Publications by authors named "Borja Fernandez-Felix"

Background: Chlamydia trachomatis (CT) is a sexually transmitted infection that requires early detection to prevent complications. This study aimed to evaluate the prevalence of CT among asymptomatic women in Spain and investigate the relationship between CT and risk factors associated with sexual practices, as well as factors such as stress and depression.

Results: We found that 3.

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Improved phenotyping in pneumonia is necessary to strengthen risk assessment. Via a feasible and multidimensional approach with basic parameters, we aimed to evaluate the effect of host response at admission on severity stratification in COVID-19 and community-acquired pneumonia (CAP). Three COVID-19 and one CAP multicenter cohorts including hospitalized patients were recruited.

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Context: There is limited knowledge about the disparities between the sexes in obesity prevalence and associated cardiovascular complications in low- and middle-income countries (LMICs).

Objective: We undertook a systematic review and meta-analysis to assess sex-specific disparities in the prevalence of obesity and cardiometabolic diseases in LMICs, the burden in women, and variations by region, country's income status, setting, and time.

Methods: We searched major databases from inception to March 2023.

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Article Synopsis
  • - The study investigates the effectiveness of four biomarkers (procalcitonin, C-reactive protein, interleukin-6, and presepsin) in predicting mortality in critically ill adults with sepsis, addressing inconsistencies found in previous research.
  • - A systematic review and meta-analysis of 60 studies involving over 15,000 patients revealed a high risk of bias in more than 60% of assessments for these biomarkers as prognostic indicators.
  • - The findings indicate that baseline measurements of these biomarkers do not reliably predict mortality outcomes, suggesting that their role in sepsis prognosis may be limited.
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We assessed whether low CD4 count and high viral load (VL) affect the response to currently preferred ART. We performed a systematic review of randomized, controlled clinical trials that analyzed preferred first-line ART and a subgroup analysis by CD4 count (≤ or >200 CD4/μL) or VL (≤ or >100 000 copies/mL). We computed the odds ratio (OR) of treatment failure (TF) for each subgroup and individual treatment arm.

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Background: Systematic reviews of studies of clinical prediction models are becoming increasingly abundant in the literature. Data extraction and risk of bias assessment are critical steps in any systematic review. CHARMS and PROBAST are the standard tools used for these steps in these reviews of clinical prediction models.

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Acute nontraumatic chest pain is a frequent reaso n for consultation in emergency departments and represents a diagnostic challenge. The objective is to estimate the risk of significant coronary artery disease (CAD) in patients with cardiogenic acute chest pain for whom the diagnosis of infarction was ruled out in the emergency department with a nondiagnostic ECG and negative high-sensitivity troponins. We prospectively recruited 1625 patients from emergency departments of seven Spanish hospitals.

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Background: The real impact of the degree of association (DoA) between endpoint components of a composite endpoint (CE) on sample size requirement (SSR) has not been explored. We estimate the impact of the DoA between death and acute myocardial infarction (AMI) on SSR of trials using use the CE of major adverse cardiac events (MACE).

Methods: A systematic review and quantitative synthesis of trials that include MACE as the primary outcome through search strategies in MEDLINE and EMBASE electronic databases.

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Background: Existing evidence on the effects of race and ethnicity on pregnancy outcomes is restricted to individual studies done within specific countries and health systems. We aimed to assess the impact of race and ethnicity on perinatal outcomes in high-income and upper-middle-income countries, and to ascertain whether the magnitude of disparities, if any, varied across geographical regions.

Methods: For this individual participant data (IPD) meta-analysis we used data from the International Prediction of Pregnancy Complications (IPPIC) Network of studies on pregnancy complications; the full dataset comprised 94 studies, 53 countries, and 4 539 640 pregnancies.

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Introduction And Objectives: The Healthy Heart Score (HHS) is a lifestyle-based equation for predicting cardiovascular disease (CVD) risk and may serve as a tool in primordial prevention. However, its performance outside North American populations is unknown. This study assessed the performance of the HHS for estimating CVD mortality in the adult population of Spain.

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Background: The ability to calculate the absolute risk of adverse pregnancy outcomes for an individual woman with gestational diabetes mellitus (GDM) would allow preventative and therapeutic interventions to be delivered to women at high-risk, sparing women at low-risk from unnecessary care. We aimed to develop, validate and evaluate the clinical utility of a prediction model for adverse pregnancy outcomes in women with GDM.

Methods: A prediction model development and validation study was conducted on data from a observational cohort.

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Background: Only very few studies have investigated the effect of the COVID-19 pandemic on the pre-hospital stroke code protocol. During the first wave, Spain was one of the most affected countries by the SARS-CoV-2 coronavirus disease pandemic. This health catastrophe overshadowed other pathologies, such as acute stroke, the leading cause of death among women and the leading cause of disability among adults.

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Background: Hysterectomy, the most common gynecological operation, requires surgeons to counsel women about their operative risks. We aimed to develop and validate multivariable logistic regression models to predict major complications of laparoscopic or abdominal hysterectomy for benign conditions.

Methods: We obtained routinely collected health administrative data from the English National Health Service (NHS) from 2011 to 2018.

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Article Synopsis
  • Propionic acidaemia (PA) is a metabolic disorder caused by a lack of the enzyme propionyl-CoA carboxylase, leading to acute decompensation and potential long-term complications from mitochondrial dysfunction.
  • A study involving seven PA patients aged 2.5 to 20 years examined the effects of Coenzyme Q10 (CoQ10) supplementation in the form of ubiquinol, showing that it corrected initially low plasma CoQ10 levels and was well tolerated.
  • Supplementation resulted in significant increases in urinary citrate and the citrate/methylcitrate ratio, indicating potential improvements in mitochondrial function and anaplerosis, warranting further investigation for preventing chronic complications in PA.
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Despite the effectiveness of available treatments, hepatitis C virus (HCV) remains a major public health problem, mainly due to the high percentage of undiagnosed individuals. We aim to create an easy-to-implement risk score to facilitate targeted HCV testing in the general population. This is a substudy derived from a prospective study in primary care in Madrid (Spain).

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Article Synopsis
  • - Propionic acidemia is a metabolic disorder caused by a deficiency in the enzyme propionyl-CoA carboxylase, leading to disturbances in metabolic pathways such as the urea cycle and issues with ammonia detoxification.
  • - An observational study conducted at Hospital Ramón y Cajal analyzed the amino acid profiles of 10 patients over two years, comparing data from stable states to episodes of metabolic crises involving ketosis and hyperammonemia.
  • - Results showed significant reductions in plasma glutamine and alanine during crises, indicating impaired anaplerosis and suggesting broader impacts on metabolic pathways related to ammonia detoxification and urea cycle amino acid synthesis.
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Objective: To develop and validate novel prediction models to personalise the risk of conversion from laparoscopic to open hysterectomy in benign conditions.

Design: Retrospective cohort study.

Settings: English NHS Hospitals between 2011 and 2018.

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Background: There are several prognostic models to estimate the risk of mortality after surgery for active infective endocarditis (IE). However, these models incorporate different predictors and their performance is uncertain.

Objective: We systematically reviewed and critically appraised all available prediction models of postoperative mortality in patients undergoing surgery for IE, and aggregated them into a meta-model.

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Article Synopsis
  • - The study aimed to determine if sex is an independent factor influencing mortality rates in ICU patients with sepsis through a systematic review and meta-analysis of existing research.
  • - The analysis included 13 studies with over 80,000 participants but found no significant sex-based differences in overall hospital or ICU mortality, although it indicated that females had a higher risk of 28-day mortality but a lower risk of 1-year mortality.
  • - Overall, the findings suggest that the effect of sex on mortality is uncertain, with concerns about the quality and consistency of the evidence affecting conclusions.
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Article Synopsis
  • Intimate partner violence (IPV) significantly impacts mothers and their children, prompting a systematic review of its prevalence during pregnancy across global studies.
  • The review analyzed 155 studies, revealing that the worldwide prevalence rates for physical, psychological, and sexual IPV in pregnancy were 9.2%, 18.7%, and 5.5%, respectively, with an average of 25% of mothers experiencing at least one type of IPV.
  • The study found substantial variations in IPV rates by continent, with notably higher rates in Africa compared to Europe, and emphasized the need for routine antenatal screening to better identify and address these issues.
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Objectives: To determine preoperative factors associated to myocardial injury after non-cardiac surgery (MINS) and to develop a prediction model of MINS.

Design: Retrospective analysis.

Setting: Tertiary hospital in Spain.

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Objective: Men have been considered to have a higher incidence of infectious diseases, with controversy over the possibility that sex could influence the prognosis of the infection. This study aimed to explore this assumption in patients admitted to the intensive care unit (ICU) with septic bacteremia.

Methods: A retrospective analysis (2006-2017) of septic patients with microbiologically confirmed bacteremia (n=440) was performed.

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Background: Propionic acidemia (PA), an inborn error of metabolism, is caused by a deficiency in propionyl-CoA carboxylase. Patients have to follow a diet restricted in the propiogenic amino acids isoleucine (Ile), valine (Val), methionine (Met) and threonine (Thr); proper adherence can prevent and treat acute decompensation and increase life expectancy. However, chronic complications occur in several organs even though metabolic control may be largely maintained.

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