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1. Comorbidities and their implications in patients with and without type 2 diabetes mellitus and heart failure with preserved ejection fraction. Findings from the rica registry

Author

Arévalo-Lorido JC, Carretero-Gómez J, Gómez-Huelgas R, Llácer P, Manzano L, Quesada Simón MA, Roca Villanueva B, González Franco Á, Cepeda JM, and Montero Pérez-Barquero M

Subjects
endocrine system diseases, nutritional and metabolic diseases
Abstract

Aim To determine if patients with heart failure and preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM) have a higher comorbidity burden than those without T2DM, if other comorbidities are preferentially associated with T2DM and if these conditions confer a worse patient prognosis. Methods and results Cohort study based on the RICA Spanish Heart Failure Registry, a multicentre, prospective registry that enrols patients admitted for decompensated HF and follows them for 1 year. We selected only patients with HFpEF, classified as having or not having T2DM and performed an agglomerative hierarchical clustering based on variables such as the presence of arrhythmia, chronic obstructive pulmonary disease, dyslipidemia, liver disease, stroke, dementia, body mass index, haemoglobin levels, estimated glomerular filtration rate and systolic blood pressure. A total of 1934 patients were analysed: 907 had T2DM (mean age 78.4 +/- 7.6 years) and 1027 did not (mean age 81.4 +/- 7.6 years). The analysis resulted in four clusters in patients with T2DM and three in the reminder. All clusters of patients with T2DM showed higher BMI and more kidney disease and anaemia than those without T2DM. Clusters of patients without T2DM had neither significantly better nor worse outcomes. However, among the T2DM patients, clusters 2, 3 and 4 all had significantly poorer outcomes, the worst being cluster 3 (HR 2.0, 95% CI 1.36-2.93,P = .001). Conclusions Grouping our patients with HFpEF and T2DM into clusters based on comorbidities revealed a greater disease burden and prognostic implications associated with the T2DM phenotype, compared with those without T2DM.

Published
2021

2. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

Author

Perkovic, V., Jardine, M. J., Neal, B., Bompoint, S., Heerspink, H. J. L., Charytan, D. M., Edwards, R., Agarwal, R., Bakris, G., Bull, S., Cannon, C. P., Capuano, G., Chu, P. -L., De Zeeuw, D., Greene, T., Levin, A., Pollock, C., Wheeler, D. C., Yavin, Y., Zhang, H., Zinman, B., Meininger, G., Brenner, B. M., Mahaffey, K. W., Perkovic, V, Mahaffey, Kw, Agarwal, R, Bakris, G, Brenner, Bm, Cannon, Cp, Charytan, Dm, de Zeeuw, D, Greene, T, Jardine, Mj, Heerspink, Hjl, Levin, A, Meininger, G, Neal, B, Pollock, C, Wheeler, Dc, Zhang, H, Zinman, B, Mcguire, Dk, Holman, R, Home, P, Scharfstein, D, Parfrey, P, Shahinfar, S, August, P, Chang, T, Sinha, Ad, Januzzi, J, Kolansky, D, Amerena, J, Hillis, G, Gorelick, P, Kissela, B, Kasner, S, Lindley, R, Fulcher, G, Ounadjela, S, Hufert, K, von Ingersleben, G, Gaglia, J, Harris, R, Hudson, M, Turchin, A, Cheifetz, A, Sheth, S, Feuerstein, J, Cohen, S, Jardine, M, Li, N, Kolesnyk, I, Aizenberg, D, Pecoits-Filho, R, Cherney, D 3rd, Obrador, G, Chertow, G, Hawley, C, Ji, L, Wada, T, Jha, V, Lim, Sk, Lim-Abrahan, Ma, Santos, F, Chae, Dw, Hwang, Sj, Vazelov, E, Rychlík, I, Hadjadj, S, Krane, V, Rosivall, L, De Nicola, L, Dreval, A, Nowicki, M, Schiller, A, Distiller, L, Górriz, Jl, Kolesnyk, M, Morren, F, Goykhman, S, David, C, Yost, L, Wang, H, Hettiarachchi, M, Thimmaiah, R, Koppolu, D, George, S, Schmidt, M, Ignjatovic, J, Chapin, L, Travis, K, Destree, M, Sood, V, Coffee, L, De Brouwer, K, Zaviriukha, V, Starzec, A, Koizumi, M, Lin, G, Chen, E, Lin, P, Leia, C, Mascaro, D, Amigo, A, Limos, A, Abrahamsen, I, Jaffer, S, Ahuad Guerrero RA, Albisu, Jp, Alvarisqueta, A, Bartolacci, I, Berli, Ma, Bordonava, A, Calella, P, Cantero, Mc, Cartasegna, Lr, Cercos, E, Coloma, Gc, Colombo, H, Commendatore, V, Cuadrado, J, Cuneo, Ca, Cusumano, Am, Douthat, Wg, Dran, Rd, Farias, E, Fernandez, Mf, Finkelstein, H, Fragale, G, Fretes, Jo, Garcia, Nh, Gastaldi, A, Gelersztein, E, Glenny, Ja, Gonzalez, Jp, Gonzalez Colaso PDC, Goycoa, C, Greloni, Gc, Guinsburg, A, Hermida, S, Juncos, Li, Klyver, Mi, Kraft, F, Krynski, F, Lanchiotti, Pv, Leon de la Fuente RA, Marchetta, N, Mele, P, Nicolai, S, Novoa, Pa, Orio, Si, Otreras, F, Oviedo, A, Raffaele, P, Resk, Jh, Rista, L, Rodriguez Papini, N, Sala, J, Santos, Jc, Schiavi, Lb, Sessa, H, Smith Casabella, T, Ulla, Mr, Valdez, M, Vallejos, A, Villarino, A, Visco, Ve, Wassermann, A, Zaidman, Cj, Cheung, Nw, Droste, C, Fraser, I, Johnson, D, Mah, Pm, Nicholls, K, Packham, D, Proietto, J, Roberts, A, Roger, S, Tsang, V, Raduan, Ra, Alves da Costa FA, Amodeo, C, Andreotti Turatti LA, Bregman, R, Camelo Sanches FC, Canani, Lh, Chacra, Ar, Cunha Borges JL, Cunha Vêncio SA, da Silva Franco RJ, D'Avila, D, de Souza Portes, E, de Souza, P, Deboni, Lm, Filho, Ff, Geloneze Neto, B, Gomes, M, Kohara, Sk, Keitel, E, Kerr Saraiva JF, Kurtz Lisboa HR, de Carvalho Contieri FL, Milagres, R, Montenegro Junior, R, Moreira de Brito, C, Nazzer Hissa, M, Nazario Sabbag ÂR, Noronha, I, Panarotto, D, Pecoits Filho, R, Pereira, Ma, Saporito, W, Scotton, As, Schuch, T, Simões de Almeida, R, Slompo Ramos, C, Soares Felício, J, Thomé, F, Tibes Hachmann JC, Yamada, S, Yoiti Hayashida, C, Zanata Petry TB, Zanella, Mt, Andreeva, V, Angelova, A, Dimitrov, S, Genadieva, V, Genova-Hristova, G, Hristozov, K, Kamenov, Z, Koundurdjiev, A, Lozanov, L, Margaritov, V, Nonchev, B, Rangelov, R, Shinkov, A, Temelkova, M, Velichkova, E, Yakov, A, Aggarwal, N, Aronson, R, Bajaj, H, Chouinard, G, Conway, J, Cournoyer, S, Daroza, G, De Serres, S, Dubé, F, Goldenberg, R, Gupta, A, Gupta, M, Henein, S, Khandwala, H, Leiter, L, Madore, F, Mcmahon, A, Muirhead, N, Pichette, V, Rabasa-Lhoret, R, Steele, A, Tangri, N, Torshizi, A, Woo, V, Zalunardo, N, Fernández Montenegro MA, Godoy Jorquera JG, Medina Fariña, M, Saavedra Gajardo, V, Vejar, M, Chen, N, Chen, Q, Gan, S, Kong, Y, Li, D, Li, W, Li, X, Lin, H, Liu, J, Lu, W, Mao, H, Ren, Y, Song, W, Sun, J, Sun, L, Tu, P, Wang, G, Yang, J, Yin, A, Yu, X, Zhao, M, Zheng, H, Accini Mendoza JL, Arcos, E, Avendano, J, Diaz Ruiz JEA, Garcia Ortiz LH, Gonzalez, A, Hernandez Triana, E, Higuera, Jd, Malaver, N, Molina de Salazar DI, Rosero, R, Terront Lozano MA, Valderrama Cometa, L, Valenzuela, A, Vargas Alonso RD, Villegas, I, Yupanqui, H, Bartaskova, D, Barton, P, Belobradkova, J, Dohnalova, L, Drasnar, T, Ferkl, R, Halciakova, K, Klokocnikova, V, Kovar, R, Lastuvka, J, Lukac, M, Pesickova, S, Peterka, K, Pumprla, J, Rychlik, I, Saudek, F, Tesar, V, Valis, M, Weiner, P, Zemek, S, Alamartine, E, Borot, S, Cariou, B, Dussol, B, Fauvel, Jp, Gourdy, P, Klein, A, Le Meur, Y, Penfornis, A, Roussel, R, Saulnier, Pj, Thervet, E, Zaoui, P, Burst, V, Faghih, M, Faulmann, G, Haller, H, Jerwan-Keim, R, Maxeiner, S, Paschen, B, Plassmann, G, Rose, L, Gonzalez Orellana RA, Haase, Fp, Moreira Diaz JP, Ramirez Roca LA, Sánchez Arenales JA, Sanchez Polo JV, Turcios Juarez, E, Csecsei, G, Csiky, B, Danos, P, Deak, L, Dudas, M, Harcsa, E, Keltai, K, Keresztesi, S, Kiss, K, Konyves, L, Major, L, Mileder, M, Molnar, M, Mucsi, J, Oroszlan, T, Ory, I, Paragh, G, Peterfai, E, Petro, G, Revesz, K, Takacs, R, Vangel, S, Vasas, S, Zsom, M, Abraham, O, Bhushan, Rs, Deepak, D, Edwin, Fm, Gopalakrishnan, N, Gracious, N, Hansraj, A, Jain, D, Keshavamurthy, Cb, Khullar, D, Manisha, S, Peringat, J, Prasad, N, Satyanarayana, Rk, Sreedhar, R, Sreelatha, M, Sudhakar, B, Vyasam, Rc, Bonadonna, R, Castellino, P, Ceriello, A, Chiovato, L, De Cosmo, S, Derosa, G, Di Carlo, A, Di Cianni, G, Frascà, G, Fuiano, G, Gambaro, G, Garibotto, G, Giorda, C, Malberti, F, Mandreoli, M, Mannucci, E, Orsi, E, Piatti, P, Santoro, D, Sasso, Fc, Serviddio, G, Stella, A, Trevisan, R, Veronelli, Am, Zanoli, L, Akiyama, H, Aoki, H, Asano, A, Iitsuka, T, Kajiyama, S, Kashine, S, Kawada, T, Kodera, T, Kono, H, Koyama, K, Kumeda, Y, Miyauchi, S, Mizuyama, K, Niiya, T, Oishi, H, Ota, S, Sakakibara, T, Takai, M, Tomonaga, O, Tsujimoto, M, Wakasugi, M, Wakida, Y, Watanabe, T, Yamada, M, Yanagida, K, Yanase, T, Yumita, W, Gaupsiene, E, Kozloviene, D, Navickas, A, Urbanaviciene, E, Abdul Ghani, R, Abdul Kadir, K, Ali, N, Che Yusof MD, Gan, Cl, Ismail, M, Kong, Wy, Lam, Sw, Lee, Ly, Loh, Cl, Manocha, Ab, Ng, Ks, Nik Ahmad NNF, Ratnasingam, V, Bin Shudim SS, Vengadasalam, P, Abraira Munoz LD, Salazar, Ma, Cruz, Jb, Soto, Mb, Ramos, Jc, Wong, Ac, Correa Rotter JR, Diaz Escalante, T, Enriquez Sosa FE, Flores Lozano, F, Flota Cervera LF, Frenk Baron, P, Garcia Ballesteros, C, Gomez Rangel JD, Herrera Jimenez LE, Irizar Santana SS, Jimenez Florez, F, Laviada Molina, H, Luna Ceballos RI, Martin Del Camp Blanco, B, Morales Franco, G, Moreno Loza OT, Mustieles Rocha, C, Obrador Vera, G, Orozco Castellanos, R, Peralta Calcaneo, J, Reyes Rosano MA, Rodriguez Pattzi, H, Rosas Guzman, J, Rucker Joerg IE, Saaveddra Sanchez SB, Sanchez Mijangos JH, Serrano Sanson, P, Tamayo, Y Orozco JA, Tellez Chavez, E, Valdes Depeda, A, Venegas Carrillo, L, Villagordoa Mesa, J, Zamarripa Escobedo, R, Baker, J, Noonan, P, Scott, R, Walker, R, Watson, E, Williams, M, Young, S, Abejuela, Z, Agra, J, Aquitania, G, Caringal, C, Comia, Rs, Delos Santos, L, Gomez, O, Jimeno, C, Tan, G, Tolentino, M, Yao, C, Yap, Ye, Ygpuara, Mdl, Bijata-Bronisz, R, Hotlos, L, Januszewicz, A, Kaczmarek, B, Kaminska, A, Lazuka, L, Madej, A, Mazur, S, Mlodawska-Choluj, D, Orlowska-Kowalik, G, Popenda, G, Rewerska, B, Sowinski, D, Angelescu, Lm, Anghel, V, Avram, Ri, Busegeanu, Mm, Cif, A, Cosma, D, Crisan, C, Demian, Ld, Ferariu, Ie, Halmagyi, I, Hancu, N, Munteanu, M, Negru, D, Onaca, Ag, Petrica, L, Popa, Ar, Ranetti, Ae, Serafinceanu, C, Toarba, C, Agafyina, A, Barbarash, O, Barysheva, O, Chizhov, D, Dobronravov, V, Glinkina, I, Grineva, E, Khirmanov, V, Kolmakova, E, Koroleva, T, Kvitkova, L, Marasaev, V, Mkrtumyan, A, Morugova, T, Nagibovich, G, Nagibovich, O, Nedogoda, S, Osipova, I, Raskina, T, Samoylova, Y, Sazonova, O, Shamkhalova, M, Shutemova, E, Shwartz, Y, Uriasyev, O, Vorobyev, S, Zateyshchikova, A, Zateyshshikov, D, Zykova, T, Antic, S, Djordjevic, M, Kendereski, A, Lalic, K, Lalic, N, Popovic-Radinovic, V, Babikova, J, Benusova, O, Buganova, I, Culak, J, Dzupina, A, Dzuponova, J, Fulop, P, Ilavska, A, Martinka, E, Ochodnicka, Z, Pella, D, Smatanova, I, Ahmed, F, Badat, A, Breedt, J, Govender, V, Govender, R, Joshi, M, Jurgens, J, Latiff, G, Lombard, L, Mookadam, M, Ngcakani, N, Nortje, H, Oosthuizen, H, Pillay-Ramaya, L, Prozesky, H, Reddy, J, Rheeder, P, Seeber, M, Cho, Ym, Jeong, Ik, Kim, Sg, Kim, Yh, Kwon, Hs, Kwon, Mj, Lee, Bw, Lee, J, Lee, Mk, Nam, Ms, Oh, Kh, Park, Cy, Park, Sh, Yoon, Kh, Alvarez Garcia, P, Asmarats Mercadal, L, Barrios, C, Cereto Castro, F, Cigarran Guldris, S, Dominquez Lopez, M, Egido de Los Rios, J, Fernandez Fresnedo, G, Galan Serrano, A, Garcia, I, Gonzalez Martinez FJ, Jodar Gimeno JE, Muñoz Lopez Mendoza, M, Malek Marin, T, Morales Portillo, C, Munar Vila MA, Muñoz Torres, M, Nieto Iglesias, J, Pantoja Perez, J, Perez Vera, M, Portoles Perez JM, Quesada Simón MA, Simo Canonge, R, Soto Gonzalez, A, Terns Riera, M, Tinahones Madueno FJ, Plaza, Mv, Chang, Ct, Chuang, Lm, Hsia, Tl, Hsieh, Ch, Lin, Cc, Lu, Yc, Sheu, Wh, Barna, O, Bilyk, Sd, Botsyurko, V, Dudar, I, Fushtey, I, Godlevska, O, Golovchenko, O, Gyrina, O, Kazmirchuk, A, Komisarenko, I, Korzh, O, Kravchun, N, Legun, O, Mankovskyy, B, Martynyuk, L, Mostovoy, Y, Pashkovska, N, Pererva, L, Pertseva, T, Samoylov, O, Smirnov, I, Svyshchenko, Y, Tomashkevych, H, Topchii, I, Tryshchuk, N, Tseluyko, V, Vizir, V, Vlasenko, M, Zlova, T, Zub, L, Abusnana, S, Railey, M, Abouglila, K, Ainsworth, P, Ali, Z, Arutchelvam, V, Barnard, M, Bellary, S, Davies, E, Davies, M, Davies, S, Dawson, A, El Kossi, M, English, P, Fraser, D, Gnudi, L, Gunstone, A, Hall, T, Hanif, W, Jackson, A, Johnson, A, Joseph, F, Krishnan, S, Kumwenda, M, Macdougall, I, Nixon, P, O'Hare, J, Philip, S, Ramtoola, S, Saxena, M, Sennik, D, Simon, G, Singh, B, Stephens, J, Strzelecka, A, Symonds, R, Turner, W, Wahba, M, Wakeling, J, Wheeler, D, Winocour, P, Abdallah, J, Abdullah, R, Abramowitz, M, Acosta, I, Aiello, J, Akright, L, Akyea-Djamson, A, Alappan, R, Alicic, R, Al-Karadsheh, A, Allison, Dc, Arauz-Pacheco, C, Arfeen, S, Arif, A, Arvind, M, Atray, N, Awad, A, Barnhill, P, Barranco, E, Barrera, C, Beacom, M, Behara, V, Belo, D, Bentley-Lewis, R, Berenguer, R, Bermudez, L, Bernardo, M, Biscoveanu, M, Bowman-Stroud, C, Brandon, D, Brusco, O, Busch, R, Canaan, Y, Chilito, A, Christensen, T, Christiano, C, Christofides, E, Chuateco, C, Cohen, K, Cohen, R, Cohen-Stein, D, Cook, C, Coyne, D, Daboul, N, Darwish, R, Daswani, A, Deck, K, Desouza, C, Dev, D, Dhillon, M, Dua, S, Eder, F, Elosegui, Am, El-Shahawy, M, Ervin, J, Esquenazi, A, Evans, J, Fishbane, S, Frias, J, Galindo-Ramos, E, Galphin, C, Ghazi, A, Gonzalez, E, Gorson, D, Gowda, A, Greco, B, Grubb, S, Gulati, R, Hammoud, J, Handelsman, S, Hartman, I, Hershon, K, Hiser, D, Hon, G, Jacob, R, Jaime, M, Jamal, A, Kaupke, C, Keightley, G, Kern, E, Khanna, R, Khitan, Z, Kim, S, Kopyt, N, Kovesdy, C, Krishna, G, Kropp, J, Kumar, A, Kumar, J, Kumar, N, Kusnir, J, Lane, W, Lawrence, M, Lehrner, L, Lentz, J, Levinson, D, Lewis, D, Liss, K, Maddux, A, Maheshwari, H, Mandayam, S, Marar, I, Mehta, B, Middleton, J, Mordujovich, J, Moreda, R, Moustafa, M, Mujica Trenche, S, Narayanan, M, Narvarte, J, Nassar, T, Newman, G, Nichol, B, Nicol, P, Nisnisan, J, Nossuli, Ak, Obialo, C, Olelewe, S, Oliver, M, O'Shaughnessy, A, Padron, J, Pankhaniya, R, Parker, R, Patel, D, Patel, G, Patel, N, Pavon, H, Perez, A, Perez, C, Perlman, A, Pettis, K, Pharr, W, Phillips, A, Purighalla, R, Quesada-Suarez, L, Ranjan, R, Rastogi, S, Rendell, M, Rich, L, Robinson, M, Rodriguez, H, Rosas, S, Saba, F, Sankaram, R, Sarin, R, Schreiman, R, Scott, D, Sekkarie, M, Sensenbrenner, J, Shakeel, M, Shanik, M, Shaw, S, Smith, S, Solomon, R, Sprague, A, Spry, L, Suchinda, P, Sultan, S, Surampudi, P, Sussman, S, Tan, A, Terrelonge, A, Thompson, M, Trespalacios, F, Trippe, B, Trueba, P, Twahirwa, M, Updegrove, J, Van Buren, P, Vannorsdall, M, Varghese, F, Velasquez-Mieyer, P, Ventrapragada, S, Vukotic, G, Wadud, K, Warren, M, Watson, H, Watts, R, Weiner, D, Welker, J, Welsh, J, Williams, S, Zaniewski-Singh, M., Perkovic, Vlado, Jardine, Meg J, Neal, Bruce, Bompoint, Severine, Heerspink, Hiddo J L, Charytan, David M, Edwards, Robert, Agarwal, Rajiv, Bakris, George, Bull, Scott, Cannon, Christopher P, Capuano, George, Chu, Pei-Ling, de Zeeuw, Dick, Greene, Tom, Levin, Adeera, Pollock, Carol, Wheeler, David C, Yavin, Yshai, Zhang, Hong, Zinman, Bernard, Meininger, Gary, Brenner, Barry M, Mahaffey, Kenneth W, collaborator: Perkovic, V, Mahaffey, Kw, Agarwal, R, Bakris, G, Brenner, Bm, Cannon, Cp, Charytan, Dm, de Zeeuw, D, Greene, T, Jardine, Mj, Heerspink, Hjl, Levin, A, Meininger, G, Neal, B, Pollock, C, Wheeler, Dc, Zhang, H, Zinman, B, Mcguire, Dk, Holman, R, Home, P, Scharfstein, D, Parfrey, P, Shahinfar, S, August, P, Chang, T, Sinha, Ad, Januzzi, J, Kolansky, D, Amerena, J, Hillis, G, Gorelick, P, Kissela, B, Kasner, S, Lindley, R, Fulcher, G, Ounadjela, S, Hufert, K, von Ingersleben, G, Gaglia, J, Harris, R, Hudson, M, Turchin, A, Cheifetz, A, Sheth, S, Feuerstein, J, Cohen, S, Jardine, M, Li, N, Kolesnyk, I, Aizenberg, D, Pecoits-Filho, R, Cherney, D 3rd, Obrador, G, Chertow, G, Hawley, C, Ji, L, Wada, T, Jha, V, Lim, Sk, Lim-Abrahan, Ma, Santos, F, Chae, Dw, Hwang, Sj, Vazelov, E, Rychlík, I, Hadjadj, S, Krane, V, Rosivall, L, De Nicola, L, Dreval, A, Nowicki, M, Schiller, A, Distiller, L, Górriz, Jl, Kolesnyk, M, Morren, F, Goykhman, S, David, C, Yost, L, Wang, H, Hettiarachchi, M, Thimmaiah, R, Koppolu, D, George, S, Schmidt, M, Ignjatovic, J, Chapin, L, Travis, K, Destree, M, Sood, V, Coffee, L, De Brouwer, K, Zaviriukha, V, Starzec, A, Koizumi, M, Lin, G, Chen, E, Lin, P, Leia, C, Mascaro, D, Amigo, A, Limos, A, Abrahamsen, I, Jaffer, S, Ahuad Guerrero, Ra, Albisu, Jp, Alvarisqueta, A, Bartolacci, I, Berli, Ma, Bordonava, A, Calella, P, Cantero, Mc, Cartasegna, Lr, Cercos, E, Coloma, Gc, Colombo, H, Commendatore, V, Cuadrado, J, Cuneo, Ca, Cusumano, Am, Douthat, Wg, Dran, Rd, Farias, E, Fernandez, Mf, Finkelstein, H, Fragale, G, Fretes, Jo, Garcia, Nh, Gastaldi, A, Gelersztein, E, Glenny, Ja, Gonzalez, Jp, Gonzalez Colaso, Pdc, Goycoa, C, Greloni, Gc, Guinsburg, A, Hermida, S, Juncos, Li, Klyver, Mi, Kraft, F, Krynski, F, Lanchiotti, Pv, Leon de la Fuente, Ra, Marchetta, N, Mele, P, Nicolai, S, Novoa, Pa, Orio, Si, Otreras, F, Oviedo, A, Raffaele, P, Resk, Jh, Rista, L, Rodriguez Papini, N, Sala, J, Santos, Jc, Schiavi, Lb, Sessa, H, Smith Casabella, T, Ulla, Mr, Valdez, M, Vallejos, A, Villarino, A, Visco, Ve, Wassermann, A, Zaidman, Cj, Cheung, Nw, Droste, C, Fraser, I, Johnson, D, Mah, Pm, Nicholls, K, Packham, D, Proietto, J, Roberts, A, Roger, S, Tsang, V, Raduan, Ra, Alves da Costa, Fa, Amodeo, C, Andreotti Turatti, La, Bregman, R, Camelo Sanches, Fc, Canani, Lh, Chacra, Ar, Cunha Borges, Jl, Cunha Vêncio, Sa, da Silva Franco, Rj, D'Avila, D, de Souza Portes, E, de Souza, P, Deboni, Lm, Filho, Ff, Geloneze Neto, B, Gomes, M, Kohara, Sk, Keitel, E, Kerr Saraiva, Jf, Kurtz Lisboa, Hr, de Carvalho Contieri, Fl, Milagres, R, Montenegro Junior, R, Moreira de Brito, C, Nazzer Hissa, M, Nazario Sabbag, Âr, Noronha, I, Panarotto, D, Pecoits Filho, R, Pereira, Ma, Saporito, W, Scotton, A, Schuch, T, Simões de Almeida, R, Slompo Ramos, C, Soares Felício, J, Thomé, F, Tibes Hachmann, Jc, Yamada, S, Yoiti Hayashida, C, Zanata Petry, Tb, Zanella, Mt, Andreeva, V, Angelova, A, Dimitrov, S, Genadieva, V, Genova-Hristova, G, Hristozov, K, Kamenov, Z, Koundurdjiev, A, Lozanov, L, Margaritov, V, Nonchev, B, Rangelov, R, Shinkov, A, Temelkova, M, Velichkova, E, Yakov, A, Aggarwal, N, Aronson, R, Bajaj, H, Chouinard, G, Conway, J, Cournoyer, S, Daroza, G, De Serres, S, Dubé, F, Goldenberg, R, Gupta, A, Gupta, M, Henein, S, Khandwala, H, Leiter, L, Madore, F, Mcmahon, A, Muirhead, N, Pichette, V, Rabasa-Lhoret, R, Steele, A, Tangri, N, Torshizi, A, Woo, V, Zalunardo, N, Fernández Montenegro, Ma, Godoy Jorquera, Jg, Medina Fariña, M, Saavedra Gajardo, V, Vejar, M, Chen, N, Chen, Q, Gan, S, Kong, Y, Li, D, Li, W, Li, X, Lin, H, Liu, J, Lu, W, Mao, H, Ren, Y, Song, W, Sun, J, Sun, L, Tu, P, Wang, G, Yang, J, Yin, A, Yu, X, Zhao, M, Zheng, H, Accini Mendoza, Jl, Arcos, E, Avendano, J, Diaz Ruiz, Jea, Garcia Ortiz, Lh, Gonzalez, A, Hernandez Triana, E, Higuera, Jd, Malaver, N, Molina de Salazar, Di, Rosero, R, Terront Lozano, Ma, Valderrama Cometa, L, Valenzuela, A, Vargas Alonso, Rd, Villegas, I, Yupanqui, H, Bartaskova, D, Barton, P, Belobradkova, J, Dohnalova, L, Drasnar, T, Ferkl, R, Halciakova, K, Klokocnikova, V, Kovar, R, Lastuvka, J, Lukac, M, Pesickova, S, Peterka, K, Pumprla, J, Rychlik, I, Saudek, F, Tesar, V, Valis, M, Weiner, P, Zemek, S, Alamartine, E, Borot, S, Cariou, B, Dussol, B, Fauvel, Jp, Gourdy, P, Klein, A, Le Meur, Y, Penfornis, A, Roussel, R, Saulnier, Pj, Thervet, E, Zaoui, P, Burst, V, Faghih, M, Faulmann, G, Haller, H, Jerwan-Keim, R, Maxeiner, S, Paschen, B, Plassmann, G, Rose, L, Gonzalez Orellana, Ra, Haase, Fp, Moreira Diaz, Jp, Ramirez Roca, La, Sánchez Arenales, Ja, Sanchez Polo, Jv, Turcios Juarez, E, Csecsei, G, Csiky, B, Danos, P, Deak, L, Dudas, M, Harcsa, E, Keltai, K, Keresztesi, S, Kiss, K, Konyves, L, Major, L, Mileder, M, Molnar, M, Mucsi, J, Oroszlan, T, Ory, I, Paragh, G, Peterfai, E, Petro, G, Revesz, K, Takacs, R, Vangel, S, Vasas, S, Zsom, M, Abraham, O, Bhushan, R, Deepak, D, Edwin, Fm, Gopalakrishnan, N, Gracious, N, Hansraj, A, Jain, D, Keshavamurthy, Cb, Khullar, D, Manisha, S, Peringat, J, Prasad, N, Satyanarayana, Rk, Sreedhar, R, Sreelatha, M, Sudhakar, B, Vyasam, Rc, Bonadonna, R, Castellino, P, Ceriello, A, Chiovato, L, De Cosmo, S, Derosa, G, Di Carlo, A, Di Cianni, G, Frascà, G, Fuiano, G, Gambaro, G, Garibotto, G, Giorda, C, Malberti, F, Mandreoli, M, Mannucci, E, Orsi, E, Piatti, P, Santoro, D, Sasso, Fc, Serviddio, G, Stella, A, Trevisan, R, Veronelli, Am, Zanoli, L, Akiyama, H, Aoki, H, Asano, A, Iitsuka, T et al, Groningen Kidney Center (GKC), and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)

Subjects
Aged, Canagliflozin, Cardiovascular Diseases, Creatinine, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Double-Blind Method, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Kidney Failure, Chronic, Male, Middle Aged, Sodium-Glucose Transporter 2 Inhibitors, Type 2 diabetes, 030204 cardiovascular system & hematology, Diabetic nephropathy, Kidney Failure, chemistry.chemical_compound, 0302 clinical medicine, 030212 general & internal medicine, 03.02. Klinikai orvostan, Dapagliflozin, Chronic, 11 Medical and Health Sciences, EMPAGLIFLOZIN, General Medicine, Life Sciences & Biomedicine, Type 2, medicine.drug, medicine.medical_specialty, Nephropathy, 03 medical and health sciences, Medicine, General & Internal, Internal medicine, Diabetes mellitus, General & Internal Medicine, CREDENCE Trial Investigators, medicine, Diabetes Mellitus, Science & Technology, business.industry, urogenital system, diabetic nephropathy, Type 2 Diabetes Mellitus, KIDNEY-DISEASE, medicine.disease, chemistry, business, Kidney disease
Abstract

BACKGROUND: Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium-glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS: In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin-angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of

Published
2019

3. PEG-Interferon-α ribavirin-induced HCV viral clearance: a pharmacogenetic multicenter Spanish study

Author

Milara, Javier, Outeda-Macias, Maria, Aumente-Rubio, Mª Dolores, Más-Serrano, Patricio, Aldaz, Azucena, Calvo, Mª Victoria, García-Simón, Mª Sergia, Martin-Barbero, Marisa, Padullés-Zamora, Núria, Schoenenberger, Juan Antonio, Saavedra-Aldrich, Marianne, Tévar-Alfonso, Enrique, Saval, Ana, Pastor-Clerigues, Alfonso, García, Marta, Margusino-Framiñan, Luis, Montero-Alvarez, Jose Luis, Merino, Esperanza, Herrero, José Ignacio, Beunza, Mónica, Conesa-Zamora, Pablo, Giménez-Manzorro, Álvaro, Comas-Sugrañes, Dolors, Cano-Marron, Manuel, Jiménez-Mutiloa, Elena, Díaz-Ruíz, Pilar, and Cortijo, Julio

Subjects
Sustained viral response, Pharmacogenetics, TNFRSF1B, Farmacogenética, Hepatitis C, Respuesta viral sostenida
Abstract

Objective: Dual PEGylated interferon-α (PEG-IFN) and ribavirin therapy has been the main hepatitis C virus (HCV) treatment of the last decade. Current direct-acting antiviral agents have improved the outcome of therapy but also have increased the cost and management complexity of treatment. The current study analyzes host genetics, viral and clinical predictors of sustained viral response (SVR) to dual PEG-IFN and ribavirin therapy in a representative Spanish population. Methods: Observational prospective multicentre pharmacogenetic cohort study conducted in 12 different hospitals of 12 different Spanish regions. A total of 98 patients with SVR and 106 with non-SVR in response to PEG-IFN and ribavirin therapy were included. 33 single nucleotide polymorphisms located in 24 different genes related with inflammatory, immune and virus response were selected. Clinical and viral data were also analyzed as candidate of SVR predictors. Results: IL-28B (rs12979860, rs7248668, rs8105790, rs8099917) and TNFRSF1B (rs1061622) genotypes, as well as TNFRSF1B/IL-10/TNFα (-308) non-TTG and TNFRSF1B/IL-10/IL-4 non-TTC haplotypes together with lower age, lower basal HCV RNA load, higher basal serum LDL cholesterol values, VHC genotypes 2 and 3 and basal low grade fibrosis 0-2 were associated with a SVR in the univariate analysis. Independent predictors of SVR in the multivariate analysis were IL-28B rs12979860 CC, TNFRSF1B/IL-10/IL-4 non-TTC along with low baseline HCV RNA load and HCV genotypes 2 and 3. Conclusions: IL-28B rs12979860 CC, TNFRSF1B/ IL-10/ IL-4 non-TTC haplotype, low baseline HCV RNA load and HCV genotypes 2 and 3 may help to predict successful outcome to PEG-IFN/ribavirin therapy in Spanish population. Objetivo: El interferón-α pegilado (IFN-PEG) junto a ribavirina ha sido el principal tratamiento de la infección por el virus de la hepatitis C (VHC) de la última década. Los agentes antivirales de acción directa actuales han mejorado los resultados de la terapia, pero también han aumentado el costo y la gestión de la complejidad del tratamiento. El presente estudio analiza factores genéticos de los pacientes, así como predictores virales y clínicos de respuesta sostenida viral (RSV) al tratamiento con IFN-PEG y ribavirina en población Española. Métodos: Estudio farmacogenético, multicéntrico, prospectivo, observacional de cohortes realizado en 12 hospitales diferentes de 12 comunidades autónomas diferentes. Se incluyeron un total de 98 pacientes con RVS y 106 sin SVR al tratamiento con IFN-PEG y ribavirina. Se seleccionaron 33 polimorfismos de nucleótido único ubicados en 24 genes diferentes relacionados con la respuesta inflamatoria, inmunológica y viral. Los datos clínicos y virales también se analizaron como candidatos predictores de RVS. Resultados: Los genotipos IL-28B (rs12979860, rs7248668, rs8105790, rs8099917) y TNFRSF1B (rs1061622), así como los haplotipos TNFRSF1B / IL-10 / TNFα (-308) no-TTG y TNFRSF1B / IL-10 / IL-4 no-TTC junto con la menor edad, menor carga de ARN-VHC basal, valores elevados de colesterol LDL en suero basal, genotipos VHC2 y 3 y bajo grado de fibrosis basal (0-2) se asociaron con una RVS en el análisis univariante. Los predictores independientes de RVS en el análisis multivariante fueron el genotipo IL-28B rs12979860 CC, el haplotipo TNFRSF1B / IL-10 / IL-4 no-TTC junto con los bajos niveles basales de VHC-ARN y los genotipos virales VHC2 y 3. Conclusiones: El genotipo IL-28B rs12979860 CC, el haplotipo TNFRSF1B / IL-10 / IL-4 haplotipos no-TTC, la carga viral basal baja y los genotipos del VHC2 y 3 pueden ayudar a predecir una buena respuesta a la terapia con IFN-PEG y ribavirina en población española.

Published
2015

4. PEG-Interferon-α ribavirin-induced HCV viral clearance: a pharmacogenetic multicenter Spanish study

Author

Milara, Javier, Outeda Macias, María, Aumente Rubio, Mª Dolores, Más Serrano, Patricio, Aldaz, Azucena, Calvo, Mª Victoria, García Simón, Mª Sergia, Martín Barbero, Marisa, SEFH-PkGen research group, Padullés Zamora, Núria, Schoenenberger, Joan Antoni, Saavedra Aldrich, Marianne, Tévar Alfonso, Enrique, Saval, Ana, Pastor Clerigues, Alfonso, García, Marta, Margusino Framiñan, Luis, Montero Álvarez, Jose Luis, Merino de Lucas, Esperanza, Herrero, Jose Ignacio, Beunza, Mónica, Conesa Zamora, Pablo, Giménez Manzorro, Álvaro, Comas Sugrañes, Dolors, Cano Marrón, Manuel, Jiménez Mutiloa, Elena, Díaz Ruíz, Pilar, and Cortijo, Julio

Subjects
Sustained viral response, Pharmacogenetics, TNFRSF1B, Farmacogenética, Hepatitis C, Respuesta viral sostenida
Abstract

Objective: Dual PEGylated interferon-α (PEG-IFN) and ribavirin therapy has been the main hepatitis C virus (HCV) treatment of the last decade. Current direct-acting antiviral agents have improved the outcome of therapy but also have increased the cost and management complexity of treatment. The current study analyzes host genetics, viral and clinical predictors of sustained viral response (SVR) to dual PEG-IFN and ribavirin therapy in a representative Spanish population. Methods: Observational prospective multicentre pharmacogenetic cohort study conducted in 12 different hospitals of 12 different Spanish regions. A total of 98 patients with SVR and 106 with non-SVR in response to PEG-IFN and ribavirin therapy were included. 33 single nucleotide polymorphisms located in 24 different genes related with inflammatory, immune and virus response were selected. Clinical and viral data were also analyzed as candidate of SVR predictors. Results: IL-28B (rs12979860, rs7248668, rs8105790, rs8099917) and TNFRSF1B (rs1061622) genotypes, as well as TNFRSF1B/IL-10/TNFα (-308) non-TTG and TNFRSF1B/IL10/IL-4 non-TTC haplotypes together with lower age, lower basal HCV RNA load, higher basal serum LDL cholesterol values, VHC genotypes 2 and 3 and basal low grade fibrosis 0-2 were associated with a SVR in the univariate analysis. Independent predictors of SVR in the multivariate analysis were IL-28B rs12979860 CC, TNFRSF1B/IL-10/IL-4 non-TTC along with low baseline HCV RNA load and HCV genotypes 2 and 3. Conclusions: IL-28B rs12979860 CC, TNFRSF1B/ IL-10/ IL-4 non-TTC haplotype, low baseline HCV RNA load and HCV genotypes 2 and 3 may help to predict successful outcome to PEG-IFN/ribavirin therapy in Spanish population. Objetivo: El interferón-α pegilado (IFN-PEG) junto a ribavirina ha sido el principal tratamiento de la infección por el virus de la hepatitis C (VHC) de la última década. Los agentes antivirales de acción directa actuales han mejorado los resultados de la terapia, pero también han aumentado el costo y la gestión de la complejidad del tratamiento. El presente estudio analiza factores genéticos de los pacientes, así como predictores virales y clínicos de respuesta sostenida viral (RSV) al tratamiento con IFN-PEG y ribavirina en población Española. Métodos: Estudio farmacogenético, multicéntrico, prospectivo, observacional de cohortes realizado en 12 hospitales diferentes de 12 comunidades autónomas diferentes. Se incluyeron un total de 98 pacientes con RVS y 106 sin SVR al tratamiento con IFNPEG y ribavirina. Se seleccionaron 33 polimorfismos de nucleótido único ubicados en 24 genes diferentes relacionados con la respuesta inflamatoria, inmunológica y viral. Los datos clínicos y virales también se analizaron como candidatos predictores de RVS. Resultados: Los genotipos IL-28B (rs12979860, rs7248668, rs8105790, rs8099917) y TNFRSF1B (rs1061622), así como los haplotipos TNFRSF1B / IL-10 / TNFα (-308) no-TTG y TNFRSF1B / IL-10 / IL-4 no-TTC junto con la menor edad, menor carga de ARN-VHC basal, valores elevados de colesterol LDL en suero basal, genotipos VHC2 y 3 y bajo grado de fibrosis basal (0-2) se asociaron con una RVS en el análisis univariante. Los predictores independientes de RVS en el análisis multivariante fueron el genotipo IL-28B rs12979860 CC, el haplotipo TNFRSF1B / IL-10 / IL-4 no-TTC junto con los bajos niveles basales de VHCARN y los genotipos virales VHC2 y 3. Conclusiones: El genotipo IL-28B rs12979860 CC, el haplotipo TNFRSF1B / IL-10 / IL-4 haplotipos no-TTC, la carga viral basal baja y los genotipos del VHC2 y 3 pueden ayudar a predecir una buena respuesta a la terapia con IFN-PEG y ribavirina en población española.

Published
2015

5. Aclaramiento del Virus de la Hepatitis C Inducido por PEG-Interferón-α y Ribavirina: Estudio Farmacogenético Multicéntrico en Hospitales Españoles

Author

Milara, Javier, Outeda Macias, María, Aumente Rubio, Mª Dolores, Más Serrano, Patricio, Aldaz, Azucena, Calvo, Mª Victoria, García Simón, Mª Sergia, Martín Barbero, Marisa, SEFH-PkGen research group, Padullés Zamora, Núria, Schoenenberger, Joan Antoni, Saavedra Aldrich, Marianne, Tévar Alfonso, Enrique, Saval, Ana, Pastor Clerigues, Alfonso, García, Marta, Margusino Framiñan, Luis, Montero Álvarez, Jose Luis, Merino de Lucas, Esperanza, Herrero, Jose Ignacio, Beunza, Mónica, Conesa Zamora, Pablo, Giménez Manzorro, Álvaro, Comas Sugrañes, Dolors, Cano Marrón, Manuel, Jiménez Mutiloa, Elena, Díaz Ruíz, Pilar, and Cortijo, Julio

Subjects
Sustained viral response, Pharmacogenetics, TNFRSF1B, Farmacogenética, Hepatitis C, Respuesta viral sostenida
Abstract

Objective: Dual PEGylated interferon-α (PEG-IFN) and ribavirin therapy has been the main hepatitis C virus (HCV) treatment of the last decade. Current direct-acting antiviral agents have improved the outcome of therapy but also have increased the cost and management complexity of treatment. The current study analyzes host genetics, viral and clinical predictors of sustained viral response (SVR) to dual PEG-IFN and ribavirin therapy in a representative Spanish population. Methods: Observational prospective multicentre pharmacogenetic cohort study conducted in 12 different hospitals of 12 different Spanish regions. A total of 98 patients with SVR and 106 with non-SVR in response to PEG-IFN and ribavirin therapy were included. 33 single nucleotide polymorphisms located in 24 different genes related with inflammatory, immune and virus response were selected. Clinical and viral data were also analyzed as candidate of SVR predictors. Results: IL-28B (rs12979860, rs7248668, rs8105790, rs8099917) and TNFRSF1B (rs1061622) genotypes, as well as TNFRSF1B/IL-10/TNFα (-308) non-TTG and TNFRSF1B/IL10/IL-4 non-TTC haplotypes together with lower age, lower basal HCV RNA load, higher basal serum LDL cholesterol values, VHC genotypes 2 and 3 and basal low grade fibrosis 0-2 were associated with a SVR in the univariate analysis. Independent predictors of SVR in the multivariate analysis were IL-28B rs12979860 CC, TNFRSF1B/IL-10/IL-4 non-TTC along with low baseline HCV RNA load and HCV genotypes 2 and 3. Conclusions: IL-28B rs12979860 CC, TNFRSF1B/ IL-10/ IL-4 non-TTC haplotype, low baseline HCV RNA load and HCV genotypes 2 and 3 may help to predict successful outcome to PEG-IFN/ribavirin therapy in Spanish population. Objetivo: El interferón-α pegilado (IFN-PEG) junto a ribavirina ha sido el principal tratamiento de la infección por el virus de la hepatitis C (VHC) de la última década. Los agentes antivirales de acción directa actuales han mejorado los resultados de la terapia, pero también han aumentado el costo y la gestión de la complejidad del tratamiento. El presente estudio analiza factores genéticos de los pacientes, así como predictores virales y clínicos de respuesta sostenida viral (RSV) al tratamiento con IFN-PEG y ribavirina en población Española. Métodos: Estudio farmacogenético, multicéntrico, prospectivo, observacional de cohortes realizado en 12 hospitales diferentes de 12 comunidades autónomas diferentes. Se incluyeron un total de 98 pacientes con RVS y 106 sin SVR al tratamiento con IFNPEG y ribavirina. Se seleccionaron 33 polimorfismos de nucleótido único ubicados en 24 genes diferentes relacionados con la respuesta inflamatoria, inmunológica y viral. Los datos clínicos y virales también se analizaron como candidatos predictores de RVS. Resultados: Los genotipos IL-28B (rs12979860, rs7248668, rs8105790, rs8099917) y TNFRSF1B (rs1061622), así como los haplotipos TNFRSF1B / IL-10 / TNFα (-308) no-TTG y TNFRSF1B / IL-10 / IL-4 no-TTC junto con la menor edad, menor carga de ARN-VHC basal, valores elevados de colesterol LDL en suero basal, genotipos VHC2 y 3 y bajo grado de fibrosis basal (0-2) se asociaron con una RVS en el análisis univariante. Los predictores independientes de RVS en el análisis multivariante fueron el genotipo IL-28B rs12979860 CC, el haplotipo TNFRSF1B / IL-10 / IL-4 no-TTC junto con los bajos niveles basales de VHCARN y los genotipos virales VHC2 y 3. Conclusiones: El genotipo IL-28B rs12979860 CC, el haplotipo TNFRSF1B / IL-10 / IL-4 haplotipos no-TTC, la carga viral basal baja y los genotipos del VHC2 y 3 pueden ayudar a predecir una buena respuesta a la terapia con IFN-PEG y ribavirina en población española.

Published
2015

6. Estudio de la eficacia del sellado con taurolidina y citrato 4% del catéter para hemodiálisis en la prevención de infección y trombosis

Author

González Martínez, Mª del Rocío, Ojeda Ramírez, Mª Dolores, García Pérez, Ana Mª, Redondo Simón, Mª del Carmen, Caro Rodríguez, Inmaculada, Huerga García, Mª Concepción, Gómez Cambronero, Marta, Molina Álvarez, Mª del Carmen, García Hita, Sonia, Fernández Palenzuela, Rocío, and Canovas Padilla, Yolanda

Subjects
trombosis, eficacia dialítica, central catheter, dialysis efficacy, catéter central, infección, sellado, infection, thrombosis, lock solution
Abstract

El uso de catéteres centrales ha aumentando de forma importante a pesar de su mayor morbi-mortalidad en comparación con las FAV. Las principales complicaciones son trombosis, bacteriemia-sepsis y limitación de la eficacia dialítica disminuyendo la calidad de vida de los pacientes y elevando el coste sanitario. En nuestra unidad, el sellado se realizaba con heparina sódica al 5% y actualmente utilizamos TauroLockTM Hep 500®, compuesta de (ciclo)-taurolidina (agente antimicrobiano biocompatible), citrato al 4% y heparina 500 UI/ml. Objetivo: Comprobar la eficacia del Taurolock para reducir la incidencia de colonización intraluminal y trombosis al compararla con heparina sódica al 5%. Material y método: Realizamos un estudio observacional longitudinal de cohorte y analizamos colonización intraluminal, trombosis, biofilm y uso de antibioterapia. Resultados: Observamos mejoría en la permeabilidad del catéter, disminución del uso de urokinasa, reducción de sesiones en unipunción y del uso de antibiótico. Conclusiones: Nuestro estudio muestra que el sellado del catéter para hemodiálisis con una solución que contiene taurolidina como antimicrobiano puede reducir significativamente la incidencia de sepsis relacionada con el catéter. La taurolidina parece se efectiva y segura y no conlleva riesgos ni efectos secundarios. La adicción de 500 ui de heparina a la solución de sellado junto con citrato al 4% ha disminuido los eventos trombóticos reduciendo el uso de fibrilolíticos y el uso de unipunción totalmente, presentando una mejoría de la eficacia dialítica. The use of central catheters has increased significantly despite their greater morbi-mortality compared to AVF. The main complications are thrombosis, bacteriaemiasepsis, and limitation of dialysis efficacy, reducing quality of life for patients and increasing the healthcare cost. In our unit, 5% heparin sodium was previously used as lock solution and we currently use TauroLockTM Hep 500®, composed of (cyclo)-taurolidine (biocompatible antimicrobial agent) 4% citrate and heparin 500 UI/ml. Objective: To verify the efficacy of Taurolock in reducing the incidence of intraluminal colonization and thrombosis compared with 5% heparin sodium. Material and method: We carried out a longitudinal observational cohort study and we analysed intraluminal colonization, thrombosis, biofilm and use of antibiotherapy. Results: We observed an improvement in catheter permeability, a reduction in the use of urokinase, reduction in unipuncture sessions and in use of antibiotic. Conclusions: Our study shows that using a lock solution that contains taurolidine as an antimicrobial agent for haemodialysis catheters can significantly reduce the incidence of catheter-related sepsis. Taurolidine appears to be effective and safe and does not entail risks or side effects. The addition of 500 iu of heparin to the lock solution together with 4% citrate has reduced thrombotic events by reducing the use of fibrilolytics and eliminating completely the use of unipuncture, presenting an improvement in dialysis efficacy.

Published
2014

7. Estudio de la eficacia del sellado con taurolidina y citrato 4% del catéter para hemodiálisis en la prevención de infección y trombosis

Author

González Martínez, Mª Rocío, Redondo Simón, Mª del Carmen, Caro Rodríguez, Inmaculada, Ojeda Ramírez, Mª Dolores, García Pérez, Ana Mª, Huerga, Mª Concepción, Gómez Cambronero, Marta, Molina Álvarez, Mª del Carmen, García Hita, Sonia, Fernández Valenzuela, Rocío, and Canovas Padilla, Yolanda

Subjects
trombosis, eficacia dialítica, catéter central, infección, sellado
Abstract

El uso de catéteres centrales ha aumentando de forma importante a pesar de su mayor morbi-mortalidad en comparación con las FAV. Las principales complicaciones son trombosis, bacteriemia-sepsis y limitación de la eficacia dialítica disminuyendo la calidad de vida de los pacientes y elevando el coste sanitario. En nuestra unidad, el sellado se realizaba con heparina sódica al 5% y actualmente utilizamos TauroLockTM Hep 500®, compuesta de (ciclo)-taurolidina (agente antimicrobiano biocompatible), citrato al 4% y heparina 500 UI/ml. Objetivo: Comprobar la eficacia del Taurolock para reducir la incidencia de colonización intraluminal y trombosis al compararla con heparina sódica al 5%. Material y método: Realizamos un estudio observacional longitudinal de cohorte y analizamos colonización intraluminal, trombosis, biofilm y uso de antibioterapia. Resultados: Observamos mejoría en la permeabilidad del catéter, disminución del uso de urokinasa, reducción de sesiones en unipunción y del uso de antibiótico. Conclusiones: Nuestro estudio muestra que el sellado del catéter para hemodiálisis con una solución que contiene taurolidina como antimicrobiano puede reducir significativamente la incidencia de sepsis relacionada con el catéter. La taurolidina parece se efectiva y segura y no conlleva riesgos ni efectos secundarios. La adicción de 500 ui de heparina a la solución de sellado junto con citrato al 4% ha disminuido los eventos trombóticos reduciendo el uso de fibrilolíticos y el uso de unipunción totalmente, presentando una mejoría de la eficacia dialítica.

Published
2014

8. Endoscopic retrograde cholangiopancreatography inEchinococcus (hydatid) cysts of the liver

Author

Tatiana Garcia, Antonio Garcia-Plaza, E. Meroño, V.F. Moreira, D. Aguilera, L. Ruiz del Arbol, and Simón Ma

Subjects
Adult, Male, Echinococcosis, Hepatic, medicine.medical_specialty, Adolescent, Urology, Perforation (oil well), Hydatid cyst, Biliary tract obstruction, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Child, Aged, Cholangiopancreatography, Endoscopic Retrograde, Endoscopic retrograde cholangiopancreatography, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Biliary fistula, Gastroenterology, General Medicine, Middle Aged, Hepatology, medicine.disease, Biliary tract, Female, Radiology, business
Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) was carried out on 19 patients with hydatid cyst of the liver, either before or after operation. Cholangiographic findings included biliary tract obstruction in 8 cases, intrinsic compression in 4 cases, laminated membranes or daughter cysts in the biliary tree in 3 cases, perforation into the biliary tract in 2 cases, stricture in the biliary ductal system in 1 case, and biliary fistula in the remaining case. Biliary tract obstruction was secondary to chemical cholangitis by formalin in 2 patients. ERCP is a useful procedure in patients with suspected intrabiliary rupture or when symptoms occur after surgical removal of the cyst.

Published
1985
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9. ERCP and allergic reactions to iodized contrast media

Author

V.F. Moreira, J.A. Gonzalez, J.L. Larraona, Conrado M. Fernandez, L. Ruiz del Arbol, Simón Ma, and E. Meroño

Subjects
Cholangiopancreatography, Endoscopic Retrograde, medicine.medical_specialty, business.industry, media_common.quotation_subject, Gastroenterology, Contrast Media, Drug Hypersensitivity, Internal medicine, Medicine, Contrast (vision), Humans, Radiology, Nuclear Medicine and imaging, business, media_common
Published
1985

10. Microflora aerobia lítica en suelos; su distribución, número y acción lítica

Author

Congregado, F., Dolores Simón, Mª., and Ramos-Cormenzana, A.

Abstract

Se aislan sobre E. coli 312 microoranismos liticos (101 Actinomicetos, 108 Myxobacterias y 103 Eubacterias). Estudiándose la actividad litica sobre otros microorganismos tanto Gram positivos (B. cereus, ST aureus y M. luteus) como Gram negativos (K. pneumoniae, E. aerogenes, P. mirabilis, S. typhimurium, B. catarrhalis, S. maceran6, Ps. aeruginosa y Az. chroococum) y una levadura (C. albicans). Se observa una mayor actividad litica para los actinomicetos, las eubacterias son más activas que las myxobacterias respecto a microorganismos Gram negativos, y viceversa para los Gram positivos. No se ha encontrado relación alguna entre tipo de suelo y distribución de especies., Three houndred and twelve lytic soU microorganisms (101 actinocyces, 108 myxobacteria and 103 eubacteria) were isolated on E. coli cells. The lytic activity on other microorganisms, was ' al so studied (The bac teria used were Gram positive (B. cereurS, sto aureus y M. luteus) and Gram negative (K. pneumoniae, E. aerogenes, P. mirabilis, S. typhimurium, B. catarrhali'3, S. macerans, PS. aeruginosa y Az. chroococum) and a yeast (Candida albicans). The greatest lytic actlvity was observed for the actinomyces isolated. The eubacteria were more active than the myxobacteria on the Gram negative organisms and the "viceversa" for the Gram positive. No relation was observed between tne type of soil and the distribution of the isolated species.

Published
1976

11. The double papilla of Vater

Author

J. Fernandez Seara, L. del Olmo, V.F. Moreira, E. Meroño, and Simón Ma

Subjects
Major duodenal papilla, Ampulla of Vater, business.industry, Gastroenterology, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Anatomy, business
Published
1985
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12. The double papilla of Vater—a reply

Author

Simón Ma, E. Meroño, V.F. Moreira, L. del Olmo, and J. Fernandez Seara

Subjects
Major duodenal papilla, business.industry, Gastroenterology, Medicine, Radiology, Nuclear Medicine and imaging, Anatomy, business
Published
1986
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13. Late presentation of chronic HBV and HCV patients seeking first time specialist care in Spain: a 2-year registry review

Author

Camila A. Picchio, Sabela Lens, Manuel Hernandez-Guerra, Juan Arenas, Raúl J. Andrade, Javier Crespo, Javier García-Samaniego, Manuel Romero-Gómez, Juan Turnes, José Luis Calleja, Miguel Ángel Simón, Trenton M. White, Mar Riveiro-Barciela, Anna Pocurull, Dalia Morales-Arraez, Alexandra Gómez, Maria Buti, Jeffrey V. Lazarus, Ministerio de Ciencia, Innovación y Universidades (España), Generalitat de Catalunya, European Commission, Agència de Gestió d'Ajuts Universitaris i de Recerca, [Picchio,CA, White,TM, Lazarus,JV] Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain. [Lens,S, Pocurull,A] Liver Unit, Hospital Clinic, Universidad de Barcelona, Barcelona, Spain. [Lens,S, Pocurull,A] IDIBAPS, University of Barcelona, Barcelona, Spain. [Lens,S, Andrade,RJ, García‑Samaniego,J, Calleja,JL, Pocurull,A, Buti,M] CIBER Hepatic and Digestive Diseases (CIBERehd), Instituto Carlos III, Madrid, Spain. [Hernandez-Guerra,M, Morales-Arraez,D] Department of Gastroenterology, University Hospital of the Canary Islands, San Cristóbal de La Laguna, Spain. [Arenas,J, Gomez,A] Biodonostia, Liver Diseases Research Group, Osakidetza Basque Health Service, Donostia University Hospital, San Sebastián, Spain. [Andrade,RJ] Unidad de Gestión Clínica de Enfermedades Digestivas, Instituto de Investigación Biomédica de Málaga‑IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain. [Crespo,J] Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain. [García-Samaniego,J] Liver Unit, Department of Gastroenterology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain. [Romero-Gómez,M] UCM Digestive Diseases, Hospital Universitario Virgen del Rocío, Institute of Biomedicine of Seville, Universidad de Sevilla, Seville, Spain. [Turnes,J] Complejo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Pontevedra, Spain. [Calleja,JL] Gastroenterology and Hepatology Department, Hospital Universitario Puerta del Hierro de, Universidad Autónoma de Madrid, Madrid, Spain. [Simón,MA] Department of Digestive Diseases, Hospital Clínico de Zaragoza, Zaragoza, Spain. [Simón,MA] Instituto de Investigación Sanitario Aragón (IIS Aragón), Zaragoza, Spain. [Riveiro-Barciela,M, Buti,M] Liver Unit, Hospital Universitario Vall d’Hebron, Barcelona, Spain., CAP, TMW, JVL acknowledge support to ISGlobal from the Spanish Ministry of Science, Innovation and Universities through the 'Centro de Excelencia Severo Ochoa 2019–2023' Programme (CEX2018-000806-S), and support from the Government of Catalonia through the CERCA Programme. CAP acknowledges support from the Secretaria d’Universitats i Recerca de la Generalitat de Catalunya and the European Social Fund as an AGAUR-funded PhD fellow. The authors would like to thank those who contributed to data collection: From the Basque Country: Leire Samaniego, Maria Vaamonde, and Edurne Almandoz. From Madrid, Dr Yza Frias, and Ana Robles. From Málaga, Enrique del Campo Herrera. From Sevilla, and Bianca Sánchez-Barbero, Javier Ampuero.

Subjects
Male, Hepatitis C, chronic, Diseases::Virus Diseases::Hepatitis, Viral, Human::Hepatitis C::Hepatitis C, Chronic [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings], Organisms::Viruses::Hepatitis Viruses::Hepacivirus [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Registries, Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Multidisciplinary, Referral and consultation, Middle Aged, Hepatitis B, Hepatitis C, Health services, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic Models [Medical Subject Headings], Diseases::Digestive System Diseases::Liver Diseases [Medical Subject Headings], Diseases::Virus Diseases::DNA Virus Infections::Hepadnaviridae Infections::Hepatitis B::Hepatitis B, Chronic [Medical Subject Headings], Medicine, Female, Liver disease, Hepatitis C crónica, Adult, Science, Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Academic Medical Centers::Hospitals, Teaching [Medical Subject Headings], Check Tags::Male [Medical Subject Headings], Diseases::Virus Diseases::Hepatitis, Viral, Human::Hepatitis C [Medical Subject Headings], Health Care::Health Services Administration::Organization and Administration::Professional Practice::Referral and Consultation [Medical Subject Headings], Article, Hepatitis B, Chronic, Progresión de la enfermedad, Humans, Enfermedades hepáticas, Hospitals, Teaching, Persons::Persons::Age Groups::Adult [Medical Subject Headings], Diseases::Virus Diseases::Hepatitis, Viral, Human::Hepatitis B [Medical Subject Headings], Aged, Retrospective Studies, Derivación y consulta, Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings], Disease progression, Hepatology, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Disease Progression [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Hepatitis B, chronic, Hepatitis C, Chronic, Check Tags::Female [Medical Subject Headings], Spain, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings], Hepatitis B crónica, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Registries [Medical Subject Headings]
Abstract

Chronic viral hepatitis infection affects an estimated 325 million people globally. People who initiate treatment after significant disease progression face increased risk of severe liver complications and death. Data are scarce on the characteristics and risk factors of people who present late to care in Spain and globally. Data were collected from January 2018 to December 2019 to report late presentation (LP) to specialist care at 11 large university hospitals in Spain to assess related risk factors using a multivariable logistic regression model. 2290 (CHB = 505, CHC = 1785) patients were analysed, with 581 (25.2%) presenting late. Hepatitis C patients more frequently reported LP compared to hepatitis B patients (28.1% vs 15.0%; p, AP, TMW, JVL acknowledge support to ISGlobal from the Spanish Ministry of Science, Innovation and Universities through the “Centro de Excelencia Severo Ochoa 2019–2023” Programme (CEX2018-000806-S), and support from the Government of Catalonia through the CERCA Programme. CAP acknowledges support from the Secretaria d’Universitats i Recerca de la Generalitat de Catalunya and the European Social Fund as an AGAUR-funded PhD fellow.

Published
2021

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