70 results on '"Gracia-Tello B"'
Search Results
2. POS0904 UNLOCKING PRECISION IN CAPILLAROSCOPY: EXTERNAL VALIDATION OF THE CAPI-SCORE ALGORITHM FOR ACCURATE PATTERN IDENTIFICATION IN NAILFOLD VIDEOCAPILLAROSCOPY
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Lledó, G., primary, Sáez-Comet, L., additional, Freire Dapena, M., additional, Mesa Navas, M. A., additional, Martín Cascón, M., additional, Guillén-Del-Castillo, A., additional, Martínez Robles, E., additional, Todoli, J. A., additional, Simeón-Aznar, C. P., additional, Varela, D. C., additional, Maldonado, G., additional, Marín Ballvé, A., additional, Longares Ibáñez, N., additional, Gracia Tello, B. D. C., additional, and Ramos Ibañez, E., additional more...
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- 2024
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3. Impact of novel coronavirus infection in patients with uveitis associated with an autoimmune disease: Result of the COVID-19-GEAS patient survey
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Fanlo, P., Espinosa, G., Adán, A., Arnáez, R., Fonollosa, A., Heras, H., Oteiza, J., del Carmelo Gracia Tello, B., Sáez Comet, L., and Pallarés, L.
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- 2021
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4. Vasculitis de gran vaso: arteritis de células gigantes y arteritis de Takayasu
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Álvarez-Troncoso, J., Gracia-Tello, B., Freire, M., and Sopeña, B.
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- 2021
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5. Capi-score: a quantitative algorithm for identifying disease patterns in nailfold videocapillaroscopy
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Gracia Tello, B C, primary, Sáez Comet, L, additional, Lledó, G, additional, Freire Dapena, M, additional, Mesa, M A, additional, Martín-Cascón, M, additional, Guillén del Castillo, A, additional, Martínez Robles, E, additional, Simeón-Aznar, C P, additional, Todolí Parra, J A, additional, Varela, D C, additional, Maldonado Vélez, G, additional, Marín Ballvé, A, additional, Aramburu Llorente, J, additional, Pérez Abad, L, additional, and Ramos Ibáñez, E, additional more...
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- 2024
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6. Systemic phenotype of sarcoidosis associated with radiological stages. Analysis of 1230 patients
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Pérez-Alvarez, R., Brito-Zerón, P., Kostov, B., Feijoo-Massó, C., Fraile, G., Gómez-de-la-Torre, R., De-Escalante, B., López-Dupla, M., Alguacil, A., Chara-Cervantes, J., Pérez-Conesa, M., Rascón, J., Garcia-Morillo, J.S., Perez-Guerrero, P., Fonseca-Aizpuru, E., Akasbi, M., Bonet, M., Callejas, J.L., De-la-Red, G., Calvo, E., Soler, C., Peral-Gutiérrez, E., Gómez-Cerezo, J.F., Cruz-Caparrós, G., Rodríguez-Fernández, S., Pinilla, B., Gato, A., Chamorro, A.J., Morcillo, C., Robles, A., Ojeda, I., Vives, M.J., de Miguel-Campo, B., Penadés, M., De-Vicente, M., Bosch, X., Pérez-de-Lis, M., González-García, A., Yllera, C., Gracia-Tello, B., Perez-Gonzalez, A., Pedrosa-Aragón, M., Tolosa, C., Sisó-Almirall, A., Pallarés, L., and Ramos-Casals, M. more...
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- 2019
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7. OP0083 ANAKINRA PLUS STANDARD OF CARE FOR THE REDUCTION OF HYPERINFLAMMATION AND RESPIRATORY DISTRESS IN PATIENTS WITH SARS-COV-2 INFECTION: A MULTICENTRE, RANDOMISED, OPEN-LABEL PHASE 2/3 TRIAL (ANA-COVID-GEAS STUDY)
- Author
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Fanlo, P., primary, Gracia Tello, B., additional, Fonseca, E., additional, Álvarez Troncoso, J., additional, González, A., additional, Prieto-González, S., additional, Freire, M., additional, Argibay, A., additional, Pallares Ferreres, L., additional, Todoli, J. A., additional, Perez Conesa, M., additional, Bujan Rivas, S., additional, and Ibañez, B., additional more...
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- 2023
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8. POS0271 CLINICAL SYMPTOMS AT GIANT CELL ARTERITIS DIAGNOSIS AS PREDICTORS OF PERMANENT VISUAL LOSS.
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Mestre-Torres, J., primary, Escalante, B., additional, Fonseca, E., additional, Martinez-Zapico, A., additional, Monteagudo, M., additional, Abdilla, M., additional, Perez Conesa, M., additional, Gracia Tello, B., additional, Prieto-González, S., additional, Fraile, G., additional, and Solans-Laqué, R., additional more...
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- 2022
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9. Characterization and Outcomes of SARS-CoV-2 Infection in Patients with Sarcoidosis
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Brito-Zerón, P., Gracia-Tello, B., Robles, A., Alguacil, A., Bonet, M., De-Escalante, B., Noblejas-Mosso, A., Gómez-de-la-Torre, R., Akasbi, M., Pérez-de-Lis, M., Pérez-Alvarez, R., Ramos-Casals, M., and Registry, on behalf of the SarcoGEAS-SEMI more...
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Adult ,Male ,medicine.medical_specialty ,SARS-Cov-2 ,Comorbidity ,comorbidities ,Microbiology ,survival ,Article ,law.invention ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,law ,Virology ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,030212 general & internal medicine ,Registries ,sarcoidosis ,Cardiopulmonary disease ,Aged ,030203 arthritis & rheumatology ,Aged, 80 and over ,business.industry ,COVID-19 ,Odds ratio ,Middle Aged ,medicine.disease ,Intensive care unit ,QR1-502 ,Hospitalization ,hospital admission ,Infectious Diseases ,Treatment Outcome ,Cohort ,Female ,Sarcoidosis ,France ,business ,Cohort study - Abstract
To analyze the clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with sarcoidosis from a large multicenter cohort from Southern Europe and to identify the risk factors associated with a more complicated infection. We searched for patients with sarcoidosis presenting with SARS-CoV-2 infection (defined according to the European Centre for Disease Prevention and Control guidelines) among those included in the SarcoGEAS Registry, a nationwide, multicenter registry of patients fulfilling the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders 1999 classification criteria for sarcoidosis. A 2:1 age-sex-matched subset of patients with sarcoidosis without SARS-CoV-2 infection was selected as control population. Forty-five patients with SARS-CoV-2 infection were identified (28 women, mean age 55 years). Thirty-six patients presented a symptomatic SARS-CoV-2 infection and 14 were hospitalized (12 required supplemental oxygen, 2 intensive care unit admission and 1 mechanical ventilation). Four patients died due to progressive respiratory failure. Patients who required hospital admission had an older mean age (64.9 vs. 51.0 years, p = 0.006), a higher frequency of baseline comorbidities including cardiovascular disease (64% vs. 23%, p = 0.016), diabetes mellitus (43% vs. 13%, p = 0.049) and chronic liver/kidney diseases (36% vs. 0%, p = 0.002) and presented more frequently fever (79% vs. 35%, p = 0.011) and dyspnea (50% vs. 3%, p = 0.001) in comparison with patients managed at home. Age- and sex-adjusted multivariate analysis identified the age at diagnosis of SARS-Cov-2 infection as the only independent variable associated with hospitalization (adjusted odds ratio 1.18, 95% conficence interval 1.04–1.35). A baseline moderate/severe pulmonary impairment in function tests was associated with a higher rate of hospitalization but the difference was not statistically significant (50% vs. 23%, p = 0.219). A close monitoring of SARS-CoV-2 infection in elderly patients with sarcoidosis, especially in those with baseline cardiopulmonary diseases and chronic liver or renal failure, is recommended. The low frequency of severe pulmonary involvement in patients with sarcoidosis from Southern Europe may explain the weak prognostic role of baseline lung impairment in our study, in contrast to studies from other geographical areas. more...
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- 2021
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10. Impacto de la infección por el nuevo coronavirus en los pacientes con uveítis asociada a una enfermedad autoinmune: resultado de la encuesta COVID-19-GEAS pacientes
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Fanlo, P., primary, Espinosa, G., additional, Adán, A., additional, Arnáez, R., additional, Fonollosa, A., additional, Heras, H., additional, Oteiza, J., additional, del Carmelo Gracia Tello, B., additional, Comet, L. Sáez, additional, and Pallarés, L., additional more...
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- 2021
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11. The challenge of comprehensive nailfold videocapillaroscopy practice: a further contribution
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Gracia Tello B, Ramos Ibañez E, Fanlo Mateo P, Sáez Cómet L, Martínez Robles E, Ríos Blanco JJ, Marí Alfonso B, Espinosa Garriga G, Todolí Parra J, Ortego Centeno N, Callejas Rubio JL, Freire Dapena M, Marín Ballvé A, Selva-O'Callaghan A, Guillén Del Castillo A, Simeón Aznar CP, and Fonollosa Pla V more...
- Abstract
OBJECTIVES: Although classification systems and scores for capillaroscopy interpretation have been published, there is a lack of homogenization for the procedure, especially in the way and place the images are taken, the counting of the capillaries and the measuring of their size. Our objective is to provide a deep learning-based software to obtain objective and exhaustive data for the whole nailfold without increasing the time or effort needed to do the examination, or requiring expensive equipment. METHODS: An automated software to count nailfold capillaries has been designed, through an exploratory image dataset of 2,713 images with 18,000 measurements of 3 different types. Subsequently, application rules have been created to detect the morphology of nailfold videocapillaroscopy images, through a training set of images. The software reliability has been evaluated with standard metrics used in the machine learning field for object detection tasks, comparing automatic and manual counting on the same NVC images. RESULTS: A mean average precision (mAP) of 0.473 is achieved for detecting and classifying capillaries and haemorrhages by their shape, and a mAP of 0.515 is achieved for detecting and classifying capillaries by their size. A precision of 83.84% and a recall of 92.44% in the identification of capillaries was estimated. CONCLUSIONS: Deep learning is a useful tool in nailfold videocapillaroscopy that allows to analyse objectively and homogeneously images taken with multiple devices. It should make the assessment of the capillary morphology in nailfold video capillaroscopy easier, quicker, more complete and accessible to everyone. more...
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- 2021
12. POS1409 AUTOMATED DETECTION OF SCLERODERMIFORM PATTERNS USING CAPILLARY.IO
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Ramos, E., primary, Guillén-Del-Castillo, A., additional, Simeón-Aznar, C. P., additional, Gracia Tello, B., additional, Fonollosa Pla, V., additional, Selva-O’callaghan, A., additional, Sáez-Comet, L., additional, Martínez Robles, E., additional, Rios, J. J., additional, Espinosa, G., additional, Todolí Parra, J. A., additional, Callejas-Rubio, J. L., additional, Ortego, N., additional, Marí-Alfonso, B., additional, Freire, M., additional, and Fanlo, P., additional more...
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- 2021
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13. POS1408 REPRODUCIBILITY OF A NEW AUTOMATIC SYSTEM (CAPILLARY.IO) IN THE ANALYSIS OF NAILFOLD CAPILLAROSCOPY IMAGES
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Gracia Tello, B., primary, Ramos, E., additional, Simeón-Aznar, C. P., additional, Fonollosa Pla, V., additional, Guillén-Del-Castillo, A., additional, Selva-O’callaghan, A., additional, Sáez-Comet, L., additional, Martínez Robles, E., additional, Rios, J. J., additional, Espinosa, G., additional, Todolí Parra, J. A., additional, Callejas-Rubio, J. L., additional, Ortego, N., additional, Marí-Alfonso, B., additional, Freire, M., additional, and Fanlo, P., additional more...
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- 2021
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14. Early measurement of blood sST2 is a good predictor of death and poor outcomes in patients admitted for COVID-19 infection
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Sánchez-Marteles, M, primary, Rubio-Gracia, J, additional, Peña-Fresneda, N., additional, Garcés-Horna, V, additional, Gracia-Tello, B, additional, Martínez-Lostao, L, additional, Crespo-Aznárez, S, additional, Pérez-Calvo, JI, additional, and Giménez-López, I, additional more...
- Published
- 2021
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15. Comparación de los índices PROFUND y PALIAR en pacientes pluripatológicos con enfermedad crónica no oncológica en fase avanzada
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Díez-Manglano, J., Gómez-Aguirre, N., Velilla-Marco, J., Lambán Aranda, M.P., de Escalante Yangüela, B., Fuertes Ruiz, D., García Aranda, A., Clemente Sarasa, C., Clemente-Sarasa, C., Fuertes-Ruiz, D., Bejarano-Tello, E., Munilla López, E., Aguirre, G., Bueno Castel, Carmen, Artajona Rodrigo, E., Gracia Tello, B., Cabrerizo García, J.L., and Yagüe Vallejo, S. more...
- Abstract
Background and objective: To compare the discrimination power of PROFUND and PALIAR indexes for predicting mortality in polypathological patients with advanced non-oncologic chronic disease. Material and methods: Prospective multicentre cohort study. We included polypathological patients with advanced non-oncologic chronic disease, who were admitted to internal medicine departments between July 1 st and December 31th, 2014. Data was collected from each patient on age, sex, categories of polypathology, advanced disease, comorbidity, functional and cognitive assessment, terminal illness symptoms, need for caregiver, hospitalisation in the past three and 12 months and number of drugs. We calculated the PROFUND and PALIAR indexes and conducted a 12-month follow-up. We assessed mortality with the Kaplan-Meier survival curves and the discrimination of indexes with the ROC curves. Results: We included 213 patients with a mean (standard deviation) age of 83.0 (7.0) years, 106 (49.8%) of whom were female. Mortality at six months was 40.4% and at 12 months 50.2%. Deceased patients scored higher scores on the PROFUND [11.2(4.2) vs 8.5(3.9); P more...
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- 2019
16. Hydration and obesity among outpatient-based population: H2Ob study
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Carretero-Gómez J, Arévalo Lorido JC, Gómez Huelgas R, De Escalante Yangüela B, Gracia Tello B, Pérez Belmonte L, Ena Muñoz J, and SEMI Working Group of Diabetes and Obesity
- Abstract
Recent evidence suggests that obese people are hypohydrated and that water consumption may be a useful indicator for the prevention and treatment of obesity. Nevertheless, there is no agreement regarding the best hydration status indicators and there are few data about the relationship between hydration and body weight. In the present study, we aim to analyze the correlation among hydration status with obesity measured by three different methods (plasma osmolarity, urinary specific gravity (USG) and urinary osmolarity) in a hospital-based outpatient population. We have carried out a cross-sectional study to evaluate the association between obesity and hydration status in 260 patients, average 56.5 +/- 15.7 years. Hydration status was estimated by means of plasma osmolarity, urine osmolarity and USG. We did show significant trend of higher urine osmolarity (P=0.03), USG (P=0.000) and plasma osmolarity (P=0.000) with an increase of weight status categories, more accurate in the case of plasma osmolarity. In a multivariate analysis, after controlled by confounders, we found that obesity was associated with plasma osmolarity (OR 1.09; 95%CI 1.02 to 1.17, P=0.009), urine osmolarity (OR 1.00; 95%CI 1.00 to 1.01, P=0.05) and USG (OR 1.02; 95%CI 1.00 to 1.04, P=0.05). Our results have shown a more accurate relationship between plasma osmolarity with all body mass index categories. This finding may have clinical implications that must be confirmed in further studies. more...
- Published
- 2018
17. Bronconeumonia bilateral por Rothia mucilaginosa
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Escalante Yangüela, B. de, Gracia Gutiérrez, A., Gracia Tello, B., Alastrué del Castaño, V., Bueno Juana, E., and Algárate Cajo, S.
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Rothia mucilaginosa ,Nódulos pulmonares ,Linezolid ,Bronchopneumonia ,Bronconeumonía ,Pulmonary nodules - Abstract
RESUMEN Rothia mucilaginosa (R. mucilaginosa), antiguamente denominada Stomatococcus mucilaginosus, es un coco Gram positivo capsulado, anaerobio facultativo, que forma parte de la flora orofaríngea normal y raramente se considera patógeno en pacientes inmunocompetentes, aunque puede producir, de forma poco habitual, infecciones graves como bacteriemias, endocarditis e infecciones respiratorias: neumonías, empiemas pleurales o sobreinfección de bronquiectasias. Presentamos el caso de un varón de 74 años diagnosticado de neumonía basal derecha de evolución tórpida con mala respuesta inicial a diversos antibióticos, con empeoramiento clínico y radiológico y aparición de bronconeumonia bilateral con imágenes pseudonodulares. En 3 cultivos de esputos y en broncoaspirado se aisló R. mucilaginosa en cultivo puro. Finalmente fue tratado con Linezolid con buena respuesta clínica y normalización de la radiografía de tórax, comprobando la desaparición de R. mucilaginosa en posteriores cultivos de esputos. Existen pocos casos documentados de neumonía por R. mucilaginosa por lo que consideramos de interés presentar éste. ABSTRACT Rothia mucilaginosa (R. mucilaginosa), formerly named Stomatococcus mucilaginosus, is a facultatively anaerobic, encapsulated gram-positive coccus, which forms part of the normal oropharyngeal and is rarely considered to be a pathogen in immunocompetent patients, although it can produce, on rare occasions, serious infections like bacteremia, endocarditis and respiratory infections; such as pneumonia, pleural empyema or superinfection of bronchiectasis. We present the case of a 74-year-old male diagnosed with right basal pneumonia of torpid evolution with poor initial response to different antibiotics, with clinical and radiological worsening and the appearance of bilateral bronchopneumonia with pseudonodular images. R. mucilaginosa in pure culture was isolated in three sputum cultures and in bronchial suction. The patient was finally treated with Linezolid with good clinical response and normalisation of the thorax radiography, confirming the disappearance of R. mucilaginosa in subsequent sputum cultures. As there are few documented cases of pneumonia due to R. mucilaginosa, we believe that presenting this case will be of interest. more...
- Published
- 2017
18. Bronconeumonia bilateral por Rothia mucilaginosa
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Escalante Yangüela,B. de, Gracia Gutiérrez,A., Gracia Tello,B., Alastrué del Castaño,V., Bueno Juana,E., and Algárate Cajo,S.
- Subjects
Rothia mucilaginosa ,Nódulos pulmonares ,Linezolid ,Bronconeumonía - Abstract
RESUMEN Rothia mucilaginosa (R. mucilaginosa), antiguamente denominada Stomatococcus mucilaginosus, es un coco Gram positivo capsulado, anaerobio facultativo, que forma parte de la flora orofaríngea normal y raramente se considera patógeno en pacientes inmunocompetentes, aunque puede producir, de forma poco habitual, infecciones graves como bacteriemias, endocarditis e infecciones respiratorias: neumonías, empiemas pleurales o sobreinfección de bronquiectasias. Presentamos el caso de un varón de 74 años diagnosticado de neumonía basal derecha de evolución tórpida con mala respuesta inicial a diversos antibióticos, con empeoramiento clínico y radiológico y aparición de bronconeumonia bilateral con imágenes pseudonodulares. En 3 cultivos de esputos y en broncoaspirado se aisló R. mucilaginosa en cultivo puro. Finalmente fue tratado con Linezolid con buena respuesta clínica y normalización de la radiografía de tórax, comprobando la desaparición de R. mucilaginosa en posteriores cultivos de esputos. Existen pocos casos documentados de neumonía por R. mucilaginosa por lo que consideramos de interés presentar éste. more...
- Published
- 2017
19. SAT0596 Thoracic involvement at diagnosis drives a differentiated clinical presentation of sarcoidosis: analysis of 1245 patients (SARCOGEAS-SEMI)
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Retamozo, S., primary, Brito-Zerón, P., additional, Pérez-Alvarez, R., additional, Kostov, B., additional, Feijoo Masso, C., additional, Fraile, G., additional, Gómez-de-la-Torre, R., additional, De-Escalante, B., additional, López-Dupla, M., additional, Alguacil, A., additional, Chara-Cervantes, J., additional, Pérez-Conesa, M., additional, Rascón, J., additional, Garcia-Morillo, J.S., additional, Perez-Guerrero, P., additional, Fonseca, E., additional, Akasbi, M., additional, Bonet, M., additional, Callejas, J.L., additional, De-la-Red, G., additional, Calvo, E., additional, Soler, C., additional, Peral-Gutiérrez, E., additional, Gómez-Cerezo, J.F., additional, Cruz-Caparrós, G., additional, Rodríguez-Fernández, S., additional, Pinilla, B., additional, Gato, A., additional, Rolo, A., additional, Morcillo, C., additional, Robles, A., additional, Ojeda, I., additional, Vives, M.J., additional, de-Miguel, B., additional, Penadés, M., additional, De-Vicente, M., additional, Bosch, X., additional, Pérez-de-Lis, M., additional, González-García, A., additional, Yllera, C., additional, Gracia-Tello, B., additional, Perez-Gonzalez, A., additional, Pedrosa, M., additional, Tolosa, C., additional, Pallarés, L., additional, and Ramos-Casals, M., additional more...
- Published
- 2018
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20. ANAKINRA PLUS STANDARD OF CARE FOR THE REDUCTION OF HYPERINFLAMMATION AND RESPIRATORY DISTRESS IN PATIENTS WITH SARSCOV-2 INFECTION: A MULTICENTRE, RANDOMISED, OPEN-LABEL PHASE 2/3 TRIAL (ANA-COVID-GEAS STUDY).
- Author
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Fanlo, P., Gracia Tello, B., Fonseca, E., Álvarez Troncoso, J., González, A., Prieto-González, S., Freire, M., Argibay, A., Pallares Ferreres, L., Todoli, J. A., Perez Conesa, M., Bujan Rivas, S., and Ibañez, B. more...
- Published
- 2023
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21. Embolismo tumoral pulmonar microvascular en paciente con tumor urotelial
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Escalante Yangüela, B. de, Rubio Gracia, J., Muñoz González, G., Gracia Tello, B., Rodero Roldán, M., and Alastrué del Castaño, V.
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Carcinoma urotelial micropapilar ,Micropapillary urothelial carcinoma ,Autopsia ,Autopsy ,Embolismo tumoral pulmonar ,Pulmonary tumor embolism - Abstract
Los embolismos tumorales pulmonares (ETP) representan una causa poco frecuente de disnea en pacientes oncológicos. La mayoría se diagnostican en pacientes con tumores avanzados, sobre todo localizados en mama, pulmón o estómago. Existen pocos casos publicados en pacientes con tumores uroteliales. Presentamos el caso de un varón de 69 años, sin diagnóstico previo de cáncer, que ingresó por disnea subaguda, con sospecha clínica inicial de tromboembolismo pulmonar (TEP). El paciente falleció al 5º día del ingreso. En la autopsia se comprobó la existencia de un tumor en pelvis renal izquierda con metástasis hepáticas y linfoganglionares múltiples y una extensa embolia pulmonar microvascular que afectaba a gran parte de los capilares y vasos sanguíneos de mediano calibre de ambos pulmones. Los ETP se consideraron responsables de la insuficiencia respiratoria progresiva y se interpretaron como la causa última de la muerte. La presentación clínica más frecuente de los ETP es la disnea, a menudo se confunden con el TEP y el diagnóstico no resulta fácil. Su pronóstico es muy malo, con una elevadísima mortalidad y su confirmación habitualmente es post-mortem. Pulmonary tumor embolisms (PTE) are an infrequent cause of dyspnea in oncological patients. The majority are diagnosed in patients with advanced tumors, above all localized in the breast, lung or stomach. There are few published cases involving patients with urothelial tumors. We present the case of a 69 year-old male, without a previous diagnosis of cancer, who was admitted due to subacute dyspnea, with clinical suspicion of pulmonary thromboembolism (PT). The patient died on the fifth day of admission. The autopsy confirmed the existence of a tumor in the left renal pelvis with hepatic and lymphoganglionary metastasis and an extensive microvascular pulmonary embolism that affected a large part of the capillaries and medium-caliber blood vessels of both lungs. PTE were considered responsible for the progressive respiratory failure and as the final cause of death. The most frequent clinical presentation of PTE is dyspnea. They are often mistaken for PT and diagnosis is not easy. Their prognosis is very bad, with extremely high mortality and confirmation is usually post-mortem. more...
- Published
- 2015
22. Sindrome de Forrestier Rosler Querol
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Suller Marti, A., Gracia-Tello, B., Velázquez, A., and Tejero, C.
- Abstract
Se trata de un varón de 67 años de edad con antecedentes de hipertensión arterial, dislipemia y cardiopatía isquémica. Ingresa por cuadro de afasia motora y síndrome vertiginoso asociado, confirmándose ictus isquémico en territorio de arteria cerebral media izquierda. Se solicitó una tomografía computarizada con angiografía que mostró como hallazgo casual una calcificación del ligamento vertebral longitudinal anterior sin compromiso de la vía aérea (fig. 1a y b), corte similar en sujeto normal. Dicha imagen se comprobó también en la radiografía simple de columna cervical con hiperostosis marcada en cara anterior de C4-C7 (fig. 2a y b), corte similar en sujeto sano. more...
- Published
- 2015
23. AB0947 The Role of Musculoskeletal Ultrasound in Managing Systemic Lupus Erythematosous and Sjogren's Syndrome in A Real Life Clinic: Table 1.
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Ntatsaki, E., primary, Gracia-Tello, B., additional, and Ciurtin, C., additional
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- 2016
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24. Síndrome de Anton con presentación atípica
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Rivero-Sanz, E., primary, Camacho-Velasquez, J.L., additional, Gracia-Tello, B., additional, and Tejero-Juste, C., additional
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- 2016
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25. Dehiscencia del canal semicircular superior detectada durante un tratamiento dental
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Crovetto Martínez, R., Martínez Rodríguez, A., Cisneros Gimeno, A.I., and Gracia Tello, B.
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Dehiscencia ,tratamiento dental ,Dehiscence ,dental treatment ,canal semicircular superior ,Tullio phenomenon ,superior semicircular canal ,fenómeno de Tullio - Abstract
La dehiscencia de canal semicircular superior del oído interno se caracteriza por la falta de cobertura ósea en la parte superior de dicho canal. Los pacientes con esta enfermedad pueden presentar vértigo cuando son sometidos a sonidos intensos, lo que se conoce como fenómeno de Tullio. Presentamos un caso clínico que asoció dicho fenómeno al fresado de un molar inferior, siendo este el primer síntoma de su enfermedad. Superior Semicircular Canal dehiscence is characterized by an osseous defect in its upper aspect. Patients with this condition may have sound-induced vertigo (Tullio phenomenon). We report a case in which a patient had a Tullio phenomenon in response to the drill of a lower molar, which is the first symptom disease. more...
- Published
- 2013
26. Embolismo tumoral pulmonar microvascular en paciente con tumor urotelial
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Escalante Yangüela, B. de, primary, Rubio Gracia, J., additional, Muñoz González, G., additional, Gracia Tello, B., additional, Rodero Roldán, M., additional, and Alastrué del Castaño, V., additional
- Published
- 2015
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27. Síndrome de Forestier-Rotés-Querol
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Suller Marti, A., primary, Gracia-Tello, B., additional, Velázquez, A., additional, and Tejero, C., additional
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- 2015
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28. Dehiscencia del canal semicircular superior detectada durante un tratamiento dental
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Crovetto Martínez, R., primary, Martínez Rodríguez, A., additional, Cisneros Gimeno, A.I., additional, and Gracia Tello, B., additional
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- 2013
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29. Differentiated Phenotypes at Diagnosis of Sarcoidosis According to the Scadding Classification: Analysis in 1230 Patients
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Retamozo, Soledad, Perez-Alvarez, Roberto, Brito-Zeron, Pilar, Kostov, Belchin, Feijoo Masso, Carlos, Fraile, Guadalupe, Gonzalez-Garcia, A., Gomez La Torre, Ricardo, De-Escalante, Begona, Lopez-Dupla, Miguel, Alguacil, Ana, Chara-Cervantes, Joel, Perez-Conesa, M., Rascon, Francisco-Javier, José-Salvador García-Morillo, Perez Guerrero, Patricia, Fonseca Aizpuru, Eva, Akasbi, Miriam, Bonet, Mariona, Luis Callejas, Jose, La Red Bellvis, Gloria, Calvo Begueria, Eva, Soler I Ferrer, Cristina, Gutierrez Ceballos, Enrique Peral, Gomez-Cerezo, J. F., Cruz Caparros, Gracia, Rodriguez Fernandez, Sergio, Pinilla, Blanca, Gato Diez, Alberto, Rolo, A., Morcillo, Cesar, Robles, Angel, Ojeda, Inmaculada, Vives, M. J., De-Miguel, Borja, Penades Vidal, Maria, Vicente, Moises, Bosh, Xavier, Perez-De-Lis, Marta, Yllera Gutierrez, Carmen, Gracia-Tello, B., Pedrosa, M., Perez-Gonzalez, A., Tolosa, Cartes, Siso-Almirall, Antoni, Pallares, Lucio, and Ramos-Casals, Manuel more...
30. Serodiscordant patients with systemic sclerosis: When antibody does not correspond to skin involvement
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Arandia, N. I., Espinosa, G., Vilella, C. T., Del Castillo, A. G., Rivas, M. R., Mayka Freire, Vargas Hitos, J. A., Todolí Parra, J. A., Carballeira, M. R., Ballvé, A. M., Argüelles, D. C., Echávarri Pérez Heredia, C. G., Ortego-Centeno, N., Martínez, L. T., Salas, X. P., Chamorro, A. J., Fraile, I. P., Muñoz, M. R., Fernández La Puebla Giménez, R. Á, Madroñero Vuelta, A. B., Del Campo, I. P. M., Heredia, I. J. P., García, A. G., Pla, V. F., Simeón Aznar, C. P., Callejas Moraga, E., Carbonell, C., Colunga, D., Fernández La Puebla, R. A., Fonollosa, V., González Echávarri, C., González García, A., Gracia Tello, B., Guillén Del Castillo, A., Iniesta, N., Jiménez Pérez Heredia, I., Madroñero, A. B., Marín Ballvé, A., Perales, I., Pestaña, M., Pla Salas, X., Pons Martín Del Campo, I., Rodríguez Carballeira, M., Rodríguez Pinto, I., Rubio Rivas, M., Ruiz Muñoz, M., Segovia, P., Simeón, C. P., Tarí, E. V., Todolí, J. A., Tolosa, C., and Trapiella, L. more...
31. Nailfold capillaroscopy.
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Gracia Tello B and Ramos Ibañez E
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- Humans, Nails, Microscopic Angioscopy, Capillaries diagnostic imaging
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- 2023
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32. [Capillaroscopy, microangiopathy, and HIV. Descriptive study of capillaroscopy findings in HIV positive patients].
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Verdejo-Muñoz G, Gálvez-Barrón C, Gracia Tello B, Gamarra Calvo S, Sanjoaquín Conde I, Catena A, and Blanco Ramos JR
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- Humans, Male, Adult, Female, Microscopic Angioscopy, Cross-Sectional Studies, Hypertension, Heart Diseases, HIV Infections complications
- Abstract
Background: In this study, we aim to evaluate microangiopathy in HIV positive patients by using capillaroscopy. To date, few studies have been published on the topic. Capillaroscopy may be a tool for early diagnosis of cardiovascular involvement in this patient population., Methodology: Cross-sectional study with HIV positive patients >18 years. The enrolment period was set from January to June 2018. The following data were collected: demographic (sex, age), laboratory tests (duration of infection, CD4 cell count, CD4:CD8 ratio, coinfection with other viruses), antiretroviral treatment, dyslipidemia, and comorbidities (active smoking, alcoholism, high blood pressure, dyslipidaemia, diabetes, cardiopathy). The capillaroscopy and blood tests were performed simultaneously. The following alterations were evaluated in the capillaroscopy: congestion, tortuosity, haemorrhage, dilations, capillary loss, and presence of megacapillaries., Results: One hundred and two patients were included; 73.5% were male, mean age was 40 years (SD: 10), and mean duration of infection 4.5 years (SD: 3.1). At diagnosis, mean CD4 cell count was 408/mm3 and CD4/CD8 ratio 0.4. A number of patients (14.7%) were coinfected with the hepatitis B virus; 31.3% were active smokers and 13.7% alcoholics. Capillaroscopy alterations were found in most study patients (93.1%): congestion (78.5%), tortuosity (77.5%), haemorrhage (13.8%), dilations (11.8%), capillary loss (5%), and megacapillaries (1%). Capillary tortuosity was associated with age and smoking; and haemorrhage with age, CD4, antiretroviral treatment, and hypertension., Conclusion: Prevalence of capillaroscopy alterations is high in HIV positive patients, particularly tortuosity and congestion. To the best of our knowledge, the later alteration has not been previously reported in this group of patients. more...
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- 2022
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33. The challenge of comprehensive nailfold videocapillaroscopy practice: a further contribution.
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Gracia Tello B, Ramos Ibañez E, Fanlo Mateo P, Sáez Cómet L, Martínez Robles E, Ríos Blanco JJ, Marí Alfonso B, Espinosa Garriga G, Todolí Parra J, Ortego Centeno N, Callejas Rubio JL, Freire Dapena M, Marín Ballvé A, Selva-O'Callaghan A, Guillén Del Castillo A, Simeón Aznar CP, and Fonollosa Pla V more...
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- Humans, Reproducibility of Results, Capillaries diagnostic imaging, Software, Microscopic Angioscopy methods, Nails diagnostic imaging, Nails blood supply
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Objectives: Although classification systems and scores for capillaroscopy interpretation have been published, there is a lack of homogenization for the procedure, especially in the way and place the images are taken, the counting of the capillaries and the measuring of their size. Our objective is to provide a deep learning-based software to obtain objective and exhaustive data for the whole nailfold without increasing the time or effort needed to do the examination, or requiring expensive equipment., Methods: An automated software to count nailfold capillaries has been designed, through an exploratory image dataset of 2,713 images with 18,000 measurements of 3 different types. Subsequently, application rules have been created to detect the morphology of nailfold videocapillaroscopy images, through a training set of images. The software reliability has been evaluated with standard metrics used in the machine learning field for object detection tasks, comparing automatic and manual counting on the same NVC images., Results: A mean average precision (mAP) of 0.473 is achieved for detecting and classifying capillaries and haemorrhages by their shape, and a mAP of 0.515 is achieved for detecting and classifying capillaries by their size. A precision of 83.84% and a recall of 92.44% in the identification of capillaries was estimated., Conclusions: Deep learning is a useful tool in nailfold videocapillaroscopy that allows to analyse objectively and homogeneously images taken with multiple devices. It should make the assessment of the capillary morphology in nailfold video capillaroscopy easier, quicker, more complete and accessible to everyone. more...
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- 2022
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34. Integrated analysis of circulating immune cellular and soluble mediators reveals specific COVID19 signatures at hospital admission with utility for prediction of clinical outcomes.
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Uranga-Murillo I, Morte E, Hidalgo S, Pesini C, García-Mulero S, Sierra JL, Santiago L, Arias M, De Miguel D, Encabo-Berzosa MDM, Gracia-Tello B, Sanz-Pamplona R, Martinez-Lostao L, Galvez EM, Paño-Pardo JR, Ramirez-Labrada A, and Pardo J more...
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers blood, CD8-Positive T-Lymphocytes virology, COVID-19 mortality, Case-Control Studies, Chemokines blood, Cytokines blood, Female, Hospitalization, Humans, Killer Cells, Natural virology, Logistic Models, Male, Middle Aged, Monocytes virology, Prospective Studies, Respiratory Tract Infections blood, Respiratory Tract Infections immunology, Severity of Illness Index, COVID-19 blood, COVID-19 immunology
- Abstract
Coronavirus disease 2019 (COVID19), caused by SARS-CoV-2, is a complex disease, with a variety of clinical manifestations ranging from asymptomatic infection or mild cold-like symptoms to more severe cases requiring hospitalization and critical care. The most severe presentations seem to be related with a delayed, deregulated immune response leading to exacerbated inflammation and organ damage with close similarities to sepsis. Methods: In order to improve the understanding on the relation between host immune response and disease course, we have studied the differences in the cellular (monocytes, CD8+ T and NK cells) and soluble (cytokines, chemokines and immunoregulatory ligands) immune response in blood between Healthy Donors (HD), COVID19 and a group of patients with non-COVID19 respiratory tract infections (NON-COV-RTI). In addition, the immune response profile has been analyzed in COVID19 patients according to disease severity. Results: In comparison to HDs and patients with NON-COV-RTI, COVID19 patients show a heterogeneous immune response with the presence of both activated and exhausted CD8+ T and NK cells characterised by the expression of the immune checkpoint LAG3 and the presence of the adaptive NK cell subset. An increased frequency of adaptive NK cells and a reduction of NK cells expressing the activating receptors NKp30 and NKp46 correlated with disease severity. Although both activated and exhausted NK cells expressing LAG3 were increased in moderate/severe cases, unsupervised cell clustering analyses revealed a more complex scenario with single NK cells expressing more than one immune checkpoint (PD1, TIM3 and/or LAG3). A general increased level of inflammatory cytokines and chemokines was found in COVID19 patients, some of which like IL18, IL1RA, IL36B and IL31, IL2, IFNα and TNFα, CXCL10, CCL2 and CCL8 were able to differentiate between COVID19 and NON-COV-RTI and correlated with bad prognosis (IL2, TNFα, IL1RA, CCL2, CXCL10 and CXCL9). Notably, we found that soluble NKG2D ligands from the MIC and ULBPs families were increased in COVID19 compared to NON-COV-RTI and correlated with disease severity. Conclusions: Our results provide a detailed comprehensive analysis of the presence of activated and exhausted CD8+T, NK and monocyte cell subsets as well as extracellular inflammatory factors beyond cytokines/chemokines, specifically associated to COVID19. Importantly, multivariate analysis including clinical, demographical and immunological experimental variables have allowed us to reveal specific immune signatures to i) differentiate COVID19 from other infections and ii) predict disease severity and the risk of death., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).) more...
- Published
- 2022
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35. Coexistence of immune-mediated diseases in sarcoidosis. Frequency and clinical significance in 1737 patients.
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Brito-Zerón P, Pérez-Alvarez R, Feijoo-Massó C, Gracia-Tello B, González-García A, Gómez-de-la-Torre R, Alguacil A, López-Dupla M, Robles A, Garcia-Morillo S, Bonet M, Cruz-Caparrós G, Fonseca-Aizpuru E, Akasbi M, Callejas JL, de Miguel-Campo B, Pérez-de-Lis M, and Ramos-Casals M more...
- Subjects
- Cohort Studies, Female, Humans, Male, Odds Ratio, Autoimmune Diseases, Sarcoidosis complications, Sarcoidosis diagnosis, Sarcoidosis epidemiology, Sjogren's Syndrome complications, Sjogren's Syndrome epidemiology
- Abstract
Objective: To analyze whether immune-mediated diseases (IMDs) occurs in sarcoidosis more commonly than expected in the general population, and how concomitant IMDs influence the clinical presentation of the disease., Methods: We searched for coexisting IMDs in patients included in the SARCOGEAS-cohort, a multicenter nationwide database of consecutive patients diagnosed according to the ATS/ESC/WASOG criteria. Comparisons were made considering the presence or absence of IMD clustering, and odds ratios (OR) and their 95% confidence intervals (CI) were calculated as the ratio of observed cases of every IMD in the sarcoidosis cohort to the observed cases in the general population., Results: Among 1737 patients with sarcoidosis, 283 (16%) patients presented at least one associated IMD. These patients were more commonly female (OR: 1.98, 95% CI: 1.49-2.62) and were diagnosed with sarcoidosis at an older age (49.6 vs. 47.5years, P<0.05). The frequency of IMDs in patients with sarcoidosis was nearly 2-fold higher than the frequency observed in the general population (OR: 1.64, 95% CI: 1.44-1.86). Significant associations were identified in 17 individual IMDs. In comparison with the general population, the IMDs with the strongest strength of association with sarcoidosis (OR>5) were common variable immunodeficiency (CVID) (OR: 431.8), familial Mediterranean fever (OR 33.9), primary biliary cholangitis (OR: 16.57), haemolytic anemia (OR: 12.17), autoimmune hepatitis (OR: 9.01), antiphospholipid syndrome (OR: 8.70), immune thrombocytopenia (OR: 8.43), Sjögren syndrome (OR: 6.98), systemic sclerosis (OR: 5.71), ankylosing spondylitis (OR: 5.49), IgA deficiency (OR: 5.07) and psoriatic arthritis (OR: 5.06). Sex-adjusted ORs were considerably higher than crude ORs for eosinophilic digestive disease in women, and for immune thrombocytopenia, systemic sclerosis and autoimmune hepatitis in men., Conclusion: We found coexisting IMDs in 1 out of 6 patients with sarcoidosis. The strongest associations were found for immunodeficiencies and some systemic, rheumatic, hepatic and hematological autoimmune diseases., (Copyright © 2021. Published by Elsevier Masson SAS.) more...
- Published
- 2021
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36. Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients.
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Rubio-Gracia J, Sánchez-Marteles M, Garcés-Horna V, Martínez-Lostao L, Ruiz-Laiglesia F, Crespo-Aznarez S, Peña-Fresneda N, Gracia-Tello B, Cebollada A, Carrera-Lasfuentes P, Pérez-Calvo JI, and Giménez-López I more...
- Abstract
Background: Risk stratification of COVID-19 patients is fundamental to improving prognosis and selecting the right treatment. We hypothesized that a combination of lung ultrasound (LUZ-score), biomarkers (sST2), and clinical models (PANDEMYC score) could be useful to improve risk stratification., Methods: This was a prospective cohort study designed to analyze the prognostic value of lung ultrasound, sST2, and PANDEMYC score in COVID-19 patients. The primary endpoint was in-hospital death and/or admission to the intensive care unit. The total length of hospital stay, increase of oxygen flow, or escalated medical treatment during the first 72 h were secondary endpoints., Results: a total of 144 patients were included; the mean age was 57.5 ± 12.78 years. The median PANDEMYC score was 243 (52), the median LUZ-score was 21 (10), and the median sST2 was 53.1 ng/mL (30.9). Soluble ST2 showed the best predictive capacity for the primary endpoint (AUC = 0.764 (0.658-0.871); p = 0.001), towards the PANDEMYC score (AUC = 0.762 (0.655-0.870); p = 0.001) and LUZ-score (AUC = 0.749 (0.596-0.901); p = 0.002). Taken together, these three tools significantly improved the risk capacity (AUC = 0.840 (0.727-0.953); p ≤ 0.001)., Conclusions: The PANDEMYC score, lung ultrasound, and sST2 concentrations upon admission for COVID-19 are independent predictors of intra-hospital death and/or the need for admission to the ICU for mechanical ventilation. The combination of these predictive tools improves the predictive power compared to each one separately. The use of decision trees, based on multivariate models, could be useful in clinical practice. more...
- Published
- 2021
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37. Point-of-care lung ultrasound assessment for risk stratification and therapy guiding in COVID-19 patients: a prospective noninterventional study.
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Rubio-Gracia J, Giménez-López I, Garcés-Horna V, López-Delgado D, Sierra-Monzón JL, Martínez-Lostao L, Josa-Laorden C, Ruiz-Laiglesia F, Pérez-Calvo JI, Crespo-Aznarez S, García-Lafuente J, Peña Fresneda N, Amores Arriaga B, Gracia-Tello B, and Sánchez-Marteles M more...
- Subjects
- Adult, Aged, Hospital Mortality, Humans, Lung diagnostic imaging, Middle Aged, Prospective Studies, Risk Assessment, SARS-CoV-2, COVID-19, Point-of-Care Systems
- Abstract
Background: Lung ultrasound is feasible for assessing lung injury caused by coronavirus disease 2019 (COVID-19). However, the prognostic meaning and time-line changes of lung injury assessed by lung ultrasound in COVID-19 hospitalised patients are unknown., Methods: Prospective cohort study designed to analyse prognostic value of lung ultrasound in COVID-19 patients by using a quantitative scale (lung ultrasound Zaragoza (LUZ)-score) during the first 72 h after admission. The primary end-point was in-hospital death and/or admission to the intensive care unit. Total length of hospital stay, increase of oxygen flow and escalation of medical treatment during the first 72 h were secondary end-points., Results: 130 patients were included in the final analysis; mean±sd age was 56.7±13.5 years. Median (interquartile range) time from the beginning of symptoms to admission was 6 (4-9) days. Lung injury assessed by LUZ-score did not differ during the first 72 h (21 (16-26) points at admission versus 20 (16-27) points at 72 h; p=0.183). In univariable logistic regression analysis, estimated arterial oxygen tension/inspiratory oxygen fraction ratio (PAFI) (hazard ratio 0.99, 95% CI 0.98-0.99; p=0.027) and LUZ-score >22 points (5.45, 1.42-20.90; p=0.013) were predictors for the primary end-point., Conclusions: LUZ-score is an easy, simple and fast point-of-care ultrasound tool to identify patients with severe lung injury due to COVID-19, upon admission. Baseline score is predictive of severity along the whole period of hospitalisation. The score facilitates early implementation or intensification of treatment for COVID-19 infection. LUZ-score may be combined with clinical variables (as estimated by PAFI) to further refine risk stratification., Competing Interests: Conflict of interest: J. Rubio-Gracia has nothing to disclose. Conflict of interest: I. Giménez-López has nothing to disclose. Conflict of interest: V. Garcés-Horna has nothing to disclose. Conflict of interest: D. López-Delgado has nothing to disclose. Conflict of interest: J.L. Sierra-Monzón has nothing to disclose. Conflict of interest: L. Martínez-Lostao has nothing to disclose. Conflict of interest: C. Josa-Laorden has nothing to disclose. Conflict of interest: F. Ruiz-Laiglesia has nothing to disclose. Conflict of interest: J.I. Pérez-Calvo has nothing to disclose. Conflict of interest: S. Crespo-Aznarez has nothing to disclose. Conflict of interest: J. García-Lafuente has nothing to disclose. Conflict of interest: N. Peña-Fresneda has nothing to disclose. Conflict of interest: B. Amores Arriaga has nothing to disclose. Conflict of interest: B. Gracia-Tello has nothing to disclose. Conflict of interest: M. Sánchez-Marteles has nothing to disclose., (Copyright ©The authors 2021.) more...
- Published
- 2021
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38. Early Measurement of Blood sST2 Is a Good Predictor of Death and Poor Outcomes in Patients Admitted for COVID-19 Infection.
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Sánchez-Marteles M, Rubio-Gracia J, Peña-Fresneda N, Garcés-Horna V, Gracia-Tello B, Martínez-Lostao L, Crespo-Aznárez S, Pérez-Calvo JI, and Giménez-López I
- Abstract
Although several biomarkers have shown correlation to prognosis in COVID-19 patients, their clinical value is limited because of lack of specificity, suboptimal sensibility or poor dynamic behavior. We hypothesized that circulating soluble ST2 (sST2) could be associated to a worse outcome in COVID-19. In total, 152 patients admitted for confirmed COVID-19 were included in a prospective non-interventional, observational study. Blood samples were drawn at admission, 48-72 h later and at discharge. sST2 concentrations and routine blood laboratory were analyzed. Primary endpoints were admission at intensive care unit (ICU) and mortality. Median age was 57.5 years [Standard Deviation (SD: 12.8)], 60.4% males. 10% of patients ( n = 15) were derived to ICU and/or died during admission. Median (IQR) sST2 serum concentration (ng/mL) rose to 53.1 (30.9) at admission, peaked at 48-72 h (79.5(64)) and returned to admission levels at discharge (44.9[36.7]). A concentration of sST2 above 58.9 ng/mL was identified patients progressing to ICU admission or death. Results remained significant after multivariable analysis. The area under the receiver operating characteristics curve (AUC) of sST2 for endpoints was 0.776 ( p = 0.001). In patients admitted for COVID-19 infection, early measurement of sST2 was able to identify patients at risk of severe complications or death. more...
- Published
- 2021
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39. Nailfold capillaroscopy in the Spanish Group of Systemic Autoimmune Diseases (GEAS). Results of an electronic survey.
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Sáez-Comet L, Fanlo-Mateo P, and Gracia-Tello B
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- Capillaries, Electronics, Humans, Microscopic Angioscopy, Nails, Autoimmune Diseases diagnosis, Scleroderma, Systemic diagnosis
- Published
- 2020
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40. External validation of the PALIAR index for patients with advanced, nononcologic chronic diseases.
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Gómez-Aguirre N, Fuertes-Ruiz D, Gracia-Tello B, Clemente-Sarasa C, Artajona-Rodrigo E, Cabrerizo-García JL, de Escalante-Yangüela B, Bueno-Castel MC, Velilla-Marco J, and Díez-Manglano J
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Logistic Models, Male, Prospective Studies, Chronic Disease mortality
- Abstract
Objective: To externally validate the PALIAR index for patients with advanced, nononcologic chronic diseases., Methods: We performed a prospective, multicenter cohort study that included patients with advanced, nononcologic chronic diseases hospitalized in internal medicine departments and treated consecutively by the researchers between July 1st and December 31st, 2014. Data were collected from each patient on age, sex, advanced disease, Charlson index, comorbidities, Barthel index, terminal illness symptoms, need for caregiver, hospitalization in the past 3 and 12 months and number of drugs. We calculated the PALIAR index and conducted a 6-month follow-up. To analyze the association between the variables and mortality, we constructed several multivariate logistic regression models., Results: The study included 295 patients with a mean age of 82.7 (8.6) years, 148 (50.2%) of whom were women. Mortality at 6 months was associated with the albumin level (OR 0.52, 95% CI 0.30-0.85, p = 0.011), and the terminal illness (OR 2.75, 95% CI 1.55-4.89, p = 0.001). The PALIAR index showed good discrimination for predicting mortality (statistical C, 0.728, 95% CI 0.670-0.787). A reduced version of the PALIAR index showed similar mortality discriminatory power., Conclusions: The PALIAR index is a reliable tool for predicting mortality in patients with advanced, nononcologic chronic diseases. more...
- Published
- 2019
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41. Derivation and validation of a predictive model for the readmission of patients with diabetes mellitus treated in internal medicine departments.
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Ena J, Gómez-Huelgas R, Gracia-Tello BC, Vázquez-Rodríguez P, Alcalá-Pedrajas JN, Carrasco-Sánchez FJ, Murcia-Casas B, Romero-Sánchez M, Segura-Heras JV, and Carretero J
- Abstract
Objectives: We developed a predictive model for the hospital readmission of patients with diabetes. The objective was to identify the frail population that requires additional strategies to prevent readmissions at 90 days., Methods: Using data collected from 1977 patients in 3 studies on the national prevalence of diabetes (2015-2017), we developed and validated a predictive model of readmission at 90 days for patients with diabetes., Results: A total of 704 (36%) readmissions were recorded. There were no differences in the readmission rates over the course of the 3 studies. The hospitals with more than 500 beds showed significantly (p=.02) higher readmission rates than those with fewer beds. The main reasons for readmission were infectious diseases (29%), cardiovascular diseases (24) and respiratory diseases (14%). Readmissions directly related to diabetic decompensations accounted for only 2% of all readmissions. The independent variables associated with hospital readmission were patient's age, degree of comorbidity, estimated glomerular filtration rate, degree of disability, presence of previous episodes of hypoglycaemia, use of insulin in treating diabetes and the use of systemic glucocorticoids. The predictive model showed an area under the ROC curve (AUC) of 0.676 (95% confidence interval [95% CI] 0.642-0.709; p=.001) in the referral cohort. In the validation cohort, the model showed an AUC of 0.661 (95% CI 0.612-0.710; p=.001)., Conclusion: The model we developed for predicting readmissions for hospitalised patients with type 2 diabetes helps identify a subgroup of frail patients with a high risk of readmission., (Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.) more...
- Published
- 2018
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42. [Bilateral bronchopneumonia due to Rothia mucilaginosa].
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De Escalante Yangüela B, Gracia Gutiérrez A, Gracia Tello B, Alastrué Del Castaño V, Bueno Juana E, and Algárate Cajo S
- Subjects
- Aged, Bronchopneumonia diagnosis, Bronchopneumonia drug therapy, Humans, Male, Bronchopneumonia microbiology, Gram-Positive Bacterial Infections diagnosis, Gram-Positive Bacterial Infections drug therapy, Micrococcaceae
- Abstract
Rothia mucilaginosa (R. mucilaginosa), formerly named Stomatococcus mucilaginosus, is a facultatively anaerobic, encapsulated gram-positive coccus, which forms part of the normal oropharyngeal and is rarely considered to be a pathogen in immunocompetent patients, although it can produce, on rare occasions, serious infections like bacteremia, endocarditis and respiratory infections; such as pneumonia, pleural empyema or superinfection of bronchiectasis. We present the case of a 74-year-old male diagnosed with right basal pneumonia of torpid evolution with a poor initial response to different antibiotics, with clinical and radiological worsening and the appearance of bilateral bronchopneumonia with pseudonodular images. R. mucilaginosa in pure culture was isolated in three sputum cultures and in bronchial suction. The patient was finally treated with Linezolid with a good clinical response and normalisation of the thorax radiography, confirming the disappearance of R. mucilaginosa in subsequent sputum cultures. As there are few documented cases of pneumonia due to R. mucilaginosa, we believe that presenting this case will be of interest. more...
- Published
- 2017
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43. Kidney disease in primary anti-phospholipid antibody syndrome.
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Gracia-Tello B and Isenberg D
- Subjects
- Antibodies, Antiphospholipid immunology, Antiphospholipid Syndrome immunology, Antiphospholipid Syndrome pathology, Autoimmune Diseases complications, Autoimmune Diseases immunology, Autoimmune Diseases pathology, Biopsy, Needle, Disease Progression, Female, Follow-Up Studies, Humans, Immunohistochemistry, Kidney Diseases pathology, Kidney Function Tests, Male, Renal Artery Obstruction drug therapy, Renal Artery Obstruction pathology, Renal Veins, Risk Assessment, Severity of Illness Index, Thrombosis etiology, Thrombosis pathology, Anticoagulants administration & dosage, Antiphospholipid Syndrome complications, Kidney Diseases drug therapy, Kidney Diseases etiology, Renal Artery Obstruction etiology, Thrombosis drug therapy
- Abstract
APS is an autoimmune disease defined by the presence of arterial or venous thrombotic events and/or pregnancy morbidity in patients who test positive for aPL. APS can be isolated (primary APS) or associated with other autoimmune diseases. The kidney is a major target organ in APS, and renal thrombosis can occur at any level within the vasculature of the kidney (renal arteries, intrarenal vasculature and renal veins). Histological findings vary widely, including ischaemic glomeruli and thrombotic lesions without glomerular or arterial immune deposits on immunofluorescence. Renal involvement in patients with definite APS is treated with long-term anticoagulants as warfarin, but new treatments are being tried. The aim of this article is to review the links between primary APS and kidney disease., (© The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.) more...
- Published
- 2017
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44. The use of rituximab in newly diagnosed patients with systemic lupus erythematosus: long-term steroid saving capacity and clinical effectiveness.
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Gracia-Tello B, Ezeonyeji A, and Isenberg D
- Abstract
Background: Previous reports indicate that treating patients with lupus (SLE) at or close to the time of diagnosis successfully without using any, or minimal, corticosteroids by using B-cell depletion (BCD) is possible in the short-term. It is not however known whether using BCD is as effective or reduces corticosteroid use in the long-term. We report the long-term (up to 7 years) use of BCD with respect to its steroid-saving capacity and clinical effectiveness in newly diagnosed SLE., Methods: Sixteen female patients with SLE were treated at, or shortly after diagnosis, with BCD therapy (BCDT) minimising the routine use of oral steroids. Post-treatment, most patients were given hydroxychloroquine (n=14) and azathioprine (n=10). The British Isles Lupus Assessment Group (BILAG) disease activity index was used for clinical assessment. Serum antidouble-stranded DNA (dsDNA) antibodies, complement (C3), erythrocyte sedimentation rate (ESR), circulating B lymphocytes (CD19
+ ) and total inmmunoglobulins were tested every 2-6 months (average of 4.5 years) (SD 2) post-treatment. Disease activity and steroid requirement were compared with three patients with SLE treated conventionally, each matched for ethnicity, sex, age, clinical features, disease duration at diagnosis and follow-up period., Results: All patients given rituximab achieved BCD. The mean number of flares during follow-up (new BILAG A or B) was 2.63 (SD 3) in the BCDT group and 4 (SD 3.6) in the controls (NS, p=0.14). Post-BCDT, mean anti-dsDNA antibody level fell from 1114 U/mL (SD 1699.3) to 194 (SD 346.7) at 18 months (p=0.043), mean serum ESR fell by >70% at 6 months maintained during follow-up and serum C3 level normalised in 8 patients. The mean cumulative prednisolone dose at 60 months for the patients who underwent BCDT (n=11) was 4745.67 mg (SD 6090 mg) vs 12 553.92 mg (SD 12 672 mg) for the controls (p=0.01)., Conclusions: Early treatment of patients with SLE with BCDT is safe, effective and enables a reduction in steroid use., Competing Interests: Competing interests: None declared. more...- Published
- 2017
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45. Austrian syndrome.
- Author
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Gracia-Tello BC, Escalante-Yangüela B, and Velilla-Soriano C
- Published
- 2016
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46. Anton's syndrome with atypical presentation.
- Author
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Rivero-Sanz E, Camacho-Velasquez JL, Gracia-Tello B, and Tejero-Juste C
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- 2016
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47. Hyperglycemia management in patients admitted to internal medicine in Spain: A point-prevalence survey examining adequacy of glycemic control and guideline adherence.
- Author
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Ena J, Gómez-Huelgas R, Romero-Sánchez M, Gaviria AZ, Calzada-Valle A, Varela-Aguilar JM, Calero-Bernal Mde L, Garcia-Contreras R, Berdún-Chéliz MA, Gracia-Tello B, Mejias-Real I, and González-Becerra C more...
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Diet statistics & numerical data, Female, Glycated Hemoglobin analysis, Humans, Hyperglycemia drug therapy, Hyperglycemia therapy, Hypoglycemic Agents therapeutic use, Insulin therapeutic use, Internal Medicine standards, Internal Medicine statistics & numerical data, Male, Middle Aged, Prevalence, Spain epidemiology, Young Adult, Guideline Adherence statistics & numerical data, Hyperglycemia epidemiology
- Abstract
Aims: Despite the increasing prevalence of hospitalized diabetic patients, there are few studies that evaluate the glycemic control and the rate of adherence to clinical practice guidelines for glucose monitoring and management in the hospital setting., Methods: Crossover study using one-day surveys of all inpatients admitted to internal medicine wards from voluntary participating hospitals across Spain. Retrospective review of medical records was used to identify patients with hyperglycemia, causes for hospitalization, patients' demographic characteristics, appropriateness of glycemic monitoring and treatment during hospitalization., Results: Among 5439 hospitalized patients studied there were 1000 (18.4%) with hyperglycemia in 111 participating hospitals. Patients mean age was 76.0±8.5 years (51.6% male). On admission, 91% had known diabetes (disease duration of 10.9±8.5 years), 5% had unknown diabetes and 4% had stress hyperglycemia. The comorbidity index (Charslon score) was 4 (interquartile range: 2 to 6) and 31% showed a high level of disability (Rankin scale). Main infringement in the process of care included lack of a recent HbA1c value (43.7%), use of sliding scale insulin therapy (20.7%), use of oral antidiabetic agents (8.9%), and less than three bedside point-of-care (POC) blood glucose test per day (17%). Glycemic target pre-meal and bedtime were achieved in 47% to 79.5% of POC. The rates of hypoglycemia (<70 mg/dL and <50mg/dL) were 10.3% and 2.4%, respectively., Conclusions: Our results suggest that there is an important gap between the clinical guidelines and both the management and the grade of glycemic control of diabetic inpatients., (Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.) more...
- Published
- 2015
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48. [Microvascular pulmonary tumor embolism in a patient with urothelial tumor].
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de Escalante Yangüela B, Rubio Gracia J, Muñoz González G, Gracia Tello B, Rodero Roldán M, and Alastrué Del Castaño V
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- Aged, Dyspnea etiology, Humans, Lung Neoplasms, Male, Prognosis, Neoplastic Cells, Circulating, Pulmonary Embolism diagnosis, Urologic Neoplasms
- Abstract
Pulmonary tumor embolisms (PTE) are an infrequent cause of dyspnea in oncological patients. The majority are diagnosed in patients with advanced tumors, above all localized in the breast, lung or stomach. There are few published cases involving patients with urothelial tumors. We present the case of a 69 year-old male, without a previous diagnosis of cancer, who was admitted due to subacute dyspnea, with clinical suspicion of pulmonary thromboembolism (PT). The patient died on the fifth day of admission. The autopsy confirmed the existence of a tumor in the left renal pelvis with hepatic and lymphoganglionary metastasis and an extensive microvascular pulmonary embolism that affected a large part of the capillaries and medium-caliber blood vessels of both lungs. PTE were considered responsible for the progressive respiratory failure and as the final cause of death. The most frequent clinical presentation of PTE is dyspnea. They are often mistaken for PT and diagnosis is not easy. Their prognosis is very bad, with extremely high mortality and confirmation is usually post-mortem. more...
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- 2015
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49. Forestier-Rotés-Querol's disease.
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Suller Marti A, Gracia-Tello B, Velázquez A, and Tejero C
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- 2015
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50. Radiological patterns of the posterior semicircular canal.
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Cisneros AI, Whyte J, Martínez C, Gracia-Tello B, Whyte A, Obón J, Crovetto R, and Crovetto MÁ
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- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Petrous Bone diagnostic imaging, Spain, Young Adult, Semicircular Canals diagnostic imaging, Tomography, Spiral Computed methods
- Abstract
Objectives: The identification and definition of the radiological patterns of the posterior semicircular canal (PSC), with a view to obtain readily applicable conclusions., Design: The parietal morphology of the PSC has been studied by multi-slice helical computed tomography (Philips Brilliance 6). We have determined the distribution of the different types of bone cover of the PSC, taking some previously notified, standardised measurements of normality as reference., Results: 318 patients have been analysed (604 petrous bone) by CT and we have distinguished five different radiological patterns: type or normal, thick, thin, pneumatised and dehiscent. The first three patterns, normal, thick and thin, have in common the existence of a compact bone interposed between PSC and posterior fossa, being in the normal pattern has a thickness of between 0.9 and 2.5 mm (327 cases, 54.13%), in the thick pattern is ≥2.6 mm (99 cases, 16.39%) and in the thin pattern is ≤1.2 mm (158 cases, 26.15%). The fourth pattern, pneumatised, is characterised by having retro labyrinthine cells between PSC and media fossa (19 cases, 3.14%). Finally, a dehiscent pattern was observed in 2 cases (0.3%)., Conclusion: We describe five different radiological patterns: type or normal, thick, thin, pneumatised and dehiscent. The thin type (<0.5 mm or papyraceous type) and the dehiscent type would be subject to producing pathology, and in some cases the latter could be a consequence of the former. more...
- Published
- 2014
- Full Text
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