Publicacions Consorci Sanitari del Maresme 2015

Publicacions Científiques CSDM 2015

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Publicacions 2015 Consorci Sanitari del Maresme.

Publicacions de l’any 2015

Biblioteca.

Direcció Acadèmica, Recerca i Innovació Consorci Sanitari del Maresme.

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Publicacions Científiques CSDM 2015

Presentació.

Aquest document recull els articles científics del Consorci Sanitari del Maresme (amb almenys un autor amb filiació CSDM) indexats al llarg de 2015 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 establerts a cada article i per Serveis (Factor d’Impacte, Factor d’impacte mig, Quartil i Posició de la revista) corresponen al Journal Citation Reports 2014, per la qual cosa són valors aproximats. Els valors definitius els tindrem el proper mes de Juliol 2016, amb l’entrada inclús d’alguna nova revista com tenim notícies de la revista Endocrinologia y Nutrición que per primera vegada entrarà al JCR. Aquest fet donarà FI a un dels articles del Servei d’Endocrinologia publicat enguany en aquesta revista.

S’inclouent els articles amb etiqueta ahead of print de PubMed encara que siguin posteriorment indexats a Medline durant l’any 2016. Els articles etiquetats ahead of print del 2014 de PubMed (que ja es van incloure a la llista de l’any passat) i que han estat indexats definitivament a Medline durant el 2015 no s’han inclòs en aquest document per evitar duplicitats.

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

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

El document s’ha tancat el dia 20 de Desembre de 2015.

Foto : Dani Olea. Comunicació

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Índex PRESENTACIÓ…………………………………………………………………………………………………………………………..……………………..

2

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

4

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

8

Neumologia – Pneumology ……………………………………………………………………………………….……………………………..…….

9

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

10

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

16

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

18

Reumatologia – Rheumatology …………………………………………………………………………………………………………….………..

18

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

19

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

21

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

22

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

27

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

28

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

29

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

32

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

34

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

35

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

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

36

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

37

Infermeria – Nursing ………………………………………….……………………………………………………………….……………………………

37

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

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NEUROLOGIA - NEUROLOGY Nº Articles indexats: 8

Factor Impacte total: 18.442

Factor d’impacte mig per article: 2.305

Ramo-Tello C, Tintoré M, Rovira A, Ramió-Torrenta L, Brieva L, Saiz A, Cano A, Carmona O, Hervás JV, Grau-López L. Baseline clinical status as a predictor of methylprednisolone response in multiple sclerosis relapses. Mult Scler. 2015 Jun 25. pii: 1352458515590648. [Epub ahead of print] PubMed PMID: 26540732 BACKGROUND: To date, there are no available factors to predict the outcome after multiple sclerosis relapse.

AIM: To investigate factors that may be useful for predicting response to methylprednisolone treatment, following a relapse of multiple sclerosis (MS).

METHODS: The study included 48 MS patients enrolled in a double-blind multicenter trial to receive intravenous versus oral high-dose methylprednisolone treatment. Associations were sought between the disability status prior to relapse and the relapse severity, determined by changes in the Expanded Disability Status Scale (EDSS) score, as well as the improvements after treatment. We also analyzed the relationships between the number of magnetic resonance imaging (MRI) gadoliniumenhancing lesions (Gd+) and improvement.

RESULTS: A higher EDSS score before relapse was associated with more severe relapses (p = 0.04) and less marked improvement (odds ratio (OR) 1.8; 95% CI (1.2-2.2); p = 0.05) after methylprednisolone treatment. Relapse severity (p = 0.29) and the number of Gd+ lesions at relapse (p = 0.41) were not related with improvement.

CONCLUSIONS: Clinical baseline status prior to MS relapse is a predictor of response to methylprednisolone treatment.

Indexat a: Medline/WOS/JCR Factor Impacte: 4.872

Quartil: 1

Categoria: Clinical Neurology

Posició: 22/192

Dorado L, Arenillas JF, López-Cancio E, Hernández-Pérez M, Pérez de la Ossa N, Gomis M, Millán M, Granada ML, Galán A, Palomeras E, Dávalos A. Metabolic Syndrome Predicts Refractoriness to Intravenous Thrombolysis in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis. 2015 Nov;24(11):2605-12. doi: 10.1016/j.jstrokecerebrovasdis.2015.07.015. Epub 2015 Sep 9. PubMed PMID: 26363707.

BACKGROUND: Metabolic syndrome (MetS) has been associated with higher resistance to clot lysis at 24 hours after tissue plasminogen activator (tPA) administration in patients with acute ischemic stroke. We aimed to test this hypothesis at earlier time points, when neurointerventional rescue procedures may still be indicated to achieve arterial recanalization.

METHODS: This is a prospective and observational study in consecutive stroke patients with MCA occlusion treated with IV tPA. MetS was diagnosed following the unified criteria of the last Joint Interim Statement 2009 participating several major organizations. The primary outcome variable was resistance to thrombolysis, defined as the absence of complete middle cerebral artery recanalization 2 hours after tPA bolus assessed by transcranial color-coded duplex or when rescue mechanical thrombectomy after IV tPA was required. Secondary outcome variables were dramatic neurological improvement (decrease in ≥10 points, or a National Institutes of Health Stroke Scale [NIHSS] score of 0-1 at 24 hours), symptomatic intracerebral hemorrhage following European-Australasian Acute Stroke Study II criteria, infarct volume at 24 hours (calculated by using the formula for irregular volumes, ABC/2), and good outcome (modified Rankin Scale score < 3) at 3 months.

RESULTS: A total of 234 patients (median baseline NIHSS score 16 [10-20]) were included and 146 (62.4%) fulfilled MetS criteria. After multivariate analysis, MetS emerged as an independent predictor of resistance to thrombolysis (odds ratio = 2.2 [1.3-4.2], P = .01) and absence of dramatic neurological improvement (odds ratio = .5 [.28-.97], P = .04). In addition, MetS conferred poorer functional outcome, higher symptomatic intracerebral hemorrhage rate, and increased infarct volume, although these associations disappeared after adjustment for covariates.

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CONCLUSIONS: MetS predicts patients with middle cerebral artery occlusion refractory to early clot dissolution after IV tPA. This finding may help in acute clinical decision-making.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.669

Quartil: 4

Categoria: Neurosciences

Posició: 194/252

Veciana M, Becerra JL, Fossas P, Muriana D, Sansa G, Santamarina E, Gaig C, Carreño M, Molins A, Escofet C, Ley M, Vivanco R, Pedro J, Miró J, Falip M; Epilepsy Group of the SCN. EEG extreme delta brush: An ictal pattern in patients with anti-NMDA receptor encephalitis. Epilepsy Behav. 2015 Aug;49:280-5. doi: 10.1016/j.yebeh.2015.04.032. Epub 2015 Jun 10. PubMed PMID: 26071995.

INTRODUCTION: The anti-NMDA receptor (NMDAr) encephalitis-associated syndrome includes neuropsychiatric symptoms, impaired consciousness, seizures, autonomic instability, and hypoventilation. The electroencephalographic (EEG) activity throughout the course of the disease has still not been well documented. We reviewed electroclinical data of patients with NMDAr encephalitis to characterize their EEG and its clinical correlation.

MATERIAL AND METHODS: We retrospectively identified 16 patients with NMDAr encephalitis from 8 Spanish medical centers, 15 of whom underwent video-EEG in the acute phase.

RESULTS: In 15 patients (11 females, median age: 37.4, range: 14-87 years), seizures occurred in 9 (60%) and status epilepticus (SE) in 5 (33.3%). Magnetic resonance imaging (MRI) was abnormal in 10 (66.6%), and CSF (cerebrospinal fluid) was normal in 3 and abnormal in 12, with positive PCR (polymerase chain reaction) for Mycoplasma pneumoniae (1/15) and herpes simple virus (1/15). An ovarian teratoma was found in 1 patient and other malignancies (small cell lung carcinoma) in 1 patient. The EEG was abnormal in the acute phase in 14/15 (93.3%). Extreme delta brush (EDB) was observed in 5 (33.3%), and the presence of EDB was associated with SE in all cases. Rhythmic delta activity without EDB was observed in 5 (33.3%), while excessive beta activity was present in 4 (26.6%). Extreme delta brush can follow a pattern of wellcharacterized electroclinical seizures.

CONCLUSIONS: Almost invariably, patients with NMDAr encephalitis had abnormal EEG. The presence of EDB, which can follow a pattern of well-characterized electroclinical seizures, in our patients was associated with seizures and SE. These findings suggest that EDB could be an evolutive pattern of an SE in NMDAr encephalitis. This article is part of a Special Issue entitled "Status Epilepticus".

Indexat a: Medline/WOS/JCR Factor Impacte: 2.257

Quartil: 2

Categoria: Psychiatry

Posició: 68/140

Pagonabarraga J, Piñol G, Cardozo A, Sanz P, Puente V, Otermín P, Legarda I, Delgado T, Serrano C, Balaguer E, Aguirregomozcorta M, Álvarez R, Kulisevsky JJ. Transdermal Rotigotine Improves Sleep Fragmentation in Parkinson's Disease: Results of the Multicenter, Prospective SLEEP-FRAM Study. Parkinsons Dis. 2015;2015:131508. doi: 10.1155/2015/131508. Epub 2015 Feb 22. PubMed PMID: 25793143 Abstract: Sleep disturbances occur frequently in patients with Parkinson's disease (PD). The aim of this study was to investigate the effects of rotigotine on sleep fluctuations in a sample of PD patients with self-reported complaints of nocturnal awakenings. This prospective, open-label, observational, and multicenter study enrolled consecutive outpatients with PD and administered rotigotine (mean dose 8.9 mg/day) for 3 months. The primary endpoint was the change from baseline in sleep fragmentation, assessed using the sleep maintenance subscale score of the Parkinson's Disease Sleep Scale (PDSS). The newly designed Parkinson's Disease Sleep Fragmentation Questionnaire (PD-SFQ) was used to measure other sleep parameters. A total of 62 patients were enrolled (mean age 70.2 years; 66% male). At 3 months, rotigotine significantly improved sleep fragmentation from baseline on the PDSS-2 sleep maintenance subscale (from 3.4 ± 0.9 to 1.9 ± 1.4; P < 0.0001). Rotigotine also significantly improved nocturnal motor symptoms (P < 0.0001), restless legs-like symptoms (P < 0.005), and nocturia (P = 0.004). Rotigotine significantly improved self-reported complaints of sleep fragmentation in Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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PD patients and could be a useful treatment to improve this specific sleep problem in PD. However, these results are based on a small and clinically heterogeneous sample so they must be taken cautiously.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.010

Quartil: 3

Categoria: Clinical Neurology

Posició: 115/192

Grau-López L, Teniente-Serra A, Tintoré M, Rovira A, Ramió-Torrenta L, Brieva L, Saiz A, Cano A, Carmona O, Hervás JV, Martínez-Cáceres EM, Ramo-Tello C. Similar biological effect of high-dose oral versus intravenous methylprednisolone in multiple sclerosis relapses. Mult Scler. 2015 Apr;21(5):646-50. doi: 10.1177/1352458514546786. Epub 2014 Aug 21.

PubMed PMID: 25145693 Abstract: Our aim was to investigate differences in immune mechanisms in multiple sclerosis (MS) relapse, after high-dose oral methylprednisolone (oMP) or intravenous methylprednisolone (ivMP). We measured serum cytokines (IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α and IFN-γ) in 39 of 49 MS patients with moderate-severe relapse, whom were treated with ivMP or oMP in a placebo-controlled, non-inferiority clinical trial. We assessed these cytokine levels at baseline and at 1 and 4 weeks post-treatment. The cytokine levels between oMP and ivMP were similar at any time. Proinflammatory cytokines (IL-6 and IFN-γ) were significantly decreased in both groups at week 1 (p = 0.05 / p = 0.03) and at week 4 (p = 0.04 / p = 0.05). This study provides further confirmatory evidence that oMP is not inferior to ivMP. Indexat a: Medline/WOS/JCR Factor Impacte: 4.872

Quartil: 1

Categoria: Clinical Neurology

Posició: 22/192

Palomeras Soler E, Fossas Felip P, Cano Orgaz AT, Sanz Cartagena P, Casado Ruiz V, Muriana Batista D. Rapid assessment of transient ischaemic attack in a hospital with no on-call neurologist. Neurologia. 2015 Jul-Aug;30(6):325-30. doi: 10.1016/j.nrl.2013.12.021. Epub 2014 Jun 18. English, Spanish. PubMed PMID: 24953410 BACKGROUND: Risk of stroke soon after a transient ischaemic attack (TIA) is high. Urgent care can reduce this risk. Our aim is to describe and evaluate the efficacy of rapid assessment of TIA patients in a hospital without a neurologist available 24 hours a day.

METHODS: In February 2007, we set up a protocol of rapid management of patients with symptoms consistent with acute TIA, with the aim of prioritising urgent care and reducing hospital admissions, without increasing risk of recurrences. We analyse our results since the protocol was implemented with particular focus on the analysis of delay in neurological and neurovascular assessment, percentage and reasons for hospitalisation, and stroke recurrence rates after 3 months.

RESULTS: Four hundred and eleven patients were studied, with a final diagnosis of TIA in 282 (68.6%). Among other diagnoses, the most frequent were a vasovagal reaction (5.6%) and confusional syndrome (4.6%). Delay between emergency arrival and neurovascular assessment was <24h in 82% of the cases, and <48 h in 93%. After neurological evaluation, 28.7% of the patients were immediately admitted to hospital (most common causes: severe stenosis of a large artery and crescendo TIA). The incidence of ischaemic stroke in TIA patients was 3.55% after 3 months and 70% of them suffered the recurrence within the first week after the initial TIA. CONCLUSIONS: In a hospital without a neurologist available 24 hours a day, early assessment and management of TIA patients can be carried out in accordance with the guidelines, and may avoid hospitalisation in most cases without increasing recurrence rates.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.381

Quartil: 4

Categoria: Clinical Neurology

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Palomeras Soler E, Fossas Felip P, Casado Ruiz V, Cano Orgaz A, Sanz Cartagena P, Muriana Batiste D. The Mataró Stroke Registry: a 10-year registry in a community hospital. Neurologia. 2015 Jun;30(5):283-9. doi: 10.1016/j.nrl.2014.01.004.

Epub 2014 Jun 19. English, Spanish. PubMed PMID: 24953407 INTRODUCTION: A prospective stroke registry leads to improved knowledge of the disease. We present data on the Mataró Hospital Registry.

METHODS: In February-2002 a prospective stroke registry was initiated in our hospital. It includes sociodemographic data, previous diseases, clinical, topographic, etiological and prognostic data. We have analyzed the results of the first 10 years.

RESULTS: A total of 2,165 patients have been included, 54.1% male, mean age 73 years. The most frequent vascular risk factor was hypertension (65.4%). Median NIHSS on admission: 3 (interquartile range, 1-8). Stroke subtype: 79.7% ischemic strokes, 10.9% hemorrhagic, and 9.4% TIA. Among ischemic strokes, the etiology was cardioembolic in 26.5%, large-vessel disease in 23.7%, and small-vessel in 22.9%. The most frequent topography of hemorrhages was lobar (47.4%), and 54.8% were attributed to hypertension. The median hospital stay was 8 days. At discharge, 60.7% of patients were able to return directly to their own home, and 52.7% were independent for their daily life activities. After 3 months these percentages were 76.9% and 62.9%, respectively. Hospital mortality was 6.5%, and after 3 months 10.9%.

CONCLUSIONS: Our patient's profile is similar to those of other series, although the severity of strokes was slightly lower.

Length of hospital stay, short-term and medium term disability, and mortality rates are good, if we compare them with other series.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.381

Quartil: 4

Categoria: Clinical Neurology

Posició: 149/192

Rodríguez-Molinero A, Samà A, Pérez-Martínez DA, Pérez López C, Romagosa J, Bayés À, Sanz P, Calopa M, Gálvez-Barrón C, de Mingo E, Rodríguez Martín D, Gonzalo N, Formiga F, Cabestany J, Catalá A. Validation of a portable device for mapping motor and gait disturbances in Parkinson's disease. JMIR Mhealth Uhealth. 2015 Feb 2;3(1):e9. doi: 10.2196/mhealth.3321. PubMed PMID: 25648406 BACKGROUND: Patients with severe idiopathic Parkinson's disease experience motor fluctuations, which are often difficult to control. Accurate mapping of such motor fluctuations could help improve patients' treatment.

OBJECTIVE: The objective of the study was to focus on developing and validating an automatic detector of motor fluctuations. The device is small, wearable, and detects the motor phase while the patients walk in their daily activities.

METHODS: Algorithms for detection of motor fluctuations were developed on the basis of experimental data from 20 patients who were asked to wear the detector while performing different daily life activities, both in controlled (laboratory) and noncontrolled environments. Patients with motor fluctuations completed the experimental protocol twice: (1) once in the ON, and (2) once in the OFF phase. The validity of the algorithms was tested on 15 different patients who were asked to wear the detector for several hours while performing daily activities in their habitual environments. In order to assess the validity of detector measurements, the results of the algorithms were compared with data collected by trained observers who were accompanying the patients all the time.

RESULTS: The motor fluctuation detector showed a mean sensitivity of 0.96 (median 1; interquartile range, IQR, 0.93-1) and specificity of 0.94 (median 0.96; IQR, 0.90-1).

CONCLUSIONS: ON/OFF motor fluctuations in Parkinson's patients can be detected with a single sensor, which can be worn in everyday life.

Indexat a: PubMed/WOS

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DIGESTIU - GASTROENTEROLOGY Nº Articles indexats: 2

Factor Impacte total: 5.923

Factor d’impacte mig per article: 2.961

Acero Fernández D, Morillas Cunill R, Ferri Iglesias MJ, Torras Collell X, Vergara Gómez M, Zaragoza Velasco N, López Nuñez C, Forné Bardera M, Delgado Gómez M, Barenys Lacha M, Torres Salinas M, Villar Fernández M, Durández Lázaro R, Mariño Mendez Z. Predictive variables of sustained virological response after early discontinuation of triple therapy with telaprevir for genotype-1 HCV infection. Gastroenterol Hepatol. 2015 Nov 21. pii: S0210-5705(15)00248-4. doi: 10.1016/j.gastrohep.2015.10.005. [Epub ahead of print] PubMed PMID: 26614733 BACKGROUND: Pivotal phase studies of telaprevir (TLV) and boceprevir (BOV) showed 10-56% rates of early treatment interruption. However, there have been no reports on the sustained virological response (SVR) rates of these patients.

AIM: To assess the SVR rate in a large cohort of patients who discontinued triple therapy with TLV or BOV for reasons other than stopping rules and to identify variables predicting SVR. MATERIAL AND METHOD: A survey was sent to 15 hospitals in Catalonia asking them to report all TLV/BOV treatments finished by 31 May 2014. Demographic, clinical, laboratory, liver fibrosis and therapeutic data were recorded for treatments with early discontinuation. Logistic regression analysis, ROC curves and prognostic assessment of the variables identified were calculated.

RESULTS: Twelve hospitals responded to the survey, representing 467 treatments and 121 (21.2%) early discontinuations, 76 (62.8%) due to stopping rules and 45 (37.2%) for other reasons. Early discontinuation was more frequent with BOV [38.2% (50/131) versus 21.1% (71/336) p<0.005], mainly due to stopping rules [78% (39/50) versus 52.1% (37/71); p=0.004]. SVR was achieved in 21/121 patients (17.4%), 19/71 (26.8%) treated with TLV and 2/50 (4.0%) treated with BOV. In patients discontinuing treatment for reasons other than stopping rules, SVR was achieved in 19/37 (55.9%) treated with TLV and in 2/11 (18.2%) treated with BOV. The SVR rate in patients treated with TLV who discontinued due to a severe adverse event was 61.5% (16/26). A logistic regression analysis was performed only with triple therapy with TLV and early discontinuation. The predictive variables of SVR were undetectable HCV-RNA at treatment week 4 and treatment length longer than 11 weeks. Treatment duration longer than 11 weeks showed the best accuracy (0.794), with a positive predictive value of 0.928.

CONCLUSIONS: Early discontinuation of TLV-based triple therapy due to reasons other than stopping rules still have a significant SVR rate (55.9%). Undetectable HVC-RNA at week 4 of treatment and treatment duration longer than 11 weeks are predictive of SVR in this subset of patients.

Indexat a: Medline/WOS/JCR Factor Impacte: 0.838

Quartil: 4

Categoria: Gastroenterology & Hepatology

Posició: 72/76

García-González MA, Bujanda L, Quintero E, Santolaria S, Benito R, Strunk M, Sopeña F, Thomson C, Pérez-Aisa A, Nicolás-Pérez D, Hijona E, Carrera-Lasfuentes P, Piazuelo E, Jiménez P, Espinel J, Campo R, Manzano M, Geijo F, Pellise M, Zaballa M, González-Huix F, Espinós J, Titó L, Barranco L, Pazo-Cid R, Lanas A. Association of PSCA rs2294008 gene variants with poor prognosis and increased susceptibility to gastric cancer and decreased risk of duodenal ulcer disease.

Int J Cancer. 2015 Sep 15;137(6):1362-73. doi: 10.1002/ijc.29500. Epub 2015 Mar 19. PubMed PMID: 25721731.

Abstract: Two recent genome-wide association studies in Asians have reported the association between the PSCA (prostate stem cell antigen) rs2294008C>T gene polymorphism and two Helicobacter pylori infection-related diseases such as gastric cancer (GC) and duodenal ulcer (DU). Since rs2294008 allele frequencies differ notably among ethnicities, we aimed to assess the role of rs2294008 on the susceptibility to GC and DU in a Caucasian population in Spain. Moreover, the relevance of rs2294008 on GC prognosis was evaluated. Genomic DNA from 603 Spanish patients with primary GC, 139 with DU and 675 healthy controls was typed for the PSCA rs2294008C>T polymorphism by PCR-TaqMan assays. H. pylori infection [odds ratio (OR): 8.27; 95% confidence interval (CI): 3.45-15.33] and nonsteroidal anti-inflammatory drugs (OR: 6.54; 95% CI: 3.1912.43) were identified as independent risk factors for DU whereas the rs2294008T allele was associated with reduced risk of developing the disease (OR: 0.52; 95% CI: 0.33-0.82). Infection with CagA strains (OR: 2.10; 95% CI: 1.63-2.34), smoking (OR: 1.93; 95% CI: 1.54-2.61), family history of GC (OR: 2.83; 95% CI: 2.01-3.83), and the rs2294008T allele (OR: 1.46; 95%

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CI: 1.07-1.99) were associated with increased risk of GC. Interestingly, the association with the rs2294008T allele was restricted to noncardia GC (OR: 1.43; 95% CI: 1.12-1.82), particularly of the diffuse histotype (OR: 1.59; 95% CI: 1.16-1.92).

Finally, Cox regression analysis identified the rs2294008T variant as a prognosis factor associated with worse overall survival in patients with diffuse-type GC (hazard ratio: 1.85; 95% CI: 1.12-3.06). From these results we conclude that the PSCA rs2294008 polymorphism is involved in the susceptibility to GC and DU, as well as in the prognosis of the diffuse-type of GC in Caucasians.

Indexat a: Medline/WOS/JCR Factor Impacte: 5.085

Quartil: 1

Categoria: Oncology

Posició: 31/211

NEUMOLOGIA - PNEUMOLOGY Nº Articles indexats: 2

Factor Impacte total: 9.459

Factor d’impacte mig per article: 4.729

González-Gutiérrez MV, Guerrero Velázquez J, Morales García C, Casas Maldonado F, Gómez Jiménez FJ, González Vargas F. Predictive Model for Anxiety and Depression in Spanish Patients with Stable Chronic Obstructive Pulmonary Disease.

Arch Bronconeumol. 2015 Oct 20. pii: S0300-2896(15)00358-0. doi: 10.1016/j.arbres.2015.09.003. [Epub ahead of print] English, Spanish. Pubmed PMID: 26497418 INTRODUCTION: The association between chronic obstructive pulmonary disease (COPD) and anxiety and depression is not yet completely characterized, and differences between countries may exist. We used a predictive model to assess this association in a Spanish population.

PATIENTS AND METHOD: Prospective transversal descriptive study of 204 patients with stable COPD. Concomitant anxiety or depression were diagnosed by psychiatric assessment, using the diagnostic criteria of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Sociodemographic, clinical and lung function parameters were analyzed.

RESULTS: In total, 36% of stable COPD patients had psychiatric comorbidities, but 76% were unaware of their diagnosis.

Nineteen percent had a pure anxiety disorder, 9.8% had isolated depression, and 7.3% had a mixed anxiety-depression disorder. Predictive variables in the multivariate analysis were younger age, higher educational level, lack of home support, higher BODE index, and greater number of exacerbations. The ROC curve of the model had an AUC of 0.765 (P<0.001).

CONCLUSIONS: In COPD, concomitant psychiatric disorders are significantly associated with sociodemographic factors.

Anxiety disorders are more common than depression. Patients with more severe COPD, according to BODE, younger patients and those with a higher educational level have a greater risk of being diagnosed with anxiety or depression in a structured psychiatric interview. In our population, most patients with psychiatric comorbidities remain unidentified.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.823

Quartil: 3

Categoria: Respiratory System

Posició: 40/58

Plaza V, Peiró M, Torrejón M, Fletcher M, López-Viña A, Ignacio JM, Quintano JA, Bardagí S, Gich I; PROMETHEUS Study Group. A repeated short educational intervention improves asthma control and quality of life. Eur Respir J. 2015 Nov;46(5):1298-307. doi: 10.1183/13993003.00458-2015. Epub 2015 Sep 24. Pubmed PMID: 26405291 Abstract: We assessed the effectiveness of an asthma educational programme based on a repeated short intervention (AEP-RSI) to improve asthma control (symptom control and future risk) and quality of life.A total of 230 adults with mild-tomoderate persistent uncontrolled asthma participated in a 1-year cluster randomised controlled multicentre study. The AEP-RSI was given in four face-to-face sessions at 3-month intervals, and included administration of a written personalised action plan and training on inhaler technique. Centres were randomised to the AEP-RSI (intervention) group or usual clinical practice group. Specialised centres using a standard educational programme were the gold standard group.A significant Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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improvement in the Asthma Control Test score was observed in all three groups (p<0.001), but improvements were higher in the intervention and gold standard groups than in the usual clinical practice group (p=0.042), which also showed fewer exacerbations (mean±sd; 1.20±2.02 and 0.56±1.5 versus 2.04±2.72, respectively) and greater increases in the Mini Asthma Quality of Life Questionnaire scores (0.95±1.04 and 0.89±0.84 versus 0.52±0.97, respectively).The AEP-RSI was effective in improving asthma symptom control, future risk and quality of life.

Indexat a: Medline/WOS/JCR Factor Impacte: 7.636

Quartil: 1

Categoria: Respiratory System

Posició: 4/58

MEDICINA INTERNA – INTERNAL MEDICINE Nº Articles indexats: 13

Factor Impacte total: 41.458

Factor d’impacte mig per article: 3.189

Santos JR, Blanco JL, Masiá M, Gutiérrez F, Pérez-Elías MJ, Iribarren JA, Force L, Antela A, Knobel H, Salavert M, López Bernaldo De Quirós JC, Pino M, Paredes R, Clotet B; Integrase Resistance Study Group in Spain (INI-VAIN Study Group); Integrase Resistance Study Group in Spain INI-VAIN Study Group. Virological failure to raltegravir in Spain: incidence, prevalence and clinical consequences. J Antimicrob Chemother. 2015 Nov;70(11):3087-95. doi: 10.1093/jac/dkv205. Epub 2015 Jul 30. PubMed PMID: 26490727.

OBJECTIVES: The objective of this study was to evaluate the incidence, prevalence and clinical consequences of virological failure (VF) to raltegravir-based regimens in Spain.

METHODS: A multicentre, retrospective, observational study was performed in 10 tertiary hospitals (January 2006 to June 2013). The study included HIV-1-infected patients with loss of virological suppression (LVS; two consecutive HIV-1 RNA ≥50 copies/mL) while receiving raltegravir. VF and low-level viraemia (LLV) were defined as two consecutive HIV-1 RNA ≥200 copies/mL and 50 to <200 copies/mL, respectively. Integrase strand-transfer inhibitor resistance was investigated at LVS. During the 48 weeks following LVS, recorded data included clinical characteristics, treatment discontinuations, AIDSassociated events and deaths. Effectiveness of therapy following LVS was evaluated by ITT and PP. Multivariate regression was used to assess predictors of efficacy.

RESULTS: Of the 15 009 HIV-infected patients in participating centres, 2782 (18.5%) had received raltegravir-based regimens. Of those, 192 (6.9%), 125 (4.5%) and 67 (2.4%) experienced LVS, VF and LLV, respectively. The incidence of VF was 1.8 (95% CI, 1.5-2.1) per 100 patients/year. The prevalence of VF was 4.5% (95% CI, 3.8%-5.3%). Integrase-associated mutations were found in 78.8% of patients with integrase genotyping results available. High-level resistance to dolutegravir was not observed. Salvage therapy failed in 34.1% of patients; progression to AIDS/death occurred in 8.3% during the first year following LVS. The latter was associated with intravenous drug use, time on raltegravir and lower CD4+ count nadir in patients who started raltegravir-based treatments as salvage regimens.

CONCLUSIONS: VF with raltegravir is infrequent, but often associated with major clinical complications in treatmentexperienced patients.

Indexat a: Medline/WOS/JCR Factor Impacte: 5.313

Quartil: 1

Categoria: Infectious Diseases

Posició: 8/78

Ferrer E, Curto J, Esteve A, Miro JM, Tural C, Murillas J, Segura F, Barrufet P, Casabona J, Podzamczer D; PISCIS Investigators. Clinical progression of severely immunosuppressed HIV-infected patients depends on virological and immunological improvement irrespective of baseline status. J Antimicrob Chemother. 2015 Dec;70(12):3332-8. doi: 10.1093/jac/dkv272. Epub 2015 Sep 25. PubMed PMID: 26410171 OBJECTIVES: The aim of this study was to analyse factors associated with progression to AIDS/death in severely immunosuppressed HIV-infected patients receiving ART. Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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METHODS: This study included naive patients from the PISCIS Cohort with CD4 <200 cells/mm(3) at enrolment and who initiated ART consisting of two nucleoside analogues plus either a PI or an NNRTI between 1998 and 2011. The PISCIS Cohort is a multicentre, observational study of HIV-infected individuals aged >18 years followed at 14 participating hospitals in Catalonia and the Balearic Islands (Spain). Clinical and laboratory parameters were assessed every 3-4 months during follow-up. Cox regression models were used to assess the effect of CD4 and viral load on the risk of progression to AIDS/death, adjusting for baseline variables and confounders.

RESULTS: 2295 patients were included and, after 5 years, 69.9% reached CD4 ≥200 cells/mm(3), 64.4% had an undetectable viral load and 482 (21%) progressed to AIDS/death. The lowest rate of disease progression was found in patients who reached both immunological and viral responses during follow-up, regardless of their baseline situation (1.9% in baseline CD4 >100 cells/mm(3) and viral load <5 log copies/mL; 2.3% in baseline CD4 ≤100 cells/mm(3) and/or viral load >5 log copies/mL). Achieving a CD4 count ≥200 cells/mm(3) was the main predictor of decreased progression to AIDS/death. In those not reaching this CD4 threshold, virological response reduced disease progression by half.

CONCLUSIONS: Even in the worse baseline scenario of CD4 ≤100 cells/mm(3) and high baseline viral loads, positive virological and immunological responses were associated with dramatic decreases in progression.

Indexat a: Medline/WOS/JCR Factor Impacte: 5.313

Quartil: 1

Categoria: Infectious Diseases

Posició: 8/78

Reyes-Urueña J, Fernàndez-López L, Force L, Daza M, Agustí C, Casabona J. [Level of impact on the public health of universal human immunodeficiency virus screening in an Emergency Department]. Enferm Infecc Microbiol Clin. 2015 Sep 1. pii: S0213-005X(15)00272-4. doi: 10.1016/j.eimc.2015.06.014. [Epub ahead of print] Spanish. PubMed PMID: 26341042 INTRODUCTION: The aim of this study was to determine the prevalence of HIV and the acceptability of rapid testing in an emergency department (ED), Barcelona (6/07/2011 to 8/03/2013).

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

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

CONCLUSION: A low prevalence of new HIV diagnoses was found among participants, although there was a high acceptability rate to perform rapid testing in the ED. Indexat a: Medline/WOS/JCR Factor Impacte: 2.172

Quartil: 3

Categoria: Infectious Diseases

Posició: 53/78

Cabré M, Ferreiro C, Arus M, Roca M, Palomera E, Serra-Prat M. Evaluation of CONUT for Clinical Malnutrition Detection and Short-Term Prognostic Assessment in Hospitalized Elderly People. J Nutr Health Aging. 2015 Aug;19(7):729-33. doi: 10.1007/s12603-015-0536-6. PubMed PMID: 26193855 OBJECTIVES: To assess agreement between the CONUT and Mini Nutritional Assessment (MNA) instruments in detecting malnutrition in hospitalized elderly patients and to determine their prognostic value compared to that of serum albumin alone in relation to in-hospital and 1-month and 6-month post-discharge mortality rates.

DESIGN: Prospective observational study.

SETTING: A Catalan regional hospital.

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PARTICIPANTS: 2155 patients admitted to an acute geriatric unit were assessed using MNA and CONUT and were followed up for 6 months after discharge.

MEASUREMENTS: On admission, data were collected on age, sex, referral, geriatric syndromes, cognitive status, functional status and nutritional status according to MNA (as the gold standard). Plasma albumin, total cholesterol and lymphocyte levels were recorded to implement CONUT. Mortality was recorded until 6 months after discharge.

RESULTS: Sample characteristics: 61.3% females, mean age 84.9 years, mean Charlson index 2.2. CONUT sensitivity and specificity for malnutrition were 43% and 71.6%, respectively, with positive and negative predictive values of 88.9% and 19.2%. MNA, CONUT and albumin alone were good predictors of mortality but showed similar sensitivity and specificity results.

CONCLUSION: CONUT agreement with MNA in nutritional risk assessments for elderly people is poor. Although CONUT is a good predictor of short-and medium-term mortality, it adds little to information provided by albumin alone.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.996

Quartil: 2

Categoria: Geriatrics & Gerontology

Posició: 21/50

Almagro P, Cabrera FJ, Diez-Manglano J, Boixeda R, Recio J, Mercade J, Yun S, Soriano JB; Working Group on COPD, Spanish Society of Internal Medicine. Comorbidome and short-term prognosis in hospitalised COPD patients: the ESMI study. Eur Respir J. 2015 Sep;46(3):850-3. doi: 10.1183/09031936.00008015. Epub 2015 Apr 21. PubMed PMID: 25900375 Abstract: Chronic obstructive pulmonary disease (COPD) patients have an increased prevalence of cardiovascular disease, cancer or psychiatric diseases, among many other comorbid conditions. This is explained in part by smoking history, along with genetic factors, ageing and the low grade inflammation characteristic of COPD [1, 2]. Although comorbidities may be present at the time of the initial diagnosis, their frequency increases with COPD progression, and are particularly common in patients with more advanced disease, especially in those hospitalised with acute exacerbations [3, 4]. These comorbidities complicate the management of COPD patients, lengthen hospital stay, cause physical functional dependency, increase number of readmissions, and are associated with decreased survival in the short, medium and long term.

Indexat a: Medline/WOS/JCR Factor Impacte: 7.636

Quartil: 1

Categoria: Respiratory System

Posició: 4/58

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

Nationwide study on the use of intravascular catheters in internal medicine departments. J Hosp Infect. 2015 Jun;90(2):135-41. doi: 10.1016/j.jhin.2015.01.024. Epub 2015 Feb 26. PubMed PMID: 25824558 BACKGROUND: The use of intravascular catheters (IVCs) in intensive care units (ICUs) has been well assessed in recent years. However, a high proportion of these devices are placed in patients outside the ICU, particularly in internal medicine departments (IMDs), where data on the quality of care are scarce.

AIM: To assess the use and management of IVCs in IMDs in Spain.

METHODS: We performed a point prevalence study of all adult inpatients on 47 IMDs from hospitals of different sizes on one day in June 2013. A local co-ordinator was appointed to assess patients and collect data from each site.

FINDINGS: Out of the 2080 adult patients hospitalized on the study day, 1703 (81.9%) had one or more IVCs (95.4% of which were peripheral devices). Infection was detected at the insertion site in 92 catheters (5.0%); 87 patients (5.2%) had signs of sepsis, but only one case was considered to be catheter-related. The local co-ordinators estimated that 19% of the catheters in place were no longer necessary. A daily record of the need for a catheter was available in only 40.6% of cases.

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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CONCLUSION: Our study shows clear opportunities for improvement regarding catheter use and care in Spanish IMDs. Strategies similar to those applied in ICUs should be implemented in IMDs. Indexat a: Medline/WOS/JCR Factor Impacte: 2.544

Quartil: 3

Categoria: Infectious Diseases

Posició: 40/78

Treviño A, Cabezas T, Lozano AB, García-Delgado R, Force L, Fernández-Montero JM, Mendoza Cd, Caballero E, Soriano V. Dolutegravir for the treatment of HIV-2 infection. J Clin Virol. 2015 Mar;64:12-5. doi: 10.1016/j.jcv.2015.01.001. Epub 2015 Jan 5. PubMed PMID: 25728072 BACKGROUND: Therapeutic options are limited for HIV-2 infected persons, largely in part due to the lack of susceptibility to HIV-1 non-nucleoside reverse transcriptase inhibitors and poor susceptibility to some HIV-1 protease inhibitors. This is particularly worrisome for HIV-2 patients with prior antiretroviral failure.

OBJECTIVES: Report the virological response to dolutegravir in HIV-2-infected individuals.

STUDY DESIGN: Retrospective observational assessment of all HIV-2 individuals treated with dolutegravir in Spain.

RESULTS: From 297 HIV-2-infected individuals recorded at the Spanish national registry, 26% received antiretroviral therapy. Six out of 8 failing on raltegravir selected for integrase resistance mutations N155H (4), Y143G (1) and Q148R (1).

Two patients bearing N155H subsequently received dolutegravir. Both experienced initially more than 1.5 log drop in plasma HIV-2 RNA and significant CD4 gains. Whereas one kept on undetectable viremia 6 months later, the other experienced viral rebound.

CONCLUSION: Dolutegravir may be a good therapeutic option for patients with HIV-2 infection, including those that previously failed other integrase inhibitors.

Indexat a: Medline/WOS/JCR Factor Impacte: 3.016

Quartil: 2

Categoria: Virology

Posició: 16/33

Gil N, Boixeda R, Mauri M, Capdevila JA. [Visual disturbances as a sign of early neurosyphilis. Two cases of neurosyphilis.]. Semergen. 2015 Jan 5. pii: S1138-3593(14)00465-1. doi: 10.1016/j.semerg.2014.11.003. [Epub ahead of print] Spanish. PubMed PMID: 25573612 Desde finales de la década de los 90 se ha descrito en grandes ciudades europeas y norteamericanas un importante aumento en el número de casos de sífilis detectados. Este incremento se atribuye fundamentalmente a un aumento en las prácticas sexuales de riesgo. Algunos autores describen aumentos de un 22% en mujeres, del 213% en varones heterosexuales y de hasta un 1.412% en varones homosexuales en ciudades del Reino Unido1. Dado que comparten mecanismo de transmisión, la sífilis y la infección por VIH se presentan con frecuencia asociadas en el mismo grupo de pacientes.

Indexat a: Medline/WOS

Pesavento R, Amitrano M, Trujillo-Santos J, Di Micco P, Mangiacapra S, López-Jiménez L, Falgá C, García-Bragado F, Piovella C, Prandoni P, Monreal M; RIETE Investigators. Fondaparinux in the initial and long-term treatment of venous thromboembolism. Thromb Res. 2015 Feb;135(2):311-7. doi: 10.1016/j.thromres.2014.11.032. Epub 2014 Dec 13.

PubMed PMID: 25543161 BACKGROUND: Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice.

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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METHODS: We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer.

RESULTS: Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p<0.05).

CONCLUSIONS: An unexpected high rate of major bleeding was observed in non-cancer patients treated with long-term fondaparinux. Our small sample does not allow to derive relevant conclusions on the use of fondaparinux in cancer patients.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.447

Quartil: 3

Categoria: Peripheral Vascular Disease

Posició: 34/60

Martínez E, Ribera E, Clotet B, Estrada V, Sanz J, Berenguer J, Rubio R, Pulido F, Larrousse M, Curran A, Negredo E, Arterburn S, Ferrer P, Álvarez ML. Switching from zidovudine/lamivudine to tenofovir/emtricitabine improves fat distribution as measured by fat mass ratio. HIV Med. 2015 Jul;16(6):370-4. doi: 10.1111/hiv.12210. Epub 2014 Dec 11.

PubMed PMID: 25496141 OBJECTIVES: Fat mass ratio (FMR) has been suggested as an objective indicator of abnormal body fat distribution in HIV infection. Although it could provide more comprehensive information on body fat changes than limb fat mass, FMR has scarcely been used in clinical trials examining body fat distribution in HIV-infected patients.

METHODS: A subanalysis of a controlled, randomized clinical trial in virologically suppressed HIV-1-infected men switching from zidovudine (ZDV)/lamivudine (3TC) to emtricitabine (FTC)/tenofovir (TDF) versus continuing on ZDV/3TC was carried out. FMR was assessed by dual X-ray absorptiometry (DEXA) for a period of 72 weeks. Lipoatrophy was defined as FMR ≥ 1.5. Multivariate linear regression models for the change in FMR from baseline were fitted.

RESULTS: Sixty-five men were randomized and treated (28 in the FTC/TDF arm and 37 in the ZDV/3TC arm), and 57 completed the study (25 and 32 in each arm, respectively). In the FTC/TDF arm, adjusted mean FMR decreased by 0.52 at week 72 (P = 0.014), and in the ZDV/3TC arm it increased by 0.13 (P = 0.491; P between arms = 0.023). Among subjects with lipoatrophy (baseline FMR ≥ 1.5), adjusted FMR decreased by 0.76 (P = 0.003) in the FTC/TDF arm and increased by 0.21 (P = 0.411; P between arms = 0.009) in the ZDV/3TC arm. Baseline FMR and treatment group were significant predictors (P < 0.05) of post-baseline changes in FMR. CONCLUSIONS: Switching from ZDV/3TC to FTC/TDF led to an improvement in FMR, compared with progressive worsening of FMR in subjects receiving ZDV/3TC, showing that fat mass not only increased but was also distributed in a healthier way after the switch.

Indexat a: Medline/WOS/JCR Factor Impacte: 3.988

Quartil: 1

Categoria: Infectious Diseases

Posició: 18/78

Vendrell E, Capdevila JA, Barrufet P, Force L, Sauca G, Martínez E, Palomera E, Serra-Prat M, Cornudella J, Llopis A, Robledo MA, Vázquez C. Mortality among methicillin-resistant Staphylococcus aureus carriers in long-term care facilities.

Rev Esp Quimioter. 2015 Apr;28(2):92-7. PubMed PMID: 25904516

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INTRODUCTION: Little is known about the natural course of patients with chronic stable illnesses colonized with methicillinresistant Staphylococcus aureus (MRSA). The aim is to determine the impact of MRSA colonization in mortality among longterm health care facility (LTHCF) residents.

METHOD: A multicenter, prospective, observational study was designed. Residents in 4 LTHCFs were classified according to MRSA carriage status and followed for 12 months. Treatment consisted of 5 days of nasal mupirocin in MRSA carriers.

RESULTS: Ninety-three MRSA-carriers among 413 residents were identified. Thirty-one MRSA-colonized patients died during the study period, 11 of whom from an infectious disease. Independent predictors of their higher mortality rates included heart failure, current neoplasm, MRSA carriage and COPD at 3 months and these same factors plus stroke, Bar-thel index <40, pressure ulcers, and older age at 12 months. MRSA-persistence was 35% and 62.5% at 3 and 12 months, respectively.

CONCLUSIONS: MRSA colonization among frail LTHCFs residents is highly prevalent, and is associated with higher mortality.

Despite treatment of MRSA carriers, many remained colonized. Factors that promote persistence of MRSA colonization, and the impact of their modification on mortality rates in these patients, need further investigation.

Indexat a: Medline/WOS/JCR Factor Impacte: 0.797

Quartil: 4

Categoria: Microbiology

Posició: 107/119

Campbell CN, Ambrosioni J, Miro JM, Esteve A, Casabona J, Navarro G, García I, Ferrer E, Force L, Tural C. The continuum of HIV care in Catalonia. AIDS Care. 2015 Nov 25:1-6. [Epub ahead of print] PubMed PMID: 26605781.

Abstract: The objective was to produce a cascade of care for Catalonia to gain a public health perspective on the overall quality of HIV services and allow comparison with other countries. It was constructed using the Integrated Epidemiological Surveillance System of HIV in Catalonia and data from the PISCIS Cohort. Estimates of the number of people living with HIV in Catalonia are modelled using Spectrum Projection Package 2011 (UNAIDS/WHO). Totals for each stage in the cascade are obtained by applying to the preceding stage a proportion estimated from available surveillance and cohort data.

Undiagnosed HIV was estimated from the European literature. The proportions retained in care, on ART and virally suppressed were derived from the PISCIS cohort. Programmatic data on ART consumption was used to validate estimates.

By the end of 2011 there were about 33,000 people living with HIV in Catalonia, 71% of which had been both diagnosed and linked to care. We estimate that 61% of all HIV infected persons were retained in care, 56% were on ART and 48% were virally suppressed. These figures data are comparable, although slightly lower, than that of France or the UK. The Cascade of HIV Care in Catalonia is similar to other western European countries such as France and the UK. Direct estimates of the undiagnosed HIV population and linkage to care are desirable but the contribution of cohort data to the cascade highlights their continued importance in HIV surveillance and design of evidence-based health strategies.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.095

Quartil: 1

Categoria: Social Sciences, Biomedical

Posició: 7/30

Boixeda R, Almagro P, Díez-Manglano J, Cabrera FJ, Recio J, Martin-Garrido I, Soriano JB. Bacterial flora in the sputum and comorbidity in patients with acute exacerbations of COPD. Int J Chron Obstruct Pulmon Dis. 2015 Dec 1;10:25812591. eCollection 2015. PubMed PMID: 26664106 Objective: To determine in patients admitted with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) the association between the isolation of potential pathogens in a conventional sputum culture and comorbidities.

Patients and methods: The ESMI study is a multicenter observational study. Patients with AE-COPD admitted to the Internal Medicine departments of 70 hospitals were included. The clinical characteristics, treatments, and comorbidities were gathered. The results of conventional sputum cultures were recorded.

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Results: A total of 536 patients were included, of which 161 produced valid sputum and a potentially pathogenic microorganism was isolated from 88 subjects (16.4%). The isolation of Pseudomonas aeruginosa (30.7%) was associated with a greater severity of the lung disease (previous admissions [P= 0.026], dyspnea scale [P=0.047], post-broncodilator forced expiratory volume in 1 second (FEV1) [P=0.005], and the BODEx index [P=0.009]); also with higher prevalence of cor pulmonale (P=0.017), heart failure (P=0.048), and cerebrovascular disease (P=0.026). Streptococcus pneumoniae (26.1%) was associated with more comorbidity according to number of diseases (P=0.018); notably, peripheral artery disease (P=0.033), hypertension (P=0.029), dyslipidemia (P=0.039), osteoporosis (P=0.0001), and depression (P=0.005).

Conclusion: Patients with AE-COPD and P. aeruginosa present higher severity of COPD, while those with S. pneumoniae present greater comorbidity. The potentially pathogenic microorganism obtained in the sputum culture depends on the associated comorbidities.

Indexat a: Medline/WOS/JCR Factor Impacte: 3.141

Quartil:

Categoria:

Posició:

ENDOCRINOLOGIA – ENDOCRINOLOGY Nº Articles indexats: 3

Factor Impacte total: 2.399

Factor d’impacte mig per article: 0.799

Zafon C, Puig-Domingo M, Biarnés J, Halperin I, Bella MR, Castells I, González C, Megía A, Santos L, García-Pascual L, Reverter JL, Pizarro E, Mauricio D; en nombre del Consorcio para el Estudio del Cáncer de Tiroides (CECaT). A descriptive study of the characteristics of differentiated thyroid cancer in Catalonia during the period 1998-2012. The CECaT registry.

Endocrinol Nutr. 2015 Jun-Jul;62(6):264-9. doi: 10.1016/j.endonu.2015.03.005. Epub 2015 May 13. English, Spanish.

PubMed PMID: 25979187 INTRODUCTION: The consortium for the study of thyroid cancer (CECaT), including 20 hospitals and one research institute, was recently created in Catalonia (Spain). One of the first initiatives of the group was to perform a descriptive analysis of the characteristics of patients with differentiated thyroid carcinoma (DTC).

PATIENTS AND METHODS: The cohort included 1,855 patients from 11 hospitals treated over a period of 15 years (19982012).

RESULTS: In this series, 1.470 (79.2%) patients were women. Mean age was 47.7 (15.7) years old. Age was significantly higher in male than in female patients, 49.3 (15) versus 47.3 (15.8); p=0.02. Papillary thyroid carcinoma accounted for 88.9% of cases. Mean tumor size was 21.5 (16) mm, and was significantly lower in females than in males, 20.1 (14.5) mm and 26.6 (20.3) mm respectively (p<0.001). After a follow-up period of 5.5 (3.7) years, information was available for 1,355 patient, of whom 1065 (78.6%) were free of disease, 239 (17.6%) had no tumor persistence, and 51 (3.8) % had died. The risk of persistent or recurrent disease was significantly associated to older age at diagnosis, male gender, larger tumor size, lymph node metastases at surgery, no signs of thyroiditis in the remaining thyroid tissue, and presence of vascular and/or extraglandular invasion.

CONCLUSIONS: Patient characteristics analyzed are similar to those reported in other parts of the world Indexat a: Medline/WOS

Julián MT, Alonso N, Ojanguren I, Pizarro E, Ballestar E, Puig-Domingo M. Hepatic glycogenosis: An underdiagnosed complication of diabetes mellitus? World J Diabetes. 2015 Mar 15;6(2):321-5. doi: 10.4239/wjd.v6.i2.321. Review.

Pubmed PMID: 25789113 ABSTRACT: Hepatic glycogenosis (HG) is characterized by excessive glycogen accumulation in hepatocytes and represents a hepatic complication of diabetes that particularly occurs in patients with longstanding poorly controlled type 1 diabetes Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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(T1D). HG has been reported to be a very rare disease, although it is believed to be extremely underdiagnosed because it is not possible to distinguish it from non-alcoholic fatty liver disease (NAFLD) unless a liver biopsy is performed. In contrast to HG, NAFLD is characterized by liver fat accumulation and is the more likely diagnosis for patients with type 2 diabetes and metabolic syndrome. The pathogenesis of HG involves the concomitant presence of insulin and excess glucose, which increases glycogen storage in the liver. HG is characterized by a transient elevation in liver transaminases and hepatomegaly. Differentiating between these two conditions is of the utmost importance because HG is a benign disease that is potentially reversible by improving glycemic control, whereas NAFLD can progress to cirrhosis. Therefore, HG should be suspected when liver dysfunction occurs in patients with poorly controlled T1D. The aim of this article is to review the epidemiology, clinical characteristics, pathogenesis and histology of HG. Indexat a: PubMed

Serra-Planas E, Aguilera E, Granada ML, Soldevila B, Salinas I, Reverter JL, Pizarro E, Pellitero S, Alonso N, Mauricio D, Puig-Domingo M. High prevalence of vitamin D deficiency and lack of association with subclinical atherosclerosis in asymptomatic patients with Type 1 Diabetes Mellitus from a Mediterranean area. Acta Diabetol. 2015 Aug;52(4):773-9. doi: 10.1007/s00592-014-0699-3. Epub 2015 Jan 10. PubMed PMID: 25572333 AIMS: Several studies linked vitamin D deficiency with coronary artery disease (CAD). The aim of this study was to evaluate the relationship between the concentrations of 25-hydroxyvitamin D (25OHD) and the presence of early atherosclerosis in asymptomatic Type 1 Diabetes (T1D) patients with no previous history of ischemic heart disease.

METHODS: One hundred and forty-five patients with T1D (age 37.8 ± 8 years, 57 % male, all Caucasian, disease duration 20.6 ± 8.3 years, HbA1c 7.6 ± 1.4 % (60.2 ± 11.1 mmol/mol), body mass index (BMI) 25.2 ± 3.5 kg/m2, 52.4 % smokers, 23 % retinopathy, 10 % nephropathy) and 48 controls matched for age, sex, BMI and smoking habit were studied. 25OHD deficiency was defined for values ≤20 ng/mL. A sun exposure questionnaire, carotid ultrasonography to determine carotid intima-media thickness (CIMT) and the presence of atheroma plaques and cardiac computed tomography for evaluation of calcium artery calcification (CACS) were performed.

RESULTS: T1D subjects showed a high proportion of 25OHD deficiency (43.2 % vs. 21.7 %, p = 0.032). Of all, 82 % of T1D patients and 92 % of controls had a calcium score of 0. CIMT was greater in patients with T1D (0.55 ± 0.14 mm vs 0.48 ± 0.15, p = 0.01) compared with controls. T1D subjects showed no differences in the results of CACS or CIMT according to the vitamin D concentrations.

CONCLUSIONS: T1D patients have lower concentrations and twice more prevalence of 25OHD deficiency than controls.

There was no association between 25OHD concentrations and subclinical CAD. Indexat a: Medline/WOS/JCR Factor Impacte: 2.399

Quartil: 3

Categoria: Endocrinology & Metabolism

Posició: 76/128

Julián MT, Pizarro E, Martínez Peralta S, García Vidal O, Casals S, Ballestar E (2015) Gynecomastia as Unusual Presentation of Primary Choriocarcinoma of the Colon: A Case Report and Literature Review. AACE Clinical Case Reports: Autumn 2015, Vol. 1, No. 4, pp. e260-e264.

Objective: Gynecomastia is the benign enlargement of male breast tissue and is the most common breast condition in males. Beta human chorionic gonadotropin (β-hCG)-secreting tumors such as choriocarcinoma are one cause of gynecomastia. This is the first report of bilateral gynecomastia secondary to malignant β-hCG-secreting choriocarcinoma located in the colon.

Methods: A 49 year-old male who presented bilateral gynecomastia was found to have a primary colonic choriocarcinoma.

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Results: Serum β-hCG levels were significantly high at 11.546 mIU/mL (normal range 0.01–5). A colonoscopy showed a stenosing mass in the sigmoid colon, and computed tomography revealed multiple liver metastases. The diagnosis of choriocarcinoma was confirmed by the histologic and immunohistochemical biopsy findings.

Conclusion: Primary colorectal choriocarcinoma is a very rare entity that should be considered in the differential diagnosis of gynecomastia.

DERMATOLOGIA – DERMATOLOGY Nº Articles indexats: 1

Factor Impacte total: 3.720

Factor d’impacte mig per article: 3.720

Puig S, Marcoval J, Paradelo C, Azon A, Bartralot R, Bel S, Bigata X, Boada A, Campoy A, Carrera C, Curco N, Dalmau J, Ferrándiz C, Ferreres JR, Formigon M, Gallardo F, Gonzalez A, Just M, Llistosella E, Marti RM, Nogues ME, Pedragosa R, Pujol JA, Roldán-Marín R, Sabat M, Salleras M, Smandia JA, Zaballos P, Plana E, Malvehy J. Melanoma incidence increases in the elderly of Catalonia but not in the younger population: effect of prevention or consequence of immigration? Acta Derm Venereol. 2015 Apr;95(4):422-6. doi: 10.2340/00015555-1997. PubMed PMID: 25367888 Abstract: All cases of MM diagnosed in 23 hospitals in Catalonia, from 2000 to 2007 were recorded and melanoma incidence calculated and adjusted for the European standard population via the direct method. The age standardised rate/100,000 inhabitants varied from 6.74 in 2000 to 8.64 in 2007 for all melanomas and from 4.79 to 5.80 for invasive MMs; the Breslow thickness was stable during the period. The increase in invasive melanoma incidence in the elderly was remarkable, the crude rate/100,000 inhabitants increasing from 11.04 (2000) to 15.49 (2007) in the 60-64 year population, while remaining more stable in the 30-34 year range, from 3.97 in 2000 to 4.55 in 2007, and with a tendency to decrease from 5.1 in 2000 to 2.5 in 2007 for the age range of 25-29 years. These lower age ranges are much more affected by immigration. Despite the large immigrant population (nearly one million immigrants arrived in Catalonia during the study period from countries with a low melanoma incidence), melanoma incidence in our region has risen considerably and this trend is likely to persist in the near future Indexat a: Medline/WOS/JCR Factor Impacte: 3.720

Quartil: 1

Categoria: Dermatology

Posició: 9/63

REUMATOLOGIA – RHEUMATOLOGY Nº Articles indexats: 1

Factor Impacte total: 2.901

Factor d’impacte mig per article: 2.901

Monfort J, Rotés-Sala D, Segalés N, Montañes FJ, Orellana C, Llorente-Onaindia J, Mojal S, Padró I, Benito P. Comparative efficacy of intra-articular hyaluronic acid and corticoid injections in osteoarthritis of the first carpometacarpal joint: results of a 6-month single-masked randomized study. Joint Bone Spine. 2015 Mar;82(2):116-21. doi: 10.1016/j.jbspin.2014.08.008. Epub 2014 Oct 11. PubMed PMID: 25311256 OBJECTIVE: The study aim was to compare the efficacy and safety of ultrasound-guided intra-articular injections of hyaluronic acid and betamethasone in the management of patients with osteoarthritis of the thumb.

METHODS: Eighty-eight evaluable patients diagnosed with osteoarthritis of the thumb (Kellgren-Lawrence grade II-III) received ultrasound-guided intra-articular treatment with hyaluronic acid (48) or betamethasone (40). In total, 3 local injections were scheduled at 7-day intervals. Assessments were performed at baseline and at 7, 14, 30, 90, and 180 days.

RESULTS: In both study groups, the pain Visual Analogue Scale and Functional Index for Hand Osteoarthritis scores decreased significantly during follow-up compared to baseline. There were no significant differences between the groups.

However, at 90 days, the functional score showed a trend towards greater clinical improvement in the hyaluronic acid group (P 0.071). A subanalysis of patients with Functional Index score≥5 and Visual Analogue Scale score≥3 at baseline

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showed a significantly higher median functionality score in the hyaluronic acid group (P 0.005 at 90 days and P 0.020 at 180 days). Further limiting analysis to a baseline pain score≥5 showed significantly greater improvement in functionality score (P 0.004 at 180 days), which was already apparent after the second intra-articular injection at 14 days (P 0.028). In this patient subset, the mean pain score also improved significantly at 180 days (P 0.02).

CONCLUSIONS: Both hyaluronic acid and betamethasone were effective and well-tolerated for the management of rhizarthrosis. Hyaluronic acid was more effective over time and more efficiently improved functionality and pain in patients with more severe symptoms Indexat a: Medline/WOS/JCR Factor Impacte: 2.901

Quartil: 2

Categoria: Rheumatology

Posició: 11/32

Montfort J, Rotes-Sala D, Segales N, Montañes FJ, Orellana C, Llorente Onaindia J, Mojal S, Padro I, Benito P. Comparaison de l’efficacité des injections d’acide hyaluronique et de corticoïdes dans la rhizarthrose : résultats à 6 mois d’une étude randomisée en simple aveugle. Rev Rhum. 2015, 82(3): 814-89 Objectif: Le but de l’étude était de comparer l’efficacité et la tolérance des injections intra-articulaires écho-guidées d’acide hyaluronique ou de bétaméthasone dans le traitement des patients atteints d’arthrose du pouce.

Méthodes: Quatre-vingt-huit patients atteints d’une arthrose du pouce (grade II-III de Kellgren-Lawrence ont reçu une injection intra-articulaire écho-guidée d’acide hyaluronique (48) ou de bétaméthasone (40). Au total, 3 injections locales ont été programmées à un intervalle de 7 jours. Les évaluations ont été réalisées à l’inclusion et à 7, 14, 30, 90, et 180 jours.

Résultats: Dans les deux groupes d’étude, l’échelle visuelle analogique et les indices fonctionnels de l’arthrose digitale ont diminué de façon significative durant le suivi. Il n’y avait pas de différence significative entre les groupes. Cependant, à 90 jours, le score fonctionnel a montré une tendance vers une meilleure amélioration dans le groupe acide hyaluronique (p = 0,071). Une sous-analyse des patients avec un indice fonctionnel ≥ 5 et une échelle visuelle analogique ≥ 3 à l’inclusion a montré un score de fonction médian plus élevé dans le groupe acide hyaluronique (p = 0,005 à 90 jours et p = 0,020 à 180 jours). Une autre analyse limitée aux patients avec un score douleur ≥ 5 a montré une meilleure amélioration des scores de fonction (p = 0,004 à 180 jours), déjà apparent après la deuxième injection intra-articulaire à 14 jours (p = 0,028). Dans ce sous-groupe de patients, le score moyen de la douleur s’est amélioré significativement à 180 jours (p = 0,02).

Conclusions: L’acide hyaluronique et la bétaméthasone sont efficaces et bien tolérés dans le traitement de la rhizarthrose.

L’acide hyaluronique s’est montré plus efficace dans la durée et a amélioré de façon plus nette l’état fonctionnel des patients avec des symptômes sévères.

ONCOLOGIA – ONCOLOGY Nº Articles indexats: 4

Factor Impacte total: 12.142

Factor d’impacte mig per article: 3.035

Remon J, Alvarez-Berdugo D, Majem M, Moran T, Reguart N, Lianes P. miRNA-197 and miRNA-184 are associated with brain metastasis in EGFR-mutant lung cancers. Clin Transl Oncol. 2015 Jul 22. [Epub ahead of print] PubMed PMID: 26199015 INTRODUCTION: The prognostic value of EGFR mutation in lung cancer patients with brain metastases is uncertain and therapeutic efficacy with EGFR TKI is limited. Looking for biomarkers closely related with early tumor changes and brain metastases in non-small cell lung cancer is warranted. MicroRNAs (miRNAs) are frequently deregulated in lung cancer. The objective of this study was to investigate whether some miRNAs are related with brain metastasis risk in EGFR-mutant nonsmall cell lung cancer patients.

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MATERIALS AND METHODS: miRNA quantification was retrospectively performed in formalin-fixed, extracranial paraffinembedded adenocarcinoma tumor tissue available from 17 human samples of advanced non-small cell lung cancer patients. Samples were classified as brain metastasis group (5 EGFR-mutant patients with initial BM, EGFRm-BM+; and 6 EGFR wild-type patients with initial BM) and the control group (6 EGFR-mutant NSCLC patients without BM). The RNA obtained was preamplified and retro-transcribed, and the miRNA was quantified with the TaqMan OpenArray Human MiRNA Panel in the QuantStudio™ 12 K Flex Real-Time PCR system.

RESULTS: miRNA-197 and miRNA-184 showed a significant higher expression in EGFRm-BM+ group than in the control group (p = 0.017 and p = 0.01, for miRNA-197 and miRNA-184, respectively), with a trend toward overexpression in BM group compared with the control group (p = 0.08 and p = 0.065, for miRNA-197 and miRNA-184, respectively), without differences in expression in BM group according to EGFR mutational status (EGFR wild type vs. EGFR-mutant: p = 0.175 and p = 0.117, for miRNA-197, miRNA-184 respectively).

CONCLUSIONS: miRNA-197 and miRNA-184 are overexpressed in EGFR-mutant patients with BM and they might be a new biomarker for stratifying the risk of BM in this subpopulation.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.077

Quartil: 3

Categoria: Oncology

Posició: 148/211

Remon J, Reguart N, Corral J, Lianes P. Malignant pleural mesothelioma: new hope in the horizon with novel therapeutic strategies. Cancer Treat Rev. 2015 Jan;41(1):27-34. doi: 10.1016/j.ctrv.2014.10.007. Epub 2014 Nov 8. Review. PubMed PMID: 25467107 Abstract: Malignant pleural mesothelioma (MPM) is a rare but aggressive malignancy of the pleura, with a strong causal link to asbestos exposure. MPM incidence has been increasing in recent years and it is not expected to fall off in the next two decades. Prognosis of MPM patients is modest since the vast majority of patients are diagnosed at advanced stage and because platinum-based chemotherapy remains the cornerstone of treatment, with no standard second line treatment.

Most current efforts to improve outcomes are based on a better understanding of the stromal compartment and deregulated pathways leading ultimately to the design of clinical trials based on novel therapeutic approaches such as immunotherapy or molecular-directed compounds. This review seeks to update the last clinical trials investigating novel agents in unresectable MPM. Indexat a: Medline/WOS/JCR Factor Impacte: 7.588

Quartil: 1

Categoria: Oncology

Posició: 15/211

Carcereny E, Morán T, Capdevila L, Cros S, Vilà L, de Los Llanos Gil M, Remón J, Rosell R. The epidermal growth factor receptor (EGRF) in lung cancer. Transl Respir Med. 2015 Feb 24;3:1. doi: 10.1186/s40247-015-0013-z. eCollection 2015.

PubMed PMID: 25810955 Abstract: In the last decade, important advances have been made in understanding of cancer biology, particularly nonsmall-cell lung cancer (NSCLC) with the discovery of oncogenic drivers of the disease. The epidermal growth factor receptor (EGFR) gene and its pathways was the first oncogenic driver discovered to be mutated and treatable in lung cancer.

Treatment with EGFR tyrosine kinase inhibitors (TKIs) is the standard of care for molecularly selected EGFR-mutant patients, while its role in unselected lung cancer patients is nowadays controversial. This review will provide an overview of the EGFR pathway and options for its treatment of lung cancer.

Indexat a: PubMed/WOS

Reguart N, Remon J. Common EGFR-mutated subgroups (Del19/L858R) in Advanced non-small-cell lung cancer: chasing better outcomes with tyrosine kinase inhibitors. Future Oncol. 2015;11(8):1245-57. doi: 10.2217/fon.15.15. Epub 2015 Jan 28. PubMed PMID: 25629371 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Abstract: Ten years ago, somatic mutations in EGFR were identified in patients with non-small-cell lung cancer.

Demonstration of the antitumor efficacy of EGF receptor-directed tyrosine kinase inhibitors resulted in their approval for the treatment of advanced non-small-cell lung cancer. Insights into the role of EGFR-sensitizing mutations and acquired and de novo T790M resistance mutations followed, and differences in progression-free survival for patients with EGFR Del19and L858R-mutated tumors treated with reversible first-generation EGF receptor tyrosine kinase inhibitors were reported.

Recently, overall survival benefit in patients with Del19- but not L858R-mutated tumors has been demonstrated after treatment with afatinib, an irreversible ErbB family blocker. Although the biology underlying this difference in survival is currently unclear, this review examines several hypotheses.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.477

Quartil: 3

Categoria: Oncology

Posició: 123/21

CIRURGIA GENERAL – GENERAL SURGERY Nº Articles indexats: 2

Factor Impacte total: 8.111

Factor d’impacte mig per article: 4.055

Khorsandi SE, Ruiz Edo N, Vilca-Melendez H, Heaton N. Caval agenesis in the pediatric liver donor. Pediatr Transplant.

2015 Sep;19(6):E139-41. doi: 10.1111/petr.12541. Epub 2015 Jun 23. PubMed PMID: 26103057 Abstract: The following is the first report of a pediatric organ donor with caval agenesis and the subsequent use of this liver for transplantation. Caval embryology and potential implications of utilizing a donor liver with caval agenesis are reviewed.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.441

Quartil: 2

Categoria: Pediatrics

Posició: 64/120

Mans E, Serra-Prat M, Palomera E, Suñol X, Clavé P. Sleeve gastrectomy effects on hunger, satiation, and gastrointestinal hormone and motility responses after a liquid meal test. Am J Clin Nutr. 2015 Sep;102(3):540-7. doi: 10.3945/ajcn.114.104307. Epub 2015 Jul 22. PubMed PMID: 26201818 BACKGROUND: The relation between hunger, satiation, and integrated gastrointestinal motility and hormonal responses in morbidly obese patients after sleeve gastrectomy has not been determined.

OBJECTIVE: The objective was to assess the effects of sleeve gastrectomy on hunger, satiation, gastric and gallbladder motility, and gastrointestinal hormone response after a liquid meal test.

DESIGN: Three groups were studied: morbidly obese patients (n = 16), morbidly obese patients who had had sleeve gastrectomy (n = 8), and nonobese patients (n = 16). The participants fasted for 10 h and then consumed a 200-mL liquid meal (400 kcal + 1.5 g paracetamol). Fasting and postprandial hunger, satiation, hormone concentrations, and gastric and gallbladder emptying were measured several times over 4 h.

RESULTS: No differences were observed in hunger and satiation curves between morbidly obese and nonobese groups; however, sleeve gastrectomy patients were less hungry and more satiated than the other groups. Antrum area during fasting in morbidly obese patients was statistically significant larger than in the nonobese and sleeve gastrectomy groups.

Gastric emptying was accelerated in the sleeve gastrectomy group compared with the other 2 groups (which had very similar results). Gallbladder emptying was similar in the 3 groups. Sleeve gastrectomy patients showed the lowest ghrelin concentrations and higher early postprandial cholecystokinin and glucagon-like peptide 1 peaks than did the other participants. This group also showed an improved insulin resistance pattern compared with morbidly obese patients.

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CONCLUSIONS: Sleeve gastrectomy seems to be associated with profound changes in gastrointestinal physiology that contribute to reducing hunger and increasing sensations of satiation. These changes include accelerated gastric emptying, enhanced postprandial cholecystokinin and glucagon-like peptide 1 concentrations, and reduced ghrelin release, which together may help patients lose weight and improve their glucose metabolism after surgery. This trial was registered at clinicaltrials.gov as NCT02414893.

Indexat a: Medline/WOS/JCR Factor Impacte: 6.670

Quartil: 1

Categoria: Nutrition & Dietetics

Posició: 3/77

MOTILITAT DIGESTIVA – GASTROINTESTINAL MOTILITY Nº Articles indexats: 10

Factor Impacte total: 43.758

Factor d’impacte mig per article: 4.375

Vilardell N, Rofes L, Arreola V, Speyer R, Clavé P. A Comparative Study Between Modified Starch and Xanthan Gum Thickeners in Post-Stroke Oropharyngeal Dysphagia. Dysphagia. 2015 Nov 25. [Epub ahead of print] PubMed PMID: 26607158 Abstract: Thickeners are used in post-stroke oropharyngeal dysphagia (OD) as a compensatory therapeutic strategy against aspirations. To compare the therapeutic effects of modified starch (MS) and xanthan gum (XG) thickeners on swallow safety and efficacy in chronic post-stroke OD patients using clinical and videofluoroscopic (VFS) assessment. Patients were studied by clinical assessment (volume-viscosity swallow test, V-VST) and VFS using 3 volumes (5, 10, 20 mL) and 3 viscosities (liquid, nectar and spoon thick), comparing MS and XG. We studied 122 patients (46MS, 76XG). (A) V-VST showed that both thickeners similarly improved safety of swallow. Prevalence of safe swallowing significantly increased with enhanced viscosity (P < 0.001 vs liquid), MS: 47.83 % at liquid, 84.93 % at nectar and 92.96 % at spoon thick; XG: 55.31 % at liquid, 77.78 % at nectar and 97.84 % at spoon thick. Patients on MS reported higher prevalence of pharyngeal residue at spoonthick viscosities. (B) VFS: increasing bolus viscosity with either thickener increased prevalence of safe swallows (P < 0.001 vs liquid), MS: 30.25 % liquid, 61.07 % nectar and 92.64 % spoon thick; XG: 29.12 % liquid, 71.30 % nectar and 89.91 % spoon thick. Penetration-aspiration scale score was significantly reduced with increased viscosity with both thickeners. MS increased oral and pharyngeal residues at nectar and spoon-thick viscosities but XG did not. Timing of airway protection mechanisms and bolus velocity were not affected by either thickener. Increasing bolus viscosity with MS and XG thickeners strongly and similarly improved safety of swallow in chronic post-stroke OD by a compensatory mechanism; in contrast only MS thickeners increased oropharyngeal residue.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.033

Quartil: 1

Categoria: Otorhinolaryngology

Posició: 10/44

Alvarez-Berdugo D, Rofes L, Farré R, Casamitjana JF, Enrique A, Chamizo J, Padrón A, Navarro X, Clavé P. Localization and expression of TRPV1 and TRPA1 in the human oropharynx and larynx. Neurogastroenterol Motil. 2015 Nov 4. doi: 10.1111/nmo.12701. [Epub ahead of print] PubMed PMID: 26530852 BACKGROUND: Previous studies have found that TRPV1 and TRPA1 receptor agonists improve swallow response in patients with oropharyngeal dysphagia (OD), but little is known about the expression of these receptors in the human oropharynx.

The aim of this study was to assess the expression and localization of TRPV1 and TRPA1 in human samples from the oropharynx of healthy patients, to provide the basis for new pharmacological treatments for OD. METHODS: Samples from oropharyngeal regions innervated by cranial nerves V, IX, and X (tongue, pharynx, and epiglottis) were obtained during ENT surgery and processed either for mRNA (21 patients) or for immunohistochemical assays (seven patients). The expression analysis was performed with RT-qPCR using ACTBh as reference gene. Hemotoxylin and eosin staining was used to study the histology; the immunohistochemical assay used (i) neuron-specific enolase to detect nerve fibers or (ii) fluorescent probes to locate TRPV1 and TRPA1.

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RESULTS: TRPV1 was expressed in the three studied regions, with higher levels in CN V region (tongue) than in CN X region (epiglottis; p < 0.05), and was localized at epithelial cells and nociceptive fibers in all studied regions. TRPA1 was also expressed in all studied regions, but was always localized below the basal lamina. No immunoreactivity for TRPA1 was found on epithelial cells.

CONCLUSIONS & INFERENCES: TRPV1 and TRPA1 are widely expressed in the human oropharynx with two distinct patterns.

Our study further confirms that TRPV1/A1 receptors are promising therapeutic targets to develop active treatments for OD patients.

Indexat a: Medline/WOS/JCR Factor Impacte: 3.587

Quartil: 1

Categoria: Clinical Neurology

Posició: 44/192

Mundet L, Ribas Y, Arco S, Clavé P. Quality of life differences in female and male patients with fecal incontinence. J Neurogastroenterol Motil. 2015 Oct 20. doi: 10.5056/jnm15088. [Epub ahead of print] PubMed PMID: 26486375 Background/Aims: To explore and compare quality of life (QoL) differences in female and male patients with fecal incontinence.

Methods: Ninety-one patients with fecal incontinence (60 women, mean (SD) age 64.13 (9.72) years; 31 men, mean (SD) age 63.61 (13.33) years) were assessed for pathophysiology (anorectal manometry and ultrasound), clinical severity (Wexner and Vaizey scales), QoL (Fecal Incontinence Quality of Life Score [FIQL]) and health status (EQ-5D).

Results: External and internal anal sphincter impairment rates were 96.5% and 70.2%, respectively, in women, compared to 30% and 43.3% respectively in men(P < 0.05). Clinical severity was similar in both sexes, with mean (SD) Wexner scores of 10.95 (4.35) for women and 9.81 (4.30) for men, and mean (SD) Vaizey scores of 13.27 (4.66) for women and 11.90 (5.22) for men. Scores for women were significantly lower for all FIQL depression and coping subscales (P < 0.001) and the EQ-5D depression subscale (P < 0.01). EQ5D index was 0.687(0.20) for women and 0.835(0.15) for men (P < 0.001). QoL was negatively affected by female gender (-1.336), anxiety/depression (-1.324) and clinical severity (-0.302), whereas age had a positive impact (0.055 per year) (P < 0.01).

Conclusions: The pathophysiology of fecal incontinence differed between the sexes. For similar severity scores, impact on QoL was higher in women. Gender had the highest impact on QoL compared to other factors. QoL measurements should be part of assessment and treatment protocols.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.296

Quartil: 3

Categoria: Clinical Neurology

Posició : 97/192

Ortega O, Sakwinska O, Combremont S, Berger B, Sauser J, Parra C, Zarcero S, Nart J, Carrión S, Clavé P. High prevalence of colonization of oral cavity by respiratory pathogens in frail older patients with oropharyngeal dysphagia.

Neurogastroenterol Motil. 2015 Dec;27(12):1804-16. doi: 10.1111/nmo.12690. Epub 2015 Sep 28. PubMed PMID: 26416412 BACKGROUND: Aspiration pneumonia (AP) is caused by dysfunctional swallowing resulting in aspiration of material colonized by respiratory pathogens. The aim of this study was to assess and compare the swallowing physiology, health status, oral health status, and oral/nasal microbiota in frail older patients (FOP) with oropharyngeal dysphagia (OD) and a control group.

METHODS: We studied 47 FOP (>70 year) with OD by videofluoroscopy (17 with acute pneumonia -APN-, 15 with prior pneumonia-PNP- and 15 without) and 14 older controls without OD (H). Oral/nasal colonization by five respiratory pathogens was evaluated by qPCR, whereas commensal microbiota composition was assessed by pyrosequencing.

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KEY RESULTS: (i) Frail older patients with OD presented similar comorbidities, poor functionality, polymedication, and prevalent videofluoroscopic signs of impaired safety of swallow (33.3-61.5%). However, patients with OD-APN also presented malnutrition, delayed laryngeal vestibule closure (409.23 ± 115.6 ms; p < 0.05), and silent aspirations (15.6%). (ii) Oral health was poor in all groups, 90% presented periodontitis and 72%, caries. (iii) Total bacterial load was similar in all groups, but higher in the oropharynx (>10(8) CFU/mL) than in the nose (<10(6) CFU/mL) (p < 0.0001). Colonization by respiratory pathogens was very high: 93% in OD patients (p < 0.05 vs H); 93% in OD-PNP (p < 0.05 vs H); 88% in OD-APN (p = 0.07 vs H), and lower in controls (67%).

CONCLUSIONS & INFERENCES: Frail older patients with OD had impaired health status, poor oral health, high oral bacterial load, and prevalence of oral colonization by respiratory pathogens and VFS signs of impaired safety of swallow, and were therefore at risk for contracting AP. Indexat a: Medline/WOS/JCR Factor Impacte: 3.587

Quartil: 1

Categoria: Clinical Neurology

Posició: 44/192

Rychter J, Ortega O, Berdun S, Arenas C, Lopez I, Espin F, Vergara P, Clavé P. Mast cell degranulation inhibits motor patterns of human ileum and sigmoid colon in vitro: relevance for postoperative ileus. Neurogastroenterol Motil. 2015 Aug;27(8):1098-109. doi: 10.1111/nmo.12589. Epub 2015 May 13. PubMed PMID: 25974622 BACKGROUND: Local release of mast cell proteases during gastrointestinal surgery is associated with the inhibition of motility and postoperative ileus (POI). We determined whether activation of intramuscular mast cell affects the motor patterns of the human ileum and colon and whether proteases are involved.

METHODS: Motor response of ileal and colonic circular muscle strips was measured in organ bath. Mast cell degranulation was induced by compound 48/80 (c48/80; 25-675 μg/mL). Motor response was quantified as tone, rhythmic phasic contractions (RPCs) and contractions to electric field stimulation (EFS; 40 Hz), and bethanechol-evoked contractions.

Ketotifen (10(-6) mol/L) and a protease inhibitor cocktail (P8340) were used to evaluate the role of mast cell mediators.

KEY RESULTS: (a) c48/80 impaired the spontaneous and the electrically evoked motor response in small bowel and colonic strips (sigmoid colon EC50 : 460.0 μg/mL for RPCs and 8.9 μg/mL for electrically evoked contraction amplitudes) and bethanechol-evoked contractions. (b) Preincubation with ketotifen (10(-6) mol/L, 1 h) prevented the impairment of RPCs and EFS-evoked contractions in the sigmoid colon and ileum but not in the right colon. (c) Preincubation with P8340 also prevented the impairment of contractions in the sigmoid colon but not in the ileum or the right colon.

CONCLUSIONS & INFERENCES: Mast cell degranulation by c48/80 inhibits the spontaneous and the nerve-mediated motor response in the human ileum and colon. The effect is partially mediated by mast cell proteases and could be relevant in the pathophysiology of POI. Indexat a: Medline/WOS/JCR Factor Impacte: 3.587

Quartil: 1

Categoria: Clinical Neurology

Posició: 44/192

Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015 May;12(5):259-70. doi: 10.1038/nrgastro.2015.49. Epub 2015 Apr 7. Review. PubMed PMID: 25850008 Abstract: Dysphagia is a symptom of swallowing dysfunction that occurs between the mouth and the stomach. Although oropharyngeal dysphagia is a highly prevalent condition (occurring in up to 50% of elderly people and 50% of patients with neurological conditions) and is associated with aspiration, severe nutritional and respiratory complications and even death, most patients are not diagnosed and do not receive any treatment. By contrast, oesophageal dysphagia is less prevalent and less severe, but with better recognized symptoms caused by diseases affecting the enteric nervous system and/or oesophageal muscular layers. Recognition of the clinical relevance and complications of oesophageal and oropharyngeal dysphagia is growing among health-care professionals in many fields. In addition, the emergence of new methods to screen and assess swallow function at both the oropharynx and oesophagus, and marked advances in understanding the Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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pathophysiology of these conditions, is paving the way for a new era of intensive research and active therapeutic strategies for affected patients. Indeed, a unified field of deglutology is developing, with new professional profiles to cover the needs of all patients with dysphagia in a nonfragmented way Indexat a: Medline/WOS/JCR Factor Impacte: 12.610

Quartil: 1

Categoria: Gastroenterology & Hepatology

Posició: 3/76

Martinez-Cutillas M, Gil V, Mañé N, Clavé P, Gallego D, Martin MT, Jimenez M. Potential role of the gaseous mediator hydrogen sulphide (H2S) in inhibition of human colonic contractility. Pharmacol Res. 2015 Mar;93:52-63. doi: 10.1016/j.phrs.2015.01.002. Epub 2015 Jan 29. PubMed PMID: 25641403 BACKGROUND: Hydrogen sulphide (H2S) is an endogenous signalling molecule that might play a physiologically relevant role in gastrointestinal motility. Cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE) are two enzymes responsible for H2S production. d,l-Propargylglycine (PAG) is a CSE inhibitor whereas both aminooxyacetic acid (AOAA) and hydroxylamine (HA) are CBS inhibitors. The characterization of H2S responses and its mechanism of action are crucial to define H2S function.

METHODS: Human colonic strips were used to investigate the role of H2S on contractility (muscle bath) and smooth muscle electrophysiology (microelectrodes). NaHS was used as a H2S donor.

RESULTS: Combination of PAG and AOAA depolarized the smooth muscle (5-6mV, n=4) and elicited a transient increase in tone (260.5±92.8mg, n=12). No effect was observed on neural mediated inhibitory junction potential or relaxation. In the presence of tetrodotoxin 1μM, NaHS concentration-dependently inhibited spontaneous contractions (EC50=329.2μM, n=18). This effect was partially reduced by the guanylyl cyclase inhibitor ODQ 10μM (EC50=2.6μM, n=12) and by l-NNA 1mM (EC50=1.4mM, n=8). NaHS reversibly blocked neural mediated cholinergic (EC50=2mM) and tachykinergic (EC50=5.7mM) contractions. NaHS concentration-dependently reduced the increase in spontaneous mechanical activity (AUC) induced by carbachol (EC50=1.9mM) and NKA (EC50=1.7mM AUC).

CONCLUSIONS: H2S might be an endogenous gasomediator regulating human colonic contractility. Its inhibitory effect is observed at high concentrations and could be mediated by a direct effect on smooth muscle with a possible synergistic effect with NO, as well as by an interaction with the cholinergic and tachykinergic neural mediated pathways.

Indexat a: Medline/WOS/JCR Factor Impacte: 4.408

Quartil: 1

Categoria: Pharmacology & Pharmacy

Posició: 28/255

Carrión S, Cabré M, Monteis R, Roca M, Palomera E, Serra-Prat M, Rofes L, Clavé P. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital.

Clin Nutr. 2015 Jun;34(3):436-42. doi: 10.1016/j.clnu.2014.04.014. Epub 2014 May 9. PubMed PMID: 24882372 BACKGROUND & AIMS: Oropharyngeal dysphagia and malnutrition are prevalent conditions in the older. The aim of this study was to explore the relationship between oropharyngeal dysphagia, nutritional status and clinical outcome in older patients admitted to an acute geriatric unit.

METHODS: We studied 1662 patients ≥70 years consecutively hospitalized with acute diseases, in whom dysphagia could be clinically assessed by the volume-viscosity swallow test and nutritional status with the Mini Nutritional Assessment(®).

Anthropometric and laboratory measurements were taken and mortality recorded during hospital stay, at 6 months and one year after discharge was recorded.

RESULTS: 47.4% (95% CI 45-49.8%) patients presented oropharyngeal dysphagia and 30.6% (95% CI 27.9%-33.3%), malnutrition. Both conditions were associated with multimorbidity, multiple geriatric syndromes and poor functional capacity (p < 0.001). However, patients with dysphagia presented increased prevalence of malnutrition (MNA(®) < 17 45.3% vs 18%, p < 0.001) regardless of their functional status and comorbidities (OR 2.31 (1.70-3.14)) and lower albumin and Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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cholesterol levels. Patients with malnutrition presented an increased prevalence of dysphagia (68.4% (95% CI 63.3-73.4)).

Patients with dysphagia and patients with malnutrition presented increased intrahospital, 6-month and 1-year mortality rates (p < 0.05). The poorest outcome was for patients with both conditions (1-year mortality was 65.8%).

CONCLUSIONS: Prevalence of dysphagia was higher than malnutrition in our older patients. Dysphagia was an independent risk factor for malnutrition, and both conditions were related to poor outcome.

Indexat a: Medline/WOS/JCR Factor Impacte: 4.476

Quartil: 1

Categoria: Nutrition & Dietetics

Posició: 9/77

Alvarez-Berdugo D, Espín F, Arenas C, López I, Clavé P, Gallego D. Changes in the response to excitatory antagonists, agonists, and spasmolytic agents in circular colonic smooth muscle strips from patients with diverticulosis.

Neurogastroenterol Motil. 2015 Nov;27(11):1600-12. doi: 10.1111/nmo.12659. Epub 2015 Aug 24. PubMed PMID: 26303606 BACKGROUND: Colonic samples from asymptomatic diverticulosis (DS) patients presented enhanced electrical field stimulation (EFS)-contractions, in an earlier study of ours, suggesting increased endogenous responses. The aim of this study was to explore changes in excitatory neuromuscular transmission and to assess the pharmacodynamics of spasmolytic agents in DS. METHODS: Circular muscle strips from sigmoid colon of DS patients (n = 30; 69.5 ± 14.8 years) and controls (n = 32; 64.7 ± 16.2 years) were studied using organ baths to evaluate the direct effect of excitatory agonists (carbachol, neurokinin A [NKA] and substance P [SP]), and the effect of antagonists (atropine and NK2 antagonist GR94800) and spasmolytic drugs (otilonium bromide [OB] and N-butyl-hyoscine) on the contractions induced by EFS-stimulation of excitatory motorneurons. qRT-PCR was also performed to compare mRNA expression of M2 , M3 , NK2 receptors and L-type calcium channels.

KEY RESULTS: Contractions to carbachol (Emax : 663.7 ± 305.6% control vs 2698.0 ± 439.5% DS; p < 0.0005) and NKA (Emax: 387.8 ± 35.6% vs 1102.0 ± 190.1%; p < 0.0005) were higher in DS group, without differences for SP. Higher potency for DS patients was observed in the concentration-response curves for atropine (pIC50 = 8.56 ± 0.15 control vs pIC50 = 9.95 ± 0.18 DS group; p < 0.005) and slightly higher for GR94800 (pIC50 = 7.21 ± 0.18 control vs pIC50 = 7.97 ± 0.32 group; p < 0.0001). Lower efficacy (Emax ) and potency (pIC50 ) was observed for spasmolytic drugs in DS, whereas no differences were found regarding the relative expression of the receptors evaluated between groups.

CONCLUSIONS & INFERENCES: The greater response to cholinergic and tachykinergic agonists and greater potency for muscarinic and NK2 antagonists observed in DS might play a role in the spasticity found in diverticular disease.

Indexat a: Medline/WOS/JCR Factor Impacte: 3.587

Quartil: 1

Categoria: Clinical Neurology

Posició: 44/192

Berdún S, Bombuy E, Estrada O, Mans E, Rychter J, Clavé P, Vergara P. Peritoneal mast cell degranulation and gastrointestinal recovery in patients undergoing colorectal surgery. Neurogastroenterol Motil. 2015 Jun;27(6):764-74. doi: 10.1111/nmo.12525. Epub 2015 Feb 9. PubMed PMID: 25677271 BACKGROUND: Degranulation of peritoneal mast cells (MCs) induced by intestinal manipulation has been proposed as a pathophysiological factor in postoperative ileus (POI). We aimed to explore the relationship between peritoneal and colonic MC degranulation and gastrointestinal (GI) recovery following colectomy.

METHODS: Patients undergoing elective laparoscopic cholecystectomy (using a laparoscope and small abdominal incisions, n = 14), and elective laparoscopic (n = 32) or open partial colectomy (through a large abdominal incision, n = 10) were studied. MC protease tryptase and chymase were studied in peritoneal fluid at the beginning, middle, and end of each surgical intervention. Density of MCs in colectomy samples were examined and oro-caecal transit time by breath test, GI function recovery by clinical composite endpoint GI-2 and association between MC proteases and clinical recovery.

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KEY RESULTS: Open and laparoscopic colectomy caused greater peritoneal release of tryptase and chymase (323.0 ng/mL [IQR: 53.05-381.4] and 118.6 ng/mL [IQR: 53.60-240.3]), than cholecystectomy (41.64 ng/mL [IQR: 11.17-90.93]) at the end of the surgical intervention. However, there were no differences between laparoscopic and open colectomy. Increased peritoneal protease release during surgery was observed in patients who developed POI after colectomy.

CONCLUSIONS & INFERENCES: Colorectal surgery causes protease release from peritoneal MCs. Protease release does not differ between both types of colectomy (laparoscopy vs laparotomy). However, MC activation is increased in colectomy patients developing POI. Therefore, degranulation of peritoneal MCs as a factor contributing to human POI after colectomy might be considered in future studies as a target to avoid POI. Indexat a: Medline/WOS/JCR Factor Impacte: 3.587

Quartil: 1

Categoria: Clinical Neurology

Posició: 44/192

Faundez-Zanuy M, Satue-Villar A, Mekyska J, Arreola V, Sanz P, Paul C, Guirao L, Serra M, Rofes L, Clavé P, SesaNogueras E, Roure J. A Multimodal Approach for Parkinson Disease Analysis. Recent Advances of Neural Networks Models and Applications, 2015; 37: 311-18.

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 1.3-2.0/10000 inhabitants. The mean age at diagnosis of PD is 55 and most patients are between 50 and 80 years old. The most obvious symptoms are movement-related; these include tremor, rigidity, slowness of movement and walking difficulties. Frequently these are the symptoms that lead to the PD diagnoses. Later, thinking and behavioral problems may arise, and other symptoms include cognitive impairment and sensory, sleep and emotional problems. In this paper we will present an ongoing project that will evaluate if voice and handwriting analysis can be reliable predictors/indicators of swallowing and balance impairments in PD. An important advantage of voice and handwritten 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: 2.268

Factor d’impacte mig per article: 0.756

Malagelada F, Del Carmen VA, Barke SJ, Guirao Cano L, Pleguezuelos Cobo E. The anterior mini-open approach for femeroacetabular impingement: Gait and functional assessment at one year post-surgery. Ann Phys Rehabil Med. 2015 Apr;58(2):60-5. doi: 10.1016/j.rehab.2014.09.013. Epub 2015 Jan 7. PubMed PMID: 25770348.

OBJECTIVE: This study aimed to evaluate the outcome of the anterior mini-open approach of the hip for femoroacetabular impingement (FAI) at one year post-surgery by use of questionnaires, functional capacity tests and biomechanical studies.

DESIGN: This is a case series prospective study. A total of 14 patients diagnosed of FAI were included. Patients were classified according to Tönnis scale. Hip joint mobility, Faber distance, pain levels (assessed on a visual analogic scale [VAS]), 6-minute walking test (6MWT), Timed up & go test (TUGT), Stairs climbing test, Lequesne functional index, and gait analysis were assessed prior to and 12 months after surgery.

RESULTS: Pain significantly improved following surgery. An improvement of 80% or more was found in 6 patients (42.85% of cases). Improvements were also seen in time support of the affected limb and in the braking force of the contralateral limb, although these are not clinically significant. No statistically significant changes were seen in functional capacity tests.

At 12 months after surgery, meralgia paraesthetica presented in 3 patients (21.4%), and a total hip arthroplasty was performed in 1 patient.

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CONCLUSIONS: There was significant reduction in pain intensity 12 months following mini-open approach for FAI compared to preoperatively. Improvement in gait analysis and functional capacity was also seen, although not statistically significant.

Indexat a: Medline/WOS

Malagelada F, Tibrewal S, Lucar GA, Jeyaseelan L, Fahmy A, Gonzalez JS. Combined Type II Odontoid Fracture With Axis Anterior Arch Fracture: A Case Report in an Elderly Patient. Geriatr Orthop Surg Rehabil. 2015 Mar;6(1):37-41. doi: 10.1177/2151458514554083. PubMed PMID: 26246952 Abstract: Associated fractures of the atlas and axis are frequent, particularly in the elderly patients following a simple lowenergy fall. This injury can be easily misdiagnosed on initial plain radiographs, and therefore computed tomography scan is a useful adjunct in patients with a degenerative spine. There is still no consensus as to the optimal treatment of combined axis-atlas fractures, and the majority of authors propose a therapeutic strategy dependent on the odontoid fracture pattern. We describe a combined atlas and axis fracture in a 92-year-old patient who was managed with nonoperative treatment in a rigid collar. The association of C1 anterior arch with a C2 type II odontoid fracture is a rare combination, which to our knowledge has never been reported following nonoperative treatment. There was a good functional outcome at 1-year follow-up with the fracture progressing to a fibrous nonunion of the odontoid process.

Indexat a: PubMed/WOS

Pedret C, Balius R, Alomar X, Vilaró J, Ruiz-Cotorro A, Minoves M. Stress fracture of the supracondylar process of the humerus in a professional tennis player. Clin J Sport Med. 2015 Jan;25(1):e20-2. doi: 10.1097/JSM.0000000000000101.

PubMed PMID: 24926912 Abstract: The supracondylar process of the humerus is an anatomic variant present in 1% of the population associated with a fibrous band, the ligament of Struthers that attaches it to the medial epicondyle, and may serve as a proximal origin of a fascicle of the pronator teres. Fractures of the supracondylar process of the humerus are extremely rare. To the best of our knowledge, this is the first report of a stress fracture of the supracondylar process. We present the case of a professional tennis player with a stress fracture of the supracondylar process who underwent surgery to avoid possible displacement and neurovascular complications. Clinicians should consider the diagnosis of a supracondylar process fracture with or without neurovascular compression when examining athletes with otherwise unexplained arm or elbow pain. Stress fracture of the supracondylar process may be secondary to the excessive traction of the pronator teres.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.268

Quartil: 1

Categoria: Sports Sciences

Posició: 18/81

REHABILITACIÓ - PHYSICAL MEDICINE & REHABILITATION Nº Articles indexats: 1

Factor Impacte total: 1.417

Factor d’impacte mig per article: 1.417

Pleguezuelos E, Ramon MA, Moreno E, Miravitlles M. [Don't forget to walk at least 30 minutes per day 5 days a week.

Why and how to prescribe physical exercise in chronic obstructive pulmonary disease]. Med Clin (Barc). 2015 May 8;144(9):418-23. doi: 10.1016/j.medcli.2014.07.027. Epub 2014 Nov 24. Spanish. PubMed PMID: 25441024 Indexat a: Medline/WOS/JCR Factor Impacte: 1.417

Quartil: 2

Categoria: Medicine, General & Internal

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Gomez-Gonzalez A, Miranda-Calderín G, Pleguezuelos-Cobos, E, Bravo-Escobar R, Lopez-Lozano A, Exposito-Tirado JA, Heredia-Torres A, Montiel-Trijillo A, Aguilera-Saborido A. Recomendaciones sobre rehabilitación cardíaca en la cardiopatía isquémica de la Sociedad de Rehabilitación Cardio-Respiratoria (SORECAR). Rehabilitacion. 2015, 49(2): 102124 Abstract: La cardiopatía isquémica supone la mayor causa de muerte en España y en el mundo occidental. El programa de rehabilitación cardíaca engloba todas las medidas para realizar prevención secundaria en estos pacientes y mejorar la morbimortalidad. Es un programa eficaz, pero su implementación es escasa y variable, siendo inferior al 5% en España, por lo que se debería priorizar estrategias para facilitar la realización de estos programas. Un grupo de expertos fue nombrado por la Sociedad Española de Rehabilitación Cardio-Respiratoria (SORECAR) para realizar una revisión de todas las evidencias disponibles en rehabilitación cardíaca y elaborar un documento aplicándolo a la práctica clínica. El resultado ha sido la elaboración final de un protocolo de actuación en rehabilitación cardíaca, con instrucciones o recomendaciones a modo de resumen. Contiene aspectos sobre rehabilitación cardíaca para disminuir la variabilidad entre dichas Unidades y crear las bases para una adecuada acreditación de Unidades de Rehabilitación Cardíaca.

PSIQUIATRIA - PSYCHIATRY Nº Articles indexats: 8

Factor Impacte total: 14.991

Factor d’impacte mig per article: 1.873

Frías Á, Palma C, Farriols N, Salvador A. Characterizing offspring of bipolar parents: a review of the literature. Actas Esp Psiquiatr. 2015 Nov;43(6):221-34. Epub 2015 Nov 1. PubMed PMID: 26631305 Abstract: Offspring of parents with bipolar disorder (O-BP) is a high-risk cohort for mental illness in general and bipolar disorder (BD) specifically. This review aims to delineate the main clinical features of O-BP, including the psychopathology, interpersonal functioning, temperamental and personality features, neurocognitive deficits and neurobiological dysfunctions. Evidence indicates that several internalizing and externalizing symptoms/disorders are more prevalent in OBP than in offspring of healthy control parents (O-HC). Furthermore, O-BP exhibits poorer interpersonal functioning than OHC. Moreover, O-BP also endorses higher activity level, emotionality and behavioral disinhibition compared to O-HC. Besides, O-BP displays greater deficits on memory, cognitive flexibility and social cognition compared to O-HC. Finally, O-BP exhibits dysfunctional modulation in cortico- subcortical areas, more white matter abnormalities and higher cortisol basal levels compared to O-HC. Overall, these findings are discussed regarding the natural course and potential risk factors or endophenotypes for major mood disorders in general and BD specifically.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.200

Quartil: 3

Categoria: Psychiatry

Posició: 104/140

Frías Á, Palma C, Farriols N, González L. Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization. Neuropsychiatr Dis Treat. 2015 Aug 26;11:223344. doi: 10.2147/NDT.S67636. eCollection 2015. Review. PubMed PMID: 26345330 BACKGROUND: With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD) has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD) category.

OBJECTIVE: We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD) based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders.

METHOD: A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria.

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RESULTS: Lifetime comorbidity rates of BDD-OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%). However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD-OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa.

CONCLUSION: Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia should be carried out.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.741

Quartil: 3

Categoria: Psychaitry

Posició: 88/140

Montesinos-Rueda L, Cañete-Crespillo J, Palma-Sevillano C, Giné-Serven E. Erythrocyte membrane polyunsaturated fatty acid (pufa) levels in a sample of patients with schizophrenia and relation with clinical and progression variables. Actas Esp Psiquiatr. 2015 Sep;43(5):170-6. Epub 2015 Sep 1. PubMed PMID: 26320895 INTRODUCTION: Previous studies have shown that erythrocyte cell membranes in patients with schizophrenia contain considerably less omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), reflecting the lower levels present in neuronal and central nervous system membranes. This phenomenon, linked to genetic, metabolic, or dietary factors, has been associated with the development of schizophrenia and the risk of developing and the severity of metabolic syndrome.

METHODS: This study is an observational study conducted in a sample of 31 patients with schizophrenia treated at the Mataró Mental Health Center (Barcelona). Its aim was to relate the erythrocyte levels of omega 3 with the clinical severity of schizophrenia and dietary habits. EPA (eicosapentaenoic acid), DHA (docosahexaenoic acid) and other membrane lipid levels were determined, as well as psychopathology, cognitive, and social functioning measures, previous evolution, and finally a survey of dietary habits.

RESULTS: Our results did not show a statistically significant correlation between erythrocyte omega-3 levels and psychopathological and clinical severity variables. Higher, statistically significant, levels were found in the group of women and in subjects with more days of admission to the day hospital. In contrast, lower values were obtained in subjects treated with long-acting antipsychotics and in sunflower oil consumers.

CONCLUSIONS: Despite not being able to demonstrate our working hypothesis, significant correlations were found that were consistent with published findings in the current literature. The need for studies with larger samples and groups of healthy controls is postulated.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.200

Quartil: 3

Categoria: Psychiatry

Posició: 104/140

Frías Á, Palma C. Comorbidity between post-traumatic stress disorder and borderline personality disorder: a review.

Psychopathology. 2015;48(1):1-10. doi: 10.1159/000363145. Epub 2014 Sep 9. Review. PubMed PMID: 25227722 BACKGROUND: Traditionally, the presence of post-traumatic stress disorder (PTSD) in subjects diagnosed with borderline personality disorder (BPD) has been the object of scant empirical research. The clarification of issues related to the different areas of study for this comorbidity is not only significant from a theoretical point of view but also relevant for clinical practice. The aim of this review is to describe the main theoretical findings and research conclusions about the comorbidity between PTSD and BPD. Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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METHODS: A literature review was carried out via PubMed and PsycINFO for the period between 1990 and September 2013. The descriptors used were 'post-traumatic stress disorder', 'borderline personality disorder', 'PTSD', 'complex PTSD' and 'BPD'.

RESULTS: Epidemiological studies show that the risk of PTSD among BPD subjects is not regularly higher than in subjects with other personality disorders. Furthermore, there is no conclusive evidence about the main aetiopathogenic mechanism of this comorbidity, either of one disorder being a risk factor for the other one or of common underlying variables.

Concerning comparative studies, several studies with PTSD-BPD subjects have found a higher severity of psychopathology and psychosocial impairment than in BPD subjects. With regard to nosological status, the main focus of controversy is the validation of 'complex PTSD', a clinical entity which may comprise a subgroup of PTSD-BPD subjects. With regard to treatment, there are preliminary evidences for the efficient treatment of psychopathology in both PTSD and BPD. CONCLUSIONS: These findings are remarkable for furthering the understanding of the link between PTSD and BPD and their implications for treatment. The results of this review are discussed, including methodological constraints that hinder external validity and consistency of referred findings.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.084

Quartil: 3

Categoria: Psychiatry

Posició: 75/140

Frías Á, Palma C, Farriols N. Comorbidity in pediatric bipolar disorder: prevalence, clinical impact, etiology and treatment. J Affect Disord. 2015 Mar 15;174:378-89. doi: 10.1016/j.jad.2014.12.008. Epub 2014 Dec 12. Review. PubMed PMID: 25545605 BACKGROUND: Research on pediatric bipolar disorder (PBD) is providing a plethora of empirical findings regarding its comorbidity. We addressed this question through a systematic review concerning the prevalence, clinical impact, etiology and treatment of main comorbid disorders involved.

METHOD: A comprehensive database search was performed from 1990 to August 2014. Overall, 167 studies fulfilled the inclusion criteria.

RESULTS: Bipolar youth tend to suffer from comorbid disorders, with highest weighted mean prevalence rate arising from anxiety disorders (54%), followed by attention deficit hyperactivity disorder (ADHD) (48%), disruptive behavior disorders (31%), and substance use disorders (SUD) (31%). Furthermore, evidence indicates that ADHD and anxiety disorders negatively affect the symptomatology, neurocognitive profile, clinical course and the global functioning of PBD. Likewise, several theories have been posited to explain comorbidity rates in PBD, specifically common risk factors, one disorder being a risk factor for the other and nosological artefacts. Lastly, randomized controlled trials highlight a stronger therapeutic response to stimulants and atomoxetine (vs. placebo) as adjunctive interventions for comorbid ADHD symptoms. In addition, research focused on the treatment of other comorbid disorders postulates some benefits from mood stabilizers and/or SGA. LIMITATIONS: Epidemiologic follow-up studies are needed to avoid the risk of nosological artefacts. Likewise, more research is needed on pervasive developmental disorders and anxiety disorders, especially regarding their etiology and treatment.

CONCLUSIONS: Psychiatric comorbidity is highly prevalent and is associated with a deleterious clinical effect on pediatric bipolarity. Different etiological pathways may explain the presence of these comorbid disorders among bipolar youth.

Standardized treatments are providing ongoing data regarding their effectiveness for these comorbidities among bipolar youth.

Indexat a: Medline/WOS/JCR Factor Impacte: 3.383

Quartil: 2

Categoria: Psychiatry

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Petry NM, Gonzalez-Ibanez A. Internet gambling in problem gambling college students. J Gambl Stud. 2015 Jun;31(2):397-408. doi: 10.1007/s10899-013-9432-3. PubMed PMID: 24337905.

Abstract: Internet gambling is popular in college students and associated with problem gambling behaviors. This study evaluated Internet gambling in 117 students participating in study evaluating brief interventions to reduce gambling; the brief interventions consisted of minimal advice, motivational enhancement therapy, and cognitive-behavioral therapy (1-4 sessions). Compared to their counterparts who did not gamble via the Internet (n = 60), those who reported recent Internet gambling (n = 57) wagered in greater frequencies and amounts and reported missing school more often and more problems with family and anxiety due to gambling. Recent Internet gamblers demonstrated similar reductions in gambling over time and in response to the brief interventions as non-Internet gamblers. These data suggest that Internet gambling is common in problem gambling college students, and students who wager over the Internet can benefit from brief interventions.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.290

Quartil: 1

Categoria: Psychology, Multidisciplinary

Posició: 26/129

Frías A, Palma C, Barón F, Varela P, Alvarez A, Salvador A, Obsessive-compulsive disorder in the perinatal period: Epidemiology, phenomenology, pathogenesis, and treatment. Anal Psicol. 2015 Jan;31(1):1-7. doi: dx.doi.org/10.6018/analesps.31.1.168511 Abstract: The aim of this review is to describe the main theoretical findings and research conclusions about obsessivecompulsive disorder (OCD) in the perinatal period. On one hand, epidemiological studies show that the risk of OCD onset and/or exacerbation could increase in this period, particularly in the puerperium. Phenomenologically, in this stage aggressive and contamination obsessions are very common and are related to the fetus or newborn. On the other hand, regarding OCD pathogenesis in this period, there is indirect evidence to suggest the participation of neuroendocrine (e.g. female gonadal steroids and oxytocin) and cognitive behavioural variables (e.g. hyper-responsibility, threat overestimation, and mental control). In terms of research, more empirical studies are needed to contrast these specific vulnerability factors.

Moreover, no empirically validated psychotherapeutic treatments (controlled trials) adapted to this OCD sub-group were found, although some studies highlight the role of cognitive behavioural therapy (CBT) as an effective intervention in the context of selective primary prevention.

Indexat a: WOS/JCR Factor Impacte: 0.504

Quartil: 3

Categoria: Psychology, Multidisciplinary

Posició: 96/129

Frías Á, Palma C, Farriols N, Martínez B. Sexual feelings toward the therapist among patients with borderline personality disorder: a case of erotomanic delusional disorder. Arch Sex Behav. 2015 Jan;44(1):3-4. doi: 10.1007/s10508-014-0433-9.

PubMed PMID: 25391585 Indexat a: Medline/WOS/JCR Factor Impacte: 2.589

Quartil: 1

Categoria: Social Sciences, Interdisciplinary

Posició: 2/95

MEDICINA INTENSIVA – INTENSIVE MEDICINE Nº Articles indexats: 3

Factor Impacte total: 10.795

Factor d’impacte mig per article: 3.598

Cillóniz C, Gabarrús A, Almirall J, Amaro R, Rinaudo M, Travierso C, Niederman M, Torres A. Bacteraemia in outpatients with community-acquired pneumonia. Eur Respir J. 2015 Nov 5. pii: ERJ-01308-2015. doi: 10.1183/13993003.01308-2015.

[Epub ahead of print] PubMed PMID: 26541537 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Abstract: Community-acquired pneumonia (CAP) is a frequent cause of morbidity and mortality worldwide. Approximately 20% of CAP patients require hospital admission [1, 2], leaving a large percentage of patients treated in the community as outpatients. In addition, bacteraemia is associated with worse outcomes, such as a higher prevalence of intensive care unit (ICU) admission and longer length of stay. Current international guidelines [1, 3, 4] do not recommend blood cultures as part of routine microbiological tests in patients managed in the community. However, there is little information regarding the prevalence and clinical impact of bacteraemia in CAP patients treated outside the hospital. Previous studies reported incidences of 2.1–7%, respectively [5–8]. However, few data exist regard predictive factors and the clinical outcomes associated with positive blood cultures in this population [8]. The current study aimed to determine the predictive factors and the clinical outcomes of bacteraemic outpatients with CAP, and describe their clinical, epidemiological and microbiological characteristics.

Indexat a: Medline/WOS/JCR Factor Impacte: 7.636

Quartil: 1

Categoria: Respiratory System

Posició: 4/58

Almirall J, Serra-Prat M, Bolíbar I, Palomera E, Roig J, Boixeda R, Bartolomé M, de la Torre M, Parra O, Torres A. Professions and Working Conditions Associated With Community-Acquired Pneumonia. Arch Bronconeumol. 2015 Dec;51(12):627-631. doi: 10.1016/j.arbres.2014.10.003. Epub 2014 Dec 24. English, Spanish. PubMed PMID: 25544548 INTRODUCTION: Community-acquired pneumonia (CAP) is not considered a professional disease, and the effect of different occupations and working conditions on susceptibility to CAP is unknown. The aim of this study is to determine whether different jobs and certain working conditions are risk factors for CAP. METHODOLOGY: Over a 1-year period, all radiologically confirmed cases of CAP (n=1,336) and age- and sex-matched controls (n=1,326) were enrolled in a population-based case-control study. A questionnaire on CAP risk factors, including work-related questions, was administered to all participants during an in-person interview.

RESULTS: The bivariate analysis showed that office work is a protective factor against CAP, while building work, contact with dust and sudden changes of temperature in the workplace were risk factors for CAP. The occupational factor disappeared when the multivariate analysis was adjusted for working conditions. Contact with dust (previous month) and sudden changes of temperature (previous 3 months) were risk factors for CAP, irrespective of the number of years spent working in these conditions, suggesting reversibility.

CONCLUSION: Some recent working conditions such as exposure to dust and sudden changes of temperature in the workplace are risk factors for CAP. Both factors are reversible and preventable.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.823

Quartil: 3

Categoria: Respiratory System

Posició: 40/58

Canadell L, Martín-Loeches I, Díaz E, Trefler S, Grau S, Yebenes JC, Almirall J, Olona M, Sureda F, Blanquer J, Rodriguez A; GETGAG. Degree of adherence to recommended antiviral treatment during the pandemic and post-pandemic periods of influenza A(H1N1)pdm09 in 148 intensive care units in Spain. Med Intensiva. 2015 May;39(4):222-33. doi: 10.1016/j.medin.2014.06.001. Epub 2014 Aug 5. English, Spanish. PubMed PMID: 25107582 OBJECTIVE: To determine the degree of antiviral treatment recommendations adherence and its impact to critical ill patients affected by influenza A(H1N1)pdm09 mortality.

DESIGN: Secondary analysis of prospective study.

SETTING: Intensive care (UCI).

PATIENTS: Patients with influenza A(H1N1)pdm09 in the 2009 pandemic and 2010-11 post-Pandemic periods.

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VARIABLES: Adherence to recommendations was classified as: Total (AT); partial in doses (PD); partial in time (PT), and nonadherence (NA). Viral pneumonia, obesity and mechanical ventilation were considered severity criteria for the administration of high antiviral dose. The analysis was performed using t-test or «chi» square. Survival analysis was performed and adjusted by Cox regression analysis.

RESULTS: A total of 1,058 patients, 661 (62.5%) included in the pandemic and 397 (37.5%) in post-pandemic period respectively. Global adherence was achieved in 41.6% (43.9% and 38.0%; P=.07 respectively). Severity criteria were similar in both periods (68.5% vs. 62.8%; P=.06). The AT was 54.7% in pandemic and 36.4% in post-pandemic period respectively (P<.01). The NA (19.7% vs. 11.3%; P<.05) and PT (20.8% vs. 9.9%, P<.01) was more frequent in the post-pandemic period.

The mortality rate was higher in the post-pandemic period (30% vs. 21.8%, P<.001). APACHE II (HR=1.09) and hematologic disease (HR=2.2) were associated with a higher mortality and adherence (HR=0.47) was a protective factor.

CONCLUSIONS: A low degree of adherence to the antiviral treatment was observed in both periods. Adherence to antiviral treatment recommendations was associated with lower mortality rates and should be recommended in critically ill patients with suspected influenza A(H1N1)pdm09.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.336

Quartil: 4

Categoria: Critical Care medicine

Posició: 24/27

Almirall J, Serra-Prat M, Bolibar I. Risk factors for community-acquired pneumonia in adults: Recommendations for its prevention. Community Acquir Infect 2015;2:32-7 Abstract: Community-acquired pneumonia (CAP) remains an important cause of morbidity and mortality in developed countries. The disease is one of the top 10 causes of death and up to the present time, standard aggressive medical care has not resulted in a decrease in mortality. Knowledge of risk factors for CAP is essential to the design of preventive measures to reduce its incidence. Preventive strategies promoting effective vaccines or identifying and acting on modifiable risk factors are of paramount importance in reducing CAP-related death. Most studies have been performed in patients referred for inpatient care or in CAP cases in which a specific pathogen has been identified, but data from population-based studies are scarcer. We present a review of the main risk factors for CAP in adults, classified in the following categories: (a) Comorbidities and their treatments, (b) demographic and socioeconomic factors, (c) lifestyle factors and (d) environmental factors. We conclude with some brief recommendations on preventive measures and vaccination.

URGÈNCIES – EMERGENCY MEDICINE Nº Articles indexats: 2

Factor Impacte total: 0

Factor d’impacte mig per article: 0

Diaz Olaizola C, Salvador Castellà N, Garcia Caballero M, Jerez Viñas N, Galvez Suarez A, Álvaro Rubio C. [ArgyllRobertson pupil.]. Semergen. 2015 Mar 2. pii: S1138-3593(15)00042-8. doi: 10.1016/j.semerg.2015.01.011. [Epub ahead of print] Spanish. PubMed PMID: 25743697 Indexat a: Medline/WOS

Diaz Olaizola C, Álvaro Rubio C, Galvez Suarez A, Campos Vall M. [Guillain-Barré and flu vaccine.]. Semergen. 2015 Feb 12. pii: S1138-3593(15)00031-3. doi: 10.1016/j.semerg.2015.01.002. [Epub ahead of print] Spanish. PubMed PMID: 25684308

Indexat a: Medline/WOS

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GERIATRIA – GERIATRIC MEDICINE Nº Articles indexats: 1

Factor Impacte total: 1.525

Factor d’impacte mig per article: 1.525

Costa-Requena G, Espinosa Val MC, Cristòfol R. Caregiver burden in end-of-life care: advanced cancer and final stage of dementia. Palliat Support Care. 2015 Jun;13(3):583-9. doi: 10.1017/S1478951513001259. Epub 2014 Mar 10. PubMed PMID: 24612777 OBJECTIVE: Considering two advanced illnesses, cancer and end-stage dementia, the aim of this study was to describe the symptoms of caregiver psychological distress and burden.

METHOD: In this cross-sectional study, regression analyses were calculated to explain the influence of psychological distress in caregiver burden. A t test was employed to compare differences between the symptoms of caregiver burden.

RESULTS: The percentage of psychological distress was similar between caregivers of cancer patients (77.6%) and caregivers of dementia patients (72.4%). In the regression analysis, cancer caregiver distress accounted for 27.9% of the variance in symptoms of burden, while dementia caregiver distress accounted for 24.4% of the variance in symptoms of burden. No significant differences were revealed when comparing caregiver burden symptoms between caregivers of the two advanced illnesses (t = 0.06; p = 0.94).

SIGNIFICANCE OF RESULTS: In end-of-life care for patients with dementia, due to significant levels of caregiver distress and burden symptoms, there is a need to support caregivers in the same way as is done for caregivers of cancer patients.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.525

Quartil: 3

Categoria: Health Policy & Services

Posició: 36/71

ATENCIÓ PRIMARIA – PRIMARY CARE Nº Articles indexats: 1

Factor Impacte total: 1.966

Factor d’impacte mig per article: 1.966

Papiol M, Serra-Prat M, Vico J, Jerez N, Salvador N, Garcia M, Camps M, Alpiste X, López J. Poor Muscle Strength and Low Physical Activity are the Most Prevalent Frailty Components in Community-Dwelling Older Adults. J Aging Phys Act. 2015 Nov 3. [Epub ahead of print] PubMed PMID: 26540738 AIM: To determine the prevalence of 5 physical frailty phenotype components and to assess the relationship between them and with other clinical factors.

METHODS: A population-based cross-sectional study was performed. Subjects ≥75 years were randomly selected from primary care databases (sampling stratified by gender). Physical frailty phenotype was assessed using Fried's criteria.

Sociodemographic data, comorbidities, nutritional status and functional capacity were assessed.

RESULTS: 126 subjects were recruited (47% women). Prevalence rates were: poor muscle strength: 50%; low physical activity: 29%; slow gait: 28%; exhaustion: 27%; and weight loss: 5%. Pre-frailty and frailty prevalence rates were 35.7% and 29.4%, respectively. Poor muscle strength and low physical activity showed a close relationship and concordance (kappa=0.92). Most frailty components were associated with outdoor activity, hours walked daily and certain comorbidities.

CONCLUSIONS: Poor muscle strength was the most prevalent frailty component and was closely associated with physical activity, suggesting that training programmes may revert or prevent frailty process.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.966

Quartil: 2

Categoria: Gerontology

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UNITAT DE RECERCA – RESEARCH UNIT Nº Articles indexats: 2

Factor Impacte total: 3.115

Factor d’impacte mig per article: 1.557

Mora M, Adam V, Palomera E, Blesa S, Díaz G, Buquet X, Serra-Prat M, Martín-Escudero JC, Palanca A, Chaves JF, PuigDomingo M; Mataró Aging Study Group. Ghrelin Gene Variants Influence on Metabolic Syndrome Components in Aged Spanish Population. PLoS One. 2015 Sep 16;10(9):e0136931. doi: 10.1371/journal.pone.0136931. eCollection 2015.

PubMed PMID: 26375586 BACKGROUND: The role of genetic variations within the ghrelin gene on cardiometabolic profile and nutritional status is still not clear in humans, particularly in elderly people.

OBJECTIVES: We investigated six SNPs of the ghrelin gene and their relationship with metabolic syndrome (MS) components.

SUBJECTS AND METHODS: 824 subjects (413 men/411 women, age 77.31±5.04) participating in the Mataró aging study (n = 310) and the Hortega study (n = 514) were analyzed. Anthropometric variables, ghrelin, lipids, glucose and blood pressure levels were measured, and distribution of SNPs -994CT (rs26312), -604GA (rs27647), -501AC (rs26802), R51Q (rs34911341), M72L (rs696217) and L90G (rs4684677) of the ghrelin gene evaluated. Genotypes were determined by multiplex PCR and SNaPshot minisequencing. MS (IDF criteria) was found in 54.9%.

RESULTS: No association between any of the SNPs and levels of total fasting circulating ghrelin levels was found. C/A-A/A genotype of M72L was associated with increased risk of central obesity according to IDF criteria, while G/A-G/G genotypes of -604GA with reduced risk. A/A genotype of -501AC polymorphism was associated to decreased BMI. In relation to lipid profile, the same genotypes of -604GA were associated with increased total cholesterol and LDL-cholesterol and -501AC with reduced triglycerides. There were no associations with systolic or diastolic blood pressure levels or with hypertension, glucose levels or diabetes and ghrelin polymorphisms. However, G/G genotype of -604GA was associated with glucose >100 mg/dL. Haplotype analysis showed that only one haplotype is associated with increased risk of waist circumference and central obesity. The analysis of subjects by gender showed an important and different association of these polymorphisms regarding MS parameters.

CONCLUSION: Ghrelin gene variants -604GA, -501AC and M72L are associated with certain components of MS, in particular to BMI and lipid profile in elderly Spanish subjects.

Indexat a: Medline/WOS/JCR Factor Impacte: 3.234

Quartil: 1

Categoria: Multidisciplinary Sciences

Posició: 9/57

Serra-Prat M, Papiol M, Monteis R, Palomera E, Cabré M. Relationship between Plasma Ghrelin Levels and Sarcopenia in Elderly Subjects: A Cross-Sectional Study. J Nutr Health Aging. 2015 Jun;19(6):669-72. doi: 10.1007/s12603-015-0550-8.

PubMed PMID: 26054503 OBJECTIVE: The aim of this study was to investigate the relationship between plasma ghrelin levels and sarcopenia in elderly people.

DESIGN: Cross-sectional study.

SETTING: Health consortium medical centers in the Maresme region, Barcelona (Spain).

PARTICIPANTS: Two groups of subjects: persons ≥70 years (elderly group) and persons 25-65 years (young adults).

MEASUREMENTS: Sarcopenia, diagnosed according to the EWGSOP definition, fasting and postprandial plasma ghrelin levels, body composition, hand grip, Barthel score, and frailty using Fried criteria.

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RESULTS: Fifty-five elderly subjects and 33 young adults were recruited. In both age groups, mean ghrelin levels were significantly higher in women than in men. However, mean ghrelin levels were similar in elderly and young men (716 vs.

752 pg mL-1, P = 0.763) as well as in elderly and young women (859 vs. 995 pg mL-1, P = 0.190). In the elderly group, subjects with sarcopenia showed significantly lower ghrelin levels than those without sarcopenia (650 vs. 899 pg mL-1, P = 0.036), but these differences disappeared when stratifying by gender. Elderly subjects without sarcopenia had the same ghrelin levels as young adults (899.3 vs. 899.6 pg mL-1). In young women, ghrelin levels correlated with fat free mass (rs = 0.58, P = 0.007) and muscular mass (rs = 0.54, P = 0.015) but these correlations were not observed in men nor in elderly women.

CONCLUSION: This cross-sectional study does not allow a definitive conclusion about the relationship between ghrelin levels and sarcopenia. Further large prospective studies are needed to test this hypothesis.

Indexat a: Medline/WOS/JCR Factor Impacte: 2.996

Quartil: 2

Categoria: Geriatrics & Gerontology

Posició: 21/50

UROLOGIA - UROLOGY Nº Articles indexats: 1

Factor Impacte total1.426

Factor d’impacte mig per article: 1.426

Ramírez Sevilla C, Admella-Salvador C, Romero-Martin JA, Llopis-Manzanera J, Barranco-Sanz MA. Bladder Leiomyosarcoma 25 Years after Treatment with Cyclophosphamide in Patient with History of Retinoblastoma. Urol Int. 2015 Dec 17. [Epub ahead of print] PubMed PMID: 26675030 Abstract: The objective of this case report is to present a rare bladder tumour in a young patient 25 years after the treatment with cyclophosphamide because of a neuroblastoma of the right eye. The first symptom of the tumour was macroscopic haematuria with dysuria and pollakiuria. The final diagnosis was dictaminated by the pathologist and the best treatment option was radical cystoprostatectomy. Leiomyosarcoma was presented in a 26-year-old patient like the third different tumour, the second was an esphenoidal meningioma. At the 8th year of follow-up after the radical surgery, the patient is free of bladder disease. Bladder leiomyosarcoma is a rare tumour of the bladder and its early diagnosis and treatment are mandatory for best prognosis.

Indexat a: Medline/WOS/JCR Factor Impacte: 1.426

Quartil: 3

Categoria: Urology & Nephrology

Posició: 49/78

INFERMERIA – NURSING Nº Articles indexats: 0

Factor Impacte total: 0

Factor d’impacte mig per article: 0

Rodriguez F, Bolíbar I, Serra-Prat M, Palomera E, Ballester MV, et al. (2014) Poor Oral Health as Risk Factor for Community-Acquired Pneumonia. J Pulm Respir Med 4:203 Objectives: Considerable evidence exists of the relationship between poor oral hygiene (therefore greater presence of plaque) and risk of pneumonia in special-care populations, including intensive care unit and nursing home settings.

However, the effect of poor oral health on the development of community-acquired pneumonia (CAP) remains to be established. We assessed the relationship between CAP and oral health in general adult population.

Study design: Over 1-year period, 1,336 incident cases of CAP and 1,326 controls were enrolled in a population-based casecontrol study. A questionnaire on CAP risk factors that included oral health-related questions, including visit to dentist in

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the last month, bleeding gums, gingivitis, dental dysaesthesia, dental prosthesis, gumboil in the last month, teeth move or lost, and periodontal disease was administered to all participants.

Results: The prevalence of dental dysaesthesia and use of dental prosthesis was significantly higher among patients with CAP than in control subjects (23.3% vs. 19.7%, P = 0.043, and 45.6% vs. 40.8%, P = 0.016, respectively), whereas visit to the dentist in the last month was a preventive factor against the development of CAP (odds ratio 0.71, 95% confidence interval 0.55-0.92, P = 0.008). Results of bivariate analysis were confirmed in the adjusted multivariate logistic regression models.

Conclusions: Poor oral health may contribute to a higher risk for CAP in adult patients. Oral hygiene practices are particularly important in subjects with dental dysaesthesia and dental prosthesis. Not only odontologists but also dental hygienists should be aware of the relationship between oral health and potentially severe lung infection.

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INDICADORS BIBLIOMÈTRICS GLOBALS Total articles publicats CSDM 2015:

74

Total articles Indexats Pubmed/Medline/WOS/JCR:

68

Articles no indexats a cap de les anteriors BDD:

Total articles per Servei:

6

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

Medicina Interna

13

Motilitat Digestiva

43.758

(4.375)

Motilitat Digestiva

10

Medicina Interna

41.458

(3.189)

Neurologia

8

Neurologia

18.442

(2.305)

Psiquiatria

8

Psiquiatria

14.991

(1.873)

Oncologia

4

Oncologia

12.142

(3.035)

Medicina Intensiva

3

Medicina Intensiva 10.795

(3.598)

Endocrinologia

3

Pneumologia

9.459

(4.729)

Traumatologia

3

Cirurgia General

8.111

(4.055)

Neumologia

2

Unitat de Recerca

6.230

(3.115)

Digestiu

2

Digestiu

5.923

(2.961)

Cirurgia General

2

Dermatologia

3.720

(3.720)

Urgències

2

Reumatologia

2.901

(2.901)

Unitat de Recerca

2

Endocrinologia

2.399

(0.799)

Geriatria

1

Traumatologia

2.268

(0.756)

Dermatologia

1

Atenció Primària

1.966

(1.966)

Reumatologia

1

Geriatria

1.525

(1.525)

Rehabilitació

1

Urologia

1.426

(1.426)

Atenció Primària

1

Rehabilitació

1.417

(1.417)

Urologia

1

Urgències

0.000

(0.000)

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Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2015

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