Publicacions Consorci Sanitari del Maresme 2016

Publicacions Científiques CSDM 2016

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Publicacions 2016

Consorci Sanitari del Maresme.

Publicacions de l’any 2016

Biblioteca.

Direcció Acadèmica, Recerca i Innovació Consorci Sanitari del Maresme.

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Publicacions Científiques CSDM 2016

Presentació.

Aquest document recull i presenta els articles científics del Consorci Sanitari del Maresme (amb almenys un autor amb filiació CSDM) indexats al llargde l’any2016 en almenys alguna de les següents bases de dades:MedLine/PubMed/Web of Science (WOS)/Journal Citation Reports (JCR).

S’ha de tenir en compte que 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 2015, per la qual cosa són valors aproximats, els valors definitius del JCR 2016 estaran disponibles el proper mes de juliol 2017.

S’inclouent els articles amb etiqueta ahead of printde PubMed encara que siguin posteriorment indexats a MedLine durant l’any 2017. No s’han inclòs els articles ahead of print del 2015 de PubMed i que han estat indexats definitivament a MedLine durant el 2016 inclosos 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 (capitols de llibres) publicats durant el 2016.

El document recull els articles indexats en el període que vadel dia 21 de desembre de 2015 a 20 desembre 2016.

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Foto : Dani Olea. Comunicació

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Publicacions Científiques CSDM 2016

Índex

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

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

4

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

5

Endocrinologia – Endocrinology ……………………………………………………………………………….…………………………..………..

8

Dermatologia – Dermatology ……………………………………………………………………………………………………………….………..

9

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

9

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

11

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

14

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

21

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

22

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

25

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

31

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

34

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

34

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

35

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

35

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

38

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

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

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NEUROLOGIA - NEUROLOGY Nº Articles indexats: 2

Factor Impacte total: 3.962 Factor d’impacte mig per article: 1.981

Jaraba S, Santamarina E, Miró J, Toledo M, Molins A, Burcet J, Becerra JL, Raspall M, Pico G, Miravet E, Cano A, Fossas P, Fernández S, Falip M. Rufinamide in children and adults in routine clinical practice. Acta Neurol Scand.

2017Jan;135(1):122-128. doi: 10.1111/ane.12572. PubMed PMID: 26923380.

OBJECTIVE: To explore the long-term effectiveness of rufinamide in managing Lennox-Gastaut Syndrome (LGS), other epileptic encephalopathies, and intractable focal epilepsies in adults and children in routine clinical practice.

METHODS: A multicentre, retrospective chart review of patients prescribed adjunctive rufinamide at seven Spanish epilepsy centres, with assessments at six and 12 months.

RESULTS: We evaluated data from 58 patients (40 male, age range 7-57 years), 25 of whom were diagnosed with LGS, 12 with other epileptic encephalopathies and 21 of whom were diagnosed with focal epilepsies, mainly frontal lobe. The mean daily rufinamide dose was 32.0 mg/kg (range 12.5-66.7 mg/kg) in children and 24.7 mg/kg (range 5.0-47.0 mg/kg) in adults, and the most commonly used concomitant antiepileptic drugs were levetiracetam and valproate. Rufinamide was discontinued in 25 patients (43.1%) during the 1-year follow-up, and the most common reason was lack of effectiveness (n = 12, 20.7% of total). The frequency of generalized tonic-clonic seizures was significantly reduced from baseline at 6 and 12 months (P = 0.001), both in patients with generalized epilepsies and in patients with focal epilepsies. Significant seizure frequency reduction from baseline was observed at 12 months (P = 0.01) for tonic/atonic seizures and at 6 months (P = 0.001) for focal seizures. Side effects were reported in 21 patients (36.2%): nausea, vomiting and weight loss were most frequent.

CONCLUSIONS:Rufinamide was well tolerated and was effective in reducing frequency of generalized tonic-clonic, tonic/atonic and focal seizures in both children and adults with severe refractory epilepsies, primarily LGS.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.559 Quartil: 2 Categoria: Clinical Neurology

Posició: 84/193

Meca-Lallana J, Hernández L, Caminero AB, Girón JM, Cano-Orgaz A, Carcelén-Gadea M, Muñoz D, Durán-Ferreras E, Martín-Hernández J, Sánchez-de la Rosa R; FATIGA Study Group.. Fatigue Improvement after Switching Multiple Sclerosis Treatment from Interferon-β to Glatiramer Acetate in Clinical Practice. Eur Neurol. 2016;76(1-2):40-7. doi: 10.1159/000447630. PubMed PMID: 27376845.

BACKGROUND/AIMS: The immunomodulatory effect of glatiramer acetate may help in reducing multiple sclerosis (MS)related fatigue; however, evidence to prove this notion especially after switching from another immunomodulatory therapy is limited. We assessed the 6-month effect of glatiramer acetate on MS-related fatigue in patients switching from interferon-β (IFN-β) in clinical practice.

METHODS: This was an observational study including 54 patients with relapsing-remitting MS that showed moderate/severe fatigue primarily caused by MS before switching from IFN-β to glatiramer acetate and received glatiramer acetate for ≥6 months in daily practice. Study data were retrospectively collected through chart review at treatment switch and over the following 6 months on glatiramer acetate.

RESULTS: Over the 6-month administration of glatiramer acetate, scores on the Modified Fatigue Impact Scale decreased: overall (p < 0.001), physical scale (p < 0.001), cognitive scale (p < 0.001), and psychosocial scale (p < 0.001). The Work Productivity and Activity Impairment Questionnaire showed improvements in work (p = 0.009) and other daily activity impairment (p < 0.001). Health-related quality of life as per the Multiple Sclerosis Impact Scale also improved: physical score (p < 0.001) and psychological score (p < 0.001).

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CONCLUSION: Patients with moderate/severe fatigue switching from IFN-β to glatiramer acetate may benefit from fatigue improvements that contribute to reduce their work/activity impairment and improve their quality of life.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.403 Quartil: 4 Categoria: Clinical Neurology

Posició: 150/193

MEDICINA INTERNA–INTERNAL MEDICINE Nº Articles indexats: 8 Factor Impacte total: 23.246 Factor d’impacte mig per article: 2.905

Troya J, Ryan P, Ribera E, Podzamczer D, Hontañón V, Terrón JA, Boix V, Moreno S, Barrufet P, Castaño M, Carrero A, Galindo MJ, Suárez-Lozano I, Knobel H, Raffo M, Solís J, Yllescas M, Esteban H, González-García J, Berenguer J, Imaz A; GESIDA-8314 Study Group.. Abacavir/Lamivudine plus Rilpivirine Is an Effective and Safe Strategy for HIV-1 Suppressed Patients: 48 Week Results of the SIMRIKI Retrospective Study. PLoS One. 2016 Oct 11;11(10):e0164455. doi: 10.1371/journal.pone.0164455. PubMed PMID: 27727331; PubMed Central PMCID: PMC5058546.

OBJECTIVES: Based on data from clinical practice, we evaluated the effectiveness and safety of switching to abacavir/lamivudine plus rilpivirine (ABC/3TC+RPV) treatment in virologically suppressed HIV-1-infected patients.

METHODS: We performed a multicenter, non-controlled, retrospective study of HIV-1-infected patients who switched treatment to ABC/3TC+RPV. Patients had an HIV-RNA <50 copies/mL for at least 24 weeks prior to changing treatments.

The primary objective was HIV-1 RNA <50 copies/mL at week 48. Effectiveness was analyzed by intention-to-treat (ITT), missing = failure and on-treatment (OT) analyses. The secondary objectives analyzed were adverse effects changes in renal, hepatic or lipid profiles, changes in CD4+ cell count and treatment discontinuations.

RESULTS: Of the 205 patients included, 75.6% were men and the median age was 49. At baseline, before switching to ABC/3TC+RPV, median time since HIV diagnosis was 13.1 years, median time with undetectable HIV-1 RNA was 6.2 years and median time of previous antiretroviral regimen was 3.1 years (48.3% patients were taking efavirenz and ABC/3TC was the most frequent backbone coformulation in 69.7% of patients). The main reasons for switching were drug toxicity/poor tolerability (60.5%) and simplification (20%). At week 48, the primary objective was achieved by 187 out of 205 (91.2%) patients by ITT analysis, and 187 out of 192 (97.4%) patients by OT analysis. The CD4+ lymphocyte count and CD4+ percentage increased significantly from baseline to week 48 by a median of 48 cells/μL (-50 to 189) and 1.2% (-1.3% to 4.1%), respectively, P<0.001. Thirty-eight adverse events (AE) were detected in 32 patients. Of these, 25 had no clear association with treatment. Three patients interrupted therapy due to AE. We observed a decrease in all lipid parameters, P<0.001, and a slight improvement in the glomerular filtration rate, P<0.01. Therapy was considered to have failed in 18 patients owing to virological failure (5 [2.4%]), toxicity/poor tolerability (4 [2%]), clinical decision (3 [1.5%]), loss to followup (3 [1.5%]), death (1 [0.5%]), and no clinical data (2 [1%]).

CONCLUSIONS: The results of this study confirms that ABC/3TC+RPV is an effective, safe, and cost-effective option for the treatment of patients with virologically stable HIV-1 infection.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.057 Quartil: 1 Categoria: Multidisciplinary, Sciences

Posició: 11/63

Capdevila JA, Guembe M, Barberán J, de Alarcón A, Bouza E, Fariñas MC, Gálvez J, Goenaga MA, Gutiérrez F, Kestler M, Llinares P, Miró JM, Montejo M, Muñoz P, Rodríguez-Creixems M, Sousa D, Cuenca J, Mestres CA; on behalf the SEICAV, SEMI, SEQ and SECTCV Societies.. 2016 Expert consensus document on prevention,diagnosis and treatment of short-term peripheral venous catheter-related infections in adult. Rev Esp Quimioter. 2016 Aug;29(4):230-8. PubMed PMID: 27580009.

Abstract: The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. Short peripheral catheters have been found to be associated with the risk of nosocomial bacteremia resulting in morbidity and Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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mortality. Staphyloccus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been elaborated by a panel of experts of the Spanish Society of Cardiovascular Infections in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy and Spanish Society of Thoracic-Cardiovascular Surgery and aims at define and establish the norm for management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance and registry, diagnosis and treatment of infection, indications for removal and stresses on continuous education as a driver for quality. Implementation of this norm will allow uniformity in usage thus minimizing the risk of infection and its complications.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.014 Quartil: 4 Categoria: Microbiology

Posició: 110/123

Domínguez A, Soldevila N, Toledo D, Godoy P, Torner N, Force L, Castilla J, Mayoral JM, Tamames S, Martín V, Egurrola M, Sanz F, Astray J, Project Pi12/02079 Working Group. Factors associated with pneumococcal polysaccharide vaccination of the elderly in Spain: A cross-sectional study. Hum Vaccin Immunother. 2016 Jul 2;12(7):1891-9. doi: 10.1080/21645515.2016.1149661. PubMed PMID: 27064311; PubMed Central PMCID: PMC4964813

Abstract: Vaccination of the elderly is an important factor in limiting the impact of pneumonia in the community. The aim of this study was to investigate the factors associated with pneumococcal polysaccharide vaccination in patients aged ≥ 65 years hospitalized for causes unrelated to pneumonia, acute respiratory disease, or influenza-like illness in Spain. We made a cross-sectional study during 2013-2014. A bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking into account sociodemographic variables and risk medical conditions. A multivariate analysis was performed using multilevel regression models. 921 patients were included; 403 (43.8%) had received the pneumococcal vaccine (394 received the polysaccharide vaccine). Visiting the general practitioner ≥ 3 times during the last year (OR = 1.79; 95% CI 1.25-2.57); having received the influenza vaccination in the 2013-14 season (OR = 2.57; 95% CI 1.72-3.84) or in any of the 3 previous seasons (OR = 11.70; 95% CI 7.42-18.45) were associated with receiving the pneumococcal polysaccharide vaccine. Pneumococcal vaccination coverage of hospitalized elderly people is low. The elderly need to be targeted about pneumococcal vaccination and activities that encourage healthcare workers to proactively propose vaccination might be useful. Educational campaigns aimed at the elderly could also help to increase vaccination coverages and reduce the burden of pneumococcal disease in the community.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.146 Quartil: 2 Categoria: Biotechnology & Applied Microbiology Posició: 80/161

Arbonés L, Capdevila JA, Ruiz Mde L, Carrion S. [Spontaneous splenic rupture as a complication of extrapulmonary tuberculosis]. Rev Esp Quimioter. 2016 Apr;29(2):109-10. Spanish. PubMed PMID: 26946525.

ABSTRACT: La tuberculosis (TBC) esplénica es una forma rara de TBC extrapulmonar. Los pacientes con SIDA o inmunodeprimidos tienen un mayor riesgo de padecerla.Se da sobretodo en el curso de una TBC miliar o raramente como infección aislada del el bazo. Éste es el tercer órgano más afectado en la TBC miliar después del pulmón y del hígado.

El 90% de las roturas esplénicas son por traumatismo existiendo pocos casos descritos de rotura espontánea de un bazo tuberculoso. En la mayoría de ocasiones acontece en pacientes inmunodeprimidos y antes de la administración de tuberculostáticos. Hay descritos escasos casos de rotura esplénica espontánea durante la quimioterapia anti-TBC y algún caso coincidiendo con el síndrome de reconstitución inflamatoria inmune. Presentamos una paciente con un hemoperitoneo secundario a rotura de bazo por TBC miliar de presentación hepatoesplénica.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.014 Quartil: 4 Categoria: Microbiology

Posició: 110/123

Domínguez À, Soldevila N, Toledo D, Godoy P, Castilla J, Force L, Morales M,Mayoral JM, Egurrola M, Tamames S, Martín V, Astray J; Working Group of the Project PI12/02079.. Factors Associated with Influenza Vaccination of Hospitalized

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Elderly Patients in Spain. PLoS One. 2016 Jan 29;11(1):e0147931. doi: 10.1371/journal.pone.0147931. PubMed PMID: 26824383; PubMed Central PMCID: PMC4732680

Abstract:Vaccination of the elderly is an important factor in limiting the impact of influenza in the community. The aim of this study was to investigate the factors associated with influenza vaccination coverage in hospitalized patients aged ≥ 65 years hospitalized due to causes unrelated to influenza in Spain. We carried out a cross-sectional study. Bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking in to account sociodemographic variables and medical risk conditions. Multivariate analysis was performed using multilevel regression models. We included 1038 patients: 602 (58%) had received the influenza vaccine in the 2013-14 season. Three or more general practitioner visits (OR = 1.61; 95% CI 1.19-2.18); influenza vaccination in any of the 3 previous seasons (OR = 13.57; 95% CI 9.45-19.48); and 23valent pneumococcal polysaccharide vaccination (OR = 1.97; 95% CI 1.38-2.80) were associated with receiving the influenza vaccine. Vaccination coverage of hospitalized elderly people is low in Spain and some predisposing characteristics influence vaccination coverage. Healthcare workers should take these characteristics into account and be encouraged to proactively propose influenza vaccination to all patients aged ≥ 65 years..

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.057 Quartil: 1 Categoria: Multidisciplinary, Sciences

Posició: 11/63

Casado I, Domínguez A, Toledo D, Chamorro J, Force L, Soldevila N, Astray J, Egurrola M, Godoy P, Mayoral JM, Tamames S, Sanz F, Castilla J; Project Pi12/2079 Working Group.. Effect of influenza vaccination on the prognosis of hospitalized influenza patients. Expert Rev Vaccines. 2016;15(3):425-32. doi: 10.1586/14760584.2016.1134328. PubMed PMID: 26690376

OBJECTIVES: This study aimed to assess whether influenza vaccination reduces the risk of severe and fatal outcomes in influenza inpatients aged ≥65 years.

METHODS: During the 2013-2014 influenza season persons aged ≥65 years hospitalized with laboratory-confirmed influenza were selected in 19 Spanish hospitals. A severe influenza case was defined as admission to the intensive care unit, death in hospital or within 30 days after admission. Logistic regression was used to compare the influenza vaccination status between severe and non-severe influenza inpatients.

RESULTS: Of 433 influenza confirmed patients, 81 (19%) were severe cases. Vaccination reduced the risk of severe illness (odds ratio: 0.57; 95%CI: 0.33-0.98). The cumulative number of influenza vaccine doses received since the 2010-2011 season was associated with a lower risk of severe influenza (odds ratio: 0.78; 95% CI 0.66-0.91).

CONCLUSION: Adherence to seasonal influenza vaccination in the elderly may reduce the risk of severe influenza outcomes.

KEYWORDS: Influenza virus; mortality; seasonal influenza vaccine; severe influenza; vaccine effectiveness

Indexat a: Medline/WOS/JCR

Factor Impacte: 4.222 Quartil: 2 Categoria: Immunology

Posició: 41/151

Nicolás D, Esteve A, Cuadros A, Campbell CN, Tural C, Podzamczer D, Murillas J, Homar F, Segura F, Force L, Vilaró J, Masabeu À, Garcia I, Mercadal J, Montoliu A, Ferrer E, Riera M, Cifuentes C, Ambrosioni J, Navarro G, Manzardo C, Clotet B, Gatell JM, Casabona J, Miró JM; PISCIS Cohort Study Investigators.. Safe Reduction in CD4 Cell Count Monitoring in Stable, Virally Suppressed Patients With HIV Infection or HIV/Hepatitis C Virus Coinfection. Clin Infect Dis. 2016 Jun 15;62(12):1578-85. doi: 10.1093/cid/ciw157. PubMed PMID: 27126346

BACKGROUND: It has been suggested that routine CD4 cell count monitoring in human immunodeficiency virus (HIV)monoinfected patients with suppressed viral loads and CD4 cell counts >300 cell/μL could be reduced to annual.

HIV/hepatitis C virus (HCV) coinfection is frequent, but evidence supporting similar reductions in CD4 cell count monitoring is lacking for this population. We determined whether CD4 cell count monitoring could be reduced in monoinfected and Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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coinfected patients by estimating the probability of maintaining CD4 cell counts ≥200 cells/µL during continuous HIV suppression.

METHODS: The PISCIS Cohort study included data from 14 539 patients aged ≥16 years from 10 hospitals in Catalonia and 2 in the Balearic Islands (Spain) since January 1998. All patients who had at least one period of 6 months of continuous HIV suppression were included in this analysis. Cumulative probabilities with 95% confidence intervals were calculated using the Kaplan-Meier estimator stratified by the initial CD4 cell count at the period of continuous suppression initiation.

RESULTS: A total of 8695 patients were included. CD4 cell counts fell to <200 cells/µL in 7.4% patients, and the proportion was lower in patients with an initial count >350 cells/µL (1.8%) and higher in those with an initial count of 200-249 cells/µL (23.1%). CD4 cell counts fell to <200 cells/µL in 5.7% of monoinfected and 11.1% of coinfected patients. Of monoinfected patients with an initial CD4 cell count of 300-349 cells/µL, 95.6% maintained counts ≥200 cells/µL. In the coinfected group with the same initial count, this rate was lower, but 97.6% of coinfected patients with initial counts >350 cells/µL maintained counts ≥200 cells/µL.

CONCLUSIONS: From our data, it can be inferred that CD4 cell count monitoring can be safely performed annually in HIVmonoinfected patients with CD4 cell counts >300 cells/µL and HIV/HCV-coinfected patients with counts >350 cells/µL

Indexat a: Medline/WOS/JCR

Factor Impacte: 8.736 Quartil: 1 Categoria: Infectious Diseases

Posició: 2/83

Capdevila JA, Guembe M, Barberán J, de Alarcón A, Bouza E, Fariñas MC, Gálvez J, Goenaga MA, Gutiérrez F, Kestler M, Llinares P, Miró JM, Montejo M, Muñoz P, Rodríguez-Creixems M, Sousa D, Cuenca J, Mestres CA; on behalf the SEICAV, SEMI, SEQ and SECTCV Societies. 2016 Expert consensus document on prevention, diagnosis and treatment of shortterm peripheral venous catheter-related infections in adult. Cir Cardiovasc. 2016 Jul-Aug;23(4):192-8

The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. The short-term use of peripheral catheters has been found to be associated with the risk of nosocomial bacteraemia, resulting in morbidity and mortality. Staphylococcus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been prepared by a panel of experts of the Spanish Society of Cardiovascular Infections, in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy, and the Spanish Society of ThoracicCardiovascular Surgery, and aims to define and establish guidelines for the management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance, registering, diagnosis and treatment of infection, indications for removal, as well as placing an emphasis on continuous education as a drive toward quality. Implementation of these guidelines will allow uniformity in use, thus minimizing the risk of infections and their complications. (C) 2016 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cirugia ToracicaCardiovascular

Indexat a: WOS

ENDOCRINOLOGIA–ENDOCRINOLOGY Nº Articles indexats: 1 Factor Impacte total: 8.784 Factor d’impacte mig per article: 8.784

Usero L, Sánchez A, Pizarro E, Xufré C, Martí M, Jaraquemada D, Roura-Mir C. Interleukin-13 Pathway Alterations Impair Invariant Natural Killer T-Cell-Mediated Regulation of Effector T Cells in Type 1 Diabetes. Diabetes. 2016 Aug;65(8):235666. doi: 10.2337/db15-1350. PubMed PMID: 27207542

Abstract: Many studies have shown that human natural killer T (NKT) cells can promote immunity to pathogens, but their regulatory function is still being investigated. Invariant NKT (iNKT) cells have been shown to be effective in preventing type 1 diabetes in the NOD mouse model. Activation of plasmacytoid dendritic cells, modulation of B-cell responses, and immune deviation were proposed to be responsible for the suppressive effect of iNKT cells. We studied the regulatory Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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capacity of human iNKT cells from control subjects and patients with type 1 diabetes (T1D) at disease clinical onset. We demonstrate that control iNKT cells suppress the proliferation of effector T cells (Teffs) through a cell contact-independent mechanism. Of note, suppression depended on the secretion of interleukin-13 (IL-13) by iNKT cells because an antibody blocking this cytokine resulted from the abrogation of Teff suppression; however, T1D-derived iNKT cells showed impaired regulation that could be attributed to the decrease in IL-13 secretion. Thus, alteration of the IL-13 pathway at disease onset may lead to the progression of the autoimmune response in T1D. Advances in the study of iNKT cells and the selection of agonists potentiating IL-13 secretion should permit new therapeutic strategies to prevent the development of T1D.

Indexat a: Medline/WOS/JCR

Factor Impacte: 8.784 Quartil: 1 Categoria: Endocrinology & Metabolism Posició: 9/133

DERMATOLOGIA–DERMATOLOGY

Nº Articles indexats: 1 Factor Impacte total: 1.267 Factor d’impacte mig per article: 1.267

Campos M, Sais G, Admella C. [Skin infection by Mycobacterium marinum]. Med Clin (Barc). 2016 Sep 26. pii: S00257753(16)30374-8. doi: 10.1016/j.medcli.2016.07.026. [Epub ahead of print] Spanish. PubMed PMID: 27686936

Varón de 56 años, trabajador en la supervisión de construcciones. Acudió por presentar múltiples nódulos inflamatorios, con ulceración central en dorso de mano y antebrazo derecho, de distribución esporotricoide de 15 días de evolución; después de presentar herida periungueal en contacto con agua estancada. Se procedió a la biopsia y cultivo de la lesión. El estudio histológico evidenció reacción granulomatosa epiteloidea celular acompa˜nada de neutrófilos. No se evidenciaron gérmenes patógenos en la biopsia, siendo las tinciones de Ziehl-Neelsen y PAS, negativas. Se inició tratamiento empírico con minociclina 100 mg/12 h. Los resultados del cultivo demostraron positividad por Mycobacterium marinum. Al mes, las lesiones prácticamente se habían resuelto.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.267 Quartil: 2 Categoria: Medicine, General & Internal Posició: 76/155

ONCOLOGIA–ONCOLOGY Nº Articles indexats: 4

Factor Impacte total: 8.120

Factor d’impacte mig per article: 2.030

Isla D, Felip E, Viñolas N, Provencio M, Majem M, Artal A, Bover I, Lianes P, DE Las Peñas R, Catot S, DE Castro J, Blasco A, Terrasa J, Gonzalez-Larriba JL, Juan O, Dómine M, Bernabe R, Garrido P. Lung Cancer in Women with a Family History of Cancer: The Spanish Female-specific Database WORLD07. Anticancer Res. 2016 Dec;36(12):6647-6653. PubMed PMID: 27919997

BACKGROUND: The WORLD07 project is a female-specific database to prospectively analyze the characteristics of Spanish women with lung cancer.

PATIENTS AND METHODS: We analyzed and compared lung cancer features in women with and without a family history of cancer/lung cancer.

RESULTS: Two thousand and sixty women were included: 876 had a family history of cancer (lung cancer, 34%) and 886 did not, with no significant differences between groups, except for smoking status (p=0.036). We found statistically significant correlations between epidermal growth factor receptor (EGFR) mutation and smoking status in patients with a family history of cancer (r=-0.211; p<0.001) and lung cancer (r=-0.176; p<0.001). Longer median overall survival was observed in women with a family history of cancer and lung cancer.

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CONCLUSION: Among Spanish women with lung cancer, a greater proportion were current smokers in those with a family history of cancer/lung cancer. There was a significant correlation between the presence of EGFR mutation and smoking.

Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

KEYWORDS: Cancer; Spanish women; WORLD07 database; epidermal growth factor receptor; family history; lung cancer risk; menopausal status; smoking.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.895 Quartil: 3 Categoria: Oncology

Posició: 159/213

Isla D, Majem M, Viñolas N, Artal A, Blasco A, Felip E, Garrido P, Remón J, Baquedano M, Borrás JM, Die Trill M, GarcíaCampelo R, Juan O, León C, Lianes P, López-Ríos F, Molins L, Planchuelo MÁ, Cobo M, Paz-Ares L, Trigo JM, de Castro J. A consensus statement on the gender perspective in lung cancer. Clin Transl Oncol. 2016 Nov 24. [Epub ahead of print] Review. PubMed PMID: 27885542.

Abstract:Lung cancer is the most common cancer globally and has the highest mortality. Although this disease is not associated with a particular gender, its incidence is rising among women, who are diagnosed at an increasingly younger age compared with men. One of the main reasons for this rise is women taking up smoking. However, many non-smoking women also develop this disease. Other risk factors implicated in the differential development of lung cancer in women are genetic predisposition, tumour histology and molecular profile. Proportionally more women than men with lung cancer have a mutation in the EGFR gene. This consensus statement reviews the available evidence about the epidemiological, biological, diagnostic, therapeutic, social and psychological aspects of lung cancer in women.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.075 Quartil: 3 Categoria: Oncology

Posició: 153/215

Caro M, Font A, Comas S, Viciano M, Remon J, Céliz P, Robles J, Musulén E, Sendrós MJ, Mesalles E, Jiménez JA, Boix J, Arellano A, Fernández-Llamazares J. Preoperative low-dose weekly cisplatin and continuous infusion fluorouracil plus hyperfractionated radiotherapy in stage II-III esophageal carcinoma. Clin Transl Oncol. 2016 Nov;18(11):1106-1113.

PubMed PMID: 26856597

BACKGROUND: The optimal regimen of preoperative chemoradiotherapy for resectable esophageal cancer has not been established. We evaluated accelerated hyperfractionated radiotherapy (RT) concurrent to low-dose weekly cisplatin and continuous infusion fluorouracil (LDCI-FU) followed by esophagectomy in patients with locally advanced squamous cell carcinoma (SCC) of the esophagus.

METHODS: Patients with clinical stage II or III SCC of the esophagus received cisplatin 30 mg/m2/week (days 1, 8, 15), LDCIFU 300 mg/m2/day (days 1-21), and concomitant RT to a dose of 45 Gy (150 cGy/fraction, 2 fractions/day) on tumor and affected lymph nodes, followed by radical esophagectomy.

RESULTS: From 1997 to 2012, 64 patients were treated with this regimen. Twenty-four patients (37 %) had grade 3 esophagitis, 18 (28 %) of whom required hospitalization. The risk of hospitalization was reduced by placement of a jejunostomy tube before starting induction chemoradiotherapy. Six patients (9 %) had grade 3-4 neutropenia. Fifty-three patients (83 %) underwent esophageal resection and complete resection was achieved in 45 (70 %). The overall median survival was 28 months (95 % CI: 20.4-35.6) and 5-year survival was 38 %. In the 18 patients attaining a pathological complete response, median survival was 132 months and 5-year survival was 72 %. Positron emission tomography standardized uptake values (PET SUVmax) post-chemoradiotherapy were associated with pathological response (p = 0.03) and survival (p = 0.04).

CONCLUSIONS: Intensive preoperative hyperfractionated RT concomitant to low-dose cisplatin and LDCI-FU is effective in patients with locally advanced SCC of the esophagus, with good pathological response and survival and manageable toxicities. Post-chemoradiotherapy PET SUVmax shows promise as a potential prognostic factor.

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Indexat a: Medline/WOS/JCR Factor Impacte: 2.075

Quartil: 3

Categoria: Oncology

Posició: 153/215

Salvador J, Urtasun JA, Duart FJ, García-Campelo R, Carbonero RG, Lianes P, Llombart A, Casado DI, Piera JM, Mateu MM, Puente J, Rivera F, Rodríguez CA, Virizuela JA, Martín M, Garrido P. Equity, barriers and cancer disparities: study of the Spanish Society of Medical Oncology on the access to oncologic drugs in the Spanish Regions. Clin Transl Oncol. 2016 Aug 25. [Epub ahead of print] Review. PubMed PMID: 27562312.

PURPOSE: The Spanish Society of Medical Oncology (SEOM) has conducted a study on the access to oncologic drugs across the 17 Spanish Regions with the aim of identifying potential heterogeneities and making proposals for eliminating the barriers identified at the different levels.

METHODS: An Expert Panel made up of medical oncologists designed a survey on certain indications approved for 11 drugs in the approach of breast cancer, melanoma, lung cancer, prostate cancer and support treatment. This survey was sent to 144 National Health System (NHS) hospitals.

RESULTS: 77 hospitals answered the survey. The information modules analysed were: scope of the Commission that establishes binding decisions related to drug access; conditions, stages and periods of drug application, approval and administration processes; barriers to accessing drugs.

CONCLUSIONS: The study shows variability in drug access. The SEOM makes proposals addressed to reducing the differences identified and homogenizing drug access conditions.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.075 Quartil: 3 Categoria: Oncology

Posició: 153/215

CIRURGIA GENERAL – GENERAL SURGERY

Nº Articles indexats: 5

Factor Impacte total: 9.416

Factor d’impacte mig per article: 1.883

Estrada O, Pulido L, Admella C, Hidalgo LA, Clavé P, Suñol X. Sentinel lymph node biopsy as a prognostic factor in nonmetastatic colon cancer: a prospective study. Clin Transl Oncol. 2016 Aug 19. [Epub ahead of print] PubMed PMID:27541595

PURPOSE: Around a third of node-negative patients with colon cancer experience a recurrence after surgery, suggesting poor staging. Sentinel lymph node techniques combined with immunochemistry could improve colon cancer staging. We prospectively assessed the effect of Sentinel node mapping on staging and survival in patients with non-metastatic colon cancer.

METHODS: An observational and prospective study was designed. 105 patients with colon cancer were selected. Patients were classified according to node involvement as: N1, with node invasion detected by the conventional techniques; upstaged, with node invasion detected only by sentinel node mapping; and N0, with negative lymph node involvement by both techniques. Five-year survival and disease-free survival rates were analysed. Multivariate regression analyses were performed to identify prognostic factors for disease-free and overall survival.

RESULTS: Sentinel node mapping was successfully applied in 78 patients: 33 % were N1; 24.5 % were up-staged (18 patients with isolated tumour cells and 1 patient with micrometastases); and 42.5 % were N0. N1 patients had the poorest overall 5year survival (65.4 %) and 5-year disease-free survival (69.2 %) rates compared with the other two groups. No significant 5year survival differences were observed between N0 patients (87.9 %) and up-staged patients (84.2 %).

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CONCLUSIONS: Patients up-staged after sentinel node mapping do not have a poorer prognosis than patients without node involvement. Detection of isolated cancer cells was not a poor prognosis factor in these patients.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.075 Quartil: 3 Categoria: Oncology

Posició: 153/215

Sánchez-Santos R, Corcelles Codina R, Vilallonga Puy R, Delgado Rivilla S, Ferrer Valls 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, Del Castillo Dejardin D, Abasolo Vega J, Mans Muntwyler E, Garcia Navarro A, Duran Escribano C, Cassinell Fernández N, Perez Climent N, Gracia Solanas JA, Garcia-Moreno Nisa F, Hernández Matias A, Valentí Azcarate V, PerezFolques JE, Navarro Garcia I, Dominguez-Adame Lanuza E, Martinez Cortijo S, González Fernández J. Prognostic Factors for Morbimortality in Sleeve Gastrectomy. The Importance of the Learning Curve. A Spanish-Portuguese Multicenter Study. Obes Surg. 2016 Dec;26(12):2829-2836. PubMed PMID: 27193106

BACKGROUND: Complications in sleeve gastrectomy (SG) can cast a shadow over the technique's good results and compromise its safety. The aim of this study is to identify risk factors for complications, and especially those that can potentially be modified to improve safety.

METHODS: A retrospective multicenter cohort study was carried out, involving the participation of 29 hospitals. Data was collected on demographic variables, associated comorbidities, technical modifications, the surgeon's experience, and postoperative morbimortality. A multivariate logistic regression analysis was carried out on risk factors (RFs) for the complications of leak/fistula, hemoperitoneum, pneumonia, pulmonary embolism, and death.

RESULTS: The following data were collected for 2882 patients: age, 43.85 ± 11.6. 32.9 % male; BMI 47.22 ± 8.79; 46.2 % hypertensive; 29.2 % diabetes2; 18.2 % smokers; bougie calibre ≥40 F 11.1 %; complications 11.7 % (2.8 % leaks, 2.7 % hemoperitoneum, 1.1 % pneumonia, 0.2 % pulmonary embolism); and death 0.6 %. RFs for complications were as follows: surgeon's experience < 20 patients, OR 1.72 (1.32-2.25); experience > 100 patients, OR 0.78 (0.69-0.87); DM2, OR1.48(1.121.95); probe > 40 F, OR 0.613 (0.429-0.876). Leak RFs were the following: smoking, OR1.93 (1.1-3.41); surgeon's experience < 20 patients, OR 2.4 (1.46-4.16); experience of 20-50 patients, OR 2.5 (1.3-4.86); experience >100 patients, OR 0.265 (0.11-0.63); distance to pylorus > 4 cm, OR 0.510 (0.29-0.91). RFs for death were as follows: smoking, OR 8.64 (2.6328.34); DM2, OR 3.25 (1.1-9.99); distance to pylorus < 5 cm, OR 6.62 (1.63-27.02).

CONCLUSIONS: The safety of SG may be compromised by nonmodifiable factors such as age >65, patient comorbidities (DM2, hypertension), and prior treatment with anticoagulants, as well as by modifiable factors such as smoking, bougie size <40 F, distance to the pylorus <4 cm, and the surgeon's experience (<50-100 cases).

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.346 Quartil: 1 Categoria: Surgery

Posició: 23/200

Hidalgo Grau LA, Ruiz Edo N, Llorca Cardeñosa S, Heredia Budó A, Estrada Ferrer Ó, Del Bas Rubia M, García Torralbo EM, Suñol Sala X. Circular mucosal anopexy: Experience and technical considerations. Cir Esp. 2016 May;94(5):287-93. doi: 10.1016/j.ciresp.2015.12.008. English, Spanish. PubMed PMID: 26997121

INTRODUCTION: Circular mucosal anopexy (CMA) achieves a more comfortable postoperative period than resective techniques. But complications and recurrences are not infrequent. This study aims to evaluate of the efficacy of CMA in the treatment of hemorrhoids and rectal mucosal prolapse (RMP).

METHOD: From 1999 to 2011, 613 patients underwent surgery for either hemorrhoids or RMP in our hospital. CMA was performed in 327 patients. Gender distribution was 196 male and 131 female. Hemorrhoidal grades were distributed as Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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follows: 28 patients had RMP, 46 2nd grade, 146 3rd grade and 107 4th grade. Major ambulatory surgery (MAS) was performed in 79.9%. Recurrence of hemorrhoids was studied and groups of recurrence and no-recurrence were compared.

Postoperative pain was evaluated by Visual Analogical Scale (VAS) as well as early complications.

RESULTS: A total of 31 patients needed reoperation (5 RMP, 2 with 2nd grade, 17 with 3rd grade,/with 4th grade). No statistically significant differences were found between the non-recurrent group and the recurrent group with regards to gender, surgical time or hemorrhoidal grade, but there were differences related to age. In the VAS, 81.3% of patients expressed a postoperative pain ≤ 2 at the first week. Five patients needed reoperation for early postoperative bleeding. Six patients needed admission for postoperative pain.

CONCLUSIONS: Recurrence rate is higher in CMA than in resective techniques. CMA is a useful technique for the treatment of hemorrhoids in MAS. Pain and the rate of complications are both low.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.000 Quartil: 3 Categoria: Surgery

Posició: 140/200

Estrada Ferrer O, Ruiz Edo N, Hidalgo Grau LA, Abadal Prades M, Del Bas Rubia M, Garcia Torralbo EM, Heredia Budo A, Suñol Sala X. Selective non-antibiotic treatment in sigmoid diverticulitis: is it time to change the traditional approach?

Tech Coloproctol. 2016 May;20(5):309-15. doi: 10.1007/s10151-016-1464-0. PubMed PMID: 27053254

BACKGROUND: A growing body of knowledge is calling into question the use of antibiotics in acute diverticulitis (AD).

Moreover, recent studies provide evidence regarding the security of treating patients with AD as outpatients. The aim of this study was to evaluate a restrictive antibiotic outpatient protocol for the treatment of mild-to-moderate episodes of AD.

METHODS: All patients with symptoms of AD presenting to our emergency department were assigned a modified Neff stage. Patients with mild AD received outpatient treatment without antibiotics. Patients with mild AD and comorbidities were admitted to receive the same treatment. Patients with moderate AD were admitted for 48 h and were then managed as outpatients until they had completed 10 days of antibiotic treatment.

RESULTS: Between April 2013 and November 2014, we attended 110 patients with a diagnosis of AD, 77 of whom we included in the study: 45 patients with mild AD and 32 with moderate AD. Of the patients with mild AD, 88.8 % successfully completed the non-antibiotic, non-admission treatment regime and 95.5 % benefited from a non-antibiotic regime, whether as outpatients or inpatients. A total of 88 % of patients with mild AD and 87.5 % of patients with moderate AD who met the inclusion criteria completed treatment as outpatients without incident. No major complications (abscess, emergency surgery) or deaths were recorded.

CONCLUSIONS: Outpatient treatment without antibiotics for patients with mild AD is safe and effective. Patients with moderate AD can be safely treated with antibiotics in a mixed regime as inpatients and outpatients.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.320 Quartil: 2 Categoria: Surgery

Posició: 60/200

Sola H, Recaj M, Castellà E, Puig P, Gubern JM, Julian JF, Fraile M. Prognostic Factors for Morbimortality in Sleeve Gastrectomy. Sentinel Node Biopsy in Special Histologic Types of Invasive Breast Cancer. J Breast Health 2016 Dec;12(2):78-82.

Objective: To assess the feasibility of sentinel node biopsy (SNB) in ductal and lobular invasive breast cancer, a group of tumors known as special histologic type (SHT) of breast cancer.

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Materials and Methods: Between January 1997 and July 2008, 2253 patients from 6 affiliated hospitals underwent SNB who had early breast cancer and clinically negative axilla. The patients’ data were collected in a multicenter database. For lymphatic mapping, all patients received an intralesional dose of radiocolloid Tc-99m (4mCi in 0.4 mL saline), at least two hours before the surgical procedure. SNB was performed by physicians from the same nuclear medicine department in all cases.

Results: Of the 2253 patients in the database, the SN identification rate was 94.5% (no radiotracer migration in 123 patients), and positive sentinel node prevalence was 22%. SHT was reported in 144 patients (6.4%) of the whole series. In this subgroup, migration of radiotracer was unsuccessful in 8 patients (identification rate was 94.4%) and SNs were positive in 7.4%. SN positivity prevalence in these tumors was variable across the subtypes. Higher probability of lymphatic spread seemed to be related to tumor invasiveness (20% of positivity in micropapillary, 15% in cribriform subtypes, and 0% in adenoid-cystic).

Conclusion: Sentinel node biopsy is feasible in special histologic subtypes of breast carcinoma with a good identification rate. Lower migration rates, however, might be associated with special histologic features (colloid subtype). Complete axillary dissection after a positive sentinel node cannot be omitted in patients with SHT breast cancer because they can be associated with further axillary disease; the reported very low incidence of axillary metastases would justify avoiding axillary dissection only in the adenoid-cystic subtype.

Indexat a: WOS

MOTILITAT DIGESTIVA – GASTROINTESTINAL MOTILITY Nº Articles indexats: 13 Factor Impacte total: 38.966 Factor d’impacte mig per article: 2.997

Cordier R, Joosten A, Clavé P, Schindler A, Bülow M, Demir N, Arslan SS,Speyer R. Evaluating the Psychometric Properties of the Eating Assessment Tool(EAT-10) Using Rasch Analysis. Dysphagia. 2016 Nov 21. [Epub ahead of print]PubMed PMID: 27873090

Abstract:Early and reliable screening for oropharyngeal dysphagia (OD) symptoms in at-risk populations is important and a crucial first stage in effective OD management. The Eating Assessment Tool (EAT-10) is a commonly utilized screening and outcome measure. To date, studies using classic test theory methodologies report good psychometric properties, but the EAT-10 has not been evaluated using item response theory (e.g., Rasch analysis). The aim of this multisite study was to evaluate the internal consistency and structural validity and conduct a preliminary investigation of the cross-cultural validity of the EAT-10; floor and ceiling effects were also checked. Participants involved 636 patients deemed at risk of OD, from outpatient clinics in Spain, Turkey, Sweden, and Italy. The EAT-10 and videofluoroscopic and/or fiberoptic endoscopic evaluation of swallowing were used to confirm OD diagnosis. Patients with esophageal dysphagia were excluded to ensure a homogenous sample. Rasch analysis was used to investigate person and item fit statistics, response scale, dimensionality of the scale, differential item functioning (DIF), and floor and ceiling effect. The results indicate that the EAT-10 has significant weaknesses in structural validity and internal consistency. There are both item redundancy and lack of easy and difficult items. The thresholds of the rating scale categories were disordered and gender, confirmed OD, and language, and comorbid diagnosis showed DIF on a number of items. DIF analysis of language showed preliminary evidence of problems with cross-cultural validation, and the measure showed a clear floor effect. The authors recommend redevelopment of the EAT-10 using Rasch analysis.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.754 Quartil: 2 Categoria: Otorhinolaryngology

Posició: 15/43

Ortega O, Rofes L, Martin A, Arreola V, López I, Clavé P. A Comparative Study Between Two Sensory Stimulation Strategies After Two Weeks Treatment on OlderPatients with Oropharyngeal Dysphagia. Dysphagia. 2016 Oct;31(5):70616. doi:10.1007/s00455-016-9736-4. PubMed PMID: 27503566

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Abstract:Oropharyngeal dysphagia (OD) is a prevalent geriatric syndrome. Treatment is based on compensatory strategies to avoid complications. New treatments based on sensory stimulation to promote the recovery of the swallowing function have proved effective in acute studies but prolonged treatment needs further research. Our aim was to evaluate and compare the effect of two, longer-term sensory treatment strategies on older patients with OD. 38 older patients (≥70 years) were studied with videofluoroscopy (pre/posttreatment) and randomized into two 10-day treatment groups: Group A-transient receptor potential vanilloid 1 (TRPV1) agonist (capsaicin 1 × 10(-5) M) and Group B-transcutaneous sensory electrical stimulation (TSES) (Intelect VitalStim, biphasic pulses, 300 μs, 80 Hz). Patients were analyzed for treatment response. Patients were old (80.47 ± 5.2 years), with comorbidities (3.11 ± 1.59 Charlson Index), polymedication (8.92 ± 3.31 drugs/patient), and mild functional impairment (86.84 ± 17.84 Barthel Index), and 28.9 % were at risk of malnutrition (MNA-sf). Overall, all patients had videofluoroscopic signs of impaired safety of swallow (ISS) with delayed oropharyngeal swallow response (OSR). After sensory stimulation, prevalence of ISS decreased to 68.42 % in both groups (P = 0.019).

There were 68.42 % responders in Group A (TRPV1) and 42.11 % in Group B (TSES). Group A responders showed an improvement in the penetration-aspiration scale (PAS, 5.23 ± 2.04 to 3 ± 1.47; P = 0.002), and the same was true for those of Group B (4.63 ± 1.41 to 2.13 ± 0.64; P = 0.007). 10-day sensory stimulation with either therapy improved safety of swallow and OSR in older patients with OD, reducing the severity of OD in a significant subgroup of these patients.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.754 Quartil: 2 Categoria: Otorhinolaryngology

Posició: 15/43

Newman R, Vilardell N, Clavé P, Speyer R. Effect of Bolus Viscosity on theSafety and Efficacy of Swallowing and the Kinematics of the Swallow Response inPatients with Oropharyngeal Dysphagia: White Paper by the European Society forSwallowing Disorders (ESSD). Dysphagia. 2016 Apr;31(2):232-49. doi:10.1007/s00455-016-9696-8.n PubMedPMID: 27016216; PubMed Central PMCID: PMC4929168

BACKGROUND: Fluid thickening is a well-established management strategy for oropharyngeal dysphagia (OD). However, the effects of thickening agents on the physiology of impaired swallow responses are not fully understood, and there is no agreement on the degree of bolus thickening.

AIM: To review the literature and to produce a white paper of the European Society for Swallowing Disorders (ESSD) describing the evidence in the literature on the effect that bolus modification has upon the physiology, efficacy and safety of swallowing in adults with OD.

METHODS: A systematic search was performed using the electronic Pubmed and Embase databases. Articles in English available up to July 2015 were considered. The inclusion criteria swallowing studies on adults over 18 years of age; healthy people or patients with oropharyngeal dysphagia; bolus modification; effects of bolus modification on swallow safety (penetration/aspiration) and efficacy; and/or physiology and original articles written in English. The exclusion criteria consisted of oesophageal dysphagia and conference abstracts or presentations. The quality of the selected papers and the level of research evidence were assessed by standard quality assessments.

RESULTS: At the end of the selection process, 33 articles were considered. The quality of all included studies was assessed using systematic, reproducible, and quantitative tools (Kmet and NHMRC) concluding that all the selected articles reached a valid level of evidence. The literature search gathered data from various sources, ranging from double-blind randomised control trials to systematic reviews focused on changes occurring in swallowing physiology caused by thickened fluids. Main results suggest that increasing bolus viscosity (a) results in increased safety of swallowing, (b) also results in increased amounts of oral and/or pharyngeal residue which may result in post-swallow airway invasion, (c) impacts the physiology with increased lingual pressure patterns, no major changes in impaired airway protection mechanisms, and controversial effects on oral and pharyngeal transit time, hyoid displacements, onset of UOS opening and bolus velocity-with several articles suggesting the therapeutic effect of thickeners is also due to intrinsic bolus properties, (d) reduces palatability of thickened fluids and (e) correlates with increased risk of dehydration and decreased quality of life although the severity of dysphagia may be an confounding factor.

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CONCLUSIONS: The ESSD concludes that there is evidence for increasing viscosity to reduce the risk of airway invasion and that it is a valid management strategy for OD. However, new thickening agents should be developed to avoid the negative effects of increasing viscosity on residue, palatability, and treatment compliance. New randomised controlled trials should establish the optimal viscosity level for each phenotype of dysphagic patients and descriptors, terminology and viscosity measurements must be standardised. This white paper is the first step towards the development of a clinical guideline on bolus modification for patients with oropharyngeal dysphagia.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.754 Quartil: 2 Categoria: Otorhinolaryngology

Posició: 15/43

Alvarez-Berdugo D, Rofes L, Casamitjana JF, Padrón A, Quer M, Clavé P.Oropharyngeal and laryngeal sensory innervation in the pathophysiology ofswallowing disorders and sensory stimulation treatments. Ann N Y Acad Sci. 2016Sep;1380(1):104-120. doi: 10.1111/nyas.13150. PubMed PMID: 27442852

Abstract: Oropharyngeal dysphagia (OD) affects older and neurological patients, causing malnutrition and dehydration and increasing the risk for aspiration pneumonia. There is evidence that sensory deficits in those populations are closely related to swallowing disorders, and several research groups are developing new therapies based on sensory stimulation of this area. More information on the sensory innervation participating in the swallow response is needed to better understand the pathophysiology of OD and to develop new treatments. This review focuses on the sensory innervation of the human oropharynx and larynx in healthy people compared with patients with swallowing disorders in order to unravel the abnormalities that may lead to the loss of sensitivity in patients with OD. We also hypothesize the pathway through which active sensory-enhancement treatments may elicit their therapeutic effect on patients with swallowing dysfunctions. As far as we know, this is the first time a review covers the anatomy, histology, ultrastructure, and molecular biology of the sensory innervation of the swallowing function.

Indexat a: Medline/WOS/JCR

Factor Impacte: 4.518 Quartil: 1 Categoria: Multidisciplinary Sciences

Posició: 8/63

Cabib C, Ortega O, Kumru H, Palomeras E, Vilardell N, Alvarez-Berdugo D,Muriana D, Rofes L, Terré R, Mearin F, Clavé P. Neurorehabilitation strategiesfor poststroke oropharyngeal dysphagia: from compensation to the recovery ofswallowing function. Ann N Y Acad Sci. 2016 Sep;1380(1):121-138. doi:10.1111/nyas.13135. PubMed PMID: 27398981

Abstract: Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition. The integrity of oropharyngeal-cortical afferent pathways can be assessed by electroencephalography through sensory-evoked potentials by pharyngeal electrical stimulation, while corticopharyngeal efferent pathways can be characterized by electromyography through motor-evoked potentials by transcranial magnetic stimulation. Dysfunction in both cortico-mediated evoked responses is associated with delayed swallow response and aspiration. Studies have reported hemispherical asymmetry on motor control of swallowing and the relevance of impaired oropharyngeal sensitivity on aspiration. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Characterization of poststroke OD is evolving from the assessment of impaired biomechanics to the sensorimotor integration processes involved in deglutition.

Treatment is also changing from compensatory strategies to promoting brain plasticity, both to recover swallow function and to improve brain-related swallowing dysfunction.

Medline/WOS/JCR

Factor Impacte: 4.518 Quartil: 1 Categoria: Multidisciplinary Sciences

Posició: 8/63

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Dziewas R, Beck AM, Clave P, Hamdy S, Heppner HJ, Langmore SE, Leischker A,Martino R, Pluschinski P, Roesler A, Shaker R, Warnecke T, Sieber CC, Volkert D, Wirth R. Recognizing the Importance of Dysphagia: Stumbling Blocks and SteppingStones in the Twenty-First Century. Dysphagia. 2016 Aug 29. [Epub ahead of print]PubMed PMID: 27571768

Abstract:The oropharyngeal swallow involves a rapid, highlycoordinated set of neuromuscular actions beginning withlip closure and terminating with opening of the upperesophageal sphincter. The central coordination of thiscomplex sensorimotor task uses a widespread network ofcortical, subcortical, and brainstem structures. Manydiseases and disorders affecting the central swallowingnetwork or downstream peripheral nerves, muscles, andstructures may result in an impaired oropharyngealswallow. In addition, aging is also associated with multifactorialchanges of swallowing physiology for whichthe term presbyphagia has been coined. Oropharyngealdysphagia broadly affects respiratory safety due to theincreased risk of aspiration, and swallowing efficacyleading to the impeding danger of insufficient nutritionand hydration.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.754 Quartil: 2 Categoria: Otorhinolaryngology

Posició: 15/43

Rofes L, Ortega O, Vilardell N, Mundet L, Clavé P. Spatiotemporalcharacteristics of the pharyngeal event-related potential in healthy subjects andolder patients with oropharyngeal dysfunction. Neurogastroenterol Motil. 2016 Aug2. doi: 10.1111/nmo.12916. [Epub ahead of print] PubMed PMID: 27485487

BACKGROUND: Oropharyngeal dysphagia (OD) is a highly prevalent symptom in older people. Appropriate oropharyngeal sensory feedback is essential for safe and efficient swallowing. However, pharyngeal sensitivity decreases with advancing age and could play a fundamental role in the physiopathology of swallowing dysfunction associated with aging. We aimed to characterize pharyngeal sensitivity and cortical response to a pharyngeal electrical stimulus in healthy volunteers (HV) and older patients with and without OD.

METHODS: Eight young HV, eight older HV without OD, and 14 older patients with OD were studied by electroencephalography through 32 scalp electrodes. Pharyngeal event-related potentials (ERP) were assessed following electrical stimulation of the pharynx. Sensory and tolerance thresholds to the electrical stimulus and latency, amplitude, and scalp current density of each ERP component were analyzed and compared. An ERP source localization study was also performed using the sLORETA software.

KEY RESULTS:Older participants (with and without OD) presented an increased sensory threshold to pharyngeal electrical stimulation (10.2 ± 1.7 mA and 11.5 ± 1.9 mA respectively), compared with young HV (6.0 ± 1.2 mA). The cortical activation of older HV in response to pharyngeal electrical stimulus was reduced compared with young HV (N2 amplitude: 0.22 ± 0.79 vs -3.10 ± 0.59, P<.05). Older patients with OD also presented disturbances to the pharyngo-cortical connection together with disrupted pattern of cortical activation.

CONCLUSIONS AND INFERENCES:Older people present a decline in pharyngeal sensory function, more severe in older patients with OD. This sensory impairment might be a critical pathophysiological element and a potential target for treatment of swallowing dysfunction in older patients.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.310 Quartil: 2 Categoria: Gastroenterology & Hepatology Posició: 26/79

Carrión S, Roca M, Costa A, Arreola V, Ortega O, Palomera E, Serra-Prat M,Cabré M, Clavé P. Nutritional status of older patients with oropharyngealdysphagia in a chronic versus an acute clinical situation. Clin Nutr. 2016 Jul26. pii: S02615614(16)30175-3. doi: 10.1016/j.clnu.2016.07.009. [Epub ahead ofprint] PubMed PMID: 27499393

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BACKGROUND: Oropharyngeal dysphagia (OD) is a prevalent risk factor for malnutrition (MN) in older patients and both conditions are related to poor outcome.

OBJECTIVE: To explore the nutritional status in older patients with OD in a chronic and an acute clinical situation.

DESIGN: We examined 95 older (≥70 years) patients with OD associated to chronic neurological diseases or aging, and 23 older patients with OD and acute community-acquired pneumonia (CAP) with videofluoroscopy; and 15 older people without OD. We collected nutritional status, measured with the Mini Nutritional Assessment (MNA®), anthropometric measurements, and biochemistry and bioimpedance for body composition. Functional status was assessed with the Barthel index.

RESULTS: 1) Taking into consideration patients with OD with chronic conditions, 51.1% presented a MNA® ≤23.5; 16.7%, sarcopenia and a) reduced visceral and muscular protein compartments and fat compartment; b) muscular weakness c) intracellular water depletion, and d) reduced body weight. Patients with OD and MNA® ≤23 needed higher levels of nectar viscosity for a safe swallow and had increased oropharyngeal residue at spoon-thick viscosity. 2) Patients with OD and CAP, 69.5%, presented an MNA® ≤23.5 and 29.4% sarcopenia, the inflammatory response of the pneumonia adding to the more severe depletion in visceral protein and muscular mass.

CONCLUSIONS: Prevalence of impaired nutritional status (malnutrition risk, and sarcopenia) among older patients with OD associated with either chronic or acute conditions is very high. In patients with OD and chronic diseases, poor nutritional status further impairs OD with an increase in oropharyngeal residue at spoon-thick viscosity. In the acute setting there is inflammation and an additional protein deficiency. These findings will help develop specific products both for OD and nutritional status in each specific clinical situation.

Indexat a: Medline/WOS/JCR

Factor Impacte: 4.487 Quartil: 1 Categoria: Nutrition & Dietetics

Posició: 10/80

Miarons M, Campins L, Palomera E, Serra-Prat M, Cabré M, Rofes L. Drugs Related to Oropharyngeal Dysphagia in Older People. Dysphagia. 2016 Oct;31(5):697-705. doi: 10.1007/s00455-016-9735-5. PubMed PMID: 27492407.

Abstract: Scientific evidence on the impact of medication on the physiology of swallowing is scarce and mainly based on clinical case reports. To evaluate the association between oropharyngeal dysphagia (OD) and chronic exposure to medication in older patients admitted to the acute geriatric unit (AGU) of a secondary hospital, we performed a retrospective cross-sectional study of 966 patients admitted to an AGU from 2008 to 2011. We reviewed (a) diagnosis of OD (assessed with the volume-viscosity swallow test, V- VST); (b) chronic patient medication classified by anatomical, therapeutic, chemical codes; and (c) demographic and clinical data. A univariate analysis was performed to determine which medications were associated with OD. A multivariate analysis adjusting for confounding clinical factors was performed to identify which of those medications were independently associated with OD. The age of patients included was 85.3 ± 6.37 years and 59.4 % were women. A total of 41.9 % presented OD. We found a possible protective effect of beta blocking agents on OD after the multivariate analysis (OR 0.54, 95 % CI 0.35-0.85). None of the categories of drugs was associated with an altered swallowing function after adjusting for confounding variables. The present study is the first one to widely investigate the association between drugs and OD, increasing understanding of their association. The role of beta blockers in OD needs to be further studied as their potentially beneficial effects on the swallowing function in older patients could help to prevent complications.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.754 Quartil: 2 Categoria: Otorhinolaryngology

Posició: 15/43

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Publicacions Científiques CSDM 2016

Bath PM, Scutt P, Love J, Clavé P, Cohen D, Dziewas R, Iversen HK, Ledl C,Ragab S, Soda H, Warusevitane A, Woisard V, Hamdy S; Swallowing Treatment UsingPharyngeal Electrical Stimulation (STEPS) Trial Investigators.. PharyngealElectrical Stimulation for Treatment of Dysphagia in Subacute Stroke: ARandomized Controlled Trial. Stroke. 2016 Jun;47(6):156270. doi:10.1161/STROKEAHA.115.012455. PubMed PMID: 27165955; PubMed Central PMCID:PMC4878285

BACKGROUND AND PURPOSE: Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials.

METHODS: We randomly assigned 162 patients with a recent ischemic or hemorrhagic stroke and dysphagia, defined as a penetration aspiration score (PAS) of ≥3 on video fluoroscopy, to PES or sham treatment given on 3 consecutive days. The primary outcome was swallowing safety, assessed using the PAS, at 2 weeks. Secondary outcomes included dysphagia severity, function, quality of life, and serious adverse events at 6 and 12 weeks.

RESULTS: In randomized patients, the mean age was 74 years, male 58%, ischemic stroke 89%, and PAS 4.8. The mean treatment current was 14.8 (7.9) mA and duration 9.9 (1.2) minutes per session. On the basis of previous data, 45 patients (58.4%) randomized to PES seemed to receive suboptimal stimulation. The PAS at 2 weeks, adjusted for baseline, did not differ between the randomized groups: PES 3.7 (2.0) versus sham 3.6 (1.9), P=0.60. Similarly, the secondary outcomes did not differ, including clinical swallowing and functional outcome. No serious adverse device-related events occurred.

CONCLUSIONS: In patients with subacute stroke and dysphagia, PES was safe but did not improve dysphagia.

Undertreatment of patients receiving PES may have contributed to the neutral result.

CLINICAL TRIAL REGISTRATION: URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25681641.

Indexat a: Medline/WOS/JCR Factor Impacte: 5.787

Quartil: 1

Categoria: Pheripheral Vascular diseases

Posició: 5/63

Gallego D, Ortega O, Arenas C, López I, Mans E, Clavé P. The effect oflevosulpiride on in vitro motor patterns in the human gastric fundus, antrum, andjejunum. Neurogastroenterol Motil. 2016 Jun;28(6):879-90. doi: 10.1111/nmo.12788.PubMed PMID: 26842870.

BACKGROUND: Levosulpiride is a 5HT4 agonist/D2 antagonist prokinetic agent used to improve gastric emptying in patients with functional dyspepsia or gastroparesis. The aim of this study was to characterize its effect on the main in vitro motility patterns in the human fundus, antrum, and jejunum.

METHODS:Circular muscle strips from human stomach (antrum and fundus) and jejunum, obtained from 46 patients undergoing bariatric surgery, were studied using organ baths. Enteric motor neurons (EMNs) were stimulated by electrical field stimulation (EFS).

KEY RESULTS:Levosulpiride, caused an increase in the EFS-induced cholinergic contractions in the gastric antrum (+37 ± 15.18% at 100 μM, pEC50 = 4.46 ± 0.14; p < 0.05, n = 8) and jejunum (+45.4 ± 22.03% at 100 μM, pEC50 = 3.78 ± 6.81; p < 0.05, n = 5), but not in the gastric fundus. It also caused a slight decrease in tone and frequency of spontaneous contractions in the jejunum, but did not have any major effect on tone or spontaneous contractions in the stomach. It did not have any effect on EFS-induced relaxations mediated by nitric oxide (NO) in the stomach (antrum and fundus) and by NO and ATP in the jejunum.

CONCLUSIONS & INFERENCES:Our results suggest that the prokinetic effects of levosulpiride in humans are mainly due to the facilitation of the release of acetylcholine by enteric motor neurons in the gastric antrum and the jejunum.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.310 Quartil: 2 Categoria: Gastroenterology & Hepatology Posició: 26/79 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2016

Wirth R, Dziewas R, Beck AM, Clavé P, Hamdy S, Heppner HJ, Langmore S,Leischker AH, Martino R, Pluschinski P, Rösler A, Shaker R, Warnecke T, SieberCC, Volkert D. Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting.Clin Interv Aging. 2016 Feb 23;11:189208. doi: 10.2147/CIA.S97481. Review.PubMed PMID: 26966356; PubMed Central PMCID: PMC4770066.

Abstract:Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.133 Quartil: 3 Categoria: Geriatrics & Gerontology

Posició: 28/49

Baijens LW, Clavé P, Cras P, Ekberg O, Forster A, Kolb GF, Leners JC, Masiero S, Mateos-Nozal J, Ortega O, Smithard DG, Speyer R, Walshe M. European Society for Swallowing Disorders - European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016 Oct 7;11:1403-1428. Review. PubMed PMID: 27785002; PubMed Central PMCID: PMC5063605.

Abstract: This position document has been developed by the Dysphagia Working Group, a committee of members from the European Society for Swallowing Disorders and the European Union Geriatric Medicine Society, and invited experts. It consists of 12 sections that cover all aspects of clinical management of oropharyngeal dysphagia (OD) related to geriatric medicine and discusses prevalence, quality of life, and legal and ethical issues, as well as health economics and social burden. OD constitutes impaired or uncomfortable transit of food or liquids from the oral cavity to the esophagus, and it is included in the World Health Organization's classification of diseases. It can cause severe complications such as malnutrition, dehydration, respiratory infections, aspiration pneumonia, and increased readmissions, institutionalization, and morbimortality. OD is a prevalent and serious problem among all phenotypes of older patients as oropharyngeal swallow response is impaired in older people and can cause aspiration. Despite its prevalence and severity, OD is still underdiagnosed and untreated in many medical centers. There are several validated clinical and instrumental methods (videofluoroscopy and fiberoptic endoscopic evaluation of swallowing) to diagnose OD, and treatment is mainly based on compensatory measures, although new treatments to stimulate the oropharyngeal swallow response are under research.

OD matches the definition of a geriatric syndrome as it is highly prevalent among older people, is caused by multiple factors, is associated with several comorbidities and poor prognosis, and needs a multidimensional approach to be treated.

OD should be given more importance and attention and thus be included in all standard screening protocols, treated, and regularly monitored to prevent its main complications. More research is needed to develop and standardize new treatments and management protocols for older patients with OD, which is a challenging mission for our societies.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.133 Quartil: 3 Categoria: Geriatrics & Gerontology

Posició: 28/49

López-de-Ipiña K, Satue-Villar A, Faundez-Sanuy M, Arreola V, Ortega O, Clavé P, Sanz-Cartagena MP, Mekyska J, Calvo P.Advances in a Multimodal Approach for Dysphagia Analysis Based on Automatic Voice Analysis in Advances in Neural Networks. Volume 54 of the series Smart Innovation, Systems and Technologies, 2016:201-211

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Publicacions Científiques CSDM 2016

Abstract:Parkinson’s disease (PD) is the second most frequent neurodegenerative disease with prevalence among general population reaching 0.1–1 %, and an annual incidence between 1.3–2.0/10,000 inhabitants. The most obvious symptoms are movement-related such as tremor, rigidity, slowness of movement and walking difficulties and frequently these are the symptoms that lead to the PD diagnoses but also they could have In this sense voice analysis is a safe, non-invasive, and reliable screening procedure for PD patients with dysphagia, which could detect patients at high risk of clinically significant aspiration. In this paper we will present a part of an ongoing project that will evaluate automatic speech analysis based on linear and non-linear features. These can be reliable predictors/indicators of swallowing and balance impairments in PD. An important advantage of voice analysis is its low intrusiveness and easy implementation in clinical practice. Thus, if a significant correlation between these simple analyses and the gold standard video-fluoroscopic analysis will imply simpler and less stressing diagnostic test for the patients as well as the use of cheaper analysis systems.

CIRURGIA ORTOPÈDICA i TRAUMA– ORTHOPEDIC SURGERY

Nº Articles indexats: 3

Factor Impacte total: 11.122 Factor d’impacte mig per article: 3.707

Pueyo-Sánchez MJ, Larrosa M, Suris X, Casado E, Auleda J, Fusté J, Ortún V. Secular trend in the incidence of hip fracture in Catalonia, Spain, 2003-2014. Age Ageing. 2016 Nov 3. [Epub ahead of print] PubMed PMID: 27810855.

OBJECTIVES: to describe the secular trend and seasonal variation in the incidence of hip fracture (HF) over 12 years (20032014) in Catalonia, the community with the highest incidence of HF in Spain.

METHODS: data about age, gender, type of fracture and month of hospitalisation among patients aged 65 years and older discharged with a diagnosis of HF were collected. Crude and age-standardised annual incidence rate were reckoned. To analyse HF trend, the age/sex-adjusted average annual change in incidence (incidence rate ratio, IRR) was calculated.

RESULTS: we identified 100,110 HF in the period, with an increase of 16.9% (women 13.4%; men 28.4%). Trochanteric fractures were the most frequent (55.8%). The crude incidence rate (per 100,000 population) decreased from 677.2 (95% confidence interval (95% CI) 662.0-692.7) to 657.6 (95% CI 644.0-671.5). The standardised incidence rate decreased from 754.0 (95% CI 738.6-769.3) to 641.5 (95% CI 627.7-655.3), with a sharp decrease in women (-16.8%) while it was stable in men. The incidence by type of fracture was stable. The trend throughout the period showed a slight decrease with IRR 0.99 (95% CI 0.98-0.99; P = 0.025). The incidence was stable in the oldest group (+85 years), while there was a downward trend in the younger groups. A significant seasonal pattern was observed, with more cases in winter and less in summer (spring as reference).

CONCLUSIONS: the secular trend reveals a decreasing incidence of HF although the absolute number has increased in the last 12 years in Catalonia. Trochanteric fractures were the most prevalent and a seasonal pattern was observed, with more cases in winter.

Indexat a: Medline/WOS/JCR

Factor Impacte: 4.201 Quartil: 1 Categoria: Geriatrics & Gerontology

Posició: 7/49

Golanó P, Vega J, de Leeuw PA, Malagelada F, Manzanares MC, Götzens V, van Dijk CN. Anatomy of the ankle ligaments: a pictorial essay. Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):944-56. doi: 10.1007/s00167-016-4059-4. PubMed PMID: 27052302

Abstract: Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail.

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2016

Indexat a: Medline/WOS/JCR Factor Impacte: 3.097

Quartil: 1

Categoria: Orthopedics

Posició: 7/74

Guerrero-Ludueña RE, Comas M, Espallargues M, Coll M, Pons M, Sabatés S, Allepuz A, Castells X. Predicting the Burden of Revision Knee Arthroplasty: Simulation of a 20-Year Horizon. Value Health. 2016 Jul-Aug;19(5):680-7. doi: 10.1016/j.jval.2016.02.018. PubMed PMID: 27565286

OBJECTIVES: To estimate future utilization scenarios for knee arthroplasty (KA) revision in the Spanish National Health System in the short- and long-term and their impact on primary KA utilization.

METHODS: A discrete-event simulation model was built to represent KA utilization for 20 years (2012-2031) in the Spanish National Health System. Data on KA utilization from 1997 to 2011 were obtained from the minimum data set. Three scenarios of future utilization of primary KA (1, fixed number since 2011; 2, fixed age- and sex-adjusted rates since 2011; and 3, projection using a linear regression model) were combined with two prosthesis survival functions (W [worse survival], from a study including primary KA from 1995 to 2000; and B [better survival], from the Catalan Registry of Arthroplasty, including primary KA from 2005 to 2013). The simulation results were analyzed in the short-term (2015) and the long-term (2030).

RESULTS: Variations in the number of revisions depended on both the primary utilization rate and the survival function applied, ranging from increases of 8.3% to 31.6% in the short- term and from 38.3% to 176.9% in the long-term, corresponding to scenarios 1-B and 3-W, respectively. The prediction of increases in overall surgeries ranged from 0.1% to 22.3% in the short-term and from 3.7% to 98.2% in the long-term.

CONCLUSIONS: Projections of the burden of KA provide a quantitative basis for future policy decisions on the concentration of high-complexity procedures, the number of orthopedic surgeons required to perform these procedures, and the resources needed.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.824 Quartil: 1 Categoria: Health Care Sciences & Services Posició: 10/88

REHABILITACIÓ - PHYSICAL MEDICINE & REHABILITATION Nº Articles indexats: 4 Factor Impacte total: 3.860 Factor d’impacte mig per article: 0.965

Guirao L, Samitier CB, Costea M, Camos JM, Majo M, Pleguezuelos E. Improvement in walking abilities in transfemoral amputees with a distal weight bearing implant. Prosthet Orthot Int. 2016 Apr 6. pii: 0309364616633920. [Epub ahead of print] PubMed PMID: 27052274.

BACKGROUND: The ability to walk with a prosthesis is the main objective of rehabilitation following amputation, and distance and speed of walking achieved are considered determining factors in amputees' perception of quality-of-life.

OBJECTIVES: To assess walking abilities and improvement in gait distance and speed parameters in patients undergoing transfemoral amputation with a femoral implant that allows distal support of the residuum.

STUDY DESIGN: Experimental before-and-after study.

METHODS: Ten transfemoral amputation patients received a titanium implant that allowed distal weight bearing of the residuum within the socket. The post-intervention follow-up period was 14 months. We evaluated the functionality using a 2-min walk test and the physiological cost index.

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Publicacions Científiques CSDM 2016

RESULTS: The etiology of amputation was traumatic in six patients (60%). The mean 2-min walk test score was 98.4 ± 19.5 m prior to the femoral implant and 122.5 ± 26.1 m at 14 months (p < 0.008), representing an improvement of 24.5%. The mean gait speed prior to the femoral implant was 0.82 ± 0.16 and 1.02 ± 0.21 m/s at 14 months (p < 0.008). The physiological cost index showed no differences (p < 0.55).

CONCLUSION: The results of this study show an improvement in the distance walked and gait speed in amputees 14 months after having received a femoral implant.

CLINICAL RELEVANCE: This article provides additional insight into the use of a femoral implant that allows distal support of the residuum to improve walking abilities and gait distance and speed parameters in patients undergoing transfemoral amputation, mainly those of vascular origin.

Indexat a: Medline/WOS/JCR Factor Impacte: 0.930 Quartil: 3 Categoria: Orthopedics

Posició: 53/74

Pleguezuelos E, Esquinas C, Moreno E, Guirao L, Ortiz J, Garcia-Alsina J, Merí A, Miravitlles M. Muscular Dysfunction in COPD: Systemic Effect or Deconditioning? Lung. 2016 Apr;194(2):249-57. doi: 10.1007/s00408-015-9838-z. PubMed PMID: 26743191.

BACKGROUND: Muscular dysfunction has been described as one of the systemic manifestations of chronic obstructive pulmonary disease (COPD).

OBJECTIVE: The aim of this study was to evaluate muscular strength of the different anatomical compartments in patients with severe COPD compared with healthy controls.

METHOD: We performed a cross-sectional study in patients with severe COPD. We evaluated the muscular strength of the respiratory muscles, flexors and extensors of the cervical spine and knee, as well as handgrip force. The 6-min walking test (6MWT) and serum inflammatory markers were also analysed.

RESULTS: Twenty-eight male patients with COPD (mean age 67.8 years, mean FEV1 (%) 39 %) and 24 male healthy controls (mean age 70.2 years) were studied. The strength of the flexors and extensors of the knee was significantly reduced in patients with COPD (p < 0.001 and p = 0.003). No differences were observed in the flexors and extensors of the cervical spine and handgrip force between groups. No correlation was observed between the muscular strength in the different anatomic compartments and the concentrations of blood inflammatory biomarkers or the metres walked in the 6MWT in COPD patients. However, a significant negative linear correlation was observed between the 6MWT and IL-6 and IL-8 levels (rho = -0.67, p = 0.001; rho = -0.57, p = 0.008). In addition, we found a negative correlation between the 6MWT and inspiratory capacity (rho = -0.755, p = 0.031).

CONCLUSIONS: Our results suggest that muscular dysfunction in patients with COPD differs in different muscular compartments. The main factor for a reduced exercise capacity was a reduction in inspiratory capacity.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.000 Quartil: 3 Categoria: Respiratory System

Posició: 37/58

Samitier CB, Guirao L, Costea M, Camós JM, Pleguezuelos E. The benefits ofusing a vacuum-assisted socket system to improve balance and gait in elderlytranstibial amputees. Prosthet Orthot Int. 2016 Feb;40(1):83-8. doi:10.1177/0309364614546927. Erratum in: Prosthet Orthot Int. 2016 Aug;40(4):NP2.PubMed PMID: 25261489.

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2016

BACKGROUND: Lower limb amputation leads to impaired balance, ambulation, and transfers. Proper fit of the prosthesis is a determining factor for successful ambulation. Vacuum-assisted socket systems extract air from the socket, which decreases pistoning and probability of soft-tissue injuries and increases proprioception and socket comfort.

OBJECTIVES: To investigate the effect of vacuum-assisted socket system on transtibial amputees' performance-based and perceived balance, transfers, and gait.

STUDY DESIGN: Quasi-experimental before-and-after study.

METHODS: Subjects were initially assessed using their prosthesis with the regular socket and re-evaluated 4 weeks after fitting including the vacuum-assisted socket system. We evaluated the mobility grade using Medicare Functional Classification Level, Berg Balance Scale, Four Square Step Test, Timed Up and Go Test, the 6-Min Walk Test, the Locomotor Capabilities Index, Satisfaction with Prosthesis (SAT-PRO questionnaire), and Houghton Scale.

RESULTS: A total of 16 unilateral transtibial dysvascular amputees, mean age 65.12 (standard deviation = 10.15) years.

Using the vacuum-assisted socket system, the patients significantly improved in balance, gait, and transfers: scores of the Berg Balance Scale increased from 45.75 (standard deviation = 6.91) to 49.06 (standard deviation = 5.62) (p < 0.01), Four Square Step Test decreased from 18.18 (standard deviation = 3.84) s to 14.97 (3.9) s (p < 0.01), Timed Up and Go Test decreased from 14.3 (standard deviation = 3.29) s to 11.56 (2.46) s (p < 0.01). The distance walked in the 6-Min Walk Test increased from 288.53 (standard deviation = 59.57) m to 321.38 (standard deviation = 72.81) m (p < 0.01).

CONCLUSION: Vacuum-assisted socket systems are useful for improving balance, gait, and transfers in over-50-year-old dysvascular transtibial amputees.

CLINICAL RELEVANCE: This study gives more insight into the use of vacuum-assisted socket systems to improve elderly transtibial dysvascular amputees' functionality and decrease their risk of falls. The use of an additional distal valve in the socket should be considered in patients with a lower activity level.

Indexat a: Medline/WOS/JCR

Factor Impacte: 0.930 Quartil: 3 Categoria: Orthopedics

Posició: 53/74

Guirao Cano L. Improvement of walking abilities in femoral amputees with adistal weight bearing implant. Ann Phys Rehabil Med. 2016 Sep;59S:e27-e28. doi:10.1016/j.rehab.2016.07.064. PubMed PMID: 27676884.

OBJECTIVE:Following a transfemoral (TF) amputation, the ability to walk with a prosthesis is the main objective of rehabilitation. The achieved speed of walking is considered a determining factor in the amputee's perception of quality of life. This experimental before-after study evaluates the walking abilities and improvement of important parameters such as gait, walking speed, pain and hours of prosthesis use in transfemoral amputees after placing a novel femoral implant that permits distal weight bearing of the residuum within a socket, adapted for distal load bearing.

MATERIAL AND METHODS:Thirty TF amputees with an amputee history of more than 12 months received an all-inside femoral implant, comprised of a femoral stem and a polyethylene spacer that allows distal load of the residuum within an adapted socket. The post-intervention follow-up period was 14 months. The applied rehabilitation schedule was our standard one, and no hardware changes were allowed during the follow-up period of 14 months, except for the adapted socket. Functionality was evaluated using the standard 2-minute walk test (2MWT) and the physiological cost index (PCI).

RESULTS:To date 19 patients (8 trauma, 8 vascular and 3 tumour patients) have finished the follow-up period. Prior to the implant placement the mean 2MWT covered distance was 103.16m (SD=33.03), and at 14 months was 124.95m (SD=39.22), (P=0.00); an increase of 21.1%. The initial mean Visual Analogue Pain (VAS) score was 2.26 (SD=2.76) and at 14 months 0.42 (SD=0.77), (P<0.005), a reduction of 81.4%. The PCI reduction (D heart rate/walking speed) was not statistically significant (P<0.596). The observed increase of oxygen consumption in the vascular group (+20.15%) also indicates an additional beneficial general health improvement for this type of patients.

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Publicacions Científiques CSDM 2016

DISCUSSION/CONCLUSION: The results of the present study show significant improvements in walking speed, pain reduction, hours of prosthesis use and general health status at 14 months after having received a femoral distal load implant in patients of different ethiology.

Indexat a: Medline

Guirao L, Samitier CB, Monago-Fernandez M, Alos J, Tibau R, Maldonado D, Rodriguez-Piñero M, Exposito-Tirado JA, Pleguezuelos E. Mejora de la distancia y velocidad de la marcha en amputados femorales con un implante de carga distal. Rev TOI. Técnica Ortopédica Internacional. 2016;4(4):5-11.

Antecedentes:La preservación de los cóndilos femorales en los pacientes desarticulados de rodilla (KDA) facilita el apoyo distal en el encaje, a diferencia de lo que ocurre con los pacientes transfemorales (TFA). Además el nivel KDA permite la transferencia directa de las cargas de apoyo a través del muñón residual por la conservación de los cóndilos femorales y, consecuentemente incrementa la independencia en la marcha y disminuye el consumo energético comparado con los TFA. La adaptación de un encaje que permita el apoyo distal del muñón y las trasmisión directa del peso es uno de los principales factores por los que los amputados KDA presentan mayor capacidad de marcha que los TFA, siendo que la capacidad de marcha, mejorar la distancia recorrida y la velocidad, se considera uno de los principales objetivos de la rehabilitación tras sufrir una amputación.

Objetivo:Evaluar la mejora en la distancia de la marcha y velocidad de marcha en pacientes sometidos a una amputación TFA, con un implante femoral que permita el apoyo distal del muñón.

Diseño del estudio:Estudio experimental antes-después.

Método:Diecinueve pacientes TFA recibieron un implante de titanio que permite el apoyo distal del muñón en el encaje. El seguimiento posterior alimplante fue de 14 meses. Se evaluaron la distancia recorrida y velocidad de marcha usando el 2 Minute Walk Test (2MWT)

Resultados:La etiología de la amputación era traumàtica en 8 pacientes (42,1%), enfermedad vascular periférica en 8 pacientes (42,1%) y debido a causas oncológicas en 3 (15,8%). La media del valor del2MWT era de 103,16±33,03 m antes del implante femoral y de 124,95±39,22 m a 14 meses post-implante (p<0,001), lo que representa una mejora del 21, 12%.

La media de la velocidad de marcha antes del implante era de 0,85±0,27 m/s y de 1,04±0,32 m/s a los 14 meses de la implantación (p<0,001).

Conclusión: Los resultados del presente estudio muestran una mejora en la distancia andada y en la velocidad de marcha en amputados TFA, 14 meses después de haber recibido un implante femoral que permite la carga distal del muñón.

Nº Articles indexats: 14

PSIQUIATRIA - PSYCHIATRY

Factor Impacte total: 33.077 Factor d’impacte mig per article: 2.362

Frias A, Palma C,Farriols N, Gonzalez L, Horta A. Anxious adult attachment may mediate the relationship between childhood emotional abuse and borderline personality disorder. Personal Ment Health. 2016 Nov;10(4):274-284. doi: 10.1002/pmh.1348. PubMed PMID: 27604841.

BACKGROUND: Childhood trauma has been associated with borderline personality disorder (BPD). However, research has not yet provided conclusive evidence concerning the mediating mechanisms.

METHODS: Seventy women diagnosed with BPD were compared with other 60 women who met DSM-IV criteria for other personality disorders on measures of childhood trauma and attachment.

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RESULTS: Patients with BPD reported higher severity of emotional, physical and sexual abuse than patients with other personality disorders. Moreover, BPD patients also showed greater preoccupied-anxious adult attachment. At model 1, logistic regression analysis revealed that only childhood emotional abuse predicted the occurrence of BPD. At model 2, this association was no longer significant, and the addition of preoccupied-anxious adult attachment was significantly associated with a greater likelihood of BPD diagnosis.

CONCLUSIONS: These findings support a specific relationship between childhood emotional abuse and the occurrence of BPD, which may be accounted for by preoccupied-anxious adult attachment.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.400 Quartil: 3 Categoria:Psychology, Social

Posició: 34/62

Frías Á, Baltasar I, Birmaher B. Comorbidity between bipolar disorder and borderline personality disorder: Prevalence, explanatory theories, and clinical impact. J Affect Disord. 2016 Sep 15;202:210-9. doi: 10.1016/j.jad.2016.05.048. Review.

PubMed PMID: 27267293.

BACKGROUND: The relationship between bipolar disorder (BD) and borderline personality disorder (BPD) has been controversial and widely debated. Specifically, the comorbidity between both disorders has yielded a plethora of research, but there are no comprehensive reviews on this issue.

OBJECTIVE: To determine the empirical evidence regarding the comorbidity between BD and BPD based on prevalence data, explanatory theories for their co-occurrence, and clinical impact of one disorder in the other.

METHOD: A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between January 1985 and August 2015 were identified. Overall, 70 studies fulfilled inclusion criteria.

RESULTS: Over a fifth of subjects showed comorbidity between BPD and BD. Empirical evidence from common underlying factors was inconclusive, but BPD appears to be a risk factor for BD. Data also indicated that the negative impact of BPD in BD (e.g., suicidality, worse mood course) was greater than vice verse.

CONCLUSIONS: Given the high prevalence of comorbidity between BD and BPD and the negative effects of BPD in subjects with BD, further studies are needed to clarify the factor associated with the comorbidity between these two disorders. This information is important to develop appropriate treatments for subjects with both disorders, improve their clinical course, and prevent the increased risk of suicidality commonly found in these subjects.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.570 Quartil: 1 Categoria:Psychiatry

Posició: 37/142

Frías Á, González L, Palma C, Farriols N. Is There a Relationship Between Borderline Personality Disorder and Sexual Masochism in Women? Arch Sex Behav. 2016 Sep 6. [Epub ahead of print] PubMed PMID: 27600835.

Abstract: Sexual masochism disorder is considered the most prevalent paraphilia among women. However, little is known about the etiology and clinical correlates involved in this disorder. We aimed at addressing this issue through a potentially high-risk clinical cohort. This case-control study consisted of 60 women who met DSM-IV criteria for borderline personality disorder (BPD) and 60 women with other personality disorders. For both groups, sexual masochism disorder comorbidity was assessed through the Structured Clinical Interview, Sexual Disorders Module. Several etiological, psychosexual, and personality features were measured. Sexual masochism disorder was 10 times higher in BPD women than in women with other personality disorders (10 vs. 0 %). Among BPD women, those with sexual masochism disorder reported more child sexual abuse, more hostile/dismissing attachments, higher sensation seeking, and more frequently exploratory/impersonal sexual fantasies than BPD without sexual masochism. Correlation analysis confirmed a significant positive relationship between disinhibition and sexual masochism severity for BPD women. Our findings point out that BPD women may represent a high-risk cohort, especially those with higher disinhibition and detached attachment. Childhood sexual abuse Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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may also play a predispositional role on this comorbidity. Further research may help to elucidate the intriguing relationship between both disorders.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.704 Quartil: 1 Categoria:Social Sciences, Interdisciplinary Posició: 3/95

Feixas G, Bados A, García-Grau E, Paz C, Montesano A, Compaña V, Salla M, Aguilera M, Trujillo A, Cañete J, MedeirosFerreira L, Soriano J, Ibarra M, Medina JC, Ortíz E, Lana F. A DILEMMA-FOCUSED INTERVENTION FOR DEPRESSION: A MULTICENTER, RANDOMIZED CONTROLLED TRIAL WITH A 3-MONTH FOLLOW-UP. Depress Anxiety. 2016 Sep;33(9):862-9. doi: 10.1002/da.22510. PubMed PMID: 27103215; PubMed Central PMCID: PMC5074295.

BACKGROUND: Since long ago it has been asserted that internal conflicts are relevant to the understanding and treatment of mental disorders, but little research has been conducted to support the claim. The aim of this study was to test the differential efficacy of group cognitive behavioral therapy (CBT) plus an intervention focused on the dilemma(s) detected for each patient versus group individual CBT plus individual CBT for treating depression. A comparative controlled trial with a 3-month follow-up was conducted.

METHODS: One hundred twenty-eight adults meeting criteria for MDD and/or dysthymia, presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct, assessed by the repertory grid technique) and who had completed seven sessions of group CBT were randomly assigned to eight sessions of individual manualized CBT or dilemma-focused therapy (DFT). The Beck Depression Inventory-II was administered at baseline, at the end of therapy and after 3 months' follow-up.

RESULTS: Multilevel mixed effects modeling yielded no significant differences between CBT and DFT with the intention-totreat sample. Equivalent effect sizes, remission, and response rates were found with completers as well. In combination with group CBT, both individual CBT and DFT significantly reduced depressive symptoms.

CONCLUSIONS: Both conditions obtained comparable results to those in the literature. Thus, the superiority of the adjunctive DFT was not demonstrated. Working with dilemmas can be seen as a promising additional target in the psychotherapy of depression, but further research is still required.

Indexat a: Medline/WOS/JCR

Factor Impacte: 5.004 Quartil: 1 Categoria: Psychiatry

Posició: 19/142

Frías Á, Palma C, Farriols N, González L. Sexuality-related issues in borderline personality disorder: A comprehensive review. Personal Ment Health. 2016 Aug;10(3):216-31. doi: 10.1002/pmh.1330. PubMed PMID: 26840032.

OBJECTIVE: Sexuality is somewhat neglected in clinical research on borderline personality disorder (BPD).

METHOD: We performed a systematic review from 1980 to November 2014 through PubMed and PsycINFO. RESULTS: Empirical evidence underscores that childhood sexual trauma may be considered a non-specific risk factor for BPD. Furthermore, individuals with BPD also display higher sexual identity disturbances and homosexual relationships than non-BPD individuals. Moreover, patients with BPD also exhibit higher sexual impulsivity than non-BPD. In addition, sexual risk behaviours among individuals with BPD are related to increased rates of sexually transmitted diseases, unwanted pregnancies, rape and commercial sexual relationships, especially among drug abusers. Although psychotherapy is widely recommended for BPD, there has been little systematic research on the effect of these treatments with respect to comorbid post-traumatic symptoms related to childhood sexual trauma.

CONCLUSIONS: Sexuality-related issues represent a major clinical topic within this population. Findings are discussed concerning their methodological limitations and clinical implications.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.400 Quartil: 3 Categoria: Psychology, Social

Posició: 34/62

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Trujillo A, Feixas G, Bados A, García-Grau E, Salla M, Medina JC, Montesano A, Soriano J, Medeiros-Ferreira L, Cañete J, Corbella S, Grau A, Lana F, Evans C. Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation - Outcome Measure. Neuropsychiatr Dis Treat. 2016 Jun 21;12:1457-66. doi: 10.2147/NDT.S103079. PubMed PMID: 27382288; PubMed Central PMCID: PMC4922811.

OBJECTIVE: The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation - Outcome Measure, a 34-item self-report questionnaire that measures the client's status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk.

METHOD: Six hundred and forty-four adult participants were included in two samples: the clinical sample (n=192) from different mental health and primary care centers; and the nonclinical sample (n=452), which included a student and a community sample.

RESULTS: The questionnaire showed good acceptability and internal consistency, appropriate test-retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with UK referential data.

Cutoff scores were calculated for clinical significant change assessment.

CONCLUSION: The Spanish version of the Clinical Outcomes in Routine Evaluation - Outcome Measure showed acceptable psychometric properties, providing support for using the questionnaire for monitoring the progress of Spanish-speaking psychotherapy clients.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.867 Quartil: 3 Categoria: Psychiatry

Posició: 86/142

Frías Ibáñez Á, González Vallespí L, Palma Sevillano C, Farriols Hernando N. Motivation for change as a predictor of treatment response for dysthymia. Psicothema. 2016 May;28(2):156-60. doi:10.7334/psicothema2015.211. PubMed PMID: 27112812.

OBJECTIVE: Dysthymia constitutes a chronic, mild affective disorder characterized by heterogeneous treatment effects.

Several predictors of clinical response and attendance have been postulated, although research on the role of the psychological variables involved in this mental disorder is still scarce.

METHOD: Fifty-four adult patients, who met criteria for dysthymia completed an ongoing naturalistic treatment based on the brief interpersonal psychotherapy (IPT-B), which was delivered bimonthly over 16 months. As potential predictor variables, the therapeutic alliance, coping strategies, perceived self-efficacy, and motivation for change were measured at baseline. Outcome variables were response to treatment (Clinical Global Impression and Beck&rsquo;s Depression Inventory) and treatment attendance.

RESULTS: Stepwise multiple linear regression analyses revealed that higher motivation for change predicted better response to treatment. Moreover, higher motivation for change also predicted treatment attendance. Therapeutic alliance was not a predictor variable of neither clinical response nor treatment attendance.

CONCLUSIONS: These preliminary findings support the adjunctive use of motivational interviewing (MI) techniques in the treatment of dysthymia. Further research with larger sample size and follow-up assessment is warranted.

Indexat a: WOS/JCR

Factor Impacte:1.245 Quartil: 2 Categoria: Psychology, Multidisciplinary Posició: 57/129

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Contreras Narváez C, Mola Gilbert M, Batlle de Santiago E, Bigas Farreres J, Giné Serven E, Cañete Crespillo J. Cannabinoid hyperemesis syndrome. A report of six new cases and a summary of previous reports. Adicciones. 2016 Mar 2;28(2):90-8. doi: 10.20882/adicciones.776. English, Spanish. PubMed PMID:26990261.

Abstract: Cannabinoid hyperemesis syndrome (CHS) is a medical condition which was identified for the first time in 2004 and affects chronic users of cannabis. It is characterized by cyclic episodes of uncontrollable vomiting as well as compulsive bathing in hot water. The episodes have a duration of two to four days. The vomiting is recognizable by a lack of response to regular antiemetic treatment, and subsides only with cannabis abstinence, reappearing in periods of consumption of this substance. The etiology of this syndrome is unknown. Up until June 2014, 83 cases of CHS were published worldwide, four of them in Spain.The first patient of CHS at Mataró Hospital was diagnosed in 2012. Since then, five new cases have been identified. The average duration between the onset of acute CHS episodes and diagnosis is 6.1 years, similar to that observed in previously published cases, an average of 3.1 years. This "delay" of CHS diagnosis demonstrates a lack of awareness with respect to this medical condition in the healthcare profession.With the objective of providing information concerning CHS and facilitating its timely diagnosis, a series of six new cases of CHS diagnosed in Mataró Hospital is presented along with a summary of cases published between 2004 and June 2014.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.780 Quartil: 4 Categoria: Substance Abuse

Posició: 15/18

Petry NM, Rehbein F, Gentile DA, Lemmens JS, Rumpf HJ, Mößle T, Bischof G, TaoR, Fung DS, Borges G, Auriacombe M, González-Ibáñez A, Tam P, O'Brien CP.Griffiths et al.'s comments on the international consensus statement of internet gaming disorder: furthering consensus or hindering progress? Addiction. 2016Jan;111(1):175-8. doi: 10.1111/add.13189.

PubMed PMID: 26669531.

Our recent paper [Petry N. M., Rehbein F., Gentile D., Lemmens J., Rumpf H. J., Mößle T. et al. An international consensus for assessing internet gaming disorder using the new DSM-5 approach. Addiction 2014; 109: 1399–406.] outlined the DSM-5 criteria for internet gaming disorder (IGD), and Griffiths et al. [Griffiths M. D., Van Rooij A., Kardefelt-Winther D., StarcevicV., Király O., Pallesen O. et al. Working towards an international consensus on criteria for assessing Internet GamingDisorder: a critical commentary on Petry et al. (2014). Addictionin press.]commented upon it. As they note, their collective opinions vary considerably, but they contend that our report does not constitute an international consensus. They also critique our interpretations of the criteria for IGD in the Diagnostic and Statistical Manual of Mental Disorders, Revision 5 (DSM-5)

Indexat a: Medline/WOS/JCR

Factor Impacte: 4.972 Quartil: 1 Categoria: Substance Abuse

Posició: 1/18

Raich A, Ballbè M, Nieva G, Cano M, Fernández T, Bruguera E, Fernández E.Safety of Varenicline for Smoking Cessation in Psychiatric and Addicts Patients. Subst Use Misuse. 2016;51(5):649-57. doi10.3109/10826084.2015.1133646.

PubMedPMID: 27050328.

Abstract: The safety of varenicline in the treatment of tobacco dependence has been questioned, in psychiatric patients.

However, most published studies have not included psychiatric patients.

OBJECTIVE:Assess the safety of varenicline for smoking cessation in patients with psychiatric disorders.

METHODS:This is a prospective, longitudinal, multicenter study. The sample is composed of three groups (patients with psychotic disorder, patients with alcohol dependence disorder and patients addicts in methadone maintenance treatment).

Patients were recruited consecutively between September 2008 and June 2009 from 11 centers. All patients received a standardized smoking cessation program with varenicline and psychological support. Adverse events of the drug were monitored at weeks 1, 2, 4, 6, 8, and 12 of treatment. Bivariate analysis has been used.

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RESULTS:None of the 90 patients included, presented a serious adverse event. The most frequent adverse effect was dry mouth (28.9%), followed by the presence of flatulence (27.8%), abnormal dreams (27.8%), and nausea (22%), especially between weeks 2 and 6 of treatment. None of the patients referred intense suicidal ideation, although two referred to moderate suicidal ideation, which was solved in one case and in the other, treatment was discontinued. Four participants (4.4%) abandoned treatment because of gastrointestinal symptoms. The initial dose of varenicline was reduced in 25% of patients during the study.

CONCLUSIONS: Gastrointestinal adverse events are the most incident in this sample of psychiatric patients and no exacerbation of psychiatric symptoms was detected, thus indicating a good safety record for varenicline use for smoking cessation in psychiatric patients.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.133 Quartil: 4 Categoria: Psychiatry

Posició: 111/142

Solé Puig M, Pérez Zapata L, Puigcerver L, Esperalba Iglesias N, Sanchez Garcia C, Romeo A, Cañete Crespillo J, Supèr H. Attention-Related Eye VergenceMeasured in Children with Attention Deficit Hyperactivity Disorder. PLoS One.2015 Dec 22;10(12):e0145281. doi: 10.1371/journal.pone.0145281. PubMed PMID:26694162; PubMed Central PMCID: PMC4690612.

Abstract: Recent evidence shows a novel role for eye vergence in orienting attention in adult subjects. Here we investigated whether such modulation in eye vergence by attention is present in children and whether it is altered in children with ADHD compared to control subjects. We therefore measured the angle of eye vergence in children previously diagnosed with ADHD while performing a cue task and compared the results to those from age-matched controls. We observed a strong modulation in the angle of vergence in the control group and a weak modulation in the ADHD group. In addition, in the control group the modulation in eye vergence was different between the informative cue and uninformative cue condition. This difference was less noticeable in the ADHD group. Our study supports the observation of deficient binocular vision in ADHD children. We argue that the observed disruption in vergence modulation in ADHD children is manifest of altered cognitive processing of sensory information. Our work may provide new insights into attention disorders, like ADHD.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.057 Quartil: 1 Categoria: Multidisciplinary, Sciences

Posició: 11/63

Sole Puig M, Pallarés JM, Perez Zapata L, Puigcerver L, Cañete J, Supèr H.Attentional Selection Accompanied by Eye Vergence as Revealed by Event-RelatedBrain Potentials. PLoS One. 2016 Dec 14;11(12):e0167646. doi: 10.1371/journal.pone.0167646. PubMed PMID: 27973591.

Abstract: Neural mechanisms of attention allow selective sensory information processing. Top-down deployment of visualspatial attention is conveyed by cortical feedback connections from frontal regions to lower sensory areas modulating late stimulus responses. A recent study reported the occurrence of small eye vergence during orienting top-down attention.

Here we assessed a possible link between vergence and attention by comparing visual event related potentials (vERPs) to a cue stimulus that induced attention to shift towards the target location to the vERPs to a no-cue stimulus that did not trigger orienting attention. The results replicate the findings of eye vergence responses during orienting attention and show that the strength and time of eye vergence coincide with the onset and strength of the vERPs when subjects oriented attention. Our findings therefore support the idea that eye vergence relates to and possibly has a role in attentional selection.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.057 Quartil: 1 Categoria: Multidisciplinary, Sciences

Posició: 11/63

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Frias A.Urgent need to assess the long-term impact of thepsychotropic medications on the cognitive profile among youth with bipolar disorder. Neuropsychiatry (London).2016;6(3):73–74

Abstract: Cognitive side-effects of psychotropic medications for bipolar disorder (BD) have been widely discussed for adult patients. Basically, prospective studies suggest that long-term treatment with lithium and second generation antipsychotics (SGA) (mainly olanzapine or risperidone) may negatively affect verbal memory/learning and psychomotor speed, respectively.

Indexat a: WOS/JCR

Factor Impacte: 1.456 Quartil: 3 Categoria: Psychiatry

Posició: 100/142

Álvaro Frías, Bárbara Martínez, Cárol Palma & Núria Farriols (2016) Clinicalimpact of comorbid major depression in subjects with posttraumatic stress disorder: A reviewof the literature, Nordic Psychology, 68:4, 257-271, DOI: 10.1080/19012276.2016.1162106

Abstract: Nearly half of those with posttraumatic stress disorder (PTSD) have co-occurring major depressive disorder. Some etiopathogenic theories and treatments have been postulated for this comorbidity.However, there are no systematic reviews aimed at addressing the clinical impactof comorbid major depression in the PTSD profile. A comprehensive database search was performedfrom 1985 to February 2015. Overall, 94 studies fulfilled the inclusion criteria. The mainevidence is described concerning several clinical criteria: PTSD symptoms and other psychopathology(suicide ideation/attempts or/and alcohol misuse), disability (quality of life and/or medicalconditions), natural course, and treatment-related features (treatment seeking, response totreatment, and/or treatment compliance/preference). Overall, comorbid major depression tendsto exert a deleterious role on the PTSD profile. This negative effect is mainly found regardingthe symptomatology, disability, and natural course of PTSD. Methodological divergences are discussedwith respect to inconsistent findings.

Indexat a: WOS/JCR

Factor Impacte: 0.432 Quartil: 3 Categoria: Psychology, Multidisciplinary Posició: 109/129

MEDICINA INTENSIVA – INTENSIVE MEDICINE Nº Articles indexats: 5

Factor Impacte total: 4.905

Factor d’impacte mig per article: 1.226

Almirall J,Güell E, Capdevila JA,Campins L,Palomera E,Martinez R,Miró G,de la Torre MC,Solsona M, Yébenes JC. Epidemiology of community-acquired severe sepsis. A population-based study. Med Clin (Barc). 2016 Aug 19;147(4):13943. doi: 10.1016/j.medcli.2016.04.015. Spanish. PubMed PMID: 27237363.

BACKGROUND AND OBJECTIVE: Most studies aimed at getting to know the incidence of severe sepsis have methodological limitations which condition results that are difficult to compare and are inapplicable when it comes to estimating the necessary resources. Our objective is to evaluate the incidence and epidemiological aspects of community-acquired severe sepsis which require intensive care unit admission.

PATIENTS AND METHOD: Prospective observational population-based study in a population of 180,000 adults over 15 years old and a general hospital with 350 beds and 14 ICU beds. All episodes of community-acquired infection requiring admission to ICU due to severe sepsis were registered over a period of 9 years. The variables analyzed were: age, sex, SAPS II score, length of stay in ICU, type of infection, isolated microorganism, and deaths during their ICU admission. A statistical bivariate analysis and a multiple logistic regression were performed.

RESULTS: Nine hundred and seventeen episodes with an average age of 65.2 years. The most frequent infectious focus was pulmonary (55.2%). The average SAPS II severity score index was 37.87 and mortality 19.7%. The annual incidence was Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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51.54 episodes per 100,000 adult inhabitants, meaning 1.97 ICU beds per day. In the multivariate analysis, the SAPS II score and a known aetiology were demonstrated as mortality risk factors.

CONCLUSIONS: This study brings us some epidemiological data from a population-based perspective which help us to care for patients better in our geographical area. The average annual incidence is 51.5 cases per 100,000 adult inhabitants which means that 2 ICU beds per day to attend this population.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.267 Quartil: 2 Categoria: Medicine, General & Internal Posició: 76/155

Rodríguez A, Martín-Loeches I, Yébenes JC. New definition of sepsis and septic shock: What does it give us? Med Intensiva. 2016 May 30. pii: S0210-5691(16)30050-X. doi: 10.1016/j.medin.2016.03.008. [Epub ahead of print] English, Spanish. PubMed PMID: 27255771.

A few days ago, new definitions of sepsis and septic shock were launched as a result of a consensus of 19 experts SCCM (Society of Critical Care Medicine) and ESICM (European Society of Intensive Care Medicine). Perhaps the greatest contribution of this expert opinion consensus has been to recognize sepsis as a difficult to characterize syndromic condition, with a cellular metabolic disorder as a lead condition along with the development of organ failure. However, as the most important feature, the new definition excludes the concept of SIRS (Systemic Inflammatory Response Syndrome) since this term is being considered of not useful anymore. The authors supported this decision mainly based on a retrospective study conducted in Australia and New Zealand2 in which it was observed (glass half-empty approach) that 1 out of 8 patients (12.5%) with sepsis and multiorgan failure (MOF) did not have at least 2 SIRS criteria. However, these results (glass halffull approach) could be reinterpreted as 7 out of 8 patients (87.5%) did present positive SIRS criteria.....

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.193 Quartil: 4 Categoria: Critical Care Medicine

Posició: 31/33

Claverias L, Marí M, Marín-Corral J, Magret M, Trefler S, Bodí M, García-España A, Yébenes JC, Pascual S, Gea J, Rodríguez A. The prognostic value of muscle regional oxygen saturation index in severe community-acquired pneumonia: a prospective observational study. J Intensive Care. 2016 Jan 19;4:7. doi: 10.1186/s40560-016-0129-4. PubMed PMID: 26788325; PubMed Central PMCID: PMC4717666.

BACKGROUND: Community-acquired pneumonia (CAP) mortality exceeds 20 % in critical care patients despite appropriate antibiotic therapy. Regional tissue oxygen saturation index (rSO2) measured with near-infrared spectroscopy (NIRS) might facilitate early detection for patients at risk of serious complications. Our objectives were to determine the relationship between early determination of rSO2 and mortality and to compare discrimination power for mortality of rSO2 and other resuscitation variables in critically ill CAP patients.

METHODS: This is a prospective observational study. Patients with CAP were enrolled within 6 h to intensive care admission. Demographics and clinical variables were recorded. rSO2 was determined using NIRS in brachioradialis muscle.

All variables were determined at baseline and 24 h after admission.

RESULTS: Forty patients were enrolled. Fourteen patients (35 %) had a baseline rSO2 < 60 % and 7 of them died (50 %).

Only 1 of 26 (3.8 %) patients with rSO2 ≥ 60 % died (p = 0.007). The area under ROC curve (AUROC) showed consistent mortality discrimination at baseline (0.84, p = 0.03) and at 24 h (0.86, p = 0.006) for rSO2 values. Cox regression analysis showed that "low" rSO2 at ICU admission (hazard ratio (HR) = 8.99; 95 % confidence interval (CI) 1.05-76.8; p = 0.045) and "low" rSO2 at 24 h (HR = 13.18; 95 % CI 1.52-113.6; p = 0.019) were variables independently associated with mortality. In contrast, other variables such as Acute Physiology and Chronic Health Evaluation (APACHE II) score (HR = 1.09; 95 % CI 0.991.19; p = 0.052) were not associated with mortality.

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CONCLUSIONS: Our findings suggest that forearm skeletal muscle rSO2 differs in patients with severe CAP according to outcome and might be an early prognosis tool

Indexat a: Pubmed

de la Torre MC, Palomera E, Serra-Prat M,Güell E, Yébenes JC, Bermejo-Martín JF, Almirall J. IgG2 as an independent risk factor for mortality in patients with community-acquired pneumonia. J Crit Care. 2016 Oct;35:115-9. doi: 10.1016/j.jcrc.2016.05.005. PubMed PMID: 27481745.

BACKGROUND: Mortality in patients with community-acquired pneumonia (CAP) remains high despite improvements in treatment.

OBJECTIVE: To determine immunoglobulin levels in patients with CAP and impact on disease severity and mortality.

METHODOLOGY: Observational study. Hospitalized patients with CAP were followed up for 30 days. Levels of immunoglobulin G (IgG) and subclasses, immunoglobulin A (IgA) and immunoglobulin M (IgM) were measured in serum within 24 hours of CAP diagnosis.

RESULTS: Three hundred sixty-two patients with CAP were enrolled -172 ward-treated and 190 intensive care unit-treated.

Intensive care unit-treated patients had significantly lower values of IgG1, IgG2, IgG3 subclasses, and IgA than ward-treated patients. Thirty-eight patients died before 30 days. Levels of IgG2 were significantly lower in non-survivors than survivors (P=.004) and IgG2 <301 mg/dL was associated with poorer survival according to both the bivariate (hazard ratio 4.47; P<.001) and multivariate (HR 3.48; P=.003) analyses.

CONCLUSIONS: Patients with CAP with IgG2 levels <301 mg/dL had a poorer prognosis and a higher risk of death. Our study suggests the usefulness of IgG2 to predict CAP evolution and to provide support measures or additional treatment.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.445 Quartil: 3 Categoria: Critical Care Medicine

Posició: 18/33

de la Torre MC, Torán P, Serra-Prat M, Palomera E, Güell E, Vendrell E,Yébenes JC, Torres A, Almirall J. Serum levels of immunoglobulins and severity ofcommunity-acquired pneumonia. BMJ Open Respir Res. 2016 Nov 28;3(1):e000152.PubMed PMID: 27933180; PubMed Central PMCID: PMC5133423.

INSTRUCTION: There is evidence of a relationship between severity of infection and inflammatory response of the immune system. The objective is to assess serum levels of immunoglobulins and to establish its relationship with severity of community-acquired pneumonia (CAP) and clinical outcome.

METHODS: This was an observational and cross-sectional study in which 3 groups of patients diagnosed with CAP were compared: patients treated in the outpatient setting (n=54), patients requiring in-patient care (hospital ward) (n=173), and patients requiring admission to the intensive care unit (ICU) (n=191).

RESULTS: Serum total IgG (and IgG subclasses IgG1, IgG2, IgG3, IgG4), IgA and IgM were measured at the first clinical visit.

Normal cutpoints were defined as the lowest value obtained in controls (≤680, ≤323, ≤154, ≤10, ≤5, ≤30 and ≤50 mg/dL for total IgG, IgG1, IgG2, IgG3, IgG4, IgM and IgA, respectively). Serum immunoglobulin levels decreased in relation to severity of CAP. Low serum levels of total IgG, IgG1 and IgG2 showed a relationship with ICU admission. Low serum level of total IgG was independently associated with ICU admission (OR=2.45, 95% CI 1.4 to 4.2, p=0.002), adjusted by the CURB-65 severity score and comorbidities (chronic respiratory and heart diseases). Low levels of total IgG, IgG1 and IgG2 were significantly associated with 30-day mortality.

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CONCLUSIONS: Patients with severe CAP admitted to the ICU showed lower levels of immunoglobulins than non-ICU patients and this increased mortality.

Indexat a: Pubmed

DIGESTIU – GASTROENTEROLOGY

Nº Articles indexats: 1

Factor Impacte total: 1.455 Factor d’impacte mig per article: 1.455

Ruiz de León San Juan A, Ciriza de Los Ríos C, Pérez de la Serna Bueno J, Canga Rodríguez-Valcárcel F, Estremera Arévalo F, García Sánchez R, Huamán Ríos JW, Pérez Fernández MT, Santander Vaquero C, Serra Pueyo J, Sevilla Mantilla C, Barba Orozco E, Bosque López MJ, Casabona Francés S, Carrión Bolorino S, Castillo Grau P, Delgado Aros S, Domínguez Carbajo AB, Fernández Orcajo P, García-Lledó J, Gigantó Tomé F, Iglesias Picazo R, Lacima Vidal G, López López P, Llabrés Rosselló M, Mas Mercader P, Mego Silva M, Mendarte Barrenetxea MU, Miliani Molina C, Oreja Arrayago M, Sánchez Ceballos F, Sánchez Prudencio S. Practical aspects of high resolution esophageal manometry. Rev Esp Enferm Dig. 2016 Dec 19;109. doi: 10.17235/reed.2016.4441/2016. [Epub ahead of print] PubMed PMID: 27990836.

Abstract: High resolution esophageal manometry (HRM) is currently under development as can be seen in the various Chicago classifications. In order to standardize criteria in certain practical aspects with limited scientific evidence, the First National Meeting for Consensus in High Resolution Manometry of the Spanish Digestive Motility Group took place, bringing together a wide group of experts. The proposals were based on a prior survey composed of 47 questions, an exhaustive review of the available literature and the experience of the participants. Methodological aspects relating to the poorly defined analysis criteria of certain new high resolution parameters were discussed, as well as other issues previously overlooked such as spontaneous activity or secondary waves. Final conclusions were drawn with practical applications.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.455 Quartil: 4

Categoria: Gastroenterology & Hepatology

Posició: 67/79

GERIATRIA – GERIATRIC MEDICINE

Nº Articles indexats: 1 Factor Impacte total: 0 Factor d’impacte mig per article: 0

Font-Ritort S, Martos-Gutiérrez JA, Montoro-Lorite M, Mundet-Pons L. [Quality of diagnosis information given to terminal cancer patients]. Enferm Clin. 2016 Nov - Dec;26(6):344-350. doi: 10.1016/j.enfcli.2016.07.006. Spanish.

PubMed PMID: 27647557.

AIM: To determine the information that terminal cancer patients have about their diagnosis, identifying key words used, and quantifying the conspiracy of silence.

METHOD: A cross-sectional, analytical study was conducted by reviewing the hospice support team data base which contains the medical history and a semi-structured interview with terminal cancer patients in the first visit to the hospice.

Demographic and socioeconomic data was collected, as well as relevant clinical information (diagnosis, prevalent symptoms, number of symptoms, patient functionality, QoL, information given, and words used).

RESULTS: Out of total of sample of 723 records, 77.87% (95% CI: 74.70-80.74) of the patients were properly informed about their diagnosis. The most used words were cancer in 26% of the patients, tumour in 51.59%, and for the remaining 10.65%, the word inflammation was used. Statistically significant differences of information were found between sexes, age, types of cancer, and hospital ward.

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CONCLUSIONS: Terminal cancer patients have knowledge on their diagnosis, suggesting that the conspiracy of silence is present to a lesser extent. This knowledge is transmitted using different words and with euphemisms.

Indexat a: Medline

ATENCIÓ PRIMARIA – PRIMARY CARE Nº Articles indexats: 1

Factor Impacte total: 0

Factor d’impacte mig per article: 0

Pérula-de Torres LA, González-Blanco V V, Luque-Montilla R, Martín-Rioboó E, Martínez-Adell MA, Ruiz-de Castroviejo J; Grupo Colaborativo estudio DOFA-AP. [Validation of taking arterial pulse in Primary Care for the detection of atrial fibrillation and other cardiac rhythm disorders in patients over 65 years old].

Semergen. 2016 Oct 20. pii: S1138-3593(16)30128-9. doi: 10.1016/j.semerg.2016.06.015. [Epub ahead of print] Spanish.

PubMed PMID: 27773624.

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%.

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

UNITAT DE RECERCA – RESEARCH UNIT Nº Articles indexats: 3

Factor Impacte total: 7.836

Factor d’impacte mig per article: 2.612

Vila L, Donnay S, Arena J, Arrizabalaga JJ, Pineda J, Garcia-Fuentes E, García-Rey C, Marín JL, Serra-Prat M, Velasco I, López-Guzmán A, Luengo LM, Villar A, Muñoz Z, Bandrés O, Guerrero E, Muñoz JA, Moll G, Vich F, Menéndez E, Riestra M, Torres Y, Beato-Víbora P, Aguirre M, Santiago P, Aranda J, Gutiérrez-Repiso C. Iodine status and thyroid function among Spanish schoolchildren aged 6-7 years: the Tirokid study. Br J Nutr. 2016 May;115(9):1623-31. doi: 10.1017/S0007114516000660. PubMed PMID: 26961225.

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Publicacions Científiques CSDM 2016

Abstract:I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6-7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods. A total of 1981 schoolchildren (52 % male) were included. The median UI was 173 μg/l, and 17·9 % of children showed UI<100 μg/l. The median UI was higher in males (180·8 v. 153·6 μg/l; P<0·001). Iodised salt (IS) intake at home was 69·8 %. IS consumption and intakes of ≥2 glasses of milk or 1 cup of yogurt/d were associated with significantly higher median UI. Median TSH was 0·90 mU/l and was higher in females (0·98 v. 0·83; P<0·001). In total, 0·5 % of children had known hypothyroidism (derived from the questionnaire) and 7·6 % had TSH levels above reference values. Median TSH was higher in schoolchildren with family history of hypothyroidism. I intake was adequate in Spanish schoolchildren. However, no correlation was found between TSH and median UI in any geographical area. The prevalence of TSH above reference values was high and its association with thyroid autoimmunity should be determined. Further assessment of thyroid autoimmunity in Spanish schoolchildren is desirable..

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.311 Quartil: 2 Categoria: Nutrition & Dietetics

Posició: 23/80

Serra-Prat M, Sist X, Saiz A, Jurado L, Domenich R, Roces A, Papiol M. Clinical and Functional Characterization of Pre-frailty among Elderly Patients Consulting Primary Care Centres. J Nutr Health Aging. 2016;20(6):653-8. doi: 10.1007%2Fs12603-016-0684-3. PubMed PMID: 27273356.

BACKGROUND: Characterization of the main features of pre-frailty may contribute to better understanding the mechanisms involved in the development of frailty.

OBJECTIVE: To characterize the pre-frail population consulting in primary care centres in Mataró (Catalonia, Spain), to describe the Fried's frailty criteria for this population and to identify the main associated factors.

DESIGN: Cross-sectional study.

SETTING: Three primary care centres in Catalonia.

PARTICIPANTS: Pre-frail subjects recruited from among persons aged 70 years and older consulting primary care centres and screened for frailty according to Fried's criteria.

MEASUREMENTS: Clinical, nutritional and functional data.

RESULTS: Frailty prevalence of 31.0% and pre-frailty prevalence of 49.0% were observed. Comorbidity was not especially frequent among elderly individuals classified as pre-frail (except for diabetes with 35.8% prevalence).

Functional status and nutritional status were both reasonably satisfactory in pre-frail subjects with mean Barthel score of 98 points and 91% classified as well nourished. Among pre-frail subjects, 35% were obese (body mass index>30); 75% reported pain; 12% had an accidental fall in the previous three months; and the mean number of medications ingested was 6.2. Weakness was the most prevalent frailty criterion (70%), followed by slowness (30%). Weakness was associated with age in men and with pain in women. Poor physical activity was associated with pain.

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CONCLUSIONS: Pre-frailty is very common among elderly subjects consulting primary care centres. Weakness, slowness, diabetes, pain and polypharmacy should alert healthcare professionals to the onset of a frailty process.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.199 Quartil: 2 Categoria: Geriatrics & Gerontology Posició: 14/49

Serra-Prat M, Papiol M, Vico J, Palomera E, Sist M, Cabre M. Factors associated with frailty in communitydwelling elderly population. A cross-sectional study; Eur Geriatr Med; 2016,7(6):531-7, doi:10.1016/j.eurger.2016.09.005

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

Objective: To identify the main social, clinical and analytical factors associated with frailty.

Methods: An observational cross-sectional study of community-dwelling individuals aged 75 years and older was performed.

Results: One hundred and seventy men and 154 women were recruited (mean age 80.1 years). Frailty was associated with age, female sex, educational level, certain comorbidities (osteoarthritis, peripheral vascular disease, stroke, depression, cancer, diabetes, dyspepsia and hypertension), geriatric syndromes, previous falls, pain, number of medications, anorexia, nutritional status, physical activity, muscle mass, obesity, anaemia, kidney function and C-reactive protein. Frailty was not associated with serum levels of ghrelin, testosterone, insulin or IGF-1.

Conclusions: Factors identified as associated with frailty may alert healthcare professionals and help them to identify subjects at risk fragilization. Good control over underlying diseases and pain, rationalizing use of medications, optimizing nutritional status and body weight, promoting physical activity and improving social support may contribute to preventing or even reverting frailty. However, these hypotheses need to be tested.

Indexat a: WOS/JCR

Factor Impacte: 1.326 Quartil: 4 Categoria: Geriatrics & Gerontology Posició: 40/49

Serra-Prat M, Papiol M, Vico J, Lorenzo I, Arus M. Community-Dwelling Older People’s Dietary Habits, Calorie Intake and Calorie Expenditure and their Relationship with Frailty. J Clin Nutr Diet. 2016, 2:1.

Aim: to describe dietary habits and calorie expenditure in a community-dwelling older population, as well as to assess the relationship between these habits and frailty and pre-frailty status.

Methods: An observational, population-based, cross-sectional study was performed among community-dwelling people aged 75 years and older. Frailty was established according to Fried criteria, dietary habits were assessed by a validated food frequency consumption questionnaire, physical activity and calorie expenditure were estimated through the International Physical Activity Questionnaire.

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Results: A total of 324 people were recruited (170 men and 154 women), with a mean age of 80.1 (3.5) years, and 94.6% considered as well nourished. In women, BMI was higher in frail and pre-frail than in robust (30, 30, and 26, respectively; p < 0.001). Study sample tended to have a diet rich in nuts, fruits and vegetables. No differencesin protein intake between frail and non-frail persons were observed, but frail persons had a lower intake of salads, nuts, fruits and fibre, as well as alcohol. Frail persons had a lower calorie intake and much lower calorie expenditure than non-frail persons, resulting in a greater positive energy balance.

Conclusion: In an older population with sufficient calorie and protein intake, lower micronutrient intake of nuts, fruits and vegetables is a risk factor for frailty. Low physical activity is also related to frailty and predisposes to positive energy balance and obesity. Health professionals must encourage older people to exercise regularly and maintain good dietary habitsincluding both good calorie and protein intake and good micronutrient intake of fruits and vegetables

FARMÀCIA - PHARMACY Nº Articles indexats: 3

Factor Impacte total: 5.388

Factor d’impacte mig per article: 1.796

Campins L, Serra-Prat M, Gózalo I, López D, Palomera E, Agustí C, Cabré M;REMEI Group. Randomized controlled trial of an intervention to improve drugappropriateness in community-dwelling polymedicated elderly people. Fam Pract.2016 Sep 7. pii: cmw073. [Epub ahead of print] PubMed PMID: 27605543.

BACKGROUND: Polypharmacy is frequent in the elderly population and is associated with potentially drug inappropriateness and drug-related problems.

OBJECTIVES: To assess the effectiveness and safety of a medication evaluation programme for community-dwelling polymedicated elderly people.

DESIGN: Randomized, open-label, multicentre, parallel-arm clinical trial with 1-year follow-up.

SETTING: Primary care centres.

PARTICIPANTS: Polymedicated (≥8 drugs) elderly people (≥70 years).

STUDY INTERVENTION: Pharmacist review of all medication according to the Good Palliative-Geriatric Practice algorithm and the Screening Tool of Older Person's Prescriptions-Screening Tool to Alert Doctors to the Right Treatment criteria and recommendations to the patient's physician.

CONTROL INTERVENTION: Routine clinical practice.

MEASUREMENTS: Recommendations and changes implemented, number of prescribed drugs, restarted drugs, primary care and emergency department consultations, hospitalizations and death.

RESULTS:About 503 (252 intervention and 251 control) patients were recruited and 2709 drugs were evaluated. About 26.5% of prescriptions were rated as potentially inappropriate and 21.5% were changed (9.1% discontinuation, 6.9% dose adjustment, 3.2% substitution and 2.2% new prescription). About 2.62 recommendations per patient were made and at least one recommendation was made for 95.6% of patients. The mean number of prescriptions per patient was significantly lower in the intervention group at 3- and 6-month follow-up. Discontinuations, dose adjustments and substitutions were significantly higher than in the control group at 3, 6 and 12 months. No differences were observed in the number of emergency visits, hospitalizations and deaths.

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CONCLUSION: The study intervention was safe, reduced potentially inappropriate medication, but did not reduce emergency visits and hospitalizations in polymedicated elderly people.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.022 Quartil: 1 Categoria: Primary Health Care

Posició: 4/20

Miarons M, Velasco M, Campins L, Fernández S, Gurrera T, Lopez-Viaplana L.Gradual thrombocytopenia induced by longterm trastuzumab exposure. J Clin Pharm Ther. 2016 Oct;41(5):563-5. doi: 10.1111/jcpt.12416. PubMed PMID: 27425556.

WHAT IS KNOWN AND OBJECTIVE:Unexplained thrombocytopenia is a common clinical problem, and the possibility of drug-induced thrombocytopenia must be considered. Moreover, chemotherapy agents are known to typically cause thrombocytopenia by suppressing haematopoiesis, but they can also cause immune thrombocytopenia in which the mechanism involves antibody-mediated platelet destruction.

CASE DESCRIPTION: We report a case of severe thrombocytopenia related to trastuzumab administration in which the patient exhibits a slow drift downward in platelet counts with repeated cycles of trastuzumab. A 70-year-old woman received a diagnosis of breast cancer and was treated with trastuzumab. She was confirmed to have a severe trastuzumabinduced thrombocytopenia after the 4th cycle. Retreatment with trastuzumab was not attempted.

WHAT IS NEW AND CONCLUSION:Considering that trastuzumab is being increasingly used and that severe thrombocytopenia is a potentially life-threatening complication, its association must be seriously considered.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.833 Quartil: 3 Categoria: Pharmacology & Pharmacy

Posició: 163/255

Campins L, Camps M, Riera A, Pleguezuelos E, Yebenes JC, Serra-Prat M. Oral Drugs Related with Muscle Wasting and Sarcopenia. A Review. Pharmacology. 2016 Aug 31;99(1-2):1-8. [Epub ahead of print] PubMed PMID: 27578190.

Abstract:Sarcopenia is a geriatric syndrome characterized by progressive and generalized loss of skeletal muscle mass and function. Reported prevalence of this geriatric syndrome, differs depending on the definition, the population and the method used to identify sarcopenia. The causes of sarcopenia are multifactorial, and can include genetic influence, immobility or disuse, endocrine factors, inflammation and nutritional deficiencies. These disorders involve an imbalance between anabolic and catabolic pathways that rules muscle mass. Many drugs taken regularly for common conditions may interact with some mechanisms that can alter the balance between protein synthesis and degradation. This may lead to a harmful or a beneficial effect on muscle mass and strength. Widely prescribed drugs could play an important role during the time of onset and development of sarcopenia. In this paper, we reviewed the current understanding of how can drugs contribute positively or negatively on sarcopenia and muscle wasting. We decided to focus this review on oral common drugs, which are usually prescribed in older adults, leaving aside other drugs as hormone therapy.

Indexat a: Medline/WOS/JCR

Factor Impacte: 1.533 Quartil: 3 Categoria: Pharmacology & Pharmacy

Posició: 191/255

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Nº Articles indexats: 2

HEMATOLOGIA – HEMATOLOGY

Factor Impacte total: 5.601 Factor d’impacte mig per article: 2.800

Sorigué M, Ribera JM, García O, Cabezón M, Vélez P, Marcé S, Xicoy B, Fernández C, Buch J, Cortes M, Plensa E, Gallardo D, Boqué C, Feliu E, Zamora L. Highly variable mutational profile of ASXL1 in myelofibrosis. Eur J Haematol. 2016 Oct;97(4):331-5. doi: 10.1111/ejh.12731. PubMed PMID: 26714837.

OBJECTIVE: Somatic mutations in ASXL1 seem to have a negative prognostic impact in patients with several myeloid neoplasms, including myelofibrosis (MF). The aim of this work was to determine the prevalence and profile of ASXL1 mutations in MF.

METHODS: We analyzed mutations in ASXL1 in 70 consecutive MF patients from 8 Spanish hospitals by means of Sanger sequencing, as well as JAK2, CALR, and MPL mutations.

RESULTS: ASXL1 mutations were found in 16/70 (23%) of cases, most commonly p.Gly646TrpfsX12 (5/16). Most mutations (13/16) were frameshift mutations. Of 54 ASXL1- wild-type patients, 32 (59%) had at least one single nucleotide polymorphism (SNP), 27 of them had g.78128C>T, g.79017A>C, and g.79085T>C [triple SNP (TSNP) patients]. The 5-yr overall survival probability of TSNP patients was 67% (95% CI, 43-91%) vs. 90% (95% CI, 77-100%) in ASXL1-WT patients (P = 0.152).

CONCLUSION: ASXL1 mutations were found in 23% of cases, p.Gly646TrpfsX12 being the most frequent. About 85% of mutations were found only in individual cases and 46% had not previously been reported, a pattern also seen in other series. Fifty percent of ASXL1-WT patients had a combination of three specific SNPs that might have a prognostic correlation that needs to be determined in larger series.

Indexat a: Medline/WOS/JCR

Factor Impacte: 2.544 Quartil: 3 Categoria: Hematology

Posició: 39/70

Del Amo E, Esteva C, Hernandez-Bou S, Galles C, Navarro M, Sauca G, Diaz A, Gassiot P, Marti C, Larrosa N, Ciruela P, Jane M, Sá-Leão R, Muñoz-Almagro C; Catalan Study Group of Invasive Pneumococcal Disease.. Serotypes and Clonal Diversity of Streptococcus pneumoniae Causing Invasive Disease in the Era of PCV13 in Catalonia, Spain. PLoS One. 2016 Mar 8;11(3):e0151125. doi: 10.1371/journal.pone.0151125. PubMed PMID: 26953887; PubMed Central PMCID: PMC4783110.

Abstract:The aim of this study was to study the serotypes and clonal diversity of pneumococci causing invasive pneumococcal disease in Catalonia, Spain, in the era of 13-valent pneumococcal conjugate vaccine (PCV13). In our region, this vaccine is only available in the private market and it is estimated a PCV13 vaccine coverage around 55% in children. A total of 1551 pneumococcal invasive isolates received between 2010 and 2013 in the Molecular Microbiology Department at Hospital Sant Joan de Déu, Barcelona, were included. Fifty-two serotypes and 249 clonal types-defined by MLST-were identified. The most common serotypes were serotype 1 (n = 182; 11.7%), 3 (n = 145; 9.3%), 19A (n = 137; 8.8%) and 7F (n = 122; 7.9%). Serotype 14 was the third most frequent serotype in children < 2 years (15 of 159 isolates). PCV7 serotypes maintained their proportion along the period of study, 16.6% in 2010 to 13.4% in 2013, whereas there was a significant proportional decrease in PCV13 serotypes, 65.3% in 2010 to 48.9% in 2013 (p<0.01). This decrease was mainly attributable to serotypes 19A and 7F. Serotype 12F achieved the third position in 2013 (n = 22, 6.4%). The most frequent clonal types found were ST306 (n = 154, 9.9%), ST191 (n = 111, 7.2%), ST989 (n = 85, 5.5%) and ST180 (n = 80, 5.2%). Despite their decrease, PCV13 serotypes continue to be a major cause of disease in Spain. These results emphasize the need for complete PCV13 vaccination.

Indexat a: Medline/WOS/JCR

Factor Impacte: 3.057 Quartil:1 Categoria: Multidisciplinary, Sciences

Posició: 11/63

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INDICADORS BIBLIOMÈTRICSGLOBALS

Total articles publicats CSDM 2016:

Total articles Indexats Pubmed/Medline/WOS/JCR:

Articles no indexats a cap de les anteriors BDD:

Total articles indexats per Servei:

Psiquiatria

74 71 3 Total Factor d’Impacte per Servei i (FI mig)

14

Motilitat Digestiva 38.966

(2.997)

Motilitat Digestiva

13

Psiquiatria

33.077

(2.362)

Medicina Interna

8

Medicina Interna

23.246

(2.905)

Cirurgia General

5

Traumatologia

11.122

(3.707)

Medicina Intensiva

5

Cirurgia General

9.416

(1.883)

Rehabilitació

4

Endocrinologia

8.784

(8.784)

Oncologia

4

Oncology

8.120

(2.030)

Farmàcia

3

Unitat de Recerca

7.836

(2.612)

Traumatologia

3

Hematology

5.601

(2.800)

Unitat de Recerca

3

Farmàcia

5.388

(1.796)

Neurologia

2

Medicina Intensiva 4.905

(1.226)

Hematologia

2

Neurologia

3.962

(1.981)

Endocrinologia

1

Rehabilitació

3.860

(0.965)

Dermatologia

1

Digestiu

1.455

(1.455)

Digestiu

1

Dermatologia

1.267

(1.267)

Atenció Primaria

1

Atenció Primària

0.000

(0.000)

Geriatria

1

Geriatria

0.000

(0.000)

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2016

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

Plantilla març-08

42

Publicacions Científiques CSDM 2016

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

Plantilla març-08

43