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Clinical hemorheology and microcirculation 12/2012; · 3.40 Impact Factor
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Clinical hemorheology and microcirculation 01/2011; 47(1):75-7. · 3.40 Impact Factor
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ABSTRACT: There are few studies on haemorheological disturbances in morbidly obese patients. The role played by the metabolic syndrome on the rheological profile of morbidly obese subjects has not yet been established, and it is not clear whether morbidly obese, but "metabolically healthy", show rheological alterations. We aimed to determine the whole rheological profile in 136 morbidly obese patients and 136 normo-weight volunteers, along with plasma lipids, inflammatory and insulin resistance parameters. Patients had statistically higher glucose, triglycerides, HbA1c, leptin, insulin, HOMA, CRP, leucocytes, fibrinogen, plasma viscosity (p < 0.001, respectively), erythrocyte aggregation at 3 s-1 (p = 0.011) and lower erythrocyte elongation index 60 Pa (p = 0.015). In the multivariate regression analysis, the anthropometric, lipidic, insulin resistance and inflammatory parameters predicted haemorheological variables (p < 0.001). No differences were observed for the rheological parameters when morbidly obese subjects with (n = 75) and without (n = 61) the metabolic syndrome were compared (p > 0.05), indicating that the altered rheological profile not only related to the metabolic syndrome, but to obesity itself. When further patients were classified as "metabolically healthy" obese (n = 23) and "metabolically unhealthy" obese (n = 113), the latter presented higher insulin resistance (insulin p < 0.01, HOMA p < 0.05, glucose p < 0.001, triglycerides p < 0.05 and HbA1c p < 0.01) than the former, but no differences in the rheological parameters (p > 0.05) were observed. When "metabolically healthy" obese (n = 23) were compared with "metabolically healthy" controls (n = 81), the former still showed higher HOMA (p < 0.001), triglycerides (p < 0.05), CRP (p < 0.001) and HbA1c (p < 0.05), higher fibrinogen (p < 0.001), plasma viscosity (p < 0.001), erythrocyte aggregation at 3 s-1 (p < 0.05), but a lower erythrocyte elongation index 60 Pa (p < 0.05). Morbidly obese subjects present a more pronounced altered rheological profile in those with metabolic alterations, although the "metabolically healthy" obese also displayed rheological alterations if compared with "metabolically healthy" non-obese controls. These rheological alterations relate to both insulin resistance and inflammation.
Clinical hemorheology and microcirculation 01/2011; 48(4):247-55. · 3.40 Impact Factor
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ABSTRACT: This study is designed to evaluate the frequency of periodontal disease in a group of patients with type 1 diabetes mellitus and how this relates with diabetes metabolic control, duration of diabetes, and presence of diabetic complications.
A comparison was made of periodontal parameters (plaque index, bleeding index, pocket depth and attachment loss) in a group of diabetic patients (n=90) versus a group of non-diabetics (n=90). Logistic regression analysis was performed to evaluate relationship between periodontal parameters and degree of metabolic control, the duration of the disease, and the appearance of complications.
Diabetics had greater bleeding index (p< 0.01), deeper periodontal pockets (p< 0.01) and more periodontal attachment loss (p< 0.01) than non-diabetics. Deficient metabolic control and presence of diabetic complication were associated with higher bleeding index and pocket depth (p<or= 0.02).
Patients with type 1 diabetes appear to show increased periodontal disease susceptibility, particularly those with poorer metabolic control or with diabetic complications.
Medicina oral, patologia oral y cirugia bucal 04/2009; 14(4):E175-9.
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ABSTRACT: Acinetobacter baumannii (AB) is a gram-negative organism that has emerged recently as a major cause of nosocomial infections, because of the extent of its antimicrobial resistance and its persistence in the hospital environment, where intensive care units are the place of greatest risk for acquiring AB. There is no treatment of choice for AB and it's treatment is based on clinical experience and in vitro susceptibility testing. Also, nowadays Acinetobacter resistance to carbapenems is common and isolates resistant to colistin and polymyxin B have been reported. Tigecycline, the 9-tert-butyl-glycylamido derivative of minocycline, exhibits a broad-spectrum of activity against numerous pathogens, including AB and several reports place it among the antimicrobials with lower MIC for AB. Tigecycline overcomes the two major mechanisms of resistance to tetracyclines (ribosomal protection and efflux), but tigecycline resistance emerging during therapy has been reported. Tigecycline efficacy has been demonstrated in clinical studies in skin and skin structure infections and in complicated intra-abdominal infections but, although it seems a good alternative for the treatment of AB infections, there is few evidence about its use in these cases and more clinical experience and adequate trials are needed. The present review shows the recent patents related to treatment by tigecycline in different AB infections.
Recent Patents on Anti-Infective Drug Discovery 07/2008; 3(2):117-22.
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ABSTRACT: To determine the association between the self-report of pain and disability and findings on lumbar MR images, and to compare two different health care providers in Spanish patients with low back pain (LBP).
Cross-sectional
A total of 278 patients, 137 men and 141 women aged 44+/-14 years submitted with low back pain (LBP) were studied. One hundred and nine patients were from the National Health System (NHS) and 169 from private practice. Patients with previous discitis, surgery, neoplasm or traumatic episodes were excluded. Every patient completed a disability questionnaire with six core items, providing a score of disability from 2 to 28. All patients had sagittal spin-echo T1 and turbo spin-echo T2, axial proton-density and MR myelography weighted images. MR images of the two most affected disc levels were read, offering an MR imaging score from 0 to 30.
Patients with a combination of LBP and sciatica showed the highest levels of disability (p=0.002). MR imaging scores only correlated with pain interference with normal work (p=0.04), but not with other disability questions. Patients from the NHS showed greater disability scores than private ones (p=0.001) and higher MR imaging scores (p=0.01).
In patients with LBP, MR imaging only correlates with pain interference with work but not with other disability questions. Differences are found between private and NHS patients, the latter being more physically affected.
Skeletal Radiology 10/2006; 35(9):641-7. · 1.54 Impact Factor
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ABSTRACT: The study was aimed at determining the association between the self-report of pain and disability by means of Northwick neck pain questionnaire (NPQ) and cervical spine MR imaging findings. A random sample of 251 patients, 132 men and 119 women aged 43+/-13 years, submitted with neck pain were investigated. Patients with previous discitis, surgery, neoplasm or hospitalized for cervical spine trauma were excluded. All patients completed the NPQ and were studied with sagittal gradient-echo T1 and turbo spin-echo T2, axial gradient-echo T2* and heavily T2 weighted MR myelographic weighted images. MR images of the two most affected disc levels were read, offering an MR imaging score from 0 to 30. There was no statistically significant correlation between NPQ and MR imaging scores. From the NPQ items, only difficulty in sleeping and numbness were related to the MR imaging score. Disc extrusion was the only MR finding almost significantly associated with NPQ (P=0.054). Neck injury did not increase NPQ scores. In patients with neck pain, NPQ scores do not correlate with MR imaging findings. NPQ and cervical spine MR imaging show different facets of the multidimensional complex of neck pain.
European Spine Journal 09/2006; 15(8):1183-8. · 1.97 Impact Factor
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ABSTRACT: To estimate the influence of the authors' country and collaboration on the probability of subsequent full publication of material from oral presentations at the 2000 European Congress of Radiology (ECR).
After searching the Medline database for articles published between 2000 and 2003, all articles that originated from presentations at the ECR in 2000 and were published in journals indexed in the Journal Citation Report were evaluated. Relative likelihood of full publication depending on the country in which an abstract originated was compared with that of Austria, which is the host country of the ECR. The chi(2) test was used to compare publication rates according to country of origin and collaboration. The median and interquartile range of the impact factor of publications according to country of origin and collaboration in the abstract were analyzed by using the Kruskal-Wallis test. The percentage of articles published in journals ranked in the top quartile (top 25% of journals according to impact factor) was calculated.
Of 1020 presentations, 403 articles (39%) with significant (P < .001) variations according to country of origin were identified. Studies originating from the United States had the highest percentage of full publication (62%; relative likelihood, 1.41), median impact factor (4.5), and percentage of articles in the top quartile (54%). Radiology was the top quartile journal, with the most articles published (60%). Impact factor differed according to country of origin (P < .001). Abstracts submitted with collaboration between (a) European countries and countries outside of Europe (other than the United States) and (b) different European countries had the highest publication rates (83% and 52%, respectively; P = .03).
The country of origin of an abstract was useful in predicting the chances of full publication of the abstract, with the United States having the highest publication rate. Authors were more likely to publish an article if it had been prepared with international collaboration.
Radiology 05/2006; 239(2):521-8. · 5.73 Impact Factor
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ABSTRACT: Diabetes mellitus is one of the most common chronic diseases in the general population. A study is made of the presence of caries in type 1 diabetic patients. The specific aim was to determine whether such patients present a greater incidence of dental caries than non-diabetic individuals. An evaluation was also made of the relationship of caries to salivary flow and to factors inherent to the disease such as the degree of metabolic control, the duration of diabetes, and the existence of chronic complications.
The study comprised 90 type 1 diabetics between 18 and 50 years of age, and a group of non-diabetic controls matched for age and sex. Visual and tactile exploration of the dentition was carried out in all cases. Oral hygiene was rated based on the O'Leary plaque index, and basal (unstimulated) and stimulated salivary flow were evaluated in both groups. In the diabetic group, correlations were established with disease control based on the mean glycosylated hemoglobin (HbA1c) value corresponding to the two years prior to examination; evolution of the disease in years; and the existence of complications such as diabetic neuropathy or retinopathy.
Under similar conditions of oral hygiene and salivary flow, the diabetic group showed a higher incidence of caries than the control group (p<0.05). Likewise, on specifically analyzing the diabetic group, metabolic control of the disease, the duration of diabetes, and the existence of complications of the disease exerted an influence upon the development of dental caries.
Qualitative salivary studies are advised to better account for this increased incidence of caries in the diabetic population.
Medicina oral, patologia oral y cirugia bucal 05/2006; 11(3):E256-60.
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ABSTRACT: According to the present case-control study about influenza vaccine acceptance among hospital workers, vaccination campaigns should focus mainly on predisposing and enabling factors, emphasizing the likelihood of acquiring influenza and the positive benefits to patients, addressing concerns about vaccine efficacy or safety, and minimizing the time required for the worker to undergo vaccination.
Infection Control and Hospital Epidemiology 02/2006; 27(1):73-7. · 3.67 Impact Factor
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ABSTRACT: To simplify the diagnostic features used by an artificial neural network compared with logistic regression (LR) in the diagnosis of calvarial metastasis with computed tomography and analyze their accuracy.
Twenty-one of 167 patients with calvarial lesions were found to have metastasis. Clinical and computed tomography data were used for LR and neural network models. Both models were tested with the leave-one-out method. The final results of each model were compared using the area under receiver operating characteristic curve (Az).
The neural network identified metastasis significantly more successfully than LR with an Az of 0.9324 +/- 0.0386 versus 0.9192 +/- 0.0373, P = .01. The most important features selected by the LR and neural network were age and edge definition.
Neural networks offer wide possibilities over statistics for the study of calvarial metastases other than their minimum clinical and radiologic features for diagnosis.
Academic Radiology 02/2004; 11(1):45-52. · 1.69 Impact Factor
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ABSTRACT: The effect of socioeconomic factors on avoidable mortality at an individual level is not well known, since most studies showing this association are based on aggregate data. The purpose of this study was to determine socioeconomic differences between those patients who die of avoidable causes and those who do not die.
A matched case-control study was carried out regarding in-hospital avoidable mortality (Holland's medical care indicators) that occurred in a university hospital serving a Spanish-Mediterranean population during a 30-month period.
We studied 82 cases of death from avoidable causes and 300 controls matched on medical care indicators and age. The variables that showed a statistically significant association with in-hospital avoidable mortality were number of diagnoses (the greater the number, the higher the risk), length of stay (patients staying seven or more days presented a lower risk), and education. Those patients with low and middle educational levels showed a greater risk of avoidable mortality (adjusted odds ratio=3.57 and 2.82, respectively) than those patients with higher levels of education.
Consistent with the findings of studies based on aggregate data, our case-control analyses indicated that among several socioeconomic variables studied, educational level was significantly associated with the risk of in-hospital avoidable mortality, regardless of age and medical care indicators. Patients with low levels of education (<6 years of schooling) were at highest risk for in-hospital avoidable mortality, followed by those with middle levels of education (7-10 years of schooling).
Public Health Reports 120(1):55-62. · 1.27 Impact Factor
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ABSTRACT: Objectives: Diabetes mellitus is one of the most common chronic diseases in the general population. A study is made of the presence of caries in type 1 diabetic patients. The specific aim was to determine whether such patients present a greater incidence of dental caries than non-diabetic individuals. An evaluation was also made of the relationship of caries to salivary flow and to factors inherent to the disease such as the degree of metabolic control, the duration of diabetes, and the existence of chronic complications. Study design: The study comprised 90 type 1 diabetics between 18 and 50 years of age, and a group of non-diabetic controls matched for age and sex. Visual and tactile exploration of the dentition was carried out in all cases. Oral hygiene was rated based on the O�Leary plaque index, and basal (unstimulated) and stimulated salivary flow were evaluated in both groups. In the diabetic group, correlations were established with disease control based on the mean glycosylated hemoglobin (HbA1c) value corresponding to the two years prior to examination; evolution of the disease in years; and the existence of complications such as diabetic neuropathy or retinopathy. Results: Under similar conditions of oral hygiene and salivary flow, the diabetic group showed a higher incidence of caries than the control group (p<0.05). Likewise, on specifically analyzing the diabetic group, metabolic control of the disease, the duration of diabetes, and the existence of complications of the disease exerted an influence upon the development of dental caries. Conclusions: Qualitative salivary studies are advised to better account for this increased incidence of caries in the diabetic population. Objetivos: La diabetes mellitus es una de las enfermedades crónicas más prevalentes en población general. Se presenta un estudio que pretende evaluar la presencia de caries en los pacientes diabéticos tipo 1. El objetivo específico era comprobar si había o no mayor incidencia de caries en diabéticos tipo 1 comparándolos con un grupo de individuos no diabéticos. También, se comprobó la relación con las tasas de flujo salival y con los factores propios de la enfermedad como el grado de control metabólico, el tiempo de evolución de la enfermedad y la existencia de complicaciones crónicas. Diseño del estudio: Se estudiaron 90 diabéticos tipo 1 de edades comprendidas entre los 18 y los 50 años de edad y un grupo de pacientes controles no diabéticos pareados por edad y sexo. Se realizó una exploración visual y táctil, en todos los dientes de los sujetos explorados. Se tuvo en cuenta el grado de la higiene oral mediante el índice de placa de O�Leary, y se estudiaron las tasas de saliva basal y estimulada en ambos grupos. En el grupo diabético se relaciono con el control de la enfermedad mediante la obtención de la media de la hemoglobina glicosilada (HbA1c) de los dos años previos a la exploración, así como la evolución de su enfermedad en años y la existencia de complicaciones como neuropatía diabética o retinopatía. Resultados: Bajo similares condiciones de higiene oral y de flujo salival, el grupo diabético resultó tener una incidencia de caries mayor que el grupo control (p<0.05). Asimismo, al estudiar específicamente al grupo diabético, ni el control metabólico de la enfermedad, ni la evolución de la enfermedad, ni la existencia de complicaciones de la diabetes tenían influencia en la instauración de caries dental. Conclusiones: Se sugiere que habría que estudiar factores cualitativos salivales que explicasen esta mayor incidencia de caries en los diabéticos.
Medicina oral, patología oral y cirugía bucal, ISSN 1698-4447, Vol. 11, Nº. 3, 2006, pags. 162-166.
