SAS - Hospital Costa del Sol
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Publication Analysis of Clinical Phenotypes through Machine Learning of First-Line H. pylori Treatment in Europe during the Period 2013–2022: Data from the European Registry on H. pylori Management (Hp-EuReg)(MDPI, 2023-09-10) Nyssen, Olga. P.; Pratesi, Pietro; Spinola, Miguel. A.; Jonaitis, Laimas; Perez-Aisa, Angeles; Vaira, Dino; Saracino, Ilaria Maria; Pavoni, Matteo; Fiorini, Giulia; Tepes, Bojan; Bordin, Dmitry. S.; Voynovan, Irina; Lanas, Angel; Martinez-Dominguez, Samuel. J.; Alfaro, Enrique; Bujanda, Luis; Pabon-Carrasco, Manuel; Hernández, Luis; Gasbarrini, Antonio; Kupcinskas, Juozas; Lerang, Frode; Smith, Sinead. M.; Gridnyev, Oleksiy; Leja, Marcis; Rokkas, Theodore; Marcos-Pinto, Ricardo; Mestrovic, Antonio; Marlicz, Wojciech; Milivojevic, Vladimir; Simsek, Halis; Kunovsky, Lumir; Papp, Veronika; Phull, Perminder. S.; Venerito, Marino; Boyanova, Lyudmila; Boltin, Doron; Niv, Yaron; Matysiak-Budnik, Tamara; Doulberis, Michael; Dobru, Daniela; Lamy, Vincent; Capelle, Lisette. G.; Trpchevska, Emilijia Nikolovska; Moreira, Leticia; Cano-Catalia, Anna; Parra, Pablo; Megraud, Francis; O'Morain, Colm; Ortega, Guillermo. J.; Gisbert, Javier. P.; Hp EuReg Investigators; [Perez-Asisa,A] Hospital Universitario Costa del Sol, Marbella, Spain.; [Pabon-Carrasco,M] Department of Gastroenterology, Hospital de Valme, Sevilla, Spain.; European Helicobacter and Microbiota Study Group (EHMSG); Spanish Association of Gastroenterology (AEG); Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd); Hp-EuReg InvestigatorsThe segmentation of patients into homogeneous groups could help to improve eradication therapy effectiveness. Our aim was to determine the most important treatment strategies used in Europe, to evaluate first-line treatment effectiveness according to year and country. Data collection: All first-line empirical treatments registered at AEGREDCap in the European Registry on Helicobacter pylori management (Hp-EuReg) from June 2013 to November 2022. A Boruta method determined the "most important" variables related to treatment effectiveness. Data clustering was performed through multi-correspondence analysis of the resulting six most important variables for every year in the 2013-2022 period. Based on 35,852 patients, the average overall treatment effectiveness increased from 87% in 2013 to 93% in 2022. The lowest effectiveness (80%) was obtained in 2016 in cluster #3 encompassing Slovenia, Lithuania, Latvia, and Russia, treated with 7-day triple therapy with amoxicillin-clarithromycin (92% of cases). The highest effectiveness (95%) was achieved in 2022, mostly in Spain (81%), with the bismuth-quadruple therapy, including the single-capsule (64%) and the concomitant treatment with clarithromycin-amoxicillin-metronidazole/tinidazole (34%) with 10 (69%) and 14 (32%) days. Cluster analysis allowed for the identification of patients in homogeneous treatment groups assessing the effectiveness of different first-line treatments depending on therapy scheme, adherence, country, and prescription year.Publication Surgical treatment for infective endocarditis in elderly patients(Elsevier, 2011-06-06) Ramirez-Duque, N.; García-Cabrera, Emilio; Ivanova-Georgieva, R.; Noureddine, Mariam; Lomas, J. M.; Hidalgo-Tenorio, Carmen; Plata, A.; Gálvez-Acebal, Juan; Ruiz-Morales, J.; de la Torre-Lima, J.; Reguera-Iglesias, José María; Martinez-Marcos, F. J.; de Alarcón, Arístides; [Ramirez-Duque,N; Garcia-Cabrera,E; Alarcon,A] Hospital Virgen del Rocio, Sevilla, Spain.; [Ivanova-Georgieva,R; Ruiz-Morales;J;] Hospital Virgen de la Victoria, Málaga, Spain.; [Noureddine,M; de la Torre-Lima,J;] Hospital Costa del Sol, Marbella, Spain.; [Lomas,JM; Martinez-Marcos,FJ] Hospital Juan Ramón Jiménez, Huelva, Spain.; [Hidalgo-Tenorio,C] Hospital Virgen de las Nieves, Granada, Spain.; [Plata,A; Reguera,JM] Hospital Carlos Haya, Malaga, Spain.; Ministerio de Sanidad y Consumo; Instituto de Salud Carlos III; Spanish Network for the Research in Infectious Diseases; Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI)Objectives: We evaluate the clinical, echographic and prognostic characteristics of infective endocarditis (IE) in a large population of elderly patients, and the results of surgical approach.Methods: Multicentric, prospective, observational cohort study with 961 consecutive left-sided IE: ;356 patients aged >= 65 years were compared with 605 younger. Indications for cardiac surgery, potential surgical risk, time and outcome, were compared.Results: Hospital-acquired endocarditis, comorbidity, renal failure and septic shock were more frequent in elderly, but embolisms were less. Intracardiac destruction and ventricular failure were similar in both groups, but significantly fewer elderly patients underwent cardiac surgery (36% vs 51%; p < 0.01), and this group showed a worse outcome (43.2% of mortality vs 27% in younger; p < 0.01), resulting age as an independent predictor of mortality (OR: 1.02 CI95%: 1.01-1.03). Compared with medical treatment, surgery showed lower percentages ofmortality compared with medical treatment (23.3% vs 31.3%; p = 0.03) in younger group, but a high mortality was observed with both procedures (47.6% vs 40.3%; p = 0.1) in the elderly.Conclusions: Although similar percentages of heart failure and intracardiac complications, increasing age is associated with higher mortality in IE. Lower rates of surgical treatment and a worse outcome after operation are common features in elderly patients.Item The role of bronchoscopy in patients with SARS-CoV-2 pneumonia.(2021-07-12) Arenas-De Larriva, Marisol; Martín-DeLeon, Roberto; Urrutia Royo, Blanca; Fernández-Navamuel, Iker; Gimenez Velando, Andrés; Nuñez García, Laura; Centeno Clemente, Carmen; Andreo García, Felipe; Rafecas Codern, Albert; Fernández-Arias, Carmen; Pajares Ruiz, Virginia; Torrego Fernández, Alfons; Rajas, Olga; Iturricastillo, Gorane; Garcia Lujan, Ricardo; Comeche Casanova, Lorena; Sánchez-Font, Albert; Aguilar-Colindres, Ricardo; Larrosa-Barrero, Roberto; García García, Ruth; Cordovilla, Rosa; Núñez-Ares, Ana; Briones-Gómez, Andrés; Cases Viedma, Enrique; Franco, José; Cosano Povedano, Javier; Rodríguez-Perálvarez, Manuel Luis; Cebrian Gallardo, Jose Joaquin; Nuñez Delgado, Manuel; Pavón-Masa, María; Valdivia Salas, Maria Del Mar; Flandes, JavierThe role of bronchoscopy in coronavirus disease 2019 (COVID-19) is a matter of debate. This observational multicentre study aimed to analyse the prognostic impact of bronchoscopic findings in a consecutive cohort of patients with suspected or confirmed COVID-19. Patients were enrolled at 17 hospitals from February to June 2020. Predictors of in-hospital mortality were assessed by multivariate logistic regression. A total of 1027 bronchoscopies were performed in 515 patients (age 61.5±11.2 years; 73% men), stratified into a clinical suspicion cohort (n=30) and a COVID-19 confirmed cohort (n=485). In the clinical suspicion cohort, the diagnostic yield was 36.7%. In the COVID-19 confirmed cohort, bronchoscopies were predominantly performed in the intensive care unit (n=961; 96.4%) and major indications were: difficult mechanical ventilation (43.7%), mucus plugs (39%) and persistence of radiological infiltrates (23.4%). 147 bronchoscopies were performed to rule out superinfection, and diagnostic yield was 42.9%. There were abnormalities in 91.6% of bronchoscopies, the most frequent being mucus secretions (82.4%), haematic secretions (17.7%), mucus plugs (17.6%), and diffuse mucosal hyperaemia (11.4%). The independent predictors of in-hospital mortality were: older age (OR 1.06; p Bronchoscopy may be indicated in carefully selected patients with COVID-19 to rule out superinfection and solve complications related to mechanical ventilation. The presence of haematic secretions in the distal bronchial tract may be considered a poor prognostic feature in COVID-19.Item HIV-Infected Subjects With Poor CD4 T-Cell Recovery Despite Effective Therapy Express High Levels of OX40 and α4β7 on CD4 T-Cells Prior Therapy Initiation.(2018-07-18) Rosado-Sánchez, Isaac; Herrero-Fernández, Inés; Genebat, Miguel; Del Romero, Jorge; Riera, Melchor; Podzamczer, Daniel; Olalla, Julián; Vidal, Francesc; Muñoz-Fernández, Mª Angeles; Leal, Manuel; Pacheco, Yolanda MHIV-infected subjects with suboptimal CD4 restoration despite suppressive combined antiretroviral treatment (cART) (immunodiscordant subjects) have been classically characterized after a variable period of time under cART. Recently, we have reported that an increased frequency of proliferating CD4 T-cells in these subjects is already present before the cART onset. The potential contribution of peripheral compensatory homeostatic proliferation (HP) is yet unknown. We aimed to analyze the expression of HP-related cellular markers on CD4 T-cells of immunodiscordant subjects before cART. We analyzed the expression of OX40 and α4β7 on peripheral CD4 T-cells from immunodiscordant and control subjects (n = 21 each group) before cART initiation, and also on available follow-up samples (after 24 month of suppressive cART). Additionally, we tested the expression of these markers in an in vitro system for the study of human HP processes. Immunodiscordant subjects showed increased levels of OX40 and α4β7 on CD4 T-cells before cART initiation. While the cART tended to reduce these levels, immunodiscordant subjects still maintained comparatively higher levels of OX40 and α4β7 after 24 months under suppressive cART. These HP-related markers were upregulated in vitro during the human HP, especially during the fast HP. Our results are compatible with exacerbated HP processes in immunodiscordant subjects, already before the cART onset.Item Influence of age, body mass index and comorbidity on major outcomes in acute pancreatitis, a prospective nation-wide multicentre study.(2018-09-03) Moran, Robert A; García-Rayado, Guillermo; de la Iglesia-García, Daniel; Martínez-Moneo, Emma; Fort-Martorell, Esther; Lauret-Braña, Eugenia; Concepción-Martín, Mar; Ausania, Fabio; Prieto-Martínez, Carlos; González-de-Cabo, Miguel; Quesada-Vázquez, Noé; Marcaide-Ruiz-de-Apodaca, M Asunción; Pajares-Díaz, José A; Díaz, Francia C; de-Benito, José L; Hinojosa-Guadix, Jennifer; Marqués-García, Pilar; Boadas, Jaume; Bajador-Andreu, Eduardo; Moreno, Oswaldo; Argüelles-Arias, Federico; Martín-Benítez, Gregorio; Tafur-Sánchez, Carla; Leal-Téllez, Jesús; Romero-Mosquera, Beatriz; Hernaez, Ruben; Papachristou, Georgios I; Singh, Vikesh K; de-Madaria, EnriqueThere are few large prospective cohort studies evaluating predictors of outcomes in acute pancreatitis. The purpose of this study was to determine the role of age and co-morbid disease in predicting major outcomes in acute pancreatitis. Data points were collected according to a predefined electronic data collection form. Acute pancreatitis and its complications were defined according to the revised Atlanta classification. Univariable and multivariable analyses were conducted using Cox proportional hazard regression and multiple logistic regression. From June 2013-February 2015, 1655 adult patients were recruited from 23 centres across Spain. Co-morbid disease, obesity, open surgical necrosectomy within 30 days, and pancreatic necrosis were independently associated with both 30-day mortality and persistent organ failure (p 85 years) was associated with mortality (p 0.05). Comorbidity and obesity are important determinates of mortality and persistent organ failure in acute pancreatitis, but in the absence of organ failure they do not appear to independently contribute to morbidity. This has important implications for severity classification and predictive models of severity in acute pancreatitis.Item Lower Survival and Increased Circulating Suppressor Cells in Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma with Deficit of Vitamin D Levels Using R-GDP Plus Lenalidomide (R2-GDP): Results from the R2-GDP-GOTEL Trial.(2021-09-15) Jiménez-Cortegana, Carlos; Sánchez-Martínez, Pilar M; Palazón-Carrión, Natalia; Nogales-Fernández, Esteban; Henao-Carrasco, Fernando; Martín García-Sancho, Alejandro; Rueda, Antonio; Provencio, Mariano; de la Cruz-Merino, Luis; Sánchez-Margalet, VíctorThe search of prognostic factors is a priority in diffuse large B-cell lymphoma (DLBCL) due to its aggressiveness. We have recently found that the level of circulating MDSCs is a good marker of survival in a translational study based on a trial (EudraCT Number: 2014-001620-29), using lenalidomide combined with R-GDP (rituximab plus gemcitabine, cisplatin, and dexamethasone). Since Vitamin D is a known immunomodulator, we have studied blood levels of these cell populations comparing patients with deficit of vitamin D levels (15 ng/mL. Mann-Whitney U test was used to compare cells distributions between groups, Wilcoxon test to compare cells distribution at different times and Spearman test to measure the association between cell populations. Patients with vitamin D deficit maintained the increased level of immune suppressor cells, whereas we observed a depletion of all immune suppressor cells in patients with normal vitamin D levels. In conclusion, we have confirmed the importance of vitamin D in the response to treatment in R/R DLBCL, suggesting that vitamin D deficit may be involved in the immune deficit of these patients, and thus, vitamin D supplementation in these patients may help to obtain a better response, warranting further investigation.Item Different Pathological Complete Response Rates According to PAM50 Subtype in HER2+ Breast Cancer Patients Treated With Neoadjuvant Pertuzumab/Trastuzumab vs. Trastuzumab Plus Standard Chemotherapy: An Analysis of Real-World Data.(2019-11-05) Díaz-Redondo, Tamara; Lavado-Valenzuela, Rocio; Jimenez, Begoña; Pascual, Tomas; Gálvez, Fernando; Falcón, Alejandro; Alamo, Maria Del Carmen; Morales, Cristina; Amerigo, Marta; Pascual, Javier; Sanchez-Muñoz, Alfonso; González-Guerrero, Macarena; Vicioso, Luis; Laborda, Aurora; Ortega, Maria Victoria; Perez, Lidia; Fernandez-Martinez, Aranzazu; Chic, Nuria; Jerez, Jose Manuel; Alvarez, Martina; Prat, Aleix; Ribelles, Nuria; Alba, EmilioBackground: Double blockade with pertuzumab and trastuzumab combined with chemotherapy is the standard neoadjuvant treatment for HER2-positive early breast cancer. Data derived from clinical trials indicates that the response rates differ among intrinsic subtypes of breast cancer. The aim of this study is to determine if these results are valid in real-world patients. Methods: A total of 259 patients treated in eight Spanish hospitals were included and divided into two cohorts: Cohort A (132 patients) received trastuzumab plus standard neoadjuvant chemotherapy (NAC), and Cohort B received pertuzumab and trastuzumab plus NAC (122 patients). Pathological complete response (pCR) was defined as the complete disappearance of invasive tumor cells. Assignment of the intrinsic subtype was realized using the research-based PAM50 signature. Results: There were more HER2-enriched tumors in Cohort A (70 vs. 56%) and more basal-like tumors in Cohort B (12 vs. 2%), with similar luminal cases in both cohorts (luminal A 12 vs. 14%; luminal B 14 vs. 18%). The overall pCR rate was 39% in Cohort A and 61% in Cohort B. Better pCR rates with pertuzumab plus trastuzumab than with trastuzumab alone were also observed in all intrinsic subtypes (luminal PAM50 41 vs. 11.4% and HER2-enriched subtype 73.5 vs. 50%) but not in basal-like tumors (53.3 vs. 50%). In multivariate analysis the only significant variables related to pCR in both luminal PAM50 and HER2-enriched subtypes were treatment with pertuzumab plus trastuzumab (Cohort B) and histological grade 3. Conclusions: With data obtained from patients treated in clinical practice, it has been possible to verify that the addition of pertuzumab to trastuzumab and neoadjuvant chemotherapy substantially increases the rate of pCR, especially in the HER2-enriched subtype but also in luminal subtypes, with no apparent benefit in basal-like tumors.Item Correlation between genomic alterations and germline mutations in men with metastatic castration-resistant prostate cancer (mCRPC)(Elsevier, 2021-09-21) Llacer Perez, C.; Oliva Fernandez, L.; Canada-Higueras, E.; Saez, M. I.; Villatoro, R.; Montesa Pino, A.; Herrera Imbroda, B.; Hernandez, D.; Lozano Mejorada, R.; Romero Laorden, N.; Marquez, M.; Grau, G.; Pineda, A.; Lopez, F. J.; Peinado, P.; Alameda, D.; Olmos, D.; Castro, E.; [Llacer Perez, C.] Hosp Univ Virgen Victoria, Dept Med Oncol, Malaga, Spain; [Oliva Fernandez, L.] Hosp Univ Virgen Victoria, Dept Med Oncol, Malaga, Spain; [Saez, M. I.] Hosp Univ Virgen Victoria, Dept Med Oncol, Malaga, Spain; [Marquez, M.] Hosp Univ Virgen Victoria, Dept Med Oncol, Malaga, Spain; [Grau, G.] Hosp Univ Virgen Victoria, Dept Med Oncol, Malaga, Spain; [Lopez, F. J.] Hosp Univ Virgen Victoria, Dept Med Oncol, Malaga, Spain; [Castro, E.] Hosp Univ Virgen Victoria, Dept Med Oncol, Malaga, Spain; [Canada-Higueras, E.] Genol Med, Genet Testing, Malaga, Spain; [Villatoro, R.] Hosp Costa Sol, Dept Med Oncol, Marbella, Spain; [Montesa Pino, A.] Hosp Reg Univ Malaga Carlos Haya, Oncol, Malaga, Spain; [Herrera Imbroda, B.] Hosp Univ Virgen Victoria, Biomed Res Inst Malaga IBIMA, Genitourinary Oncol Traslat Res Grp, Urol Unit, Malaga, Spain; [Hernandez, D.] Hosp Reg Univ Malaga, Urol Unit, Malaga, Spain; [Lozano Mejorada, R.] CNIO Ctr Nacl Invest Oncol, Dept Prostate Canc Clin Res, Madrid, Spain; [Romero Laorden, N.] CNIO Ctr Nacl Invest Oncol, Dept Prostate Canc Clin Res, Madrid, Spain; [Pineda, A.] Biomed Res Inst Malaga IBIMA, Genitourinary Oncol Traslat Res Grp, Malaga, Spain; [Peinado, P.] Biomed Res Inst Malaga IBIMA, Genitourinary Oncol Traslat Res Grp, Malaga, Spain; [Alameda, D.] Biomed Res Inst Malaga IBIMA, Genitourinary Oncol Traslat Res Grp, Malaga, Spain; [Olmos, D.] CNIO Ctr Nacl Invest Oncol, Prostate Canc, Madrid, Spain; Instituto de Salud Carlos IIIItem Treatment in CARD eligible metastatic castration resistant prostate cancer (mCRPC) patients according to the status of germline HRR mutations: Cabazitaxel (CBZ) vs enzalutamide/abiraterone(Elsevier, 2020-09-01) Llacer Perez, C.; Romero Laorden, N.; Lozano Mejorada, R.; Piulats, J. M.; Puente, J.; Lorente Estelles, D.; Medina, A.; Cattrini, C.; Vitrone, F. M.; Almagro, E.; Borrega Garcia, P.; Lainez, N.; Rivera, L.; Villatoro, R.; Hernandez, A.; Rodriguez-Vida, A.; Lopez-Casas, P. P.; Gallardo, E.; Castro Marcos, E.; Olmos Hidalgo, D.; [Llacer Perez, C.] Hosp Univ Virgen de la Victoria & Reg, Inst Invest Biomed Malaga IBIMA, Med Oncol Dept, CNIO IBIMA Unit, Malaga, Spain; [Romero Laorden, N.] CNIO Ctr Nacl Invest Oncol, Prostate Canc, Madrid, Spain; [Lozano Mejorada, R.] CNIO Ctr Nacl Invest Oncol, Prostate Canc Clin Res Unit, Madrid, Spain; [Cattrini, C.] CNIO Ctr Nacl Invest Oncol, Prostate Canc Clin Res Unit, Madrid, Spain; [Rivera, L.] CNIO Ctr Nacl Invest Oncol, Prostate Canc Clin Res Unit, Madrid, Spain; [Lopez-Casas, P. P.] CNIO Ctr Nacl Invest Oncol, Prostate Canc Clin Res Unit, Madrid, Spain; [Piulats, J. M.] Catalan Inst Oncol, Med Oncol, Barcelona, Spain; [Puente, J.] Hosp Clin Univ San Carlos, Dept Med Oncol, Madrid, Spain; [Lorente Estelles, D.] Hosp Gen Univ Castellon, Med Oncol Dept, Castellon de La Plana, Spain; [Medina, A.] Ctr Oncol Galicia, Med Oncol Dept, La Coruna, Spain; [Vitrone, F. M.] CNIO Ctr Nacl Invest Oncol, Dept Med Oncol, Madrid, Spain; [Almagro, E.] Hosp Univ Quironsalud Madrid, Med Oncol Dept, Pozuelo De Alarcon, Spain; [Borrega Garcia, P.] Hosp San Pedro de Alcantara, Med Oncol Dept, Caceres, Spain; [Lainez, N.] Complejo Hosp Navarra, Med Oncol Dept, Pamplona, Spain; [Villatoro, R.] Hosp Univ Costa del Sol, Med Oncol Dept, Marbella, Spain; [Hernandez, A.] Inst Oncol, Onkologikoa, Donostia San Sebastian, Spain; [Rodriguez-Vida, A.] Hosp Mar, Med Oncol Dept, Barcelona, Spain; [Gallardo, E.] Univ Autonoma Barcelona, Med Oncol Dept, Parc Tauli Hosp Univ, Inst Invest & Innovacio Parc Tauli I3PT, Barcelona, Spain; [Castro Marcos, E.] Hosp Univ Virgen de la Victoria, Med Oncol, Malaga, Spain; [Castro Marcos, E.] Inst Invest Biomed Malaga, Malaga, Spain; [Olmos Hidalgo, D.] CNIO Spanish Natl Canc Ctr, Prostate Canc Clin Res Unit, Madrid, SpainItem Impact of treatment in long-term survival patients with follicular lymphoma: A Spanish Lymphoma Oncology Group registry.(2017-05-11) Provencio, Mariano; Sabín, Pilar; Gomez-Codina, Jose; Torrente, Maria; Calvo, Virginia; Llanos, Marta; Gumá, Josep; Quero, Cristina; Blasco, Ana; Cruz, Miguel Angel; Aguiar, David; García-Arroyo, Francisco; Lavernia, Javier; Martinez, Natividad; Morales, Manuel; Saez-Cusi, Alvaro; Rodriguez, Delvys; de la Cruz, Luis; Sanchez, Jose Javier; Rueda, Antonio; GOTEL (Spanish Lymphoma Oncology Group)Follicular lymphoma is the second most common non-Hodgkin lymphoma in the United States and Europe. However, most of the prospective randomized studies have very little follow-up compared to the long natural history of the disease. The primary aim of this study was to investigate the long-term survival of our series of patients with follicular lymphoma. A total of 1074 patients with newly diagnosed FL were enrolled. Patients diagnosed were prospectively enrolled from 1980 to 2013. Median follow-up was 54.9 months and median overall survival is over 20 years in our series. We analyzed the patients who are still alive beyond 10 years from diagnosis in order to fully assess the prognostic factors that condition this group. Out of 166 patients who are still alive after more than 10 years of follow-up, 118 of them (73%) are free of evident clinical disease. Variables significantly associated with survival at 10 years were stage A longer follow-up and a large series demonstrated a substantial population of patients with follicular lymphoma free of disease for more than 10 years.Item Cross-modal symbolic processing can elicit either an N2 or a protracted N2/N400 response.(2016-03-23) Griffiths, Oren; Le Pelley, Mike E; Jack, Bradley N; Luque, David; Whitford, Thomas JA cross-modal symbolic paradigm was used to elicit EEG activity related to semantic incongruence. Twenty-five undergraduate students viewed pairings of visual lexical cues (e.g., DOG) with congruent (50% of trials) or incongruent (50%) auditory nonlexical stimuli (animal vocalizations; e.g., sound of a dog woofing or a cat meowing). In one condition, many different pairs of congruent/incongruent stimuli were shown, whereas in a second condition only two pairs of stimuli were repeatedly shown. A typical N400-like pattern of incongruence-related activity (including activity in the N2 time window) was evident in the condition using many stimuli, whereas the incongruence-related activity in the two-stimuli condition was confined to differential N2-like activity. A supplementary analysis excluded stimulus characteristics as the source of this differential activity between conditions. We found that a single individual performing a fixed task can demonstrate either a protracted N400-like pattern of activity or a more temporally focused N2-like pattern of activity in response to the same stimulus, which suggests that the N2 may be a precursor to the protracted N400 response.Item Sun exposure and protection habits in transplant athletes: an international survey(Wiley, 2021-12-08) Navarrete-De Galvez, M.; Ruiz Sanchez, J. M.; Navarrete-De Galvez, E.; Aguilera, J.; Rivas-Ruiz, F.; de Troya-Martin, M.; Herrera-Ceballos, E.; de Galvez, M., V; [Navarrete-De Galvez, M.] Hosp Comarcal Axarquia, Internal Med Serv, Malaga, Spain; [Ruiz Sanchez, J. M.] Univ Malaga, Photobiol Dermatol Lab, Dept Med & Dermatol, Med Res Ctr, Campus Univ Teatinos S-N, Malaga 29071, Spain; [Aguilera, J.] Univ Malaga, Photobiol Dermatol Lab, Dept Med & Dermatol, Med Res Ctr, Campus Univ Teatinos S-N, Malaga 29071, Spain; [Herrera-Ceballos, E.] Univ Malaga, Photobiol Dermatol Lab, Dept Med & Dermatol, Med Res Ctr, Campus Univ Teatinos S-N, Malaga 29071, Spain; [de Galvez, M., V] Univ Malaga, Photobiol Dermatol Lab, Dept Med & Dermatol, Med Res Ctr, Campus Univ Teatinos S-N, Malaga 29071, Spain; [Navarrete-De Galvez, E.] Univ Malaga, Dept Graph Express Design & Projects, Project Engn Area, Malaga, Spain; [Rivas-Ruiz, F.] Hosp Costa del Sol, Dermatol Serv & Res Unit, Malaga, Spain; [de Troya-Martin, M.] Hosp Costa del Sol, Dermatol Serv & Res Unit, Malaga, Spain; [Herrera-Ceballos, E.] Hosp Clin Univ Virgen de la Victoria, Dermatol Serv, Malaga, Spain; Spanish Ministry of Science and Innovation; Universidad de Malaga/CBUABackground Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of carcinogenesis. Objective The aim of this study was to analyze sun-related behaviors and knowledge in transplant athletes, examine the frequency of sunburns, and explore associations with a history of skin cancer. Materials and methods Cross-sectional descriptive study. Participants (n = 170) in the XXI World Transplant Games from >50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer. Results The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1-2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged 50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer. Results The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1-2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged 15 years and 79.5% spent >1-2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged 1-2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes agedItem Importance of research nursing role determining the germline study in metastatic prostate cancer patients(Elsevier, 2021-09-21) Ferreira, P. Peinado; Perez, C. Llacer; Grau, G.; Fernandez, L. Oliva; Canada-Higueras, E.; Herrera-Imbroda, B.; Hernandez, D.; Saez, M. I.; Villatoro, R.; Pino, A. Montesa; Lopez, F. J.; Marquez, M.; Pineda, A.; Olmos, D.; Castro, E.; [Ferreira, P. Peinado] Biomed Res Inst Malaga IBIMA, Genitourinary Tumor Unit, Malaga, Spain; [Grau, G.] Biomed Res Inst Malaga IBIMA, Genitourinary Tumor Unit, Malaga, Spain; [Lopez, F. J.] Biomed Res Inst Malaga IBIMA, Genitourinary Tumor Unit, Malaga, Spain; [Marquez, M.] Biomed Res Inst Malaga IBIMA, Genitourinary Tumor Unit, Malaga, Spain; [Pineda, A.] Biomed Res Inst Malaga IBIMA, Genitourinary Tumor Unit, Malaga, Spain; [Perez, C. Llacer] Hosp Clin Virgen Victoria, Med Oncol Dept, Malaga, Spain; [Fernandez, L. Oliva] Hosp Clin Virgen Victoria, Med Oncol Dept, Malaga, Spain; [Saez, M. I.] Hosp Clin Virgen Victoria, Med Oncol Dept, Malaga, Spain; [Canada-Higueras, E.] Genol Med, Genet Testing, Malaga, Spain; [Herrera-Imbroda, B.] Hosp Univ Virgen Victoria, Biomed Res Inst Malaga IBIMA, Urol Unit, Malaga, Spain; [Hernandez, D.] Hosp Reg Univ, Urol, Malaga, Spain; [Villatoro, R.] Hosp Costa Sol, Agencia Sanitaria Costa Sol, Med Oncol, Marbella, Spain; [Pino, A. Montesa] Hosp Reg Univ Malaga Carlos Haya, Oncol, Malaga, Spain; [Olmos, D.] CNIO Ctr Nacl Invest Oncol, Med Oncol Dept, Madrid, Spain; [Castro, E.] Hosp Clin Virgen Victoria, Med Oncol Dept, Malaga, SpainItem Molecular features in liquid biopsy of early (EO) and late-onset colorectal cancer (LO)(Elsevier, 2021-09-21) Alcaide-Garcia, J.; Benavides, M.; Alvarez, M.; Sevilla, I.; Ales Diaz, I. C.; Robles Lasarte, M.; Muriel Lopez, C.; Navarro Perez, V.; Miranda, A.; Kushnir, M.; Faull, I.; Fernandez De Sousa, C.; Alba, E.; [Alcaide-Garcia, J.] Univ Reg Virgen Victoria, UGC Intercentros Oncologia Medica Hospi, Dept Med Oncol, Malaga, Spain; [Benavides, M.] Univ Reg Virgen Victoria, UGC Intercentros Oncologia Medica Hospi, Dept Med Oncol, Malaga, Spain; [Sevilla, I.] Univ Reg Virgen Victoria, UGC Intercentros Oncologia Medica Hospi, Dept Med Oncol, Malaga, Spain; [Ales Diaz, I. C.] Univ Reg Virgen Victoria, UGC Intercentros Oncologia Medica Hospi, Dept Med Oncol, Malaga, Spain; [Muriel Lopez, C.] Univ Reg Virgen Victoria, UGC Intercentros Oncologia Medica Hospi, Dept Med Oncol, Malaga, Spain; [Alvarez, M.] Univ Malaga, Sch Med, Pathol Dept, Mol Biol Canc Lab CIMES, Malaga, Spain; [Robles Lasarte, M.] Agencia Sanitaria Costa Sol Hosp Costa Sol, Dept Oncol Med, Marbella, Spain; [Miranda, A.] Agencia Sanitaria Costa Sol Hosp Costa Sol, Dept Oncol Med, Marbella, Spain; [Navarro Perez, V.] Agencia Sanitaria Costa Sol Hosp Costa Sol, Dept Oncol Med, Jaen, Spain; [Kushnir, M.] Guardant Hlth, Med Affairs, London, England; [Faull, I.] Guardant Hlth, Oncol, Barcelona, Spain; [Fernandez De Sousa, C.] CIMES, Molecular Biol Canc Lab, Malaga, Spain; [Alba, E.] CIBERONC ISCIII, Univ Reg Virgen Victoria IBIMA, UGC Intercentros Oncologia Med Hosp, Oncol Dept, Malaga, Spain; Guardant HealthItem Effectiveness of a physiotherapy and nutrition program in patients with coronary artery disease: randomized controlled trial(Oxford univ press, 2021-07-01) Gomez, Munoz E.; Sempere-Rubio, N.; Blesa, J.; Iglesias, P.; Mico, L.; Sanchez-Torrijos, J.; Girbes, V.; Soriano, J. M.; Espi-Lopez, G. V.; Mesa-Rico, R.; Timonet-Andreu, E.; Canca-Sanchez, J. C.; Senra, S.; Fernandez-Oliver, A. L.; Marques-Sule, E.; [Gomez, Munoz E.] Univ Valencia, Valencia, Spain; [Sempere-Rubio, N.] Univ Valencia, Valencia, Spain; [Blesa, J.] Univ Valencia, Valencia, Spain; [Soriano, J. M.] Univ Valencia, Valencia, Spain; [Espi-Lopez, G. V.] Univ Valencia, Valencia, Spain; [Marques-Sule, E.] Univ Valencia, Valencia, Spain; [Iglesias, P.] Univ Valencia, Univ Clin Nutr Phys Activ & Physiotherapy, Valencia, Spain; [Mico, L.] Univ Valencia, Univ Clin Nutr Phys Activ & Physiotherapy, Valencia, Spain; [Sanchez-Torrijos, J.] Spanish Heart Fdn, Heart Inst Valencia, Valencia, Spain; [Girbes, V.] Spanish Heart Fdn, Heart Inst Valencia, Valencia, Spain; [Mesa-Rico, R.] Hosp Costa Sol, Marbella, Spain; [Timonet-Andreu, E.] Hosp Costa Sol, Marbella, Spain; [Canca-Sanchez, J. C.] Hosp Costa Sol, Marbella, Spain; [Senra, S.] Hampshire Hosp NHS Fdn Trust, Basingstoke & North Hampshire Hosp, Basingstoke, Hants, England; [Fernandez-Oliver, A. L.] Univ Hosp Clin, Dept Cardiol, Malaga, SpainItem Multidisciplinary program based in physiotherapy and nutrition in coronary artery disease patients: randomized controlled trial(Oxford univ press, 2021-07-01) Gomez, Munoz E.; Sempere-Rubio, N.; Blesa, J.; Iglesias, P.; Mico, L.; Sanchez-Torrijos, J.; Girbes, V.; Soriano, J. M.; Espi-Lopez, G.; Mesa-Rico, R.; Timonet-Andreu, E.; Canca-Sanchez, J. C.; Senra, S.; Fernandez-Oliver, A. L.; Marques-Sule, E.; [Gomez, Munoz E.] Univ Valencia, Valencia, Spain; [Sempere-Rubio, N.] Univ Valencia, Valencia, Spain; [Blesa, J.] Univ Valencia, Valencia, Spain; [Soriano, J. M.] Univ Valencia, Valencia, Spain; [Espi-Lopez, G.] Univ Valencia, Valencia, Spain; [Marques-Sule, E.] Univ Valencia, Valencia, Spain; [Iglesias, P.] Univ Valencia, Univ Clin Nutr Phys Act & Physiotherapy, Valencia, Spain; [Mico, L.] Univ Valencia, Univ Clin Nutr Phys Act & Physiotherapy, Valencia, Spain; [Sanchez-Torrijos, J.] Spanish Heart Fdn, Heart Inst Valencia, Valencia, Spain; [Girbes, V.] Spanish Heart Fdn, Heart Inst Valencia, Valencia, Spain; [Mesa-Rico, R.] Hosp Costa Sol, Marbella, Spain; [Timonet-Andreu, E.] Hosp Costa Sol, Marbella, Spain; [Canca-Sanchez, J. C.] Hosp Costa Sol, Marbella, Spain; [Senra, S.] Hampshire Hosp NHS Fdn Trust, Basingstoke & North Hampshire Hosp, Basingstoke, Hants, England; [Fernandez-Oliver, A. L.] Univ Hosp Clin, Dept Cardiol, Malaga, SpainItem Clinical Characteristics and Risk Factors of Respiratory Failure in a Cohort of Young Patients Requiring Hospital Admission with SARS-CoV2 Infection in Spain: Results of the Multicenter SEMI-COVID-19 Registry.(2021-08-11) Díaz-Simón, Raquel; Lalueza, Antonio; Lora-Tamayo, Jaime; Rubio-Rivas, Manuel; Mendo, Cristina Llamazares; Martínez, María Luisa Taboada; Méndez, Cristina Asencio; Pesqueira Fontán, Paula M; Cruz, Ana Fernández; Cabrera, Juan Luis Romero; Rodríguez, Begoña Cortés; Rubio, Aurora Espinar; de Ávila, Vicente Serrano Romero; García, Gema Maria García; Osorio, Luis Cabeza; González-Fernández, María; Noya, Amara González; Wittel, Máximo Bernabeu; Fernandez, Francisco Arnalich; Sempere, Verónica Martínez; Artero, Arturo; Loureiro-Amigo, Jose; Huelgas, Ricardo Gómez; Santos, Juan Miguel Antón; Lumbreras, Carlos; SEMI-COVID-19 NetworkAge is a risk factor for COVID severity. Most studies performed in hospitalized patients with SARS-CoV2 infection have shown an over-representation of older patients and consequently few have properly defined COVID-19 in younger patients who require hospital admission. The aim of the present study was to analyze the clinical characteristics and risk factors for the development of respiratory failure among young (18 to 50 years) hospitalized patients with COVID-19. This retrospective nationwide cohort study included hospitalized patients from 18 to 50 years old with confirmed COVID-19 between March 1, 2020, and July 2, 2020. All patient data were obtained from the SEMI-COVID Registry. Respiratory failure was defined as the ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2 ratio) ≤200 mmHg or the need for mechanical ventilation and/or high-flow nasal cannula or the presence of acute respiratory distress syndrome. During the recruitment period, 15,034 patients were included in the SEMI-COVID-19 Registry, of whom 2327 (15.4%) were younger than 50 years. Respiratory failure developed in 343 (14.7%), while mortality occurred in 2.3%. Patients with respiratory failure showed a higher incidence of major adverse cardiac events (44 (13%) vs 14 (0.8%), p320 U/I (OR, 1.69; 95% CI, 1.18 to 2.42; p=0.0039), AST >35 mg/dL (OR, 1.74; 95% CI, 1.2 to 2.52; p=0.003), sodium 35 mg/dL (OR, 1.74; 95% CI, 1.2 to 2.52; p=0.003), sodium 8 mg/dL (OR, 2.42; 95% CI, 1.72 to 3.41; p Young patients with COVID-19 requiring hospital admission showed a notable incidence of respiratory failure. Obesity, SAHS, alcohol abuse, and certain laboratory parameters were independently associated with the development of this complication. Patients who suffered respiratory failure had a higher mortality and a higher incidence of major cardiac events, venous thrombosis, and hospital stay.Item Combination of Tocilizumab and Steroids to Improve Mortality in Patients with Severe COVID-19 Infection: A Spanish, Multicenter, Cohort Study.(2020-12-06) Ruiz-Antorán, Belén; Sancho-López, Aránzazu; Torres, Ferrán; Moreno-Torres, Víctor; de Pablo-López, Itziar; García-López, Paulina; Abad-Santos, Francisco; Rosso-Fernández, Clara M; Aldea-Perona, Ana; Montané, Eva; Aparicio-Hernández, Ruth M; Llop-Rius, Roser; Pedrós, Consuelo; Gijón, Paloma; Hernández-Carballo, Carolina; Pedrosa-Martínez, María J; Rodríguez-Jiménez, Consuelo; Prada-Ramallal, Guillermo; Cabrera-García, Lourdes; Aguilar-García, Josefa A; Sanjuan-Jimenez, Rocío; Ortiz-Barraza, Evelyn I; Sánchez-Chica, Enrique; Fernández-Cruz, Ana; TOCICOV-study groupWe aimed to determine the impact of tocilizumab use on severe COVID-19 (coronavirus disease 19) pneumonia mortality. We performed a multicentre retrospective cohort study in 18 tertiary hospitals in Spain from March to April 2020. Consecutive patients admitted with severe COVID-19 treated with tocilizumab were compared to patients not treated with tocilizumab, adjusting by inverse probability of the treatment weights (IPTW). Tocilizumab's effect in patients receiving steroids during the 48 h following inclusion was analysed. During the study period, 506 patients with severe COVID-19 fulfilled the inclusion criteria. Among them, 268 were treated with tocilizumab and 238 patients were not. Median time to tocilizumab treatment from onset of symptoms was 11 days [interquartile range (IQR) 8-14]. Global mortality was 23.7%. Mortality was lower in patients treated with tocilizumab than in controls: 16.8% versus 31.5%, hazard ratio (HR) 0.514 [95% confidence interval (95% CI) 0.355-0.744], p These results show that survival of patients with severe COVID-19 is higher in those treated with tocilizumab than in those not treated and that tocilizumab's effect adds to that of steroids administered to non-intubated patients with COVID-19 during the first 48 h of presenting with respiratory failure despite oxygen therapy. Randomised controlled studies are needed to confirm these results. European Union electronic Register of Post-Authorization Studies (EU PAS Register) identifier, EUPAS34415.Item COPD is Associated with Higher Prevalence of Back Pain: Results of a Population-Based Case-Control Study, 2017.(2020-11-02) Fuentes-Alonso, Marta; López-de-Andrés, Ana; Palacios-Ceña, Domingo; Jimenez-Garcia, Rodrigo; Lopez-Herranz, Marta; Hernandez-Barrera, Valentin; Perez-Farinos, Napoleon; Ji, Zichen; de-Miguel-Diez, JavierWe aimed to assess whether patients suffering from COPD have a higher prevalence of chronic back pain (neck and low back pain) than age-, sex-, and residence-matched non-COPD controls. We also aimed to identify which variables are associated with chronic neck pain (CNP) and chronic low back pain (CLBP) among COPD patients. We carried out a retrospective case-control study using data obtained from the Spanish National Health Survey conducted in 2017. We analyzed data from 1034 COPD and 1034 matched non-COPD controls. The prevalence of CNP and CLBP was 38.20% and 45.16%, respectively, among COPD patients and 22.82% and 28.34% for non-COPD controls, respectively (p The prevalence of CNP and CLBP was significantly higher among COPD patients than among non-COPD controls after adjusting for age, sex and other relevant clinical variables. Our findings add new data to the knowledge of chronic pain in COPD patients.Item Outpatients' Opinion And Experience Regarding Telepharmacy During The COVID-19 Pandemic: The Enopex Project(Dove medical press ltd, 2021-01-01) Margusino-Framinan, Luis; Fernandez-Llamazares, Cecilia M.; Negro-Vega, Eva; Tortajada-Goitia, Begona; Lizeaga, Garbine; Mercadal-Orfila, Gabriel; Almeida-Gonzalez, Carmen; Morillo-Verdugo, Ramon; [Margusino-Framinan, Luis] A Coruna Univ Hosp, Dept Pharm, La Coruna, Spain; [Fernandez-Llamazares, Cecilia M.] Gen Univ Gregorio Maranon Hosp, Dept Pharm, Madrid, Spain; [Negro-Vega, Eva] Getafe Univ Hosp, Dept Pharm, Madrid, Spain; [Tortajada-Goitia, Begona] Costa del Sol Hosp, Dept Pharm, Marbella, Spain; [Lizeaga, Garbine] Donostia Univ Hosp, Dept Pharm, San Sebastian, Spain; [Mercadal-Orfila, Gabriel] Mateu Orfila Hosp, Dept Pharm, Menorca, Spain; [Almeida-Gonzalez, Carmen] Virgen de Valme Univ Hosp, Stat & Methodol Dept, Seville, Spain; [Morillo-Verdugo, Ramon] Virgen de Valme Univ Hosp, Dept Pharm, Seville, Spain; Spanish Society of Hospital PharmacistsBackground: Telepharmacy, as a remote pharmaceutical care procedure, is being used worldwide during the COVID-19 pandemic, with the aim of preserving the health of patients and professionals. Its future development should incorporate the assessment of patient perception, but no research study has investigated it.Objective: The objective was to poll the opinions and experiences of outpatients with telepharmacy through a purpose-developed questionnaire and to assess it's quality through an internal validity and reliability analysis.Methods: Cross-sectional observational study of adult patients who used telepharmacy services during the COVID-19 lockdown period in Spain. The subjects answered a 24-item questionnaire, after giving their informed consent. Place of delivery, informed pharmacotherapeutic follow-up, opinion about telepharmacy, future development, ethics/satisfaction, and coordination constituted the six questionnaire categories. After assessing the adequate sample size with the Kaiser-Meyer-Olkin test, the Bartlett sphericity test analyzed the validity of the questionnaire. The intraclass correlation coefficient and Cronbach's alpha coefficient calculations verified the reliability and internal consistency.Results: A total of 9442 interviews were administered to patients from 81 hospitals, of which 8079 were valid (52.8% female). A 54.1% were aged between 41-65 years; 42.7% had been in treatment for more than 5 years; 42.8% lived between 6-31 miles from the hospital. As many as 96.7% of patients were "satisfied" or "very satisfied" with telepharmacy, 97.5% considering it complementary to their usual follow-up; 55.9% expressed a preference for being followed up face to face when visiting the hospital. 75.6% said they had rather receive their medication at home. The sample size obtained was deemed appropriate [the Kaiser-Meyer-Olkin test (0.789) and Bartlett's sphericity test (p