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Jose-Ramon Blanco

Bio: Jose-Ramon Blanco is an academic researcher from University of Oviedo. The author has contributed to research in topics: DLCO & Diffusing capacity. The author has an hindex of 2, co-authored 4 publications receiving 19 citations.

Papers
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Journal ArticleDOI
TL;DR: In this paper, a study aimed to describe lung function in patients recovering from COVID-19 hospitalization and to identify biomarkers in serum and induced sputum samples from these patients.

59 citations

Journal ArticleDOI
TL;DR: The deprescribing process shared by professionals and patients definitively would improve management of treatment in this population of HIV-infected persons and should be a priority group.
Abstract: In recent decades, the life expectancy of HIV-infected patients has increased considerably, to the extent that the disease can now be considered chronic. In this context of progressive aging, HIV-infected persons have a greater prevalence of comorbid conditions. Consequently, they usually take more non-antiretroviral drugs, and their drug therapy are more complex. This supposes a greater risk of drug interactions, of hospitalization, falls, and death. In the last years, deprescribing has gained attention as a means to rationalize medication use. Review of the different therapeutic approach that includes optimization of polypharmacy and control and reduction of potentially inappropriate prescription. There are several protocols for systematizing the deprescribing process. The most widely used tool is the Medication Regimen Complexity Index, an index validated in HIV-infected persons. Anticholinergic medications are the agents that have been most associated with major adverse effects so, various scales have been employed to measure it. Other tools should be employed to detect and prevent the use of potentially inappropriate drugs. Prioritization of candidates should be based, among others, on drugs that should always be avoided and drugs with no justified indication. The deprescribing process shared by professionals and patients definitively would improve management of treatment in this population. Because polypharmacy in HIV-infected patients show that a considerable percentage of patients could be candidates for deprescribing, we must understand the importance of deprescribing and that HIV-infected persons should be a priority group. This process would be highly feasible and effective in HIV-infected persons.

18 citations

Journal ArticleDOI
TL;DR: This work reviews aspects related to immune activation and inflammation in PLWH, their consequences, and the potential strategies to reduce immune activation in HIV-infected individuals on ART.
Abstract: Introduction: Thanks to antiretroviral therapy (ART), persons living with HIV (PLWH), have a longer life expectancy. However, immune activation and inflammation remain elevated, even after viral suppression, and contribute to morbidity and mortality in these individuals. Areas covered: We review aspects related to immune activation and inflammation in PLWH, their consequences, and the potential strategies to reduce immune activation in HIV-infected individuals on ART. Expert opinion: When addressing a problem, it is necessary to thoroughly understand the topic. This is the main limitation faced when dealing with immune activation and inflammation in PLWH since there is no consensus on the ideal markers to evaluate immune activation or inflammation. To date, the different interventions that have addressed this problem by targeting specific mediators have not been able to significantly reduce immune activation or its consequences. Given that there is currently no curative intervention for HIV infection, more studies are necessary to understand the mechanism underlying immune activation and help to identify potential therapeutic targets that contribute to improving the life expectancy of HIV-infected individuals.

6 citations

Journal ArticleDOI
TL;DR: In this paper, an ensemble of superantiferromagnetic nanoparticles has been produced to perform a detailed analysis of magnetic excitations using inelastic neutron scattering, which reveals the existence of a crystalline electric field.
Abstract: An ensemble of superantiferromagnetic ${\mathrm{NdCu}}_{2}$ nanoparticles has been produced to perform a detailed analysis of magnetic excitations using inelastic neutron scattering. Neutron diffraction measurements indicate a mean nanoparticle size of $\ensuremath{\langle}D\ensuremath{\rangle}\ensuremath{\approx}13$ nm, where the bulk commensurate antiferromagnetic structure is retained at the nanoparticle core. Magnetic measurements evidence the interaction among the magnetic moments located at the nanoparticle surface to be strong enough to establish a spin glass behavior. Specific heat analyses show a broad Schottky contribution, revealing the existence of a crystalline electric field. Inelastic neutron scattering analyses disclose that the splitting of the crystalline electric field levels associated with the ${\mathrm{Nd}}^{3+}$ ions, as well as the spin-wave excitations that emerged below the N\'eel transition $({T}_{\mathit{\text{N}}}\ensuremath{\approx}6 \mathrm{K})$ in polycrystalline ${\mathrm{NdCu}}_{2}$ are maintained in the nanoparticle state. We have been able to isolate the scattering contribution arising from the nanoparticle surface where both crystalline electric field splitting and the collective magnetic excitations are well-defined despite the symmetry breaking. Quantitative analyses of this surface scattering reveal that finite-size effects and microstrain lead to a partial inhibition of the transitions from the ground state to the first excited level, as well as a positive shift $(\ensuremath{\sim}15%)$ of the energy associated to collective magnon excitations.

3 citations


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Journal ArticleDOI
TL;DR: Wang et al. as discussed by the authors conducted an ambidirectional cohort study of COVID-19 survivors who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7 and May 29, 2020.

578 citations

Journal ArticleDOI
TL;DR: In this article, a living systematic review was conducted to synthesize evidence on Long Covid characteristics, to inform clinical management, rehabilitation, and interventional studies to improve long term outcomes.
Abstract: Background: While it is now apparent clinical sequelae (often called Long Covid) may persist after acute Covid-19, their nature, frequency, and aetiology are poorly characterised. This study aims to regularly synthesise evidence on Long Covid characteristics, to inform clinical management, rehabilitation, and interventional studies to improve long term outcomes. Methods: A living systematic review. Medline, CINAHL (EBSCO), Global Health (Ovid), WHO Global Research Database on Covid-19, LitCOVID, and Google Scholar were searched up to 17th March 2021. Published studies including at least 100 people with confirmed or clinically suspected Covid-19 at 12 weeks or more post-onset were included. Results were analysed using descriptive statistics and meta-analyses to estimate prevalence with 95% confidence intervals (CIs). Results: Thirty-nine studies were included: 32 cohort, six cross-sectional, and one case-control. Most showed high or moderate risk of bias. None were set in low-income countries, limited studies included children. Studies reported on 10,951 people (48% female) in 12 countries. Most followed-up post hospital discharge (78%, 8520/10951). The longest mean follow-up was 221.7 (SD: 10.9) days post Covid-19 onset. An extensive range of symptoms with wide prevalence was reported, most commonly weakness (41%; 95% CI 25% to 59%), malaise (33%; 95% CI 15% to 57%), fatigue (31%; 95% CI 24% to 39%), concentration impairment (26%; 95% CI 21% to 32%), and breathlessness (25%; 95% CI 18% to 34%). Other frequent symptoms included musculoskeletal, neurological, and psychological. 37% (95% CI 18% to 60%) of people reported reduced quality of life. Conclusion: Long Covid is a complex condition with heterogeneous symptoms. The nature of the studies precludes a precise case definition or evaluation of risk factors. There is an urgent need for prospective, robust, standardised controlled studies into aetiology, risk factors, and biomarkers to characterise Long Covid in different at-risk populations and settings. Systematic review registration: The protocol was prospectively registered on the PROSPERO database (CRD42020211131).

352 citations

Journal ArticleDOI
TL;DR: Overall, the evidence for follow-up care for patients with long COVID is limited and more evidence and research is emerging to understand the causes, mechanisms and risks of long CO VID consequences.
Abstract: Patients diagnosed with coronavirus disease 2019 (COVID-19) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection frequently experience symptom burden post-acute infection or post-hospitalisation. We aimed to identify optimal strategies for follow-up care that may positively impact the patient's quality of life (QoL). A European Respiratory Society (ERS) Task Force convened and prioritised eight clinical questions. A targeted search of the literature defined the timeline of “long COVID” as 1–6 months post-infection and identified clinical evidence in the follow-up of patients. Studies meeting the inclusion criteria report an association of characteristics of acute infection with persistent symptoms, thromboembolic events in the follow-up period, and evaluations of pulmonary physiology and imaging. Importantly, this statement reviews QoL consequences, symptom burden, disability and home care follow-up. Overall, the evidence for follow-up care for patients with long COVID is limited. Follow-up care of patients infected with SARS-CoV-2 is crucial and may improve their quality of life. More evidence and research is emerging to understand the causes, mechanisms and risks of long COVID consequences. https://bit.ly/3J1WMWy

66 citations

Journal ArticleDOI
TL;DR: This is the first meta-analysis measuring the association between factors present during COVID-19 hospitalization and long-term sequelae and the role of female sex and acute disease severity as independent prognostic factors must be confirmed in robust longitudinal studies with longer follow-up.
Abstract: Evidence shows that a substantial proportion of patients with COVID-19 experiences long-term consequences of the disease, but the predisposing factors are poorly understood. We conducted a systematic review and meta-analysis to identify factors present during COVID-19 hospitalization associated with an increased risk of exhibiting new or persisting symptoms (Post-COVID-19 Syndrome, PCS). MedLine and WebOfScience were last searched on 30 September 2021. We included English language clinical trials and observational studies investigating prognostic factors for PCS in adults previously hospitalized for COVID-19, reporting at least one individual prospective follow-up of minimum 12 weeks. Two authors independently assessed risk of bias, which was judged generally moderate. Risk factors were included in the analysis if their association with PCS was investigated by at least two studies. To summarize the prognostic effect of each factor (or group of factors), odds ratios were estimated using raw data. Overall, 20 articles met the inclusion criteria, involving 13,340 patients. Associations were statistically significant for two factors: female sex with any symptoms (OR 1.52; 95% CI 1.27–1.82), with mental health symptoms (OR 1.67, 95% CI 1.21–2.29) and with fatigue (OR 1.54, 95% CI 1.32–1.79); acute disease severity with respiratory symptoms (OR 1.66, 95% CI 1.03–2.68). The I² statistics tests were calculated to quantify the degree of study heterogeneity. This is the first meta-analysis measuring the association between factors present during COVID-19 hospitalization and long-term sequelae. The role of female sex and acute disease severity as independent prognostic factors must be confirmed in robust longitudinal studies with longer follow-up. Identifying populations at greatest risk for PCS can enable the development of targeted prevention and management strategies. Systematic review registration: PROSPERO CRD42021253467.

64 citations

Journal ArticleDOI
TL;DR: Long COVID is a complex syndrome with protracted heterogeneous symptoms, and patients who experience post-COVID-19 sequelae require personalized treatment as well as ongoing support.
Abstract: Though the acute effects of SARS-CoV-2 infection have been extensively reported, the long-term effects are less well described. Specifically, while clinicians endure to battle COVID-19, we also need to develop broad strategies to manage post-COVID-19 symptoms and encourage those affected to seek suitable care. This review addresses the possible involvement of the lung, heart and brain in post-viral syndromes and describes suggested management of post-COVID-19 syndrome. Post-COVID-19 respiratory manifestations comprise coughing and shortness of breath. Furthermore, arrhythmias, palpitations, hypotension, increased heart rate, venous thromboembolic diseases, myocarditis and acute heart failure are usual cardiovascular events. Among neurological manifestations, headache, peripheral neuropathy symptoms, memory issues, lack of concentration and sleep disorders are most commonly observed with varying frequencies. Finally, mental health issues affecting mental abilities and mood fluctuations, namely anxiety and depression, are frequently seen. Finally, long COVID is a complex syndrome with protracted heterogeneous symptoms, and patients who experience post-COVID-19 sequelae require personalized treatment as well as ongoing support.

62 citations