69 results on '"M. Alsina Gibert"'
Search Results
2. Validación de la versión española del cuestionario Wound-QoL
- Author
-
E. Conde Montero, R. Sommer, M. Augustin, C. Blome, R. Cabeza Martínez, C. Horcajada Reales, M. Alsina Gibert, R. Ramón Sapena, A. Peral Vázquez, J. Montoro López, S. Guisado Muñoz, L. Pérez Jerónimo, P. de la Cueva Dobao, N. Kressel, and N. Mohr
- Subjects
Chronic wound ,Health care research ,Patient burden ,Wound care ,Patient-centred care ,Quality of life ,Dermatology ,RL1-803 ,Internal medicine ,RC31-1245 - Abstract
Resumen: Antecedentes y objetivos: El Wound-QoL es un cuestionario validado para medir la calidad de vida en pacientes con heridas crónicas, que fue desarrollado originalmente para su uso en alemán.El objetivo de este estudio fue traducir el cuestionario Wound-QoL para su uso en la práctica clínica y estudios de investigación en España, así como validar esta versión. Materiales y métodos: Se realizaron dos traducciones independientes del Wound-QoL, directa e inversa, a partir de la versión original en alemán, seguidas de un consenso de expertos sobre las versiones resultantes. Después de su perfeccionamiento se realizó un estudio piloto y posteriormente el estudio de validación. Resultados: Se incluyó un total de 115 pacientes. La edad media fue de 69,5 (DE 14,5) años, y el 60,0% eran mujeres. La versión española del Wound-QoL mostró una excelente consistencia interna (índice alfa de Cronbach > 0,8 en todas las escalas). El análisis factorial dio como resultado las mismas escalas que la versión original. Se objetivaron características satisfactorias de la distribución de la puntuación global y de las subescalas. La validez de constructo y la validez convergente con otros resultados (calidad de vida genérica, tasa de curación) fueron satisfactorias. La gran mayoría de los pacientes consideraron que el cuestionario era una herramienta sencilla y factible. El tiempo medio necesario para completar el cuestionario fue de 5 minutos. El 99,1% de los participantes consideraron que las preguntas eran fáciles de entender y el 94,7% declaró que personal. Conclusiones: La versión española del Wound-QoL muestra una excelente validez en la práctica clínica. Por lo tanto, puede ser recomendada para su uso tanto en la rutina clínica como en los ensayos. Abstract: Background and aims: The Wound-QoL is a validated and feasible questionnaire for measuring disease-specific health-related quality of life in chronic wounds, originally developed for use in German.The objective of this study was to translate the Wound-QoL for use in clinical care and in clinical trials in Spain and to validate this version. Materials and methods: Two independent fourth- and back translations of the Wound-QoL from the original German version were conducted, followed by an expert consensus of the resulting versions. After refinement, the final tool was piloted in N = 10 patients and then used in the validation study. Results: A total of 115 patients were recruited. Mean age was 69.5 (SD 14.5) years, 60.0% were female. The Spanish version of Wound-QoL showed high internal consistency (Cronbach's alpha > 0.8 in all scales). Factor analysis resulted in the same scales as the original version. There were satisfactory distribution characteristics of the global score and the subscales. Construct validity and convergent validity with other outcomes (generic QoL, healing rate) were satisfactory. The vast majority of patients considered the Wound-QoL a simple and feasible tool. Mean time needed for completing the questionnaire was 5 minutes. Overall, 99.1% of the participants found it easy to understand the questions and 94.7% stated that the questionnaire suits the personal situation. Conclusions: The Spanish version of the Wound-QoL shows good validity in clinical practice. It can be recommended for use in clinical routine and trials.
- Published
- 2021
- Full Text
- View/download PDF
3. [Translated article] Contact Dermatitis in Patients With Chronic Leg Ulcers: A Case Series
- Author
-
D. Rizo-Potau, J. Riera-Monroig, Á. Pomar Matias, and M. Alsina Gibert
- Subjects
Dermatology ,RL1-803 ,Internal medicine ,RC31-1245 - Published
- 2022
- Full Text
- View/download PDF
4. Validación de la versión española del cuestionario Wound-QoL
- Author
-
A Peral Vázquez, Nicole Mohr, M. Alsina Gibert, Matthias Augustin, C Horcajada Reales, J Montoro López, S. Guisado Muñoz, Christine Blome, L. Perez Jeronimo, E. Conde Montero, P. de la Cueva Dobao, R Ramón Sapena, N Kressel, R Cabeza Martínez, and Rachel Sommer
- Subjects
Quality of life ,Health care research ,medicine.medical_specialty ,Validation study ,Patient-centred care ,Dermatology ,030204 cardiovascular system & hematology ,German ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Cronbach's alpha ,Internal consistency ,Medicine ,Chronic wound ,Internal medicine ,business.industry ,Construct validity ,General Medicine ,Wound care ,RC31-1245 ,humanities ,language.human_language ,Clinical trial ,Convergent validity ,RL1-803 ,Patient burden ,language ,Physical therapy ,business - Abstract
Resumen: Antecedentes y objetivos: El Wound-QoL es un cuestionario validado para medir la calidad de vida en pacientes con heridas crónicas, que fue desarrollado originalmente para su uso en alemán.El objetivo de este estudio fue traducir el cuestionario Wound-QoL para su uso en la práctica clínica y estudios de investigación en España, así como validar esta versión. Materiales y métodos: Se realizaron dos traducciones independientes del Wound-QoL, directa e inversa, a partir de la versión original en alemán, seguidas de un consenso de expertos sobre las versiones resultantes. Después de su perfeccionamiento se realizó un estudio piloto y posteriormente el estudio de validación. Resultados: Se incluyó un total de 115 pacientes. La edad media fue de 69,5 (DE 14,5) años, y el 60,0% eran mujeres. La versión española del Wound-QoL mostró una excelente consistencia interna (índice alfa de Cronbach > 0,8 en todas las escalas). El análisis factorial dio como resultado las mismas escalas que la versión original. Se objetivaron características satisfactorias de la distribución de la puntuación global y de las subescalas. La validez de constructo y la validez convergente con otros resultados (calidad de vida genérica, tasa de curación) fueron satisfactorias. La gran mayoría de los pacientes consideraron que el cuestionario era una herramienta sencilla y factible. El tiempo medio necesario para completar el cuestionario fue de 5 minutos. El 99,1% de los participantes consideraron que las preguntas eran fáciles de entender y el 94,7% declaró que personal. Conclusiones: La versión española del Wound-QoL muestra una excelente validez en la práctica clínica. Por lo tanto, puede ser recomendada para su uso tanto en la rutina clínica como en los ensayos. Abstract: Background and aims: The Wound-QoL is a validated and feasible questionnaire for measuring disease-specific health-related quality of life in chronic wounds, originally developed for use in German.The objective of this study was to translate the Wound-QoL for use in clinical care and in clinical trials in Spain and to validate this version. Materials and methods: Two independent fourth- and back translations of the Wound-QoL from the original German version were conducted, followed by an expert consensus of the resulting versions. After refinement, the final tool was piloted in N = 10 patients and then used in the validation study. Results: A total of 115 patients were recruited. Mean age was 69.5 (SD 14.5) years, 60.0% were female. The Spanish version of Wound-QoL showed high internal consistency (Cronbach's alpha > 0.8 in all scales). Factor analysis resulted in the same scales as the original version. There were satisfactory distribution characteristics of the global score and the subscales. Construct validity and convergent validity with other outcomes (generic QoL, healing rate) were satisfactory. The vast majority of patients considered the Wound-QoL a simple and feasible tool. Mean time needed for completing the questionnaire was 5 minutes. Overall, 99.1% of the participants found it easy to understand the questions and 94.7% stated that the questionnaire suits the personal situation. Conclusions: The Spanish version of the Wound-QoL shows good validity in clinical practice. It can be recommended for use in clinical routine and trials.
- Published
- 2021
5. Syphilis Maligna: A Presentation to Bear in Mind
- Author
-
X. Fustà-Novell, D. Morgado-Carrasco, A. Barreiro-Capurro, C. Manzardo, M. Alsina-Gibert, Irene Fuertes-de Vega, José-Luís Blanco, Anna González, Asunción Moreno, Miriam Álvarez, and Jordi Bosch
- Subjects
medicine.medical_specialty ,Histology ,business.industry ,Human immunodeficiency virus (HIV) ,Dermatology ,Secondary syphilis ,medicine.disease ,medicine.disease_cause ,Response to treatment ,Pathology and Forensic Medicine ,Serology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Hiv patients ,Medicine ,Syphilis ,030212 general & internal medicine ,Differential diagnosis ,Presentation (obstetrics) ,business - Abstract
Malignant syphilis is an uncommon form of secondary syphilis associated with HIV infection. Clinically, it is characterized by necrotic nodules and generalized ulcerated lesions. We present 4 cases of malignant syphilis diagnosed after evaluating syphilis cases diagnosed at our hospital between 2012 and 2016. We describe the epidemiologic, clinical, histiopathologic, and serologic characteristics of malignant syphilis and explore its response to treatment and association with HIV infection. Although malignant syphilis is uncommon, there has been an increase in the number of cases published in recent years, particularly in young HIV-positive patients. Malignant syphilis must be contemplated in the differential diagnosis of HIV patients with ulcerated, necrotic lesions.
- Published
- 2019
6. Sífilis maligna, una presentación de sífilis a tener en cuenta
- Author
-
X. Fustà-Novell, D. Morgado-Carrasco, A. Barreiro-Capurro, C. Manzardo, M. Alsina-Gibert, Irene Fuertes-de Vega, José-Luís Blanco, Anna González, Asunción Moreno, Miriam Álvarez, and Jordi Bosch
- Subjects
General Medicine - Abstract
Resumen La sifilis maligna es una forma infrecuente de sifilis secundaria asociada a la infeccion por el VIH, caracterizada clinicamente por nodulos necroticos y lesiones ulceradas generalizadas. Presentamos 4 pacientes diagnosticados de sifilis maligna tras revisar los casos de sifilis diagnosticados en nuestro centro entre 2012 y 2016. Describimos los aspectos epidemiologicos, clinicos, histopatologicos y serologicos, asi como su relacion con el VIH y la respuesta al tratamiento. Aunque se trate de una forma de sifilis poco frecuente, en los ultimos anos ha aumentado el numero de casos publicados, principalmente pacientes jovenes infectados por el VIH. Es necesario incluir la sifilis maligna en el diagnostico diferencial de pacientes infectados por el VIH con lesiones ulceradas y necroticas.
- Published
- 2019
7. Descripción de los pacientes que reciben biológicos como primer tratamiento sistémico en el registro BIOBADADERM durante el periodo 2008-2016
- Author
-
F.J. Gómez-García, José L. López-Estebaranz, I. Belinchón Romero, C. Muñoz Santos, R. Rivera Díaz, Mar Llamas-Velasco, G. Carretero Hernández, J.M. Carrascosa Carrillo, E. Daudén Tello, M. Ferrán Farrés, P. de la Cueva-Dobao, J.L. Sánchez-Carazo, M. Alsina Gibert, Enrique Herrera-Ceballos, Ignacio García-Doval, A. González Quesada, M.V. Mendiola Fernández, D.P. Ruiz Genao, Carlos Ferrándiz, and Miguel Ángel Descalzo
- Subjects
030203 arthritis & rheumatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,General Medicine - Abstract
Resumen Introduccion y objetivos La utilizacion clinica habitual de los farmacos biologicos en el tratamiento de la psoriasis es en segunda linea, es decir, tras el uso previo de un farmaco clasico. Sin embargo, en casos particulares –particularidades del paciente o criterio medico– se realiza la indicacion en primera linea. No existen estudios sobre las caracteristicas demograficas, clinicas y de seguridad de los pacientes que reciben farmaco biologico en primera linea. Como objetivo primario se pretende determinar dichas caracteristicas de acuerdo con la iniciacion de la terapia biologica en primera o segunda linea. Material y metodo Se realizo un estudio descriptivo, multicentrico, de 181 pacientes que iniciaron tratamiento biologico como primer farmaco sistemico para control de su psoriasis moderada-grave, y que forman parte del Registro Espanol de Acontecimientos Adversos Asociados con Medicamentos Biologicos en Dermatologia, entre enero de 2008 y noviembre de 2016. Resultados Los pacientes de ambos grupos son muy similares, si bien se evidencia que el grupo que recibe el biologico en primera linea presenta una edad mas avanzada, sin que se justifique por gravedad de la enfermedad (PASI) ni por el tiempo de evolucion de esta desde el diagnostico. En este grupo de pacientes es mas frecuente la presencia de hipertension, diabetes y hepatopatia. No hemos encontrado diferencias en motivos de suspension ni seguridad entre ambos grupos. Conclusiones No se han encontrado diferencias relevantes entre los 2 grupos, lo cual refuerza la seguridad de los farmacos biologicos en este contexto.
- Published
- 2018
8. Description of Patients Treated with Biologic Drugs as First-Line Systemic Therapy in the BIOBADADERM Registry Between 2008 and 2016
- Author
-
I. Belinchón Romero, M. Alsina Gibert, E. Daudén Tello, F.J. Gómez-García, R. Rivera Díaz, Carlos Ferrándiz, Miguel Ángel Descalzo, Ignacio García-Doval, C. Muñoz Santos, Enrique Herrera-Ceballos, A. González Quesada, M.V. Mendiola Fernández, J.L. Sánchez-Carazo, J.M. Carrascosa Carrillo, M. Ferrán Farrés, José L. López-Estebaranz, Mar Llamas-Velasco, G. Carretero Hernández, D.P. Ruiz Genao, and P. de la Cueva-Dobao
- Subjects
030203 arthritis & rheumatology ,Drug ,medicine.medical_specialty ,Histology ,business.industry ,media_common.quotation_subject ,Dermatology ,medicine.disease ,Systemic therapy ,Pathology and Forensic Medicine ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Drug withdrawal ,Liver disease ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,Psoriasis ,medicine ,Observational study ,Adverse effect ,business ,media_common - Abstract
Introduction and objectives Biologic drugs are usually prescribed as second-line treatment for psoriasis, that is, after the patient has first been treated with a conventional psoriasis drug. There are, however, cases where, depending on the characteristics of the patient or the judgement of the physician, biologics may be chosen as first-line therapy. No studies to date have analyzed the demographics or clinical characteristics of patients in this setting or the safety profile of the agents used. The main aim of this study was to characterize these aspects of first-line biologic therapy and compare them to those observed for patients receiving biologics as second-line therapy. Material and method We conducted an observational study of 181 patients treated in various centers with a systemic biologic drug as first-line treatment for moderate to severe psoriasis between January 2008 and November 2016. All the patients were registered in the Spanish Registry of Adverse Events Associated with Biologic Drugs in Dermatology. Results The characteristics of the first- and second-line groups were very similar, although the patients receiving a biologic as first-line treatment for their psoriasis were older. No differences were observed for disease severity (assessed using the PASI) or time to diagnosis. Hypertension, diabetes, and liver disease were all more common in the first-line group. There were no differences between the groups in terms of reasons for drug withdrawal or occurrence of adverse effects. Conclusions No major differences were found between patients with psoriasis receiving biologic drugs as first- or second-line therapy, a finding that provides further evidence of the safety of biologic therapy in patients with psoriasis.
- Published
- 2018
9. Respuesta a secukinumab tras fracaso terapéutico con ustekinumab en seis pacientes con psoriasis en placas
- Author
-
Xavier Fustà-Novell, Daniel Morgado-Carrasco, M. Alsina Gibert, and J. Riera-Monroig
- Subjects
business.industry ,Medicine ,General Medicine ,business - Published
- 2018
10. Response to Secukinumab after Treatment Failure with Ustekinumab in 6 Patients with Plaque Psoriasis
- Author
-
M. Alsina Gibert, Daniel Morgado-Carrasco, Xavier Fustà-Novell, and J. Riera-Monroig
- Subjects
Plaque psoriasis ,medicine.medical_specialty ,Histology ,business.industry ,Ustekinumab ,medicine ,Secukinumab ,Dermatology ,business ,After treatment ,Pathology and Forensic Medicine ,medicine.drug - Published
- 2018
11. Sexually Transmitted Infections: Experience in a Multidisciplinary Clinic in a Tertiary Hospital (2010-2013)
- Author
-
P. García-de Olalla, T. Estrach-Panella, M. Alsina-Gibert, J. Bosch-Mestres, J.L. Blanco-Arévalo, A. González-Cordón, I. Fuertes-de Vega, and N. Moreno-Ribera
- Subjects
medicine.medical_specialty ,Pediatrics ,Histology ,business.industry ,Lymphogranuloma venereum ,virus diseases ,Dermatology ,urologic and male genital diseases ,medicine.disease ,medicine.disease_cause ,female genital diseases and pregnancy complications ,Pathology and Forensic Medicine ,Men who have sex with men ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,medicine ,Urethritis ,Sex organ ,Syphilis ,030212 general & internal medicine ,business ,Chlamydia trachomatis ,Proctitis - Abstract
Background The number of consultations for sexually transmitted infections (STIs) is increasing in Spain. The aim of this study was to describe and analyze the epidemiological, behavioral, clinical, and microbiological characteristics of patients registered at the STI unit of a tertiary hospital. Methods This was a retrospective, single-center descriptive study carried out between 2010 and 2013 in a multidisciplinary unit specialized in STIs, situated in a tertiary hospital. Epidemiological, clinical, and behavioral data were gathered using a face-to-face interview and a standardized questionnaire. Samples were collected for microbiology analysis. Results The study included 546 patients: 96% were men, 41% had human immunodeficiency virus (HIV) infection, and 56% were men who have sex with men. The reasons for consultation were the following: urethritis; genital, anal, or perianal ulcers; proctitis; oral ulcers; sexual contact with a person with a known STI; and high-risk sexual contact. The most common microbiological diagnoses were Neisseria gonorrhoeae in urethritis, Treponema pallidum in genital and anal or perianal ulcers, and Chlamydia trachomatis lymphogranuloma venereum serovars in proctitis. The highest prevalences of the main STIs studied occurred in homosexual men with HIV infection. Conclusion This study confirms the increase in the incidence of STIs in recent years and the epidemiological characteristics of the HIV/STI epidemic in Spain.
- Published
- 2016
12. Infecciones de transmisión sexual: experiencia de una consulta multidisciplinar en un hospital terciario (2010-2013)
- Author
-
P. García-de Olalla, T. Estrach-Panella, N. Moreno-Ribera, J.L. Blanco-Arévalo, J. Bosch-Mestres, A. González-Cordón, I. Fuertes-de Vega, and M. Alsina-Gibert
- Subjects
030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,General Medicine - Abstract
Resumen Introduccion Las infecciones de transmision sexual son un motivo de consulta creciente en nuestro medio. El objetivo de este trabajo es describir y analizar las caracteristicas epidemiologicas, conductuales, clinicas y microbiologicas de los pacientes registrados en una unidad de infecciones de transmision sexual de un hospital terciario. Metodos Estudio descriptivo, retrospectivo y unicentrico realizado en una unidad multidisciplinar especializada en infecciones de transmision sexual de un hospital terciario entre 2010 y 2013. Se recogieron datos epidemiologicos, clinicos y conductuales mediante entrevista oral abierta y cuestionario estandarizado, y se llevo a cabo la obtencion de muestras para estudio microbiologico. Resultados Se estudiaron 546 pacientes, de los cuales fueron 96% varones, 41% infectados por el VIH, 56% hombres que tienen sexo con hombres. Los motivos de consulta mas prevalentes fueron: uretritis, ulceras genitales y/o anales/perianales, proctitis, ulceras orales, contacto sexual de persona con ITS conocida y contacto sexual de riesgo. Los diagnosticos microbiologicos mas frecuentes fueron: Neisseria gonorrhoeae en uretritis, Treponema pallidum en ulceras genitales y/o anales/perianales y Chlamydia trachomatis serovares de linfogranuloma venereo en proctitis. Las principales ITS estudiadas fueron mas prevalentes en varones homosexuales e infectados por el VIH. Conclusion Se confirma el incremento en la incidencia de las infecciones de transmision sexual en los ultimos anos y las caracteristicas epidemiologicas de la epidemia VIH/ITS de nuestro entorno.
- Published
- 2016
13. Cutaneous Leishmaniasis: 20 Years’ Experience in a Spanish Tertiary Care Hospital
- Author
-
Priscila Giavedoni, Teresa Estrach, Irene Fuertes, M. Alsina Gibert, and Pilar Iranzo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Histology ,Adolescent ,Endemic Diseases ,medicine.medical_treatment ,Antiprotozoal Agents ,Emigrants and Immigrants ,Leishmaniasis, Cutaneous ,HIV Infections ,Comorbidity ,Dermatology ,Pathology and Forensic Medicine ,Tertiary Care Centers ,Immunocompromised Host ,Young Adult ,Meglumine ,Africa, Northern ,Cutaneous leishmaniasis ,Chart review ,Epidemiology ,Organometallic Compounds ,medicine ,Humans ,Adverse effect ,Aged ,Retrospective Studies ,Immune status ,Meglumine Antimoniate ,business.industry ,Immunosuppression ,Leishmaniasis ,Middle Aged ,Tertiary care hospital ,medicine.disease ,Surgery ,Latin America ,Spain ,Female ,business - Abstract
Background and objectives Cutaneous leishmaniasis is the most common form of leishmaniasis, which is endemic in Spain. The aim of this study was to evaluate the epidemiological and clinical characteristics of cutaneous leishmaniasis seen in our hospital over a period of 20 years, with a particular focus on clinical differences according to immune status and origin of infection Materials and methods We performed a chart review of 67 cases of cutaneous leishmaniasis diagnosed between 1992 and 2012. Follow-up data were available for 54 patients. Results Fifty-four patients with cutaneous leishmaniasis were included in the study. Of these, 26 had been diagnosed between 1992 and 2002 and 28 between 2003 and 2012. The mean age at diagnosis was 49 years, there was a predominance of male patients, and the mean time from onset of symptoms to consultation was 3 months. The most common clinical manifestations were plaques and ulcers. Most of the immunodepressed patients and patients with imported leishmaniasis had skin ulcers and/or multiple lesions. During the first decade of the study, diagnosis was based on clinical and histologic findings. These were supported by molecular techniques in the second decade. Pentavalent antimonials were the treatment of choice, producing good results and very few adverse effects Conclusion The number of patients with cutaneous leishmaniasis and with compromised immune status was similar in the periods 1992-2002 and 2003-2013, but more cases of imported leishmaniasis were diagnosed in the second period. Patients with ulcers and/or multiple lesions should be evaluated to rule out immunosuppression or infection by Leishmania species from other parts of the world. Both systemic and intralesional meglumine antimonate was effective and safe
- Published
- 2015
14. Leishmaniasis cutánea. Experiencia de 20 años en un hospital español de tercer nivel
- Author
-
Priscila Giavedoni, Irene Fuertes, M. Alsina Gibert, Teresa Estrach, and Pilar Iranzo
- Subjects
General Medicine - Abstract
Resumen Introduccion y objetivos La leishmaniasis es endemica en Espana, siendo la leishmaniasis cutanea la forma mas habitual de presentacion. El objetivo del estudio fue valorar las caracteristicas epidemiologicas y clinicas de la leishmaniasis cutanea en las ultimas 2 decadas, haciendo hincapie en las diferencias clinicas segun el estado inmunitario del paciente y el origen de la infeccion. Materiales y metodos Se revisaron retrospectivamente 67 historias clinicas de pacientes diagnosticados de leishmaniasis entre 1992 y 2012, de ellas 54 eran cutaneas, y con datos de seguimiento. Resultados Se incluyeron 54 pacientes: 26 diagnosticados entre 1992-2002 y 28 entre 2003-2012. La edad media fue de 49 anos, con un predominio en varones y un tiempo medio de evolucion previo a la consulta de 3 meses. Las manifestaciones clinicas mas frecuentes fueron placas y ulceras. La mayoria de pacientes inmunodeprimidos y con leishmaniasis importada presentaron lesiones ulceradas y/o multiples. El diagnostico se baso en los hallazgos clinico-patologicos en la primera decada, asociandose el diagnostico por metodos moleculares en la segunda. El tratamiento de eleccion fue los antimoniales pentavalentes, con buenos resultados y escasos efectos adversos. Conclusion El numero de casos y de pacientes inmunodeprimidos fueron similares en ambas decadas, diagnosticandose un mayor numero de leishmaniasis importada en la segunda. En los pacientes con lesiones multiples y/o ulceradas deberian descartarse la inmunosupresion del huesped y la infeccion por cepas importadas. El tratamiento con antimoniato de meglumina fue eficaz y seguro, tanto por via sistemica como intralesional.
- Published
- 2015
15. Evidence-Based Guidelines of the Spanish Psoriasis Group on the Use of Biologic Therapy in Patients With Psoriasis in Difficult-to-Treat Sites (Nails, Scalp, Palms, and Soles)
- Author
-
M. Alsina Gibert, C. Ferrándiz Foraster, L. Puig Sanz, M.C. Rodríguez Cerdeira, Ricardo Ruiz-Villaverde, M. Ribera Pibernat, S.E. Marrón Moya, I. Belinchón Romero, E. Herrera Acosta, M.J. Aldunce Soto, E. Daudén Tello, J.M. Carrascosa Carrillo, R.F. Lafuente-Urrez, E. Fonseca Capdevila, Manuel Sánchez-Regaña, and D. Vidal Sarró
- Subjects
medicine.medical_specialty ,Histology ,business.industry ,Dermatology ,Evidence-based medicine ,medicine.disease ,Infliximab ,Pathology and Forensic Medicine ,Etanercept ,Clinical trial ,medicine.anatomical_structure ,Psoriasis ,Scalp ,Ustekinumab ,medicine ,Adalimumab ,skin and connective tissue diseases ,business ,medicine.drug - Abstract
Psoriatic lesions affecting the scalp, nails, palms, and the soles of the feet are described as difficult-to-treat psoriasis and require specific management. Involvement of these sites often has a significant physical and emotional impact on the patient and the lesions are difficult to control with topical treatments owing to inadequate penetration of active ingredients and the poor cosmetic characteristics of the vehicles used. Consequently, when difficult-to-treat sites are involved, psoriasis can be considered severe even though the lesions are not extensive. Scant information is available about the use of biologic therapy in this setting, and published data generally comes from clinical trials of patients who also had moderate to severe extensive lesions or from small case series and isolated case reports. In this article we review the quality of the scientific evidence for the 4 biologic agents currently available in Spain (infliximab, etanercept, adalimumab, and ustekinumab) and report level i evidence for the use of biologics to treat nail psoriasis (level of recommendation A) and a somewhat lower level of evidence in the case of scalp involvement and palmoplantar psoriasis.
- Published
- 2014
16. Directrices del grupo español de psoriasis (GEP) basadas en la evidencia para el uso de medicamentos biológicos en pacientes con psoriasis en localizaciones de difícil tratamiento (uñas, cuero cabelludo, palmas y plantas)
- Author
-
M. Alsina Gibert, S.E. Marrón Moya, J.M. Carrascosa Carrillo, Manuel Sánchez-Regaña, E. Daudén Tello, C. Ferrándiz Foraster, E. Fonseca Capdevila, R.F. Lafuente-Urrez, Ricardo Ruiz-Villaverde, D. Vidal Sarró, I. Belinchón Romero, L. Puig Sanz, M.C. Rodríguez Cerdeira, E. Herrera Acosta, M. Ribera Pibernat, and M.J. Aldunce Soto
- Subjects
General Medicine - Abstract
Resumen El termino de psoriasis en localizaciones de dificil tratamiento se emplea para hacer referencia a la psoriasis localizada en el cuero cabelludo, las unas, las palmas y las plantas y que requiere un manejo diferenciado. A menudo los pacientes presentan un importante impacto fisico y emocional, unido a la dificultad para controlar adecuadamente sus lesiones con tratamientos topicos, debido a una insuficiente penetracion de los principios activos y la escasa cosmeticidad de los vehiculos empleados. Esta circunstancia justifica que la psoriasis en estas localizaciones pueda ser considerada grave, a pesar de su extension limitada. La experiencia con terapias biologicas en estas localizaciones es escasa, en general en el contexto de ensayos clinicos de formas extensas de psoriasis moderada y grave, junto con series limitadas o casos aislados. En el presente articulo se presenta la calidad de la evidencia cientifica para los 4 agentes biologicos disponibles en Espana (infliximab, etanercept, adalimumab y ustekinumab) siendo de nivel i en el caso de la psoriasis ungueal (nivel de recomendacion A) y algo inferior en la psoriasis del cuero cabelludo y palmoplantar.
- Published
- 2014
17. Description of Patients Treated with Biologic Drugs as First-Line Systemic Therapy in the BIOBADADERM Registry Between 2008 and 2016
- Author
-
G, Carretero Hernández, C, Ferrándiz, R, Rivera Díaz, E, Daudén Tello, P, de la Cueva-Dobao, F J, Gómez-García, E, Herrera-Ceballos, I, Belinchón Romero, J L, López-Estebaranz, M, Alsina Gibert, J L, Sánchez-Carazo, M, Ferrán Farrés, A, González Quesada, J M, Carrascosa Carrillo, M, Llamas-Velasco, M V, Mendiola Fernández, D, Ruiz Genao, C, Muñoz Santos, I, García-Doval, and M A, Descalzo
- Subjects
Adult ,Male ,Biological Products ,Drug Substitution ,Tumor Necrosis Factor-alpha ,Antibodies, Monoclonal ,Comorbidity ,Middle Aged ,Drug Utilization ,Age Distribution ,Spain ,Humans ,Psoriasis ,Female ,Registries ,Immunosuppressive Agents ,Aged - Abstract
Biologic drugs are usually prescribed as second-line treatment for psoriasis, that is, after the patient has first been treated with a conventional psoriasis drug. There are, however, cases where, depending on the characteristics of the patient or the judgement of the physician, biologics may be chosen as first-line therapy. No studies to date have analyzed the demographics or clinical characteristics of patients in this setting or the safety profile of the agents used. The main aim of this study was to characterize these aspects of first-line biologic therapy and compare them to those observed for patients receiving biologics as second-line therapy.We conducted an observational study of 181 patients treated in various centers with a systemic biologic drug as first-line treatment for moderate to severe psoriasis between January 2008 and November 2016. All the patients were registered in the Spanish Registry of Adverse Events Associated with Biologic Drugs in Dermatology.The characteristics of the first- and second-line groups were very similar, although the patients receiving a biologic as first-line treatment for their psoriasis were older. No differences were observed for disease severity (assessed using the PASI) or time to diagnosis. Hypertension, diabetes, and liver disease were all more common in the first-line group. There were no differences between the groups in terms of reasons for drug withdrawal or occurrence of adverse effects.No major differences were found between patients with psoriasis receiving biologic drugs as first- or second-line therapy, a finding that provides further evidence of the safety of biologic therapy in patients with psoriasis.
- Published
- 2017
18. Syphilis Maligna: A Presentation to Bear in Mind
- Author
-
X, Fustà-Novell, D, Morgado-Carrasco, A, Barreiro-Capurro, C, Manzardo, M, Alsina-Gibert, and Jordi, Bosch
- Subjects
Adult ,Humans ,HIV Infections ,Syphilis ,Middle Aged ,Retrospective Studies - Abstract
Malignant syphilis is an uncommon form of secondary syphilis associated with HIV infection. Clinically, it is characterized by necrotic nodules and generalized ulcerated lesions. We present 4 cases of malignant syphilis diagnosed after evaluating syphilis cases diagnosed at our hospital between 2012 and 2016. We describe the epidemiologic, clinical, histiopathologic, and serologic characteristics of malignant syphilis and explore its response to treatment and association with HIV infection. Although malignant syphilis is uncommon, there has been an increase in the number of cases published in recent years, particularly in young HIV-positive patients. Malignant syphilis must be contemplated in the differential diagnosis of HIV patients with ulcerated, necrotic lesions.
- Published
- 2017
19. Response to Secukinumab after Treatment Failure with Ustekinumab in 6 Patients with Plaque Psoriasis
- Author
-
D, Morgado-Carrasco, J, Riera-Monroig, X, Fustà-Novell, and M, Alsina Gibert
- Subjects
Adult ,Male ,Remission Induction ,Antibodies, Monoclonal ,Humans ,Psoriasis ,Ustekinumab ,Dermatologic Agents ,Treatment Failure ,Middle Aged ,Antibodies, Monoclonal, Humanized ,Retrospective Studies - Published
- 2017
20. Risk of adverse events in psoriasis patients receiving classic systemic drugs and biologics in a 5-year observational study of clinical practice: 2008-2013 results of the Biobadaderm registry
- Author
-
G, Carretero, C, Ferrandiz, E, Dauden, F, Vanaclocha Sebastián, F J, Gómez-García, E, Herrera-Ceballos, P, De la Cueva-Dobao, I, Belinchón, J L, Sánchez-Carazo, M, Alsina-Gibert, J L, López-Estebaranz, M, Ferrán, R, Torrado, J M, Carrascosa, C, Carazo, R, Rivera, R, Jiménez-Puya, I, García-Doval, and Sagrario, Galiano Mejias
- Subjects
Adult ,Male ,medicine.medical_specialty ,Dermatology ,Antibodies, Monoclonal, Humanized ,Lower risk ,Risk Assessment ,Receptors, Tumor Necrosis Factor ,Etanercept ,Keratolytic Agents ,Internal medicine ,Ustekinumab ,medicine ,Humans ,Psoriasis ,Prospective Studies ,Registries ,Adverse effect ,Prospective cohort study ,Aged ,Proportional Hazards Models ,Biological Products ,Proportional hazards model ,business.industry ,Incidence (epidemiology) ,Anti-Inflammatory Agents, Non-Steroidal ,Hazard ratio ,Adalimumab ,Antibodies, Monoclonal ,Middle Aged ,Acitretin ,Infliximab ,Surgery ,Methotrexate ,Infectious Diseases ,Spain ,Immunoglobulin G ,Relative risk ,Cyclosporine ,Female ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
Background Biobadaderm is the Spanish registry of psoriasis patients receiving systemic treatment in clinical practice. Objective To compare the safety of biologics and classic systemic treatment. Methods Prospective cohort of patients receiving biologics and classic systemic therapies between 2008 and 2013 in 12 hospitals are included. We registered demographic data, diagnoses, comorbidities, treatments and adverse events (AE). We obtained raw relative risks (RR) for specific AE. Multivariate analysis consisted of Cox models adjusting for age, gender, chronic hepatic disease and previous cancer. Results A total of 1030 patients received biologics (2061 AE in 3681 person-years), 926 patients classic systemic drugs (1015 AE in 1517 person-years). Ninety-three per cent of AE in both groups were non-serious, 6% serious and 0.003% fatal. The age- and gender-adjusted hazard ratio of AE was lower in the biologics group [hazard ratio 0.6 (95% CI: 0.5–0.7)].We found no differences in rates of serious and mortal AE. Some system organ class AE rates differed between both groups. As limitations: Prescription bias might affect the incidence of AE in both groups. Association of drug and AE was based on timing: associations might not be causal. Conclusion Patients receiving biologics had lower risk of AE. We did not find differences in the risk of serious or fatal AE.
- Published
- 2014
21. Determination of adalimumab and etanercept trough levels and drug antibodies in long-term psoriasis treatment: a single-centre cohort study
- Author
-
M. Alsina-Gibert and Juan Jorge Manríquez
- Subjects
musculoskeletal diseases ,Drug ,Adult ,Male ,medicine.medical_specialty ,Time Factors ,media_common.quotation_subject ,Anti-Inflammatory Agents ,Enzyme-Linked Immunosorbent Assay ,Dermatology ,Antibodies ,Etanercept ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Psoriasis Area and Severity Index ,Internal medicine ,Psoriasis ,medicine ,Adalimumab ,Humans ,Prospective Studies ,Prospective cohort study ,media_common ,Aged ,030203 arthritis & rheumatology ,Dose-Response Relationship, Drug ,business.industry ,Tumor Necrosis Factor-alpha ,Middle Aged ,medicine.disease ,Treatment Outcome ,Female ,Sample collection ,business ,Immunosuppressive Agents ,medicine.drug ,Cohort study ,Follow-Up Studies - Abstract
SummaryBackground An algorithm based on measurement of a serum tumour necrosis factor antagonists (anti-TNF) and antidrug antibodies (ADA) has been proposed previously to guide dose escalation or therapy switching in the early (i.e. the first months of) treatment of psoriasis by anti-TNF. In long-term treatment of responding patients with psoriasis, it is usual to empirically reduce standard doses of anti-TNF to reduce exposure while maintaining clinical response. The relationship between serum anti-TNF, ADA levels and clinical efficacy in long-term treated patients with psoriasis has not yet been determined, so the potential role of these parameters in guiding dose escalation in this scenario is unknown. Aims To evaluate the relationship between drug/ADA levels and clinical efficacy in a group of patients with psoriasis undergoing long-term treatment with adalimumab or etanercept. Methods This was a single-centre, prospective, cohort study of patients with psoriasis receiving adalimumab or etanercept for a minimum of 48 weeks. All patients were started on the standard dose, but some adalimumab users had a reduced frequency of administration. Clinical efficacy was measured using the Psoriasis Area and Severity Index. Serum concentrations were measured by ELISA. Clinical assessment and blood sample collection were carried out simultaneously within 24 h before the next drug administration. Results In total, 21 patients were enrolled (67 simultaneous clinical and serum determinations: 38 receiving adalimumab, 29 receiving etanercept). We did not find any association between serum anti-TNF levels and clinical response. None of the patients developed ADA. Conclusions ADA and anti-TNF levels are not related to clinical effectiveness in patients with psoriasis undergoing long-term treatment with adalimumab or etanercept.
- Published
- 2016
22. Aplicación de membrana amniótica en el tratamiento de las úlceras crónicas de extremidades inferiores
- Author
-
S. Pedregosa-Fauste and M. Alsina-Gibert
- Subjects
General Medicine - Abstract
Resumen Introduccion Las ulceras vasculares (venosas y arteriales) de las extremidades inferiores afectan aproximadamente al 1% de la poblacion. Para su tratamiento pueden utilizarse equivalentes cutaneos vivos procedentes de donantes cadavericos o desarrollados mediante bioingenieria tisular. Un 25% de las ulceras no se resuelven, lo que conlleva dolor y perdida de autonomia para los pacientes, ademas de un aumento de la morbilidad y de los costes sanitarios. La membrana amniotica aplicada en ulceras corneales ha demostrado poseer propiedades antimicrobianas y bacteriostaticas, y ser capaz de proteger la herida sin inducir respuesta inmunologica. En ulceras postromboticas y quemaduras tambien se han descrito estas mismas cualidades. Objetivos Valorar la eficacia de la aplicacion del injerto de membrana amniotica en las ulceras vasculares cronicas refractarias de extremidades inferiores. Pacientes y metodos Se aplico el injerto de membrana amniotica en cuatro ulceras refractarias de tres pacientes. Se calculo el tiempo medio de epitelizacion total o parcial de la lesion mediante el registro del area y se valoro el dolor mediante escala visual analogica, en las semanas 0, 4, 8, 12 y 16. Resultados En la semana 8 se observo la epitelizacion completa de una ulcera y la reduccion del 50% de las otras tres. En la semana 16 la reduccion del area fue de media un 81,93% en los cuatro casos. La intensidad del dolor percibido se redujo un 86,6%. No se detectaron efectos adversos. Conclusiones La membrana amniotica puede ser una alternativa eficaz en el tratamiento de las ulceras vasculares cronicas refractarias de extremidades inferiores.
- Published
- 2012
23. Amniotic Membrane Transplantation in the Treatment of Chronic Lower Limb Ulcers
- Author
-
S. Pedregosa-Fauste and M. Alsina-Gibert
- Subjects
education.field_of_study ,medicine.medical_specialty ,Histology ,Debridement ,Visual analogue scale ,business.industry ,medicine.medical_treatment ,Population ,Dermatology ,Pathology and Forensic Medicine ,Surgery ,Transplantation ,Refractory ,Cadaver ,medicine ,education ,Wound healing ,Adverse effect ,business - Abstract
Introduction Approximately 1% of the general population have venous or arterial lower limb ulcers. These lesions can be treated with biological skin substitutes such as cadaver skin or tissue-engineered skin equivalents, but treatment fails in 25% of cases, resulting in pain and loss of patient autonomy, as well as increased morbidity and health care costs. In the treatment of corneal ulcers, amniotic membrane has been shown to have antimicrobial and bacteriostatic properties, and to protect the wound without eliciting an immune response. The same properties have been reported in the treatment of burns and postthrombotic ulcers. Objectives To assess the effectiveness of amniotic membrane transplantation in the treatment of refractory chronic leg ulcers. Patients and methods Amniotic membrane was grafted onto 4 refractory ulcers in 3 patients. The mean time required for partial and complete reepithelialization was calculated by measuring the wound area at weeks 0, 4, 8, 12, and 16. Pain intensity was assessed at the same intervals using a visual analog scale. Results Complete wound reepithelialization was achieved for 1 ulcer by week 8; in the other 3 cases, there was a 50% reduction in size compared to baseline. At week 16, the mean reduction in wound size for the 4 ulcers was 81.93%. The corresponding reduction in pain intensity was 86.6%. No adverse effects were observed. Conclusions Amniotic membrane transplantation might be an effective alternative for the treatment of refractory chronic vascular ulcers on the lower limbs.
- Published
- 2012
24. Estudio coste-beneficio del trasplante de membrana amniótica para úlceras venosas de extremidades inferiores refractarias a tratamiento convencional
- Author
-
M. Alsina-Gibert, L. Sampietro-Colom, S. Pedregosa-Fauste, S. Gutiérrez-Moreno, and P. Ayala-Blanco
- Subjects
General Medicine - Abstract
Resumen Introduccion El tratamiento estandar compresivo de las ulceras venosas de extremidades inferiores no promueve la cicatrizacion. El autoinjerto es uno de los tratamientos que acelera la reparacion tisular, sin embargo, su aplicacion es dificil en pacientes pluripatologicos o cuando se requieren aplicaciones multiples. La membrana amniotica se ha empleado como material de cobertura y como epitelizante, por lo que podria ser una buena opcion terapeutica para cuando el autoinjerto no este indicado. Objetivos Analizar el estado de conocimiento cientifico sobre la seguridad y la eficacia de la membrana amniotica y comparar los costes de los injertos disponibles actualmente (autoinjertos, membrana amniotica y sustitutos cutaneos biocompatibles) para promover la reparacion tisular de las ulceras venosas. Material y metodos Se realizo una busqueda y revision sistematica de la literatura cientifica hasta marzo del 2010 sobre el uso de la membrana amniotica como tratamiento de las ulceras venosas. Asimismo, se realizo un analisis coste-minimizacion (horizonte temporal 3 y 6 meses). Se consideraron los costes directos sanitarios. Para comprobar la estabilidad de los resultados se llevo a cabo un analisis de sensibilidad. Resultados Se identifico un unico estudio sobre seguridad y eficacia. El analisis de costes mostro que el autoinjerto es siempre la opcion mas barata (1.053 € versus 1.825 € membrana amniotica, 5.767 € sustitutos cutaneos biocompatibles). A los 6 meses la membrana amniotica costaria 6.765 € menos que el uso de los sustitutos cutaneos biocompatibles. Conclusiones El transplante de membrana amniotica para la reepitelizacion de ulceras venosas refractarias al tratamiento convencional es una opcion terapeutica de gran potencial, pero aun en estado experimental. El autoinjerto es el tratamiento mas eficiente; pero la membrana amniotica es mas economica que los sustitutos cutaneos biocompatibles.
- Published
- 2011
25. Cost-Benefit Analysis of Amniotic Membrane Transplantation for Venous Ulcers of the Legs That Are Refractory to Conventional Treatment
- Author
-
L. Sampietro-Colom, S. Gutiérrez-Moreno, M. Alsina-Gibert, P. Ayala-Blanco, and S. Pedregosa-Fauste
- Subjects
medicine.medical_specialty ,Histology ,Amnion ,business.industry ,Conventional treatment ,Treatment options ,Dermatology ,Compression therapy ,Pathology and Forensic Medicine ,Surgery ,Transplantation ,surgical procedures, operative ,medicine.anatomical_structure ,Refractory ,Concomitant ,Medicine ,business ,Wound healing - Abstract
Background Standard compression therapy for venous ulcers of the legs does not promote healing. Although autografting accelerates tissue repair, it is difficult to use in patients with concomitant diseases or when multiple grafts are required. The amniotic membrane has been used as a covering material and promotes epithelialization, making it a good potential treatment option when autografts are not indicated. Objectives To analyze the literature on the safety and efficacy of amniotic membrane grafting and compare the cost of currently available grafts (autografts, amniotic membrane grafts, and biocompatible skin substitutes) to promote tissue repair in venous ulcers. Material and methods A systematic review of the literature on the use of amniotic membrane grafts for the treatment of venous ulcers was performed up to 2010. A cost-minimization analysis of direct healthcare costs was then performed (at 3 and 6 months). A sensitivity analysis was performed to confirm the stability of the results. Results Only 1 study addressing safety and efficacy was identified. The cost-minimization analysis showed that autografts are always the least-expensive option (€ 1053 compared with € 1825 for amniotic membrane grafts and € 5767 for biocompatible skin grafts). At 6 months, however, amniotic membrane grafts would have cost € 6765 less than the use of biocompatible skin substitutes. Conclusions Despite having excellent therapeutic potential for the re-epithelialization of venous ulcers that do not respond to conventional treatment, amniotic membrane transplant remains an experimental therapy. Autograft is the most efficient treatment but amniotic membrane graft is less expensive than the use of biocompatible skin substitutes.
- Published
- 2011
26. Sexually Transmitted Infections: Experience in a Multidisciplinary Clinic in a Tertiary Hospital (2010-2013)
- Author
-
N, Moreno-Ribera, I, Fuertes-de Vega, J L, Blanco-Arévalo, J, Bosch-Mestres, A, González-Cordón, T, Estrach-Panella, P, García-de Olalla, and M, Alsina-Gibert
- Subjects
Male ,Tertiary Care Centers ,Gonorrhea ,Risk Factors ,Spain ,Sexually Transmitted Diseases ,Humans ,Female ,HIV Infections ,Homosexuality ,Syphilis ,Chlamydia Infections ,Retrospective Studies - Abstract
The number of consultations for sexually transmitted infections (STIs) is increasing in Spain. The aim of this study was to describe and analyze the epidemiological, behavioral, clinical, and microbiological characteristics of patients registered at the STI unit of a tertiary hospital.This was a retrospective, single-center descriptive study carried out between 2010 and 2013 in a multidisciplinary unit specialized in STIs, situated in a tertiary hospital. Epidemiological, clinical, and behavioral data were gathered using a face-to-face interview and a standardized questionnaire. Samples were collected for microbiology analysis.The study included 546 patients: 96% were men, 41% had human immunodeficiency virus (HIV) infection, and 56% were men who have sex with men. The reasons for consultation were the following: urethritis; genital, anal, or perianal ulcers; proctitis; oral ulcers; sexual contact with a person with a known STI; and high-risk sexual contact. The most common microbiological diagnoses were Neisseria gonorrhoeae in urethritis, Treponema pallidum in genital and anal or perianal ulcers, and Chlamydia trachomatis lymphogranuloma venereum serovars in proctitis. The highest prevalences of the main STIs studied occurred in homosexual men with HIV infection.This study confirms the increase in the incidence of STIs in recent years and the epidemiological characteristics of the HIV/STI epidemic in Spain.
- Published
- 2015
27. Risk of Reactivation of Hepatitis B Virus Infection in Psoriasis Patients Treated With Biologics: A Retrospective Analysis of 20 Cases From the BIOBADADERM Database
- Author
-
J, Sanz-Bueno, F, Vanaclocha, I, García-Doval, R, Torrado, G, Carretero, E, Daudén, D, Patricia Ruiz-Genao, M M, Alsina-Gibert, B, Pérez-Zafrilla, G, Pérez-Rial, and R, Rivera
- Subjects
Male ,Hepatitis B virus ,Databases, Factual ,Tumor Necrosis Factor-alpha ,Antibodies, Monoclonal ,Viral Load ,Hepatitis B Antigens ,Hepatitis B, Chronic ,Antirheumatic Agents ,Carrier State ,DNA, Viral ,Humans ,Psoriasis ,Female ,Ustekinumab ,Virus Activation ,Dermatologic Agents ,Hepatitis B Antibodies ,Follow-Up Studies ,Retrospective Studies - Abstract
A 5% risk of reactivation of hepatitis B virus (HBV) infection has been reported in patients with diseases other than psoriasis treated with tumor necrosis factor inhibitors. The aim of this study was to investigate the risk of HBV reactivation in patients with a past history of HBV infection who were receiving biologic therapy for psoriasis.This was a multicenter study of 20 patients with psoriasis who were treated with at least 1 biologic agent. All the patients had serologic evidence of past HBV infection (positive total hepatitis B core antibody and negative hepatitis B surface antibody). We analyzed the clinical, serological, and liver function variables recorded before, during, and at the end of follow-up. The viral load at the end of follow-up was also analyzed for all patients.None of the patients fulfilled the criteria for HBV reactivation at the end of a median follow-up period of 40 months. Combining our data with data from other studies of psoriasis patients with a past history of HBV infection who were treated with a biologic, we calculated a maximum estimated risk of HBV reactivation for a mean follow-up period of 30 months of 2.7 reactivations per 100 patients.Biologic therapy did not cause HBV reactivation in our series of patients. Nonetheless, because of the potentially serious complications associated with HBV reactivation, it is important to measure viral load in patients with a history of HBV infection prior to initiation of biologic therapy to rule out occult carriage. These patients should also be monitored regularly in conjunction with a hepatologist.
- Published
- 2014
28. Immunobullous disease and ulcerative colitis - the need of an accurate diagnosis
- Author
-
Pilar Iranzo and M. Alsina-Gibert
- Subjects
medicine.medical_specialty ,business.industry ,Immunobullous disease ,Diagnostico diferencial ,Dermatology ,medicine.disease ,Ulcerative colitis ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Differential diagnosis ,business - Published
- 2016
29. Evidence-based guidelines of the spanish psoriasis group on the use of biologic therapy in patients with psoriasis in difficult-to-treat sites (nails, scalp, palms, and soles)
- Author
-
M, Sánchez-Regaña, M J, Aldunce Soto, I, Belinchón Romero, M, Ribera Pibernat, R F, Lafuente-Urrez, J M, Carrascosa Carrillo, C, Ferrándiz Foraster, L, Puig Sanz, E, Daudén Tello, D, Vidal Sarró, R, Ruiz-Villaverde, E, Fonseca Capdevila, M C, Rodríguez Cerdeira, M M, Alsina Gibert, E, Herrera Acosta, and S E, Marrón Moya
- Subjects
Biological Therapy ,Foot Dermatoses ,Biological Factors ,Nail Diseases ,Evidence-Based Medicine ,Scalp Dermatoses ,Humans ,Psoriasis ,Hand Dermatoses - Abstract
Psoriatic lesions affecting the scalp, nails, palms, and the soles of the feet are described as difficult-to-treat psoriasis and require specific management. Involvement of these sites often has a significant physical and emotional impact on the patient and the lesions are difficult to control with topical treatments owing to inadequate penetration of active ingredients and the poor cosmetic characteristics of the vehicles used. Consequently, when difficult-to-treat sites are involved, psoriasis can be considered severe even though the lesions are not extensive. Scant information is available about the use of biologic therapy in this setting, and published data generally comes from clinical trials of patients who also had moderate to severe extensive lesions or from small case series and isolated case reports. In this article we review the quality of the scientific evidence for the 4 biologic agents currently available in Spain (infliximab, etanercept, adalimumab, and ustekinumab) and report level i evidence for the use of biologics to treat nail psoriasis (level of recommendation A) and a somewhat lower level of evidence in the case of scalp involvement and palmoplantar psoriasis.
- Published
- 2013
30. Amniotic membrane transplantation in the treatment of chronic lower limb ulcers
- Author
-
M, Alsina-Gibert and S, Pedregosa-Fauste
- Subjects
Wound Healing ,Treatment Outcome ,Biological Dressings ,Debridement ,Leg Ulcer ,Humans ,Middle Aged ,Aged ,Pain Measurement - Abstract
Approximately 1% of the general population have venous or arterial lower limb ulcers. These lesions can be treated with biological skin substitutes such as cadaver skin or tissue-engineered skin equivalents, but treatment fails in 25% of cases, resulting in pain and loss of patient autonomy, as well as increased morbidity and health care costs. In the treatment of corneal ulcers, amniotic membrane has been shown to have antimicrobial and bacteriostatic properties, and to protect the wound without eliciting an immune response. The same properties have been reported in the treatment of burns and postthrombotic ulcers.To assess the effectiveness of amniotic membrane transplantation in the treatment of refractory chronic leg ulcers.Amniotic membrane was grafted onto 4 refractory ulcers in 3 patients. The mean time required for partial and complete re-epithelialization was calculated by measuring the wound area at weeks 0, 4, 8, 12, and 16. Pain intensity was assessed at the same intervals using a visual analog scale.Complete wound re-epithelialization was achieved for 1 ulcer by week 8; in the other 3 cases, there was a 50% reduction in size compared to baseline. At week 16, the mean reduction in wound size for the 4 ulcers was 81.93%. The corresponding reduction in pain intensity was 86.6%. No adverse effects were observed.Amniotic membrane transplantation might be an effective alternative for the treatment of refractory chronic vascular ulcers on the lower limbs.
- Published
- 2011
31. Nail psoriasis: a retrospective study on the effectiveness of systemic treatments (classical and biological therapy)
- Author
-
M, Sánchez-Regaña, J, Sola-Ortigosa, M, Alsina-Gibert, M, Vidal-Fernández, and P, Umbert-Millet
- Subjects
Male ,Time Factors ,Adalimumab ,Antibodies, Monoclonal ,Middle Aged ,Antibodies, Monoclonal, Humanized ,Severity of Illness Index ,Infliximab ,Biological Therapy ,Nail Diseases ,Treatment Outcome ,Cyclosporine ,Humans ,Psoriasis ,Female ,Dermatologic Agents ,Aged ,Retrospective Studies - Abstract
Nail psoriasis represents a challenge for specialists. There is no comparative study of systemic treatment's effectiveness at this site.Evaluate the response of nail psoriasis to classical and biological therapy and to compare the effectiveness and safety of the different treatments.We performed a retrospective study of 84 patients with moderate-severe psoriasis seen at our Department between January 2006 and January 2009.Psoriasis was severe in 53.4%. In 75% of cases, the fingernails were affected, and the mixed form was the most frequently subtype. The mean baseline scores on the PASI and the NAPSI were 23.12 and 14.7 respectively; the correlation between the two scores fell at weeks 12 and 24 but had risen again at week 48. The baseline NAPSI score tended to be lower in women and significantly higher in patients over 65 years of age, family history of psoriasis, severe psoriasis and nail matrix involvement. In our series, 58.3% received classical treatment (acitretin, methotrexate, cyclosporin, PUVA, NUVB, REPUVA, RENUVB) and 41.7% received biological treatment (infliximab, efalizumab, etanercept, adalimumab).Significant reductions were found (P0.05) in the mean NAPSI scores at 12, 24 and 48 weeks with all the antipsoriatic agents except NUVB; significantly greater with cyclosporine (P0.01) and biological as infliximab and adalimumab at 12 and 24 weeks (differences between treatments disappeared at 48 weeks).The response to treatment is slower in the nail lesions than in the skin lesions. The improvement of nail psoriasis is significant both with the classical treatments significantly higher in cyclosporin; and biological treatment (infliximab and adalimumab at 12 and 24 weeks).
- Published
- 2011
32. [Cost-benefit analysis of amniotic membrane transplantation for venous ulcers of the legs that are refractory to conventional treatment]
- Author
-
S, Gutiérrez-Moreno, M, Alsina-Gibert, L, Sampietro-Colom, S, Pedregosa-Fauste, and P, Ayala-Blanco
- Subjects
Skin, Artificial ,Wound Healing ,Biological Dressings ,Cost-Benefit Analysis ,Biocompatible Materials ,Health Care Costs ,Skin Transplantation ,Transplantation, Autologous ,Varicose Ulcer ,Treatment Outcome ,Debridement ,Spain ,Humans ,Transplantation, Homologous ,Amnion ,Health Expenditures - Abstract
Standard compression therapy for venous ulcers of the legs does not promote healing. Although autografting accelerates tissue repair, it is difficult to use in patients with concomitant diseases or when multiple grafts are required. The amniotic membrane has been used as a covering material and promotes epithelialization, making it a good potential treatment option when autografts are not indicated.To analyze the literature on the safety and efficacy of amniotic membrane grafting and compare the cost of currently available grafts (autografts, amniotic membrane grafts, and biocompatible skin substitutes) to promote tissue repair in venous ulcers.A systematic review of the literature on the use of amniotic membrane grafts for the treatment of venous ulcers was performed up to 2010. A cost-minimization analysis of direct healthcare costs was then performed (at 3 and 6 months). A sensitivity analysis was performed to confirm the stability of the results.Only 1 study addressing safety and efficacy was identified. The cost-minimization analysis showed that autografts are always the least-expensive option (€ 1053 compared with € 1825 for amniotic membrane grafts and € 5767 for biocompatible skin grafts). At 6 months, however, amniotic membrane grafts would have cost € 6765 less than the use of biocompatible skin substitutes.Despite having excellent therapeutic potential for the re-epithelialization of venous ulcers that do not respond to conventional treatment, amniotic membrane transplant remains an experimental therapy. Autograft is the most efficient treatment but amniotic membrane graft is less expensive than the use of biocompatible skin substitutes.
- Published
- 2010
33. [Systemic treatment of bacterial infections]
- Author
-
M, Alsina-Gibert and I, Fuertes-Vega
- Subjects
Bacteria ,Species Specificity ,Drug Administration Routes ,Drug Resistance, Multiple, Bacterial ,Wound Infection ,Humans ,Bacterial Infections ,Drug Administration Schedule ,Anti-Bacterial Agents - Abstract
In the last years, there has been a great increase of bacterial resistance to the most frequently used antibiotics. Several factors should be considered when deciding to treat a cutaneous infection with a systemic treatment: characteristics of the patient, infection severity, prevalence and local resistance patterns of pathogens, and properties of available drugs.
- Published
- 2007
34. [Slipping rib syndrome as a cause of recurrent abdominal pain in children]
- Author
-
M, Alsina Gibert, J, Carnicer de la Pardina, R, Ullot Font, C, Escofet Soteras, and J A, Muñoz Gutiérrez
- Subjects
Male ,Cartilage ,Recurrence ,Humans ,Female ,Ribs ,Syndrome ,Child ,Abdominal Pain - Abstract
The slipping rib syndrome can be produced by a direct or indirect traumatism over the sternal tip of the costal cartilages 8, 9 and 10. The main complains are abdominal pain in the right or left upper abdominal, quadrants, and sometimes a sensation of rubbing or slipping of the ribs. The hoocking maneuver is useful in the diagnosis of this syndrome. Three clinical cases of the slipping rib syndrome are reported. This syndrome must be taken into account is the differential diagnosis of the abdominal pain in pediatric patients.
- Published
- 1990
35. [Sweet's syndrome: report of two cases (author's transl)]
- Author
-
J M, Miró Meda, J, Mensa Pueyo, M, Alsina Gibert, M A, Moreno Camacho, F, Segura Porta, and J, García San Miguel
- Subjects
Diagnosis, Differential ,Fever ,Adrenal Cortex Hormones ,Erythema ,Leukocytosis ,Neutrophils ,Humans ,Female ,Syndrome ,Middle Aged ,Skin Diseases, Infectious ,Skin - Abstract
In 1964 Sweet described a new syndrome, characterized by the association of fever, neutrophilic leukocytosis, erythematous plaque affecting the extremities, neck and face, with histologically verified polymorphonuclear perivascular dermal infiltrates and a rapid response to corticosteroids. Although some 100 cases have since then been described the pathogenesis remains obscure. We present two cases which showed all criteria for Sweet's syndrome, in which the initial presentation of acute onset with fever, multiple skin lesions and especially the poor general state on one, made use at first think of an infectious process such as staphylococcal or gonococcal sepsis, in which case diagnosis must be differential. Only when the causal agent is known and an early skin biopsy is done can correct diagnosis and treatment be established.
- Published
- 1981
36. Contact Dermatitis in Patients with Chronic Leg Ulcers: A Case Series.
- Author
-
Rizo-Potau D, Riera-Monroig J, Pomar Matias Á, and Alsina Gibert M
- Subjects
- Humans, Patch Tests, Dermatitis, Contact, Leg Ulcer etiology
- Published
- 2022
- Full Text
- View/download PDF
37. Effective Treatment of Lymphogranuloma venereum Proctitis With Azithromycin.
- Author
-
Blanco JL, Fuertes I, Bosch J, De Lazzari E, Gonzalez-Cordón A, Vergara A, Blanco-Arevalo A, Mayans J, Inciarte A, Estrach T, Martinez E, Cranston RD, Gatell JM, and Alsina-Gibert M
- Subjects
- Adult, Azithromycin therapeutic use, Chlamydia trachomatis, Homosexuality, Male, Humans, Male, Lymphogranuloma Venereum drug therapy, Proctitis drug therapy, Sexual and Gender Minorities
- Abstract
Background: Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by Chlamydia trachomatis (CT) serovars L1, L2, and L3 and is endemic among men who have sex with men (MSM) in Europe. We evaluated weekly oral azithromycin 1 g for 3 weeks as a treatment for LGV proctitis., Methods: This is an open clinical trial with convenience allocation according to treating physician preferences. Adults with clinical proctitis received a single dose of 1 g of intramuscular ceftriaxone and were subsequently allocated to receive (i) doxycycline 100 mg twice daily for 21 days (Doxycycline group) or (ii) azithromycin 1 g orally once weekly for 3 weeks (Azithromycin group). LGV cure (primary endpoint) was defined as resolution of symptoms at week 6 (clinical cure, LGV-CC), with an additional supporting negative rectal polymerase chain reaction (PCR) at week 4 (microbiological cure, LGV-MC), if available., Results: One hundred and twenty-five individuals with LGV clinical proctitis were included. All were MSM, and 96% were living with human immunodeficiency virus (HIV). Eighty-two were in the Azithromycin group, and 43 were in the Doxycycline group. LGV cure on a modified intention-to-treat analysis (primary endpoint), occurred in 80 of 82 (98%) in the Azithromycin group versus 41 of 43 (95%) in the Doxycycline group (treatment difference [95% confidence interval {CI}] 2.2% [-3.2, 13.2]). LGV-MC occurred in 70 of 72 (97%) vs 15 of 15 (100%) in the Azithromycin group and Doxycycline group, respectively (treatment difference [95% CI] -2.8% [-9.6; 17.7]). Adverse events were similar in both treatment groups., Conclusions: Our findings support extended azithromycin dosing as an alternative treatment option for symptomatic LGV proctitis and provides the rationale for future randomized trials., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
- View/download PDF
38. Validation of the Spanish Wound-QoL Questionnaire.
- Author
-
Conde Montero E, Sommer R, Augustin M, Blome C, Cabeza Martínez R, Horcajada Reales C, Alsina Gibert M, Ramón Sapena R, Peral Vázquez A, Montoro López J, Guisado Muñoz S, Pérez Jerónimo L, de la Cueva Dobao P, Kressel N, and Mohr N
- Subjects
- Aged, Factor Analysis, Statistical, Female, Humans, Spain, Surveys and Questionnaires, Quality of Life, Translations
- Abstract
Background and Aims: The Wound-QoL is a validated and feasible questionnaire for measuring disease-specific health-related quality of life in chronic wounds, originally developed for use in German. The objective of this study was to translate the Wound-QoL for use in clinical care and in clinical trials in Spain and to validate this version., Materials and Methods: Two independent fourth- and back translations of the Wound-QoL from the original German version were conducted, followed by an expert consensus of the resulting versions. After refinement, the final tool was piloted in N=10 patients and then used in the validation study., Results: A total of 115 patients were recruited. Mean age was 69.5 (SD 14.5) years, 60.0% were female. The Spanish version of Wound-QoL showed high internal consistency (Cronbach's alpha>0.8 in all scales). Factor analysis resulted in the same scales as the original version. There were satisfactory distribution characteristics of the global score and the subscales. Construct validity and convergent validity with other outcomes (generic QoL, healing rate) were satisfactory. The vast majority of patients considered the Wound-QoL a simple and feasible tool. Mean time needed for completing the questionnaire was 5minutes. Overall, 99.1% of the participants found it easy to understand the questions and 94.7% stated that the questionnaire suits the personal situation., Conclusions: The Spanish version of the Wound-QoL shows good validity in clinical practice. It can be recommended for use in clinical routine and trials., (Copyright © 2020 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
39. Nonclassical pemphigus with exclusively IgG anti-desmocollin 3-specific antibodies.
- Author
-
Iranzo P, Ishii N, Hashimoto T, and Alsina-Gibert M
- Subjects
- Aged, Enzyme-Linked Immunosorbent Assay, Epithelium metabolism, Female, Humans, Pemphigus diagnosis, Antibodies blood, Desmocollins immunology, Immunoglobulin G metabolism, Pemphigus immunology
- Abstract
We describe a patient with nonclassical clinical and histopathological features of pemphigus with exclusively IgG antibodies against desmocollin (Dsc) 3 detected by enzyme-linked immunosorbent assay of recombinant eukaryotic protein of Dsc1-Dsc3. The absence of antibodies against other known targets, such as desmogleins, reinforces the role of anti-Dsc antibodies in the pathophysiology of atypical pemphigus., (© 2019 The Australasian College of Dermatologists.)
- Published
- 2019
- Full Text
- View/download PDF
40. Syphilis Maligna: A Presentation to Bear in Mind.
- Author
-
Fustà-Novell X, Morgado-Carrasco D, Barreiro-Capurro A, Manzardo C, and Alsina-Gibert M
- Subjects
- Adult, HIV Infections complications, Humans, Middle Aged, Retrospective Studies, Syphilis blood, Syphilis epidemiology, Syphilis etiology, Syphilis diagnosis
- Abstract
Malignant syphilis is an uncommon form of secondary syphilis associated with HIV infection. Clinically, it is characterized by necrotic nodules and generalized ulcerated lesions. We present 4 cases of malignant syphilis diagnosed after evaluating syphilis cases diagnosed at our hospital between 2012 and 2016. We describe the epidemiologic, clinical, histiopathologic, and serologic characteristics of malignant syphilis and explore its response to treatment and association with HIV infection. Although malignant syphilis is uncommon, there has been an increase in the number of cases published in recent years, particularly in young HIV-positive patients. Malignant syphilis must be contemplated in the differential diagnosis of HIV patients with ulcerated, necrotic lesions., (Copyright © 2019 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
41. Sexually transmitted diseases of the anus and rectum: Causal agents, coinfections, HIV infection and high-risk sexual behaviour.
- Author
-
Morgado-Carrasco D, Alsina Gibert M, Bosch Mestres J, Álvarez Martínez M, Blanco Arévalo JL, and Fuertes de Vega I
- Subjects
- Adult, Aged, Anus Diseases etiology, Anus Diseases virology, Bisexuality, Coinfection epidemiology, Comorbidity, Condoms statistics & numerical data, HIV Infections epidemiology, Homosexuality, Male, Humans, Illicit Drugs, Incidence, Lymphogranuloma Venereum epidemiology, Lymphogranuloma Venereum transmission, Lymphogranuloma Venereum virology, Male, Middle Aged, Proctitis epidemiology, Proctitis etiology, Rectal Diseases etiology, Rectal Diseases virology, Retrospective Studies, Sexually Transmitted Diseases etiology, Sexually Transmitted Diseases virology, Spain epidemiology, Substance-Related Disorders epidemiology, Syphilis epidemiology, Syphilis etiology, Syphilis transmission, Travel, Young Adult, Anus Diseases epidemiology, Rectal Diseases epidemiology, Sexually Transmitted Diseases epidemiology, Unsafe Sex
- Abstract
Introduction and Objective: Sexually transmitted infections of the rectum and anus (STI-RA) mainly affect men who have sex with men (MSM). The incidence of STI-RA among them has increased in recent years., Material and Methods: Retrospective study in patients with diagnoses of STI-RA in an STI unit during the years 2014 and 2015. Epidemiological, clinical and microbiological data were collected., Results: We included 95 patients, all of whom were MSM; 88.42% were HIV+; 67.17% did not use a condom during their most recent sexual intercourse; 17.91% had had sex with sex workers and 72.22% had used drugs during sexual intercourse during the previous year. A percentage of 32.92 reported symptoms that had lasted longer than 30 days. Lymphogranuloma venereum (LGV) was diagnosed in 54.73% of the patients. All patients who presented with proctitis and perianal ulcers were diagnosed with LGV infection. All those who presented perianal ulcers without proctitis were diagnosed with syphilis., Conclusions: All the patients affected by STI-RA were MSM, most of them HIV+, had engaged in high-risk sexual behaviour and had suffered prolonged symptomatology. Clinical and microbiological characteristics of STI-AR could help adjust the empiric therapy., (Copyright © 2018 Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
42. Corrigendum to "Genetically defined variants of toll-like receptors 3, 7 and 9 as phenotype and risk modifier factors for psoriasis" [89 (March (3)) (2018) 301-304].
- Author
-
Julià M, Consuegra-Fernández M, Guilabert A, Muñoz C, Esteve A, Armiger-Borràs N, Santiago F, Arias MT, Romaní J, Ferrándiz C, Carrascosa JM, Pedrosa E, Alsina-Gibert M, Lozano F, and Mascaró-Galy JM
- Published
- 2018
- Full Text
- View/download PDF
43. Description of Patients Treated with Biologic Drugs as First-Line Systemic Therapy in the BIOBADADERM Registry Between 2008 and 2016.
- Author
-
Carretero Hernández G, Ferrándiz C, Rivera Díaz R, Daudén Tello E, de la Cueva-Dobao P, Gómez-García FJ, Herrera-Ceballos E, Belinchón Romero I, López-Estebaranz JL, Alsina Gibert M, Sánchez-Carazo JL, Ferrán Farrés M, González Quesada A, Carrascosa Carrillo JM, Llamas-Velasco M, Mendiola Fernández MV, Ruiz Genao D, Muñoz Santos C, García-Doval I, and Descalzo MA
- Subjects
- Adult, Age Distribution, Aged, Antibodies, Monoclonal adverse effects, Antibodies, Monoclonal therapeutic use, Biological Products adverse effects, Comorbidity, Drug Substitution, Drug Utilization, Female, Humans, Immunosuppressive Agents adverse effects, Male, Middle Aged, Psoriasis epidemiology, Spain epidemiology, Tumor Necrosis Factor-alpha antagonists & inhibitors, Biological Products therapeutic use, Immunosuppressive Agents therapeutic use, Psoriasis drug therapy, Registries
- Abstract
Introduction and Objectives: Biologic drugs are usually prescribed as second-line treatment for psoriasis, that is, after the patient has first been treated with a conventional psoriasis drug. There are, however, cases where, depending on the characteristics of the patient or the judgement of the physician, biologics may be chosen as first-line therapy. No studies to date have analyzed the demographics or clinical characteristics of patients in this setting or the safety profile of the agents used. The main aim of this study was to characterize these aspects of first-line biologic therapy and compare them to those observed for patients receiving biologics as second-line therapy., Material and Method: We conducted an observational study of 181 patients treated in various centers with a systemic biologic drug as first-line treatment for moderate to severe psoriasis between January 2008 and November 2016. All the patients were registered in the Spanish Registry of Adverse Events Associated with Biologic Drugs in Dermatology., Results: The characteristics of the first- and second-line groups were very similar, although the patients receiving a biologic as first-line treatment for their psoriasis were older. No differences were observed for disease severity (assessed using the PASI) or time to diagnosis. Hypertension, diabetes, and liver disease were all more common in the first-line group. There were no differences between the groups in terms of reasons for drug withdrawal or occurrence of adverse effects., Conclusions: No major differences were found between patients with psoriasis receiving biologic drugs as first- or second-line therapy, a finding that provides further evidence of the safety of biologic therapy in patients with psoriasis., (Publicado por Elsevier España, S.L.U.)
- Published
- 2018
- Full Text
- View/download PDF
44. Response to Secukinumab after Treatment Failure with Ustekinumab in 6 Patients with Plaque Psoriasis.
- Author
-
Morgado-Carrasco D, Riera-Monroig J, Fustà-Novell X, and Alsina Gibert M
- Subjects
- Adult, Antibodies, Monoclonal, Humanized, Humans, Male, Middle Aged, Remission Induction, Retrospective Studies, Treatment Failure, Ustekinumab therapeutic use, Antibodies, Monoclonal therapeutic use, Dermatologic Agents therapeutic use, Psoriasis drug therapy
- Published
- 2018
- Full Text
- View/download PDF
45. Dynamics of plasma cytokines in a patient with deficiency of interleukin-36 receptor antagonist successfully treated with anakinra.
- Author
-
Podlipnik S, Morgado-Carrasco D, Fustà-Novell X, Mensa-Vilaró A, Arostegui JI, Alsina-Gibert M, and Mascaró JM Jr
- Subjects
- Cytokines metabolism, Humans, Interleukins antagonists & inhibitors, Interleukins deficiency, Interleukins genetics, Male, Middle Aged, Psoriasis genetics, Dermatologic Agents therapeutic use, Interleukin 1 Receptor Antagonist Protein therapeutic use, Psoriasis drug therapy
- Published
- 2018
- Full Text
- View/download PDF
46. Risk factors for antimicrobial-resistant Neisseria gonorrhoeae and characteristics of patients infected with gonorrhea.
- Author
-
Fuertes de Vega I, Baliu-Piqué C, Bosch Mestres J, Vergara Gómez A, Vallés X, and Alsina Gibert M
- Subjects
- Adult, Cross-Sectional Studies, Drug Resistance, Bacterial, Female, Gonorrhea epidemiology, Humans, Male, Microbial Sensitivity Tests, Retrospective Studies, Risk Factors, Gonorrhea drug therapy, Gonorrhea microbiology, Neisseria gonorrhoeae drug effects
- Abstract
Background: There are very few data available regarding risk factors associated with antibiotic resistant-Neisseria gonorrhoeae., Methods: A study was conducted on 110 samples from 101 patients with gonococcal infection, in order to describe their characteristics and compare them with the antimicrobial susceptibility profile of their samples., Results: An association was observed between resistant infections and heterosexual men, older age, concurrent sexually transmitted infection, and unsafe sexual behaviors., Conclusion: There is a need for improved data on the risk factors associated with antibiotic resistant gonococcal infection in order to identify risk groups, and to propose public health strategies to control this infection., (Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
47. Genetically defined variants of toll-like receptors 3, 7 and 9 as phenotype and risk modifier factors for psoriasis.
- Author
-
Julià M, Consuegra-Fernández M, Guilabert A, Muñoz C, Esteve A, Armiger-Borràs N, Santiago F, Arias MT, Romaní J, Ferrándiz C, Carrascosa JM, Pedrosa E, Alsina-Gibert M, Lozano F, and Mascaró-Galy JM
- Subjects
- Adult, Age of Onset, Aged, Case-Control Studies, Female, Follow-Up Studies, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Psoriasis diagnosis, Risk Factors, Severity of Illness Index, Psoriasis genetics, Toll-Like Receptor 3 genetics, Toll-Like Receptor 7 genetics, Toll-Like Receptor 9 genetics
- Published
- 2018
- Full Text
- View/download PDF
48. Syphilis epidemics: a descriptive study of patients diagnosed in a tertiary hospital between 2011 and 2015.
- Author
-
Fustà X, Fuertes I, Lugo-Colón R, Blanco JL, Baras N, and Alsina-Gibert M
- Subjects
- Adult, Coinfection diagnosis, Coinfection epidemiology, Female, HIV Infections diagnosis, HIV Infections epidemiology, Humans, Incidence, Male, Risk Factors, Spain epidemiology, Syphilis diagnosis, Tertiary Care Centers, Epidemics, Syphilis epidemiology
- Abstract
Background and Objective: In the last decade, the incidence of syphilis has increased in our health area. Our objective is to describe the epidemiological and clinical characteristics of patients diagnosed with syphilis at our centre and their relationship with HIV., Patients and Methods: The clinical and epidemiological variables of patients diagnosed with syphilis in a third-level hospital over a period of 4.5 years, as well as their HIV status, were analysed through a descriptive study., Results: There was a significant increase in the incidence of syphilis in the period 2011-2015. We included 220 patients, 98% men (94% MSM). 62% were HIV+ and 89% came in early/infectious stages of the disease. 7% were concomitantly diagnosed with HIV. There was a high number of sexual partners and frequent use of drugs associated with sexual activity (46%)., Conclusions: The incidence of syphilis has increased in our centre in the last 2 years. The most affected group is MSM, with high HIV prevalence and risk behaviours for STI acquisition., (Copyright © 2017 Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
49. Determination of adalimumab and etanercept trough levels and drug antibodies in long-term psoriasis treatment: a single-centre cohort study.
- Author
-
Manriquez J and Alsina-Gibert M
- Subjects
- Adalimumab administration & dosage, Adalimumab immunology, Adult, Aged, Anti-Inflammatory Agents administration & dosage, Anti-Inflammatory Agents immunology, Anti-Inflammatory Agents pharmacokinetics, Dose-Response Relationship, Drug, Enzyme-Linked Immunosorbent Assay, Etanercept administration & dosage, Etanercept immunology, Female, Follow-Up Studies, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents immunology, Immunosuppressive Agents pharmacokinetics, Male, Middle Aged, Prospective Studies, Psoriasis drug therapy, Time Factors, Treatment Outcome, Tumor Necrosis Factor-alpha antagonists & inhibitors, Adalimumab pharmacokinetics, Antibodies immunology, Etanercept pharmacokinetics, Tumor Necrosis Factor-alpha blood
- Abstract
Background: An algorithm based on measurement of a serum tumour necrosis factor antagonists (anti-TNF) and antidrug antibodies (ADA) has been proposed previously to guide dose escalation or therapy switching in the early (i.e. the first months of) treatment of psoriasis by anti-TNF. In long-term treatment of responding patients with psoriasis, it is usual to empirically reduce standard doses of anti-TNF to reduce exposure while maintaining clinical response. The relationship between serum anti-TNF, ADA levels and clinical efficacy in long-term treated patients with psoriasis has not yet been determined, so the potential role of these parameters in guiding dose escalation in this scenario is unknown., Aims: To evaluate the relationship between drug/ADA levels and clinical efficacy in a group of patients with psoriasis undergoing long-term treatment with adalimumab or etanercept., Methods: This was a single-centre, prospective, cohort study of patients with psoriasis receiving adalimumab or etanercept for a minimum of 48 weeks. All patients were started on the standard dose, but some adalimumab users had a reduced frequency of administration. Clinical efficacy was measured using the Psoriasis Area and Severity Index. Serum concentrations were measured by ELISA. Clinical assessment and blood sample collection were carried out simultaneously within 24 h before the next drug administration., Results: In total, 21 patients were enrolled (67 simultaneous clinical and serum determinations: 38 receiving adalimumab, 29 receiving etanercept). We did not find any association between serum anti-TNF levels and clinical response. None of the patients developed ADA., Conclusions: ADA and anti-TNF levels are not related to clinical effectiveness in patients with psoriasis undergoing long-term treatment with adalimumab or etanercept., (© 2016 British Association of Dermatologists.)
- Published
- 2017
- Full Text
- View/download PDF
50. Sexually Transmitted Infections: Experience in a Multidisciplinary Clinic in a Tertiary Hospital (2010-2013).
- Author
-
Moreno-Ribera N, Fuertes-de Vega I, Blanco-Arévalo JL, Bosch-Mestres J, González-Cordón A, Estrach-Panella T, García-de Olalla P, and Alsina-Gibert M
- Subjects
- Chlamydia Infections epidemiology, Female, Gonorrhea epidemiology, HIV Infections epidemiology, Homosexuality, Humans, Male, Retrospective Studies, Risk Factors, Sexually Transmitted Diseases diagnosis, Spain epidemiology, Syphilis epidemiology, Sexually Transmitted Diseases epidemiology, Tertiary Care Centers
- Abstract
Introduction: The number of consultations for sexually transmitted infections (STIs) is increasing in Spain. The aim of this study was to describe and analyze the epidemiological, behavioral, clinical, and microbiological characteristics of patients registered at the STI unit of a tertiary hospital., Methods: This was a retrospective, single-center descriptive study carried out between 2010 and 2013 in a multidisciplinary unit specialized in STIs, situated in a tertiary hospital. Epidemiological, clinical, and behavioral data were gathered using a face-to-face interview and a standardized questionnaire. Samples were collected for microbiology analysis., Results: The study included 546 patients: 96% were men, 41% had human immunodeficiency virus (HIV) infection, and 56% were men who have sex with men. The reasons for consultation were the following: urethritis; genital, anal, or perianal ulcers; proctitis; oral ulcers; sexual contact with a person with a known STI; and high-risk sexual contact. The most common microbiological diagnoses were Neisseria gonorrhoeae in urethritis, Treponema pallidum in genital and anal or perianal ulcers, and Chlamydia trachomatis lymphogranuloma venereum serovars in proctitis. The highest prevalences of the main STIs studied occurred in homosexual men with HIV infection., Conclusion: This study confirms the increase in the incidence of STIs in recent years and the epidemiological characteristics of the HIV/STI epidemic in Spain., (Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.