section, Department of Internal Medicine, Hospital Universitari i Politècnic La Fe, Departament de Salut Valencia La Fe, Valencia, Spain
| | - Aleida Martínez-Zapico
- Autoimmune Diseases Unit, UGC Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Carmen Díaz-Pedroche
- Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Guadalupe Fraile
- Department of Internal Medicine, Hospital Ramón y Cajal, Madrid, Spain
| | | | - Eva Fonseca
- Department of Internal Medicine, Hospital de Cabueñes, Gijón, Spain
| | - Angel Robles
- Department of Internal Medicine, Hospital La Paz, Madrid, Spain
| | - María P Vaquero-Herrero
- Department of Internal Medicine, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - María Andrés Calvo
- Department of Internal Medicine, Hospital Rio Hortega Valladolid, Valladolid, Spain
| | - María José Forner
- Department of Internal Medicine, Hospital Clínico de Valencia, Valencia, Spain
| | - Cesar Morcillo
- Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA-Sanitas, Barcelona, Spain
| | - José Larrañaga
- Department of Internal Medicine, Hospital Xeral, Vigo, Spain
| | | | - Manuel Ruiz-Muñoz
- Department of Internal Medicine, Hospital Universitario Fundacion Alcorcón, Alcorcón, Spain
| | | | | | - Asun Aljibe Aguilar
- Immunopathology Section, Department of Internal Medicine, Hospital Universitari i Politècnic La Fe, Departament de Salut Valencia La Fe, Valencia, Spain
| | - Luis Caminal-Montero
- Autoimmune Diseases Unit, UGC Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Pedro Castro
- Medical Intensive Care Unit, Department of Medicine, ICMiD, Hospital Clínic, Barcelona, Spain
| | - Victoria Morell Massó
- Immunopathology Section, Department of Internal Medicine, Hospital Universitari i Politècnic La Fe, Departament de Salut Valencia La Fe, Valencia, Spain
| | - Alejandra Flores-Chavez
- Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.,Biomedical Research Unit 02, Clinical Epidemiology Research Unit, UMAE, Specialties Hospital, Western Medical Center, Mexican Institute for Social Security (IMSS), Guadalajara, Mexico.,Postgraduate Program of Medical Science, University Center for Biomedical Research (CUIB), University of Colima, Colima, Mexico
| | - Manuel Ramos-Casals
- Laboratory of Autoimmune Diseases Josep Font, CELLEX-IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.,Department of Autoimmune Diseases, ICMiD, Hospital Clínic, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
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Rubio-Rivas M, Corbella X, Pestaña-Fernández M, Tolosa-Vilella C, Castillo AGD, Colunga-Argüelles D, Trapiella-Martínez L, Iniesta-Arandia N, Castillo-Palma MJ, Sáez-Comet L, Egurbide-Arberas MV, Ortego-Centeno N, Freire M, Vargas-Hitos JA, Ríos-Blanco JJ, Todolí-Parra JA, Rodríguez-Carballeira M, Marín-Ballvé A, Segovia-Alonso P, Pla-Salas X, Madroñero-Vuelta AB, Ruiz-Muñoz M, Fonollosa-Pla V, Simeón-Aznar CP. Correction to: First clinical symptom as a prognostic factor in systemic sclerosis: results of a retrospective nationwide cohort study. Clin Rheumatol 2018; 37:2303-2304. [DOI: 10.1007/s10067-018-4179-y] [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: 11/28/2022]
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11
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Rubio-Rivas M, Corbella X, Pestaña-Fernández M, Tolosa-Vilella C, Guillen-Del Castillo A, Colunga-Argüelles D, Trapiella-Martínez L, Iniesta-Arandia N, Castillo-Palma MJ, Sáez-Comet L, Egurbide-Arberas MV, Ortego-Centeno N, Freire M, Vargas-Hitos JA, Ríos-Blanco JJ, Todolí-Parra JA, Rodríguez-Carballeira M, Marín-Ballvé A, Segovia-Alonso P, Pla-Salas X, Madroñero-Vuelta AB, Ruiz-Muñoz M, Fonollosa-Pla V, Simeón-Aznar CP, Callejas Moraga E, Calvo E, Carbonell C, Castillo MJ, Chamorro AJ, Colunga D, Corbella X, Egurbide MV, Espinosa G, Fonollosa V, Freire M, García Hernández FJ, González León R, Guillén Del Castillo A, Iniesta N, Lorenzo R, Madroñero AB, Marí B, Marín A, Ortego-Centeno N, Pérez Conesa M, Pestaña M, Pla X, Ríos Blanco JJ, Rodríguez Carballeira M, Rubio Rivas M, Ruiz Muñoz M, Sáez Comet L, Segovia P, Simeón CP, Soto A, Tarí E, Todolí JA, Tolosa C, Trapiella L, Vargas Hitos JA, Verdejo G. First clinical symptom as a prognostic factor in systemic sclerosis: results of a retrospective nationwide cohort study. Clin Rheumatol 2017; 37:999-1009. [PMID: 29214548 DOI: 10.1007/s10067-017-3936-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/07/2017] [Accepted: 11/27/2017] [Indexed: 12/21/2022]
Abstract
The objective of the study is to determine the importance of the mode of onset as prognostic factor in systemic sclerosis (SSc). Data were collected from the Spanish Scleroderma Registry (RESCLE), a nationwide retrospective multicenter database created in 2006. As first symptom, we included Raynaud's phenomenon (RP), cutaneous sclerosis, arthralgia/arthritis, puffy hands, interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), and digestive hypomotility. A total of 1625 patients were recruited. One thousand three hundred forty-two patients (83%) presented with RP as first symptom and 283 patients (17%) did not. Survival from first symptom in those patients with RP mode of onset was higher at any time than those with onset as non-Raynaud's phenomenon: 97 vs. 90% at 5 years, 93 vs. 82% at 10 years, 83 vs. 62% at 20 years, and 71 vs. 50% at 30 years (p < 0.001). In multivariate analysis, factors related to mortality were older age at onset, male gender, dcSSc subset, ILD, PAH, scleroderma renal crisis (SRC), heart involvement, and the mode of onset with non-Raynaud's phenomenon, especially in the form of puffy hands or pulmonary involvement. The mode of onset should be considered an independent prognostic factor in systemic sclerosis and, in particular, patients who initially present with non-Raynaud's phenomenon may be considered of poor prognosis.
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Affiliation(s)
- Manuel Rubio-Rivas
- Department of Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Xavier Corbella
- Department of Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Melany Pestaña-Fernández
- Department of Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Carles Tolosa-Vilella
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain
| | | | - Dolores Colunga-Argüelles
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | - Nerea Iniesta-Arandia
- Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatología, Hospital Clínic, Barcelona, Spain
| | - María Jesús Castillo-Palma
- Collagenosis and Pulmonary Hypertension Unit, Department of Internal Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Luis Sáez-Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Mayka Freire
- Thrombosis and Vasculitis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | | | | | | | | | - Adela Marín-Ballvé
- Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Pablo Segovia-Alonso
- Department of Internal Medicine, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Xavier Pla-Salas
- Department of Internal Medicine, Consorci Hospitalari de Vic, Barcelona, Spain
| | | | - Manuel Ruiz-Muñoz
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Vicent Fonollosa-Pla
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carmen Pilar Simeón-Aznar
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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González-Sánchez M, Galán-Mercant A, Ruiz-Muñoz M, Mateo-Angulo A, Cuesta-Vargas A. Kinematic analysis of ambulation comparing obese and normal-weight people. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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