Publications by authors named "Mar Fernandez"

: The ability to predict a long duration of mechanical ventilation (MV) by clinicians is very limited. We assessed the value of machine learning (ML) for early prediction of the duration of MV > 14 days in patients with moderate-to-severe acute respiratory distress syndrome (ARDS). : This is a development, testing, and external validation study using data from 1173 patients on MV ≥ 3 days with moderate-to-severe ARDS.

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Introduction: In patients with acute respiratory distress syndrome (ARDS), the PaO2/FiO2 ratio at the time of ARDS diagnosis is weakly associated with mortality. We hypothesized that setting a PaO2/FiO2 threshold in 150 mm Hg at 24 h from moderate/severe ARDS diagnosis would improve predictions of death in the intensive care unit (ICU). Methods: We conducted an ancillary study in 1303 patients with moderate to severe ARDS managed with lung-protective ventilation enrolled consecutively in four prospective multicenter cohorts in a network of ICUs.

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Objectives: To establish the epidemiological characteristics, ventilator management, and outcomes in patients with acute hypoxemic respiratory failure (AHRF), with or without acute respiratory distress syndrome (ARDS), in the era of lung-protective mechanical ventilation (MV).

Design: A 6-month prospective, epidemiological, observational study.

Setting: A network of 22 multidisciplinary ICUs in Spain.

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Objectives: To develop a scoring model for stratifying patients with acute respiratory distress syndrome into risk categories (Stratification for identification of Prognostic categories In the acute RESpiratory distress syndrome score) for early prediction of death in the ICU, independent of the underlying disease and cause of death.

Design: A development and validation study using clinical data from four prospective, multicenter, observational cohorts.

Setting: A network of multidisciplinary ICUs.

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Importance: Daily spontaneous breathing trials (SBTs) are the best approach to determine whether patients are ready for disconnection from mechanical ventilation, but mode and duration of SBT remain controversial.

Objective: To evaluate the effect of an SBT consisting of 30 minutes of pressure support ventilation (an approach that is less demanding for patients) vs an SBT consisting of 2 hours of T-piece ventilation (an approach that is more demanding for patients) on rates of successful extubation.

Design, Setting, And Participants: Randomized clinical trial conducted from January 2016 to April 2017 among 1153 adults deemed ready for weaning after at least 24 hours of mechanical ventilation at 18 intensive care units in Spain.

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Objective: To assess whether the psychological variables perceived stress, neuroticism and coping strategies, are associated with Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Syndrome (PMDD).

Design: Case-control study with incident cases using the Spanish public healthcare system.

Setting: 3 major public hospitals and one family counseling and planning center.

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Background: Spontaneous breathing trials (SBT) can be exhausting, but the preventive role of rest has never been studied. This study aimed to evaluate whether reconnection to mechanical ventilation (MV) for 1 h after the effort of a successful SBT could reduce the need for reintubation in critically ill patients.

Methods: Randomized multicenter trial conducted in 17 Spanish medical-surgical intensive care units (Oct 2013-Jan 2015).

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The aim of this work is the preparation of an active nanovehicle for the effective administration of α-tocopheryl succinate (α-TOS). α-TOS is loaded in the core of nanoparticles (NPs) based on amphiphilic pseudo-block copolymers of N-vinyl pyrrolidone and a methacrylic derivative of α-TOS. These well-defined spherical NPs have sizes below 165 nm and high encapsulation efficiencies.

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In this work, we consider the extent to which the presence of multivalent ions in solution modifies the equilibrium and dynamics of the energy production in a capacitive cell built with ion-exchange membranes in contact with high surface area electrodes. The cell potential in open circuit (OCV) is controlled by the difference between both membrane potentials, simulated as constant volume charge regions. A theoretical model is elaborated for steady state OCV, first in the case of monovalent solutions, as a reference.

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Objective: To estimate the incidence of early-onset dementia (EOD) and to compare the clinical characteristics of EOD vs late-onset dementia (LOD) in a geographically defined area.

Methods: We used data from the Registry of Dementia of Girona (ReDeGi), an epidemiologic surveillance system of dementia. The ReDeGi is a standardized clinical registry of new dementia cases diagnosed in the 7 hospitals of the Health Region of Girona (Catalonia, Spain), which encompasses an area of 5,517 km(2) and 690,207 inhabitants.

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Introduction: The Positive and Negative Syndrome Scale (PANSS) is a widely used instrument for measuring symptomatology in patients with schizophrenia. Numerous studies have analyzed the factorial structure of this scale and have suggested a fivefactor model, namely: negative, positive, excited, anxiety/depression, and disorganized (or cognitive). The latter factor has been related to neuropsychological tests, with a view to analyzing its utility as a measure of cognitive functioning in schizophrenia, but data are inconclusive.

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New injectable acrylic formulations have been prepared to be applied in restoration processes for intervertebral disks (IVDs). The solid phase of the formulations is composed of poly(methyl methacrylate) (PMMA), incorporating in some cases chondroitin sulphate (CS) as a regenerative bioactive molecule, whereas the liquid phase is constituted by an amphiphilic macromonomer (MT), 2-hydroxyethyl methacrylate (HEMA) and, in some formulations, acrylic acid (AA). The curing parameters and the mechanical properties of the IVD formulations make them excellent candidates for intervertebral application.

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Films and sponges of chitosan (CHI), chitosan/hyaluronic acid (CHI-HA) and chitosan/chondroitin sulphate (CHI-CHOS), were prepared by film deposition or lyophilization (sponges), avoiding the formation of interpolyelectrolyte complexes. The biological behaviour of the systems was analysed by studying the cell behaviour using a fibroblast cell line and standard biological MTT and Alamar Blue tests. The morphology of films, sponges and cell seeded samples was analysed by ESEM.

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A polyglycerol with dendritic structure (PGLD) was synthesized by ring-opening polymerization of deprotonated glycidol using a polyglycerol as core functionality in a step-growth process. Then, PGLD reacted with O-carboxymethylated chitosan to obtain PGLD-chitosan dendrimer (PGLD-Ch). After the reaction of PGLD-Ch with boric acid, there was a marked increase in the bulk viscosity evidencing physically that boron can initiate a charge transfer complex formation, (PGLD-Ch)B.

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One of the problems of percutaneous vertebroplasty attributed to the use of acrylic cements is related to the radiopacity of the formulation. The use of bismuth salicylate as the radiopaque agent is proposed in this work, taking into account the high radiopacity of organobismuth compounds used in dental applications and the possible analgesic effect of salicylic acid. Various cements formulated with this compound (some of them modified with polyethylene oxide) were examined.

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An injectable delivery system for prednisolone has been prepared based on a self-curing formulation comprised of poly(methyl methacrylate) particles and hydroxyethyl methacrylate as monomer. The polymerisation reaction was initiated by the redox system 4,4'-bis (dimethylaminobenzydrol)/benzoyl peroxide (BZN/BPO) and followed at 25 degrees C by measuring the time-temperature profile. A maximum temperature of 53 degrees C and a setting time of 15 min were obtained, calculated according to standard specifications.

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Hydrophilic polymeric drugs bearing "Triflusal" (4-trifluoromethylsalicylic acid), a drug widely used as antithrombogenic agent (Disgren), have been prepared by free radical copolymerization of methacryloyloxyethyl [2-(acetyloxy)-4-(trifluoromethyl)] benzoate (HTRF) and N,N'-dimethylacrylamide (DMA). The reactivity ratios of both monomers have been determined by 1H NMR spectra by applying non-linear least square treatments to the copolymerization equation (terminal model), and the kinetic parameters obtained indicated that the microstructure of copolymer chains is homogeneous, with a random distribution of the active HTRF units along the copolymer chains. That means that for the copolymer system THDMA22 used in this work, HTRF units are mainly isolated in relatively long DMA sequences.

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Poly(methyl methacrylate), PMMA, and of PMMA/Poly(epsilon-caprolactone), PCL, microspheres were loaded with different amounts of cholesterol by using a supercritical carbon dioxide (SC-CO2) impregnation process in order to use a clean technique with the absence of organic solvents, and to provide information for the infusion of additives into nonporous polymeric substrates. A conventional dissolution-evaporation method was also used to obtain PMMA and PMMA-PCL microparticles loaded with cholesterol. The obtained microspheres were characterized by environmental scanning electronic microscope, ESEM, nuclear magnetic resonance spectroscopy, NMR, and differential scanning calorimetry, DSC, thermal analysis.

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Copolymers containing functional groups with activity as antiaggregating agents for platelets, based on random chains of metacryloyloxyethyl [2-(acetyloxy)-4-(trifluoromethyl)]benzoate, TH, and 2-acrylamido-2-metylpropanesulfonic acid, AMPS, with AMPS molar fractions ranging from 0.1 to 0.4, have been prepared.

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The in vitro aqueous behaviour of a metacryloyloxyethyl [2-(acetyloxy)-4-(trifluoromethyl)]benzoate (THEMA)/N,N'-dimethylacrylamide (DMA) copolymer with a THEMA molar content of 39% (labeled THDMA39) has been investigated. This composition has been selected to achieve a system able to keep both the non-water solubility during the release and the resorbability (and the water solubility) after the completion of the drug release. This copolymer exhibited, at pH 7.

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