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Rev Esp Quimioter 2024, 37(5): 369-386

New materials and complications of prostheses in humans: situation in Spain

MARÍA VALLET-REGÍ, ARÍSTIDES DE ALARCÓN, ENRIQUE GÓMEZ BARRENA, JOSEP A. PLANELL, JACOBO SILVA, EMILIO BOUZA

Published: 23 May 2024

http://www.doi.org/10.37201/req/039.2024

Prostheses or implantable medical devices (IMDs) are parts made of natural or artificial materials intended to replace a body structure and therefore must be well tolerated by living tissues. The types of IMDs currently available and usable are very varied and capable of replacing almost any human organ. A high but imprecise percentage of Spaniards are carriers of one or more IMDs to which they often owe their quality of life or survival. IMDs are constructed with different types of materials that are often combined in the same prosthesis. These materials must combine harmlessness to human tissues with high wear resistance. Their durability depends on many factors both on the host and the type of prosthesis, but the vast majority last for more than 10-15 years or remain in function for the lifetime of the patient. The most frequently implanted IMDs are placed in the heart or great vessels, joints, dental arches or breast and their most frequent complications are classified as non-infectious, particularly loosening or intolerance, and infectious. Complications, when they occur, lead to a significant increase in morbidity, their repair or replacement multiplies the health care cost and, on occasions, can cause the death of the patient. The fight against IMD complications is currently focused on the design of new materials that are more resistant to wear and infection and the use of antimicrobial substances that are released from these materials. Their production requires multidisciplinary technical teams, but also a willingness on the part of industry and health authorities that is not often found in Spain or in most European nations. Scientific production on prostheses and IMD in Spain is estimated to be less than 2% of the world total, and probably below what corresponds to our level of socio-economic development. The future of IMDs involves, among other factors, examining the potential role of Artificial Intelligence in their design, knowledge of tissue regeneration, greater efficiency in preventing infections and taking alternative treatments beyond antimicrobials, such as phage therapy. For these and other reasons, the Ramón Areces Foundation convened a series of experts in different fields related to prostheses and IMDs who answered and discussed a series of questions previously formulated by the Scientific Council. The following lines are the written testimony of these questions and the answers to them.

Rev Esp Quimioter 2024;  37(5): 369-386 [Full-text PDF]


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Rev Esp Quimioter 2024; 37(4): 362-364

Evolución de los serotipos de Salmonella spp y su sensibilidad antibiótica en el Departamento de Salud Castellón

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]


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Rev Esp Quimioter 2024; 37(4): 365-366

Detección del virus de Epstein-Barr en úlceras genitales femeninas

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]


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Rev Esp Quimioter 2024; 37(4): 367-368

Bacteriemia producida por Enterocloster aldenensis en un paciente oncológico

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]


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Rev Esp Quimioter 2024, 37(4): 323-333

Early source control of infection in patients seen in the emergency department: a systematic review

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]


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Rev Esp Quimioter 2024, 37(4): 341-350

Progression of subclinical cardiovascular disease in patients with HIV

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]


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Rev Esp Quimioter 2024; 37(3): 283-284

Glecaprevir/pibrentasvir en combinación con ribavirina como terapia de rescate en hepatitis C crónica

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]


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Rev Esp Quimioter 2024; 37(3): 281-282

Artritis séptica por Pasteurella multocida

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]


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Rev Esp Quimioter 2024; 37(3): 252-256

The role of viral diagnostic tests in respiratory tract infections: moving forward

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]


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Rev Esp Quimioter 2024; 37(3): 266-269

Biofilm prevention concentration of clarithromycin against clinically relevant species of nontuberculous mycobacteria

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]


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