Hospital Santa Creu Research Articles

Phase I / II Study on Infusion of Alloreactive or Ex Vivo il-15 Stimulated Natural Killer Cells after Haploidentical Stem Cell Transplantation in Pediatric Patients with Acute Leukemia (PHINK): A Study of the Spanish Hematopoietic Stem Cell Transplantation Group (GETH)

Background: Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is a highly complicated but effective procedure for high-risk pediatric leukemia in the absence of an HLA-identical donor. Post-transplant relapse is the main problem for patient survival. According to literature, Natural Killer (NK) cells play a potent role as inducers of the graft-versus-leukemia (GvL) effect in haplo-HSCT. The presence of alloreactive NK cells correlates with a lower relapse rate, improved engraftment, decreasing graft-versus-recipient disease (GvHD) and viral infection risk. In the absence of donor-recipient NK cell alloreactivity, other NK cell activation strategies are necessary. We propose a phase I/II clinical trial with dose escalation, multicenter, framed in the GETH, to determine dose-limiting toxicity (DLT) and the maximum tolerated dose (MTD) of a single infusion of alloreactive NK cells (Allo-NK) or NK cells stimulated ex vivo with IL-15 (IL15-NK) after haplo-HSCT in pediatric patients with high-risk leukemias. Methods: Eighteen pediatric patients with high-risk leukemia were recruited between September 16, 2020, and May 12, 2023, at 5 hospitals in Spain, Hospital Universitario La Paz, Hospital Universitario Gregorio Marañón, Hospital Universitario Niño Jesús, Hospital Universitario Central of Asturias and Hospital Santa Creu and Sant Pau. Patients were stratified in 2 treatment groups: Allo-NK (n=9) or IL15-NK (n=9), depending on the KIR disparity between donor and recipient. Our phase I/II clinical trial presents a dose-escalation design (3+3). The treatment cohorts are divided into cohort 1 (up to 2x10 7 cells/kg), cohort 2 (2-5x10 7 cells/kg) and cohort 3 (5-10x10 7 cells/kg). We have monitored infections reactivation, as well as, chimerism and engraftment after transplantation. In Allo-NK group, the KIR clone that provides alloreactivity in the NK cell was also tracked. The phenotypic profile and functional capacity of NK cells present in the patient up to 360 days after transplantation have also been analyzed. Results: Nine patients (4 in Allo-NK and 5 in IL-15NK) were included in cohort 1, 7 patients (4 in Allo-NK and 3 in IL-15NK) in cohort 2 and 2 patients (1 in Allo-NK and 1 in IL-15NK) in cohort 3. We were unable to complete the dose escalation design initially proposed due to the high weight of some patients and the unavailability of ex vivo expanded NK cells. In IL15-NK group patients presented a higher prevalence of B-ALL (p=0.018) and had received a previous transplant (p=0.082). NK cell infusions of IL15-NK group showed higher expression of CD25 and CD69 receptors and higher functional capacity. In the Allo-NK group, the most prevalent KIR-reactive clone was KIR2DL1 (55.6%). We also observed a tendency for KIR2DL1 alloreactive clone to increase from 30 (8,18%) to 360 (25,63%) days after transplantation. Regarding clinical outcomes in 2 study arms, the incidence of severe (Grades III-IV) acute GvHD was 22.2% and severe chronic GvHD was only observed in 1 (5.6%) patient (Table 1). The incidence any infection or endothelial vascular complications were 72% and 33% respectively. No statistical differences were observed in GvHD, infections and endothelial vascular complications. We found 2 relapses, 1 in each study arm (11.1%). Five patients died, 1 (5.6%) because of disease progression and 4 (22.2%) because transplant related complications (TRM) (Table 1). Dividing patients into the 3 dose-escalation cohorts, we found no significant differences between cohorts in the primary clinical outcomes analysed. One-years overall survival (OS) and disease-free survival (DFS) was 72.22% (CI95% 51.93-100) and GvHD-free/relapse-free survival (GRSF) was 64.1% (CI95% 44.62-92.1), finding no significant differences between either 2 study arms or the 3 dose-escalation cohorts. Regarding the analysis of the NK phenotype, we observed a tendency to increase the expression of CD16 and CD57 receptors between 30 to 360 days after transplantation in both groups. Conclusions: Two study arms shows similar data respect to clinical outcome. Patients infused with IL-15-stimulated NK cells showed similar toxicity to the alloreactive NK group. According to dose escalation, we observed no association between increased toxicity and increased number of infused NK cells. We were unfortunately unable to complete cohort 3 because of the cells/kg ratio in some patients.

Impact of Early Referral to Palliative Care in Patients with Interstitial Lung Disease.

Background: Interstitial lung diseases (ILDs) have a major impact on survival and quality of life but only a small percentage of patients are referred for palliative care (PC). Objective: To assess the impact of early PC referral on hospital admissions, emergency department visits, and place of death in the last year of life. Design: This is a single-center retrospective observational study. Setting/Subjects: Subjects were patients with ILDs who attended the respiratory department of Hospital Santa Creu i Sant Pau (Barcelona, Spain) between 2011 and 2019. Results: Of the 51 included patients, 45% received early PC referral. Logistic regression indicated that early PC referral was independently associated with a lower risk of hospital admissions in the last year of life (OR = 0.16; 95% CI 0.03-0.75; p = 0.02) and a lower risk of dying in hospital (OR = 0.11; 95% CI 0.02-0.5; p = 0.009). Conclusion: Early PC referral reduces the need for hospitalization and enables domiciliary death.

Hypopituitarism and pregnancy: clinical characteristics, management and pregnancy outcome

PurposeTo describe the clinical characteristics, management and pregnancy outcome of women with prepregnancy hypopituitarism (HYPO) that received care at our center.MethodsRetrospective study describing 12 pregnancies in women with prepregnancy HYPO (two or more pituitary hormonal deficiencies under replacement treatment) that received care during pregnancy at Hospital Santa Creu i Sant Pau. Clinical characteristics, management and pregnancy outcome were systematically collected.ResultsAverage patients’ age was 35 years and HYPO duration at the beginning of pregnancy was 19 years. The most frequent cause of HYPO was surgical treatment of a sellar mass (8 pregnancies). Eight pregnancies were in primigravid women and 10 required assisted reproductive techniques. The hormonal deficits before pregnancy were as follows: GH in 12 women, TSH in 10, gonadotropin in 9, ACTH in 5 and ADH in 2. All deficits were under hormonal substitution except for GH deficit in 4 pregnancies. During pregnancy, 4 new deficits were diagnosed. The dosage of replacement treatment for TSH, ACTH and ADH deficits was increased and GH was stopped. Average gestational age at birth was 40 weeks, gestational weight gain was excessive in 9 women, 8 patients required induction/elective delivery and cesarean section was performed in 6. Average birthweight was 3227 g. No major complications were observed. Five women were breastfeeding at discharge.ConclusionsIn this group of women with long-standing HYPO, with careful clinical management (including treatment of new-onset hormonal deficits) pregnancy outcome was satisfactory but with a high rate of excessive gestational weight gain and cesarean section.

Normalization of blood clotting characteristics using prothrombin complex concentrate, fibrinogen and FXIII in an albumin based fluid: experimental studies in thromboelastometry

BackgroundColloid fluids supplemented with adequate combinations of coagulation factor concentrates with the capability to restore coagulation could be a desirable future treatment component in massive transfusion.MethodsStarting from a coagulation factor and blood cell-free albumin solution we added Prothrombin Complex Concentrate, Fibrinogen Concentrate and Factor XIII in different combinations and concentrations to analyze their properties to restore thromboelastometry parameters without the use of plasma. Further analysis under the presence of platelets was performed for comparability to whole blood conditions.ResultsAlbumin solutions enriched with Fibrinogen Concentrate, Factor XIII and Prothrombin Complex Concentrate at optimized concentrations show restoring coagulation potential. Prothrombin Complex Concentrate showed sufficient thrombin formation for inducing fibrinogen polymerization. The combination of Prothrombin Complex Concentrate and Fibrinogen Concentrate led to the formation of a stable in vitro fibrin clot. Fibrinogen and Factor XIII showed excellent capacity to improve fibrin clot firmness expressed as Amplitude at 10 min and Maximal Clot Firmness. Fibrinogen alone, or in combination with Factor XIII, was able to restore normal Amplitude at 10 min and Maximal Clot Firmness values. In the presence of platelets, the thromboelastometry surrogate parameter for thrombin generation (Clotting Time) improves and normalizes when compared to whole blood.ConclusionsCombinations of coagulation factor concentrates suspended in albumin solutions can restore thromboelastometry parameters in the absence of plasma. This kind of artificial colloid fluids with coagulation-restoring characteristics might offer new treatment alternatives for massive transfusion.Trial registrationStudy registered at the institutional ethic committee “Institut de Recerca, Hospital Santa Creu i Sant Pau, with protocol number IIBSP-CFC-2013-165.

Structural Gray and White Matter Differences in Patients With Type 1 Diabetes and Impaired Awareness of Hypoglycemia.

Type 1 diabetes (T1D) is associated with an increased risk of cognitive decline, where severe hypoglycemia (SH) and impaired awareness of hypoglycemia (IAH) may play a role. While there is evidence of a possible association between IAH and brain damage, the potential brain changes remain poorly characterized by magnetic resonance imaging (MRI). To investigate whether there are structural brain differences in a group of T1D patients with IAH compared with normal awareness of hypoglycemia (NAH). General practice, population-based, cross-sectional study (July 2018 to July 2019). Endocrinology Department, Hospital Santa Creu i Sant Pau. A total of 40 T1D patients (20 each with IAH and NAH) matched for age, sex, T1D duration, and education level. Using different neuroimaging techniques, we compared whole-brain gray matter (GM) and white matter (WM) differences. We used voxel-based morphometry and cortical surface area analysis methods to assess GM differences, and fractional anisotropy (FA) to assess WM differences. Compared with patients with T1D-NAH, patients with T1D-IAH had reduced GM volumes and cortical surface areas, especially in frontal and parietal regions (P < 0.05 corrected), and also showed reduced FA values in major WM tracts. The observed MRI differences correlated with both SH frequency and IAH severity. MRI for patients with T1D show that IAH is associated with brain changes involving both GM and WM. Further research is needed to elucidate whether the observed differences are a consequence of increased SH episode frequency and increased IAH severity.

Observational Study of Complexity in a Psychiatric Hospital Unit

ABSTRACT&#x0D; Objectives: 1. Describe the possible variables that may be related to a psychiatric complex patient at the Acute Psychiatric Unit of Santa Creu i Sant Pau Hospital. 2. Determine the usefulness of the standard concept of chronic complex patient in a psychiatric patient.&#x0D; Methods: Cross sectional, observational, and quantitative study were conducted in Hospital Santa Creu i Sant Pau, Barcelona. 46 patients admitted at the Acute Psychiatric Ward from March to May 2018 were included in the study. The scales used were: PANSS, HDRS, YMRS, EEAG, FAST, CGI, EQ-VAS and Zarit Burden. The number of extended stays in health institutions, need for social assistance, previous admissions and duration of hospital stay were also evaluated.&#x0D; &#x0D; Results: There is no difference in the need for social assistance between chronic complex patient (11%) and non-chronic complex patient (18.9%). Also, no difference was noted among the scales FAST, CGI, EEAG, EQ-VAS and Zarit Burden. Upon analysis of the variables, the result of the quality of life is correlated with: 1. PANSS_N (p&lt;0.0044) 2. FAST finances (p&lt;0.0027) 3. FAST cognitive (p&lt;0.0018).&#x0D; &#x0D; Conclusion: The standard definition of a Chronic Complex Patient does not fit the needs of complexity in a psychiatric patient.&#x0D; &#x0D; DeCS: quality of life, multimorbidity, caregiver, psychiatric

Mobile therapeutic attention for treatment-resistant schizophrenia (m-RESIST): a prospective multicentre feasibility study protocol in patients and their caregivers

IntroductionTreatment-resistant schizophrenia (TRS) is a severe form of schizophrenia. In the European Union, approximately 40% of people with schizophrenia have TRS. Factors such as the persistence of positive symptoms or...

1417P - Multi-gene panels: new clinical experience in hereditary breast and ovarian cancer

Background: Mutations in BRCA1 and BRCA2 genes explain about 22% of families meeting testing criteria for hereditary breast/ovary cancer (HBOC). Next-generation sequencing based multi-gene panels allow the analysis of a high number of genes simultaneously with a high sensitivity and are currently integrated into clinical practice. Methods: A total of 177 women/families with clinical criteria for HBOC underwent genetic testing with a 26-gene commercial panel related to hereditary cancer. The analysis included 150 women with a personal diagnosis of BC/OC meeting national consensus for testing except 7 patients that did not comply these criteria, 6 healthy women at high-risk with ≥1 BC/OC affected first-degree relative and 21 patients with a previous BRCA1/2 negative result by other techniques. Results: A total of 11 BRCA1/2 mutations were identified three of which were previously undetected by other techniques. Mutations in other high or moderate BC/OC risk genes were found: one new mutation in RAD51D gene, two mutations in CHEK2 gene, one mutation in ATM gene, one mutation in PALB2 gene and two probably pathogenic variants in PALB2 and CHEK2 genes (according to predictors in silico). In addition, 8 variants of uncertain significance were detected. Subsequently, members of any of these 18 HBOC families started presymptomatic genetic diagnosis and prevention strategies. Conclusions: In contrast to traditional sequential testing, the incorporation of multi-gene panels in our clinical practice has allowed us to obtain a more efficient genetic diagnosis on a greater number of families. Detecting actionable mutations in either previous BRCA1/2 negative or other HBOC associated families will optimize candidate identification for changes in medical management. The determination of the pathogenicity of frequent variants of uncertain significance in high or moderate penetrance genes remains the main challenge for cancer geneticists. Legal entity responsible for the study: Hospital Santa Creu i Sant Pau Funding: None Disclosure: All authors have declared no conflicts of interest.

Transitional Care and Patient Experience Workshop

Upon the Integrated Care Exchange program initiated between Oldham CCG and Catalan healthcare providers (Hospital Clinic, CHV, CAPSE and CASAP) and co-organised by AQuA and IFIC in 2014-2015, we do aim to continue the learning exchange around a central topic: Transitional Care. We propose a double session. The first one will address different interventions in Transitional Care to be compared following a similar presentation pattern that will allow to identify the lessons learns in three key aspects: value sources, SWOT analysis, scale-up and sustainability in the long run. Interventions selected: 1. Virtual integration model: hospital and primary care in Vic 2. Emergency care as key place for transition management: geriatric assessment, situational diagnostic and community resources management The second session will cover the patient perspective in the transition within and among health institutions. Patient experience is a driver for healthcare improvement in transitional care. Interventions selected: 1. Patient participatioin in integrated care (Oldham CCG) 2. Person-centered prescription (Hospital Santa Creu) 3. The patient journey of diabetic patients (CASAP) We have already secured presentations from: Hospital Santa Creu (Vic, Spain), CASAP (Castelldefels, Spain), Oldham CCG (Oldham, UK). We are open to accomodate presentations for third parties that fit the topic.

Polypharmacy and Adherence: Key Components of Integrated Care Findings from the SIMPATHY Project

Context, aims and objectives : As many as half of all patients with chronic conditions are using their medicines in a way that is not fully effective, resulting in sub-optimal treatment and subsequent increases in hospitalisations and emergency department visits. High levels of inappropriate prescribing further compound this problem. These issues are especially germane to older patients. Safe and effective pharmacotherapy remains one of the greatest challenges in this population, where models of healthcare delivery lag behind the enormous growth in single disease focused pharmacotherapy. The implications for safe, efficient, effective and sustainable deployment of healthcare resources are significant from both a healthcare systems and societal perspective. Integrated care models have the potential to mitigate inappropriate polypharmacy, while simultaneously diminishing problems related to poor adherence. Project SIMPATHY addresses both of these issues by aiming to stimulate and support innovation throughout the European Union regarding the management of polypharmacy and adherence in the older patient. The SIMPATHY Consortium has completed case studies in eight EU countries, providing useful insights into how different health care systems address this challenge. This workshop will present these findings, using them as a basis for discussion on the practicalities of integrating new practices into existing workflow, highlighting the opportunities that an integrated care model can provide. Target participants : Policymakers, health system administrators, managers, clinicians Proposed structure and timing : What do we mean when we say polypharmacy? How does it apply to me? Alpana Mair; Deputy Chief Pharmaceutical Officer for Scotland, Healthcare Quality and Strategy Directorate, Scottish Government Health Department Medicines management should be a key component of integrated care, affecting nearly all providers in all settings, and is paramount in the older population. However, health care providers are often faced with problems related to inappropriate management of polypharmacy and poor adherence by patients. This presentation will introduce the audience to the concept of polypharmacy and adherence, its importance, and what tools and evidence already exist to create solutions. Looking at Europe: A diverse and emerging picture of polypharmacy Jennifer McIntosh; Research Scientist at Hospital Clinic Barcelona / FCRB Building on original research undertaken by the SIMPATHY Consortium, a picture of current policies around polypharmacy in Europe has emerged. The picture is complex, with multiple economic, social, and cultural factors explaining the development of these programmes. The details of this picture provide a strong foundation for the development of future policies for appropriate management of polypharmacy. This presentation will detail the findings of 8 European case studies, showcasing current approaches polypharmacy management. _(Important: The details of each case study will be presented in a set of 8 posters that will be submitted to the conference by each institution carying out the work)_ Scaling up polypharmacy management: The Scottish success story Alpana Mair; Deputy Chief Pharmaceutical Officer for Scotland, Healthcare Quality and Strategy Directorate, Scottish Government Health Department Implementing a new programme into existing practice is one of the most challenging aspects of creating integrated health care systems. The Scottish National Health Service has achieved this by successfully developing and implementing a comprehensive polypharmacy management policy throughout their healthcare system. This programme has become a model on an international level, and is currently a reference point for the development of European wide policies to address polypharmacy in the elderly. This presentation will describe the rationale that prompted the development of the Scottish programme, unique features of the programme including leveraging national level patient data to identify patients at risk for inappropriate polypharmacy, and management strategies that facilitated the integration of the programme into daily practice on a wide scale. Polypharmacy and teamwork: The Catalan multidisciplinary experience Carles Codina; Head of Pharmacy Department at Hospital Clinic Barcelona - Consorci Hospitalari de Vic Nuria Molist; physician at the Acute Geriatrician Unit Consorci Hospitalari de Vic - Hospital Santa Creu de Vic Introducing new practices requires champions, especially in complex institutions. Although multidisciplinary teams are becoming the functional decision making unit, their implementation requires support from multiple stakeholders. Pharmacists in particular have a central role to play on these teams in developing a new understanding about the importance of appropriate polypharmacy management. This presentation will describe the development and implementation of a patient centred multidisciplinary care team, highlighting the role both the pharmacy and geriatric medicine departments played in creating a successful and sustainable programme. Facilitated discussion Albert Alonso (moderator); Innovation Directorate at Hospital Clinic Barcelona This work has been supported by the SIMPATHY project, grant agreement number 663082, co-funded by the European Commission CHAFEA Health Program

Breast cancer in young women

Breast cancer is the leading cause of death in women under 30 years of age. In young women, breast tumors usually exhibit more aggressive features then their older counterparts, including larger tumor size, a higher incidence of poorly differentiated tumors, positive lymph nodes, high proliferation rates, higher incidence of HER2, a higher prevalence of basal-like histologic subtype, and the absence of endocrine receptors. After age, positive family history for breast cancer is among the highest risk factors for developing the disease. Approximately, 5–10% of breast cancers is considered directly related to inherited mutations in BRCA1/BRCA2 genes. Women carrying these mutations have a lifetime risk of breast cancer of 60–80%. Thus, genetic screening at the time of diagnosis is warranted in order to undertake opportune prophylactic measures. Digital mammography is the gold-standard for the diagnosis of breast cancer. However, due to particularities of the breast tissue in young women, ultrasound and magnetic resonance imaging are the preferred methods to diagnose no palpable breast lesions and to further characterize mammographic findings. Nonetheless, even if imaging studies are negative, suspicious breast masses should be biopsied under MRI or ultrasound guidance. Conflict of interest The authors have no conflict of interest. A. Barnadas (&) Hospital Santa Creu i Sant Pau, Barcelona, Spain e-mail: abarnadasm@santpau.cat C. Vazquez Instituto Valenciano de Oncologia, Valencia, Spain e-mail: cvazquez@fivo.org 123 Breast Cancer Res Treat (2010) 123:1 DOI 10.1007/s10549-010-1049-y

First-line treatment with sunitinib monotherapy in patients with advanced urothelial cancer ineligible for cisplatin-based chemotherapy: Pretreatment levels of IL8 and Hounsfield units as predictors of clinical benefit.

Article Tools Genitourinary Cancer Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/jco.2010.28.15_suppl.4540 Journal of Clinical Oncology - published online before print May 20, 2010 First-line treatment with sunitinib monotherapy in patients with advanced urothelial cancer ineligible for cisplatin-based chemotherapy: Pretreatment levels of IL8 and Hounsfield units as predictors of clinical benefit. J. BellmuntxJ. BellmuntSearch for articles by this author , J. L. Gonzalez-LarribaxJ. L. Gonzalez-LarribaSearch for articles by this author , J. P. MarotoxJ. P. MarotoSearch for articles by this author , J. CarlesxJ. CarlesSearch for articles by this author , D. E. CastellanoxD. E. CastellanoSearch for articles by this author , B. MelladoxB. MelladoSearch for articles by this author , E. GallardoxE. GallardoSearch for articles by this author , J. L. Perez-GraciaxJ. L. Perez-GraciaSearch for articles by this author , X. Villanueva Sr.xX. Villanueva Sr.Search for articles by this author , J. AlbanellxJ. AlbanellSearch for articles by this author Show More Hospital del Mar, IMIM, Barcelona, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Santa Creu, Barcelona, Spain; Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Clinic, Barcelona, Spain; Corporacio Parc Tauli, Sabadell, Spain; Clinica Universidad de Navarra, Pamplona, Spain; Hospital del Mar, Barcelona, Spain https://doi.org/10.1200/jco.2010.28.15_suppl.4540 Abstract Abstract 4540 Background: There is a need for improving therapy in "unfit" patients (pts) who are not able to receive standard cisplatinum-based chemotherapy and to look for response predictors. VEGF is expressed in transitional cell carcinoma and its overexpression is associated with an aggressive behavior; targeting angiogenesis maybe a rational approach. Methods: This is a multicenter, open-label, phase II clinical trial assessing oral sunitinib at 50 mg daily in a 4/2-week schedule as first-line in "unfit" urothelial cancer pts. Eligibility criteria to define "unfit" included creatinine clearance under 60 ml/min but over 30 ml/min and performance status ≥ 1 (ECOG). Pretreatment sequential serum samples and measurements of Hounsfield units were collected in pts undergoing treatment. 14 potential serum markers (cytoquines, soluble receptors, growth factors and methaloproteases) were studied (xMAP Technology of Luminex Corp). Results: 37 pts with median age of 75 years were enrolled between July 2006 and September 2009. Bladder was the most frequent primary tumor site. Visceral disease included lung (33.3 %), liver (12%) and bone metastases (12%). Median number of cycles was 2.4 (1-6). Twenty-seven pts are evaluable for efficacy; 3 PRs (8.1%) were obtained, one not confirmed due to brain mets progression; 14 pts (53.8%) had SD lasting > 3m; clinical benefit rate of 62% and median PFS being 5.9 m. Three pts are still on therapy. Most frequent toxicities were fatigue, neutropenia and thrombopenia, hypertension, hand-foot syndrome, stomatitis, haematuria, and epistaxis. IL8 baseline levels were significantly increased in nonresponders and significantly associated with PFS. Final correlative analysis with Hounsfield units is ongoing. Conclusions: Sunitinib first line in “unfit” bladder pts shows significant benefit in 62 % of pts with a median PFS of 5.9 m. leading to a delay on time to start chemotherapy. Baseline levels of IL8 were able to predict benefit and warrant further study as predictive marker of sunitinib activity. Supported by FISS PI061239 and Cellex Foundation. No significant financial relationships to disclose. © 2010 by American Society of Clinical Oncology

Producción científica de los servicios de dermatología españoles en revistas internacionales: 1997-2006

BackgroundThe aim of this study was to determine the scientific output in international journals by Spanish dermatologists between 1997 and 2006 using PubMed. Material and methodsPublications were identified with the following search query: (dermat*) and (spain or espagne or espanha or espana or spanien), with the limit “affiliation”. Articles described in PubMed as “journal articles” or “reviews” were included and those published in Spanish journals excluded. ResultsWe identified 1018 articles: 492 published between 1997 and 2001, and 526 published between 2002 and 2006. The majority were case reports (705, 69.3 %), but there were also 120 reviews (11.8 %). Most of the articles were published in dermatology journals with Science Citation Index impact factors (877, 86.1 %), with the following representing the main ones: Contact Dermatitis (129, 12.7 %), Journal of the European Academy of Dermatology and Venereology (115, 11.3 %), and the British Journal of Dermatology (86, 8.4 %). Nine institutions accounted for more than 50 % of the articles published. Notable among them were the following: Hospital Universitario La Princesa in Madrid (78, 7.7 %), Hospital Santa Creu i Sant Pau in Barcelona (71, 7.1 %), and Hospital Clínic in Barcelona (63, 6.2 %). Seven provinces produced 80 % of the publications, with Madrid (257, 25.2 %), Barcelona (244, 24.0 %), and A Coruña (98, 9.6 %) accounting for the highest proportion. Five autonomous communities accounted for 82 % of the publications: Madrid (257, 25.2 %), Catalonia (251, 24.7 %), Galicia (116, 11.4 %), the Autonomous Community of Valencia (112, 11.0 %), and Andalusia (96,9.4 %). ConclusionsThe scientific output in international journals has remained stable over the last decade. Authors and institutions from Barcelona and Madrid continued to be the most productive.

Scientific Output of Spanish Dermatology Departments in International Journals, 1997-2006

Background The aim of this study was to determine the scientific output in international journals by Spanish dermatologists between 1997 and 2006 using PubMed. Material and methods Publications were identified with the following search query: (dermat*) and (Spain or Espagne or Espanha or Espana or Spanien), with the limit «affiliation». Articles described in PubMed as «journal articles» or «reviews» were included and those published in Spanish journals excluded. Results We identified 1018 articles: 492 published between 1997 and 2001, and 526 published between 2002 and 2006. The majority were case reports (705, 69.3%), but there were also 120 reviews (11.8%). Most of the articles were published in dermatology journals with Science Citation Index impact factors (877, 86.1%), with the following representing the main ones: Contact Dermatitis (129, 12.7%), Journal of the European Academy of Dermatology and Venereology (115, 11.3%), and the British Journal of Dermatology (86, 8.4%). Nine institutions accounted for more than 50% of the articles published. Notable among them were the following: Hospital Universitario La Princesa in Madrid (78, 7.7%), Hospital Santa Creu i Sant Pau in Barcelona (71, 7.1%), and Hospital Clínic in Barcelona (63, 6.2%). Seven provinces produced 80% of the publications, with Madrid (257, 25.2%), Barcelona (244, 24.0%), and A Coruña (98, 9.6%) accounting for the highest proportion. Five autonomous communities accounted for 82% of the publications: Madrid (257, 25.2%), Catalonia (251, 24.7%), Galicia (116, 11.4%), the Autonomous Community of Valencia (112, 11.0%), and Andalusia (96, 9.4%). Conclusions The scientific output in international journals has remained stable over the last decade. Authors and institutions from Barcelona and Madrid continued to be the most productive.

Renal Safety of Tenofovir Disoproxil Fumarate in HIV-1 Treatment-experienced Patients with Adverse Events Related to Prior NRTI Use

Renal Safety of Tenofovir Disoproxil Fumarate in HIV-1 Treatment-experienced Patients with Adverse Events Related to Prior NRTI Use

Producción científica de los dermatólogos españoles en revistas internacionales por centros e instituciones (1987-2000)

Abstract—Objective: Analysis of the scientific production of Spanish dermatologists in international journals, in relation to the centers with which they are affiliated, between 1987 and 2000. Material and MethodsWe selected the citable documents published between 1987 and 2000 in the 48 journals in the “Dermatology” section of Journal Citation Reports and in Index Medicus included in the MedLine database. We also studied the documents from journals not included in the aforementioned sections if the first listed author was a dermatologist. ResultsThe 1,312 documents analyzed were affiliated with 115 centers. Four institutions authored 25 % of the documents: Hospital Clínic i Provincial in Barcelona (n = 104 documents; 7.9%), Hospital de la Santa Creu i Sant Pau in Barcelona (n = 101; 7.7%), Hospital Clínico San Carlos in Madrid (n = 83; 6.3 %) and Hospital General in Valencia (n = 72; 5.6%). Along with these centers, Fundación Jiménez Díaz in Madrid (n = 68; 4.8%), Hospital Virgen de la Macarena in Seville (n = 67, 5.1 %), Hospital La Princesa in Madrid (n = 63; 4.8%), Hospital Ramón y Cajal in Madrid (n = 52; 4%) and Hospital de Cruces in Barakaldo (n = 52; 4 %) accounted for 50% of the production. When this production was weighted by number of hospital beds, the top-ranking centers were Hospital Santa Creu i Sant Pau in Barcelona (131 art./1000 beds), Clínica Universitaria in Navarre (117 art./1000 beds), Hospital Clínic i Provincial in Barcelona (116.2 art./1000 beds), Hospital General in Valencia (116.1 art./1000 beds), Fundación Jiménez Díaz in Madrid (108 art./1000 beds) and Hospital La Princesa in Madrid (107 art./1000 beds). ConclusionsHospital Clínic i Provincial and Hospital Santa Creu i Sant Pau in Barcelona, along with Hospital Clínico San Carlos in Madrid, were the most productive centers in absolute terms; however, after weighting by number of beds, Clínica Universitaria in Navarre rose to second place over other centers.

Evaluación de la producción científica en los servicios de otorrinolaringología españoles durante el período 1998-2002

ObjectivesTo count the scientific contributions that were carried out at the Otorhinolarngology Departments in Spain from 1998 to 2002 years and to measure their scientific relevance using different bibliometrics tools. MethodsAbstracts of articles located on MedLine (www.ncbi.nih.gov/PubMed) that have been published by Otorhinolaryngology departments in Spain, by a specific designed search strategy. Papers were classified by journal type (national/ international) and study design (original or clinical case). A rank of productivity per hospital was design according to the following variables: total number of articles, total number of originals and cummulative impact factor (according to the category assigned by the Journal of Citation Reports, (2000) from the Institute for Scientific Information). ResultsA total of 18472 papers were located, being 703 papers from 116 Otorhinolaryngology departments in Spain. This represents a 4% of the world’s scientific production. There were 196 international and 498 papers in Spanish journals; in addition, 439 were original articles and 265 clinical cases. The centers in Spain with the most relevant scientific productivity are: Hospital Central de Asturias, Hospital Virgen del Rocío de Sevilla, Hospital La Paz de Madrid, Hospital Santa Creu i San Pau de Barcelona, Clínica Universitaria de Navarra and Clínica Puerta de Hierro de Madrid (all of them with a cummulated impact factor in 5 years > 10).