Person: Tardaguila García, Aroa
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First Name
Aroa
Last Name
Tardaguila García
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Enfermería, Fisioterapia y Podología
Department
Enfermería
Area
Enfermería
Identifiers
11 results
Search Results
Now showing 1 - 10 of 11
Item Variables That Could Influence Healing Time in Patients with Diabetic Foot Osteomyelitis(Journal of Clinical Medicine, 2023) Tardaguila García, Aroa; Álvaro Afonso, Francisco Javier; García Madrid, Marta; López Moral, Mateo; Sanz Corbalán, Irene; Lázaro Martínez, José LuisAim: To compare the healing time in patients with diabetic foot osteomyelitis according to the presence or absence of clinical signs of infection, variation of blood parameters, the presence of different radiological signs, and the treatment received for the management of osteomyelitis. Methods: A prospective observational study was carried out in a specialised Diabetic Foot Unit between November 2014 and November 2018. A total of 116 patients with osteomyelitis were included in the study (treated by either a surgical or medical approach). During the baseline visit, we assessed the diagnosis of osteomyelitis, demographic characteristics and medical history, vascular and neurological examination, clinical signs of infection, increased blood parameters, radiological signs of osteomyelitis, and the treatment to manage osteomyelitis. We analysed the association between the presence of clinical signs of infection, variation of blood parameters, presence of radiological signs, and treatment received for management of osteomyelitis with the healing time. Results: The mean time to ulcer healing was 15.8 ± 9.7 weeks. Concerning healing times, we did not find an association with the presence of clinical signs of infection or with the increase in blood parameters, except in the case of eosinophils, which with higher values appear to increase the healing time (U = 66, z = −2.880, p = 0.004). Likewise, no relationship has been found between healing time and the appearance of the different radiological signs of osteomyelitis, nor depending on the treatment administered for the management of osteomyelitis. Conclusion: High levels of eosinophils are associated with a longer healing time of diabetic foot ulcers complicated with osteomyelitis, finding no other factors related to increased healing time.Item Correlation between Empirical Antibiotic Therapy and Bone Culture Results in Patients with Osteomyelitis(Adv Skin Wound Care, 2019) Tardaguila García, Aroa; Lázaro Martínez, José Luis; Sanz Corbalán, Irene; García Álvarez, Yolanda; Álvaro Afonso, Francisco Javier; García Morales, Esther AliciaObjective: To analyze the correlation between empirical antibiotic therapies prescribed in primary care centers by general practitioners and the microbiology results of bone culture in patients with diabetic foot-related osteomyelitis. Methods: This observational study involved 80 patients with diabetic foot ulcers and clinically suspected osteomyelitis. The patients were taking antibiotics prescribed by general practitioners to treat diabetic foot infections. Bone samples were taken from every patient for microbiology analysis in a specialized diabetic foot unit. Main outcome measure: The sensitivity of the bone cultures to antibiotics was compared with the patient's previous antibiotic therapy, and antibiotic and bacterial resistance were analyzed. Main results: The bone cultures from only 16 patients (22.3%) showed sensitivity to the antibiotics that the patient had been prescribed. Fifty-six patients (77.8%) displayed bacterial resistance to the antibiotic that they were taking. Conclusions: Awareness and implementation of international antibiotic stewardship guidelines are poor in primary care centers. It is important to establish strategies that foster a better understanding of treatment management standards and ensure the proper implementation of guidelines.Item A non‐invasive method for diagnosing plantar warts caused by human papillomavirus (HPV)(Journal of Medical Virology, 2021) García Oreja, Sara; Álvaro Afonso, Francisco Javier; Sevillano Fernández, David; Tardaguila García, Aroa; López Moral, Mateo; Lázaro Martínez, José LuisThe methods that are used for the diagnostic confirmation of human papillomavirus (HPV) include excisional biopsy and histopathological studies or polymerase chain reaction (PCR). They are invasive, laborious, and subject to ethical restrictions due to the benign nature of these warts. This study aims to analyse the accuracy of noninvasive swab samples to diagnose plantar warts. Fifty plantar warts were included in the study. Skin swabs and hyperkeratosis skin scales were collected from each wart. Multiplex PCR was performed to detect and type the HPVs. The prevalence of HPV in this study was 90% when the sample was obtained using the wart scraping method and 94% when it was obtained using swabs and the new method. In 45 of the 45 positive samples (sensitivity: 100%), the result between the wart scab and wart swab were almost identical. The genotyping result was identical in all 46 patients who had a positive result using both methods. The swab method appears to be a simple and accurate technique to diagnose plantar warts due to HPV. It is a noninvasive technique that could be performed even by inexperienced professionals and in patients with pain or a fear of needles.Item Complications associated with the approach to metatarsal head resection in diabetic foot osteomyelitis(International Wound Journal, 2018) Tardaguila García, Aroa; Sanz Corbalán, Irene; Molines Barroso, Raúl Juan; Álvaro Afonso, Francisco Javier; García Álvarez, Yolanda; Lázaro Martínez, José LuisThe aim of this study was to evaluate the recovery time and the development of complications in the dorsal and plantar approach to metatarsal head resections (MHR) in patients with diabetic foot ulcers complicated by osteomyelitis. A retrospective study was carried out involving 108 patients who underwent MHRs for the treatment of diabetic foot osteomyelitis. Two cohorts were defined: dorsal approach with incision closed with sutures and plantar approach with ulcer healed using conservative treatment. The main outcomes were the weeks until healing and complications related to the approaches. Fifty-three patients (49.1%) underwent a plantar approach and 55 (50.9%) a dorsal approach. Both approaches rendered similar healing times. However, the patients undergoing a dorsal approach developed more post-surgical complications than patients treated through a plantar approach. The dorsal approach intervention was performed on smaller and shallower ulcers; however, more complications developed at follow up using this approach than through a plantar approach for MHR complicated with osteomyelitis.Item Analysis of Plantar Pressure Pattern after Metatarsal Head Resection. Can Plantar Pressure Predict Diabetic Foot Reulceration?(Journal of Clinical Medicine, 2021) García Madrid, Marta; García Álvarez, Yolanda; Álvaro Afonso, Francisco Javier; García Morales, Esther Alicia; Tardaguila García, Aroa; Lázaro Martínez, José LuisTo evaluate the metatarsal head that was associated with the highest plantar pressure after metatarsal head resection (MHR) and the relations with reulceration at one year, a prospective was conducted with a total of sixty-five patients with diabetes who suffered from the first MHR and with an inactive ulcer at the moment of inclusion. Peak plantar pressure and pressure time integral were recorded at five specific locations in the forefoot: first, second, third, fourth, and fifth metatarsal heads. The highest value of the four remaining metatarsals was selected. After resection of the first metatarsal head, there is a displacement of the pressure beneath the second metatarsal head (p < 0.001). Following the resection of the minor metatarsal bones, there was a medial displacement of the plantar pressure. In this way, plantar pressure was displaced under the first metatarsal head following resection of the second or third head (p = 0.001) and under the central heads after resection of the fourth or fifth metatarsal head (p < 0.009 and p < 0.001 respectively). During the one-year follow-up, patients who underwent a metatarsal head resection in the first and second metatarsal heads suffered transfer lesion in the location with the highest pressure. Patients who underwent a minor metatarsal head resection (second–fifth metatarsal heads) showed a medial transference of pressure. Additionally, following the resection of the first metatarsal head there was a transference of pressure beneath the second metatarsal head. Increase of pressure was found to be a predictor of reulceration in cases of resection of the first and second metatarsal heads.Item Efficacy of cryotherapy for plantar warts: A systematic review and meta‐analysis(Dermatologic Therapy, 2022) García Oreja, Sara; Álvaro Afonso, Francisco Javier; Tardaguila García, Aroa; López Moral, Mateo; García Madrid, Marta; Lázaro Martínez, José LuisRecent systematic reviews of plantar warts continue to consider cryotherapy as one of the treatments of choice, but this method appears to have lower cure rates than alternative treatments. A systematic review using meta-analyses of the efficacy of cryotherapy in plantar warts treatment was performed. Systematic electronic searches were conducted. The primary endpoint was complete clearance of plantar warts. Risk-of-bias assessment was based on Cochrane Handbook recommendations. Meta-analyses used Review Manager v5.4.1 software. Cryotherapy appears to have lower cure rates than other treatments (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.12–0.78) with substantial heterogeneity (I2 = 80%). A second subgroup analysis had low heterogeneity (I2 = 28.2%). Subgroup analysis showed that plantar wart cure rates were significantly lower with cryotherapy compared to the physical treatment group (OR 0.05, 95% CI 0.01–0.49) with substantial heterogeneity (I2 = 79%), and antiviral, chemotherapy, and retinoid group (OR 0.30, 95% CI 0.14–0.66) without heterogeneity (I2 = 0%). Intralesional versus spray-on cryotherapy appears to be more effective (OR 0.21, 95% CI 0.09–0.48). No difference in efficacy between two rounds of 10-s and four rounds of 5-s freeze–thaw cycles in cryotherapy was found. Evidence of the superiority of antivirals and chemotherapy over cryotherapy in the treatment of plantar warts was found. However, no evidence supports the superiority or inferiority of cryotherapy compared to other treatments.Item Microbiological culture combined with PCR for the diagnosis of onychomycosis: Descriptive analysis of 121 patients(Mycoses, 2023) Navarro Pérez, David; García Oreja, Sara; Tardaguila García, Aroa; León Herce, Diego; Álvaro Afonso, Francisco Javier; Lázaro Martínez, José LuisBackground: Onychomycosis is the most common nail pathology, involving various pathogens such as dermatophytes, moulds and yeasts. Objective: The objective of this study was to observe the prevalence of onychomycosis, analyse the most appropriate diagnostic test, and assess the distribution of pathogens based on age, sex, quarter of the year, duration of symptoms and previous treatment. Methods: Retrospectively, mycological culture and PCR data and results were collected from 121 patients. Results: Of the 121 samples, 57% (69/121) tested positive when both microbiological study techniques were combined. The prevalence of onychomycosis was higher when PCR was performed (52.1%) compared to microbiological culture (33.1%). Among the 81 samples negative by microbiological culture, 31 were positive by PCR. Similarly, of the 58 samples negative by PCR, eight were positive by microbiological culture. Diagnostic accuracy data (with 95% confidence intervals) for PCR, using microbiological culture as the gold standard, were as follows: sensitivity of 0.8, specificity of 0.62, positive predictive value of 0.51 and negative predictive value of 0.86. The most frequently identified pathogen was Trichophyton rubrum, and the hallux nail plate was the most commonly affected location. However, no statistically significant associations were found between sex, age, quarter of the year and affected area with culture and PCR results. Conclusion: Combining microbiological culture and PCR can increase the detection rate of onychomycosis and help avoid false-negative results.Item Bacterial Diversity and Antibiotic Resistance in Patients with Diabetic Foot Osteomyelitis(Antibiotics, 2023) Álvaro Afonso, Francisco Javier; García Álvarez, Yolanda; Tardaguila García, Aroa; García Madrid, Marta; López Moral, Mateo; Lázaro Martínez, José LuisThis study analysed the bacterial diversity, antibiotic susceptibility, and resistance in patients with complications of diabetic foot osteomyelitis (DFO). A retrospective observational study was carried out between September 2019 and September 2022 and involved 215 outpatients with a diagnosis of DFO at a specialized diabetic foot unit. A total of 204 positive bone cultures were isolated, including 62.7% monomicrobial cultures, and 37.3% were formed with at least two microorganisms. We observed that Proteus spp., Coagulase-negative staphylococci (CoNS), Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Corynebacterium were the most frequently isolated microorganisms and accounted for more than 10% of the DFO cases. With stratification by Grampositive (GP) and Gram-negative (GN) bacteria, we observed that 91.6% of cultures presented at least one GP bacteria species, and 50.4% presented at least one GN bacteria species. The most common GP species were CoNS (29%), S. aureus (25.8%), and Corynebacterium spp. (14%). The most frequent GN species consisted of Proteus spp. (32%), P. aeruginosa (23.3%), and E. coli (17.5%). The main antibiotics with resistance to GP-dominated infections were penicillins without �-lactamase inhibitor, and those in GN-dominated infections were sulfonamides and penicillins without �-lactamase. Significant differences were not observed in mean healing time in DFU with acute osteomyelitis (12.76 weeks (4.50;18)) compared to chronic osteomyelitis (15.31 weeks (7;18.25); p = 0.101) and when comparing cases with soft tissue infection (15.95 (6;20)) and those without such an infection (16.59 (7.25;19.75), p = 0.618). This study shows that when treatment of DFO is based on early surgical treatment, the type of DFO and the presence of soft infection are not associated with different or worse prognoses.Item Inter‐observer reliability of the Onychomycosis Severity Index depending on clinical experience: A review of 50 cases(Mycoses, 2024) Navarro Pérez, David; García Oreja, Sara; Tardaguila García, Aroa; León Herce, Diego; Álvaro Afonso, Francisco Javier; Lázaro Martínez, José LuisBackground: Onychomycosis (ONM) is the most prevalent nail unit pathology, and its severity and monitoring are often based on the visual judgement of clinicians.Objective: The objective of this study is to assess the reliability of the Onychomycosis Severity Index (OSI) classification when utilized by three clinicians with varying lev-els of clinical experience: an experienced podiatrist (with 5 years of experience), a moderately experienced podiatrist (with 2 years of experience) and an inexperienced podiatrist (a recent graduate familiar with the OSI classification but lacking clinical experience). Additionally, we compared the severity assessments made through visual inspection with those determined using the OSI by different clinicians.Methods: We evaluated reliability using the intraclass correlation index (ICC), analys-ing 50 images of ONM.Results: The OSI demonstrated a very high level of reliability (ICC: 0.889) across cli-nicians, irrespective of their experience levels. Conversely, a statistically significant increase in severity was observed when comparing visual assessments with the OSI (p< .001) for ONM severity evaluation.Conclusion: The OSI proves to be a reproducible classification system, regardless of the clinical experience of the practitioner employing it.Item Metalloproteinases in chronic and acute wounds: A systematic review and meta-analysis(Wound repair and regeneration, 2019) Tardaguila García, Aroa; García Morales, Esther Alicia; García Alamino, Josep María; Álvaro Afonso, Francisco Javier; Molines Barroso, Raúl Juan; Lázaro Martínez, José LuisA systematic review and meta-analysis were undertaken in order to explore the influence of matrix metalloproteinases and their diagnostic methods in chronic and acute wounds. Searches were conducted in the PubMed (Medline) and Embase (Elsevier) databases from inception to late November 2017. We included clinical trials enrolling patients with cutaneous chronic and acute wounds where a validated diagnostic method was employed for metalloproteinases. We excluded in vitro, animal or preclinical studies, nonoriginal articles, and studies without available data for analysis. In addition, references of narrative and systematic reviews were scrutinized for additional articles. Eight studies met the inclusion criteria. Results revealed that the most frequently determined matrix metalloproteinases were MMP-2 and MMP-9, and were found in 54.5% of wounds. MMP-9 was present in more than 50% of the chronic wounds with a range from 37 to 78%. However, metalloproteinases were found in only 20% of acute wounds, and other types of metalloproteinases were also observed (MMP-2 and MMP-3). On the basis of the available evidence, high levels of metalloproteinases have been correlated with significantly delayed wound healing in wounds of a variety of etiologies.