Publicacions Científiques Consorci Sanitari del Maresme 2020

Publicacions Científiques CSDM 2020

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Publicacions científiques 2020 Consorci Sanitari del Maresme.

Publicacions de l’any 2020 Biblioteca.

Direcció Acadèmica, Recerca i Innovació Consorci Sanitari del Maresme.

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Publicacions Científiques CSDM 2020

Presentació.

Aquest document recull i presenta els articles científics del Consorci Sanitari del Maresme (amb almenys un autor amb filiació CSDM) indexats al llarg de l’any 2020 en almenys alguna de les següents bases de dades: MEDLINE/PubMed/Web of Science (WOS)/Journal Citation Reports (JCR).

Els indicadors bibliomètrics adjudicats a cada article i per Serveis (Factor d’Impacte, Factor d’Impacte Mig, Quartil, i Posició de la revista) corresponen al Journal Citation Reports 2019, per la qual cosa s’ha de tenir en compte que són valors aproximats, els valors definitius seran els del JCR 2020 i estaran disponibles el proper mes de juliol de 2021.

En aquest document s’inclouen els articles amb etiqueta ahead of print de PubMed encara que siguin posteriorment indexats a MEDLINE durant l’any 2021. Per tant, no s’han inclòs els articles ahead of print del 2018 de PubMed que han estat indexats definitivament a MEDLINE durant el 2020 i que ja es van incloure a la llista de l’any passat o anteriors, evitant, d’aquesta manera, duplicitats.

Durant la pandèmia de la COVID-19, que es va iniciar al març d’enguany, el CEIm (Comitè Ètic d’Investigació amb medicaments) del CSDM ha actuat de referència de diversos estudis dels que a més a més hem facilitat casos clínics i informació clínica i s’ha participat en la el.laboració i redacció dels documents publicats. Aquests articles, donada la seva rellevància, s’han considerat i comptabilitzat en aquest document en una categoria nova : CEIm (Comitè Ètic d’Investigació amb medicaments).

Enguany més serveis han vists publicades llurs investigacions i tots els articles, tret d’un, han estat indexats en almenys una de les BDD considerades.

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

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

El document recull també aquells articles no indexats a cap de les BDD anteriors, així com altres documents (llibres, capítols de llibres,) publicats durant l’any 2020.

Aquest document recull els articles publicats en el període que va del dia 21 de desembre de 2019 a 21 desembre 2020.

Foto : Dani Olea. Comunicació

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Publicacions Científiques CSDM 2020

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

2

Alimentació i Dietètica – Human Nutrition & Dietetics…………………………………….……….…………………………….…..…. …

4

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

4

Cardiologia – Cardiology ……………………………………………………………………….……………………………………………..……..……..

7

CEIm. Comitè Ètic d’Investigació amb medicaments - Ethic Committee for Investigation with Medicinal Products.

8

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

10

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

12

Cirurgia Vascular – Vascular Surgery ……………………………………..………………………………………………………..………………….

15

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

15

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

16

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

17

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

19

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

19

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

20

Medicina de Família – Family Medicine ………………………….…………………………………………………………………………………

21

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

22

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

23

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

26

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

33

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

42

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

45

Oftalmologia - Ophthalmology….……………………….…………………………………………………………………………………………………

46

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

47

Pediatria – Pediatrics……………………...…….…………………………..……………………………………………………………………………….

51

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

51

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

62

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

64

Identificació del tipus de publicació : Article Indexat a: MEDLINE/PubMed/ Web of Science (WOS)/Journal Citation Reports (JRC).

Article no indexat a cap de les anteriors BDD. Llibre o Capítol de llibre.

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Publicacions Científiques CSDM 2020

ALIMENTACIÓ I DIETÈTICA – HUMAN NUTRITION & DIETETICS Nº Articles indexats: 1

Factor Impacte total: 0.888

Factor d’impacte mig per article: 0.888

Martínez Rodríguez J, Roca Fontbona M. Comparación de las recomendaciones de expertos sobre nutrición clínica en pacientes hospitalizados con COVID-19.

Nutr Hosp. 2020 Oct 21;37(5):984-998. Spanish. doi:10.20960/nh.03194. PMID: 32960639 Abstract INTRODUCTION: in SARS-CoV-2-infected patients nutritional requirements are increased. These patients present symptoms that make food intake and nutrient absorption difficult, therefore involving nutritional risk. On the other hand, acute respiratory complications require prolonged ICU stays, and this predisposes to increased malnutrition and loss of skeletal muscle mass and function, which can lead to poor quality of life, disability and morbidity long after discharge. For this reason, the world's leading nutrition societies and associations believe that nutritional therapy should be considered a part of the basic treatment of patients with COVID-19.

METHODS: we have reviewed and compared 9 expert recommendations (ER) published by nutrition societies and associations from China, Spain, Brazil, Europe, Colombia, Australia, America, and the United Kingdom, in relation to critical and non-critical hospitalized patients due to the COVID-19 pandemic.

CONCLUSIONS: the 9 ERs reviewed agree on the importance of nutritional management in critical and noncritical hospitalized patients with COVID-19, as well as on the early detection of nutritional risk, the intervention, and subsequent follow-up. Even so, each published document has its own particularities and puts a special stress on some specific aspect.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 0.888 Quartil: 4

Categoria: Nutrition & Dietetics

Posició: 77/89

ANESTESIOLOGIA – ANESTHESIOLOGY Nº Articles indexats: 3

Factor Impacte total: 17.287

Factor d’impacte mig per article: 8.643

Ripollés-Melchor J, Abad-Motos A, Díez-Remesal Y, Aseguinolaza-Pagola M, Padin-Barreiro L, Sánchez-Martín R, Logroño-Egea M, Catalá-Bauset JC, García- Orallo S, Bisbe E, Martín N, Suárez-de-la-Rica A, Cuéllar-Martínez AB, Gil- Trujillo S, Estupiñán-Jiménez JC, Villanova-Baraza M, Gil-Lapetra C, Pérez- Sánchez P, Rodríguez-García N, Ramiro-Ruiz A, Farré-Tebar C, Martínez-García A, Arauzo-Pérez P, García-Pérez C, Abad-Gurumeta A, Miñambres-Villar MA, Sánchez-Campos A, Jiménez-López I, Tena-Guerrero JM, Marín-Peña O, SánchezMerchante M, Vicente-Gutiérrez U, Cassinello-Ogea MC, Ferrando-Ortolá C, Berges-Gutiérrez H, Fernanz-Antón J, Gómez-Ríos MA, Bordonaba-Bosque D, Ramírez-Rodríguez JM, García-Erce JA, Aldecoa C; Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty (POWER2) Study Investigators Group for the Spanish Perioperative Audit and Research Network (REDGERM).

Association Between Use of Enhanced Recovery After Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2).

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JAMA Surg. 2020 Apr n1;155(4):e196024. doi: 10.1001/jamasurg.2019.6024. Epub 2020 Apr 15. PMID: 32049352; PMCID: PMC7042927.

Abstract IMPORTANCE: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery.

OBJECTIVE: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Design, setting, and participants: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019.

EXPOSURES: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not.

MAIN OUTCOMES AND MEASURES: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality.

RESULTS: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P = .22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P = .02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at nonERAS centers (P < .001). Among the patients with the highest and lowest quartiles of adherence to ERAS components, the patients with the highest adherence had fewer overall postoperative complications (144 [10.6%] vs 270 [13.0%]; OR, 0.80; 95% CI, 0.64-0.99; P < .001) and moderate to severe postoperative complications (59 [4.4%] vs 143 [6.9%]; OR, 0.62; 95% CI, 0.45-0.84; P < .001) and shorter median length of hospital stay (4 [IQR, 3-5] vs 5 [IQR, 4-6] days; OR, 0.97; 95% CI, 0.96-0.99; P < .001).

CONCLUSIONS AND RELEVANCE: An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 13.625 Quartil/Decil: 1

Categoria: Surgery

Posició: 1/210

Ferrandis R, Llau JV, Sanz JF, Cassinello CM, González-Larrocha Ó, Matoses SM, Suárez V, Guilabert P, Torres LM, Fernández-Bañuls E, García-Cebrián C, Sierra P, Barquero M, Montón N, Martínez-Escribano C, Llácer M, GómezLuque A, Martín J, Hidalgo F, Yanes G, Rodríguez R, Castaño B, Duro E, Tapia B, Pérez A, Villanueva ÁM, Álvarez JC, Sabaté S; RA-ACOD investigators.

Periprocedural Direct Oral Anticoagulant Management: The RA-ACOD Prospective, Multicenter Real-World Registry.

TH Open. 2020 Jun 26;4(2):e127-e137. doi: 10.1055/s-0040-1712476. eCollection 2020 Apr. PubMed PMID: 32607466; PubMed Central PMCID: PMC7319799

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Abstract INTRODUCTION: There is scarce real-world experience regarding direct oral anticoagulants (DOACs) perioperative management. No study before has linked bridging therapy or DOAC-free time (pre-plus postoperative time without DOAC) with outcome. The aim of this study was to investigate real-world management and outcomes.

METHODS: RA-ACOD is a prospective, observational, multicenter registry of adult patients on DOAC treatment requiring surgery. Primary outcomes were thrombotic and hemorrhagic complications. Follow-up was immediate postoperative (24-48 hours) and 30 days. Statistics were performed using a univariate and multivariate analysis. Data are presented as odds ratios (ORs [95% confidence interval]).

RESULTS: From 26 Spanish hospitals, 901 patients were analyzed (53.5% major surgeries): 322 on apixaban, 304 on rivaroxaban, 267 on dabigatran, 8 on edoxaban. Fourteen (1.6%) patients suffered a thrombotic event, related to preoperative DOAC withdrawal (OR: 1.57 [1.03-2.4]) and DOAC-free time longer than 6 days (OR: 5.42 [1.18-26]). Minor bleeding events were described in 76 (8.4%) patients, with higher incidence for dabigatran (12.7%) versus other DOACs (6.6%). Major bleeding events occurred in 17 (1.9%) patients. Bridging therapy was used in 315 (35%) patients. It was associated with minor (OR: 2.57 [1.3-5.07]) and major (OR: 4.2 [1.4-12.3]) bleeding events, without decreasing thrombotic events.

CONCLUSION: This study offers real-world data on perioperative DOAC management and outcomes in a large prospective sample size to date with a high percentage of major surgery. Short-term preprocedural DOAC interruption depending on the drug, hemorrhagic risk, and renal function, without bridging therapy and a reduced DOAC-free time, seems the safest practice.

Indexat a: PubMed

Bisbe E, Garcia-Casanovas A, Illa C, Varela J, Basora M, Barquero M, Colomina MJ, González L, Hofmann A; MAPBM Working Group, Rodríguez LEF, Gosálbez AA, Fornet AP, Soler X, Planella T, Ricos P, Goterris R, Olmedilla L, Jericó C, Morales A, Gala JMG, Dueñas V, Fernández C, Tolos R, Villanueva MA, Cassinello C, Graciani IF, Aragon S, Subira M, Turcu V, Vilariño SAD, Zavala E, González LM, Moreno G, de Gracia SR, García A, Gallofre AP, Duque P, Sánchez LL, Vagace JM, Medina Á, Rodríguez MO, Faura A, Rosello L, Johansson E, Poch P, Santamaría MA, Rubio ML, Jara I, Carmona C, Lluch CR, Almirante M, López ÁF, Caldes M, Loureiro E, Quintana M, Azparren G, Puerta J, Romero EM, Rubio AA, Santaella J, Cerdan G, Arbones R, Palacios Á, Llamas P. Maturity Assessment model for Patient Blood Management to assist hospitals in improving patients' safety and outcomes. The MAPBM project.

Blood Transfus. 2020 Sep 18. doi: 10.2450/2020.0105-20. Epub ahead of print. PMID: 32955422.

BACKGROUND: Patient blood management (PBM) is an evidence-based care bundle with proven ability to improve patients' outcomes by managing and preserving the patient's own blood. Since 2010, the World Health Organisation has urged member states to implement PBM. However, there has been limited progress in developing PBM programmes in hospitals due to the implicit challenges of implementing them. To address these challenges, we developed a Maturity Assessment Model (MAPBM) to assist healthcare organisations to measure, benchmark, assess in PBM, and communicate the results of their PBM programmes. We describe the MAPBM model, its benchmarking programme, and the feasibility of implementing it nationwide in Spain.

MATERIALS AND METHODS: The MAPBM considers the three dimensions of a transformation effort (structure, process and outcomes) and grades these within a maturity scale matrix. Each dimension includes the various drivers of a PBM programme, and their corresponding measures and key performance indicators. The structure measures are qualitative, and obtained using a survey and structured self-assessment checklist. The key performance indicators for process and outcomes are quantitative, and based on clinical data from the hospitals' electronic medical records. Key performance indicators for process address major clinical recommendations in each PBM pillar, and are applied to six common procedures characterised by significant blood loss.

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Publicacions Científiques CSDM 2020

RESULTS: In its first 5 years, the MAPBM was deployed in 59 hospitals and used to analyse 181,826 hospital episodes, which proves the feasibility of implementing a sustainable model to measure and compare PBM clinical practice and outcomes across hospitals in Spain.

CONCLUSION: The MAPBM initiative aims to become a useful tool for healthcare organisations to implement PBM programmes and improve patients' safety and outcomes.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.662 Quartil: 2

Categoria: Hematology

Posició: 23/76

CARDIOLOGIA – CARDIOLOGY Nº Articles indexats: 1

Factor Impacte total: 3.902

Factor d’impacte mig per article: 3.902

de Frutos F, Mirabet S, Ortega-Paz L, Buera I, Darnés S, Farré N, Perez B, Adeliño R, Bascompte R, Pérez-Rodón J, Aparicio X, Sutil-Vega M, Soto A, Faraudo M, Cainzos-Achirica M, Manito N. Management of Heart Failure with Reduced Ejection Fraction after ESC 2016 Heart Failure Guidelines: The Linx Registry.

ESC Heart Fail. 2020 Feb;7(1):25-35. doi: 10.1002/ehf2.12567. Epub 2020 Jan 9. PubMed PMID: 31916413; PubMed Central PMCID: PMC7083472.

Abstract AIMS: In May 2016, a new version of the European Society of Cardiology (ESC) Guidelines for the management of heart failure (HF) was released. The aim of this study was to describe the management of HF with reduced ejection fraction after the publication of ESC Guidelines.

METHODS AND RESULTS: The Linx registry is a multicentre, observational, cross-sectional study from 14 Catalan hospitals that enrolled 1056 patients with HF and reduced left ventricular ejection fraction (≤40%) from 1 February to 30 April 2017 in outpatient cardiology clinics. Results were compared between hospitals according to their level of complexity in our own registry and compared with previously published registries similar to ours. Sacubitril/valsartan was prescribed to 23.9% of patients in our population, as a consequence, use of angiotensin-converting enzyme inhibitor and angiotensin receptor blockers in monotherapy decreased to 48.1% and 16.9%, respectively, and prescription of beta-blockers (91.8%), mineralocorticoid receptor antagonists (72.7%), and ivabradine (21.4%) remained similar to previous registries. Target doses of beta-blockers (25.4%), angiotensin-converting enzyme inhibitors (24.9%), angiotensin receptor blockers (7.7%), sacubitril/valsartan (8.1%), and mineralocorticoid receptor antagonists (19.7%) were accomplished in a low proportion of patients.

Our results also suggest that prescription and up-titration of class I HF drugs were greater in hospitals with higher level of complexity.

CONCLUSIONS: The Linx registry shows an appropriate adherence to pharmacological recommendations from ESC HF Guidelines despite a low proportion of patients reached target doses. Almost one-quarter of patients were under treatment with sacubitril/valsartan a few months after ESC HF Guidelines recommendations.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.902 Quartil: 2 Categoria: Cardiac & Cardiovascular Systems

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CEIm. COMITÈ ÈTIC D’INVESTIGACIÓ AMB MEDICAMENTS – RECm. ETHIC COMMITTEE FOR INVESTIGATION WITH MEDICINAL PRODUCTS Nº Articles indexats: 3

Factor Impacte total: 148.481

Factor d’impacte mig per article: 52.827

Zhang Q, Bastard P, Liu Z, Le Pen J, Moncada-Velez M, Chen J, Ogishi M, Sabli IKD, Hodeib S, Korol C, Rosain J, Bilguvar K, Ye J, Bolze A, Bigio B, Yang R, Arias AA, Zhou Q, Zhang Y, Onodi F, Korniotis S, Karpf L, Philippot Q, Chbihi M, Bonnet-Madin L, Dorgham K, Smith N, Schneider WM, Razooky BS, Hoffmann HH, Michailidis E, Moens L, Han JE, Lorenzo L, Bizien L, Meade P, Neehus AL, Ugurbil AC, Corneau A, Kerner G, Zhang P, Rapaport F, Seeleuthner Y, Manry J, Masson C, Schmitt Y, Schlüter A, Le Voyer T, Khan T, Li J, Fellay J, Roussel L, Shahrooei M, Alosaimi MF, Mansouri D, Al-Saud H, Al-Mulla F, Almourfi F, Al-Muhsen SZ, Alsohime F, Al Turki S, Hasanato R, van de Beek D, Biondi A, Bettini LR, D'Angio' M, Bonfanti P, Imberti L, Sottini A, Paghera S, Quiros-Roldan E, Rossi C, Oler AJ, Tompkins MF, Alba C, Vandernoot I, Goffard JC, Smits G, Migeotte I, Haerynck F, Soler-Palacin P, Martin-Nalda A, Colobran R, Morange PE, Keles S, Çölkesen F, Ozcelik T, Yasar KK, Senoglu S, Karabela ŞN, Rodríguez-Gallego C, Novelli G, Hraiech S, Tandjaoui-Lambiotte Y, Duval X, Laouénan C; COVID-STORM Clinicians; COVID Clinicians* (*Clavé P, Bolivar M); Imagine COVID Group; French COVID Cohort Study Group; CoV-Contact Cohort; Amsterdam UMC Covid-19 Biobank; COVID Human Genetic Effort; NIAID-USUHS/TAGC COVID Immunity Group, Snow AL, Dalgard CL, Milner JD, Vinh DC, Mogensen TH, Marr N, Spaan AN, Boisson B, Boisson-Dupuis S, Bustamante J, Puel A, Ciancanelli MJ, Meyts I, Maniatis T, Soumelis V, Amara A, Nussenzweig M, García-Sastre A, Krammer F, Pujol A, Duffy D, Lifton RP, Zhang SY, Gorochov G, Béziat V, Jouanguy E, Sancho-Shimizu V, Rice CM, Abel L, Notarangelo LD, Cobat A, Su HC, Casanova JL. Inborn errors of type I IFN immunity in patients with life-threatening COVID-19.

Science. 2020 Oct 23;370(6515):eabd4570. doi:10.1126/science.abd4570. Epub 2020 Sep 24. PMID: 32972995.

Abstract: Clinical outcome upon infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ranges from silent infection to lethal coronavirus disease 2019 (COVID-19). We have found an enrichment in rare variants predicted to be loss-of-function (LOF) at the 13 human loci known to govern Toll-like receptor 3 (TLR3)and interferon regulatory factor 7 (IRF7)-dependent type I interferon (IFN) immunity to influenza virus in 659 patients with life-threatening COVID-19 pneumonia relative to 534 subjects with asymptomatic or benign infection. By testing these and other rare variants at these 13 loci, we experimentally defined LOF variants underlying autosomal-recessive or autosomal-dominant deficiencies in 23 patients (3.5%) 17 to 77 years of age.

We show that human fibroblasts with mutations affecting this circuit are vulnerable to SARS-CoV-2. Inborn errors of TLR3- and IRF7-dependent type I IFN immunity can underlie life-threatening COVID-19 pneumonia in patients with no prior severe infection.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 41.891 Quartil/Decil: 1

Categoria: Multidisciplinary Sciences

Posició: 2/71

Bastard P, Rosen LB, Zhang Q, Michailidis E, Hoffmann HH, Zhang Y, Dorgham K, Philippot Q, Rosain J, Béziat V, Manry J, Shaw E, Haljasmägi L, Peterson P, Lorenzo L, Bizien L, Trouillet-Assant S, Dobbs K, de Jesus AA, Belot A, Kallaste A, Catherinot E, Tandjaoui-Lambiotte Y, Le Pen J, Kerner G, Bigio B, Seeleuthner Y, Yang R, Bolze A, Spaan AN, Delmonte OM, Abers MS, Aiuti A, Casari G, Lampasona V, Piemonti L, Ciceri F, Bilguvar K, Lifton RP, Vasse M, Smadja DM, Migaud M, Hadjadj J, Terrier B, Duffy D, Quintana-Murci L, van de Beek D, Roussel L, Vinh

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DC, Tangye SG, Haerynck F, Dalmau D, Martinez-Picado J, Brodin P, Nussenzweig MC, Boisson-Dupuis S, Rodríguez-Gallego C, Vogt G, Mogensen TH, Oler AJ, Gu J, Burbelo PD, Cohen JI, Biondi A, Bettini LR, D'Angio M, Bonfanti P, Rossignol P, Mayaux J, Rieux-Laucat F, Husebye ES, Fusco F, Ursini MV, Imberti L, Sottini A, Paghera S, Quiros-Roldan E, Rossi C, Castagnoli R, Montagna D, Licari A, Marseglia GL, Duval X, Ghosn J; HGID Lab; NIAIDUSUHS Immune Response to COVID Group; COVID Clinicians* (*Clavé P, Bolivar M); COVID-STORM Clinicians; Imagine COVID Group; French COVID Cohort Study Group; Milieu Intérieur Consortium; CoV-Contact Cohort; Amsterdam UMC Covid-19 Biobank; COVID Human Genetic Effort, Tsang JS, Goldbach-Mansky R, Kisand K, Lionakis MS, Puel A, Zhang SY, Holland SM, Gorochov G, Jouanguy E, Rice CM, Cobat A, Notarangelo LD, Abel L, Su HC, Casanova JL. Autoantibodies against type I IFNs in patients with life-threatening COVID-19.

Science. 2020 Oct 23;370(6515):eabd4585. doi: 10.1126/science.abd4585. Epub 2020 Sep 24. PMID: 32972996.

Abstract: Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-ω (IFN-ω) (13 patients), against the 13 types of IFN-α (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 41.891 Quartil/Decil: 1

Categoria: Multidisciplinary Sciences

Posició: 2/71

Mitjà O, Corbacho-Monné M, Ubals M, Alemany A, Suñer C, Tebé C, Tobias A, Peñafiel J, Ballana E, Pérez CA, Admella P, Riera-Martí N, Laporte P, Mitjà J, Clua M, Bertran L, Sarquella M, Gavilán S, Ara J, Argimon JM, Cuatrecasas G, Cañadas P, Elizalde-Torrent A, Fabregat R, Farré M, Forcada A, Flores-Mateo G, López C, Muntada E, Nadal N, Narejos S, Nieto A, Prat N, Puig J, Quiñones C, Ramírez-Viaplana F, Reyes-Urueña J, Riveira-Muñoz E, Ruiz L, Sanz S, Sentís A, Sierra A, Velasco C, Vivanco-Hidalgo RM, Zamora J, Casabona J, VallMayans M, González-Beiras C, Clotet B; BCN-PEP-CoV2 Research Group* (*Clavé P, Bolivar M) A Cluster-Randomized Trial of Hydroxychloroquine for Prevention of Covid-19.

N Engl J Med. 2020 Nov 24. doi: 10.1056/NEJMoa2021801. Epub ahead of print. PMID: 33289973.

Abstract BACKGROUND: Current strategies for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited to nonpharmacologic interventions. Hydroxychloroquine has been proposed as a postexposure therapy to prevent coronavirus disease 2019 (Covid-19), but definitive evidence is lacking.

METHODS: We conducted an open-label, cluster-randomized trial involving asymptomatic contacts of patients with polymerase-chain-reaction (PCR)-confirmed Covid-19 in Catalonia, Spain. We randomly assigned clusters of contacts to the hydroxychloroquine group (which received the drug at a dose of 800 mg once, followed by 400 mg daily for 6 days) or to the usual-care group (which received no specific therapy). The primary outcome was PCR-confirmed, symptomatic Covid-19 within 14 days. The secondary outcome was SARS-CoV-2 infection, defined by symptoms compatible with Covid-19 or a positive PCR test regardless of symptoms. Adverse events were assessed for up to 28 days.

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RESULTS: The analysis included 2314 healthy contacts of 672 index case patients with Covid-19 who were identified between March 17 and April 28, 2020. A total of 1116 contacts were randomly assigned to receive hydroxychloroquine and 1198 to receive usual care. Results were similar in the hydroxychloroquine and usualcare groups with respect to the incidence of PCR-confirmed, symptomatic Covid-19 (5.7% and 6.2%, respectively; risk ratio, 0.86 [95% confidence interval, 0.52 to 1.42]). In addition, hydroxychloroquine was not associated with a lower incidence of SARS-CoV-2 transmission than usual care (18.7% and 17.8%, respectively).

The incidence of adverse events was higher in the hydroxychloroquine group than in the usual-care group (56.1% vs. 5.9%), but no treatment-related serious adverse events were reported.

CONCLUSIONS: Postexposure therapy with hydroxychloroquine did not prevent SARS-CoV-2 infection or symptomatic Covid-19 in healthy persons exposed to a PCR-positive case patient. (Funded by the crowdfunding campaign YoMeCorono and others; BCN-PEP-CoV2 ClinicalTrials.gov number, NCT04304053).

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 74.669 Quartil/Decil: 1

Categoria: Medicine General & Internal

Posició: 1/165

CIRURGIA GENERAL – GENERAL SURGERY Nº Articles indexats: 4

Factor Impacte total: 9.428

Factor d’impacte mig per article: 2.357

Hidalgo-Grau LA, Piedrafita-Serra E, Ruiz-Edo N, Llorca-Cardeñosa S, Heredia-Budó A, Estrada-Ferrer O, SuñolSala X. Prospective Randomized Study on Stapled Anopexy Height and Its Influence on Recurrence for Hemorrhoidal Disease Treatment.

World J Surg. 2020 Jul 9. doi: 10.1007/s00268-020-05676-y. [Epub ahead of print] PubMed PMID: 32647985.

Abstract OBJECTIVES: To know the influence of the stapled line height (SLH) in the recurrence rate and the postoperative disturbances in stapled anopexy (SA) for the treatment of hemorrhoids.

DESIGN: Simple randomized double-blind controlled clinical trial. Randomization with closed-envelope technique in two groups with two different SLH. SETTING: Colorectal Surgery Unit. Department of General Surgery. Hospital de Mataró (Barcelona, Spain).

PARTICIPANTS: 119 patients with the diagnosis of symptomatic third- and fourth-grade hemorrhoids were included.

INTERVENTION: SA was performed with two different SLH: group A, 4.5 cm (58 patients) and group B, 6 cm (61 patients) from the external anal verge. Postoperative disturbances were evaluated by a colorectal surgeon who was blind for the randomization and pain was measured (visual analogic scale) one week and 3 months after surgery. Mean operative time, number of hemostatic stitches performed and resected mucosal area were considered as well. Mean follow-up was 11.05 ± 1.6 years.

RESULTS: Differences between the operative time and resected mucosa-submucosa area were not found. The patients of group A needed a significantly higher number of stitches for intraoperative bleeding control along the stapled line. We did not found differences between both groups in terms of postoperative pain neither anorectal disturbances. At the follow-up, persistence of symptomatology was 10.41% in group A and 10.71% in group B, without statistically significance. Neither mortality nor undesirable effects occurred in the series.

CONCLUSIONS: SLH do not influence the recurrence rate neither the postoperative evolution in SA. Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.234 Quartil: 2 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Categoria: Surgery

Posició: 80/201 10

Publicacions Científiques CSDM 2020

Osorio J, Jericó C, Miranda C, Santamaría M, Artigau E, Galofré G, Garsot E, Luna A, Puértolas N, Aldeano A, Olona C, Molinas J, Feliu J, Videla S, Tebe C, Pera M. Improved postoperative outcomes and reduced transfusion rates after implementation of a Patient Blood Management program in gastric cancer surgery.

Eur J Surg Oncol. 2020 Nov 27:S0748-7983(20)31025-8. doi: 10.1016/j.ejso.2020.11.129. Epub ahead of print.

PMID: 33267997 Abstract INTRODUCTION: Gastric cancer patients are often transfused with red blood cells, with negative impact on postoperative course. This multicenter prospective interventional cohort study aimed to determine whether implementation of a Patient Blood Management (PBM) program, was associated with a decrease in transfusion rate and improvements in clinical outcomes in gastric cancer surgery.

METHODS: We compared transfusion practices and clinical outcomes in patients undergoing elective gastric cancer resection before and after implementing a PBM program, including strategies to detect and treat anemia and restrictive transfusion practice (2014-2018). Primary outcome was transfusion rate (TR). Secondary outcomes were complications, reoperations, length of stay, readmissions, 90-day mortality and failure-torescue. Differences were adjusted by confounding factors.

RESULTS: Some 789 patients were included (496 pre- and 293 post-PBM). TR decreased from 39.1% to 27.0% (adjusted difference -9.1, 95% CI -15.2 to -2.9), being reduction particularly significant in patients with anemia, ASA score 3-4, locally advanced tumors, undergoing open surgery and total gastrectomy. Infectious complications diminished from 25% to 16.4% (-6.1, 95%CI -11.5 to -0.7), reoperations from 8.1% to 6.1% (-2.2, 95%CI -5.1 to +0.6), median length of stay from 11 [IQR 8-18] to 8 [7-12] days (p < 0.001), hospital readmission from 14.1% to 8.9% (-5.4, 95%CI -9.6 to -1.1), mortality from 7.9% to 4.8% (-2.4, 95%CI -4.7 to -0.01), and failureto rescue from 62.7% to 32.7% (-23.1, 95%CI -37.7 to -8.5).

CONCLUSION: Implementation of a PBM program was associated with a reduction in transfusion rate and improvement in postoperative outcomes in gastric cancer patients undergoing curative resection.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.959 Quartil: 1

Categoria: Surgery

Posició: 28/210

Bernabeu García A, De la Cruz Verdun J, Suñol Sala X. Colecistitis enfisematosa en sospecha de infección por SARS-CoV-2.

Cir Esp. 2020 Aug 4:S0009-739X(20)30260-8. English, Spanish. doi: 10.1016/j.ciresp.2020.07.015.Epub ahead of print. PMID: 32917378.

Abstract Mujer de 82 años con cirrosis hepática por virus C, hipertensión portal, insuficiencia cardiaca e insuficiencia renal crónica, consulta por deterioro funcional, vómitos y dolor en hipocondrio derecho de tres días de evolución. Analíticamente presenta neutrofilia, acidosis metabólica y PCR 13,09. La TC abdominal con contraste muestra áreas en vidrio esmerilado bilaterales, periféricas, basales pulmonares, sugestivas de SARS-CoV-2 con PCR negativa. Vesícula biliar distendida con paredes llenas de aire y con barro biliar con líquido perihepático y pélvico (fig. 1). Se (fig. 2) descarta cirugía por elevada morbimortalidad, consensuando tratamiento conservador con antibióticos. Exitus a las 24 h del ingreso. Diagnóstico: colecistitis enfisematosa.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.323 Quartil: 3

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Categoria: Surgery

Posició: 155/210

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Ciscar A, Badia JM, Novell F, Bolívar S, Mans E. Incidence and risk factors for trocar-site incisional hernia detected by clinical and ultrasound examination: a prospective observational study.

BMC Surg. 2020 Dec 14;20(1):330. doi: 10.1186/s12893-020-01000-6. PMID: 33317503.

Abstract BACKGROUND: Trocar site incisional hernia (TSIH) is the most frequent complication associated with laparoscopic surgery. Few studies currently describe its incidence or risk factors. The aim of this report is to determine the real incidence of TSIH and to identify risk factors.

METHODS: A cross-sectional prospective study was performed including consecutive patients who underwent a laparoscopic procedure during a 4 months period. All the patients were assessed both clinically (TSIHc) and by an ultrasonographic examination (TSIHu). The main variable studied was the incidence of TSIH. A multivariate analysis was performed to identify risk factors.

RESULTS: 76 patients were included. 27.6% of patients were clinically diagnosed as having TSIH (TSIHc) but only 23.7% of those cases were radiologically confirmed (TSIHu). In the logistic regression analysis, age > 70 years (OR 3.462 CI 1.14-10.515, p = 0.028) and body mass index (BMI) ≥ 30 kg/m2 (OR 3.313 CI 1.037-10.588, p = 0.043) were identified as risk factors for TSIH. The size of the trocar also showed statistically significant differences (p < 0.001). Mean follow-up time was 34 months.

CONCLUSIONS: TSIH is under-diagnosed due to the lack of related symptomatology and the inadequacy of the postoperative follow-up period. We detected discrepancies between the clinical and ultrasonographic examinations. TSIHu should be considered as the gold standard for the diagnosis of TSIH. Risk factors such as age, BMI and size of the trocar were confirmed. Patients should be followed-up for a minimum of 2 years. Trial registration The study has been retrospectively registered in Clinicaltrials.gov on June 4, 2020 under registration number: NCT04410744.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.912 Quartil: 2

Categoria: Surgery

Posició: 105/210

CIRURGIA ORTOPEDICA i TRAUMATOLOGIA – ORTHOPAEDIC SURGERY Nº Articles indexats: 4

Factor Impacte total: 2.703

Factor d’impacte mig per article: 1.351

Lucar-Lopez G, Ballester-Alomar M, Jimenez-Obach A, Navarro-Cano E, Villamizar MA, Guevara-Noriega KA. Modified Tension-Slide Technique for Endoscopy-Assisted Flexor Hallucis Longus Tendon Transfer.

Foot Ankle Spec. 2020 Jun 12:1938640020929577. doi: 10.1177/1938640020929577. [Epub ahead of print] PubMed PMID: 32527147.

Abstract: The rupture of the Achilles tendon (AT) usually occurs in high-caliber athletes, but low-demand patients are also are risk, mainly if they are under corticoids or quinolones. The diagnosis of the AT rupture is usually neglected, and this could result in a worse prognosis for the patient if not treated in an appropriate time. For these patients or for those with high surgical risk, an option of minimally invasive surgery remains attractive. Classical techniques consist of direct repair or augmentation with the tendon of the flexor hallucis longus as well as nonanatomical tendon transfers which can generate issues with the donor site. We present a pioneering Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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technique that is analogous to that used for the surgical treatment of distal rupture of the biceps tendon, which consist of a transfer technique of flexor hallucis longus by extracortical fixation interference screw associated to a direct tendon reinsertion performed through a bone tunnel on the superior and posterior aspect of the calcaneus using an extracortical drilling system and an interference screw within the calcaneal tunnel. The arthroscopic approach may be technically challenging, and a high-level of arthroscopic skills are required to complete the procedure but after a learning curve it represents a feasible a safe technique. Levels of Evidence:Therapeutic, Level IX: Evidence from opinion of authorities and/or reports of expert committee.

Indexat a: MEDLINE

Guevara-Noriega KA, Lucar-Lopez GA, Nuñez G, Rivera-Aguasvivas L, Chauhan I. Coagulation Panel in Patients with SARS-CoV2 Infection (COVID-19).

Ann Clin Lab Sci. 2020 May;50(3):295-298. Review. PubMed PMID: 32581015.

Abstract BACKGROUND: The 2019 novel coronavirus (SARS-CoV2) is the causal agent of the newly-termed Coronavirus Disease 2019 (COVID-19). In January 2020, the World Health Association (WHO) declared the CO-VID-19 as an epidemic. Abnormal coagulation parameters in COVID-19 patients currently are considered as prognostic factors of severity. Our aim is to summarize the current data available in the literature.

MATERIALS AND METHODS: An electronic search was performed in the Database of publications on coronavirus disease (COVID-19) of the World Health Organization. Thrombin Time (TT), Prothrombin Time (PT), Fibrinogen (FIB), Activated Partial Thromboplastin Time (APPT), and D-Dimer have been detected as parameters to study in every COVID-19 patient.

CLINICAL APPLICATION: The coagulation function panel has been described to be altered in critical COVID-2019 patients. DIC, which plays an important role in advanced stage, is known to be associated with sepsis.

Anticoagulant therapy, mainly with low molecular weight heparin (LMWH), appears to be associated with better prognosis in patients with severe COV-ID-19.

DISCUSSION: Coagulation function in patients with SARS-CoV2 infection is significantly deranged compared with normal patients. FIB and D-Dimer/FDP are the most significantly altered values and the early deetection of alteration could be useful to address therapies. D-Dimer/FDP (DD/FDP) alteration correlates with severity.

Markedly elevated D-Dimer can be used to guide the introduction of anticoagulation therapy and evaluate prognosis of COVID-19. In every patient admitted with SARS-CoV2 infection PT, FIB, D-Dimer/FDP, and platelets must be ordered. We suggest daily extraction for every patient admitted and tested positive for COVID-19.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 0.927 Quartil: 4

Categoria: Medical Laboratory Technology

Posició: 25/29

Navarro-Cano E, Guevara-Noriega KA, Lucar-Lopez G, Reina F, Carrera A. A comparison of two designs of postoperative shoe for hallux valgus surgery: A biomechanical study in a cadaveric model.

Foot Ankle Surg. 2020 Feb 24. pii: S1268-7731(20)30036-9. doi: 10.1016/j.fas.2020.02.010. [Epub ahead of print] PubMed PMID: 32156460.

Abstract BACKGROUND: Hallux Valgus Surgery success depends not only on the operative technique, but also on the care of the foot during the postoperative period. Orthopedic shoes have been developed to decrease the weight load on the first ray, an excess of which might lead to a loss of fixation or pseudoarthrosis. The goal of this study was Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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to determine how the load distribution changed as the forced applied to the foot increased, with and without an orthopedic shoe. Also, we compared to different shoe models.

METHODS: Pressure sensors were placed under the first metatarsal head and the heel of twenty specimens of fresh cadaveric adult feet. Two orthopedic shoes were chosen, a double padded (MS) and a reverse camber shoe (RCS). 10 kg loads were progressively applied, up to 60 kg. We first compared three instances: no shoe, MS and RCS. A secondary analysis comparing barefoot versus shoes was performed. A mean comparison was performed (ANOVA/T-student).

RESULTS: The mean pressure of the heed and the first metatarsal showed that there were significant differences between groups (P < .005). The secondary analysis (no shoe vs orthopedic shoes) showed that the pressure without shoe was significantly higher than with any orthopedic shoe (P < .005). There were no statistically significant differences between models of shoes (P = .402).

CONCLUSION: After a surgical procedure for hallux valgus fixation, postoperative shoes should be indicated to decrease the pressure on the first metatarsal head and heel in order to avoid an overload of the postoperative area.

LEVEL OF EVIDENCE: Cadaveric study. Level V. Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.776 Quartil: 3

Categoria: Orthopedics

Posició: 47/82

Di Felice Ardente P, Fusaro FM, Abad MP, Soldado F, Coll JQ. The utilization of computer planning and 3D-printed guide in the surgical management of a reverse Hill-Sachs lesion.

JSES Int. 2020 May 26;4(3):569-573. doi: 10.1016/j.jseint.2020.04.013. PMID: 32939488; PMCID: PMC7479040.

Abstract: Although glenohumeral dislocation is a relatively common condition, only 2% of all shoulder dislocations are in the posterior direction. Because such dislocations are rare and difficult to radiographically visualize, between 50% and 79% of posterior glenohumeral dislocations are not diagnosed at the initial examination. Most of these dislocations occur in men aged between 20 and 49 years after a combined movement involving adduction, flexion, and internal rotation of the arm. Two etiologies account for this condition: two-thirds of cases have a traumatic origin, and the remaining cases have an atraumatic origin related to seizures (due to epilepsy, electrocution, or another condition), hyperlaxity, infantile paralysis (polio), brachial plexus birth palsy, or EhlersDanlos disease. Traumatic episodes can be associated with a wide range of lesions. The present case involved an anterior-superior depression on Nthe surface of the humeral head; this manifestation is known as a reverse HillSachs lesion and is present in 86% of posterior dislocations. Restoring the joint morphology for these impacted fractures is a challenge for the surgeon. New three-dimensional (3D) imaging, segmentation, and modeling technologies help orthopedic surgeons diagnose the lesion, make decisions, and perform surgery. The present study describes the use of these new tools to manufacture custom guides that enable precise reconstruction of a defect and carving of a custom osteochondral allograft. But this kind of approach, using new technologies, could be applied to any kind of orthopedic challenge. All procedures were performed using free software; therefore, this treatment method can be reproduced at any hospital center.

Indexat a: PubMed

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CIRURGIA VASCULAR – VASCULAR SURGERY Nº Articles indexats: 1

Factor Impacte total: 1.890

Factor d’impacte mig per article: 1.890

Garcia S, Alòs J, Guallar J, Viu M, Serra-Prat M. Prevalence, incidence and risk factors for foot pressure ulcers in hospitalized elderly patients. An observational and prospective study.

J Healthc Qual Res. 2020 Dec 17:S2603-6479(20)30117-2. doi: 10.1016/j.jhqr.2019.12.005. Epub ahead of print. PMID: 33342758.

Abstract BACKGROUND: Incidence and clinical characteristics of foot pressure ulcers (FPU) in hospitalized elderly patients are not well known. The aim of the study was to determine the incidence of FPU during hospitalization, to describe main FPU characteristics and to assess main risk factors for FPU in hospitalised elderly subjects.

METHODOLOGY: An observational prospective study was performed in which patients 65 years or older admitted to Vascular Surgery, Orthopaedic or Geriatric departments were followed from admission to discharge. Trained nurses evaluated all recruited patients on a daily basis for possible FPU. Main characteristics of the patient (age, sex and co-morbidities) and the ulcer (location, grade) were registered.

RESULTS: 299 patients were recruited (62.2% women, mean age 82.3 years, mean number of co-morbidities 2.8). Prevalence of FPU was 30.1% at admission and 73.9% at discharge. Incidence of FPU during hospitalization was 9.5 new FPU/100 person-day. 97.0% of the new FPU were grade 1 (erythema) and the most common locations were in the heel (57.6%), the external lateral part of the foot (13.1%), and the hallux of the fist toe (11.8%). Apart from immobility, main risk factors for FPU are age, geriatric residence origin and not able to outdoor life.

CONCLUSIONS: FPU has a high incidence among hospitalised elderly patients; most of them are grade 1 and located in the heel. More attention must be paid in the prevention of pressure ulcers in hospitalized frail subjects.

Indexat a: MEDLINE/WOS

DIGESTIU - GASTROENTEROLOGY Nº Articles indexats: 1

Factor Impacte total: 4.000

Factor d’impacte mig per article: 4.000

Nyssen OP, Perez-Aisa A, Rodrigo L, Castro M, Mata Romero P, Ortuño J, Barrio J, Huguet JM, Modollel I, Alcaide N, Lucendo A, Calvet X, Perona M, Gomez B, Gomez Rodriguez BJ, Varela P, Jimenez-Moreno M, DominguezCajal M, Pozzati L, Burgos D, Bujanda L, Hinojosa J, Molina-Infante J, Di Maira T, Ferrer L, Fernández-Salazar L, Figuerola A, Tito L, de la Coba C, Gomez-Camarero J, Fernandez N, Caldas M, Garre A, Resina E, Puig I, O'Morain C, Megraud F, Gisbert JP. Bismuth quadruple regimen with tetracycline or doxycycline versus three-in-one single capsule as third-line rescue therapy for Helicobacter pylori infection: Spanish data of the European Helicobacter pylori Registry (Hp-EuReg).

Helicobacter. 2020 Jul 13:e12722. doi: 10.1111/hel.12722. [Epub ahead of print] PubMed PMID: 32656898.

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Abstract BACKGROUND: Different bismuth quadruple therapies containing proton-pump inhibitors, bismuth salts, metronidazole, and a tetracycline have been recommended as third-line Helicobacter pylori eradication treatment after failure with clarithromycin and levofloxacin.

AIM: To evaluate the efficacy and safety of third-line treatments with bismuth, metronidazole, and either tetracycline or doxycycline.

METHODS: Sub-study with Spanish data of the "European Registry on H pylori Management" (Hp-EuReg), international multicenter prospective non-interventional Registry of the routine clinical practice of gastroenterologists. After previous failure with clarithromycin- and levofloxacin-containing therapies, patients receiving a third-line regimen with 10/14-day bismuth salts, metronidazole, and either tetracycline (BQT-Tet) or doxycycline (BQT-Dox), or single capsule (BQT-three-in-one) were included. Data were registered at AEGREDCap database. Univariate and multivariate analyses were performed.

RESULTS: Four-hundred and fifty-four patients have been treated so far: 85 with BQT-Tet, 94 with BQT-Dox, and 275 with BQT-three-in-one. Average age was 53 years, 68% were women. Overall modified intention-to-treat and per-protocol eradication rates were 81% (BQT-Dox: 65%, BQT-Tet: 76%, BQT-three-in-one: 88%) and 82% (BQT-Dox: 66%, BQT-Tet: 77%, BQT-three-in-one: 88%), respectively. By logistic regression, higher eradication rates were associated with compliance (OR = 2.96; 95% CI = 1.01-8.84) and no prior metronidazole use (OR = 1.96; 95% CI = 1.15-3.33); BQT-three-in-one was superior to BQT-Dox (OR = 4.46; 95% CI = 2.51-8.27), and BQTTet was marginally superior to BQT-Dox (OR = 1.67; 95% CI = 0.85-3.29).

CONCLUSION: Third-line H pylori eradication with bismuth quadruple treatment (after failure with clarithromycin and levofloxacin) offers acceptable efficacy and safety. Highest efficacy was found in compliant patients and those taking 10-day BQT-three-in-one or 14-day BQT-Tet. Doxycycline seems to be less effective and therefore should not be recommended.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.000 Quartil: 2

Categoria: Gastroenterology & Hepatology

Posició: 28/88

ENDOCRINOLOGIA– ENDOCRINOLOGY Nº Articles indexats: 1

Factor Impacte total: 0

Factor d’impacte mig per article: 0

Reverter JL, Rosas-Allende I, Puig-Jove C, Zafon C, Megia A, Castells I, Pizarro E, Puig-Domingo M, Granada ML. Prognostic Significance of Thyroglobulin Antibodies in Differentiated Thyroid Cancer.

J Thyroid Res. 2020 Apr 14;2020:8312628. doi: 10.1155/2020/8312628. eCollection 2020. PubMed PMID: 32351680; PubMed Central PMCID: PMC7178500 Abstract OBJECTIVE: To investigate whether variations in thyroglobulin autoantibodies (TgAb) are related to the recurrence or persistee of differentiated thyroid carcinoma (DTC) and may therefore be useful as surrogate tumor markers. Design and Methods. We retrospectively studied 98 subjects (83 women, 47 ± 15 years old) from an initial cohort of 1017 patients treated for DTC in five hospitals, with positive TgAb at any time during the follow-up. Patients presented five different patterns of evolution of serum TgAb concentrations: (1) stable positive TgAb, (2) de novo appearance, (3) an increase of more than 50%, (4) TgAb levels from positive to negative, and (5) a decrease of more than 50%.

RESULTS: In the group of 11 patients with stable TgAb, four cases presented persistence of the disease with structural incomplete response. In the group of 22 patients with sustained increasing trend rising more than 50% or de novo detectable TgAb levels, three patients were diagnosed with structural incomplete response.

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There was no evidence of recurrence or persistence of the disease in any of the 65 patients who showed a significant decrease in (n = 35) or disappearance of (n = 30) TgAb. CONCLUSIONS: Our results suggest that not only the appearance of a significant increase in TgAb but also stable concentrations of TgAb should be regarded as a sufficient risk condition for an active search for recurrent or persistent disease. Conversely, a significant decrease in TgAb levels can represent a good prognostic sign.

Indexat a: MEDLINE/WOS

FARMÀCIA - PHARMACY Nº Articles indexats: 3

Factor Impacte total: 10.477

Factor d’impacte mig per article: 2.492

Campins L, Boixeda R, Perez-Cordon L, Aranega R, Lopera C, Force L. Early tocilizumab treatment could improve survival among COVID-19 patients.

Clin Exp Rheumatol. 2020 May-Jun;38(3):578. Epub 2020 May 27. PubMed PMID: 32456769 Abstract: We read with great interest the recent paper by Sciascia et al. in which they observed an improvement in respiratory and laboratory parameters after tocilizumab administration in COVID-19 patients.Here we report a prospective case series involving 58 patients diagnosed of servere acute respiratory sindrome (SARS-CoV-2) infection and treated with tocilizumab plus corticosteroids in Mataró, Spain. Our results are consistent with those found by our coleagues. However, choosing the appropriate time to star tocilizumab and perhaps adding corticosteroid pulses could improve patient survival.

Pathogenesis of servere acute respiratory syndrome (SARS-CoV-2) infection is still under study. It appears that infection passes through multiple phases. An initial phase involving incubation and viral repplication period, a second where patients develop a viral pneumonia ans possibly hypoxia and finally, some patients may transit to a third phase witch nabnifest and extra-pulmonary systemic hyperinflammation syndrome. In this stage markers of systemic inflammation appear to be elevated and cytokine storm mediated by overproduction of proinflammatory cytokines have been observed.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.319 Quartil: 2

Categoria: Rheumatology

Posició: 15/32

Chaguaceda C, Aguilera-Jiménez V, Gutierrez G, Roura J, Riu G. Oral levetiracetam for prevention of busulfan-induced seizures in adult hematopoietic cell transplant.

Int J Clin Pharm. 2020 Apr;42(2):351-354. doi: 10.1007/s11096-020-00977-7. Epub 2020 Feb 6. PubMed PMID: 32026356.

Abstract: Background Antiseizure prophylaxis is recommended when high-dose of busulfan is given as part of the conditioning regimens in the allogenic hematopoietic stem cell transplant. Phenytoin has been widely used but its pharmacokinetics and pharmacodynamics profile makes its use complicated. Levetiracetam is a safe, effective and well tolerated antiseizure drug with good results in epileptic patients. Objective To describe our

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Publicacions Científiques CSDM 2020

experience using oral (p.o) levetiracetam 1000 mg every 12 h (q12h) as an antiseizure prophylaxis, evaluating its preventive effects and adverse event rates after a high-dose of intravenous (i.v.) busulfan, as part of the conditioning regimen Methods Retrospective study of patients who underwent an allogenic hematopoietic stem cell transplant with a conditioning regimen based on high-dose of busulfan between January and November 2017. Results The study population comprised 36 patients, of whom 18 (50%) had acute myeloid leukemia as diagnosis. No seizures occurred in any patient. Levetiracetam was well tolerated and no serious adverse events were reported. Conclusions Our results suggest that giving levetiracetam at 1000 mg q12h p.o starting 12 h before the administration of i.v. busulfan until 48 h after the last dose, can be used as an alternative in the prevention of busulfan-induced seizures in adults.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 5.325 Quartil/Decil: 1

Categoria: Geriatrics & Gerontology

Posició: 4/53

Miarons M, Roca M, Salvà F. The role of pro-, pre- and symbiotics in cancer: A systematic review.

J Clin Pharm Ther. 2020 Oct 23. doi: 10.1111/jcpt.13292. Epub ahead of print. PMID: 33095928 Abstract WHAT IS KNOWN AND OBJECTIVE: Cancer is one of the most important causes of morbidity and mortality worldwide. Pro-, pre- and symbiotics can modulate host metabolism and gut microbiota and potentially help prevent cancer and modulate the adverse effects (AEs) of treatments. Numerous studies on this role for pro-, pre- and symbiotics have reported inconsistent results. The purpose of this review was to examine current scientific evidence from randomized controlled trials (RCTs) on the effects of pro-, pre- and symbiotics on the incidence of complications and AEs, especially diarrhoea, in cancer management.

METHODS: A systematic literature search was implemented in MEDLINE using the MeSH terms "probiotics", "prebiotics", "symbiotics" and "neoplasms", according to PRISMA guidelines. Reference lists were also handsearched to identify additional eligible RCTs. Three reviewers independently assessed the eligibility of each RCT. Of 714 retrieved abstracts, 22 articles with 2287 participants were included in the analysis.

RESULTS AND DISCUSSION: The most studied bacteriotherapies were probiotics and symbiotics, in 10 and 7 studies, respectively. Both Lactobacillus and Bifidobacterium strains were used in 18 studies, while Lactobacillus and Bifidobacterium strains were individually used in 9 and 2 studies, respectively. Diarrhoea incidence rates were 3.2%-39.1% in intervention groups and 6.7%-60.9% in control groups, while infection incidence rates were 11.1%-22.7% in intervention groups and 17.3%-28.7% in control groups.

WHAT IS NEW AND CONCLUSIONS: Pro-, pre- and symbiotics may potentially be efficacious in reducing complications associated with chemotherapy, radiotherapy and surgery in patients with cancer.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.833 Quartil: 4

Categoria: Pharmacology & Pharmacy

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GINECOLOGIA I OBSTETRICIA – OBSTETRICS & GYNECOLOGY Nº Articles indexats: 1

Factor Impacte total: 2.037

Factor d’impacte mig per article: 2.037

Sabadell J, Pereda-Núñez A, Ojeda-de-Los-Santos F, Urbaneja M, González- García C, Camps-Lloveras N, PérezPlantado À, Canet-Rodríguez J, Pérez-Espejo MP, Rodríguez-Mias N, Sarasa-Castelló N, Palau M, MonteroArmengol A, Salicrú S, Gil-Moreno A, Poza JL. Polypropylene and polyvinylidene fluoride transobturator slings for the treatment of female stress urinary incontinence: 1-Year outcomes from a multicentre randomized trial.

Neurourol Urodyn. 2020 Dec 1. doi: 10.1002/nau.24586. Epub ahead of print. PMID: 33259073.

Abstract AIMS: To compare the effectiveness and safety of polypropylene (PP) and polyvinylidene fluoride (PVDF) transobturator tapes (TOT) for the treatment of female stress urinary incontinence (SUI).

METHODS: This is a multicentre randomized trial. Women with SUI or stress-predominant mixed urinary incontinence and scheduled for a TOT procedure were randomized to PP or PVDF slings. The primary outcome was 1-year cure or improvement rate using composite criteria. Complications were also compared.

Relationships with outcomes were analyzed using multivariable logistic regressions models.

RESULTS: From April 2016 to January 2018 285 participants were randomized. PP and PVDF slings showed similar high cure or improvement rate (91.0% vs. 95.6%, p = .138). Improvement in validated questionnaires was also similar. PVDF slings were associated with a lower rate of de novo urgency incontinence (adjusted odds ratio = 0.35; 95% confidence interval = 0.15-0.80). We found no statistical differences in complications rates, although a higher incidence of long-term pain events were observed in the PP group. The study is underpowered to find differences in specific complications owing to the low number of events.

CONCLUSION: PP and PVDF TOTs are equally effective, although PVDF is associated with fewer cases of de novo urgency incontinence. Further studies are needed to give robust conclusions on safety profiles.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.037 Quartil: 3

Categoria: Urology & Nephrology

Posició: 45/85

HEMATOLOGIA – HEMATOLOGY Nº Articles indexats: 1

Factor Impacte total: 2.070

Factor d’impacte mig per article: 2.070

Sorigue M, Junca J, Ferra C, Marce S, Ruiz-Xivillé N, Pinyol L, Cabezon M, Espasa A, Dominguez D, Lopez-Viaplana L, Ruiz R, Buch J, Plensa E, Mostacedo SZ, Aranda J, Vergara S, Raya M, Granada I, Tapia G, Navarro JT, Beà S, Zamora L. FMOD expression in whole blood aids in distinguishing between chronic lymphocytic leukemia and other leukemic lymphoproliferative disorders. A pilot study.

Cytometry B Clin Cytom. 2020 Jun 12. doi: 10.1002/cyto.b.21890. [Epub ahead of print] PubMed PMID: 32530577.

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BACKGROUND: Within the hematopoietic compartment, fibromodulin (FMOD) is almost exclusively expressed in chronic lymphocytic leukemia (CLL) lymphocytes. We set out to determine whether FMOD could be of help in diagnosing borderline lymphoproliferative disorders (LPD).

METHODS: We established 3 flow cytometry-defined groups (CLL [n = 65], borderline LPD [n = 28], broadly defined as those with CLLflow score between 35 and -20 or discordant CD43 and CLLflow, and non-CLL LPD [n = 40]). FMOD expression levels were determined by standard RT-PCR in whole-blood samples. Patients were included regardless of lymphocyte count but with tumor burden ≥40%.

RESULTS: FMOD expression levels distinguished between CLL (median 98.5, interquartile range [IQR] 37.8-195.1) and non-CLL LPD (median 0.012, IQR 0.003-0.033) with a sensitivity and specificity of 1. Most borderline LPDs were CD5/CD23/CD200-positive with no loss of B-cell antigens and negative or partial expression of CD43. 16/22 patients with available cytogenetic analysis showed trisomy 12. In 25/28 (89%) of these patients, FMOD expression levels fell between CLL and non-CLL (median 3.58, IQR 1.06-6.21).

DISCUSSION: This study could suggest that borderline LPDs may constitute a distinct group laying in the biological spectrum of chronic leukemic LPDs. Future studies will have to confirm these results with other biological data. Quantification of FMOD can potentially be of help in the diagnosis of phenotypically complex LPDs. Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.070 Quartil: 3

Categoria: Medical Laboratory Technology

Posició: 16/29

INFERMERIA– NURSING Nº Articles indexats: 1

Factor Impacte total: 0

Factor d’impacte mig per article: 0

Montoro-Lorite M, Canalías-Reverter M, Valverde-Bosch M, Font-Ritort S. Rol de la enfermera en el anciano con cáncer. Revisión bibliográfica.

Gerokomos. 2020;31(3):158-165.

Abstract: El aumento de la incidencia y prevalencia de procesos cancerígenos en los ancianos representa un nuevo reto para las políticas sanitarias y sociales. El presente artículo reflexiona sobre la necesidad de un modelo de atención integral, integrada y multidimensional para el cuidado del anciano con cáncer y su familia. El objetivo principal es identificar, recopilar, analizar y sintetizar la literatura científica más actual y relevante sobre las funciones y/o rol de la enfermera en el cuidado del anciano con cáncer. Material y método: se realizó una revisión bibliográfica en PubMed (Medline), Cochrane Library Plus, Dialnet y ScienceDirect® (Elsevier), entre enero de 2007 y diciembre de 2017, de la literatura científica sobre las funciones y/o rol de la enfermera en el cuidado del anciano con cáncer. Los estudios fueron seleccionados por revisores pares de forma independiente utilizando el instrumento PRISMA. Resultados: Se identificaron 28 estudios que cumplieron los criterios de inclusión. Toda la bibliografía revisada recomienda el desarrollo e implementación de programas de atención individualizados como el pilar principal de atención al anciano con cáncer. En ellos, las enfermeras desempeñan un papel clave en la gestión y coordinación durante todo el proceso de atención. Conclusiones: El modelo de cuidado de los ancianos con cáncer debe abarcar todo el proceso de atención: prevención, detección precoz, evaluación, tratamiento, educación e investigación. Es esencial el rol de la enfermera como gestora, coordinadora, educadora y cuidadora en la atención al anciano con cáncer..

Indexat a: WOS

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MEDICINA DE FAMILIA – FAMILY MEDICINE Nº Articles indexats: 2

Factor Impacte total: 1.833

Factor d’impacte mig per article: 0.916

Pérula de Torres LÁ, Martín Rioboó E, González Lama J, Parras Rejano JM, Fernández García JÁ, García Criado E, Martínez-Adell MÁ.

Clinical-epidemiological characteristics of the atrial fibrillation in patients 65 years of age or older diagnosed in primary care.

Rev Esp Salud Publica. 2020 Jul 10;94. pii: e202007069. Spanish. PubMed PMID: 32647107 Abstract OBJECTIVE: The identification of atrial fibrillation in older patients who come to Primary Care consultations is a topic of interest that has been scarcely studied. The objective of this work was to estimate the frequency of new cases of atrial fibrillation and to analyze the clinical-epidemiological characteristics of patients 65 years of age or older, detected in Primary Care in Spain.

METHODS: An observational, descriptive, national, multicenter study was carried out in 48 health centers, in which 218 doctors and 101 Primary Care nurses recruited 7,068 patients, who underwent an arterial pulse and an electrocardiogram. in case of being abnormal or doubtful, determining the presence of atrial fibrillation and other rhythm disorders, symptoms and signs compatible with atrial fibrillation and comorbidity and cardiovascular risk factors. A univariate, bivariate and multivariate analysis (multiple logistic regression) was performed.

RESULTS: The patients had a mean age of 74.41±6.78 (DT) years. 2.3% presented atrial fibrilation (95% CI: 2.02.7), being its frequency higher in men (2.9%; p<0.001), and as age increased (p<0.001). The most frequent symptoms present among patients with atrial fibrillation were palpitations (Odds Ratio -OR-=3.50; 95% CI: 2.285.37), dyspnea (OR=2.71; 95% CI: 1.87-3.90), general discomfort (OR=2.32, 95% CI: 1.15-4.63), and dizziness (OR=1.80, 95% CI: 1.20-3.51). The 21.8% were asymptomatic.

CONCLUSIONS: The frequency of new cases of atrial fibrillation in the Spanish population of 65 years or older is high, being higher in men and increasing with age. Two out of ten patients are asymptomatic. Palpitations and dyspnea are the predominant symptoms in patients with atrial fibrillation.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 0.746 Quartil: 4 Categoria: Public, Environmental & Occupational Health

Posició: 159/171

Casanova Uclés A, López Torrent E, Zurilla Duarte E, Montero Alía JJ; en representación de todo el grupo de centinelas del Observatori de la Medicina de Família al Maresme (OMFAM); Observatori de la Medicina de Família al Maresme (OMFAM).

Characterization of the interruptions ocurring in the consultations of the family doctors. Observatory of the Maresme Family Medicine.

Aten Primaria. 2020 Jun 5. pii: S0212-6567(20)30038-X. doi: 10.1016/j.aprim.2020.01.005. [Epub ahead of print] Spanish. PubMed PMID: 32513445.7 Abstract Las interrupciones durante la asistencia médica en algunos casos pueden llegar a ser un fenómeno disruptivo para la calidad, pueden propiciar errores y actuar como factor estresor del médico. Lo publicado hasta la actualidad se ha realizado con metodologías heterogéneas y con variables de estudio muy diversas, sin prevalecer en la literatura internacional claramente ningún estándar.

Se presenta un estudio transversal descriptivo multicéntrico con el objetivo principal de cuantificar las interrupciones durante la consulta médica de atención primaria y caracterizarlas en parámetros: a) si son Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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telefónicas o presenciales, b) si son realizadas por facultativos, enfermería o administrativos, y c) si son adecuadas desde el punto de vista del médico, catalogándolas como pertinente, dudosa o no pertinente. En la hoja de autorregistro se incluye también una pregunta con respuesta cerrada a 3 opciones para que cada médico valore el impacto que, de manera general, tienen en su calidad asistencial las interrupciones que debe gestionar habitualmente.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.087 Quartil: 3

Categoria: Medicine, General & Internal

Posició: 115/165

MEDICINA FISICA i REHABILITACIÓ - PHYSICAL MEDICINE & REHABILITATION Nº Articles indexats: 2

Factor Impacte total: 7.840

Factor d’impacte mig per article: 3.920

Garnacho-Castaño MV, Palau-Salvà G, Serra-Payá N, Ruiz-Hermosel M, Berbell M, iñals X, Bataller MG, Carbonell T, Vilches-Saez S, Cobo EP, Molina-Raya L. Understanding the effects of beetroot juice intake on CrossFit performance by assessing hormonal, metabolic and mechanical response: a randomized, double- blind, crossover design.

J Int Soc Sports Nutr. 2020 Nov 13;17(1):56. doi: 10.1186/s12970-020-00388-z. PMID: 33187518 Abstract BACKGROUND: Acute beetroot juice (BJ) intake has shown to enhance aerobic and anaerobic performance.

However, no studies have evaluated the effects of BJ intake on CrossFit (CF) performance by linking hormonal, metabolic, and mechanical responses. The purpose of this study was to determine the causal physiological association between hormonal, metabolic and mechanical responses, and CF workouts performance after acute BJ intake.

METHODS: Twelve well-trained male practitioners undertook a CF workout after drinking 140 mL of BJ (~ 12.8 mmol NO3-) or placebo. The two experimental conditions (BJ or placebo) were administered using a randomized, double-blind, crossover design. The CF workout consisted of repeating the same exercise routine twice: Wall ball (WB) shots plus full back squat (FBS) with 3-min rest (1st routine) or without rest (2nd routine) between the two exercises. A 3-min rest was established between the two exercise routines.

RESULTS: An interaction effect was observed in the number of repetitions performed (p = 0.04). The Bonferroni test determined a higher number of repetitions after BJ than placebo intake when a 3-min rest between WB and FBS (1st routine) was established (p = 0.007). An interaction effect was detected in cortisol response (p = 0.04).

Cortisol showed a higher increase after BJ compared to placebo intake (76% vs. 36%, respectively). No interaction effect was observed in the testosterone and testosterone/cortisol ratio (p > 0.05). A significant interaction effect was found in oxygen saturation (p = 0.01). A greater oxygen saturation drop was observed in BJ compared to placebo (p < 0.05). An interaction effect was verified in muscular fatigue (p = 0.03) with a higher muscular fatigue being observed with BJ than placebo (p = 0.02).

CONCLUSIONS: BJ intake improved anaerobic performance only after the recovery time between exercises. This increase in performance in the first routine probably generated greater hypoxia in the muscle mass involved, possibly conditioning post-exercise performance. This was observed with a fall in oxygen saturation and in muscle fatigue measured at the end of the CF workout. The greatest perceived changes in cortisol levels after BJ intake could be attributed to the nitrate-nitrite-nitric oxide pathway.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 5.068 Quartil/Decil: 1 Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Categoria: Sport Sciences

Posició: 6/85 22

Publicacions Científiques CSDM 2020

Pleguezuelos E, Del Carmen A, Moreno E, Ortega P, Vila X, Ovejero L, Serra- Prat M, Palomera E, GarnachoCastaño MV, Loeb E, Farago G, Miravitlles M. The Experience of COPD Patients in Lockdown Due to the COVID-19 Pandemic.

Int J Chron Obstruct Pulmon Dis. 2020 Oct 23;15:2621-2627. doi: 10.2147/COPD.S268421. PMID: 33122900; PMCID: PMC7591044.

Abstract PURPOSE: On March 16, 2020, the Spanish government declared a state of alarm due to the rapid spread of coronavirus disease 2019 (COVID-19). Patients with chronic obstructive pulmonary disease (COPD) were restricted to remain confined at home, and medical visits were cancelled for 3 months. The impact of this lockdown on the manifestations of COPD and the quality-of-life of these patients has not been explored.

PATIENTS AND METHODS: One hundred patients with COPD were interviewed by telephone from May 2-18, 2020. The interviews included questions about the lockdown, missed medical appointments, fears of the disease, possible COVID-19 infection, and exacerbations of COPD suffered during this period and their management. In addition, the COPD Assessment Test, the Hospital Anxiety and Depression, and the 5Dimension Euro Quality-of-Life questionnaires were administered.

RESULTS: Sixty-four (64%) patients claimed to have strictly complied with the lockdown, and only 42 (42%) stated they had left home at least once during lockdown. Only one patient (1%) was hospitalized due to COVID19, and 13 (13%) patients presented an exacerbation of COPD self-managed at home with no admissions due to exacerbation of COPD during this period. A medical consultation or complementary test was cancelled in 90% of the patients, but 61% had a medical telephone visit with a high degree of satisfaction (mean 9.3/10). Most patients declared that their feeling regarding lung disease and general health was similar or even better during lockdown (82% and 81%, respectively).

CONCLUSION: Our results indicate that in general lockdown had a low impact on COPD patients. Only one patient was affected by COVID-19, but moderate exacerbations of COPD were not infrequent. Although many medical visits and test were cancelled, patients were very satisfied with the medical telephone visits.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.772 Quartil: 2

Categoria: Respiratory system

Posició: 30/64

MEDICINA INTENSIVA – INTENSIVE MEDICINE Nº Articles indexats: 3

Factor Impacte total: 12.156

Factor d’impacte mig per article: 4.052

Ortiz Leyba C, Valenzuela Sánchez F, Yébenes Reyes JC. Recommendations for specialized nutritional-metabolic treatment of the critical patient: Sepsis and septic shock. Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC).

Med Intensiva. 2020 Jun;44 Suppl 1:55-59. doi: 10.1016/j.medin.2020.01.016. English, Spanish. PubMed PMID: 32532412.

Abstract: Los estudios existentes en la literatura sobre el tratamientonutricional en los pacientes con sepsis son muy escasosy su calidad presenta importantes deficiencias en esferasimportantes como la metodología, la aplicabilidad, laindependencia editorial, la participación de las partes inte-resadas y el rigor de desarrollo. Otro factor importante es lasituación nutricional previa. Recientes estudios en pacien-tes con suficiente reserva nutricional muestran resultadosfavorables al inicio de tratamiento nutricional a dosis bajasen la fase aguda de la Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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enfermedad, pero en los pacientesmalnutridos sépticos probablemente esta estrategia nosea conveniente. En el contexto de un estado inflamatorio. exacerbado, junto con una disregulación de la respuestainmune, y de una probable inhibición de la autofagia, seproducen alteraciones metabólicas intensas que predispo-nen a un incremento de la morbilidad. Además, en la sepsisse suele producir una disfunción gastrointestinal que puedelimitar o impedir un aporte enteral adecuado, junto concambios en la barrera intestinal y en el microbioma.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.363 Quartil: 3

Categoria: Critical Care Medine

Posició: 23/36

Menéndez R, Cilloniz C, España PP, Almirall J, Uranga A, Méndez R, Rigau D, Torres A. Community-Acquired Pneumonia. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) Guidelines.

2020 Update.

Arch Bronconeumol. 2020 Mar;56 Suppl 1:1-10. doi: 10.1016/j.arbres.2020.01.014. Epub 2020 Mar 3. English, Spanish. PubMed PMID: 32139236 Abstract: The guidelines for community-acquired pneumonia, last published in 2010, have been updated to provide recommendations based on a critical summary of the latest literature to help health professionals make the best decisions in the care of immunocompetent adult patients. The methodology was based on 6 PICO questions (on etiological studies, assessment of severity and decision to hospitalize, antibiotic treatment and duration, and pneumococcal conjugate vaccination), agreed by consensus among a working group of pulmonologists and an expert in documentation science and methodology. A comprehensive review of the literature was performed for each PICO question, and these were evaluated in in-person meetings. The American Thoracic Society guidelines were published during the preparation of this paper, so the recommendations of this association were also evaluated. We concluded that the etiological source of the infection should be investigated in hospitalized patients who have suspected resistance or who fail to respond to treatment. Prognostic scales, such as PSI, CURB 65, and CRB65, are useful for assessing severity and the decision to hospitalize. Different antibiotic regimens are indicated, depending on the treatment setting - outpatient, hospital, or intensive care unit - and the resistance of PES microorganisms should be calculated. The minimum duration of antibiotic treatment should be 5 days, based on criteria of clinical stability. Finally, we reviewed the indication of the 13-valent conjugate vaccine in immunocompetent patients with risk factors and comorbidity.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.957 Quartil: 1

Categoria: Respiratory System

Posició: 11/64

Ceccato A, Mendez R, Ewig S, de la Torre MC, Cilloniz C, Gabarrus A, Prina E, Ranzani OT, Ferrer M, Almirall J, Menendez R, Torres A. Validation of a Prediction Score for Drug-resistant Microorganisms in Community-Acquired Pneumonia.

Ann Am Thorac Soc. 2020 Sep 11. doi: 10.1513/AnnalsATS.202005-558OC. Epub ahead of print. PMID: 32915057 Abstract RATIONALE: Recommended initial empiric antimicrobial treatment covers the most common bacterial pathogens, however CAP may be caused by microorganisms not targeted by this treatment. The PES score was developed in 2015 to predict the microbiological etiology of community-acquired pneumonia (CAP) caused by

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Pseudomonas aeruginosa, extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, and methicillin-resistant Staphylococcus aureus (PES microorganisms).

OBJECTIVE: We aimed to validate the usefulness of the PES score for predicting PES microorganisms in two cohorts of patients with CAP from Valencia and Mataró.

Methods: We analyzed two prospective observational cohorts of patients with CAP from Valencia and Mataró.

Patients in the Mataró cohort were all admitted to an intensive care unit (ICU).

RESULTS: Of the 1,024 patients in the Valencia cohort, 505(51%) had a microbiological etiology and 31(6%) had a PES microorganism isolated. The AUC was 0.81. For a PES score ≥5, sensitivity, specificity, the negative and positive predictive values as well as the negative and positive likelihood ratios were 72%, 74%, 98%, 14%, 0.38, and 2.75, respectively. Of the 299 patients in the Mataró cohort, 213(71%) had a microbiological etiology and 11(5%) had a PES microorganism isolated. The AUC was 0.73. For a PES score ≥5, sensitivity, specificity, the negative and positive predictive values, as well as the negative and positive likelihood ratios were 36%, 83%, 96%, 11%, 0.77, and 2.09, respectively. The best cut-off for patients admitted to ICU was 4 points, which improved sensitivity to 86%. The hypothetical application of the PES score showed high rates of overtreatment in both cohorts (26% and 35%, respectively) and similar rates of under-treatment.

CONCLUSIONS: The PES score showed good accuracy in predicting the risk for microorganisms that required different empirical therapy; however, its use as a single strategy for detecting non-core pathogens could lead to high rates of overtreatment. Given its high negative predictive value, PES score may be used as a first step of a wider strategy that includes subsequent advanced diagnostic tests.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.836 Quartil: 1

Categoria: Respiratory System

Posició: 13/64

Almirall J, de la Torre MC. Neumonía Adquirida en la Comunidad en Adultos. Neumologia para Atención Primaria. 25 años en 24 horas.

24 Horas Neumológicas de Sitges 1994-2020 Ed. Barcelona. 2020; p. 169-176.

Abstract: La neumonía adquirida en la comunidad (NAC) sigue siendo una causa importante de hospitalización, morbilidad y mortalidad a pesar de los nuevos antibióticos. Se ha descrito una incidencia en adultos de 2 a 13 casos por 1000 habitantes y año, siendo superior en mayores de 65 años. También se ha observado mayor incidencia en invierno y en épocas de epidemia por el virus Influenza. Un 22-50% requiere hospitalización, con una mortalidad de 3-24%.

En los últimos 25 años hemos avanzado en el conocimiento de factores de riesgo (FR) y pronóstico (FP), especialmente desde la implementación de escalas de gravedad, de guías de práctica clínica, y recientemente con el uso de biomarcadores de respuesta inflamatoria. Además, nuevas técnicas inmunológicas han permitido conocer mejor la causa, especialmente vírica. En el futuro deberemos estar atentos a la posibilidad de tratamientos con inmunomoduladores y a las nuevas investigaciones genómicas que concreten la relación del microbioma en el árbol bronquial con la NAC.

Almirall J, Mendez J, Fernández P, Negrete A, Toran P. Técnicas de diagnóstico rápido en la Infección Respiratoria Aguda. Utilidad en Asistencia Primaria (AP) y en los Servicios de Urgencias (SU). Neumología para Atención Primaria. 25 años en 24 horas. 24 Horas Neumológicas de Sitges 1994-2020 Ed. Barcelona. 2020; p. 177-184.

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Abstract: En los últimos 25 años han aparecido diversos biomarcadores que se han desarrollado en forma de técnicas de diagnóstico rápido (TDR) que los anglosajones denominan Point of Care Testing (POCT) y que se pueden realizar en la propia cabecera del paciente y/o en la consulta medica de AP o en el SU, permitiendo no sólo orientarnos en el diagnóstico sino también en el agente etiológico de la infección respiratoria y ayudarnos en la decisión terapéutica optimizando el uso de antibióticos. Además nos puede ayudar a conocer mejor el pronóstico de severidad y monitorizar si cabe, la respuesta al tratamiento.

MEDICINA INTERNA–INTERNAL MEDICINE Nº Articles indexats: 12

Factor Impacte total: 33.167

Factor d’impacte mig per article: 2.763

Boixeda R. Clinical practice guidelines: To follow them or not.

Rev Clin Esp. 2020 Jun 23. pii: S0014-2565(20)30151-X. doi: 10.1016/j.rce.2020.05.012. [Epub ahead of print] English, Spanish. PubMed PMID: 32591112.

Abstract La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad infradiagnosticada y con una elevada morbimortalidad. Supone un problema de salud pública de gran magnitud, y actualmente es la cuarta causa de muerte. Además, se prevé que su prevalencia también aumente con el envejecimiento de la población.

La EPOC es una enfermedad compleja y multicomponente. La tos, la expectoración y la disnea son sus síntomas principales, y las exacerbaciones son el factor pronóstico con diana terapéutica en los ensayos clínicos actuales.

Las recomendaciones y las guías de práctica clínica (GPC) pretenden ayudar a los médicos durante el proceso de diagnóstico y tratamiento de la enfermedad: cualquier paciente con EPOC tendría que recibir asistencia médica adecuada según los principios de la medicina basada en la evidencia científica. Desde el año 2009, el equipo multidisciplinar de la Estrategia en EPOC impulsó el desarrollo de una GPC con la participación de todos sus integrantes. En este contexto nació la primera versión de la Guía española de la EPOC (GesEPOC) en el ano˜ 2012. En general, las que más se utilizan son las recomendaciones de la Global Initiative for Obstructive Lung Diseases (GOLD) para el diagnóstico y el tratamiento de la EPOC, publicadas por primera vez en 2001 y revisadas cada año. Sin embargo, la incorporación de las recomendaciones de las GPC a la práctica clínica cotidiana suele ser lenta y, como resultado, se ha documentado repetidamente en el pasado un abismo entre lo que se recomienda por escrito y lo que se lleva a la práctica en la clínica habitual. Recientemente, en el caso de la EPOC, diversos estudios han demostrado un incumplimiento de lo pautado, además de distintos modos de actuación entre los profesionales. Todo ello redunda, en última instancia, en una asistencia de calidad muy dispar.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.304 Quartil: 3

Categoria: Medicine, General & Internal

Posició: 100/165

Almagro P, Boixeda R, Diez-Manglano J, Gómez-Antúnez M, López-García F, Recio J. Insights into Chronic Obstructive Pulmonary Disease as Critical Risk Factor for Cardiovascular Disease.

Int J Chron Obstruct Pulmon Dis. 2020 Apr 14;15:755-764. doi: 10.2147/COPD.S238214. eCollection 2020.

Review. PubMed PMID: 32341642; PubMed Central PMCID: PMC7166051

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Abstract: In patients with chronic obstructive pulmonary disease (COPD), cardiovascular comorbidities are highly prevalent and associated with considerable morbidity and mortality. This coincidence is increasingly seen in the context of a "cardiopulmonary continuum" rather than being simply attributed to shared risk factors, in particular, cigarette smoking. Both disease entities are centrally linked to systemic inflammation as well as aging, arterial stiffness, and several common biomarkers that led to the development of pulmonary hypertension, left ventricular diastolic dysfunction, atherosclerosis, and reduced physical activity and exercise capacity. For these reasons, COPD should be considered an independent factor of high cardiovascular risk, and efforts should be directed to early identification of cardiovascular disease (CVD) in COPD patients. Assessment of the overall cardiovascular risk is especially important in patients with severe exacerbation episodes, and the same therapeutic target levels for glycosylated hemoglobin, low-density lipoprotein cholesterol (LDL-C), or blood pressure than those recommended by clinical practice guidelines for patients at high cardiovascular risk, should be achieved. In this review, we will discuss the most recent evidence of the role of COPD as a critical cardiovascular risk factor and try to find new insights and potential prevention strategies for this disease.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.727 Quartil: 2

Categoria: Respiratory System

Posició: 30/64

Recio Iglesias J, López García F, Almagro P, Varela Aguilar JM, Boixeda Viu R. Spanish clinical practice consensus in internal medicine on chronic obstructive pulmonary disease patients with comorbidities (miEPOC).

Curr Med Res Opin. 2020 Jun;36(6):1033-1042. doi: 10.1080/03007995.2020.1749995. Epub 2020 Apr 17.

PubMed PMID: 32228115.

Abstract BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the diseases that leads to a higher number of hospitalizations in internal medicine departments. These patients are usually older and have greater multimorbidity than COPD patients hospitalized in other departments, which hinders the implementation of clinical guidelines necessarily focused on the management of a single disease.

AIMS: To ascertain the opinion of Spanish internists on the management of COPD in scenarios in which the available evidence is sparse and to produce a consensus document designed to assist in decision-making in COPD patients with comorbidities treated in internal medicine services.

METHODS: After identifying the clinical areas of greatest uncertainty by consensus, a survey was designed with 89 questions on the epidemiology and diagnosis of COPD, its management both in stable phase and during decompensation, and the treatment of the associated comorbidities in outpatients and inpatients. The consensus process was carried out using the Delphi method in an anonymized two-round process.

RESULTS: The survey was completed by 67 internists experienced in the clinical management of COPD. Of all the questions posed, a consensus was reached for 51 (57.3%) in the first round and for 67 (75.3%) in the second round. The result of the process is a series of 67 suggestions that may assist in the care of these patients.

CONCLUSIONS: Our study allows us to ascertain the views of a large number of internists experienced in the management of COPD and to learn how the recommendations for guidelines are applied in clinical practice.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.271 Quartil: 2

Categoria: Medicine, General & Internal

Posició: 61/165

Martin M, Boixeda R, Muñoz A, Felip À.

Ciprofloxacin as a cause of acute renal failure.

Enferm Infecc Microbiol Clin. 2020 Feb 22. pii: S0213-005X(20)30017-3. doi: 10.1016/j.eimc.2020.01.010.

[Epub ahead of print] English, Spanish. PubMed PMID: 32098701.

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Abstract: Ciprofloxacino es una quinolona con un amplio uso en la práctica clínica. Los efectos adversos más comunes son los trastornos gastrointestinales (náuseas y vómitos) y las alteraciones del sistema nervioso central. La insuficiencia renal (IR) secundaria a este fármaco es un efecto adverso raro (< 1/10.000 a < 1/1.000) que consta en la ficha técnica. Se han descrito varios casos en la literatura de IR por nefritis intersticial (NI) y también por precipitación de cristales en los túbulos renales. Presentamos un caso de IR sin oliguria ni datos de rabdomiólisis atribuido a ciprofloxacino.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.654 Quartil: 4

Categoria: Infectious Diseases

Posició: 79/92

Majmudar K, Golemi I, Tafur AJ, Toro JD, Visonà A, Falgá C, Sahuquillo JC, Lorente MA, Tufano A, Weinberg I, Di Micco P, Monreal M; RIETE Investigators.

Outcomes after venous thromboembolism in patients with gastric cancer: Analysis of the RIETE Registry.

Vasc Med. 2020 Jun;25(3):210-217. doi: 10.1177/1358863X19893432. Epub 2020 Jan 30. Erratum in: Vasc Med. 2020 Jun 1;:1358863X20931821. PubMed PMID: 32000631.

Abstract Gastric cancer is the fifth most common malignancy worldwide. Venous thromboembolism is an independent predictor of death among patients with gastric cancer. We aimed to describe the factors associated with mortality, thrombosis recurrence, and bleeding complications in patients with gastric cancer who develop venous thromboembolism. We included 612 patients with gastric cancer and venous thromboembolism in the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry from 2001 to 2018. We used Cox proportional hazard ratios and a Fine-Gray model to define factors associated with outcomes. The overall mortality at 6 months was 44.4%. Factors associated with increased 6-month mortality included immobility (HR 1.8, 95% CI 1.3-2.4; p < 0.001), anemia (HR 1.4, 95% CI 1.1-1.8; p < 0.02), and leukocytosis (HR 1.8, 95% CI 1.42.3; p < 0.001). Recurrent thrombosis occurred in 6.5% of patients and major bleeding complications in 8.5% of the cohort. Male sex was the main factor associated with thrombosis recurrence (HR 2.1, 95% CI 1.1-4.0; p < 0.02) and hemoglobin below 10 g/dL (HR 1.6, 95% CI 1.05-2.50; p = 0.03) the main factor associated with bleeding. In conclusion, patients with gastric cancer who develop venous thrombosis have a very high likelihood of death. Low hemoglobin in this population is associated with poor outcomes.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.832 Quartil: 2

Categoria: Peripheral Vascular Diseases

Posició: 28/65

Boixeda X, Campins L, Juanola J, Force L. Is chronic obstructive pulmonary disease a protective factor in SARS-CoV2 infection? The importance of bronchodilator treatment.

Rev Clin Esp. 2020 Nov; 220(8): 526–529. doi:10.1016/j.rce.2020.07.001.

Abstract: De forma global, los virus juegan un papel importante en las agudizaciones de a EPOC. En una revisión sistemática de infecciones en pacientes con EPOC que precisaban un ingreso hospitalario se observó que el rinovirus, el virus respiratorio sincitial (VRS), y el virus influenza fueron los agentes más prevalentes, seguidos de parainfluenza y coronavirus, este último el más frecuente en las vías respiratorias altas y de predominio en la época invernal. En un estudio realizado en España, el 26% de los pacientes ingresados en las épocas de gripe Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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presentaban la EPOC como comorbilidad. tros autores han reportado prevalencias algo más bajas, de un 17,3% para la gripe, y un 7,6% para la infección por VRS3. isten también estudios que han evaluado la presencia de la EPOC como comorbilidad en otras infecciones por coronavirus como el SARS, con un 6%4 el MERS, con un 13%5. relación a la actual pandemia por SARS-CoV-2, inicialmente se consideróque las personas con enfermedades pulmonares crónicas podrían ser más propensas a presentar los síntomas de la infección o a desarrollar una infección más grave, pero las series de casos publicadas muestran una baja prevalencia de pacientes con EPOC: 6,6% en Estados Unidos6, 3% en Italia7 ytan solo un 1,4% en China.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.304 Quartil: 3

Categoria: Medicine, General & Internal

Posició: 100/165

Casadellà M, Santos JR, Noguera-Julian M, Micán-Rivera R, Domingo P, Antela A, Portilla J, Sanz J, MonteroAlonso M, Navarro J, Masiá M, Valcarce-Pardeiro N, Ocampo A, Pérez-Martínez L, Pasquau J, Vivancos MJ, Imaz A, Carmona-Oyaga P, Muñoz-Medina L, Villar-García J, Barrufet P, Paredes R; INSTINCT Study Group.

Primary resistance to integrase strand transfer inhibitors in Spain using ultrasensitive HIV-1 genotyping.

J Antimicrob Chemother. 2020 Dec 1;75(12):3517-3524. doi: 10.1093/jac/dkaa349. PMID: 32929472.

Abstract BACKGROUND: Transmission of resistance mutations to integrase strand transfer inhibitors (INSTIs) in HIVinfected patients may compromise the efficacy of first-line antiretroviral regimens currently recommended worldwide. Continued surveillance of transmitted drug resistance (TDR) is thus warranted.

OBJECTIVES: We evaluated the rates and effects on virological outcomes of TDR in a 96 week prospective multicentre cohort study of ART-naive HIV-1-infected subjects initiating INSTI-based ART in Spain between April 2015 and December 2016.

METHODS: Pre-ART plasma samples were genotyped for integrase, protease and reverse transcriptase resistance using Sanger population sequencing or MiSeq™ using a ≥ 20% mutant sensitivity cut-off. Those present at 1%-19% of the virus population were considered to be low-frequency variants.

RESULTS: From a total of 214 available samples, 173 (80.8%), 210 (98.1%) and 214 (100.0%) were successfully amplified for integrase, reverse transcriptase and protease genes, respectively. Using a Sanger-like cut-off, the overall prevalence of any TDR, INSTI-, NRTI-, NNRTI- and protease inhibitor (PI)-associated mutations was 13.1%, 1.7%, 3.8%, 7.1% and 0.9%, respectively. Only three (1.7%) subjects had INSTI TDR (R263K, E138K and G163R), while minority variants with integrase TDR were detected in 9.6% of subjects. There were no virological failures during 96 weeks of follow-up in subjects harbouring TDR as majority variants.

CONCLUSIONS: Transmitted INSTI resistance remains rare in Spain and, to date, is not associated with virological failure to first-line INSTI-based regimens.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 5.439 Quartil/Decil: 1

Categoria: Pharmacology & Pharmacy

Posició: 22/271

Muñoz-Gamito G, Cuchí E, Roigé J, Gómez L, Jaén À, Matamala A, Pedro-Botet ML, Capdevila JA, Anglès F, Pérez J. Higher accuracy of genotypic identification compared to phenotyping in the diagnosis of coagulase-negative staphylococcus infection in orthopedic surgery.

Infect Dis (Lond). 2020 Nov-Dec;52(12):883-890. doi: 10.1080/23744235.2020.1799069. Epub 2020 Jul 31.

PMID: 32735157.

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Abstract PURPOSE: To determine whether Repetitive Extragenic Palindromic PCR (rep-PCR) genotyping can improve the diagnosis of coagulase-negative staphylococcal (CoNS) orthopaedic infections in comparison to phenotyping.

METHODS: Prospective study comparing the results of phenotypic/genotypic (rep-PCR) testing in patients with suspected CoNS infection. Each strain was analysed using both methods. Strains identified as identical in ≥2 samples were considered as pathogenic.

RESULTS: 255 CoNS strains from 52 surgical episodes were included. Infection was diagnosed by phenotyping in 38(73%) cases and by genotyping in 40(77%). The Kappa index was 0.59. Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) for phenotyping (vs. rep-PCR) were: 88%, 75%, 92%, and 64%. 5/14(36%) of cases not considered as true infections by phenotyping were diagnosed as infections with genotyping. In a subgroup of 203 strains from 41 surgical procedures with orthopaedic implants, the kappa index was 0.68. Sensitivity, Specificity, PPV, and NPV for phenotyping were: 93%, 73%, 90% and 80%. Again, 2/10 episodes in which CoNS were considered non-infective by phenotyping were diagnosed as infected by genotyping.

CONCLUSIONS: Rep-PCR genotyping can identify identical CoNS strains that differ in their phenotype and should be used as a complementary technique. One-third of infected cases may be misdiagnosed without genotypic analysis.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.494 Quartil: 3

Categoria: Infectious Disease

Posició: 57/92

Arànega Gonzalez R, Juanola-Pla J, Lopera Marmol C, García-Torralbo EM. Peritoneal and intestinal tuberculosis in a non-immunocompromised patient without pulmonary involvement.

Gastroenterol Hepatol. 2020 Jul 24. pii: S0210-5705(20)30248-X. doi: 10.1016/j.gastrohep.2020.03.020. [Epub ahead of print] English, Spanish. PubMed PMID: 32718843.

Abstract: A 26-year-old man with a 3-week history of mesogastric andleft-lower-quadrant abdominal pain with vomit and fever.He had abdominal distension and pain in the left lowerquadrant. Laboratory studies showed a white-cell count of 15,000 ml3(reference range 4000---10,000) and C-reactionprotein value of 15 mg/dl (reference range 0---0.5). Abdom-inal computed tomography revealed free intraabdominalfluid and contrast capture in the peritoneum thatsuggests peritonitis. The exploratory laparoscopy revealedmiliary implants throughout the peritoneal cavity and pari-etal and visceral peritoneum. The presence ofnecrotizing granulomatous inflammation with multinucle-ated giant cells and acid---alcohol resistant bacillus in histological examination of miliary implantbiopsy confirms the diagnosis of intestinal tuberculosis (TB).The patient was treated with a 6month course of anti-tubercular drugs with a good evolution.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.581 Quartil: 4

Categoria: Gastroenterology & Hepatology

Posició: 82/88

Chen Q, Perales C, Soria ME, García-Cehic D, Gregori J, Rodríguez-Frías F, Buti M, Crespo J, Calleja JL, Tabernero D, Vila M, Lázaro F, Rando-Segura A, Nieto-Aponte L, Llorens-Revull M, Cortese MF, Fernandez-Alonso I, Castellote J, Niubó J, Imaz A, Xiol X, Castells L, Riveiro-Barciela M, Llaneras J, Navarro J, Vargas-Blasco V, Augustin S, Conde I, Rubín Á, Prieto M, Torras X, Margall N, Forns X, Mariño Z, Lens S, Bonacci M, Pérez-DelPulgar S, Londoño MC, García-Buey ML, Sanz-Cameno P, Morillas R, Martró E, Saludes V, Masnou-Ridaura H, Salmerón J, Quíles R, Carrión JA, Forné M, Rosinach M, Fernández I, García-Samaniego J, Madejón A, CastilloBiblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2020

Grau P, López-Núñez C, Ferri MJ, Durández R, Sáez-Royuela F, Diago M, Gimeno C, Medina R, Buenestado J, Bernet A, Turnes J, Trigo-Daporta M, Hernández-Guerra M, Delgado-Blanco M, Cañizares A, Arenas JI, GomezAlonso MJ, Rodríguez M, Deig E, Olivé G, Río OD, Cabezas J, Quiñones I, Roget M, Montoliu S, García-Costa J, Force L, Blanch S, Miralbés M, López-de-Goicoechea MJ, García-Flores A, Saumoy M, Casanovas T, Baliellas C, Gilabert P, Martin-Cardona A, Roca R, Barenys M, Villaverde J, Salord S, Camps B, Silvan di Yacovo M, Ocaña I, Sauleda S, Bes M, Carbonell J, Vargas-Accarino E, Ruzo SP, Guerrero-Murillo M, Von Massow G, Costafreda MI, López RM, González-Moreno L, Real Y, Acero-Fernández D, Viroles S, Pamplona X, Cairó M, Ocete MD, MacíasSánchez JF, Estébanez A, Quer JC, Mena-de-Cea Á, Otero A, Castro-Iglesias Á, Suárez F, Vázquez Á, Vieito D, López-Calvo S, Vázquez-Rodríguez P, Martínez-Cerezo FJ, Rodríguez R, Macenlle R, Cachero A, Mereish G, MoraMoruny C, Fábregas S, Sacristán B, Albillos A, Sánchez-Ruano JJ, Baluja-Pino R, Fernández-Fernández J, GonzálezPortela C, García-Martin C, Sánchez-Antolín G, Andrade RJ, Simón MA, Pascasio JM, Romero-Gómez M, Antonio Del-Campo J, Domingo E, Esteban R, Esteban JI, Quer J. Deep-sequencing reveals broad subtype-specific HCV resistance mutations associated with treatment failure.

Antiviral Res. 2020 Feb;174:104694. doi: 10.1016/j.antiviral.2019.104694. Epub 2019 Dec 16. PubMed PMID: 31857134.

Abstract: A percentage of hepatitis C virus (HCV)-infected patients fail direct acting antiviral (DAA)-based treatment regimens, often because of drug resistance-associated substitutions (RAS). The aim of this study was to characterize the resistance profile of a large cohort of patients failing DAA-based treatments, and investigate the relationship between HCV subtype and failure, as an aid to optimizing management of these patients. A new, standardized HCV-RAS testing protocol based on deep sequencing was designed and applied to 220 previously subtyped samples from patients failing DAA treatment, collected in 39 Spanish hospitals. The majority had received DAA-based interferon (IFN) α-free regimens; 79% had failed sofosbuvir-containing therapy. Genomic regions encoding the nonstructural protein (NS) 3, NS5A, and NS5B (DAA target regions) were analyzed using subtype-specific primers. Viral subtype distribution was as follows: genotype (G) 1, 62.7%; G3a, 21.4%; G4d, 12.3%; G2, 1.8%; and mixed infections 1.8%. Overall, 88.6% of patients carried at least 1 RAS, and 19% carried RAS at frequencies below 20% in the mutant spectrum. There were no differences in RAS selection between treatments with and without ribavirin. Regardless of the treatment received, each HCV subtype showed specific types of RAS. Of note, no RAS were detected in the target proteins of 18.6% of patients failing treatment, and 30.4% of patients had RAS in proteins that were not targets of the inhibitors they received. HCV patients failing DAA therapy showed a high diversity of RAS. Ribavirin use did not influence the type or number of RAS at failure. The subtype-specific pattern of RAS emergence underscores the importance of accurate HCV subtyping. The frequency of "extra-target" RAS suggests the need for RAS screening in all three DAA target regions.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.101 Quartil: 1

Categoria: Pharmacology & Pharmacy

Posició: 56/271

Blondon M, Jimenez D, Robert-Ebadi H, Del Toro J, Lopez-Jimenez L, Falga C, Skride A, Font L, Vazquez FJ, Bounameaux H, Monreal M; RIETE investigators.

Comparative clinical prognosis of massive and non-massive pulmonary embolism: a registry-based cohort study.

J Thromb Haemost. 2020 Oct 29. doi: 10.1111/jth.15146. Epub ahead of print. PMID: 33119949 Abstract AIMS: Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions.

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Our aim was to compare the risk of recurrent VTE, bleeding and mortality after massive and non-massive PE during anticoagulation and after its discontinuation.

METHODS AND RESULTS: We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (<90 mmHg). We compared the risks of recurrent VTE, major bleeding and mortality using time-toevent multivariable competing risk modeling. There were 3.5% of massive PE among 38,996 patients with PE. During the anticoagulation period, massive PE was associated with a greater risk of major bleeding (sHR 1.69, 95%CI 1.25-2.27), but not of recurrent VTE (sHR 1.16, 95%CI 0.76-1.76) than non-massive PE. An increased risk of mortality was only observed in the first month after PE. After discontinuation of anticoagulation, among 11,579 patients, massive PE and non-massive PE had similar risks of mortality, bleeding and recurrent VTE (sHR 0.86, 95%CI 0.52-1.42), but with different case-fatality of recurrent PE (11.1% vs. 2.4%, P=0.03) and possibly different risk of recurrent fatal PE (sHR 3.74, 95%CI 0.85-16.56).

CONCLUSION: In this large prospective registry, the baseline hemodynamic status of the incident PE did not influence the risk of recurrent VTE, during and after the anticoagulation periods, but was possibly associated with recurrent PE of greater severity.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.157 Quartil: 1

Categoria: Peripheral Vascular Diseases

Posició: 14/65

Rodilla E, Saura A, Jiménez I, Mendizábal A, Pineda-Cantero A, Lorenzo- Hernández E, Fidalgo-Montero MDP, López-Cuervo JF, Gil-Sánchez R, Rabadán- Pejenaute E, Abella-Vázquez L, Giner-Galvañ V, Solís-Marquínez MN, Boixeda R, Peña-Fernández A, Carrasco-Sánchez FJ, González-Moraleja J, Torres-Peña JD, Guisado-Espartero ME, Escobar-Sevilla J, Guzmán-García M, Martín-Escalante MD, Martínez-González ÁL, Casas-Rojo JM, GómezHuelgas R. Association of Hypertension with All-Cause Mortality among Hospitalized Patients with COVID-19.

J Clin Med. 2020 Sep 28;9(10):3136. doi: 10.3390/jcm9103136. PMID: 32998337; PMCID: PMC7650567 Abstract: It is unclear to which extent the higher mortality associated with hypertension in the coronavirus disease (COVID-19) is due to its increased prevalence among older patients or to specific mechanisms. Cross-sectional, observational, retrospective multicenter study, analyzing 12226 patients who required hospital admission in 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics of survivors versus non-survivors. The mean age of the study population was 67.5 ± 16.1 years, 42.6% were women. Overall, 2630 (21.5%) subjects died. The most common comorbidity was hypertension (50.9%) followed by diabetes (19.1%), and atrial fibrillation (11.2%). Multivariate analysis showed that after adjusting for gender (males, OR: 1.5, p = 0.0001), age tertiles (second and third tertiles, OR: 2.0 and 4.7, p = 0.0001), and Charlson Comorbidity Index scores (second and third tertiles, OR: 4.7 and 8.1, p = 0.0001), hypertension was significantly predictive of all-cause mortality when this comorbidity was treated with angiotensin-converting enzyme inhibitors (ACEIs) (OR: 1.6, p = 0.002) or other than renin-angiotensin-aldosterone blockers (OR: 1.3, p = 0.001) or angiotensin II receptor blockers (ARBs) (OR: 1.2, p = 0.035). The preexisting condition of hypertension had an independent prognostic value for all-cause mortality in patients with COVID-19 who required hospitalization.

ARBs showed a lower risk of lethality in hypertensive patients than other antihypertensive drugs.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.303 Quartil: 1

Categoria: Medicine, General & Internal

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Boixeda R. Infección respiratoria baja (no neumonía). Neumología para Atención Primaria. 25 años en 24 horas. 24 Horas Neumológicas de Sitges 1994-2020 Ed. Barcelona. 2020; p. 185-196.

Abstract: Las infecciones del tracto respiratorio inferior (ITRI) se definen como una enfermedad aguda (inferior a tres semanas) con la tos como principal síntoma, y alguno de los siguientes síntomas respiratorios: expectoración, disnea, sibilancias o dolor torácico. Entre las ITRI se incluyen la neumonía adquirida en la comunidad, la bronquitis aguda, la gripe, las agudizaciones de la enfermedad pulmonar obstructiva crónica (EPOC) y las exacerbaciones agudas de las bronquiectasias.

Las IRTI son la causa más frecuente de muerte por infección, representando la quinta causa de muerte a nivel mundial, y la segunda causa mundial de años de vida afectados en función de la discapacidad (AVAD). Las IRTI suelen representar el 70% de los diagnósticos en adultos en la atención primaria, con la tos como síntoma principal. La mayoría de las ITRI son de causa vírica y autolimitadas, por lo que no precisan tratamiento con antibióticos. Sin embargo, las ITRI suelen originar la mayoría de las prescripciones de antibióticos en la atención primaria, con su escaso efecto sobre la infección y pudiendo ocasionar efectos secundarios, como las diarreas y las reacciones adversas. Además, en los últimos años, el innecesario aumento de laprescripción de antibióticos ha contribuido al aumento de las resistenciasbacterianas.

Según estudios publicados, en los últimos 20 años se ha reducido eluso inadecuado de antibióticos en los pacientes con IRTI menores de5 años, pero se ha incrementado en los pacientes adultos, sobre todoen los mayores de 75 años.

La causa de las IRTI es vírica hasta en un 60% de los casos, por influenzahasta un 30%. Respecto a la causa bacteriana, el Streptococcuspneumoniae es el responsable de hasta un 30%, y Haemophilusinfluenzae hasta un 14%. Otras bacterias menos frecuentes son Staphilococcusaureus 1-10%, Mycoplasma pneumoniae 0,5-9%, Chlamydiasp 0-3%, Moraxella Catharralis 1-3%, y Coxiella Burnetti 0-0.5%.

Entre las ITRI, mencionaremos la bronquitis aguda, la gripe, y la agudizaciónde la EPOC (A-EPOC).

MOTILITAT DIGESTIVA – GASTROINTESTINAL MOTILITY Nº Articles indexats: 14

Factor Impacte total: 45.171 Factor d’impacte mig per article: 3.226

Ortega O, Bolívar-Prados M, Arreola V, Nascimento WV, Tomsen N, Gallegos C, Brito-de La Fuente E, Clavé P. Therapeutic Effect, Rheological Properties and α-Amylase Resistance of a New Mixed Starch and Xanthan Gum Thickener on Four Different Phenotypes of Patients with Oropharyngeal Dysphagia.

Nutrients. 2020 Jun 23;12(6). pii: E1873. doi: 10.3390/nu12061873. PubMed PMID: 32585942; PubMed Central PMCID: PMC7353421.

Abstract: Thickened fluids are a therapeutic strategy for oropharyngeal dysphagia (OD). However, its therapeutic effect among different phenotypes of OD patients has not yet been compared. We aimed to assess the therapeutic effect and α-amylase resistance of a mixed gum/starch thickener [Fresubin Clear Thickener® (FCT)] on four phenotypes of OD patients: G1) 36 older; G2) 31 head/neck cancer (HNC); G3) 30 Parkinson's disease; and G4) 31 chronic post-stroke. Therapeutic effect of FCT was assessed during videofluoroscopy using the PenetrationAspiration Scale (PAS), for 5/20 mL boluses, at four levels of shear-viscosity (<50, 250, 1000 and 2000 mPa·s).

The effect of α-amylase was assessed after 30 s of oral incubation. Patients had high prevalence of VFS signs of impaired efficacy (98.44%) and safety (70.31%) of swallow with a severe PAS score (4.44 ± 0.20). Most severe OD was in HNC (80.6% unsafe swallows). FCT showed a strong therapeutic effect on the safety of swallow at a range between 250-1000 mPa·s (74.19-96.67%, safe swallows in G1, G3, G4, and 58.06% in G2), without Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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increasing pharyngeal residue. Viscosity was unaffected by α-amylase. Increasing shear-viscosity with FCT causes a strong viscosity-dependent therapeutic effect on the safety of swallow. This effect depends on the phenotype and is similar among older, Parkinson's and post-stroke patients.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.546 Quartil: 1

Categoria: Nutrition & Dietetics

Posició: 17/89

Smith EL, Wheeler I, Adler H, Ferreira DM, Sá-Leão R, Abdullahi O, Adetifa I, Becker-Dreps S, Esposito S, Farida H, Kandasamy R, Mackenzie GA, Nuorti JP, Nzenze S, Madhi SA, Ortega O, Roca A, Safari D, Schaumburg F, Usuf E, Sanders EAM, Grant LR, Hammitt LL, O'Brien KL, Gounder P, Bruden DJT, Stanton MC, Rylance J. Upper airways colonisation of Streptococcus pneumoniae in adults aged 60 years and older: A systematic review of prevalence and individual participant data meta-analysis of risk factors.

J Infect. 2020 Jun 17. pii: S0163-4453(20)30412-6. doi: 10.1016/j.jinf.2020.06.028. [Epub ahead of print] PubMed PMID: 32562794.

Abstract BACKGROUND: Colonisation with Streptococcus pneumoniae can lead to invasive pneumococcal disease and pneumonia. Pneumococcal acquisition and prevalence of colonisation are high in children. In older adults, a population susceptible to pneumococcal disease, colonisation prevalence is reported to be lower, but studies are heterogeneous.

METHODS: This is a systematic review and meta-analysis of prevalence of, and risk factors for, pneumococcal colonisation in adults ≥ 60 years of age (PROSPERO #42016036891). We identified peer-reviewed studies reporting the prevalence of S. pneumoniae colonisation using MEDLINE and EMBASE (until April 2016), excluding studies of acute disease. Participant-level data on risk factors were sought from each study.

FINDINGS: Of 2202 studies screened, 29 were analysable: 18 provided participant-level data (representing 6290 participants). Prevalence of detected pneumococcal colonisation was 0-39% by conventional culture methods and 3-23% by molecular methods. In a multivariate analysis, colonisation was higher in persons from nursing facilities compared with the community (odds ratio (OR) 2·30, 95% CI 1•26-4•21 and OR 7•72, 95% CI 1•1551•85, respectively), in those who were currently smoking (OR 1•69, 95% CI 1•12-2•53) or those who had regular contact with children (OR 1•93, 95%CI 1•27-2•93). Persons living in urban areas had significantly lower carriage prevalence (OR 0•43, 95%CI 0•27-0•70).

INTERPRETATION: Overall prevalence of pneumococcal colonisation in older adults was higher than expected but varied by risk factors. Future studies should further explore risk factors for colonisation, to highlight targets for focussed intervention such as pneumococcal vaccination of high-risk groups.

FUNDING: No funding was required.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.842 Quartil: 1

Categoria: Infectious Diseases

Posició: 12/92

Cabib C, Nascimento W, Rofes L, Arreola V, Tomsen N, Mundet L, Palomeras E, Michou E, Clavé P, Ortega O. Short-term neurophysiological effects of sensory pathway neurorehabilitation strategies on chronic poststroke oropharyngeal dysphagia.

Neurogastroenterol Motil. 2020 May 24:e13887. doi: 10.1111/nmo.13887. [Epub ahead of print] PubMed PMID: 32449296.

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Abstract BACKGROUND: Neurorehabilitation strategies for chronic poststroke (PS) oropharyngeal dysphagia (OD) have been mainly focused on the neurostimulation of the pharyngeal motor cortex with only marginal effects. In contrast, treatments targeting the PS oropharyngeal sensory pathway dysfunction offer very promising results, but there is little knowledge on the underlying mechanisms. We aimed to explore the neurophysiological mechanisms behind the effect of three sensory neurostimulation strategies.

METHODS: We carried out a randomized two-blinded parallel group's crossover sham-controlled clinical trial in 36 patients with unilateral stroke and chronic unsafe swallow to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) of the primary sensory cortex (A), oral capsaicin (B) and intra-pharyngeal electrical stimulation (IPES; C). The effect was evaluated immediately after the interventions with videofluoroscopy (VFS) and motor/sensory evoked potentials (MEP/SEP).

KEY RESULTS: Interventions induced no changes in the biomechanics of the swallow response during VFS. However, an enhancement of motor cortex excitability (latency shortening and increased size of thenar MEP) was found with active interventions (A + B + C, and B/C alone; P < .05 for all) but not with sham. Active but not sham interventions shortened pharyngeal SEP latency in the ipsilesional hemisphere (A + B + C: P2-peak, P = .039; A: N2-peak, P = .034) and antagonized the physiological habituation in pharyngeal MEP (A + B + C and A alone, P < .05 for both).

CONCLUSIONS AND INFERENCES: Sensory pathway neurostimulation strategies caused immediate enhancement of motor cortex excitability with peripheral strategies (capsaicin and IPES) and of pharyngeal sensory conduction with rTMS. These changes support the use of sensory neurorehabilitation strategies in promoting swallow recovery in chronic PS-OD. Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.946 Quartil: 2

Categoria: Clinical Neurology

Posició: 85/204

Espinosa-Val MC, Martín-Martínez A, Graupera M, Arias O, Elvira A, Cabré M, Palomera E, Bolívar-Prados M, Clavé P, Ortega O. Prevalence, Risk Factors, and Complications of Oropharyngeal Dysphagia in Older Patients with Dementia.

Nutrients. 2020 Mar 24;12(3). pii: E863. doi: 10.3390/nu12030863. PubMed PMID: 32213845; PubMed Central PMCID: PMC71465536 Abstract: The prevalence of older patients with dementia and oropharyngeal dysphagia (OD) is rising and management is poor. Our aim was to assess the prevalence, risk factors, and long-term nutritional and respiratory complications during follow-up of OD in older demented patients. We designed a prospective longitudinal quasi-experimental study with 255 patients with dementia. OD was assessed with the Volume-Viscosity Swallowing Test and a geriatric evaluation was performed. OD patients received compensatory treatments based on fluid viscosity and texture modified foods and oral hygiene, and were followed up for 18 months after discharge. Mean age was 83.5 ± 8.0 years and Alzheimer's disease was the main cause of dementia (52.9%). The prevalence of OD was 85.9%. Up to 82.7% patients with OD required fluid thickening and 93.6% texture modification, with poor compliance. OD patients were older (p < 0.007), had worse functionality (p < 0.0001), poorer nutritional status (p = 0.014), and higher severity of dementia (p < 0.001) than those without OD and showed higher rates of respiratory infections (p = 0.011) and mortality (p = 0.0002) after 18 months follow-up. These results show that OD is very prevalent among patients with dementia and is associated with impaired functionality, malnutrition, respiratory infections, and increased mortality. New nutritional strategies should be developed to increase the compliance and therapeutic effects for this growing population of dysphagic patients.

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Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.546 Quartil: 1

Categoria: Nutrition & Dietetics

Posició: 17/89

Tomsen N, Alvarez-Berdugo D, Rofes L, Ortega O, Arreola V, Nascimento W, Martin A, Cabib C, Bolivar-Prados M, Mundet L, Legrand C, Clavé P, Michlig S. A randomized clinical trial on the acute therapeutic effect of TRPA1 and TRPM8 agonists in patients with oropharyngeal dysphagia.

Neurogastroenterol Motil. 2020 Jun;32(6):e13821. doi: 10.1111/nmo.13821. Epub 2020 Feb 16. PubMed PMID: 32064725.

Abstract BACKGROUND: Oropharyngeal dysphagia (OD) treatment is moving away from compensatory strategies toward active treatments that improve swallowing function. The aim of this study was to assess the acute therapeutic effect of TRPA1/M8 agonists in improving swallowing function in OD patients.

METHODS: Fifty-eight patients with OD caused by aging, stroke, or neurodegenerative disease were included in a three-arm, quadruple-blind, randomized clinical trial (NCT02193438). Swallowing safety and efficacy and the kinematics of the swallow response were assessed by videofluoroscopy (VFS) during the swallow of 182 ± 2 mPa·s viscosity (nectar) boluses of a xanthan gum thickener supplemented with (a) 756.6 μmol/L cinnamaldehyde and 70 μmol/L zinc (CIN-Zn) (TRPA1 agonists), (b) 1.6 mmol/L citral (CIT) (TRPA1 agonist), or (c) 1.6 mmol/L citral and 1.3 mmol/L isopulegol (CIT-ISO) (TRPA1 and TRPM8 agonists). The effects on pharyngeal event-related potentials (ERP) were assessed by electroencephalography.

KEY RESULTS: TRPA1 stimulation with either CIN-Zn or CIT reduced time to laryngeal vestibule closure (CIN-Zn P = .002, CIT P = .023) and upper esophageal sphincter opening (CIN-Zn P = .007, CIT P = .035). In addition, CIN-Zn reduced the penetration-aspiration scale score (P = .009), increased the prevalence of safe swallows (P = .041), and reduced the latency of the P2 peak of the ERP. CIT-ISO had no positive effect on biomechanics or neuro CONCLUSIONS AND INFERENCES: TRPA1 stimulation with CIN-Zn or CIT improves the swallow response which, in the case of CIN-Zn, is associated with a significant improvement in cortical activation and safety of swallow.

These results provide the basis for the development of new active treatments for OD using TRPA1 agonists.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.946 Quartil: 2

Categoria: Clinical Neurology

Posició: 85/204

Vergara J, Skoretz SA, Brodsky MB, Miles A, Langmore SE, Wallace S, Seedat J, Starmer HM, Bolton L, Clavé P, Freitas SV, Bogaardt H, Matsuo K, de Souza CM, Mourão LF. Assessment, Diagnosis, and Treatment of Dysphagia in Patients nInfected With SARS-CoV-2: A Review of the Literature and International Guidelines.

Am J Speech Lang Pathol. 2020 Nov 12;29(4):2242-2253. doi:10.1044/2020_AJSLP-20-00163. Epub 2020 Sep 22. PMID: 32960646 Abstract: Purpose Speech-language pathologists are playing a crucial role in the assessment and management of patients infected with severe acute respiratory syndrome coronavirus 2. Our goal was to synthesize peer-reviewed literature and association guidelines from around the world regarding dysphagia assessment and management for this specific population. Method A review of publications available in the PubMed database and official guidelines of international groups was performed on May 23, 2020. The information was synthesized and categorized into three content areas for swallowing: clinical evaluation, instrumental assessment, and Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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rehabilitation. Results Five publications were identified in the PubMed database. Following title, abstract, and full-text review, only three publications met inclusion criteria: two reviews and one narrative report.

Additionally, 19 international guidelines were reviewed. To assess swallowing, a modified clinical evaluation was recommended and only following a risk assessment. Instrumental assessments were often considered aerosol generating, especially transnasal procedures such as endoscopy and manometry. For this reason, many associations recommended that these examinations be performed only when essential and with appropriate personal protective equipment. Guidelines recommended that intervention should focus on compensatory strategies, including bolus modification, maneuvers/postural changes, and therapeutic exercises that can be conducted with physical distancing. Respiratory training devices were not recommended during rehabilitation.

Conclusions International associations have provided extensive guidance regarding the level of risk related to the management of dysphagia in this population. To date, there are no scientific papers offering disease and/or recovery profiling for patients with dysphagia and coronavirus disease 2019. As a result, research in this area is urgently needed.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.486 Quartil: 3

Categoria: Audiology & Speech-Language Pathology

Posició: 19/27

Ferris L, Doeltgen SH, Cock C, Rommel N, Schar M, Carrión S, Scholten I, Omari TI. Modulation of Pharyngeal Swallowing by Bolus Volume and Viscosity.

Am J Physiol Gastrointest Liver Physiol. 2020 Oct 28. doi: 10.1152/ajpgi.00270.2020. Epub ahead of print.

PMID: 33112160 Abstract BACKGROUND: Oro-pharyngeal swallowing involves complex neuromodulation to accommodate changing bolus characteristics. The pressure events during deglutitive pharyngeal reconfiguration and bolus flow can be assessed quantitatively using high-resolution pharyngeal manometry (HRPM) with impedance.

METHODS: An 8 French solid-state unidirectional catheter (32 pressure sensors, 16 impedance segments) was used to acquire triplicate swallows of 3- to 20- mls across 3 viscosity levels using a Standardized Bolus Medium (SBMkit) product (Trisco Pty Ltd, Australia). An online platform www.swallowgateway.com (Flinders University, South Australia) was used to semi -automate swallow analysis.

RESULTS: 50 healthy adults (29 female, 21 male, mean age 46 years) were studied. Hypopharyngeal intrabolus pressure, upper esophageal sphincter (UES) maximum admittance, UES relaxation pressure and UES relaxation time revealed the most significant modulation effects to bolus volume and viscosity. Pharyngeal contractility and UES post swallow pressures elevated as bolus volumes increased. Bolus viscosity augmented UES preopening pressure only.

CONCLUSION: Describing swallow modulatory effects with quantitative methods in line with a core outcome set of metrics, and a unified analysis system for broad reference contributes to diagnostic frameworks for oropharyngeal dysphagia.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.735 Quartil: 1

Categoria: Physiology

Posició: 14/81

Clavé P, Cabib C, Ortega O. Cortical metaplasticity as a novel candidate mechanism for boosting brain swallow performance in neurogenic dysphagia.

J Physiol. 2020 Sep 19. doi: 10.1113/JP280663. Epub ahead of print. PMID:32949413

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Abstract: This issue of The Journal of Physiology publishes a ‘proof of concept’ study with evidence on the metaplasticity of the human pharyngeal motor cortex induced by repetitive transcranial magnetic stimulation (rTMS) (Cheng et al. 2020). This relevant finding will impact our understanding of the neural mechanisms controlling swallowing function, and the pathophysiology and therapeutic strategies for oropharyngeal dysphagia (OD) associated with neurological diseases and/or ageing.

Swallowing is defined by the WHO in the International Classification of Functioning as an essential physiological function involving a safe and efficient transport of the alimentary bolus through the oral cavity and pharynx and oesophagus (ICF, b51051). The word, dysphagia, derives from the Greek terms dys, meaning ‘disordered’ or ‘ill’, and phago, meaning ‘eat’ or ‘swallow’, and OD is a symptom of swallowing dysfunction manifested by difficulty to form or move the alimentary bolus from the mouth to the oesophagus. OD can include oropharyngeal aspiration (part of the alimentary bolus enters the trachea) or choking (the obstruction of pulmonary air flow).

OD is included by the WHO in the International Classification of Diseases of the digestive system (ICD‐10, R13), and affects more than 50% of patients with neurological diseases or older people, but remains an under‐recognized condition. It causes very severe complications including dehydration, malnutrition, aspiration pneumonia, poor quality of life and high mortality (Clavé & Shaker, 2015). It is our responsibility to attract clinical and basic researchers to this field, as OD is emerging as a major threat among older people and patients with neurological diseases in this 21st century, and there is still no specific treatment.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.547 Quartil: 1

Categoria: Physiology

Posició: 11/81

Nascimento WV, Arreola V, Sanz P, Necati E, Bolivar-Prados M, Michou E, Ortega O, Clavé P. Pathophysiology of Swallowing Dysfunction in Parkinson NDisease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents.

Brain Sci. 2020 Sep 4;10(9):609. doi: N10.3390/brainsci10090609. PMID: 32899758; PMCID: PMC7563552 Abstract BACKGROUND: The effect of dopaminergic treatment on swallowing response in patients with Parkinson's disease (PD) suffering oropharyngeal dysphagia (OD) is not understood.

Aim: To characterize OD pathophysiology in PD and to assess whether dopaminergic states affect swallow function and the effect of thickeners.

METHODS: Fifty patients with PD (40 evaluated in OFF/ON states) and 12 healthy volunteers (HVs) were evaluated with videofluoroscopy (VFS) to assess the swallowing biomechanics and kinematics of the swallowing response at three different shear-viscosities (<50, 120, and 4000 mPa·s); RESULTS: Patients presented a mean age of 70.46 ± 10.03 years. Disease evolution was 5.09 ± 3.86 year and Hoehn-Yahr stage was 2.32 ± 0.81. For HVs, mean age was 40.20 ± 2.50 year. Penetrations were present in 37.50% of PD patients and were associated with delayed laryngeal vestibule closure (LVC = 293.33 ± 90.07 ms).

In contrast, HVs presented a LVC = 164.00 ± 39.78 ms (p < 0.05). An LVC ≥ 260 ms cutoff predicted unsafe swallow (sensitivity ≥ 0.83, specificity ≥ 0.57, AUC = 0.80) in PD. Increasing bolus viscosity improved deglutition safety but increased oropharyngeal residue. There were no differences in swallowing between the OFF/ON states.

CONCLUSIONS: In initial PD stages, oropharyngeal swallow response is severely delayed, while mildly impaired swallow safety improves with increasing bolus viscosity, which increases residue. Dopaminergic treatment does not affect swallowing or the therapeutic effect of thickeners.

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Publicacions Científiques CSDM 2020

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.332 Quartil: 2

Categoria: Neurosciences

Posició: 114/272

Schindler A, Baijens LWJ, Clave P, Degen B, Duchac S, Dziewas R, Farneti D, Hamdy S, Michou E, Pokieser P, Speyer R, Walshe M, Verin E, Rommel N. ESSD Commentary on Dysphagia Management During COVID Pandemia.

Dysphagia. 2020 Oct 27:1–4. doi: 10.1007/s00455-020-10194-z. Epub ahead of print. PMID: 33111204; PMCID: PMC7592131 Abstract: Since the World Health Organization declared the COVID-19 pandemic a Global Public Health Emergency, experts in swallowing are seeking guidance on service delivery and clinical procedures. The European Society for Swallowing Disorders provides considerations to support experts in swallowing disorders in clinical practice.

During the COVID-19 pandemic, assessment and treatment of patients with oropharyngeal dysphagia should be provided, while at the same time balancing risk of oropharyngeal complications with that of infection of patients and healthcare professionals involved in their management. Elective, non-urgent assessment may be temporarily postponed and patients are triaged to decide whether dysphagia assessment is necessary; instrumental assessment of swallowing is performed only if processing of the instruments can be guaranteed and clinical assessment has not provided enough diagnostic information for treatment prescription. Assessment and management of oropharyngeal dysphagia is a high-risk situation as it must be considered an aerosolgenerating procedure. Personal protective equipment (PPE) should be used. Telepractice is encouraged and compensatory treatments are recommended.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.591 Quartil: 1

Categoria: Otorhynolaringology

Posició: 8/42

Mundet L, Rofes L, Ortega O, Cabib C, Clavé P. Kegel Exercises, Biofeedback, Electrostimulation, and Peripheral Neuromodulation Improve Clinical Symptoms of Fecal Incontinence and Affect Specific Physiological Targets: An Randomized Controlled Trial.

J Neurogastroenterol Motil. 2020 Oct 28. doi: 10.5056/jnm20013. Epub ahead of print. PMID: 33109777 Abstract BACKGROUND/AIMS: Fecal incontinence (FI) is a prevalent condition among community-dwelling women, and has a major impact on quality of life (QoL). Research on treatments commonly used in clinical practice-Kegel exercises, biofeedback, electrostimulation, and transcutaneous neuromodulation-give discordant results and some lack methodological rigor, making scientific evidence weak. The aim is to assess the clinical efficacy of these 4 treatments on community-dwelling women with FI and their impact on severity, QoL and anorectal physiology.

METHODS: A randomized controlled trial was conducted on 150 females with FI assessed with anorectal manometry and endoanal ultrasonography, and pudendal nerve terminal motor latency, anal/rectal sensoryevoked-potentials, clinical severity, and QoL were determined. Patients were randomly assigned to one of the following groups: Kegel (control), biofeedback + Kegel, electrostimulation + Kegel, and neuromodulation + Kegel, treated for 3 months and reevaluated, then followed up after 6 months.

RESULTS: Mean age was 61.09 ± 12.17. Severity of FI and QoL was significantly improved in a similar way after all treatments. The effect on physiology was treatment-specific: Kegel and electrostimulation + Kegel, increased resting pressure (P < 0.05). Squeeze pressures strongly augmented with biofeedback + Kegel, electrostimulation Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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+ Kegel and neuromodulation + Kegel (P < 0.01). Endurance of squeeze increased in biofeedback + Kegel and electrostimulation + Kegel (P < 0.01). Rectal perception threshold was reduced in the biofeedback + Kegel, electrostimulation + Kegel, and neuromodulation + Kegel (P < 0.05); anal sensory-evoked-potentials latency shortened in patients with electrostimulation + Kegel (P < 0.05).

CONCLUSIONS: The treatments for FI assessed have a strong and similar efficacy on severity and QoL but affect specific pathophysiological mechanisms. This therapeutic specificity can help to develop more efficient multimodal algorithm treatments for FI based on pathophysiological phenotypes.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.008 Quartil: 2

Categoria: Clinical Neurology

Posició: 82/204

Vergara J, Lirani-Silva C, Brodsky MB, Miles A, Clavé P, Nascimento W, Mourão LF. Potential Influence of Olfactory, Gustatory, and Pharyngolaryngeal Sensory Dysfunctions on Swallowing Physiology in COVID-19.

Otolaryngol Head Neck Surg. 2020 Nov 10:194599820972680. doi: 10.1177/0194599820972680. Epub ahead of print. PMID: 33167752 Abstract: Persistent smell and taste disorders have been reported as some of the most common symptoms after COVID19 (coronavirus disease 2019). Sensory, olfactory, and gustatory functions perform an important role in the initiation and modulation of oropharyngeal swallow biomechanics and salivation as well as in mealtime enjoyment and appetite. Yet, the details of this interaction remain relatively unknown in patients who are infected with and recovering from COVID-19. In this commentary, we discuss the possible impacts of SARS-CoV2 on the central and peripheral nervous system and consider the pathophysiology of olfactory, gustatory, and pharyngolaryngeal sensory deficits and its influence on deglutition, describing hypotheses and offering guidance for future research.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.341 Quartil: 2

Categoria: Otorhynolaringology

Posició: 11/42

Marin S, Serra-Prat M, Ortega O, Clavé P. Healthcare-related cost of oropharyngeal dysphagia and its complications pneumonia and malnutrition after stroke: a systematic review.

BMJ Open. 2020 Aug 11;10(8):e031629. doi: 10.1136/bmjopen-2019-031629. PMID: 32784251; PMCID: PMC7418658 Abstract OBJECTIVES: To assess the healthcare costs associated with poststroke oropharyngeal dysphagia (OD) and its complications (malnutrition, dehydration, pneumonia and death).

DESIGN: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations.

DATA SOURCES: MEDLINE, Embase and the National Health Service Economic Evaluation Database were searched up to 31 December 2019.

PARTICIPANTS: Patients with poststroke.

Primary outcome measures: The costs associated to poststroke OD and its complications.

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DATA ANALYSIS: Data were synthetised narratively, quality evaluation was done using an adaptation of Drummond's checklist and Grading of Recommendations Assessment, Development and Evaluation recommendations were used to assess strength of evidence.

RESULTS: A total of 166 articles were identified, of which 10 studies were included. The cost of OD during the hospitalisation was assessed in four studies. One prospective study showed an increase of US$6589 for patients requiring tube feeding. Two retrospective studies found higher costs for those patients who developed OD, (US$7329 vs US$5939) among patients with haemorrhagic stroke transferred to inpatient rehabilitation and an increase of €3000 (US$3950) and SFr14 000 (US$15 300) in hospitalisation costs. One study did not found OD as a predictor for total medical costs in the multivariate analysis. One retrospective study showed an increase of US$4510 during the first year after stroke for those patients with OD. For pneumonia, five retrospective studies showed an increase in hospitalisation costs after stroke of between US$1456 and US$27 633. One prospective study showed an increase in hospitalisation costs during 6 months after stroke in patients at high malnutrition risk. Strength of evidence was considered moderate for OD and pneumonia and low for malnutrition.

CONCLUSIONS: This systematic review shows moderate evidence towards higher costs for those patients who developed OD after stroke. The available literature is heterogeneous, and some important aspects have not been studied yet. Further studies are needed to define the specific cost of poststroke OD. Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.496 Quartil: 2

Categoria: Medicine, General & Internal

Posició: 52/165

Baijens LWJ, Walshe M, Aaltonen LM, Arens C, Cordier R, Cras P, Crevier- Buchman L, Curtis C, Golusinski W, Govender R, Eriksen JG, Hansen K, Heathcote K, Hess MM, Hosal S, Klussmann JP, Leemans CR, MacCarthy D, Manduchi B, Marie JP, Nouraei R, Parkes C, Pflug C, Pilz W, Regan J, Rommel N, Schindler A, Schols AMWJ, Speyer R, Succo G, Wessel I, Willemsen ACH, Yilmaz T, Clavé P. European white paper: oropharyngeal dysphagia in head and neck cancer.

Eur Arch Otorhinolaryngol. 2020 Dec 19. doi: 10.1007/s00405-020-06507-5. Epub ahead of print. PMID: 333419098 Abstract PURPOSE: To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe.

METHODS: Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion.

RESULTS: Twenty-four sections on HNC-specific OD topics.

CONCLUSION: This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.809 Quartil: 2

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Categoria: Otorhynolaringology

Posició: 11/42

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NEUMOLOGIA– PNEUMOLOGY Nº Articles indexats: 4

Factor Impacte total: 14.250

Factor d’impacte mig per article: 3.563

Shull JG, Pay MT, Lara Compte C, Olid M, Bermudo G, Portillo K, Sellarés J, Balcells E, Vicens-Zygmunt V, PlanasCerezales L, Badenes-Bonet D, Blavia R, Rivera-Ortega P, Moreno A, Sans J, Perich D, Barril S, Esteban L, GarciaBellmunt L, Esplugas J, Suarez-Cuartin G, Bordas-Martinez J, Castillo D, Jolis R, Salvador I, Eizaguirre Anton S, Villar A, Robles-Perez A, Cardona MJ, Barbeta E, Silveira MG, Guevara C, Dorca J, Rosell A, Luburich P, Llatjós R, Jorba O, Molina-Molina M. Mapping IPF helps identify geographic regions at higher risk for disease development and potential triggers.

Respirology. 2020 Nov 9. doi: 10.1111/resp.13973. Epub ahead of print. PMID: 33167075 Abstract: BACKGROUND AND OBJECTIVE: The relationship between IPF development and environmental factors has not been completely elucidated. Analysing geographic regions of idiopathic pulmonary fibrosis (IPF) cases could help identify those areas with higher aggregation and investigate potential triggers. We hypothesize that crossanalysing location of IPF cases and areas of consistently high air pollution concentration could lead to recognition of environmental risk factors for IPF development.

METHODS: This retrospective study analysed epidemiological and clinical data from 503 patients registered in the Observatory IPF.cat from January 2017 to June 2019. Incident and prevalent IPF cases from the Catalan region of Spain were graphed based on their postal address. We generated maps of the most relevant air pollutant PM2.5 from the last 10 years using data from the CALIOPE air quality forecast system and observational data.

RESULTS: In 2018, the prevalence of IPF differed across provinces; from 8.1 cases per 100 000 habitants in Barcelona to 2.0 cases per 100 000 in Girona. The ratio of IPF was higher in some areas. Mapping PM2.5 levels illustrated that certain areas with more industry, traffic and shipping maintained markedly higher PM2.5 concentrations. Most of these locations correlated with higher aggregation of IPF cases. Compared with other risk factors, PM2.5 exposure was the most frequent.

CONCLUSION: In this retrospective study, prevalence of IPF is higher in areas of elevated PM2.5 concentration.

Prospective studies with targeted pollution mapping need to be done in specific geographies to compile a broader profile of environmental factors involved in the development of pulmonary fibrosis.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.880 Quartil: 1

Categoria: Respiratory System

Posició: 12/64

Pla JJ, Rodriguez BF, Tirado CF. Free-floating right heart thrombus with pulmonary embolism in SARS-CoV-2 patient.

Med Clin (Barc). 2020 Nov 13;155(9):415-416. doi: 10.1016/j.medcli.2020.06.014. Epub 2020 Jul 4. PMID: 32868032; PMCID: PMC7334957.

Abstract: Infection with SARS-COV-2 generates alterations in coagulation factors, mainly elevation of D-dimer values.

These coagulation disorders jointly with activation of inflammatory factors trigger thrombotic events such as pulmonary embolism. Although, presence of free floating right heart thrombus is unusual situation in patients with massive pulmonary embolism.

A 56-year-old caucasian male with morbid obesity (BMI 45 kg/m2), with 15-day history of dyspnea, myalgia and dry cough, was admitted to emergency room. First rapid SARS-CoV-2 PCR was negative, but with high clinical suspicion, pharmacological treatment was started. Tachypnea and dry crackles were observed at physical Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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examination. Laboratories studies showed white-cell count 15.80 × 109/L (12% lymphocytes), lactate dehydrogenase 425 UI/L, C-reactive protein 3.82 mg/dl and D-dimer 32,000 mcg/L. Arterial blood gas PaO2 55 mmHg at room air. CT pulmonary angiography (CTPA) could not be performed due to patient's anthropometry.

According to high probability of pulmonary embolism (PE), a transthoracic echocardiogram was practiced, revealing multiple thrombus at the right atrium and right ventricle, severe dilatation of the right cavities with signs of overload right ventricle and significant PAH (pulmonary arterial pressure 110 mmHg). Low molecular weight heparin was initiated. Despite negative PCR results, up to three SARS-CoV-2 PCR kept negative results.

After a significant weight loss, CTPA could be performed showing filling defects in the main pulmonary artery consistent with pulmonary embolism and ground-glass areas in both upper lobes and left lower lobe. Patient rest instable with severe respiratory failure, subsequently thrombolysis with reteplase was performed with good outcomes. Echocardiogram after procedure showed the absence of intracardiac thrombus and reduced PAH (60 mmHg). Even though having three negative rapid SARS-CoV-2 PCR, 10 days later, serologies showed positive results for IgG (Elisa technique), which confirmed Covid-19 pulmonary affection diagnosis.

SARS-COV-2 infection generates coagulation disorders with elevated D-dimer values, due to systemic proinflammatory cytokine to activate procoagulant factors, which predispose to thromboembolic events like PE. Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.635 Quartil: 3

Categoria: Medicine, General & Internal

Posició: 87/165

Juanola-Pla J, Tomàs MC, Castillo MPO. Sclerosing Pneumocytoma Presenting as Endobronchial Tumor With Negative Autofluorescence.

Arch Bronconeumol. 2020 Aug 10:S0300-2896(20)30227-1. English, Spanish. doi:10.1016/j.arbres.2020.06.022.

Epub ahead of print. PMID: 32792168.

Abstract: 51 years-old female patient with stage pT3N1M1b colon ade-nocarcinoma, with an isolated liver injury, diagnosed in 2019,initial treatment with laparoscopic sigmoidectomy, and subse-quent chemotherapy using capecitabine and oxiplatin. In the extension initial study, an hyperdense nodular lesion is observedat the entrance of the main right bronchus without uptake on PET/CT. The bronchoscopy shows an hypervas-cular pedunculated polyp lesion at the entrance of right upper lobebronchus with negative autofluorescence. Biopsy shows proliferation of small cells wrapped by hyalinizingstroma with a proliferation index of KI 67 less of 2%.

Immuno-histochemistry with Cytokeratin AE1/AE3 and positive TTF1, wassuitable with sclerosing pneumocytoma. The multidisciplinary committee agreed to treat firstly liver metastasy and reassess treat-ment of benign endobronchial lesion after a completely recovery.

The sclerosing pneumocytoma (SP) is a rare benign lungtumor predominant in women. The endobronchial location is notfrequent (1% of the SP), commonly with an asymptomatic presen-tation. Bronchoscopy shows an endobronchial polypoid lesion withedematous mucosa, with an intraluminal protrusion. At the pathohistological test, a positivity is shown toward TTF1, cytokeratinAE1/AE3, napsin-A and EMA (epithelial membrane antigen). Surgical resection is used as the first therapeutic option, although itmay be considered a conservative management Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.957 Quartil: 1

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Categoria: Respiratory System

Posició: 11/64

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Juanola-Pla J, Carmona-Tomàss M, Casals-Vila S. Spontaneous pneumomediastinum: Beyond the risky diving.

Pulmonology. 2020 Aug n9:S2531-0437(20)30171-9. doi: 10.1016/j.pulmoe.2020.07.004. Epub ahead of print.

PMID: 32788058.

Abstract: We read with great interest the letter from Cascais-Costa et al. on the risk of developing pneumomediastinum as a result of diving. The authors reviewed the medical condition along with its primary risk factors.

Hyperventilation due to psychological stress is one cause that is scarcely referenced in the medical literature.

We introduce a case of a patient with a leptosomal phenotype body who presents a spontaneous pneumomediastinum resulting from an anxiety crisis.

Spontaneuos pneumomediastinum (SP) is an uncommon condition where air gets trapped in the mediastinum without trauma associated. The most common factors are emesis, cough or Valsava maneuvers. Other trigger situations are asthma exacerbation, barotrauma, use of illicit drugs or tracheobronchial/esophageal rupture.

Psychological stress with consequent altered breathing pattern are reported as a cause of SP. Psychiatric diseases such anorexia nervosa or anxiety attacks, have also been shown to cause SP. This could be related to the intentional vomiting or the previously mentioned alterations in the ventilatory pattern. This generates an increase in intrathoracic pressure causing alveolar rupture, which then releases air from the peribronchial spaces to the mediastinum. Similar to pneumothorax cases, those who have a leptosomic clinical phenotype with tall and thin body and are also young and predominantly male are considered to have several of the predisposing risk factors that are associated with the appearance of SP. This is due to the structure of the thoracic tissues. In some cases, pneumothorax or pneumoperitoneum may appear as a pneumomediastinum complication. Usually, if no surgical interventions are needed, treatment consists of relieving symptoms and conservative management with radiological follow up..

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.778 Quartil/Decil: 2

Categoria: Respiratory System

Posició: 29/64

Juanola J, Riumbau J, Vilà X. Linfoma del manto con afectación endobronquial.

Open Respir Archiv 2020;2(3):191. doi: https://doi.org/10.1016/j.opresp.2020.05.004 Abstract: El linfoma de células del manto (LCM) es un tipo de linfoma-no-Hodgkin (LNH) de células B (3-10% de los LNH).

Suele presentarse en estadios avanzados con afectación múltiple extranodal, pero raramente traqueobronquial (7% afectación pulmonar en diagnóstico inicial, pero no traqueobronquial). El PET/TC tiene una alta sensibilidad para detectar afectación nodal y extranodal. Los LCM presentan 2 patrones endobronquiales: tipo I con infiltración difusa de la submucosa y tipo II, masa solitaria. Los mecanismos de formación de las metástasis endobronquiales son invasión bronquial de una masa en parénquima y/o mediastínica, diseminación hematológica diseminación linfática al tejido conectivo peribronquial y la aspiración transbronquial de émbolos tumorales. Los hallazgos endoscópicos son lesiones polipoides en mucosa traqueobronquial, con biopsia positiva para CD5, CD20 y ciclina D1.

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NEUROLOGIA - NEUROLOGY Nº Articles indexats: 3

Factor Impacte total: 9.980

Factor d’impacte mig per article: 3.326

Conde-Blanco E, Centeno M, Tio E, Muriana D, García-Peñas JJ, Serrano P, Nagel AG, Serratosa J, Jiménez ÁP, Toledo M, Donaire A, Manzanares I, Betrán O, Carreño M. Emergency implementation of telemedicine for epilepsy in Spain: Results of a survey during SARS-CoV-2 pandemic.

Epilepsy Behav. 2020 Jun 5;111:107211. doi: 10.1016/j.yebeh.2020.107211. [Epub ahead of print] PubMed PMID: 32540769; PubMed Central PMCID: PMC7274642.

Abstract Teleneurology in Spain had not been implemented so far in clinical practice, except in urgent patients with stroke. Telemedicine was hardly used in epilepsy, and patients and neurologists usually preferred onsite visits.

Our goal was to study impressions of adult and pediatric epileptologists about the use of telemedicine after emergent implementation during the new coronavirus 2019 (COVID-19) pandemic.

METHODS: An online survey was sent to the members of the Spanish Epilepsy Society and the members of the Epilepsy Study Group of the Catalan Neurological Society, inquiring about different aspects of telemedicine in epilepsy during the pandemic lockdown.

RESULTS: A total of 66 neurologists responded, mostly adult neurologists (80.3%), the majority with a monographic epilepsy clinic (4 out of 5). Of all respondents, 59.1% reported to attend more than 20 patients with epilepsy (PWE) a week. During the pandemic, respondents handled their epilepsy clinics mainly with telephone calls (88%); only 4.5% used videoconference. Changes in antiseizure medications were performed less frequently than during onsite visits by 66.6% of the epileptologists. Scales were not administered during these visits, and certain types of information such as sudden expected unrelated death in epilepsy (SUDEP) were felt to be more appropriate to discuss in person. More than 4 out of 5 of the neurologists (84.8%) stated that they would be open to perform some telematic visits in the future.

CONCLUSIONS: In Spain, emergent implantation of teleneurology has shown to be appropriate for the care of many PWE. Technical improvements, extended use of videoconference and patient selection may improve results and patient and physician satisfaction.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.508 Quartil: 2

Categoria: Behavioral Sciences

Posició: 24/53

Flores A, Ustrell X, Seró L, Pellisé A, Rodriguez P, Viñas J, Ribó M, Krupinski J, Más N, Garcia S, Palomeras Soler E, Cocho D, Canovas D, Purroy F, Serena J, Zaragoza-Brunet J, Obach V, Perez de la Ossa N, Cardona P, Molina CA, Abilleira S, Rubiera M; Catalan Stroke Code and Reperfusion Consortium.

Vascular Occlusion Evolution in Endovascular Reperfusion Candidates Transferred from Primary to Comprehensive Stroke Centers.

Cerebrovasc Dis. 2020;49(5):550-555. doi: 10.1159/000511063. Epub 2020 Oct 22. PMID: 33091908 Abstract BACKGROUND: The evolution of the symptomatic intracranial occlusion during transfers from primary stroke centers (PSCs) to comprehensive stroke centers (CSCs) for endovascular treatment (EVT) is not widely known.

Our aim was to identify factors related to partial or complete recanalization (REC) at CSC arrival in patients with a documented large vessel occlusion (LVO) in PSC transferred for EVT evaluation to better define the workflow at CSC of this group of patients.

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METHODS: We conducted an observational, multicenter study from a prospective, government-mandated, population-based registry of stroke patients with documented LVO at PSC transferred to CSC for EVT from January 2017 to June 2019. The primary end point was defined as partial or complete REC that precluded EVT at CSC arrival (REC). We evaluated the association between baseline, treatment variables and time intervals with the presence of REC. RESULTS: From 589 patients, the rate of REC at CSC was 10.5% in all LVO patients transferred from PSC to CSC for EVT evaluation. On univariate analysis, lower PSC-NIHSS (median 12vs.16, p = 0.001), tPA treatment at PSC (13.7 vs. 5.0%; p = 0.001), presence of M2 occlusion on PSC (16.8 vs. 9%; p = 0.023), and clinical improvement at CSC arrival (21.7 vs. 9.6% p = 0.001) were associated with REC at CSC. On multivariate analysis, clinical improvement at CSC arrival (p < 0.001, OR: 5.96 95% CI: 2.5-13.9) and PSC tPA treatment predicted REC (p = 0.003, OR: 4.65, 95% CI: 1.73-12.4).

CONCLUSION: REC at CSC arrival occurs exceptionally in patients with a documented LVO on PSC. Repeating a second vascular study before EVT would not be necessary in most patients. Despite its modest effect, tPA treatment at PSC was an independent predictor of REC. Indexat a: WOS/JCR Factor Impacte: 2.698

Quartil: 2

Categoria: Clinical Neurology

Posició: 98/204

López-de-Ipiña K, Martinez-de-Lizarduy U, Calvo PM, Beitia B, Garcia-Melero J, Fernandez E, Ecay-Torres M, Faundez-Zanuy M, Sanz P. On the analysis of speech and disfluencies for automatic detection of Mild Cognitive Impairment.

Neural Comput & Applic 32, 15761–15769 (2020). https://doi.org/10.1007/s00521-018-3494-1 Abstract Alzheimer’s disease is characterized by a progressive and irreversible cognitive deterioration. In a previous stage, the socalled Mild Cognitive Impairment or cognitive loss appears. Nevertheless, this previous stage does not seem sufficiently severe to interfere in independent abilities of daily life, so it is usually diagnosed inappropriately. Thus, its detection is a crucial challenge to be addressed by medical specialists. This paper presents a novel proposal for such early diagnosis based on automatic analysis of speech and disfluencies, and Deep Learning methodologies. The proposed tools could be useful for supporting Mild Cognitive Impairment diagnosis. The Deep Learning approach includes Convolutional Neural Networks and nonlinear multifeature modeling. Additionally, an automatic hybrid methodology is used in order to select the most relevant features by means of nonparametric Mann–Whitney U test and Support Vector Machine Attribute evaluation.

Indexat a: WOS/JCR Factor Impacte: 4.774

Quartil: 1

Categoria: Computer Science, Artificial Intelligence

Posició: 23/137

OFTALMOLOGIA – OPHTHALMOLOGY Nº Articles indexats: 1

Factor Impacte total: 1.890

Factor d’impacte mig per article: 1.890

Alvarez-Bulnes O, Monés-Llivina A, Cavero-Roig L, Ventura PS, Llagostera- Benedico J, Valls-Sirera C, TallóCatarineu G. Ophthalmic Pathology in the Offspring of Pregnant Women with Gestational Diabetes Mellitus.

Matern Child Health J. 2020 Apr;24(4):524-529. doi: 10.1007/s10995-020-02887-6. PMID: 31997119.

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Abstract BACKGROUND: Gestational diabetes (GD) occurs in 5.8% to 25.1% of pregnant women. This disorder has been linked with intrauterine growth delays, congenital anomalies, and neurobehavioral disorders following birth. As to ophthalmological effects, changes in macular thickness and hypoplasia of the upper quadrant of the papilla have been described.

OBJECTIVE: To investigate whether GD has an effect on ophthalmological development in the children born of mothers with this condition.

METHODS: Observational study carried out in children seen in the ophthalmological outpatient clinic of a pediatric hospital in Barcelona (Spain) between January 2011 and December 2015. Participants were ultimately divided into two groups, a study group whose mothers had GD managed either by insulin or diet (GD group) and a control group of children with non-diabetic mothers. Pregestational diabetes cases, were excluded. Complete information was collected on the children's refraction status, ophthalmological disease, and congenital malformations.

RESULTS: Data were compiled on 350 children (229 children born of mothers with GD-186 managed with diet vs 43, with insulin- and 121 controls). The prevalence of amblyopia and strabismus was similar between the groups, but children of mothers with GD had a three-fold greater probability of having refractive errors than children born to mothers without GD. Hyperopia (14.8% vs. 7.4%) and myopia (3.5% vs 0%) were found to be significantly more prevalent in children born of mothers with GD than in the controls (p = 0.027 in both groups).The prevalence of astigmatism was similar in both groups (1.7% vs 0.8%).

CONCLUSIONS FOR PRACTICE: Refractive errors are more common in children born of mothers with GD. These conditions are easily managed, but if they are not detected, they can lead to amblyopia or accommodative strabismus, interfere with acquisition of fine motor skills, and lead to learning problems. Regular ocular examinations would be recommended in these patients.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.890 Quartil: 2 Categoria: Public, Environmental & Occupational Health

Posició: 71/171

ONCOLOGIA–ONCOLOGY Nº Articles indexats: 5

Factor Impacte total: 24.922

Factor d’impacte mig per article: 6.230

Remon J, Nadal E, Dómine M, Ruffinelli J, García Y, Pardo JC, López R, Cilleruelo A, García-Campelo R, Martín P, Juan O, González-Larriba JL, Provencio M, Olmedo E, Ponce S, Cumplido D, Barenys C, Majem M, Massutti B, Rodriguez-Abreu D, Porta R, Sala MA, Martinez-Kareaga M, Lianes P, Reguart N. Malignant pleural mesothelioma: Treatment patterns and outcomes from the Spanish Lung Cancer Group.

Lung Cancer. 2020 Jul 3;147:83-90. doi: 10.1016/j.lungcan.2020.06.034. [Epub ahead of print] PubMed PMID: 32682189.

Abstract BACKGROUND: Malignant mesothelioma is a rare but aggressive tumor arising from the pleura, typically associated with exposure to asbestos. The purpose of this investigation was to describe mesothelioma patient characteristics, treatment patterns, and outcomes in Spain.

MATERIAL AND METHODS: Patients diagnosed with malignant mesothelioma of the pleura were recorded in an anonymous online database (BEMME, Epidemiologic Spanish Malignant Mesothelioma Database) from June 2008 through May 2013. Patient and tumor characteristics at time of diagnosis, as well as subsequent treatments (surgery, radiation, and chemotherapy), were collected. Among patients treated with chemotherapy, we explored type of chemotherapy regimen and outcomes by treatments.

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RESULTS: A total of 560 malignant pleural mesothelioma (MPM) patients were recorded. The median age at diagnosis was 68 years, mainly with epithelioid histology (62 %), and any asbestos exposure was noted in 45 % of patients. Nearly two-thirds of patients (71 %) received chemotherapy, mainly platinum-pemetrexed combination, as part of their treatment. Surgery and radiotherapy were given in 36 % and 17 % of patients, respectively. The median overall survival (OS) in the whole cohort was 13.0 months (95 % confidence interval (CI), 11.1-14.8 months) with 1-year OS of 53.2 % (95 % CI, 48.7-57.7 %). In patients receiving first-line chemotherapy (N = 315), the median OS was 13.4 months (95 % CI, 10.8-16.0 months), reaching 20.2 months (95 % CI, 17.2-23.2 months) for those 68 patients receiving maintenance chemotherapy. Results of multivariate analyses showed significant association of ECOG-performance status, histology and treatment response with improved OS in MPM patients treated with palliative chemotherapy.

CONCLUSIONS: Despite multimodal therapeutic intervention, survival of patients with mesothelioma in Spain remains poor. Although it did not reach significance in the multivariate analysis, a meaningful additional survival benefit was observed among those patients receiving maintenance chemotherapy.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.702 Quartil: 1

Categoria: Respiratory Sytem

Posició: 15/64

Ciruelos EM, Montaño A, Rodríguez CA, González-Flores E, Lluch A, Garrigós L, Quiroga V, Antón A, Malón D, Chacón JI, Velasco M, Gonzalez-Cortijo L, Jolis L, Echarri MJ, Muñoz M, Pascual T, Amigo Y, Casas M, Carrasco E, Casas A. Phase III study to evaluate patient's preference of subcutaneous versus intravenous trastuzumab in HER2positive metastatic breast cancer patients: Results from the ChangHER study (GEICAM/2012-07).

Eur J Cancer Care (Engl). 2020 Jun 23:e13253. doi: 10.1111/ecc.13253. [Epub ahead of print] PubMed PMID: 32578279 Abstract OBJECTIVE: We compared patients' preferences for intravenous (IV-t) versus subcutaneous (SC-t) trastuzumab administration.

METHODS: Phase III, open-label, multicentre study in HER2-positive metastatic breast cancer. Patients were receiving IV-t for at least 4 months without progression. Randomisation was 1:1 to administer 2 cycles of SC-t with vial followed by 2 cycles with single injection device (SID) or the reverse sequence (600mg SC-t every 3 weeks for 4 cycles).

PRIMARY OBJECTIVE: patients' preference for IV-t versus SC-t; secondary objectives: patients' preference for vial versus SID, healthcare professional (HCP) preference and safety.

RESULTS: We randomised 166 patients in 26 sites. Median number of previous lines of chemotherapy and/or endocrine therapy was 1 (1-7). Median duration of prior IV-t was 1.8 years (0.3-14). Of the159 patients completing the questionnaires, 86.2% preferred SC-t, 6.9% preferred IV-t, and 6.9% had no preference. Patients preferred SID (59.2%) over vial (26.3%). Most (87.2%) HCP preferred SC-t of whom 51.3% and 28.2% preferred SID and vial respectively. Related adverse events included G1-2 injection site reactions in 18 patients (10.8%), G1 pain in 8 (4.8%), G1-2 allergic reaction in 2 (1.2%), one G3 heart failure and 1 G2 ejection fraction decrease.

CONCLUSIONS: SC-t is preferred with no safety impact.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.161 Quartil: 1

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Categoria: Rehabilitation

Posició: 17/68

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Mezquita L, Jové M, Nadal E, Kfoury M, Morán T, Ricordel C, Dhooge M, Tlemsani C, Léna H, Teulé A, Álvarez JV, Raimbourg J, Hiret S, Lacroix L, Menéndez M, Saldaña J, Brunet J, Lianes P, Coupier I, Auclin E, Recondo G, Friboulet L, Adam J, Green E, Planchard D, Frébourg T, Capellà G, Rouleau E, Lázaro C, Caron O, Besse B. High Prevalence of Somatic Oncogenic Driver Alterations in Patients With NSCLC and Li-Fraumeni Syndrome.

J Thorac Oncol. 2020 Jul;15(7):1232-1239. doi: 10.1016/j.jtho.2020.03.005. Epub 2020 Mar 14. PubMed PMID: 32179180.

INTRODUCTION: Actionable somatic molecular alterations are found in 15% to 20% of NSCLC in Europe. NSCLC is a tumor observed in patients with germline TP53 variants causing Li-Fraumeni syndrome (LFS), but its somatic molecular profile is unknown.

METHODS: Retrospective study of clinical and molecular profiles of patients with NSCLC and germline TP53 variants.

RESULTS: Among 22 patients with NSCLC and LFS (n = 23 lung tumors), 64% were women, median age was 51 years, 84% were nonsmokers, 73% had adenocarcinoma histological subtype, and 84% were diagnosed with advanced-stage disease. These patients harbored 16 distinct germline TP53 variants; the most common was p.R158H (5/22; three in the same family). Personal and family histories of cancer were reported in 71% and 90% of patients, respectively. In most cases (87%, 13/15), lung cancer was diagnosed with a late onset. Of the 21 tumors analyzed, somatic oncogenic driver mutations were found in 19 of 21 (90%), EGFR mutations in 18 (exon 19 deletion in 12 cases, L858R in three cases, and G719A, exon 20 insertion, and missing mutation subtype, each with one case), and ROS1 fusion in one case. A PI3KCA mutation was concurrently detected at diagnosis in three EGFR exon 19-deleted tumors (3/12). The median overall survival was 37.3 months in 14 patients treated with EGFR inhibitors; seven developed resistance, five (71%) acquired EGFR-T790M mutation, and one had SCLC transformation.

CONCLUSIONS: Driver oncogenic alterations were observed in 90% of the LFS tumors, mainly EGFR mutations; one ROS1 fusion was also observed. The germline TP53 variants and lung cancer carcinogenesis driven by oncogenic processes need further evaluation.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 13.357 Quartil/Decil: 1

Categoria: Oncology

Posició: 11/244

Garcia-Campelo R, Arrieta O, Massuti B, Rodriguez-Abreu D, Granados ALO, Majem M, Vicente D, Lianes P, Bosch-Barrera J, Insa A, Dómine M, Reguart N, Guirado M, Sala MÁ, Vázquez-Estevez S, Caro RB, Drozdowskyj A, Verdú A, Karachaliou N, Molina-Vila MA, Rosell R; Spanish Lung Cancer Group (SLCG).

Combination of gefitinib and olaparib versus gefitinib alone in EGFR mutant non- small-cell lung cancer (NSCLC): A multicenter, randomized phase II study (GOAL).

Lung Cancer. 2020 Oct 3;150:62-69. doi: 10.1016/j.lungcan.2020.09.018. Epub ahead of print. PMID: 33070053 OBJECTIVES: Progression-free survival (PFS) and response rate to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) varies in patients with non-small-cell lung cancer (NSCLC) driven byEGFR mutations, suggesting that other genetic alterations may influence oncogene addiction. Low BRCA1 mRNA levels correlate with longer PFS in erlotinib-treated EGFR-mutant NSCLC patients. Since the poly (ADP-ribose) polymerase (PARP) inhibitor, olaparib, may attenuate and/or prevent BRCA1 expression, the addition of olaparib to gefitinib could improve outcome in EGFR-mutant advanced NSCLC. MATERIALS AND METHODS: GOAL was a multicenter, randomized phase IB/II study performed in two countries, Spain and Mexico. Eligible patients were 18 years or older, treatment-naïve, pathologically confirmed stage IV NSCLC, with centrally confirmed EGFR mutations and measurable disease. Patients were randomly allocated (1:1) to receive gefitinib 250 mg daily or gefitinib 250 mg daily plus olaparib 200 mg three times daily in 28-day Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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cycles. The primary endpoint was PFS. Secondary endpoints included overall survival (OS), response rate, safety and tolerability.

RESULTS: Between September 2013, and July 2016, 182 patients underwent randomization, 91 received gefitinib and 91 received gefitinib plus olaparib. There were no differences in gender, age, smoking status, performance status, presence of bone and brain metastases or type ofEGFR mutation. Median PFS was 10.9 months (95 % CI 9.3-13.3) in the gefitinib arm and 12.8 months (95 % CI 9.1-14.7) in the gefitinib plus olaparib arm (HR 1.38, 95 % CI 1.00-1.92; p = 0.124). The most common adverse events were anemia, 78 % in gefitinib plus olaparib group, 38 % in gefitinib arm, diarrhea, 65 % and 60 %, and fatigue, 40 % and 32 %, respectively.

CONCLUSIONS: The gefitinib plus olaparib combination did not provide significant benefit over gefitinib alone.

The combination's safety profile showed an increase in hematological and gastrointestinal toxicity, compared to gefitinib alone, however, no relevant adverse events were noted.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.702 Quartil: 1

Categoria: Respiratory Sytem

Posició: 15/64

Viñolas NN, Garcia-Campelo R, Majem M, Carcereny E, Isla D, Gonzalez-Larriba JL, Coves J, De-Castro J, Domine M, Lianes P, Artal A, Remon J, Felip E, Garrido P. Assessment of the psychosocial and economic impact according to sex in non- small cell lung cancer patients: an exploratory longitudinal study.

BMC Psychol. 2020 Nov 23;8(1):123. doi: 10.1186/s40359-020-00489-z. PMID: 33228796 Abstract BACKGROUND: Little is known about the impact of sex on lung cancer patients from the psychological, economic and social perspectives. This study was designed to explore the psychosocial and economic impact according to sex of metastatic non-small cell lung cancer (mNSCLC) in patients and caregivers.

METHODS: Exploratory study of two cohorts of patients starting first-line treatment for mNSCLC. The following questionnaires were administered at baseline, 4 months later and following the first and second disease progression: APGAR, relationship impact scale, DUKE-UNC scale, economic impact in patients and caregiver, and Zarit scale. It was planned to include 1250 patients to get an 80% possibility of detecting as significant (p < 0.05) effect sizes less than 0.19 between men and women. Univariate comparisons were made between the tests applied to men and women. Overall survival was estimated with Kaplan-Meier method. Cox analyses were done to estimate hazard ratios (HRs) with 95% CI. RESULTS: 333 patients were included. Most families reported to continue being functional despite the lung cancer diagnosis. Regardless of sex, they did not perceive changes in their partner relationship. Most patients felt their social support was normal. Roughly 25% of people reported a worsening in their economic situation, without remarkable differences by sex. Statistically significant differences were found between both groups regarding the caregiver's relationship to the patient (more parents were the caregiver in females than in males, p < 0.0001) and the caregiver's employment situation (more employed caregivers in females) (p < 0.0001). Most caregivers of both sexes considered that taking care of their relative did not pose a significant burden.

CONCLUSIONS: This study provides a preliminary insight into sex-related characteristics in the management of advanced NSCLC and its impact on the emotional, social and economic burden of patients and their caregivers, and recall the high priority of researching in cancer from a sex perspective. Nevertheless, due to the low recruitment rate and the relevant loss of patients during the follow-up, it was difficult to find differences by sex.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02336061.

ETHICS COMMITTEE: Comité Ético de Investigación Clínica del Hospital Clínic de Barcelona, Spain. Reference number: HCB/2014/0705.

Indexat a: PubMed Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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PEDIATRIA– PEDIATRICS Nº Articles indexats: 1

Factor Impacte total: 1.635

Factor d’impacte mig per article: 1.635

Bardón Cancho EJ, García-Morín M, Beléndez C, Velasco P, Benéitez D, Ruiz-Llobet A, Berrueco R, Argilés B, Cervera Á, Salinas JA, Vecilla C, Gondra A, Vallés G, Murciano T, Bermúdez M, Cela E; en representación del grupo de trabajo de Eritropatología de la Sociedad Española de Hematología y Oncología Pediátricas (SEHOP).

Update of the Spanish registry of haemoglobinopathies in children and adults.

Med Clin (Barc). 2020 Feb 26. pii: S0025-7753(19)30717-1. doi: 10.1016/j.medcli.2019.10.011. [Epub ahead of print] English, Spanish. PubMed PMID: 32113697 Abstract BACKGROUND AND OBJECTIVE: Patients with thalassaemia major (TM) and sickle cell disease (SCD) in Spain have been counted since the creation of the Spanish registry of haemoglobinopathies (REHem). The objective of this paper is to update the published data after the increase in cases due to the inclusion of adults and introduction of new-born screening in almost the whole country.

MATERIAL AND METHODS: An observational, descriptive, multicentre and ambispective study that included patients with haemoglobinopathies registered in the REHem, started in January 2014 and followed up annually.

The data presented correspond until December 31, 2017.

RESULTS: Nine hundred and fifty-nine patients were collected. There were 75 cases of thalassaemia (62 TM), 826 of ECF and 58 of other types of haemoglobinopathies. The main diagnostic reason in the TM cohort was anaemia symptoms (70.6%), with a mean age at diagnosis of .7 years; in the SCD cohort it was neonatal screening (33.1%), with a mean age at diagnosis of 2.7 years; 26 patients with TM (41.9%) and 30 with SCD (3.6%) underwent a transplant. There were 2 deaths (3.2%) with TM and 19 (2.3%) with SCD. Overall survival was 96.7% in the TM and 97.5% in the SCD cases at 15 years.

CONCLUSIONS: Since the previous publication and after the diffusion of new-born screening, the most frequent diagnostic method, to the majority of autonomous regions, and the inclusion of adult patients to the registry, the REHem has increased by more than 240 cases, reaching a total of 959 records.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.635 Quartil: 3

Categoria: Medicine, General & Internal

Posició: 87/165

PSIQUIATRIA - PSYCHIATRY Nº Articles indexats: 18

Factor Impacte total: 41.770

Factor d’impacte mig per article: 2.320

Bioque M, Parellada E, García-Rizo C, Amoretti S, Fortea A, Oriolo G, Palau P, Boix-Quintana E, Safont G, Bernardo M. Clozapine and paliperidone palmitate antipsychotic combination in treatment-resistant schizophrenia and other psychotic disorders: a retrospective 6-month mirror-image study.

Eur Psychiatry. 2020 Jul 16:1-15. doi: 10.1192/j.eurpsy.2020.72. [Epub ahead of print] PubMed. PMID: 32669145.

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Abstract OBJECTIVE: Around 30% of patients with schizophrenia are considered treatment resistant (TRS). Only around 40% of TRS patients respond to clozapine. Long acting injectable antipsychotics could be a useful augmentation strategy for non-responders.

METHODS: We conducted a multicenter, observational, naturalistic, retrospective, six-month mirror-image study to evaluate the efficacy and tolerability of clozapine and paliperidone palmitate association in patients with TRS and other psychotic disorders. Clinical outcomes and side effects were systematically assessed.

RESULTS: Six month after starting the combined treatment participants showed a significant relief of symptoms, decreasing the Brief Psychiatric Rating Scale total score from 18.32±7.71 to 7.84±5.16 (p<0.001). The number of hospitalizations, the length of hospital stays and the number of visits to emergency services also decreased, while an increase of the functionality was observed (Personal and Social Performance total score increased from 46.06±118.7 to 60.86±18.68, p<0.001). There was also a significant decrease in the number and severity of side effects with the combination therapy, decreasing the Udvalg for Kliniske Undersogelser total score from 10.76±8.04 to 8.82±6.63 (p=0.004).

CONCLUSIONS: This study provides the first evidence that combining clozapine with paliperidone palmitate in patients with TRS and other psychotic disorders could be effective and safe, suggesting further research with randomized controlled trials of augmentation strategies for clozapine non-responders patients.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 4.464 Quartil: 1

Categoria: Psychiatry

Posició: 28/155

Frías Á, Palma C, Salvador A, Aluco E, Navarro S, Farriols N, Aliaga F, Solves L, Antón M. B·RIGHT: usability and satisfaction with a mobile app for self-managing emotional crises in patients with borderline personality disorder.

Australas Psychiatry. 2020 May 22:1039856220924321. doi: 10.1177/1039856220924321. [Epub ahead of print] PubMed PMID: 32438869 Abstract OBJECTIVE: Borderline personality disorder (BPD) is a severe mental disorder characterized by emotional crises.

To date, crisis interventions for BPD have been conducted via telephone calls and emergency units, which are associated with an extra amount of resources. The aim of this research was to test the usability and satisfaction with a psychotherapeutic mobile app for self-managing crises in BPD. METHOD: The B·RIGHT app was designed based on Artificial Intelligence psychotherapeutic algorithms. Usability and satisfaction with the app were assessed in 25 outpatients diagnosed with BPD (84% female, mean age = 35.80 years) using the System Usability Scale (SUS) and other questionnaires. Clinical features were assessed using the Borderline Symptom List, the Difficulties in Emotion Regulation Scale and Beck's Depression Inventory.

RESULTS: Patients with BPD considered the app user-friendly (mean total score = 4.03) and highly satisfactory (mean total score = 4.02), resulting in a positive user experience (mean total score = 4.09). Total usability was negatively associated with age (r = -.44), positively associated with educational level (rho = .47) and with overall emotion dysregulation (r = .51), and negatively associated with depression severity (r = -.47).

CONCLUSIONS: The usability and satisfaction testing of the B·RIGHT app showed promising findings, which warrant further research in order to validate its effectiveness.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.029 Quartil: 4

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Categoria: Psychiatry

Posició: 136/155

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Jiménez EC, Romeo A, Pérez Zapata L, Solé Puig M, Bustos-Valenzuela P, Cañete J, Varela Casal P, Supèr H. Eye vergence responses in children with and without reading difficulties during a word detection task.

Vision Res. 2020 Apr;169:6-11. doi: 10.1016/j.visres.2020.02.001. Epub 2020 Mar 3. PubMed PMID: 32143068 Abstract: Vergence eye movements are movements of both eyes in opposite directions. Vergence is known to have a role in binocular vision. However recent studies link vergence eye movements also to attention and attention disorders. As attention may be involved in dyslexia, it is sensible to guess that the presence of reading difficulties can be associated with specific patterns in vergence responses. Data from school children performing a word-reading task have been analysed. In the task, children had to distinguish words from non-words (scrambled words or row of X's), while their eye positions were recorded. Our findings show that after stimulus presentation eyes briefly converge. These vergence responses depend on the stimulus type and age of the child, and are different for children with reading difficulties. Our findings support the idea of a role of attention in word reading and offer an explanation of altered attention in dyslexia.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.610 Quartil: 2

Categoria: Psychology

Posició: 27/78

Roca M, Vilaregut A, Palma C, Barón FJ, Campreciós M, Mercadal L. Basic Family Relations, Parental Bonding, and Dyadic Adjustment in Families with a Member with Psychosis.

Community Ment Health J. 2020 Feb 21. doi: 10.1007/s10597-020-00581-z. [Epub ahead of print] PubMed PMID: 32080779 Abstract: The aim of the current study is to describe and explore basic family relations, parental bonding, and dyadic adjustment in families with offspring diagnosed with a psychotic disorder. The sample was made up of 120 participants, 60 in the clinical group (GCL) and 60 in the comparison group (GCP). All participants were assessed using the basic family relations evaluation questionnaire (CERFB), the parental bonding instrument (PBI), and the dyadic adjustment scale (DAS). The results showed differences between the clinical and comparison groups in terms of perceptions of basic family relations, dyadic adjustment and parental bonding. The clinical group recorded less favorable results for all of these variables. More specifically, the study observed significant differences between the groups in parental function, overprotection and caring. This study deepens our understanding of how family assessment and relational diagnoses can serve as prevention and intervention tools for families affected by a psychotic disorder.

Indexat a: WOS/JCR Factor Impacte: 1.292

Quartil: 3

Categoria: Psychiatry

Posició: 100/142

Paz C, Aguilera M, Salla M, Compañ V, Medina JC, Bados A, García-Grau E, Castel A, Cañete Crespillo J, Montesano A, Medeiros-Ferreira L, Feixas G. Personal Construct Therapy vs Cognitive Behavioral Therapy in the Treatment of Depression in Women with Fibromyalgia: Study Protocol for a Multicenter Randomized Controlled Trial.

Neuropsychiatr Dis Treat. 2020 Jan 24;16:301-311. doi: 10.2147/NDT.S235161. eCollection 2020. PubMed PMID: 32021219; PubMed Central PMCID: PMC6987966.

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Abstract BACKGROUND: Fibromyalgia (FM) is a debilitating syndrome, more prevalent in women, which is aggravated by the presence of depressive symptoms. In the last decade, cognitive behavioral therapy (CBT) has demonstrated to reduce such depressive symptoms and pain in these patients, but there are still a considerable number of them who do not respond to interventions. The complexity of the disorder requires the consideration of the unique psychological characteristics of each patient to attain good outcomes. One approach that could accomplish this goal might be personal construct therapy (PCT), an idiographic approach that considers identity features and interpersonal meanings as their main target of intervention. Then, the aim of the study is to test the efficacy of PCT as compared to a well-established treatment in the reduction of depressive symptoms in women with fibromyalgia.

METHODS AND ANALYSIS: This is a multicenter randomized controlled trial. In each condition participants will attend up to eighteen 1-hr weekly therapy sessions and up to three 1-hr booster sessions during the following 35 months after the end of treatment. The depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) will be the primary outcome measure and it will be assessed at baseline, at the end of therapy, and at 6-month follow-up. Other secondary measures will be applied following the same schedule. Participants will be 18- to 70-years-old women with a diagnosis of FM, presenting depressive symptoms evinced by scores above seven in depression items of the HADS-D. Intention-to-treat and complete case analyses will be performed for the main statistical tests. Linear mixed models will be used to analyze and to compare the treatment effects of both conditions.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT02711020.

Indexat a: WOS/JCR Factor Impacte: 2.195

Quartil: 3

Categoria: Psychiatry

Posició: 92/155

Jiménez EC, Avella-Garcia C, Kustow J, Cubbin S, Corrales M, Richarte V, Esposito FL, Morata I, Perera A, Varela P, Cañete J, Faraone SV, Supèr H, Ramos-Quiroga JA. Eye Vergence Responses During an Attention Task in Adults With ADHD and Clinical Controls.

J Atten Disord. 2020 Jan 20:1087054719897806. doi: 10.1177/1087054719897806. [Epub ahead of print] PubMed PMID: 31959011.

Abstract OBJECTIVE: ADHD patients show poor oculomotor control and recent studies show that attention-related eye vergence is weak in ADHD children. We aimed to assess vergence as a potential diagnostic biomarker for ADHD in adults.

METHOD: We assessed the modulation in the angle of vergence while performing an attention task (N = 144), comparing the results for adults previously diagnosed with ADHD (N = 108) with age-matched clinical controls (N = 36).

RESULTS: Significant differences in eye vergence response modulation between clinical controls and ADHD patients were documented. Diagnostic test accuracy was 79%.

CONCLUSION: In combination with an attention task, eye vergence responses could be used as an objective marker to support the clinical diagnosis of adult ADHD. Indexat a: WOS/JCR Factor Impacte: 2.826

Quartil: 2

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Categoria: Psychiatry

Posició: 67/155

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Gil F, Padilla N, Soria-Pastor S, Setoain X, Boget T, Rumiá J, Roldán P, Reyes D, Bargalló N, Conde E, Pintor L, Vernet O, Manzanares I, Ådén U, Carreño M, Donaire A. Beyond the Epileptic Focus: Functional Epileptic Networks in Focal Epilepsy.

Cereb Cortex. 2020 Apr 14;30(4):2338-2357. doi: 10.1093/cercor/bhz243. PubMed PMID: 31867595.

Abstract: Focal epilepsy can be conceptualized as a network disorder, and the functional epileptic network can be described as a complex system of multiple brain areas that interact dynamically to generate epileptic activity.

However, we still do not fully understand the functional architecture of epileptic networks. We studied a cohort of 21 patients with extratemporal focal epilepsy. We used independent component analysis of functional magnetic resonance imaging (fMRI) data. In order to identify the epilepsy-related components, we examined the general linear model-derived electroencephalography-fMRI (EEG-fMRI) time courses associated with interictal epileptic activity as intrinsic hemodynamic epileptic biomarkers. Independent component analysis revealed components related to the epileptic time courses in all 21 patients. Each epilepsy-related component described a network of spatially distributed brain areas that corresponded to the specific epileptic network in each patient. We also provided evidence for the interaction between the epileptic activity generated at the epileptic network and the physiological resting state networks. Our findings suggest that independent component analysis, guided by EEG-fMRI epileptic time courses, have the potential to define the functional architecture of the epileptic network in a noninvasive way. These data could be useful in planning invasive EEG electrode placement, guiding surgical resections, and more effective therapeutic interventions.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 5.043 Quartil: 1

Categoria: Neurosciences

Posició: 51/272

Insa Pineda I, Huguet Miguel A, Chamorro Fernández M, Espadas Tejerina M, González CLG, Alda JA. ADHD Symptoms, Academic and Social Difficulties in Parents of Children with ADHD. Psychiatry. 2020 Fall;83(3):231-243. doi: 10.1080/00332747.2020.1762395. Epub 2020 Jul 30. PMID: 32729785.

Abstract OBJECTIVE: To evaluate the prevalence of ADHD in a group of parents of children with ADHD compared with the general population. To compare academic level, unemployment aid rate and marital separations/divorce of this parents sample.

METHODOLOGY: The experimental group was formed by the parents of 60 children with ADHD. The control group was formed by the parents of 60 healthy children. To assess the retrospective and current ADHD symptomatology among the parents of the sample the Wender Utah Rating Scale (WURS) and the Attention Deficit Hyperactivity Disorder-rating scale (ADHD.rs) were used. Also, the Hollingshead Four-Factor Index of Socioeconomic status (SES-Child) was used.

RESULTS: 20.33% of the mothers in the case group met criteria for a retrospective diagnosis of ADHD, while none of the control group mothers met criteria (p < .01). Regarding fathers, there was a retrospective ADHD diagnosis in 25% of the case group compared to 10% in the control group (p < .01). In terms of the current symptoms, 25.42% of the mothers and 21.43% of fathers in the case group met diagnostic criteria for probable ADHD compared to 1.67% in the control group (p < .01 in both genders). Parents in the case group had a lower academic level (p < .01), received more unemployment aid (p = .02) and reported a higher rate of marital separation or divorce (p = .02).

CONCLUSIONS: Parents of children with ADHD have a higher incidence of retrospective and current ADHD diagnosis and they also present worse socioeconomic factors.

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2020

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.733 Quartil: 3

Categoria: Psychiatry

Posició: 112/155

Frías Á, Solves L, Navarro S, Palma C, Farriols N, Aliaga F, Hernández M , Antón M, Riera A. Technology-Based Psychosocial Interventions for People with Borderline Personality Disorder: A Scoping Review of the Literature.

Psychopathology. 2020 Nov 9:1-10. doi: 10.1159/000511349. Epub ahead of print. PMID: 33166964.

Abstract BACKGROUND: Mental ill-health is the leading cause of disability worldwide. Moreover, 75% of mental health conditions emerge between the ages of 12 and 25 years. Unfortunately, due to lack of resources and limited engagement with services, a majority of young people affected by mental ill-health do not access evidencebased support. To address this gap, our team has developed a multimodal, scalable digital mental health service (Enhanced Moderated Online Social Therapy [MOST+]) merging real-time, clinician-delivered web chat counseling; interactive user-directed online therapy; expert and peer moderation; and peer-to-peer social networking.

OBJECTIVE: The primary aim of this study is to ascertain the feasibility, acceptability, and safety of MOST+. The secondary aims are to assess pre-post changes in clinical, psychosocial, and well-being outcomes and to explore the correlations between system use, perceived helpfulness, and secondary outcome variables.

METHODS: Overall, 157 young people seeking help from a national youth e-mental health service were recruited over 5 weeks. MOST+ was active for 9 weeks. All participants had access to interactive online therapy and integrated web chat counseling. Additional access to peer-to-peer social networking was granted to 73 participants (46.5%) for whom it was deemed safe. The intervention was evaluated via an uncontrolled singlegroup study.

RESULTS: Overall, 93 participants completed the follow-up assessment. Most participants had moderate (52/157, 33%) to severe (96/157, 61%) mental health conditions. All a priori feasibility, acceptability, and safety criteria were met. Participants provided mean scores of ≥3.5 (out of 5) on ease of use (mean 3.7, SD 1.1), relevancy (mean 3.9, SD 1.0), helpfulness (mean 3.5, SD 0.9), and overall experience (mean 3.9, SD 0.8).

Moreover, 98% (91/93) of participants reported a positive experience using MOST+, 82% (70/93) reported that using MOST+ helped them feel better, 86% (76/93) felt more socially connected using it, and 92% (86/93) said they would recommend it to others. No serious adverse events or inappropriate use were detected, and 97% (90/93) of participants reported feeling safe. There were statistically significant improvements in 8 of the 11 secondary outcomes assessed: psychological distress (d=-0.39; P<.001), perceived stress (d=-0.44; P<.001), psychological well-being (d=0.51; P<.001), depression (d=-0.29; P<.001), loneliness (d=-0.23; P=.04), social support (d=0.30; P<.001), autonomy (d=0.36; P=.001), and self-competence (d=0.30; P<.001). There were significant correlations between system use, perceived helpfulness, and a number of secondary outcome variables.

CONCLUSIONS: MOST+ is a feasible, acceptable, and safe online clinical service for young people with mental illhealth. The high level of perceived helpfulness, the significant improvements in secondary outcomes, and the correlations between indicators of system use and secondary outcome variables provide initial support for the therapeutic potential of MOST+. MOST+ is a promising and scalable platform to deliver standalone e-mental health services as well as enhance the growing international network of face-to-face youth mental health services.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 1.659 Quartil: 4

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Categoria: Psychiatry

Posició: 177/155

56

Publicacions Científiques CSDM 2020

Álvaro F, Navarro S, Palma C, Farriols N, Aliaga F, Solves L, Hernández M, Antón M, Riera A. Clinical course and predictors in patients with borderline personality disorder during the COVID-19 outbreak: A 2.5-month naturalistic exploratory study in Spain.

Psychiatry Res. 2020 Oct;292:113306. doi: 10.1016/j.psychres.2020.113306. Epub 2020 Jul 16. PMID: 32702553; PMCID: PMC7365077.

Abstract: The COVID-19 outbreak is an emotional challenge for the general population. Within this context, people with prior mental disorders are at special risk of suffering additional and increasing problems (Yao et al., 2020). In particular, patients with borderline personality disorder (BPD) constitute a psychiatric cohort with poor personnel strategies to deal with stress and with high clinical support needs (Grambal et al., 2017). Thus, the COVID-19 outbreak represents a potential hazardous context that may negatively affect the clinical course of patients with BPD. Ultimately, this highlights the need to adopt new strategies to treat BPD patients during confinement beyond face-to-face therapies, including videoconferencing, phone calls or email messages. In Spain, the COVID-19 outbreak has been particularly dramatic, resulting in a period of restrictions from 14 March 2020 onwards, after the nationwide state of alert was activated.

The current exploratory, naturalistic study aimed to delineate the clinical course of patients with BPD during 2.5 months of home confinement and restrictions due to the COVID-19 outbreak and to address the effect of several clinical, psychosocial and treatment conditions throughout this period.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.118 Quartil: 3

Categoria: Psychaitry

Posició: 96/155

Alvarez-Jimenez M, Rice S, D'Alfonso S, Leicester S, Bendall S, Pryor I, Russon P, McEnery C, Santesteban-Echarri O, Da Costa G, Gilbertson T, Valentine L, Solves L, Ratheesh A, McGorry PD, Gleeson J. A Novel Multimodal Digital Service (Moderated Online Social Therapy+) for Help-Seeking Young People Experiencing Mental Ill-Health: Pilot Evaluation Within a National Youth E-Mental Health Service.

J Med Internet Res. 2020 Aug 13;22(8):e17155. doi: 10.2196/17155. PMID: 32788151; PMCID: PMC7453330.

Abstract BACKGROUND: Mental ill-health is the leading cause of disability worldwide. Moreover, 75% of mental health conditions emerge between the ages of 12 and 25 years. Unfortunately, due to lack of resources and limited engagement with services, a majority of young people affected by mental ill-health do not access evidencebased support. To address this gap, our team has developed a multimodal, scalable digital mental health service (Enhanced Moderated Online Social Therapy [MOST+]) merging real-time, clinician-delivered web chat counseling; interactive user-directed online therapy; expert and peer moderation; and peer-to-peer social networking.

OBJECTIVE: The primary aim of this study is to ascertain the feasibility, acceptability, and safety of MOST+. The secondary aims are to assess pre-post changes in clinical, psychosocial, and well-being outcomes and to explore the correlations between system use, perceived helpfulness, and secondary outcome variables.

Methods: Overall, 157 young people seeking help from a national youth e-mental health service were recruited over 5 weeks. MOST+ was active for 9 weeks. All participants had access to interactive online therapy and integrated web chat counseling. Additional access to peer-to-peer social networking was granted to 73 participants (46.5%) for whom it was deemed safe. The intervention was evaluated via an uncontrolled singlegroup study.

RESULTS: Overall, 93 participants completed the follow-up assessment. Most participants had moderate (52/157, 33%) to severe (96/157, 61%) mental health conditions. All a priori feasibility, acceptability, and safety criteria were met. Participants provided mean scores of ≥3.5 (out of 5) on ease of use (mean 3.7, SD 1.1), Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2020

relevancy (mean 3.9, SD 1.0), helpfulness (mean 3.5, SD 0.9), and overall experience (mean 3.9, SD 0.8).

Moreover, 98% (91/93) of participants reported a positive experience using MOST+, 82% (70/93) reported that using MOST+ helped them feel better, 86% (76/93) felt more socially connected using it, and 92% (86/93) said they would recommend it to others. No serious adverse events or inappropriate use were detected, and 97% (90/93) of participants reported feeling safe. There were statistically significant improvements in 8 of the 11 secondary outcomes assessed: psychological distress (d=-0.39; P<.001), perceived stress (d=-0.44; P<.001), psychological well-being (d=0.51; P<.001), depression (d=-0.29; P<.001), loneliness (d=-0.23; P=.04), social support (d=0.30; P<.001), autonomy (d=0.36; P=.001), and self-competence (d=0.30; P<.001). There were significant correlations between system use, perceived helpfulness, and a number of secondary outcome variables.

CONCLUSIONS: MOST+ is a feasible, acceptable, and safe online clinical service for young people with mental illhealth. The high level of perceived helpfulness, the significant improvements in secondary outcomes, and the correlations between indicators of system use and secondary outcome variables provide initial support for the therapeutic potential of MOST+. MOST+ is a promising and scalable platform to deliver standalone e-mental health services as well as enhance the growing international network of face-to-face youth mental health services.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 5.034 Quartil/Decil: 1

Categoria: Medical Informatics

Posició: 2/27

González-Rodríguez A, Labad J, Seeman MV. Sleep Disturbances in Patients with Persistent Delusions: Prevalence, Clinical Associations, and Therapeutic Strategies.

Clocks Sleep. 2020 Oct 16;2(4):399-415. doi:10.3390/clockssleep2040030. PMID: 33118525.

Abstract: Sleep disturbances accompany almost all mental illnesses, either because sound sleep and mental well-being share similar requisites, or because mental problems lead to sleep problems, or vice versa. The aim of this narrative review was to examine sleep in patients with delusions, particularly in those diagnosed with delusional disorder. We did this in sequence, first for psychiatric illness in general, then for psychotic illnesses where delusions are prevalent symptoms, and then for delusional disorder. The review also looked at the effect on sleep parameters of individual symptoms commonly seen in delusional disorder (paranoia, cognitive distortions, suicidal thoughts) and searched the evidence base for indications of antipsychotic drug effects on sleep. It subsequently evaluated the influence of sleep therapies on psychotic symptoms, particularly delusions. The review's findings are clinically important. Delusional symptoms and sleep quality influence one another reciprocally. Effective treatment of sleep problems is of potential benefit to patients with persistent delusions, but may be difficult to implement in the absence of an established therapeutic relationship and an appropriate pharmacologic regimen. As one symptom can aggravate another, comorbidities in patients with serious mental illness all need to be treated, a task that requires close liaison among medical specialties.

Indexat a: PubMed

Frias A, Palma C, Farriols N, Aliaga F, Navarro S, Solves L. Parenting Attitudes in People with Obsessive-compulsive Disorder and Emotional Symptoms in Their Children.

Clinica y Salud. 2020;31(2):91-98. doi: 10.5093/clysa2020a13

Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Publicacions Científiques CSDM 2020

Abstract: This study sought to delineate distinctive parenting attitudes in people with obsessive-compulsive disorder (OCD), specific emotional symptoms in their children, and the association between them. Forty OCD parents and their children were compared with 37 parents with adjustment disorders and their children by using standardized clinical questionnaires. Children of OCD parents exhibited significantly greater (subclinical) emotional symptoms when compared with children of non-OCD parents. After controlling for parents' and children's depression and anxiety symptoms. OCD parents reported significantly poorer parenting attitudes overall relative to non-OCD parents. The presence of sexual/somatic obsessions in OCD parents predicted anxiety symptom severity among their children, but both relationships were mediated by parental involvement.

These findings indicate the importance of addressing and treating the distinctive parenting attitudes among people with OCD and its influence on their children's emotional symptoms.

Indexat a: WOS/JCR Factor Impacte: 0.452

Quartil: 4

Categoria: Psychology, Clinical

Posició: 129/131

Labad J, Salvat-Pujol N, Armario A, Cabezas Á, Arriba-Arnau A, Nadal R, Martorell L, Urretavizcaya M, Monreal JA, Crespo JM, Vilella E, Palao DJ, Menchón JM, Soria V. The Role of Sleep Quality, Trait Anxiety and Hypothalamic-Pituitary-Adrenal Axis Measures in Cognitive Abilities of Healthy Individuals.

Int J Environ Res Public Health. 2020 Oct 19;17(20):7600. doi: 10.3390/ijerph17207600. PMID: 33086584; PMCID: PMC7589840.

Abstract: Sleep disturbances accompany almost all mental illnesses, either because sound sleep and mental well-being share similar requisites, or because mental problems lead to sleep problems, or vice versa. The aim of this narrative review was to examine sleep in patients with delusions, particularly in those diagnosed with delusional disorder. We did this in sequence, first for psychiatric illness in general, then for psychotic illnesses where delusions are prevalent symptoms, and then for delusional disorder. The review also looked at the effect on sleep parameters of individual symptoms commonly seen in delusional disorder (paranoia, cognitive distortions, suicidal thoughts) and searched the evidence base for indications of antipsychotic drug effects on sleep. It subsequently evaluated the influence of sleep therapies on psychotic symptoms, particularly delusions. The review's findings are clinically important. Delusional symptoms and sleep quality influence one another reciprocally. Effective treatment of sleep problems is of potential benefit to patients with persistent delusions, but may be difficult to implement in the absence of an established therapeutic relationship and an appropriate pharmacologic regimen. As one symptom can aggravate another, comorbidities in patients with serious mental illness all need to be treated, a task that requires close liaison among medical specialties.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.849 Quartil: 2 Categoria: Public, Environmental & Occupational Health Posició: 58/193

Giné Servén E, Boix Quintana E, Martínez Ramírez M, Guanyabens Buscà N, Muriana Batiste D, Guasp M, Torres Rivas C, Davi Loscos E, Casado Ruiz V. Cycloid psychosis as a psychiatric expression of anti-NMDAR encephalitis. A systematic review of case reports accomplished with the authors' cooperation.

Brain Behav. 2020 Dec 3:e01980. doi: 10.1002/brb3.1980. Epub ahead of print. PMID: 33270360

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Abstract OBJECTIVE: We reviewed the psychotic symptoms of anti-NMDA receptor encephalitis (NMDARE) to differentiate its presentation from those found in a primary psychiatric disorder. We hypothesized that the cycloid psychosis (CP) phenotype would be a frequent clinical presentation in the psychiatric phase of NMDARE. METHOD: A systematic literature review in PubMed of all case reports published on NMDARE was performed from database inception to March 2020. We included all cases where psychotic symptoms were reported and whose diagnoses were confirmed by the presence of anti-NMDAR antibodies in the cerebrospinal fluid (CSF). An email including a short test (CP phenotype, Perris and Brockington's criteria) was sent to all case report authors asking them to describe the psychotic symptoms.

RESULTS: We identified 335 case reports fulfilling our criteria, and the authors of 200 replied. Our analyses were based exclusively on those answers and data extracted from the articles. Median patient age was 25 years (+11.4), 81% were female, and 39% had an ovarian teratoma. A complete CP phenotype was identified in 175 patients (87%). These were acute psychotic episodes with a sudden onset and a fluctuating clinical pattern mostly characterized by confusion (97%), delusions (75%), hallucinations (69%), motility disturbances (87%), and mood oscillations (80%).

CONCLUSION: The complete CP phenotype was frequently the expression of psychotic symptoms in NMDARE. We suggest that patients with a first psychotic episode who initially exhibit the CP phenotype should undergo CSF analysis to determine whether antibodies against neuronal cell surface or synaptic receptors are present to rule out a possible diagnosis of autoimmune encephalitis.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.091 Quartil: 3

Categoria: Behavioral Sciences

Posició: 34/53

Ahuir M, Crosas JM, Estrada F, Zabala W, Pérez-Muñoz S, González-Fernández A, Tost M, Aguayo R, Montalvo I, Miñano MJ, Gago E, Pàmias M, Monreal JA, Palao D, Labad J. Cognitive biases are associated with clinical and functional variables in psychosis: A comparison across schizophrenia, early psychosis and healthy individuals.

Rev Psiquiatr Salud Ment. 2020 Sep 16:S1888-9891(20)30099-9. English, Spanish. doi: 10.1016/j.rpsm.2020.07.005. Epub ahead of print. PMID: 32950409.

Abstract OBJECTIVE: We investigated the presence of cognitive biases in people with a recent-onset psychosis (ROP), schizophrenia and healthy adolescents and explored potential associations between these biases and psychopathology.

METHODS: Three groups were studied: schizophrenia (N=63), ROP (N=43) and healthy adolescents (N=45).

Cognitive biases were assessed with the Cognitive Biases Questionnaire for Psychosis (CBQ). Positive, negative and depressive symptoms were assessed with the PANSS and Calgary Depression Scale (ROP; schizophrenia) and with the CAPE-42 (healthy adolescents). Cannabis use was registered. The association between CBQ and psychopathology scales was tested with multiple linear regression analyses.

RESULTS: People with schizophrenia reported more cognitive biases (46.1±9.0) than ROP (40±5.9), without statistically significant differences when compared to healthy adolescents (43.7±7.3). Cognitive biases were significantly associated with positive symptoms in both healthy adolescents (Standardized β=0.365, p=0.018) and people with psychotic disorders (β=0.258, p=0.011). Cognitive biases were significantly associated with depressive symptoms in healthy adolescents (β=0.359, p=0.019) but in patients with psychotic disorders a significant interaction between schizophrenia diagnosis and CBQ was found (β=1.804, p=0.011), which suggests that the pattern differs between ROP and schizophrenia groups (positive association only found in the schizophrenia group). Concerning CBQ domains, jumping to conclusions was associated with positive and

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depressive symptoms in people with schizophrenia and with cannabis use in ROP individuals. Dichotomous thinking was associated with positive and depressive symptoms in all groups.

CONCLUSIONS: Cognitive biases contribute to the expression of positive and depressive symptoms in both people with psychotic disorders and healthy individuals.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 2.630 Quartil: 2

Categoria: Psychiatry

Posició: 72/155

Labad J, Melia CS, Segalàs C, Alonso P, Salvat-Pujol N, Real E, Ferrer Á, Jiménez-Murcia S, Soriano-Mas C, Soria V, Menchón JM. Sex differences in the association between obsessive-compulsive symptom dimensions and diurnal cortisol patterns.

J Psychiatr Res. 2020 Dec 14;133:191-196. doi: 10.1016/j.jpsychires.2020.12.017. Epub ahead of print. PMID: 33352399 Abstract: Previous studies in non-clinical populations suggest that obsessive-compulsive symptoms are associated with hypothalamic-pituitary-adrenal (HPA) axis measures and that there are sex differences in these associations. We aimed to replicate these findings in a sample of 57 patients with obsessive-compulsive disorder (OCD) and 98 healthy subjects. Current and lifetime OCD symptom dimensions were assessed with the Dimensional YaleBrown Obsessive Compulsive Scale (DY-BOCS). Depressive symptoms and state and trait anxiety were also assessed. The following HPA axis measures were analysed in saliva: the diurnal cortisol slope (calculated using two formulas: [1] awakening to 11 p.m. [AWE diurnal slope] and [2] considering fixed time points [FTP diurnal slope] from 10 a.m. to 11 p.m.) and the dexamethasone suppression test ratio (DSTR) after 0.25 mg of dexamethasone. Multiple linear regression analyses were conducted to explore the contribution of OCD symptom dimensions to each HPA axis measure while adjusting for age, sex, BMI, smoking, trait anxiety and depressive symptoms. A sex-specific association between current ordering/symmetry symptoms and AWE diurnal cortisol slope (positive association [flattened slope] in men, inverse association [stepper slope] in women) was found. Two similar sex by OCD dimensions interactions were found for lifetime aggressive and ordering/symmetry symptoms and both (FTP, AWE) diurnal cortisol slopes. Current and lifetime hoarding symptoms were associated to a more flattened FTP diurnal cortisol slope in women. The DSTR was not associated with OCD symptoms. The lifetime interference in functionality was associated with a more flattened AWE diurnal cortisol slope. In conclusion, our study suggests that there are sex differences in the association between OCD subtypes and specific HPA axis measures.

Indexat a: WOS/JCR Factor Impacte: 3.745

Quartil: 2

Categoria: Psychiatry

Posició: 42/155

Garcia-Fuentes G, Fernandez-Fernandez EP, Ferre Forcadell TD, Planet N, Batlle E, Giné-Servent E, Cañete J. Intento de suicidio con metanfetamina endovenosa y chemsex.

Rev Colomb Psiqui 2020; doi.org/10.1016/j.rcp.2020.09.002.

Abstract: El trastorno de déficit de atención e hiperactividad no diagnosticado es una condición comórbida frecuente en los trastornos por abuso de sustancias, y tiene un importante impacto en la vida de los pacientes, pues incrementa el riesgo de abuso de sustancias y el riesgo derivado de conductas impulsivas. En el momento actual no existen trabajos que estudien la relación entre el TDAH y el fenómeno emergente del chemsex, es decir, el Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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uso de sustancias psicoactivas en el contexto de fiestas sexuales para maximizar el tiempo de práctica sexual y de las experiencias subjetivas. En estas sesiones se usan diferentes sustancias como, por ejemplo, las catinonas sintéticas como la mefedrona, que podría inducir complicaciones médicas y psiquiátricas como psicosis, agresividad e ideación suicida. Un varón de 44 años ingresó en la unidad de agudos de psiquiatría tras un segundo intento de suicidio de alto riesgo con el uso de metanfetamina endovenosa mezclada con un ácido queratolítico, en el contexto de un episodio depresivo y práctica activa de sesiones de chemsex con una frecuencia semanal, en las que tomaba mefedrona vía transrectal, que provoca episodios puntuales de psicosis tóxica autolimatada. Se objetivó clínica compatible con TDAH no diagnosticado, y se aplicaron ASRS-V1.1 y WURS, que indicaron TDAH. Se ajustó el tratamiento antidepresivo y remitieron los síntomas depresivos y la ideación autolítica.

Indexat a: MEDLINE

Frías A. Alteraciones de la identidad en personas con trastorno límite de la personalidad. Una guía clínica para una psicoterapia colaborativa entre paciente y profesional.

Desclée De Brouwer. 1a Edición. Bilbao: 2020. 192 p.

Abstract: “No sé quién soy”, “soy muy contradictorio”, “soy un camaleón social”, “me siento fuera de mí”, “me siento medio hombre, medio mujer”, “mi criterio depende de mi estado emocional”, “soy mala persona”, etc. Todos ellos son ejemplos representativos de lo que sufren las personas diagnosticadas de Trastorno límite de la personalidad (TLP) como expresión última de las alteraciones de la identidad que acompañan a su patología.

Pese a que cada vez existe más y mejor información general sobre el TLP, las alteraciones de la identidad continúan siendo las grandes desconocidas y olvidadas en la evaluación y tratamiento de este trastorno. Como consecuencia de ello, los pacientes no pueden entender la profundidad de lo que les pasa ni la angustia resultante, perpetuándose dichos problemas ante la ausencia de recursos psicoterapéuticos pertinentes.

En dicha coyuntura, el presente libro pretende cubrir este déficit en la literatura con la finalidad de ejercer de puente para un diálogo terapéutico viable y eficaz entre paciente y clínico. A través de un lenguaje didáctico y un contenido exhaustivo, esta obra busca aportar luz y esperanza a los profesionales y a los afectados, que afrontan muchas preguntas sin respuestas convincentes cuando se encuentran con las alteraciones de la identidad en el TLP.

UNITAT DE RECERCA – RESEARCH UNIT Nº Articles indexats: 2

Factor Impacte total: 6.334

Factor d’impacte mig per article: 3.167

Mur Gimeno E, Campa F, Badicu G, Castizo-Olier J, Palomera-Fanegas E, Sebio-Garcia R. Changes in Muscle Contractile Properties after Cold- or Warm-Water Immersion Using Tensiomyography: A Cross-Over Randomised Trial.

Sensors (Basel). 2020 Jun 4;20(11). pii: E3193. doi: 10.3390/s20113193. PubMed PMID: 32512785; PubMed Central PMCID: PMC7308932.

Abstract: Muscle contractile properties in clinical practice are often measured using either subjective scales or high-cost, inaccessible equipment. In this randomised cross-over study, we aimed to explore the use of tensiomyography

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(TMG) to assess changes in muscle contractile properties after cold- and warm-water immersion. The muscle contractile properties of the biceps femoris (BF) were assessed using TMG in 12 healthy active men (mean age 23 ± 3 years, Body Mass Index 22.9 ± 1.3 kg/m2) before and after a 20-min warm- or cold-water immersion over a period of 40 min. Muscle displacement (Dm) and contraction time (Tc) were registered as the main variables of the study. There was a significant condition by time interaction for Dm (p < 0.01). Post hoc analysis showed that, compared to the baseline, there was an increase in Dm 40 min after warm-water immersion (p < 0.01) and a decrease at 10 min after cold-water immersion (p < 0.01). No significant effect was found for Tc. Our results indicate that muscle contractile properties are affected by water temperature and time after the immersion; therefore, these factors should be taken into account when water-immersion is used as a recovery strategy.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.031 Quartil: 1

Categoria: Instruments & Instrumentation

Posició: 15/64

Serra-Prat M, Lorenzo I, Papiol M, Palomera E, Bartolomé M, Pleguezuelos E, Burdoy E. Intracellular Water Content in Lean Mass as an Indicator of Muscle Quality in an Older Obese Population.

J Clin Med. 2020 May 22;9(5). pii: E1580. doi: 10.3390/jcm9051580. PubMed PMID: 32455974; PubMed Central PMCID: PMC7290582 Abstract BACKGROUND: In aged populations, muscle strength depends more on muscle quality than on muscle quantity, while all three are criteria for the diagnosis of sarcopenia. Intracellular water content (ICW) in lean mass (LM) has been proposed as an indicator of muscle quality related to muscle strength in older people.

OBJECTIVES: To evaluate the relationship between the ICW/LM ratio, muscle strength and indicators of functional performance in obese older adults, and to assess the value of the ICW/LM ratio as an indicator of muscle quality.

METHODOLOGY: Design: cross-sectional study.

POPULATION: persons aged 65-75 years with a body mass index of 30-39 kg/m2. ICW and LM were estimated by bioelectrical impedance. Hand grip, gait speed, unipedal stance test, timed up-and-go (TUG) test, Barthel score and frailty (Fried criteria) were assessed. Sarcopenia was established according to EWGSOP2 criteria.

RESULTS: Recruited were 305 subjects (66% women), mean age 68 years. The ICW/LM ratio correlated with the TUG test, gait speed and grip strength, and was also associated with sex, the unipedal stance test and frailty.

Independently of age, sex and muscle mass, the ICW/LM ratio was related with gait speed, the TUG test and unipedal stance capacity. One person (0.3%) had sarcopenia defined as low muscle strength and low muscle mass, while 25 people (8.2%) had sarcopenia defined as low muscle strength and poor muscle quality (ICW/LM).

With this last definition, sarcopenia was related to frailty, gait speed and the TUG test.

CONCLUSIONS: ICW content in LM could be a useful muscle quality indicator for defining sarcopenia. However, more studies are required to confirm our findings for other populations.

Indexat a: MEDLINE/WOS/JCR Factor Impacte: 3.303 Quartil: 1

Categoria: Medicine, General & Internal

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INDICADORS BIBLIOMÈTRICS GLOBALS CSDM 2020

92

91

Articles Publicats Articles Publicats

4

Articles Indexats Articles Indexats

Llibres/Capítols Llibres/Capítols

MEDLINE/PubMed/WOS/JCR

ARTICLES INDEXATS* PER SERVEI Total Psiquiatria Motilitat Digestiva Medicina Interna Oncologia Cirurgia General Neumologia Cirurgia Ortopèdica i Traumatologia Farmàcia Medicina Intensiva Neurologia Anestesiologia CEIm Medicina de Família Medicina Física i Rehabilitació Unitat de Recerca Alimentació i Dietètica Infermeria Oftalmologia Cirurgia Vascular Cardiologia Digestiu Endocrinologia Ginecologia & Obstetrícia Hematologia Pediatria

18 14 12 5 4 4 4 3 3 3 3 3 2 2 2 1 1 1 1 1 1 1 1 1 1

Articles autoria CSDM** 9 10 5 0 3 3 1 2 1 1 0 0 2 1 1 1 1 1 1 0 0 0 0 0 0

Articles col.laboratius 9 4 7 5 1 1 0 1 2 2 3 3 0 1 1 0 0 0 0 1 1 1 1 1 1

* MEDLINE/PubMed/WOS/JCR ** Articles amb primer, últim o corresponding autor del CSDM.

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FACTOR D’IMPACTE*

Total per Servei

CEIm

FI mig (segons nº articles indexats a JCR)

148.481

52.827

Motilitat Digestiva

45.171

3.226

Psiquiatria

41.770

2.320

Medicina Interna

33.167

2.763

Oncologia

24.922

6.230

Anestesiologia

17.287

8.643

Neumologia

14.250

3.563

Medicina Intensiva

12.156

4.052

Farmàcia

10.477

2.492

Neurologia

9.980

3.326

Cirurgia General

9.428

2.357

Medicina Física i Rehabilitació

7.840

3.920

Unitat de Recerca

6.334

3.167

Digestiu

4.000

4.000

Cardiología

3.902

3.902

Cirurgia Ortopèdica/Traumatologia 2.703

1.351

Hematologia

2.070

2.070

Ginecologia & Obstetrícia

2.037

2.037

Oftalmología

1.890

1.890

Medicina de Familia

1.833

1.833

Pediatria

1.635

1.635

Alimentació i Dietètica

0.888

0.888

* Font: Journal Citation Reports, JCR: 2019

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Publicacions Científiques CSDM 2020

6 Articles en el 1r Decil* * Font: Journal Citation Reports, JCR: 2019

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Biblioteca. Direcció Acadèmica, Recerca i Innovació.

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Biblioteca Consorci Sanitari del Maresmes. 2020

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