Mª DOLORES TIRADO-BALAGUER, ALBERTO ARNEDO-PENA, SUSANA SABATER-VIDAL, ROSARIO MORENO-MUÑOZ
Published: 22 May 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/153.2023
Rev Esp Quimioter 2024; 37(4): 362-364 [Texto completo PDF]
JORDI REINA, ANE ITURBE
Published: 21 May 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/005.2024
Rev Esp Quimioter 2024; 37(4): 365-366 [Texto completo PDF]
FERNANDO COBO, VIRGINIA PÉREZ-CARRASCO, LETICIA CASTELLANO-SÁNCHEZ, JOSÉ A. GARCÍA-SALCEDO, JOSÉ MARÍA NAVARRO-MARÍ
Published: 17 May 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/025.2024
Rev Esp Quimioter 2024; 37(4): 367-368 [Texto completo PDF]
AGUSTÍN JULIÁN-JIMÉNEZ, ROCÍO LORENZO ÁLVAREZ, VICTORIA GUTIÉRREZ BUENO, MIRANDA SÁNCHEZ TRUJILLO, DARÍO EDUARDO GARCÍA
Published: 14 May 2024
http://www.doi.org/10.37201/req/027.2024
Introduction and objective. The term source (or focus) control encompasses all those physical measures that can be used to reduce the inoculum and modify those factors in the infectious medium that promote microbial growth or foreign antimicrobial defenses of the host. The main objective of this systematic review (SR) is to know and compare whether early detection and control of the focus (in less than 6 hours) in adult patients treated in the ED for severe infection or sepsis, compared to not controlling the focus or delayed focus control (more than 12 hours) is more effective and safer (improves clinical evolution, mortality, complications, hospital stay or need for ICU admission).
Method. A systematic review is carried out following the PRISMA regulations in the databases of PubMed, Web of Science, EMBASE, Lilacs, Cochrane, Epistemonikos, Tripdatabase and ClinicalTrials.gov from January 2000 to December 31, 2023 without language restrictions and using a combination of MESH terms: “Source Control”, “Early” “Infection OR Bacterial Infection OR Sepsis”, “Emergencies OR Emergency OR Emergency Department” and “Adults”. Observational cohort studies were included. No meta-analysis techniques were performed, but results were compared narratively.
Results. A total of 1,658 articles were identified, of which 2 that met the inclusion criteria and were classified as high quality were finally analyzed. The included studies represent a total of 2,404 patients with 678 cases in which an intervention was performed to control the focus (28.20%). In the first study, 28-day mortality was lower in patients who underwent an intervention to control the focus (12.3% vs. 22.5%; P <0.001), with an adjusted HR of 0.538 (95% CI: 0.389-0.744; P<0.001). In the second, it was demonstrated that the time elapsed from when the patient was evaluated for the first time and was hemodynamically stabilized, until the start of surgery was associated with his survival at 60 days with an OR of 0.31 (95% CI: 0.19-0.45; P <0.0001). In fact, for each hour of delay an adjusted OR of 0.29 (95% CI: 0.16-0.47; P<0.0001) is established. So if the intervention is performed before 2 hours at 60 days, 98% of the patients are still alive, if it is performed between 2-4 hours it is reduced to 78%, if it is between 4-6 hours it drops to 55%, but if it is done for more than 6 hours there will be no survivors at 60 days.
Conclusions. This review shows that source control carried out after the evaluation of patients attending the ED reduces short-term mortality (30-60 days) and that it would be advisable to implement any required source control intervention as soon as possible, ideally early (within 6 hours).
Rev Esp Quimioter 2024; 37(4): 323-333 [Texto completo PDF]
MARINA FAYOS, FRANCISCO ARNAIZ DE LAS REVILLAS, VICENTE GONZÁLEZ QUINTANILLA, CLAUDIA GONZÁLEZ-RICO, CONCEPCIÓN FARIÑAS-ÁLVAREZ, JOSÉ ANTONIO PARRA, MARÍA CARMEN FARIÑAS
Published: 29 April 2024
http://www.doi.org/10.37201/req/033.2024
Introduction. Human immunodeficiency virus (HIV) infected patients are at increased risk of cardiovascular disease (CVD). Multidetector computed tomography (MDCT) stratifies cardiovascular risk in asymptomatic patients with subclinical atherosclerosis. The aim of this study was to determine the ability of MCTD and clinical and laboratory parameters to assess subclinical CVD progression in HIV patients.
Material and methods. Prospective longitudinal cohort study of patients with at least 10 years of HIV infection and 5 years of antiretroviral therapy history, low cardiovascular risk and monitored for 6 years (2015–2021). All patients underwent clinical assessment, blood analysis, carotid ultrasound, and gated MDCT in 2015 and 2021.
Results. Sixty-three patients (63.5% male) with a mean age of 49.9 years (standard deviation [SD], 10.5) were included in 2015; 63 of them were followed until 2021. Comparing the results from 2015 with those from 2021, Systematic Coronary Risk Estimation-2 (SCORE2) was 2.9% (SD, 2.1) vs. 4.4% (SD,3.1); Multi-Ethnic Study of Atherosclerosis score (MESA risk) was 3.4 (SD 5.8) vs. 6.0 (SD 8.6); coronary artery calcification CAC) score >100 was 11.1% vs. 25.4% (P < 0.05); and 11% vs. 27% had carotid plaques (P = 0.03).
Conclusions. After six years of follow-up, an increase in SCORE2, carotid plaques, CAC scoring and MESA risk was observed. MDCT findings, along with other clinical and laboratory parameters, could play an important role as a marker of CVD progression in the evaluation of patients with HIV and low cardiovascular risk.
Rev Esp Quimioter 2024; 37(4): 341-350 [Full-text PDF]
MARÍA DEL MAR SÁNCHEZ SUÁREZ, ALICIA MARTÍN ROLDÁN, MARÍA ROSA CANTUDO CUENCA
Published: 19 April 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/020.2024
Rev Esp Quimioter 2024; 37(3): 283-284 [Texto completo PDF]
CARMEN PIÑA DELGADO, MARÍA NIEVES CARMONA TELLO, MARGARITA BOLAÑOS RIVERO, MARÍA DEL CARMEN LAVILLA SALGADO, ISABEL DE MIGUEL MARTÍNEZ
Published: 17 April 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/019.2024
Rev Esp Quimioter 2024; 37(3): 281-282 [Texto completo PDF]
RAÚL ORTÍZ DE LEJARAZU, JOSÉ M. EIROS, FRANCISCO LÓPEZ-MEDRANO, MILAGROS MONTES, ALFREDO TAGARRO, MARÍA TOMÁS
Published: 12 April 2024
http://www.doi.org/10.37201/req/150.2023
The increased knowledge on virology and the increased potential of their diagnostic has risen several relevant question about the role of an early viral diagnosis and potential early treatment on the management of respiratory tract infections (RTI). In order to further understand the role of viral diagnostic tests in the management of RTI, a panel of experts was convened to discuss about their potential role, beyond what had been agreed in Influenza. The objective of this panel was to define the plausible role of aetiologic viral diagnostic into clinical management; make recommendations on the potential expanded use of such tests in the future and define some gaps in the management of RTI. Molecular Infection Viral Diagnostic (mIVD) tests should be used in all adult patients admitted to Hospital with RTI, and in paediatric patients requiring admission or who would be referred to another hospital for more specialised care. The increased use of mIVD will not only reduce the inappropriate use of antibiotics so reducing the antibiotic microbe resistance, but also will improve the outcome of the patient if an aetiologic viral therapy can be warranted, saving resource requirements and improving patient flows. Implementing IVD testing in RTI has various organizational benefits as well, but expanding its use into clinical settings would need a cost-effectiveness strategy and budget impact assessment.
Rev Esp Quimioter 2024; 37(3): 252-256 [Full-text PDF] [Supplementary material PDF]
ABRAR SENHAJI-KACHA, ARIJ AKIR, ANTONIO BRONCANO-LAVADO, JAIME ESTEBAN
Published: 11 April 2024
http://www.doi.org/10.37201/req/014.2024
Introduction. Mycobacterium avium complex (MAC) and Mycobacterium abscessus are a group of nontuberculous mycobacteria (NTM) that have been described as human pathogens. Their ability to develop biofilms in tissues and medical devices is one of the most important pathogenicity factors, with important implications in diagnosis and treatment. Macrolides are usually considered one of the bases of this treatment.
Methods. Here we have studied the biofilm prevention concentration (BPC) of 16 strains (n=16) with clarithromycin to avoid the biofilm development by these NTM.
Results. In this study, all M. abscessus strains have similar BPC, while MAC strains showed different values. For MAC the concentrations ranged between 1-16 mg/L, while for M. abscessus the concentration was 32 mg/L for all strains except one that was 64 mg/L.
Conclusions. These results open the possibility of using macrolides for the prevention of biofilm development in patients with a risk of developing NTM disease.
Rev Esp Quimioter 2024; 37(3): 266-269 [Full-text PDF]
TELMO FERNANDEZ DE CASADEVANTE, XABIER CAMINO, AINHOA ARTECHE, ANA ALONSO, PAUL MARTINAGE
Published: 10 April 2024
LETTER TO THE EDITOR
http://www.doi.org/10.37201/req/141.2023
Rev Esp Quimioter 2024; 37(3): 274-275 [Texto completo PDF]
