Hospital General Universitario Gregorio Marañón

About: Hospital General Universitario Gregorio Marañón is a healthcare organization based out in Madrid, Spain. It is known for research contribution in the topics: Population & Transplantation. The organization has 11975 authors who have published 12386 publications receiving 244847 citations.

Mortality-related factors after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: the burden of clinical features

Abstract: Background There is limited information about factors associated with mortality of patients with chronic obstructive pulmonary disease (COPD) admitted to hospital because of an acute exacerbation. Methods A retrospective cohort study including all patients admitted to hospital through our emergency department (ED) was conducted. A total of 972 electronic discharge reports were reviewed. Patient baseline features, aspects concerning acute exacerbation, as well as demographic, cardiac ultrasound, and microbiological data were collected. Results In-hospital mortality rate was 6.4%. Of 315 patients with mild exacerbation according to Anthonisen criteria, only 1 died. In the univariate analysis, moderate to severe acute exacerbation of COPD, age older than 75 years, severe COPD, abnormal blood gas values, onset of complications during hospital stay, radiologic consolidation, a positive result in a microbiological respiratory sample, home oxygenotherapy, admission to the intensive care unit, left ventricular ejection fraction, and department of admission were statistically significant (P Conclusion We found that clinical aspect appears the most relevant of all potential determinants of in-hospital mortality for patients admitted for acute exacerbation of COPD. Thus, the clinical assessment and therapeutic decision taken in this first moment at the ED are the key that predict the prognosis of this patients. These data suggest that the risk of mortality after the admission to hospital of patients with COPD because of an acute exacerbation can be successfully predicted by making a clinical assessment at the ED.

Secondary forms of Takotsubo cardiomyopathy: A whole different prognosis:

Abstract: Background:Takotsubo syndrome (TKS) usually mimics an acute coronary syndrome. However, several clinical forms have been reported. Our aim was to assess if different stressful triggers had prognost...

Urokinase Versus VATS for Treatment of Empyema: A Randomized Multicenter Clinical Trial

Abstract: BACKGROUND AND OBJECTIVE: Parapneumonic empyema (PPE) is a frequent complication of acute bacterial pneumonia in children There is limited evidence regarding the optimal treatment of this condition The aim of this study was to compare the efficacy of drainage plus urokinase versus video-assisted thoracoscopic surgery in the treatment of PPE in childhood METHODS: This prospective, randomized, multicenter clinical trial enrolled patients aged RESULTS: A total of 103 patients were randomized to treatment and analyzed; 53 were treated with thoracoscopy and 50 with urokinase There were no differences in demographic characteristics or in the main baseline characteristics between the 2 groups No statistically significant differences were found between thoracoscopy and urokinase in the median postoperative stay (10 vs 9 days), median hospital stay (14 vs 13 days), or days febrile after treatment (4 vs 6 days) A second intervention was required in 15% of children in the thoracoscopy group versus 10% in the urokinase group (P = 47) CONCLUSIONS: Drainage plus urokinase instillation is as effective as video-assisted thoracoscopic surgery as first-line treatment of septated PPE in children

Increased prevalence of acute tubulointerstitial nephritis

Abstract: Acute tubulointerstitial nephritis (ATIN) is a common cause of acute kidney injury (AKI) for which early treatment improves prognosis. The recent increase in prevalence has not been reflected in the literature. The aim of our study was to analyse all native kidney biopsies performed from 1994 to 2009 and included in the Spanish Registry of Glomerulonephritis with a histological diagnosis of ATIN. We assessed the prevalence of ATIN, associated clinical syndromes and urinary sediment abnormalities. We divided the population into two groups according to age: adults (15–65 years) and elderly patients (>65 years). We collected a total of 17 680 native kidney biopsies from 120 hospitals in Spain. The overall prevalence of ATIN was 2.7%. When the analysis was restricted to patients with AKI, the prevalence increased to 12.9%. During the 16 years of follow-up, there was a significant increase in prevalence (from 3.6% in the first 4 years to 10.5% in the last 4 years), which was more marked among elderly patients (from 1.6 to 12.3%). The most common clinical manifestations were AKI, microscopic haematuria, non-nephrotic proteinuria, leucocyturia and arterial hypertension, which were more frequent in the elderly. The prevalence of ATIN has increased in recent years, especially in patients aged >65 years. This could be due to an increase in drug-associated ATIN, which would justify early renal biopsy to identify ATIN and reduce the probability of progression to chronic kidney disease. Although, our data are not able to corroborate this fact.