110 results on '"Gil-Guillen V"'
Search Results
2. Early rehospitalization after hip fracture in elderly patients: risk factors and prognosis
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Lizaur-Utrilla, A., Serna-Berna, R., Lopez-Prats, F. A., and Gil-Guillen, V.
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- 2015
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3. Mortality prediction models after radical cystectomy for bladder tumour: A systematic review and critical appraisal
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Sarrio-Sanz P, Martinez-Cayuelas L, Lumberas B, Sanchez-Caballero L, Palazon-Bru A, Gil-Guillen V, and Gomez-Perez L
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models ,urinary bladder neoplasms ,mortality ,radical cystectomy ,nomograms - Abstract
Introduction To identify risk-predictive models for bladder-specific cancer mortality in patients undergoing radical cystectomy and assess their clinical utility and risk of bias. Methods Systematic review (CRD42021224626:PROSPERO) in Medline and EMBASE (from their creation until 31/10/2021) was screened to include articles focused on the development and internal validation of a predictive model of specific cancer mortality in patients undergoing radical cystectomy. CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) and Prediction model Risk Of Bias ASsessment Tool (PROBAST) were applied. Results Nineteen observational studies were included. The main predictors were sociodemographic variables, such as age (18 studies, 94.7%) and sex (17, 89.5% studies), tumour characteristics (TNM stage (18 studies, 94.7%), histological subtype/grade (15 studies, 78.9%), lymphovascular invasion (10 studies, 52.6%) and treatment with chemotherapy (13 studies, 68.4%). C-index values were presented in 14 studies. The overall risk of bias assessed using PROBAST led to 100% of studies being classified as high risk (the analysis domain was rated to be at high risk of bias in all the studies), and 52.6% showed low applicability. Only 5 studies (26.3%) included an external validation and 2 (10.5%) included a prospective study design. Conclusions Using clinical predictors to assess the risk of bladder-specific cancer mortality is a feasibility alternative. However, the studies showed a high risk of bias and their applicability is uncertain. Studies should improve the conducting and reporting, and subsequent external validation studies should be developed.
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- 2022
4. Genito Pelvic Pain/Penetration Disorder (GPPPD) in Spanish Women-Clinical Approach in Primary Health Care: Review and Meta-Analysis
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Berenguer-Soler M, Navarro-Sanchez A, Compan-Rosique A, Luri-Prieto P, Navarro-Ortiz R, Gomez-Perez L, Perez-Tomas C, Font-Julia E, Gil-Guillen V, Cortes-Castell E, Navarro-Cremades F, Montejo A, Arroyo-Sebastian M, and Perez-Jover V
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primary health care ,female ,Spanish scientific publications ,penetration pain disorder ,vaginismus ,Spain ,dyspareunia ,genito-pelvic ,vulvodynia ,women ,sexual pain - Abstract
Sexuality is a component of great relevance in humans. Sexual disorders are a major public health problem representing a high prevalence in the general population. DSM-5 genito-pelvic pain/penetration disorder (GPPPD) includes dyspareunia and vaginismus (DSM-IV-TR). To assess the importance of research on these disorders in Spain, we evaluated the Spanish scientific publications of primary and community care. The objective was to quantify the magnitude of the publications of GPPPD in Spanish women in primary and community care. For this, we used the method of conducting a systematic review and meta-analysis of studies evaluating GPPPD. As main results, of the 551 items found, we selected 11 studies that met the inclusion criteria. In primary care in Spain, one in nine women has these disorders; the percentage of women with GPPPD in this study (raw data) was 11.23% (95% CI: 0-29%) (vaginismus 5%; penetration pain 8.33%; dyspareunia 16.45%). These percentages can differ of those from other countries, and they are at the top of the data of the European countries (9-11.9%). There is much variability in the studies found in the world with respect to the prevalence of these health problems.
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- 2022
5. Control de las cifras de presión arterial en diabéticos tipo 2 tratados con insulina: Blood pressure control in diabetics type 2 treated with insulin
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Márquez Contreras, E., Casado Martínez, J.J., Martín de Pablos, J.L., Gil Guillén, V., Ferraro García, J., Chaves González, R., and Fernández Ortega, A.
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- 2010
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6. Estudio de farmacovigilancia con lercanidipino. Datos del estudio ZANyCONTROL
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Abellán Alemán, J., Gil Guillén, V., Merino Sánchez, J., Llisterri Caro, J.L., and Leal Hernández, M.
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- 2009
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7. Valoración del riesgo cardiovascular en la fase transversal del estudio Mediterránea
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Gil-Guillén, V., Merino-Sánchez, J., Sánchez-Ruiz, T., Amorós-Barber, T., Aznar-Vicente, J., Abellán-Alemán, J., Llisterri-Caro, J.L., and Orozco-Beltrán, D.
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- 2009
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8. Long-term survival after Acute Ischemic Stroke by types of reperfusion therapy, sex and chronic treatments of cardiovascular conditions
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Juan Ballesta-Ors, Eulalia Muria-Subirats, Sonia Abilleira, Queralt-Tomas M Lluïsa, González-Henares Ma, Gil-Guillen V Fco, and Jose Luis Clua-Espuny
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Community and Home Care ,medicine.medical_specialty ,education.field_of_study ,business.industry ,medicine.medical_treatment ,Population ,Group ii ,Thrombolysis ,Mechanical thrombectomy ,Reperfusion therapy ,Internal medicine ,Long term survival ,medicine ,Cardiology ,education ,business ,Medical therapy ,Acute ischemic stroke - Abstract
Purpose: Compare long-term survival by sex after reperfusion therapies with simultaneous medical therapy of cardiovascular conditions. Methods: AIS patients identified from the population-based register between 01Jan2011 and 31Dec2012 and classified into: 1) AIS + intravenous thrombolysis [group I], 2) AIS + mechanical thrombectomy with or without intravenous thrombolysis [group II], and 3) AIS + medical therapy alone (no reperfusion therapies) [group III]. Follow-up went through up until December 2016. Statistical approaches were employed for analyzing survival outcomes and their relationship with reperfusion therapy.
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- 2018
9. Influence of Pharmaceutical Copayment on Emergency Hospital Admissions: A 1978-2018 Time Series Analysis in Spain
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Palazon-Bru A, Calvo-Perez M, Rico-Ferreira P, Anunciacion Freire-Ballesta M, Francisco Gil-Guillen V, and De los Angeles Carbonell-Torregrosa M
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pharmacy ,inpatients ,copayment ,health expenditures ,cost control ,hospitalization - Abstract
No studies have evaluated the influence of pharmaceutical copayment on hospital admission rates using time series analysis. Therefore, we aimed to analyze the relationship between hospital admission rates and the influence of the introduction of a pharmaceutical copayment system (PCS). In July 2012, a PCS was implemented in Spain, and we designed a time series analysis (1978-2018) to assess its impact on emergency hospital admissions. Hospital admission rates were estimated between 1978 and 2018 each month using the Hospital Morbidity Survey in Spain (the number of urgent hospital admissions per 100,000 inhabitants). This was conducted for men, women and both and for all-cause, cardiovascular and respiratory hospital discharges. Life expectancy was obtained from the National Institute of Statistics. The copayment variable took a value of 0 before its implementation (pre-PCS: January 1978-June 2012) and 1 after that (post-PCS: July 2012-December 2018). ARIMA (Autoregressive Integrated Moving Average) (2,0,0)(1,0,0) models were estimated with two predictors (life expectancy and copayment implementation). Pharmaceutical copayment did not influence hospital admission rates (with p-values between 0.448 and 0.925) and there was even a reduction in the rates for most of the analyses performed. In conclusion, the PCS did not influence hospital admission rates. More studies are needed to design health policies that strike a balance between the amount contributed by the taxpayer and hospital admission rates.
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- 2021
10. A modified Delphi consensus study to identify improvement proposals for COPD management amongst clinicians and administrators in Spain
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Arriero-Marin J, Orozco-Beltran D, Carratala-Munuera C, Lopez-Pineda A, Gil-Guillen V, Soler-Cataluna J, Chiner-Vives E, Garcia R, and Quesada J
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respiratory tract diseases - Abstract
Aims To identify the obstacles hindering the appropriate management of chronic obstructive pulmonary disease (COPD) in Spain based on consensus amongst clinicians and administrators. Methods A two-round modified Delphi questionnaire was sent to clinicians (pulmonologists and GPs) and administrators, all experts in COPD. The scientific committee developed the statements and selected the participating experts. Four areas were explored: diagnosis, training, treatment, and clinical management. Panellists' agreement was assessed using a 9-point Likert scale, with scores of 1 to 3 indicating disagreement and 7 to 9, agreement. Consensus was considered to exist when 70% of the participants agreed or disagreed with the statement. Results Respective response rates for the first and second round were 68% and 91% for clinicians, and 60% and 100% for administrators. The statements attracting the highest degree of consensus were: "Not enough nursing resources (time, staff, duties) are allocated for performing spirometry" (85.3% clinicians; 75% administrators); "Nurses need specific training in COPD" (84.8% clinicians; 100% administrators); "Rehabilitation programs are necessary for treating patients with COPD" (94.1% clinicians; 91.7% administrators); and "Integrated care processes facilitate the deployment of educational programs on COPD" (79.4% clinicians; 83.3% administrators). Conclusions This document can inform the development and implementation of specific initiatives addressing the existing obstacles in COPD management. What's known COPD is a prevalent and underdiagnosed disease that causes substantial morbidity and mortality. The National COPD Strategy established objectives and work programmes to apply in Spain. There are barriers impeding the application of interventions contemplated in the COPD strategy. What's new Different agents involved in COPD management agree that the main challenges to improve COPD management are resource shortages in primary care nursing and lack of training in the use of COPD clinical guidelines. Clinicians and administrators involved in COPD management support the implementation of urgent measures to tackle the underdiagnosis of COPD, especially in primary care, along with the routine inclusion of respiratory rehabilitation programmes for COPD.
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- 2021
11. Validation of the Center of Applied Psychology Female Sexuality Questionnaire (CAPFS-Q)
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Tirado-Gonzalez S, Navarro-Sanchez A, Compan-Rosique A, Luri-Prieto P, Rodriguez-Marin J, Van-der Hofstadt-Roman C, Soler M, Navarro-Cremades F, Gil-Guillen V, Ortiz R, Montejo A, and Perez-Jover V
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validity ,female ,questionnaire ,psychometry ,sexuality - Abstract
Instruments for the measurement of human sexuality include self-report measures used to assess sexual functioning, but many of them have not yet been validated. The Center of Applied Psychology Female Sexual Questionnaire (CAPFS-Q) is an original self-report instrument. It has been developed for the study of sexuality in specific non-clinical populations, such as female university students of Medicine and other Health Sciences. The CAPFS-Q includes 26 items, organized as follows: sociodemographic and relevant data (four items); aspects of sexual relations with partner (five items); sexual practices (12 from 13 items); and dysfunctional aspects of sexual relations (four items). CAPFS-Q validity and reliability were examined in a sample of Spanish female university students of Health Sciences. Exploratory and confirmatory factor analysis (FA) showed a four-factor structure which explained 71.6% of the variance. This initial version of the CAPFS-Q is a reliable measure of women's sexual behavior, with a dimensionality that replicates the initial theoretical content and with adequate indicators of internal consistency, validity, and test-retest reliability. It is easy to administer and to complete.
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- 2021
12. A critical appraisal of the prognostic predictive models for patients with sepsis: Which model can be applied in clinical practice?
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Beneyto-Ripoll C, Palazon-Bru A, Llopez-Espinos P, Martinez-Diaz A, Gil-Guillen V, and Carbonell-Torregrosa M
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Background Sepsis is associated with high mortality and predictive models can help in clinical decision-making. The objective of this study was to carry out a systematic review of these models. Methods In 2019, we conducted a systematic review in MEDLINE and EMBASE (CDR42018111121:PROSPERO) of articles that developed predictive models for mortality in septic patients (inclusion criteria). We followed the CHARMS recommendations (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies), extracting the information from its 11 domains (Source of data, Participants, etc). We determined the risk of bias and applicability (participants, outcome, predictors and analysis) through PROBAST (Prediction model Risk Of Bias ASsessment Tool). Results A total of 14 studies were included. In the CHARMS extraction, the models found showed great variability in its 11 domains. Regarding the PROBAST checklist, only one article had an unclear risk of bias as it did not indicate how missing data were handled while the others all had a high risk of bias. This was mainly due to the statistical analysis (inadequate sample size, handling of continuous predictors, missing data and selection of predictors), since 13 studies had a high risk of bias. Applicability was satisfactory in six articles. Most of the models integrate predictors from routine clinical practice. Discrimination and calibration were assessed for almost all the models, with the area under the ROC curve ranging from 0.59 to 0.955 and no lack of calibration. Only three models were externally validated and their maximum discrimination values in the derivation were from 0.712 and 0.84. One of them (Osborn) had undergone multiple validation studies. Discussion Despite most of the studies showing a high risk of bias, we very cautiously recommend applying the Osborn model, as this has been externally validated various times.
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- 2021
13. A Systematic Review of Clinical Trials Assessing Sexuality in Hysterectomized Patients
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Martinez-Cayuelas L, Sarrio-Sanz P, Palazon-Bru A, Verdu-Verdu L, Lopez-Lopez A, Gil-Guillen V, Romero-Maroto J, and Gomez-Perez L
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abdominal ,vaginal ,hysterectomy ,sexuality - Abstract
In hysterectomized patients, even though there is still controversy, evidence indicates that in the short term, the vaginal approach shows benefits over the laparoscopic approach, as it is less invasive, faster and less costly. However, the quality of sexual life has not been systematically reviewed in terms of the approach adopted. Through a systematic review, we analyzed (CRD42020158465 in PROSPERO) the impact of hysterectomy on sexual quality and whether there are differences according to the surgical procedure (abdominal or vaginal) for noncancer patients. MEDLINE (through PubMed), Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Scopus were reviewed to find randomized clinical trials assessing sexuality in noncancer patients undergoing total hysterectomy, comparing vaginal and abdominal (laparoscopic and/or open) surgery. Three studies that assessed the issue under study were finally included. Two of these had a low risk of bias (Cochrane risk of bias tool); one was unclear. There was significant variability in how sexuality was measured, with no differences between the two approaches considered in the review. In conclusion, no evidence was found to support one procedure (abdominal or vaginal) over another for non-oncological hysterectomized patients regarding benefits in terms of sexuality.
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- 2021
14. Trends in premature mortality due to ischemic heart disease in Spain from 1998 to 2018
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Hervella M, Carratala-Munuera C, Orozco-Beltran D, Lopez-Pineda A, Bertomeu-Gonzalez V, Gil-Guillen V, Pascual R, and Quesada J
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Avoidable mortality ,Epidemiology ,Ischemic heart disease ,Population ,Mortality ,Primary care - Abstract
Introduction and objectives: Ischemic heart disease (IHD) is the leading cause of death and one of the leading causes of disability. The aim of this study was to analyze trends in premature mortality due to IHD in patients younger than 75 years in Spain from 1998 to 2018 by region. Methods: Observational study of temporal trends in premature mortality due to IHD in Spain by region and sex from 1998 to 2018. The study population included resident citizens aged between 0 and 74 years. The data sources were the continuous population register and the mortality registry of the National Institute of Statistics. We calculated age-adjusted mortality rates and their average annual percent change estimated by Poisson models. Results: During the study period, mortality rates due to IHD decreased, both in the country as a whole and by provinces (53% in men and 61% in women), with an average annual percent change of -3.92% and -5.07%, respectively. In the first year (1998), mortality was unequally distributed among provinces, with higher mortality in the south of Spain. Conclusions: Premature mortality due to IHD significantly decreased in Spain during the study period in both sexes to roughly half of initial cases. This decrease was statistically significant in almost all regions. Interprovincial differences in mortality and their variation also decreased in recent years. (C) 2020 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
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- 2021
15. Gender Differences in the Diagnosis of Dyslipidemia: ESCARVAL-GENERO
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Soriano-Maldonado C, Lopez-Pineda A, Orozco-Beltran D, Quesada J, Alfonso-Sanchez J, Pallares-Carratala V, Navarro-Perez J, Gil-Guillen V, Martin-Moreno J, and Carratala-Munuera C
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primary health care ,diagnostic inertia ,gender differences ,dyslipidemia - Abstract
Evidence shows that objectives for detecting and controlling dyslipidemia are not being effectively met, and outcomes differ between men and women. This study aimed to assess gender-related differences in diagnostic inertia around dyslipidemia. This ambispective, epidemiological, cohort registry study included adults who presented to public primary health care centers in a Spanish region from 2008 to 2012, with dyslipidemia and without cardiovascular disease. Diagnostic inertia was defined as the registry of abnormal diagnostic parameters-but no diagnosis-on the person's health record in a window of six months from inclusion. A total of 58,970 patients were included (53.7% women) with a mean age of 58.4 years in women and 57.9 years in men. The 6358 (20.1%) women and 4312 (15.8%) men presenting diagnostic inertia had a similar profile, although in women the magnitude of the association with younger age was larger. Hypertension showed a larger association with diagnostic inertia in women than in men (prevalence ratio 1.81 vs. 1.56). The overall prevalence of diagnostic inertia in dyslipidemia is high, especially in women. Both men and women have a higher risk of cardiovascular morbidity and mortality.
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- 2021
16. Trends in Hospital Admissions for Chronic Obstructive Pulmonary Disease in Men and Women in Spain, 1998 to 2018
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Orozco-Beltran D, Arriero-Marin J, Carratala-Munuera C, Soler-Cataluna J, Lopez-Pineda A, Gil-Guillen V, and Quesada J
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inpatients ,disease progression ,chronic obstructive ,sex ,pulmonary disease - Abstract
The prevalence of chronic obstructive pulmonary disease (COPD) is rising faster in women in some countries. An observational time trends study was performed to assess the evolution of hospital admissions for COPD in men and women in Spain from 1998 to 2018. ICD-9 diagnostic codes (490-492, 496) from the minimum basic data set of hospital discharges were used. Age-standardised admission rates were calculated using the European Standard Population. Joinpoint regression models were fitted to estimate the annual percent change (APC). In 2018, the age-standardised admission rate per 100,000 population/year for COPD was five times higher in men (384.8, 95% CI: 381.7, 387.9) than in women (78.6, 95% CI: 77.4, 79.9). The average annual percent change (AAPC) was negative over the whole study period in men (-1.7%/year, 95% CI: -3.1, -0.2) but positive from 2010 to 2018 (1.1%/year, 95% CI: -0.8, 2.9). In women, the APC was -6.0% (95%CI: -7.1, -4.9) from 1998 to 2010, but the trend reversed direction in the 2010-2018 period (7.8%/year, 95% CI: 5.5, 10.2). Thus, admission rates for COPD decreased from 1998 to 2010 in both men and women but started rising again until 2018, modestly in men and sharply in women.
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- 2021
17. Impact of a clinical pathway on cardiovascular risk in patients with diabetes
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Fernandez-Planelles M, Palazon-Bru A, Calvo-Perez M, Pico-Alfonso A, and Gil-Guillen V
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type 2 ,diabetes mellitus ,risk factors ,organization and administration ,Critical pathways ,population health management ,cardiovascular diseases - Abstract
OBJECTIVES: Clinical pathways (CPs) are interventions that target the way clinical practice guidelines are applied. They can be implemented in different diseases, including diabetes. In this study we evaluated the impact of the implementation of a CP in the control of cardiovascular risk factors and the occurrence of new events in patients with type 2 diabetes. METHODS: A pre- and post-intervention population-based study in a Spanish region, conducted in 2014-2016. Variables before and after the intervention were: screening; good control of diabetes, dyslipidemia and hypertension; hypoglycemia and hyperglycemic decompensation; obesity; cardiovascular events; diabetic ketoacidosis; hyperglycemic and hypoglycemic coma. Proportional differences and parameters of clinical relevance (absolute and relative risk reduction, relative risk and number needed to treat) were calculated. RESULTS: The CP achieved an improvement in all outcomes, reducing events and increasing control of different cardiovascular parameters. The greatest improvement was in metabolic control (HbA1c) (37.1% in younger patients and 34.0% in older patients) and screening (5.4%). Indicators of clinical relevance showed that the CP was able to improve metabolic control of diabetes with little effort and great benefit. CONCLUSION: The CP was of considerable benefit to metabolic control as well as control of dyslipidemia and obesity. Screening for diabetes also benefitted. The CP decreased the incidence of events, especially of angina pectoris.
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- 2021
18. Gender Inequalities in Diagnostic Inertia around the Three Most Prevalent Cardiovascular Risk Studies: Protocol for a Population-Based Cohort Study
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Carratala-Munuera C, Lopez-Pineda A, Orozco-Beltran D, Quesada J, Alfonso-Sanchez J, Pallares-Carratala V, Soriano-Maldonado C, Navarro-Perez J, Gil-Guillen V, and Martin-Moreno J
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sex factors ,disease management ,public health ,risk factors ,cardiovascular diseases - Abstract
Evidence shows that objectives for detecting and controlling cardiovascular risk factors are not being effectively met, and moreover, outcomes differ between men and women. This study will assess the gender-related differences in diagnostic inertia around the three most prevalent cardiovascular risk factors: dyslipidemia, arterial hypertension, and diabetes mellitus, and to evaluate the consequences on cardiovascular disease incidence. This is an epidemiological and cohort study. Eligible patients will be adults who presented to public primary health care centers in a Spanish region from 2008 to 2011, with hypertension, dyslipidemia, or/and diabetes and without cardiovascular disease. Participants' electronic health records will be used to collect the study variables in a window of six months from inclusion. Diagnostic inertia of hypertension, dyslipidemia, and/or diabetes is defined as the registry of abnormal diagnostic parameters-but no diagnosis-on the person's health record. The cohort will be followed from the date of inclusion until the end of 2019. Outcomes will be cardiovascular events, defined as hospital admission due to ischemic cardiopathy, stroke, and death from any cause. The results of this study could inform actions to rectify the structure, organization and training of health care teams in order to correct the inequality.
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- 2021
19. Estudio ZANyCONTROL. Papel de la oficina de farmacia
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Abellán Alemán, J., Gil Guillén, V., Merino Sánchez, J., Llisterri Caro, J.L., and Leal Hernández, M.
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- 2008
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20. La inercia clínica profesional y el incumplimiento farmacológico: ¿cómo influyen en el control de la hipertensión arterial? Estudio CUMAMPA
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Márquez Contreras, E., Martín de Pablos, J.L., Gil Guillén, V., Martel Claros, N., Motero Carrasco, J., and Casado Martínez, J.J.
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- 2008
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21. Debridement with prosthesis retention and antibiotherapy vs. two-stage revision for periprosthetic knee infection within 3 months after arthroplasty: a case–control study
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Lizaur-Utrilla, A., Gonzalez-Parreño, S., Gil-Guillen, V., and Lopez-Prats, F.A.
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- 2015
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22. [Cardiovascular preventive recommendations. PAPPS 2020 update]
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Orozco-Beltran D, Brotons Cuixart C, Aleman Sanchez J, Banegas Banegas J, Cebrian-Cuenca A, Gil Guillen V, Martin Rioboo E, and Navarro Perez J
- Abstract
The recommendations of the semFYC's Program for Preventive Activities and Health Promotion (PAPPS) for the prevention of cardiovascular diseases (CVD) are presented. The following sections are included: Epidemiological review, where the current morbidity and mortality of CVD in Spain and its evolution as well as the main risk factors are described; Cardiovascular (CV) risk tables and recommendations for the calculation of CV risk; Main risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, describing the method for their diagnosis, therapeutic objectives and recommendations for lifestyle measures and pharmacological treatment; Indications for antiplatelet therapy, and recommendations for screening of atrial fibrillation. The quality of testing and the strength of the recommendation are included in the main recommendations.
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- 2020
23. Randomized clinical trial to determine the effectiveness of CO-oximetry and anti-smoking brief advice in a cohort of kidney transplant patients who smoke
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Seijo-Bestilleiro R, Seoane-Pillado T, Pertega-Diaz S, Gonzalez-Martin C, Valdes-Canedo F, Balboa-Barreiro V, Fernandez-Rivera C, Alonso-Hernandez A, Cao-Vilarino M, Gil-Guillen V, and Garcia-Rodriguez M
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"Smoking cessation" ,"Controlled clinical trial" ,"Nicotine dependence" ,"Carbon monoxide" ,"Kidney transplantation" - Abstract
Background: measure the efficacy of exhaled carbon monoxide (CO) measurement plus brief advisory sessions to reduce smoking exposure and smoking behaviour in kidney transplant recipients. Methods: Randomized, controlled, open-label clinical trial at a Spanish hospital. Smoking kidney transplant recipients giving their consent to participate were randomized to control (brief advice, n=63) or intervention group (brief advisory session plus measuring exhaled CO, n=59). Measurements: Sociodemographic characteristics, cardiovascular risk factors, treatment, rejection episodes, infections, self-reported smoking, drug use, level of dependence and motivation to stop smoking (Fagerstrom's and Richmond's test) and stage of change (Prochaska and DiClemente's Stages). Efficacy was assessed at 3, 6, 9 and 12 months as: cotinine test, CO levels in exhaled air, nicotine dependence, motivational stages of change, motivation to stop smoking, pattern of tobacco use and smoking cessation rates. Logistic regression models were computed. Results: At 12 months of follow-up, differences were found in exhaled CO between the intervention and control group(6.1 +/- 6.8vs.10.2 +/- 9.7ppm;p=0.028). Carboxyhemoglobin levels were lower in the intervention group as well as the positive cotinine test (1.2 +/- 1.2%vs.2.0 +/- 2.4%;p=0.039),(53.4%vs.74.2%). At 12 months, intervention reduces the probability of a positive urine test by 28%. Conclusions: Co-oximetry is a clinically relevant intervention for reduction of tobacco exposure in kidney transplant recipients.
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- 2020
24. A critical appraisal of the clinical applicability and risk of bias of the predictive models for mortality and recurrence in patients with oropharyngeal cancer: Systematic review
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Palazon-Bru A, Mares-Garcia E, Lopez-Bru D, Mares-Arambul E, Folgado-de la Rosa D, Carbonell-Torregrosa M, and Gil-Guillen V
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recurrence ,death ,statistical models ,mortality ,oropharyngeal neoplasms - Abstract
The use of predictive models is becoming widespread. However, these models should be developed appropriately (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modeling Studies [CHARMS] and Prediction model Risk Of Bias ASsessment Tool [PROBAST] statements). Concerning mortality/recurrence in oropharyngeal cancer, we are not aware of any systematic reviews of the predictive models. We carried out a systematic review of the MEDLINE/EMBASE databases of those predictive models. In these models, we analyzed the 11 domains of the CHARMS statement and the risk of bias and applicability, using the PROBAST tool. Six papers were finally included in the systematic review and all of them presented high risk of bias and several limitations in the statistical analysis. The applicability was satisfactory in five out of six studies. None of the models could be considered ready for use in clinical practice.
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- 2020
25. Barriers associated with poor control in Spanish diabetic patients. A consensus study
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Carratalá-Munuera, M. C., Gil-Guillen, V. F., Orozco-Beltran, D., Navarro-Pérez, J., Caballero-Martínez, F., Álvarez-Guisasola, F., García-Soidán, J., Fluixá-Carrascosa, C., Franch-Nadal, J., Martín-Rioboó, E., Carrillo-Fernández, L., and Artola-Menéndez, S.
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- 2013
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26. Screening for sight threatening diabetic retinopathy using non-mydriatic retinal camera in a primary care setting: to dilate or not to dilate?
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Baeza, M., Orozco-Beltrán, D., Gil-Guillen, V. F., Pedrera, V., Ribera, M. C., Pertusa, S., and Merino, J.
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- 2009
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27. Influencia de distintos ambientes sobre los valores de la presión arterial medida con dispositivo automático
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Llisterri Caro, J.L., Gil Guillén, V., Abellán Alemán, J., Merino Sánchez, J., Sanchís Doménech, C., and Navarro Lima, A.
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- 2005
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28. A systematic review of predictive models for recurrence and mortality in patients with tongue cancer
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Palazon-Bru A, Mares-Garcia E, Lopez-Bru D, Mares-Arambul E, Gil-Guillen V, and Carbonell-Torregrosa M
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models ,head and neck neoplasms ,tongue neoplasms ,review literature as topic ,statistical - Abstract
Introduction Predictive models must meet clinical/methodological standards to be used in clinical practice. However, no critique of those models relating to mortality/recurrence in tongue cancer has been done bearing in mind the accepted standards. Methods We conducted a systematic review evaluating the methodology and clinical applicability of predictive models for mortality/recurrence in tongue cancer published in MEDLINE and Scopus. For each model, we analysed (domains of CHARMS, Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) the following: source of data, participants, outcome to be predicted, candidate predictors, sample size, missing data, model development, model performance, model evaluation, results and interpretation and discussion. Results We found two papers that included eight prediction models, neither of which adhered to the CHARMS recommendations. Conclusion Given the quality of tongue cancer models, new studies following current consensus are needed to develop predictive tools applicable in clinical practice.
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- 2019
29. Clinical inertia in hypertension: a new holistic and practical concept within the cardiovascular continuum and clinical care process
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Pallares-Carratala V, Bonig-Trigueros I, Palazon-Bru A, Esteban-Giner M, Gil-Guillen V, and Giner-Galvan V
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Clinical inertia ,hypertension ,diagnosis ,medical errors ,therapeutics ,cardiovascular diseases - Abstract
Purpose: Recognition of clinical inertia is essential to improve the control of chronic diseases. Although it is very intuitive, a better interpretation of the concept of clinical inertia is lacking, likely due to its high complexity.Materials and Methods: After a review of the published articles, we propose a practical vision of inertia, contextualized within the clinical process of hypertension care.Results: This new vision enables the integration of previous terms and definitions of clinical inertia, as well as proposing specific strategies for its reduction.Conclusion: Although some concepts should be considered as justified inertia' or investigator inertia', the idea that inertia may be present throughout the continuum of care gives physicians a holistic view of the problem that is easily applicable to their clinical practice. Measures to overcome inertia are complicated because of the intrinsic complexity of the concept.
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- 2019
30. A scoring system to predict recurrence in patients with differentiated thyroid cancer
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Lopez-Bru D, Palazon-Bru A, Folgado-de la Rosa D, and Gil-Guillen V
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thyroid gland ,prognosis ,endocrine gland neoplasms ,models ,thyroid Neoplasms ,recurrence ,statistical ,mobile applications - Abstract
Objectives: Though predictive models have been constructed to determine the risk of recurrence in differentiated thyroid carcinoma, various aspects of these models are inadequate. Therefore, we aimed to construct, internally validate and implement on a mobile application a scoring system to determine this risk within 10 years. Design: A retrospective cohort study in 1984-2016. Setting: A Spanish region. Participants: We enrolled 200 patients with differentiated thyroid carcinoma without distant metastasis at diagnosis. Main outcome measures: Time-to-recurrence. A risk table was constructed based on the sum of points to estimate the likelihood of recurrence. The model was internally validated and implemented as a mobile application for Android. Results: Predictive factors were follicular histology, T, N and multifocality. This risk table had a C-statistic of 0.723. The calibration was satisfactory. Conclusions: This study provides an instrument able to predict rapidly and very simply which patients with differentiated thyroid carcinoma have a greater risk of recurrence.
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- 2019
31. The premature closure of ROMPA clinical trial: mortality reduction in septic shock by plasma adsorption
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Gimenez-Esparza C, Portillo-Requena C, Colomina-Climent F, Allegue-Gallego J, Galindo-Martinez M, Molla-Jimenez C, Anton-Pascual J, Marmol-Peis E, Dolera-Moreno C, Rodriguez-Serra M, Martin-Ruiz J, Fernandez-Arroyo P, Blasco-Ciscar E, Canovas-Robles J, Gonzalez-Hernandez E, Sanchez-Moran F, Solera-Suarez M, Torres-Tortajada J, Palazon-Bru A, and Gil-Guillen V
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adult intensive & critical care ,clinical trials ,infectious diseases - Abstract
Objectives Coupled Plasma Filtration and Adsorption (CPFA) use in septic shock remains controversial. The objective is to clarify whether the application of high doses of CPFA in addition to the current clinical practice could reduce hospital mortality in septic shock patients in Intensive Care Units at 28 days and at 90 days follow-up. Design We designed a prospective randomised clinical trial, Reduccion de la Mortalidad Plasma-Adsorcion (ROMPA), to demonstrate an absolute mortality reduction of 20% (alpha=0.05; 1-beta=0.8; n=190 (95x2)). Setting Being aware of the pitfalls associated with previous medical device trials, we developed a training programme to improve CPFA use (especially clotting problems). The protocol was approved by the ethics committees of all participating centres. Circumstances beyond our control produced a change in recruitment conditions unacceptable to ROMPA researchers and the trial was discontinued. Participants By closure, five centres from an initial 10 fulfilled the necessary trial criteria, with 49 patients included, 30 in the control group (CG) and 19 in the intervention group (IG). Intervention CPFA. Main outcome measures Hospital mortality at 28 days and 90 days follow-up. Results After 28 days, 14 patients died (46.7%) from the CG and 11 (57.9%) from the IG, not reaching statistical significance (p=0.444). At 90 days, 19 patients had died (63.3%) from the CG and 11 patients (57.9%) from the IG, (p=0.878). The adjustment by propensity score or the use of the Kaplan-Meier technique failed to achieve statistical difference, neither by Intention to Treat nor by the Actual Intervention Received. Conclusion We herewith present the results gained from the prematurely closed trial. The results are inconclusive due to low statistical power but we consider that this data is of interest for the scientific community and potentially necessary for any ensuing debate.
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- 2019
32. Control of diabetes and cardiovascular risk factors in patients with type 2 diabetes in primary care. The gap between guidelines and reality in Spain
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Orozco-Beltrán, D., Gil-Guillen, V. F., Quirce, F., Navarro-Perez, J., Pineda, M., Gomez-de-la-Cámara, A., Pita, S., Diez-Espino, J., Mateos, J., Merino, J., and Serrano-Rios, M.
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- 2007
33. Association analysis between hyperuricemia and long term mortality after acute coronary syndrome in three subgroups of patients
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Lopez-Pineda A, Cordero A, Carratala-Munuera C, Orozco-Beltran D, Quesada J, Bertomeu-Gonzalez V, Gil-Guillen V, and Bertomeu-Martinez V
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- 2018
34. Mortality and cardiovascular disease burden of uncontrolled diabetes in a registry-based cohort: the ESCARVAL-risk study
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Navarro-Perez J, Orozco-Beltran D, Gil-Guillen V, Pallares V, Valls F, Fernandez A, Perez-Navarro A, Sanchis C, Dominguez-Lucas A, Martin-Moreno J, Redon J, and Tellez-Plaza M
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- 2018
35. Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study (vol 12, e0186196, 2017)
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Orozco-Beltran D, Gil-Guillen V, Redon J, Martin-Moreno J, Pallares-Carratala V, Navarro-Perez J, Valls-Roca F, Sanchis-Domenech C, Fernandez-Gimenez A, Perez-Navarro A, Bertomeu-Martinez V, Bertomeu-Gonzalez V, Cordero A, de la Torre M, Trillo J, Carratala-Munuera C, Pita-Fernandez S, Uso R, Durazo-Arvizu R, Cooper R, Sanz G, Castellano J, Ascaso J, Carmena R, and Tellez-Plaza M
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- 2018
36. El incumplimiento terapéutico en el tratamiento de la hipertensión arterial en España. Análisis de los estudios publicados entre 1984 y 2001
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Márquez Contreras, E., Casado Martínez, J.J., de la Figuera Won-Vichman, M., Gil Guillén, V., and Martell, N.
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- 2002
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37. Inappropriate use of medication by elderly, polymedicated, or multipathological patients with chronic diseases
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Universitat Rovira i Virgili, Pérez-Jover V; Mira J; Carratala-Munuera C; Gil-Guillen V; Basora J; López-Pineda A; Orozco-Beltrán D, Universitat Rovira i Virgili, and Pérez-Jover V; Mira J; Carratala-Munuera C; Gil-Guillen V; Basora J; López-Pineda A; Orozco-Beltrán D
- Abstract
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. The growth of the aging population leads to the increase of chronic diseases, of the burden of multimorbility, and of the complexity polypharmacy. The prevalence of medication errors rises in patients with polypharmacy in primary care, and this is a major concern to healthcare systems. This study reviews the published literature on the inappropriate use of medicines in order to articulate recommendations on how to reduce it in chronic patients, particularly in those who are elderly, polymedicated, or multipathological. A systematic review of articles published from January 2000 to October 2015 was performed using MEDLINE, EMBASE, PsychInfo, Scopus, The Cochrane Library, and Index Medicus databases. We selected 80 studies in order to analyse the content that addressed the question under consideration. Our literature review found that half of patients know what their prescribed treatment is; that most of elderly people take five or more medications a day; that in elderly, polymedicated people, the probability of a medication error occurring is higher; that new tools have been recently developed to reduce errors; that elderly patients can understand written information but the presentation and format is an important factor; and that a high percentage of patients have remaining doubts after their visit. Thus, strategies based on the evidence should be applied in order to reduce medication errors.
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- 2018
38. Repeated seasonal influenza vaccination among elderly in Europe: Effects on laboratory confirmed hospitalised influenza
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Rondy, M., Launay, O., Castilla, J., Costanzo, S., Puig-Barbera, J., Gefenaite, G., Larrauri, A., Rizzo, C., Pitigoi, D., Syrjanen, R. K., Machado, A., Filipovic, S. K., Horvath, J. K., Paradowska-Stankiewicz, I., Marbus, S., Moren, A., Valenciano, M., Lenzi, N., Lesieur, Z., Loulergue, P., Galtier, F., Ray, M., Foulongne, V., Letois, F., Merle, C., Vanhems, P., Lina, B., Casado, I., Diaz-Gonzalez, J., Guevara, M., Martinez-Baz, I., Fernandino, L., Navascues, A., Ezpeleta, C., Chamorro, J., Barrado, L., Ortega, M. T., De Gaetano Donati, K., Cauda, R., Donato, C., Taccari, F., Campana, L., Santangelo, R., Perlasca, F., Fichera, G., Dara, M., Iacoviello, L., Olivieri, M., Alfonsi, V., Bella, A., Puzelli, S., Castrucci, M. R., Orsi, A., Ansaldi, F., Manini, I., Montomoli, E., Chironna, M., Germinario, C., Diez-Domingo, J., Sanudo, B., Carratala Munuera, C., Correcher Medina, P., Gil Guillen, V., Larrea Gonzalez, R., Limon Ramirez, R., Mico Esparza, J. L., Mollar Maseres, J., Otero Reigada, M. C., Tortajada Girbes, M., Schwarz Chavarri, G., Ambrozaitis, A., Jancoriene, L., Zablockiene, B., Zagminas, K., Aukse, M., Damuleviciene, G., Grimalauskaite, R., Kuliese, M., Lesauskaite, V., Velyvyte, D., Niesters, H., Stolk, R. P., Zagmines, K., Rahamat-Langendoen, J., Gherasim, A., Pozo, F., Altzibar, J., Arraras, J. G., Cilla, G., Marco, E., Vidal Garcia, M., Omenaca, M., Ivanciuc, A. E., Lupulescu, E., Lazar, M., Cherciu, C. M., Tecu, C., Mihai, M. E., Nitescu, M., Leca, D., Ceausu, E., Nohynek, H., Ikonen, N., Haveri, A., Gomez, V., Nunes, B., Rodrigues, A. P., Gomes, V., Corte-Real, R., Pocas, J., Peres, M. J., Visekruna Vucina, V., Kaic, B., Novosel, I. P., Petrovic, G., Ferenczi, A., Oroszi, B., Korczynska, M. R., Brydak, L. B., Cieslik-Tarkota, R., Rozwadowska, B., Skolimowska, G., Hulboj, D., Jakubik, A., Meijer, A., Van Gageldonk-Lafeber, A. B., Research Council of Lithuania, and European Union
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0301 basic medicine ,Male ,Veterinary medicine ,Immunology and Microbiology (all) ,medicine.disease_cause ,Polymerase Chain Reaction ,Aged ,Aged, 80 and over ,Case-Control Studies ,Clinical Laboratory Techniques ,Europe ,Female ,Hospitalization ,Humans ,Influenza A Virus, H1N1 Subtype ,Influenza A Virus, H3N2 Subtype ,Influenza B virus ,Influenza Vaccines ,Influenza, Human ,Respiratory Tract Infections ,Seasons ,Sentinel Surveillance ,Vaccination ,Molecular Medicine ,Veterinary (all) ,Public Health, Environmental and Occupational Health ,Infectious Diseases ,Seasonal influenza ,IMOVE+ ,0302 clinical medicine ,80 and over ,Influenza A Virus ,Influenza A virus ,030212 general & internal medicine ,Respiratory tract infections ,virus diseases ,3. Good health ,H3N2 Subtype ,Public Health ,Human ,medicine.medical_specialty ,Influenza vaccine ,030106 microbiology ,Virus ,Hospital ,03 medical and health sciences ,Repeated Vaccination ,Internal medicine ,medicine ,H1N1 Subtype ,Influenza Vaccine Effectiveness ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Environmental and Occupational Health ,Cuidados de Saúde ,Case-control study ,Influenza ,Negative case ,influenza vaccination, test negative case control, vaccine effectiveness ,business - Abstract
In Europe, annual influenza vaccination is recommended to elderly. From 2011 to 2014 and in 2015-16, we conducted a multicentre test negative case control study in hospitals of 11 European countries to measure influenza vaccine effectiveness (IVE) against laboratory confirmed hospitalised influenza among people aged ≥65years. We pooled four seasons data to measure IVE by past exposures to influenza vaccination. We swabbed patients admitted for clinical conditions related to influenza with onset of severe acute respiratory infection ≤7days before admission. Cases were patients RT-PCR positive for influenza virus and controls those negative for any influenza virus. We documented seasonal vaccination status for the current season and the two previous seasons. We recruited 5295 patients over the four seasons, including 465A(H1N1)pdm09, 642A(H3N2), 278 B case-patients and 3910 controls. Among patients unvaccinated in both previous two seasons, current seasonal IVE (pooled across seasons) was 30% (95%CI: -35 to 64), 8% (95%CI: -94 to 56) and 33% (95%CI: -43 to 68) against influenza A(H1N1)pdm09, A(H3N2) and B respectively. Among patients vaccinated in both previous seasons, current seasonal IVE (pooled across seasons) was -1% (95%CI: -80 to 43), 37% (95%CI: 7-57) and 43% (95%CI: 1-68) against influenza A(H1N1)pdm09, A(H3N2) and B respectively. Our results suggest that, regardless of patients' recent vaccination history, current seasonal vaccine conferred some protection to vaccinated patients against hospitalisation with influenza A(H3N2) and B. Vaccination of patients already vaccinated in both the past two seasons did not seem to be effective against A(H1N1)pdm09. To better understand the effect of repeated vaccination, engaging in large cohort studies documenting exposures to vaccine and natural infection is needed. The Lithuanian I-MOVE+ study sites were supported by a grant from the Research Council of Lithuania (SEN-03/2015). The IMOVE+ project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 634446. GlaxoSmithKline, Sanofi Pasteur and Sanofi Pasteur MSD financially supported the InNHOVE network. They had no role in study design, data collection, pooled analysis, and publication. We are grateful to all patients, medical staff, study nurses and epidemiologists from the twelve study sites who actively participated in the study. info:eu-repo/semantics/publishedVersion
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- 2017
39. [Not Available]
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Maiques Galan A, Brotons Cuixart C, Banegas Banegas J, Martin Rioboo E, Lobos-Bejarano J, Alvarez F, Aleman Sanchez J, Navarro Perez J, Orozco-Beltran D, Leon C, and Gil Guillen V
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- 2016
40. Therapeutic compliance with rivaroxaban in preventing stroke in patients with non-valvular atrial fibrillation: CUMRIVAFA study
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Marquez-Contreras, E, Martell-Carlos, N, Gil-Guillen, V, De la Figuera-Von Wichmann, M, Sanchez-Lopez, E, Marquez-Rivero, S, Gil-Gil, I, and Hermida-Campa, E
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Rivaroxaban ,Therapeutic compliance ,Non-valvular atrial fibrillation ,Preventing stroke ,Oral anticoagulants - Abstract
Objective: To assess compliance with treatment with rivaroxaban in patients with non-valvular atrial fibrillation. Methods: Prospective, longitudinal, multicenter study, developed in 160 Spanish primary or specialized care centers. We included 412 patients treated with rivaroxaban, prescribed for stroke prevention. Three visits were conducted: baseline, 6 and 12 months. Compliance was measured by using electronic monitors (MEMSs) that use a digital record in the form of a microchip in the lid of the drug container that automatically controls its opening and registers the time and date of the opening. We calculated the average compliance percentage (CP), global and daily compliance. We considered compliance to be when CP was 80-100%. Results: Three hundred and seventy patients ended the study (mean age 75.19, SD: 7.5 years). Global compliance was 84.1% (CI=79.21-88.99%) and 80.3% (CI=74.98-85.62%) after 6 and 12 months respectively. Daily compliance was 83.5% (CI=78.53-88.57%) and 80% (CI=74.65-85.35%) at 6 and 12 months. Significant differences in the CP between 6 and 12 months were observed. Global CP was 90.77% after 6 months and 89.65% at the end of the study. Daily CP was 90.14% and 87.66% at 6 and 12 months. There were significant CP differences between 6 and 12 months. Non-compliance was associated with a higher number of concomitant diseases, number of drugs taken and weight. Conclusions: The percentage of compliance with rivaroxaban was high. A profile of variables that need to be modified in current medical practice, associated with non-compliance, was detected.
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- 2016
41. Renal function and attributable risk of death and cardiovascular hospitalization in patients with cardiovascular risk factors from a registry-based cohort: the Estudio Cardiovascular Valencia-risk study
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Tellez-Plaza M, Orozco-Beltran D, Gil-Guillen V, Pita-Fernandez S, Navarro-Perez J, Pallares V, Valls F, Fernandez A, Perez-Navarro A, Sanchis C, Dominguez-Lucas A, Martin-Moreno J, ESCARVAL Study Grp, and Redon J
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hypertension ,diabetes ,dyslipidemia ,attributable risk ,chronic kidney disease - Abstract
Background:Information about the attributable risk associated with renal dysfunction in patients with cardiovascular risk factors is lacking.Objective:We aimed to estimate the attributable risk associated with chronic kidney disease Epidemiology Collaboration-estimated glomerular filtration rate (eGFR), for all-cause mortality, and cardiovascular hospitalization.Design, setting, and participants:Prospective study of study participants with cardiovascular risk factors in 2008-2012. We included 52007 cardiovascular disease-free men and women aged 30 years or older with hypertension, diabetes, or dyslipidemia, who underwent routine health examinations in primary care.Results:A total of 6639 (12.8%) patients had eGFR below 60ml/min per 1.73m(2) and among them 1782 (3.4%) had 45ml/min per 1.73m(2) or lower. During an average follow-up time of 3.2 years, 54.12 deaths, 99.98 coronary heart disease (CHD) hospitalizations, and 90.64 stroke hospitalizations/10000 person-years were recorded. The population attributable risks associated with having a GFR lower than 60ml/min per 1.73m(2) were 6.9% (95% confidence interval=2.07, 10.65) for all-cause mortality, 6.8% (4.3, 9.4) for CHD hospitalization, and 4.1% (1.02, 7.00) for stroke hospitalization. Participants with increasing number of cardiovascular risk factors displayed increasing population attributable risks associated to a GFR less than 60ml/min per 1.73m(2) for all-cause mortality and CHD (P heterogeneity 0.002 and 0.05, respectively).Conclusion:In a large general practice cohort of patients with cardiovascular disease risk factors, decreasing eGFR levels were associated with additional attributed risk of mortality and cardiovascular disease. Our findings underscore that intensified efforts are needed to reduce the cardiovascular disease burden associated to chronic kidney disease.
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- 2016
42. Transdiscal screw versus pedicle screw fixation for high-grade L5-S1 isthmic spondylolisthesis in patients younger than 60 years: a case-control study
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Collados-Maestre, I, Lizaur-Utrilla, A, Bas-Hermida, T, Pastor-Fernandez, E, and Gil-Guillen, V
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Transacral screw ,Sacrolumbar ,Transdiscal screw ,Pedicle screw ,Transvertebral screw ,Spondylolisthesis ,Outcome - Abstract
To compare outcomes between transdiscal and conventional pedicle fixation for high-grade L5-S1 spondylolisthesis. This was a retrospective case-control study with patients prospectively followed. Twenty-five consecutive patients with mean age of 36.7 years underwent transdiscal fixation, and 31 other with mean age of 42.0 years to pedicle fixation were clinically and radiographically compared. Clinical assessments were performed using Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), Short-Form 12 (SF-12), and pain visual analog scale (VAS). Radiographic spinopelvic parameters were also evaluated. The mean follow-up was 2.7 years (range 2.0-5.3). Preoperative data were comparable between groups. Surgery time, blood loss, and hospital stay were similar between groups. At last follow-up, clinical and radiographic outcomes were significantly improved in both groups. Postoperatively, both lumbar and leg pain VAS were similar between groups, but ODI (20.2 vs. 31.6, p = 0.010), COMI (1.6 vs. 2.8, p = 0.012), and SF-12 physical (84.3 vs. 61.5, p = 0.004) and mental (81.5 vs. 69.4, p = 0.021) scores were significantly better in the transdiscal group. The neurologic complication rate was similar in both groups. There were 4 pseudoarthroses in the pedicle group, and none in the transdiscal group. L5-S1 transdiscal screw fixation provided better functional and radiographic outcomes at medium-term than conventional pedicle fixation for high-grade spondylolisthesis, although transdiscal sacral screws are difficult to place in correct position.
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- 2016
43. Highest Plasma Phenylalanine Levels in (Very) Premature Infants on Intravenous Feeding; A Need for Concern
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Cortes-Castell E, Sanchez-Gonzalez P, Palazon-Bru A, Bosch-Gimenez V, Manero-Soler H, Juste-Ruiz M, Rizo-Baeza M, and Gil-Guillen V
- Abstract
Objective To analyse the association in newborns between blood levels of phenylalanine and feeding method and gestational age. Study Design This observational, cross-sectional study included a sample of 11,829 infants between 2008 and 2013 in a Spanish region. Data were recorded on phenylalanine values, feeding method [breast, formula, mixed (breast plus formula), or partial or fully intravenous feeding], gestational age in weeks (= 37), gender and days since birth at the moment of blood collection. Outcomes were [phenylalanine] and [phenylalanine] >= 95th percentile. Associations were analysed using multivariate models [linear (means difference) and logistic regression (adjusted odds ratios)]. Results Higher phenylalanine values were associated with lower gestational age (p
- Published
- 2015
44. Scoring System for Mortality in Patients Diagnosed with and Treated Surgically for Differentiated Thyroid Carcinoma with a 20-Year Follow-Up
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Lopez-Bru D, Palazon-Bru A, la Rosa D, and Gil-Guillen V
- Abstract
Background Differentiated thyroid carcinoma (DTC) is associated with an increased mortality. Few studies have constructed predictive models of all-cause mortality with a high discriminating power for patients with this disease that would enable us to determine which patients are more likely to die. Objective To construct a predictive model of all-cause mortality at 5, 10, 15 and 20 years for patients diagnosed with and treated surgically for DTC for use as a mobile application. Design We undertook a retrospective cohort study using data from 1984 to 2013. Setting All patients diagnosed with and treated surgically for DTC at a general university hospital covering a population of around 200,000 inhabitants in Spain. Participants The study involved 201 patients diagnosed with and treated surgically for DTC (174, papillary; 27, follicular). Exposures Age, gender, town, family history, type of surgery, type of cancer, histological subtype, micro-carcinoma, multicentricity, TNM staging system, diagnostic stage, permanent post-operative complications, local and regional tumor persistence, distant metastasis, and radioiodine therapy. Main outcome measure All-cause mortality. Methods A Cox multivariate regression model was constructed to determine which variables at diagnosis were associated with mortality. Using the model a risk table was constructed based on the sum of all points to estimate the likelihood of death. This was then incorporated into a mobile application. Results The mean follow-up was 8.8 +/- 6.7 years. All-cause mortality was 12.9%(95% confidence interval [CI]: 8.3- 17.6%). Predictive variables: older age, local tumor persistence and distant metastasis. The area under the ROC curve was 0.81 (95% CI: 0.72- 0.91, p< 0.001). Conclusion This study provides a practical clinical tool giving a simple and rapid indication (via a mobile application) of which patients with DTC are at risk of dying in 5, 10, 15 or 20 years. Nonetheless, caution should be exercised until validation studies have corroborated our results.
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- 2015
45. Use of QR and EAN-13 codes by older patients taking multiple medications for a safer use of medication
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Mira J, Guilabert M, Carrillo I, Fernandez C, Vicente M, Orozco-Beltran D, and Gil-Guillen V
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Patient safety ,Automatic data processing ,Cell phone ,Software design ,Information storage and retrieval/methods - Abstract
Background: Older persons following a prolonged complex drug regimen often make mistakes when taking their medication. Currently, the widespread use of tablets and smartphones has encouraged the development of applications to support self-management of medication. Objective: The aim of this study was to design, develop and assess an app that transforms medication-associated ean-13 (barcodes) and Quick Response codes (QR) into verbal instructions, to enable safer use of medication by the elderly patients taking multiple medications. Methods: Meetings were held in which participated a total of 61 patients. Results: The results showed that patients appreciated the application and found it useful for safer use of medicines. Conclusions: The study results support the use of such technology to increase patient safety taking multiple medications safety. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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- 2015
46. Effectiveness of influenza vaccination programme in preventing hospital admissions, Valencia, 2014/15 early results
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Puig-Barbera J, Mira-Iglesias A, Tortajada-Girbes M, Lopez-Labrador FX, Belenguer-Varea A, Carballido-Fernandez M, Carbonell-Franco E, Carratala-Munuera C, Limon-Ramirez R, Mollar-Maseres J, Del Carmen Otero-Reigada M, Schwarz-Chavarri G, Tuells J, and Gil-Guillen V
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virus diseases - Abstract
Preliminary results for the 2014/15 season indicate low to null effect of vaccination against influenza A(H3N2)-related disease. As of week 5 2015, there have been 1,136 hospital admissions, 210 were due to influenza and 98% of subtype A strains were H-3. Adjusted influenza vaccine effectiveness was 33% (range: 6-53%) overall and 40% (range: 13% to 59%) in those 65 years and older. Vaccination reduced by 44% (28-68%) the probability of admission with influenza.
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- 2015
47. Barriers and Solutions to Improve Therapeutic Adherence from the Perspective of Primary Care and Hospital-Based Physicians
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Carratalá-Munuera C, Cortés-Castell E, Márquez-Contreras E, Castellano JM, Perez-Paramo M, López-Pineda A, and Gil-Guillen VF
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treatment adherence and compliance ,chronic disease ,general practioners ,family practice ,hospital medicine ,consensus ,Medicine (General) ,R5-920 - Abstract
Concepción Carratalá-Munuera,1 Ernesto Cortés-Castell,2 Emilio Márquez-Contreras,3 José Maria Castellano,4,5 María Perez-Paramo,6 Adriana López-Pineda,1 Vicente F Gil-Guillen1 1Department of Clinical Medicine, Miguel Hernandez University, San Juan de Alicante, Spain; 2Department of Pharmacology, Pediatrics, and Organic Chemistry, Miguel Hernandez University, San Juan de Alicante, Spain; 3Primary Health Center of Molino de la Vega, Huelva, Spain; 4Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; 5Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario Monteprincipe, Grupo HM Hospitales, Madrid, Spain; 6Medical Department, Pfizer GEP SLU, Madrid, SpainCorrespondence: Adriana López-Pineda, Miguel Hernandez University, Ctra. Nnal. 332 Alicante-Valencia s/n, San Juan de Alicante, 03550, Spain, Tel +1 34 965919309, Email adriannalp@hotmail.comPurpose: To identify the barriers affecting treatment adherence in patients with chronic disease and to determine solutions through the physician’s opinion of primary care and hospital settings.Methods: An observational study using the nominal group technique was performed to reach a consensus from experts. A structured face-to-face group discussion was carried out with physicians with more than 10 years of experience in the subject of treatment adherence/compliance in either the primary care setting or the hospital setting. The experts individually rated a list of questions using the Likert scale and prioritized the top 10 questions to identify barriers and seek solutions afterward. The top 10 questions that obtained the maximum score for both groups of experts were prioritized. During the final discussion group, participating experts analyzed the prioritized items and debated on each problem to reach consensual solutions for improvement.Results: A total of 17 professionals experts participated in the study, nine of them were from a primary care setting. In the expert group from the primary care setting, the proposed solution for the barrier identified as the highest priority was to simplify treatments, measure adherence and review medication. In the expert group from the hospital setting, the proposed solution for the barrier identified as the highest priority was training on motivational clinical interviews for healthcare workers undergraduate and postgraduate education. Finally, the expert participants proposed implementing an improvement plan with eight key ideas.Conclusion: A consensual improvement plan to facilitate the control of therapeutic adherence in patients with chronic disease was developed, taking into account expert physicians’ opinions from primary care and hospital settings about barriers and solutions to address therapeutic adherence in patients with chronic disease.Keywords: treatment adherence and compliance, chronic disease, general practitioners, family practice, hospital medicine, consensus
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- 2022
48. [PP.03.29] LIPID PROFILE AND INCIDENCE OF CARDIOVASCULAR DISEASE IN A MEDITERRANEAN HIGH-RISK POPULATION
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Orozco-Beltran, D., primary, Tellez-Plaza, M., additional, Gil-Guillen, V., additional, Fernandez, S. Pita, additional, Navarro-Pérez, J., additional, Pallares, V., additional, Valls, F., additional, Fernandez, A., additional, Perez-Navarro, A.M., additional, Sanchis, C., additional, Dominguez-Lucas, A., additional, Martin-Moreno, J.M., additional, Sanz, G., additional, and Redon, J., additional
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- 2016
- Full Text
- View/download PDF
49. 2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals
- Author
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Rondy, M., Launay, O., Puig-Barbera, J., Gefenaite, G., Castilla, J., De Gaetano Donati, Katleen, Galtier, F., Hak, E., Guevara, M., Costanzo, S., Moren, A., Lenzi, N., Lesieur, Z., Bonmarin, I., Duval, X., Costa, Y., Kanagaratnam, A., Yazdapanah, Y., Caseris, M., Dournon, N., Papo, T., Dossier, A., Becheur, H., Pelletier, A. -L., Mal, H., Marceau, A., Aubier, M., Bories, R., Casalino, E., Choquet, C., Houhou, N., Loulergue, P., Kanaan, R., Dumas, F., Postil, D., Alcolea, S., Rogez, S., Vanhaems, P., Regis, C., Merle, C., Foulongne, V., Ray, M., Maugueret-Doublet, V., Bourdin, A., Landreau, L., Konate, A., Corne, P., Sebbane, M., Klouche, K., Leglise, M. -S., Valette, M., Lina, B., Carrat, F., Chau, F., Diez-Domingo, J., Escribano-Lopez, B., Arnedo-Pena, A., Ruiz-Garcia, M., Tortajada-Girbes, M., Munuera, C. C., Sanudo, J. B., Larrea-Gonzalez, R., Gil-Guillen, V., Schwarz-Chavarri, G., Rahamat-Langendoen, J., Niesters, H., Ambrozaitis, A., Jancoriene, L., Mickiene, A., Kuliese, M., Velyvyte, D., Stolk, R. P., Zagminas, K., Ezpeleta, C., Chamorro, J., Artajo, P., Lameiro, F., Navascues, A., Ortega, M., Torres, M., Irure, J. J. G., Irisarri, F., Cenoz, M. G., Martinez-Baz, I., Cauda, Roberto, Donato, C., Santangelo, Rosaria, Perlasca, F., Fichera, Giovanni, Dara, M., Iacoviello, L., Olivieri, M., de Gaetano Donati K., Cauda R. (ORCID:0000-0002-1498-4229), Santangelo R. (ORCID:0000-0002-8056-218X), Fichera G., Rondy, M., Launay, O., Puig-Barbera, J., Gefenaite, G., Castilla, J., De Gaetano Donati, Katleen, Galtier, F., Hak, E., Guevara, M., Costanzo, S., Moren, A., Lenzi, N., Lesieur, Z., Bonmarin, I., Duval, X., Costa, Y., Kanagaratnam, A., Yazdapanah, Y., Caseris, M., Dournon, N., Papo, T., Dossier, A., Becheur, H., Pelletier, A. -L., Mal, H., Marceau, A., Aubier, M., Bories, R., Casalino, E., Choquet, C., Houhou, N., Loulergue, P., Kanaan, R., Dumas, F., Postil, D., Alcolea, S., Rogez, S., Vanhaems, P., Regis, C., Merle, C., Foulongne, V., Ray, M., Maugueret-Doublet, V., Bourdin, A., Landreau, L., Konate, A., Corne, P., Sebbane, M., Klouche, K., Leglise, M. -S., Valette, M., Lina, B., Carrat, F., Chau, F., Diez-Domingo, J., Escribano-Lopez, B., Arnedo-Pena, A., Ruiz-Garcia, M., Tortajada-Girbes, M., Munuera, C. C., Sanudo, J. B., Larrea-Gonzalez, R., Gil-Guillen, V., Schwarz-Chavarri, G., Rahamat-Langendoen, J., Niesters, H., Ambrozaitis, A., Jancoriene, L., Mickiene, A., Kuliese, M., Velyvyte, D., Stolk, R. P., Zagminas, K., Ezpeleta, C., Chamorro, J., Artajo, P., Lameiro, F., Navascues, A., Ortega, M., Torres, M., Irure, J. J. G., Irisarri, F., Cenoz, M. G., Martinez-Baz, I., Cauda, Roberto, Donato, C., Santangelo, Rosaria, Perlasca, F., Fichera, Giovanni, Dara, M., Iacoviello, L., Olivieri, M., de Gaetano Donati K., Cauda R. (ORCID:0000-0002-1498-4229), Santangelo R. (ORCID:0000-0002-8056-218X), and Fichera G.
- Abstract
While influenza vaccines aim to decrease the incidence of severe influenza among high-risk groups, evidence of influenza vaccine effectiveness (IVE) among the influenza vaccine target population is sparse. We conducted a multicentre test-negative case–control study to estimate IVE against hospitalised laboratoryconfirmed influenza in the target population in 18 hospitals in France, Italy, Lithuania and the Navarre and Valencia regions in Spain. All hospitalised patients aged ≥18 years, belonging to the target population presenting with influenza-like illness symptom onset within seven days were swabbed. Patients positive by reverse transcription polymerase chain reaction for influenza virus were cases and those negative were controls. Using logistic regression, we calculated IVE for each influenza virus subtype and adjusted it for month of symptom onset, study site, age and chronic conditions. Of the 1,972 patients included, 116 were positive for influenza A(H1N1)pdm09, 58 for A(H3N2) and 232 for influenza B. Adjusted IVE was 21.3% (95% confidence interval (CI): -25.2 to 50.6; n=1,628), 61.8% (95% CI: 26.8 to 80.0; n=557) and 43.1% (95% CI: 21.2 to 58.9; n=1,526) against influenza A(H1N1) pdm09, A(H3N2) and B respectively. Our results suggest that the 2012/13 IVE was moderate against influenza A(H3N2) and B and low against influenza A(H1N1) pdm09.
- Published
- 2015
50. PP.30.14
- Author
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Tellez-Plaza, M., primary, Orozco-Beltran, D., additional, Gil-Guillen, V., additional, Navarro-Pérez, J., additional, Pallares, V., additional, Valls, F., additional, Fernandez, A., additional, Martin-Moreno, J.M., additional, Sanchis, C., additional, Dominguez-Lucas, A., additional, and Redon, J., additional
- Published
- 2015
- Full Text
- View/download PDF
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