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Characteristics and in-hospital mortality of elderly patients with heart failure in spanish hospitals

Journal of Geriatric Cardiology 2023年第4期20卷 247-255页

作者： Alberto Esteban-Fernández manuel anguita-sánchez Juan Luis Bonilla-Palomas María anguita-Gámez María García JoséLuis Bernal Náyade Del Prado Cristina Fernández-Pérez Julián Pérez-Villacastin Juan JoséGómez-Doblas Francisco Javier Elola Cardiology Department Hospital Universitario Severo OchoaMadridSpain Cardiology Department Hospital Universitario Reina SofíaCórdobaSpain Cardiology Department Hospital San Juan de la CruzÚbedaSpain Cardiology Department Hospital Clínico San CarlosMadridSpain Fundación Instituto para la Mejora de la Asistencia sanitaria MadridSpain Management Control Department Hospital Universitario 12 de OctubreMadridSpain Department of Preventive Medicine Área Sanitaria de Santiago de Compostela y BarbanzaInstituto de Investigación de SantiagoSantiago de CompostelaSpain Cardiology Department Hospital Universitario Virgen de la VictoriaMálagaSpain

BACKGROUND The prevalence of heart failure(HF)increases with age,and it is one of the leading causes of hospitalization and death in older patients.However,there are little data on in-hospital mortality in patients with HF≥75 years in spain.METHODs A retrospective analysis of the spanish Minimum Basic Data set was performed,including all HF episodes discharged from public hospitals in spain between 2016 and 2019.Coding was performed using the International Classification of Diseases,10th Revision.Patients≥75 years with HF as the principal diagnosis were selected.We calculated:(1)the crude in-hospital mortality rate and its distribution according to age and sex;(2)the risk-standardized in-hospital mortality ratio;and(3)the association between in-hospital mortality and the availability of an intensive cardiac care unit(ICCU)in the hospital.REsULTs We included 354,792 HF episodes of patients over 75 years.The mean age was 85.2±5.5 years,and 59.2%of patients were women.The most frequent comorbidities were renal failure(46.1%),diabetes mellitus(35.5%),valvular disease(33.9%),cardiorespiratory failure(29.8%),and hypertension(26.9%).In-hospital mortality was 12.7%,and increased with age[odds ratio(OR)=1.07,95%CI:1.07–1.07,Ps lower in women(OR=0.96,95%CI:0.92–0.97,Ps of mortality were the presence of cardiogenic shock(OR=19.5,95%CI:16.8–22.7,Pstroke(OR=3.5,95%CI:3.0–4.0,Pspitals with ICCU,the in-hospital risk-adjusted mortality tended to be lower(OR=0.85,95%CI:0.72–1.00,P=0.053).CONCLUsIONs In-hospital mortality in patients with HF≥75 years between 2016 and 2019 was 12.7%,higher in males and elderly patients.The main predictors of mortality were cardiogenic shock,stroke,and advanced cancer.There was a trend toward lower mortality in centers with an ICCU.

关键词： patients mortality diagnosis

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Real-World Evidence in Localized Pancreatic: Coping with Uncertainty in Unselected Populations

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Journal of Cancer Therapy 2024年第4期15卷 164-178页

作者： María I. Pamies Ramón Diana Ibarra anguita Paula Rodríguez Payá Alvaro Muñoz Abad David sánchez García María Valero Revert Beatriz Grau Mirete Mariano Martínez Marín Alicia Calero Amaro Lorena Rodríguez Cazalla Javier Gallego Plazas Medical Oncology Department Elche University Hospital Elche (Alicante) Spain General surgery Department Elche University Hospital Elche (Alicante) Spain General surgery Department Vega Baja Hospital Orihuela (Alicante) Spain

Background: Localized pancreatic cancer, including resectable (R), borderline resectable (BR) and locally advanced unresectable disease (LAU), is considered in clinical guidelines for diverse treatment options based on clinical trials in selected populations. Hence, exploring with real world evidence (RWE) clinicians’ preferences for treatment options and their results seems pertinent. Methods: In a set of consecutive patients with localized pancreatic cancer assisted in a third level hospital from January 2013 to December 2022, medical records, symptoms, diagnostic process, distribution between subtypes, and treatment plans, with safety and efficacy results, were assessed. Results: A total of 152 patients with localized disease were included (43.4% R, 21.0% BR, 33.6% LAU). The population characteristics exemplified differences between daily practice and clinical trials. Tumor location and symptoms were as expected. Treatment plan was conditioned by Ps or comorbidities in 23.0% of patients. In patients with R disease, surgery followed by different adjuvant chemotherapy (CT) regimes was the antineoplastic treatment of choice (64.8%) with efficacy results (Os 37.5 months;95% CI 18.4 - 56.7), in the range of contemporary standards. The common use of neoadjuvant CT for BR disease (94.4%), with surgery in 50% of them, and its results (Os 30.8 months;95% CI 10.5 - 51.2) reflected current controversies of treatment recommendations and evolution in this scenario. Paliative CT with or without radiotherapy was the standard specific treatment in LAU disease (95.1%) with survival results (PFs: 10.8 months;95% CI 8.8 - 12.7. Os: 20.3 months;95% CI 13.5 - 27.2) that justify the distinct character and the specific study of this entity. Conclusion: RWE for localized pancreatic cancer aroused from the analysis of this population confirms the distinct nature of patients assisted in daily practice, as well as mirrors the complexity of decision making in clinical assumptions in which achieving stronger evidence should be paramount.

关键词： Real-World Evidence Localized Pancreatic Cancer

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Effect of surfactants on the Thermoelectric Performance of Double-Walled Carbon Nanotubes

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Energy & Environmental Materials 2023年第1期6卷 274-280页

作者： Zakaria saadi simon G.King Jose V.anguita Vlad stolojan s.Ravi P.silva Department of Electrical and Electronic Engineering Advanced Technology InstituteUniversity of SurreyGuildford GU27XHUK

Thermoelectrics are a promising solution to the recovery of some of the 60%of the worldwide energy wasted as heat.However,their conversion efficiency is low and the best performing materials are brittle,toxic,and made of expensive ceramics.The challenge in developing better performing materials is in disrupting the electrical vs thermal conductivity correlation,to achieve low thermal conductivity simultaneously with a high electrical conductivity.Carbon nanotubes allow for the decoupling of the electronic density of states from the phonon density of states and this paper shows that flexible,thin films of double-walled carbon nanotube(DWCNT)can form effective n-and p-doped semiconductors that can achieve a combined seebeck coefficient of 157.6µV K^(−1),the highest reported for a single DWCNT device to date.This is achieved through selected surfactant doping,whose role is correlated with the length of the hydrocarbon chain of the hydrophobic tail group of the surfactant’s molecules.CNTs functionalized with Triton X-405 show the highest output power consisting of a single junction of p-and n-type thermoelectric elements,reaching as high as 67 nW for a 45 K temperature gradient.Thus enabling flexible,cheaper,and more efficient thermoelectric generators through the use of functionalized CNTs.

关键词： carbon nanotubes DWCNT functionalization surfactant thermoelectric

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serum levels of the novel adipokine isthmin-1 are associated with obesity in pubertal boys

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World Journal of Pediatrics 2023年第9期19卷 864-872页

作者： Francisco Javier Ruiz‑Ojeda Augusto anguita‑Ruiz Maria C.Rico Rosaura Leis Gloria Bueno Luis A.Moreno Mercedes Gil‑Campos Ángel Gil Concepción M.Aguilera Department of Biochemistry and Molecular Biology Ⅱ School of PharmacyUniversity of GranadaGranadaSpain Instituto de Investigación Biosanitaria Ibs.GRANADA 18012 GranadaSpain Institute of Nutrition and Food Technology“JoséMataix” Center of Biomedical ResearchUniversity of GranadaAvda.del Conocimiento S/N.18016 ArmillaGranadaSpain RG Adipocytes and Metabolism Institute for Diabetes and ObesityHelmholtz Center Munich85764 MunichGermany Barcelona Institute for Global Health ISGlobal08003 BarcelonaSpain CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038)Institute of Health Carlos Ⅲ(ISCⅢ)28029 MadridSpain Unit of Investigation in Human Nutrition Growth and Development of Galicia(GALINUT)University of Santiago de Compostela(USC)Santiago de CompostelaSpain Pediatric Nutrition Research Group Institute of Sanitary Research of Santiago de Compostela(IDIS)CHUS-USC15706 Santiago de CompostelaSpain Unit of Pediatric Gastroenterology Hepatology and NutritioPediatric ServiceUniversity Clinical Hospital of Santiago(CHUS)15706 Santiago de CompostelaSpain GENUD Research group Institute of Sanitary Research of Aragón(IIS Aragón)University of ZaragozaZaragozaSpain Instituto Agroalimentario de Aragón(IA2) Universidad de Zaragoza-CITAZaragozaSpain Unit of Pediatric Endocrinology University Clinical Hospital Lozano Blesa50009 ZaragozaSpain Metabolism and Investigation Unit Reina Sofa University HospitalMaimónides Institute of Biomedicine Research of Córdoba(IMIBIC)University of Córdoba14071 CórdobaSpain

Objectives To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1(IsM1)and obesity-related phenotypes in a population of spanish children and to investigate the plausible molecular alterations behind the alteration of the serum levels of this protein in children with obesity.Methods The study population is a sub-cohort of the PUBMEP research project,consisting of a cross-sectional population of 119 pubertal children with overweight(17 boys,19 girls),obesity(20 boys,25 girls),and normal weight(17 boys,21 girls).All subjects were classified into experimental groups according to their sex,obesity,and insulin resistance(IR)status.They were counted anthropometry,glucose and lipid metabolism,inflammation and cardiovascular biomarkers as well as isthmin-1(IsM1)serum levels.This population was intended as a discovery population to elucidate the relationship between obesity and IsM1 levels in children.Furthermore,the study population had blood whole-genome DNA methylation examined,allowing deepening into the obesity–IsM1 molecular relationship.Results Higher serum IsM1 levels were observed in boys with obesity than in normal weight(P=0.004)and overweight(P=0.007)boys.IsM1 serum levels were positively associated with body mass index(BMI)Z-score(P=0.005)and fat mass(P=0.058)and negatively associated with myeloperoxidase(MPO)(P=0.043)in boys.Although we did not find associations between IsM1 serum levels and metabolic outcomes in girls,which may indicate a putative sexual dimorphism,fat mass was positively associated in all children,including boys and girls(P=0.011).DNA methylation levels in two-enhancer-related CpG sites of IsM1(cg03304641 and cg14269097)were associated with serum levels of IsM1 in children.Conclusions IsM1 is associated with obesity in boys at the pubertal stage,elucidating how this protein might be of special relevance as a new biomarker of obesity in children.Further studies including a longitudinal design during puberty are needed.

关键词： Children Epigenetics Isthmin-1 Obesity Puberty

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Community‑based screening of Chagas disease among Latin American migrants in a non‑endemic country: an observational study

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Infectious Diseases of Poverty 2021年第5期10卷 14-27页

作者： Violeta Ramos‑sesma Miriam Navarro Jara Llenas‑García Concepción Gil‑anguita Diego Torrus‑Tendero Philip Wikman‑Jorgensen María García‑López Concepción Amador‑Prous María‑Paz Ventero‑Martín Pedro Guevara‑Hernández Ana Garijo‑saiz Ares sanchez‑sanchez Cristina Bernal‑Alcaraz Ana‑Isabel Pujades‑Tarraga Roser Muñoz‑Perez María Flores‑Chávez José‑manuel Ramos‑Rincón Internal Medicine service HLA Inmaculada HospitalGranadaSpain Public Health Science History and Gynecology DepartmentUniversidad Miguel Hernández de ElcheAlicanteSpain Epidemiology Unit Public Health Center of Elche AlicanteSpain Internal Medicine Department Hospital Vega Baja de Orihuela(AlicanteSpain)-Foundation for the Promotion of Health and Biomedical Research of the Valencia Region(FISABIO)AlicanteSpain Clinical Medicine Department University Miguel Hernández of ElcheSant Joan d’AlacantSpain Internal Medicine Department Hospital Marina BaixaLa Vila Joiosa(AlicanteSpain)-FISABIOAlicanteSpain Internal Medicine Department General University Hospital of Alicante–Biomedical and Health Research Institute of Alicante(ISABIAL)AlicanteSpain Parasitology Area University Miguel Hernández of ElcheSant Joan d’AlacantSpain Internal Medicine Department University Hospital of Sant Joan(Sant Joan d’AlacantSpain)–FISABIOAlicanteSpain Microbiology service General University Hospital of Alicante–ISABIALAlicanteSpain Pediatric Department General University Hospital of Alicante–ISABIALAlicanteSpain Digestive service General University Hospital of Alicante–ISABIALAlicanteSpain Reference and Research Laboratory in Parasitology National Center of Microbiology/Mundo Sano FoundationMadridSpain

Background:Chagas disease is a parasitic disease endemic to Latin America,but it has become a disease of global concern due to migration fows.Asymptomatic carriers may host the parasite for years,without knowing they are infected.The aim of this study is to assess prevalence of Chagas disease and evaluate the participants’level of knowl‑edge between Latin American migrants attending a community-based screening campaign.Methods:Three community-based campaigns were performed in Alicante(spain)in 2016,2017 and 2018,including educational chats and blood tests for Trypanosoma cruzi serology.Participants completed a questionnaire assessing knowledge about the mechanisms of transmission,disease presentation,diagnosis,and treatment.People seroposi‑tive for T.cruzi underwent diagnostic confrmation by two diferent tests.Results were analyzed by multivariable logistic regression and expressed as adjusted odds ratios(aORs),adjusting for age,sex,and time in spain.Results:A total of 596 participants were included in the study;17%were aged under 18 years.Prevalence in adults was 11%[54/496;95%confdence interval(CI):8.3–14.5%]versus 0%among children.All but one case were in Bolivians.Diagnosis was independently associated with having been born in Bolivia(aOR:102,95%CI:13–781)and a primary school-level education(aOR:2.40,95%CI:1.14–5.06).Of 54 people diagnosed with Chagas disease(most of whom were asymptomatic),42(77.7%)returned to the clinic at least once,and 24(44.4%)received treatment.Multivariable analysis showed that coming from Argentina(aOR:13,95%CI:1.61–1188)or Bolivia(aOR:1.90,95%CI:1.19–3.39)and having received information about Chagas disease in spain(aOR:4.63,95%CI:2.54–8.97)were associ‑ated with a good level of knowledge on the disease.Having primary level studies(aOR:0.59,95%CI:0.34–0.98)and coming from Ecuador(aOR:4.63,95%CI:2.52–847)were independently associated with a lower level of knowledge.Conclusions:Community-based interventions are a good strategy for diagnosing neglected diseases such as Chagas disease in

关键词： Chagas disease Trypanosoma cruzi Knowledge Community-based intervention Migrant Early diagnosis screening

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sexist Prejudice of Primary school Children in Different Urban and Rural Contexts of spain

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Journal of Contemporary Educational Research 2018年第4期2卷 6-9页

作者： Oscar Navarro Juana Maria anguita Angel Luis Gonzalez Francisco Javier sanchez-Verdejo Department of Pedagogy University of Castilla-La ManchaCiudad RealSpain

At present,a great deal of historical gender prejudice is still visible in society.It is essential to eliminate these invisible barriers that impede achieving real equality between men and women.This article seeks to provide a vision of the perception of primary school girls and boys regarding the masculine and feminine genders.A questionnaire was given to groups of schoolchildren in different locations,including rural areas and large cities such as Madrid,the capital of spain.In addition to detect prejudice toward one of the two genders,some of the most often repeated answers were taken into account.On several occasions,one of the two sexes,or the two,was linked to intelligence or to the ideal of beauty.However,differences were not observed in all cases.Comments are made on the most relevant data regarding the predisposition among children to link girls with more passive attitudes than boys.For many years,society has fought to achieve real equality between the two sexes.However,there is still a great deal to be done,and the younger generations have the responsibility of succeeding in having the two sexes live together in a more egalitarian society.The role of education is to encourage this process.

关键词： prejudices stereotype gender children primary school

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在与心肌的梗塞介绍的就医的病人的心率的预示的意义

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World Journal of Cardiology 2012年第1期4卷 15-19页

作者： Lorenzo Fácila Pedro Morillas Juan Quiles Federico soria Alberto Cordero Pilar Mazón manuel anguita Cándido Martín-Luengo Jose Ramón Gonzalez-Juanatey Vicente Bertomeu Department of Cardiology Consorcio Hospitalario General de Valencia Department of Cardiology Hospital Universitario de San Juan Department of Cardiology Hospital Virgen de la Arrixaca Department of Cardiology Hospital Clínico Universitario Santiago de Compostela Department of Cardiology Hospital Reina Sofía Department of Cardiology Hospital Universitario de Salamanca

AIM: To investigate the prognostic significance of resting heart rate in patients with acute coronary syndrome (ACs), independent of other known factors. METHODs: Patients 40 years of age or older who had been admitted with acute coronary syndrome (ACs) to one of the 94 hospitals participating in the Prevalence of Peripheral Arterial Disease in Patients with Acute Coronary syndrome (PAMIsCA) study were included. Patients were divided into two groups based on their resting heart rate (HR ≥ or s were recording during a follow-up period of 1 year. REsULTs: There were 1054 ACs patients analyzed (43.5% with sT segment elevation and 56.5% without elevation). Mean age was 66.6 ± 11.7 years, 70.6% were male and 29.4% of subjects were female. During follow-up, more patients in the HR ≥ 70 bpm group were hospitalized for heart failure and they also had a higher mortality rate. In the multivariate analysis, a heart rate of ≥ 70 bpm was independently related to overall mortality during the follow-up period (hazard ratio 2.5; 95% confidence interval, 1.26-4.97, P = 0.009). CONCLUsION: A resting heart rate ≥ 70 bpm in patients who survive an ACs is an indicator of a high risk of suffering cardiovascular events during follow-up.

关键词： Heart rate Myocardial infarction Prognosis

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