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Aznar ML, Espinosa-Pereiro J, Saborit N, Jové N, Sánchez Martinez F, Pérez-Recio S, Vitoria A, Sanjoaquin I, Gallardo E, Llenas-García J, Pomar V, García IO, Cacho J, Goncalves De Freitas L, San Martin JV, García Rodriguez JF, Jiménez-Fuentes MÁ, De Souza-Galvao ML, Tórtola T, Zules R, Molina I, Sánchez-Montalvá A. Impact of the COVID-19 pandemic on tuberculosis management in Spain. Int J Infect Dis 2021; 108:300-305. [PMID: 33930543 PMCID: PMC8078060 DOI: 10.1016/j.ijid.2021.04.075] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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: 02/09/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 12/22/2022] Open
Abstract
Background The impact of COVID-19 on the diagnosis and management of tuberculosis (TB) patients is unknown. Methods Participating centres completed a structured web-based survey regarding changes to TB patient management during the COVID-19 pandemic. The study also included data from participating centres on patients aged ≥18 diagnosed with TB in 2 periods: March 15 to June 30, 2020 and March 15 to June 30, 2019. Clinical variables and information about patient household contacts were retrospectively collected. Results A total of 7 (70%) TB units reported changes in their usual TB team operations. Across both periods of study, 169 patients were diagnosed with active TB (90 in 2019, 79 in 2020). Patients diagnosed in 2020 showed more frequent bilateral lesions in chest X-ray than patients diagnosed in 2019 (P = 0.004). There was a higher percentage of latent TB infection and active TB among children in households of patients diagnosed in 2020, compared with 2019 (P = 0.001). Conclusions The COVID-19 pandemic has caused substantial changes in TB care. TB patients diagnosed during the COVID-19 pandemic showed more extended pulmonary forms. The increase in latent TB infection and active TB in children of patient households could reflect increased household transmission due to anti-COVID-19 measures.
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Affiliation(s)
- M L Aznar
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Mycobacteria Infection Study Group (GEIM, Spanish acronym) from Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, Spanish acronym), Spain.
| | - J Espinosa-Pereiro
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Saborit
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Jové
- Unitat Clínica de Tuberculosis, Hospital del Mar, Barcelona, Spain
| | | | - S Pérez-Recio
- Tuberculosis Unit, Service of Infectious Diseases, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - A Vitoria
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - I Sanjoaquin
- Infectious Diseases Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - E Gallardo
- Internal Medicine Department, Hospital Vega Baja-FISABIO Orihuela (Alicante, Spain), Clinical Medicine Department, Miguel Hernández University, Elche, Alicante, Spain
| | - J Llenas-García
- Internal Medicine Department, Hospital Vega Baja-FISABIO Orihuela (Alicante, Spain), Clinical Medicine Department, Miguel Hernández University, Elche, Alicante, Spain
| | - V Pomar
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Av. Sant Antoni Mª Claret, 167, 08025 Barcelona, Spain
| | - I O García
- Microbiology and Infection's Control Department, Hospital Universitario de Canarias, Tenerife, Spain
| | - J Cacho
- Microbiology Department, Hospital Universitario de Getafe, Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, Spain
| | | | - J V San Martin
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - J F García Rodriguez
- Infectious Diseases Unit, Complexo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | | | | | - T Tórtola
- Microbiology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Zules
- Preventive Medicine and Epidemiology Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - I Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain; Mycobacteria Infection Study Group (GEIM, Spanish acronym) from Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, Spanish acronym), Spain
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Romero A, Barrachina L, Ranera B, Remacha A, Moreno B, de Blas I, Sanz A, Vázquez F, Vitoria A, Junquera C, Zaragoza P, Rodellar C. Comparison of autologous bone marrow and adipose tissue derived mesenchymal stem cells, and platelet rich plasma, for treating surgically induced lesions of the equine superficial digital flexor tendon. Vet J 2017; 224:76-84. [DOI: 10.1016/j.tvjl.2017.04.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 04/03/2017] [Accepted: 04/12/2017] [Indexed: 12/24/2022]
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Ardanaz N, Vázquez FJ, Romero A, Remacha AR, Barrachina L, Sanz A, Ranera B, Vitoria A, Albareda J, Prades M, Zaragoza P, Martín-Burriel I, Rodellar C. Inflammatory response to the administration of mesenchymal stem cells in an equine experimental model: effect of autologous, and single and repeat doses of pooled allogeneic cells in healthy joints. BMC Vet Res 2016; 12:65. [PMID: 27029614 PMCID: PMC4815220 DOI: 10.1186/s12917-016-0692-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [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: 06/30/2015] [Accepted: 03/23/2016] [Indexed: 01/01/2023] Open
Abstract
Background Mesenchymal stem cells (MSCs) transplantation has become a promising therapeutic choice for musculoskeletal injuries. Joint-related disorders are highly prevalent in horses. Therefore, these animals are considered as suitable models for testing MSC-based therapies for these diseases. The aim of this study was to investigate the clinical and inflammatory responses to intra-articular single and repeat dose administration of autologous or of pooled allogeneic MSCs in healthy equine healthy joints. Six horses were intra-articularly injected with a single autologous dose of bone marrow derived MSCs (BM-MSCs) and two separate doses of allogeneic BM-MSCs pooled from several donors. All contralateral joints were injected with Lactated Ringer’s Solution (LRS) as the control vehicle. Signs of synovitis and lameness were evaluated at days 0, 1, 2, 3, 5 and 10 after injection. Total protein (TP), white blood cell count (WBC) and neutrophil count (NC) in synovial fluid were also measured at the same time-points. Results A mild synovial effusion without associated lameness was observed after all BM-MSCs injections. The second allogeneic injection caused the lowest signs of synovitis. Local temperature slightly increased after all BM-MSCs treatments compared to the controls. TP, WBC and NC in synovial fluids also increased during days 1 to 5 after all BM-MSCs injections. Both, clinical and synovial parameters were progressively normalized and by day 10 post-inoculation appeared indistinguishable from controls. Conclusions Intra-articular administration of an allogeneic pool of BM-MSCs represents a safe therapeutic strategy to enhance MSCs availability. Importantly, the absence of hypersensitivity response to the second allogeneic BM-MSCs injection validates the use of repeat dose treatments to potentiate the therapeutic benefit of these cells. These results notably contribute to the development of stem cell based therapies for equine and human joint diseases. Electronic supplementary material The online version of this article (doi:10.1186/s12917-016-0692-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- N Ardanaz
- Servicio de Cirugía y Medicina Equina, Hospital Veterinario, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - F J Vázquez
- Servicio de Cirugía y Medicina Equina, Hospital Veterinario, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - A Romero
- Servicio de Cirugía y Medicina Equina, Hospital Veterinario, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - A R Remacha
- Laboratorio de Genética Bioquímica LAGENBIO, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - L Barrachina
- Servicio de Cirugía y Medicina Equina, Hospital Veterinario, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain.,Laboratorio de Genética Bioquímica LAGENBIO, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - A Sanz
- Laboratorio de Genética Bioquímica LAGENBIO, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - B Ranera
- Laboratorio de Genética Bioquímica LAGENBIO, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - A Vitoria
- Servicio de Cirugía y Medicina Equina, Hospital Veterinario, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - J Albareda
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario Lozano Blesa, Universidad de Zaragoza, San Juan Bosco, 15, Zaragoza, 50009, Spain
| | - M Prades
- Departament de Medicina i Cirugia Animal, Universidad Autónoma de Barcelona, Edifici H, UAB, 08193 Bellaterra, Barcelona, Spain
| | - P Zaragoza
- Laboratorio de Genética Bioquímica LAGENBIO, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - I Martín-Burriel
- Laboratorio de Genética Bioquímica LAGENBIO, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain
| | - C Rodellar
- Laboratorio de Genética Bioquímica LAGENBIO, Universidad de Zaragoza, C/Miguel Servet, 177, Zaragoza, 50013, Spain.
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Delgado MT, Altisent R, Gómez C, Vitoria A, Ferrández C, Bielsa F. [Auditing the performance of the physician facing patient alcohol consumption]. Aten Primaria 1993; 11:170-3. [PMID: 8467051] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To assess the Primary Care doctor's performance when faced with his/her patients' alcohol consumption. DESIGN Retrospective evaluation of data on procedures by means of explicit normative criteria and implicit check-up of those not complying. SETTING Urban health centre. PATIENTS A random and institutionally based sample, over a week, of patients of both sexes who came for a general medical consultation (eleven blocks) without prior appointment. RESULTS 110 clinical histories were evaluated. 60% were not asked about alcohol consumption. In the cases of those who were asked, the amount consumed was specified. Excessive consumption was recorded in the notes as a health risk factor in 87%. A liver profile was requested for 62%. Advice to give up or reduce alcohol consumption was given in all cases. CONCLUSIONS Poor compliance with the assessment criteria chosen justifies the implementation of the corrective measures proper to quality control methodology. We underline the importance of generalizing the implementation of the Programme of Preventive Activities in Primary Care and the need to improve health professionals' training and motivation on the question.
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Affiliation(s)
- M T Delgado
- Unidad Docente de Medicina Familiar y Comunitaria, Centro de Salud Actur, Zaragoza
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