Institution
Hospital General Universitario Gregorio Marañón
Healthcare•Madrid, Spain•
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.
Topics: Population, Transplantation, Myocardial infarction, Intensive care, COPD
Papers published on a yearly basis
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TL;DR: This guideline is based on current evidence and expert opinion and consists of 61 recommendations that address the indications for H EN, relevant access devices and their use, the products recommended, the monitoring and criteria for termination of HEN, and the structural requirements needed to perform HEN.
204 citations
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University of Medicine and Health Sciences1, Icahn School of Medicine at Mount Sinai2, Wyss Institute for Biologically Inspired Engineering3, Broad Institute4, Harvard University5, Howard Hughes Medical Institute6, University of Pittsburgh7, Nagoya University8, Hospital General Universitario Gregorio Marañón9, King Abdulaziz University10, University of Santiago de Compostela11, Karolinska Institutet12, University of California, San Francisco13, Goethe University Frankfurt14
TL;DR: Damaging, nonsynonymous PZMs within critical exons of prenatally expressed genes were more common in ASD probands than controls, and genes carrying these PZM were enriched for expression in the amygdala.
Abstract: We systematically analyzed postzygotic mutations (PZMs) in whole-exome sequences from the largest collection of trios (5,947) with autism spectrum disorder (ASD) available, including 282 unpublished trios, and performed resequencing using multiple independent technologies. We identified 7.5% of de novo mutations as PZMs, 83.3% of which were not described in previous studies. Damaging, nonsynonymous PZMs within critical exons of prenatally expressed genes were more common in ASD probands than controls (P < 1 × 10-6), and genes carrying these PZMs were enriched for expression in the amygdala (P = 5.4 × 10-3). Two genes (KLF16 and MSANTD2) were significantly enriched for PZMs genome-wide, and other PZMs involved genes (SCN2A, HNRNPU and SMARCA4) whose mutation is known to cause ASD or other neurodevelopmental disorders. PZMs constitute a significant proportion of de novo mutations and contribute importantly to ASD risk.
203 citations
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TL;DR: Early valve replacement during index hospitalization (early surgery) vs medical therapy was not associated with lower mortality compared with medical therapy in the overall cohort, and prosthetic valve endocarditis remains associated with a high 1-year mortality rate.
Abstract: IMPORTANCE: There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE). OBJECTIVE: To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive medical therapy alone, after controlling for survival and treatment selection bias. DESIGN, SETTING, AND PARTICIPANTS: Participants were enrolled between June 2000 and December 2006 in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective, multinational, observational cohort of patients with infective endocarditis. Patients hospitalized with definite right- or left-sided PVE were included in the analysis. We evaluated the effect of treatment assignment on mortality, after adjusting for biases using a Cox proportional hazards model that included inverse probability of treatment weighting and surgery as a time-dependent covariate. The cohort was stratified by probability (propensity) for surgery, and outcomes were compared between the treatment groups within each stratum. INTERVENTIONS: Valve replacement during index hospitalization (early surgery) vs medical therapy. MAIN OUTCOMES AND MEASURES: In-hospital and 1-year mortality. RESULTS: Of the 1025 patients with PVE, 490 patients (47.8%) underwent early surgery and 535 individuals (52.2%) received medical therapy alone. Compared with medical therapy, early surgery was associated with lower in-hospital mortality in the unadjusted analysis and after controlling for treatment selection bias (in-hospital mortality: hazard ratio [HR], 0.44 [95% CI, 0.38-0.52] and lower 1-year mortality: HR, 0.57 [95% CI, 0.49-0.67]). The lower mortality associated with surgery did not persist after adjustment for survivor bias (in-hospital mortality: HR, 0.90 [95% CI, 0.76-1.07] and 1-year mortality: HR, 1.04 [95% CI, 0.89-1.23]). Subgroup analysis indicated a lower in-hospital mortality with early surgery in the highest surgical propensity quintile (21.2% vs 37.5%; P = .03). At 1-year follow-up, the reduced mortality with surgery was observed in the fourth (24.8% vs 42.9%; P = .007) and fifth (27.9% vs 50.0%; P = .007) quintiles of surgical propensity. CONCLUSIONS AND RELEVANCE: Prosthetic valve endocarditis remains associated with a high 1-year mortality rate. After adjustment for differences in clinical characteristics and survival bias, early valve replacement was not associated with lower mortality compared with medical therapy in the overall cohort. Further studies are needed to define the effect and timing of surgery in patients with PVE who have indications for surgery.
202 citations
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TL;DR: Continuous subcutaneous apomorphine infusion is an effective option for patients with PD and severe fluctuations, poorly controlled by conventional oral drug treatment.
Abstract: Continuous subcutaneous apomorphine infusion (CSAI) is, at present, an alternative option for advanced Parkinson's disease (PD) with motor fluctuations. We studied the evolution of patients with PD and severe motor fluctuations long-term treated with CSAI. We reviewed data from 82 patients with PD (mean age, 67 +/- 11.07; disease duration, 14.39 +/- 5.7 years) and severe motor fluctuations referred to 35 tertiary hospitals in Spain. These patients were long-term treated (for at least 3 months) with CSAI and tolerated the procedure without serious side effects. We compared the baseline data of these 82 patients (before CSAI) with those obtained from the last follow-up visit of each patient. The mean follow-up of CSAI was 19.93 +/- 16.3 months. Mean daily dose of CSAI was 72.00 +/- 21.38 mg run over 14.05 +/- 1.81 hours. We found a statistically significant reduction in off-hours, according to self-scoring diaries (6.64 +/- 3.09 vs. 1.36 +/- 1.42 hours/day, P < 0.0001), total and motor UPDRS scores (P < 0.0001), dyskinesia severity (P < 0.0006), and equivalent dose of antiparkinsonian therapy (1,405 +/- 536.7 vs. 800.1 +/- 472.9 mg of levodopa equivalent units P < 0.0001). CSAI is an effective option for patients with PD and severe fluctuations, poorly controlled by conventional oral drug treatment.
202 citations
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Autonomous University of Madrid1, New York University2, Università telematica San Raffaele3, Mount Sinai Hospital4, University of Miami5, Hospital General Universitario Gregorio Marañón6, Heidelberg University7, University of California, Davis8, Wayne State University9, Memorial Sloan Kettering Cancer Center10, University of Eastern Piedmont11, Lahey Hospital & Medical Center12
TL;DR: Based on analysis of the largest known cohort of patients with RCC along with IVC and atrialThrombus involvement, tumour thrombus level is an independent predictor of survival and supports the changes to the latest AJCC/UICC staging system.
201 citations
Authors
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Name | H-index | Papers | Citations |
---|---|---|---|
David H. Adams | 155 | 1613 | 117783 |
Stefanie Dimmeler | 147 | 574 | 81658 |
Stuart J. Pocock | 145 | 684 | 143547 |
M. I. Martínez | 134 | 1251 | 79885 |
Guy A. Rouleau | 129 | 884 | 65892 |
Jose L. Jimenez | 124 | 654 | 64226 |
Antoni Torres | 120 | 1238 | 65049 |
Paul P. Tak | 112 | 591 | 57689 |
Luis A. Diaz | 111 | 596 | 75036 |
Frans Van de Werf | 109 | 747 | 63537 |
José Luis Zamorano | 105 | 695 | 133396 |
Francisco Sánchez-Madrid | 102 | 527 | 43418 |
Francesco Locatelli | 99 | 820 | 42454 |
Roberto M. Lang | 96 | 823 | 56638 |
Carlos Simón | 95 | 589 | 31147 |