Concordance analysis between liquid biopsy (ctDNA) and tumor DNA molecular profiles from panel-based next-generation sequencing.

Introduction: Analysis of circulating tumor DNA (ctDNA), also known as liquid biopsy, has been postulated to be a useful test in the prognostication, molecular profiling, and monitoring of cancer patients. In this series we aimed to analyze the concordance between the mutation status of formalin-fixed paraffin-embedded (FFPE) tumor samples and matched ctDNA, considering tumor molecular profiling as the gold standard technique.

Methods: This retrospective study included cancer patients with complete diagnostics and gene mutations detected in a previous FFPE tumor tissue Next-Generation Sequencing (NGS) study with a matched frozen plasma sample available for an NGS ctDNA assay.

Detection and management of inadequate vascular access device implantation in the subclavian artery.

We present a case of a female patient with ovarian cancer who had an inadvertent vascular access device implantation in the subclavian artery, being detected after 10 days. She was successfully treated with a covered stent without immediate complications.

Update and recommendations in decision making referred to limitation of advanced life support treatment.

The Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) Bioethics Working Group has developed recommendations on the Limitation of Advanced Life Support Treatment (LLST) decisions, with the aim of reducing variability in clinical practice and of improving end of life care in critically ill patients. The conceptual framework of LLST and futility are explained. Recommendations referred to new forms of LLST encompassing also the adequacy of other treatments and diagnostic methods are developed.

Obesity and Alzheimer's disease, does the obesity paradox really exist? A magnetic resonance imaging study.

Mid-life obesity is an established risk factor for Alzheimer's disease (AD) dementia, whereas late-life obesity has been proposed as a protective state. Weight loss, which predates cognitive decline, might explain this obesity paradox on AD risk. We aimed to assess the impact of late life obesity on brain structure taking into account weight loss as a potential confounder.

Molecular characterization of OXA-48 carbapenemase-producing Klebsiella pneumoniae strains after a carbapenem resistance increase in Catalonia.

Introduction: To characterize OXA-48 carbapenemase-producing Klebsiella pneumoniae strains isolated after an increase in carbapenem resistance in Catalonia.

Methodology: K. pneumoniae identification, antimicrobial susceptibility studies, the Modified Hodge Test method, amplification of antimicrobial resistance genes (against β-lactamases, quinolones and aminoglycosides), molecular typing (by PFGE and MLST), conjugation assays, plasmid characterization (PBRT-PCR and Southern blot), a description of mobile genetic elements and statistical analysis were done.

Weight loss in the healthy elderly might be a non-cognitive sign of preclinical Alzheimer's disease.

Weight loss has been proposed as a sign of pre-clinical Alzheimer Disease (AD). To test this hypothesis, we have evaluated the association between longitudinal changes in weight trajectories, cognitive performance, AD biomarker profiles and brain structure in 363 healthy controls from the Alzheimer´s Disease Neuroimaging Initiative (mean follow-up 50.5±30.

Impact of neonatal morbidity on the risk of developmental delay in late preterm infants.

Background: Late preterm infants (LPI) have a higher risk of developmental delay (DD) than term-born infants. The association of perinatal complications with specific morbidity is not clear.

Aim: (1) To compare the risk of DD at 4years of age between LPI who have presence or absence of any morbidity associated with the prematurity at birth, called complicated (cLPI) or uncomplicated (uLPI), and term-born infants, (2) to determine maternal and perinatal factors associated with risk of DD, and (3) to analyze, in LPI, the association between perinatal morbidity and risk of DD.

Cost-effectiveness of a Barcelona home care program for individuals with multimorbidity.

To improve the efficiency and effectiveness of care and optimize healthcare resources, a home healthcare program was created for individuals with multiple chronic conditions. Demographic and clinical characteristics of the 261 individuals (mean age 84) included in the program from its inception in 2011 through 2013 (mean stay in the program 203±192 days) were prospectively analyzed. The number of hospital admissions, length of stay, and costs for individuals admitted to the program were compared for two time periods: the 6 months before admission to the program and their stay in the program.

Evolution and prognosis of long intensive care unit stay patients suffering a deterioration: A multicenter study.

Purpose: The prognosis of a patient who deteriorates during a prolonged intensive care unit (ICU) stay is difficult to predict. We analyze the prognostic value of the serialized Sequential Organ Failure Assessment (SOFA) score and other variables in the early days after a complication and to build a new predictive score.

Materials And Methods: EPIPUSE (Evolución y pronóstico de los pacientes con ingreso prolongado en UCI que sufren un empeoramiento, Evolution and prognosis of long intensive care unit stay patients suffering a deterioration) study is a prospective, observational study during a 3-month recruitment period in 75 Spanish ICUs.

Limitation of life-sustaining treatment in patients with prolonged admission to the ICU. Current situation in Spain as seen from the EPIPUSE Study.

Objective: Limitation of life-sustaining treatment (LLST) is a recommended practice in certain circumstances. Limitation practices are varied, and their application differs from one center to another. The present study evaluates the current situation of LLST practices in patients with prolonged admission to the ICU who suffer worsening of their condition.

Relationship between volume and survival in closed intensive care units is weak and apparent only in mechanically ventilated patients.

Background: Recent studies have found an association between increased volume and increased intensive care unit (ICU) survival; however, this association might not hold true in ICUs with permanent intensivist coverage. Our objective was to determine whether ICU volume correlates with survival in the Spanish healthcare system.

Methods: Post hoc analysis of a prospective study of all patients admitted to 29 ICUs during 3 months.

[Prospective multicenter study of adverse drug reactions in hospitalized elderly patients].

Background And Objective: The incidence of adverse drug reactions (ADRs) in hospitalized elderly patients is an important clinical problem. The purpose of this study was to determine the incidence of ADRs in elderly in-patients, to analyze the factors involved in their presentation and to evaluate the reactions detected.

Patients And Method: Prospective multicenter study in patients older than 65 years during their stay in hospital or nursing home.

[External tutor of ePTFE in tracheal stenosis. Clinical application].

Acquired tracheal stenosis in children can be either to direct cervicothoracic trauma or to post-intubation. Resection and end-to-end anastomosis continues to be the treatment of choice. The high rate of restenosis is directly related to anastomotic tension in resections of more than 2 cm.

[Clinical indications for echography in acute pyelonephritis in adult women].

Background: Echography is a non-invasive procedure which detects abnormalities in kidney and/or urinary tract.

Objective: To determine whether the routine use of an echography in women with the diagnosis of acute pyelonephritis (APN) provides relevant findings to diagnosis and determines a change in therapy.

Material And Methods: A total of 100 patients admitted to the hospital with the diagnosis of APN who had undergone an echography were studied.

[Effectiveness of exercise echocardiography in the diagnosis of left bundle branch block. A case report].

A left bundle branch block is very often suggestive of cardiac diseases. Left bundle branch block is also present with angina in patients with normal coronary arteries. We report a case of a man with a left bundle branch block in which the most effective, rapid and economic method of diagnosis was exercise echocardiography.

[Acute hepatitis caused by intravenous amiodarone].

Amiodarone is an antiarrhythmic agent very often used in clinical practice in spite of its large array of adverse effects. We report one patient case with acute hepatitis following intravenous amiodarone treatment and its possible etiology. Our conclusion is the importance of a strict control of parameters in the hepatic functions in patients who require amiodarone therapy.