Pérez-García, A. (Alejandra)
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- Extravasación espontánea renal (tres casos)(1977) Pérez-García, A. (Alejandra); Alberola-Gómez-Escolar, I. (Ignacio); Merino-Angulo, J. (J.); Lopez-Martinez, F. (F.); Calonge-Domínguez, M. (María); Lecumberri-Thomas, I. (I.)Se describen tres casos de extravasación espontánea renal, haciéndose una revisión de la literatura al respecto, con descripción de los signos radiológicos que son típicos y diagnósticos de este fenómeno y cuyo tratamiento es conservador.
- Predictors of mortality and poor outcome in cancer patients with E. faecium bloodstream infection(Gobierno de Navarra, 2015) Landecho, M.F. (Manuel F.); Pérez-García, A. (Alejandra); Mauleón, E. (E.); Pozo, J.C. (Juan C.) del; Beunza, J.J. (Juan José); Gea, A. (Alfredo)Background. To analyze predictors of mortality and poor outcome in cancer patients diagnosed with E. faecium bloodstream infection. Methods. Demographic, clinical and microbiological data were collected (January 1998-June 2011). Results. After multivariate analysis, presence of a urinary catheter was associated with a worse 7-day prognosis, and higher mortality at discharge. A high Charlson index was also associated with higher 7-day mortality. Conclusion. Presence of a urinary catheter was associated with poor 7-day prognosis and higher mortality at discharge in the present series.
- Enterococcal bloodstream infection. Design and validation of a mortality prediction rule(John Wiley & Sons Ltd, 2016) Landecho, M.F. (Manuel F.); Lucena, F. (Felipe); Huerta, A. (Ana); Alegre, F. (Félix); Pérez-García, A. (Alejandra); Conde-Estevez, D. (David); Pozo, J.L. (José Luis) del; Gómez, J. (J.); Mauleón, E. (E.); Beunza, J.J. (Juan José); Grau, S. (Santiago); Terradas-Robledo, R. (Roser); Gea, A. (Alfredo)Background: To develop a prediction rule to describe the risk of death as a result of enterococcal bloodstream infection. Methods: A prediction rule was developed by analysing data collected from 122 patients diagnosed with entero- coccal BSI admitted to the Clınica Universidad de Navarra (Pamplona, Spain); and validated by confirming its accuracy with the data of an external population (Hospital del Mar, Barcelona). Results: According to this model, independent sig- nificant predictors for the risk of death were being diabetic, have received appro- priate treatment, severe prognosis of the underlying diseases, have renal failure, received solid organ transplant, malignancy, source of the bloodstream infection and be immunosuppressed. The prediction rule showed a very good calibration (Hosmer–Lemeshow statistic, P = 0.93) and discrimination for both training and testing sets (area under ROC curve = 0.84 and 0.83 respectively). Conclusions: The predictive rule was able to predict risk of death as a result of enterococcal bloodstream infection as well as to identify patients, who being below the thresh- old value, will have a low risk of death with a negative predictive value of 96%.
- Hepatitis C core antigen: Diagnosis and monitoring of patients infected with hepatitis C virus(Elsevier, 2019) Navascués, A. (Ana); Pérez-García, A. (Alejandra); Aguinaga, A. (Aitziber); Castilla, J. (Jesús); Ezpeleta, C. (Carmen)Introduction: New efficient strategies are needed for the assessment of active hepatitis C virus (HCV) infection. The aim of this study was to evaluate the ability of HCV core antigen (HCV-cAg) as a marker of active HCV infection in newly diagnosed patients, for treatment monitoring, and for the detection of therapeutic failure. Materials and methods: A prospective study was conducted at a regional reference hospital in Spain. HCV- cAg and viral load (RNA-HCV) were tested in plasma or serum samples from three patient groups: new diagnosis, treatment monitoring, and treatment failure. The treatment monitoring group was tested at the beginning of treatment, at 4 weeks post-initiation, at the end of treatment, and at 12 weeks post- treatment completion. The Architect HCV core antigen assay was performed for HCV-cAg testing, and viral load was quantified with the Cobas 6800 system. Results: A total of 303 samples from 124 patients were analyzed. Excellent correlation was seen between HCV-cAg and HCV-RNA (R2 = 0.932). The optimal cut-off value was 3 fmol/l in the receiver operating characteristics curve analysis, and the area under the curve was 0.987 (95% confidence interval 0.972– 1.000). HCV-cAg sensitivity and specificity were 97% and 95%, respectively. Most diverging results were observed in the treatment follow-up group. Conclusions: HCV-cAg demonstrated good sensitivity and specificity as a marker for active HCV infection, new diagnosis, detection of antiviral therapeutic failure, and treatment monitoring.
- Interim efecctiveness of trivalen influenza vaccine in a Seaton dominated by lineage mismatched influenza B, northern Spain, 2017/18.(Eurosurveillance, 2018) Martínez-Baz, I. (Iván); Navascués, A. (Ana); Pérez-García, A. (Alejandra); Ezpeleta, G. (Guillermo); Aguinaga, A. (Aitziber); Castilla, J. (Jesús); Pozo, F. (Francisco); Casado, I. (Itziar); Ezpeleta, C. (Carmen)The 2017/18 interim estimate of trivalent influenza vaccine effectiveness (VE) was 39% (95% confidence interval: 20-54) in Navarre. Compared with individuals unvaccinated in the current and five previous seasons, VE against influenza B was 41% for current and any prior doses, 67% for current vaccination only, and 22% for any prior doses, and 43%, 51% and 54%, respectively against influenza A(H3N2). This suggests moderate VE despite predominance of lineage mismatched influenza B.
- Progress in the elimination of hepatitis C virus infection in Spain: a population-based cohort study(Public Library of Science, 2018) San-Miguel, R. (Ramon); Martínez-Baz, I. (Iván); Pérez-García, A. (Alejandra); Burgui, C. (Cristina); Goñi-Esarte, S. (Silvia); Repáraz, J. (Jesús); Aguinaga, A. (Aitziber); Castilla, J. (Jesús); Juanbeltz, R. (Regina); Casado, I. (Itziar); Ezpeleta, C. (Carmen); Zozaya, J.M. (José Manuel)Background: The World Health Organization set targets to eliminate hepatitis C virus (HCV) infection through detection and treatment of all cases by 2030. This study aimed to describe the progress and difficulties in the elimination of HCV infection in Navarra, Spain. Methods: Using electronic healthcare databases, we performed a population-based prospective cohort study to describe changes in the prevalence of diagnosed active HCV infection at the beginning of 2015 and the end of 2017, the rate of new diagnoses and the rate of post-treatment viral clearance (PTVC) during this period. Results: At the beginning of 2015 there were 1503 patients diagnosed with positive HCV-RNA, 2.4 per 1000 inhabitants, and at the end of 2017 the prevalence had decreased by 47%. In the study period, 333 (18 per 100,000 person-years) new positive HCV-RNA cases were detected, but only 76 (23%; 4.2 per 100,000 person-years) did not have anti-HCV antibodies previously detected. Prevalent cases and new diagnoses of active infection were more frequent in men, people born in 1950-1979, HIV-infected patients and in those with lower income levels. Among patients with HCV-RNA, 984 achieved PTVC (22.7 per 100 person-years). PTVC was less frequent in patients born before 1940, in immigrants and in patients with lower income levels. Conclusions: The prevalence of diagnosed active HCV infection has dropped by almost half over three years, because the number of patients with PTVC was much higher than the number of new diagnoses. Interventions specifically targeted at population groups with less favourable trends may be necessary.
- Detection of Respiratory Viruses in Deceased Persons, Spain, 2017(Centers for Disease Control and Prevention, 2018) Martínez-Baz, I. (Iván); Navascués, A. (Ana); Pérez-García, A. (Alejandra); Aguinaga, A. (Aitziber); Castilla, J. (Jesús); Floristan-Floristan, M.Y. (María Yugo); Casado, I. (Itziar); Ezpeleta, C. (Carmen)During the 2016–17 influenza season in Spain, we tested specimens from 57 elderly deceased persons for respira- tory viruses. Influenza viruses were detected in 18% of the specimens and any respiratory virus in 47%. Only 7% of participants had received a diagnosis of infection with the detected virus before death.