Articles publicats (Medicina i Cirurgia)
Permanent URI for this collection
Browse
Recent Submissions
- ItemOpen AccessOutcomes and predictors of mortality in patients with severe COVID-19 and COPD admitted to ICU: A multicenter study(Elsevier, 2025-09) Fernández Barat, Laia; Motos, Ana; Canseco Ribas, Joan; Gabarrús, Albert; López Aladid, Ruben; Alvaro Meca, Alejandro; Ceccato, Adrián; García, Nadia; Ferrer, Miquel; Battaglini, Denise; Ávarez Napagao, Sergio; García Gasulla, Dario; Ferrer, Ricard; de Gonzalo Calvo, David; Lorente, José Ángel; Menéndez, Rosario; Peñuelas, Oscar; Riera, Jordi; Rodríguez, Alejandro; Amaya Villar, Rosario; Añón, José; Balan Mariño, Ana; Barberà, Carme; Barberán, José; Blandino Ortiz, Aaron; Boado, Maria Victoria; Bofill, Neus; Bustamante Munguira, Elena; Caballero, Jesús; Cantón Bulnes, María Luisa; Carbajales Pérez, Cristina; Carbonell, Nieves; Catalán González, Mercedes; Del Carmen de la Torre, Maria; Díaz, Emili; Estella, Ángel; Figueras, Albert; de Frutos, Raul; Franco, Nieves; Galbán, Cristóbal; Gallego, Elena; García Garmendia, José Luis; González Gutiérrez, Jessica; Gómez, José; Gumucio Sanguino, Víctor; Huerta, Arturo; Jorge García, Ruth Noemí; Loza Vázquez, Ana; Marin Corral, Judith; Martin Delgado, María Cruz; Martínez de la Gándara, Amalia; Martínez Varela, Ignacio; Albaiceta, Guillermo; Nieto, Maite; Peñasco, Yhivian; Pérez Bastida, Leire; Pérez García, Felipe; Pozo Laderas, Juan Carlos; Ricart, Pilar; Sagredo, Víctor; Sánchez Miralles, Ángel; Sancho Chinesta, Susana; Socias, Lorenzo; Solé Violan, Jordi; Suarez Sipmann, Fernando; Tamayo Lomas, Luis; Trenado, José; Úbeda, Alejandro; Jorge Valdivia, Luis; Vidal, Pablo; Bermejo Martin, Jesús; Barbé Illa, Ferran; Torres, AntoniBackground High mortality rates among patients with chronic obstructive pulmonary disease (COPD) admitted to intensive care units (ICUs) during the COVID-19 pandemic highlight the need for tailored clinical management strategies. Study Design and Methods Epidemiological, clinical, and laboratory data were collected in REDCap for 6512 patients hospitalized with COVID-19 across 55 Spanish ICUs. Patients were stratified into three groups: those with COPD, those with other chronic respiratory diseases (CRD), and those without respiratory comorbidities (No CRD). The primary outcome was to determine clinical predictors for 90-day mortality, focusing on the COPD group. A propensity score matching (PSM) method was applied to analyze the effects of respiratory support, biomarkers, and immunomarkers. Results Patients with COPD (n = 328) exhibited a 50% mortality rate compared to 33% of those with other chronic respiratory diseases (CRD, n = 547), and those without respiratory comorbidities (No CRD, n = 5124). Among COPD patients, 95% of whom had Acute Respiratory Distress Syndrome (ARDS) due to COVID-19, the use of a high-flow nasal cannula (HFNC) was associated with reduced 90-day mortality (hazard ratio: 0.54 (95% Confidence Interval [0.31–0.95]). At a molecular scale, lower IgG levels but higher viral load and TNF-alpha, Vascular Cell Adhesion Molecule-1 (VCAM-1), and Fas Cell Surface Death Receptor (Fas) were associated with mortality in the COPD group. Conclusions In COPD patients with ARDS due to COVID-19, the use of HFNC was associated with a better prognosis. The dysregulation in biomarkers and immunomarkers in COPD patients and its association with mortality highlight the need for further targeted therapeutic strategies.
- ItemOpen AccessMicroRNA mapping of bronchial aspirate for molecular phenotyping and prognostication in patients on mechanical ventilation(Elsevier, 2025-10) Molinero, Marta; Benítez, Iván; Perez Pons, Manel; Rodríguez Muñoz, Carlos; Gómez, Silvia; García Hidalgo, María; Sanchez Rodriguez, Miguel; Gort Paniello, Clara; Moncusí Moix, Anna; Torres Cortada, Gerard; Ayestarán, Jose Ignacio; Socias, Lorenzo; Zuil, María; Motos, Ana; Fernández Barat, Laia; Canseco, Joan; Nuñez, María Recuerda; Ortega, Alicia; Postigo, Tamara; Caballero, Jesús; Barberà, Carme; González Gutiérrez, Jessica; Torres, Antoni; Barbé Illa, Ferran; Bermejo Martin, Jesús; Estella, Ángel; de Gonzalo Calvo, DavidThe application of microRNA (miRNA) profiling in respiratory biospecimens, particularly bronchial aspirate (BAS), remains underexplored. Here, we aimed to validate and refine miRNA quantification in BAS samples to establish its suitability for molecular phenotyping. This was a multicenter study including 288 COVID-19 patients on invasive mechanical ventilation. Respiratory biospecimens included BAS, tracheal aspirate, and bronchoalveolar lavage fluid samples. A predesigned miRNA panel was evaluated using RT-qPCR. Biomarker evaluation and functional assessment were subsequently conducted. An initial technical validation phase corroborated the reproducibility of miRNA profiling in BAS samples. Comparative analyses of miRNA expression profiles across respiratory samples revealed distinct miRNA patterns among biospecimens. In the biomarker analysis, two miRNA ratios, miR-34c-5p/miR-34a-5p and miR-34c-5p/miR-125b-5p, were inversely associated with intensive care unit (ICU) survival (hazard ratio [HR]: 0.18 and 0.17, respectively) during the discovery phase. Risk and survival analyses in the test phase confirmed the reproducibility of the miR-34c-5p/miR-34a-5p ratio (hazard ratio [HR] = 0.17). Functional analyses revealed the utility of miRNA profiling in BAS for identifying pathogenic pathways and developing therapeutic targets. Overall, these findings position miRNA profiling in BAS samples as a valuable approach for biomarker discovery, identification of pathophysiological mechanisms, and development of targeted pulmonary therapies.
- ItemOpen AccessContinuous vital sign monitoring for predicting hospital length of stay: a feasibility study in chronic obstructive pulmonary disease and chronic heart failure patients(BMC, 2025-09) Juez Garcia, Ivan; Benítez, Iván; Torres Cortada, Gerard; González Gutiérrez, Jessica; Utrillo, Laia; Pérez, Anna; Varvará, Natalia; Cuadrat, Irene; Barbé Illa, Ferran; de Batlle, JordiBackground Vital signs monitoring provides clinicians with real-time information regarding patients’ current medical condition. We hypothesize that applying comprehensive analytical methods to underutilized, routinely collected vital signs data can yield valuable insights to support clinical decision-making. In this study, we present a novel approach for vital signs time series analysis applied to hospitalization length of stay (LOS) prediction in chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) patients. Methods Heart rate (HR), respiratory rate (RR) and peripheral oxygen saturation (SpO2) were continuously monitored during the first 24 h of hospital admission in COPD and CHF patients admitted to general, non-ICU hospital wards. The resulting time series were submitted to a comprehensive analysis through a highly comparative, massive feature extraction. We identified key patterns associated with hospitalization length of stay (LOS). Finally, we developed a predictive model for hospitalization LOS combining predictive features from the three vital signs time series. Results A total of 101 patients were enrolled in the study, 74 of whom were eligible for analysis (39 COPD and 35 CHF patients). Periodicity and self-correlation in HR and RR time series were associated to hospitalization LOS. In SpO2 time series, short-term fluctuations and local dynamics were associated to hospitalization LOS. The predictive model for hospitalization LOS was built using nineteen predictive features and achieved an area under the curve (AUC) of 0.975, an accuracy of 0.944, a sensitivity of 0.979, and a specificity of 0.900 in 10-fold cross-validation. Conclusion Through a comprehensive feature-based analysis, we identified key patterns in HR, RR, and SpO₂ time series associated with hospitalization LOS in COPD and CHF patients and a compact set of features that can accurately predict LOS in COPD and CHF patients using only routinely collected data from the first 24 h of admission.
- ItemOpen AccessDocumented vaccination as proof of immunity compared to serology in medical students(Taylor & Francis, 2025-09) Godoy i García, Pere; Toledo, Diana; Casas , Irma; Colmenares, Karen; Vilella, Anna; Prat, Andreu; Mormeneo-Bayo, Saray; Bartolomé, Rosa; Ibarz Escuer, Mercedes; Dominguez, AngelaWe analyzed immunity to vaccine-preventable diseases and the predictive value of documented vaccination versus serological results for medical students in Catalonia (Spain). Epidemiological study of antibody seroprevalence and vaccination in medical students at four teaching units of medicine. Blood samples were drawn from participants who completed an epidemiology questionnaire. For seven diseases, we calculated the positive predictive value (PPV) percentages (and 95% CI) reflecting the protection afforded by self-reported vaccination histories compared to serology results. We enrolled 146 medical students (participation 25.7%; 146/569), 79.5% (116/146) women, mean (SD) age 22.6 (1.6) years. Most students (84.2%; 123/146) were fully vaccinated, 18 were unaware of their vaccination status, and 5 students were not vaccinated. Of the six overseas students, only three could document their vaccination status (OR = 6.0; 95% CI: 1.1–31.8). In documented vaccination terms, PPVs for immunological protection were high for varicella (100%), COVID-19 (99.1%), hepatitis A (98.9%), and rubella (94.8%), but was substantially lower for measles (90.0%), mumps (85.9%), and hepatitis B (67.2%). The predictive value of documented vaccination history compared to serology as proof of immunity was above 90% for most vaccines except for measles, mumps, and hepatitis B.
- ItemOpen AccessHepatitis A in Spain: Evolution of hospitalization in the period 2000-2021(PLoS, 2025-09) Domínguez, Angela; Torner, Núria; Soldevila, Núria; Varela, Carmen; Guerrero Vadillo, María; Peñuelas, Marina; Avellón, Ana; Borràs, Eva; Martínez, Ana; Plans, Pedro; Pericas, Carles; Rius, Cristina; Godoy i García, PereBackground Hepatitis A is an acute disease of the liver caused by the hepatitis A virus (HAV). Chronic liver disease, other viral hepatitis coinfections, and age over 50 years are the main host factors associated with an increased risk of complications. We investigated the evolution of hepatitis A hospitalizations and in-hospital deaths during 2000–2021 in Spain according to demographic characteristics, presence of other sexually transmitted infections, and vaccination strategy (universal or risk-group vaccination). Methods Using data from the Spanish National Health System’s Minimum Basic Data Set, we calculated age-standardized cumulative hospitalization incidence and 95% confidence interval (CI), factors associated with hospital stay, and hospitalization deaths. Adjusted OR (aOR) values were calculated using a multivariate logistic regression model. Results The Spanish cumulative hospitalization incidence for hepatitis A over the 22-year period was 8.84 per 1 000 000 globally and 12.54 and 5.26 per 1 000 000 for men and women, respectively (RR = 2.38; 95% CI: 2.28–2.50). Median length of stay was 4 days (range 0−85). Factors associated with hospitalization >7 days were age groups 40−59 and ≥60 years (aOR 1.58; 95% CI: 1.37–1.82 and aOR 5.09; 95% CI: 4.01–6.47, respectively), cirrhosis (aOR 6.11; 95% CI: 2.59–14.43), and presence of HIV and HBV (aOR 1.65; 95% CI: 1.15–2.38 and 2.01; 95% CI: 1.03–3.63, respectively). In-hospital deaths were associated with age ≥ 60 years (aOR 35.23; 95% CI: 11.12–111.58), hospitalization >7 days (aOR 4.37; 95% CI: 1.80–10.58), cirrhosis (aOR 8.84; 95% CI: 2.37–32.99), and HCV infection (aOR 8.66; 95% CI: 1.57–47.87). The cumulative hospitalization incidence was lower in regions implementing universal vaccination (RR 0.79; 95% CI: 0.75–0.84). Conclusion Results of studies based on characteristics of hospitalized hepatitis A cases taking into account the existing prevention policies can be useful to have a better knowledge about its evolving epidemiology and to improve the prevention and control of the disease.