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Ortiz A, Quiroga B, Díez J, Escalada San Martín FJ, Ramirez L, Pérez Maraver M, Martínez-Berganza Asensio ML, Arranz Arija JÁ, Alvarez-Ossorio Fernández JL, Córdoba R, Brotons Muntó F, Cancelo Hidalgo MJ, Carles Reverter J, Plasencia-Rodríguez C, Carretera Gómez J, Guijarro C, Freijo Guerrero MDM, de Sequera P. The Spanish Scientific Societies before the ESC 2021 guidelines on vascular disease prevention: Generalizing the measurement of albuminuria to identify vascular risk and prevent vascular disease. Nefrologia 2023; 43:245-250. [PMID: 37407308 DOI: 10.1016/j.nefroe.2023.06.005] [Citation(s) in RCA: 1] [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] [Received: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 07/07/2023] Open
Abstract
The 2021 guidelines on the prevention of vascular disease (VD) in clinical practice published by the European Society of Cardiology (ESC) and supported by 13 other European scientific societies recognize the key role of screening for chronic kidney disease (CKD) in the prevention of VD. Vascular risk in CKD is categorized based on measurements of estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (ACR). Thus, moderate CKD is associated with a high vascular risk and severe CKD with a very high vascular risk requiring therapeutic action, and there is no need to apply other vascular risk scores when vascular risk is already very high due to CKD. Moreover, the ESC indicates that vascular risk assessment and the subsequent decision algorithm should start with measurement of eGFR and ACR. To optimize the implementation of the ESC 2021 guidelines on the prevention of CVD in Spain, we consider that: 1) Urine testing for albuminuria using ACR should be part of the clinical routine at the same level as blood glucose, cholesterolemia, and GFR estimation when these are used to make decisions on CVD risk. 2) Spanish public and private health services should have the necessary means and resources to optimally implement the ESC 2021 guidelines for the prevention of CVD in Spain, including ACR testing.
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Affiliation(s)
- Alberto Ortiz
- Sociedad Española de Nefrología (S.E.N.); Servicio de Nefrología, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Borja Quiroga
- Sociedad Española de Nefrología (S.E.N.); Servicio de Nefrología, IIS-La Princesa, Hospital Universitario de la Princesa, Madrid, Spain.
| | - Javier Díez
- Sociedad Española de Nefrología (S.E.N.); Center of Applied Medical Research and School of Medicine, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red de la Enfermedades Cardiovasculares (CIBERCV), Carlos III Institute of Health, Madrid, Spain
| | | | - Leblic Ramirez
- Servicio de Angiología y Cirugía Vascular, Hospital Universitario de la Paz, Madrid, Spain; Sociedad Española de Angióloga y Cirugía Vascular (SEACV)
| | - Manuel Pérez Maraver
- Servicio de Endocrinología, Hospital Universitari Bellvitge, Barcelona, Spain; Sociedad Española de Diabetes (SED)
| | | | - José Ángel Arranz Arija
- Servicio de Oncología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Sociedad Española de Oncología Médica (SEOM)
| | | | - Raúl Córdoba
- Servicio de Hematología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; Sociedad Española de Hematología y Hemoterapia (SEHH)
| | - Franscisco Brotons Muntó
- Centro de Salud Trinitat, Valencia, Spain; Sociedad Española de Medicina de Familia y Comunitaria (semFYC)
| | - María Jesús Cancelo Hidalgo
- Servicio de Ginecología y Obstetricia, Hospital Universitario de Guadalajara, Universidad de Alcalá, Guadalajara, Spain; Sociedad Española de Ginecología y Obstetricia (SEGO)
| | - Joan Carles Reverter
- Servicio de Hematología, Hospital Clínic, Barcelona, Spain; Sociedad Española de Trombosis y Hemostasia (SETH)
| | | | - Juana Carretera Gómez
- Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, Spain; Sociedad Española de Medicina Interna (SEMI)
| | - Carlos Guijarro
- Servicio de Medicina Interna, Hospital Universitario Fundación Alcorcón - Universidad Rey Juan-Carlos, Madrid, Spain; Sociedad Española de Arterioesclerosis (SEA)
| | - M Del Mar Freijo Guerrero
- Sociedad Española de Nefrología (S.E.N.); Servicio de Neurología, Hospital de Cruces, Baracaldo, Spain; En representación del Grupo de Estudio de Enfermedades Cerebrovasculares de la Sociedad Española de Neurología
| | - Patricia de Sequera
- Sociedad Española de Nefrología (S.E.N.); Servicio de Nefrología, Hospital Universitario Infanta Leonor, Universidad Complutense De Madrid, Madrid, Spain
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Ortiz A, Quiroga B, Díez J, Martín FJES, Ramirez L, Maraver MP, Lourdes Martínez-Berganza Asensio M, Ángel Arranz Arija J, Luis Alvarez-Ossorio Fernández J, Córdoba R, Muntó FB, Hidalgo MJC, Reverter JC, Plasencia-Rodríguez C, Gómez JC, Guijarro C, del Mar Freijo Guerrero M, Sequera PD. Las Sociedades Científicas españolas ante la guía ESC 2021 de prevención de la enfermedad vascular: generalizar la medida de la albuminuria para identificar el riesgo cardiovascular y prevenir la enfermedad vascular. Nefrologia 2023. [DOI: 10.1016/j.nefro.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
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Casellas Caro M, Hidalgo MJC, García-Erce JA, Baquero Úbeda JL, Torras Boatella MG, Gredilla Díaz E, Ruano Encinar M, Martín Bayón I, Nicolás Picó J, Arjona Berral JE, Muñoz Solano A, Jiménez Merino S, Cerezales M, Cuervo J. Applying reflective multicriteria decision analysis to understand the value of therapeutic alternatives in the management of gestational and peripartum anaemia in Spain. BMC Pregnancy Childbirth 2022; 22:157. [PMID: 35216553 PMCID: PMC8881868 DOI: 10.1186/s12884-022-04481-w] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of the FeminFER project was to assess the value of ferric carboxymaltose following a multicriteria decision analysis in obstetrics and gynaecology in Spain. METHODS Ferric carboxymaltose (FCM) and ferrous sulphate were evaluated using the EVIDEM framework. Ten stakeholders participated to collect different perspectives. The framework was adapted considering evidence retrieved with a PICO-S search strategy and grey literature. Criteria/subcriteria were weighted by level of relevance and an evidence-based decision-making exercise was developed in each criterion; weights and scores were combined to obtain the value of intervention relative to each criterion/subcriterion, that were further combined into the Modulated Relative Benefit-Risk Balance (MRBRB). RESULTS The most important criterion favouring FCM was Compared Efficacy/Effectiveness (0.183 ± 0.07), followed by Patient Preferences (0.059 ± 0.10). Only Direct medical costs criterion favoured FS (-0.003 ± 0.03). MRBRB favoured FCM; 0.45 ± 0.19; in a scale from -1 to + 1. CONCLUSIONS In conclusion, considering the several criteria involved in the decision-making process, participants agreed with the use of FCM according to its MRBRB.
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Affiliation(s)
- Manel Casellas Caro
- Department of Obstetrics, Hospital Universitari Vall d´Hebron, Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain
| | - María Jesús Cancelo Hidalgo
- Department of Obstetrics and Gynecology, Hospital Universitario Guadalajara, Calle Donante de Sangre, 19002, Guadalajara, S/N, Spain
| | - José Antonio García-Erce
- Banco de Sangre Y Tejidos de Navarra, Servicio Navarro de Salud-Osasunbidea, Calle Irunlarrea, 3, 31008, Pamplona, Spain
- Grupo Español de Rehabilitación Multimodal (GERM), Instituto Aragonés de Ciencias de La Salud, Avenida San Juan Bosco, 13, 50009, Zaragoza, Spain
- PBM Group, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana, 261, 28046, Madrid, Spain
| | | | - Maria Glòria Torras Boatella
- Àrea d'Innovació, Hospital Universitari Bellvitge, Carrer de La Feixa Llarga, L'Hospitalet de Llobregat, 08907, Barcelona, S/N, Spain
- Institut Català de La Salut, Barcelona, Spain
| | - Elena Gredilla Díaz
- Anaesthesia Department, Hospital La Paz, Paseo de La Castellana, 261, 28046, Madrid, Spain
| | | | - Israel Martín Bayón
- CS Polop-La Nucía, Avenida de Sagi Barba, 24, Polop, La Nucía, 03520, Alicante, Spain
| | - Jordi Nicolás Picó
- Hospital Universitari Mutua Terrasa, Plaça del Doctor Robert, 5, 08221, Terrassa, Spain
| | | | - Alberto Muñoz Solano
- Department of Obstetrics and Gynecology, Hospital Universitario Marqués de Valdecilla, Avenida de Valdecilla, 25, 39008, Santander, Spain
| | | | - Mónica Cerezales
- Axentiva Solutions S.L., Calle Monte Cerrau, 28, 33006, Asturias, Oviedo, Spain
| | - Jesús Cuervo
- Axentiva Solutions S.L., Calle Monte Cerrau, 28, 33006, Asturias, Oviedo, Spain.
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Cancelo Hidalgo MJ. [Milk as a health vehicle in pregnancy and lactation]. NUTR HOSP 2019; 36:44-48. [PMID: 31368341 DOI: 10.20960/nh.02807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION The importance of a correct diet and nutrition before pregnancy to the end of lactation seems to be without doubt with the scientific information and evidence that we have today. Despite this, recent studies have shown that the mother´s diet is not as adequate as it should be and deficiencies of certain critical nutrients have been detected at this stage. The importance of a correct nutrition of the mother at this stage has already been recognized for decades and today we can affirm that it will affect not only the development of the fetus but also the genetic organization of the future metabolic response of the child and later of the adult. Several recent publications seem to have made clear that they seem to relate maternal nutrition with a possible programming effect related to the appearance of various metabolic alterations in adult life giving rise to the possible appearance of various chronic diseases. For this reason, gestation is going to be a challenge for the mother at the nutritional level due to increase energy and nutrient needs and their relationship to maternal and child health. In the daily diet, milk and milk products are critical sources of nutrients for the correct development of the fetus and the early development of the child. The purpose of this text is to highlight them, to review the effects of conventional dairy products and dairy products fortified with various nutrients on nutritional status during pregnancy and lactation.
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Cancelo Hidalgo MJ. [Hormonal treatments for hemorrhaging secondary to fibroids. An alternative or complement to surgery?]. Med Clin (Barc) 2013; 141 Suppl 1:30-4. [PMID: 24314565 DOI: 10.1016/s0025-7753(13)70050-2] [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: 10/25/2022]
Abstract
The main objective of treatment in women with uterine fibroids is the control of associated symptoms such as abnormal uterine bleeding, pain and pressure. Although the cost and potential adverse effects of the long-term use of medical treatment may limit its use for a long time, this alternative should be considered before indicating surgical treatment. At present, we have a considerable variety of drugs that, although not specific treatments for fibroids, may be used for the short to medium-term management of bleeding; however, we have still not found an alternative that eliminates the need for invasive treatments. Further research in this field is therefore warranted. Given the heterogeneity of fibroids and the lack of effective treatments in controlling their growth, the identification of signals that stimulate the onset and growth of these fibroids opens doors to the development of new therapies. In the future we may be able to differentiate classes of fibroids by molecular techniques and thereby implement specific treatments that control their development and their associated symptoms.
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Affiliation(s)
- María Jesús Cancelo Hidalgo
- Servicio de Ginecología y Obstetricia, Hospital Universitario de Guadalajara, Universidad de Alcalá, Guadalajara, España.
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