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6. Uso de terapia antihiperglucemiante con beneficio cardiovascular en pacientes con diabetes tipo 2 que requieren hospitalización: un estudio transversal

Author

Gavin Blanco, Olga, Alvarez Padin, Pilar, Segarra Soria, Mar, Ena Muñoz, Javier, Sánchez Muñoz, Luis Ángel, Zapatero Gaviria, Antonio, Pardo, Anna, Arenas García, Víctor, López Reboiro, Manuel Lorenzo, Vaquero Herrero, María Paz, Carretero Gómez, Juana, Menéndez Saldaña, Araceli, Solís Marquínez, Marta Nataya, García Olid, Amelia, Mateos Polo, Lourdes, Wikman, Philip, Chacón Moreno, Agustín Diego, Blázquez Encinar, Julio César, Fuente Cosío, Sara, Carrasco Sánchez, Francisco Javier, Loscos Aranda, Silvia, Jiménez Rodríguez, Angel, Toresano López, Daniel, González Becerra, Concepción, Valero Novella, Beatriz, Otero Moreiras, Antón, Sánchez Lora, Fernando Javier, Tejero Delgado, María de los Ángeles, Said Criado, Ismael, Ruiz Arabí, Elisa, Aranda Lobo, Judit, Llorente García, Joaquín, Aguirre Alastuey, María Elena, Castro Jiménez, Joaquín, Taboada Martínez, María Luisa, González Noya, Amara, Dios Díez, Paula, Abad Requejo, Pedro, Rabassa, Antonio, Roura, Aychel Elena, Ferullo, José Ignacio, Calvo Romero, José María, Usandizaga de Antonio, Esther, Martín Domínguez, Cristina, García Andreu, María del Mar, Villalba García, María Victoria, Soler i Ferrer, Cristina, Luque Calderón, María José, Ríos Prego, Mónica, Madridano Cobo, Olga, Pesqueira Fontán, Paula M., García Cors, Montserrat, Diaz, Vanesa, Gámez Mancera, Rosa María, Parra Virto, Alejandro, Cortés Rodríguez, Begoña, López Ríos, María del Carmen, Cánovas García, Víctor Miguel, Pujades Tárraga, Ana Isabel, Gómez Antúnez, María, Casado Escribano, Pedro Pablo, Ostos Ruiz, Ana Isabel, Arjol, Anna, Estrada Álvarez, Francisco, Tarabini-Castellani, Paola, Godoy, Rita, Rodríguez Mangas, Covadonga, Bacete Cebrián, Marta, Lobo Antuña, Marta, Beato Pérez, José Luis, Macía Rodríguez, Cristina, Agudo, Paloma, de Escalante Yangüela, Begoña, Alcalá Pedrajas, José Nicolás, Giménez Miranda, Luis, Polo Romero, Francisco Javier, Ortega Reina, Marta, Igúzquiza Pellejero, María Jesús, Varela Aguilar, José Manuel, Casuso Sáenz, M. Elena, Delgado Verges, Carlos, Marí Alfonso, Begoña, Cabrerizo García, José Luis, Fernández Regueiro, Rebeca, Ferreiro-Mazon Jenaro, María Mercedes, Castillo Rubio, Rafael, Llamazares Mendo, Cristina, Mejías Real, Inmaculada, de Andrés David, Carlos, Soria Fernández-Llamazares, Guillermo, Pérez Soto, María Isabel, Helguera Amezua, Cristina, Gracia Lorenzo, Virginia, Flores Lledó, Ornella, Mato Jimeno, Víctor, García González, Diego José, Ausín García, Cristina, Moragón Ledesma, Sergio, Muela Molinero, Alberto, Chimeno Viñas, María Montserrat, García Tello, Borja, López Caleya, Juan Francisco, Fernández-Madera Martínez, Rosa, Martínez López, María del Mar, Santos Seoane, Sagrario María, Argüello, Carlota, Muñoz Blanco, Arturo, Morán Casta, Claudia, Yllera, Carmen, Mejide Rodríguez, Lucía, Folgueras, María, Rodríguez Suárez, Sara, Guil García, María, Ena, J., Carretero-Gómez, J., Zapatero-Gaviria, A., Carrasco Sánchez, F.J., del Romero-Sánchez, M., González-Becerra, C., Blazquez-Encinar, J.C., Iguzquiza-Pellejero, M.J., de Escalante Yangüela, B., and Gómez-Huelgas, R.

Published
2021
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9. Ecografía Multiórgano en infección por SARS-COV2

Author

Alba Hernández Píriz, David Jiménez Virumbrales, Raquel Barba Martín, Jesús Canora Lebrato, Antonio Zapatero Gaviria, and Gonzalo García De Casasola Sánchez

Subjects
enfermedad por coronavirus 2019 (covid-19), síndrome respiratorio agudo grave por coronavirus 2, ecografía clínica multiórgano, ecografía en el punto de atención, ecografía pulmonar, Medicine, Internal medicine, RC31-1245
Abstract

Objetivo: Existe una creciente evidencia con respecto a los hallazgos ecográficos y la COVID-19, destacando la ecografía multiórgano para el diagnóstico y el seguimiento de estos pacientes. El objetivó fue describir los hallazgos ecográficos a nivel pulmonar, cardiaco y del sistema venoso profundo de extremidades inferiores en pacientes con infección por SARS-COV-2. Material y Métodos: Estudio prospectivo, transversal y observacional realizado en pacientes con COVID-19 confirmado a los que se les realizó una ecografía multiórgano en el punto de atención durante la hospitalización. Resultados: Un total de 107 pacientes se inscribieron. El 100% de los pacientes tenían afectación pulmonar (93,4% bilateral). Las zonas pulmonares más afectadas fueron la posteroinferior (94,39%) y la lateral (89,72%). Se observó consolidaciones subpleurales en el 71% de los pacientes y consolidaciones mayores de 1 cm en el 25%. A mayor afectación pulmonar ecográfica, mayor grado de insuficiencia respiratoria. 2 pacientes presentaron TVP proximal en extremidades inferiores. Se realizaron 27 Angiotomografía computarizada confirmándose tromboembolismo pulmonar en 14 pacientes. Los hallazgos ecocardiográficos más frecuentes fueron: alteración de la relajación del ventrículo izquierdo e hipertrofia ventricular izquierda. Todos los pacientes con enfermedad tromboembólica tenían una afectación pulmonar ecográfica grave o crítica. Conclusión: la ecografia multiórgano puede ser útil para las manifestaciones de la COVID-19. El grado de afectación ecográfica pulmonar se relacionó con el grado de insuficiencia respiratoria y con la presencia de ETEV. La relación entre TVP y TEP fue más baja de lo esperado. La afectación cardiaca fue poco relevante en nuestra serie.

Published
2022
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14. Alternative CPAP methods for the treatment of secondary serious respiratory failure due to pneumonia by COVID-19

Author

Mateos-Rodríguez, Alonso, Ortega-Anselmi, Justo, Candel-González, Francisco Javier, Canora-Lebrato, Jesús, Fragiel-Saavedra, Marcos, Hernández-Píriz, Alba, Behzadi-Koocahni, Navid, González-del Castillo, Juan, Pérez-Alonso, Antonio, de la Cruz-Conty, María Luisa, García-de Casasola, Gonzalo, Marco-Martínez, Javier, and Zapatero-Gaviria, Antonio

Published
2021
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15. Métodos alternativos de CPAP para el tratamiento de insuficiencia respiratoria grave secundaria a neumonía por COVID-19

Author

Mateos-Rodríguez, Alonso, Ortega-Anselmi, Justo, Candel-González, Francisco Javier, Canora-Lebrato, Jesús, Fragiel-Saavedra, Marcos, Hernández-Píriz, Alba, Behzadi-Koocahni, Navid, González-del Castillo, Juan, Pérez-Alonso, Antonio, de la Cruz-Conty, María Luisa, García-de Casasola, Gonzalo, Marco-Martínez, Javier, and Zapatero-Gaviria, Antonio

Published
2021
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22. Inpatient hospital fatality related to coding (ICD-9-CM) of the influenza diagnosis in Spain (2009–2015)

Author

J. M. San-Román-Montero, R. Gil Prieto, C. Gallardo Pino, J. Hinojosa Mena, A. Zapatero Gaviria, and A. Gil de Miguel

Subjects
Influenza virus, Epidemiology, Hospitalizations, Inhospital mortality, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background To analyze hospitalization episodes with an ICD-9 diagnosis code of influenza (codes 487 and 488) in any diagnostic position from 2009 to 2015 in the Spanish hospital surveillance system. Methods Information about age, length of stay in hospital, mortality, comorbidity with an influenza diagnosis code between 1 October 2009 and 30 September 2015 was obtained from the National Surveillance System for Hospital Data (Conjunto Mínimo Básico de Datos, CMBD). Results 52,884 hospital admissions were obtained. A total of 24,527 admissions corresponded to diagnoses ICD-9 code 487 (46.4%), and 28,357 (53.6%) corresponded to ICD-9 code 488. The global hospitalization rates were 8.7 and 10.6 per 100,000 people, respectively. Differences between the two diagnostic groups were found for each of the six analyzed seasons. The diagnostic ICD-9-CM 488, male gender, and high-risk patients classified by risk vaccination groups showed direct relationship with inpatient hospital death. Conclusions Influenza diagnosis was present in a significant number of hospital admissions. The code used for diagnosis (ICD-9-CM 488), male sex, age groups and associated risk clinical conditions showed a direct relationship with inpatient hospital fatality.

Published
2019
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29. Positioning document on incorporating point-of-care ultrasound in Internal Medicine departments

Author

Torres Macho, J., García Sánchez, F.J., Garmilla Ezquerra, P., Beltrán Romero, L., Canora Lebrato, J., Casas Rojo, J.M., Arribas Arribas, P., López Palmero, S., Pintos Martínez, S., Cepeda Rodrigo, J.M., Luordo, D., Beltrán López, M., Méndez Bailón, M., Rodilla Sala, E., Manzano Espinosa, L., Zapatero Gaviria, A., and García de Casasola, G.

Published
2018
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30. Documento de posicionamiento sobre la incorporación de la ecografía clínica en los servicios de Medicina Interna

Author

Torres Macho, J., García Sánchez, F.J., Garmilla Ezquerra, P., Beltrán Romero, L., Canora Lebrato, J., Casas Rojo, J.M., Arribas Arribas, P., López Palmero, S., Pintos Martínez, S., Cepeda Rodrigo, J.M., Luordo, D., Beltrán López, M., Méndez Bailón, M., Rodilla Sala, E., Manzano Espinosa, L., Zapatero Gaviria, A., and García de Casasola, G.

Published
2018
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34. Humoral and Cellular Response after mRNA Vaccination in Nursing Homes: Influence of Age and of History of COVID-19

Author

Jesús San Román, Francisco Javier Candel, Juan Carlos Sanz, Paloma López, Rocío Menéndez-Colino, Pablo Barreiro, María del Mar Carretero, Marta Pérez-Abeledo, José Manuel Viñuela-Prieto, Belén Ramos, Jesús Canora, Raquel Barba, Antonio Zapatero-Gaviria, Franciso Javier Martínez-Peromingo, and on behalf of the Investigators of the SeroVAC Study

Subjects
COVID-19, SARS-CoV-2, nursing homes, older adults, occupational, vaccine, Medicine
Abstract

Background: Most residents and staff in nursing homes have received full vaccination. Factors related to the immune response to vaccination might be related to the risk of future severe COVID-19 and may guide the need for vaccine boosters. Design: Nursing homes that were tested in a point survey in July-October 2020 were again analyzed after a vaccination campaign in June-July 2021. Immune responses according to IgG against nucleocapsid and spike antigens, and CD4 and CD8 interferon-gamma release assay against spike antigens, were evaluated. Results: A total of 1973 subjects were tested (61.7% residents, 48.3% staff), with a mean (SD) follow-up of 46.4 (3.6) weeks between assessments. More than half of residents and more than a third of staff had evidence of COVID-19 before vaccination; 26.9% and 22.7% had seroreversion of IgG-N, and 8.9% and 4.6% had IgG-N seroconversion at second assessment, respectively. Up to 96.8% of residents and 98.1% of workers had positive IgG-S after a mean of 19.9 (2.1) weeks after vaccination. In residents with vs without a history of COVID-19, IgG-S titers were 4.11 (0.54) vs. 2.73 (0.74) logAU/mL (p < 0.001); in workers these titers were 3.89 (0.61) vs. 3.15 (0.64) logAU/mL (p < 0.001). Linear regression analysis showed that younger age (OR: −0.03 per 10 years-older [95% CI, −0.04 to −0.02], p < 0.001) and evidence of COVID-19 (OR: 1.14 [95% CI, 1.08 to 1.20], p < 0.001) are associated with greater IgG-S titers after vaccination. A direct association was found between IgG-S titers and the intensity of IFN-gamma response against spike antigens. Conclusions: Waning of humoral response and reinfection seems to be more frequent in older as compared to younger adults, although cellular responses shortly after vaccination are comparable between these groups. Younger age and prior COVID-19 are related to greater humoral response after vaccination against SARS-CoV-2.

Published
2022
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42. Heart failure and in-hospital mortality in elderly patients after elective noncardiac surgery in Spain

Author

Manuel Méndez-Bailón, José Luis Bernal Sobrino, Javier Marco-Martínez, Javier Elola-Somoza, María García Márquez, Cristina Fernández-Pérez, Javier Azana-Gómez, José Luis García-Klepzig, Emmanuel Andrès, Antonio Zapatero-Gaviria, Raquel Barba-Martin, Jesus Canora-Lebrato, and Noel Lorenzo-Villalba

Subjects
Aged, 80 and over, Heart Failure, Postoperative Complications, Elective Surgical Procedures, Spain, Humans, Female, Hospital Mortality, General Medicine, Aged, Retrospective Studies
Abstract

Patients with heart failure (HF) undergoing noncardiac surgical procedures is rising worldwide. This study was aiming at analyzing the impact of heart failure (HF) on the outcomes (mortality, complications, readmissions, and length of stay) of elderly patients undergoing elective major noncardiac surgical procedures in Spain.A retrospective observational study of patients undergoing noncardiac surgery was conducted. The Minimum Basic Data Set (MBDS) was used to collect information about the demographic characteristics of patients discharged from hospitals of the Spanish National Health System (SNHS), variables related to patients' medical conditions and surgeries conducted during the episode.A total of 996,986 selected procedures in the discharge record were identified in the period 2007-2015. HF was recorded as a secondary diagnosis in 22,367 discharges (2.24%). The mean age of patients was 76.6±7.27 years, with a difference in patients without and with HF: 76.5 (95% CI: 76.47-76.50) vs 82.8 (95% CI: 82.71-82.90). The number of selected surgical procedures increased by 13.2% (117,487 in 2015 vs. 103,744 in 2007), and the proportion of presence HF as a comorbidity increased by 24.4% (2.4% in 2015 v 1.9% in 2007). The proportion of women was higher in the HF group: 53.2% (95% CI: 53.18-53.22) vs 64.3% (95% CI: 64.20-64.44), with a longer average length of stay: 7.9 (95% CI: 7.9-7.9) vs 14.9 (95% CI 14.7-15.0) days, and women had a higher proportion of comorbidities. HF was found to be an independent risk factor in-hospital mortality in the multilevel risk adjustment model (OR=2.3; 95% CI: 2.2-2.4).Patients with HF undergoing any of the selected surgical procedures are older; there was women predominance and there is also an important burden of comorbidities than patients without HF undergoing these surgical procedures. HF in the selected procedures, increasing in-hospital mortality, mean length of stay, and the occurrence of adverse events in the Spanish population. The percentage of patients with HF who underwent the selected surgical procedures increased in the study period.

Published
2022
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43. Uso de terapia antihiperglucemiante con beneficio cardiovascular en pacientes con diabetes tipo 2 que requieren hospitalización: un estudio transversal

Author

Marta Ortega Reina, Alejandro Parra Virto, Carlota Argüello, Paula M. Pesqueira Fontán, Guillermo Soria Fernández-Llamazares, José María Calvo Romero, Pilar Alvarez Padin, Pedro Pablo Casado Escribano, Cristina Martín Domínguez, Lucía Mejide Rodríguez, Rosa Fernández-Madera Martínez, Agustín Diego Chacón Moreno, Manuel Lorenzo López Reboiro, Olga Madridano Cobo, C. González-Becerra, Anna Pardo, Covadonga Rodríguez Mangas, Juana Carretero Gómez, A. Zapatero-Gaviria, Anna Arjol, Mar Segarra Soria, Claudia Morán Casta, Cristina Ausín García, Rafael Castillo Rubio, Araceli Menéndez Saldaña, Philip Wikman, Marta Nataya Solís Marquínez, María del Mar Martínez López, Antón Otero Moreiras, Javier Ena, Fernando Javier Sánchez Lora, María Isabel Pérez Soto, Sergio Moragón Ledesma, B. de Escalante Yangüela, Ismael Said Criado, Aychel Elena Roura, Esther Usandizaga de Antonio, Sagrario María Santos Seoane, Diego José García González, Elisa Ruiz Arabí, Francisco Javier Polo Romero, Antonio Zapatero Gaviria, Begoña Cortés Rodríguez, Javier Ena Muñoz, Olga Gavin Blanco, María Luisa Taboada Martínez, Carlos Delgado Verges, Amara González Noya, Silvia Loscos Aranda, Rebeca Fernández Regueiro, Begoña Marí Alfonso, María Paz Vaquero Herrero, Alberto Muela Molinero, Víctor Mato Jimeno, María del Mar García Andreu, María Montserrat Chimeno Viñas, Vanesa Diaz, Rita Godoy, Montserrat García Cors, F.J. Carrasco Sánchez, Paula Dios Díez, María Folgueras, Lourdes Mateos Polo, M. Elena Casuso Sáenz, J.C. Blazquez-Encinar, Francisco Javier Carrasco Sánchez, Joaquín Castro Jiménez, Paloma Agudo, María Mercedes Ferreiro-Mazon Jenaro, María Victoria Villalba García, Begoña de Escalante Yangüela, María Elena Aguirre Alastuey, Pedro Abad Requejo, Joaquín Llorente García, Beatriz Valero Novella, Carlos de Andrés David, M. del Romero-Sánchez, Borja García Tello, Sara Rodríguez Suárez, Víctor Arenas García, Carmen Yllera, Ana Isabel Pujades Tárraga, María del Carmen López Ríos, Francisco Estrada Álvarez, Arturo Muñoz Blanco, Concepción González Becerra, Judit Aranda Lobo, Marta Bacete Cebrián, María Gómez Antúnez, Antonio Rabassa, M.J. Iguzquiza-Pellejero, Víctor Miguel Cánovas García, Luis Ángel Sánchez Muñoz, Ana Isabel Ostos Ruiz, José Nicolás Alcalá Pedrajas, Cristina Helguera Amezua, Angel Jiménez Rodríguez, Julio César Blázquez Encinar, José Manuel Varela Aguilar, Virginia Gracia Lorenzo, María Jesús Igúzquiza Pellejero, Ricardo Gómez-Huelgas, José Luis Cabrerizo García, Inmaculada Mejías Real, Marta Lobo Antuña, Luis Giménez Miranda, Paola Tarabini-Castellani, Cristina Soler i Ferrer, María José Luque Calderón, Rosa María Gámez Mancera, José Luis Beato Pérez, Daniel Toresano López, Amelia García Olid, Sara Fuente Cosío, José Ignacio Ferullo, María Guil García, J. Carretero-Gómez, Mónica Ríos Prego, Cristina Llamazares Mendo, Juan Francisco López Caleya, Cristina Macía Rodríguez, María de los Ángeles Tejero Delgado, and Ornella Flores Lledó

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

Resumen Objetivo Evaluar el uso de la terapia con beneficio cardiovascular en pacientes con DM tipo 2 previo al ingreso en servicios de medicina interna. Metodos Estudio transversal en un dia de los pacientes con DM tipo 2 hospitalizados en servicios de medicina interna. Se recogieron variables demograficas y antropometricas, datos de laboratorio y utilizacion de farmacos antihiperglucemiantes. La variable desenlace fue la proporcion y los determinantes de uso de inhibidores del cotransportador sodio-glucosa 2 (iSGLT2) y de agonistas del receptor del peptido similar al glucagon tipo 1 (AR-GLP1). Resultados Se incluyeron 928 pacientes pertenecientes a 74 hospitales. La edad media fue 78,9 anos (DE: 10,86), un 50% varones. Un total de 557 (60%) presentaba cardiopatia isquemica, 189 (20,4%) enfermedad cerebrovascular, 293 (31,6%) insuficiencia cardiaca, 274 (29,5%) enfermedad renal cronica y 129 (13,9%) enfermedad arterial periferica. Los antihiperglucemiantes utilizados previo al ingreso fueron: sulfonilureas (5.7%), biguanidas (49.1%), inhibidores de la alfa-glucosidasa (0,2%), pioglitazona (0%), iDPP4 (39%), iSGLT2 (5,8%), AR-GLP1 (2,6%) y analogos de insulina basal (24%). La edad mayor de 75 anos fue el factor determinante principal para no utilizar iSGLT2 (OR ajustada 0,28; intervalo de confianza al 95%: 0,10-0,74; p = 0,039) o AR-GLP1 (OR ajustada 0,09; intervalo de confianza al 95%: 0,02-0,46; p = 0,006). Discusion Una gran proporcion de pacientes ancianos con DM tipo 2 de muy alto riesgo cardiovascular no recibe terapia antihiperglucemiante con farmacos de probado beneficio cardiovascular. El tratamiento mas frecuentemente utilizado fue metformina e iDPP4. Existe un margen de mejora en el tratamiento en esta poblacion de muy alto riesgo.

Published
2021
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