97 results on '"Ana Alarcón"'
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2. Retos en la aplicación de la hipotermia terapéutica no servo-controlada durante el transporte neonatal en Cataluña
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Nuria Torre Monmany, Sara Maya Gallego, Teresa Esclapés Giménez, Marta Sardà Sánchez, Olalla Rodríguez Losada, Aina Martínez Planas, Olga Oller Fradera, Ana Alarcón, and Elisabeth Esteban
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Asphyxia neonatorum ,Hypoxic-ischemic encephalopathy ,Passive cooling ,Servo-controlled cooling ,Therapeutic hypothermia ,Neonatal transport ,Pediatrics ,RJ1-570 - Abstract
Resumen: Introducción: La hipotermia terapéutica (HTT) es el único tratamiento que ha demostrado aumentar la posibilidad de supervivencia libre de secuelas en los recién nacidos (RNs) afectos de encefalopatía hipóxico-isquémica (EHI), recomendándose iniciarla lo antes posible. Lo más frecuente es que los pacientes tributarios de HTT no nazcan en los centros de referencia (CR) .requiriendo ser transportados. Métodos: Estudio observacional descriptivo prospectivo de RNs con EHI moderada-grave trasladados en hipotermia terapéutica no servo-controlada por los dos equipos de transporte neonatal y pediátrico terrestres de Cataluña (abril 2018-noviembre 2019). Resultados: 51 pacientes. Mediana de tiempo de estabilización 68 minutos (p25-75, 45 – 85 min), traslado 30 minutos (p25-75, 15 – 45 min). Media de edad a la llegada al CR 4 horas y 18 minutos (DE 96 min). Medidas terapéuticas adoptadas: apagar la incubadora 43 (84,3%), bolsas de hielo 11 (21,6%) y ambas 11 (21,5%) pacientes. Se consiguió la temperatura rectal (TR) diana en 19 (37,3%) pacientes. No hubo diferencias en el sobre-enfriamiento según las medidas usadas para la aplicación de la HTT no servo-controlada (HTTnc). La duración del traslado no se relacionó con diferencias en la estabilización de la temperatura ni en la consecución de la temperatura objetivo. Conclusiones: La monitorización de la TR en el centro emisor es un pilar fundamental en la estabilización del paciente y la aplicación de la HTTnc. Existe una clara área de mejora en la eficacia de la HTTnc durante el transporte. La HTT servo-controlada sería una opción para poder ofrecer las mismas posibilidades terapéuticas a los RNs extramuros de los CR. Abstract: Introduction: Therapeutic hypothermia (TH) improves survival and neurological prognosis in hypoxic-ischemic encephalopathic (HIE) babies, being better the sooner TH is implemented. HIE babies are born more frequently in a non-cooling centre and need to be referred. Methods: Prospective-observational study (April 18–November 19). Newborns (≥34 weeks of gestational age (GA) and >1800 g) with moderate/severe HIE on non-servocontrolled therapeutic hypothermia by the two neonatal transport teams in Catalonia. Results: 51 newborns. The median stabilisation and transport time were 68 min (p25–75, 45–85 min) and 30 min (p25–75, 15–45 min), respectively. The mean age at arrival at the receiving unit was 4 h and 18 min (SD 96.6). The incubator was set off in 43 (84%), iced-packs 11 (21.5%) and both (11, 21.5%). Target temperature was reached in 19 (37.3%) babies. There was no differences in the overcooling in relation to the measures applied. The transport duration was not related with temperature stabilisation or target temperature reachiness. Conclusions: Rectal temperature monitorisation is compulsory for the stabilisation and the application of non-servocontrolled hypothermia during transport. There is still time for improving in the administration of this treatment during transport. Servo-controlled hypothermia would be a better alternative to improve the management of HIE babies.
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- 2021
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3. Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia
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Nuria Torre Monmany, Sara Maya Gallego, Teresa Esclapés Giménez, Marta Sardà Sánchez, Olalla Rodríguez Losada, Aina Martínez Planas, Olga Oller Fradera, Ana Alarcón, and Elisabeth Esteban
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Asfixia neonatal ,Encefalopatía hipoxico-isquémica ,Hipotermia pasiva ,Hipotermia servo-controlada ,Hipotermia terapéutica ,Transporte neonatal ,Pediatrics ,RJ1-570 - Abstract
Introduction: Therapeutic hypothermia (TH) improves survival and neurological prognosis in hypoxic-ischemic encephalopathic (HIE) babies, being better the sooner TH is implemented. HIE babies are born more frequently in a non-cooling centre and need to be referred. Methods: Prospective-observational study (April 18 2018 – November 19 2019). Newborns (≥34 weeks of gestational age (GA) and >1800 g) with moderate/severe HIE on non-servocontrolled therapeutic hypothermia by the two neonatal transport teams in Catalonia. Results: 51 newborns. The median stabilisation and transport time were 68 min (p25–75, 45–85 min) and 30 min (p25–75, 15–45 min), respectively. The mean age at arrival at the receiving unit was 4 h and 18 min (SD 96.6). The incubator was set off in 43 (84%), iced-packs 11 (21.5%) and both (11, 21.5%). Target temperature was reached in 19 (37.3%) babies. There were no differences in the overcooling in relation to the measures applied. The transport duration was not related with temperature stabilisation or target temperature reachiness. Conclusions: Rectal temperature monitorisation is compulsory for the stabilisation and the application of non-servocontrolled hypothermia during transport. There is still time for improving in the administration of this treatment during transport. Servo-controlled hypothermia would be a better alternative to improve the management of HIE babies. Resumen: Introducción: La hipotermia terapéutica (HTT) es el único tratamiento que ha demostrado aumentar la posibilidad de supervivencia libre de secuelas en los recién nacidos (RNs) afectos de encefalopatía hipóxico-isquémica (EHI), recomendándose iniciarla lo antes posible. Lo más frecuente es que los pacientes tributarios de HTT no nazcan en los centros de referencia (CR), requiriendo ser transportados. Métodos: Estudio observacional descriptivo prospectivo de RNs con EHI moderada-grave trasladados en hipotermia terapéutica no servo-controlada por los dos equipos de transporte neonatal y pediátrico terrestres de Cataluña (abril 2018-noviembre 2019). Resultados: 51 pacientes. Mediana de tiempo de estabilización 68 minutos (p25-75, 45 – 85 min), traslado 30 minutos (p25-75, 15 – 45 min). Media de edad a la llegada al CR 4 horas y 18 minutos (DE 96 min). Medidas terapéuticas adoptadas: apagar la incubadora 43 (84,3%), bolsas de hielo 11 (21,6%) y ambas 11 (21,5%) pacientes. Se consiguió la temperatura rectal (TR) diana en 19 (37,3%) pacientes. No hubo diferencias en el sobre-enfriamiento según las medidas usadas para la aplicación de la HTT no servo-controlada (HTTnc). La duración del traslado no se relacionó con diferencias en la estabilización de la temperatura ni en la consecución de la temperatura objetivo. Conclusiones: La monitorización de la TR en el centro emisor es un pilar fundamental en la estabilización del paciente y la aplicación de la HTTnc. Existe una clara área de mejora en la eficacia de la HTTnc durante el transporte. La HTT servo-controlada sería una opción para poder ofrecer las mismas posibilidades terapéuticas a los RNs extramuros de los CR.
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- 2021
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4. Long-term antibiotic prophylaxis regimen compared to short-term antibiotic prophylaxis regimen in patients undergoing orthognathic surgery
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Matthias Wallach, Javier Cuéllar, Francisca Verdugo-Paiva, and Ana Alarcón
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orthognathic surgery ,long term antibiotic prophylaxis ,short term antibiotic prophylaxis ,epistemonikos ,grade ,Medicine ,Medicine (General) ,R5-920 - Abstract
INTRODUCTION Orthognathic surgery, being an invasive surgical procedure, may present significant postoperative morbidities for the patient. Among the most frequently described complications is surgical site infection. The administration of prophylactic antibiotics prior to this type of procedure is a common practice, however, the cost-benefit of the use of antibiotics, the type of antibiotics, the route of administration, the dosage, and the regimen to be used have not been clearly defined and are still considered a controversial issue. In this summary of evidence, we will compare long-term antibiotic prophylaxis with short-term prophylaxis. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified five systematic reviews including nine studies overall, of which all nine were randomized trials. We conclude that administering a long-term prophylactic antibiotic regimen probably decreases the risk of surgical site infection and that it may increase the risk of hospital stay longer than two days, nevertheless, regarding this last point, the certainty of the evidence is low.
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- 2020
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5. Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain
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Belén Fernández Colomer, Manuel Sánchez-Luna, Concepción de Alba Romero, Ana Alarcón, Ana Baña Souto, Fátima Camba Longueira, María Cernada, Zenaida Galve Pradell, María González López, M. Cruz López Herrera, Carmen Ribes Bautista, Laura Sánchez García, Elena Zamora Flores, Adelina Pellicer, Clara Alonso Díaz, Cristina Herraiz Perea, Dolores Sabina Romero Ramírez, Isabel de las Cuevas Terán, Isabel Pescador Chamorro, José Luis Fernández Trisac, Luis Arruza Gómez, Luis Miguel Cardo Fernández, Mª Jesús García García, Marta Nicolás López, Miryam Hortelano López, Mónica Riaza Gómez, Natalio Hernández González, Raquel González Sánchez, Sílvia Zambudio Sert, Susana Larrosa Capacés, and Vanesa Matías del Pozo
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coronavirus disease 2019 ,SARS-CoV-2 infection ,neonates ,epidemiology–descriptive ,hospital-acquired infection ,community-acquired infection ,Pediatrics ,RJ1-570 - Abstract
Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain.Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected.Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients.Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.
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- 2020
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6. Cerebrospinal fluid levels of neuron-specific enolase predict the severity of brain damage in newborns with neonatal hypoxic-ischemic encephalopathy treated with hypothermia.
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Marisol-Zulema León-Lozano, Juan Arnaez, Ana Valls, Gemma Arca, Thais Agut, Ana Alarcón, and Alfredo Garcia-Alix
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Medicine ,Science - Abstract
OBJECTIVES:To investigate whether cerebrospinal fluid levels of neuron-specific enolase (CSF-NSE) during the first 72 hours correlate with other tools used to assess ongoing brain damage, including clinical grading of hypoxic-ischemic encephalopathy (HIE), abnormal patterns in amplitude integrated electroencephalography (aEEG), and magnetic resonance imaging (MRI), as well as with the neurodevelopmental outcomes at two years of age. MATERIAL AND METHODS:Prospective observational study performed in two hospitals between 2009 and 2011. Forty-three infants diagnosed with HIE within 6 hours of life were included. HIE was severe in 20 infants, moderate in 12, and mild in 11. Infants with moderate-to-severe HIE received whole-body cooling. Both the HIE cohort and a control group of 59 infants with suspected infection underwent measurement of CSF-NSE concentrations at between 12 and 72 hours after birth. aEEG monitoring was started at admission and brain MRI was performed within the first 2 weeks. Neurodevelopment was assessed at 24 months. RESULTS:The HIE group showed higher levels of CSF-NSE than the control group: median 70 ng/ml (29; 205) vs 10.6 ng/ml (7.7; 12.9); p
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- 2020
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7. Renal Involvement in Congenital Cytomegalovirus Infection: A Systematic Review
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María Ríos-Barnés, Clàudia Fortuny, Ana Alarcón, and Antoni Noguera-Julian
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congenital infection ,congenital nephrotic syndrome ,cytomegalovirus ,ganciclovir ,inclusion bodies ,renal tubules ,Biology (General) ,QH301-705.5 - Abstract
Background: Congenital cytomegalovirus (cCMV) infection is the most frequent mother-to-child transmitted infection worldwide and a prevalent cause of neonatal disease and long-term morbidity. The kidney is a target organ for CMV, which replicates in renal tubules and is excreted in large quantities in urine for years in children with cCMV infection. Nonetheless, kidney disease has rarely been reported in cCMV-infected patients. Objective: We aimed to describe the available data on renal involvement in patients with cCMV infection at the pathologic, functional, anatomical, and/or clinical levels. Methods: A systematic search was performed in the MEDLINE/PubMed, SCOPUS, and Cochrane databases. Studies describing any renal involvement in fetuses or neonates aged ≤3 weeks at diagnosis of microbiologically confirmed cCMV infection were eligible. Results: Twenty-four articles were included, with a very low level of evidence. Pathologic findings in autopsy studies universally described CMV typical inclusion bodies in tubular cells. No functional studies were identified. cCMV infection was not associated with an increased risk of kidney malformations. Congenital nephrotic syndrome was the most common clinical condition associated with cCMV, but a causal relationship cannot be established. Conclusions: Typical pathological features of cCMV infection are very common in renal tissue, but they do not seem to entail significant consequences at the anatomical or clinical levels.
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- 2021
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8. How I treat adverse effects of CAR-T cell therapy
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Lucrecia Yáñez, Ana Alarcón, Miriam Sánchez-Escamilla, and Miguel-Angel Perales
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2019
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9. Guía de la Sociedad Española de Infectología Pediátrica sobre prevención, diagnóstico y tratamiento de la infección neonatal por virus herpes simplex
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Fernando Baquero Artigao, Luis M. Prieto Tato, José Tomás Ramos Amador, Ana Alarcón Allen, María de la Calle, Marie Antoinette Frick, Ana Goncé Mellgren, María Isabel González Tomé, David Moreno Pérez, and Antoni Noguera Julian
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Neonatal infection ,Herpes simplex virus ,Mother-to-child transmission prevention ,Pediatrics ,RJ1-570 - Abstract
Resumen: La infección herpética neonatal es una entidad muy poco frecuente pero que se asocia a una alta morbimortalidad. La mayor parte de los neonatos afectos adquieren la infección por virus herpes simplex en el periodo periparto. Para que ocurra esta transmisión es necesaria la excreción viral genital, con o sin síntomas, alrededor del momento del parto. Existen intervenciones basadas en la evidencia para prevenir la transmisión del virus herpes simplex al recién nacido. La realización de una cesárea en presencia de lesiones herpéticas, y la disminución de la excreción viral administrando en las últimas semanas del embarazo tratamiento antiviral a gestantes con herpes genital activo, son las mejores medidas preventivas de las que se dispone. El diagnóstico y tratamiento precoz del herpes neonatal requiere de un alto índice de sospecha, sobre todo en ausencia de lesiones cutáneas. Se recomienda descartar la infección por herpes neonatal en aquellos recién nacidos con lesiones cutaneomucosas, afectación del sistema nervioso central o cuadro séptico de origen no aclarado. El pronóstico de los neonatos con enfermedad cutánea en la era del aciclovir a dosis altas es excelente. El tratamiento antiviral disminuye la mortalidad de las formas diseminadas y con afectación exclusiva del sistema nervioso central, pero también mejora el pronóstico neurológico en los casos de enfermedad diseminada. De forma notable, la introducción del tratamiento supresor con aciclovir oral durante los meses siguientes a la infección aguda ha mejorado el pronóstico neurológico en los pacientes con afectación del sistema nervioso central. Abstract: Neonatal herpes simplex virus infections are rare, but are associated with significant morbidity and mortality. Most newborns acquire herpes simplex virus infection in the peripartum period. For peripartum transmission to occur, women must be shedding the virus in their genital tracts symptomatically or asymptomatically around the time of delivery. There are evidence-based interventions in pregnancy to prevent the transmission to the newborn. Caesarean section should be performed in the presence of herpetic lesions, and antiviral prophylaxis in the last weeks of pregnancy is recommended to suppress genital tract herpes simplex virus at the time of delivery. The diagnosis and early treatment of neonatal herpes simplex virus infections require a high index of suspicion, especially in the absence of skin lesions. It is recommended to rule out herpes simplex virus infections in those newborns with mucocutaneous lesions, central nervous system involvement, or septic appearance. The prognosis of newborns with skin, eye, and/or mouth disease in the high-dose acyclovir era is very good. Antiviral treatment not only improves mortality rates in disseminated and central nervous system disease, but also improves the rates of long-term neurodevelopmental impairment in the cases of disseminated disease. Interestingly, a 6-month suppressive course of oral acyclovir following the acute infection has improved the neurodevelopmental prognosis in patients with CNS involvement.
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- 2018
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10. The Spanish Society of Paediatric Infectious Diseases guidelines on the prevention, diagnosis and treatment of neonatal herpes simplex infections
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Fernando Baquero Artigao, Luis M. Prieto Tato, José Tomás Ramos Amador, Ana Alarcón Allen, María de la Calle, Marie Antoinette Frick, Ana Goncé Mellgren, María Isabel González Tomé, David Moreno Pérez, and Antoni Noguera Julian
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Infección neonatal ,Virus herpes simplex ,Prevención de la transmisión maternoinfantil ,Pediatrics ,RJ1-570 - Abstract
Neonatal herpes simplex virus infections are rare, but are associated with significant morbidity and mortality. Most newborns acquire herpes simplex virus infection in the peripartum period. For peripartum transmission to occur, women must be shedding the virus in their genital tracts symptomatically or asymptomatically around the time of delivery. There are evidence-based interventions in pregnancy to prevent the transmission to the newborn. Caesarean section should be performed in the presence of herpetic lesions, and antiviral prophylaxis in the last weeks of pregnancy is recommended to suppress genital tract herpes simplex virus at the time of delivery. The diagnosis and early treatment of neonatal herpes simplex virus infections require a high index of suspicion, especially in the absence of skin lesions. It is recommended to rule out herpes simplex virus infections in those newborns with mucocutaneous lesions, central nervous system involvement, or septic appearance. The prognosis of newborns with skin, eye, and/or mouth disease in the high-dose acyclovir era is very good. Antiviral treatment not only improves mortality rates in disseminated and central nervous system disease, but also improves the rates of long-term neurodevelopmental impairment in the cases of disseminated disease. Interestingly, a 6-month suppressive course of oral acyclovir following the acute infection has improved the neurodevelopmental prognosis in patients with CNS involvement. Resumen: La infección herpética neonatal es una entidad muy poco frecuente pero que se asocia a una alta morbimortalidad. La mayor parte de los neonatos afectos adquieren la infección por virus herpes simplex en el periodo periparto. Para que ocurra esta transmisión es necesaria la excreción viral genital, con o sin síntomas, alrededor del momento del parto. Existen intervenciones basadas en la evidencia para prevenir la transmisión del virus herpes simplex al recién nacido. La realización de una cesárea en presencia de lesiones herpéticas, y la disminución de la excreción viral administrando en las últimas semanas del embarazo tratamiento antiviral a gestantes con herpes genital activo, son las mejores medidas preventivas de las que se dispone. El diagnóstico y tratamiento precoz del herpes neonatal requiere de un alto índice de sospecha, sobre todo en ausencia de lesiones cutáneas. Se recomienda descartar la infección por herpes neonatal en aquellos recién nacidos con lesiones cutaneomucosas, afectación del sistema nervioso central o cuadro séptico de origen no aclarado. El pronóstico de los neonatos con enfermedad cutánea en la era del aciclovir a dosis altas es excelente. El tratamiento antiviral disminuye la mortalidad de las formas diseminadas y con afectación exclusiva del sistema nervioso central, pero también mejora el pronóstico neurológico en los casos de enfermedad diseminada. De forma notable, la introducción del tratamiento supresor con aciclovir oral durante los meses siguientes a la infección aguda ha mejorado el pronóstico neurológico en los pacientes con afectación del sistema nervioso central.
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- 2018
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11. Subsequent Malignancies After CD19-Targeted Chimeric Antigen Receptor T Cells in Patients With Lymphoma
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Lorenc, Rachel, Shouval, Roni, Flynn, Jessica R., Devlin, Sean M., Saldia, Amethyst, De Abia, Alejandro Luna, De Lapuerta, Magdalena Corona, Tomas, Ana Alarcon, Cassanello, Giulio, Leslie, Lori A., Rejeski, Kai, Lin, Richard J., Scordo, Michael, Shah, Gunjan L., Palomba, M. Lia, Salles, Gilles, Park, Jae, Giralt, Sergio A., Perales, Miguel-Angel, Ip, Andrew, and Dahi, Parastoo B.
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- 2024
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12. Bioética de la investigación biomédica con población mapuche
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Ana Alarcón
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Bioética y cultura ,Pueblos indígenas e investigación ,Sociedad mapuche ,Anthropology ,GN1-890 ,Sociology (General) ,HM401-1281 - Abstract
Este trabajo presenta un análisis meta-etnográfico de las investigaciones biomédicas realizadas con población mapuche durante los años 1993 a 2003, con el objeto de examinar la pertinencia cultural de los aspectos éticos involucrados en el proceso de investigación. Los principios bioéticos de autonomía, justicia y beneficencia orientan desde hace largo tiempo los procedimientos de investigación biomédica con seres humanos. Sin embargo, la aplicación universal de principios filosóficos occidentales aparece cuestionable y a veces inapropiada en sociedades multiculturales o pluriétnicas. Por ejemplo, el considerar preponderante el ejercicio de la autonomía individual en sociedades basadas en sistemas familiares y religiosos, obtener un consentimiento informado en lengua distinta a la materna, la configuración estereotipada del sujeto de investigación, aplicar procedimientos que excluyen la idea cultural de daño a través de la manipulación corporal, y la omisión del principio de justicia en los resultados de investigación, son aspectos resultantes de este trabajo, y que denotan la ausencia de una bioética aplicada al contexto, situación y cultura de los sujetos de estudio. En consecuencia un análisis que vincule bioética y cultura en los procesos de investigación podrían contribuir a diseñar, en conjunto con la sociedad mapuche y otros grupos étnicos, un marco de regulaciones éticas culturalmente pertinentes para la ejecución de estudios biomédicos.
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- 2004
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13. Identifying an optimal fludarabine exposure for improved outcomes after axi-cel therapy for aggressive B-cell non-Hodgkin lymphoma
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Scordo, Michael, Flynn, Jessica R., Gonen, Mithat, Devlin, Sean M., Parascondola, Allison, Tomas, Ana Alarcon, Shouval, Roni, Brower, Jamie, Porter, David L., Schuster, Stephen J., Bachanova, Veronika, Maakaron, Joseph, Maziarz, Richard T., Chen, Andy I., Nastoupil, Loretta J., McGuirk, Joseph P., Oluwole, Olalekan O., Ip, Andrew, Leslie, Lori A., Bishop, Michael R., Riedell, Peter A., and Perales, Miguel-Angel
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- 2023
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14. Chimeric antigen receptor T-cell therapy yields similar outcomes in patients with and without cytokine release syndrome
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Bhaskar, Shakthi T., Patel, Vivek G., Porter, David L., Schuster, Stephen J., Nastoupil, Loretta J., Perales, Miguel-Angel, Tomas, Ana Alarcon, Bishop, Michael R., McGuirk, Joseph P., Maziarz, Richard T., Chen, Andy I., Bachanova, Veronika, Maakaron, Joseph E., Riedell, Peter A., and Oluwole, Olalekan O.
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- 2023
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15. Low toxicity and excellent outcomes in patients with DLBCL without residual lymphoma at the time of CD19 CAR T-cell therapy
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Perales, Miguel-Angel, Maziarz, Richard T., Riedell, Peter A., McGuirk, Joseph P., Bachanova, Veronika, Porter, David L., Nastoupil, Loretta J., Oluwole, Olalekan O., Wudhikarn, Kitsada, Tomas, Ana Alarcon, Flynn, Jessica R., Devlin, Sean M., Brower, Jamie, Schuster, Stephen J., and Bishop, Michael R.
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- 2023
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16. Allogeneic Hematopoietic Cell Transplantation after Chimeric Antigen Receptor T Cell Therapy in Large B Cell Lymphoma
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Fried, Shalev, Shouval, Roni, Walji, Moneeza, Flynn, Jessica R., Yerushalmi, Ronit, Shem-Tov, Noga, Danylesko, Ivetta, Tomas, Ana Alarcon, Fein, Joshua A., Devlin, Sean M., Sauter, Craig S., Shah, Gunjan L., Kedmi, Meirav, Jacoby, Elad, Shargian, Liat, Raanani, Pia, Yeshurun, Moshe, Perales, Miguel-Angel, Nagler, Arnon, Avigdor, Abraham, and Shimoni, Avichai
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- 2023
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17. The Simplified Comorbidity Index: a new tool for prediction of nonrelapse mortality in allo-HCT
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Shouval, Roni, Fein, Joshua A., Cho, Christina, Avecilla, Scott T., Ruiz, Josel, Tomas, Ana Alarcon, Sanchez-Escamilla, Miriam, Flores, Nerea Castillo, Yáñez, Lucrecia, Barker, Juliet N., Dahi, Parastoo, Giralt, Sergio A., Geyer, Alexander I., Gyurkocza, Boglarka, Jakubowski, Ann A., Lin, Richard J., O'Reilly, Richard J., Papadopoulos, Esperanza B., Politikos, Ioannis, Ponce, Doris M., Sauter, Craig S., Scordo, Michael, Shaffer, Brian, Shah, Gunjan L., Sullivan, James P., Tamari, Roni, van den Brink, Marcel R.M., Young, James W., Nagler, Arnon, Devlin, Sean, Shimoni, Avichai, and Perales, Miguel-Angel
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- 2022
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18. Site-Specific Response Rates in Large B-Cell Lymphomas Treated with CD19-CART Therapy.
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Luna, Alejandro, primary, Corona, Magdalena, additional, Flynn, Jessica, additional, Devlin, Sean M., additional, Luttwak, Efrat, additional, Landego, Ivan, additional, Dahi, Parastoo B., additional, Lin, Dr. Richard J., additional, Parascondola, Allison, additional, Palomba, M. Lia, additional, Shah, Gunjan L., additional, Scordo, Michael, additional, Imber, Brandon S., additional, Tomas, Ana Alarcón, additional, Salles, Gilles, additional, Park, Jae H., additional, Perales, Miguel-Angel, additional, and Shouval, Roni, additional
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- 2024
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19. List of contributors
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Antman-Passig, Merav, primary, Carlsson, Sigrid V., additional, Danila, Daniel C., additional, Diaz, Maria, additional, Duffy, Michael J., additional, Ekanayake Weeramange, Chameera, additional, Fleisher, Martin, additional, Gill, Emily L., additional, Heller, Daniel A., additional, Hoofnagle, Andrew N., additional, Horoszko, Christopher P., additional, Hutcherson, Shelby M., additional, Kim, Mijin, additional, Li, Jieli, additional, Lilja, Hans, additional, Luu, Hung S., additional, McCash, Samuel I., additional, Meng, Qing H., additional, Müller Bark, Juliana, additional, Murata, Kazunori, additional, Nguyen, Freddy T., additional, Patel, Khushbu, additional, Pentsova, Elena I., additional, Perales, Miguel-Angel, additional, Pessin, Melissa S., additional, Phipps, William S., additional, Punyadeera, Chamindie, additional, Rakheja, Dinesh, additional, Ramanathan, Lakshmi V., additional, Rasheduzzaman, Mohammad, additional, Roth, Mara Y., additional, Shuford, Christopher M., additional, Thoren, Katie L., additional, Tomás, Ana Alarcón, additional, Trevisan França de Lima, Lucas, additional, Wudhikarn, Kitsada, additional, and Yaari, Zvi, additional
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- 2022
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20. Chimeric antigen receptor T cells and management of toxicities: implications of biomarkers
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Wudhikarn, Kitsada, primary, Tomás, Ana Alarcón, additional, Murata, Kazunori, additional, and Perales, Miguel-Angel, additional
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- 2022
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21. Geriatric syndromes in 2-year, progression-free survivors among older recipients of allogeneic hematopoietic cell transplantation
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Lin, Richard J., Baser, Raymond E., Elko, Theresa A., Korc-Grodzicki, Beatriz, Shahrokni, Armin, Maloy, Molly A., Young, James W., Tamari, Roni, Shah, Gunjan L., Shaffer, Brian C., Scordo, Michael, Sauter, Craig S., Ponce, Doris M., Politikos, Ioannis, Perales, Miguel-Angel, Papadopoulos, Esperanza B., Gyurkocza, Boglarka, Dahi, Parastoo B., Cho, Christina, Barker, Juliet N., Tomas, Ana Alarcón, Flores, Nerea Castillo, Sanchez-Escamilla, Míriam, Segundo, Lucrecia Yáñez San, Jakubowski, Ann A., and Giralt, Sergio A.
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- 2021
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22. Bridging Radiation Rapidly and Effectively Cytoreduces High-Risk Relapsed/Refractory Aggressive B Cell Lymphomas Prior to Chimeric Antigen Receptor T Cell Therapy
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Hubbeling, Harper, Silverman, Emily A., Michaud, Laure, Tomas, Ana Alarcon, Shouval, Roni, Flynn, Jessica, Devlin, Sean, Wijetunga, N. Ari, Tringale, Kathryn R., Batlevi, Connie, Dahi, Parastoo, Giralt, Sergio, Lin, Richard, Park, Jae, Scordo, Michael, Sauter, Craig, Shah, Gunjan, Hajj, Carla, Salles, Gilles, Schoder, Heiko, Palomba, M. Lia, Perales, Miguel-Angel, Yahalom, Joachim, and Imber, Brandon S.
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- 2023
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23. Vitamin D Insufficiency and Clinical Outcomes with Chimeric Antigen Receptor T-Cell Therapy in Large B-cell Lymphoma
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Nath, Karthik, Tomas, Ana Alarcon, Flynn, Jessica, Fein, Joshua A., Alperovich, Anna, Anagnostou, Theodora, Batlevi, Connie Lee, Dahi, Parastoo B., Fingrut, Warren B., Giralt, Sergio A., Lin, Richard J., Palomba, M. Lia, Peled, Jonathan U., Salles, Gilles, Sauter, Craig S., Scordo, Michael, Fraint, Ellen, Feuer, Elise, Shah, Nishi, Slingerland, John B., Devlin, Sean, Shah, Gunjan L., Gupta, Gaurav, Perales, Miguel-Angel, and Shouval, Roni
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- 2022
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24. Applications of Hypnosis as an Adjuvant in Oncological Settings: A Systematic Review
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Marc Franch, Ana Alarcón, and Antonio Capafons
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Complementary and Manual Therapy ,Clinical Psychology - Published
- 2023
25. Intensive parenting and elective bilingualism English/Spanish in Spanish monolingual families: From language ideologies to practice
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Esther Nieto Moreno de Diezmas and Ana Alarcón Utrera
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Linguistics and Language ,Language and Linguistics ,Education - Abstract
In our globalised economy, English proficiency is currently a priority for Spanish families, as it is fundamental for ensuring their children’s future economic and personal welfare. As a sign of good parenting, families are increasingly acting as linguistic entrepreneurs and adopting family language policies oriented to provide their children with the best methodologies to enhance English learning, thereby investing their personal and financial capital in extracurricular classes, local English camps, and stays abroad. In searching for more natural learning environments, those parents with knowledge of English emulate native bi/multilingual families and raise their children in English and Spanish. This type of non-native elective bilingualism upbringing is gaining momentum in Spain and deserves further scrutiny. Therefore, this paper is devoted to better understand this phenomenon by means of the study of 16 Spanish families who are raising their children in English and Spanish. Their family language policy (FLP) will be analysed in terms of language beliefs, language management and language practices. Results reflect parents’ desires and imagined identities with English as a metaphor of accomplishment, as well as their emotional implications, disruptions and negotiations to bring to fruition this complex socialization practice.
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- 2022
26. Prospective geriatric assessment and geriatric consultation in CAR T-cell therapy for older patients with lymphoma
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Lin, Richard J., Kim, Soo Jung, Brown, Samantha, Elko, Theresa A., Ruiz, Josel D., Hanley, Danielle M., Lia Palomba, M., Perales, Miguel-Angel, Shah, Gunjan L., Dahi, Parastoo B., Scordo, Michael, Sauter, Craig S., Batlevi, Connie L., Tomas, Ana Alarcon, Shouval, Roni, Lee, Nicole, Pavkovic, Emma A., Engstler, Danielle E., Park, Jae H., Salles, Gilles A., Devlin, Sean M., Korc-Grodzicki, Beatriz, Hamlin, Paul A., and Giralt, Sergio A.
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- 2023
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27. Retos en la aplicación de la hipotermia terapéutica no servo-controlada durante el transporte neonatal en Cataluña
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Olga Oller Fradera, Ana Alarcón, Aina Martínez Planas, Olalla Rodríguez Losada, Nuria Torre Monmany, Elisabeth Esteban, Teresa Esclapés Giménez, Marta Sardà Sánchez, Sara Maya Gallego, Institut Català de la Salut, [Torre Monmany N, Rodríguez Losada O] Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España. Unidad de Neonatología, Hospital Parc Taulí, Sabadell, España. Unidad de Transporte Aéreo Pediátrico y Neonatal, Hospital Parc Taulí, Sabadell, España. [Maya Gallego S] Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España. [Esclapés Giménez T] Unitat de Transport Pediàtric i Neonatal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Neonatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Rodríguez Losada O] Unitat de Transport Pediàtric i Neonatal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Martínez Planas A] Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España. Unidad de Hospitalización de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona. España. [Oller Fradera O] Unitat de Transport Pediàtric i Neonatal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Cures Intensives Pediàtriques, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Therapeutics::Emergency Treatment::Transportation of Patients [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Servo-controlled cooling ,Cardiovascular Diseases::Vascular Diseases::Cerebrovascular Disorders::Brain Ischemia::Hypoxia-Ischemia, Brain [DISEASES] ,Transport de malalts i ferits ,Pediatrics ,RJ1-570 ,Asphyxia neonatorum ,Hipotermia terapéutica ,Hipotermia servo-controlada ,Hypoxic-ischemic encephalopathy ,Therapeutic hypothermia ,Transporte neonatal ,Otros calificadores::/terapia [Otros calificadores] ,Hipotermia pasiva ,Asfixia neonatal ,terapéutica::crioterapia::hipotermia inducida [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Therapeutics::Cryotherapy::Hypothermia, Induced [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Hipotèrmia induïda ,Other subheadings::/therapy [Other subheadings] ,enfermedades cardiovasculares::enfermedades vasculares::trastornos cerebrovasculares::isquemia cerebral::hipoxia-isquemia encefálica [ENFERMEDADES] ,Malalties cerebrovasculars en els infants - Tractament ,Passive cooling ,Pediatrics, Perinatology and Child Health ,terapéutica::tratamiento de urgencia::transporte de pacientes [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Neonatal transport ,Encefalopatía hipoxico-isquémica - Abstract
Transporte neonatal; Encefalopatía hipoxico-isquémica; Hipotermia Transport neonatal; Encefalopatia hipoxico-isquèmica; Hipotèrmia Neonatal transport; Hypoxic-ischemic encephalopathy; Hypothermia Introducción La hipotermia terapéutica (HTT) es el único tratamiento que ha demostrado aumentar la posibilidad de supervivencia libre de secuelas en los recién nacidos (RNs) afectos de encefalopatía hipóxico-isquémica (EHI), recomendándose iniciarla lo antes posible. Lo más frecuente es que los pacientes tributarios de HTT no nazcan en los centros de referencia (CR) .requiriendo ser transportados. Métodos Estudio observacional descriptivo prospectivo de RNs con EHI moderada-grave trasladados en hipotermia terapéutica no servo-controlada por los dos equipos de transporte neonatal y pediátrico terrestres de Cataluña (abril 2018-noviembre 2019). Resultados 51 pacientes. Mediana de tiempo de estabilización 68 minutos (p25-75, 45 – 85 min), traslado 30 minutos (p25-75, 15 – 45 min). Media de edad a la llegada al CR 4 horas y 18 minutos (DE 96 min). Medidas terapéuticas adoptadas: apagar la incubadora 43 (84,3%), bolsas de hielo 11 (21,6%) y ambas 11 (21,5%) pacientes. Se consiguió la temperatura rectal (TR) diana en 19 (37,3%) pacientes. No hubo diferencias en el sobre-enfriamiento según las medidas usadas para la aplicación de la HTT no servo-controlada (HTTnc). La duración del traslado no se relacionó con diferencias en la estabilización de la temperatura ni en la consecución de la temperatura objetivo. Conclusiones La monitorización de la TR en el centro emisor es un pilar fundamental en la estabilización del paciente y la aplicación de la HTTnc. Existe una clara área de mejora en la eficacia de la HTTnc durante el transporte. La HTT servo-controlada sería una opción para poder ofrecer las mismas posibilidades terapéuticas a los RNs extramuros de los CR. Introduction Therapeutic hypothermia (TH) improves survival and neurological prognosis in hypoxic-ischemic encephalopathic (HIE) babies, being better the sooner TH is implemented. HIE babies are born more frequently in a non-cooling centre and need to be referred. Methods Prospective-observational study (April 18–November 19). Newborns (≥34 weeks of gestational age (GA) and >1800 g) with moderate/severe HIE on non-servocontrolled therapeutic hypothermia by the two neonatal transport teams in Catalonia. Results 51 newborns. The median stabilisation and transport time were 68 min (p25–75, 45–85 min) and 30 min (p25–75, 15–45 min), respectively. The mean age at arrival at the receiving unit was 4 h and 18 min (SD 96.6). The incubator was set off in 43 (84%), iced-packs 11 (21.5%) and both (11, 21.5%). Target temperature was reached in 19 (37.3%) babies. There was no differences in the overcooling in relation to the measures applied. The transport duration was not related with temperature stabilisation or target temperature reachiness. Conclusions Rectal temperature monitorisation is compulsory for the stabilisation and the application of non-servocontrolled hypothermia during transport. There is still time for improving in the administration of this treatment during transport. Servo-controlled hypothermia would be a better alternative to improve the management of HIE babies.
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- 2021
28. 46 - Chimeric Antigen Receptor T-Cell Therapy Yields Similar Outcomes in Patients with and without Cytokine Release Syndrome
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Bhaskar, Shakthi T, Patel, Vivek, Porter, David L., Schuster, Stephen J., Nastoupil, Loretta J., Perales, Miguel-Angel, Tomas, Ana Alarcon, Bishop, Michael R., McGuirk, Joseph P., Maziarz, Richard T, Chen, Andy I., Bachanova, Veronika, Riedell, Peter A., and Oluwole, Dr. Olalekan O.
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- 2023
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29. Estrategias y prácticas culturales que favorecen el desarrollo de niñas y niños mapuche hasta los 4 años. La Araucanía, Chile
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Ana Alarcón, Paula Astudillo, Marcela Castro, and Soledad Perez
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Fuel Technology ,Energy Engineering and Power Technology - Abstract
Este es un estudio etnográfico realizado durante los años 2017 y 2018, en ocho comunidades rurales Mapuche de la región de La Araucanía. Su objetivo es describir las prácticas y estrategias culturales que utilizan las familias Mapuche para apoyar la estimulación y desarrollo de sus niños/as pequeños. Los datos se obtuvieron mediante observaciones en terreno y entrevistas en profundidad con 16 familias y bajo su consentimiento informado. El análisis fue textual e inductivo, utilizando el programa Atlas.ti8. Las estrategias de estimulación y desarrollo se realizan mediante procesos de participación y colaboración activa de los niños y niñas en la dinámica familiar-comunitaria, observando, escuchando y practicando con los mayores. También se activan prácticas ancestrales como, realizar ceremonias de protección espiritual, ayudarles a explorar la naturaleza, estimular la imitación de sonidos, escuchar su idioma, practicar juegos tradicionales, escuchar cuentos, historias, adivinanzas, y dichos que les relatan las familias o personas de la comunidad. Las prácticas culturales de cuidado y estimulación del desarrollo de la niñez Mapuche están inmersas en la cotidianidad de la cultura, algunas son adaptaciones que las familias han ido desarrollando para proteger, cuidar, y estimular a sus niños y niñas. La naturaleza y la propia cultura Mapuche otorgan el espacio, ritmo y forma de estimulación para que los niños/as lleguen a ser colaboradores, respetuosos y autónomos.
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- 2021
30. Prevalence and diagnostic accuracy of microcephaly in a pediatric cohort in Brazil: a retrospective cross-sectional study
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Alfredo García-Alix, Antoni Soriano-Arandes, Thamirys Cosmo Gillo Fajardo, Stephanno Gomes Pereira Sarmento, Saulo Duarte Passos, Steven S. Witkin, Nemésio Florence Vieira Filho, Alify Bertoldo da Silva, Antonio Fernandes Moron, Ana Alarcón, Ana Paula Antunes Pascalicchio Bertozzi, Rosa Estela Gazeta, Institut Català de la Salut, [Bertozzi APAP, Gazeta RE] Faculdade de Medicina de Jundiaí, Departamento de Pediatria, Jundiaí, SP, Brazil. [Fajardo TCG] Faculdade de Medicina de Jundiaí, Laboratório de Infectologia Pediátrica, Jundiaí, SP, Brazil. [Moron AF] Universidade de São Paulo (USP), Instituto de Medicina Tropical, São Paulo, SP, Brazil. [Soriano-Arandes A] Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Salut Internacional-Tuberculosi, Vall Hebron Hospital Universitari - Drassanes, Barcelona, Spain. [Alarcon A] Hospital Universitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Department of Neonatology, Esplugues de Llobregat, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Pediatrics ,Microcephaly ,Epidemiology ,Cross-sectional study ,localizaciones geográficas::Américas::América del Sur::Brasil [DENOMINACIONES GEOGRÁFICAS] ,Intrauterine growth restriction ,Congenital abnormalities ,Zika virus ,Cohort Studies ,0302 clinical medicine ,Pregnancy ,Prevalence ,Other subheadings::/diagnosis [Other subheadings] ,Cervell - Malalties - Diagnòstic - Brasil ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,Virus Diseases::Arbovirus Infections::Zika Virus Infection [DISEASES] ,Child ,Anthropometry ,biology ,Zika Virus Infection ,Gestational age ,Arbovirosis - Brasil ,Geographic Locations::Americas::South America::Brazil [GEOGRAPHICALS] ,Cohort ,Female ,Brazil ,Congenital, Hereditary, and Neonatal Diseases and Abnormalities::Congenital Abnormalities::Musculoskeletal Abnormalities::Craniofacial Abnormalities::Congenital, Hereditary, and Neonatal Diseases and Abnormalities::Congenital Abnormalities::Microcephaly [DISEASES] ,Cohort study ,medicine.medical_specialty ,enfermedades y anomalías neonatales congénitas y hereditarias::anomalías congénitas::anormalidades musculoesqueléticas::anomalías craneofaciales::enfermedades y anomalías neonatales congénitas y hereditarias::anomalías congénitas::microcefalia [ENFERMEDADES] ,Otros calificadores::/diagnóstico [Otros calificadores] ,virosis::infecciones por arbovirus::infección por el virus del Zika [ENFERMEDADES] ,RJ1-570 ,03 medical and health sciences ,030225 pediatrics ,medicine ,Humans ,Retrospective Studies ,business.industry ,Infant, Newborn ,Infant ,Retrospective cohort study ,Zika Virus ,medicine.disease ,biology.organism_classification ,Cross-Sectional Studies ,Pediatrics, Perinatology and Child Health ,business - Abstract
Anormalitats congènites; Epidemiologia; Microcefàlia Anomalías congénitas; Epidemiología; Microcefalia Congenital abnormalities; Epidemiology; Microcephaly Objective We sought to describe the prevalence of microcephaly and to compare the different cutoff points established by the Brazilian Ministry of Health at various times during a Zika virus epidemic. As a secondary aim, we investigated the possible etiology of the microcephaly. Method This retrospective study utilized newborn participants in the Zika Cohort Study Jundiaí. Newborns from the Zika Cohort Study Jundiaí with an accurate gestational age determination and complete anthropometric data were analyzed, and microcephaly was diagnosed according to the INTERGROWTH-21st curve. At delivery, fluids were tested for specific antibodies and for viruses. Brain images were evaluated for microcephaly. Receiver Operating Characteristic curves were plotted to define the accuracy of different cutoff points for microcephaly diagnosis. Results Of 462 eligible newborns, 19 (4.1%) were positive for microcephaly. Cutoff points corresponding to the curves of the World Health Organization yielded the best sensitivity and specificity. Three of the microcephaly cases (15.8%) were positive for Zika virus infections; nine (47.4%) had intrauterine growth restriction; one had intrauterine growth restriction and was exposed to Zika virus; three had a genetic syndrome (15.8%); and three had causes that had not been determined (15.8%). Conclusions Microcephaly prevalence was 4.1% in this study. Cutoff values determined by the World Health Organization had the highest sensitivity and specificity in relation to the standard IG curve. The main reason for microcephaly was intrauterine growth restriction. All possible causes of microcephaly must be investigated to allow the best development of an affected baby. This work and this manuscript were supported by the Fundação de Amparo à Pesquisa do Estado de São Paulo (SDP#grant 2016/08578-0), the Brazilian Ministry of Health (SDP#grant 861306/2017 and 861307/2017), and the London School of Hygiene and Tropical Medicine (SDP#grant PC0002/16).
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- 2021
31. Management of prolonged cytopenia following CAR T-cell therapy
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Magdalena Corona, Roni Shouval, Ana Alarcón, Jessica Flynn, Sean Devlin, Connie Batlevi, Simon Mantha, Maria Lia Palomba, Michael Scordo, Gunjan Shah, Craig Sauter, Miguel-Ángel Perales, and Parastoo B. Dahi
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Transplantation ,Humans ,Hematology ,Immunotherapy, Adoptive ,Thrombocytopenia - Published
- 2022
32. Extended Perinatal Mortality Audit in a Rural Hospital in India
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Jyothi Suchitra, Xavier Krauel, Quique Bassat, Yadamala Balasubbaiah, Dasarath Ramaiah, Ana Alarcón, Joaquín Américo Astete, Nuria Torre Monmany, and Manolo Fillol
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Gestational hypertension ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Eclampsia ,Perinatal mortality ,Obstetrics ,business.industry ,Obstetrics and Gynecology ,Audit ,Disease ,medicine.disease ,female genital diseases and pregnancy complications ,Preeclampsia ,Rural hospital ,03 medical and health sciences ,0302 clinical medicine ,Pediatrics, Perinatology and Child Health ,medicine ,030212 general & internal medicine ,Neonatal death ,business ,reproductive and urinary physiology - Abstract
Objective The aim of the study is to describe the status of perinatal mortality (PM) in an Indian rural hospital. Study design Retrospective analysis of data was compiled from PM meetings (April 2017 to December 2018) following "Making Every Baby Count: audit and review of stillbirths and neonatal deaths (ENAP or Every Newborn Action Plan)." Results The study includes 8,801 livebirths, 105 stillbirths (SBs); 74 antepartum stillbirths [ASBs], 22 intrapartum stillbirths [ISBs], and nine unknown timing stillbirths [USBs]), 39 neonatal deaths or NDs (perinatal death or PDs 144). The higher risks for ASBs were maternal age >34 years, previous history of death, and/or SBs. Almost half of the PDs could be related with antepartum complications. More than half of the ASB were related with preeclampsia/eclampsia and abruptio placentae; one-third of the ISB were related with preeclampsia/eclampsia and gestational hypertension, fetal growth restriction, and placental dysfunction. The main maternal conditions differed between PDs (p = 0.005). The main causes of the ND were infections, congenital malformations, complications of prematurity, intrapartum complications, and unknown. The stillbirth rate was 11.8/1,000 births, neonatal mortality rate 4.4/1,000 livebirths, and perinatal mortality rate 15.8/1,000 births. Conclusion This is the first study of its kind in Andhra Pradesh being the first step for the analysis and prevention of PM. Key points · Many conditions that lead to stillbirths are linked to neonatal deaths and PM has been outside of the global parameters from the last decades.. · This is the first study following International Classification of Disease perinatal mortality codes and the audit of ENAP in Andhra Pradesh.. · Extended PM and mortality are mainly caused by similar preventable and treatable conditions..
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- 2021
33. Vertical transmission of Zika virus and its outcomes: a Bayesian synthesis of prospective studies
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Carlo Giaquinto, Catherine Peckham, A E Ades, Francesco Bonfante, Ana Alarcón, Claire Thorne, and Antoni Soriano-Arandes
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0301 basic medicine ,medicine.medical_specialty ,Zika virus ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Credible interval ,Humans ,latent mixture model ,media_common.cataloged_instance ,Prospective Studies ,030212 general & internal medicine ,Pregnancy Complications, Infectious ,European union ,Prospective cohort study ,ZIKV ,media_common ,Fetus ,biology ,Zika Virus Infection ,Transmission (medicine) ,Obstetrics ,business.industry ,Clinical study design ,Causal effect ,Infant, Newborn ,evidence synthesis ,Bayes Theorem ,Articles ,Zika Virus ,medicine.disease ,biology.organism_classification ,Latent class model ,Infectious Disease Transmission, Vertical ,030104 developmental biology ,Infectious Diseases ,Latent Class Analysis ,In utero ,Vertical transmission ,Female ,Pregnancy Trimesters ,business - Abstract
Summary Background Prospective studies of Zika virus in pregnancy have reported rates of congenital Zika syndrome and other adverse outcomes by trimester. However, Zika virus can infect and damage the fetus early in utero, but clear before delivery. The true vertical transmission rate is therefore unknown. We aimed to provide the first estimates of underlying vertical transmission rates and adverse outcomes due to congenital infection with Zika virus by trimester of exposure. Methods This was a Bayesian latent class analysis of data from seven prospective studies of Zika virus in pregnancy. We estimated vertical transmission rates, rates of Zika-virus-related and non-Zika-virus-related adverse outcomes, and the diagnostic sensitivity of markers of congenital infection. We allowed for variation between studies in these parameters and used information from women in comparison groups with no PCR-confirmed infection, where available. Findings The estimated mean risk of vertical transmission was 47% (95% credible interval 26 to 76) following maternal infection in the first trimester, 28% (15 to 46) in the second, and 25% (13 to 47) in the third. 9% (4 to 17) of deliveries following infections in the first trimester had symptoms consistent with congenital Zika syndrome, 3% (1 to 7) in the second, and 1% (0 to 3) in the third. We estimated that in infections during the first, second, and third trimester, respectively, 13% (2 to 27), 3% (−5 to 14), and 0% (−7 to 11) of pregnancies had adverse outcomes attributable to Zika virus infection. Diagnostic sensitivity of markers of congenital infection was lowest in the first trimester (42% [18 to 72]), but increased to 85% (51 to 99) in trimester two, and 80% (42 to 99) in trimester three. There was substantial between-study variation in the risks of vertical transmission and congenital Zika syndrome. Interpretation This preliminary analysis recovers the causal effects of Zika virus from disparate study designs. Higher transmission in the first trimester is unusual with congenital infections but accords with laboratory evidence of decreasing susceptibility of placental cells to infection during pregnancy. Funding European Union Horizon 2020 programme.
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- 2021
34. Hipotermia terapéutica en el recién nacido a término o casi término con encefalopatía hipóxico-isquémica
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Alix, Alfredo García and Allen, Ana Alarcón
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- 2013
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35. Prenatal diagnosis of <scp>Kagami‐Ogata</scp> syndrome
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Montserrat Milà Recasens, Montserrat Izquierdo Renau, Josep Maria Martínez Crespo, Joan Sabrià Bach, Cristina Molinet Coll, Ana Alarcón Allen, Olga Gómez Del Rincón, and David Monk
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Thorax ,Polyhydramnios ,Pediatrics ,medicine.medical_specialty ,Respiratory distress ,business.industry ,Prenatal diagnosis ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,Protuberant abdomen ,Abdominal wall ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Intellectual disability ,medicine ,Radiology, Nuclear Medicine and imaging ,business ,Congenital disorder - Abstract
Kagami-Ogata syndrome (KOS14) is a rare congenital disorder associated with defective genomic imprinting of the chromosome 14q32 domain. Typical features include polyhydramnios, small and bell-shaped thorax, coat-hanger ribs, dysmorphic facial features, abdominal wall defects, placentomegaly, severe postnatal respiratory distress and intellectual disability. To the best of our knowledge, this may be the first case where ultrasound findings such as: severe polyhydramnios, a small bell- shaped thorax, a protuberant abdomen and characteristic dysmorphic face prompted directed family interrogation finally leading to the prenatal diagnosis of KOS14.
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- 2020
36. Chimeric antigen receptor T cells and management of toxicities: implications of biomarkers
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Kitsada Wudhikarn, Ana Alarcón Tomás, Kazunori Murata, and Miguel-Angel Perales
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- 2022
37. Chapter 8 - Chimeric antigen receptor T cells and management of toxicities: implications of biomarkers
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Wudhikarn, Kitsada, Tomás, Ana Alarcón, Murata, Kazunori, and Perales, Miguel-Angel
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- 2022
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38. Letter to the Editor on the original article: Lower prevalence of congenital cytomegalovirus infection in Portugal: possible impact of COVID-19 lockdown?
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María, Ríos-Barnés, Melissa Andrea, Fontalvo, Nerea, Liñán, Montserrat, Plana, María, Moreno, Cristina, Esteva, Carmen, Muñoz-Almagro, Antoni, Noguera-Julian, and Ana, Alarcón
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Congenital ,Portugal ,SARS-CoV-2 ,Short Communication ,Pediatrics, Perinatology and Child Health ,Communicable Disease Control ,Cytomegalovirus Infections ,Prevalence ,CMV ,Screening ,Pools ,COVID-19 ,Humans - Abstract
Cytomegalovirus (CMV) is the most frequent cause of congenital infection all over the world. Its prevalence ranges from 0.2 to 2.2%. Transmission from children to their pregnant mothers is a well-known risk factor, particularly if they attend a childcare centre. This study aims to compare the prevalence of CMV congenital infection (CMV_CI) in Portugal (Lisbon) between two studies, performed respectively in 2019 and 2020. In the 2019 study, performed in two hospitals, we found a 0.67% CMV_CI prevalence, using a pool strategy previously tested with saliva samples. In the 2020 study, using the same pool approach in four hospitals (the previous and two additional), and based on 1277 samples, the prevalence was 0.078%. Conclusion: The close temporal coincidence with COVID-19 lockdown suggests that these measures may have had a significant impact on this reduction, although other explanations cannot be ruled-out. What is Known:• Cytomegalovirus is the leading cause of congenital infection.• Behavioural measures decrease cytomegalovirus seroconversion in pregnant women.What is New:• From 2019 to 2020 there was a significant reduction in the prevalence of congenital CMV infection.
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- 2021
39. Conventional and novel [18F]FDG PET/CT features as predictors of CAR-T cell therapy outcome in large B-cell lymphoma
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Doris Leithner, Jessica R. Flynn, Sean M. Devlin, Audrey Mauguen, Teng Fei, Shang Zeng, Junting Zheng, Brandon S. Imber, Harper Hubbeling, Marius E. Mayerhoefer, Akshay Bedmutha, Efrat Luttwak, Magdalena Corona, Parastoo B. Dahi, Alejandro Luna de Abia, Ivan Landego, Richard J. Lin, M. Lia Palomba, Michael Scordo, Jae H. Park, Ana Alarcon Tomas, Gilles Salles, Daniel Lafontaine, Laure Michaud, Gunjan L. Shah, Miguel-Angel Perales, Roni Shouval, and Heiko Schöder
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Lymphoma ,Positron emission tomography ,Biomarker ,Immunotherapy ,CAR-T ,Radiomics ,Diseases of the blood and blood-forming organs ,RC633-647.5 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Relapse and toxicity limit the effectiveness of chimeric antigen receptor T-cell (CAR-T) therapy for large B-cell lymphoma (LBCL), yet biomarkers that predict outcomes and toxicity are lacking. We examined radiomic features extracted from pre-CAR-T 18F-fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) scans (n = 341) of 180 patients (121 male; median age, 66 years). Three conventional (maximum standardized uptake value [SUVmax], metabolic tumor volume [MTV], total lesion glycolysis [TLG]) and 116 novel radiomic features were assessed, along with inflammatory markers, toxicities, and outcomes. At both pre-apheresis and pre-infusion time points, conventional PET features of disease correlated with elevated inflammatory markers. At pre-infusion, MTV was associated with grade ≥ 2 cytokine release syndrome (odds ratio [OR] for 100 mL increase: 1.08 [95% confidence interval (CI), 1.01–1.20], P = 0.031), and SUVmax was associated with failure to achieve complete response (CR) (OR 1.72 [95% CI, 1.24–2.43], P
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- 2024
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40. Renal Involvement in Congenital Cytomegalovirus Infection: A Systematic Review
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Ana Alarcón, Claudia Fortuny, María Ríos-Barnés, and Antoni Noguera-Julian
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0301 basic medicine ,Microbiology (medical) ,Ganciclovir ,Pediatrics ,medicine.medical_specialty ,ganciclovir ,QH301-705.5 ,030106 microbiology ,congenital nephrotic syndrome ,Congenital cytomegalovirus infection ,valganciclovir ,Autopsy ,inclusion bodies ,Disease ,Review ,Communicable diseases ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,Cytomegaloviruses ,Virology ,Medicine ,030212 general & internal medicine ,Biology (General) ,Congenital nephrotic syndrome ,Pathological ,cytomegalovirus ,Kidney ,Kidney diseases ,renal tubules ,business.industry ,Malalties infeccioses ,medicine.disease ,congenital infection ,viruria ,medicine.anatomical_structure ,Citomegalovirus ,Malalties del ronyó ,business ,medicine.drug ,Kidney disease - Abstract
Background: Congenital cytomegalovirus (cCMV) infection is the most frequent mother-to-child transmitted infection worldwide and a prevalent cause of neonatal disease and long-term morbidity. The kidney is a target organ for CMV, which replicates in renal tubules and is excreted in large quantities in urine for years in children with cCMV infection. Nonetheless, kidney disease has rarely been reported in cCMV-infected patients. Objective: We aimed to describe the available data on renal involvement in patients with cCMV infection at the pathologic, functional, anatomical, and/or clinical levels. Methods: A systematic search was performed in the MEDLINE/PubMed, SCOPUS, and Cochrane databases. Studies describing any renal involvement in fetuses or neonates aged ≤3 weeks at diagnosis of microbiologically confirmed cCMV infection were eligible. Results: Twenty-four articles were included, with a very low level of evidence. Pathologic findings in autopsy studies universally described CMV typical inclusion bodies in tubular cells. No functional studies were identified. cCMV infection was not associated with an increased risk of kidney malformations. Congenital nephrotic syndrome was the most common clinical condition associated with cCMV, but a causal relationship cannot be established. Conclusions: Typical pathological features of cCMV infection are very common in renal tissue, but they do not seem to entail significant consequences at the anatomical or clinical levels.
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- 2021
41. [Challenges in the application of non-servocontrolled therapeutic hypothermia during neonatal transport in Catalonia]
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Marta Sardà Sánchez, Olga Oller Fradera, Olalla Rodríguez Losada, Sara Maya Gallego, Teresa Esclapés Giménez, Ana Alarcón, Elisabeth Esteban, Nuria Torre Monmany, Aina Martínez Planas, Institut Català de la Salut, [Torre Monmany N, Rodríguez Losada O] Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain. Unidad de Neonatología, Hospital Parc Taulí, Sabadell, Spain. Unidad de Transporte Aéreo Pediátrico y Neonatal, Hospital Parc Taulí, Sabadell, Spain. [Maya Gallego S] Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain. [Esclapés Giménez T] Unitat de Transport Pediàtric i Neonatal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Neonatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Rodríguez Losada O] Unitat de Transport Pediàtric i Neonatal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Martínez Planas A] Unidad de Transporte Pediátrico y Neonatal, Hospital Sant Joan de Déu, Esplugues de Llobregat, España. Unidad de Hospitalización de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona. Spain. [Oller Fradera O] Unitat de Transport Pediàtric i Neonatal, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Unitat de Cures Intensives Pediàtriques, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Brain Ischemia::Hypoxia-Ischemia, Brain [DISEASES] ,Transport time ,Therapeutics::Emergency Treatment::Transportation of Patients [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Gestational Age ,enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::isquemia cerebral::hipoxia-isquemia encefálica [ENFERMEDADES] ,Pediatrics ,Transport de malalts i ferits ,RJ1-570 ,Hipotermia terapéutica ,Hypothermia, Induced ,Hipotermia servo-controlada ,Management of Technology and Innovation ,Humans ,Medicine ,Prospective Studies ,Transporte neonatal ,Hipotermia pasiva ,Otros calificadores::/terapia [Otros calificadores] ,Asfixia neonatal ,terapéutica::crioterapia::hipotermia inducida [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,business.industry ,Infant, Newborn ,Therapeutics::Cryotherapy::Hypothermia, Induced [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Infant ,Gestational age ,Rectal temperature ,Mean age ,Hipotèrmia induïda ,Other subheadings::/therapy [Other subheadings] ,Hypothermia ,Malalties cerebrovasculars en els infants - Tractament ,Neonatal transport ,Spain ,Anesthesia ,Hypoxia-Ischemia, Brain ,terapéutica::tratamiento de urgencia::transporte de pacientes [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,medicine.symptom ,business ,Encefalopatía hipoxico-isquémica - Abstract
Transporte neonatal; Encefalopatía hipoxico-isquémica; Hipotermia Transport neonatal; Encefalopatia hipoxico-isquèmica; Hipotèrmia Neonatal transport; Hypoxic-ischemic encephalopathy; Hypothermia Introduction Therapeutic hypothermia (TH) improves survival and neurological prognosis in hypoxic-ischemic encephalopathic (HIE) babies, being better the sooner TH is implemented. HIE babies are born more frequently in a non-cooling centre and need to be referred. Methods Prospective-observational study (April 18 2018 – November 19 2019). Newborns (≥34 weeks of gestational age (GA) and >1800 g) with moderate/severe HIE on non-servocontrolled therapeutic hypothermia by the two neonatal transport teams in Catalonia. Results 51 newborns. The median stabilisation and transport time were 68 min (p25–75, 45–85 min) and 30 min (p25–75, 15–45 min), respectively. The mean age at arrival at the receiving unit was 4 h and 18 min (SD 96.6). The incubator was set off in 43 (84%), iced-packs 11 (21.5%) and both (11, 21.5%). Target temperature was reached in 19 (37.3%) babies. There were no differences in the overcooling in relation to the measures applied. The transport duration was not related with temperature stabilisation or target temperature reachiness. Conclusions Rectal temperature monitorisation is compulsory for the stabilisation and the application of non-servocontrolled hypothermia during transport. There is still time for improving in the administration of this treatment during transport. Servo-controlled hypothermia would be a better alternative to improve the management of HIE babies. Introducción La hipotermia terapéutica (HTT) es el único tratamiento que ha demostrado aumentar la posibilidad de supervivencia libre de secuelas en los recién nacidos (RNs) afectos de encefalopatía hipóxico-isquémica (EHI), recomendándose iniciarla lo antes posible. Lo más frecuente es que los pacientes tributarios de HTT no nazcan en los centros de referencia (CR), requiriendo ser transportados. Métodos Estudio observacional descriptivo prospectivo de RNs con EHI moderada-grave trasladados en hipotermia terapéutica no servo-controlada por los dos equipos de transporte neonatal y pediátrico terrestres de Cataluña (abril 2018-noviembre 2019). Resultados 51 pacientes. Mediana de tiempo de estabilización 68 minutos (p25-75, 45 – 85 min), traslado 30 minutos (p25-75, 15 – 45 min). Media de edad a la llegada al CR 4 horas y 18 minutos (DE 96 min). Medidas terapéuticas adoptadas: apagar la incubadora 43 (84,3%), bolsas de hielo 11 (21,6%) y ambas 11 (21,5%) pacientes. Se consiguió la temperatura rectal (TR) diana en 19 (37,3%) pacientes. No hubo diferencias en el sobre-enfriamiento según las medidas usadas para la aplicación de la HTT no servo-controlada (HTTnc). La duración del traslado no se relacionó con diferencias en la estabilización de la temperatura ni en la consecución de la temperatura objetivo. Conclusiones La monitorización de la TR en el centro emisor es un pilar fundamental en la estabilización del paciente y la aplicación de la HTTnc. Existe una clara área de mejora en la eficacia de la HTTnc durante el transporte. La HTT servo-controlada sería una opción para poder ofrecer las mismas posibilidades terapéuticas a los RNs extramuros de los CR.
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- 2021
42. Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI)
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Marianne Leruez-Ville, Christos Chatzakis, Daniele Lilleri, Daniel Blazquez-Gamero, Ana Alarcon, Nicolas Bourgon, Ina Foulon, Jacques Fourgeaud, Anna Gonce, Christine E. Jones, Paul Klapper, André Krom, Tiziana Lazzarotto, Hermione Lyall, Paulo Paixao, Vassiliki Papaevangelou, Elisabeth Puchhammer, George Sourvinos, Pamela Vallely, Yves Ville, and Ann Vossen
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Congenital cytomegalovirus infection ,Guidelines ,Prenatal ,Neonatal ,Postnatal ,Public aspects of medicine ,RA1-1270 - Abstract
Summary: Congenital cytomegalovirus (cCMV) infection carries a significant burden with a 0.64% global prevalence and a 17–20% chance of serious long-term effects in children. Since the last guidelines, our understanding, particularly regarding primary maternal infections, has improved. A cCMV guidelines group was convened under the patronage of the European Society of Clinical Virology in April 2023 to refine these insights. The quality and validity of selected studies were assessed for potential biases and the GRADE framework was employed to evaluate quality of evidence across key domains. The resulting recommendations address managing cCMV, spanning prevention to postnatal care. Emphasizing early and accurate maternal diagnosis through serological tests enhances risk management and prevention strategies, including using valaciclovir to prevent vertical transmission. The guidelines also strive to refine personalized postnatal care based on risk assessments, ensuring targeted interventions for affected families.
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- 2024
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43. Neonates Born to Mothers With COVID-19: Data From the Spanish Society of Neonatology Registry
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Carmen Ribes Bautista, Fátima Camba Longueira, Manuel Sánchez-Luna, Ana María Baña Souto, Ana Alarcón Allen, María González López, Elena Zamora Flores, Laura Sánchez García, Maria Cernada Badia, Zenaida Galve Pradell, M. Cruz López Herrera, Concepción de Alba Romero, and Belen Fernandez Colomer
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Adult ,medicine.medical_specialty ,Population ,Breastfeeding ,Rooming-in Care ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,030225 pediatrics ,Epidemiology ,medicine ,Humans ,Neonatology ,Prospective Studies ,Registries ,Pregnancy Complications, Infectious ,Prospective cohort study ,education ,Pandemics ,education.field_of_study ,business.industry ,Obstetrics ,Cesarean Section ,SARS-CoV-2 ,Infant, Newborn ,COVID-19 ,medicine.disease ,Infectious Disease Transmission, Vertical ,Kangaroo-Mother Care Method ,Breast Feeding ,Spain ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business ,Breast feeding ,Infant, Premature - Abstract
OBJECTIVES: To describe neonatal and maternal characteristics of the largest prospective cohort of newborns from mothers with coronavirus disease 2019 (COVID-19), the data of which were prospectively collected from the nationwide registry of the Spanish Society of Neonatology. METHODS: Between March 8, 2020, and May 26, 2020, the data of 503 neonates born to 497 mothers diagnosed with COVID-19 during pregnancy or at the time of delivery were collected by 79 hospitals throughout Spain. RESULTS: Maternal symptoms were similar to that of the general population, with 5% of severe forms. In 45.8% of asymptomatic women at the time of delivery, severe acute respiratory syndrome coronavirus 2 infection was detected because of recommendations established in Spain to perform COVID-19 screening in all women admitted to the hospital for labor. The rate of preterm deliveries was 15.7% and of cesarean deliveries, 33%. The most common diagnostic test was detection of viral RNA by polymerase chain reaction of nasopharyngeal swabs at a median age of 3 hours after delivery (1–12 hours). Almost one-half of neonates were left skin-to-skin after delivery, and delayed clamping of umbilical cords was performed in 43% of neonates. Also, 62.3% of asymptomatic neonates were managed with rooming-in. Maternal milk was received by 76.5% of neonates, 204 of them as exclusive breastfeeding. CONCLUSIONS: The current study indicates that there is no need for separation of mothers from neonates, allowing delayed cord clamping and skin-to-skin contact along with maintenance of breastfeeding in a high percentage of newborns from mothers with COVID-19.
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- 2020
44. Geriatric syndromes in two-year, progression-free survivors among older recipients of allogeneic hematopoietic cell transplantation
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Lin, Richard J., Baser, Raymond E., Elko, Theresa A., Korc-Grodzicki, Beatriz, Shahrokni, Armin, Maloy, Molly A., Young, James W., Tamari, Roni, Shah, Gunjan L., Shaffer, Brian C., Scordo, Michael, Sauter, Craig S., Ponce, Doris M., Politikos, Ioannis, Perales, Miguel-Angel, Papadopoulos, Esperanza B., Gyurkocza, Boglarka, Dahi, Parastoo B., Cho, Christina, Barker, Juliet N., Tomas, Ana Alarcón, Flores, Nerea Castillo, Sanchez-Escamilla, Míriam, Segundo, Lucrecia Yáñez San, Jakubowski, Ann A., and Giralt, Sergio A.
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Hematopoietic Stem Cell Transplantation ,Humans ,Transplantation, Homologous ,Survivors ,Syndrome ,Article ,Disease-Free Survival ,Aged - Published
- 2020
45. A paired trial comparing mononuclear cell collection in two machines for further inactivation through an inline or offline extracorporeal photopheresis procedure
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Rafael F. Duarte, Piedad Ussetti, Myriam Aguilar, José Rafael Cabrera, José Luis Bueno, Clara Gonzalez‐Santillana, Ana Alarcón, Daniel Naya, Rosalía Alonso, Irene Romera, and Guiomar Bautista
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Male ,Collection Time ,Immunology ,Blood Pressure ,030204 cardiovascular system & hematology ,Peripheral blood mononuclear cell ,03 medical and health sciences ,0302 clinical medicine ,Paired samples ,Heart Rate ,Extracorporeal Photopheresis ,Humans ,Immunology and Allergy ,Effective treatment ,Medicine ,Clinical efficacy ,Bronchiolitis Obliterans ,business.industry ,Temperature ,Hematology ,Photopheresis ,Leukocytes, Mononuclear ,Female ,Nuclear medicine ,business ,030215 immunology - Abstract
BACKGROUND Extracorporeal photopheresis (ECP) is an effective treatment. However, protocols differ widely, and some questions, such as the number of cells to be collected or the number of ECP treatment days per treatment cycle, are still unsolved. The aim of this study was to compare a multistep (offline) (Spectra Optia and Macogenic G2) against an integrated (inline) ECP system (Therakos Cellex system) with respect to mononuclear cell (MNC) collection. STUDY DESIGN AND METHODS The number and quality parameters of the MNC products collected were evaluated together with some machine parameters, such as collection time. Comparisons were made through paired sample analysis with the t test. RESULTS Fourteen patients underwent 15 double-paired procedures using both ECP protocols. The average MNC collected in the multistep procedure was 77.4 × 108 , four times more than in the integrated procedure (18.5 × 108 ). MNC purity (84.4% vs. 63.8%) and enrichment (27.9 vs. 5.9) in the product collected were also higher in the multistep procedure. The whole ECP time was higher in the multistep than in the integrated procedure (272 vs. 106 min), but the calculated time to collect 25 × 108 MNCs in the multistep was shorter compared with the one-step procedure (77.8 vs. 172 min). All these differences between the two protocols were statistically significant. CONCLUSIONS These two ECP protocols are different with respect to MNC collection and length of procedure. Some unresolved questions, such as the better MNC dose to inactivate or the number of consecutive days that ECP should be performed for optimal clinical efficacy, require further review.
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- 2018
46. Evaluation of an Age-Friendly City and Its Effect on Life Satisfaction: A Two-Stage Study
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Antonio Caballer, Ana Alarcón, and Raquel Flores
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Gerontology ,Male ,Aging ,Health, Toxicology and Mutagenesis ,Population ,Public policy ,Personal Satisfaction ,Article ,03 medical and health sciences ,Survey methodology ,0302 clinical medicine ,Empirical research ,active ageing ,Humans ,030212 general & internal medicine ,Cities ,education ,life satisfaction ,Aged ,Aged, 80 and over ,education.field_of_study ,030214 geriatrics ,age-friendly cities ,Public Health, Environmental and Occupational Health ,Life satisfaction ,Focus Groups ,Middle Aged ,Focus group ,Active ageing ,Cohort ,demographic ageing ,Quality of Life ,Environment Design ,Female ,Psychology - Abstract
Due to the ageing of the world&rsquo, s population, age-friendly cities are emerging to promote active ageing by optimising opportunities for health, participation and safety, in order to improve the quality of life of older people. Despite initiatives in different countries, there is a lack of empirical research exploring their impact on older people. The objective of this study is to evaluate an age-friendly city by analysing its relationship with life satisfaction, taking into account the age cohort variables of the elderly and whether they live alone or with someone else. A two-stage study, in which 66 subjects participated in the qualitative analysis (focus groups) in Stage I and 203 of the quantitative analysis (survey methodology) or Stage II. Despite the differences found in the different groups of elderly persons, for all of them the domains of outdoor spaces and buildings, and community support and health services, are significantly related to life satisfaction, with the latter showing itself to be a predictor of such satisfaction. It is important to take into account the different groups of elderly persons, so as to be able to establish suitable specific actions. This study aims to make a contribution to the development of public policies that influence the life satisfaction of the elderly.
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- 2019
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47. Riesgo de hemorragia postquirúrgica en pacientes bajo tratamiento antitrombótico sometidos a cirugía oral: Revisión Sistemática y Metaanálisis
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Gabriel Zamorano, Rosa Rojo, Julio Villanueva, Ignacio Araya, Diego Vergara, Lorena Núñez, Sebastián Felipe Sánchez Zapata, Stefan Domancic, Ana Alarcón, Josefina Salazar, and Nicolás Yanine
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General Medicine - Published
- 2018
48. Geriatric syndromes in 2-year, progression-free survivors among older recipients of allogeneic hematopoietic cell transplantation
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Lin, Richard J., primary, Baser, Raymond E., additional, Elko, Theresa A., additional, Korc-Grodzicki, Beatriz, additional, Shahrokni, Armin, additional, Maloy, Molly A., additional, Young, James W., additional, Tamari, Roni, additional, Shah, Gunjan L., additional, Shaffer, Brian C., additional, Scordo, Michael, additional, Sauter, Craig S., additional, Ponce, Doris M., additional, Politikos, Ioannis, additional, Perales, Miguel-Angel, additional, Papadopoulos, Esperanza B., additional, Gyurkocza, Boglarka, additional, Dahi, Parastoo B., additional, Cho, Christina, additional, Barker, Juliet N., additional, Tomas, Ana Alarcón, additional, Flores, Nerea Castillo, additional, Sanchez-Escamilla, Míriam, additional, Segundo, Lucrecia Yáñez San, additional, Jakubowski, Ann A., additional, and Giralt, Sergio A., additional
- Published
- 2020
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49. The geriatric syndrome of sarcopenia impacts allogeneic hematopoietic cell transplantation outcomes in older lymphoma patients
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Lin, Richard J., primary, Michaud, Laure, additional, Lobaugh, Stephanie M., additional, Nakajima, Reiko, additional, Mauguen, Audrey, additional, Elko, Theresa A., additional, Ruiz, Josel D., additional, Maloy, Molly A., additional, Sauter, Craig S., additional, Dahi, Parastoo B., additional, Perales, Miguel-Angel, additional, Shah, Gunjan L., additional, Castillo Flores, Nerea, additional, Sanchez-Escamilla, Míriam, additional, Tomas, Ana Alarcón, additional, San Segundo, Lucrecia Yáñez, additional, Cho, Christina, additional, Politikos, Ioannis, additional, Kim, Soo Jung, additional, Korc-Grodzicki, Beatriz, additional, Devlin, Sean M., additional, Scordo, Michael, additional, Schöder, Heiko, additional, Giralt, Sergio A., additional, and Hamlin, Paul A., additional
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- 2020
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50. Granuloma Periférico de Células Gigantes e Hiperparatiroidismo. Presentación de un Caso
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Katty Schnettler, Ana Alarcón-Arratia, Carolina Ulloa-Marin, and Maximiliano Muñoz-Repetto
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business.industry ,insuficiencia renal crónica ,Medicine ,granuloma periférico ,células gigantes ,business ,hiperparatiroidismo - Abstract
RESUMEN: Se presenta el caso de un paciente sexo femenino 31 años, insuficienciente renal crónica en hemodiálisis, hipertensa secundaria, consulta por aumento de volumen oral en relación a encía marginal vestibular izquierda, 6 meses de evolución. Al examen se observa aumento de volumen de 15 mm en relación a piezas. 3.6 y 3.7. Radiografía muestra compromiso periodontal pieza 3.7. Se realiza biopsia excisional y exodoncia pieza 3.7. Histopatología informa granuloma periférico de células gigantes. Se solicitan exámenes de laboratorio para estudio de hiperparatiroidismo (PTH elevada, calcemia fosfatemia normales). Evoluciona favorablemente. Sin signos de recidiva a los 3 meses. El diagnóstico histopatológico de lesión de células gigantes debe ser complementado con la clínica, exámenes de laboratorio e imagenología, el objetivo final es definir si tal diagnóstico corresponde a un tumor pardo, a un granuloma central de células gigantes o a un granuloma periférico de células gigantes. En la literatura los reportes de asociación entre granuloma periférico de células gigantes e hiperparatiroidismo son escasos. Este caso corresponde a granuloma periférico células gigantes, asociado a hipersecreción de paratohormona.
- Published
- 2019
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