Publications by authors named "Francisco Hernandez-Perez"
Article Synopsis
- * A total of 614 patients from nine studies were analyzed, showing the score's ability to predict in-hospital mortality with an area under the curve (AUC) of 0.678 and for V-A-ECMO mortality with an AUC of 0.652, both statistically significant.
- * Results indicate that the PC-ECMO score can be an effective tool for assessing patient risk in clinical settings, making it useful for future research and potential treatment strategies.
Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia.
Front Oncol
February 2024
Background: A heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC).
Methods: A population-based case-control study was conducted.
Antibodies directed against donor-specific human leukocyte antigens (HLAs) can be detected de novo after heart transplantation and play a key role in long-term survival. De novo donor-specific antibodies (dnDSAs) have been associated with cardiac allograft vasculopathy, antibody-mediated rejection, and mortality. Advances in detection methods and international guideline recommendations have encouraged the adoption of screening protocols among heart transplant units.
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- Patients undergoing postcardiotomy V-A-ECMO have a high risk of early mortality, with a 66.7% in-hospital mortality rate found in the analysis of 1269 patients across 25 hospitals.
- The study utilized a systematic review and methods like propensity score matching to identify performance differences among hospitals, revealing that some hospitals had significantly higher mortality rates than others.
- The research indicates that lower annual volumes of V-A-ECMO procedures may lead to worse outcomes, and it highlights the potential for improvement in many hospitals' results for this treatment.
Article Synopsis
- Endomyocardial biopsy (EMB) is important for diagnosing fulminant myocarditis in adults, but its timing and effects on patient outcomes are still being studied.
- In a study involving 419 patients across 36 centers, those who had an early EMB (within 2 days of ICU admission) showed significantly better survival rates (63%) without needing heart transplants or LVAD compared to those with delayed EMB (40%).
- The research suggests that early EMB is associated with lower mortality rates and better overall outcomes, supporting its prompt use in ICU patients suspected of having fulminant myocarditis.
Article Synopsis
- The Spanish heart transplant registry provides annual updates, with the latest focusing on data from 2022 regarding clinical characteristics and survival outcomes of heart transplants.
- In 2022, there were 311 heart transplants, marking a 3.0% increase from 2021, while demographic and clinical characteristics remained consistent with previous years.
- Over the past decade, survival rates have stabilized at 1 year (81.4%) and 3 years (73.4%), with a noted decrease in urgent transplants and the use of circulatory support devices.
Article Synopsis
- A study was conducted to assess the prevalence and prognostic significance of donor-transmitted coronary artery disease (TCAD) in heart transplant patients across 11 Spanish hospitals from 2008 to 2018.
- Out of 1,918 heart transplant patients, 937 had coronary angiography (c-angio) within the first three months, revealing that 18.3% had TCAD, with 6.9% having significant TCAD (s-TCAD) and 11.4% having nonsignificant TCAD (ns-TCAD).
- The study found that while s-TCAD did not significantly impact overall survival, it was linked to a higher risk of cardiovascular death and major adverse cardiovascular events, indicating a
Article Synopsis
- Postcardiotomy veno-arterial extracorporeal membrane oxygenation (V-A-ECMO) has a high mortality rate, and determining which patients are at the greatest risk for death is challenging, making clinical judgment essential for initiating the procedure.
- A systematic review analyzed data from 1269 patients across 10 studies, revealing that higher arterial lactate levels at the start of V-A-ECMO correlate with increased in-hospital mortality rates and a significant cut-off level of 6.8 mmol/L for predicting outcomes.
- The findings suggest that monitoring arterial lactate levels may aid clinicians in making more informed decisions on when to start V-A-ECMO, especially in older patients with elevated lactate levels.
Article Synopsis
- Despite advances in mechanical circulatory support, patients with cardiogenic shock still have a poor prognosis, prompting the need for improved rapid care initiatives.
- This document emphasizes the importance of a structured "SC code" to enhance the organization, activation, and care flow for cardiogenic shock patients.
- The authors aim to outline the unique aspects of cardiogenic shock, team logistics, management strategies, and the challenges of implementing an SC code in both adult and pediatric cases.
Background: It is unclear whether peripheral arterial cannulation is superior to central arterial cannulation for postcardiotomy veno-arterial extracorporeal membrane oxygenation (VA-ECMO).
Methods: A systematic review was conducted using PubMed, Scopus, and Google Scholar to identify studies on postcardiotomy VA-ECMO for the present individual patient data (IPD) meta-analysis. Analysis was performed according to the intention-to-treat principle.
Background: The outcomes of heart-lung transplant (HLT) are worse than those of heart transplant (HT) and lung transplant alone; this and the availability of mechanical assistance have meant that the indications for HLT have been changing. This study aims to analyze the evolution of indications for HLT in a country of 47 million inhabitants.
Methods: We performed a retrospective observational study of all HLTs performed in Spain (performed in 2 centers) from 1990 to 2020.
Article Synopsis
- - The LEONE-HT study investigates the poor heart transplant (HT) survival rates and the role of anti-HLA antibodies, which may cause cardiac allograft dysfunction in patients receiving heart transplants.
- - It involves a cohort of HT patients, comparing those with positive anti-HLA antibodies to those without, utilizing advanced assessment methods like imaging and immunological analyses to understand the extent of myocardial damage.
- - Ethical standards for the study are met, adhering to global guidelines, and findings will be shared through patient associations and registered on clinicaltrials.gov for transparency.
Article Synopsis
- There is limited understanding of how gender affects the clinical presentation, treatment, and outcomes of patients experiencing cardiogenic shock (CS), particularly in a hospital setting.
- The study aimed to explore gender-related differences in characteristics, management, and in-hospital mortality among CS patients, while also evaluating the prognostic accuracy of the SCAI classification for predicting mortality by sex.
- An analysis of 163 CS patients showed that women were less likely to smoke and had lower rates of certain conditions compared to men, but in-hospital survival rates were similar across genders, indicating no significant differences in outcomes.
Background: The COVID-19 pandemic has had a great impact and high cost on the education of physicians that has not been determined in the long term.
Objective: To determine the impact of COVID-19 on undergraduate interns and how it affected their academic training.
Material And Methods: Mixed study.
Introduction And Objectives: Endomyocardial biopsy (EMB) is the only technique able to establish an etiological diagnosis of myocarditis or inflammatory cardiomyopathy (ICM). The aim of this study was to analyze the clinical profile, outcomes, and prognostic factors of patients with suspected myocarditis/ICM undergoing EMB.
Methods: We retrospectively analyzed the clinical characteristics, histological findings, and follow-up data of all patients with suspected myocarditis or ICM who underwent EMB between 1997 and 2019 in a Spanish tertiary hospital.
Background: Cardiac allograft vasculopathy (CAV) remains a major cause of morbidity and mortality among long-term heart transplant recipients. There is an unmet need for a non-invasive biomarker of CAV that could obviate the need to perform surveillance coronary angiograms in these patients. Our aim was to evaluate the performance of Donor-derived Cell Free DNA (dd-cfDNA) as a biomarker of CAV.
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- Controlled donation after circulatory death (cDCD) is an emerging method to expand the organ donor pool, with new techniques allowing heart transplants from cDCD donors to become viable.
- A case in Spain involved a 43-year-old female donor whose heart was successfully procured using thoraco-abdominal normothermic regional perfusion, contrasting with traditional methods that required ex-situ devices.
- This case demonstrates the potential for effective heart transplantation from cDCD donors while also paving the way for increased multiorgan donation opportunities.
Introduction And Objectives: The present report describes the clinical characteristics and outcomes of heart transplants in Spain and updates the data to 2019.
Methods: We describe the clinical characteristics and outcomes of heart transplants performed in Spain in 2019, as well as trends in this procedure from 2010 to 2018.
Results: In 2019, 300 transplants were performed (8794 since 1984; 2745 between 2010 and 2019).
Article Synopsis
- Early recognition and risk stratification are important for managing cardiogenic shock (CS), but there are concerns about lower adherence to recommendations in women with cardiovascular diseases.
- Data from the Red-Shock registry included 793 patients, revealing that women were older and had different health backgrounds but showed similar treatment approaches and in-hospital mortality rates compared to men.
- Both CardShock and IABP-SHOCK II risk scores were effective in predicting in-hospital mortality for both men and women, indicating that gender does not significantly affect management or outcomes in CS.