SAS - Hospital Alto Guadalquivir

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  • Publication
    Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.
    (2022) Estella, Á; Garcia Garmendia, J L; de la Fuente, C; Machado Casas, J F; Yuste, M E; Amaya Villar, R; Estecha, M A; Yaguez Mateos, L; Cantón Bulnes, M L; Loza, A; Mora, J; Fernández Ruiz, L; Díez Del Corral Fernández, B; Rojas Amezcua, M; Rodriguez Higueras, M I; Díaz Torres, I; Recuerda Núñez, M; Zaheri Beryanaki, M; Rivera Espinar, F; Matallana Zapata, D F; Moreno Cano, S G; Gimenez Beltrán, B; Muñoz, N; Sainz de Baranda Piñero, A; Bustelo Bueno, P; Moreno Barriga, E; Rios Toro, J J; Pérez Ruiz, M; Gómez González, C; Breval Flores, A; de San José Bermejo Gómez, A; Ruiz Cabello Jimenez, M A; Guerrero Marín, M; Ortega Ordiales, A; Tejero-Aranguren, J; Rodriguez Mejías, C; Gomez de Oña, J; de la Hoz, C; Ocaña Fernández, D; Ibañez Cuadros, S; Garnacho Montero, J; Work Group of Infectious Disease (GTEI) de la Sociedad Andaluza de Medicina Intensiva y Unidades coronarias SAMIUC
    The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. Prospective descriptive multicenter cohort study. 26 Intensive care units (ICU) from Andalusian region in Spain. Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. None. Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission 6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission 470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.
  • Publication
    Neuroprotective Effect of 3',4'-Dihydroxyphenylglycol in Type-1-like Diabetic Rats-Influence of the Hydroxytyrosol/3',4'-dihydroxyphenylglycol Ratio.
    (2022-03-08) Rodríguez-Pérez, María Dolores; Pérez de Algaba, Inmaculada; Martín-Aurioles, Esther; Arrebola, María Monsalud; Ortega-Hombrados, Laura; Verdugo, Cristina; Fernández-Prior, María África; Bermúdez-Oria, Alejandra; De La Cruz, José Pedro; González-Correa, José Antonio
    The aim of this study was to assess the possible neuroprotective effect of 3',4'-dihydroxyphenylglycol (DHPG), a polyphenol from extra virgin olive oil (EVOO), in an experimental model of diabetes and whether this effect is modified by the presence of another EVOO polyphenol, hydroxytyrosol (HT). The neuroprotective effect was assessed in a hypoxia-reoxygenation model in brain slices and by quantifying retinal nerve cells. The animals were distributed as follows: (1) normoglycemic rats (NDR), (2) diabetic rats (DR), (3) DR treated with HT (5 mg/kg/day p.o.), (4) DR treated with DHPG (0.5 mg/kg/day), or (5) with 1 mg/kg/day, (6) DR treated with HT plus DHPG 0.5 mg/kg/day, or (7) HT plus 1 mg/kg/day p.o. DHPG. Diabetic animals presented higher levels of oxidative stress variables and lower numbers of neuronal cells in retinal tissue. The administration of DHPG or HT reduced most of the oxidative stress variables and brain lactate dehydrogenase efflux (LDH) as an indirect index of cellular death and also reduced the loss of retinal cells. The association of DHPG+HT in the same proportions, as found in EVOO, improved the neuroprotective and antioxidant effects of both polyphenols.
  • Publication
    Correction: Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885.
    (2022-09-30) Chaparro, María; Garre, Ana; Núñez Ortiz, Andrea; Diz-Lois Palomares, María Teresa; Rodríguez, Cristina; Riestra, Sabino; Vela, Milagros; Benítez, José Manuel; Fernández Salgado, Estela; Sánchez Rodríguez, Eugenia; Hernández, Vicent; Ferreiro-Iglesias, Rocío; Ponferrada Díaz, Ángel; Barrio, Jesús; Huguet, José María; Sicilia, Beatriz; Martín-Arranz, María Dolores; Calvet, Xavier; Ginard, Daniel; Alonso-Abreu, Inmaculada; Fernández-Salazar, Luis; Varela Trastoy, Pilar; Rivero, Montserrat; Vera-Mendoza, Isabel; Vega, Pablo; Navarro, Pablo; Sierra, Mónica; Cabriada, José Luis; Aguas, Mariam; Vicente, Raquel; Navarro-Llavat, Mercè; Echarri, Ana; Gomollón, Fernando; Guerra Del Río, Elena; Piñero, Concepción; Casanova, María José; Spicakova, Katerina; Ortiz de Zarate, Jone; Torrella Cortés, Emilio; Gutiérrez, Ana; Alonso-Galán, Horacio; Hernández-Martínez, Álvaro; Marrero, José Miguel; Lorente Poyatos, Rufo; Calafat, Margalida; Martí Romero, Lidia; Robledo, Pilar; Bosch, Orencio; Jiménez, Nuria; Esteve Comas, María; Duque, José María; Fuentes Coronel, Ana María; Josefa Sampedro, Manuela; Sesé Abizanda, Eva; Herreros Martínez, Belén; Pozzati, Liliana; Fernández Rosáenz, Hipólito; Crespo Suarez, Belén; López Serrano, Pilar; Lucendo, Alfredo J; Muñoz Vicente, Margarita; Bermejo, Fernando; Ramírez Palanca, José Joaquín; Menacho, Margarita; Carmona, Amalia; Camargo, Raquel; Torra Alsina, Sandra; Maroto, Nuria; Nerín de la Puerta, Juan; Castro, Elena; Marín-Jiménez, Ignacio; Botella, Belén; Sapiña, Amparo; Cruz, Noelia; Forcelledo, José Luis F; Bouhmidi, Abdel; Castaño-Milla, Carlos; Opio, Verónica; Nicolás, Isabel; Kutz, Marcos; Abraldes Bechiarelli, Alfredo; Gordillo, Jordi; Ber, Yolanda; Torres Domínguez, Yolanda; Novella Durán, María Teresa; Rodríguez Mondéjar, Silvia; Martínez-Cerezo, Francisco J; Kolle, Lilyan; Sabat, Miriam; Ledezma, Cesar; Iyo, Eduardo; Roncero, Óscar; Irisarri, Rebeca; Lluis, Laia; Blázquez Gómez, Isabel; Zapata, Eva María; José Alcalá, María; Martínez Pascual, Cristina; Montealegre, María; Mata, Laura; Monrobel, Ana; Hernández Camba, Alejandro; Hernández, Luis; Tejada, María; Mir, Alberto; Galve, María Luisa; Soler, Marta; Hervías, Daniel; Gómez-Valero, José Antonio; Barreiro-de Acosta, Manuel; Rodríguez-Artalejo, Fernando; García-Esquinas, Esther; Gisbert, Javier P; On Behalf Of The EpidemIBD Study Group Of Geteccu,
    The authors wish to make the following corrections to this paper [...].
  • Publication
    Chronic Obstructive Pulmonary Disease in Elderly Patients with Acute and Advanced Heart Failure: Palliative Care Needs-Analysis of the EPICTER Study.
    (2022-06-27) Méndez-Bailón, Manuel; Lorenzo-Villalba, Noel; Romero-Correa, Miriam; Josa-Laorden, Claudia; Inglada-Galiana, Luis; Menor-Campos, Eva; Gómez-Aguirre, Noelia; Clemente-Sarasa, Carolina; Salas-Campos, Rosario; García-Redecillas, Carmen; Asenjo-Martínez, María; Trullàs, Joan Carles; Cortés-Rodríguez, Begoña; de la Guerra-Acebal, Carla; Serrado Iglesias, Ana; Aparicio-Santos, Reyes; Formiga, Francesc; Andrès, Emmanuel; Aramburu-Bodas, Oscar; Salamanca-Bautista, Prado; On Behalf Of Epicter Study Group,
    Introduction: There are studies that evaluate the association between chronic obstructive pulmonary disease (COPD) and heart failure (HF) but there is little evidence regarding the prognosis of this comorbidity in older patients admitted for acute HF. In addition, little attention has been given to the extracardiac and extrapulmonary symptoms presented by patients with HF and COPD in more advanced stages. The aim of this study was to evaluate the prognostic impact of COPD on mortality in elderly patients with acute and advanced HF and the clinical manifestations and management from a palliative point of view. Methods: The EPICTER study (“Epidemiological survey of advanced heart failure”) is a cross-sectional, multicenter project that consecutively collected patients admitted for HF in 74 Spanish hospitals. Demographic, clinical, treatment, organ-dependent terminal criteria (NYHA III-IV, LVEF
  • Publication
    Impact of the COVID-19 Pandemic on Healthcare Activity in the Regional Hospitals of Andalusia (Spain).
    (2022-01-12) Lopez-Villegas, Antonio; Bautista-Mesa, Rafael Jesus; Baena-Lopez, Miguel Angel; Garzon-Miralles, Antonio; Castellano-Ortega, Miguel Angel; Leal-Costa, Cesar; Peiro, Salvador
    (1) Background: The large global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has overloaded the public health systems and reduced the regular healthcare activity, leading to a major health crisis. The main objective of this study was to carry out a comparative evaluation of the healthcare activities in the hospitals of Eastern Andalusia, Spain. (2) Methods: In this study, an observational, multicentered, and retrospective approach was adopted to compare the healthcare activities of the Poniente Hospital (PH) and the Alto Guadalquivir Health Agency (AGHA). Data was collected over a period of 24 months, i.e., from 1 January 2019 to 31 December 2020, and the variables evaluated were: patients seen in the hospital emergency service (HES), X-ray tests performed, patients cited in outpatient consultations, surgical interventions performed, and patients included in the waiting list. (3) Results: The analysis of the above-mentioned variables revealed a significant reduction in the number of patients registered in 2020 at HES as compared to that in 2019 for both PH (p = 0.002) and AGHA (p
  • Publication
    Teledermatology versus Face-to-Face Dermatology: An Analysis of Cost-Effectiveness from Eight Studies from Europe and the United States.
    (2022-02-22) López-Liria, Remedios; Valverde-Martínez, María Ángeles; López-Villegas, Antonio; Bautista-Mesa, Rafael Jesús; Vega-Ramírez, Francisco Antonio; Peiró, Salvador; Leal-Costa, Cesar
    (1) Background: The aim of this systematic review was to compare the cost-effectiveness of two follow-up methods (face-to-face and telemedicine) used in dermatology in the last ten years. (2) Methods: A search for articles that included economic analyses was conducted in August 2021 in the databases PubMed, Medline, Scielo and Scopus using the following keywords: "Cost-Benefit Analysis", "Dermatology", "Telemedicine", "Primary Health Care", as well as other search terms and following the PICOS eligibility criteria. (3) Results: Three clinical trials and five observational studies were analyzed, providing information for approximately 16,539 patients (including four cost-minimization or saving analyses, three cost-effectiveness analyses, and one cost-utility analysis) in Europe and the United States. They describe the follow-up procedures in each of the cases and measure and analyze the direct and indirect costs and effectiveness. All the articles indicate that teledermatology lowers costs and proves satisfactory to both patients and professionals. (4) Conclusions: Although it has been found that follow-up via teledermatology can be more efficient than traditional hospital follow-up, more work is needed to establish evaluation protocols and procedures that measure key variables more equally and demonstrate the quality of the evidence of said studies.
  • Publication
    Clusters of inflammation in COVID-19: descriptive analysis and prognosis on more than 15,000 patients from the Spanish SEMI-COVID-19 Registry.
    (2022-03-02) Rubio-Rivas, Manuel; Mora-Luján, José María; Formiga, Francesc; Corrales González, Miguel Ángel; García Andreu, María Del Mar; Moreno-Torres, Víctor; García García, Gema María; Alcalá Pedrajas, José N; Boixeda, Ramon; Pérez-Lluna, Leticia; Cortés-Rodríguez, Begoña; Mella-Pérez, Carmen; Navas Alcántara, María de la Sierra; López Reboiro, Manuel Lorenzo; Alfaro-Lara, Verónica; Pérez-Martín, Santiago; Martín-Oterino, José Ángel; Gracia Gutiérrez, Anyuli; Martín-Urda Díez-Canseco, Anabel; Comas Casanova, Pere; Pérez García, Cristina; Varona, José F; Gómez-Huelgas, Ricardo; Antón-Santos, Juan-Miguel; Lumbreras-Bermejo, Carlos; SEMI-COVID-19 Network
    Uncontrolled inflammation following COVID-19 infection is an important characteristic of the most seriously ill patients. The present study aims to describe the clusters of inflammation in COVID-19 and to analyze their prognostic role. This is a retrospective observational study including 15,691 patients with a high degree of inflammation. They were included in the Spanish SEMI-COVID-19 registry from March 1, 2020 to May 1, 2021. The primary outcome was in-hospital mortality. Hierarchical cluster analysis identified 7 clusters. C1 is characterized by lymphopenia, C2 by elevated ferritin, and C3 by elevated LDH. C4 is characterized by lymphopenia plus elevated CRP and LDH and frequently also ferritin. C5 is defined by elevated CRP, and C6 by elevated ferritin and D-dimer, and frequently also elevated CRP and LDH. Finally, C7 is characterized by an elevated D-dimer. The clusters with the highest in-hospital mortality were C4, C6, and C7 (17.4% vs. 18% vs. 15.6% vs. 36.8% vs. 17.5% vs. 39.3% vs. 26.4%). Inflammation clusters were found as independent factors for in-hospital mortality. In detail and, having cluster C1 as reference, the model revealed a worse prognosis for all other clusters: C2 (OR = 1.30, p = 0.001), C3 (OR = 1.14, p = 0.178), C4 (OR = 2.28, p 
  • Publication
    Does admission acetylsalicylic acid uptake in hospitalized COVID-19 patients have a protective role? Data from the Spanish SEMI-COVID-19 Registry.
    (2021-11-29) Formiga, Francesc; Rubio-Rivas, Manuel; Mora-Luján, José María; Escudero, Samara Campos; Martinez, Rosa Fernandez Madera; Mendez-Bailón, Manuel; Campo, Pedro Durán-Del; Pérez, Andrea Riaño; García-Sánchez, Francisco-Javier; Alcalá-Pedrajas, José Nicolás; Hernández, Sergio Arnedo; Milian, Almudena Hernández; Díez, Ana Latorre; Sánchez, Ricardo Gil; Boixeda, Ramon; Vicente, Julio; Cortes, Begoña; Pérez, Carmen Mella; Espartero, María Esther Guisado; Castro, José López; Suárez, Santiago Rodríguez; Varona, Jose F; Gomez-Huelgas, Ricardo; Ramos-Rincón, Jose Manuel; SEMI-COVID-19 SEMI-COVID-19 Network
    Acetylsalicylic acid (ASA) is widely used in the treatment and prevention of cardiovascular disorders. Our objective is to evaluate its possible protective role, not only in mortality but also in other aspects such as inflammation, symptomatic thrombosis, and intensive care unit (ICU) admission in hospitalized COVID-19 patients. We realized an observational retrospective cohort study of 20,641 patients with COVID-19 pneumonia collected and followed-up from Mar 1st, 2020 to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Propensity score matching (PSM) was performed to determine whether treatment with ASA affected outcomes in COVID-19 patients. On hospital admission, 3291 (15.9%) patients were receiving ASA. After PSM, 3291 patients exposed to ASA and 2885 not-exposed patients were analyzed. In-hospital mortality was higher in the ASA group (30.4 vs. 16.9%, p 
  • Publication
    The Use of Corticosteroids or Tocilizumab in COVID-19 Based on Inflammatory Markers.
    (2021-10-18) Rubio-Rivas, Manuel; Mora-Luján, José M; Montero, Abelardo; Aguilar García, Josefa Andrea; Méndez Bailón, Manuel; Fernández Cruz, Ana; Oriol, Isabel; Teigell-Muñoz, Francisco-Javier; Dendariena Borque, Beatriz; De la Peña Fernández, Andrés; Fernández González, Raquel; Gil Sánchez, Ricardo; Fernández Fernández, Javier; Catalán, Marta; Cortés-Rodríguez, Begoña; Mella Pérez, Carmen; Montero Rivas, Lorena; Suárez Fuentetaja, Rebeca; Ternero Vega, Jara Eloísa; Ena, Javier; Martin-Urda Díez-Canseco, Anabel; Pérez García, Cristina; Varona, José F; Casas-Rojo, José Manuel; Millán Núñez-Cortés, Jesús; SEMI-COVID-19 Network
    The inflammatory cascade is the main cause of death in COVID-19 patients. Corticosteroids (CS) and tocilizumab (TCZ) are available to treat this escalation but which patients to administer it remains undefined. We aimed to evaluate the efficacy of immunosuppressive/anti-inflammatory therapy in COVID-19, based on the degree of inflammation. A retrospective cohort study with data on patients collected and followed up from March 1st, 2020, to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Patients under treatment with CS vs. those under CS plus TCZ were compared. Effectiveness was explored in 3 risk categories (low, intermediate, high) based on lymphocyte count, C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and D-dimer values. A total of 21,962 patients were included in the Registry by May 2021. Of these, 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). The primary outcome of the study was in-hospital mortality. Secondary outcomes were the composite variable of in-hospital mortality, requirement for high-flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIMV), invasive mechanical ventilation (IMV), or intensive care unit (ICU) admission. A total of 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). No significant differences were observed in either the low/intermediate-risk category (1.5% vs. 7.4%, p=0.175) or the high-risk category (23.1% vs. 20%, p=0.223) after propensity score matching. A statistically significant lower mortality was observed in the very high-risk category (31.9% vs. 23.9%, p=0.049). The prescription of CS alone or in combination with TCZ should be based on the degrees of inflammation and reserve the CS plus TCZ combination for patients at high and especially very high risk.
  • Publication
    New insights into antibody levels against SARS-CoV-2 for healthcare personnel vaccinated with tozinameran (Comirnaty).
    (2022-11-03) Fernández-Suárez, Antonio; Jiménez Coronado, Rosa; Clavijo Aroca, Carlos; Navarro Martín, Estrella; Qmega Qmega, Amir; Díaz-Iglesias, José Miguel
    The aim of this study is to determine the levels of spike protein IgG and total antibodies in subjects vaccinated against SARS-CoV-2 (both infected and non-infected) and the titer evolution over time. In addition, we also addressed the performance of each of the included platforms in the study, as they are intended to measure antibody levels in naturally infected patients. An observational study including 288 volunteer healthcare professionals vaccinated against SARS-CoV-2 (Comirnaty™) at the Andújar Alto Guadalquivir Hospital. Serum samples were obtained in September 2020 and 14 and 90 days after administration of the second dose. The following in vitro methods were used: Elecsys Anti-SARS-CoV-2 N and Elecsys Anti-SARS-CoV-2 S (Roche, Germany) and EliA SARS-CoV-2-Sp1 IgG (Thermo Fisher Scientific, Germany). For the Elecsys S method at 1/10 dilution and for the EliA Sp1 IgG method at 1/5 dilution, 54% and 19% of samples were out of range, respectively. The vaccine activated a high humoral response- 0 to 3000 BAU/mL being the "normal titer range" in all volunteers. Patients vaccinated after COVID-19 exhibited higher total S antibody load values than non-vaccinated volunteers while showing the same response for S IgG isotype. Titers decreased up to 86% in the case of S IgG neutralizing antibodies. The characterization of human response to SARS-CoV-2 vaccines is still far from being completely elucidated. It is important to increase the methods dynamic range to study humoral response evolution in depth and decide whether booster doses or seasonal vaccination plans will be necessary to definitively control the pandemic.
  • Publication
    Coronavirus disease 2019 hospitalization outcomes in persons with and without HIV in Spain.
    (2022) Olalla-Sierra, Julián; Martín-Escalante, María Dolores; García-Alegría, Javier; Rubio-Rivas, Manuel; de Miguel-Campo, Borja; Zurita-Etayo, María; Arbones-Fernández, Laia; Alcalá-Pedrajas, José N; Roldán-Silvestre, Alicia; Cortés-Rodríguez, Begoña; Casas-Rojo, José Manuel; Núñez-Cortés, Jesús Millán; SEMI-COVID-19 Network
    To compare coronavirus disease 2019 (COVID-19) hospitalization outcomes between persons with and without HIV. Retrospective observational cohort study in 150 hospitals in Spain. Patients admitted from 1 March to 8 October 2020 with COVID-19 diagnosis confirmed by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 positive) PCR test in respiratory tract samples. The primary data source was the COVID-19 Sociedad Española de Medicina Interna's registry (SEMI-COVID-19). Demographics, comorbidities, vital signs, laboratory parameters, and clinical severity as well as treatments received during admission, treatment duration, ICU admission, use of invasive mechanical ventilation, and death were recorded. Factors associated with mortality and the composite of ICU admission, invasive mechanical ventilation, and death, were analyzed. Data from 16 563 admissions were collected, 98 (0.59%) of which were of persons with HIV infection. These patients were younger, the percentage of male patients was higher, and their Charlson comorbidity index was also higher. Rates of mortality and composite outcome of ICU admission, invasive mechanical ventilation or death were lower among patients with HIV infection. In the logistic regression analysis, HIV infection was associated with an adjusted odds ratio of 0.53 [95% confidence interval (CI) 0.29-0.96] for the composite outcome. HIV infection was associated with a lower probability of ICU admission, invasive mechanical ventilation, or death.
  • Publication
    Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.
    (2022) Ramos-Rincón, José-Manuel; Bernabeu-Wittel, Máximo; Fiteni-Mera, Isabel; López-Sampalo, Almudena; López-Ríos, Carmen; García-Andreu, María-Del-Mar; Mancebo-Sevilla, Juan-José; Jiménez-Juan, Carlos; Matía-Sanz, Marta; López-Quirantes, Pablo; Rubio-Rivas, Manuel; Paredes-Ruiz, Diana; González-San-Narciso, Candela; González-Vega, Rocío; Sanz-Espinosa, Pablo; Hernández-Milián, Almudena; Gonzalez-Noya, Amara; Gil-Sánchez, Ricardo; Boixeda, Ramon; Alcalá-Pedrajas, José-Nicolás; Palop-Cervera, Marta; Cortés-Rodríguez, Begoña; Guisado-Espartero, María-Esther; Mella-Pérez, Carmen; Gómez-Huelgas, Ricardo; SEMI-COVID-19 Network
    COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. This is a cross-sectional analysis within a retrospective cohort of hospitalized patients ≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. Of 6 189 patients ≥75 years, 1 185 (19.1%) were LTCF residents and 4 548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs 82.1 years), mostly female (61.6% vs 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.
  • Publication
    Correlations Between Cutaneous Malignant Melanoma and Other Cancers: An Ecological Study in Forty European Countries
    (Wolters kluwer medknow publications, 2016-05-01) Serrano, Pablo Fernandez-Crehuet; Serrano, Jose Luis Fernandez-Crehuet; Allam, Mohamed Farouk; Navajas, Rafael Fernandez-Crehuet; [Serrano, Pablo Fernandez-Crehuet] Reina Sofia Univ Hosp, IMIBIC, Dept Dermatol, Cordoba, Spain; [Serrano, Jose Luis Fernandez-Crehuet] Alto Guadalquivir Hosp, Dept Dermatol, Jaen, Spain; [Allam, Mohamed Farouk] Univ Cordoba, Dept Prevent Med & Publ Hlth, Fac Med, Avenida Menendez Pidal,s n, Cordoba 14004, Spain; [Navajas, Rafael Fernandez-Crehuet] Univ Cordoba, Dept Prevent Med & Publ Hlth, Fac Med, Avenida Menendez Pidal,s n, Cordoba 14004, Spain
    Background: The presence of noncutaneous neoplasms does not seem to increase the risk of cutaneous malignant melanoma; however, it seems to be associated with the development of other hematological, brain, breast, uterine, and prostatic neoplasms. An ecological transversal study was conducted to study the geographic association between cutaneous malignant melanoma and 24 localizations of cancer in forty European countries.Methods: Cancer incidence rates were extracted from GLOBOCAN database of the International Agency for Research on Cancer. We analyzed the age-adjusted and gender-stratified incidence rates for different localizations of cancer in forty European countries and calculated their correlation using Pearson's correlation test.Results: In males, significant correlations were found between cutaneous malignant melanoma with testicular cancer (r = 0.83 [95% confidence interval (CI): 0.68-0.89]), myeloma (r = 0.68 [95% CI: 0.46-0.81]), prostatic carcinoma (r = 0.66 [95% CI: 0.43-0.80]), and non-Hodgkin lymphoma (NHL) (r = 0.63 [95% CI: 0.39-0.78]). In females, significant correlations were found between cutaneous malignant melanoma with breast cancer (r = 0.80 [95% CI: 0.64-0.88]), colorectal cancer (r = 0.72 [95% CI: 0.52-0.83]), and NHL (r = 0.71 [95% CI: 0.50-0.83]).Conclusions: These correlations call to conduct new studies about the epidemiology of cancer in general and cutaneous malignant melanoma risk factors in particular.
  • Publication
    Physicians' attitudes toward the problem of unnecessary tests and procedures
    (Elsevier, 2016-11-01) Luis Zambrana-Garcia, Jose; Lozano Rodriguez-Mancheno, Aquiles; [Luis Zambrana-Garcia, Jose] Hosp Montilla, Coordinac Asistencial, Agencia Sanit Alto Guadalquivir, Montilla, Cordoba, Spain; [Lozano Rodriguez-Mancheno, Aquiles] Hosp Alto Guadalquivir, Coordinac Asistencial, Agencia Sanit Alto Guadalquivir, Andujar, Jaen, Spain
  • Publication
    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 Network
    Age 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.
  • Publication
    Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study.
    (2021-06-29) Chaparro, María; Garre, Ana; Núñez Ortiz, Andrea; Diz-Lois Palomares, María Teresa; Rodríguez, Cristina; Riestra, Sabino; Vela, Milagros; Benítez, José Manuel; Fernández Salgado, Estela; Sánchez Rodríguez, Eugenia; Hernández, Vicent; Ferreiro-Iglesias, Rocío; Ponferrada Díaz, Ángel; Barrio, Jesús; Huguet, José María; Sicilia, Beatriz; Martín-Arranz, María Dolores; Calvet, Xavier; Ginard, Daniel; Alonso-Abreu, Inmaculada; Fernández-Salazar, Luis; Varela Trastoy, Pilar; Rivero, Montserrat; Vera-Mendoza, Isabel; Vega, Pablo; Navarro, Pablo; Sierra, Mónica; Cabriada, José Luis; Aguas, Mariam; Vicente, Raquel; Navarro-Llavat, Mercè; Echarri, Ana; Gomollón, Fernando; Guerra Del Río, Elena; Piñero, Concepción; Casanova, María José; Spicakova, Katerina; Ortiz de Zarate, Jone; Torrella Cortés, Emilio; Gutiérrez, Ana; Alonso-Galán, Horacio; Hernández-Martínez, Álvaro; Marrero, José Miguel; Lorente Poyatos, Rufo; Calafat, Margalida; Martí Romero, Lidia; Robledo, Pilar; Bosch, Orencio; Jiménez, Nuria; Esteve Comas, María; Duque, José María; Fuentes Coronel, Ana María; Josefa Sampedro, Manuela; Sesé Abizanda, Eva; Herreros Martínez, Belén; Pozzati, Liliana; Fernández Rosáenz, Hipólito; Crespo Suarez, Belén; López Serrano, Pilar; Lucendo, Alfredo J; Muñoz Vicente, Margarita; Bermejo, Fernando; Ramírez Palanca, José Joaquín; Menacho, Margarita; Carmona, Amalia; Camargo, Raquel; Torra Alsina, Sandra; Maroto, Nuria; Nerín de la Puerta, Juan; Castro, Elena; Marín-Jiménez, Ignacio; Botella, Belén; Sapiña, Amparo; Cruz, Noelia; Forcelledo, José Luis F; Bouhmidi, Abdel; Castaño-Milla, Carlos; Opio, Verónica; Nicolás, Isabel; Kutz, Marcos; Abraldes Bechiarelli, Alfredo; Gordillo, Jordi; Ber, Yolanda; Torres Domínguez, Yolanda; Novella Durán, María Teresa; Rodríguez Mondéjar, Silvia; Martínez-Cerezo, Francisco J; Kolle, Lilyan; Sabat, Miriam; Ledezma, Cesar; Iyo, Eduardo; Roncero, Óscar; Irisarri, Rebeca; Lluis, Laia; Blázquez Gómez, Isabel; Zapata, Eva María; José Alcalá, María; Martínez Pascual, Cristina; Montealegre, María; Mata, Laura; Monrobel, Ana; Hernández Camba, Alejandro; Hernández, Luis; Tejada, María; Mir, Alberto; Galve, María Luisa; Soler, Marta; Hervías, Daniel; Gómez-Valero, José Antonio; Barreiro-de Acosta, Manuel; Rodríguez-Artalejo, Fernando; García-Esquinas, Esther; Gisbert, Javier P; On Behalf Of The EpidemIBD Study Group Of Geteccu,
    (1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p
  • Publication
    Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19.
    (2021-06-15) Roy-Vallejo, Emilia; Sánchez Purificación, Aquilino; Torres Peña, José David; Sánchez Moreno, Beatriz; Arnalich, Francisco; García Blanco, María José; López Miranda, José; Romero-Cabrera, Juan Luis; Herrero Gil, Carmen Rosario; Bascunana, José; Rubio-Rivas, Manuel; Pintos Otero, Sara; Martínez Sempere, Verónica; Ballano Rodríguez-Solís, Jesús; Gil Sánchez, Ricardo; Luque Del Pino, Jairo; González Noya, Amara; Navas-Alcántara, María Sierra; Cortés Rodríguez, Begoña; Alcalá, José Nicolás; Suárez-Lombraña, Ana; Andrés Soler, Jorge; Gómez-Huelgas, Ricardo; Casas-Rojo, José Manuel; Millán Núñez-Cortés, Jesús; On Behalf Of The Semi-Covid-Network,
    Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p
  • Publication
    Her2-Positive and Microsatellite Instability Status in Gastric Cancer-Clinicopathological Implications.
    (2021-05-25) Bermúdez, Ana; Arranz-Salas, Isabel; Mercado, Silvia; López-Villodres, Juan A; González, Virginia; Ríus, Francisca; Ortega, María V; Alba, Carmen; Hierro, Isabel; Bermúdez, Diego
    Gastric cancer (GC) is one of the leading causes of cancer-related death. The combination of new molecular classifications with clinicopathological data could contribute to the individualization of patients and to the development of new therapeutic strategies. We examined the various associations in two molecular types of GC: HER2-positive (human epidermal growth factor receptor 2) and microsatellite instability (MSI), assessing their influence on treatment and prognosis. A retrospective study of 142 GC patients was performed with molecular characterization through HER2 overexpression and DNA repair protein expression for MSI. The percentage of HER2-positive tumors was 13.4%, predominantly in men. Correlations were found with intestinal type, metastases, advanced stages and chemotherapy. Almost 75% of HER2-positive patients died. MSI occurred in 16.2%, associated with advanced age, female sex, distal location and intestinal type. These patients had few metastases and low stages. The percentage of deaths was higher among MSI patients who received perioperative chemotherapy. The determination of HER2 and MSI status in GC is important for their association with specific clinicopathological features and for their prognostic and predictive value.
  • Publication
    Calcifediol Treatment and Hospital Mortality Due to COVID-19: A Cohort Study.
    (2021-05-21) Alcala-Diaz, Juan F; Limia-Perez, Laura; Gomez-Huelgas, Ricardo; Martin-Escalante, Maria D; Cortes-Rodriguez, Begoña; Zambrana-Garcia, Jose L; Entrenas-Castillo, Marta; Perez-Caballero, Ana I; López-Carmona, Maria D; Garcia-Alegria, Javier; Lozano Rodríguez-Mancheño, Aquiles; Arenas-de Larriva, Maria Del Sol; Pérez-Belmonte, Luis M; Jungreis, Irwin; Bouillon, Roger; Quesada-Gomez, Jose Manual; Lopez-Miranda, Jose
    Calcifediol has been proposed as a potential treatment for COVID-19 patients. To compare the administration or not of oral calcifediol on mortality risk of patients hospitalized because of COVID-19. Retrospective, multicenter, open, non-randomized cohort study. Hospitalized care. Patients with laboratory-confirmed COVID-19 between 5 February and 5 May 2020 in five hospitals in the South of Spain. Patients received calcifediol (25-hydroxyvitamin D3) treatment (0.266 mg/capsule, 2 capsules on entry and then one capsule on day 3, 7, 14, 21, and 28) or not. In-hospital mortality during the first 30 days after admission. A total of 537 patients were hospitalized with COVID-19 (317 males (59%), median age, 70 years), and 79 (14.7%) received calcifediol treatment. Overall, in-hospital mortality during the first 30 days was 17.5%. The OR of death for patients receiving calcifediol (mortality rate of 5%) was 0.22 (95% CI, 0.08 to 0.61) compared to patients not receiving such treatment (mortality rate of 20%; p 7 mmol/L, respiratory rate ≥ 30/min, systolic blood pressure Among patients hospitalized with COVID-19, treatment with calcifediol, compared with those not receiving calcifediol, was significantly associated with lower in-hospital mortality during the first 30 days. The observational design and sample size may limit the interpretation of these findings.
  • Publication
    [Risk scores in acute heart failure].
    (2021-04-28) Zambrana-Luque, J L; Valdivia-Marchal, M; Zambrana-García, J L