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Institution

Hospital General Universitario Gregorio Marañón

HealthcareMadrid, 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.


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Journal ArticleDOI
TL;DR: This consensus document defines the objectives of the PROA (namely, to improve the clinical results of patients with infections, to minimise the adverse events associated to the use of antimicrobials including the emergence and spread of antibiotic resistance), and provides recommendations for the implementation of these programs in Spanish hospitals.
Abstract: The antimicrobial agents are unique drugs for several reasons. First, their efficacy is higher than other drugs in terms of reduction of morbidity and mortality. Also, antibiotics are the only group of drugs associated with ecological effects, because their administration may contribute to the emergence and spread of microbial resistance. Finally, they are used by almost all medical specialties. Appropriate use of antimicrobials is very complex because of the important advances in the management of infectious diseases and the spread of antibiotic resistance. Thus, the implementation of programs for optimizing the use of antibiotics in hospitals (called PROA in this document) is necessary. This consensus document defines the objectives of the PROA (namely, to improve the clinical results of patients with infections, to minimise the adverse events associated to the use of antimicrobials including the emergence and spread of antibiotic resistance, and to ensure the use of the most cost-efficacious treatments), and provides recommendations for the implementation of these programs in Spanish hospitals. The key aspects of the recommendations are as follows. Multidisciplinary antibiotic teams should be formed, under the auspices of the Infection Committees. The PROA need to be considered as part of institutional programs and the strategic objectives of the hospital. The PROA should include specific objectives based on measurable indicators, and activities aimed at improving the use of antimicrobials, mainly through educational activities and interventions based more on training activities directed to prescribers than just on restrictive measures.

152 citations

Journal ArticleDOI
TL;DR: Although the study failed to show a statistically significant difference between arms, it did show an improved SVR in females, and adding metformin to peginterferon and ribavirin was safe and improved insulin sensitivity.

151 citations

Journal ArticleDOI
TL;DR: The present review will emphasize the molecular mechanisms underlying the effects of statins on endothelial function and oxidative stress, and inhibition of small GTP-binding proteins, Rho, Ras and Rac, seems to play an important role in mediating the pleiotropic effects ofstatins.
Abstract: Atherosclerosis and its complications represent the major cause of death in developed countries. Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A [HMGCoA] reductase and consequently inhibitors of cholesterol biosynthesis. Statins have been described as the most potent class of drugs to reduce serum cholesterol levels. In clinical trials, statins are beneficial in primary and secondary prevention of coronary heart disease. Statins, were initially designed as cholesterol-lowering drugs. However, these drugs, besides their lipid-lowering properties, exert a number of protective effects on the cardiovascular system that emerged over the past years. The benefits observed with statin treatment appear to be greater than that might be expected from reduction in lipid levels alone, suggesting effects beyond cholesterol lowering. These cholesterol-independent effects have been called "pleiotropic". The cholesterol-independent or "pleiotropic" effects of statins involve improvement of endothelial function, stability of atherosclerotic plaques, decrease of oxidative stress and inflammation, and inhibition of thrombogenic response. These pleiotropic effects of statins have been proposed as key properties of these drugs to reduce cardiovascular morbidity and mortality. The present review will emphasize the molecular mechanisms underlying the effects of statins on endothelial function and oxidative stress. In particular, inhibition of small GTP-binding proteins, Rho, Ras and Rac, which are regulated by isoprenoids [farnesyl pyrophosphate and geranylgeranyl pyrophosphate], seems to play an important role in mediating the pleiotropic effects of statins.

151 citations

Journal ArticleDOI
TL;DR: The EWG concluded that the current level of evidence did not lend itself to the development of clinical guidelines and decided to publish the results of their work as a pragmatic report.
Abstract: Our objective in this study was to summarize the relevant knowledge on depression in palliative care and to provide a framework for clinical, scientific and educational efforts at improving its management. The Research Steering Committee (RSC) of the European Association of Palliative Care (EAPC) established an Expert Working Group (EWG) to address the issue of depression in palliative care. Each invited expert was allocated a specific topic and was asked to review the literature. These reviews were presented during the Sixth Congress of the EAPC in 1999 and then discussed in a closed meeting with members of the RSC. Based on these reviews, and the discussions that followed their presentation, a first draft of the paper was produced and circulated among the invited experts and members of the RSC who had been present at the meetings. After some debate the manuscript was revised, and a second draft was circulated, this time also to RSC members who had not attended the meetings. All persons consulted have agreed on this final version of the report. The EWG concluded that the current level of evidence did not lend itself to the development of clinical guidelines and decided to publish the results of their work as a pragmatic report. The report is divided into four sections, focusing on detection, training and nonpharmacological and pharmacological treatment of depression in palliative care. For each of these sections, general considerations are addressed on the basis of the literature review and of clinical experience and a short description of unresolved issues and recommendations is provided. Underdetection and undertreatment of depression is a serious problem in palliative care. Training of the nonpsychiatric staff should therefore have the highest priority. A proactive, flexible and comprehensive strategy embracing clinical, scientific, and educational aspects is advocated.

151 citations

Journal ArticleDOI
TL;DR: Bvacizumab increased the proportion of patients achieving a 15% improvement in patient-reported abdominal/GI symptoms during chemotherapy for platinum-resistant ovarian cancer.
Abstract: Purpose To determine the effects of bevacizumab on patient-reported outcomes (PROs; secondary end point) in the AURELIA trial. Patients and Methods Patients with platinum-resistant ovarian cancer were randomly assigned to chemotherapy alone (CT) or with bevacizumab (BEV-CT). PROs were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Ovarian Cancer Module 28 (EORTC QLQ-OV28) and Functional Assessment of Cancer Therapy–Ovarian Cancer symptom index (FOSI) at baseline and every two or three cycles (8/9 weeks) until disease progression. The primary PRO hypothesis was that more patients receiving BEV-CT than CT would achieve at least a 15% (≥ 15-point) absolute improvement on the QLQ-OV28 abdominal/GI symptom subscale (items 31-36) at week 8/9. Patients with missing week 8/9 questionnaires were included as unimproved. Questionnaires from all assessments until disease progression were analyzed using mixed-model repeated-measures (MMRM) analysis. Sensitiv...

151 citations


Authors

Showing all 12014 results

NameH-indexPapersCitations
David H. Adams1551613117783
Stefanie Dimmeler14757481658
Stuart J. Pocock145684143547
M. I. Martínez134125179885
Guy A. Rouleau12988465892
Jose L. Jimenez12465464226
Antoni Torres120123865049
Paul P. Tak11259157689
Luis A. Diaz11159675036
Frans Van de Werf10974763537
José Luis Zamorano105695133396
Francisco Sánchez-Madrid10252743418
Francesco Locatelli9982042454
Roberto M. Lang9682356638
Carlos Simón9558931147
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202317
202246
20211,186
20201,045
2019898
2018637