114 results on '"Gasalla, M."'
Search Results
2. Consenso multidisciplinar sobre prevención y tratamiento de la tuberculosis en pacientes candidatos a tratamiento biológico. Adaptación al paciente dermatológico
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Rodríguez-Jiménez, P., Mir-Viladrich, I., Chicharro, P., Solano-López, G., López-Longo, F.J., Taxonera, C., Sánchez-Martínez, P., Martínez-Lacasa, X., García-Gasalla, M., Dorca, J., Arias-Guillén, M., García-García, J.M., and Dauden, E.
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- 2018
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3. Towards a better future for biodiversity and people: Modelling Nature Futures
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Kim, H., Peterson, G., Cheung, W., Ferrier, S., Alkemade, R., Arneth, A., Kuiper, J., Okayasu, S., Pereira, L., Acosta, L., Chaplin-Kramer, R., den Belder, E., Eddy, T., Johnson, J., Karlsson-Vinkhuyzen, S., Kok, M., Leadley, P., Leclere, D., Lundquist, C., Rondinini, C., Scholes, R., Schoolenberg, M., Shin, Y.-J., Stehfest, E., Stephenson, F., Visconti, P., van Vuuren, D., Wabnitz, C., José Alava, J., Cuadros-Casanova, I., Davies, K., Gasalla, M., Halouani, G., Harfoot, M., Hashimoto, S., Hickler, T., Hirsch, T., Kolomytsev, G., Miller, B., Ohashi, H., Gabriela Palomo, M., Popp, A., Paco Remme, R., Saito, O., Rashid Sumalia, U., Willcock, S., Pereira, H., Kim, H., Peterson, G., Cheung, W., Ferrier, S., Alkemade, R., Arneth, A., Kuiper, J., Okayasu, S., Pereira, L., Acosta, L., Chaplin-Kramer, R., den Belder, E., Eddy, T., Johnson, J., Karlsson-Vinkhuyzen, S., Kok, M., Leadley, P., Leclere, D., Lundquist, C., Rondinini, C., Scholes, R., Schoolenberg, M., Shin, Y.-J., Stehfest, E., Stephenson, F., Visconti, P., van Vuuren, D., Wabnitz, C., José Alava, J., Cuadros-Casanova, I., Davies, K., Gasalla, M., Halouani, G., Harfoot, M., Hashimoto, S., Hickler, T., Hirsch, T., Kolomytsev, G., Miller, B., Ohashi, H., Gabriela Palomo, M., Popp, A., Paco Remme, R., Saito, O., Rashid Sumalia, U., Willcock, S., and Pereira, H.
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The Nature Futures Framework (NFF) is a heuristic tool for co-creating positive futures for nature and people. It seeks to open up a diversity of futures through mainly three value perspectives on nature – Nature for Nature, Nature for Society, and Nature as Culture. This paper describes how the NFF can be applied in modelling to support decision-making. First, we describe key considerations for the NFF in developing qualitative and quantitative scenarios: i) multiple value perspectives on nature as a state space where pathways improving nature toward a frontier can be represented, ii) mutually reinforcing key feedbacks of social-ecological systems that are important for nature conservation and human wellbeing, iii) indicators of multiple knowledge systems describing the evolution of complex social-ecological dynamics. We then present three approaches to modelling Nature Futures scenarios in the review, screening, and design phases of policy processes. This paper seeks to facilitate the integration of relational values of nature in models and strengthen modelled linkages across biodiversity, nature’s contributions to people, and quality of life.
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- 2023
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4. Deliverable 3.2. Maps of present ecosystem pressures (fishing, shipping, pollution and other)
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Fernandes, J.A., Mateo, M., Sagarminaga, Y., Lekunberri, X., Furey, T., Kozachenco, M., Pedreschi, D., Proud, R., Ostle, C., Shannon, L., Sink, K., Skein, L., Majiedt, P., Souza, V. A., Garcia Scherer, M. E., Gasalla, M. A., Ribeiro Gandra, T. B., Floeter, S. R., Bonetti, J., Ramirez, E., Llope, M., Gomes, I., Serrano, D., Pham, C., Afonso, P., Brierley, A., and Chust, G.
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The goal of this deliverable is to assess availability of FAIR spatial data about human activity using global datasets, and to identify obstacles (knowledge gaps) to mapping their corresponding environmental pressures at the scale of the Atlantic Ocean basin to support ecosystem-based management. It also provides advice towards improving mapping based on machine learning/artificial intelligence (AI). WP1 & 7 identified the sectors affecting the marine environment, the pressures they create, and the ecological characteristics affected. Eighteen sectors, with 19 associated pressures that could impact 25 different ecosystem components were identified. In this deliverable, only the widely distributed sectors relevant across the whole ocean are considered: fishing, shipping, aquaculture, oil exploitation, telecommunications, scientific exploration and seabed minerals. Fishing intensity by main groups of fishing gears has been estimated by supervised classification of Automatic Identification System (AIS) data. These approaches have been able to distinguish between fishing and routing activity of individual vessels, while assigning up to 7 main fishing gear types. These are aggregated here into pelagic and bottom fishing activities to match the grouping of ecosystem components in these two groups. AIS data is most useful in the high seas since in coastal areas, smaller vessels do not require AIS, except in some regions of Europe. At the Canary Current Sea CS pelagic fishing shows the highest intensities around the Canaries and Cabo Verde archipelagos and all the way from western Sahara to Guinea-Bissau. On the contrary, bottom trawling concentrates closer to the coast off the coasts of northern Morocco and from western Sahara to Guinea-Bissau. At North Mid Atlantic Ridge CS scale, AIS data shows pelagic fishing is widely distributed except in the northern part, and bottom fishing seems to be concentrated on the Islands. At South Mid Atlantic Ridge CS, scale AIS data shows a wide distribution of pelagic fishing whereas bottom fishing seems to be poorly covered. At Brazilian Shelf CS scale, bottom and pelagic fishing are widely distributed on the area. Shipping activities can be also inferred from AIS data. AIS systems reporting position through a satellite system are mandatory in all passenger ships irrespective of size, all vessels > 300 MT (gross) transiting international routes, and any cargo ship > 500 MT transiting within national waters. Global patterns reveal that highest shipping intensity is concentrated in coastal areas with narrow routes connecting Asia, Africa and Europe. Connectivity between these continents and America is broader with a medium intensity over large areas. This can be observed in the Europe connection with North America, Europe connection to South America, South Africa connection with South America and in the connection of Asia with North America and with Australia. At the Atlantic scale, the areas of highest shipping intensity are concentrated in European coastal waters. These higher intensity paths cross the southern Celtic Sea, Canary Current, and western Benguela Current case studies. The rest of the case studies also contain relatively high intensity paths, but not as extreme. The large area covered by high intensity paths in Canary Current, Benguela Current and South Brazilian Shelf case studies is noteworthy. The North Mid Atlantic has moderate intensity paths covering most of its area with two higher intensity paths crossing it. The Norwegian Sea and the South Mid Atlantic Ridge case studies include large areas of low shipping intensity. We focus on three main sources of pollution: 1) Marine litter (widespread diffuse input), and in particular plastics (microplastics and macroplastics) and 2) Aquaculture platforms, as proxy of marine pollution sources (point source). feed, leading to major environmental concerns. 3) River discharges and nutrients (in between widespread and point source). Although river discharge and associated nutrients are a natural pressure in the coastal environment, anthropogenically polluted rivers can significantly alter the health of marine ecosystems, especially as metallic pollutants are associated with sediments. Open litter data is sparse and focused mainly on European waters. Continuous Plankton Recorder, which can also be used to sample plastics, covers not only European waters, but also an important part of Northwest Atlantic area. After revising multiples sources of river discharges and nutrients discharges the WaterGAP 2.2d model and the Global River Water Quality Archive have been identified as the best sources of data at the Atlantic Ocean and global scales. Aquaculture data is very limited even in European open datasets and it can be addressed applying machine learning to satellite data. Other seabed related data include oil exploitation, telecommunications, scientific exploration and seabed minerals. These data are integrated for European waters in EMODnet Seabed Habitats. In the Norwegian Sea, Celtic Sea, Benguela Current and South Brazilian Shelf additional local sources of oil exploitation data were available. In terms of telecommunications data, published data are predominantly landing stations and schematic routes. Regarding accurate spatial data on scientific surveys, only a few openly available sources have been identified at national and regional levels, and metadata are not standardised to be able to easily identify specific locations. Seabed mineral potential has been collated by EMODnet Seabed Habitats for most of the case study areas, except for the Benguela Current where local data were provided. Additional seabed mineral data were also provided for the South Brazilian Shelf, North Mid Atlantic Ridge and Benguela Current case study areas. The term big data was coined to capture the meaning of the emerging trend in large and heterogeneous data exploitation. In addition to its sheer volume, big data exhibit other unique characteristics as compared with traditional data. For instance, big data are commonly unstructured and require real-time analysis. This development calls for new computer science related system architectures for data acquisition, transmission, storage, and large-scale data processing mechanisms. Big data techniques enhanced by machine learning methods can increase the use of such data and their applicability to ecosystem-based management. Machine learning has already proven its potential in marine science. It has been applied, for example, to fisheries forecasting, automatic classification of plankton samples, identification of schools by species of fish in acoustic survey data, litter classification and litter forecasting. However, if AI methods are not fit for purpose, then trade-offs to accomplish appropriate performances can be missed or overfitting can lead to over confidence on AI capacity if proper validation and ground truth verification is not performed. This report highlights big data and machine learning-based datasets that are available to perform assessments at the level of the whole Atlantic Ocean. These datasets focus on the activities that impact open-ocean marine environments (shipping, fishing and litter) and coastal areas (river discharges and flows, and the growing aquaculture activity). The differentiation between fishing and non-fishing (e.g. travel) activities of fishing vessels as well as distinguishing the fishing gear is needed to go from mapping activities to pressures. For example, a fishing vessel en route to a fishing site will generate different levels and types of noise and emissions than it will whilst fishing. Noise and emissions will also differ depending on the fishing gear being used. Furthermore, the highest direct pressure exerted on the ecosystem occurs during fishing due to the removal of fish and bycatch, or litter generation from losing fishing gear and/or onboard activities. Members of ICES working group WGSHIP are actively working on the development of a conceptual framework for mapping the pressures and impacts of shipping.
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- 2023
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5. Forum on Scenarios for Climate and Societal Futures: Meeting Report
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van Ruijven, B., Carlsen, H., Chaturvedi, V., Ebi, K., Fuglestvedt, J., Gasalla, M., Harrison, P.A., Kok, K., Kriegler, E., Leininger, J., Monteith, S., O'Neill, B.C., Pereira, L., Pichs-Madruga, R., Riahi, K., Seneviratne, S., Sillman, J., Takahashi, K., Tebaldi, C., and Van Vuuren, D.P.
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The second Scenarios Forum took place in June 2022 in Laxenburg, Austria. The goal of the second Scenarios Forum was to bring together the diverse set of communities using or developing scenarios in climate change and sustainability analysis to exchange experiences, ideas, and lessons learned; identify opportunities for synergies and collaboration between communities; reflect on the use of scenarios; and identify knowledge gaps for future research. The Scenarios Forum 2022 brought together over 500 researchers onsite and online to share experiences to date on progress toward this goal. The Forum confirmed that the SSP-RCP framework is being widely and increasingly used across a variety of research communities and assessment processes in the climate and biodiversity communities. Key discussions on future needs during the Scenarios Forum included the need for expansion of the solution space to facilitate a wider diversity of response strategies, broadening the labeling of scenarios to facilitate connection to other communities, initiating a discussion on high-end community scenarios and the tension in the scenarios framework between providing building-blocks for scientists and identifying key community-level scenarios.
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- 2022
6. Strategies to reengage patients lost to follow up in HIV care in high income countries, a scoping review
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Palacio Vieira, Jorge, Reyes Urueña, Juliana Maria, Imaz, Arkaitz, Bruguera, Andreu, Force, Lluís, Ortí Llaveria, Amat, Llibre, Josep María, Vilaró, Ingrid, Homar Borràs, Francesc, Falcó, Vicenç, Riera, Melchor, Navarro, G., Cortés, C., Mallolas Masferrer, Josep, Manzardo, Christian, Tiraboschi, Juan Manuel, Curran, Adrian, Burgos, J., Gracia Mateo, María, Gutiérrez, Maria del Mar, Murillas Angoiti, Javier, Segura, F., García Gasalla, M., Gonzalez, E., Vidal, Francesc, Peraire, Joaquim, Leon, E., Masabeu, Àngels, Dalmau, D., Jaén, Angels, Almuedo Riera, Alex, Giralt, D., Raventós, B., Gargoulas, F., Vanrell, T., Rubia, J. C., Vilà, J., Ferrés, M., Morell, B., Tamayo, M., Ambrosioni, J., Laguno, M., Martínez, M., Blanco, J. L., Garcia Alcaide, F., Martínez, E., Jou, A., Clotet i Sala, Bonaventura, Saumoy, Maria, Silva, A., Prieto, P., Navarro Bernabé, Joan, Ribera, Esteban, Gurgui Ferrer, Mercedes, Ribas, Maria Àngels, Campins, Antoni, Fanjul, Francisco, Leyes, M., Peñaranda, María, Martin, L., Vilchez, H., Calzado, S., Cervantes, M., Amengual, M. J., Navarro, M., Payeras, T., Cifuentes, Carmen, Abdulghani, N., Comella, T., Vargas, Montserrat, Viladés, Consuelo, Barrufet, Pilar M., Chivite, Ivan, Chamarro, E., Escrig, C., Cairó, Mireia, Martinez Lacasa, X., Font, R., Meyer, Sebastián, Hernandez, Juanse, Picis Study Group, Domingo, Pere (Domingo Pedrol), Lazzari, Elisa de, Miró, Josep M., Casabona, Jordi, Moreno, Sergio, Diaz, Yesika, Aceiton, Jordi, Muntada, Esteve, Podzamczer Palter, Daniel, Institut Català de la Salut, [Palacio-Vieira J] Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Badalona, Spain. CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain. Hospital Clinic-Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain. [Reyes-Urueña JM] Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Badalona, Spain. CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain. Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain. [Imaz A] HIV and STI Unit, Department of Infectious Diseases, Bellvitge University Hospital-IDIBELL, L’Hospitalet de Llobregat, Spain. [Bruguera A] Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Badalona, Spain. Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain. [Force L] Internal Medicine, Hospital de Mataró-Consorci Sanitari del Maresme, Mataró, Spain. [Llaveria AO] Internal Medicine, Hospital Verge de la Cinta de Tortosa, Tortosa, Spain. [Falcó V] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, and Vall d'Hebron Barcelona Hospital Campus
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medicine.medical_specialty ,virosis::infecciones por virus ARN::infecciones por Retroviridae::infecciones por Lentivirus::infecciones por VIH [ENFERMEDADES] ,Scopus ,HIV Infections ,Lost to follow-up ,Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Lost to Follow-Up [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Phone ,Patient compliance [LCSH] ,Humans ,Medicine ,Virus Diseases::RNA Virus Infections::Retroviridae Infections::Lentivirus Infections::HIV Infections [DISEASES] ,business.industry ,Linkage ,Developed Countries ,técnicas de investigación::métodos epidemiológicos::diseño de la investigación epidemiológica::pérdidas en el seguimiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Public health ,Public Health, Environmental and Occupational Health ,HIV ,Grey literature ,Reengagement ,Family medicine ,Income ,Cohort studies ,Infeccions per VIH ,Cooperació dels malalts ,Public aspects of medicine ,RA1-1270 ,Biostatistics ,business ,Pacients - Participació ,Research Article ,Cohort study ,HIV infections - Abstract
Estudios de cohortes; VIH; Pérdida de seguimiento Cohort studies; HIV; Lost to follow-up Estudis de cohorts; VIH; Pèrdua del seguiment Background Despite remarkable achievements in antiretroviral therapy (ART), losses to follow-up (LTFU) might prevent the long-term success of HIV treatment and might delay the achievement of the 90–90-90 objectives. This scoping review is aimed at the description and analysis of the strategies used in high-income countries to reengage LTFU in HIV care, their implementation and impact. Methods A scoping review was done following Arksey & O′Malley’s methodological framework and recommendations from Joanna Briggs Institute. Peer reviewed articles were searched for in Pubmed, Scopus and Web of Science; and grey literature was searched for in Google and other sources of information. Documents were charted according to the information presented on LTFU, the reengagement procedures used in HIV units in high-income countries, published during the last 15 years. In addition, bibliographies of chosen articles were reviewed for additional articles. Results Twenty-eight documents were finally included, over 80% of them published in the United States later than 2015. Database searches, phone calls and/or mail contacts were the most common strategies used to locate and track LTFU, while motivational interviews and strengths-based techniques were used most often during reengagement visits. Outcomes like tracing activities efficacy, rates of reengagement and viral load reduction were reported as outcome measures. Conclusions This review shows a recent and growing trend in developing and implementing patient reengagement strategies in HIV care. However, most of these strategies have been implemented in the United States and little information is available for other high-income countries. The procedures used to trace and contact LTFU are similar across reviewed studies, but their impact and sustainability are widely different depending on the country studied. The project leading to these results (PISCIS Cohort) has received funding from “la Caixa” Banking Foundation under the project code LCF/PR/PR17/51120008. This work is supported by a grant from the Foundation Marató TV3 (project code 239/C/2018) aimed at the analysis of the LTFU patients of the PISCIS Cohort. The funding bodies played no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
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- 2021
7. Towards a better future for biodiversity and people: modelling Nature Futures
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Kim, H., Peterson, G., Cheung, W., Ferrier, S., Alkemade, R., Arneth, A., Kuiper, J., Okayasu, S., Pereira, L., Acosta, L., Chaplin-Kramer, R, den Belder, E., Eddy, T., Johnson, J., Karlsson-Vinkhuysen, S., Kok, M., Leadley, P., Leclere, D., Lundquist, C., Rondinini, C., Scholes, R., Schoolenberg, M., Shin, Y., Stehfest, E., Stephenson, F., Visconti, P., van Vuuren, D., Wabnitz, C., Alava, J., Cuadros-Casanova, Ivon, Davies, K., Gasalla, M., Halouani, G., Harfoot, M., Hashimoto, S., Hickler, T., Hirsch, T., Kolomytsev, G., Miller, B., Ohashi, H., Palomo, M., Popp, A., Remme, R., Saito, O., Sumaila, R., Willcock, S., Pereira, H., Kim, H., Peterson, G., Cheung, W., Ferrier, S., Alkemade, R., Arneth, A., Kuiper, J., Okayasu, S., Pereira, L., Acosta, L., Chaplin-Kramer, R, den Belder, E., Eddy, T., Johnson, J., Karlsson-Vinkhuysen, S., Kok, M., Leadley, P., Leclere, D., Lundquist, C., Rondinini, C., Scholes, R., Schoolenberg, M., Shin, Y., Stehfest, E., Stephenson, F., Visconti, P., van Vuuren, D., Wabnitz, C., Alava, J., Cuadros-Casanova, Ivon, Davies, K., Gasalla, M., Halouani, G., Harfoot, M., Hashimoto, S., Hickler, T., Hirsch, T., Kolomytsev, G., Miller, B., Ohashi, H., Palomo, M., Popp, A., Remme, R., Saito, O., Sumaila, R., Willcock, S., and Pereira, H.
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The expert group on scenarios and models of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services initiated the development of the Nature Futures Framework for developing scenarios of positive futures for nature, to help inform assessments of policy options. This new scenarios and modelling Framework seeks to open up diversity and plurality of perspectives by differentiating three main value perspectives on nature – Nature for Nature (intrinsic values of nature), Nature for Society (instrumental values) and Nature as Culture (relational values). This paper describes how the Nature Futures Framework can be applied in modelling to support policy processes by identifying key interventions for change in realizing a diversity of desirable futures. First, the paper introduces and elaborates on key building blocks of the framework for developing qualitative scenarios and translating them into quantitative scenarios: i) multiple value perspectives on nature and the Nature Futures frontier representing diverse preferences, ii) incorporating mutual and key feedbacks of social-ecological systems in Nature Futures scenarios, and iii) indicators describing the evolution of social-ecological systems with complementary knowledge and data. This paper then presents three possible application approaches to modelling Nature Futures scenarios to support the i) review, ii) implementation and iii) design phases of policy processes. The main objective of this paper is to facilitate the integration of the relational values of nature in models, through improved indicators and other forms of evidence, and to strengthen modelled linkages across biodiversity, ecosystems, nature’s contributions to people, and quality of life to identify science- and knowledge-based interventions and to enhance ecological understanding for achieving sustainable futures. The paper aims at stimulating the development of new scenarios and models based on this new framework by a wide c
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- 2021
8. Rapid classification and prediction of COVID-19 severity by MALDI-TOF mass spectrometry analysis of serum peptidome
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Antonio Oliver, García-Gasalla M, Sebastián Albertí, Pablo A Fraile-Ribot, Gabriel Martorell, Antonio Doménech-Sánchez, and Rosa M. Gomila
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Early detection ,Mass spectrometry ,MALDI-TOF Mass Spectrometry ,Gastroenterology ,Text mining ,Liquid chromatography–mass spectrometry ,Internal medicine ,medicine ,Mass spectrum ,Effective treatment ,business - Abstract
Classification and early detection of severe COVID-19 patients is urgently required to establish an effective treatment. Here, we tested the utility of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) to classify and predict the severity of COVID-19 in a clinical setting. We used this technology to analyse the mass spectra profiles of the sera from 80 COVID-19 patients, clinically classified as mild (33), severe (26) and critical (21), and 20 healthy controls. We found a clear variability of the serum peptidome profile depending on COVID-19 severity. Seventy-eight peaks were significantly different and 12 at least four fold more intense in the set of critical patients than in the mild ones. Analysis of the resulting matrix of peak intensities by machine learning approaches classified severe (severe and critical) and non-severe (mild) patients with a 90% of accuracy. Furthermore, machine learning predicted correctly the favourable outcome of the severe patients in 85% of the cases and the unfavourable in 38% of the cases. Finally, liquid chromatography mass spectrometry analysis of sera identified five proteins that were significantly upregulated in the critical patients. They included serum amyloid proteins A1 and A2, which probably yielded the most intense peaks with m/z 11,530 and 11,686 detected by MALDI-TOF MS.In summary, we demonstrated the potential of the MALDI-TOF MS as a bench to bedside technology to aid clinicians in their decisions to classify COVID-19 patients and predict their evolution.
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- 2020
9. Mannose-binding lectin exon 1 and promoter polymorphisms in tuberculosis disease in a mediterranean area
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García-Gasalla, M., Llambí, Milá J., Losada-López, I., Cifuentes-Luna, C., Fernández-Baca, V., Pareja-Bezares, A., Mir-Villadrich, I., and Payeras-Cifré, A.
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- 2014
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10. Discontinuation of dolutegravir, elvitegravir/cobicistat and raltegravir because of toxicity in a prospective cohort
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Montoliu, A, Miro, JM, Domingo, P, Riera, M, Curran, A, Homar, F, Ambrosioni, J, Abdulghani, N, Force, L, Peraire, J, Vilaro, J, Masabeu, A, Orti, AJ, Dalmau, D, Casabona, J, Reyes, J, Bruguera, A, Muntada, E, Podzamczer, D, Llibre, JM, Navarro, G, Cortes, C, Falco, V, Mallolas, J, Manzardo, C, Imaz, A, Tiraboschi, J, Burgos, J, Mateo, MG, Gutierrez, MM, Murillas, J, Segura, F, Garcia-Gasalla, M, Puig, T, Vidal, F, Leon, E, Jaen, A, Almuedo, A, De Lazzari, E, Giralt, D, Martin, M, Gargoulas, F, Vanrell, T, Rubia, JC, Vila, J, Ferres, M, Morell, B, Tamayo, M, Laguno, M, Martinez, M, Blanco, JL, Garcia-Alcaide, F, Rojas, J, Martinez, E, Jou, A, Clotet, B, Saumoy, M, Silva, A, Prieto, P, Ribera, JNIE, Gurgui, M, Campins, AA, Fanjul, FJ, Leyes, M, Penaranda, M, Martin, L, Vilchez, H, Calzado, S, Cervantes, M, Amengual, MJ, Navarro, M, Payeras, T, Cifuentes, C, Comella, T, Vargas, M, Vilades, C, Barrufet, P, Chivite, I, Chamarro, E, Escrig, C, Cairo, M, Martinez-Lacasa, X, Font, R, Deig, E, Meyer, S, and Hernandez, J
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integrase strand transfer inhibitors ,elvitegravir/cobicistat ,neuropsychiatric toxicity ,raltegravir ,adverse events ,dolutegravir - Abstract
Objectives The aim of the study was to assess the rates of discontinuation of integrase inhibitor regimens because of any neuropsychiatric adverse event (NPAE) and the factors associated with discontinuation. Methods A population-based, prospective, multicentre cohort study was carried out. Treatment-naive subjects starting therapy with a regimen containing integrase inhibitors, or those switching to such a regimen, with plasma HIV-1 RNA < 50 HIV-1 RNA copies/mL in 14 hospitals in Catalonia or the Balearic Islands (Spain) were included in the study. Every discontinuation because of adverse events (AEs) was double-checked directly with treating physicians. Multivariable Cox models identified factors correlated with discontinuation. Results A total of 4165 subjects (37% treatment-naive) started regimens containing dolutegravir (n = 1650; 91% with abacavir), raltegravir (n = 930) or elvitegravir/cobicistat (n = 1585). There were no significant differences among regimens in the rate of discontinuation because of any AE. Rates of discontinuation because of NPAEs were low but higher for dolutegravir/abacavir/lamivudine [2.1%; 2.9 (95% confidence interval (CI) 2.0, 4.2) discontinuations/100 patients/year] versus elvitegravir/cobicistat (0.5%; 0.8 (95% CI 0.3, 1.5) discontinuations/100 patients/year], with significant differences among centres for dolutegravir/abacavir/lamivudine and NPAEs (P = 0.003). We identified an association of female gender and lower CD4 count with increased risk of discontinuation because of any AE [Incidence ratio (IR) 2.3 (95% CI 1.4, 4.0) and 1.8 (95% CI 1.1, 2.8), respectively]. Female gender, age > 60 years and abacavir use were not associated with NPAE discontinuations. NPAEs were commonly grade 1-2, and had been present before and improved after drug withdrawal. Conclusions In this large prospective cohort study, patients receiving dolutegravir, raltegravir or elvitegravir/cobicistat did not show significant differences in the rate of discontinuation because of any toxicity. The rate of discontinuations because of NPAEs was low, but was significantly higher for dolutegravir than for elvitegravir/cobicistat, with significant differences among centres, suggesting that greater predisposition to believe that a given adverse event is caused by a given drug of some treating physicians might play a role in the discordance seen between cohorts.
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- 2019
11. Giant cell arteritis associated with demyelinating polyradiculoneuropathy
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GASALLA, M GARCÍA, BANGO, M YEBRA, NÚÑEZ, J A VARGAS, PITA, S MELLOR, ALVARADO, M GARCÍA, ALONSO, A DE ABAJO, and GOIZUETA, G
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- 2001
12. QuantiFERON-TB Gold In-Tube as a Confirmatory Test for Tuberculin Skin Test in Tuberculosis Contact Tracing: A Noninferiority Clinical Trial
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Muñoz L, Santin M, Alcaide F, Ruíz-Serrano MJ, Gijón P, Bermúdez E, Domínguez-Castellano A, Navarro MD, Ramírez E, Pérez-Escolano E, López-Prieto MD, Gutiérrez-Rodriguez J, Anibarro L, Calviño L, Trigo M, Cifuentes C, García-Gasalla M, Payeras A, Gasch O, Espasa M, Agüero R, Ferrer D, Casas X, Gonzalez-Cuevas MA, García-Zamalloa A, Bikuña E, Lecuona M, Galindo R, Ramírez-Lapausa M, and Carrillo R
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latent tuberculosis infection ,preventive therapy ,interferon-gamma release assays ,tuberculin skin test - Abstract
BACKGROUND: Screening strategies based on interferon-? release assays in tuberculosis contact tracing may reduce the need for preventive therapy without increasing subsequent active disease. METHODS: We conducted an open-label, randomized trial to test the noninferiority of a 2-step strategy with the tuberculin skin test (TST) followed by QuantiFERON-TB Gold In-Tube (QFT-GIT) as a confirmatory test (the TST/QFT arm) to the standard TST-alone strategy (TST arm) for targeting preventive therapy in household contacts of patients with tuberculosis. Participants were followed for 24 months after randomization. The primary endpoint was the development of tuberculosis, with a noninferiority margin of 1.5 percentage points. RESULTS: A total of 871 contacts were randomized. Four contacts in the TST arm and 2 in the TST/QFT arm developed tuberculosis. In the modified intention-to-treat analysis, this accounted for 0.99% in the TST arm and 0.51% in the TST/QFT arm (-0.48% difference; 97.5% confidence interval [CI], -1.86% to 0.90%); in the per-protocol analysis, the corresponding rates were 1.67% and 0.82% in the TST and TST/QFT arms, respectively (-0.85% difference; 97.5% CI, -3.14% to 1.43%). Of the 792 contacts analyzed, 65.3% in the TST arm and 42.2% in the TST/QFT arm were diagnosed with tuberculosis infection (23.1% difference; 95% CI, 16.4% to 30.0%). CONCLUSIONS: In low-incidence settings, screening household contacts with the TST and using QFT-GIT as a confirmatory test is not inferior to TST-alone for preventing active tuberculosis, allowing a safe reduction of preventive treatments. CLINICAL TRIALS REGISTRATION: NCT01223534.
- Published
- 2018
13. Results of a multi-faceted educational intervention to prevent peripheral venous catheter-associated bloodstream infections
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Garcia-Gasalla, M., primary, Arrizabalaga-Asenjo, M., additional, Collado-Giner, C., additional, Ventayol-Aguiló, L., additional, Socias-Mir, A., additional, Rodríguez-Rodríguez, A., additional, Pérez-Seco, M.-C., additional, and Payeras-Cifré, A., additional
- Published
- 2019
- Full Text
- View/download PDF
14. An integrated framework for assessing coastal community vulnerability across cultures, oceans and scales
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Aswani, S., primary, Howard, J. A. E., additional, Gasalla, M. A., additional, Jennings, S., additional, Malherbe, W., additional, Martins, I. M., additional, Salim, S. S., additional, Van Putten, I. E., additional, Swathilekshmi, P. S., additional, Narayanakumar, R., additional, and Watmough, G. R., additional
- Published
- 2018
- Full Text
- View/download PDF
15. Executive summary of the guidelines for the use of interferon-gamma release assays in the diagnosis of tuberculosis infection
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Santin, M, Garcia-Garcia, JM, Rigau, D, Altet, N, Anibarro, L, Casas, I, Diez, N, Garcia-Gasalla, M, Martinez-Lacasa, X, Penas, A, Perez-Escolano, E, Sanchez, F, and Dominguez, J
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Prevention ,Interferon-gamma release assays ,Tuberculosis ,Latent tuberculosis infection ,Guideline - Abstract
Interferon-gamma release assays are widely used for the diagnosis of tuberculosis infection in Spain. However, there is no consensus on their application in specific clinical scenarios. To develop a guideline for their use, a panel of experts comprising specialists in infectious diseases, respiratory diseases, microbiology, pediatrics and preventive medicine, together with a methodologist, conducted a systematic literature search, summarized the findings, rated the quality of the evidence, and formulated recommendations following the GRADE (Grading of Recommendations of Assessment Development and Evaluations) methodology. This document provides evidence-based guidance on the use of interferon-gamma release assays for the diagnosis of tuberculosis infection in patients at the risk of tuberculosis or suspected of having active disease. The guidelines will be applicable to specialist and primary care, and public health. (C) 2016 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.
- Published
- 2016
16. Guidelines for the use of interferon-? release assays in the diagnosis of tuberculosis infection
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Santin M., García-García J.-M., Domínguez J., Rigau D., Altet N., Anibarro L., Casas I., Díez N., García-Gasalla M., Martínez-Lacasa X., Penas A., Pérez-Escolano E., and Sánchez F.
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tuberculin test ,child ,predictive value ,health care personnel ,adult ,practice guideline ,screening ,organ transplantation ,immune deficiency ,preventive medicine ,Article ,inflammatory disease ,biological therapy ,contact examination ,sensitivity and specificity ,Spain ,Human immunodeficiency virus infection ,hematopoietic stem cell transplantation ,Practice Guidelines as Topic ,standards ,Humans ,Tuberculosis ,human ,interferon gamma release assay ,Interferon-gamma Release Tests - Abstract
Introduction: Interferon-gamma release assays are widely used for the diagnosis of tuberculosis infection in low-prevalence countries. However, there is no consensus on their application. The objective of this study was to develop guidelines for the use of interferon-gamma release assays in specific clinical scenarios in Spain. Methods: A panel of experts comprising specialists in infectious diseases, respiratory diseases, microbiology, pediatrics and preventive medicine, together with a methodologist, formulated the clinical questions and outcomes of interest. They conducted a systematic literature search, summarized the evidence and rated its quality, and prepared the recommendations following the GRADE (Grading of Recommendations of Assessment Development and Evaluations) methodology. Results: The panel prepared recommendations on the use of interferon-gamma release assays for the diagnosis of tuberculosis infection in the contact-tracing study (both adults and children), health care workers, immunosuppressed patients (patients infected with human immunodeficiency virus, patients with chronic immunomediated inflammatory diseases due to start biological therapy and patients requiring organ transplant) and for the diagnosis of active tuberculosis. Most recommendations were weak, mainly due to the lack of good quality evidence to balance the clinical benefits and disadvantages of the interferon-gamma release assays as compared with the tuberculin skin test. Conclusion: This document provides evidence-based guidance on the use of interferon-gamma release assays for the diagnosis of tuberculosis infection in patients at risk of tuberculosis or with suspicion of active disease. The guidelines will be applicable in specialist and primary care and in public health settings. © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
- Published
- 2016
17. An integrated framework for assessing coastal community vulnerability across cultures, oceans and scales.
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Aswani, S., Howard, J. A. E., Gasalla, M. A., Jennings, S., Malherbe, W., Martins, I. M., Salim, S. S., Van Putten, I. E., Swathilekshmi, P. S., Narayanakumar, R., and Watmough, G. R.
- Subjects
ECOLOGICAL models ,COMMUNITY organization ,OCEAN ,COMMUNITIES ,SEAWATER - Abstract
Coastal communities are some of the most at-risk populations with respect to climate change impacts. It is therefore important to determine the vulnerability of such communities to co-develop viable adaptation options. Global efforts to address this issue include international scientific projects, such as Global Learning for Local Solutions (GULLS), which focuses on five fast warming regions of the southern hemisphere and aims to provide an understanding of the local scale processes influencing community vulnerability that can then be up-scaled to regional, country and global levels. This paper describes the development of a new social and ecological vulnerability framework which integrates exposure, sensitivity and adaptive capacity with the social livelihoods and food security approaches. It also measures community flexibility to understand better the adaptive capacity of different levels of community organization. The translation of the conceptual framework to an implementable method is described and its application in a number of "hotspot" countries, where ocean waters are warming faster than the rest of the world, is presented. Opportunities for cross-cultural comparisons to uncover similarities and differences in vulnerability and adaptation patterns among the study's coastal communities, which can provide accelerated learning mechanisms to other coastal regions, are highlighted. The social and ecological framework and the associated survey approach allow for future integration of local-level vulnerability data with ecological and oceanographic models. [ABSTRACT FROM AUTHOR]
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- 2019
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18. Climate impacts and oceanic top predators : moving from impacts to adaptation in oceanic systems
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Hobday, A. J., Young, J. W., Abe, O., Costa, D. P., Cowen, R. K., Evans, K., Gasalla, M. A., Kloser, R., Maury, Olivier, and Weng, K. C.
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Fisheries ,Climate change ,Climate variability ,Pelagic ecosystems - Abstract
Climate impacts are now widely reported from coastal marine systems, but less is known for the open ocean. Here we review progress in understanding impacts on large pelagic species presented at an international workshop for the Climate Impacts on Oceanic Top Predators programme, and discuss the future with regard to the next phase of adaptation-focused research. Recent highlights include a plan to map the distribution of key species in the foodweb using both acoustics and biochemical techniques, and development of a new data sharing and access tool for fisheries and associated data, including socio-economic information. A common research focus in pelagic ecosystems is on understanding climate variability and climate change impacts on marine species, but a greater emphasis on developing future scenarios and adaptation options is needed. Workshop participants also concluded that engagement with and provision of science support to regional fisheries management organisations are critical elements for ensuring successful uptake of research. This uptake will be required for future management of fisheries as global warming continues such that some open ocean top predators can be sustainably harvested, impacts on conservation-dependent species can be avoided, and ecosystem function is not compromised.
- Published
- 2013
19. Tuberculosis cutánea en una zona de Mallorca (2003-2011)
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Losada-López, I., García-Gasalla, M., Taberner, R., Cifuentes-Luna, C., Arquinio, L., Terrasa, F., and Pérez, M.C.
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- 2012
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20. Prognosis of 2009 A(H1N1) influenza in hospitalized pregnant women in a context of early diagnosis and antiviral therapy
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Jesús Rodríguez-Baño, José A. Oteo, Leyes M, Martínez-Sánchez N, M.C. Fariñas, Jordi Carratalà, Jerónimo Pachón, García-Gasalla M, Paño-Pardo, Lucía Ortega, Ferran Segura, Novel Influenza A, Francisco López-Medrano, Diego Viasus, J. Torre-Cisneros, and Tomás Pumarola
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Adult ,medicine.medical_specialty ,Adolescent ,Context (language use) ,Antiviral Agents ,law.invention ,Young Adult ,Matched cohort ,Influenza A Virus, H1N1 Subtype ,Oseltamivir ,law ,Pregnancy ,Internal medicine ,A h1n1 influenza ,Pandemic ,Influenza, Human ,medicine ,Humans ,Pharmacology (medical) ,Pregnancy Complications, Infectious ,Intensive care medicine ,Prospective cohort study ,Pandemics ,Pharmacology ,business.industry ,Antiviral therapy ,Middle Aged ,medicine.disease ,Intensive care unit ,Infectious Diseases ,Spain ,Female ,business - Abstract
Background Initial reports suggested that novel A(H1N1) influenza virus (2009 A[H1N1]v) infection was significantly more severe in pregnant than in non-pregnant women. In Spain, antiviral therapy was recommended for pregnant women from the beginning of the 2009 pandemic. Methods The prospective cohort study included consecutive pregnant and non-pregnant women of reproductive age with a proven diagnosis of 2009 A(H1N1)v admitted to any of the 13 participating Spanish hospitals between 12 June and 10 November 2009. Results In total, 98 pregnant and 112 non-pregnant women with proven 2009 A(H1N1)v hospitalized during the study period were included. Influenza was more severe among non-pregnant patients than pregnant patients with respect to outcomes of both intensive care unit admission (18% versus 2%; PConclusions 2009 A(H1N1)v influenza was not associated with worse outcomes in hospitalized pregnant women compared with non-pregnant ones of reproductive age in a context of early diagnosis and antiviral therapy.
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- 2011
21. Neumonía por Rhodoccocus equi en paciente con infección por el VIH: A propósito de un caso
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Marco Lattur, M. D., García Gasalla, M., Arribas Escobar, V., Soleto Roncero, M. J., and Bassa Malondra, A.
- Published
- 2008
22. Peptostreptococcus Endocarditis: presentation of two cases and literature review
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Bassa Malondra, A., García Gasalla, M., Cladera, A., and Gaeau, M.
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stomatognathic diseases ,fluids and secretions ,stomatognathic system ,Peptostreptococcus endocarditis ,otorhinolaryngologic diseases ,Endocarditis por Peptostreptococcus ,bacterial infections and mycoses - Abstract
Describimos dos nuevos casos de endocarditis por Peptostreptococcus, uno de ellos sobre válvula protésica y causado por P. micros, y otro caso de endocarditis tricuspídea por P. assacharolyticus en un paciente ADVP. Revisamos los 9 casos previamente publicados en la literatura de endocarditis causada por anaerobios del género Peptostreptococcus. We describe two new cases of Peptostreptococcus endocarditis, one case of Peptostreptococcus micros prosthetic valve endocarditis and the other of Peptostreptococcus assaccharolyticus tricuspid native valve endocarditis in an intravenous drug user (IDU) patient and review nine cases previously reported.
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- 2008
23. Enfermedad por Listeria monocytogenes
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Hernández-Milián, A., primary, García Gasalla, M., additional, Díaz Antolín, P., additional, and Payeras Cifré, A., additional
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- 2014
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- View/download PDF
24. Climate impacts and oceanic top predators: Moving from impacts to adaptation in oceanic systems
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Hobday, A., Young, J., Abe, O., Costa, D., Cowen, R., Evans, K., Gasalla, M., Kloser, Rudy, Maury, O., Weng, K., Hobday, A., Young, J., Abe, O., Costa, D., Cowen, R., Evans, K., Gasalla, M., Kloser, Rudy, Maury, O., and Weng, K.
- Abstract
Climate impacts are now widely reported from coastal marine systems, but less is known for the open ocean. Here we review progress in understanding impacts on large pelagic species presented at an international workshop for the Climate Impacts on Oceanic Top Predators programme, and discuss the future with regard to the next phase of adaptation-focused research. Recent highlights include a plan to map the distribution of key species in the foodweb using both acoustics and biochemical techniques, and development of a new data sharing and access tool for fisheries and associated data, including socio-economic information. A common research focus in pelagic ecosystems is on understanding climate variability and climate change impacts on marine species, but a greater emphasis on developing future scenarios and adaptation options is needed. Workshop participants also concluded that engagement with and provision of science support to regional fisheries management organisations are critical elements for ensuring successful uptake of research. This uptake will be required for future management of fisheries as global warming continues such that some open ocean top predators can be sustainably harvested, impacts on conservation-dependent species can be avoided, and ecosystem function is not compromised. © 2013 Springer Science+Business Media Dordrecht.
- Published
- 2013
25. Neumonía por Rhodococcus equi en un paciente con infección por el VIH. A propósito de un caso
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Marco Lattur, M.D., García Gasalla, M., Arribas Escobar, V., Soleto Roncero, M.J., and Bassa Malondra, A.
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- 2009
- Full Text
- View/download PDF
26. Neumonía por Rhodoccocus equi en paciente con infección por el VIH: A propósito de un caso
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Marco Lattur, M. D., primary, García Gasalla, M., additional, Arribas Escobar, V., additional, Soleto Roncero, M. J., additional, and Bassa Malondra, A., additional
- Published
- 2008
- Full Text
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27. Endocarditis por Peptostreptococcus: presentación de dos casos y revisión de la literatura
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Bassa Malondra, A., primary, García Gasalla, M., additional, Cladera, A., additional, and Gaeau, M., additional
- Published
- 2008
- Full Text
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28. Captura de lulas (Mollusca: Cephalopoda) pela pesca industrial desembarcada em Santos: Comparação após 4 décadas.
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Gasalla, M. A., primary, Postuma, F. A., additional, and Tomás, A. R. G., additional
- Published
- 2005
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29. Imagen de la semana
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Cifuentes Luna C, Garcia Gasalla M, Juan i Roca M, and Vila i Mas T
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medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,business ,Dermatology ,Norwegian scabies - Published
- 2006
30. Pseudotumor inflamatorio: presentación de 12 casos
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García Gasalla, M., primary, Yebra Bango, M., additional, Vargas Núñez, J.A., additional, González Martín, F.M., additional, and Salas Antón, C., additional
- Published
- 2001
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31. Resolution of Symptoms of Esophageal Compression Due to Mediastinal Tuberculosis After Treatment with Corticosteroids
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García‐Gasalla, M., primary, Yebra‐Bango, M., additional, and Villarreal, M., additional
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- 1998
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- View/download PDF
32. Giant cell arteritis associated with demyelinating polyradiculoneuropathy.
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García Gasalla, M, Yebra Bango, M, Vargas Núñez, J A, Mellor Pita, S, García Alvarado, M, de Abajo Alonso, A, and Goizueta, G
- Published
- 2001
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33. Resolution of Symptoms of Esophageal Compression Due to Mediastinal Tuberculosis After Treatment with Corticosteroids.
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Gasalla, M. García, Bango, M. Yebra, Lomas, M. Villarreal García, and Pita, S. Mellor
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- 1998
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34. Impact of heat waves on human morbidity and hospital admissions in a city of the western mediterranean area.
- Author
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Bujosa Mateu A, Alegre Latorre L, Comas MV, Salom J, García Gasalla M, Planas Bibiloni L, Orfila Timoner J, and Murillas Angoiti J
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- Humans, Hot Temperature adverse effects, Extreme Heat adverse effects, Acute Kidney Injury epidemiology, Spain epidemiology, Cities epidemiology, Morbidity, Male, Female, Middle Aged, Stroke epidemiology, Patient Admission statistics & numerical data, Hospitalization statistics & numerical data, Emergency Service, Hospital statistics & numerical data, Heat Stroke epidemiology
- Abstract
Purpose: The effect of heat waves on mortality is well known, but current evidence on morbidity is limited. Establishing the consequences of these events in terms of morbidity is important to ensure communities and health systems can adapt to them., Methods: We thus collected data on total daily emergency hospital admissions, admissions to critical care units, emergency department admissions, and emergency admissions for specific diagnoses to Hospital Universitario de Son Espases from 1 January 2005 to 31 December 2021. A heat wave was defined as a period of ≥ 2 days with a maximum temperature ≥ 35 °C, including a 7 day lag effect (inclusive). We used a quasi-Poisson generalized linear model to estimate relative risks (RRs; 95%CI) for heat wave-related hospital admissions., Results: Results showed statistically significant increases in total emergency admissions (RR 1.06; 95%CI 1 - 1.12), emergency department admissions (RR 1.12; 95%CI 1.07 - 1.18), and admissions for ischemic stroke (RR 1.26; 95%CI 1.02 - 1.54), acute kidney injury (RR 1.67; 95%CI 1.16 - 2.35), and heat stroke (RR 18.73, 95%CI 6.48 - 45.83) during heat waves., Conclusion: Heat waves increase hospitalization risk, primarily for thromboembolic and renal diseases and heat strokes., (© 2024. The Author(s).)
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- 2024
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35. Implementing a new HCV model of care for people who use drugs.
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Herranz Mochales A, Picchio CA, Nicolàs A, Macià MD, Fernández-Baca MV, Serrano J, Bonet L, Trelles M, Sansó A, Rubí AR, Zamora A, García-Gasalla M, Buti M, Vilella À, and Lazarus JV
- Abstract
Background & Aims: An estimated 50 million individuals have chronic hepatitis C virus (HCV) infection worldwide and people who use drugs (PWUD) are disproportionately affected. Persistent stigma and discrimination make it challenging for PWUD to access healthcare, potentially hindering HCV elimination progress in this population. To mitigate healthcare access barriers in PWUD, an HCV care model that simplified screening and linkage to care pathways was developed and rolled out in the Balearic Islands, Spain., Methods: The prospective multicentre community model of care was implemented in 21 centres serving PWUD. This model involved: (1) participant recruitment and HCV antibody screening onsite via a point-of-care anti-HCV test, phlebotomy, or laboratory records; (2) HCV RNA, HBsAg and anti-HIV testing via a dried blood spot or phlebotomy; (3) linkage to specialist care and treatment prescription via telemedicine, when required; and (4) onsite monitoring of: (a) sustained virologic response (SVR) 4 and ≥12 weeks after treatment completion and; (b) potential new HCV infection or reinfection ∼1 year after phase 1 or SVR ≥12 monitoring. Care model acceptability was assessed., Results: Between April 2021 and April 2023, 1,423 participants were recruited, of whom 464 (33%) were anti-HCV+ and 170 (12%) had detectable HCV RNA. Of the latter, 147 (86%) initiated therapy, of whom 124 (84%) completed it. SVR ≥12 monitoring was performed in 95 (77%) of these, of whom 88 (93%) had undetectable HCV RNA. Upon re-screening, four HCV reinfections were detected. Over 90% accepted study participation and screening and treatment decentralisation., Conclusions: This adapted care model, which decentralised screening, diagnosis, and treatment, effectively increased healthcare access among PWUD, improving progress towards HCV elimination in this population in Spain., Impact and Implications: People who use drugs (PWUD) are among the most affected by chronic hepatitis C virus (HCV) infection globally. A simplified model of care was implemented in 21 centres serving this population across the Balearic Islands, Spain, to offer HCV care to 1,423 PWUD in 2021-2023. This decentralised screening, diagnosis, and treatment model resulted in an HCV cure rate of 93% of those who both completed therapy and were monitored post treatment completion. The Hepatitis C Free Balears model can guide the HCV elimination efforts of regional health authorities and other stakeholders in the rest of Spain and other parts of the world., (© 2024 The Author(s).)
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- 2024
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36. Clinical Characteristics and Microorganisms Isolated in Community-Acquired Pneumonia in the COVID-19 Period.
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Gavalda M, Fullana MI, Ferre A, Peña RR, Armendariz J, Torrallardona O, Magraner A, Lorenzo A, García C, Mut G, Planas L, Iglesias C, Fraile-Ribot P, Macia Romero MD, Riera M, and García-Gasalla M
- Abstract
Introduction: Community-acquired pneumonia is a leading cause of mortality and hospital admissions. The aetiology remains unknown in 30-65% of the cases. Molecular tests are available for multiple pathogen detection and are under research to improve the causal diagnosis., Methods: We carried out a prospective study to describe the clinical characteristics and aetiology of community-acquired pneumonia during the COVID-19 pandemic and to assess the diagnostic effectivity of the microbiological tests, including a molecular test of respiratory pathogens (FilmArray™ bioMérieux)., Results: From the 1st of February 2021 until the 31st of March 2022, 225 patients were included. Failure in microorganism identification occurred in approximately 70% of patients. Streptococcus pneumoniae was the most common isolate. There were 5 cases of viral pneumonia. The tested FilmArray exhibited a low positivity rate of 7% and mainly aided in the diagnosis of viral coinfections., Conclusions: Despite our extensive diagnostic protocol, there is still a low rate of microorganism identification. We have observed a reduction in influenza and other viral pneumoniae during the COVID-19 pandemic. Having a high NEWS2 score on arrival at the emergency department, an active oncohematological disease or chronic neurological conditions and a positive microbiological test result were related to worse outcomes. Further research is needed to determine the role of molecular tests in the microbiological diagnosis of pneumonia., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Meritxell Gavalda et al.)
- Published
- 2024
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37. Analysis of vaccine responses after anti-CD20 maintenance in B-cell lymphoma in the Balearic Islands. A single reference center experience.
- Author
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Gutierrez A, Alonso A, Garcia-Recio M, Perez S, Garcia-Maño L, Martinez-Serra J, Ros T, Garcia-Gasalla M, Ferrer J, Vögler O, Alemany R, Salar A, Sampol A, and Bento L
- Subjects
- Humans, COVID-19 Vaccines, Spain, Immunoglobulins, Intravenous, Agammaglobulinemia, Vaccines, COVID-19, Lymphoma, B-Cell drug therapy
- Abstract
Introduction: The use of maintenance approaches with anti-CD20 monoclonal antibodies has improved the outcomes of B-cell indolent lymphomas but may lead to significant peripheral B-cell depletion. This depletion can potentially hinder the serological response to neoantigens., Methods: Our objective was to analyze the effect of anti-CD20 maintenance therapy in a reliable model of response to neoantigens: SARS-CoV-2 vaccine responses and the incidence/severity ofCOVID-19 in a reference hospital., Results: In our series (n=118), the rate of vaccination failures was 31%. Through ROC curve analysis, we determined a cutoff for SARS-CoV-2 vaccine serologic response at 24 months from the last anti-CD20 dose. The risk of severe COVID-19 was notably higher within the first 24months following the last anti-CD20 dose (52%) compared to after this period (just 18%) (p=0.007). In our survival analysis, neither vaccine response nor hypogammaglobulinemia significantly affected OS. While COVID-19 led to a modest mortality rate of 2.5%, this figure was comparable to the OS reported in the general immunocompetent population. However, most patients with hypogammaglobulinemia received intravenous immunoglobulin therapy and all were vaccinated. In conclusion, anti-CD20 maintenance therapy impairs serological responses to SARS-CoV-2 vaccines., Discussion: We report for the first time that patients during maintenance therapy and up to 24 months after the last anti-CD20 dose are at a higher risk of vaccine failure and more severe cases of COVID-19. Nevertheless, with close monitoring, intravenous immunoglobulin supplementation or proper vaccination, the impact on survival due to the lack of serological response in this high-risk population can be mitigated, allowing for the benefits of anti-CD20 maintenance therapy, even in the presence of hypogammaglobulinemia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gutierrez, Alonso, Garcia-Recio, Perez, Garcia-Maño, Martinez-Serra, Ros, Garcia-Gasalla, Ferrer, Vögler, Alemany, Salar, Sampol and Bento.)
- Published
- 2023
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38. Hyperinflammatory Immune Response in COVID-19: Host Genetic Factors in Pyrin Inflammasome and Immunity to Virus in a Spanish Population from Majorca Island.
- Author
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Martínez-Pomar N, Cunill V, Segura-Guerrero M, Pol-Pol E, Escobar Oblitas D, Pons J, Ayestarán I, Pruneda PC, Losada I, Toledo-Pons N, García Gasalla M, and Ferrer Balaguer JM
- Abstract
The hyperinflammatory response caused by SARS-CoV-2 infection contributes to its severity, and many critically ill patients show features of cytokine storm (CS) syndrome. We investigated, by next-generation sequencing, 24 causative genes of primary immunodeficiencies whose defect predisposes to CS. We studied two cohorts with extreme phenotypes of SARS-CoV-2 infection: critical/severe hyperinflammatory patients (H-P) and asymptomatic patients (AM-risk-P) with a high risk (older age) to severe COVID-19. To explore inborn errors of the immunity, we investigated the presence of pathogenic or rare variants, and to identify COVID-19 severity-associated markers, we compared the allele frequencies of common genetic polymorphisms between our two cohorts. We found: 1 H-P carries the likely pathogenic variant c.887-2 A>C in the IRF7 gene and 5 H-P carries variants in the MEFV gene, whose role in the pathogenicity of the familial Mediterranean fever (FMF) disease is controversial. The common polymorphism analysis showed three potential risk biomarkers for developing the hyperinflammatory response: the homozygous haplotype rs1231123A/A-rs1231122A/A in MEFV gene, the IFNAR2 p.Phe8Ser variant, and the CARMIL2 p.Val181Met variant. The combined analysis showed an increased risk of developing severe COVID-19 in patients that had at least one of our genetic risk markers (odds ratio (OR) = 6.2 (95% CI) (2.430-16.20)).
- Published
- 2023
- Full Text
- View/download PDF
39. Elevated complement C3 and increased CD8 and type 1 helper lymphocyte T populations in patients with post-COVID-19 condition.
- Author
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Garcia-Gasalla M, Berman-Riu M, Rodriguez A, Iglesias A, Fraile-Ribot PA, Toledo-Pons N, Pol-Pol E, Ferré-Beltrán A, Artigues-Serra F, Martin-Pena ML, Pons J, Murillas J, Oliver A, Riera M, and Ferrer JM
- Subjects
- Humans, Female, Cytokines metabolism, Lymphocyte Subsets, CD8-Positive T-Lymphocytes, Biomarkers metabolism, Complement C3 metabolism, COVID-19 metabolism
- Abstract
Background: Biological markers associated to post-COVID-19 condition (PCC) have not been clearly identified., Methods: Eighty-two patients attending our post-COVID-19 outpatient clinic were recruited and classified as fully recovered (40.2%) or presenting with PCC (59.8%). Clinical and radiological data, laboratory markers, cytokines, and lymphocyte populations were analyzed., Results: Median number of days after hospitalization was 78.5 [p25-p75: 60-93] days. PCC was significantly more frequent in women, in patients with a previously critical COVID-19, and in those with two or more comorbidities. No differences were found in lymphocyte counts, ferritin, C-reactive protein, D-dimer or sCD25, IL-1β, IL-1Ra, IL-6, CXCL8, IL-17A, IL-18, IL-22, IFN-γ, TNF-α, and IL-10 cytokines levels. PCC patients showed significantly higher levels of complement factor C3 than fully recovered patients: median C3 128 mg/dL [p25-p75:107-135] vs 111 mg/dL [p25-p75: 100-125] (p =.005), respectively. In the flow cytometry assessment of peripheral blood lymphocyte subpopulations, PCC patients showed significantly increased CD8 populations compared to fully recovered patients: median CD8: 529 [p25-p75: 384-683] vs 370/mm
3 [p25-p75:280-523], p =.007. When type 1, 2, 17/22, and 17.1 helper and follicular T lymphocyte subpopulations were analyzed, the frequency of Th1 was significantly higher in PCC patients compared to fully recovered patients (30% vs 38.5%, p =.028)., Conclusion: Patients with a post-COVID-19 condition showed significantly increased immunological parameters of inflammation (complement factor C3 and CD8 and Th1 T lymphocyte populations) compared to fully recovered patients. These parameters could be used as biological markers of this condition., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2023
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40. Reversions of QuantiFERON-TB Gold Plus in tuberculosis contact investigation: A prospective multicentre cohort study.
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Pérez-Recio S, Grijota-Camino MD, Anibarro L, Rabuñal-Rey R, Sabria J, Gijón-Vidaurreta P, Pomar V, García-Gasalla M, Domínguez-Castellano Á, Trigo M, Santos MJ, Cebollero A, Rodríguez S, Moga E, Penas-Truque A, Martos C, Ruiz-Serrano MJ, Garcia-de-Cara EI, Alcaide F, and Santin M
- Subjects
- Adult, Humans, Cohort Studies, Prospective Studies, Tuberculosis diagnosis, Tuberculosis, Pulmonary diagnosis, Latent Tuberculosis
- Abstract
Background: Interferon-y Release Assays (IGRA) reversions have been reported in different clinical scenarios for the diagnosis of tuberculosis (TB) infection. This study aimed to determine the rate of QuantiFERON-TB Gold Plus (QFT-Plus) reversions during contact investigation as a potential strategy to reduce the number of preventive treatments., Methods: Prospective, multicentre cohort study of immunocompetent adult contacts of patients with pulmonary TB tested with QFT-Plus. Contacts with an initial positive QFT-Plus (QFT-i) underwent a second test within 4 weeks (QFT-1), and if negative, underwent a repeat test 4 weeks later (QFT-2). Based on the QFT-2 result, we classified cases as sustained reversion if they remained negative and as temporary reversion if they turned positive., Results: We included 415 contacts, of whom 96 (23.1%) had an initial positive test (QFT-i). Following this, 10 had negative QFT-1 results and 4 (4.2%) of these persisted with a negative result in the QFT-2 (sustained reversions). All four sustained reversions occurred in contacts with IFN-γ concentrations between ≥0.35 and ≤0.99 IU•mL-1 in one or both QFT-i tubes., Conclusion: In this study, TB contact investigations rarely reveal QFT-Plus reversion. These results do not support retesting cases with an initial positive result to reduce the number of preventive treatments., Competing Interests: The authors have read the journal’s policy and the authors of this manuscript have the following competing interests: M. S. received fees for participating in an advisory board with Pfizer Ltd (2 hours). The remaining authors declare no conflicts of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Pérez-Recio et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2023
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41. Fever and migratory nodules in the lung.
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Alonso Carballo A, Belzunce Capó JF, Iglesias Escobar C, and García Gasalla M
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- Humans, Lung diagnostic imaging, Fever
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- 2023
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42. Sclerosing mesenteritis due to Mycobacterium genavense infection: A case report.
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Artigues Serra F, García-Gasalla M, Campins A, González de Cabo M, Morales R, Peña RR, Gallegos MC, and Riera M
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- Adult, Anti-Bacterial Agents therapeutic use, Humans, Male, Nontuberculous Mycobacteria, Mycobacterium, Mycobacterium Infections complications, Panniculitis, Peritoneal diagnosis, Panniculitis, Peritoneal therapy
- Abstract
Rationale: Since its first identification in the early 1990s, Mycobacterium genavense has been considered and opportunistic pathogen. It mainly causes gastrointestinal symptoms, but also disseminated infections in severely immunosuppressed patients. Sclerosing mesenteritis is a long-term complication with high morbidity and mortality. As it is a rare condition, there are no specific guidelines for its management. We report a challenging case of persistent M. genavense infection, and propose surgery as an alternative treatment strategy., Patient Concerns: A 38-year-old Caucasian man presented to the emergency room with fever, abdominal pain, and night sweats for 3 months. HIV screening revealed a previously unknown HIV-1 infection, with a CD4 cell count of 216 cell/µL and viral load of 361.000 copies/mL at diagnosis. A body CT-scan showed mild splenomegaly as well as mesenteric and retroperitoneal enlarged lymph nodes. Fine needle aspiration revealed the presence of acid-fast bacilli, but mycobacterial cultures were negative. In the second sample, 16S RNA sequencing yielded a diagnosis of M. genavense infection. Despite 2 years of corticosteroids and antimycobacterial treatment excluding rifampicin due to a severe cutaneous reaction, there was no clinical improvement and an increase in the mesenteric lymph node size was observed, with a sclerosing transformation of the mesentery. A surgical approach was proposed to release small bowel loops and to remove fibrin. A second surgery was required due to an acute peritonitis ought to yeyunal segmental isquemia and perforation. Finally, the patient evolved favorably, and antimycobacterial drugs were suspended without relapse., Lessons: Despite a prolonged multidrug strategy, some patients develop persistent M. genavense infection. Once sclerosing mesenteritis is established, clinicians have few treatment options. Surgery should be considered in patients with sclerosing mesenteritis or bowel obstruction. The combination of medical and surgical treatment could be a potential cure for these patients., Competing Interests: The authors have no funding and conflicts of interests to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2022
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43. Increased mRNA Levels of ADAM17 , IFITM3 , and IFNE in Peripheral Blood Cells Are Present in Patients with Obesity and May Predict Severe COVID-19 Evolution.
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Pomar CA, Bonet ML, Ferre-Beltrán A, Fraile-Ribot PA, García-Gasalla M, Riera M, Picó C, and Palou A
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Gene expression patterns in blood cells from SARS-CoV-2 infected individuals with different clinical phenotypes and body mass index (BMI) could help to identify possible early prognosis factors for COVID-19. We recruited patients with COVID-19 admitted in Hospital Universitari Son Espases (HUSE) between March 2020 and November 2021, and control subjects. Peripheral blood cells (PBCs) and plasma samples were obtained on hospital admission. Gene expression of candidate transcriptomic biomarkers in PBCs were compared based on the patients’ clinical status (mild, severe and critical) and BMI range (normal weight, overweight, and obesity). mRNA levels of ADAM17, IFITM3, IL6, CXCL10, CXCL11, IFNG and TYK2 were increased in PBCs of COVID-19 patients (n = 73) compared with controls (n = 47), independently of sex. Increased expression of IFNE was observed in the male patients only. PBC mRNA levels of ADAM17, IFITM3, CXCL11, and CCR2 were higher in those patients that experienced a more serious evolution during hospitalization. ADAM17, IFITM3, IL6 and IFNE were more highly expressed in PBCs of patients with obesity. Interestingly, the expression pattern of ADAM17, IFITM3 and IFNE in PBCs was related to both the severity of COVID-19 evolution and obesity status, especially in the male patients. In conclusion, gene expression in PBCs can be useful for the prognosis of COVID-19 evolution., Competing Interests: The authors declare no conflict of interest.
- Published
- 2022
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44. Hyperinflammatory State and Low T1 Adaptive Immune Response in Severe and Critical Acute COVID-19 Patients.
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Garcia-Gasalla M, Berman-Riu M, Pons J, Rodríguez A, Iglesias A, Martínez-Pomar N, Llompart-Alabern I, Riera M, Ferré Beltrán A, Figueras-Castilla A, Murillas J, and Ferrer JM
- Abstract
Background: A better understanding of COVID-19 immunopathology is needed to identify the most vulnerable patients and improve treatment options., Objective: We aimed to identify immune system cell populations, cytokines, and inflammatory markers related to severity in COVID-19., Methods: 139 hospitalized patients with COVID-19-58 mild/moderate and 81 severe/critical-and 74 recovered patients were included in a prospective longitudinal study. Clinical data and blood samples were obtained on admission for laboratory markers, cytokines, and lymphocyte subsets study. In the recovered patients, lymphocyte subsets were analyzed 8-12 weeks after discharge., Results: A National Early Warning Score 2 >2 (OR:41.4; CI:10.38-167.0), ferritin >583 pg/mL (OR:16.3; CI: 3.88-69.9), neutrophil/lymphocyte ratio >3 (OR: 3.5; CI: 1.08-12.0), sIL-2rα (sCD25) >512 pg/mL (OR: 3.3; CI: 1.48-7.9), IL-1Ra >94 pg/mL (OR: 3.2; IC: 1.4-7.3), and IL-18 >125 pg/mL (OR: 2.4; CI: 1.1-5.0) were associated with severe/critical COVID-19 in the multivariate models used. Lower absolute values of CD3, CD4, CD8, and CD19 lymphocytes together with higher frequencies of NK cells, a CD4 and CD8 activated (CD38+HLA-DR+) memory T cell and effector memory CD45RA+ (EMRA) phenotype, and lower T regulatory cell frequencies were found in severe/critical patients relative to mild/moderate and recovered COVID-19 patients. A significant reduction in Th1, Tfh1, and Tc1 with higher Th2, Tfh2, Tc2, and plasma cell frequencies was found in the most severe cases., Conclusion: A characteristic hyperinflammatory state with significantly elevated neutrophil/lymphocyte ratio and ferritin, IL-1Ra, sIL-2rα, and IL-18 levels together with a "low T1 lymphocyte signature" was found in severe/critical COVID-19 patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Garcia-Gasalla, Berman-Riu, Pons, Rodríguez, Iglesias, Martínez-Pomar, Llompart-Alabern, Riera, Ferré Beltrán, Figueras-Castilla, Murillas and Ferrer.)
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- 2022
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45. Identification of Recent Tuberculosis Exposure Using QuantiFERON-TB Gold Plus, a Multicenter Study.
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Pérez-Recio S, Pallarès N, Grijota-Camino MD, Sánchez-Montalvá A, Barcia L, Campos-Gutiérrez S, Pomar V, Rabuñal-Rey R, Balcells ME, Gazel D, Montiel N, Vicente D, Goić-Barišić I, Schön T, Paues J, Mareković I, Cacho-Calvo J, Barac A, Goletti D, García-Gasalla M, Barcala JM, Tórtola MT, Anibarro L, Suárez-Toste I, Moga E, Gude-Gonzalez MJ, Naves R, Karslıgil T, Martin-Peñaranda T, Stevanovic G, Trigo M, Rubio V, Karaoğlan İ, Bayram N, Alcaide F, Tebé C, and Santin M
- Subjects
- Adult, Aged, Antigens, Bacterial immunology, CD8-Positive T-Lymphocytes immunology, Environmental Exposure analysis, Female, Humans, Male, Middle Aged, Risk, Sensitivity and Specificity, Tuberculosis diagnosis, Contact Tracing methods, Interferon-gamma immunology, Interferon-gamma Release Tests methods, Latent Tuberculosis diagnosis, Mycobacterium tuberculosis immunology
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We investigated whether the difference of antigen tube 2 (TB2) minus antigen tube 1 (TB1) (TB2-TB1) of the QuantiFERON-TB gold plus test, which has been postulated as a surrogate for the CD8
+ T-cell response, could be useful in identifying recent tuberculosis (TB) exposure. We looked at the interferon gamma (IFN-γ) responses and differences in TB2 and TB1 tubes for 686 adults with QFT-plus positive test results. These results were compared among groups with high (368 TB contacts), low (229 patients with immune-mediated inflammatory diseases [IMID]), and indeterminate (89 asylum seekers or people from abroad [ASPFA]) risks of recent TB exposure. A TB2-TB1 value >0.6 IU·ml-1 was deemed to indicate a true difference between tubes. In the whole cohort, 13.6%, 10.9%, and 11.2% of cases had a TB2>TB1 result in the contact, IMID, and ASPFA groups, respectively ( P = 0.591). The adjusted odds ratios (aORs) for an association between a TB2-TB1 result of >0.6 IU·ml-1 and risk of recent exposure versus contacts were 0.71 (95% confidence interval [CI], 0.31 to 1.61) for the IMID group and 0.86 (95% CI, 0.49 to 1.52) for the ASPFA group. In TB contact subgroups, 11.4%, 15.4%, and 17.7% with close, frequent, and sporadic contact had a TB2>TB1 result ( P = 0.362). The aORs versus the close subgroup were 1.29 (95% CI, 0.63 to 2.62) for the frequent subgroup and 1.55 (95% CI, 0.67 to 3.60) for the sporadic subgroup. A TB2-TB1 difference of >0.6 IU·ml-1 was not associated with increased risk of recent TB exposure, which puts into question the clinical potential as a proxy marker for recently acquired TB infection. IMPORTANCE Contact tuberculosis tracing is essential to identify recently infected people, who therefore merit preventive treatment. However, there are no diagnostic tests that can determine whether the infection is a result of a recent exposure or not. It has been suggested that by using the QuantiFERON-TB gold plus, an interferon gamma (IFN-γ) release assay, a difference in IFN-γ production between the two antigen tubes (TB2 minus TB1) of >0.6 IU·ml-1 could serve as a proxy marker for recent infection. In this large multinational study, infected individuals could not be classified according to the risk of recent exposure based on differences in IFN-γ in TB1 and TB2 tubes that were higher than 0.6 IU·ml-1 . QuantiFERON-TB gold plus is not able to distinguish between recent and remotely acquired tuberculosis infection, and it should not be used for that purpose in contact tuberculosis tracing.- Published
- 2021
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46. Efficacy and Safety of Sarilumab in patients with COVID19 Pneumonia: A Randomized, Phase III Clinical Trial (SARTRE Study).
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Sancho-López A, Caballero-Bermejo AF, Ruiz-Antorán B, Múñez Rubio E, García Gasalla M, Buades J, González Rozas M, López Veloso M, Muñoz Gómez A, Cuenca Abarca A, Durán Del Campo P, Ibáñez F, Díaz de Santiago A, Romero Y, Calderón J, Pintos I, Ferre Beltrán A, Centeno Soto G, Campos J, Ramos Martínez A, Avendaño-Solá C, and Fernández Cruz A
- Abstract
Introduction: SARS-CoV-2 pneumonia is often associated with hyper-inflammation. The cytokine-storm-like is one of the targets of current therapies for coronavirus disease 2019 (COVID-19). High Interleukin-6 (IL6) blood levels have been identified in severe COVID-19 disease, but there are still uncertainties regarding the actual role of anti-IL6 antagonists in COVID-19 management. Our hypothesis was that the use of sarilumab plus corticosteroids at an early stage of the hyper-inflammatory syndrome would be beneficial and prevent progression to acute respiratory distress syndrome (ARDS)., Methods: We randomly assigned (in a 1:1 ratio) COVID-19 pneumonia hospitalized patients under standard oxygen therapy and laboratory evidence of hyper-inflammation to receive sarilumab plus usual care (experimental group) or usual care alone (control group). Corticosteroids were given to all patients at a 1 mg/kg/day of methylprednisolone for at least 3 days. The primary outcome was the proportion of patients progressing to severe respiratory failure (defined as a score in the Brescia-COVID19 scale ≥ 3) up to day 15., Results: A total of 201 patients underwent randomization: 99 patients in the sarilumab group and 102 patients in the control group. The rate of patients progressing to severe respiratory failure (Brescia-COVID scale score ≥ 3) up to day 15 was 16.16% in the Sarilumab group versus 15.69% in the control group (RR 1.03; 95% CI 0.48-2.20). No relevant safety issues were identified., Conclusions: In hospitalized patients with Covid-19 pneumonia, who were under standard oxygen therapy and who presented analytical inflammatory parameters, an early therapeutic intervention with sarilumab plus standard of care (including corticosteroids) was not shown to be more effective than current standard of care alone. The study was registered at EudraCT with number: 2020-002037-15., (© 2021. The Author(s).)
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- 2021
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47. Facial Nerve Palsy as a Neurological Manifestation of COVID-19.
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Martins ASP, Losa FJF, Rueda HHV, and García-Gasalla M
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Facial nerve palsy is the most frequent acute mononeuropathy and it is often of viral etiology, although many other causes have been identified. It has recently been described as a potential manifestation of COVID-19. We report the case of a patient with recent history of diarrhea and malaise that was admitted to the hospital presenting right facial paresis with orbicular muscle involvement. Nasopharyngeal swab tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the real-time reverse transcription polymerase chain reaction and magnetic resonance imaging showed no structural changes. During the hospital stay, the patient showed clinical improvement, and no other symptoms were observed. This case presentation suggests a possible association between neuropathies and SARS-CoV-2 infection., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Global Infectious Diseases.)
- Published
- 2021
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48. Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission.
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García-Gasalla M, Ferrer JM, Fraile-Ribot PA, Ferre-Beltrán A, Rodríguez A, Martínez-Pomar N, Ramon-Clar L, Iglesias A, Losada-López I, Fanjul F, Pou JA, Llompart-Alabern I, Toledo N, Pons J, Oliver A, Riera M, and Murillas J
- Abstract
Background: Early identification of COVID-19 patients at risk of critical illness is a challenging endeavor for clinicians. We aimed to establish immunological, virological, and routine laboratory markers, which, in combination with clinical information, may allow identifying such patients., Methods: Blood tests to measure neutrophil/lymphocyte ratio (NLR) and levels of ferritin, CRP, D-dimer, complement components (C3 and C4), cytokines, and lymphocyte subsets, as well as SARS-Cov-2 RT-PCR tests, were performed in COVID-19-confirmed cases within 48 hours of admission. RT-PCR cycle threshold (Ct) values from oropharyngeal or nasopharyngeal swabs were determined on the day of admission. Symptom severity was categorized as mild (grade 1), severe (grade 2), or critical (grade 3)., Results: Of 120 patients who were included, 49 had mild, 32 severe, and 39 critical COVID-19. Levels of ferritin >370 ng/mL (OR 16.4, 95% CI 5.3-50.8), D-dimer >440 ng/mL (OR 5.45, 95% CI 2.36-12.61), CRP >7.65 mg/dL (OR 11.54, 95% CI 4.3-30.8), NLR >3.77 (OR 13.4, 95% CI 4.3-41.1), IL-6 >142.5 pg/mL (OR 8.76, 95% CI 3.56-21.54), IL-10 >10.8 pg/mL (OR 16.45, 95% CI 5.32-50.81), sIL-2r α (sCD25) >804.5 pg/mL (OR 14.06, 95% CI 4.56-43.28), IL-1Ra >88.4 pg/mL (OR 4.54, 95% CI 2.03-10.17), and IL-18 >144 pg/mL (OR 17.85, 95% CI 6.54-48.78) were associated with critical COVID-19 in the univariate age-adjusted analysis. This association was confirmed in the multivariate age-adjusted analysis only for ferritin, CRP, NLR, IL-10, sIL-2r α , and IL-18. T, B, and NK cells were significantly decreased in critical patients. SARS-CoV-2 was not detected in blood except in 3 patients who had indeterminate results. RT-PCR Ct values from oropharyngeal or nasopharyngeal swabs on admission were not related to symptom severity., Conclusion: Ferritin, D-dimer, CRP, NLR, cytokine (IL-18 and IL-10), and cytokine receptor (IL-6, IL1-Ra, and sCD25) test results combined with clinical data can contribute to the early identification of critical COVID-19 patients., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 Mercedes García-Gasalla et al.)
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- 2021
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49. Use of Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry Analysis of Serum Peptidome to Classify and Predict Coronavirus Disease 2019 Severity.
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Gomila RM, Martorell G, Fraile-Ribot PA, Doménech-Sánchez A, Albertí M, Oliver A, García-Gasalla M, and Albertí S
- Abstract
Background: Classification and early detection of severe coronavirus disease 2019 (COVID-19) patients is required to establish an effective treatment. We tested the utility of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) to classify and predict the severity of COVID-19., Methods: We used MALDI-TOF MS to analyze the serum peptidome from 72 patients with COVID-19 (training cohort), clinically classified as mild (28), severe (23), and critical (21), and 20 healthy controls. The resulting matrix of peak intensities was used for Machine Learning (ML) approaches to classify and predict COVID-19 severity of 22 independent patients (validation cohort). Finally, we analyzed all sera by liquid chromatography mass spectrometry (LC-MS/MS) to identify the most relevant proteins associated with disease severity., Results: We found a clear variability of the serum peptidome profile depending on COVID-19 severity. Forty-two peaks exhibited a log fold change ≥1 and 17 were significantly different and at least 4-fold more intense in the set of critical patients than in the mild ones. The ML approach classified clinical stable patients according to their severity with 100% accuracy and correctly predicted the evolution of the nonstable patients in all cases. The LC-MS/MS identified 5 proteins that were significantly upregulated in the critical patients. They included the serum amyloid protein A2, which probably yielded the most intense peak detected by MALDI-TOF MS., Conclusions: We demonstrate the potential of the MALDI-TOF MS as a bench to bedside technology to aid clinicians in their decision making regarding patients with COVID-19., (© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
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- 2021
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50. Paper biosensors for detecting elevated IL-6 levels in blood and respiratory samples from COVID-19 patients.
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Adrover-Jaume C, Alba-Patiño A, Clemente A, Santopolo G, Vaquer A, Russell SM, Barón E, González Del Campo MDM, Ferrer JM, Berman-Riu M, García-Gasalla M, Aranda M, Borges M, and de la Rica R
- Abstract
Decentralizing COVID-19 care reduces contagions and affords a better use of hospital resources. We introduce biosensors aimed at detecting severe cases of COVID-19 in decentralized healthcare settings. They consist of a paper immunosensor interfaced with a smartphone. The immunosensors have been designed to generate intense colorimetric signals when the sample contains ultralow concentrations of IL-6, which has been proposed as a prognosis biomarker of COVID-19. This is achieved by combining a paper-based signal amplification mechanism with polymer-filled reservoirs for dispensing antibody-decorated nanoparticles and a bespoken app for color quantification. With this design we achieved a low limit of detection (LOD) of 10
-3 pg mL-1 and semi-quantitative measurements in a wide dynamic range between 10-3 and 102 pg mL-1 in PBS. The assay time is under 10 min. The low LOD allowed us to dilute blood samples and detect IL-6 with an LOD of 1.3 pg mL-1 and a dynamic range up to 102 pg mL-1 . Following this protocol, we were able to stratify COVID-19 patients according to different blood levels of IL-6. We also report on the detection of IL-6 in respiratory samples (bronchial aspirate, BAS) from COVID-19 patients. The test could be easily adapted to detect other cytokines such as TNF-α and IL-8 by changing the antibodies decorating the nanoparticles accordingly. The ability of detecting cytokines in blood and respiratory samples paves the way for monitoring local inflammation in the lungs as well as systemic inflammation levels in the body., Competing Interests: The authors report no declarations of interest., (© 2020 Elsevier B.V. All rights reserved.)- Published
- 2021
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