Publications by authors named "Juan M Diaz"

Obesity is a global health concern that has been increasing over the years, and it is associated with several pathophysiological changes affecting the respiratory system, including alveolar hypoventilation. Obesity hypoventilation syndrome (OHS) is one of the six subtypes of sleep-hypoventilation disorders. It is defined as the presence of obesity, chronic alveolar hypoventilation leading to daytime hypercapnia and hypoxia, and sleep-disordered breathing.

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One of the most frequent diffuse interstitial lung diseases is hypersensitivity pneumonitis. It is related to exposure to diverse antigens, causing fibrosis in advanced stages, making the differential diagnosis with interstitial pulmonary fibrosis difficult as it overlaps with the usual interstitial pneumonia pattern. On the other hand, there are interstitial lung diseases associated with ANCA, such as microscopic polyangiitis, which is also related to the usual interstitial pneumonia pattern.

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Background & Aims: Genetic ancestry or racial differences in health outcomes exist in diseases associated with systemic inflammation (eg, COVID-19). This study aimed to investigate the association of genetic ancestry and race with acute-on-chronic liver failure (ACLF), which is characterized by acute systemic inflammation, multi-organ failure, and high risk of short-term death.

Methods: This prospective cohort study analyzed a comprehensive set of data, including genetic ancestry and race among several others, in 1274 patients with acutely decompensated cirrhosis who were nonelectively admitted to 44 hospitals from 7 Latin American countries.

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Article Synopsis
  • Current prognostic scores for acutely decompensated cirrhosis patients, especially those with acute-on-chronic liver failure, often underestimate mortality risk due to not accounting for systemic inflammation's impact.
  • A study used serum metabolomics from two large European cohorts to identify key metabolites linked to short-term mortality, leading to the creation of two new predictive models.
  • Both models significantly outperformed the existing MELDNa score in predicting death within 28 days of hospital admission, demonstrating better accuracy in patients with acute-on-chronic liver failure.
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  • Diabetes can be a risk factor for cancer, but there is limited research on how post-transplant diabetes mellitus (PTDM) influences cancer risk after organ transplants.
  • In a study of Spanish patients without diabetes before transplant, researchers found that PTDM did not generally increase cancer risk, but indicated a significant association with renal cell cancer (RCC).
  • The study suggests that patients with PTDM should be monitored closely for RCC due to their higher risk compared to those without PTDM.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causal agent of Coronavirus disease 2019 (COVID-19), a pandemic disease declared in 2020. The clinical manifestations of this pathology are heterogeneous including fever, cough, dyspnea, anosmia, headache, fatigue, taste dysfunction, among others. Survivors of COVID-19 have demonstrated several persistent symptoms derived from its multisystemic physiopathology.

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  • Staphylococcus aureus and Candida albicans often coexist in biofilm-related infections (like denture stomatitis and periodontitis), but their combined biofilm characteristics aren't fully understood.
  • The study aimed to explore the biofilm density, synergy, composition, structure, and stability of these two microorganisms against antimicrobial measures.
  • Results indicated that fetal bovine serum (FBS) reduced biofilm formation for S. aureus, while glucose or FBS positively influenced C. albicans growth, with C. albicans acting as a structural scaffold for S. aureus adherence in their complex biofilm.
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Sarcopenia is a prevalent condition that predicts prognosis in patients awaiting liver transplantation (LT). The gold standard for the diagnosis of sarcopenia is the assessment of the muscular area at L3 with computed tomography (CT) scan (skeletal muscle index [SMI]), but the routine use of CT scan is limited in clinical practice. Thus, we designed a single-center observational study aimed to evaluate the clinical factors associated with the presence of sarcopenia by SMI, and to build a score capable of predicting or excluding the presence of sarcopenia in patients on the LT waiting list (WL).

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Background: Data on renal replacement therapy (RRT) for end-stage renal disease were collected by the European Renal Association (ERA) Registry via national and regional renal registries in Europe and countries bordering the Mediterranean Sea. This article provides a summary of the 2019 ERA Registry Annual Report, including data from 34 countries and additional age comparisons.

Methods: Individual patient data for 2019 were provided by 35 registries and aggregated data by 17 registries.

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Article Synopsis
  • The study investigates how ApxI, a toxin from Actinobacillus pleuropneumonia, induces rapid cell death in porcine alveolar macrophages and endothelial cells through a process called pyroptosis, which is dependent on the NLRP3 inflammasome and caspase-1 activation.
  • Researchers used various inhibitors to block caspase-1 and the NLRP3 inflammasome, finding that these treatments reduced cell death caused by ApxI, indicating the involvement of these pathways in the cell death process.
  • The findings reveal that ApxI triggers pyroptosis in alveolar macrophages for the first time, highlighting the significant role of the N
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Objective: This review will identify and describe the content and assess the quality of available decision aids aimed at adults with advanced chronic kidney disease with medical indication to start dialysis who need to choose one of the two dialysis modalities.

Introduction: The lack of evidence regarding the superiority of the different options for dialysis, hemodialysis, and peritoneal dialysis, indicated in advanced chronic kidney disease, makes the shared decision-making process especially important.

Inclusion Criteria: We will include decision aids from published studies and non-published material aimed at adults with advanced chronic kidney disease.

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Background: The use of flash-glucose monitoring system FreeStyle Libre (FSL) has demonstrated benefits in metabolic control and quality of life in different populations with diabetes mellitus (DM), being funded in many countries. Due to this, DM subjects on hemodialysis (HD) are using FSL despite the accuracy in this population being unclear. The aims of the present study are to assess the accuracy of FSL in DM subjects on HD, its relationship to hydration status, and patient satisfaction.

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Urinary tract infections (UTIs) affect more than 150 million people, with a cost of over 3.5 billion dollars, each year. is associated with 70-80% of UTIs.

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Background: Mechanically isolated stromal vascular fraction (tSVF, tissue SVF) is a potent regenerative solution, increasingly used as a therapeutic modality for a variety of pathologies. With recent evidence conclusively favoring mechanical isolation over enzymatic alternatives, the therapeutic share and indications of tSVF are expected to grow even further.

Objectives: The aim of this study was to provide a systematic review of all studies reporting on the use of tSVF.

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TagB, TagC (andem utotransporter enes and ), and Sha (erine-protease emagglutinin utotransporter) are recently described members of the SPATE (serine protease autotransporters of ) family. These SPATEs can cause cytopathic effects on bladder cells and contribute to urinary tract infection in a mouse model. Bladder epithelial cells form an important barrier in the urinary tract.

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Chronic kidney disease (CKD) is a multifactorial disorder with an important genetic component, and several studies have demonstrated potential associations with allelic variants. In addition, CKD patients are also characterized by high levels of genomic damage. Nevertheless, no studies have established relationships between DNA damage, or genomic instability present in CKD patients, and gene polymorphisms.

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Background: Cystatin C (CysC) is an early biomarker of renal dysfunction scarcely studied in patients awaiting liver transplantation (LT). Sarcopenia is frequent in cirrhosis and impacts prognosis. We aimed to assess the capability of these factors to predict survival and acute-on-chronic liver failure (ACLF) in patients awaiting LT, as well as early post-LT outcomes.

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Chronic kidney disease (CKD) patients have many affected physiological pathways. Variations in the genes regulating these pathways might affect the incidence and predisposition to this disease. A total of 722 Spanish adults, including 548 patients and 174 controls, were genotyped to better understand the effects of genetic risk loci on the susceptibility to CKD.

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Prediabetes and post-transplant diabetes mellitus affect about 20-30% of renal transplant patients. The latter is a risk factor for cardiovascular disease. However, no clear evidence linking prediabetes and cardiovascular disease is available.

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Objectives: We aimed to evaluate the effect of acute-on-chronic liver failure (ACLF) on patients' 1-year post-liver transplant (LT) survival. In addition, we evaluated the effect of ACLF on the development of post-LT chronic kidney disease (CKD) and early allograft dysfunction (EAD).

Patients And Methods: A retrospective cohort of patients who underwent transplantation from 2010 to 2016 was studied.

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Background: Mean platelet volume (MPV) is a risk factor for cardiovascular and inflammatory diseases.

Aim: To evaluate the association between high MPV and 90-day mortality after an episode of venous thromboembolism (VTE).

Material And Methods: Retrospective cohort of 594 patients with a median age of 73 years (58% women) with a first episode VTE, included in an institutional Thromboembolic Disease registry between 2014 and 2015.

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Spontaneous bacterial peritonitis is the most frequent bacterial infection in patients with cirrhosis. The reported incidence varies between 7% and 30% in hospitalized patients with cirrhosis and ascites, representing one of their main complications. Outcomes in patients with spontaneous bacterial peritonitis are poor since acute kidney injury, acute-on-chronic liver failure, and death occur in as much as 54%, 60%, and 40% of the patients, respectively, at midterm.

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Objective: Few studies carried out more than 20 years ago have evaluated spontaneous bacterial peritonitis (SBP) recurrence in patients receiving secondary antibiotic prophylaxis. These studies reported a 1-year recurrence rate of 20-26%. Changes in the bacteriology of SBP over the last few years might have negative effects on secondary prophylaxis.

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Introduction: Despite the high incidence of posttransplant diabetes mellitus (PTDM) among high-risk recipients, no studies have investigated its prevention by immunosuppression optimization.

Methods: We conducted an open-label, multicenter, randomized trial testing whether a tacrolimus-based immunosuppression and rapid steroid withdrawal (SW) within 1 week (Tac-SW) or cyclosporine A (CsA) with steroid minimization (SM) (CsA-SM), decreased the incidence of PTDM compared with tacrolimus with SM (Tac-SM). All arms received basiliximab and mycophenolate mofetil.

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