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2. Factors that determine the loss of control when reducing therapy by steps in the treatment of moderate-severe asthma in standard clinical practice: A multicentre Spanish study

Author

López, Jesús Jiménez, Orenes, Miguel Ángel Moscardó, Montaño, Patricia Prieto, Toro, Miguel Torrecillas, Oliver, Begoña Cueva, Torres, Ángel Ferrer, Delgado, Purificación González, Rodríguez, Teodorikez Wilfox Jiménez, Auli, Brian Vila, Yebenes, Juan José Zapata, Berasategui, María Teresa Audicana, Jiménez, Marta Frias, Ruibio, Nieves Hurtado De Mendoza, Azagra, Marta Velasco, Fernández, Jose Antonio Álvarez, Sainz, Sara Acero, González, Rosa Mª Blanco, Nieves, María Estela Gómez, Carpio, Diego Aisa, Sellés, Núria Angrill, García, Cristina Berastegui, Lessmann, Astrid Crespo, Carrillo, David De La Rosa, Pla, Jordi Juanola, Giraldo, Alejandra López, Sánchez, Olga Luengo, Rivera, Carlos Martínez, Olondris, Pilar Martínez, Gall, Xavier Muñoz, Nogués, Ester Pinto, Coimerma, Francisco Planas, Carroz, Karina Portillo, Blanch, Antoni Riba, Ortún, Mª Luisa Rivera, Berenguer, Dan Sánchez, Batlles, Joan Serra, Mitjà, Pere Serra, Sagardía, Ana Sogo, Retes, Lorena Soto, Combas, Joan Valldeperas, Giralte, Xavier Vila, Zubeldia, Ignacio Ansotegui, Ercoreca, Ignacio Antepara, Peña, Miguel Herrerías, Pascual, María Milagros Iriberri, Michelena, Carmen Jaca, Castro, Adolfo Lahuerta, Legarreta, Amaia Laita, Llorente, Paula Losada, Prieto, Joaquina Prieto, Lorenzo, Vanessa Zorrilla, Gil, Lidia Alonso, Muñoz, Juan Pablo García, Durantez, Marisa Marcos, Miguel, Teresa Peña, Ahmida, Tahar, Izquierdo, María Isabel Alvarado, Olbah, Michael Alwakil, Muñoz, Aurelio Arnedillo, Núñez, Ignacio García, Fernández, Diego Gutiérrez, Camacho, Antonio Letran, Pellon, Luis Fernández, Miguel, Eva Maria Morchon, Portal, Félix Ortiz, Raducan, Isabela, Prats, Juan Antonio Royo, Segarra, María Dolores Salvador, Soler, Frederic Tatay, Naon, Alberto Levy, Bonilla, Pedro Galindo, Muñoz, Francisco Luis Gil, Calderón, Patricia Mata, Costa, Luis Manuel Entrenas, Aparicio, Marina Blanco, Pazos, Jose Manuel García, Paz, Vanessa García, Barcala, Francisco-Javier González, Sotes, Pilar Iriarte, Rodríguez, Pedro Jorge Marcos, Nieto, Fernando Molina, Orjales, Ramón Nuñez, Martín, Carracedo Sevillano, Antelo, Juan Suárez, Rodríguez, Julia Tábara, Español, Santiago Aparicio, Nieto, Carlos Sabadell, Talaverano, Gladis Sabater, Rodríguez, Mª Mar Escribano, López, José Fernando Florido, Jiménez, María Ángeles Lara, Vílchez, María José Rojas, Palacín, Susana Chic, Quintana, Silvia Dorronsoro, Echeverria, Jose Antonio Navarro, Guardia, Eduardo Figueroa De La, Jara, Belén Hinojosa, García, Victoria Moreno, Vazquez, Lucía Valverde, De Sus, Joaquín Cegoñino, Santonio, Jose, López, Juan Alfonso Almagro, Campillo, Eduardo Arcalá, Molina, Compaired Villa Jose María Cruz, Venegas, Antonia Dolores Soto, Martínez, Patricia Benito, Reinosa, Begoña Blanco, Parra, Beatriz Fernández, García, Domingo Fernández, Gutiérrez, Virginia Serrano, Lobera, Adolfo Velez Ruiz De, Alcon, Silvia Lara, González, Francisco Carballada, Fernández, Teresa González, Lázaro, Joaquín Martín, Macenlle, Noemí Mengual, Viteri, Soledad Alonso, Amerigo, Darío Antolín, Bobolea, Irina, Aguirre, M Del Puerto Cano, Contreras, Remedios Cardenas, Arias, Fernando Carrillo, Álvarez, Mercedes Cimarra, Martínez, Eva Belén De Higes, Campos, Rocío Magdalena Díaz, Cano, María Del Mar Gandolfo, Rodríguez, Leticia García, Tejada, Jose Andrés García Romero De, Mancebo, Eloina González, Seco, Emma González, Torralba, Fernando González, Santana, Aythamy Henríquez, Herrera, Pilar De Lys Herráez, Mosquete, María Ruth Herrero, Rodríguez, Pedro Landete, Ballesteros, Belén López-Muñiz, Vicente, Ester Mohedano, Chacón, Beatriz Morales, Fernández, Antonio Moreno, García, Esther Muñoz, Castillejo, Elena Ojeda, Serrano, Fernando Pedraza, Acevedo, Yesenia Peña Acevedo, Rojo, Raquel Pérez, Ruiz-Rico, Natividad Quílez, Pinedo, Ángela Ramos, Jiménez, Beatriz Rodríguez, Rodríguez, Mercedes Rodríguez, Ingelmo, Ana Rosado, Peña, Antonio Ruiz, González, María José Sánchez, Trujillo, María Jesús Trujillo, Fuertes, Laura Vázquez, Albelda, Concepción Vila, Meniz, Alexandra Yago, Grovas, Ricardo Ismael Aguilar Perez, Ramírez, José Alcázar Ramírez Alcázar, Muñoz, José Manuel Barceló, Manzanares, Miguel Bentabol, Martínez, Gustavo De Luiz, Luna, Francisco Linde De, Paez, Alfonso Miranda, Tejada, Ezequiel Ortega Sáenz De, Galo, Alicia Padilla, Cornejo, Manuel Pérez Estrada, Esojo, Carmen Soria, Alemán, Ángel Francisco Abellán, Rumayor, María Consuelo Alcalde, Espinosa, Rubén Andújar, Mora, Roberto Bernabeu, Lancharro, Francisco Javier Campano, Urra, Tamara Gutiérrez, Martín, Sonia Herrero, Lizaldre, Alfredo Resano, Quintas, R. Dacal, Martínez-Moragón, E., Delgado, J., Mogrovejo, S., and Fernández-Sánchez, T.

Published
2020
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3. Factores que condicionan la pérdida de control al reducir escalones terapéuticos en el tratamiento del asma moderada-grave en la práctica clínica habitual: estudio español multicéntrico

Author

Martínez-Moragón, E., Delgado, J., Mogrovejo, S., Fernández-Sánchez, T., Jesús, Jiménez López, Ángel, Moscardó Orenes Miguel, Patricia, Prieto Montaño, Miguel, Torrecillas Toro, Begoña, Cueva Oliver, Ángel, Ferrer Torres, Purificación, González Delgado, Wilfox, Jiménez Rodríguez Teodorikez, Brian, Vila Auli, José, Zapata Yebenes Juan, Teresa, Audicana Berasategui María, Marta, Frias Jiménez, Nieves, Hurtado de Mendoza Ruibio, Marta, Velasco Azagra, Antonio, Álvarez Fernández Jose, Sara, Acero Sainz, Rosa, Blanco González M., Estela, Gómez Nieves María, Diego, Aisa Carpio, Núria, Angrill Sellés, Cristina, Berastegui García, Astrid, Crespo Lessmann, David, De La Rosa Carrillo, Jordi, Juanola Pla, Alejandra, López Giraldo, Olga, Luengo Sánchez, Carlos, Martínez Rivera, Pilar, Martínez Olondris, Xavier, Muñoz Gall, Ester, Pinto Nogués, Francisco, Planas Coimerma, Karina, Portillo Carroz, Antoni, Riba Blanch, Luisa, Rivera Ortún M., Dan, Sánchez Berenguer, Joan, Serra Batlles, Pere, Serra Mitjà, Ana, Sogo Sagardía, Lorena, Soto Retes, Joan, Valldeperas Combas, Xavier, Vila Giralte, Ignacio, Ansotegui Zubeldia, Ignacio, Antepara Ercoreca, Miguel, Herrerías Peña, Milagros, Iriberri Pascual María, Carmen, Jaca Michelena, Adolfo, Lahuerta Castro, Amaia, Laita Legarreta, Paula, Losada Llorente, Joaquina, Prieto Prieto, Vanessa, Zorrilla Lorenzo, Lidia, Alonso Gil, Pablo, García Muñoz Juan, Marisa, Marcos Durantez, Teresa, Peña Miguel, Tahar, Ahmida, Isabel, Alvarado Izquierdo María, Michael, Alwakil Olbah, Aurelio, Arnedillo Muñoz, Ignacio, García Núñez, Diego, Gutiérrez Fernández, Antonio, Letran Camacho, Luis, Fernández Pellon, Maria, Morchon Miguel Eva, Félix, Ortiz Portal, Isabela, Raducan, Antonio, Royo Prats Juan, Dolores, Salvador Segarra María, Frederic, Tatay Soler, Alberto, Levy Naon, Pedro, Galindo Bonilla, Luis, Gil Muñoz Francisco, Patricia, Mata Calderón, Manuel, Entrenas Costa Luis, Marina, Blanco Aparicio, Manuel, García Pazos Jose, Vanessa, García Paz, Francisco-Javier, González Barcala, Pilar, Iriarte Sotes, Jorge, Marcos Rodríguez Pedro, Fernando, Molina Nieto, Ramón, Nuñez Orjales, Carracedo, Sevillano Martín, Juan, Suárez Antelo, Julia, Tábara Rodríguez, Santiago, Aparicio Español, Carlos, Sabadell Nieto, Gladis, Sabater Talaverano, Mar, Escribano Rodríguez M., Fernando, Florido López José, Ángeles, Lara Jiménez María, José, Rojas Vílchez María, Susana, Chic Palacín, Silvia, Dorronsoro Quintana, Antonio, Navarro Echeverria Jose, Eduardo, Figueroa de la Guardia, Belén, Hinojosa Jara, Victoria, Moreno García, Lucía, Valverde Vazquez, Joaquín, Cegoñino de Sus, Santonio, Compaired Villa Jose, Alfonso, Almagro López Juan, Eduardo, Arcalá Campillo, María, Cruz Molina Jose, Dolores, Soto Venegas Antonia, Patricia, Benito Martínez, Begoña, Blanco Reinosa, Beatriz, Fernández Parra, Domingo, Fernández García, Virginia, Serrano Gutiérrez, Adolfo, Velez Ruiz de Lobera, Silvia, Lara Alcon, Francisco, Carballada González, Teresa, González Fernández, Joaquín, Martín Lázaro, Noemí, Mengual Macenlle, Soledad, Alonso Viteri, Darío, Antolín Amerigo, Irina, Bobolea, Puerto, Cano Aguirre M. del, Remedios, Cardenas Contreras, Fernando, Carrillo Arias, Mercedes, Cimarra Álvarez, Belén, De Higes Martínez Eva, Magdalena, Díaz Campos Rocío, Mar, Gandolfo Cano María del, Leticia, García Rodríguez, Andrés, García Romero de Tejada Jose, Eloina, González Mancebo, Emma, González Seco, Fernando, González Torralba, Aythamy, Henríquez Santana, Lys, Herráez Herrera Pilar de, Ruth, Herrero Mosquete María, Pedro, Landete Rodríguez, Belén, López-Muñiz Ballesteros, Ester, Mohedano Vicente, Beatriz, Morales Chacón, Antonio, Moreno Fernández, Esther, Muñoz García, Elena, Ojeda Castillejo, Fernando, Pedraza Serrano, Yesenia, Peña Acevedo Acevedo, Raquel, Pérez Rojo, Natividad, Quílez Ruiz-Rico, Ángela, Ramos Pinedo, Beatriz, Rodríguez Jiménez, Mercedes, Rodríguez Rodríguez, Ana, Rosado Ingelmo, Antonio, Ruiz Peña, José, Sánchez González María, Jesús, Trujillo Trujillo María, Laura, Vázquez Fuertes, Concepción, Vila Albelda, Alexandra, Yago Meniz, Ismael, Aguilar Perez Grovas Ricardo, José, Alcázar Ramírez Alcázar Ramírez, Manuel, Barceló Muñoz José, Miguel, Bentabol Manzanares, Gustavo, De Luiz Martínez, Francisco, Linde de Luna, Alfonso, Miranda Paez, Ezequiel, Ortega Sáenz de Tejada, Alicia, Padilla Galo, Manuel, Pérez Estrada Cornejo, Carmen, Soria Esojo, Francisco, Abellán Alemán Ángel, Consuelo, Alcalde Rumayor María, Rubén, Andújar Espinosa, Roberto, Bernabeu Mora, Javier, Campano Lancharro Francisco, Tamara, Gutiérrez Urra, Sonia, Herrero Martín, Alfredo, Resano Lizaldre, and Raquel, Dacal Quintas

Published
2020
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4. Respuestas jurídicas frente a la corrupción política.

Author

Cueva, Lorenzo Morillas, Director, Ortúzar, Ignacio F. Benítez, Blanca, María José Cruz, Rubia, Antonio Garrido, Rodríguez, Alberto Mora, Abolafio, Juan José Romero, Cueva, Lorenzo Morillas, Paños, Miguel Ángel Cano, Caparrós, José E. Sáinz-Cantero, Navarrete, Miguel Ángel Moreno, Villalobos, M.ª Concepción Pérez, Olivares, Gonzalo Quintero, Sanz, Jesús Barquín, del Rosal Blasco, Bernardo, Jiménez, Aixa Gálvez, Benito, Ignacio Lledó, Jaramillo, Cristina Domingo, Yébenes, Juan Rafael Benítez, Lara, José Manuel Pérez, Calderón, Jesús Mª García, Gómez, Ramón Terol, Izquierdo, Eva Mª Domínguez, Robert, María José Sánchez, Espejo, Belén Macías, Méndez, Carlos García, Herrera, Erik García, Azuara, Carlos Antonio Vázquez, Alves, Léo da Silva, R., Jaime Náquira, S., Roberto Salim-Hanna, Villar, Israel Ortiz, Hernández, Cristina Callejón, Cueva, Lorenzo Morillas, Ortúzar, Ignacio F. Benítez, Blanca, María José Cruz, Rubia, Antonio Garrido, Rodríguez, Alberto Mora, Abolafio, Juan José Romero, Cueva, Lorenzo Morillas, Paños, Miguel Ángel Cano, Caparrós, José E. Sáinz-Cantero, Navarrete, Miguel Ángel Moreno, Villalobos, M.ª Concepción Pérez, Olivares, Gonzalo Quintero, Sanz, Jesús Barquín, del Rosal Blasco, Bernardo, Jiménez, Aixa Gálvez, Benito, Ignacio Lledó, Jaramillo, Cristina Domingo, Yébenes, Juan Rafael Benítez, Lara, José Manuel Pérez, Calderón, Jesús Mª García, Gómez, Ramón Terol, Izquierdo, Eva Mª Domínguez, Robert, María José Sánchez, Espejo, Belén Macías, Méndez, Carlos García, Herrera, Erik García, Azuara, Carlos Antonio Vázquez, Alves, Léo da Silva, R., Jaime Náquira, S., Roberto Salim-Hanna, Villar, Israel Ortiz, and Hernández, Cristina Callejón

Published
2020
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5. Profundización en la sensibilización y formación en la accesibilidad e inclusión de las personas con discapacidad visual al proceso de enseñanza-aprendizaje dentro de la UCM

Author

Recas Piorno, Joaquín, Arbues Bedia, Jose, Bermudez Cabra, Antonio, Carreño Gea, Pablo, Carrera García, Juan Manuel, González Montero, María Guadalupe, González Vides, Leonela, Guerra Gallegos, Michelle Benacir, Guijarro Mata-García, María, Gutiérrez Hernández, Ángel Luis, Maestro Mañanes, Enrique, Martín Pérez, Yolanda, Muñoz Carenas, Jaime, Peña Quineche, David, Rodríguez Montes, María, Santos Peñas, Matilde, Valor Yebenes, Juan Antonio, Zuloaga Uria, Luis, Recas Piorno, Joaquín, Arbues Bedia, Jose, Bermudez Cabra, Antonio, Carreño Gea, Pablo, Carrera García, Juan Manuel, González Montero, María Guadalupe, González Vides, Leonela, Guerra Gallegos, Michelle Benacir, Guijarro Mata-García, María, Gutiérrez Hernández, Ángel Luis, Maestro Mañanes, Enrique, Martín Pérez, Yolanda, Muñoz Carenas, Jaime, Peña Quineche, David, Rodríguez Montes, María, Santos Peñas, Matilde, Valor Yebenes, Juan Antonio, and Zuloaga Uria, Luis

Abstract

El presente proyecto, SENSIVISUAL-UCM-II, supone una continuidad en los procesos de formación y sensibili-zación de la comunidad universitaria en el uso de tecnologías de información y comuni-cación, TICs, accesibles para personas con discapacidad visual, donde debe prevalecer el derecho a la atención equitativa y de calidad, permitiendo su plena inclusión educativa y social, mediante el respeto a sus necesidades específicas. El presente proyecto conti-nua con el trabajo realizado y pretende ahondar en la adecuación de contenidos docen-tes mediante el uso de herramientas concretas que mejoren el proceso de enseñanza-aprendizaje para personas con déficit visual, siguiendo con el objetivo de la plena inclu-sión de estos alumnos en el aula. SENSIVISUAL-UCM-II persigue la mejora de la calidad docente y de los servicios vinculados a procesos de innovación en materia de inclusión y diversidad, centrándose en los alumnos con discapacidad visual, y bajo la referencia del Aprendizaje por Servicio. La propuesta educativa de este proyecto combina proce-sos de aprendizaje y de servicio a la comunidad en un mismo proyecto, en el que los compañeros de las personas con discapacidad visual aprenden, generando los materia-les didácticos y potenciando el trabajo colaborativo en los grupos de clase, a la vez que trabajan en necesidades reales de la comunidad con la finalidad de mejorarla. Bajo este objetivo, las acciones llevadas a cabo harán que la comunidad universitaria, tanto profe-sores, alumnos como personal de administración y servicios, se implique en la mejora de la institución en su conjunto y del servicio que ésta ha de dar a la sociedad, consiguiendo colocarnos como universidad de referencia en accesibilidad e inclusión.

Published
2022

6. Factores que condicionan la pérdida de control al reducir escalones terapéuticos en el tratamiento del asma moderada-grave en la práctica clínica habitual: estudio español multicéntrico

Author

Andújar Espinosa Rubén, Rodríguez Rodríguez Mercedes, Rivera Ortún M. Luisa, Velasco Azagra Marta, Arcalá Campillo Eduardo, Moreno Fernández Antonio, Álvarez Fernández Jose Antonio, De Higes Martínez Eva Belén, Audicana Berasategui María Teresa, González Mancebo Eloina, Prieto Prieto Joaquina, Herráez Herrera Pilar de Lys, Valverde Vazquez Lucía, Escribano Rodríguez M. Mar, Cueva Oliver Begoña, Lahuerta Castro Adolfo, Prieto Montaño Patricia, Torrecillas Toro Miguel, Zorrilla Lorenzo Vanessa, Peña Miguel Teresa, Moscardó Orenes Miguel Ángel, Ahmida Tahar, Blanco González M. Rosa, Bernabeu Mora Roberto, Dorronsoro Quintana Silvia, Mengual Macenlle Noemí, Royo Prats Juan Antonio, Marcos Durantez Marisa, Fernández García Domingo, Alcalde Rumayor María Consuelo, Gutiérrez Fernández Diego, Marcos Rodríguez Pedro Jorge, Martín Lázaro Joaquín, Berastegui García Cristina, Blanco Aparicio Marina, Entrenas Costa Luis Manuel, García Romero de Tejada Jose Andrés, E. Martínez-Moragón, Sevillano Martín Carracedo, Soria Esojo Carmen, Jiménez Rodríguez Teodorikez Wilfox, Herrero Mosquete María Ruth, Nuñez Orjales Ramón, Antepara Ercoreca Ignacio, Tábara Rodríguez Julia, Ferrer Torres Ángel, González Fernández Teresa, Bobolea Irina, Bentabol Manzanares Miguel, García Muñoz Juan Pablo, Laita Legarreta Amaia, Morchon Miguel Eva Maria, Carballada González Francisco, Rodríguez Jiménez Beatriz, De Luiz Martínez Gustavo, Rojas Vílchez María José, Velez Ruiz de Lobera Adolfo, Vázquez Fuertes Laura, Campano Lancharro Francisco Javier, Fernández Pellon Luis, Losada Llorente Paula, González Barcala Francisco-Javier, Galindo Bonilla Pedro, Ortiz Portal Félix, Gómez Nieves María Estela, Aisa Carpio Diego, Ramos Pinedo Ángela, Miranda Paez Alfonso, Martínez Olondris Pilar, Padilla Galo Alicia, Cruz Molina Jose María, Planas Coimerma Francisco, Navarro Echeverria Jose Antonio, Compaired Villa Jose Santonio, Pedraza Serrano Fernando, Florido López José Fernando, Herrero Martín Sonia, Almagro López Juan Alfonso, Morales Chacón Beatriz, Cimarra Álvarez Mercedes, T. Fernández-Sánchez, Aparicio Español Santiago, Salvador Segarra María Dolores, Pinto Nogués Ester, Jiménez López Jesús, González Seco Emma, Barceló Muñoz José Manuel, Muñoz Gall Xavier, Soto Venegas Antonia Dolores, García Paz Vanessa, en nombre del grupo de investigación Step, García Pazos Jose Manuel, López Giraldo Alejandra, Mohedano Vicente Ester, Ojeda Castillejo Elena, Blanco Reinosa Begoña, Ansotegui Zubeldia Ignacio, Trujillo Trujillo María Jesús, Díaz Campos Rocío Magdalena, Dacal Quintas Raquel, Serra Batlles Joan, Luengo Sánchez Olga, Iriberri Pascual María Milagros, Martínez Rivera Carlos, Alvarado Izquierdo María Isabel, Iriarte Sotes Pilar, Sánchez González María José, Gil Muñoz Francisco Luis, S. Mogrovejo, Valldeperas Combas Joan, González Torralba Fernando, Serrano Gutiérrez Virginia, Peña Acevedo Acevedo Yesenia, Ruiz Peña Antonio, Alcázar Ramírez Alcázar Ramírez José, Abellán Alemán Ángel Francisco, Henríquez Santana Aythamy, Landete Rodríguez Pedro, Soto Retes Lorena, García Rodríguez Leticia, Raducan Isabela, Hinojosa Jara Belén, Cano Aguirre M. del Puerto, Muñoz García Esther, López-Muñiz Ballesteros Belén, Juanola Pla Jordi, Carrillo Arias Fernando, García Núñez Ignacio, Yago Meniz Alexandra, Gutiérrez Urra Tamara, Lara Alcon Silvia, De La Rosa Carrillo David, Alwakil Olbah Michael, Vila Albelda Concepción, Figueroa de la Guardia Eduardo, Quílez Ruiz-Rico Natividad, Herrerías Peña Miguel, Crespo Lessmann Astrid, Suárez Antelo Juan, Portillo Carroz Karina, Vila Giralte Xavier, Lara Jiménez María Ángeles, Ortega Sáenz de Tejada Ezequiel, Gandolfo Cano María del Mar, Acero Sainz Sara, Alonso Viteri Soledad, Alonso Gil Lidia, Sabater Talaverano Gladis, Sogo Sagardía Ana, Zapata Yebenes Juan José, Hurtado de Mendoza Ruibio Nieves, Molina Nieto Fernando, Cegoñino de Sus Joaquín, Sabadell Nieto Carlos, Benito Martínez Patricia, Pérez Estrada Cornejo Manuel, Tatay Soler Frederic, Vila Auli Brian, Mata Calderón Patricia, Levy Naon Alberto, Moreno García Victoria, Jaca Michelena Carmen, Serra Mitjà Pere, Arnedillo Muñoz Aurelio, Resano Lizaldre Alfredo, Pérez Rojo Raquel, Rosado Ingelmo Ana, Antolín Amerigo Darío, Chic Palacín Susana, Cardenas Contreras Remedios, Angrill Sellés Núria, González Delgado Purificación, Fernández Parra Beatriz, Aguilar Perez Grovas Ricardo Ismael, J. Delgado, Riba Blanch Antoni, Frias Jiménez Marta, Sánchez Berenguer Dan, Linde de Luna Francisco, and Letran Camacho Antonio

Subjects
03 medical and health sciences, 0302 clinical medicine, business.industry, Medicine, 030212 general & internal medicine, General Medicine, business, Humanities
Abstract

Resumen Introduccion Aunque las guias de practica clinica recomiendan un ajuste continuado del tratamiento del asma, reduciendo la medicacion de mantenimiento cuando se alcanza el control (step-down), existen pocos estudios de practica clinica habitual orientados a recabar informacion de los factores que condicionan su fracaso. Objetivo Determinar los factores que condicionan en la practica clinica habitual el fracaso del step-down en los pacientes asmaticos moderados-graves controlados con una combinacion de glucocorticoides inhalados/agonistas beta-2 adrenergicos de accion larga. Metodo Estudio multicentrico retrospectivo sobre 374 pacientes con asma moderada-grave controlada con glucocorticoides inhalados/agonistas beta-2 adrenergicos de accion larga en quienes el facultativo indico en 2016 un step-down. Resultados El step-down fracaso en el 41,7%. Los factores relacionados con el fracaso fueron: la mayor edad del paciente (p = 0,006), la presencia de 2 o mas comorbilidades (p = 0,016), el mayor nivel de gravedad (persistente grave vs. persistente moderada) (p 40 anos) (p = 0,045), cuanto mas alto es el escalon terapeutico previo (p = 0,003) y posterior al cambio (p Conclusion En condiciones de practica clinica habitual el step-down fracasa en un porcentaje alto de pacientes y se recomienda indicarlo cuando el paciente lleve mas de 6 meses controlado.

Published
2020

7. Factors that determine the loss of control when reducing therapy by steps in the treatment of moderate-severe asthma in standard clinical practice: A multicentre Spanish study

Author

Zapata Yebenes Juan José, Vila Auli Brian, González Delgado Purificación, Hurtado de Mendoza Ruibio Nieves, Vila Giralte Xavier, Florido López José Fernando, Mata Calderón Patricia, De Higes Martínez Eva Belén, Almagro López Juan Alfonso, Peña Acevedo Acevedo Yesenia, Carballada González Francisco, Jiménez López Jesús, Navarro Echeverria Jose Antonio, Compaired Villa Jose Santonio, Levy Naon Alberto, Losada Llorente Paula, Martínez Olondris Pilar, Moreno García Victoria, Mohedano Vicente Ester, Barceló Muñoz José Manuel, Alonso Viteri Soledad, Alonso Gil Lidia, Aguilar Perez Grovas Ricardo Ismael, Jaca Michelena Carmen, en nombre del grupo de investigación Step, García Pazos Jose Manuel, Dacal Quintas Raquel, Cimarra Álvarez Mercedes, Salvador Segarra María Dolores, Torrecillas Toro Miguel, Gutiérrez Fernández Diego, Iriarte Sotes Pilar, Serra Mitjà Pere, López Giraldo Alejandra, Sabater Talaverano Gladis, Berastegui García Cristina, Álvarez Fernández Jose Antonio, Raducan Isabela, Hinojosa Jara Belén, Blanco Aparicio Marina, Rivera Ortún M. Luisa, Sogo Sagardía Ana, Cegoñino de Sus Joaquín, Pérez Rojo Raquel, Prieto Montaño Patricia, García Romero de Tejada Jose Andrés, Soto Venegas Antonia Dolores, García Paz Vanessa, Dorronsoro Quintana Silvia, S. Mogrovejo, Valverde Vazquez Lucía, Peña Miguel Teresa, Fernández García Domingo, Serrano Gutiérrez Virginia, Moscardó Orenes Miguel Ángel, Rosado Ingelmo Ana, Sabadell Nieto Carlos, Lara Jiménez María Ángeles, Ortega Sáenz de Tejada Ezequiel, Molina Nieto Fernando, Soto Retes Lorena, Mengual Macenlle Noemí, Rodríguez Jiménez Beatriz, Gandolfo Cano María del Mar, Antolín Amerigo Darío, Chic Palacín Susana, Acero Sainz Sara, Herrero Mosquete María Ruth, Moreno Fernández Antonio, Entrenas Costa Luis Manuel, Lara Alcon Silvia, Sánchez González María José, Cardenas Contreras Remedios, González Mancebo Eloina, Rojas Vílchez María José, Zorrilla Lorenzo Vanessa, Rodríguez Rodríguez Mercedes, González Barcala Francisco-Javier, Vázquez Fuertes Laura, De La Rosa Carrillo David, Alwakil Olbah Michael, Galindo Bonilla Pedro, Campano Lancharro Francisco Javier, Fernández Pellon Luis, Fernández Parra Beatriz, Quílez Ruiz-Rico Natividad, Herrerías Peña Miguel, Benito Martínez Patricia, Pérez Estrada Cornejo Manuel, Aparicio Español Santiago, Velasco Azagra Marta, Arcalá Campillo Eduardo, Alcalde Rumayor María Consuelo, Aisa Carpio Diego, Miranda Paez Alfonso, Tatay Soler Frederic, Sevillano Martín Carracedo, Gómez Nieves María Estela, González Seco Emma, De Luiz Martínez Gustavo, Planas Coimerma Francisco, Angrill Sellés Núria, Cruz Molina Jose María, Soria Esojo Carmen, Bentabol Manzanares Miguel, Blanco Reinosa Begoña, Martínez Rivera Carlos, Ansotegui Zubeldia Ignacio, Audicana Berasategui María Teresa, Iriberri Pascual María Milagros, Alvarado Izquierdo María Isabel, Valldeperas Combas Joan, Herráez Herrera Pilar de Lys, Velez Ruiz de Lobera Adolfo, González Fernández Teresa, Blanco González M. Rosa, Marcos Durantez Marisa, Linde de Luna Francisco, Letran Camacho Antonio, Bernabeu Mora Roberto, Sánchez Berenguer Dan, Muñoz García Esther, Jiménez Rodríguez Teodorikez Wilfox, Padilla Galo Alicia, García Muñoz Juan Pablo, Arnedillo Muñoz Aurelio, Vila Albelda Concepción, Figueroa de la Guardia Eduardo, Laita Legarreta Amaia, Andújar Espinosa Rubén, Crespo Lessmann Astrid, T. Fernández-Sánchez, J. Delgado, Abellán Alemán Ángel Francisco, Escribano Rodríguez M. Mar, Resano Lizaldre Alfredo, Portillo Carroz Karina, Yago Meniz Alexandra, Riba Blanch Antoni, Martín Lázaro Joaquín, Ortiz Portal Félix, Frias Jiménez Marta, Royo Prats Juan Antonio, Pedraza Serrano Fernando, Pinto Nogués Ester, Díaz Campos Rocío Magdalena, Luengo Sánchez Olga, Serra Batlles Joan, Bobolea Irina, Ojeda Castillejo Elena, González Torralba Fernando, E. Martínez-Moragón, Ruiz Peña Antonio, Alcázar Ramírez Alcázar Ramírez José, Nuñez Orjales Ramón, Trujillo Trujillo María Jesús, Gil Muñoz Francisco Luis, Morales Chacón Beatriz, Morchon Miguel Eva Maria, Carrillo Arias Fernando, García Núñez Ignacio, Ramos Pinedo Ángela, Gutiérrez Urra Tamara, Ahmida Tahar, Marcos Rodríguez Pedro Jorge, Henríquez Santana Aythamy, Landete Rodríguez Pedro, Suárez Antelo Juan, García Rodríguez Leticia, Cano Aguirre M. del Puerto, López-Muñiz Ballesteros Belén, Juanola Pla Jordi, Muñoz Gall Xavier, Antepara Ercoreca Ignacio, Tábara Rodríguez Julia, Ferrer Torres Ángel, Herrero Martín Sonia, Prieto Prieto Joaquina, Cueva Oliver Begoña, and Lahuerta Castro Adolfo

Subjects
medicine.medical_specialty, business.industry, Severe asthma, Asthma treatment, Retrospective cohort study, General Medicine, medicine.disease, Disease control, Clinical Practice, 03 medical and health sciences, 0302 clinical medicine, Patient age, Internal medicine, medicine, 030212 general & internal medicine, Severity level, business, Asthma
Abstract

Although the clinical practice guidelines recommend continuous adjustment of asthma treatment and reducing the maintenance drugs when achieving control (step-down), there are few studies of standard clinical practice aimed at collecting information on the factors that determine step-down failure.To determine the factors that determine step-down failure in standard clinical practice of patients with moderate-severe asthma controlled by a combination of inhaled glucocorticoids and long-acting beta agonists.A multicentre retrospective study included 374 patients with moderate-severe asthma controlled with inhaled glucocorticoids and long-acting beta agonists for whom the physician indicated a step-down in 2016.The step-down failed in 41.7% of the patients. The following factors were related to failure: greater patient age (P=.006), presence of at least 2 comorbidities (P=.016), greater severity level (severe persistent vs. moderate persistent) (P.001), greater age at diagnosis (40 years) (P=.045), the higher the therapeutic step before (P=.003) and after the change (P.001), the shorter the time of improvement/control prior to the change (P=.019), lower FEVIn standard clinical practice conditions, step-down fails in a high percentage of patients, and the suggestion is to indicate step-down when the patient has had more than 6 months of disease control.

Published
2020

12. Factors that determine the loss of control when reducing therapy by steps in the treatment of moderate-severe asthma in standard clinical practice: A multicentre Spanish study

Author

Martínez-Moragón, E., primary, Delgado, J., additional, Mogrovejo, S., additional, Fernández-Sánchez, T., additional, López, Jesús Jiménez, additional, Orenes, Miguel Ángel Moscardó, additional, Montaño, Patricia Prieto, additional, Toro, Miguel Torrecillas, additional, Oliver, Begoña Cueva, additional, Torres, Ángel Ferrer, additional, Delgado, Purificación González, additional, Rodríguez, Teodorikez Wilfox Jiménez, additional, Auli, Brian Vila, additional, Yebenes, Juan José Zapata, additional, Berasategui, María Teresa Audicana, additional, Jiménez, Marta Frias, additional, Ruibio, Nieves Hurtado De Mendoza, additional, Azagra, Marta Velasco, additional, Fernández, Jose Antonio Álvarez, additional, Sainz, Sara Acero, additional, González, Rosa Mª Blanco, additional, Nieves, María Estela Gómez, additional, Carpio, Diego Aisa, additional, Sellés, Núria Angrill, additional, García, Cristina Berastegui, additional, Lessmann, Astrid Crespo, additional, Carrillo, David De La Rosa, additional, Pla, Jordi Juanola, additional, Giraldo, Alejandra López, additional, Sánchez, Olga Luengo, additional, Rivera, Carlos Martínez, additional, Olondris, Pilar Martínez, additional, Gall, Xavier Muñoz, additional, Nogués, Ester Pinto, additional, Coimerma, Francisco Planas, additional, Carroz, Karina Portillo, additional, Blanch, Antoni Riba, additional, Ortún, Mª Luisa Rivera, additional, Berenguer, Dan Sánchez, additional, Batlles, Joan Serra, additional, Mitjà, Pere Serra, additional, Sagardía, Ana Sogo, additional, Retes, Lorena Soto, additional, Combas, Joan Valldeperas, additional, Giralte, Xavier Vila, additional, Zubeldia, Ignacio Ansotegui, additional, Ercoreca, Ignacio Antepara, additional, Peña, Miguel Herrerías, additional, Pascual, María Milagros Iriberri, additional, Michelena, Carmen Jaca, additional, Castro, Adolfo Lahuerta, additional, Legarreta, Amaia Laita, additional, Llorente, Paula Losada, additional, Prieto, Joaquina Prieto, additional, Lorenzo, Vanessa Zorrilla, additional, Gil, Lidia Alonso, additional, Muñoz, Juan Pablo García, additional, Durantez, Marisa Marcos, additional, Miguel, Teresa Peña, additional, Ahmida, Tahar, additional, Izquierdo, María Isabel Alvarado, additional, Olbah, Michael Alwakil, additional, Muñoz, Aurelio Arnedillo, additional, Núñez, Ignacio García, additional, Fernández, Diego Gutiérrez, additional, Camacho, Antonio Letran, additional, Pellon, Luis Fernández, additional, Miguel, Eva Maria Morchon, additional, Portal, Félix Ortiz, additional, Raducan, Isabela, additional, Prats, Juan Antonio Royo, additional, Segarra, María Dolores Salvador, additional, Soler, Frederic Tatay, additional, Naon, Alberto Levy, additional, Bonilla, Pedro Galindo, additional, Muñoz, Francisco Luis Gil, additional, Calderón, Patricia Mata, additional, Costa, Luis Manuel Entrenas, additional, Aparicio, Marina Blanco, additional, Pazos, Jose Manuel García, additional, Paz, Vanessa García, additional, Barcala, Francisco-Javier González, additional, Sotes, Pilar Iriarte, additional, Rodríguez, Pedro Jorge Marcos, additional, Nieto, Fernando Molina, additional, Orjales, Ramón Nuñez, additional, Martín, Carracedo Sevillano, additional, Antelo, Juan Suárez, additional, Rodríguez, Julia Tábara, additional, Español, Santiago Aparicio, additional, Nieto, Carlos Sabadell, additional, Talaverano, Gladis Sabater, additional, Rodríguez, Mª Mar Escribano, additional, López, José Fernando Florido, additional, Jiménez, María Ángeles Lara, additional, Vílchez, María José Rojas, additional, Palacín, Susana Chic, additional, Quintana, Silvia Dorronsoro, additional, Echeverria, Jose Antonio Navarro, additional, Guardia, Eduardo Figueroa De La, additional, Jara, Belén Hinojosa, additional, García, Victoria Moreno, additional, Vazquez, Lucía Valverde, additional, De Sus, Joaquín Cegoñino, additional, Santonio, Jose, additional, López, Juan Alfonso Almagro, additional, Campillo, Eduardo Arcalá, additional, Molina, Compaired Villa Jose María Cruz, additional, Venegas, Antonia Dolores Soto, additional, Martínez, Patricia Benito, additional, Reinosa, Begoña Blanco, additional, Parra, Beatriz Fernández, additional, García, Domingo Fernández, additional, Gutiérrez, Virginia Serrano, additional, Lobera, Adolfo Velez Ruiz De, additional, Alcon, Silvia Lara, additional, González, Francisco Carballada, additional, Fernández, Teresa González, additional, Lázaro, Joaquín Martín, additional, Macenlle, Noemí Mengual, additional, Viteri, Soledad Alonso, additional, Amerigo, Darío Antolín, additional, Bobolea, Irina, additional, Aguirre, M Del Puerto Cano, additional, Contreras, Remedios Cardenas, additional, Arias, Fernando Carrillo, additional, Álvarez, Mercedes Cimarra, additional, Martínez, Eva Belén De Higes, additional, Campos, Rocío Magdalena Díaz, additional, Cano, María Del Mar Gandolfo, additional, Rodríguez, Leticia García, additional, Tejada, Jose Andrés García Romero De, additional, Mancebo, Eloina González, additional, Seco, Emma González, additional, Torralba, Fernando González, additional, Santana, Aythamy Henríquez, additional, Herrera, Pilar De Lys Herráez, additional, Mosquete, María Ruth Herrero, additional, Rodríguez, Pedro Landete, additional, Ballesteros, Belén López-Muñiz, additional, Vicente, Ester Mohedano, additional, Chacón, Beatriz Morales, additional, Fernández, Antonio Moreno, additional, García, Esther Muñoz, additional, Castillejo, Elena Ojeda, additional, Serrano, Fernando Pedraza, additional, Acevedo, Yesenia Peña Acevedo, additional, Rojo, Raquel Pérez, additional, Ruiz-Rico, Natividad Quílez, additional, Pinedo, Ángela Ramos, additional, Jiménez, Beatriz Rodríguez, additional, Rodríguez, Mercedes Rodríguez, additional, Ingelmo, Ana Rosado, additional, Peña, Antonio Ruiz, additional, González, María José Sánchez, additional, Trujillo, María Jesús Trujillo, additional, Fuertes, Laura Vázquez, additional, Albelda, Concepción Vila, additional, Meniz, Alexandra Yago, additional, Grovas, Ricardo Ismael Aguilar Perez, additional, Ramírez, José Alcázar Ramírez Alcázar, additional, Muñoz, José Manuel Barceló, additional, Manzanares, Miguel Bentabol, additional, Martínez, Gustavo De Luiz, additional, Luna, Francisco Linde De, additional, Paez, Alfonso Miranda, additional, Tejada, Ezequiel Ortega Sáenz De, additional, Galo, Alicia Padilla, additional, Cornejo, Manuel Pérez Estrada, additional, Esojo, Carmen Soria, additional, Alemán, Ángel Francisco Abellán, additional, Rumayor, María Consuelo Alcalde, additional, Espinosa, Rubén Andújar, additional, Mora, Roberto Bernabeu, additional, Lancharro, Francisco Javier Campano, additional, Urra, Tamara Gutiérrez, additional, Martín, Sonia Herrero, additional, Lizaldre, Alfredo Resano, additional, and Quintas, R. Dacal, additional

Published
2020
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14. Nutritrauma: A Key Concept for Minimising the Harmful Effects of the Administration of Medical Nutrition Therapy

Author

Universitat Rovira i Virgili, Carlos Yebenes, Juan; Campins, Lluis; Martinez de Lagran, Itziar; Bordeje, Lluisa; Lorencio, Carol; Grau, Teodoro; Carlos Montejo, Juan; Bodi, Maria; Serra-Prat, Mateu;Spanish Soc Critical Care, Universitat Rovira i Virgili, and Carlos Yebenes, Juan; Campins, Lluis; Martinez de Lagran, Itziar; Bordeje, Lluisa; Lorencio, Carol; Grau, Teodoro; Carlos Montejo, Juan; Bodi, Maria; Serra-Prat, Mateu;Spanish Soc Critical Care

Abstract

Critically ill patients often require life support measures such as mechanical ventilation or haemodialysis. Despite the essential role of nutrition in patients' recovery, the inappropriate use of medical nutrition therapy can have deleterious effects, as is the case with the use of respiratory, circulatory, or renal support. To increase awareness and to monitor the effects of inappropriate medical nutrition therapy, we propose to introduce the concept of nutritrauma in clinical practice, defined as metabolic adverse events related to the inappropriate administration of medical nutrition therapy or inadequate nutritional monitoring.

Published
2019

18. Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching study

Author

Universitat Rovira i Virgili, Moreno, Gerard; Rodriguez, Alejandro; Reyes, Luis F.; Gomez, Josep; Sole-Violan, Jordi; Diaz, Emili; Bodi, Maria; Trefler, Sandra; Guardiola, Juan; Yebenes, Juan C.; Soriano, Alex; Garnacho-Montero, Jose; Socias, Lorenzo; Ortiz, Maria del Valle; Correig, Eudald; Marin-Corral, Judith; Vallverdu-Vidal, Montserrat; Restrepo, Marcos I.; Torres, Antoni; Martin-Loeches, Ignacio;GETGAG Study Grp, Universitat Rovira i Virgili, and Moreno, Gerard; Rodriguez, Alejandro; Reyes, Luis F.; Gomez, Josep; Sole-Violan, Jordi; Diaz, Emili; Bodi, Maria; Trefler, Sandra; Guardiola, Juan; Yebenes, Juan C.; Soriano, Alex; Garnacho-Montero, Jose; Socias, Lorenzo; Ortiz, Maria del Valle; Correig, Eudald; Marin-Corral, Judith; Vallverdu-Vidal, Montserrat; Restrepo, Marcos I.; Torres, Antoni; Martin-Loeches, Ignacio;GETGAG Study Grp

Abstract

To determine clinical predictors associated with corticosteroid administration and its association with ICU mortality in critically ill patients with severe influenza pneumonia.Secondary analysis of a prospective cohort study of critically ill patients with confirmed influenza pneumonia admitted to 148 ICUs in Spain between June 2009 and April 2014. Patients who received corticosteroid treatment for causes other than viral pneumonia (e.g., refractory septic shock and asthma or chronic obstructive pulmonary disease [COPD] exacerbation) were excluded. Patients with corticosteroid therapy were compared with those without corticosteroid therapy. We use a propensity score (PS) matching analysis to reduce confounding factors. The primary outcome was ICU mortality. Cox proportional hazards and competing risks analysis was performed to assess the impact of corticosteroids on ICU mortality.A total of 1846 patients with primary influenza pneumonia were enrolled. Corticosteroids were administered in 604 (32.7%) patients, with methylprednisolone the most frequently used corticosteroid (578/604 [95.7%]). The median daily dose was equivalent to 80 mg of methylprednisolone (IQR 60-120) for a median duration of 7 days (IQR 5-10). Asthma, COPD, hematological disease, and the need for mechanical ventilation were independently associated with corticosteroid use. Crude ICU mortality was higher in patients who received corticosteroids (27.5%) than in patients who did not receive corticosteroids (18.8%, p < 0.001). After PS matching, corticosteroid use was associated with ICU mortality in the Cox (HR = 1.32 [95% CI 1.08-1.60], p < 0.006) and competing risks analysis (SHR = 1.37 [95% CI 1.12-1.68], p = 0.001).Administration of corticosteroids in patients with severe influenza pneumonia is ass

Published
2018

19. El procedimiento de actuación ante los órganos de la jurisdicción de vigilancia penitenciaria. Hacia un Derecho Procesal Penitenciario

Author

Benítez Yébenes, Juan Rafael and Benítez Yébenes, Juan Rafael

Subjects
Law--Spain, Criminal law--Spain
Abstract

Aunque centrado especialmente en el procedimiento de actuación –de ahí su título–, este trabajo también aborda otras cuestiones relativas a los orígenes, marco normativo y aspectos orgánicos del Juez de Vigilancia Penitenciaria, pues podemos afirmar que este Juez es el gran desconocido del organigrama de la jurisdicción española, de tal modo que el conocimiento de estas cuestiones, constituye un presupuesto necesario para conocer el procedimiento por el que debe actuar sus competencias.Cuando se han cumplido ya más de 35 años desde que entraron en funcionamiento estos Jueces, “pieza clave de nuestro sistema penitenciario” según las propias palabras del Tribunal Constitucional, el legislador español ha demostrado que no tiene una idea clara de qué es lo que quiere que sea el Juez de Vigilancia, al que tiene abandonado, como lo demuestra su falta de interés hacia el mismo al no haber regulado aún el correspondiente procedimiento para que pueda desempeñar eficazmente sus funciones.Mejorar el sistema penitenciario no es sólo hacer más cárceles, más modernas, con más medios técnicos, y con mejores instalaciones de todo tipo. De nada vale todo esto sin la eficaz intervención del Juez de Vigilancia en orden a la tutela judicial efectiva de los internos, para lo que precisa estar dotado de la herramienta procesal adecuada.Con este trabajo hemos querido aportar un granito de arena, una gota de agua que pueda servir de alivio ante esta sequía legislativa. Juan Rafael Benítez Yébenes es Doctor en Derecho por la Universidad de Córdoba. Magistrado, destinado actualmente en la Sección Séptima de la Audiencia Provincial de Málaga, con sede en Melilla. También desempeña en régimen de compatibilidad (art. 94.5 LOPJ) el cargo de Juez de Vigilancia Penitenciaria de esta Ciudad. Profesor asociado de Derecho Procesal de la Universidad de Granada en el campus de Melilla. Fundó y preside la Asociación Melillense de Estudios Penitenciarios.

Published
2017

20. Intra-Abdominal Pressure as a Marker of Enteral Nutrition Intolerance in Critically Ill Patients. The PIANE Study

Author

Luisa Bordeje, M., Montejo, Juan C., Lidon Mateu, M., Solera, Manuel, Acosta, Jose A., Juan, Mar, Garcia-Cordoba, Francisco, Garcia-Martinez, Miguel A., Gastaldo, Rosa, Acosta, Jose, Albert, Inmaculada, Alec, Alfonso, Luisa Bordeje, Ma, Calvo, Enrique, Ferre, Merce, Garcia de Lorenzo, Abelardo, Angel Garcia-Martinez, Miguel, Gonzalez-Iglesias, Carlos, Iglesias, Rayden, Lorencio, Carol, Martinez de la Gandara, Amalia, Lidon Mateu, Ma, Mesejo, Alfonso, Martinez-Garcia, Pilar, Carlos Montejo, Juan, Luisa Navarrete, Ma, Ortiz-Leyba, Carlos, Robles, Angel, Sanchez-Alvarez, Carmen, Vaquerizo, Clara, Vila, Belen, Carlos Yebenes, Juan, Zabarte, Mercedes, and PIANE STUDY GRP SPAIN

Subjects
Male, Gastrointestinal Diseases - etiology, Gastrointestinal Diseases, medicine.medical_treatment, humanos, asistencia del enfermo crítico, intensive care unit, Gastroenterology, Enteral administration, Group B, law.invention, 0302 clinical medicine, law, estudios prospectivos, Abdomen, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, mediana edad, anciano, Nutrition and Dietetics, Respiration, enfermedades gastrointestinales, respiración, gastrointestinal complications, Middle Aged, Intensive care unit, Intensive Care Units, presión, medicine.anatomical_structure, intra-abdominal pressure, Female, lcsh:Nutrition. Foods and food supply, medicine.medical_specialty, Critical Care, Critical Illness, unidades de cuidados intensivos, enfermedad crítica, lcsh:TX341-641, Article, enteral nutrition intolerance, 03 medical and health sciences, Internal medicine, Pressure, medicine, Humans, enteral nutrition, nutrición enteral, Aged, Mechanical ventilation, business.industry, 030208 emergency & critical care medicine, Respiration, Artificial, Critical Illness - therapy, Parenteral nutrition, business, Complication, Biomarkers, Food Science
Abstract

To determine whether elevated intra-abdominal pressure (IAP) is associated with a higher rate of enteral nutrition-related gastrointestinal (GI) complications, to assess the value of IAP as a predictor of enteral nutrition (EN) intolerance. Intensive Care Unit (ICU) patients on mechanical ventilation requiring at least 5 days of EN were recruited for a prospective, observational, non-interventional, multicenter study. EN was performed and GI complications were managed with an established protocol. IAP was determined via a urinary catheter. Patients who developed any GI complications were considered as presenting EN intolerance. Variables related to EN, IAP and GI complications were monitored daily. Statistical analysis compared patients without GI complications (group A) vs. GI complications (group B). 247 patients were recruited from 28 participating ICUs (group A: 119, group B: 128). No differences between groups were recorded. Patients in group B (p &lt, 0.001) spent more days on EN (8.1 ± 8.4 vs. 18.1 ± 13.7), on mechanical ventilation (8.0 ± 7.7 vs. 19.3 ± 14.9) and in the ICU (12.3 ± 11.4 vs. 24.8 ± 17.5). IAP prior to the GI complication was (14.3 ± 3.1 vs. 15.8 ± 4.8) (p &lt, 0.003). The best IAP value identified for EN intolerance was 14 mmHg but it had low sensitivity and specificity. Although a higher IAP was associated with EN intolerance, IAP alone did not emerge as a good predictor of EN intolerance in critically ill patients.

Published
2019

21. Towards a Data Governance Framework for Third Generation Platforms.

Author

Yebenes, Juan and Zorrilla, Marta

Subjects
SOFTWARE architecture, INDUSTRY 4.0, MANUFACTURING processes, CLOUD computing
Abstract

The fourth industrial revolution considers data as a business asset and therefore this is placed as a central element of the software architecture (data as a service) that will support the horizontal and vertical digitalization of industrial processes. The large volume of data that the environment generates, its heterogeneity and complexity, as well as its reuse for later processes (e.g. analytics, IA) requires the adoption of policies, directives and standards for its right governance. Furthermore, the issues related to the use of resources in the cloud computing must be taken into account with the aim of meeting the requirements of performance and security of the different processes. This article, in the absence of frameworks adapted to this new architecture, proposes an initial schema for developing an effective data governance programme for third generation platforms, that means, a conceptual tool which guides organizations to define, design, develop and deploy services aligned with its vision and business goals in I4.0 era. [ABSTRACT FROM AUTHOR]

Published
2020
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23. Risk Factors for Noninvasive Ventilation Failure in Critically Ill Subjects With Confirmed Influenza Infection

Author

Rodríguez, Alejandro, primary, Ferri, Cristina, additional, Martin-Loeches, Ignacio, additional, Díaz, Emili, additional, Masclans, Joan R, additional, Gordo, Federico, additional, Sole-Violán, Jordi, additional, Bodí, María, additional, Avilés-Jurado, Francesc X, additional, Trefler, Sandra, additional, Magret, Monica, additional, Moreno, Gerard, additional, Reyes, Luis F, additional, Marin-Corral, Judith, additional, Yebenes, Juan C, additional, Esteban, Andres, additional, Anzueto, Antonio, additional, Aliberti, Stefano, additional, and Restrepo, Marcos I, additional

Published
2017
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24. The prognostic value of muscle regional oxygen saturation index in severe community-acquired pneumonia: a prospective observational study

Author

Universitat Rovira i Virgili, Claverias, Laura; Mari, Michael; Marin-Corral, Judith; Magret, Monica; Trefler, Sandra; Bodi, Maria; Garcia-Espana, Antonio; Carlos Yebenes, Juan; Pascual, Sergi; Gea, Joaquim; Rodriguez, Alejandro, Universitat Rovira i Virgili, and Claverias, Laura; Mari, Michael; Marin-Corral, Judith; Magret, Monica; Trefler, Sandra; Bodi, Maria; Garcia-Espana, Antonio; Carlos Yebenes, Juan; Pascual, Sergi; Gea, Joaquim; Rodriguez, Alejandro

Abstract

Background: Community-acquired pneumonia (CAP) mortality exceeds 20 % in critical care patients despite appropriate antibiotic therapy. Regional tissue oxygen saturation index (rSO2) measured with near-infrared spectroscopy (NIRS) might facilitate early detection for patients at risk of serious complications. Our objectives were to determine the relationship between early determination of rSO2 and mortality and to compare discrimination power for mortality of rSO2 and other resuscitation variables in critically ill CAP patients. Methods: This is a prospective observational study. Patients with CAP were enrolled within 6 h to intensive care admission. Demographics and clinical variables were recorded. rSO2 was determined using NIRS in brachioradialis muscle. All variables were determined at baseline and 24 h after admission. Results: Forty patients were enrolled. Fourteen patients (35 %) had a baseline rSO2 < 60 % and 7 of them died (50 %). Only 1 of 26 (3.8 %) patients with rSO2 >= 60 % died (p = 0.007). The area under ROC curve (AUROC) showed consistent mortality discrimination at baseline (0.84, p = 0.03) and at 24 h (0.86, p = 0.006) for rSO2 values. Cox regression analysis showed that low rSO2 at ICU admission (hazard ratio (HR) = 8.99; 95 % confidence interval (CI) 1.05-76.8; p = 0.045) and low rSO2 at 24 h (HR = 13.18; 95 % CI 1.52-113.6; p = 0.019) were variables independently associated with mortality. In contrast, other variables such as Acute Physiology and Chronic Health Evaluation (APACHE II) score (HR = 1.09; 95 % CI 0.99-1.19; p = 0.052) were not associated with mortality. Conclusions: Our findings suggest that forearm skeletal muscle rSO2 differs in patients with severe CAP according to outcome and might be an early prognosis tool.

Published
2016

26. Risk Factors for Noninvasive Ventilation Failure in Critically 111 Subjects With Confirmed Influenza Infection.

Author

Rodríguez, Alejandro, Ferri, Cristina, Martin-Loeches, Ignacio, Díaz, Emili, Masclans, Joan R., Gordo, Federico, Sole-Violán, Jordi, Bodí, María, Avilés-Jurado, Francesc X., Trefler, Sandra, Magret, Monica, Moreno, Gerard, Reyes, Luis F., Marin-Corral, Judith, Yebenes, Juan C., Esteban, Andres, Anzueto, Antonio, Aliberti, Stefano, and Restrepo, Marcos I.

Subjects
INFLUENZA complications, ADULT respiratory distress syndrome treatment, ALGORITHMS, APACHE (Disease classification system), CHI-squared test, CONFIDENCE intervals, DECISION trees, FISHER exact test, PROBABILITY theory, RESEARCH funding, T-test (Statistics), LOGISTIC regression analysis, SECONDARY analysis, TREATMENT effectiveness, SEVERITY of illness index, POSITIVE pressure ventilation, HOSPITAL mortality, KAPLAN-Meier estimator, ODDS ratio, MANN Whitney U Test
Abstract

BACKGROUND: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality. METHODS: This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation. Three groups of subjects were compared: (1) subjects who received NIV immediately after ICU admission for ARF and then failed (NIV failure group); (2) subjects who received NIV immediately after ICU admission for ARF and then succeeded (NIV success group); and (3) subjects who received invasive mechanical ventilation immediately after ICU admission for ARF (invasive mechanical ventilation group). Profiles of subjects with risk factors for NIV failure were obtained using CHAID analysis. RESULTS: Of 1,898 subjects, 806 underwent NIV, and 56.8% of them failed. Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, infiltrates in chest radiograph, and ICU mortality (38.4% vs 6.3%) were higher (P < .001) in the NIV failure than in the NIV success group. SOFA score was the variable most associated with NIV failure, and 2 cutoffs were determined. Subjects with SOFA ≥ 5 had a higher risk of NIV failure (odds ratio = 3.3, 95% CI 2.4-4.5). ICU mortality was higher in subjects with NIV failure (38.4%) compared with invasive mechanical ventilation subjects (31.3%, P = .018), and NIV failure was associated with increased ICU mortality (odds ratio = 11.4, 95% CI 6.5-20.1). CONCLUSIONS: An automatic and non-subjective algorithm based on CHAID decision-tree analysis can help to define the profile of patients with different risks of NIV failure, which might be a promising tool to assist in clinical decision making to avoid the possible complications associated with NIV failure. [ABSTRACT FROM AUTHOR]

Published
2017
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27. Oral Drugs Related with Muscle Wasting and Sarcopenia. A Review.

Author

Campins, Lluis, Camps, Marcella, Riera, ariadna, Pleguezuelos, Eulogio, Yebenes, Juan Carlos, and Serra-Prat, Mateu

Subjects
ORAL medication, SARCOPENIA, HORMONE therapy, DISEASE progression, AGE of onset, THERAPEUTICS
Abstract

Sarcopenia is a geriatric syndrome characterized by progressive and generalized loss of skeletal muscle mass and function. Reported prevalence of this geriatric syndrome, differs depending on the definition, the population and the method used to identify sarcopenia. The causes of sarcopenia are multifactorial, and can include genetic influence, immobility or disuse, endocrine factors, inflammation and nutritional deficiencies. These disorders involve an imbalance between anabolic and catabolic pathways that rules muscle mass. Many drugs taken regularly for common conditions may interact with some mechanisms that can alter the balance between protein synthesis and degradation. This may lead to a harmful or a beneficial effect on muscle mass and strength. Widely prescribed drugs could play an important role during the time of onset and development of sarcopenia. In this paper, we reviewed the current understanding of how can drugs contribute positively or negatively on sarcopenia and muscle wasting. We decided to focus this review on oral common drugs, which are usually prescribed in older adults, leaving aside other drugs as hormone therapy. [ABSTRACT FROM AUTHOR]

Published
2017
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28. 668

Author

Roca, Ricard Ferrer, primary, Yebenes, Juan, additional, Ruiz-Rodriguez, Juan Carlos, additional, Artigas, Antonio, additional, Bosch, Anna, additional, Bustins, Montse, additional, and Cleries, Montse, additional

Published
2013
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