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1.
Respir Med ; 188: 106619, 2021 11.
Article in English | MEDLINE | ID: mdl-34555702

ABSTRACT

BACKGROUND: Invasive fungal infections (IFI) are increasing in prevalence in recent years. In the last few months, the rise of COVID-19 patients has generated a new escalation in patients presenting opportunistic mycoses, mainly by Aspergillus. Candida infections are not being reported yet. OBJECTIVES: We aimed to determine the prevalence of systemic candidiasis in patients admitted to ICUs due to severe pneumonia secondary to SARS-CoV-2 infection and the existence of possible associated risk factors that led these patients to develop candidiasis. PATIENTS/METHODS: We designed a study including patients with a confirmed diagnosis of COVID-19. RESULTS: The prevalence of systemic candidiasis was 14.4%, and the main isolated species were C. albicans and C. parapsilosis. All patients that were tested positive for Candida spp. stayed longer in the ICU in comparison to patients who tested negative. Patients with candidiasis had higher MuLBSTA score and mortality rates and a worse radiological involvement. In our study, Candida spp. isolates were found in patients that were submitted to: tocilizumab, tocilizumab plus systemic steroids, interferon type 1ß and Lopinavir-Ritonavir. CONCLUSIONS: Results suggested a high prevalence of systemic candidiasis in severe COVID-19-associated pneumonia patients. Patients with Candidiasis had the worst clinical outcomes. Treatment with tocilizumab could potentialize the risk to develop systemic candidiasis.


Subject(s)
COVID-19/complications , Candidiasis/epidemiology , Coinfection/epidemiology , Pneumonia/epidemiology , Aged , COVID-19/diagnosis , Candida albicans , Candida parapsilosis , Candidiasis/complications , Candidiasis/diagnosis , Coinfection/diagnosis , Critical Care , Female , Humans , Male , Middle Aged , Pneumonia/microbiology , Pneumonia/virology , Prevalence , Prospective Studies , Risk Factors
2.
Mycoses ; 64(2): 144-151, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33217071

ABSTRACT

BACKGROUND: As the global coronavirus pandemic (COVID-19) spreads across the world, new clinical challenges emerge in the hospital landscape. Among these challenges, the increased risk of coinfections is a major threat to the patients. Although still in a low number, due to the short time of the pandemic, studies that identified a significant number of hospitalised patients with COVID-19 who developed secondary fungal infections that led to serious complications and even death have been published. OBJECTIVES: In this scenario, we aim to determine the prevalence of invasive fungal infections (IFIs) and describe possible associated risk factors in patients admitted due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. PATIENTS/METHODS: We designed an open prospective observational study at the Rey Juan Carlos University Hospital (Mostoles, Spain), during the period from February 1 to April 30, 2020. RESULTS: In this article, we reported seven patients with COVID-19-associated pulmonary aspergillosis (CAPA) who had a poor prognosis. Severely ill patients represent a high-risk group; therefore, we must actively investigate the possibility of aspergillosis in all of these patients. Larger cohort studies are needed to unravel the role of COVID-19 immunosuppressive therapy as a risk factor for aspergillosis. CONCLUSIONS: As the pandemic continues to spread across the world, further reports are needed to assess the frequency of emergent and highly resistant reemergent fungal infections during severe COVID-19. These coinfections are leading a significant number of patients with COVID-19 to death due to complications following the primary viral disease.


Subject(s)
COVID-19/complications , Invasive Pulmonary Aspergillosis/etiology , Opportunistic Infections/microbiology , Adult , Aged , Aspergillus/genetics , Aspergillus/isolation & purification , Aspergillus/physiology , COVID-19/virology , Female , Hospitalization , Humans , Intermediate Care Facilities/statistics & numerical data , Invasive Pulmonary Aspergillosis/microbiology , Male , Middle Aged , Opportunistic Infections/etiology , Prevalence , Prospective Studies , SARS-CoV-2/physiology , Spain
5.
Arch. bronconeumol. (Ed. impr.) ; 53(12): 667-674, dic. 2017. tab, graf
Article in Spanish | IBECS | ID: ibc-169970

ABSTRACT

Introducción: Las limitaciones de la vida sexual de los pacientes con enfermedades crónicas desempeñan un importante papel en su calidad de vida. La información disponible sobre el impacto de la enfermedad asmática en la vida sexual de las personas es muy limitada. Material y métodos: Estudio transversal, observacional y multicéntrico. Se reclutaron pacientes asmáticos y sujetos sanos, a los que se les efectuó una entrevista en la que se recogieron datos demográficos y clínicos y en donde además cumplimentaron los siguientes cuestionarios: la escala Goldberg Anxiety-Depression Scale (GADS) para la valoración de la existencia de comorbilidad psiquiátrica, y en varones el Índice Internacional de la Función Eréctil (IIEF) y en mujeres el Índice de la Función Sexual Femenina (FSFI). Resultados: Se incluyeron un total de 276 casos, de los que 172 eran asmáticos (63 hombres y 109 mujeres) con una media de edad de 42 (± 14) años y 104 controles (53 hombres y 51 mujeres) con una media de edad de 39 (± 12) años. El asma presentaba una evolución de 15 años y su gravedad se distribuía: 6,4% intermitente, 17,9% persistente leve, 47,4% moderada y 28,2% grave. La enfermedad se consideró controlada en un 57,7%, parcialmente controlada en un 28,2% y no controlada en un 14,1%. Las mujeres asmáticas presentaron una mayor limitación de la vida sexual que las mujeres del grupo control, con una puntuación total del FSFI de 22,1 (± 9) frente a 26,5 (± 6,8), respectivamente (p < 0,005). Y los varones asmáticos, una significativa mayor disfunción eréctil, con una puntuación total del IIFE de 59,5 (± 12,5) frente a 64,3 (± 8,2), respectivamente (p < 0,05). Se observó además una relación entre la existencia de problemas sexuales y un peor control del asma. Conclusiones: La enfermedad asmática condiciona una peor calidad de vida sexual en las personas afectadas. Estos resultados deberían promover, en la práctica clínica habitual, el interés de los profesionales sanitarios por determinar y paliar las posibles limitaciones sexuales de sus pacientes con asma (AU)


Introduction: Sexual limitations play an important role in the quality of life of patients with chronic diseases. Very limited information is available on the impact of asthma on the sexual functioning of these individuals. Materials and methods: Cross-sectional, observational, multicenter study. Asthma patients and healthy individuals were recruited. All subjects participated in an interview in which demographic and clinical data were recorded, and completed the Goldberg Anxiety-Depression Scale (GADS) to evaluate the presence of concomitant psychiatric disease. Men also completed the International Index of Erectile Function (IIEF), and women, the Female Sexual Function Index (FSFI). Results: A total of 276 cases were included, comprising 172 asthma patients (63 men and 109 women) with a mean age of 42 (± 14) years, and 104 controls (52 men and 51women) with a mean age of 39 (± 12) years. Time since onset of asthma was 15 years and severity distribution was: 6.4% intermittent, 17.9% mild persistent, 47.4% moderate, and 28.2% severe. Disease was considered controlled in 57.7%, partially controlled in 28.2%, and uncontrolled in 14.1%. Women with asthma had greater sexual limitations than women in the control group, with a total FSFI score of 22.1 (± 9) compared to 26.5 (± 6.8), respectively (P < .005). Men with asthma had significantly more severe erectile dysfunction with a total IIEF score of 59.5 (± 12.5) compared to 64.3 (± 8.2) in male controls (P < .05). An association was also observed between sexual problems and poorer asthma control. Conclusions: Asthma is associated with a poorer sexual quality of life among patients. These results should arouse the interest of healthcare professionals in detecting and alleviating possible sexual limitations among their asthma patients in routine clinical practice (AU)


Subject(s)
Humans , Asthma/psychology , Sexuality/psychology , Sexual Dysfunctions, Psychological/epidemiology , Case-Control Studies , Quality of Life , Sickness Impact Profile , Psychometrics/instrumentation
6.
Arch Bronconeumol ; 53(12): 667-674, 2017 Dec.
Article in English, Spanish | MEDLINE | ID: mdl-28647305

ABSTRACT

INTRODUCTION: Sexual limitations play an important role in the quality of life of patients with chronic diseases. Very limited information is available on the impact of asthma on the sexual functioning of these individuals. MATERIALS AND METHODS: Cross-sectional, observational, multicenter study. Asthma patients and healthy individuals were recruited. All subjects participated in an interview in which demographic and clinical data were recorded, and completed the Goldberg Anxiety-Depression Scale (GADS) to evaluate the presence of concomitant psychiatric disease. Men also completed the International Index of Erectile Function (IIEF), and women, the Female Sexual Function Index (FSFI). RESULTS: A total of 276cases were included, comprising 172asthma patients (63 men and 109 women) with a mean age of 42 (±14) years, and 104 controls (52men and 51women) with a mean age of 39 (±12) years. Time since onset of asthma was 15 years and severity distribution was: 6.4% intermittent, 17.9% mild persistent, 47.4% moderate, and 28.2% severe. Disease was considered controlled in 57.7%, partially controlled in 28.2%, and uncontrolled in 14.1%. Women with asthma had greater sexual limitations than women in the control group, with a total FSFI score of 22.1 (±9) compared to 26.5 (±6.8), respectively (P<.005). Men with asthma had significantly more severe erectile dysfunction with a total IIEF score of 59.5 (±12.5) compared to 64.3 (±8.2) in male controls (P<.05). An association was also observed between sexual problems and poorer asthma control. CONCLUSIONS: Asthma is associated with a poorer sexual quality of life among patients. These results should arouse the interest of healthcare professionals in detecting and alleviating possible sexual limitations among their asthma patients in routine clinical practice.


Subject(s)
Asthma/epidemiology , Sexual Dysfunction, Physiological/epidemiology , Adult , Anxiety/epidemiology , Arousal , Asthma/etiology , Asthma/physiopathology , Asthma/psychology , Case-Control Studies , Comorbidity , Cross-Sectional Studies , Depression/epidemiology , Disease Progression , Erectile Dysfunction/epidemiology , Female , Humans , Male , Middle Aged , Physical Exertion , Quality of Life , Rhinitis/epidemiology , Severity of Illness Index , Sexual Dysfunction, Physiological/physiopathology , Smoking/epidemiology , Smoking/physiopathology , Spirometry
7.
Arch. bronconeumol. (Ed. impr.) ; 49(7): 289-296, jul. 2013. tab
Article in Spanish | IBECS | ID: ibc-114169

ABSTRACT

Introducción: Las guías clínicas de asma recomiendan la adopción de conductas de evitación alergénica. Para poder adoptarlas, los pacientes deben conocer las alergias que tienen. Sin embargo, este grado de conocimiento no ha sido hasta ahora evaluado. Los objetivos principales del estudio fueron determinar, en pacientes con asma alérgica: a) el grado de conocimiento de sus propias sensibilizaciones alérgicas; b) el porcentaje que conocen todas sus alergias y que, además, siguen normas de evitación alergénica (NEA) frente a todas ellas, y c) el eventual impacto de dicho grado de conocimiento sobre el nivel de control del asma. Pacientes y métodos: Estudio descriptivo, prospectivo y multicéntrico, con inclusión de 147 pacientes reclutados en 9 consultas externas de neumología. Tras verificar el diagnóstico previo de asma alérgica, se cumplimentó un cuestionario registrando los niveles de control y gravedad del asma, los resultados de los estudios de alergia previos, y la descripción y el número de sensibilizaciones alérgicas conocidas por el paciente y de NEA seguidas. Resultados: Tan solo 72 (49%) pacientes conocían todas sus sensibilizaciones alérgicas y únicamente 48 (33%) seguían, además, NEA frente a todos los alérgenos a los que eran alérgicos. No se demostró que existiera ninguna relación entre el grado de conocimiento de las propias sensibilizaciones alérgicas y el nivel de control del asma (p = 0,544). Conclusiones: El conocimiento global acerca de la naturaleza alérgica de su enfermedad, entre los pacientes asmáticos visitados en los servicios de neumología españoles, es insuficiente. Además, un adecuado conocimiento de las propias alergias no parece repercutir, por sí solo, en un mejor control del asma. Todo ello parece cuestionar la eficacia de las estrategias educativas actuales en este campo y, en consecuencia, estas deberían revisarse (AU)


Background: Asthma guidelines recommend the adoption of allergen avoidance measures (AAM). To do so, patients need to know their own allergies. However, this degree of knowledge has not yet been assessed. The aims of this study were to determine, in allergic asthma patients: (I) the degree of knowledge of their own allergic sensitizations; (II) the percentage of those who knew all their allergies and, in addition, adopted AAM against all of them, and (III) the possible impact of this degree of knowledge on the level of asthma control. Patients and methods: Descriptive, prospective and multicentre study, including 147 patients from 9 Respiratory Medicine outpatient clinics. After confirming the previous allergic asthma diagnosis, a questionnaire was completed. It included asthma control and severity levels, results of previous allergy tests, and the description and number of allergic sensitizations known by the patients and AAM followed. Results: Only 72 (49%) patients knew all their allergic sensitizations and only 48 (33%) were also following AAM against all the allergens to which they were allergic. No relationship was established between the degree of knowledge of their own allergies and the level of asthma control (P=0.544). Conclusions: Overall knowledge about the allergic nature of their disease among asthmatic patients attending Spanish Respiratory Medicine Departments is inadequate. Furthermore, a higher degree of knowledge of their allergies does not seem to lead, by itself, to better asthma control. Both findings seem to question the effectiveness of current educational strategies in this field and consequently, and they should be revised (AU)


Subject(s)
Humans , Male , Female , Allergens , Allergens/therapeutic use , Desensitization, Immunologic/instrumentation , Asthma/epidemiology , Asthma/immunology , Asthma/prevention & control , Skin Tests/instrumentation , Skin Tests/methods , Skin Tests , Environmental Pollution/prevention & control , Environmental Pollution/statistics & numerical data , Health Education/methods , Desensitization, Immunologic/methods , Desensitization, Immunologic , Health Education/trends , Health Education , Skin Tests/trends
8.
Arch Bronconeumol ; 49(7): 289-96, 2013 Jul.
Article in English, Spanish | MEDLINE | ID: mdl-23566766

ABSTRACT

BACKGROUND: Asthma guidelines recommend the adoption of allergen avoidance measures (AAM). To do so, patients need to know their own allergies. However, this degree of knowledge has not yet been assessed. The aims of this study were to determine, in allergic asthma patients: i)the degree of knowledge of their own allergic sensitizations; ii)the percentage of those who knew all their allergies and, in addition, adopted AAM against all of them, and iii)the possible impact of this degree of knowledge on the level of asthma control. PATIENTS AND METHODS: Descriptive, prospective and multicentre study, including 147patients from 9 Respiratory Medicine outpatient clinics. After confirming the previous allergic asthma diagnosis, a questionnaire was completed. It included asthma control and severity levels, results of previous allergy tests, and the description and number of allergic sensitizations known by the patients and AAM followed. RESULTS: Only 72 (49%) patients knew all their allergic sensitizations and only 48 (33%) were also following AAM against all the allergens to which they were allergic. No relationship was established between the degree of knowledge of their own allergies and the level of asthma control (P=.544). CONCLUSIONS: Overall knowledge about the allergic nature of their disease among asthmatic patients attending Spanish Respiratory Medicine Departments is inadequate. Furthermore, a higher degree of knowledge of their allergies does not seem to lead, by itself, to better asthma control. Both findings seem to question the effectiveness of current educational strategies in this field and consequently, they should be revised.


Subject(s)
Allergens/adverse effects , Asthma/psychology , Health Knowledge, Attitudes, Practice , Hypersensitivity/psychology , Outpatients/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Allergic Agents/therapeutic use , Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , Asthma/etiology , Asthma/prevention & control , Educational Status , Female , Humans , Hypersensitivity/complications , Male , Middle Aged , Outpatient Clinics, Hospital , Patient Education as Topic , Patient Medication Knowledge , Prospective Studies , Pulmonary Medicine , Spain , Surveys and Questionnaires , Young Adult
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