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Morales-Ortega A, Duarte-Millán MÁ, Canora-Lebrato J, Zapatero-Gaviria A. [Point-of-care ultrasound: Indications and utility in internal medicine]. Med Clin (Barc) 2024; 162:190-196. [PMID: 38016854 DOI: 10.1016/j.medcli.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/24/2023] [Accepted: 08/26/2023] [Indexed: 11/30/2023]
Affiliation(s)
- Alejandro Morales-Ortega
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España; Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, España.
| | | | - Jesús Canora-Lebrato
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España
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Duarte-Millán MÁ, Bernal-Bello D, Frutos-Pérez B, Canora-Lebrato J. Point-of-care ultrasonography in large vessel involvement by IgG4-related disease: an opportunity for monitoring? Rheumatology (Oxford) 2023; 62:e30-e31. [PMID: 35861403 DOI: 10.1093/rheumatology/keac420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
| | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Jesús Canora-Lebrato
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Hernández-Píriz A, Tung-Chen Y, Jiménez-Virumbrales D, Ayala-Larrañaga I, Barba-Martín R, Canora-Lebrato J, Zapatero-Gaviria A, García De Casasola-Sánchez G. Usefulness of lung ultrasound in the early identification of severe COVID-19: results from a prospective study. Med Ultrason 2022; 24:146-152. [PMID: 34762722 DOI: 10.11152/mu-3263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
AIM There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in lung ultrasound (LUS); however, its role in predicting the prognosis has yet to be explored. The aim of the study was to assess the relationship between lung ultrasound findings with the degree of respiratory failure measured by the PaO2/FiO2 ratio (PaFi) andthe prognosis of these patients: need for non-invasive mechanical ventilation (NIMV), admission to the Intensive Care Unit (ICU) and mortality. MATERIAL AND METHOD Prospective, longitudinal and observational study performed in patients with confirmed COVID-19 underwent a LUS examination and laboratory tests. RESULTS A total of 107 patients were enrolled: 93.4% with bilateral involvement and 73.83% presented at least one consolidation. A good inverse correlation (Rho Spearman coefficient -0.897) between the ultrasound score and PaFi was obtained. The AUC for identification of patients with more severe respiratory failure, a moderate and severe ARDS, was 0.97 (CI 95%: 0.95-1) and a cut-off score of 34.5 showed a sensitivity of 0.94 and a specificity of 0.91. The Kappa index showed a high concordance (0.83) of the classification by ultrasound lunginvolvement and ARDS. CONCLUSIONS The combination of the ultrasound score and the presence of respiratory failure can easily identify patients with a higher risk to present complications.
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Affiliation(s)
- Alba Hernández-Píriz
- - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
| | - Yale Tung-Chen
- - Department of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Madrid, Spain - Department of Medicine, Universidad Alfonso X, 28691 Villanueva de la Cañada, Madrid, Spain.
| | - David Jiménez-Virumbrales
- - Department of Cardiology, Hospital Universitario Severo Ochoa, 28911 Leganés, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
| | - Ibone Ayala-Larrañaga
- - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain.
| | - Raquel Barba-Martín
- - Department of Internal Medicine, Hospital Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
| | - Jesús Canora-Lebrato
- - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
| | - Antonio Zapatero-Gaviria
- - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
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Morales-Ortega A, Canora-Lebrato J, Ruiz-Giardín JM. L’échographie mobile pour diagnostiquer la pneumonie. CMAJ 2021; 193:E1824-E1825. [PMID: 34844945 PMCID: PMC8654892 DOI: 10.1503/cmaj.210038-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
| | - Jesús Canora-Lebrato
- Service de médecine interne, Hôpital universitaire de Fuenlabrada, Madrid, Espagne
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Morales-Ortega A, Canora-Lebrato J, Ruiz-Giardín JM. Bedside ultrasonography for the diagnosis of pneumonia. CMAJ 2021; 193:E1463-E1464. [PMID: 34544786 PMCID: PMC8476221 DOI: 10.1503/cmaj.210038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Jesús Canora-Lebrato
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Hernández-Píriz A, Tung-Chen Y, Jiménez-Virumbrales D, Ayala-Larrañaga I, Barba-Martín R, Canora-Lebrato J, Zapatero-Gaviria A, Casasola-Sánchez GGD. Importance of Lung Ultrasound Follow-Up in Patients Who Had Recovered from Coronavirus Disease 2019: Results from a Prospective Study. J Clin Med 2021; 10:3196. [PMID: 34300362 PMCID: PMC8307687 DOI: 10.3390/jcm10143196] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 07/03/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 01/08/2023] Open
Abstract
There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in lung ultrasounds, however, their role in predicting the prognosis has yet to be explored. Our objective was to assess the usefulness of lung ultrasound in the short-term follow-up (1 and 3 months) of patients with SARS-CoV-2 pneumonia, and to describe the progression of the most relevant lung ultrasound findings. We conducted a prospective, longitudinal and observational study performed in patients with confirmed COVID-19 who underwent a lung ultrasound examination during hospitalization and repeated it 1 and 3 months after hospital discharge. A total of 96 patients were enrolled. In the initial ultrasound, bilateral involvement was present in 100% of the patients with mild, moderate or severe ARDS. The most affected lung area was the posteroinferior (93.8%) followed by the lateral (88.7%). Subpleural consolidations were present in 68% of the patients and consolidations larger than 1 cm in 24%. One month after the initial study, only 20.8% had complete resolution on lung ultrasound. This percentage rose to 68.7% at 3 months. Residual lesions were observed in a significant percentage of patients who recovered from moderate or severe ARDS (32.4% and 61.5%, respectively). In conclusion, lung injury associated with COVID-19 might take time to resolve. The findings in this report support the use of lung ultrasound in the short-term follow-up of patients recovered from COVID-19, as a radiation-sparing, easy to use, novel care path worth exploring.
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Affiliation(s)
- Alba Hernández-Píriz
- Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain; (A.H.-P.); (I.A.-L.); (J.C.-L.); (A.Z.-G.)
- Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain;
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
| | - Yale Tung-Chen
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Madrid, Spain
- Department of Medicine, Universidad Alfonso X, 28691 Villanueva de la Cañada, Madrid, Spain
| | - David Jiménez-Virumbrales
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
- Department of Cardiology, Hospital Universitario Severo Ochoa, 28911 Leganés, Spain
| | - Ibone Ayala-Larrañaga
- Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain; (A.H.-P.); (I.A.-L.); (J.C.-L.); (A.Z.-G.)
| | - Raquel Barba-Martín
- Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain;
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
- Department of Internal Medicine, Hospital Rey Juan Carlos, 28933 Móstoles, Madrid, Spain
| | - Jesús Canora-Lebrato
- Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain; (A.H.-P.); (I.A.-L.); (J.C.-L.); (A.Z.-G.)
- Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain;
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
| | - Antonio Zapatero-Gaviria
- Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain; (A.H.-P.); (I.A.-L.); (J.C.-L.); (A.Z.-G.)
- Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain;
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
| | - Gonzalo García De Casasola-Sánchez
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
- Department of Internal Medicine, Hospital Infanta Cristina, 28981 Parla, Madrid, Spain
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Mateos-Rodríguez A, Ortega-Anselmi J, Candel-González FJ, Canora-Lebrato J, Fragiel-Saavedra M, Hernández-Píriz A, Behzadi-Koocahni N, González-Del Castillo J, Pérez-Alonso A, de la Cruz-Conty ML, García-de Casasola G, Marco-Martínez J, Zapatero-Gaviria A. Alternative CPAP methods for the treatment of secondary serious respiratory failure due to pneumonia by COVID-19. Medicina Clínica (English Edition) 2021; 156:55-60. [PMID: 33521312 PMCID: PMC7832656 DOI: 10.1016/j.medcle.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/23/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Alonso Mateos-Rodríguez
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Servicio de Urgencias Médicas de Madrid SUMMA112, Madrid, Spain
- Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain
| | - Justo Ortega-Anselmi
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | | | - Jesús Canora-Lebrato
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Marcos Fragiel-Saavedra
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Alba Hernández-Píriz
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Navid Behzadi-Koocahni
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Servicio de Urgencias Médicas de Madrid SUMMA112, Madrid, Spain
| | - Juan González-Del Castillo
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Antonio Pérez-Alonso
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Servicio de Asistencia Municipal de Urgencias y Rescates-Protección Civil, Madrid, Spain
| | | | | | - Javier Marco-Martínez
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Antonio Zapatero-Gaviria
- Hospital de Campaña IFEMA COVID-19, Madrid, Spain
- Hospital Universitario de Fuenlabrada, Madrid, Spain
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Mateos-Rodríguez A, Ortega-Anselmi J, Candel-González FJ, Canora-Lebrato J, Fragiel-Saavedra M, Hernández-Píriz A, Behzadi-Koocahni N, González-Del Castillo J, Pérez-Alonso A, de la Cruz-Conty ML, García-de Casasola G, Marco-Martínez J, Zapatero-Gaviria A. [Alternative CPAP methods for the treatment of secondary serious respiratory failure due to pneumonia by COVID-19]. Med Clin (Barc) 2020; 156:55-60. [PMID: 33239247 PMCID: PMC7833909 DOI: 10.1016/j.medcli.2020.09.006] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/04/2022]
Abstract
Introducción El uso de dispositivos que aportan presión positiva continua en la vía aérea ha demostrado mejoría en diversas patologías que producen insuficiencia respiratoria. En el episodio de pandemia por COVID-19, el uso de estos dispositivos se ha generalizado, pero, debido a la escasez de dispositivos convencionales de presión positiva continua en la vía aérea (CPAP), se han fabricado dispositivos alternativos. El objetivo de este estudio es describir el uso de estos, así como su eficacia. Material y métodos Se recogen datos de pacientes ingresados por neumonía por COVID-19 en el Hospital de Campaña de IFEMA, así como datos de pacientes con insuficiencia respiratoria y necesidad de soporte ventilatorio. Resultados Estudio realizado sobre un total de 23 pacientes, con fecha de ingreso de entre el 24 de marzo y el 28 de abril en IFEMA. Se empleó CPAP alternativa en cinco pacientes (21,7%), mientras que, en los 18 restantes (78,3%) se usó un soporte ventilatorio con mascarilla reservorio o Ventimask efecto Venturi. Se observó un aumento progresivo de la saturación en aquellos pacientes en los que se empleó CPAP alternativa (de 94% de promedio a 98 y 99% de promedio, tras 30 y 60 minutos con la máscara, respectivamente), aunque este cambio no resultó significativo (p = 0,058 y p = 0,122, respectivamente). De igual manera, no se observó un cambio significativo de frecuencia respiratoria al inicio y al final de la medición en pacientes que usaron CPAP alternativa (p = 0,423) pero sí entre los que no la usaron (p = 0,001). Se observó una mejoría estadísticamente significativa en la variable de saturación de oxígeno/fracción inspirado de oxígeno en los pacientes que usaron CPAP alternativa (p = 0,040). Conclusión El uso de estos dispositivos ha ayudado al trabajo ventilatorio de varios pacientes, mejorando sus parámetros de oxigenación. Para observar mejor la evolución de los pacientes sometidos a esta terapia y compararlos con pacientes con otro tipo de soporte ventilatorio, son necesarios más estudios en los que se aleatorice su uso.
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Affiliation(s)
- Alonso Mateos-Rodríguez
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Servicio de Urgencias Médicas de Madrid SUMMA112, Madrid, España; Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España.
| | - Justo Ortega-Anselmi
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Hospital Universitario Clínico San Carlos, Madrid, España
| | | | - Jesús Canora-Lebrato
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Hospital Universitario de Fuenlabrada, Madrid, España
| | - Marcos Fragiel-Saavedra
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Hospital Universitario Clínico San Carlos, Madrid, España
| | - Alba Hernández-Píriz
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Hospital Universitario de Fuenlabrada, Madrid, España
| | - Navid Behzadi-Koocahni
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Servicio de Urgencias Médicas de Madrid SUMMA112, Madrid, España
| | - Juan González-Del Castillo
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Hospital Universitario Clínico San Carlos, Madrid, España
| | - Antonio Pérez-Alonso
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Servicio de Asistencia Municipal de Urgencias y Rescates-Protección Civil, Madrid, España
| | | | - Gonzalo García-de Casasola
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Hospital Universitario Infanta Cristina, Madrid, España
| | - Javier Marco-Martínez
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Hospital Universitario Clínico San Carlos, Madrid, España
| | - Antonio Zapatero-Gaviria
- Hospital de Campaña IFEMA COVID-19, Madrid, España; Hospital Universitario de Fuenlabrada, Madrid, España
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Rueda-Camino JA, Saíz-Lou EM, Del Peral-Rodríguez LJ, Satué-Bartolomé JÁ, Zapatero-Gaviria A, Canora-Lebrato J. Prognostic utility of bedside lung ultrasound before discharge in patients with acute heart failure with preserved ejection fraction. Med Clin (Barc) 2020; 156:214-220. [PMID: 32546316 DOI: 10.1016/j.medcli.2020.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVE The utility of lung ultrasound as a prognostic tool for patients with acute heart failure is well known, but most studies have been conducted in mixed groups of patients with preserved and reduced ejection fraction. While some subgroup analysis suggests that lung ultrasound is useful regardless of ejection fraction, no specific studies have addressed this question. Our objective is to determine the utility of bedside lung ultrasound as a prognostic tool for patients with preserved ejection fraction, acute heart failure. MATERIAL AND METHODS Prospective cohort study with 3-month follow-up after bedside lung ultrasound before discharge in patients hospitalized for acute heart failure with preserved ejection fraction. The number of Blines was determined. Two groups were formed: less than 15Blines (unexposed) and 15Blines or more (exposed). They were compared in terms of readmission and death attributable to worsening heart failure. RESULTS The exposed group was at higher risk of readmission (HR: 2.39; 95%CI: 1.12-5.12; P=.024), even after multivariable adjustment (HR: 2.46; 95%CI: 1.11-5.46, P=.03). Differences between groups in terms of mortality were not statistically significant (HR: 1.28; 95%CI: .23-6.98). CONCLUSION Subclinical congestion evaluated with lung ultrasound before discharge is associated with worse prognosis in patients with acute heart failure and preserved ejection fraction. Patients with 15Blines are 2.5times more likely to be readmitted for acute heart failure than less congestive patients.
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Affiliation(s)
- José Antonio Rueda-Camino
- Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España; Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Móstoles, Madrid, España.
| | - Elena María Saíz-Lou
- Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | | | | | - Antonio Zapatero-Gaviria
- Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España; Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - Jesús Canora-Lebrato
- Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España; Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
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Zapatero-Gaviria A, Gómez-Huelgas R, Canora-Lebrato J, Ena-Muñoz J, Romero-Sánchez M, Mendez-Bailón M, Marco-Martínez J, Barba-Martín R. Analysis of hospitalizations by cardiovascular disease in the population with diabetes in Spain. Rev Clin Esp 2019. [DOI: 10.1016/j.rceng.2018.09.006] [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: 10/27/2022]
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Zapatero-Gaviria A, Gómez-Huelgas R, Canora-Lebrato J, Ena-Muñoz J, Romero-Sánchez M, Mendez-Bailón M, Marco-Martínez J, Barba-Martín R. Análisis de las hospitalizaciones por enfermedad cardiovascular en población diabética en España. Rev Clin Esp 2019; 219:124-129. [DOI: 10.1016/j.rce.2018.09.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 12/24/2022]
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Rueda-Camino J, Bernal-Bello D, Canora-Lebrato J, Velázquez-Ríos L, García de Viedma-García V, Guerrero-Santillán M, Duarte-Millán M, Cristóbal-Bilbao R, Zapatero-Gaviria A. High doses of systemic corticosteroids in patients hospitalized for exacerbation of chronic obstructive pulmonary disease. A cohort study. Rev Clin Esp 2017. [DOI: 10.1016/j.rceng.2017.07.003] [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: 11/26/2022]
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Rueda-Camino JA, Bernal-Bello D, Canora-Lebrato J, Velázquez-Ríos L, García de Viedma-García V, Guerrero-Santillán M, Duarte-Millán MA, Cristóbal-Bilbao R, Zapatero-Gaviria A. High doses of systemic corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease. A cohort study. Rev Clin Esp 2017; 217:504-509. [PMID: 28865758 DOI: 10.1016/j.rce.2017.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/06/2017] [Accepted: 07/30/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess the effect of high doses of corticosteroids in patients hospitalised for exacerbation of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS A prospective cohort study was conducted on patients hospitalized with COPD between January and March 2015, grouped according to the glucocorticoid dosage administered (cutoff, 40mg of prednisone/day). We compared the results of hospital stay, readmission and mortality at 3 months of discharge. RESULTS We analysed 87 patients. The median daily dose was 60mg of prednisone (interquartile range, 46.67-82.33mg/day), and the administration route was intravenous in 96.6% of the cases. We established a relative risk (RR) for hospital stays longer than 8 days of 1.095 (95% CI 0.597-2.007; P=.765) when steroid dosages greater than 40mg/day were employed. In these patients, the hazard ratio (HR) for readmission in the 3 months after discharge was 0.903 (95% CI 0.392-2.082; P=.811), and the mortality was 1.832 (95% CI 0.229-16.645; P=.568). Neither the RR nor the HR varied in a statistically significant manner after adjusting for confounding factors. CONCLUSIONS A daily dose greater than 40mg of prednisone in patients hospitalised for COPD exacerbation was not associated with a shorter hospital stay or a reduction in readmissions or mortality at 3 months.
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Affiliation(s)
- J A Rueda-Camino
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.
| | - D Bernal-Bello
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - J Canora-Lebrato
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - L Velázquez-Ríos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | | | - M Guerrero-Santillán
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - M A Duarte-Millán
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - R Cristóbal-Bilbao
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - A Zapatero-Gaviria
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
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Canora-Lebrato J, Barba-Martín R, Perales-Fraile I, Marco-Martínez J, Plaza-Cantelli S, Zapatero-Gaviria A. Descripción de las altas hospitalarias en pacientes con lupus eritematoso sistémico. Rev Clin Esp 2012; 212:432-9. [DOI: 10.1016/j.rce.2012.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 04/24/2012] [Accepted: 06/03/2012] [Indexed: 10/28/2022]
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Díaz-Lagares C, Pérez-Alvarez R, García-Hernández FJ, Ayala-Gutiérrez MM, Callejas JL, Martínez-Berriotxoa A, Rascón J, Caminal-Montero L, Selva-O'Callaghan A, Oristrell J, Hidalgo C, Gómez-de-la-Torre R, Sáez L, Canora-Lebrato J, Camps MT, Ortego-Centeno N, Castillo-Palma MJ, Ramos-Casals M. Rates of, and risk factors for, severe infections in patients with systemic autoimmune diseases receiving biological agents off-label. Arthritis Res Ther 2011; 13:R112. [PMID: 21745378 PMCID: PMC3239350 DOI: 10.1186/ar3397] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 03/17/2011] [Accepted: 07/11/2011] [Indexed: 02/08/2023] Open
Abstract
Introduction The purpose of this observational study was to analyze the rates, characteristics and associated risk factors of severe infections in patients with systemic autoimmune diseases (SAD) who were treated off-label with biological agents in daily practice. Methods The BIOGEAS registry is an ongoing Spanish prospective cohort study investigating the long-term safety and efficacy of the off-label use of biological agents in adult patients with severe, refractory SAD. Severe infections were defined according to previous studies as those that required intravenous treatment or that led to hospitalization or death. Patients contributed person-years of follow-up for the period in which they were treated with biological agents. Results A total of 344 patients with SAD treated with biological agents off-label were included in the Registry until July 2010. The first biological therapies included rituximab in 264 (77%) patients, infliximab in 37 (11%), etanercept in 21 (6%), adalimumab in 19 (5%), and 'other' agents in 3 (1%). Forty-five severe infections occurred in 37 patients after a mean follow-up of 26.76 months. These infections resulted in four deaths. The crude rate of severe infections was 90.9 events/1000 person-years (112.5 for rituximab, 76.9 for infliximab, 66.9 for adalimumab and 30.5 for etanercept respectively). In patients treated with more than two courses of rituximab, the crude rate of severe infection was 226.4 events/1000 person-years. A pathogen was identified in 24 (53%) severe infections. The most common sites of severe infection were the lower respiratory tract (39%), bacteremia/sepsis (20%) and the urinary tract (16%). There were no significant differences relating to gender, SAD, agent, other previous therapies, number of previous immunosuppressive agents received or other therapies administered concomitantly. Cox regression analysis showed that age (P = 0.015) was independently associated with an increased risk of severe infection. Survival curves showed a lower survival rate in patients with severe infections (log-rank and Breslow tests < 0.001). Conclusions The rates of severe infections in SAD patients with severe, refractory disease treated depended on the biological agent used, with the highest rates being observed for rituximab and the lowest for etanercept. The rate of infection was especially high in patients receiving three or more courses of rituximab. In patients with severe infections, survival was significantly reduced. Older age was the only significant predictive factor of severe infection.
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Affiliation(s)
- Cándido Díaz-Lagares
- Laboratorio de Enfermedades Autoinmunes Josep Font, IDIBAPS, Hospital Clínic, C/Villarroel, Barcelona, 08036, Spain
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Canora-Lebrato J, Navega-Fernández J, Ramos-López M, Cabezudo-Pedraza J. Imagen de la semana. Med Clin (Barc) 2006; 127:320. [PMID: 17051684 DOI: 10.1016/s0025-7753(06)72249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J Canora-Lebrato
- Servicios de Medicina Interna, Hospital de Fuenlabrada, Madrid, España
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Moya-Mateo EM, Canora-Lebrato J, Galindo-Andugar MA, García-Largacha M. Neumonía por Rhodococcus equi en un paciente en tratamiento con glucocorticoides. Med Clin (Barc) 2006; 127:197-8. [PMID: 16834958 DOI: 10.1157/13090715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Rodríguez-Cuartero A, Pérez-Blanco FJ, Canora-Lebrato J. Takayasu arteritis and renovascular hypertension. Clin Nephrol 2001; 55:176-7. [PMID: 11269685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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