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Velasco M, Galán MI, Casas ML, Pérez-Fernández E, Martínez-Ponce D, González-Piñeiro B, Castilla V, Guijarro C. Impact of Previous Coronavirus Disease 2019 on Immune Response After a Single Dose of BNT162b2 Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine. Open Forum Infect Dis 2021; 8:ofab299. [PMID: 34258322 PMCID: PMC8244747 DOI: 10.1093/ofid/ofab299] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Immune response after a single dose of BNT162b2 vaccine was markedly increased in subjects with previous severe acute respiratory syndrome coronavirus 2 infection, reaching similar immunoglobulin titers to those elicited by the full 2 doses in naive cases, and increased modestly after the second dose. These data may inform the priority of the boosting dose.
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Affiliation(s)
- María Velasco
- Infectious Diseases and Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Maria Isabel Galán
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Maria Luisa Casas
- Laboratory Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | - Diana Martínez-Ponce
- Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | | | - Carlos Guijarro
- Rey Juan Carlos University, Internal Medicine Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain
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Cases Corona CM, Arroyo Santayana A, Acedo JM, Casas ML, Dominguez Torres P, Diaz Enamorado Y, Landaluce-Triska E, Tato Ribera A, Fernandez Juarez GM. MO176IS IT REALLY INDICATED TO INCREASE FLUID INTAKE IN ELDERLY PATIENTS DURING SUMMER MONTHS? Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab092.0054] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Thirst mechanism is essential to maintain an adequate osmolarity and homeostasis. During summer heat waves, there is an increased morbidity and mortality in elderly patients that has led to generally recommend an increase in fluid intake in all elderly patients beyond thirst stimulation, even in those independent patients with free access to water.
The aim of this study was to observe the differences in calculated serum osmolarity (cOsm) between young, elderly and very elderly patients who were neither institutionalized nor hospitalized, in different seasons throughout the year.
Method
We conducted a retrospective cross-sectional study in outpatients between 18-104 years old that had undergone a blood test between July 2019 and January 2020, in which serum osmolarity could be calculated. Patients with serum creatinine above 1.5 mg/dl were excluded.
Results
The study included 45236 blood samples from 41132 patients, 56.1% were female. 50% of patients were between 18 and 65 years old, 45.4% were between 65 and 85 years old and 4.6% were >85 years old. The mean cOsm in patients between 18-65 years was 288.3 mOsm/kg, compared to 289.8 mOsm/kg in those between 65- 85 years old (p<0.0001). In patients >85 years, mean cOsm was 289.4 mOsm/kg.
When comparing cOsm between different seasons of the year, cOsm in summer months was about 1 mOsm/kg higher than in autumn-winter (288.9 mOsm/kg vs 287.8 mOsm/kg in young patients, p=0.0001; 290.5 mOsm/kg vs 289.4 mOsm/kg in elderly patients, p=0.0001). In the very elderly (>85 years) the difference was smaller and non-significant (289.6mOsm/kg vs 289.1mOsm/kg).
Conclusion
Under physiologic conditions, patients >65 years have a slightly higher calculated serum osmolarity than younger patients, nevertheless staying within normal range. These differences only increase in 1 mOsm/kg during the summer months. Therefore, it is not indicated to force an increase in fluid intake in the elderly or very elderly population under physiologic conditions.
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Affiliation(s)
| | | | | | | | | | | | | | - Ana Tato Ribera
- Hospital Universitario Fundación Alcorcón, Nephrology , Spain
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Guijarro C, Pérez-Fernández E, González-Piñeiro B, Meléndez V, Goyanes MJ, Renilla ME, Casas ML, Sastre I, Velasco M. Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain. Rev Clin Esp 2021; 221:264-273. [PMID: 38108497 PMCID: PMC7678416 DOI: 10.1016/j.rce.2020.10.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIAL AND METHODS We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS The crude cumulative incidence among migrants (n=20,419) was higher than among Spaniards (n=131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p<.001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=.007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p<.001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p<.001). CONCLUSIONS Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.
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Affiliation(s)
- C Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - B González-Piñeiro
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - V Meléndez
- Concejalía de Asuntos sociales, Mayores y Salud Pública, Ayuntamiento de Alcorcón, Alcorcón, Madrid, España
| | - M J Goyanes
- Unidad de Microbiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M E Renilla
- Unidad de Urgencias, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M L Casas
- Unidad de Laboratorio, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - I Sastre
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M Velasco
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Medicina Interna, Sección Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
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4
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Guijarro C, Pérez-Fernández E, González-Piñeiro B, Meléndez V, Goyanes MJ, Renilla ME, Casas ML, Sastre I, Velasco M. Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain. Rev Clin Esp 2021; 221:264-273. [PMID: 33998512 DOI: 10.1016/j.rceng.2020.10.005] [Citation(s) in RCA: 3] [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: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIALS AND METHODS We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS The crude cumulative incidence among migrants (n = 20419) was higher than among Spaniards (n = 131599): 8.81 and 6.51 and per 1000 inhabitants, respectively (p < .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found in people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p = .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p < .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p < .001). CONCLUSIONS Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.
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Affiliation(s)
- C Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - B González-Piñeiro
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - V Meléndez
- Concejalía de Asuntos Sociales, Mayores y Salud Pública, Ayuntamiento de Alcorcón, Alcorcón, Madrid, Spain
| | - M J Goyanes
- Unidad de Microbiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M E Renilla
- Unidad de Urgencias, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M L Casas
- Unidad de Laboratorio, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - I Sastre
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M Velasco
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Medicina Interna, Sección Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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López-Hoyos M, Lizaso MT, Rodríguez JJ, Sanz ML, Labrador-Horrillo M, Ramos R, Martín-Esteban M, Pastor R, Hernández MD, Casas ML, Peláez A, García BE. Quantitative measurement of allergen-specific immunoglobulin E levels in mass units (ng/mL): an interlaboratory comparison. J Investig Allergol Clin Immunol 2012; 22:387-389. [PMID: 23101323] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- M López-Hoyos
- Servicio Inmunología, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain.
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Ocana S, Casas ML, Buhigas I, Lledo JL. Diagnostic strategy for occult hepatitis B virus infection. World J Gastroenterol 2011; 17:1553-7. [PMID: 21472120 PMCID: PMC3070125 DOI: 10.3748/wjg.v17.i12.1553] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 12/09/2010] [Accepted: 12/16/2010] [Indexed: 02/06/2023] Open
Abstract
In 2008, the European Association for the study of the liver (EASL) defined occult hepatitis B virus infection (OBI) as the “presence of hepatitis B virus (HBV) DNA in the liver (with detectable or undetectable HBV DNA in the serum) of individuals testing hepatitis B surface antigen (HBsAg) negative by currently available assays”. Several aspects of occult HBV infection are still poorly understood, including the definition itself and a standardized approach for laboratory-based detection, which is the purpose of this review. The clinical significance of OBI has not yet been established; however, in terms of public health, the clinical importance arises from the risk of HBV transmission. Consequently, it is important to detect high-risk groups for occult HBV infection to prevent transmission. The main issue is, perhaps, to identify the target population for screening OBI. Viremia is very low or undetectable in occult HBV infection, even when the most sensitive methods are used, and the detection of the viral DNA reservoir in hepatocytes would provide the best evaluation of occult HBV prevalence in a defined set of patients. However, this diagnostic approach is obviously unsuitable: blood detection of occult hepatitis B requires assays of the highest sensitivity and specificity with a lower limit of detection < 10 IU/mL for HBV DNA and < 0.1 ng/mL for HBsAg.
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Fernandez-Rodriguez CM, Gutierrez ML, Lledó JL, Casas ML. Influence of occult hepatitis B virus infection in chronic hepatitis C outcomes. World J Gastroenterol 2011; 17:1558-62. [PMID: 21472121 PMCID: PMC3070126 DOI: 10.3748/wjg.v17.i12.1558] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 10/26/2010] [Accepted: 11/02/2010] [Indexed: 02/06/2023] Open
Abstract
Persistence of hepatitis B virus-DNA in the sera, peripheral blood mononuclear cells or in the liver of hepatitis B surface antigen (HBsAg)-negative patients with or without serological markers of previous exposure (antibodies to HBsAg and/or to HB-core antigen) defines the entity called occult hepatitis B infection (OBI). Co-infection with hepatitis B and hepatitis C viruses is frequent in highly endemic areas. While this co-infection increases the risk of liver disease progression, development of cirrhosis and hepatocellular carcinoma and also increases the rate of therapeutic failure to interferon-based treatments than either virus alone, a potentially negative effect of OBI on clinical outcomes and of therapeutic response to current antiviral regimes of patients with chronic hepatitis C remains inconclusive.
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Fernández-Rodríguez CM, López-Serrano P, Alonso S, Gutiérrez ML, Lledó JL, Pérez-Calle JL, Temiño R, Cacho G, Nevado M, Casas ML, Gasalla JM, Bonet B. Long-term reversal of hypocholesterolaemia in patients with chronic hepatitis C is related to sustained viral response and viral genotype. Aliment Pharmacol Ther 2006; 24:507-12. [PMID: 16886916 DOI: 10.1111/j.1365-2036.2006.03000.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Genotype-3 of hepatitis C virus (HCV) has been associated with serum lipid changes (reversible with sustained viral response) and liver steatosis. AIM To characterize the relationships among hepatic steatosis, cholesterol and sustained viral response in these patients. METHODS Patients (n = 215) with chronic hepatitis C (157 with genotype-1 of HCV) had age, body mass index, gender, alcohol intake, glycaemia, serum lipids, transaminases, grade and stage (METAVIR and Scheuer), degree of liver steatosis, sustained viral response, insulinaemia, leptinaemia, beta-hydroxybutyrate and glycerol measured, and were compared with 32 hepatitis B virus (HBV)-infected subjects. RESULTS Genotype-3 of HCV patients had age-adjusted hypocholesterolaemia and more frequent hepatic steatosis (P < 0.001). Steatosis was inversely correlated with serum cholesterol (P < 0.01) and directly with viral load (P < 0.03). In patients with genotype-3 of HCV and sustained viral response, serum cholesterol increased from 138 (95% CI: 120-151) to 180 mg/dL (95% CI: 171-199) 12 months after treatment conclusion (P < 0.0001). By contrast, cholesterol values were unchanged in genotype-3 of HCV non-responders and in patients with genotype-1 of HCV regardless of response. Rising cholesterol in sustained viral response did not parallel the changes in beta-hydroxybutyrate. CONCLUSIONS Besides causing hepatic steatosis, genotype-3 specifically decreases serum cholesterol. This interference with the metabolic lipid pathway is related to viral load, is reversed with sustained viral response, and seems unrelated to mitochondrial dysfunction.
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González C, García-Berrocal B, Talaván T, Casas ML, Navajo JA, González-Buitrago JM. Clinical evaluation of a microsphere bead-based flow cytometry assay for the simultaneous determination of anti-thyroid peroxidase and anti-thyroglobulin antibodies. Clin Biochem 2005; 38:966-72. [PMID: 16168980 DOI: 10.1016/j.clinbiochem.2005.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 05/16/2005] [Revised: 07/27/2005] [Accepted: 08/15/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Multiplexing technologies based on the use of microspheres as the solid phase have opened new possibilities for the analysis of autoantibodies. As an alternative to the traditional immunoassays, it is possible to use these methods in combination with flow cytometry for simultaneous measurement of anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies. DESIGN AND METHODS We studied 127 serum samples sent to our laboratory for the quantitation of anti-TPO and anti-Tg antibodies. Clinical information was available for all of the patients studied. The samples were analyzed simultaneously for both antibodies by flow cytometry (FIDIS, BMD, France), and individually for each of the antibodies by an automated enzyme immunoassay (UniCap, Pharmacia Diagnostics, Germany). RESULTS A significant association between the results was observed. The kappa agreement indices between the methods were 0.859 and 0.832 for anti-TPO and anti-Tg, respectively. Discrepant results between the two techniques were observed with no common cause. Anti-TPO and anti-Tg antibodies exhibited a non-Gaussian distribution. The areas under the ROC curves were similar for both methods used; for anti-TPO, 0.884 (Pharmacia) and 0.853 (BMD), and for anti-Tg, 0.833 (Pharmacia) and 0.837 (BMD). CONCLUSION Cytometry multiplex technology offers a true alternative to conventional immunoassays in the analysis of anti-TPO and anti-Tg antibodies.
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Affiliation(s)
- Concepción González
- Servicio de Bioquímica, Laboratorio de Autoinmunidad, Hospital Universitario, Salamanca, Spain
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Fernández-Rodriguez CM, Gutiérrez ML, Serrano PL, Lledó JL, Santander C, Fernández TP, Tomás E, Cacho G, Nevado M, Casas ML. Factors influencing the rate of fibrosis progression in chronic hepatitis C. Dig Dis Sci 2004; 49:1971-6. [PMID: 15628736 DOI: 10.1007/s10620-004-9603-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Alcohol consumption, age at infection, and male gender have been identified as risk factors for faster fibrosis progression in patients with chronic hepatitis C (CHC). Yet the influence of liver steatosis, light to moderate alcohol consumption, or iron overload on this progression remains controversial. To analyze the effect of individual risk factors and their interaction on fibrosis progression in a group of patients with CHC and a definite date of infection, we studied 133 consecutive untreated patients. Covariates included were age, body mass index (BMI), gender, age at infection, alcohol intake, serum lipids, glycemia, serum ALT, AST, GGT, iron, and ferritin, grade and stage (METAVIR and Scheuer), and hepatic stainable iron (Perl's stain). The rate of fibrosis progression was inferred from the METAVIR score. By logistic regression analysis, hepatic steatosis (odds ratio [OR], 3.035; 95% confidence interval [CI], 1.16-7.93), serum ferritin levels higher than 290 ng/ml (OR, 5.5; 1.6-18.65), and light to moderate ethanol intake (1-50 g/day) (OR, 5.22; 1.5-17.67) were independently associated with faster fibrosis progression. There was no effect of interaction between these variables on the rate of fibrosis progression. Liver steatosis, serum ferritin levels, and light to moderate alcohol intake are associated with faster fibrosis progression in chronic hepatitis C. Combination of these factors did not further accelerate this progression. The impact of modification of these factors on progression should be tested in longitudinal studies.
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Alonso Díaz de Durana MD, Fernández-Rivas M, Casas ML, Esteban E, Cuevas M, Tejedor MA. Anaphylaxis during negative penicillin skin prick testing confirmed by elevated serum tryptase. Allergy 2003; 58:159. [PMID: 12622750 DOI: 10.1034/j.1398-9995.2003.00056_2.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Casas ML, Casas MC, Hervella FD, Izquierdo C, Castro A, Otero A. [Traumatic asphyxia and continuous venovenous hemofiltration. Report of a case]. Rev Esp Anestesiol Reanim 1997; 44:30-2. [PMID: 9148347] [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: 02/04/2023]
Abstract
A 32-year-old man was admitted with traumatic asphyxia, with aspiration to the bronchi after being buried under sand. The condition progressed to respiratory distress syndrome and systemic inflammatory response. Because ventilatory and hemodynamic deterioration was rapid and severe, in spite of mechanical ventilation and vasoactive drugs, we instated early continuous arteriovenous hemofiltration, which also allowed us to meet the patient's full nutritional needs. We believe that the patient's very satisfactory progress can be attributed to the early use of this procedure, along with appropriate specific treatment.
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Affiliation(s)
- M L Casas
- Servicio de Anestesia, Reanimación y Terapia del Dolor, Complexo Hospitalario Cristal Piñor, Orense
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Abstract
Oxygen consumption was measured in infants, children, and adolescents during diagnostic heart catheterizations. A total of 825 measurements of oxygen consumption (VO2) was performed in 504 subjects using a semiopen hood system and a paramagnetic oxygen analyzer. In 256 subjects under 3 years of age, body dimensions and heart rate were found to be significant factors for oxygen consumption. The regression equation for both sexes was: VO2/BSA (ml/min.m2) = 3.42.height (cm) - 7.83.weight (kg) + 0.38.HR - 54.1 (r2 = 0.39, SD = 38.7), where BSA is body surface area and HR is heart rate. VO2/BSA was significantly lower in infants less than 3 months of age (133 +/- 33 ml/min.m2) compared with infants of 3-12 months (171 +/- 37 ml/ min.m2; p < 0.01). In 272 children aged 3 years and older and adolescents, gender was a significant factor in oxygen consumption together with BSA and HR. The regression line equation for males was VO2/BSA (ml/ min.m2) = 0.79.HR - 7.4.BSA(m2) + 108.1 (r2 = 0.45, SD = 34.2). The regression line equation for females is VO2/BSA (ml/min.m2) = 0.77.HR - 5.2.BSA(m2) + 106.8 (r2 = 0.43, SD = 34.4). Hematocrit, systemic oxygen saturation, and blood pressure were not significant factors. The predictive value of nomograms for oxygen consumption is limited because of the large interindividual variations not explained by differences in gender, body size, or simple hemodynamic variables. Preferably, oxygen consumption is measured; but if nomograms for oxygen consumption are used for hemodynamic assessment, the wide confidence intervals should be considered.
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Affiliation(s)
- B P Lundell
- Department of Pediatrics, St. Göran's Children's Hospital, Karolinska Institute, Stockholm, Sweden
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