Publicacions cientifiques csdm 2017

Publicacions Científiques CSDM 2017

Publicacions científiques 2017

‘

Consorci Sanitari del Maresme.

Publicacions de l’any 2017

Biblioteca.

Direcció Acadèmica, Recerca i Innovació Consorci Sanitari del Maresme.

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Publicacions Científiques CSDM 2017

Presentació.

Aquest document recull i presenta els articles científics del Consorci Sanitari del Maresme (amb almenys un autor amb filiació CSDM) indexats al llarg de l’any 2017 en almenys alguna de les següents bases de dades: MEDLINE/PubMed/Web of Science (WOS)/Journal Citation Reports (JCR).

Els indicadors bibliomètrics adjudicats a cada article i per Serveis (Factor d’Impacte, Factor d’Impacte Mig, Quartil, i Posició de la revista) corresponen al Journal Citation Reports 2016, per la qual cosa s’ha de tenir en compte que són valors aproximats, els valors definitius del JCR 2017 estaran disponibles el proper mes de juliol 2018.

S’inclouent els articles amb etiqueta ahead of print de PubMed encara que siguin posteriorment indexats a MEDLINE durant l’any 2017. Per tant, no s’han inclòs els articles ahead of print del 2016 de PubMed i que han estat indexats definitivament a MEDLINE durant el 2017 i que ja es van incloure a la llista de l’any passat evitant, d’aquesta manera, possibles duplicitats.

No s’han considerat aquells articles que els autors CSDM consten dins de grups d’investigació (col.laboradors).

I tampoc s’han considerat aquells articles indexats però que corresponen a resums/abstracts de congresos.

El document recull també aquells articles no indexats a cap de les BDD anteriors, així com altres documents (capítols de llibres…) publicats durant l’any 2017.

Aquest document recull els articles publicats en el període que va del dia 21 de desembre de 2016 a 20 desembre 2017.

Foto : Dani Olea. Comunicació

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Publicacions Científiques CSDM 2017

Índex

PRESENTACIÓ…………………………………………………………………………………………………………………………..……………………..

2

Neurologia – Neurology ……………………………………………………………………………………………….……………..……..…………..

4

Medicina Interna – Internal Medicine ……………………………………………………………………….………………………………..….

7

Oncologia – Oncology …………………………………………………………………………………………………………………………..………..

14

Cirurgia General – General Surgery …………………………………………………………………………….…………………………………..

17

Motilitat Digestiva – Gastrointestinal Motility ……………………………………………………………………………………..………..

18

Cirurgia Ortopèdica i Traumatologia – Orthopedic Surgery ………………………….……………………………………..…………

25

Medicina Física y Rehabilitació – Physical Medicine & Rehabilitation…………….……………………………………..…………

26

Psiquiatria - Psychiatry …………………………………………………………………………………………….……………………………………..

28

Medicina Intensiva – Intensive Care Medicine ………………………………………………………………………………………………..

34

Digestiu – Gastroenterology ………………………..…………………………………………………………….…………………………………..

38

Geriatria - Geriatrics ………………………………………….……………………………………………………………….……………………………

40

Atenció Primària – Primary Care ………………………….………………………………………………………………………………………….

41

Unitat de Recerca – Research Unit ……………………...…….……………………………………………………………………………………

42

Farmàcia – Pharmacy ……………………...…….…………………………..………………………………………………………………………….

43

Hematologia – Hematology ….……………………….……………………………………………..………………….…………………………….

45

Urgències – Emergency Medicine ….……………………….……………………………………………..………………….……………………

46

Ginecologia & Obstetricia – Obstetrics & Gynecology….……………………….…………………………………………………………

47

Anestesiologia – Anesthesiology….……………………….…………………………………………………………………………………………

48

Urologia – Urology….……………………….………………………………………………………………………………………………………………

48

INDICADORS BIBLIOMÈTRICS GLOBALS………………………….……………………………………………………………………………………..

50

Identificació del tipus de publicació :

Article Indexat MEDLINE/PubMed/ Web of Science (WOS)/Journal Citation Reports (JRC).

Article no indexat a cap de les anteriors BDD.

Llibre o Capítol de llibre.

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Publicacions Científiques CSDM 2017

NEUROLOGIA - NEUROLOGY

Nº Articles indexats: 5

Factor Impacte total: 18.477 Factor d’impacte mig per article: 4.619

Sepúlveda M, Aldea M, Escudero D, Llufriu S, Arrambide G, Otero-Romero S, Sastre-Garriga J, Romero-Pinel L, Martínez-Yélamos S, Sola-Valls N, Armangué T, Sotoca J, Escartín A, Robles-Cedeño R, Ramió-Torrentà L, PresasRodríguez S, Ramo-Tello C, Munteis E, Pelayo R, Gubieras L, Brieva L, Ortiz N, Hervás M, Mañé-Martínez MA, Cano A, Vela E, Tintoré M, Blanco Y, Montalban X, Graus F, Saiz A. Epidemiology of NMOSD in Catalonia: Influence of the new 2015 criteria in incidence and prevalence estimates.

Mult Scler. 2017 Oct 1:1352458517735191. doi: 10.1177/1352458517735191. [Epub ahead of print] PubMed PMID: 28984163

Abstract BACKGROUND: Population-based studies on neuromyelitis optica spectrum disorders (NMOSD) are limited, and it is unclear whether the rates have changed with the implementation of the new 2015 criteria.

OBJECTIVES: To estimate the incidence and prevalence of NMOSD in Catalonia (Spain), using both the 2006 and the 2015 criteria.

METHODS: In this clinic-based retrospective study, patients diagnosed with NMOSD between 2006 and 2015 were identified using multiple sources, including direct contact to all Catalan hospitals, identification of cases through the Catalan Health Surveillance System, and registry of antibodies to aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG-IgG) in a reference laboratory. The incidence rate was calculated for the period 1 January 2006-1 January 2016 and prevalence for the date 1 January 2016.

RESULTS: We identified 74 patients (by the 2015 criteria). Most patients were Caucasian (81%), and female (76%) with a median age at disease onset of 42 years (range, 10-76 years). In total, 54 (73%) patients were positive for AQP4-IgG, 11 (15%) double-seronegative, and 9 (12%) MOG-IgG-positive. Rates of incidence and prevalence (0.63/1,000,000 person-years and 0.89/100,000, respectively) were 1.5-fold higher than those reported by the 2006 criteria. Lowest rates were seen in children and elder people and highest in women and middle-aged people (40-59 years). The female predominance was lost in incident AQP4-IgG-seronegative children and AQP4-IgG-positive elder people. MOG-IgG and double-seronegativity contributed similarly but did not influence the long-term outcome.

CONCLUSION: The new criteria increase the estimates, but NMOSD remains as a rare disease. The differences in age- and sex-specific estimates highlight the importance of the serologic classification.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 4.840 Quartil: 1 Categoria: Clinical Neurology

Posició: 29/194

Purroy F, Vena A, Cánovas D, Cardona P, Cocho D, Cuadrado-Godia E, Chamorro A, Dávalos A, Garcés M, Gomis M, Krupinski J, Palomeras E, Ribó M, Roquer J, Rubiera M, Sanahuja J, Saura J, Serena J, Ustrell X, Vargas M, Benabdelhak I, Abilleira S, Gallofré M; Catalan Stroke Code and Reperfusion Consortium.

Influence of Hospital Type on Outcomes of Individuals Aged 80 and Older with Stroke Treated Using Intravenous Thrombolysis.

J Am Geriatr Soc. 2017 Sep;65(9):E117-E122. doi: 10.1111/jgs.14935. Epub 2017 Jun 2. PubMed PMID: 28574595

Abstract OBJECTIVES: The aim of the study was to confirm the safety and effectiveness of using intravenous thrombolysis (IVT) with individuals aged 80 and older in routine practice in different hospital settings.

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Publicacions Científiques CSDM 2017

DESIGN: Observasional registry.

SETTING: Prospective multicenter population-based registry of acute stroke patients treated with reperfusion therapies in Catalonia, Spain (Sistema Online d'Informació de l'Ictus Agut).

PARTICIPANTS: Individuals treated only with IVT (N = 3,231; 1,189 (36.8%) aged ≥80).

MEASUREMENTS: Symptomatic intracranial hemorrhage, mortality, and favorable outcome (modified Rankin Scale (mRS) score = 0-2) at 3 months were evaluated according to hospital characteristics. Treating hospitals were classified in three categories: comprehensive stroke centers (CSCs), primary stroke centers (PSCs), and community hospitals operating a telestroke system (TS). First individuals aged 80 and older were compared with those younger than 80, and then participants aged 80 and older were focused on.

RESULTS: Participants aged 80 and older had significantly higher baseline National Institute of Health Stroke Scale (NIHSS) scores, longer onset to treatment times, and worse outcomes than younger participants. For participants aged 80 and older, 90-day mortality was 23.2%, with 38.7% having favorable outcomes at 3 months.

Symptomatic intracranial hemorrhage (SICH; Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy definition) was observed in 4.7% of subjects. None of the risk factors differed significantly between participants treated in different types of hospitals. Basal stroke severity measured according to NIHSS score was not significantly different either. The three different types of hospitals achieved similar outcomes, although the TS and PSC hospitals had significantly higher proportions of SICH (6.3% and 6.3%, respectively) than the CSC (3.2%).

CONCLUSION: Older adults with acute stroke treated with IVT had similar outcomes regardless of hospital characteristics.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 4.388 Quartil: 1 Categoria: Geriatrics & Gerontology Posició: 8/49

Puñet-Ortiz J, Hervás-García JV, Teniente-Serra A, Cano-Orgaz A, Mansilla MJ, Quirant-Sánchez B, NavarroBarriuso J, Fernández-Sanmartín MA, Presas-RodríguezS, Ramo-Tello C, Martínez-Cáceres EM. Monitoring CD49d receptor occupancy: A method to optimize and personalize natalizumab therapy in multiple sclerosis patients.

Cytometry B Clin Cytom. 2017 Apr 5. doi: 10.1002/cyto.b.21527. [Epub ahead of print] PubMed PMID: 28378895

Abstract BACKGROUND: In natalizumab-treated relapsing-remitting MS (RRMS) patients, various extended interval dosing strategies are under evaluation to minimize severe treatment-associated side effects, mainly progressive multifocal leukoencephalopathy development. Up to now, it has not been presented any approach, even in form of assay design, to determine the optimal percentage of CD49d receptor occupancy (RO) associated with a favorable clinical, radiological, and immunological response.

METHODS: A multiparametric quantitative flow cytometry method was settled to measure CD49d RO on peripheral blood lymphocytes. The analytical protocol was tested in a 6-month follow-up from 19 RRMS patients treated with the natalizumab standard dosing of every 4 weeks or an extended-interval dosing of every 6 weeks.

RESULTS: Extended natalizumab dose schedule promoted an increase of CD49d molecules per cell surface and a reduction of CD49d RO levels. The reduction observed on CD49d RO was not only depending on dose schedule but also on individual parameters such as body mass. Interestingly, individual clinical outcome was apparently the same between the different dose schedules or even better with the extended interval dosing.

CONCLUSIONS: Following up CD49d RO levels with a well-regulated monitoring work scheme is crucial to further identify over-/under-treated patients and to define a safe, personalized natalizumab regimen. © 2017 International Clinical Cytometry Society.

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Publicacions Científiques CSDM 2017

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.474 Quartil: 2

Categoria: Pathology

Posició: 24/79

Fernández-Cadenas I, Mendióroz M, Giralt D, Nafria C, Garcia E, Carrera C,Gallego-Fabrega C, DominguesMontanari S, Delgado P, Ribó M, Castellanos M,Martínez S, Freijo M, Jiménez-Conde J, Rubiera M, Alvarez-Sabín J, Molina CA,Font MA, Grau Olivares M, Palomeras E, Perez de la Ossa N, Martinez-Zabaleta M,Masjuan J, Moniche F, Canovas D, Piñana C, Purroy F, Cocho D, Navas I, Tejero C, Aymerich N, Cullell N, Muiño E, Serena J, Rubio F, Davalos A, Roquer J, ArenillasJF, Martí-Fábregas J, Keene K, Chen WM, Worrall B, Sale M, Arboix A, Krupinski J, Montaner J; GRECOS Study Group.

GRECOS Project (Genotyping Recurrence Risk of Stroke): The Use of Genetics to Predict the Vascular Recurrence After Stroke.

Stroke. 2017 May;48(5):1147-1153. doi: 10.1161/STROKEAHA.116.014322. Epub 2017 Apr 14. PubMed PMID: 28411264

Abstract BACKGROUND AND PURPOSE: Vascular recurrence occurs in 11% of patients during the first year after ischemic stroke (IS) or transient ischemic attack. Clinical scores do not predict the whole vascular recurrence risk; therefore, we aimed to find genetic variants associated with recurrence that might improve the clinical predictive models in IS. METHODS: We analyzed 256 polymorphisms from 115 candidate genes in 3 patient cohorts comprising 4482 IS or transient ischemic attack patients. The discovery cohort was prospectively recruited and included 1494 patients, 6.2% of them developed a new IS during the first year of follow-up. Replication analysis was performed in 2988 patients using SNPlex or HumanOmni1-Quad technology. We generated a predictive model using Cox regression (GRECOS score [Genotyping Reurrence Risk of Stroke]) and generated risk groups using a classification tree method.

RESULTS: The analyses revealed that rs1800801 in the MGP gene (hazard ratio, 1.33; P=9×10-03), a gene related to artery calcification, was associated with new IS during the first year of follow-up. This polymorphism was replicated in a Spanish cohort (n=1.305); however, it was not significantly associated in a North American cohort (n=1.683). The GRECOS score predicted new IS (P=3.2×10-09) and could classify patients, from low risk of stroke recurrence (1.9%) to high risk (12.6%). Moreover, the addition of genetic risk factors to the GRECOS score improves the prediction compared with previous Stroke Prognosis Instrument-II score (P=0.03).

CONCLUSIONS: The use of genetics could be useful to estimate vascular recurrence risk after IS. Genetic variability in the MGP gene was associated with vascular recurrence in the Spanish population.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 6.032 Quartil: 1 Categoria: Clinical Neurology

Posició: 17/194

Martinez-Castrillo JC, Pena-Segura JL, Sanz-Cartagena P, Alonso-Curco X,Arbelo-Gonzalez JM, Arriola-Pereda G, Coll-Bosch MD, Conejero-Casares JA,Garcia-Ribes A, Jauma-Classen S, Pagonabarraga J, Vidal-Valls J, Garcia-Ruiz PJ. [Myths and evidence on the use of botulinum toxin: spasticity in adults and inchildren with cerebral palsy].

Rev Neurol. 2017 May 16;64(10):459-470. Spanish.PubMed PMID: 28497442

Abstract INTRODUCTION: Spasticity is a medical problem with a high incidence that significantly impact on the quality of life of patients and their families.

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AIM: To analyze and to answer different questions about the use of botulinum toxin type A (BTA) in our clinical practice.

DEVELOPMENT: A group of experts in neurology develop a list of topics related with the use of BTA. Two big groups were considered: spasticity in adults and in children with cerebral palsy. A literature search at PubMed for English, French, and Spanish language articles published up to June 2016 was performed. The manuscript was structured as a questionnaire that includes those questions that, according to the panel opinion, could generate more controversy or doubt. The initial draft was reviewed by the expert panel members to allow for modifications, and after subsequent revisions for achieving the highest degree of consensus, the final text was then validated. Different questions about diverse aspects of spasticity in adults, such as methods for evaluating spasticity, infiltration techniques, doses, number of infiltration points, etc. Regarding spasticity in children with cerebral palsy, the document included questions about minimum age of infiltration, methods of analgesia, etc.

CONCLUSIONS: This review is a tool for continuous training for neurologist and rehabilitation specialist and residents of both specialties, about different specific areas of the management of BTA.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 0.743 Quartil: 4 Categoria: Pathology

Posició: 177/194

MEDICINA INTERNA–INTERNAL MEDICINE Nº Articles indexats:12 Factor Impacte total: 45.296 Factor d’impacte mig per article: 3.774

Capdevila-Reniu A, Capdevila JA. Peripheral venous catheter, a dangerous weapon. Key points to improve its use.

Rev Clin Esp. 2017 Nov;217(8):464-467. doi: 10.1016/j.rce.2017.04.001. Epub 2017 May 31. English, Spanish.

PubMed PMID: 28576382.

Abstract: Catheter-related bacteremia is one of the most important causes of nosocomial infection. Is associated to high rates of morbidity and mortality, including an economic burden. Peripheral venous catheter bacteremia is a leading cause of nosocomial infection in internal medicine departments. In this article, we review some important key points to improve its use and avoid infections.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 0.971 Quartil: 3 Categoria: Medicine, General & Internal Posició: 100/155

Guembe M, Pérez-Granda MJ, Capdevila JA, Barberán J, Pinilla B, Martín-Rabadán P, Bouza E; NUVE Study Group.

Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments.

J Hosp Infect. 2017 Nov;97(3):260-266. doi: 10.1016/j.jhin.2017.07.008. Epub 2017 Jul 14. PubMed PMID: 28716670

Abstract BACKGROUND: The use of peripheral venous catheters (PVCs) has increased outside intensive care units, as has the rate of PVC-associated-bloodstream infection (PVC-BSI). PVCs are widely used in internal medicine departments (IMDs), but data on the incidence of PVC-BSI and its characteristics in IMDs are scarce.

AIM: To assess the incidence of PVC-BSI episodes detected in IMDs in Spain.

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Publicacions Científiques CSDM 2017

METHODS: A one-year multi-centre prospective observational cohort study in 14 Spanish IMDs was undertaken.

Adult patients admitted with at least one PVC and bacteraemia were included in the study. Demographic and clinical data were provided by local coordinators.

FINDINGS: Seventy episodes of PVC-BSI were recorded, representing an overall rate of 1.64 PVC-BSI episodes/1000 IMD admissions. The mean age of patients was 67.44 (standard deviation 16.72) years. It was estimated that 25.7% of PVCs were no longer necessary. Staphylococcus aureus was the most frequently isolated micro-organism (41.7%). Phlebitis was clinically evident in 44 (62.9%) episodes, and proved to be an independent predictor of catheter insertion in emergency departments (odds ratio 5.44). The crude and attributable mortality rates were 12.9% and 5.7%, respectively.

CONCLUSIONS: PVCs carry a significant risk for bacteraemia in Spanish IMDs. Phlebitis is not always clinically evident in patients with bacteraemia in this population. The study findings support the need for educational and interventional preventive measures in both IMDs and emergency departments to reduce the rate of PVC-BSI and associated comorbidities, and costs.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 3.126 Quartil: 2 Categoria: Infectious Diseases

Posició: 32/84

Caniglia EC, Phillips A, Porter K, Sabin CA, Winston A, Logan R, Gill J,Vandenhende MA, Barger D, Lodi S, Moreno S, Arribas JR, Pacheco A, Cardoso SW,Chrysos G, Gogos C, Abgrall S, Costagliola D, Meyer L, Seng R, van Sighem A,Reiss P, Muga R, Hoyos SP, Braun D, Hauser C, Barrufet P, Leyes M, Tate J,Justice A, Hernán MA. Commonly Prescribed Antiretroviral Therapy Regimens andIncidence of AIDS-Defining Neurological Conditions.

J Acquir Immune Defic Syndr. 2018 Jan 1;77(1):102-109. doi: 10.1097/QAI.0000000000001562. PubMed PMID:28991888

Abstract BACKGROUND: The differential effects of commonly prescribed combined antiretroviral therapy (cART) regimens on AIDS-defining neurological conditions (neuroAIDS) remain unknown.

SETTING: Prospective cohort studies of HIV-positive individuals from Europe and the Americas included in the HIV-CAUSAL Collaboration.

METHODS: Individuals who initiated a first-line cART regimen in 2004 or later containing a nucleoside reverse transcriptase inhibitor backbone and either atazanavir, lopinavir, darunavir, or efavirenz were followed from cART initiation until death, lost to follow-up, pregnancy, the cohort-specific administrative end of follow-up, or the event of interest, whichever occurred earliest. We evaluated 4 neuroAIDS conditions: HIV dementia and the opportunistic infections toxoplasmosis, cryptococcal meningitis, and progressive multifocal leukoencephalopathy. For each outcome, we estimated hazard ratios for atazanavir, lopinavir, and darunavir compared with efavirenz via a pooled logistic model. Our models were adjusted for baseline demographic and clinical characteristics.

RESULTS: Twenty six thousand one hundred seventy-two individuals initiated efavirenz, 5858 initiated atazanavir, 8479 initiated lopinavir, and 4799 initiated darunavir. Compared with efavirenz, the adjusted HIV dementia hazard ratios (95% confidence intervals) were 1.72 (1.00 to 2.96) for atazanavir, 2.21 (1.38 to 3.54) for lopinavir, and 1.41 (0.61 to 3.24) for darunavir. The respective hazard ratios (95% confidence intervals) for the combined end point were 1.18 (0.74 to 1.88) for atazanavir, 1.61 (1.14 to 2.27) for lopinavir, and 1.36 (0.74 to 2.48) for darunavir. The results varied in subsets defined by calendar year, nucleoside reverse transcriptase inhibitor backbone, and age.

CONCLUSION: Our results are consistent with an increased risk of neuroAIDS after initiating lopinavir compared with efavirenz, but temporal changes in prescribing trends and confounding by indication could explain our findings.

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Publicacions Científiques CSDM 2017

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 3.935 Quartil: 1 Categoria: Infectious Disaeases

Posició: 20/84

Domínguez À, Soldevila N, Toledo D, Torner N, Force L, Pérez MJ, Martín V, Rodríguez-Rojas L, Astray J, Egurrola M, Sanz F, Castilla J; Working Group of the Project PI12/02079.

Effectiveness of 23-valent pneumococcal polysaccharide vaccination in preventing community-acquired pneumonia hospitalization and severe outcomes in the elderly in Spain.

PLoS One. 2017 Feb 10;12(2):e0171943. doi: 10.1371/journal.pone.0171943. eCollection 2017. PubMed PMID: 28187206

Abstract: Pneumococcal pneumonia is a serious cause of morbidity and mortality in the elderly, but investigation of the etiological agent of community-acquired pneumonia (CAP) is not possible in most hospitalized patients. The aim of this study was to estimate the effect of pneumococcal polysaccharide vaccination (PPSV23) in preventing CAP hospitalization and reducing the risk of intensive care unit admission (ICU) and fatal outcomes in hospitalized people aged ≥65 years. We made a multicenter case-control study in 20 Spanish hospitals during 2013-2014 and 2014-2015. We selected patients aged ≥65 years hospitalized with a diagnosis of pneumonia and controls matched by sex, age and date of hospitalization. Multivariate analysis was performed using conditional logistic regression to estimate vaccine effectiveness and unconditional logistic regression to evaluate the reduction in the risk of severe and fatal outcomes. 1895 cases and 1895 controls were included; 13.7% of cases and 14.4% of controls had received PPSV23 in the last five years. The effectiveness of PPSV23 in preventing CAP hospitalization was 15.2% (95% CI -3.1-30.3). The benefit of PPSV23 in avoiding ICU admission or death was 28.1% (95% CI -14.3-56.9) in all patients, 30.9% (95% CI -32.2-67.4) in immunocompetent patients and 26.9% (95% CI -38.6-64.8) in immunocompromised patients. In conclusion, PPSV23 showed a modest trend to avoidance of hospitalizations due to CAP and to the prevention of death or ICU admission in elderly patients hospitalized with a diagnosis of CAP.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.806 Quartil: 1 Categoria: Multidisciplinary Sciences Posició: 15/64

Suárez-Varela MM, Llopis A, Fernandez-Fabrellas E, Sanz F, Perez-Lozano MJ, Martin V, Astray J, Castilla J, Egurrola M, Force L, Toledo D, Domínguez À. Working group of project pi12/02079 ‘effectiveness of influenza and pneumococcal polysaccharide 23-valent vaccines in people aged 65 years and more’.

Asthma and influenza vaccination in elderly hospitalized patients: Matched case-control study in Spain.

J Asthma. 2017 Jun 21:1-11. doi: 10.1080/02770903.2017.1332204. [Epub ahead of print] PubMed PMID: 28636411

Abstract OBJECTIVES: Influenza infection is an exacerbating factor for asthma, and its prevention is critical in managing asthmatic patients. We investigated the effect of influenza vaccination on asthmatic and non-asthmatic patients hospitalized with laboratory-confirmed influenza in Spain.

METHODS: We made a matched case-control study to assess the frequency of hospitalization for influenza in people aged ≥65 years. Hospitalized patients with unplanned hospital admissions were recruited from 20 hospitals representing seven Spanish regions. Cases were defined as those hospitalized due to a laboratoryconfirmed influenza infection and controls were matched by age, sex, and hospital. Data were obtained from clinical records, and patients stratified by clinical asthma history. Vaccination status and asthma due to influenza

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Publicacions Científiques CSDM 2017

infection were analyzed according to sociodemographic variables and medical risk conditions. Multivariable analysis was made using conditional logistic regression models.

RESULTS: 582 hospitalized patients with influenza (15.8% asthmatic) and 1,570 hospitalized patients without influenza (7.9% asthmatic) were included. In the multivariable conditional logistic regression using unvaccinated and non-asthmatic patients as the reference group, vaccination significantly prevented influenza in nonasthmatic patients (aOR = 0.63; 95% CI: 0.45, 0.88) and also showed a trend for a possibly protective effect in asthmatic patients (aOR = 0.79; 95% CI: 0.34, 1.81).

CONCLUSION: Our results suggest that influenza vaccination could be a protective factor for asthmatic patients, although the results are inconclusive and further research is required. Practically, given the better clinical evolution of vaccinated asthma cases, and the lack of better evidence, the emphasis on vaccination of this group should continue.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.746 Quartil: 3 Categoria: Allergy

Posició: 19/26

Blanco-Molina Á, Trujillo-Santos J, Pesavento R, Rosa V, Falgá C, Tolosa C, Mazzolai L, Sampériz Á, Duce R, Monreal M; RIETE Investigators.

Outcome after discontinuing anticoagulant therapy in women with venous thromboembolism during hormonal use.

Thromb Res. 2017 Mar;151 Suppl 1:S6-S10. doi: 10.1016/S0049-3848(17)30059-2. PubMed PMID: 28262237

Abstract INTRODUCTION: Whether women developing venous thromboembolism (VTE) while using hormonal therapy should be classified as having "unprovoked" or "provoked" VTE is controversial.

METHODS: We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to compare the rate of symptomatic VTE recurrences after discontinuing anticoagulation in 3 subgroups of women aged ≤50years without cancer, pregnancy or puerperium: (1) those with hormonal therapy and no additional risk factors (hormonal users only); (2) those with unprovoked VTE; and (3) those with additional risk factors, with or without hormonal therapy.

RESULTS: As of March 2016, 1513 women had been followed-up for at least one month after discontinuing anticoagulation. Of these, 654 (43%) were hormonal users only, 390 (26%) had unprovoked VTE and 469 (31%) had transient risk factors with or without hormonal therapy. After discontinuing anticoagulation, the rate of VTE recurrences in women with hormonal use only (2.44 per 100 patient-years; 95% CI: 1.53-3.69) was significantly lower than in those with unprovoked VTE (6.03; 95% CI: 3.97-8.77) and similar to those with transient risk factors (2.58; 95% CI: 1.50-4.13). Interestingly, the rate of VTE recurrences presenting as pulmonary embolism in women with hormonal use only (0.55 per 100 patient-years; 95% CI: 0.18-1.29) was similar to those with transient risk factors (0.46; 95% CI: 0.09-1.33) and 4-fold lower than in women with unprovoked VTE (2.23; 95% CI: 1.07-4.10).

CONCLUSIONS: After discontinuing anticoagulation, the rate of VTE recurrences in hormonal users only was significantly lower than in women with unprovoked VTE and similar to the rate in women with additional risk factors.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.650 Quartil: 2 Categoria: Hematology

Posició: 34/70

Cabré M, Elias L, Garcia M, Palomera E, Serra-Prat M. Avoidablehospitalizations due to adverse drug reactions in an acute geriatric unit.Analysis of 3,292 patients.

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Med Clin (Barc). 2017 Oct 6. pii:S0025-7753(17)30676-0. doi: 10.1016/j.medcli.2017.06.075. [Epub ahead of print]English, Spanish. PubMed PMID: 28992984

Abstract OBJECTIVE: To determine prevalence of admissions due to an adverse drug reaction (ADR) and determine whether or not admission was avoidable, and what drugs and risk factors were implicated.

DESIGN:Cross-sectional observational study.

STUDY SAMPLE: All patients hospitalized in an acute geriatric unit during the period January 2001 to December 2010 were studied.

MEASUREMENT: To determine whether admissions were due toADR, we used the World Health OrganizationUppsala Monitoring Centre criteria and the Naranjo scale. Beers criteria were used to detect potentially inappropriate medication.

RESULTS: A total of 3,292 patients (mean age 84.7 years, 60.1% women) were studied. Of these, 197 (6%) were admissions for ADR and nearly three quarters (76.4%, 152 cases) were considered avoidable admissions. The 5 most frequent drugs associated with admissions for ADR were digoxin, nonsteroidal anti-inflammatory drugs, benzodiazepines, diuretics and antibiotics. Independent risk factors for admissions for ADR were being female (OR 1.84; 95% CI 1.30-2.61), inappropriate medication according to Beers criteria (OR 4.20; 95% CI 2.90-6.03), polypharmacy (>5 drugs) (OR 1.50; 95% CI 1.04-2.13), glomerular filtration rate<30mL/min (OR 3; 95% CI 2.124.23) and sedative use (OR 1.40; 95% CI 1-1.91).

CONCLUSION: ADR were responsible for 6% of admissions to an acute geriatric unit, and over 75% of these admissions were considered avoidable. Associated risk factors were being female, inappropriate medication, polypharmacy, renal insufficiency and sedative use.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.125 Quartil: 3 Categoria: Medicine, General & Internal Posició: 91/155

Boixeda R, Capdevila JA, Vicente V, Palomera E, Juanola J, Albiach L, Rex A, Almirall J. Gamma globulin fraction of the proteinogram and chronic obstructivpulmonary disease exacerbations.

Med Clin (Barc). 2017 Aug 10;149(3):107-113 doi: 10.1016/j.medcli.2016.12.042. Epub 2017 Feb 21. English, Spanish. PubMedPMID: 28233558

Abstract OBJECTIVES: To evaluate the levels of the serum gamma globulin fraction in proteinograms as a biomarker to assess the severity, and to predict the mortality and new exacerbations in patients admitted for an exacerbation of a COPD. PATIENTS AND METHODS: The VIRAE study was carried out on a cohort of patients hospitalized for an exacerbation of probable infectious origin of COPD over a period of 2 years. The levels of the serum gamma globulin fraction were analyzed in the proteinogram of 120 patients. The main clinical indicators of severity were also evaluated. Key features were compared in 2 groups (gamma fraction in the proteinogram greater or less than 6.6g/dl).

RESULTS: The levels of the serum gamma fraction in the proteinogram correlated with the FEV1 (P=.009), the CRP (P=.04), and the number of readmissions after 6 months of hospitalization (P=.04). We observed a good association with the GOLD scale, the BODE index and the mMRC dyspnea scale; and also with treatment with oral corticoids and home oxygen therapy. We did not find it to be a good predictor of mortality, despite observing increased mortality rates one year after hospital admission in patients with low levels of the factor.

CONCLUSIONS: The levels of the gamma globulin fraction in proteinograms has a good correlation with the FEV1. In addition, they are associated with a greater severity of patients with COPD. This simple biomarker may be useful in identifying high-risk patients.

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.125 Quartil: 3

Categoria: Medicine, General & Internal

Posició: 91/155

Reyes-Urueña J, Fernàndez-López L, Force L, Daza M, Agustí C, Casabona J. Level of impact on the public health of universal human immunodeficiency virus screening in an Emergency Department.

Enferm Infecc Microbiol Clin. 2017 Aug - Sep;35(7):434-437. doi: 10.1016/j.eimc.2015.06.014. Epub 2015 Sep 1. English, Spanish. PubMed PMID: 26341042

Abstract INTRODUCTION: The aim of this study was to determine the prevalence of HIV and the acceptability of rapid testing in an emergency department (ED), Barcelona (6/07/2011 to 8/03/2013).

METHOD: A convenience sample was used, depending on nurse availability in the ED. Participants signed an informed consent. Results were confirmed by conventional methods.

RESULT: A total of 2,140 individuals were offered testing, and 5% rejected taking part (107/2,140). Three subjects (3/2,033 [0.15%]) had confirmed reactive test. Individuals with a higher education were more likely to perform a rapid HIV test in ED (P<.005).

CONCLUSION: A low prevalence of new HIV diagnoses was found among participants, although there was a high acceptability rate to perform rapid testing in the ED.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.714 Quartil: 3 Categoria: Microbiology

Posició: 89/125

Navarro J, Laguno M, Vilchez HH, Guardiola JM, Carrion JA, Force L, Cairó M, Cifuentes C, Vilaró J, Cucurull J, Marco A, Roget M, Erice E, Crespo M; Catalano-Balear Study Group.

Efficacy and safety of direct antiviral agents in a cohort of cirrhotic HCV/HIV-coinfected patients.

J Antimicrob Chemother. 2017 Oct 1;72(10):2850-2856. doi: 10.1093/jac/dkx223. PubMed PMID: 29091196

Abstract BACKGROUND: New direct-acting antiviral agents (DAAs) have shown great efficacy and tolerability in clinical trials and real-life cohorts. However, data are scarce regarding efficacy and safety in cirrhotic HCV/HIVcoinfected patients.

METHODS: A multicentre prospective analysis was performed in 13 Spanish hospitals, including all cirrhotic HCV/HIV-coinfected patients starting DAA combinations from January to December 2015. Sustained virological response 12 weeks after treatment (SVR12) was analysed. Withdrawal due to toxicity and/or hepatic decompensation and change in liver stiffness measurement (LSM) after HCV treatment were evaluated.

RESULTS: Patients (n = 170) were mostly male (n = 125; 74.3%) with the following HCV genotype (Gt) distribution: Gt-1a, 68 (40%); Gt-1b, 21 (12.4%); Gt-4, 47 (27.6%); and Gt-3, 26 (15.3%). Baseline median LSM was 20.6 kPa (IQR 16.1-33.7) and log10 HCV-RNA 6.1 IU/mL (IQR 5.7-6.5). Most patients had a Child-Pugh class A score (n = 127; 74.7%) and 28 (16.5%) had prior hepatic decompensation. There were 89 (52.4%) pretreated patients with 40.4% (n = 36) of null responders. Preferred regimens were as follows: sofosbuvir/ledipasvir + ribavirin, 43 (25.3%) patients; sofosbuvir + simeprevir + ribavirin, 34 (20%); sofosbuvir/ledipasvir, 26 (15.3%) and sofosbuvir + daclatasvir + ribavirin, 25 (14.7%). Overall SVR12 was 92.9% (158/170), without differences between genotypes. Pretreated patients had lower SVR12 rates compared with naive (88.8% versus 97.5%; P = 0.026). Treatment failures were as follows: 7 (4.1%) relapses; 2 (1.2%) lost to follow-up; 1 (0.6%) toxicity-related discontinuation; 1 (0.6%) hepatic decompensation; and 1 (0.6%) viral Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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breakthrough. On-treatment hepatic decompensation was recorded in four (2.4%) patients (encephalopathy and ascites, two each). Paired LSM in 33 patients showed a decrease of 5.6 kPa (95% CI 1.8-9.2; P = 0.004).

CONCLUSIONS: In our cohort of cirrhotic HCV/HIV-coinfected patients, DAAs were highly safe and efficacious.

Viral eradication was associated with a significant decrease in liver stiffness.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 5.071 Quartil: 1 Categoria: Infectious Disease

Posició: 9/84

Pulido F, Ribera E, Lagarde M, Pérez-Valero I, Palacios R, Iribarren JA, Payeras A, Domingo P, Sanz J, Cervero M, Curran A, Rodríguez-Gómez FJ, Téllez MJ, Ryan P, Barrufet P, Knobel H, Rivero A, Alejos B, Yllescas M, Arribas JR; DUAL-GESIDA-8014-RIS-EST45 Study Group.

Dual Therapy With Darunavir and Ritonavir Plus Lamivudine vs Triple Therapy With Darunavir and Ritonavir Plus Tenofovir Disoproxil Fumarate and Emtricitabine or Abacavir and Lamivudine for Maintenance of Human Immunodeficiency Virus Type 1 Viral Suppression: Randomized, Open-Label, Noninferiority DUAL-GESIDA 8014-RIS-EST45 Trial.

Clin Infect Dis. 2017 Nov 29;65(12):2112-2118. doi: 10.1093/cid/cix734. PubMed PMID: 29020293

Abstract BACKGROUND: Our objective was to assess the therapeutic noninferiority of dual therapy with darunavir/ritonavir and lamivudine compared to triple therapy with darunavir/ritonavir plus 2 nucleos(t)ides for maintenance of human immunodeficiency virus type 1 (HIV-1) suppression.

METHODS: This was a multicenter, open-label, noninferiority trial (margin 12%). Patients with HIV-1 RNA <50 copies/mL for 6 months or longer on triple therapy with darunavir/ritonavir and 2 nucleos(t)ides (tenofovir disoproxil fumarate and emtricitabine or abacavir and lamivudine) and with no resistance were randomized to continue therapy (n = 128) or switch to darunavir/ritonavir and lamivudine (n = 129). The primary endpoint was the proportion of participants with HIV-RNA <50 copies/mL after 48 weeks of follow-up according to the snapshot algorithm.

RESULTS: A total of 249 participants received study drugs (intention-to-treat exposed). The proportion of participants with HIV-RNA <50 copies/mL in the dual- and triple-therapy arms was 88.9% (112/126) and 92.7% (114/123; difference, -3.8%; 95% confidence interval, -11.0 to 3.4), respectively. Four participants in the dualtherapy arm and 2 in the triple-therapy arm developed protocol-defined virological failure. Switching to dual therapy was associated with a significant increase in total, low-density lipoprotein, and high-density lipoprotein (HDL) cholesterol, but not in the total-to-HDL cholesterol ratio. Serious adverse events and study drug discontinuations due to adverse events occurred in 4.8% vs 4.9%P = .97) and in 0.8% (1/126) vs 1.6% P = .55) in dual therapy vs triple therapy, respectively.

CONCLUSIONS: Dual therapy with darunavir/ritonavir and lamivudine demonstrated noninferior therapeutic efficacy and similar tolerability compared to triple therapy.

CLINICAL TRIALS REGISTRATION: NCT02159599

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 8.216 Quartil: 1 Categoria: Infectious Disease

Posició: 4/84

Ordi-Ros J, Sáez-Comet L, Pérez-Conesa M, Vidal X, Mitjavila F, Castro Salomó A, Cuquet Pedragosa J, OrtizSantamaria V, Mauri Plana M, Cortés-Hernández J. Enteric-coated mycophenolate sodium versus azathioprine in patients with active systemic lupus erythematosus: a randomised clinical trial. Ann Rheum Dis. 2017 Sep;76(9):1575-1582. doi: 10.1136/annrheumdis-2016-210882. Epub 2017 Apr 27. PubMed PMID: 28450313 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Abstract OBJECTIVE: To compare the efficacy and safety of enteric-coated mycophenolate sodium (EC-MPS) versus azathioprine (AZA) in patients with active systemic lupus erythematosus (SLE) disease.

METHODS: A multicentre, 24-month, superiority, open-label, randomised controlled trial (NCT01112215) was conducted with 240 patients (120 per arm) receiving either EC-MPS (target dose: 1440 mg/day) or AZA (target dose: 2 mg/kg/day) in addition to prednisone and/or antimalarials. The primary endpoint was the proportion of patients achieving clinical remission, assessed by SLE Disease Activity Index 2000 (SLEDAI-2K) and British Isles Lupus Assessment Group (BILAG), at 3 and 24 months. Secondary endpoints included time to clinical remission, BILAG A and B flare rates, time to flare, corticosteroid reduction and adverse events (AEs).

RESULTS: Proportion of patients achieving clinical remission (clinical SLEDAI=0) was higher in the EC-MPS group at 3 (32.5% vs 19.2%; treatment difference, 13.3 (CI 2.3 to 24), p=0.034) and 24 months (71.2% vs 48.3%; treatment difference, 22.9 (CI 10.4 to 34.4), p<0.001). EC-MPS was superior with respect to time to clinical remission (HR 1.43; 95% CI 1.07 to 1.91; p=0.017). BILAG A/B and B flares occurred more frequently in the AZA group (71.7% vs 50%, p=0.001 and 21.67% vs 8.3%, p=0.004, respectively). EC-MPS was superior with respect to time to first BILAG A/B (HR 1.81; 95% CI 1.3 to 2.56; p=0.0004) and BILAG A flare (HR 2.84; 95% CI 1.37 to 5.89; p=0.003). AEs were similar in both groups except for leucopenia that occurred more frequently with AZA. CONCLUSIONS: EC-MPS was superior to AZA in treating SLE and preventing further relapses.

TRIAL REGISTRATION NUMBER: NCT01112215; Results.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 12.811 Quartil: 1 Categoria: Rheumatology

Posició: 1/30

ONCOLOGIA–ONCOLOGY

Nº Articles indexats: 5

Factor Impacte total: 30.425 Factor d’impacte mig per article: 6.085

Mayo-de-Las-Casas C, Jordana-Ariza N, Garzón-Ibañez M, Balada-Bel A, Bertrán-Alamillo J, Viteri-Ramírez S, Reguart N, Muñoz-Quintana MA, Lianes-Barragan P, Camps C, Jantús E, Remon-Massip J, Calabuig S, Aguiar D, Gil ML, Viñolas N, Santos-Rodríguez AK, Majem M, García-Peláez B, Villatoro S, Pérez-Rosado A, Monasterio JC, Ovalle E, Catalán MJ, Campos R, Morales-Espinosa D, Martínez-Bueno A, González-Cao M, González X, MoyaHorno I, Sosa AE, Karachaliou N, Rosell R, Molina-Vila MA. Large scale, prospective screening of EGFR mutations in the blood of advanced NSCLC patients to guide treatment decisions.

Ann Oncol. 2017 Sep 1;28(9):2248-2255. doi: 10.1093/annonc/mdx288. PubMed PMID: 28911086

Abstract BACKGROUND: In a significant percentage of advanced non-small-cell lung cancer (NSCLC) patients, tumor tissue is unavailable or insufficient for genetic analyses. We prospectively analyzed if circulating-free DNA (cfDNA) purified from blood can be used as a surrogate in this setting to select patients for treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).

PATIENTS AND METHODS: Blood samples were collected in 119 hospitals from 1138 advanced NSCLC patients at presentation (n = 1033) or at progression to EGFR-TKIs (n = 105) with no biopsy or insufficient tumor tissue.

Serum and plasma were sent to a central laboratory, cfDNA purified and EGFR mutations analyzed and quantified using a real-time PCR assay. Response data from a subset of patients (n = 18) were retrospectively collected.

RESULTS: Of 1033 NSCLC patients at presentation, 1026 were assessable; with a prevalence of males and former or current smokers. Sensitizing mutations were found in the cfDNA of 113 patients (11%); with a majority of Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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females, never smokers and exon 19 deletions. Thirty-one patients were positive only in plasma and 11 in serum alone and mutation load was higher in plasma and in cases with exon 19 deletions. More than 50% of samples had <10 pg mutated genomes/µl with allelic fractions below 0.25%. Patients treated first line with TKIs based exclusively on EGFR positivity in blood had an ORR of 72% and a median PFS of 11 months. Of 105 patients screened after progression to EGFR-TKIs, sensitizing mutations were found in 56.2% and the p.T790M resistance mutation in 35.2%.

CONCLUSIONS: Large-scale EGFR testing in the blood of unselected advanced NSCLC patients is feasible and can be used to select patients for targeted therapy when testing cannot be done in tissue. The characteristics and clinical outcomes to TKI treatment of the EGFR-mutated patients identified are undistinguishable from those positive in tumor.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 11.856 Quartil: 1 Categoria: Oncology

Posició: 10/217

Viñolas N, Garrido P, Isla D, Provencio M, Majem M, Artal A, Carcereny E, Garcia Campelo R, Lianes P, De La Peñas R, Felip E. Lung Cancer in Never-Smoking Women: A Sub-Analysis of the Spanish Female-Specific Database WORLD07.

Cancer Invest. 2017 May 28;35(5):358-365. doi: 10.1080/07357907.2017.1295461. Epub 2017 Mar 28.

PubMed PMID: 28350480

Abstract: The WORLD07 study characterizes lung cancer in Spanish women. This analysis investigated lung cancer features in never-smoking women. Of 2072 women recruited, 2035 were analyzed. Patient characteristics and demographics were similar for current/former smokers and never smokers. Among never smokers, 38.3% were exposed to passive smoking. Non-small-cell lung cancer was the most common type (78.8% of current/former smokers and 96.1% of never smokers) and adenocarcinoma the most common histology (69.1% and 83.4% respectively). There was a high incidence of lung cancer in Spanish never-smoking women and a high proportion (about 50%) had mutant epidermal growth factor receptor.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.007 Quartil: 3 Categoria: Oncology

Posició: 158/213

Remon J, Isla D, Garrido P, de Castro J, Majem M, Viñolas N, Artal A, Carcereny E, García-Campelo MR, Lianes P, Provencio M, Juan O, Diz P, Blanco R, Lopez-Castro R, Maestu I, Vadell C, Felip E. Efficacy of tyrosine kinase inhibitors in EGFR-mutant lung cancer women in a real-world setting: the WORLD07 database.

Clin Transl Oncol. 2017 Dec;19(12):1537-1542. doi: 10.1007/s12094-017-1700-8. Epub 2017 Jun 28. PubMed PMID: 28660482

Abstract BACKGROUND: The WORLD07 project is a female specific database to assess the characteristics of women with lung cancer.

METHODS: WORLD07 database sets up in 2007, and prospectively stores clinical characteristics, treatment, outcome, and follow-up of lung cancer women. All women with epidermal growth factor receptor (EGFR) mutation non-small cell lung cancer (NSCLC) were selected for this analysis.

RESULTS: From October 2007 to December 2012, a total of 1775 NSCLC women were recruited. EGFR mutation was identified in 34.4% of patients. Upfront EGFR tyrosine kinase inhibitor (TKI) reported a response rate of

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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60%, a median progression-free survival of 11.7 months, and median overall survival of 23.0 months. EGFR TKI, EGFR-mutation type, and smoking status did not impact in the outcome of treated women.

CONCLUSION: Prevalence of EGFR mutation in women with NSCLC is higher than overall population with NSCLC. Efficacy of EGFR TKI in this real-world setting is similar to that previously reported.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.353 Quartil: 3 Categoria: Oncology

Posició: 141/217

Abad A, Martínez-Balibrea E, Viéitez JM, Orduña VA, García Alfonso P, Manzano JL, Massutí B, Benavides M, Carrato A, Zanui M, Gallego J, Grávalos C, Conde V, Provencio M, Valladares M, Salazar R, Sastre J, Montagut C, Rivera F, Aranda E. Genotype-based selection of treatment for patients with advanced colorectal cancer (SETICC): a pharmacogenetic-based randomized phase II trial.

Ann Oncol. 2017 Nov 14. doi: 10.1093/annonc/mdx737. [Epub ahead of print] PubMed PMID: 29145602

Abstract BACKGROUND: There has been little progress toward personalized therapy for patients with metastatic colorectal cancer (mCRC). TYMS-3' untranslated region (UTR) 6 bp ins/del and ERCC1-118C/T polymorphisms were previously reported to facilitate selecting patients for fluoropyrimidine-based treatment in combination with oxaliplatin as first-line therapy. We assessed the utility of these markers in selecting therapy for patients with mCRC. PATIENTS AND METHODS: This randomized, open-label phase II trial compared bevacizumab plus XELOX (control) versus treatment tailored according to TYMS-3'UTR 6 bp ins/del and ERCC1-118C/T polymorphisms.

Patients randomized to the experimental treatment received bevacizumab plus FUOX, FUIRI, XELIRI, or XELOX depending on their combination of favorable polymorphisms for FUOX treatment (TYMS-3'UTR ins/del or del/del; ERCC1-118T/T). Progression-free survival (PFS) was the primary endpoint.

RESULTS: Overall, 195 patients were randomized (control n=65; experimental n=130). The primary objective was not met: median PFS was 9.4 months in the control group and 10.1 months in the experimental group (P=0.745).

Median overall survival was similar in both groups (16.5 versus 19.1 months, respectively; P=0.797). Patients in the experimental group had a significantly higher overall response rate (ORR; 65% versus 47% in the control group; P=0.042) and R0 resection rate (86% versus 44%, respectively; P=0.018). Neuropathy, hand-foot syndrome, thrombocytopenia, and dysesthesia were significantly less common in the experimental group.

CONCLUSIONS: This study did not show survival benefits after treatment personalization based on polymorphisms in mCRC. However, the improved overall response rate and R0 resection rate and fewer disabling toxicities suggest that tailoring therapy by TYMS-3'UTR and ERCC1-118 polymorphisms warrants further investigation in patients with mCRC. ClinicalTrials.gov: NCT01071655.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 11.856 Quartil: 1 Categoria: Oncology

Posició: 10/217

Rivera F, Andres R, Felip E, Garcia-Campelo R, Lianes P, Llombart A, Piera JM, Puente J, Rodriguez CA, Vera R, Virizuela JA, Martin M, Garrido P. Medical oncology future plan of the Spanish Society of Medical Oncology: challenges and future needs of the Spanish oncologists.

Clin Transl Oncol. 2017 Apr;19(4):508-518. doi: 10.1007/s12094-016-1595-9. Epub 2016 Dec 22. Review.

PubMed PMID: 28005259 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Abstract PURPOSE: The SEOM Future Plan is aimed at identifying the main challenges, trends and needs of the medical oncology speciality over the next years, including potential oncologist workforce shortages, and proposing recommendations to overcome them.

METHODS: The estimations of the required medical oncologists workforce are based on an updated Medical Oncologist Register in Spain, Medical Oncology Departments activity data, dedication times and projected cancer incidence. Challenges, needs and future recommendations were drawn from an opinion survey and an advisory board.

RESULTS: A shortage of 211 FTE medical oncologist specialists has been established. To maintain an optimal ratio of 158 new cases/FTE, medical oncology workforce should reach 1881 FTE by 2035.

CONCLUSIONS: Main recommendations to face the growing demand and complexity of oncology services include a yearly growth of 2.5% of medical oncologist's workforce until 2035, and development and application of more accurate quality indicators for cancer care and health outcomes measure.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.353 Quartil: 3 Categoria: Oncology

Posició: 141/217

CIRURGIA GENERAL – GENERAL SURGERY Nº Articles indexats: 1

Factor Impacte total: 1.276 Factor d’impacte mig per article: 1.276

Sanchez Santos R, Corcelles R, Vilallonga Puy R, Delgado Rivilla S, Ferrer JV, Foncillas Corvinos J, Masdevall Noguera C, Socas Macias M, Gomes P, Balague Ponz C, de Tomas Palacios J, Ortiz Sebastian S, Sanchez Pernaute A, Puche Pla JJ, Sabench Pereferrer F, Abasolo Vega J, Suñol Sala X, Garcia Navarro A, Duran Escribano C, Cassinello Fernandez N, Perez N, Gracia Solanas JA, Garcia-Moreno Nisa F, Hernández Matias A, Valentí Azcarate V, Perez Folques JE, Navarro Garcia I, Dominguez-Adame Lanuza E, Martinez Cortijo S, González Fernández J. Prognostic factors of weight loss after sleeve gastrectomy: Multi centre study in Spain and Portugal.

Cir Esp. 2017 Mar;95(3):135-142. doi: 10.1016/j.ciresp.2017.02.002. Epub 2017 Mar 18. English, Spanish.

PubMed PMID: 28325497

Abstract INTRODUCTION: Sleeve gastrectomy (SG) has become a technique in its own right although a selective or global indication remains controversial. The weight loss data at 5 years are heterogeneous. The aim of the study is to identify possible prognostic factors of insufficient weight loss after SG. METHODS: A SG retrospective multicenter study of more than one year follow-up was performed. Failure is considered if EWL>50%. Univariate and multivariate study of Cox regression were performed to identify prognostic factors of failure of weight loss at 1, 2 and 3 years of follow up.

RESULTS: A total of 1,565 patients treated in 29 hospitals are included. PSP per year: 70.58±24.7; 3 years 69.39±29.2; 5 years 68.46±23.1. Patients with EWL<50 (considered failure): 17.1% in the first year, 20.1% at 3 years, 20.8% at 5 years. Variables with influence on the weight loss failure in univariate analysis were: BMI>50kg/m2, age>50years, DM2, hypertension, OSA, heart disease, multiple comorbidities, distance to pylorus> 4cm, bougie>40F, treatment with antiplatelet agents. The reinforcement of the suture improved results. In multivariate study DM2 and BMI are independent factors of failure.

CONCLUSION: The SG associates a satisfactory weight loss in 79% of patients in the first 5 years; however, some variables such as BMI>50, age>50, the presence of several comorbidities, more than 5cm section of the pylorus or bougie>40F can increase the risk of weight loss failure.

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.276 Quartil: 3

Categoria: Surgery

Posició: 129/197

Julià E, Picart G, Serra C, Nieto M, Hernández GM, Gubern JM Programa de cirugía mayor ambulatoria para cáncer de mama: experiencia en el Hospital de Mataró.

Rev Senol Patol Mamar. 2017;30 (1):3-9.

Abstract Objetivos: Estudiar los resultados obtenidos desde el pleno funcionamiento del programa de cirugía mayor ambulatoria para cáncer de mama en nuestro centro.

Métodos: Análisis retrospectivo de las pacientes intervenidas de cáncer de mama dentro del programa desde enero del 2012 hasta diciembre del 2014. Se han estudiado el número de pacientes tratadas en el programa, el tipo de procedimientos quirúrgicos realizados, la evolución del índice de sustitución del tratamiento quirúrgico para el cáncer de mama, la tasa y las causas de conversión a ingreso y los motivos de no inclusión en el programa.

Resultados: Durante este período 369 pacientes fueron intervenidas de cáncer de mama, de las cuales 161 fueron incluidas en el programa. El índice de sustitución global fue del 44%. Del 2012 al 2014, la tasa de conversión al ingreso fue del 10% (18 pacientes) siendo las 2 primeras causas la linfadenectomía axilar por positividad del ganglio centinela (12 pacientes) y las complicaciones postoperatorias inmediatas médicas o anestésicas (5 pacientes); 31 pacientes no fueron incluidas en el programa: 19 (61%) por comorbilidades médicas, 5 (16%) por motivos sociales y 7 (23%) por decisión del cirujano responsable.

Conclusiones: La cirugía ambulatoria para el tratamiento del cáncer de mama se muestra factible y segura.

Desde el inicio del programa el índice de sustitución ha aumentado de forma progresiva, presentando una buena tasa de satisfacción por parte de las pacientes tratadas.

MOTILITAT DIGESTIVA – GASTROINTESTINAL MOTILITY Nº Articles indexats: 11

Factor Impacte total: 40.769 Factor d’impacte mig per article: 4.529

Martín A, Ortega O, Clavé P. Oropharyngeal dysphagia, a new geriatric syndrome.

Rev Esp Geriatr Gerontol. 2017 Nov 20. pii: S0211-139X(17)30209-3. doi: 10.1016/j.regg.2017.10.005. [Epub ahead of print] Spanish. PubMed PMID: 29162276.

Abstract: Los trastornos de la función deglutoria (disfagia orofaríngea [DO], aspiración orofaríngea) son una pandemia emergente y se están convirtiendo en uno de los principales retos de la medicina geriátrica. La DO es un problema de salud incluido en la International Classification of Diseases de la Organización Mundial de la Salud y se define como la dificultad para formar y/o desplazar el bolo alimentario de manera segura y eficaz desde la boca al esófago, e incluye las aspiraciones orofaríngeas. La DO se asocia íntimamente al envejecimiento y ya es más que evidente que el envejecimiento es y será una de las principales características sociodemográficas de nuestra sociedad. Nuestro principal mensaje es que hay que estar preparados para este enorme reto. Este editorial está dirigido a divulgar iniciativas de la European Society for Swallowing Disorders (ESSD) desarrolladas en cooperación con sociedades geriátricas europeas (European Union Geriatric Medicine Society [EUGMS]) y líderes de opinión en medicina geriátrica de Europa, EE. UU. y Japón, dirigidas a definir los últimos avances en el manejo de la disfagia en ancianos, el White Paper sobre la disfagia como síndrome

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geriátrico y la reunión internacional de expertos sobre la disfagia en el anciano (7 th ESSD Congress and World Dysphagia Summit 2017, http://essd2017.com/)

Indexat a: MEDLINE

Dziewas R, Baijens L, Schindler A, Verin E, Michou E, Clavé P; European Society for Swallowing Disorders.

European Society for Swallowing Disorders FEES Accreditation Program for Neurogenic and Geriatric Oropharyngeal Dysphagia.

Dysphagia. 2017 Dec;32(6):725-733. doi: 10.1007/s00455-017-9828-9. Epub 2017 Aug 4. PubMed PMID: 28779300

Abstract: The oropharyngeal swallow involves a rapid, highly coordinated set of neuromuscular actions beginning with lip closure and terminating with opening of the upper esophageal sphincter. The central coordination of this complex sensorimotor task uses a widespread network of cortical, subcortical, and brainstem structures. Many diseases and disorders affecting the central swallowing network or downstream peripheral nerves, muscles, and structures may result in an impaired oropharyngeal swallow, i.e., neurogenic oropharyngeal dysphagia (OD). In addition, aging is also associated with multifactorial changes of swallowing physiology for which the term presbyphagia has been coined. OD has been reported in about 10–27% of older community dwelling residents. In the nursing home, setting numbers are significantly higher and cross the 50% margin, which is similar to figures reported for older individuals admitted to hospital with a diagnosis of pneumonia. Disease-specific prevalence data for OD are also substantial. Thus, disordered swallowing is reported in more than half of acute stroke patients and patients with traumatic brain injury, at least one-third of patients with Parkinson’s disease and dementia and a significant number of patients with neuromuscular disorders, such as amyotrophic lateral sclerosis and myasthenia gravis. In view of the demographic shift, especially with increasing numbers of very old people, i.e., those aged over 85 years, these already alarming figures will further increase in the coming years since many underlying pathologies, particularly stroke, dementia and Parkinson’s disease, are age related . It has been estimated up to 16 million US, 40 million EU and 8 million Japanese citizens require care for dysphagia. The clinical consequences of dysphagia are directly linked to the patient’s overall prognosis, and may include aspiration pneumonia, malnutrition, and dehydration. In the presence of disordered swallowing, mortality is increased and elevated rates of infectious complications have been reported for several medical conditions, such as stroke or Parkinson’s disease, but are also present in other patient populations. In addition, older patients discharged from general hospitals with both dysphagia and malnutrition presented a mortality rate of 65.8% at 1 year follow-up.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.077 Quartil: 2 Categoria: Otorhinolaryngology

Posició: 12/42

Alvarez-Berdugo D, Rofes L, Arreola V, Martin A, Molina L, Clavé P. A comparative study on the therapeutic effect of TRPV1, TRPA1, and TRPM8 agonists on swallowing dysfunction associated with aging and neurological diseases.

Neurogastroenterol Motil. 2017 Aug 11. doi: 10.1111/nmo.13185. [Epub ahead of print] PubMed PMID: 28799699

Abstract BACKGROUND: Oropharyngeal sensory impairment is a potential target to treat swallowing dysfunction in patients with oropharyngeal dysphagia (OD).

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AIM: To assess the therapeutic effect of stimulating oropharyngeal sensory afferents with TRPV1, TRPA1, or TRPM8 agonists vs increasing bolus viscosity in older and neurologic patients with OD by comparing four studies of similar experimental design.

METHODS: Swallow function of 142 older patients with impaired safety of swallow at nectar ([50-350] mPa·s) viscosity was evaluated with videofluoroscopy (VFS) while treated with TRPV1 (150 μmol/L), TRPV1/A1 (150 μmol/L and 1 mmol/L), or TRPM8 (1 mmol/L or 10 mmol/L) agonists or modified starch (MS) at spoon thick viscosity (>1750 mPa·s).

RESULTS: TRPV1 stimulation with capsaicinoids reduced penetrations by 50%, pharyngeal residue by 80%, and LVC time by 24.38% and increased bolus velocity by 36.51%. TRPV1/A1 stimulation with piperine reduced penetrations by 56.32%, LVC time by 25.55% and increased bolus velocity by 23.63%. TRPM8 stimulation with menthol 1 mmol/L reduced penetrations by 37.5% while 10 mmol/L reduced LVC time by 18.44%. Thickeners reduced penetrations by 77.11%, but increased pharyngeal residue by 19.89%, delayed LVC by 41.73%, and reduced bolus velocity by 13.44%.

CONCLUSION: Natural capsaicinoids have a stronger therapeutic effect on VFS signs and swallow response by stimulating TRPV1 than TRPV1/A1 or TRPM8 agonists. While TRP stimulants increased bolus velocity and reduced swallow response times, thickeners reduced bolus velocity and further delayed the swallow response.

This study sets the bases to develop new pharmacologic strategies for older patients with OD, moving away from compensation toward the recovery of swallow function

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 3.617 Quartil: 1 Categoria: Clinical Neurology

Posició:44/194

Ortega O, Martín A, Clavé P. Diagnosis and Management of Oropharyngeal Dysphagia Among Older Persons, State of the Art. J Am Med Dir Assoc. 2017 Jul 1;18(7):576-582. doi: 10.1016/j.jamda.2017.02.015. Epub 2017 Apr 12. Review.

PubMed PMID: 28412164

Abstract: Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization and defined as the difficulty or inability to move a bolus safely and effectively from the oral cavity to the esophagus, and can include aspirations, choking, and residue. OD is pandemic among different phenotypes of older people, affecting between 27% and 91% of the population 70 years or older. Although OD can be diagnosed by welldefined clinical methods and complementary explorations, in the clinical setting OD is seldom systematically screened and treated, and awareness among the medical/geriatric community is scarce. The etiology of OD in this population includes many concomitant risk factors with neurogenic and neurodegenerative processes, muscular weakness, and sarcopenia. The pathophysiology includes mechanical deficits in the swallow response (mainly delayed laryngeal vestibule closure time and weak tongue thrust), reduced pharyngeal sensitivity, and sensory/motor central nervous system impairments. Recently, OD has been recognized as a geriatric syndrome due to its high prevalence and its relationship with many comorbidities and their poor outcomes, including malnutrition, respiratory infections and aspiration pneumonia, functional disability and frailty, institutionalization and increased readmissions, and mortality. There is an evidence-based and effective treatment for OD in the elderly mainly oriented to compensating swallow impairments through adaptation of fluid viscosity and solid food textures to avoid aspiration and choking, and improving nutritional status and oral health to avoid respiratory infections. This has been defined as the minimal effective treatment to be provided to this population. New treatments aiming at recovering the swallowing function are under research with promising results, and the near future will provide us with methods to stimulate the swallow response with pharmacological or physical stimuli.

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Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 5.775 Quartil: 1

Categoria: Gesriatrics & Gerontology

Posició: 4/49

Verin E, Clavé P, Bonsignore MR, Marie JP, Bertolus C, Similowski T, Laveneziana P. Oropharyngeal dysphagia: when swallowing disorders meet respiratory diseases.

Eur Respir J. 2017 Apr 12;49(4). pii: 1602530. doi: 10.1183/13993003.02530-2016. Print 2017 Apr. PubMed PMID: 28404653

Abstract: The recent European Respiratory Society (ERS) Annual Meeting in London (September, 2016) has seen the beginning of a collaboration between the ERS and the European Society for Swallowing Disorders (ESSD) based on the importance (incidence and prevalence) of often unrecognised swallowing disorders in respiratory diseases. Oropharyngeal dysphagia includes penetration of food, drink or saliva into the larynx, aspiration into the trachea, and oropharyngeal residue. It is a major complaint among many patients with neurological diseases and among the elderly . The prevalence of functional oropharyngeal dysphagia is very high: it affects more than 30% of patients who have had a cerebrovascular accident, 52%–82% patients with neurodegenerative diseases, more than 35% of patients with head and neck diseases and more than 60% of elderly institutionalised patients .

Swallowing is defined as “the function of clearing food and drink through the oropharynx, and oesophagus into the stomach at an appropriate rate and speed”. Oropharyngeal dysphagia is a clinical symptom, defined by the difficulty to move the alimentary bolus from the mouth to the oesophagus. However, the term is often used, not fully appropriately, to mean a disorder or disease of swallow function. Many patients affected are unaware of their swallow dysfunction. Swallowing is one of the most complex stereotyped patterns of motor behaviour involving over 25 pairs of muscles in the mouth, pharynx, larynx and oesophagus.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 10.569 Quartil: 1 Categoria: Respiratory System

Posició: 3/59

Clavé P, Tack J. Efficacy of otilonium bromide in irritable bowel syndrome: a pooled analysis.

Therap Adv Gastroenterol. 2017 Mar;10(3):311-322. doi: 10.1177/1756283X16681708. Epub 2017 Jan 16.

PubMed PMID: 28246548; PubMed Central PMCID: PMC5305018

Abstract BACKGROUND: Otilonium bromide (OB) is a spasmolytic agent acting as an L-type calcium channel antagonist in intestinal and colonic smooth muscle cells (SMCs). We analyzed three independent clinical trials with homogeneous design on patients with irritable bowel syndrome (IBS). After 2 weeks receiving placebo, patients were randomized to receive OB (3 × 40 mg daily) or placebo for 15 weeks. We aimed to perform a pooled analysis of the data from these homogeneous clinical trials to evaluate the efficacy of OB treatment on symptoms and global response of patients.

METHODS: A total of 883 patients with IBS (69.8% women, mean age 46.2 years, 43.8% mixed type) were included, 442 treated with OB and 441 with placebo. The efficacy results from the three studies at weeks 5, 10 and 15 were pooled in an intention-to-treat (ITT) strategy, analyzed with a logistic regression model and described by forest plots.

RESULTS: Despite a placebo effect in all efficacy variables, a significant therapeutic effect of OB was observed at weeks 10 and 15 with reference to: (a) intensity and frequency of abdominal pain; (b) rate of responders as evaluated by patients (71.8% at week 10 and 77.2% at week 15); (c) severity of bloating; (d) rate of responders as evaluated by physicians (55% at week 10 and 63.9% at week 15). No significant OB effect was observed in stool frequency and consistency.

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CONCLUSIONS: OB is more effective than placebo in IBS treatment. Therapeutic benefits are significant after 10 weeks and are maximal after 15 weeks of treatment.

Indexat a: PubMed/WOS/JCR

Factor Impacte: 3.648 Quartil: 2 Categoria: Gastroenterology & Hepatology Posició: 23/79

Cabib C, Ortega O, Vilardell N, Mundet L, Clavé P, Rofes L. Chronic post-stroke oropharyngeal dysphagia is associated with impaired cortical activation to pharyngeal sensory inputs.

Eur J Neurol. 2017 Nov;24(11):1355-1362. doi: 10.1111/ene.13392. Epub 2017 Sep 5. PubMed PMID: 28872738

Abstract BACKGROUND AND PURPOSE: The role of afferent sensory pathways in the pathophysiology of post-stroke oropharyngeal dysphagia is not known. We hypothesized that patients with chronic post-stroke dysphagia (PSD) would show impaired sensory cortical activation in the ipsilesional hemisphere.

METHODS: We studied 28 chronic unilateral post-stroke patients [17 PSD and 11 post-stroke non-dysphagic patients (PSnD)] and 11 age-matched healthy volunteers. Event-related sensory-evoked potentials to pharyngeal stimulation (pSEP) and sensory thresholds were assessed. We analyzed pSEP peak latency and amplitude (N1, P1, N2 and P2), and neurotopographic stroke characteristics from brain magnetic resonance imaging.

RESULTS: Healthy volunteers presented a highly symmetric bihemispheric cortical pattern of brain activation at centroparietal areas (N1-P1 and N2-P2) to pharyngeal stimuli. In contrast, an asymmetric pattern of reduced ipsilesional activation was found in PSD (N2-P2; P = 0.026) but not in PSnD. PSD presented impaired safety of swallow (penetration-aspiration score: 4.3 ± 1.6), delayed laryngeal vestibule closure (360.0 ± 70.0 ms) and higher National Institute of Health Stroke Scale (7.0 ± 6.2 vs. 1.9 ± 1.4, P = 0.001) and Fazekas scores (3.0 ± 1.4 vs. 2.0 ± 1.1; P < 0.05) than PSnD. pSEP showed a unilateral delay at stroke site exclusively for PSD (peak-latency interhemispheric difference vs. PSnD: N1, 6.5 ± 6.7 vs. 1.1 ± 1.0 ms; N2, 32.0 ± 15.8 vs. 4.5 ± 4.9 ms; P < 0.05).

CONCLUSIONS: Chronic post-stroke oropharyngeal dysphagia is associated with stroke severity and degree of leukoaraoisis. Impaired conduction and cortical integration of pharyngeal sensory inputs at stroke site are key features of chronic PSD. These findings highlight the role of sensory pathways in the pathophysiology of poststroke oropharyngeal dysphagia and offer a potential target for future treatments.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 3.988 Quartil: 1 Categoria: Clinical Neurology

Posició: 41/194

Vilardell N, Rofes L, Arreola V, Martin A, Muriana D, Palomeras E, Ortega O, Clavé P. Videofluoroscopic assessment of the pathophysiology of chronic poststroke oropharyngeal dysphagia.

Neurogastroenterol Motil. 2017 Oct;29(10):1-8. doi: 10.1111/nmo.13111. Epub 2017 May 25. PubMed PMID: 28547922

Abstract BACKGROUND AND PURPOSE: Oropharyngeal dysphagia (OD) is a major complaint following stroke, associated with poor clinical outcome and high mortality rates. We aimed at characterizing the kinematics of swallow response associated with unsafe swallowing in chronic poststroke patients with OD. PATIENTS AND METHODS: Consecutive poststroke patients with a positive volume-viscosity swallow test for OD 3 months following stroke were studied by videofluoroscopy (VFS). Demographical and clinical factors and kinematics of swallow response were compared between those poststroke patients with safe swallow Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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(penetration-aspiration scale, PAS≤2) and those with unsafe swallow (PAS≥3). Receiver operating characteristic (ROC) curves were drawn for laryngeal vestibule closure (LVC) time which predicts unsafe swallow.

RESULTS: We studied 73 poststroke patients (76.7±9.3 years, 53.4% male) by VFS (60.4% with impaired safety, PAS=4.47±1.44, and 95.9% with impaired efficacy of swallow). Poststroke patients with unsafe swallow presented a poorer functional (Rankin 2.2±1.6 vs 1.2±1.0, P<.012) and nutritional status (MNA-sf≤11, 34.2% vs 7.4%, P<.05) than poststroke patients with safe swallow. Poststroke patients with unsafe swallow presented a significant delay in LVC time (406.4±99.5 ms vs 318.9±80.4 ms; P<.05) and weaker tongue bolus propulsion forces (0.771±0.450 mJ vs 1.638±3.212 mJ; P=.043). LVC time ≥340 ms predicts unsafe swallow in chronic poststroke patients with a diagnostic accuracy of 0.78.

CONCLUSIONS: Impaired safety of swallow in chronic poststroke patients is caused by specific impairments in swallow response including delayed timing of airway protection mechanisms and weak tongue propulsion forces. Treatments aiming to restore swallowing function in poststroke patients with OD should be targeted to improve these critical biomechanical events.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 3.617 Quartil: 1 Categoria: Clinical Neurology

Posició: 44/194

Santander C, Perea E, Caldas M, Clavé P. Catheter-based high-frequency intraluminal ultrasound imaging is a powerful tool to study esophageal dysmotility patients.

Ann N Y Acad Sci. 2017 May;1395(1):60-66. doi:10.1111/nyas.13313. Epub 2017 Jan 31. Review. PubMed PMID: 28141904

Abstract: High-resolution manometry (HRM) is currently the most important diagnostic test for esophageal motility disorders, providing information on the contraction pattern of the circular muscle layer, which helps classify these esophageal motor diseases. However, with the increasing development of ultrasound, other techniques, such as high-frequency intraluminal ultrasound (HFIUS), have gained importance. This technique uses a flexible shaft with a central wire integrated into a standard endoscope, which facilitates real-time sonography. Its main utility is to provide anatomical information on the structure of the esophageal wall, including both the circular and longitudinal layers that constitute the esophageal muscularis propria. Increasing knowledge about these motility disorders has led to the hypothesis that, in addition to an abnormal contraction pattern of the circular muscle, an overall increased muscle thickness and an abnormal longitudinal muscle contraction could be added as pathophysiological factors. The increase in muscle thickness could be an important indicator of the severity of diseases, such as achalasia, distal esophageal spasm, or hypercontractile esophagus. More studies are required before definitive conclusions can be reached, but HFIUS employed simultaneously with HRM could provide a more complete and precise evaluation of these esophageal motor disorders.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 4.706 Quartil: 1 Categoria: Multidisciplinary Sciences Posició: 8/64

Oliveira DL, Moreira EA, de Freitas MB, Gonçalves JA, Furkim AM, Clavé P. Pharyngeal Residue and Aspiration and the Relationship with Clinical/Nutritional Status of Patients with Oropharyngeal Dysphagia Submitted to Videofluoroscopy.

J Nutr Health Aging. 2017;21(3):336-341. doi: 10.1007/s12603-016-0754-6. PubMed PMID: 28244575

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OBJECTIVES: The aim of this study was to investigate the association between the videofluoroscopic (VFS) signs of impaired efficacy (pharyngeal residue) and safety (aspiration) swallowing and the clinical/nutritional status of patients with suspect of dysphagia.

DESIGN: A cross-sectional study was conducted with patients submitted to videofluoroscopy.

SETTING AND PARTICIPANTS: Data of 76 patients were analyzed between March 2011 and December 2014.

MEASUREMENTS: The clinical history and VFS exams of patients ≥ 38 years were retrospectively analyzed.

RESULTS: 88% patients presented Oropharyngeal Dysphagia (OD), 44.7% presented laryngeal penetration and 32% presented aspiration. 78% patients presented pharyngeal residue. Aspiration was associated with Head Neck Cancer (HNC) [Prevalence Ratio (PR): 2.27, p = 0.028] and cardiovascular disease (PR 1.96, p = 0.027).

Underweight [Body Mass Index < 18.5 kg/m2] was not associated with the presence of aspiration. Underweight patients with OD had a higher prevalence rate of pharyngeal residue than those normally nourished (100% vs.

78%) (PR 1.34, p = 0.011). Pharyngeal residue was associated with male sex (PR 1.32, p = 0.040), neurodegenerative disease (PR 1.57, p = 0.021), stroke (PR 1.62, p = 0.009), cerebral palsy (PR 1.76, p = 0.006) and HNC (PR 1.73, p = 0.002).

CONCLUSION: In the present study, neurologic diseases, HNC, male sex and underweight were associated to impaired swallowing efficacy. Underweight, independently of the other variables, was not associated with impaired swallowing safety.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.772 Quartil: 2 Categoria: Geriatrics & Gerontology Posició: 21/49

Gallegos C, Brito-de la Fuente E, Clavé P, Costa A, Assegehegn G. Nutritional Aspects of Dysphagia Management.

Adv Food Nutr Res. 2017;81:271-318. doi: 10.1016/bs.afnr.2016.11.008. Epub 2016 Dec 23. Review. PubMed PMID: 28317607

Abstract: This chapter describes the nutritional aspects of dysphagia management by starting with the definition of these two conditions (dysphagia and malnutrition) that share three main clinical characteristics: (a) their prevalence is very high, (b) they can lead to severe complications, and (c) they are frequently underrecognized and neglected conditions. From an anatomical standpoint, dysphagia can result from oropharyngeal and/or esophageal causes; from a pathophysiological perspective, dysphagia can be caused by organic or structural diseases (either benign or malignant) or diseases causing impaired physiology (mainly motility and/or perception disorders). This chapter gathers up-to-date information on the screening and diagnosis of oropharyngeal dysphagia, the consequences of dysphagia (aspiration pneumonia, malnutrition, and dehydration), and on the nutritional management of dysphagic patients. Concerning this last topic, this chapter reviews the rheological aspects of swallowing and dysphagia (including shear and elongational flows) and its influence on the characteristics of the enteral nutrition for dysphagia management (solid/semisolid foods and thickened liquids; ready-to-use oral nutritional supplements and thickening powders), with special focus on the real characteristics of the bolus after mixing with human saliva.

Indexat a: MEDLINE/WOS/

López-de-Ipiña K, Calvo P, Faundez-Zanuy M, Clavé P, Nascimento W, Martinez de Lizarduy U, Alvarez D, Arreola V, Ortega O, Mekyska J, Sanz-Cartagena P Automatic voice analysis for dysphagia detection Speech, Language and Hearing 2017; Vol. 0 , Iss. 0,0

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Abstract Purpose: A videofluoroscopic analysis is the gold standard approach to determine whether a dysphagia problem exists. This procedure is invasive as it involves radiation but also provides the most direct physical evidence of swallowing problems. The main goal of this study was to evaluate an automatic tool based on voice analysis to support medical detection of dysphagia.

Methods: An automatic voice analysis system has been developed. Prior to (basal) and immediately following (viscosity) swallowing liquids of varying viscosity and volume, individuals with Parkinson Disease were required to produce the same test word. The acoustic features (linear and non-linear) of this word were then analyzed with regard to specific situations by standard and Machine Learning methods.

Results: The results indicated a high degree of accuracy in detecting voice associated with basal and viscosity states.

Conclusion: Thus, while the gold standard of dysphagia diagnosis continues to involve video-fluoroscopy analysis, the consideration of voice analysis may prove to be a far simpler and less invasive approach to diagnosis by advanced voice features.

Ortega O, Espinosa MC. Oropharyngeal Dysphagia and Dementia. 2017, In: . Medical Radiology. Springer, Berlin, Heidelberg:p. 1-13

Abstract: Dementia is one of the leading causes of dysfunctionality and disability among older people and has a high physical, psychological, social, and economic impact. Oropharyngeal dysphagia (OD) is a frequent condition in patients with dementia of various types, including early stages, showing a delayed and prolonged swallow, and usually self-feeding difficulties and feeding dependency. In addition, OD is associated with several complications and negative outcomes such as malnutrition, respiratory infections, aspiration pneumonia and increased hospital stay, health-resource consumption, and mortality. OD should therefore be systematically screened, managed, and treated in patients with dementia, taking into account their intrinsic characteristics.

The aim of this chapter is to present an overview of the prevalence, pathophysiology, diagnosis, complications, and treatment of OD in patients with dementia.

CIRURGIA ORTOPÈDICA i TRAUMA– ORTHOPEDIC SURGERY Nº Articles indexats: 2

Factor Impacte total: 3.227 Factor d’impacte mig per article: 3.227

Bucci G, Lucar-López G, Sanchez-Gonzalez J, Malagelada F, Palencia Lopez J, Guevara-Noriega KA. Axillary artery injury and brachial plexus palsy as a complication of proximal humerus fractures.

J Orthop. 2017 Jun 24;14(3):340-341. doi: 10.1016/j.jor.2017.06.001. eCollection 2017 Sep. PubMed PMID: 28706376

Abstract: Proximal humerus fractures are common injuries and represent approximately 5% of all fractures.

These fractures are infrequently associated with neurovascular injuries. The axillary artery is commonly ruptured in high energy injuries around the shoulder, which are associated with multiple rupture of nerves.

However, the artery or its branches are also easily damaged by low-energy injuries in older people with atheromatous vessels. This study describes a case of axillary artery injury associated with radial nerve palsy after proximal humerus fracture, based on the literature review, offers suggestions for the early diagnosis and effective treatment of this uncommon injury

Indexat a: PubMed/WOS

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Katthagen JC, Bucci G, Moatshe G, Tahal DS, Millett PJ. Improved outcomes with arthroscopic repair of partial-thickness rotator cuff tears: a systematic review.

Knee Surg Sports Traumatol Arthrosc. 2017 May 19. doi: 10.1007/s00167-017-4564-0. [Epub ahead of print] PubMed PMID: 28526996

Abstract PURPOSE: The optimum treatment strategy for the surgical management of partial-thickness rotator cuff tears (PTRCT) is evolving. In this study, two research questions were sought to be answered: "Does the repair technique for PTRCTs involving >50% of the tendon thickness have an effect on structural and functional outcomes of arthroscopic repair?" and "Is there a difference in outcomes of arthroscopically treated articular- and bursal-sided PTRCTs?".

METHODS: A systematic review according to the PRISMA statement was conducted to identify all literature published reporting on outcomes of arthroscopic treatment of PTRCTs classified with the Ellman classification with minimum 2-year follow-up. Prospective randomized trials were eligible for quantitative synthesis. A total of 19 studies, published between 1999 and 2015, met the inclusion criteria of this systematic review. Two studies reporting outcomes of articular-sided PTRCTs with prospective randomized study design were included in quantitative synthesis calculations.

RESULTS: Arthroscopic repair of PTRCTs >50% thickness results in significant pain relief and good to excellent functional outcomes. When in situ repair was compared with repair of the tendon after completion to fullthickness RCT, there were no significant differences in functional or structural outcomes or complication rates.

The best treatment method for low-grade PTRCTs remains unclear.

CONCLUSIONS: The repair technique (in situ repair versus repair of the tendon after completion to full-thickness RCT) did not significantly affect the outcomes for arthroscopic repair of PTRCTs >50% thickness. The current literature contains evidence for inferior outcomes and higher failure rates after arthroscopic debridement of bursal-sided compared to articular-sided PTRCTs, and some evidence suggests that repair of lower-grade bursalsided tears may be beneficial over debridement.

LEVEL OF EVIDENCE: IV

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 3.227 Quartil: 1 Categoria: Orthopedics

Posició: 8/76

REHABILITACIÓ - PHYSICAL MEDICINE & REHABILITATION

Nº Articles indexats: 3

Factor Impacte total: 7.261 Factor d’impacte mig per article: 2.420

Pleguezuelos E, Guirao L, Moreno E, Samitier B, Ortega P, Vila X, Majó M, González MV, Ovejero L, Juanola J, Gómez A, Miravitlles M. Safety of Rehabilitation Program for COPD Patients.

Arch Bronconeumol. 2017 Aug 5. pii: S0300-2896(17)30221-1. doi: 10.1016/j.arbres.2017.06.012. [Epub ahead of print] English, Spanish. PubMed PMID: 28789812

Abstract: Pulmonary rehabilitation (PR) is a comprehensive intervention based on thorough patient assessment followed by patient-tailored therapies, which include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of patients with chronic respiratory disease and to promote long-term adherence to health-enhancing behaviors.1 Physical exercise prescription is the cornerstone of rehabilitation in COPD patients, but performance of physical exercise is not without complications.2 Studies analyzing the complications of cardiac rehabilitation (CR) have demonstrated a

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low incidence of fatal and nonfatal complications. However, the incidence of complications of PR in COPD patients has not been analyzed.

The objective of this retrospective analysis with longitudinal follow-up was to identify the incidence of complications in COPD patients who performed PR in two hospitals from January 2013 to September 2016.

Patients were included if they were older than 40 years, smokers or former smokers of at least 10 pack-years, with a diagnosis of severe COPD based on a post-bronchodilator spirometry showing a FEV1/FVC <0.7 and FEV1 (% predicted) <50% and were included in the PR program. The exclusion criteria were: other respiratory diseases, cardiovascular, neurological and metabolic pathologies in the acute phase or uncontrolled.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.979 Quartil: 2 Categoria: Respiratory System

Posició: 21/79

Ramon MA, Esquinas C, Barrecheguren M, Pleguezuelos E, Molina J, Quintano JA, Roman-Rodríguez M, Naberan K, Llor C, Roncero C, Miravitlles M. Self-reported daily walking time in COPD: relationship with relevant clinical and functional characteristics.

Int J Chron Obstruct Pulmon Dis. 2017 Apr 13;12:1173-1181. doi: 10.2147/COPD.S128234. eCollection 2017.

PubMed PMID: 28458527

Abstract OBJECTIVES: The aim of the study was to confirm the safety and effectiveness of using intravenous thrombolysis (IVT) with individuals aged 80 and older in routine practice in different hospital settings.

DESIGN: Observasional registry.

SETTING: Prospective multicenter population-based registry of acute stroke patients treated with reperfusion therapies in Catalonia, Spain (Sistema Online d'Informació de l'Ictus Agut).

PARTICIPANTS: Individuals treated only with IVT (N = 3,231; 1,189 (36.8%) aged ≥80).

MEASUREMENTS: Symptomatic intracranial hemorrhage, mortality, and favorable outcome (modified Rankin Scale (mRS) score = 0-2) at 3 months were evaluated according to hospital characteristics. Treating hospitals were classified in three categories: comprehensive stroke centers (CSCs), primary stroke centers (PSCs), and community hospitals operating a telestroke system (TS). First individuals aged 80 and older were compared with those younger than 80, and then participants aged 80 and older were focused on.

RESULTS: Participants aged 80 and older had significantly higher baseline National Institute of Health Stroke Scale (NIHSS) scores, longer onset to treatment times, and worse outcomes than younger participants. For participants aged 80 and older, 90-day mortality was 23.2%, with 38.7% having favorable outcomes at 3 months.

Symptomatic intracranial hemorrhage (SICH; Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy definition) was observed in 4.7% of subjects. None of the risk factors differed significantly between participants treated in different types of hospitals. Basal stroke severity measured according to NIHSS score was not significantly different either. The three different types of hospitals achieved similar outcomes, although the TS and PSC hospitals had significantly higher proportions of SICH (6.3% and 6.3%, respectively) than the CSC (3.2%).

CONCLUSION: Older adults with acute stroke treated with IVT had similar outcomes regardless of hospital characteristics

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.157 Quartil: 2 Categoria: Respiratory System

Posició: 20/59

Pleguezuelos E, Miravitlles M. Prescription of physical activity in chronic obstructive pulmonary disease… and beyond.

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Med Clin (Barc). 2017 Jul 7;149(1):24-25. doi: 10.1016/j.medcli.2016.12.014. Epub 2017 Jan 28. English, Spanish. PubMed PMID: 28143651.

Introducción: ¿Podemos mejorar la supervivencia en la enfermedad pulmonar obstructiva crónica (EPOC)? ¿Cómo? ¿Cuál es esa novedad en el tratamiento? ¿Es un nuevo fármaco? ¿Cómo se prescribe? En realidad no se trata de un nuevo fármaco, si no de la prescripción de actividad física (AF). En efecto, la actividad física debe considerarse parte del tratamiento de la EPOC y se debe prescribir igual que un principio activo. Este tratamiento tan «novedoso», ya se recomendaba hace más de 2000 años. Citando a Platón «. . .la falta de actividad destruye el buen estado del ser humano, mientras que el movimiento y el ejercicio metódico lo guarda y lo conserva. . .». Existe una sólida evidencia que apoya los beneficios de la actividad física en al menos 26 enfermedades crónicas, además un nivel adecuado de actividad física se asocia a una reducción en la mortalidad por cualquier causa de aproximadamente un 30% ¿Qué otros tratamientos existen con esta eficacia?

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.125 Quartil: 3 Categoria: Medicine, General & Internal Posició: 91/155

Guirao L, Samitier B, Alos J, Tibau R, Pleguezuelos E Osteointegración con el sistema Keep Walking Advanced® en una paciente amputada transfemoral.

Rehabilitacion 2017;51:129-33

Abstract: Aproximadamente una tercera parte de los pacientes con una amputación transfemoral van a padecer problemas crónicos relacionados con el encaje de su prótesis. El 72% de los pacientes amputados refieren sudoración o sensación de calor por culpa del encaje, el 62% reportan lesiones cutáneas o irritaciones de la piel del muñón, el 53% fatiga del muñón, el 51% dolor del muñón y el 38% acaban abandonando el uso de la prótesis. La osteointegración es una técnica que evita estos problemas generados en la piel del paciente, ya que permite un anclaje directo de la prótesis al implante intramedular colocado en el fémur del paciente.

Presentamos el caso de una paciente amputada transfemoral de 38 años tratada mediante una cirugía de osteointegración con el implante Keep Walking Advanced® para mejorar el uso de la prótesis sin la necesidad de encaje.

PSIQUIATRIA - PSYCHIATRY Nº Articles indexats: 8

Factor Impacte total: 19.403 Factor d’impacte mig per article: 2.425

Frías Á, Palma C, Solves L, Martínez B, Salvador A. Differential symptomatology and functioning in borderline personality disorder across age groups.

Psychiatry Res. 2017 Dec;258:44-50. doi: 10.1016/j.psychres.2017.0 9.081. Epub 2017 Sep 28. PubMed PMID: 28985552

Abstract: There is increasing research aimed at addressing whether patients with borderline personality disorder (BPD) may exhibit variations in symptomatology and functioning according to their chronological age.

The current study consisted of 169 outpatients diagnosed with BPD, who were divided into four age groups as follows: 16-25 years (n = 41), 26-35 years (n = 43), 36-45 years (n = 45), and 46 and more years (n = 40). Age groups were compared for symptomatology, normal personality traits, psychiatric comorbidities, functioning, and treatment-related features. The younger group had significantly higher levels of physical/verbal aggression and suicide attempts relative to the older group. Conversely, the older group had significantly greater severity of somatization, depression, and anxiety symptoms. In addition, the older group showed significantly greater functional impairment overall and across physical/psychological domains, specifically when compared to the Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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younger group. Overall, these findings may suggest that age-related symptoms should be considered when diagnosing BPD. Also, functional impairments should be the target interventions for older BPD patients.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.528 Quartil:2 Categoria:Psychiatry

Posició: 66/142

Gomis O, Palma C, Farriols N. Domiciliary intervention in psychosis: a systematic review.

Actas Esp Psiquiatr. 2017 Nov;45(6):290-302. Epub 2017 Nov 1. PubMed PMID: 29199763

Abstract BACKGROUND: This theoretical study reviews the main findings and research on home-based treatment for psychosis. The principal purpose was to analyze the various types of home-based service and make recommendations for a service that would meet the needs of both first-episode and resistant patients. We compare the Early Intervention Service, which aims to reduce the range of untreated psychosis (DUP) with other types of home-care and similar interventions that have already been implemented: crisis resolution home teams (CRHTs), Open Dialogue Approach (ODA), social skills training (SST) and foster homes.

METHOD: We searched electronic bibliographic databases including PubMed, PsycINFO, and Discovery for relevant publications appearing between 2005 and 2015. Ninetythree publications were deemed eligible for inclusion; 9 of these were systematic reviews and the rest were scientific papers or books.

DISCUSSION: We describe in this review the most widely used home-based interventions, including individual and family therapy. Multidisciplinary teams carry out all the interventions discussed. There does not appear to be a form of psychotherapy, which is effective in treating resistant patients.

CONCLUSIONS: Home-based interventions improve adherence to treatment, everyday living and social skills and also have a beneficial impact on family conflicts and other social conflicts. As a whole result, the number of incomes is reduced, patients&#8217; quality of life and autonomy are increased and inclusion and community living are improved.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 0.813 Quartil: 3 Categoria:Psychiatry

Posició: 106/142

Sandoval LR, González BL, Stone WS, Guimond S, Rivas CT, Sheynberg D, Kuo SS, Eack S, Keshavan MS. Effects of peer social interaction on performance during computerized cognitive remediation therapy in patients with early course schizophrenia: A pilot study.

Schizophr Res. 2017 Sep 4. pii: S0920-9964(17)30525-X. doi: 10.1016/j.schres.2017.08.049. [Epub ahead of print] PubMed PMID: 28882686

Abstract BACKGROUND: Recent studies show that computer-based training enhances cognition in schizophrenia; furthermore, socialization has also been found to improve cognitive functions. It is generally believed that nonsocial cognitive remediation using computer exercises would be a pre-requisite for therapeutic benefits from social cognitive training. However, it is also possible that social interaction by itself enhances non-social cognitive functions; this possibility has scarcely been explored in schizophrenia patients. This pilot study examined the effects of computer-based neurocognitive training, along with social interaction either with a peer (PSI) or without one (N-PSI). We hypothesized that PSI will enhance cognitive performance during computerized exercises in schizophrenia, as compared with N-PSI.

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METHODS: Sixteen adult participants diagnosed with schizophrenia or schizoaffective disorder participating in an ongoing trial of Cognitive Enhancement Therapy completed several computerized neurocognitive remediation training sessions (the Orientation Remedial Module©, or ORM), either with a peer or without a peer.

RESULTS: We observed a significant interaction between the effect of PSI and performance on the different cognitive exercises (p<0.05). More precisely, when patients performed the session with PSI, they demonstrated better cognitive performances than with N-PSI in the ORM exercise that provides training in processing speed, alertness, and reaction time (the standard Attention Reaction Conditioner, or ARC) (p<0.01, corrected). PSI did not significantly affect other cognitive domains such as target detection and spatial attention.

CONCLUSION: Our findings suggest that PSI could improve cognitive performance, such as processing speed, during computerized cognitive training in schizophrenia. Additional studies investigating the effect of PSI during cognitive remediation are needed to further evaluate this hypothesis.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 3.986 Quartil: 1 Categoria:Psichiatry

Posició: 32/142

Frías Á, Navarro S, Palma C, Farriols N, Aliaga F, Salvador A, Aluco E, Martínez B, Solves L. Early maladaptive schemas associated with dimensional and categorical psychopathology in patients with borderline personality disorder.

Clin Psychol Psychother. 2017 Aug 17. doi: 10.1002/cpp.2123. [Epub ahead of print] PubMed PMID: 28833873

Abstract OBJECTIVE: To ascertain the foundations for a schema-focused therapy model for the treatment of borderline personality disorder.

METHODS: The sample consisted of 102 borderline personality disorder outpatients. Dimensional psychopathology was assessed using the Scale for Suicidal Ideation, the Aggression Questionnaire, and the Symptom CheckList Revised. Categorical psychopathology was measured using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders, Patient Edition.

Stepwise linear/logistic multiple regression analyses were used to determine the predictive role of the schema domains tested by the Young Schema Questionnaire on both types of psychopathology. Receiver operating characteristic curves were calculated for those binary outcomes.

RESULTS: Regarding dimensional psychopathology, disconnection/rejection predicted greater suicidal ideation (β = .39, p = .002), physical/overt aggressiveness (β = .27, p = .05), and psychotic-like symptoms, such as paranoid ideation (β = .35, p = .003). Other-directedness predicted greater anger/inner aggressiveness (β = .22, p = .05) and internalizing symptoms, such as phobic anxiety (β = .39, p = .001). Regarding categorical psychopathology, disconnection/rejection significantly predicted the presence of lifetime comorbidities with eating disorders (adjusted odds ratio [AOR] = 1.12, 95% CI = 0.99-1.24) and posttraumatic stress disorder (AOR = 1.2, 95% CI = 1.04-1.3), resulting in a good balance of sensitivity/specificity, respectively (.97/.96 and .88/.89).

Other-directedness significantly predicted the absence of lifetime comorbidity with substance-use disorders (AOR = .74, 95% CI = 0.57-0.95). These relationships remained significant after controlling for confounders (e.g., comorbidity with other personality disorders, clinical global severity).

CONCLUSIONS: Two schema domains, disconnection/rejection and other-directedness, were directly associated with dimensional and categorical psychopathology among borderline personality disorder patients. These findings provide further information about the foundations and target interventions when implementing schema-focused therapy on this population.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.933 Quartil: 2 Categoria: Clinical Psychology

Posició: 56/121 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Pérez V, Salavert A, Espadaler J, Tuson M, Saiz-Ruiz J, Sáez-Navarro C, Bobes J, Baca-García E, Vieta E, Olivares JM, Rodriguez-Jimenez R, Villagrán JM, Gascón J, Cañete-Crespillo J, Solé M, Saiz PA, Ibáñez Á, de Diego-Adeliño J; AB-GEN Collaborative Group, Menchón JM. Efficacy of prospective pharmacogenetic testing in the treatment of major depressive disorder: results of a randomized, double-blind clinical trial.

BMC Psychiatry. 2017 Jul 14;17(1):250. doi: 10.1186/s12888-017-1412-1. PubMed PMID: 28705252

Abstract BACKGROUND: A 12-week, double-blind, parallel, multi-center randomized controlled trial in 316 adult patients with major depressive disorder (MDD) was conducted to evaluate the effectiveness of pharmacogenetic (PGx) testing for drug therapy guidance.

METHODS: Patients with a CGI-S ≥ 4 and requiring antidepressant medication de novo or changes in their medication regime were recruited at 18 Spanish public hospitals, genotyped with a commercial PGx panel (Neuropharmagen®), and randomized to PGx-guided treatment (n = 155) or treatment as usual (TAU, control group, n = 161), using a computer-generated random list that locked or unlocked psychiatrist access to the results of the PGx panel depending on group allocation. The primary endpoint was the proportion of patients achieving a sustained response (Patient Global Impression of Improvement, PGI-I ≤ 2) within the 12-week follow-up. Patients and interviewers collecting the PGI-I ratings were blinded to group allocation. Betweengroup differences were evaluated using χ2-test or t-test, as per data type.

RESULTS: Two hundred eighty patients were available for analysis at the end of the 12-week follow-up (PGx n = 136, TAU n = 144). A difference in sustained response within the study period (primary outcome) was not observed (38.5% vs 34.4%, p = 0.4735; OR = 1.19 [95%CI 0.74-1.92]), but the PGx-guided treatment group had a higher responder rate compared to TAU at 12 weeks (47.8% vs 36.1%, p = 0.0476; OR = 1.62 [95%CI 1.00-2.61]), and this difference increased after removing subjects in the PGx-guided group when clinicians explicitly reported not to follow the test recommendations (51.3% vs 36.1%, p = 0.0135; OR = 1.86 [95%CI 1.13-3.05]). Effects were more consistent in patients with 1-3 failed drug trials. In subjects reporting side effects burden at baseline, odds of achieving a better tolerability (Frequency, Intensity and Burden of Side Effects Rating Burden subscore ≤2) were higher in the PGx-guided group than in controls at 6 weeks and maintained at 12 weeks (68.5% vs 51.4%, p = 0.0260; OR = 2.06 [95%CI 1.09-3.89]).

CONCLUSIONS: PGx-guided treatment resulted in significant improvement of MDD patient's response at 12 weeks, dependent on the number of previously failed medication trials, but not on sustained response during the study period. Burden of side effects was also significantly reduced.

TRIAL REGISTRATION: European Clinical Trials Database 2013-002228-18 , registration date September 16, 2013; ClinicalTrials.gov NCT02529462 , retrospectively registered: August 19, 2015.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.613 Quartil: 2 Categoria: Psychiatry

Posició: 63/142

Frías Á, Dickstein DP, Merranko J, Gill MK, Goldstein TR, Goldstein BI, Hower H, Yen S, Hafeman DM, Liao F, Diler R, Axelson D, Strober M, Hunt JI, Ryan ND, Keller MB, Birmaher B. Longitudinal cognitive trajectories and associated clinical variables in youth with bipolar disorder.

Bipolar Disord. 2017Jun;19(4):273-284. doi: 10.1111/bdi.12510. Epub 2017 Jun 27. PubMed PMID: 28653799

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Abstract OBJECTIVE: There is substantial interest in delineating the course of cognitive functioning in bipolar (BP) youth.

However, there are no longitudinal studies aimed at defining subgroups of BP youth based on their distinctive cognitive trajectories and their associated clinical variables.

METHOD: Cognitive functioning was measured in 135 participants from the Course and Outcome of BP Youth (COBY) study using several subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB).

Youth were prospectively evaluated three times on average every 13.75 months over 2.5 years. Clinical and functional outcomes were assessed using the Longitudinal Interval Follow-Up Evaluation (LIFE).

RESULTS: Latent class growth analysis identified three longitudinal patterns of cognitive functioning based on a general cognitive index: class 1, "persistently high" (N=21; 15.6%); class 2, "persistently moderate" (N=82; 60.74%); and class 3, "persistently low" (N=32; 23.7%). All classes showed normal cognitive functioning when compared with the CANTAB normative data. After adjustment for confounders, youth from class 3 had a significantly greater percentage of time with overall, manic, and depressive syndromal symptoms than youth in the other two classes. Also, after adjustment for confounders, youth from class 3 had significantly poorer global, academic, and social functioning than youth from class 1.

CONCLUSIONS: BP youth showed normal overall cognitive functioning that remained stable during the follow-up within each class. However, 24% of BP youth showed poorer cognitive functioning than the other BP youth. This subgroup had poorer mood course and functioning, and may benefit from cognitive remediation and early management with evidence-based pharmacological treatments.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 4.531 Quartil: 1 Categoria: Clinical Neurology

Posició: 30/194

Navarro-Gómez S, Frías Á, Palma C. Romantic Relationships of People with Borderline Personality: A Narrative Review.

Psychopathology. 2017;50(3):175-187. doi: 10.1159/000474950. Epub 2017 May 19. PubMed PMID: 28521314.

Abstract BACKGROUND: Romantic relationships are one of the most interesting areas of interpersonal functioning in people with borderline personality. The aim of this narrative review was to synthesise empirical findings on this issue.

SAMPLING AND METHODS: The PubMed and PsycINFO databases were searched for pertinent materials published between 1980 and March 2016. Thirty articles met the inclusion criteria.

RESULTS: Several longitudinal and cross-sectional studies showed that people with borderline personality disorder (BPD) or BPD traits had more - but less prolonged - romantic relationships than people without BPD. The stable relationships of people with BPD or with BPD traits were also less satisfying and more hostile than those of people without BPD. People with BPD or BPD traits had relationships characterised by insecure attachment and passive-aggressive communications. Personality disorders and anxious attachment were more prevalent among the partners of people with BPD or with BPD traits when compared with partners of people without BPD. CONCLUSION: Unstable and chaotic romantic relationships are at the core of interpersonal dysfunction in BPD. More longitudinal research is needed to delineate the relationship between BPD symptoms and romantic relationship dysfunction, including the modulating role of the partner's clinical features in such an association.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.604 Quartil: 3 Categoria: Psychiatry

Posició: 97/142

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Solé Puig M, Romeo A, Cañete Crespillo J, Supèr H. Eye vergence responses during a visual memory task.

Neuroreport. 2017 Feb 8;28(3):123-127. doi: 10.1097/WNR.0000000000000734. PubMed PMID: 28121809

Abstract: In a previous report it was shown that covertly attending visual stimuli produce small convergence of the eyes, and that visual stimuli can give rise to different modulations of the angle of eye vergence, depending on their power to capture attention. Working memory is highly dependent on attention. Therefore, in this study we assessed vergence responses in a memory task. Participants scanned a set of 8 or 12 images for 10 s, and thereafter were presented with a series of single images. One half were repeat images - that is, they belonged to the initial set - and the other half were novel images. Participants were asked to indicate whether or not the images were included in the initial image set. We observed that eyes converge during scanning the set of images and during the presentation of the single images. The convergence was stronger for remembered images compared with the vergence for nonremembered images. Modulation in pupil size did not correspond to behavioural responses. The correspondence between vergence and coding/retrieval processes of memory strengthen the idea of a role for vergence in attention processing of visual information.

Indexat a: WOS/JCR

Factor Impacte:1.395 Quartil: 4 Categoria: Neurosciences

Posició: 223/259

Calzada A, Farriols N, Bruna O, Ramirez S, Palma C, Frias A, Aliaga F. Perfil psicopatológico de pacientes con depresión en la salud mental pública Rev Psicoter. 2017, 28(107):1-12.

Abstract: El suicidio es la segunda causa de muerte no natural a nivel mundial, por lo que es evidente que la prevención, evaluación y su tratamiento son imprescindibles. Objetivo: evaluar el perfil de un grupo de pacientes con depresión atendidos en un servicio de salud mental público en formato grupal. Las variables evaluadas son: la ideación suicida, la desesperanza, el perfil los trastornos de personalidad, los niveles ansiedad, la inteligencia emocional, la autoestima y la calidad de vida subjetiva. Método: esta evaluación forma parte del estudio AFRONTA, para la prevención del suicidio y la promoción de la salud mental. La muestra estuvo formada por 80 pacientes con el diagnóstico de depresión tratados en el centro de salud mental del Consorci Sanitari del Maresme. Resultados y discusión: Se observan correlaciones significativas de la autoestima con casi la totalidad de las variables evaluadas, por lo que se muestra como un constructo crucial a evaluar en la población estudiada. Asimismo, la variable desesperanza se muestra más relacionada con otras variables clínicas que la de la depresión medida con el BDI. La reparación de las emociones (según el TMMS-24) correlaciona con ambas variables citadas, demostrándose como una variable básica a tener en cuenta tanto en la evaluación como en el tratamiento. No existen diferencias en las variables evaluadas entre los sujetos que presentan un trastorno de personalidad y los que no la presentan, a excepción de la autoestima. Tampoco se encuentran diferencias en ambos grupos en referencia al impulso suicida pero sí en los intentos autolíticos, que es superior en el grupo con trastorno de personalidad.

Frias A (Editor), Aliaga F, Aluco E, Calzada A, Farriols N, Martinez B, Ramirez S, Palma C, Salvador A. Vivir con el Trastorno Límite de Personalidad. Una guía clínica para pacientes (Serendipity). 1a Ed. Bilbao: Desclée De Brouwer; 2017, 176 p.

Abstract: El Trastorno Límite de la Personalidad es una alteración psiquiátrica grave y crónica que afecta al 2% de la población general adulta. Entre otros síntomas clínicos, se caracteriza por una elevada impulsividad e Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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inestabilidad del ánimo, lo cual afecta negativamente a las relaciones personales (familia, amistades y parejas) y al desarrollo académico o laboral de las personas que lo padecen. La propia sintomatología del trastorno dificulta el cumplimiento de un tratamiento periódico y duradero. Bastantes personas con TLP abandonan el tratamiento psicológico y/o psiquiátrico al cabo de pocos meses. Otras muchas lo siguen de manera intermitente a lo largo de los años. En dicho contexto, esta guía clínica pretende dotar a los afectados de una herramienta terapéutica novedosa para afrontar su sufrimiento diario. Con un lenguaje sencillo y múltiples ejemplos, ofrece una descripción de los principales síntomas y sus consecuencias, así como distintas recomendaciones para hacerles frente a lo largo del tiempo y en diferentes ambientes. Constituye un recurso clínico idóneo para las personas con TLP que buscan mejorar la comprensión y manejo de su trastorno más allá de las sesiones con sus profesionales de referencia. Del mismo modo, puede ser de utilidad para aquellos profesionales y familiares que buscan una aproximación al trastorno desde la óptica del paciente. Álvaro Frías Ibáñez (Ed.)Valencia (1981), es psicólogo especialista en Psicología clínica y doctor en Psicología. Completó su formación postdoctoral en el Western Psychiatric Institute and Clinic (Pittsburgh, Estados Unidos). Desde hace años trabaja en el servicio de Psiquiatría del hospital de Mataró (Barcelona), donde compagina su labor asistencial con la tutoría de los Psicólogos Internos Residentes. A nivel clínico es responsable del Programa de tratamiento en pacientes diagnosticados de Trastorno Límite de la Personalidad. Es autor de numerosas publicaciones internacionales sobre dicho trastorno.

MEDICINA INTENSIVA – INTENSIVE MEDICINE Nº Articles indexats: 6

Factor Impacte total: 13.350 Factor d’impacte mig per article: 2.225

Ferrer R, Mateu X, Maseda E, Yébenes JC, Aldecoa C, De Haro C, Ruiz-Rodriguez JC, Garnacho-Montero J. Non-oncotic properties of albumin. A multidisciplinary vision about the implications for critically ill patients.

Expert Rev Clin Pharmacol. 2017 Dec 8:1-13. doi: 10.1080/17512433.2018.1412827. [Epub ahead of print] PubMed PMID: 29219627

Abstract: Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today's critical care unit is also linked to its multiple pharmacological effects. Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients. Such binding to albumin is frequently lessened in critically ill patients with hypoalbuminemia. These changes could result in sub-optimal treatment. Albumin has immunomodulatory capacity by binding several bacterial products. Albumin also influences vascular integrity, contributing to the maintenance of the normal capillary permeability. Moreover, the albumin molecule encompasses several antioxidant properties, thereby significantly reducing reoxygenation injury, which is especially important in sepsis. In fact, most studies of albumin administration are a combination of a degree of resuscitation with a degree of maintenance or supplementation of albumin. Expert commentary: The potential clinical benefits of the use of albumin in selected critically ill patients such as sepsis seem related to its immunomodulatory and anti-inflammatory effects, antioxidant properties, antibiotic transportation and endothelial stabilization. Additional studies are warranted to further elucidate the underlying physiologic and molecular rationale.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.939 Quartil: 2 Categoria: Pharmacology & Phamarcy Posició: 95/257

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Almirall J, Serra-Prat M, Bolíbar I, Balasso V. Risk Factors for Community-Acquired Pneumonia in Adults: A Systematic Review of Observational Studies.

Respiration. 2017;94(3):299-311. doi: 10.1159/000479089. Epub 2017 Jul25. PubMed PMID: 28738364

Abstract: We performed a systematic review of the literature to establish conclusive evidence of risk factors for community-acquired pneumonia (CAP). Observational studies (cross-sectional, case-control, and cohort studies) the primary outcome of which was to assess risk factors for CAP in both hospitalized and ambulatory adult patients with radiologically confirmed pneumonia were selected. The Newcastle-Ottawa Scale specific for cohort and case-control designs was used for quality assessment. Twenty-nine studies (20 case-control, 8 cohort, and 1 cross-sectional) were selected, with 44.8% of them focused on elderly subjects ≥65 years of age and 34.5% on mixed populations (participants' age >14 years). The median quality score was 7.44 (range 5-9).

Age, smoking, environmental exposures, malnutrition, previous CAP, chronic bronchitis/chronic obstructive pulmonary disease, asthma, functional impairment, poor dental health, immunosuppressive therapy, oral steroids, and treatment with gastric acid-suppressive drugs were definitive risk factors for CAP. Some of these factors are modifiable. Regarding other factors (e.g., gender, overweight, alcohol use, recent respiratory tract infections, pneumococcal and influenza vaccination, inhalation therapy, swallowing disorders, renal and liver dysfunction, diabetes, and cancer) no definitive conclusion could be established. Prompt assessment and correction of modifiable risk factors could reduce morbidity and mortality among adult CAP patients, particularly among the elderly.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.772 Quartil: 2 Categoria: Respiratory System

Posició: 25/59

Rodríguez A, Ferri C, Martin-Loeches I, Díaz E, Masclans JR, Gordo F, Sole-Violán J, Bodí M, Avilés-Jurado FX, Trefler S, Magret M, Moreno G, Reyes LF, Marin-Corral J, Yebenes JC, Esteban A, Anzueto A, Aliberti S, Restrepo MI; Grupo Español de Trabajo Gripe A Grave (GETGAG)/Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) Working Group; 2009-2015 H1N1 SEMICYUC Working Group investigators.

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

Respir Care. 2017 Oct;62(10):1307-1315. doi: 10.4187/respcare.05481. Epub 2017 Jul 11. PubMed PMID: 28698265

Abstract BACKGROUND: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality.

METHODS: This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation.

Three groups of subjects were compared: (1) subjects who received NIV immediately after ICU admission for ARF and then failed (NIV failure group); (2) subjects who received NIV immediately after ICU admission for ARF and then succeeded (NIV success group); and (3) subjects who received invasive mechanical ventilation immediately after ICU admission for ARF (invasive mechanical ventilation group). Profiles of subjects with risk factors for NIV failure were obtained using CHAID analysis.

RESULTS: Of 1,898 subjects, 806 underwent NIV, and 56.8% of them failed. Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, infiltrates in chest radiograph, and ICU mortality (38.4% vs 6.3%) were higher (P < .001) in the NIV failure than in the NIV success group. SOFA score was the variable most associated with NIV failure, and 2 cutoffs were determined. Subjects Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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with SOFA ≥ 5 had a higher risk of NIV failure (odds ratio = 3.3, 95% CI 2.4-4.5). ICU mortality was higher in subjects with NIV failure (38.4%) compared with invasive mechanical ventilation subjects (31.3%, P = .018), and NIV failure was associated with increased ICU mortality (odds ratio = 11.4, 95% CI 6.5-20.1).

CONCLUSIONS: An automatic and non-subjective algorithm based on CHAID decision-tree analysis can help to define the profile of patients with different risks of NIV failure, which might be a promising tool to assist in clinical decision making to avoid the possible complications associated with NIV failure.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.733 Quartil: 4 Categoria: Respiratory System

Posició: 45/59

Yébenes JC. Early detection of sepsis: To adapt or to die.

Med Clin (Barc). 2017 Sep 8;149(5):209-210. doi: 10.1016/j.medcli.2017.04.002. Epub 2017 May 22. English, Spanish. PubMed PMID: 28545952

Abstract: El trabajo de García et al. publicado en este número de Medicina Clínica es un buen punto de partida para varias reflexiones en relación con la detección, el tratamiento y el pronóstico de los pacientes con sepsis. El trabajo se centra en un subgrupo de pacientes con baja probabilidad de muerte estimada por SOFA (< 10%).

Este subgrupo de pacientes está poco estudiado y puede parecer carente de interés clínico. Sin embargo, comparto la inquietud de los autores. Ingresar en el hospital con una probabilidad de muerte del 10% no es un dato nada tranquilizador para un paciente o sus familiares. En cualquier otro ámbito, esta letalidad sería motivo de profundas reflexiones y movilizaciones, especialmente sabiendo que una parte de esta letalidad es evitable optimizando su detección y tratamiento. La incidencia, complejidad y morbimortalidad asociada al proceso asistencial de la sepsis, requiere la mayor atención por parte de las autoridades sanitarias y actitudes proactivas por parte de profesionales, instituciones y responsables políticos.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.125 Quartil: 3 Categoria: Medicine, General & Internal Posició: 91/155

Yébenes JC, Ruiz-Rodriguez JC, Ferrer R, Clèries M, Bosch A, Lorencio C, Rodriguez A, Nuvials X, Martin-Loeches I, Artigas A; SOCMIC (Catalonian Critical Care Society) Sepsis Working Group.

Epidemiology of sepsis in Catalonia: analysis of incidence and outcomes in a European setting.

Ann Intensive Care. 2017 Dec;7(1):19. doi: 10.1186/s13613-017-0241-1. Epub 2017 Feb 20. PubMed PMID: 28220453

Abstract BACKGROUND: Up-to-date identification of local trends in sepsis incidence and outcomes is of considerable public health importance. The aim of our study was to estimate annual incidence rates and in-hospital mortality trends for hospitalized patients with sepsis in a European setting, while avoiding selection bias in relation to different complexity hospitals.

METHODS: A large retrospective analysis of a 5-year period (2008-2012) was conducted of hospital discharge records obtained from the Catalan Health System (CatSalut) Minimum Basic Data Set for Acute-Care Hospitals (a mandatory population-based register of admissions to all public and private acute-care hospitals in Catalonia).

Patients hospitalized with sepsis were detected on the basis of ICD-9-CM codes used to identify acute organ dysfunction and infectious processes.

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RESULTS: Of 4,761,726 discharges from all acute-care hospitals in Catalonia, 82,300 cases (1.72%) had sepsis diagnoses. Annual incidence was 212.7 per 100,000 inhabitants/year, rising from 167.2 in 2008 to 261.8 in 2012.

Length of hospital stay fell from 18.4 to 15.3 days (p < .00001), representing a relative reduction of 17%.

Hospital mortality fell from 23.7 to 19.7% (p < .0001), representing a relative reduction of 16.9%. These differences were confirmed in the multivariate analysis (adjusted for age group, sex, comorbidities, ICU admission, emergency admission, organ dysfunction, number of organ failures, sepsis source and bacteraemia).

CONCLUSIONS: Sepsis incidence has risen in recent years, whereas mortality has fallen. Our findings confirm reports for other parts of the world, in the context of scarce administrative data on sepsis in Europe.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 3.656 Quartil: 2 Categoria: Critical Care Medicine

Posició: 9/33

Rodríguez F, Duran A, Muñoz Z, Palomera E, Serra-Prat M, Boixeda R, Vicente V, Almirall J. Oral health and risk of pneumonia in asthmatic pacients with inhaled treatment.

Med Clin (Barc). 2017 Sep 22. pii: S0025-7753(17)30652-8. doi:10.1016/j.medcli.2017.07.024. [Epub ahead of print] English, Spanish. PubMedPMID: 28947297

Abstract INTRODUCTION AND OBJECTIVE: Asthma is a chronic disease requiring inhaled treatment and in addition it is a risk factor (RF) of pneumonia. In the oropharyngeal cavity there are numerous species of bacteria that could be dragged to the bronco-alveolar level.

OBJECTIVE: to decide whether oral health is a community acquired pneumonia (CAP) RF in asthmatic patients who are taking inhaled treatment, and determining whether the frequency of use of inhalation devices and the type of inhaled drug are CAP RF. PATIENTS AND METHOD: Case-control study in asthmatic population with inhaled treatment. We recruited 126 asthmatic patients diagnosed with pneumonia by clinical and radiological criteria (cases) and 252 asthmatics not diagnosed with pneumonia during the last year (controls), matched by age. The main factor of study was the General Oral Health Assessment Index (GOHAI) score.

RESULTS: Bivariated analysis showed a statistically significant association of CAP with a GOHAI score≤57 points (poor oral health) (OR 1.69), anticholinergic treatment (OR 2.41), 6 or more inhalations (3.23), chamber use (OR 1.62), FEV1 (OR 0.98), altered functionality (OR 2.08) and psychiatric disorders or depression (OR 0.41). The multivariated analysis shows an independent association of performing 6 or more inhalations per day (OR 2.74) and functional impairment (OR 1.67).

CONCLUSIONS: The results suggest that poor oral health may be a CAP RF.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.125 Quartil: 3 Categoria: Medicine, General & Internal Posició: 91/155

Arméstar F, Almirall J, Mesalles E, Módol JM, Giménez M, Roca J, Sauca G, de la Torre M, Catalán B. Factores pronósticos de la neumonía neumocócica grave.

Rev Med Trujillo 2017;12 (1):3-9.

Abstract Objetivo: Determinar los factores asociados con mortalidad en pacientes con neumonía neumocócica grave.

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Pacientes y Métodos: Estudio retrospectivo realizado en dos centros hospitalarios durante el periodo 19962009, con pacientes afectos de neumonía neumocócica bacteriémica grave. En todos los pacientes se aisló Streptococcus pneumoniae en el cultivo de sangre. Analizamos parámetros clínicos y analíticos.

Resultados: Fueron incluidos 70 pacientes, los cuales fueron hospitalizados en unidades de medicina intensiva.

La edad media fue 55 años (SD 16.28), el 64% fueron hombres. Los valores de los índices de gravedad fueron: APACHE II 19.8 (SD 9,75), SOFA: 7.6 (SD 3.9) y PSI: 113.43 (SD 32). Las sensibilidad antibiótica fue: penicilina el 80%, cefotaxima el 97 %, eritromicina el 81 % y el 98% a levofloxacino. La mortalidad hospitalaria fue del 25%. El análisis multivariado mostró que la resistencia a los macrólidos (Odds Ratio= 28.34 , 95% Confidence Interval= 1.61- 498.91, p = 0.02) y los índices de gravedad: APACHEII (Odds Ratio= 0.73 , 95% Confidence Interval= 0.590.89, p=0.002), SOFA (Odds Ratio= 0.60 , 95% Confidence Interval= 0.43-0.84, p=0.003) y PSI (Odds Ratio = 0.93, 95% Confidence Interval= 0.90-0.97, p=0.002) se correlacionaron con la mortalidad de estos enfermos.

Conclusiones: La resistencia a los macrólidos y una alta puntuación en los índices de gravedad APACHE II, SOFA y PSI son factores asociados con mayor riesgo de mortalidad en pacientes con neumonía neumocócica grave.

DIGESTIU – GASTROENTEROLOGY Nº Articles indexats: 3

Factor Impacte total: 19.815 Factor d’impacte mig per article: 6.605

Ardevol A, Ibañez-Sanz G, Profitos J, Aracil C, Castellvi JM, Alvarado E, Cachero A, Horta D, Miñana J, GomezPastrana B, Pavel O, Dueñas E, Casas M, Planella M, Castellote J J, Villanueva C. Survival of patients with cirrhosis and acute peptic ulcer bleeding compared with variceal bleeding using current first-line therapies.

Hepatology. 2017 Jul 17. doi: 10.1002/hep.29370. [Epub ahead of print] PubMed PMID: 28714072

Abstract: The presence of cirrhosis increases the mortality of patients with peptic ulcer bleeding (PUB). Both acute variceal bleeding (AVB) and PUB are associated with substantial mortality in cirrhosis. This multicenter cohort study was performed to assess whether the mortality of cirrhotic patients with PUB is different from that of those with AVB. Patients with cirrhosis and acute gastrointestinal bleeding were consecutively included and treated with somatostatin and PPI infusion from admission and with antibiotic prophylaxis. Emergency endoscopy with endoscopic therapy was performed within the first 6-hours. 646 patients with AVB and 144 with PUB were included. There were baseline differences between groups, such as use of gastro-erosive drugs or βblockers. Child-Pugh and MELD scores were similar. Further bleeding was more frequent in AVB-group than in those PUB-group (18% vs 10%; OR= 0.50, 95%CI= 0.29-0.88). However, mortality risk at 45-day was similar in both groups (19% in AVB-group vs 17% in PUB-group; OR= 0.85, 95% CI= 0.55-1.33, P= 0.48). Different parameters, such as Child-Pugh score, AKI, ACLF or presence of shock or bacterial infection, but not the cause of bleeding, were related to the risk of death. Only 2% of PUB-group vs 3% of AVB-group died with uncontrolled bleeding (P= 0.39), while the majority of patients in either group died from liver failure or due to other comorbidities.

CONCLUSIONS: Using current first-line-therapy, patients with cirrhosis and acute peptic ulcer bleeding have a similar survival than those with variceal bleeding. The risk of further bleeding is higher in patients with variceal hemorrhage. However, few patients in both groups died from uncontrolled bleeding, while the cause of death was usually related to liver failure or co-morbidities. This article is protected by copyright. All rights reserved.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 13.246 Quartil: 1 Categoria: Gastroenterology & Hepatology Posició: 4/79

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Carrera-Lasfuentes P, Lanas A, Bujanda L, Strunk M, Quintero E, Santolaria S, Benito R, Sopeña F, Piazuelo E, Thomson C, Pérez-Aisa A, Nicolás-Pérez D, Hijona E, Espinel J, Campo R, Manzano M, Geijo F, Pellise M, Zaballa M, González-Huix F,Espinós J, Titó L, Barranco L, D'Amato M, García-González MA. Relevance of DNA repair gene polymorphisms to gastric cancer risk and phenotype.

Oncotarget. 2017 May 30;8(22):35848-35862. doi: 10.18632/oncotarget.16261. PubMed PMID: 28415781

Abstract: Variations in DNA repair genes have been reported as key factors in gastric cancer (GC) susceptibility but results among studies are inconsistent. We aimed to assess the relevance of DNA repair gene polymorphisms and environmental factors to GC risk and phenotype in a Caucasian population in Spain.

Genomic DNA from 603 patients with primary GC and 603 healthy controls was typed for 123 single nucleotide polymorphisms in DNA repair genes using the Illumina platform. Helicobacter pylori infection with CagA strains (odds ratio (OR): 1.99; 95% confidence interval (CI): 1.55-2.54), tobacco smoking (OR: 1.77; 95% CI: 1.22-2.57), and family history of GC (OR: 2.87; 95% CI: 1.85-4.45) were identified as independent risk factors for GC. By contrast, the TP53 rs9894946A (OR: 0.73; 95% CI: 0.56-0.96), TP53 rs1042522C (OR: 0.76; 95% CI: 0.56-0.96), and BRIP1 rs4986764T (OR: 0.55; 95% CI: 0.38-0.78) variants were associated with lower GC risk. Significant associations with specific anatomopathological GC subtypes were also observed, most notably in the ERCC4 gene with the rs1799801C, rs2238463G, and rs3136038T variants being inversely associated with cardia GC risk.

Moreover, the XRCC3 rs861528 allele A was significantly increased in the patient subgroup with diffuse GC (OR: 1.75; 95% CI: 1.30-2.37). Our data show that specific TP53, BRIP1, ERCC4, and XRCC3 polymorphisms are relevant in susceptibility to GC risk and specific subtypes in Caucasians.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 5.168 Quartil: 1 Categoria: Oncology

Posició: 44/217

Martínez-Guillén M, Gornals JB, Consiglieri CF, Castellvi JM, Loras C. EUS-guided recanalization of complete gastrointestinal strictures.

Rev Esp Enferm Dig. 2017 Sep;109(9):643-647. doi: 10.17235/reed.2017.4972/2017. PubMed PMID: 28724308

Abstract BACKGROUND AND AIM: Complete gastrointestinal strictures are a technically demanding problem. In this setting, an anterograde technique is associated with a high risk of complications and a combined anterograderetrograde technique requires a prior ostomy. Our aim was to assess the outcome of a first case series for the management of complete gastrointestinal strictures using endoscopic ultrasound (EUS)-guided puncture as a novel endoscopic approach.

PATIENTS AND METHODS: This retrospective case-series describes four cases that were referred for treatment of complete benign gastrointestinal strictures, three upper and one lower. Recanalization was attempted with EUS-guided puncture using a 22G or 19G needle and contrast filling was visualized by fluoroscopy. Afterwards, a cystotome and/or a dilator balloon were used under endoscopic and fluoroscopic guidance. A fully covered metal stent was placed in two cases, keeping the strictures open in order to prevent another stricture.

Feasibility, adverse events, efficacy and the number of dilations required after recanalization were evaluated.

RESULTS: Technical and clinical success was achieved in three of the four cases (75%). A first dilation was performed using a dilator balloon in all successful cases and fully covered metal stents were used in two cases.

These patients underwent a consecutive number of balloon dilatations (range 1-4) and all three were able to eat a soft diet. No adverse events were related to the EUS-guided approach. In the failed case with a long stricture (> 3 cm), an endoscopic rendezvous technique was attempted which caused a pneumothorax requiring a chest tube placement.

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CONCLUSION: EUS-guided recanalization, as a first approach in the treatment of complete digestive stricture, is a feasible and promising procedure that can help to avoid major surgery.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.401 Quartil: 4 Categoria: Gastroenterology & Hepatology Posició: 70/79

GERIATRIA – GERIATRIC MEDICINE

Nº Articles indexats: 0

Factor Impacte total: 0 Factor d’impacte mig per article: 0

Martínez-Suárez E, Morón-Carande N, Martos-Gutiérrez JA, Cristofol-Allue R. Endocarditis sobre válvula biológica con embolismo mesentérico Rev Mult Ger Gerontol. 2017; 22(2):1-8

Abstract: Se presenta el caso de una paciente de 84 años que acude a urgencias por debilidad, con tendencia al sueño, astenia, anorexia y febrícula. Con los antecedentes de la paciente y el resultado de las pruebas complementarias se orienta como endocarditis sobre válvula biológica. La paciente posteriormente presenta una complicación clínica embólica en forma de cuadro de abdomen agudo. El objetivo de la presentación es comentar un caso de endocarditis sobre válvula biològica. Se recuerdan brevemente las caracterísitcas de la endocarditis y sus principales complicaciones.

Martínez-Suárez E, Espinosa-Val MC, Martos-Gutiérrez JA, Serra-Prat M, Cristofol-Allue R. Prevalencia y factores de riesgo asociados a disfagia en lapoblación anciana con deterioro cognitivo atendida en unaunidad de psicogeriatría Rev Mult Ger Gerontol. 2017; 22(2):1-9

Abstract: La disfagia es un problema prevalente en población envejecida. Influye sobre el estado nutricional, la capacidad funcional, el estado de ánimo y la interacción social. Además está asociada con una mayor morbimortalidad.Se ha realizado un estudio observacional transversal de 182 pacientes que acudieron a consultas externas de psicogeriatría, con recogida retrospectiva de los datos. Se ha valorado la prevalencia de disfagia en esta población con deterioro cognitivo mediante el cuestionario EAT-10 y el test clínico del método del volumen-viscosidad. De los pacientes incluidos más del 40% (41,3%) presentaban disfagia orofaríngea.La presencia de disfagia se asoció de manera significativa con un mayor deterioro en la capacidad funcional (índice de Barthel), en la función cognitiva (MEC) y con un estadío evolutivo de la demencia (GDS) mas avanzado. Es importante una detección y tratamiento precoz de la disfagia para garantizar un abordaje integral a través de un equipo multidisciplinar.

Vinaixa L, Navarro-Pastor B, Salas M, Pujol J, Gutierrez T, Deus J Perfil cognitivo según el subtipode dislexia del desarrollo.

Psicosom. psiquiatr. 2017;(1)2:24-33

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Abstract Introducción: La dislexia del desarrollo (DD) no se considera una entidad homogénea y se estiman diferentessubtipos. En consecuencia, es factible plantearse perfiles cognitivos distintos en función del subtipo deDD. Objetivo: Definir el perfil cognitivo (intelectivo y psicolingüístico) en cinco posibles subtipos de DD. Método: Muestra de 62 menores (39 niños), de 9,5 a 12 años de edad, con diagnóstico clínico y psicométrico de DD. Paradefinir el perfil cognitivo se utilizó la adaptación española de la Escala de Inteligencia de Wechsler para niños(WISC-IV) y del Test de Habilidades Psicolingüísticas de Illinois (ITPA).

Resultados: Se obtuvieron diferenciassignificativas entre el subtipo dislexia-disgrafía por disaudiabilidad y los subtipos dislexia-disgrafía grafomotoray dislexia-disgrafía mixta en el índice de razonamiento perceptivo (p=0,002) y los subtests de cubos (p=0,021)y conceptos (p=0,016) del WISC-IV, y entre el subtipo dislexiadisgrafía por disaudiabilidad y dislexia-disgrafíamixta en la subescala de integración auditiva del ITPA (p=0,021).

Se observaron otras diferencias con tendenciaestadística, pero no significativas, en el perfil cognitivo para cada subtipo de DD. Conclusiones: Los resultadosson consistentes con estudios previos que sugieren la posibilidad de definir perfiles cognitivos diferenciadossegún el subtipo de DD. Con ello se pretende mejorar el diagnóstico clínico diferencial en la DD.

ATENCIÓ PRIMARIA – PRIMARY CARE Nº Articles indexats: 1

Factor Impacte total: 1.125

Factor d’impacte mig per article: 1.125

González Blanco V, Pérula de Torres LÁ, Martín Rioboó E, Martínez Adell MÁ, Parras Rejano JM, González Lama J, Ruiz Moruno J, Martín Alvarez R, Fernández García JÁ, Ruiz de Castroviejo J, Roldán Villalobos A, Ruiz Moral R; grupo de estudio colaborativo DOFA-AP. Opportunistic screening for atrial fibrillation versus detecting symptomatic patients aged 65 years and older: A cluster-controlled clinical trial.

Med Clin (Barc). 2017 Jan 6;148(1):8-15. doi: 10.1016/j.medcli.2016.07.036. Epub 2016 Oct 26. English, Spanish. PubMed PMID: 28196583

Abstract INTRODUCTION: Atrial fibrillation (AF) is the most frequent arrhythmia in clinical practice and has important prognostic implications. The objective of this study was to demonstrate the validity and the reliability of taking the arterial pulse (TAP) in patients over 65 years for detecting in AF and other rhythm disorders.

MATERIALS AND METHODS: A descriptive, observational, multicentre study to validate a diagnostic test within in a controlled clinical trial.

SETTING: 39 Primary Care Centres in the Spanish National Health Service. A total of 318 physicians and nurses took part in the analysis of validity, and 166 of them took part in the analysis of reliability. The professionals were previously called to a meeting in which they took the arterial pulses, and were given 4 ECGs to interpret.

The participants TAP of 864 patients followed by an ECG to confirm the cardiac rhythm. Sensitivity, specificity and predictive values were estimated to assess the criterial validity and the simple concordance index to check reproducibility.

RESULTS: The sensitivity of pulse measurement for detecting AF detection was 99.4% (95% CI: 97.9-100.0), with a specificity of 30.7% (95% CI: 26.1-35.3), a positive predictive value of 36.6% (95% CI 32.0-41.2), and negative predictive value of 99.2% (97.3-100.0). The simple concordance between the researchers and the cardiologist for the ECG diagnosis of AF ranged between 84.9% and 91.6%.

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CONCLUSIONS: The TAP has a high sensitivity but a low specificity to detect AF. It is a reliable test for the opportunistic screening of arrhythmias in patients aged over 65 years.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.125 Quartil: 3 Categoria: Medicine, General & Internal Posició: 91/155

UNITAT DE RECERCA – RESEARCH UNIT

Nº Articles indexats: 1

Factor Impacte total: 4.282

Factor d’impacte mig per article: 4.282

Serra-Prat M, Sist X, Domenich R, Jurado L, Saiz A, Roces A, Palomera E, Tarradelles M, Papiol M. Effectiveness of an intervention to prevent frailty in pre-frail community-dwelling older people consulting in primary care: a randomised controlled trial.

Age Ageing. 2017 May 1;46(3):401-407. doi: 10.1093/ageing/afw242. PubMed PMID: 28064172

Abstract Background: evidence on the effectiveness of interventions to prevent frailty is scarce.

Objective: to assess the effect of an intervention in preventing frailty progression in pre-frail older people.

Study design: a randomised, open label, controlled trial with two parallel arms.

Population: community-dwelling pre-frail older people (≥70 years) consulting in primary care.

Intervention: nutritional assessment (and derivation to a Nutritional Unit for usual care in the event of nutritional risk) and a physical activity programme including aerobic exercise and a set of mixed strengthening, balance and coordination exercises.

Control group: patients receiving the usual care.

Main outcome measure: prevalence of frailty (Fried criteria) at 12 months.

Secondary outcomes measures: functional capacity (Barthel index), falls and nutritional status (Short-Form Mini Nutritional Assessment) on follow-up at 12 months.

Results: one hundred and seventy-two participants were recruited and randomised (mean age: 78.3 years; mean number of Fried criteria: 1.45). Thirty-nine participants (22.6%) were dropped out during the study. At follow-up, 4.9% of the intervention group and 15.3% of the control group had evolved to frailty, for a crude odds ratio (OR) of 0.29 (95% confidence interval [CI]: 0.08-1.08; P = 0.052) and an adjusted (by age, gender and number of co-morbidities) OR of 0.19 (95% CI: 0.04-0.95; P = 0.044). Intervention group showed a higher outdoors walking hour per day (0.97 versus 0.73; P = 0.019) but no difference was observed in muscle strength, gait speed or other functional indicators.

Conclusion: an intervention focused on physical exercise and maintaining good nutritional status may be effective in preventing frailty in community-dwelling pre-frail older individuals.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 4.282 Quartil: 1 Categoria: Geriatrics & Gerontology Posició: 9/49

Serra-Prat M, Papiol M, Vico J, Palomera E, Arús M, Cabré M.

Incidence and Risk Factors for Frailty in the Community-Dwelling Elderly Population. A Two- Year Follow-Up Cohort Study.

J Gerontol Geriatr Res. 2017; 6: 452.

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Abstract Background: Frailty is a highly prevalent geriatric syndrome and a major public health problem. Designing effective preventive measures requires an understanding of frailty mechanisms and risk factors.

Objective: To estimate the incidence of frailty and identify the main risk factors for frailty in community dwelling elderly individuals.

Design: Cohort study followed up over 2 years.

Participants: Non-frail community-dwelling individuals aged 75 years and older.

Measurements: Socio-demographic variables, co-morbidities, lifestyle, nutritional status, anabolic hormones, inflammatory markers, physical exercise and body composition. Frailty, assessed annually, was defined according to Fried criteria.

Results: 278 subjects were recruited (mean age 79.9 years; 42.8% women). Frailty incidence was estimated as 6.8 new cases/100 person-years. Risk factors for frailty were being female, arthrosis, depression, dyspepsia number of medications, being unable to stand on 1 foot for 5 seconds, a positive Timed Up-and-Go test, Barthel Index score <90, a high waist-hip ratio, high cholesterol and interleukin-6 levels and low glomerular filtration Physical exercise was a protective factor for frailty. Risk factors for frailty in men were number of comorbidities, tricipital skinfold and previous handgrip, and in women, insulin resistance and cortisol levels.

Conclusion: The fact that certain modifiable risk factors for frailty were identified would suggest that better control of underlying diseases and inflammatory processes, a review of prescribed medications, physical exercise and correction of obesity and hypercholesterolaemia could be effective interventions to reduce frailty in communitydwelling elderly subjects. However, the effectiveness of such interventions needs to be demonstrated by welldesigned clinical trials.

FARMÀCIA - PHARMACY

Nº Articles indexats: 4

Factor Impacte total: 8.499 Factor d’impacte mig per article: 2.124

Campins L, Serra-Prat M, Palomera E, Bolibar I, Martínez MÀ, Gallo P. Reduction of pharmaceutical expenditure by a drug appropriateness intervention in polymedicated elderly subjects in Catalonia (Spain).

Gac Sanit. 2017 Nov 18. pii: S0213-9111(17)30220-0. doi: 10.1016/j.gaceta.2017.09.002. [Epub ahead of print] PubMed PMID: 29162290

Abstract OBJECTIVE: To assess the monetary savings resulting from a pharmacist intervention on the appropriateness of prescribed drugs in community-dwelling polymedicated (≥8 drugs) elderly people (≥70 years).

METHOD: An evaluation of pharmaceutical expenditure reduction was performed within a randomised, multicentre clinical trial. The study intervention consisted of a pharmacist evaluation of all drugs prescribed to each patient using the "Good Palliative-Geriatric Practice" algorithm and the "Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment" criteria (STOPP/START). The control group followed the routine standard of care. A time horizon of one year was considered and cost elements included human resources and drug expenditure.

RESULTS: 490 patients (245 in each group) were analysed. Both groups experienced a decrease in drug expenditure 12 months after the study started, but this decrease was significantly higher in the intervention group than in the control group (-14.3% vs.-7.7%; p=0.041). Total annual drug expenditure decreased 233.75 €/patient (95% confidence interval [95%CI]: 169.83-297.67) in the intervention group and 169.40 €/patient (95%CI: 103.37-235.43) in the control group over a one-year period, indicating that 64.30 € would be the drug expenditure savings per patient a year attributable to the study intervention. The estimated return per Euro invested in the programme would be 2.38 € per patient a year on average.

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CONCLUSIONS: The study intervention is a cost-effective alternative to standard care that could generate a positive return of investment.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.768 Quartil: 3 Categoria: Public, Environ. & Occup. Health Posició: 94/176

Miarons M. Pharmacy preceptorship in the emergency department.

Emerg Med J. 2017 Oct;34(10):694. doi: 10.1136/emermed-2017-206856. Epub 2017 Aug 16. PubMed PMID: 28814480.

I read with interest the article Emergency medicine pharmacists on an international scale by Coralic and Hayes.1 Clinical pharmacy services in Emergency Medicine (EM) are well established in North America, but far less common in Europe. As part of my 4-year pharmacy residency in Spain, I recently undertook a pharmacy preceptorship in the United States of America (USA), at the Emergency Department (ED) of the University Medical Center, Tucson Arizona, which has 100 000 visits annually and at the ED of the University of Rochester Medical Center, Rochester, New York, USA, with an annual census of 120 000 patients. The objectives of this experience were: (1) to gain knowledge in best practices in acute trauma and medical resuscitation, (2) to participate in the bedside care of patients under supervision and (3) to establish international relationships for collaborative pharmacy research and education...

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.861 Quartil: 2 Categoria: Emergency Medicine

Posició: 10/24

Miarons M, Cabib C, Barón FJ, Rofes L. Evidence and decision algorithm for the withdrawal of antipsychotic treatment in the elderly with dementia and neuropsychiatric symptoms.

Eur J Clin Pharmacol. 2017 Nov;73(11):1389-1398. doi: 10.1007/s00228-017-2314-3. Epub 2017 Aug 5. Review.

PubMed PMID: 28780696

Abstract PURPOSE: Antipsychotics (APs) are commonly used to manage neuropsychiatric symptoms (NPS) in elderly patients with dementia, even though several large studies have demonstrated an association between AP treatment and increased morbidity and mortality in people with dementia. The aim of this study is to review the scientific literature of the use of AP in the elderly with dementia and to propose an algorithm to assist in decision-making regarding the withdrawal of APs. METHODS: A computerized literature search (MEDLINE: 1966 to December 2016, EMBASE: 1982 to December 2016) was used to locate relevant literature. Keywords in the search included terms from Medical Subject Headings (MESH) and EMBASE thesaurus (EMTREE). The following terms were used in the MESH database and EMTREE thesaurus: Aged, Antipsychotic Agents, Behavioral Symptoms and Dementia.

RESULTS: Earlier studies of APs used in elderly patients with dementia suggest that, in most elderly demented patients, APs can be withdrawn with no effect on behaviour. These patients are likely to benefit from the algorithm we propose to assist clinicians in the withdrawal of APs. CONCLUSIONS: In this paper, we review the potential risks and benefits of discontinuing AP treatment in elderly demented patients with NPS and propose an algorithm to assist in decision-making regarding AP withdrawal.

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Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 2.902 Quartil: 3

Categoria: Pharmacology & Pharmacy

Posició: 97/256

Miarons Font M, Rofes Salsench L. Antipsychotic medication and oropharyngeal dysphagia: systematic review.

Eur J Gastroenterol Hepatol. 2017 Dec;29(12):1332-1339. doi: 10.1097/MEG.0000000000000983. PubMed PMID: 29023321

Abstract: The association between antipsychotics (also known as neuroleptics) and oropharyngeal dysphagia (OD) has been suggested in several case reports. The purpose of this systematic review was to examine the effect of antipsychotic medication on OD. A systematic literature search was carried out according to PRISMA guidelines using the electronic databases Pubmed and Embase. In Pubmed, we used the MeSH terms 'antipsychotic agents' OR 'tranquilizing agents' combined with 'deglutition disorders' OR 'deglutition'. In Embase, we used the Emtree terms 'neuroleptic agents' combined with 'swallowing' OR 'dysphagia'. Two reviewers assessed the eligibility of each report independently. The level of evidence of the included studies was also assessed according to pre-established criteria. Case reports were excluded. We found 18 clinical studies of dysphagia related to antipsychotics: 12 were related both to typical and atypical antipsychotics, four to atypical antipsychotics and two to typical antipsychotics. According to the clinical studies included, prevalence of patients with swallowing problems taking antipsychotics ranged from 21.9 to 69.5% whereas prevalence of patients without swallowing problems taking antipsychotics ranged from 5 to 30.5%. The available evidence suggests considering an etiology of dysphagia in patients with swallowing problems who are taking antipsychotics, even if no other symptoms are present. Although few general conclusions can be drawn from current evidence, both typical and atypical antipsychotics can be associated with OD.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 1.968 Quartil: 4 Categoria: Gastroenterology & Hepatology Posició: 60/79

HEMATOLOGIA – HEMATOLOGY

Nº Articles indexats: 0 Factor Impacte total: 0 Factor d’impacte mig per article: 0

Plensa-Alberca E, López-Viaplana L. Guía de manejo de las enfermedades falciformes. Grupo Español de Eritropatología de la Asociación Española de Hematología y Hemoterapia. Part II, Chapter 2, Manejo de las complicaciones agudas. Fiebre. Infección.

Osteomielitis. Madrid: 2017 Oct;97(4):p. 63-66

Abstract: La fiebre es un síntoma frecuente en varias complicaciones de la enfermedad falciforme (EF). Aunque suele ser la primera manifestación de una infección bacteriana invasiva, también puede estar presente en otras complicaciones graves de la EF, como el síndrome torácico agudo (STA) o las crisis vasooclusivas (CVO). Por lo tanto, los pacientes con EF y fiebre se han de evaluar y tratar de manera precoz para reducir su morbimortalidad. Los pacientes con EF tipo SS o con EF/β°-talasemia son los que tienen un mayor riesgo de bacteriemia, debido a la pérdida precoz del funcionalismo esplénico. Pacientes con EF tipo SC o EF/β+-talasemia tienen un menor riesgo, pero superior al de la población normal.

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URGÈNCIES – EMERGENCY MEDICINE

Nº Articles indexats: 2

Factor Impacte total: 0.735 Factor d’impacte mig per article: 0.735

Jacob J, Zorrilla J, Gené E, Alonso G, Rimbau P, Casarramona F, Netto C, Sánchez P, Hernández R, Escalada X, Miró Ò.

Non-invasive ventilation in emergency departments in public hospitals in Catalonia. The VENUR-CAT study.

Med Intensiva. 2017 Jun 15. pii: S0210-5691(17)30174-2. doi: 10.1016/j.medin.2017.05.002. [Epub ahead of print] English, Spanish. PubMed PMID: 28625339

Abstract OBJECTIVES: To know the implementation and characteristics of non-invasive ventilation (NIV) in the Emergency Departments (EDs) of public hospitals in Catalonia (Spain) and analyze possible differences based on the typology, degree of activity and the availability of an Intensive Care Unit (ICU) in the hospital.

DESIGN: A non-interventional, descriptive study was carried out, using a structured questionnaire divided into 3sections: 1) professional experience and training; 2) devices used; and 3) clinical scenarios and the use of NIV. SETTING: Persons responsible for public EDs in Catalonia.

RESULTS: Fifty-two of the 54 public EDs in Catalonia responded (96.3%). Fifty-one perform NIV, which is mainly initiated by emergency care physicians (78.5%); 66.7% maintain the patient in the ED until discharge; and in 43.1% of the cases the length of stay is>24h. Of the EDs, 39.2% have their own protocol, 35.3% of which are established by consensus with other departments (more frequently in non-county hospitals [P=.012], and centers with an ICU [P=.014]), while 25.5% have no protocol, and 43.1% register the activity. Training represents the greatest difficulty for the implementation of NIV, but 19.6% do not provide specific training. When support is needed, the main physician of reference is the intensivist (35.3%) (more frequently in non-county hospitals [P=.012], and centers with an ICU [P=.002]).

CONCLUSIONS: In most EDs in Catalonia, NIV is performed by emergency care physicians. Areas needing improvement include drainage of patients once NIV has been started, the promotion of protocols, registry of activity, and training of the healthcare professionals.

Indexat a: MEDLINE/WOS/JCR

Factor Impacte: 0.735 Quartil:4 Categoria: Critical Care Medicine

Posició: 31/33

Salat D, Serra-Prat M, Palomera E, Vendrell E, Lavado A, Bartolome M, Boixeda R , Almirall J. Benzodiazepine Use and Risk of Community-Acquired Pneumonia in a Population-Based Cohort Study From North-Eastern Spain Clin Med Insights Ther. 2017;9: Article first published online: February 16, 2017; Issue published: January 1, 2017

Abstract BACKGROUND: Benzodiazepine (Bz) exposure has been identified as a risk factor of community-acquired pneumonia (CAP) in some observational studies, but this remains controversial. This study was designed to quantify the risk of CAP associated with treatment with Bz. METHODS: All individuals >= 14 years of age registered in any of 3 primary health care providers in our area between January 2011 and May 2013 were included in the study. This resulted in a population of 51 912 individuals who contributed to a total of 1 496 680 person-months of observation. Previously anonymized data for each participant were obtained from their personal health records and the official prescription database. The primary outcome measures were the incidence of CAP during the study period and the relative risk (RR) that could be attributed to Bz exposure.

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RESULTS: A total of 696 CAP cases were diagnosed. Incidence density was 12.4 cases per 1000 person-years in individuals exposed to Bz and 4.51 cases per 1000 person-years in those who were not. Benzodiazepine exposure increased the risk of CAP in the whole population (RR: 2.76, 95% confidence interval: 2.35-3.25) and in all the evaluated subgroups. Stratified analysis showed an interaction only with age (RR: 2.99 in patients under 65 years and 1.78 in those aged 65 or older). Benzodiazepine exposure was associated with an excess 0.79 cases of CAP per 100 person-years.

CONCLUSIONS: Benzodiazepine exposure increases the risk of CAP. Given the clinical relevance of CAP, prescribers should be aware of this potentially preventable risk and consider it while newly prescribing Bz.

Indexat a: WOS

Casarramona F, Módol JM. Mataró 2016: punt d'innovació i coneixement ReMUE.c@t 2017;4(1):9

Abstract: Sempre havia sentit a dir que la distancia entre un somni i la realitat es mesurava en "voluntat". En el nostre cas crec que ho podem confirmar. Fa molts anys, en tornar d'un dels primers congressos nacionals de SEMES, comentàvem amb el Carles Cuadrada, en aquells moments Cap de Servei d'Urgències de Mataró: "Això ho podríem portar algun dia a Mataró". És cert han passat molts anys i molts congressos, Nacionals Catalans i Nacionals Espanyols. A la meva incorporació a la junta de SoCMUE, coincidint amb plena crisi econòmica es va desvetllar novament la inquietud per portar l'organització del Congrés Català a Mataró i, perquè no dir-ho, intentar donar aire fresc i motivació a una plantilla llastrada pels successius esdeveniments dels darrers anys.

Podria dir-vos que ha estat una feina dura i complicada, això sempre n'augmenta el valor, però crec que no seria fidel a la realitat. Va ser una candidatura treballada amb temps i, quan hi penso, crec que amb més temps potser hauríem incorporat idees que no vàrem poder desenvolupar. Un dels èxits de l'organització crec que ha estat el d'intentar sumar tot el que teníem al nostre entorn, trencar motllos. Ens vàrem preguntar: es pot treballar amb hospitals de diferents titularitats i diferents nivells assistencials? Aquests hospitals tot i que físicament són molt propers, queden molt allunyats. Podem establir sinergies amb escoles universitàries o espais/campus Tecnològics?...

GINECOLOGIA & OBSTETRICIA – OBSTETRICS & GYNECOLOGY Nº Articles indexats: 0

Factor Impacte total: 0 Factor d’impacte mig per article: 0

Carabias-Meseguer P, Alsina-Maqueda A, Rosado-Rubio C, Pérez-Plantado A, Genover-Llimona E Nueva propuesta quirúrgica para úteros miomatosos grandes: histerectomíaasistida inversa.

Prog Obstet Ginecol.2017;60(1):47-52

Abstract Objetivo: describir una nueva técnica que combina la vía vaginal y la laparoscopia en caso de úteros grandes y con poca movilidad permitiendo evitar la vía laparotómica.

Material y métodos: se realiza un estudio descriptivo y retrospectivo entre marzo de 2011 y abril de 2013. Se recogen 15 casos realizados con esta técnica en el Hospital de Mataró. Se analizan la edad, la paridad, número de cesáreas u otras cirugías anteriores ya fuesen abdominales o vaginales, estado hormonal de la paciente, tamañouterino clínico y por ecografía, prolapso uterino, incontinencia de orina, hemoglobina pre y post

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quirúrgicas, sangradodurante la cirugía, peso por anatomía patológica, diagnóstico anatomopatológico y días de hospitalización.

Resultados: la media de edad de las pacientes fue de 46,7 años. El motivo de consulta en el 53,3% de los casos fue por metrorragia y en el 46,7% por tumoración abdominal. El peso medio de las piezas quirúrgicas fue de 705 gy no hubo complicaciones importantes asociadas a la cirugía. La media de tiempo operatorio fue de 122 minutos.

Conclusiones: si bien los avances en la vía laparoscópica han permitido realizar histerectomías de úteros miomatososcon éxito, dejando en un segundo plano la vía abdominal, todavía existen casos de úteros grandes conpoca movilidad lateral que nos obligan a realizar un abordaje abdominal. Para estas situaciones, nuestro grupo,realiza una traquelectomía simple vía vaginal con posterior histerectomía subtotal vía laparoscópica. Se trata deuna alternativa viable, segura, con una baja tasa de complicaciones y con una estancia hospitalaria reducida, porlo que parece una opción razonable en casos seleccionados.

ANESTESIOLOGIA– ANESTHESIOLOGY Nº Articles indexats: 0

Factor Impacte total: 0 Factor d’impacte mig per article: 0

Martín-López MA, Hidalgo-Grau LA, Yuste-Graupera M, Prats-Maeso M. Estudios comparativos en la gestión clínica: ¿están justificadas las técnicas espinales en cirugía ambulatoria?

Cir May Amb 2017; 22 (1): 33-40

Abstract Introducción: La técnica anestésica adecuada es imprescindible en Cirurgía Mayor Ambulatoria (CMA) para disminuir la estancia de los pacientes en la unidad y los efectos no deseados. Existe controversia en cuanto a la utilización de las técnicas neuro-axiales en los centros CMA. Material y métodos: Revisión en la base de datos Pumes entre los años 2000 y 2015 con las palabras clave “spinal anesthesia” y “ambulatory surgery”. Estudios comparativos entre técnicas anestésicas, anestésicos locales y dosis, adicción de fentanilo. Experiencia en nuestra unidad entre los años 2010 y 2014.

Resultados: Estudios comparativos entre técnicas (Anestesia Intradural [AI] vs. General, bloqueo periférico, con sedación). Favorecen la anestesia intradural de ser posible. Diferente dosificación de anestésico local: mejores resultados a menores dosis. Adicción de fentanilo: resultados no concluyentes. Diferentes anestésicos locales: prilocaína con menores efectos no deseados, alta más precoz con lidocaína.

Conclusiones: La AI es una opción válida en CMA, adecuado la técnica a los pacientes y los procedimientos. La situación ideal sería utilizar preferentemente prilocaína a la menor dosis posible y asociado a fentanilo.

UROLOGIA– UROLOGY

Nº Articles indexats: 1

Factor Impacte total: 0 Factor d’impacte mig per article: 0

Ramirez Sevilla C, Admella Salvador C, Feliu Canaleta J, Llopis Manzanera J, Barranco Sanz MA, Romero Martin JA, Bernal Salguero S. Two Case Reports of Benign Testicular Mesothelioma and Review of the Literature.

Case Rep Oncol Med. 2017;2017:5419635. doi: 10.1155/2017/5419635. Epub 2017 Jan 12. PubMed PMID: 28168071

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Abstract: Mesothelioma is usually diagnosed in people over the age of 50 with large history of asbestos-related exposure. It is frequently located in pleural cavity, peritoneum, and pericardium. At the testicles the mesothelioma had been reported first in 1957 like a malignant non-germ-cells tumor. The objective is to present two case reports of benign testicular mesothelioma and review of the literature.

Indexat a: PubMed

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INDICADORS BIBLIOMÈTRICS GLOBALS CSDM 2017

77 65 3

Articles Publicats Articles Publicats

Articles Indexats Articles Indexats

Llibres/Capítols Llibres/Capítols MEDLINE/PubMed/WOS/JCR

Total articles indexats per Servei:

Factor d’Impacte Total per Servei i FI mig (segons nº articles indexats a JCR*)

Medicina Interna

12

Medicina Interna

45.296

(3.774)

Motilitat Digestiva

11

Motilitat Digestiva 40.765

(4.529)

Psiquiatria

8

Oncologia

30.425

(6.085)

Medicina Intensiva

6

Digestiu

19.815

(6.605)

Neurologia

5

Psiquiatria

19.403

(2.425)

Oncologia

5

Neurologia

18.477

(4.619)

Farmàcia

4

Medicina Intensiva 13.350

(2.225)

Rehabilitació

3

Farmàcia

8.499

(2.124)

Digestiu

3

Rehabilitació

7.261

(2.420)

Traumatologia

2

Unitat de Recerca

4.282

(4.282)

Urgències

2

Traumatologia

3.227

(3.227)

Atenció Primària

1

Cirurgia General

1.276

(1.276)

Cirurgia General

1

Atenció Primària

1.225

(1.225)

Unitat de Recerca

1

Urgències

0.735

(0.735)

Urologia

1

Urologia

0.000 (0.000)

* Font: Journal Citation Reports, JCR: 2016 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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