Articles publicats (IRBLleida)
Permanent URI for this collection
L'IRBLleida és un centre de recerca conjunt entre la Universitat i el Departament de Salut de la Generalitat de Catalunya. Té com a funció potenciar les sinergies de recerca biomèdica entre ambdós institucions i està compromès en avançar en la recerca biomèdica com a mitja per millorar la salut de la població i facilitar una activitat assistencial òptima en situacions de malaltia. [Més informació].
Browse
Recent Submissions
- ItemOpen AccessNonpharmacological interventions to promote sleep in the adult critical patients unit: A scoping review(Elsevier, 2025) Carrera, Maria P.; Alegria, Leyla; Brockmann, Pablo; Repetto, Paula; Leonard, Douglas; Cádiz, Rodrigo; Paredes, Fabio; Rojas, Idalid; Moya, Ana; Oviedo, Vanessa; García, Patricio; Henríquez Beltrán, Mario; Bakker, JanBackground: Sleep and circadian rhythms are markedly altered in intensive care unit (ICU) patients. Numerous factors related to the patient and the ICU environment affect the ability to initiate and maintain sleep. Therefore, nonpharmacological interventions could play an essential role in improving sleep and circadian rhythm. Objective: The aim of this study was to examine nonpharmacological interventions evaluated for promoting sleep in adult ICUs. Methods: A scoping review was conducted, including randomised controlled trials, nonrandomised controlled trials, quasi-experimental trials, and other controlled studies investigating the effects of nonpharmacological interventions promoting sleep in adult ICU patients. Results: A total of 57 articles and 14 ongoing trials were included in the review, of which 38 were randomised clinical trials. Nine nonpharmacological interventions to improve sleep in critically ill patients were evaluated: earplugs and/or eye masks, aromatherapy, bundles, music intervention, massage or acupressure, noise masking, bright light, and dynamic light. Most included trials simultaneously assessed the effect of more than one intervention on perceived sleep quality using questionnaires. The association between the interventions and improved sleep varied. In the case of multicomponent interventions, it is difficult to identify which components might have influenced sleep improvement. Conclusions: Numerous studies have evaluated various nonpharmacological interventions to promote sleep in critically ill patients, several of which improved perceived sleep quality. However, the substantial variability of the assessed interventions and their implementation complicates drawing reliable conclusions.
- ItemOpen AccessTheory of mind in schizophrenia through a clinical liability approach: a sib-pair study(Frontiers Media, 2024) Giralt López, Maria; Miret, Salvador; Campanera, S.; Moreira, M.; Sotero-Moreno, A.; Krebs, M. O.; Fañanás Saura, Lourdes; Fatjó-Vilas, MarBackground: Consistent findings indicate that Theory of Mind (ToM) is impaired in schizophrenia (SZ). To investigate whether such deficits are trait- or state-dependent, we investigated if ToM is modified by clinical liability markers (such as basic symptoms and psychotic-like experiences), focusing on the analysis of unaffected siblings of individuals diagnosed with SZ. Methods: The study included a total of 65 participants: 38 patients diagnosed with a schizophrenia-spectrum disorder and 27 healthy siblings. ToM was assessed using the Hinting Task (HT), Basic symptoms with The Frankfurt Complaint Questionnaire (FCQ), Psychotic-like-experiences with the Community Assessment of Psychic Experiences (CAPE) and Family history with the Family Interview for Genetic Studies. Results: First, a comparison of HT performance between patients and siblings (linear mixed model adjusted for age, sex and Intelligence Quotient (IQ)) showed that patients presented lower scores than siblings (p = 0.022). These differences did not remain significant after adjusting for clinical vulnerability markers. Second, within siblings, linear regression analyses (adjusted for age, sex, IQ and family history) showed that higher FCQ Depressiveness and CAPE negative scores were related to poorer ToM performance (p = 0.007 and p = 0.032, respectively). Conclusion: Our findings suggest that clinical liability markers are valuable for delineating variations in ToM capabilities within healthy individuals. Moreover, our results indicate that ToM deficits are not solely linked to SZ but also extend to its clinical vulnerability, suggesting that ToM could serve as an endophenotypic marker. This implies that ToM could help distinguish particularly susceptible individuals from a population at risk, such as those with a genetic predisposition (siblings).
- ItemOpen AccessProgressive systemic inflammation precedes decompensation in compensated cirrhosis(Elsevier, 2005) Sánchez-Aldehuelo, Rubén; Villanueva, Cándido; Genescà, Joan; García-Pagán, Juan Carlos; Castillo, Elisa; Calleja, José Luis; Aracil, Carles; Bañares, Rafael; Téllez, Luis; Paule, Lorena; Morillas, Rosa María; Poca, María; Peñas, Beatriz; Augustin, Salvador; Abraldes, Juan G.; Alvarado-Tapias, Edilmar; Bosch, Jaume; Albillos, AgustínBackground & aims: Systemic inflammation is a driver of decompensation in cirrhosis with unclear relevance in the compensated stage. We evaluated inflammation and bacterial translocation markers in compensated cirrhosis and their dynamics in relation to the first decompensation. Methods: This study is nested within the PREDESCI trial, which investigated non-selective beta-blockers for preventing decompensation in compensated cirrhosis and clinically significant portal hypertension (CSPH: hepatic venous pressure gradient ≥10 mmHg). Blood biomarkers were measured at baseline and at 1 and 2 years in patients who remained compensated and had available samples (n = 164). Values of patients with CSPH were split at each time point by decompensation development in the next time interval after sampling. We also included 54 patients with cirrhosis and subclinical portal hypertension (PH) and 35 controls. We assessed markers of inflammation (interleukin-6 [IL-6], tumor necrosis factor-alpha, von Willebrand factor [vWF], C-reactive protein), macrophage activation (CD14, CD163), intestinal barrier integrity (fatty acid-binding protein [FABP], haptoglobin), and bacterial translocation (lipopolysaccharide [LPS]). Results: IL-6, CD163, and vWF were higher (p <0.01) at baseline in patients with cirrhosis and CSPH compared to those with subclinical PH and controls. IL-6 increased (p <0.05) at 1 year in patients with CSPH, with a greater rise in those who developed decompensation. CD163 was higher (p <0.01) in patients who decompensated at baseline and 1 and 2 years. FABP was elevated (p <0.01) in patients with CSPH compared to subclinical PH and controls at baseline and 1 year, while haptoglobin was lower (p <0.01). LPS was higher (p <0.01) in patients with CSPH than in those with subclinical PH and controls and increased at 1 year regardless of decompensation development. Conclusions: Inflammation and bacterial products are present in the systemic circulation in patients with compensated cirrhosis and CSPH. Progressive inflammation precedes the first decompensation. Impact and implications: Systemic inflammation drives cirrhosis progression during the decompensated stage, but its role in the compensated stage is unclear. We evaluated biomarkers of systemic inflammation, intestinal barrier integrity and bacterial translocation in patients with compensated cirrhosis and their dynamics in relation to the first decompensation. We demonstrate that low-grade inflammation and bacterial products are present in the systemic circulation in compensated cirrhosis, provided clinically significant portal hypertension has developed. We also show that worsening of systemic inflammation precedes the development of first clinical decompensation.
- ItemOpen AccessClinical and ultrasound characteristics in patients with sars-cov-2 pneumonia, associated with hospitalization prognosis. e-covid Project(BioMed Central, 2024) Fàbrega Ramon, Noemí; Ortega Bravo, Marta; Torres Cortada, Gerard; Sol, Joaquim; Solanes Cabús, Mònica; Palacín Peruga, Jose MaríaBackground: During the COVID-19 pandemia, the imaging test of choice to diagnose COVID-19 pneumonia as chest computed tomography (CT). However, access was limited in the hospital setting and patients treated in Primary Care (PC) could only access the chest x-ray as an imaging test. Several scientific articles that demonstrated the sensitivity of lung ultrasound, being superior to chest x-ray [Cleverley J et al., BMJ 370, 202013] and comparable to CT scan [Tung-Chen Y et al., Ultrasound Med Biol 46:2918-2926, 2020], promoted the incorporation of this technique in the assessment of COVID-19 patients in PC. [Pérez J et al., Arch. Bronconeumol 56:27-30, 2020; Gargani L et al., Eur Heart J Cardiovasc Imaging 21:941-8, 2020, Soldati G et al., J Ultrasound Med 39:1459, 2020] A prior study in our territory (Lleida, Spain) was designed to predict complications (hospital admission) of COVID-19 pneumonia in PC patients, being different patterns of Lung ultrasounds (LUS) risk factors for hospital admission. [Martínez Redondo J et al., Int J Environ Res Public Health 18:3481, 2021] The rationale for conducting this study lies in the urgent need to understand the determinants of severity and prognosis in COVID-19 patients with interstitial pneumonia, according to its lung ultrasound patterns. This research is crucial to provide a deeper understanding of how these pre-existing ultrasound patterns related to disease progression influence the medical treatment. Methods: The objective of the study is to generate predictive models of lung ultrasound patterns for the prediction of lung areas characteristics associated with hospitalizations and admissions to the Intensive Care Unit (ICU) associated with COVID-19 disease, using ultrasound, sociodemographic and medical data obtained through the computerized medical history. Results: A single relevant variable has been found for the prediction of hospitalization (number of total regions with potentially pathological presence of B lines) and one for the prediction of ICU admission (number of regions of the right lung with potentially pathological presence of B lines). In both cases it has been determined that the optimal point for classification was 2 or more lung affected areas. Those areas under the curve have been obtained with good predictive capacity and consistency in both cohorts. Conclusions: The results of this study will contribute to the determination of the ultrasound prognostic value based on the number of lung areas affected, the presence of pulmonary condensation or the irregularity of pleural effusion patterns in COVID-19 patients, being able to be extended to other lung viral infections with similar patterns.
- ItemOpen AccessAssociation of smoking with disease progression in persons with multiple sclerosis undergoing autologous hematopoietic cell transplantation: a single-center experience(Permanyer, 2024) Fernandez Lara, Danitza; Porcel Pérez, José Manuel; Robles Hernández, Robinson; Lira-Lara, Olivia; Melgar de la Paz, Miranda; Gallardo Pérez, Moisés M.; Olivares Gazca, Juan C.; Ruiz Delgado, Guillermo J.; Ruiz Argüelles, Guillermo JoséBackground: Smoking remains a significant issue that increases the prevalence of multiple sclerosis (MS) and its progression to secondary progressive forms. Objectives: The goal is to identify the relationship between smoking and disease progression in MS patients who have undergone autologous hematopoietic stem cell transplantation (auto-HSCT) at the Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico. Methods: This retrospective study involved MS patients treated with auto-HSCT, followed for 12 months. The response to transplantation was measured using the difference in Expanded Disability Status Scale (EDSS) scores before and 12 months after the transplant. A difference of -0.5 or greater indicated a good response, while a difference below 0.5 indicated a poor response. Results: The study included 419 patients, with a median age of 47 years (IQR: 40-53). The majority were non-smokers (315) compared to smokers/ex-smokers (104). In patients with PMSS, EDSS stabilization at 12 months was observed in both smokers/ex-smokers (median 6, interquartile range (IQR) = 1 vs. 6, IQR = 1, p = 0.466) and non-smokers (median 6, IQR = 1 vs. 6, IQR = 1.5, p = 0.001), although non-smokers showed a statistically significant difference. Conclusion: Smoking may negatively impact MS progression, especially in its progressive forms.