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Article ; Online: Recomendaciones para la elaboración de informes y documentación en los casos de consultoría de ética clínica.

Galván-Román, José María / García Sanz, Íñigo / Fernández Bueno, Julia / Real de Asúa, Diego

2023 Volume 161, Issue 2, Page(s) 78–83

Title translation	Recommendations for documentation and report drafting of clinical ethics consultation cases.
MeSH term(s)	Humans ; Ethics Consultation ; Ethics, Clinical ; Documentation ; Ethics Committees, Clinical
Language	Spanish
Publishing date	2023-05-27
Publishing country	Spain
Document type	Journal Article
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2023.05.002
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Article ; Online: Adults with Down syndrome challenge another paradigm: When aging no longer entails arterial hypertension.

Roy-Vallejo, Emilia / Galván-Román, José María / Moldenhauer, Fernando / Real de Asúa, Diego

Journal of clinical hypertension (Greenwich, Conn.)

2020 Volume 22, Issue 7, Page(s) 1127–1133

Abstract: The paradigmatic relationship between aging and atherosclerotic cardiovascular events does not apply to all patient populations. Though trisomy 21 (T21) and its phenotypic expression, Down syndrome (DS), are conditions that involve premature aging, the ... ...

Abstract	The paradigmatic relationship between aging and atherosclerotic cardiovascular events does not apply to all patient populations. Though trisomy 21 (T21) and its phenotypic expression, Down syndrome (DS), are conditions that involve premature aging, the cardiovascular system of adults with DS appears to be particularly spared from this early senescence. Despite a higher prevalence of some classic cardiovascular risk factors in adults with DS than in the general population, such as dyslipidemia, obesity, or sedentarism, these individuals do not develop hypertension or suffer major cardiovascular events as they age. The protective factors that prevent the development of hypertension in T21 are not well established. Genes like RCAN1 and DYRK1A, both on chromosome 21 and over-expressed in adults with DS, appear to play a major role in cardiovascular prevention. Their regulation of the renin-angiotensin-aldosterone system (RAAS) and neprilysin synthesis could underlie the constitutive protection against arterial hypertension in adults with DS and explain the absence of increased arterial stiffness in this population. A better understanding of these molecular pathways could have enormous implications for the clinical management of adults with DS and might foster the development of novel therapeutic targets in cardiovascular prevention for the general population.
MeSH term(s)	Adult ; Aging ; DNA-Binding Proteins ; Down Syndrome/complications ; Down Syndrome/genetics ; Humans ; Hypertension/epidemiology ; Muscle Proteins ; Renin-Angiotensin System ; Vascular Stiffness
Chemical Substances	DNA-Binding Proteins ; Muscle Proteins ; RCAN1 protein, human
Language	English
Publishing date	2020-07-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2077222-1
ISSN	1751-7176 ; 1524-6175
ISSN (online)	1751-7176
ISSN	1524-6175
DOI	10.1111/jch.13930
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Article: Inflammatory status and prognosis of locally advanced non-small cell lung cancer.

Galvan-Roman, José María / Curbelo, José / Aspa, Javier

Journal of thoracic disease

2017 Volume 9, Issue 9, Page(s) 2782–2785

Language	English
Publishing date	2017-12-18
Publishing country	China
Document type	Editorial ; Comment
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd.2017.08.27
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Article ; Online: Diagnostic Assessment of Respiratory and Hemodynamic Changes Related to Prone Position in COVID-19 Patients.

López-Viñas, Laura / Roy-Vallejo, Emilia / Rocío-Martín, Esmeralda / de la Rosa Santiago, Elena / Zamora García, Enrique / Galván-Román, Jose María / Wix-Ramos, Rybel

Disaster medicine and public health preparedness

2023 Volume 17, Page(s) e475

Abstract: Objective: To study the respiratory patterns and the hemodynamic variations related to postural changes in inpatients with coronavirus disease (COVID-19).: Methods: This report is a prospective study in a cohort of inpatients admitted with COVID-19. ... ...

Abstract	Objective: To study the respiratory patterns and the hemodynamic variations related to postural changes in inpatients with coronavirus disease (COVID-19). Methods: This report is a prospective study in a cohort of inpatients admitted with COVID-19. We recruited 10 patients admitted to the hospital with moderate or severe COVID-19 who showed improvement in oxygen saturation with prone positioning. We performed cardiorespiratory polygraphy and hemodynamic evaluations by thoracic electrical bioimpedance. Results: We observed a median minimum oxygen saturation of 85.00% (IQR: 7.00) in the supine position versus 91.00% (IQR: 8.00) ( Conclusion: This brief report describes the effects of prone positioning on respiratory and hemodynamic variables in 10 patients with moderate or severe COVID-19.
MeSH term(s)	Humans ; Prone Position ; Prospective Studies ; COVID-19/diagnosis ; Hemodynamics ; Patient Positioning ; COVID-19 Testing
Language	English
Publishing date	2023-09-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2375268-3
ISSN	1938-744X ; 1935-7893
ISSN (online)	1938-744X
ISSN	1935-7893
DOI	10.1017/dmp.2023.152
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Article: Consultoría en ética clínica: modelos europeos y nuevas propuestas en España.

Galván Román, José María / Fernández Bueno, Julia / Sánchez González, Miguel Ángel / Real de Asúa Cruzat, Diego

Cuadernos de bioetica : revista oficial de la Asociacion Espanola de Bioetica y Etica Medica

2021 Volume 32, Issue 104, Page(s) 75–87

Abstract: To date, healthcare ethics committees (HEC) have been the only ethics consultation model in the hospital setting in Spain, though their usefulness for ethical conflict resolution in daily practice has been questioned. Individual clinical ethics ... ...

Title translation	Clinical Ethics Consultation: current European models and novel approaches in Spain.
Abstract	To date, healthcare ethics committees (HEC) have been the only ethics consultation model in the hospital setting in Spain, though their usefulness for ethical conflict resolution in daily practice has been questioned. Individual clinical ethics consultation (CEC) is a complementary ethics consultation model, which has proved efficacious in real-time ethical problem-solving. Although CEC is widely used in North America, its implementation in Europe is still marginal. In this document we present the general characteristics of CEC services, comparing their potential advantages and risks to those of HECs. We will then share relevant European experiences in CEC, as well as review the few CEC initiatives in Spain. Finally, we will share our recent CEC implementation strategy in a national, medium-sized, teaching hospital. We will summarise the minimum requirements that such a CEC service must meet in order to carry out its consulting activity: organisational flexibility, well-trained professionals, with sufficient clinical experience, economical support, and organisational dependency on HECs.
MeSH term(s)	Ethics Committees, Clinical ; Ethics Consultation ; Ethics, Clinical ; Europe ; Spain
Language	Spanish
Publishing date	2021-03-16
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2546303-2
ISSN	1132-1989
ISSN	1132-1989
DOI	10.30444/CB.89
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Article ; Online: Evaluation of congenital and acquired heart diseases in a Spanish cohort of adults with Down syndrome.

Rabes, Laura / Adán-Lirola, Laura / González-Molina, María Del Pilar / Galván-Román, José María / Moldenhauer, Fernando / Roy-Vallejo, Emilia / Real de Asúa, Diego

Scientific reports

2022 Volume 12, Issue 1, Page(s) 22461

Abstract: To describe congenital and acquired heart diseases in a Spanish cohort of adults with Down syndrome (DS), which could inform potential health recommendations for this population. Cross-sectional, observational study of adults with DS evaluated ... ...

Abstract	To describe congenital and acquired heart diseases in a Spanish cohort of adults with Down syndrome (DS), which could inform potential health recommendations for this population. Cross-sectional, observational study of adults with DS evaluated consecutively at a tertiary care, outpatient center between January 1 and December 31, 2019. The study population comprised 937 patients (51.8% men; median [IQR] age, 42 [18] years). An echocardiogram was available in the clinical chart of 420 patients (44.8%). The diagnosis of any form of heart disease was confirmed in 211 patients (22.5%): 101 (10.8%) had congenital heart defects, 80 (8.5%) simultaneous congenital and valvular heart diseases, and 30 (3.2%) isolated valvular heart disease. 111 patients (52.6% of those with congenital or valvular heart disease) had received corrective cardiac surgery. A total of 65 individuals were receiving medical management alone (30.8%), while 35 did not require any treatment because their cardiac disease was mild (16.6%). We found a high overall prevalence of heart disease in patients with DS, higher than previously reported for the pediatric population. Management of cardiovascular disease in adults with DS differs from that of the general population and should include universal echocardiography-based screening.
MeSH term(s)	Male ; Humans ; Child ; Adult ; Female ; Down Syndrome/complications ; Down Syndrome/epidemiology ; Cross-Sectional Studies ; Heart Defects, Congenital/epidemiology ; Heart Defects, Congenital/etiology ; Cardiac Surgical Procedures/adverse effects ; Heart Valve Diseases/complications
Language	English
Publishing date	2022-12-28
Publishing country	England
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-26918-0
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Article: Diaphragm impairment in patients admitted for severe COVID-19.

López-Viñas, Laura / Vega-Villar, Juan / Rocío-Martín, Esmeralda / García-García, Patricia / De La Rosa Santiago, Elena / Galván-Román, Jose María / Wix-Ramos, Rybel

European journal of translational myology

2022 Volume 32, Issue 2

Abstract: Among patients affected by the virus COVID-19, physicians have observed ventilation disorders. It is relevant to assess neurological involvement, including the role of diaphragmatic function. Its possible impairment could be related to the systemic ... ...

Abstract	Among patients affected by the virus COVID-19, physicians have observed ventilation disorders. It is relevant to assess neurological involvement, including the role of diaphragmatic function. Its possible impairment could be related to the systemic inflammatory response and disease progression that both typify COVID-19 infection. We distinguished two groups (severe group (SG) and mild group (MG)) according to the severity of respiratory symptomatology. We performed neurophysiological and sonography studies to evaluate the diaphragmatic function. Regarding the sonography variables, we identified statistically significant differences in the right mean diaphragmatic thickness along with the expiration, showing 1.56 mm (SEM: 0.11) in the SG vs 1.92 mm (SEM: 0.19) in the MG (p = 0.042). The contractibility of both hemidiaphragms was 15% lower in the severe group, though this difference is not statistically significant. In our examination of the neurophysiological variables, in the amplitude responses, we observed a greater difference between responses from both phrenic nerves as follows: the raw differences in amplitude were 0.40 μV (SEM: 0.14) in the SG vs 0.35 μV (SEM: 0.19) in the MG and the percentage difference was 25.92% (SEM: 7.22) in the SG vs 16.28% (SEM: 4.38%) in the MG. Although diaphragmatic dysfunction is difficult to detect, our combined functional and morphological approach with phrenic electroneurograms and chest ultrasounds could improve diagnostic sensitivity. We suggest that diaphragmatic dysfunction could play a relevant role in respiratory disturbance in hospitalised patients with severe COVID-19.
Language	English
Publishing date	2022-06-21
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2545577-1
ISSN	2037-7460 ; 2037-7452
ISSN (online)	2037-7460
ISSN	2037-7452
DOI	10.4081/ejtm.2022.10460
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Article ; Online: Usefulness of circulating microRNAs miR-146a and miR-16-5p as prognostic biomarkers in community-acquired pneumonia.

Galván-Román, José María / Lancho-Sánchez, Ángel / Luquero-Bueno, Sergio / Vega-Piris, Lorena / Curbelo, Jose / Manzaneque-Pradales, Marcos / Gómez, Manuel / de la Fuente, Hortensia / Ortega-Gómez, Mara / Aspa, Javier

PloS one

2020 Volume 15, Issue 10, Page(s) e0240926

Abstract: Introduction: Patients with community-acquired pneumonia (CAP) undergo a dysregulated host response that is related to mortality. MicroRNAs (miRNAs) participate in this response, but their expression pattern and their role as biomarkers in CAP have not ... ...

Abstract	Introduction: Patients with community-acquired pneumonia (CAP) undergo a dysregulated host response that is related to mortality. MicroRNAs (miRNAs) participate in this response, but their expression pattern and their role as biomarkers in CAP have not been fully characterized. Methods: A prospective observational study was performed in a cohort of 153 consecutive patients admitted to hospital with CAP. Clinical and analytical variables were collected, and the main outcome variable was 30-day mortality. Small RNA was purified from plasma of these patients obtained on the first day of admission, and miRNA expression was analyzed by RT-PCR. Univariate and multivariate analyses were carried out through the construction of a logistic regression model. The proposed model was compared with established prognostic clinical scales using ROC curve analysis. Results: The mean age of the patients included was 74.7 years [SD 15.9]. Their mean PSI was 100.9 [SD 34.6] and the mean modified Charlson index was 2.9 [SD 3.0]. Both miR-146a and miR-16-5p showed statistically significant association with 30-day mortality after admission due to CAP (1.10 vs. 0.23 and 51.74 vs. 35.23, respectively), and this association remained for miR-16-5p in the multivariate analysis adjusted for age, gender and history of bronchoaspiration (OR 0.95, p = 0.021). The area-under-the-curve (AUC) of our adjusted multivariate model (AUC = 0.954 95%CI [0.91-0.99]), was better than those of prognostic scales such as PSI (AUC = 0.799 [0.69-0.91]) and CURB-65 (AUC = 0.722 [0.58-0.86]). Conclusions: High levels of miR-146a-5p and miR-16-5p upon admission due to CAP are associated with lower mortality at 30 days of follow-up. Both miRNAs could be used as biomarkers of good prognosis in subjects hospitalized with CAP.
MeSH term(s)	Aged ; Aged, 80 and over ; Biomarkers/blood ; Community-Acquired Infections/blood ; Community-Acquired Infections/genetics ; Community-Acquired Infections/mortality ; Female ; Hospitalization ; Humans ; Male ; MicroRNAs/blood ; MicroRNAs/genetics ; Middle Aged ; Prognosis ; Prospective Studies ; Survival Analysis ; Up-Regulation
Chemical Substances	Biomarkers ; MIRN146 microRNA, human ; MIRN16 microRNA, human ; MicroRNAs
Language	English
Publishing date	2020-10-23
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0240926
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Article ; Online: A Differential Signature of Circulating miRNAs and Cytokines Between COVID-19 and Community-Acquired Pneumonia Uncovers Novel Physiopathological Mechanisms of COVID-19.

Martínez-Fleta, Pedro / Vera-Tomé, Paula / Jiménez-Fernández, María / Requena, Silvia / Roy-Vallejo, Emilia / Sanz-García, Ancor / Lozano-Prieto, Marta / López-Sanz, Celia / Vara, Alicia / Lancho-Sánchez, Ángel / Martín-Gayo, Enrique / Muñoz-Calleja, Cecilia / Alfranca, Arantzazu / González-Álvaro, Isidoro / Galván-Román, José María / Aspa, Javier / de la Fuente, Hortensia / Sánchez-Madrid, Francisco

Frontiers in immunology

2022 Volume 12, Page(s) 815651

Abstract: Coronavirus Disease 2019 (COVID-19) pneumonia is a life-threatening infectious disease, especially for elderly patients with multiple comorbidities. Despite enormous efforts to understand its underlying etiopathogenic mechanisms, most of them remain ... ...

Abstract	Coronavirus Disease 2019 (COVID-19) pneumonia is a life-threatening infectious disease, especially for elderly patients with multiple comorbidities. Despite enormous efforts to understand its underlying etiopathogenic mechanisms, most of them remain elusive. In this study, we compared differential plasma miRNAs and cytokines profiles between COVID-19 and other community-acquired pneumonias (CAP). A first screening and subsequent validation assays in an independent cohort of patients revealed a signature of 15 dysregulated miRNAs between COVID-19 and CAP patients. Additionally, multivariate analysis displayed a combination of 4 miRNAs (miR-106b-5p, miR-221-3p, miR-25-3p and miR-30a-5p) that significantly discriminated between both pathologies. Search for targets of these miRNAs, combined with plasma protein measurements, identified a differential cytokine signature between COVID-19 and CAP that included EGFR, CXCL12 and IL-10. Significant differences were also detected in plasma levels of CXCL12, IL-17, TIMP-2 and IL-21R between mild and severe COVID-19 patients. These findings provide new insights into the etiopathological mechanisms underlying COVID-19.
MeSH term(s)	Biomarkers/blood ; COVID-19/blood ; COVID-19/immunology ; Circulating MicroRNA/blood ; Cohort Studies ; Community-Acquired Infections/blood ; Community-Acquired Infections/immunology ; Cytokines/blood ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Pneumonia/blood ; Pneumonia/immunology
Chemical Substances	Biomarkers ; Circulating MicroRNA ; Cytokines
Language	English
Publishing date	2022-01-11
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2021.815651
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Article: Gastroenterology - Evolution of specialty choice in recent years.

Curbelo, José / Galván-Román, José-María / Sánchez-Lasheras, Fernando / Romeo, Jose María / Fernández-Somoano, Ana / Villacampa, Tomás / Baladrón, Jaime

Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

2017 Volume 109, Issue 9, Page(s) 614–618

Abstract: Introduction: Gastroenterology is one of the medical specialties offered to residency training candidates each year. This project analyzes the data associated with the choice of a Gastroenterology residency program in recent years.: Material and ... ...

Abstract	Introduction: Gastroenterology is one of the medical specialties offered to residency training candidates each year. This project analyzes the data associated with the choice of a Gastroenterology residency program in recent years. Material and methods: Data related to specialty selection were obtained from official reports with regard to the allocation of residency places by the Spanish Ministry of Health, Social Services and Equality. Information was collected from various teaching centers via their training guides, the Spanish National Catalogue of Hospitals and the National Transplant Organization. Results: The median consecutive number involved in the choice of Gastroenterology training has decreased year after year, and this specialty is now positioned among the five most commonly selected residency programs in 2015. The median number of hospitals with a higher number of beds, adult liver transplantation activities and dedicated GI bleeding units is significantly lower. This is also true when centers are analyzed according to the presence of specific Gastroenterology on-call shifts for residents or their association with medical schools. Data from the past five years highlight Madrid, Aragón and the Basque Country as the autonomous communities where Gastroenterology is the most popular. Centers selected by candidates with the lowest median consecutive numbers from 2011-2015 included the university hospitals Ramón y Cajal, Santiago de Compostela and Gregorio Marañón. Conclusions: Gastroenterology has gradually escalated in the ranking of residency choices and is now one of the five most popular options. Potential residents prefer larger centers with complex-care patients and more research activity.
Language	English
Publishing date	2017-09
Publishing country	Spain
Document type	Journal Article
ZDB-ID	1070381-0
ISSN	1130-0108 ; 0212-7512
ISSN	1130-0108 ; 0212-7512
DOI	10.17235/reed.2017.4977/2017
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