Publications by authors named "Sanmartin M"
Objective: To evaluate the effectiveness of a virtual community of practice (vCoP) in improving the activation of individuals with ischemic heart disease (IHD).
Method: We conducted a randomized controlled trial. A total of 282 patients with IHD from Madrid, Catalonia, and the Canary Islands were randomly allocated to an intervention or a control group.
Objective: To assess the prognostic impact of a routine invasive strategy according to the frailty burden in patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the MOSCA-FRAIL clinical trial.
Methods: The MOSCA-FRAIL trial randomized 167 frail patients, defined by a Clinical Frailty Scale (CFS) ≥ 4, with NSTEMI to an invasive or conservative strategy. The primary endpoint was the number of days alive and out of hospital (DAOH) one year after discharge.
Article Synopsis
- The MOSCA-FRAIL trial examined the effects of invasive versus conservative treatment strategies in frail patients aged 70 and older with non-ST-segment elevation myocardial infarction (NSTEMI).
- The study included 167 participants and focused on various geriatric conditions, finding that invasive management had a notable survival benefit primarily for those with lower frailty levels (CFS=4).
- Results suggested that frailty, as indicated by the Clinical Frailty Scale (CFS), is an important factor in determining the risks and benefits of treatment, with a CFS score greater than 4 potentially signaling a need for more cautious decision-making.
Association between Heat Vulnerability Index and Stroke Severity.
Int J Environ Res Public Health
August 2024
Background: Socioeconomically disadvantaged neighborhoods are particularly vulnerable to heat-related illnesses. We aim to investigate the association between the heat vulnerability index (HVI), an established neighborhood-level metric of heat-related mortality risk, and acute ischemic stroke (AIS) severity.
Methods: We conducted a retrospective analysis of consecutive AIS admissions to a comprehensive stroke center between 2012 and 2021.
Background: The COVID-19 pandemic introduced unprecedented challenges to medical education systems and medical students worldwide, making it necessary to adapt teaching to a remote methodology during the academic year 2020-2021. The aim of this study was to characterize the association between medical professionalism and dropout intention during the pandemic in Peruvian medical schools.
Methods: A cross-sectional online-survey-based study was performed in four Peruvian medical schools (two public) during the academic year 2020-2021.
Article Synopsis
- The study aimed to evaluate how accurate cone-beam CT (CBCT) is in diagnosing different types of intracranial hemorrhage (ICH), focusing on intraparenchymal, subarachnoid, and intraventricular hemorrhages.
- A meta-analysis included seven studies with 466 patients, using multidetector CT as the reference standard; findings showed high sensitivity (0.88) and specificity (0.99) for identifying ICH.
- The results indicated that while CBCT has moderate diagnostic odds ratios, it demonstrates high specificity, particularly for intraparenchymal hemorrhage with a sensitivity of 0.98.
Objectives: As indications for acute ischemic stroke treatment expand, it is unclear whether disparities in treatment utilization and outcome still exist. The main objective of this study was to investigate disparities in acute ischemic stroke treatment and determine impact on outcome.
Materials And Methods: Retrospective observational cohort study of consecutive ischemic stroke admissions to a comprehensive stroke center from 2012-2021 was performed.
Article Synopsis
- Early discharge following a STEMI (heart attack) can benefit patients and healthcare systems, but its implementation is limited due to safety concerns.* -
- In a study involving 1,105 patients who had primary PCI for STEMI, 453 patients (41%) were discharged within 48 hours, with an average age of about 62 years.* -
- The results showed that early discharge was safe, with only 0.2% experiencing a non-fatal heart event, and only 1.1% requiring readmission for cardiovascular issues.*
In angiosperms, wound-derived signals travel through the vasculature to systemically activate defence responses throughout the plant. In Arabidopsis thaliana, activity of vasculature-specific Clade 3 glutamate receptor-like (GLR) channels is required for the transmission of electrical signals and cytosolic Ca ([Ca]) waves from wounded leaves to distal tissues, triggering activation of oxylipin-dependent defences. Whether nonvascular plants mount systemic responses upon wounding remains unknown.
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- The MOSCA-FRAIL trial investigated treatment approaches for frail patients (aged ≥70) with non-ST-segment elevation myocardial infarction (NSTEMI) and found no significant difference in health outcomes after one year between invasive and conservative strategies.
- Following extended follow-up until January 2023, the analysis of 167 patients indicated similar survival times and readmission rates, revealing that neither treatment significantly outperformed the other.
- Overall, while initial outcomes suggested that invasive treatment might lead to shorter survival in the first year, the long-term results demonstrated inconclusive differences, highlighting the need for personalized treatment decisions in frail older adults.
Introduction: Direct-to-angiography (DTA) is a novel care pathway for endovascular treatment (EVT) of acute ischemic stroke (AIS) that has been shown to reduce time-to-treatment and improve clinical outcomes for EVT-eligible patients. The institutional costs of adopting the DTA pathway and the many factors affecting costs have not been studied. In this study, we assess the costs and main cost drivers associated with the DTA pathway compared to the conventional CT pathway for patients presenting with AIS and suspected LVO in the anterior circulation.
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- Microbiological control in dentistry faces challenges due to drug-resistant microorganisms, prompting the use of Antimicrobial Photodynamic Therapy (PDT) as an effective technique for reducing microbial presence.
- PDT involves using a photosensitizer dye followed by exposure to low-power lasers, making it applicable across various dental specialties, particularly in pediatric dentistry where microorganism management is critical.
- The article reviews the specific protocols for PDT application in children’s dentistry, emphasizing the importance of parameters like photosensitizer type and light delivery methods, while highlighting ongoing research to optimize its use in clinical practice.
Article Synopsis
- The study investigates whether there is a sex-based disparity in neuro-imaging and treatment utilization for acute ischemic stroke (AIS) patients, focusing on socio-economic factors.
- Analysis of data from over 7,500 AIS cases revealed that male patients had higher use of CT angiography (CTA) but lower rates of intravenous thrombolysis compared to female patients, despite similar endovascular thrombectomy rates.
- The findings suggest that the differences in imaging utilization may be influenced by implicit biases, yet overall acute treatment rates and early outcomes for both sexes remained comparable.
Background: Although patients with COVID-19 have a higher risk of acute ischemic stroke (AIS), the impact on stroke outcomes remains uncertain.
Aims: To determine the clinical outcomes of patients with AIS and COVID-19 (AIS-COVID+).
Methods: We performed a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.
Breast cancer is the predominant form of carcinoma among women worldwide, with 70% of advanced patients developing bone metastases, with a high mortality rate. In this sense, the bone marrow (BM) mesenchymal stem/stromal cells (MSCs) are critical for BM/bone homeostasis, and failures in their functionality, transform the BM into a pre-metastatic niche (PMN). We previously found that BM-MSCs from advanced breast cancer patients (BCPs, infiltrative ductal carcinoma, stage III-B) have an abnormal profile.
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- This study is the first randomized clinical trial to compare invasive versus conservative treatment strategies for frail, older patients (≥70 years) with non-ST-segment elevation acute myocardial infarction (NSTEMI).
- Conducted across 13 hospitals in Spain from 2017 to 2021, it included 167 patients and measured primary outcomes like days alive and out of the hospital (DAOH) and the rates of cardiac-related complications.
- Results showed that while conservatively managed patients had slightly more DAOH (312 days) compared to those managed invasively (284 days), the difference was not statistically significant, and no major differences in mortality were found between the two groups. *
Objective: Clinical outcomes following endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) treatment are highly time sensitive. Remote robotic (RR)-EVT systems may be capable of mitigating time delays in patient transfer from a primary stroke center (PSC) to a comprehensive/thrombectomy-capable stroke center. However, health economic evidence is needed to assess the costs and benefits of an RR-EVT system.
View Article and Find Full Text PDFPurpose: The increased use of neuroimaging and innovations in ischemic stroke (IS) treatment have improved outcomes, but the impact on median hospital costs is not well understood.
Methods: A retrospective study was conducted using Medicare 5% claims data for 75,525 consecutive index IS hospitalizations for patients aged ≥65 years from 2012 to 2019 (values in 2019 dollars). IS episode cost was calculated in each year for trend analysis and stratified by cost components, including neuroimaging (CT angiography [CTA], CT perfusion [CTP], MRI, and MR angiography [MRA]), treatment (endovascular thrombectomy [EVT] and/or intravenous thrombolysis), and patient sociodemographic factors.
Background: Evidence has shown that endovascular thrombectomy (EVT) treatment improves clinical outcomes. Yet, its benefit remains uncertain in patients with large established infarcts as defined by ASPECTS (Alberta Stroke Program Early CT Score) <6. This study evaluates the cost-effectiveness of EVT, compared with standard care (SC), in acute ischemic stroke (AIS) patients with ASPECTS 3-5.
View Article and Find Full Text PDFBackground: Patients with acute myocardial infarction (MI) are at high risk of upcoming events, in particular heart failure (HF), but reliable stratification methods are lacking. Our goal was to evaluate the potential role of circulating miRNAs as prognostic biomarkers in patients presenting with MI.
Methods And Results: We conducted a prospective study among 311 consecutive patients hospitalized with MI (65% ST-segment elevation MI & median age of 55 years) with long-term follow-up.
Background And Objective: lthough intravenous contrast in neuroimaging has become increasingly important in selecting patients for stroke treatment, clinical concerns remain regarding contrast-associated acute kidney injury (CA-AKI). Given the increasing utilization of CT angiography and/or perfusion coupled with cerebral angiography, the purpose of this study was to assess the association of CA-AKI and multi-dose iodinated contrast in acute ischemic stroke (AIS) patients.
Materials And Methods: etrospective review of AIS patients at a comprehensive stroke center was performed from January 2018 to December 2019.
Article Synopsis
- Biomedical research applications in Spain require a positive ethical opinion from Research Ethics Committees (RECs) before execution, but there's little info on optimizing this review process to reduce delays.
- A study analyzed 125 research applications from La Rioja, Spain, during 2019-2020, looking at factors like the principal investigator’s profile, study design, and the ethical review process to identify what predicts favorable outcomes in the initial review.
- Results showed an increase in submissions and indicated that having a strong principal investigator and well-prepared informed consent methods significantly improved the chances of getting approval at the first review. Issues in informed consent and methods are leading causes of delays.
Background: Rapid screening and accurate diagnosis of acute myocardial infarction are critical to reduce the progression of myocardial necrosis, in which proteolytic degradation of myocardial extracellular matrix plays a major role. In previous studies, we found that targeting the extracellular matrix metalloprotease inducer (EMMPRIN) by injecting nanoparticles conjugated with the specific EMMPRIN-binding peptide AP9 significantly improved cardiac function in mice subjected to ischemia/reperfusion.
Methods: In a porcine model of coronary ischemia/reperfusion, we tested the theragnostic effects of administering 0.
is the second leading cause of death worldwide, with 10.0 million cancer deaths in 2020. Despite advances in targeted therapies, some pharmacological drawbacks associated with anticancer chemo and immunotherapeutic agents include high toxicities, low bioavailability, and drug resistance.
View Article and Find Full Text PDFBreast cancer is the most common type of cancer and the leading cause of death among women. Recent evidence suggests that mesenchymal stromal/stem cells and cancer-associated fibroblasts (CAFs) have an essential role in cancer progression, invasion and therapy resistance. Therefore, they are considered as highly promising future therapeutic targets against breast cancer.
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