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91.
Laura Català Cristina Rius Patricia García de Olalla Jeanne L. Nelson Josep Alvarez Sofía Minguell Neus Camps María Rosa Sala Carlos Arias Irene Barrabeig Mónica Carol Roser Torra Neus Cardeñosa Tomas Pumarola Joan A. Caylà 《Enfermedades infecciosas y microbiología clínica》2012
Introduction
Pandemic A/H1N1 influenza emerged in Mexico at the end of March 2009. Since then, it is still important to provide evidences that contributed to the international spread of the virus and to ascertain the attack rate of this new strain of influenza among the first cases in Spain that led to identify the first transmission in Europe.Methods
Three pandemic A/H1N1 influenza groups related to an overseas flight were studied: 71 student group, 94 remaining passengers, and 68 contacts of confirmed cases. The attack rate with their 95% confidence interval (CI) among the student group and contacts was calculated. On April 26th, when the first cases were notified, strong preventive measures were implemented among the student group and the contacts of the confirmed cases.Results
On 27th April, the first pandemic A/H1N1 influenza cases confirmed in Spain were three students that came back from Mexico by airplane. A student generated the first native case in Spain and one of the first cases in Europe. Similar attack rates were found between the student group (14.1%; CI: 12.1–16.1) and their contacts (13.2%; CI: 4.4–22.0), but no cases among remaining passengers were detected, suggesting low transmission risk during air travel.Conclusion
The first cases of pandemic A/H1N1 influenza in Spain were imported by airplane from Mexico. Preventive efforts to reduce the impact of the influenza influenced that primary and secondary rates were lower than first estimations by WHO. 相似文献92.
93.
94.
Juan José Soler-Cataluña Borja Cosío José Luis Izquierdo José Luis López-Campos José M. Marín Ramón Agüero Adolfo Baloira Santiago Carrizo Cristóbal Esteban Juan B. Galdiz M. Cruz González Marc Miravitlles Eduard Monsó Teodoro Montemayor Josep Morera Francisco Ortega Germán Peces-Barba Luis Puente José Miguel Rodríguez Ernest Sala Jaume Sauleda Joan B. Soriano José Luis Viejo 《Archivos de bronconeumología》2012
Introduction
Although asthma and COPD are different pathologies, many patients share characteristics from both entities. These cases can have different evolutions and responses to treatment. Nevertheless, the evidence available is limited, and it is necessary to evaluate whether they represent a differential phenotype and provide recommendations about diagnosis and treatment, in addition to identifying possible gaps in our understanding of asthma and COPD.Methods
A nation-wide consensus of experts in COPD in two stages: 1) during an initial meeting, the topics to be dealt with were established and a first draft of statements was elaborated with a structured «brainstorming» method; 2) consensus was reached with two rounds of e-mails, using a Likert-type scale.Results
Consensus was reached about the existence of a differential clinical phenotype known as «Overlap Phenotype COPD-Asthma», whose diagnosis is made when 2 major criteria and 2 minor criteria are met. The major criteria include very positive bronchodilator test (increase in FEV1 ≥ 15% and ≥ 400 ml), eosinophilia in sputum and personal history of asthma. Minor criteria include high total IgE, personal history of atopy and positive bronchodilator test (increase in FEV1 ≥ 12% and ≥ 200 ml) on two or more occasions. The early use of individually-adjusted inhaled corticosteroids is recommended, and caution must be taken with their abrupt withdrawal. Meanwhile, in severe cases the use of triple therapy should be evaluated. Finally, there is an obvious lack of specific studies about the natural history and the treatment of these patients.Conclusions
It is necessary to expand our knowledge about this phenotype in order to establish adequate guidelines and recommendations for its diagnosis and treatment. 相似文献95.
96.
Calvo N Nadal M Berruezo A Andreu D Arbelo E Tolosana JM Guasch E Matiello M Matas M Alsina X Sitges M Brugada J Mont L 《Revista espa?ola de cardiología》2012,65(2):131-138
Introduction and objectives
The outcomes of atrial fibrillation ablation procedures vary widely between different centers. Our objective was to analyze the results and complications of this procedure in our center and identify factors predicting the efficacy and safety of atrial fibrillation ablation.Methods
In total, 726 atrial fibrillation ablation procedures were performed in our center between 2002 and 2009. Beginning in January 2008, a protocol for anticoagulation and conscious sedation was systematically applied. Outcomes and complications could therefore be compared in 2 well-differentiated groups: group A included 419 procedures performed prior to 2008 and group B included 307 procedures completed after 2008 using the new protocol.Results
During an average follow-up of 8.7 months, 60.9% of patients were arrhythmia-free after one or repeat procedures. After only 1 procedure, the success rate was 41% and significantly higher in group B (51.6% vs 35.2% in group A; P=.001). There were 31 major complications (4.2%), 26 in group A (6.2%) and 5 in group B (1.6%) (P=.002). The implementation of the new protocol was an independent predictor of the absence of complications (odds ratio=0.406; 95% confidence interval, 0.214-0.769; P<.006).Conclusions
Systematic application of an anticoagulation and conscious sedation protocol is associated with improved results and fewer complications of atrial fibrillation ablation. Factors not evaluated in the present study, such as operator experience and ongoing improvements in atrial fibrillation ablation technology, could have influenced these findings.Full English text available from:www.revespcardiol.org 相似文献97.
Both prior literature and reported managerial practices have claimed that the Balanced Scorecard is a management tool that can help organizations to effectively implement strategies. In this article, we examine some of the contributions, dilemmas, and limitations of Balanced Scorecards in health care organizations. First, we describe the evolution of Balanced Scorecards from multidimensional performance measurement systems to causal representations of formulated strategies, and analyze the applicability of Balanced Scorecards in health care settings. Next, we discuss several issues under debate regarding Balanced Scorecard adoption in health care organizations. We distinguish between issues related to the design of Balanced Scorecards and those related to the use of these tools. We conclude that the Balanced Scorecard has the potential to contribute to the implementation of strategies through the strategically-oriented performance measurement systems embedded within it. However, effective adoption requires the adaptation of the generic instrument to the specific realities of health care organizations. 相似文献
98.
Barba P Sampol A Calbacho M Gonzalez J Serrano J Martínez-Sánchez P Fernández P García-Boyero R Bueno J Ribera JM 《American journal of hematology》2012,87(6):631-634
The present study reports the Spanish PETHEMA group experience in 31 heavily pretreated relapsed/refractory acute lymphoblastic leukemia (ALL) and lymphoma (LL) patients treated with clofarabine-based regimens. The complete remission (CR) rate was 31% (median CR duration of 3 months [range 2–28]) and the overall survival probability at 1 year was 10% (95%CI 4–16%). Responses were seen in B and T lineage diseases and in patients with adverse cytogenetics. Hematological and infectious grade >3 toxicities were found in 100 and 67% of the patients, respectively, with 7 (23%) treatment-related deaths. Other organ toxicities were infrequent. Clofarabine-based chemotherapy regimens might induce CRs in ALL and LL patients, but hematological toxicity and infections may limit their use in heavily pretreated patients. 相似文献
99.
Ignacio Ferreira-González MD PhD Josep R. Marsal Aida Ribera Gaietà Permanyer-Miralda Bruno García-Del Blanco Gerard Martí Purificación Cascant Mónica Masotti-Centol Xavier Carrillo Josepa Mauri Nuria Batalla Eduard Larrousse Eva Martín Antonio Serra José Ramón Rumoroso Rafael Ruiz-Salmerón Jose M. de la Torre Angel Cequier Jose A. Gómez-Hospital Fernando Alfonso Victoria Martín-YusteManel Sabatè PhD David García-Dorado 《Journal of the American College of Cardiology》2012
100.
Josep Rodés-Cabau John G. Webb Anson Cheung Jian Ye Eric Dumont Mark Osten Christopher M. Feindel Madhu K. Natarajan James L. Velianou Giussepe Martucci Benoît DeVarennes Robert Chisholm Mark Peterson Christopher R. Thompson David Wood Stefan Toggweiler Ronen Gurvitch Samuel V. Lichtenstein Daniel Doyle Robert DeLarochellière Kevin Teoh Victor Chu Kevin Bainey Kevin Lachapelle Asim Cheema David Latter Jean G. Dumesnil Philippe Pibarot Eric Horlick 《Journal of the American College of Cardiology》2012