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Article ; Online: Initial presentation of Boerhaave syndrome as hydropneumothorax and septic shock.

Lence Massa, Beatriz / López Lago, Ana / Santiago Langarica, Aitziber

Medicina intensiva

2023

Language	English
Publishing date	2023-12-21
Publishing country	Spain
Document type	Journal Article
ISSN	2173-5727
ISSN (online)	2173-5727
DOI	10.1016/j.medine.2023.12.002
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Article ; Online: Minimal invasive fluorescence methods to quantify advanced glycation end products (AGEs) in skin and plasma of humans.

Almengló, Cristina / Rodriguez-Ruiz, Emilio / Alvarez, Ezequiel / López-Lago, Ana / González-Juanatey, José Ramón / Garcia-Allut, Jose L

Methods (San Diego, Calif.)

2021 Volume 203, Page(s) 103–107

Abstract: Advanced glycation end products (AGEs) are non-enzymatic modifications of proteins and lipids, which are spontaneously produced in the body in relation with several human diseases. Their relevance on protein functions alteration, either structural or ... ...

Abstract	Advanced glycation end products (AGEs) are non-enzymatic modifications of proteins and lipids, which are spontaneously produced in the body in relation with several human diseases. Their relevance on protein functions alteration, either structural or enzymatic is under study, but their value as biomarkers or predictors of disease progression and clinical outcomes is unquestionable. The heterogeneity and amplitude of these modifications make their analysis difficult, although, different methods have been developed for specific AGEs based on colorimetric reactions, immunoassays or chromatography. However, for a massive application on human population, methods based on the autofluorescence of some AGEs stand out. Several qualities of these methods such as label-free measurement, rapidity, cost-effectiveness, and minimal invasiveness make them very useful for periodic measurements in critically ill patients and for the analysis of large populations. Here we explain the rationale of these methods, and we present a step-by-step protocol and the equipment requirements to carry out the estimation of AGE content in skin and plasma. AGE plasma content and skin accumulation are temporally related, so AGE plasmatic levels are a possible predictor of skin AGE content. On the other hand, AGE skin accumulation is a surrogate or an indicator of past AGE levels in plasma and in the rest of the body. AGE levels or their variations have shown to be related with prognosis of several diseases, so they can be used as predictor biomarkers for clinicians.
MeSH term(s)	Biomarkers/metabolism ; Fluorescence ; Glycation End Products, Advanced/analysis ; Glycation End Products, Advanced/metabolism ; Humans ; Prognosis ; Skin/chemistry
Chemical Substances	Biomarkers ; Glycation End Products, Advanced
Language	English
Publishing date	2021-01-04
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1066584-5
ISSN	1095-9130 ; 1046-2023
ISSN (online)	1095-9130
ISSN	1046-2023
DOI	10.1016/j.ymeth.2020.12.003
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Article: Minimal invasive fluorescence methods to quantify advanced glycation end products (AGEs) in skin and plasma of humans

Almengló, Cristina / Rodriguez-Ruiz, Emilio / Alvarez, Ezequiel / López-Lago, Ana / González-Juanatey, José Ramón / Garcia-Allut, Jose L.

Methods. 2020 Dec. 28,

2020

Abstract	Advanced glycation end products (AGEs) are non-enzymatic modifications of proteins and lipids, which are spontaneously produced in the body in relation with several human diseases. Their relevance on protein functions alteration, either structural or enzymatic is under study, but their value as biomarkers or predictors of disease progression and clinical outcomes is unquestionable.The heterogeneity and amplitude of these modifications make their analysis difficult, although, different methods have been developed for specific AGEs based on colorimetric reactions, immunoassays or chromatography. However, for a massive application on human population, methods based on the autofluorescence of some AGEs stand out. Several qualities of these methods such as label-free measurement, rapidity, cost-effectiveness, and minimal invasiveness make them very useful for periodic measurements in critically ill patients and for the analysis of large populations.Here we explain the rationale of these methods, and we present a step-by-step protocol and the equipment requirements to carry out the estimation of AGE content in skin and plasma.AGE plasma content and skin accumulation are temporally related, so AGE plasmatic levels are a possible predictor of skin AGE content. On the other hand, AGE skin accumulation is a surrogate or an indicator of past AGE levels in plasma and in the rest of the body. AGE levels or their variations have shown to be related with prognosis of several diseases, so they can be used as predictor biomarkers for clinicians.
Keywords	biomarkers ; chromatography ; colorimetry ; cost effectiveness ; disease progression ; equipment ; fluorescence ; human population ; humans ; prognosis
Language	English
Dates of publication	2020-1228
Publishing place	Elsevier Inc.
Document type	Article
Note	Pre-press version
ZDB-ID	1066584-5
ISSN	1095-9130 ; 1046-2023
ISSN (online)	1095-9130
ISSN	1046-2023
DOI	10.1016/j.ymeth.2020.12.003
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Article ; Online: First-Days Reduction of Plasma and Skin Advanced Glycation End Products is Related to Outcome in Septic Patients.

Rodriguez-Ruiz, Emilio / Lopez-Lago, Ana / Hernandez-Vaquero, Rebeca / Granja-Gomez, Isabel / Estany-Gestal, Ana / Alvarez, Ezequiel / Garcia-Gonzalez, Miguel / Garcia-Allut, Jose L

Shock (Augusta, Ga.)

2019 Volume 53, Issue 4, Page(s) 400–406

Abstract: Background: Advanced glycation end products (AGEs) are a result of nonenzymatic glycation of proteins and lipids, which can attach to either their cell surface receptor (RAGE) or its soluble form (sRAGE). Evidence exists for the implication of AGE-RAGE ... ...

Abstract	Background: Advanced glycation end products (AGEs) are a result of nonenzymatic glycation of proteins and lipids, which can attach to either their cell surface receptor (RAGE) or its soluble form (sRAGE). Evidence exists for the implication of AGE-RAGE axis in sepsis, but data are still insufficient and conflicting. We aimed to analyze the kinetics of plasma and skin AGEs and sRAGE during sepsis, and their association with outcome in septic patients. Methods: We performed a prospective observational study. We enrolled 90 consecutive patients with severe sepsis or septic shock, within the first 24 h of Intensive Care Unit admission. During the first 5 days of sepsis, we measured plasma autofluorescence (PAF) and skin autofluorescence (SAF) as surrogates of circulating and skin AGEs, respectively. sRAGE was measured on days 1, 3, and 5. Delta values were defined as the difference between the PAF, SAF, or sRAGE on a specific day and the value on day 1. Results: 28-day mortality was 18%. Bivariate analysis found that ΔPAF3-1, ΔPAF4-1, ΔPAF5-1, and ΔSAF5-1 were significantly associated with 28-day mortality. Additionally, sRAGE1 was inversely correlated to ΔPAF4-1 (r = -0.250, P = 0.019) and ΔPAF5-1 (r = -0.246, P = 0.024), and significantly associated with 28-day mortality. In an adjusted multivariate logistic regression analysis, ΔPAF2-1, ΔPAF3-1, ΔPAF4-1, ΔPAF5-1, and ΔSAF5-1 were associated with 28-day mortality. Conclusions: Kinetics of plasma and skin AGEs during the first days of sepsis are independently associated with mortality, where a decrease of plasma and skin AGEs are related to higher mortality.
MeSH term(s)	Aged ; Aged, 80 and over ; Biomarkers/metabolism ; Critical Care ; Female ; Glycation End Products, Advanced/metabolism ; Humans ; Male ; Middle Aged ; Outcome Assessment, Health Care ; Prospective Studies ; Receptor for Advanced Glycation End Products/metabolism ; Sepsis/metabolism ; Sepsis/mortality ; Sepsis/therapy ; Skin/metabolism ; Survival Rate ; Time Factors
Chemical Substances	Biomarkers ; Glycation End Products, Advanced ; Receptor for Advanced Glycation End Products
Language	English
Publishing date	2019-07-02
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	1185432-7
ISSN	1540-0514 ; 1073-2322
ISSN (online)	1540-0514
ISSN	1073-2322
DOI	10.1097/SHK.0000000000001396
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Article ; Online: Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients.

Galli, Flavia / Bindo, Francesco / Motos, Anna / Fernández-Barat, Laia / Barbeta, Enric / Gabarrús, Albert / Ceccato, Adrián / Bermejo-Martin, Jesús F / Ferrer, Ricard / Riera, Jordi / Peñuelas, Oscar / Lorente, José Ángel / de Gonzalo-Calvo, David / Menéndez, Rosario / Gonzalez, Jessica / Misuraca, Sofia / Palomeque, Andrea / Amaya-Villar, Rosario / Añón, José Manuel /

Balan Mariño, Ana / Barberà, Carme / Barberán, José / Blandino Ortiz, Aaron / Bustamante-Munguira, Elena / Caballero, Jesús / Cantón-Bulnes, María Luisa / Carbajales Pérez, Cristina / Carbonell, Nieves / Catalán-González, Mercedes / de Frutos, Raul / Franco, Nieves / Galbán, Cristóbal / Lopez Lago, Ana / Gumucio-Sanguino, Víctor D / de la Torre, Maria Del Carmen / Díaz, Emilio / Estella, Ángel / Gallego Curto, Elena / García-Garmendia, José Luis / Gómez, José Manuel / Huerta, Arturo / Jorge García, Ruth Noemí / Loza-Vázquez, Ana / Marin-Corral, Judith / Martin Delgado, María Cruz / Martínez de la Gándara, Amalia / Martínez Varela, Ignacio / Lopez Messa, Juan / M Albaiceta, Guillermo / Nieto, María Teresa / Novo, Mariana Andrea / Peñasco, Yhivian / Pérez-García, Felipe / Pozo-Laderas, Juan Carlos / Ricart, Pilar / Sagredo, Victor / Sánchez-Miralles, Angel / Sancho Chinesta, Susana / Roche-Campo, Ferran / Socias, Lorenzo / Solé-Violan, Jordi / Suarez-Sipmann, Fernando / Tamayo Lomas, Luis / Trenado, José / Úbeda, Alejandro / Valdivia, Luis Jorge / Vidal, Pablo / Boado, Maria Victoria / Rodríguez, Alejandro / Antonelli, Massimo / Blasi, Francesco / Barbé, Ferran / Torres, Antoni

Intensive care medicine

2023 Volume 49, Issue 8, Page(s) 934–945

Abstract: Purpose: Although the prevalence of community-acquired respiratory bacterial coinfection upon hospital admission in patients with coronavirus disease 2019 (COVID-19) has been reported to be < 5%, almost three-quarters of patients received antibiotics. ... ...

Abstract	Purpose: Although the prevalence of community-acquired respiratory bacterial coinfection upon hospital admission in patients with coronavirus disease 2019 (COVID-19) has been reported to be < 5%, almost three-quarters of patients received antibiotics. We aim to investigate whether procalcitonin (PCT) or C-reactive protein (CRP) upon admission could be helpful biomarkers to identify bacterial coinfection among patients with COVID-19 pneumonia. Methods: We carried out a multicentre, observational cohort study including consecutive COVID-19 patients admitted to 55 Spanish intensive care units (ICUs). The primary outcome was to explore whether PCT or CRP serum levels upon hospital admission could predict bacterial coinfection among patients with COVID-19 pneumonia. The secondary outcome was the evaluation of their association with mortality. We also conducted subgroups analyses in higher risk profile populations. Results: Between 5 February 2020 and 21 December 2021, 4076 patients were included, 133 (3%) of whom presented bacterial coinfection. PCT and CRP had low area under curve (AUC) scores at the receiver operating characteristic (ROC) curve analysis [0.57 (95% confidence interval (CI) 0.51-0.61) and 0.6 (95% CI, 0.55-0.64), respectively], but high negative predictive values (NPV) [97.5% (95% CI 96.5-98.5) and 98.2% (95% CI 97.5-98.9) for PCT and CRP, respectively]. CRP alone was associated with bacterial coinfection (OR 2, 95% CI 1.25-3.19; p = 0.004). The overall 15, 30 and 90 days mortality had a higher trend in the bacterial coinfection group, but without significant difference. PCT ≥ 0.12 ng/mL was associated with higher 90 days mortality. Conclusion: Our study suggests that measurements of PCT and CRP, alone and at a single time point, are not useful for ruling in or out bacterial coinfection in viral pneumonia by COVID-19.
MeSH term(s)	Humans ; Procalcitonin ; C-Reactive Protein/metabolism ; Calcitonin ; Coinfection/epidemiology ; Critical Illness ; COVID-19/complications ; Biomarkers ; ROC Curve ; Retrospective Studies
Chemical Substances	Procalcitonin ; C-Reactive Protein (9007-41-4) ; Calcitonin (9007-12-9) ; Biomarkers
Language	English
Publishing date	2023-07-28
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-023-07161-1
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Article ; Online: Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.

Benítez, Iván D / de Batlle, Jordi / Torres, Gerard / González, Jessica / de Gonzalo-Calvo, David / Targa, Adriano D S / Gort-Paniello, Clara / Moncusí-Moix, Anna / Ceccato, Adrián / Fernández-Barat, Laia / Ferrer, Ricard / Garcia-Gasulla, Dario / Menéndez, Rosario / Motos, Anna / Peñuelas, Oscar / Riera, Jordi / Bermejo-Martin, Jesús F / Peñasco, Yhivian / Ricart, Pilar /

Martin Delgado, María Cruz / Aguilera, Luciano / Rodríguez, Alejandro / Boado Varela, Maria Victoria / Suarez-Sipmann, Fernando / Pozo-Laderas, Juan Carlos / Solé-Violan, Jordi / Nieto, Maite / Novo, Mariana Andrea / Barberán, José / Amaya Villar, Rosario / Garnacho-Montero, José / García-Garmendia, Jose Luis / Gómez, José M / Lorente, José Ángel / Blandino Ortiz, Aaron / Tamayo Lomas, Luis / López-Ramos, Esther / Úbeda, Alejandro / Catalán-González, Mercedes / Sánchez-Miralles, Angel / Martínez Varela, Ignacio / Jorge García, Ruth Noemí / Franco, Nieves / Gumucio-Sanguino, Víctor D / Huerta Garcia, Arturo / Bustamante-Munguira, Elena / Valdivia, Luis Jorge / Caballero, Jesús / Gallego, Elena / Martínez de la Gándara, Amalia / Castellanos-Ortega, Álvaro / Trenado, Josep / Marin-Corral, Judith / Albaiceta, Guillermo M / de la Torre, Maria Del Carmen / Loza-Vázquez, Ana / Vidal, Pablo / Lopez Messa, Juan / Añón, Jose M / Carbajales Pérez, Cristina / Sagredo, Victor / Bofill, Neus / Carbonell, Nieves / Socias, Lorenzo / Barberà, Carme / Estella, Angel / Valledor Mendez, Manuel / Diaz, Emili / López Lago, Ana / Torres, Antoni / Barbé, Ferran

The Lancet regional health. Europe

2022 Volume 18, Page(s) 100422

Abstract: Background: The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, ...

Abstract	Background: The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae. Methods: Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admission; clinical and biological parameters, in-hospital procedures and complications throughout the stay; and, clinical complications, persistent symptoms and sequelae at 3 and 6 months. Findings: Latent class analysis identified 3 phenotypes using training and test subcohorts: low-morbidity (n=3385; 58%), younger and with few comorbidities; high-morbidity (n=2074; 35%), with high comorbid burden; and renal-morbidity (n=407; 7%), with chronic kidney disease (CKD), high comorbidity burden and the worst oxygenation profile. Renal-morbidity and high-morbidity had more in-hospital complications and higher mortality risk than low-morbidity (adjusted HR (95% CI): 1.57 (1.34-1.84) and 1.16 (1.05-1.28), respectively). Corticosteroids, but not tocilizumab, were associated with lower mortality risk (HR (95% CI) 0.76 (0.63-0.93)), especially in renal-morbidity and high-morbidity. Renal-morbidity and high-morbidity showed the worst lung function throughout the follow-up, with renal-morbidity having the highest risk of infectious complications (6%), emergency visits (29%) or hospital readmissions (14%) at 6 months (p<0.01). Interpretation: Comorbidity-based phenotypes were identified and associated with different expression of in-hospital complications, mortality, treatment response, and sequelae, with CKD playing a major role. This could help clinicians in day-to-day decision making including the management of post-discharge COVID-19 sequelae. Funding: ISCIII, UNESPA, CIBERES, FEDER, ESF.
Language	English
Publishing date	2022-05-29
Publishing country	England
Document type	Journal Article
ISSN	2666-7762
ISSN (online)	2666-7762
DOI	10.1016/j.lanepe.2022.100422
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Article ; Online: Cystatin C provides more information than other renal function parameters for stratifying risk in patients with acute coronary syndrome.

García Acuña, José M / González-Babarro, Eva / Grigorian Shamagian, Lilian / Peña-Gil, Carlos / Vidal Pérez, Rafael / López-Lago, Ana M / Gutiérrez Feijoó, Mario / González-Juanatey, José R

Revista espanola de cardiologia

2009 Volume 62, Issue 5, Page(s) 510–519

Abstract: Introduction and objectives: The protein cystatin C has a stable plasma concentration and is eliminated exclusively by the kidneys. The aim of this study was to determine the prognostic value of cystatin C in patients with acute coronary syndrome (ACS).! ...

Abstract	Introduction and objectives: The protein cystatin C has a stable plasma concentration and is eliminated exclusively by the kidneys. The aim of this study was to determine the prognostic value of cystatin C in patients with acute coronary syndrome (ACS). Methods: The prospective study included 203 hospitalized ACS patients. Clinical evaluation during the first 24 hours of hospitalization included a hemogram and measurement of creatinine, cystatin C, total and fractionated cholesterol and markers of myocardial necrosis. The glomerular filtration rate (GFR) was estimated using the MDRD (Modification of Diet in Renal Disease) equation. A comparison was made between two groups of patients divided according to a serum cystatin-C level above or below 0.95 mg/L. The mean follow-up period was 151 days. Results: In total, 90 patients (44.3%) had a cystatin-C level < or =0.95 mg/L and 113 (55.7%) had a level >0.95 mg/L. Those with a cystatin-C level >0.95 mg/L had poorer in-hospital outcomes, including more frequent heart failure (51.3% vs. 13.3%; P=.001) and higher in-hospital mortality (17.6% vs. 3.3%; P=.001), as well as higher mortality throughout follow-up (22.0% vs. 5.6%; P=.001). Multivariate analysis adjusted for age, ejection fraction and troponin-I and high-sensitivity C-reactive protein concentrations showed that cystatin C was the most powerful independent predictor of a cardiovascular event (relative risk=1.91; 95% confidence interval, 1.03-3.53). Patients with a GFR >60 mL/1.73 m(2) and a cystatin-C level >0.95 mg/L had higher in-hospital mortality (10.2% vs. 3.9%; P=.001). Conclusions: Measurement of cystatin C in high-risk ACS patients may be clinically useful for risk stratification during hospitalization, particularly in those with a normal GFR.
MeSH term(s)	Acute Coronary Syndrome/epidemiology ; Aged ; Biomarkers ; Cystatin C/blood ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Kaplan-Meier Estimate ; Kidney Function Tests ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Risk Assessment
Chemical Substances	Biomarkers ; Cystatin C
Language	Spanish
Publishing date	2009-05
Publishing country	Spain
Document type	Journal Article
ZDB-ID	128925-1
ISSN	1579-2242 ; 0300-8932
ISSN (online)	1579-2242
ISSN	0300-8932
DOI	10.1016/s1885-5857(09)71833-x
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Article ; Online: Initial presentation of Boerhaave syndrome as hydropneumothorax and septic shock.

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Article ; Online: Minimal invasive fluorescence methods to quantify advanced glycation end products (AGEs) in skin and plasma of humans.

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Article: Minimal invasive fluorescence methods to quantify advanced glycation end products (AGEs) in skin and plasma of humans

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Article ; Online: First-Days Reduction of Plasma and Skin Advanced Glycation End Products is Related to Outcome in Septic Patients.

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Article ; Online: Procalcitonin and C-reactive protein to rule out early bacterial coinfection in COVID-19 critically ill patients.

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Article ; Online: Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study.

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Article ; Online: Cystatin C provides more information than other renal function parameters for stratifying risk in patients with acute coronary syndrome.

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