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.

Manejo del síndrome coronario agudo sin elevación del segmento ST en España. Estudio DESCARTES (Descripción del Estado de los Síndromes Coronarios Agudos en un Registro Temporal Español)

Abstract: Introduccion y objetivos Se dispone de escasa informacion acerca de la situacion asistencial a escala poblacional de los sindromes coronarios agudos sin elevacion del segmento ST (SCASEST) en Espana. El objetivo es conocer la situacion de la atencion medica a los pacientes con SCASEST en Espana, desde una perspectiva representativa de la realidad estatal. Pacientes y metodo Registro prospectivo de pacientes consecutivos con SCASEST ingresados en 52 hospitales espanoles con distintos recursos cardiologicos, seleccionados al azar y que cumplieron con los criterios de control de calidad del estudio. Resultados Entre abril y mayo de 2002 se recluto a 1.877 pacientes con una edad promedio de 69 anos. El 93% tenia algun factor de riesgo y 73% antecedentes cardiovasculares. Un 76% presentaba un electrocardiograma anormal y un 53% elevacion de las troponinas. El 27% fue ingresado en una unidad coronaria o de cuidados intensivos. Se estudio al 56% de los pacientes mediante ecocardiografia, al 39% mediante una prueba de deteccion de isquemia y al 41% mediante coronariografia. En el hospital, un 88% recibio aspirina, un 81% heparina, un 37% clopidogrel, un 12% inhibidores de la glucoproteina IIb/IIIa, un 63% bloqueadores beta, un 46% inhibidores de la enzima de conversion de la angiotensina y un 52% estatinas. Se realizo revascularizacion coronaria en el 24% de los pacientes. El diagnostico final fue angina en el 54%, infarto en el 28% y otros diagnosticos en el 18%. La mortalidad fue del 3,7% a los 28 dias y del 7,8% a 6 los meses. Conclusiones DESCARTES es el primer registro representativo de la actividad asistencial en la atencion a los SCASEST en Espana. Se demuestra que, pese a que son pacientes de alto riesgo, reciben una atencion suboptima segun lo recomendado.

Molecular Identification and Antifungal Susceptibility of Yeast Isolates Causing Fungemia Collected in a Population-Based Study in Spain in 2010 and 2011

Abstract: We report the molecular identifications and antifungal susceptibilities of the isolates causing fungemia collected in the CANDIPOP population-based study conducted in 29 Spanish hospitals. A total of 781 isolates (from 767 patients, 14 of them having mixed fungemia) were collected. The species found most frequently were Candida albicans (44.6%), Candida parapsilosis (24.5%), Candida glabrata (13.2%), Candida tropicalis (7.6%), Candida krusei (1.9%), Candida guilliermondii (1.7%), and Candida lusitaniae (1.3%). Other Candida and non-Candida species accounted for approximately 5% of the isolates. The presence of cryptic species was low. Compared to findings of previous studies conducted in Spain, the frequency of C. glabrata has increased. Antifungal susceptibility testing was performed by using EUCAST and CLSI M27-A3 reference procedures; the two methods were comparable. The rate of fluconazole-susceptible isolates was 80%, which appears to be a decrease compared to findings of previous studies, explained mainly by the higher frequency of C. glabrata. Using the species-specific breakpoints and epidemiological cutoff values, the rate of voriconazole and posaconazole in vitro resistance was low (<2%). In the case of C. tropicalis, using the EUCAST procedure, the rate of azole resistance was around 20%. There was a correlation between the previous use of azoles and the presence of fluconazole-resistant isolates. Resistance to echinocandins was very rare (2%), and resistance to amphotericin B also was very uncommon. The sequencing of the hot spot (HS) regions from FKS1 or FKS2 genes in echinocandin-resistant isolates revealed previously described point mutations. The decrease in the susceptibility to fluconazole in Spanish isolates should be closely monitored in future studies.