Nuestros investigadores

Félix Alegre Garrido

Publicaciones científicas más recientes (desde 2010)

Autores: Gouya, L., (Autor de correspondencia); Ventura, P.; Balwani, M. ; et al.
ISSN 0270-9139  Vol. 71  Nº 5  2020  págs. 1546 - 1558
Background and Aims Acute hepatic porphyria comprises a group of rare genetic diseases caused by mutations in genes involved in heme biosynthesis. Patients can experience acute neurovisceral attacks, debilitating chronic symptoms, and long-term complications. There is a lack of multinational, prospective data characterizing the disease and current treatment practices in severely affected patients. Approach and Results EXPLORE is a prospective, multinational, natural history study characterizing disease activity and clinical management in patients with acute hepatic porphyria who experience recurrent attacks. Eligible patients had a confirmed acute hepatic porphyria diagnosis and had experienced >= 3 attacks in the prior 12 months or were receiving prophylactic treatment. A total of 112 patients were enrolled and followed for at least 6 months. In the 12 months before the study, patients reported a median (range) of 6 (0-52) acute attacks, with 52 (46%) patients receiving hemin prophylaxis. Chronic symptoms were reported by 73 (65%) patients, with 52 (46%) patients experiencing these daily. During the study, 98 (88%) patients experienced a total of 483 attacks, 77% of which required treatment at a health care facility and/or hemin administration (median [range] annualized attack rate 2.0 [0.0-37.0]). Elevated levels of hepatic delta-aminolevulinic acid synthase 1 messenger ribonucleic acid levels, delta-aminolevulinic acid, and porphobilinogen compared with the upper limit of normal in healthy individuals were observed at baseline and increased further during attacks. Patients had impaired quality of life and increased health care utilization. Conclusions Patients experienced attacks often requiring treatment in a health care facility and/or with hemin, as well as chronic symptoms that adversely influenced day-to-day functioning. In this patient group, the high disease burden and diminished quality of life highlight the need for novel therapies.
Autores: Naik, H.; Desnick, R.; Gouya, L. ; et al.
ISSN 0028-3878  Vol. 92  Nº 15  2019 
Autores: Alegre, Félix; Rifón, José Juan; et al.
ISSN 1130-0108  Vol. 110  Nº 11  2018  págs. 734 - 736
We present the case of a liver transplant (LT) recipient donor who developed graft versus host disease (GVHD).The main features were cutaneous rash, diarrhea and pancytopenia. Mesenchymal cells were administered as part of the treatment. This is the first case of a patient with GVHD after LT reported to date. Despite the treatment, there was no improvement in aplasia or gastrointestinal symptoms and the patient died due to a disseminated infection.
Autores: Gouya, L. ; Bloomer, J.; Balwani, M. ; et al.
ISSN 0168-8278  Vol. 68  2018  págs. S80 - S81
Autores: Gouya, L.; Balwani, M.; Bissell, D. M.; et al.
ISSN 0168-8278  Vol. 68  2018  págs. S622 - S623
Autores: Gouya, L. ; Balwani, M. ; Bissell, D. M.; et al.
ISSN 0168-8278  Vol. 68  2018  págs. S622 - S622
Autores: Gouya, L. ; Bloomer, J. R. ; Balwani, M.; et al.
ISSN 1098-3015  Vol. 21  2018  págs. S125
Autores: Rosado, I. A.; Morales, María Isabel; et al.
ISSN 0269-4727  Vol. 42  Nº 5  2017  págs. 638 - 641
What is known and objectiveChylous ascites is a rare condition. The most frequent causes are lymphomas, solid malignancies, abdominal trauma and cirrhosis. Isolated case reports describe the relationship between calcium channel blockers (CCB) and chyloperitoneum. Lercanidipine is a third-generation dihydropyridine with low rate of adverse events. We describe a case of lercanidipine-induced chylous ascites. Case summaryAn 80-year-old white female with hypertension treated with lercanidipine, developed chylous ascites and abdominal pain after the dosage of the CCB was doubled. The initial suspicion was a hidden neoplasm, but after a thorough research, no apparent cause was detected and the symptoms resolved after the drug was suspended. What is new and conclusionCalcium channel blockers should be considered as possible causes in cases of chyloperitoneum of unknown aetiology.
Autores: Pérez, Alejandra; Landecho, Manuel Fortún; et al.
ISSN 1368-5031  Vol. 70  Nº 2  2016  págs. 147-155
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 threshold value, will have a low risk of death with a negative predictive value of 96%
Autores: Alegre, Félix; Huerta, Ana; Landecho, Manuel Fortún; et al.
ISSN 1590-8658  Vol. 48  Nº 2  2016  págs. 209 - 210
Autores: Anderson, K. E. ; Balwani, M.; Ventura, P. ; et al.
ISSN 0270-9139  Vol. 64  Nº Supl  2016  págs. 285A
Autores: Alegre, Félix; Landecho, Manuel Fortún; Huerta, Ana; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 10  Nº 6  2015  págs. e0130989
Background Application of illness-severity scores in Intermediate Care Units (ImCU) shows conflicting results. The aim of the study is to design a severity-of-illness score for patients admitted to an ImCU. Methods We performed a retrospective observational study in a single academic medical centre in Pamplona, Spain. Demographics, past medical history, reasons for admission, physiological parameters at admission and during the first 24 hours of ImCU stay, laboratory variables and survival to hospital discharge were recorded. Logistic regression analysis was performed to identify variables for mortality prediction. Results A total of 743 patients were included. The final multivariable model (derivation cohort = 554 patients) contained only 9 variables obtained at admission to the ImCU: previous length of stay 7 days (6 points), health-care related infection (11), metastatic cancer (9), immunosuppressive therapy (6), Glasgow comma scale 12 (10), need of non-invasive ventilation (14), platelets 50000/mcL (9), urea 0.6 g/L (10) and bilirubin 4 mg/dL (9). The ImCU severity score (ImCUSS) is generated by summing the individual point values, and the formula for determining the expected in-hospital mortality risk is: eImCUSS points*0.099 ¿ 4,111 / (1 + eImCUSS points*0.099 ¿ 4,111). The model showed adequate calibration and discrimination. Performance of ImCUSS (validation cohort = 189 patients) was comparable to that of SAPS II and 3. Hosmer-Lemeshow goodness-of-fit C test was ¿2 8.078 (p=0.326) and the area under receiver operating curve 0.802. Conclusions ImCUSS, specially designed for intermediate care, is based on easy to obtain variables at admission to ImCU. Additionally, it shows a notable performance in terms of calibration and mortality discrimination.
Autores: Martínez, Diego; Alegre, Félix; Carmona, Francisco de Asís; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 10  Nº 10  2015  págs. e0139702.
These results suggest that SAPS II and 3 should be customized with additional patient-risk factors to improve mortality prediction in patients undergoing NIV in intermediate car
Autores: Lucena, Juan Felipe; Huerta, Ana; Alegre, Félix; et al.
ISSN 1575-1813  Vol. 16  Nº 2  2015  págs. 163
Autores: Landecho, Manuel Fortún; Alegre, Félix; Lucena, Juan Felipe; et al.
ISSN 0887-8994  Vol. 51  Nº 3  2014  págs. e9-e10
Currently there is no strong evidence to recommend any determined trough plasma levels, and thus we wait for additional observations and clinical trials to clarify the optimal dosage required to avoid unnecessary side effects. Meanwhile, we have found a safe and acceptable response with plasma levels within the lower range of efficacy described.
Autores: Alegre, Félix; Herrero, José Ignacio; Iñarrairaegui, Mercedes; et al.
ISSN 1784-3227  Vol. 76  Nº 2  2013  págs. 246-50
Patients with heart failure have increased liver stiffness, that appears to be related with the severity of heart failure
Autores: Barbero, R.; Rodríguez, Carlos Manuel; Pérez-Vizcaíno, F.; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 8  Nº 1  2013  págs. e52683
Zolmitriptan reduces portal hypertension and non-selective beta-blockers can improve this effect. Combination therapy deserves consideration for patients with portal hypertension failing to respond to non-selective beta-blockers.
Autores: Pascual, Juan Ignacio; et al.
ISSN 0890-5096  Vol. 27  Nº 7  2013  págs. 974.e1 - 974.e6
In the last 20 years, endovascular procedures have radically altered the treatment of diseases of the aorta. The objective of endovascular treatment of dissections is to close the entry point to redirect blood flow toward the true lumen, thereby achieving thrombosis of the false lumen. In extensive chronic dissections that have evolved with the formation of a large aneurysm, the dissection is maintained from the end of the endoprosthesis due to multiple orifices, or reentries, that communicate with the lumens. In addition, one of the primary limitations of this technique is when the visceral arteries have disease involvement. In this report we present a case where, despite having treated the entire length of the descending thoracic aorta, the dissection was maintained distally, leading to progression of the diameter of the aneurysm. After reviewing the literature, and to the best of our knowledge, we describe the first case in which renal autotransplant was performed to allow for subsequent exclusion of the aorta at the thoracoabdominal level using a fenestrated endoprosthesis for the celiac trunk and the superior mesenteric artery.
Autores: Lucena, Juan Felipe; Alegre, Félix; Martínez, Diego; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 8  Nº 10  2013  págs. e77229
Objective: The efficacy and reliability of prognostic scores has been described extensively for intensive care, but their role for predicting mortality in intermediate care patients is uncertain. To provide more information in this field, we have analyzed the performance of the Simplified Acute Physiology Score (SAPS) II and SAPS 3 in a single center intermediate care unit (ImCU). Materials and Methods: Cohort study with prospectively collected data from all patients admitted to a single center ImCU in Pamplona, Spain, from April 2006 to April 2012. The SAPS II and SAPS 3 scores with respective predicted mortality rates were calculated according to standard coefficients. Discrimination was evaluated by calculating the area under receiver operating characteristic curve (AUROC) and calibration with the Hosmer-Lemeshow goodness of fit test. Standardized mortality ratios (SMR) with 95% confidence interval (95% CI) were calculated for each model. Results: The study included 607 patients. The observed in-hospital mortality was 20.1% resulting in a SMR of 0.87 (95% CI 0.73-1.04) for SAPS II and 0.56 (95% CI 0.47-0.67) for SAPS 3. Both scores showed acceptable discrimination, with an AUROC of 0.76 (95% CI 0.71-0.80) for SAPS II and 0.75 (95% CI 0.71- 0.80) for SAPS 3. Calibration curves showed similar performance based on Hosmer-Lemeshow goodness of fit C-test: (X2=12.9, p=0.113) for SAPS II and (X2=4.07, p=0.851) for SAPS 3. Conclusions: Although both scores overpredicted mortality, SAPS II showed better discrimination for patients admitted to ImCU in terms of SMR.
Autores: Lucena, Juan Felipe, (Autor de correspondencia); Alegre, Félix; Rodil, Raquel; et al.
ISSN 1553-5592  Vol. 7  Nº 5  2012  págs. 411 - 415
An ImCU led by hospitalists showed encouraging results regarding patient survival and SAPS II is an useful tool for prognostic evaluation in this population. Intermediate care serves as an expansion of role for hospitalists; and clinicians, trainees and patients may benefit from co-management and teaching opportunities at this unique level of care.
Autores: Herrero, José Ignacio; Pardo, Fernando; Rotellar, Fernando; et al.
Revista: Transplantation Proceedings
ISSN 0041-1345  Vol. 43  Nº 3  2011  págs. 690 - 691
Fewer than 25% of potential liver donors became effective donors leading us to conclude that adult living donor liver transplantation has a low applicability
Autores: Herrero, José Ignacio; Pardo, Fernando; D'Avola, Delia; et al.
Revista: Liver Transplantation
ISSN 1527-6465  Vol. 17  Nº 4  2011  págs. 402 - 408
Liver transplant recipients have an increased risk of malignancy. Smoking is related to some of the most frequent causes of posttransplant malignancy. The incidence and risk factors for the development of neoplasia related to smoking (head and neck, lung, esophageal, and kidney and urinary tract carcinomas) were studied in 339 liver transplant recipients. Risk factors for the development of smoking-related neoplasia were also studied in 135 patients who had a history of smoking so that it could be determined whether smoking withdrawal was associated with a lower risk of malignancy. After a mean follow-up of 7.5 years, 26 patients were diagnosed with 29 smoking-related malignancies. The 5- and 10-year actuarial rates were 5% and 13%, respectively. In multivariate analysis, smoking and older age were independently associated with a higher risk of malignancy. In the smoker subgroup, the variables related to a higher risk of malignancy were active smoking and older age. In conclusion, smoking withdrawal after liver transplantation may have a protective effect against the development of neoplasia
Autores: D'Avola, Delia; Iñarrairaegui, Mercedes; Pardo, Fernando; et al.
ISSN 1068-9265  Vol. 18  Nº 7  2011  págs. 1964 - 1971
Autores: Landecho, Manuel Fortún; Alegre, Félix; et al.
ISSN 0190-9622  Vol. 64  Nº 6  2011  págs. e121-1
Autores: Iñarrairaegui, Mercedes; Rodríguez-Fraile, M; et al.
Revista: International Journal of Radiation Oncology, Biology, Physics
ISSN 0360-3016  Vol. 77  Nº 5  2010  págs. 1441 - 1448
Autores: Alegre, Félix; Carlos, Silvia;
Libro:  Conceptos de salud pública y estrategias preventivas. Un manual para ciencias de la salud
2013  págs. 245 - 254
Autores: Alegre, Félix; Carlos, Silvia;
Título: Paludismo
Libro:  Compendio de salud pública
2011  págs. 307 - 312
Autores: Landecho, Manuel Fortún; Alegre, Félix; Bustos, César Egberto; et al.
Libro:  La clínica y el laboratorio: interpretación de análisis y pruebas
2010  págs. 33 - 104
Autores obra completa: Jesús M. Prieto Valtueña, José Ramón Yuste Ara. Cap. 2