Search

Aim: Assessing the effect of statin therapy at hospital admission for COVID-19 on in-hospital mortality. Methods and results: Retrospective observational study. Patients taking statins were 11 years older and had significantly more comorbidities than patients who were not taking statins. A genetic matching (GM) procedure was performed prior to analysis of the mortality risk. A Cox proportional hazards model was used for the cause-specific hazard (CSH) function, and a competing-risks Fine and Gray (FG) model was also used to study the direct effects of statins on risk.Data from reverse transcription-polymerase chain reaction-confirmed 2157 SARS-CoV-2-infected patients (1234 men, 923 women; age: 67 y/o (IQR 54-78)) admitted to the hospital were retrieved from the clinical records in anonymized manner. 353 deaths occurred. 581 patients were taking statins. Univariate test after GM showed a significantly lower mortality rate in patients on statin therapy than the matched non-statin group (19.8% vs. 25.4%, χ2 with Yates continuity correction: p = 0.027). The mortality rate was even lower in patients (n = 336) who maintained their statin treatments during hospitalization compared to the GM non-statin group (17.4%; p = 0.045). The Cox model applied to the CSH function (HR = 0.58(CI: 0.39-0.89); p = 0.01) and the competing risks FG model (HR = 0.60(CI: 0.39-0.92); p = 0.02) suggest that statins are associated with reduced COVID-19-related mortality. Conclusions: A lower SARS-CoV-2 infection-related mortality was observed in patients treated with statin therapy prior to hospitalization. Statin therapy should not be discontinued due to the global concern of the pandemic or in patients hospitalized for COVID-19.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Dislipèmies; Factors de risc Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Dislipidemias; Factores de riesgo Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Dyslipidaemias; Risk factors Lipids are indispensable in the SARS-CoV-2 infection process. The clinical significance of plasma lipid profile during COVID-19 has not been rigorously evaluated. We aim to ascertain the association of the plasma lipid profile with SARS-CoV-2 infection clinical evolution. Observational cross-sectional study including 1411 hospitalized patients with COVID-19 and an available standard lipid profile prior (n: 1305) or during hospitalization (n: 297). The usefulness of serum total, LDL, non-HDL and HDL cholesterol to predict the COVID-19 prognosis (severe vs mild) was analysed. Patients with severe COVID-19 evolution had lower HDL cholesterol and higher triglyceride levels before the infection. The lipid profile measured during hospitalization also showed that a severe outcome was associated with lower HDL cholesterol levels and higher triglycerides. HDL cholesterol and triglyceride concentrations were correlated with ferritin and D-dimer levels but not with CRP levels. The presence of atherogenic dyslipidaemia during the infection was strongly and independently associated with a worse COVID-19 infection prognosis. The low HDL cholesterol and high triglyceride concentrations measured before or during hospitalization are strong predictors of a severe course of the disease. The lipid profile should be considered as a sensitive marker of inflammation and should be measured in patients with COVID-19. The work was supported by unrestricted grants from the Institut de Investigació Sanitària Pere Virgili (IISPV) and Xarxa de Unitat de Lipids i Ateriosclerosis (XULA) de Catalunya.

Acromegaly is a rare disease with nonspecific symptoms with acral enlargement being almost universally present at diagnosis. The estimated prevalence is 40–125 cases/million but targeted universal screening studies have found a higher prevalence (about 10 fold). The aim of the ACROSAHS study was to investigate the prevalence of acromegaly and acromegaly comorbidities in patients with sleep apnea symptoms and acral enlargement. ACROSAHS was a Spanish prospective non-interventional epidemiological study in 13 Hospital sleep referral units. Facial and acral enlargement symptoms including: ring size and shoe size increase, tongue, lips and jaws enlargement, paresthesia or carpal tunnel syndrome and widening of tooth spaces, as well as other typical acromegaly comorbidities were recorded with a self-administered questionnaire of patients who attended a first visit for sleep apnea symptoms between 09/2013 and 07/2014. Serum insulin-like growth factor type 1 (IGF1) was measured in patients with ≥1 acral symptom to determine the prevalence of acromegaly. Of the 1557 patients enrolled, 1477 with complete data (72% male) were analyzed. 530 patients (36%) reported at least 1 acral enlargement symptom and were tested for IGF-1, 41 were above range, persisted in 7, and among those, 2 cases of acromegaly were diagnosed (prevalence of at least 1.35 cases/1000). Overall, 1019 patients (69%) had ≥2 acromegaly symptoms and should have been screened according to guidelines; moreover 373 patients (25%) had ≥1 symptom of acral enlargement plus ≥3 other acromegaly symptoms. In conclusion, in patients with sleep apnea symptoms and acral enlargement, we found an acromegaly prevalence of at least 1.35 cases per 1000 and a high prevalence of typical acromegaly symptoms. It is important that sleep specialists are aware of acromegaly symptoms to aid with acromegaly diagnosis., The study was investigator initiated and was partially sponsored by Ipsen Pharma, S.A., Spain

Aim To describe the, incidence, the changes in the etiology and the prognosis of lower respiratory tract infection (LRTI) in HIV infected patients, presenting by the first time to the Emergency Department (ED), during years 2000-2010. Study design Prospective collection of data. Metbods Data were collected on the first visit of HIV-infected patients at our ED due to a LRTI, (defined according to the criteria of the European Respiratory Society), between 1/1/2000 and 31/12/2010. A series of epidemiological and laboratory variables as well as the need for admission to the intensive care unit (ICU). LRTI etiology were also collected. The influence ofthe mentioned variables on 30-day mortality were analyzed. Results One hundred thirty one patients were included. LRTI represented 27% of visits to the ED by HIV-infected patients. Mean age was 39±9 years. 72% of patients were males. 18% required admission to the ICU. The most frequent LRTI was pneumonia by P. jiroveci in 35 cases, bacterial penumonia in 27 and pulmonary tuberculosis in 20. LRTI incidence gradually reduced significantly over time from 6.13 × 1000 patients/year in year 2000 to 0.23 × 1000 patients/year in 2010 (p, Objetivo Describir la incidencia, la etiología y el pronóstico de la infección de las vías espiratorias bajas (IVRB) en los pacientes VIH, que acudieron a un Servicio de Urgencias (SU), durante el período del 2000–2010. Diseño del estudio Estudio prospectivo de 10 años de evolución. Métodos Se recogió únicamente el primer episodio del paciente que acude al SU por IRVB (definida según la European Respiratory Society). Se analizaron una serie de variables epidemiológicas y de laboratorio, así como la necesidad de ingreso en una unidad de cuidados intensivos (UCI). Se estudió la etiología de la IRVB y la incidencia. Finalmente se analizaron la influencia de las variables con la mortalidad a 30 días. Resultados Se incluyeron un total de 131 pacientes. La edad media fue de 39 ± 9 años. El 72% de los pacientes eran varones y el 18% de los pacientes requirieron ingreso en la UCI. La IRVB más frecuente fue la neumonía por P. jirovecci, seguida de la neumonía bacteriana en 27 y la tuberculosis pulmonar en 20. La incidencia de IRVB se ha ido reduciendo gradualmente de forma significativa, 6,13 × 1.000 pacientes/año en 2000 a 0,23 × 1.000 pacientes/año en 2010 (p < 0,05). El análisis de regresión logística mostró que la única variable que predijo mortalidad fue el ingreso en UCI (p < 0,05; OR: 73,01). Conclusión La IRVB es una enfermedad cuya incidencia y etiología han ido disminuyendo y cambiando respectivamente, probablemente en relación con la utilización generalizada del TAR. Sin embargo, todavía presenta una mortalidad nada despreciable, que es mayor cuando el paciente requiere ingreso en la UCI.

La implantación desde 2009 de las nuevas titulaciones de Grado, de acuerdo con el nuevo marco educativo establecido a través del Espacio Europeo de Educación Superior (EEES), ha supuesto un crecimiento notable en la oferta de títulos en las distintas Universidades del estado español. En particular, en la Universidad Autónoma de Madrid, la oferta académica de títulos es cercana al centenar. En estas circunstancias, el aprovechamiento de los recursos de la Universidad es una máxima para cualquier equipo de gestión bien al nivel de centros (Facultades y Escuela) e, inclusive, al nivel de la propia Universidad. Por tanto, el objetivo que se ha pretendido realizar mediante este Trabajo Fin de Grado ha sido el de crear una aplicación que facilite y de soporte a la gestión de las sesiones de examen, con el propósito de automatizar toda la funcionalidad que supone la realización de múltiples pruebas de evaluación coincidentes en el espacio y en el tiempo. La implantación de sistemas de gestión y control como el que proponemos posibilitaría la coincidencia de pruebas de distintas asignaturas en un mismo aula, permitiendo un aprovechamiento de los recursos, materiales y humanos, más adecuado que en la actualidad. En el procedimiento actual no se llevan a cabo tareas como el control de estudiantes en la entrada y salida de la sesión, la realización de exámenes de distintas asignaturas en el mismo aula o la asignación de los asientos en el aula, entre otras. Todas estas funciones se podrían realizar con la aplicación que se ha desarrollado en este proyecto: “Gestión de aulas de examen”. Para ello se ha realizado un estudio de distintas tecnologías para averiguar cuáles se adaptaban mejor a este proyecto, además de analizar los aspectos más importantes a tener en cuenta a la hora de realizar una sesión de exámenes. Por otra parte se precisa que esta gestión sea fluida, lo que requiere aportar una interfaz intuitiva a la aplicación y el uso de un lector de código de barras que agilice la entrada y salida de los estudiantes de la sesión. La aplicación desarrollada está orientada al uso por parte de los miembros de un tribunal, desde el momento que se inicia la sesión de examen hasta que concluye. En su estado actual constituye una aplicación piloto de posibles proyectos de innovación docente futuros., The implementation since 2009 of the new degree, according to the new educational framework established by the European Higher Education Area (EHEA) has been a remarkable growth in the supply of securities in the various universities of the Spanish state. In particular, the Autonomous University of Madrid, the academic offerings of securities is close to hundred. In these circumstances, the use of University resources is a maximum for any management team either at the level of schools (Colleges and School), and even at the level of the university. Therefore, the objective has sought performed through this Bachelor Thesis was to create an application that facilitates and supports management review sessions, in order to automate all the functionality that involves making multiple matching evaluation tests in space and in time. The implementation of management and control systems such as we propose would allow matching tests in different subjects in the same classroom, allowing use of resources, material and human, more appropriate today. In the current procedure does not perform tasks like checking students in and out of the meeting, the holding of examinations in different subjects in the same classroom or the allocation of seats in the classroom, among others. All these functions could be performed with the application that has been developed in this project: "Managing examination rooms." This has made a study of various technologies to determine which are best suited to this project, in addition to analyzing the most important aspects to consider when performing a test session. Furthermore it is stated that this management is fluid, which requires providing an intuitive interface to the application and use of a barcode reader to expedite the entry and exit of students in the session. The developed application is geared for use by members of the court, from the time the review session begins until concludes. In its current state is a pilot application of possible future teaching innovation projects.