Person:
Zamorano León, José Javier

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First Name
José Javier
Last Name
Zamorano León
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Salud Pública y Materno-Infantil
Area
Medicina Preventiva y Salud Pública
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Search Results

Now showing 1 - 10 of 46
  • Publication
    Use of Cardiac Procedures in People with Diabetes during the COVID Pandemic in Spain: Effects on the In-Hospital Mortality
    (MDPI, 2023-01-02) López de Andrés, Ana; Jiménez García, Rodrigo; Carabantes Alarcón, David; Hernández Barrera, Valentín; Miguel Yanes, José María de; Miguel Díez, Javier de; Zamorano León, José Javier; Barrio, Jose Luis del; Cuadrado Corrales, Natividad
    We aimed to assess the effect of the COVID-19 pandemic in Spain on people with diabetes undergoing cardiac procedures, such as coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), open surgical valve replacement (OSVR), and transcatheter valve implantation (TCVI). We compared the year 2019 with the year 2020. We conducted an observational study using data from the Spanish National Hospital Discharge Database from 1 January 2019 to 31 December 2020. In 2020, a total of 21,067 cardiac procedures were performed on people with diabetes compared with 24,675 in the previous year. The use of CABG, PCI, OSVR and TCVI decreased from 2019 to 2020 by 13.9%, 14.8%, 21.4% and 2.9%, respectively. In 2020, patients had a significantly higher mean Charlson Comorbidity Index than in 2019 for all the cardiac procedures analyzed. In-hospital mortality (IHM) was higher (p > 0.05) for all the procedures in the year 2020. Over the entire period, female sex was a significant risk factor for IHM among those who underwent CABG, PCI and OSVR (OR 1.94, 95%CI 1.41–2.66; OR 1.19, 95%CI 1.05–1.35; and OR 1.79, 95%CI 1.38–2.32, respectively). The sensitivity analysis including two more years, 2017 and 2018, confirmed that female patients and comorbidity were risk factors for IHM in patients with diabetes regardless of whether it was during the pandemic era or before. We conclude that the frequency of cardiac procedures among people with diabetes declined in 2020. IHM did not change significantly in the COVID-19 era.
  • Publication
    Physical activity among adults with chronic obstructive pulmonary disease in Spain (2014-2020): Temporal trends, sex differences, and associated factors
    (Elsevier, 2023-11-09) Llamas Saez, Carlos; Saez Vaquero, Teresa; Jiménez García, Rodrigo; López De Andrés, Ana Isabel; Carabantes Alarcón, David; Zamorano León, José Javier; Cuadrado Corrales, María Natividad; Omaña Palanco, Ricardo; Miguel Díez, Javier De; Pérez Farinós, José Napoleón
    Objectives: To evaluate trends in the prevalence of physical activity (PA) from 2014 to 2020; to identify sex differences and sociodemographic and health-related factors associated with PA in individuals with chronic obstructive pulmonary disease (COPD); and to compare PA between individuals with and without COPD. Methods: Cross-sectional and case-control study. Source: European Health Interview Surveys for Spain (EHISS) conducted in 2014 and 2020. We included sociodemographic and health-related covariates. We compared individuals with and without COPD after matching for age and sex. Results: The number of adults with COPD was 1086 and 910 in EHISS2014 and EHISS2020, respectively. In this population, self-reported “Medium or high frequency of PA” remained stable (42.9% in 2014 and 43.5% in 2020; p = 0.779). However, the percentage who walked on two or more days per week rose significantly over time (63.4%–69.9%; p = 0.004). Men with COPD reported more PA than women with COPD in both surveys. After matching, significantly lower levels of PA were recorded in COPD patients than in adults without COPD. Multivariable logistic regression confirmed this trend in COPD patients and showed that male sex, younger age, higher educational level, very good/good self-perceived health, and absence of comorbidities, obesity, and smoking were associated with more frequent PA. Conclusions: The temporal trend in PA among Spanish adults with COPD is favorable, although there is much room for improvement. Insufficient PA is more prevalent in these patients than in the general population. Sex differences were found, with significantly more frequent PA among males with COPD
  • Publication
    Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps
    (MPDI, 2021-08-27) Castillo Pardo de Vera, José Luis del; Navarro Cuéllar, Carlos; Navarro Cuéllar, Ignacio; Cebrián Carretero, José Luis; Bacián Martínez, Sandra; García Hidalgo Alonso, María Isabel; Sánchez Pérez, Arturo; Zamorano León, José Javier; López Farré, Antonio J.; Navarro Vila, Carlos
    Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (p < 0.05). The average time of surgery was 6.6 ± 0.14 h in patients reconstructed with OM, compared to the LD flap, which was 8.91 ± 0.32 h and the ALT flap with 7.53 ± 0.22 h (p < 0.05). A two-team approach was performed in all patients for OM flaps and ALT flaps, but only in two patients reconstructed with the LD flap (p < 0.001). In patients reconstructed with the OM flap, a very satisfactory or satisfactory result was reported in seven patients (77.8%). Eight patients reported a very unsatisfactory or unsatisfactory result with LD flap (80%) and 10 patients with ALT flap (90.9%) (p = 0.002). The mean hospital stay after surgery was not statistically significant (p > 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (p = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be considered for reconstruction of extensive scalp defects.
  • Publication
    Sex Differences in Temporal Trends in Hospitalizations and In-Hospital Mortality in Patients with Sarcoidosis in Spain from 2001 to 2020
    (MDPI, 2022-09-13) López Muñiz Ballesteros, Belén; Noriega, Concepción; López de Andrés, Ana; Jiménez García, Rodrigo; Zamorano León, José Javier; Carabantes Alarcón, David; Miguel Díez, Javier de
    (1) Background: We aimed to analyze temporal trends in hospitalization and in-hospital mortality (IHM) in patients with sarcoidosis in Spain from 2001–2020. (2) Methods: Using the Spanish National Hospital Discharge Database, we included patients (aged ≥ 20 years) hospitalized with a sarcoidosis code in any diagnostic field. (3) Results: We included 44,195 hospitalizations with sarcoidosis (56.34% women). The proportion of women decreased over time, from 58.76% in 2001 and 2002 to 52.85% in 2019 and 2020 (p < 0.001). The crude rates per 100,000 inhabitants increased by 4.02% per year among women and 5.88% among men. These increments were confirmed using Poisson regression analysis, which yielded an IRR of 1.03; 95% CI 1.01–1.04 for women and 1.04; 95% CI 1.02–1.06 for men. During the study period, no significant sex differences in IHM were recorded. Older age, COVID-19, respiratory failure, and the need for mechanical ventilation were independent predictors of IHM in men and women hospitalized with sarcoidosis, with IHM remaining stable over time. (4) Conclusions: The number of hospital admissions among patients with sarcoidosis in Spain increased threefold from 2001 to 2020. Although the incidence rates were higher in women, the trend followed that the incidence rates between sexes became closer. IHM was similar among men and women, with no significant change over time in either sex after multivariable analysis.
  • Publication
    Assessment of Quality of Life in Head-and-Neck Oncologic Patients with Intraoral Soft-Tissue Defects Reconstructed with Buccinator Myomucosal Flap
    (MDPI, 2022-12-15) Agea Martínez, Marc; Antúnez Conde, Raúl; Navarro Cuéllar, Carlos; Tousidonis Rial, Manuel Alejandro; Navarro Cuéllar, Ignacio; López López, Ana María; Gascón Alonso, Dafne; Sada Urmeneta, Ángela; Zamorano León, José Javier
    The aim of this study is to evaluate the functional outcomes and quality of life (QoL) in oncologic patients with intraoral defects reconstructed with the buccinator myomucosal flap. A retrospective study was performed involving 39 patients with intraoral soft-tissue defects, reconstructed with a buccinator myomucosal flap during a six-year period. Patients completed the European Organization for Research and Treatment of Cancer questionnaires, the standard questionnaire (QLQ-C30) and the head-and-neck specific module (QLQ-H&N35). Thirty-nine patients with a mean age of 61.23 ± 15.80 years were included in the study. Thirty-three patients were diagnosed with an oncological condition (84.61%). Six patients (15.38%) developed orosinusal communication and underwent extensive debridement. The median global-health-status score was 79.27 and emotional performance was the lowest scoring, with a mean score of 76.93. As for the symptom items, the most outstanding were dental problems (33.33), oral opening (31.62) and dry mouth (37.61), followed by sticky saliva (24.79), problems with social eating (21.15) and pain (19.87). The most significant symptoms were radiotherapy-related adverse effects such as pain, fatigue, dental problems and dry mouth. Patients reconstructed with the buccinator myomucosal flap develop a good quality of life for all types of activities, and a correct function and aesthetics. Postoperative radiotherapy is associated with a poorer quality of life, and can lead to impairment of several symptoms such as swallowing, oral opening and dry mouth.
  • Publication
    Trends in asthma hospitalizations among adults in Spain: Analysis of hospital discharge data from 2011 to 2020
    (Elsevier, 2022-10-12) Caballlero Segura, Francisco; López de Andrés, Ana; Jiménez García, Rodrigo; Miguel Yanes, José María de; Hernández Barrera, Valentín; Carabantes Alarcón, David; Zamorano León, José Javier; Miguel Díez, Javier de
    Aims: To analyze trends in asthma hospitalizations in patients over 15 years of age in Spain. To identify possible changes in incidence, demographic characteristics, clinical conditions, and outcomes. Methods: We conducted an observational retrospective epidemiological study using the Spanish National Hospital Discharge Database and included all patients hospitalized with a diagnosis of asthma from 2011 to 2020. Results: A total of 1,102,923 patients were hospitalized with a code for asthma in any diagnostic position; of these, 153,749 (13.94%) had asthma coded as the primary diagnosis (asthma exacerbation). The number of patients with an asthma exacerbation decreased over time, from 15,356 in 2011 to 8804 in 2020. In-hospital mortality (IHM) remained low (around 1.5%) and stable in this subgroup of patients. When the diagnosis of asthma appeared in any diagnostic position, hospitalizations increased for all ages and sexes. In this case, a significant change was observed for IHM, which increased from 3.27% in 2011–12 to 4.36% in 2019–20 (p < 0.001). The main risk factors for IHM in both cases were age over 65 years, need for mechanical ventilation, and associated diagnoses of pneumonia, heart disease, or atrial fibrillation. In contrast, obesity was a predictor of lower mortality. Conclusion: Our results suggest a decline in the incidence of hospitalizations for asthma exacerbations from 2011 to 2020. In contrast, the number of patients with asthma in any diagnostic position increased progressively, as did mortality, probably owing to an increase in comorbidities in a gradually ageing population.
  • Publication
    Sex-Related Disparities in the Incidence and Outcomes of Community-Acquired Pneumonia among Type 2 Diabetes Patients: A Propensity Score-Matching Analysis Using the Spanish National Hospital Discharge Database for the Period 2016–2019
    (MPDI, 2021-09-02) López de Andrés, Ana; Jiménez García, Rodrigo; Hernández Barrera, Valentín; Miguel Díez, Javier de; Miguel Yanes, José María de; Carabantes Alarcón, David; Zamorano León, José Javier; Sanz Rojo, Sara; López Herranz, Marta
    (1) Background: To analyze incidence, clinical characteristics, procedures, and in-hospital outcomes among patients hospitalized with community-acquired pneumonia (CAP) according to the presence of T2DM in Spain (2016–2019) and to assess the role of gender among those with T2DM. (2) Methods: Using the Spanish National Hospital Discharge Database, we estimated hospitalized CAP incidence. Propensity score matching was used to compare population subgroups. (3) Results: CAP was coded in 520,723 patients, of whom 140,410 (26.96%) had T2DM. The hospitalized CAP incidence was higher in patients with T2DM (both sexes) (IRR 4.25; 95% CI 4.23–4.28). The hospitalized CAP incidence was higher in men with T2DM than in women with T2DM (IRR 1.46; 95% CI 1.45–1.47). The hospitalized CAP incidence among T2DM patients increased over time; however, the in-hospital mortality (IHM) decreased between 2016 and 2019. IHM was higher among non-T2DM men and women than matched T2DM men and women (14.23% and 14.22% vs. 12.13% and 12.91%; all p < 0.001, respectively), After adjusting for confounders, men with T2DM had a 6% higher mortality risk than women (OR 1.06; 95% CI 1.02–1.1). (4) Conclusions: T2DM is associated with a higher hospitalized CAP incidence and is increasing overtime. Patients hospitalized with CAP and T2DM have lower IHM. Male sex is a significant risk factor for mortality after CAP among T2DM patients.
  • Publication
    Desarrollo de algoritmos predictivos por inteligencia artificial (Deep-learning) para asegurar el éxito del alumno
    (2021-04) López Farré, Antonio José; García Fernández, Miguel Ángel; Collado Yurrita, Luis Rodolfo; Álvarez-Salas Walther, Luis Antonio; Zamorano León, José Javier; Calle Purón, María Elisa; Giner Nogueras, Manuel; Lahera Juliá, Vicente; Hidalgo Pérez, José Ignacio; Gómez García, María Victoria; Fernández López, María Josefa; Serrano Ruiz Calderón, Rocío Milagros; Hernández Artiles, Marta; Hernández Ramón, Silvia; Freixer Ballesteros, Gala; Zekri, Khaoula; Larrea Cruz, María Begoña
    Breve descripción La adaptación de los planes de estudio a la normativa y a los criterios propuestos por el Espacio Europeo de Educación Superior (EEES) ha conllevado un importante reto de innovación pedagógica, y cambios significativos en el proceso enseñanza-aprendizaje. El sistema universitario español acumula ya una trayectoria y un bagaje importante de experiencias, buenas prácticas e innovaciones que se han ido encaminando hacia la continua mejora de la calidad de la formación ofertada. El proceso de cambio en el que está inmersa hoy en día la Educación Superior demanda nuevos sistemas y procedimientos de enseñanza y evaluación. Dos de los cambios derivados de la implantación del EEES son la elaboración de los plantes de estudio por competencias generales, transversales y específicas, y el diseño de herramientas e iniciativas de mejora de la calidad de los programas formativos, entre otros aspectos. En el contexto anterior, en el presente proyecto se han aplicado una serie de herramientas tecnológicas con el objetivo de mejorar la actividad docente que pretenden implantarse de forma transversal entre asignaturas del grado de Nutrición y Dietética Humana de la Facultad de Medicina de la Universidad Complutense. Además, esta novedosa iniciativa podría utilizarse en cualquier asignatura de cualquier grado de cualquier Facultad de la Universidad Complutense o incluso de otras Universidades. En concreto, el proyecto identifica al comienzo del curso académico a aquellos/as alumnos/as que tendrán dificultades para superar diferentes asignaturas del grado de Nutrición y Dietética Humana, para que el profesorado tome diferentes medidas docentes preventivas desde el mismo comienzo del curso académico. La identificación de estos alumnos al comienzo del curso académico se realizó mediante técnicas de inteligencia artificial para generar un algoritmo de predicción autoalimentado, considerando fundamentalmente una serie de parámetros académicos de los alumnos/as. El proyecto busca reforzar el aprendizaje de los/as alumnos/as que presenten dificultades en superar una asignatura. Esta iniciativa Innova-Docencia es una propuesta innovadora, que conlleva la realización de una actividad común en el que han intervenido personal PDI, PAS y estudiantes.
  • Publication
    Desarrollo de recursos educativos y de un ecosistema de colaboración para la enseñanza de la Epidemiología y Salud Pública
    (2022-06-29) López de Andrés, Ana; Albaladejo Vicente, Romana; Cuadrado Pérez, María Luz; Elvira Martínez, Carlos María; Hernandez Jiménez,, José Antonio; Hoyos Miller, Juan Eduardo; Jiménez García, Rodrigo; Jiménez Trujillo, Isabel; Lopez de la Horra, Pablo; López Herranz, Marta; Miguel Díez, Javier de; Villanueva Orbáiz, María Rosa Rita; Zamorano León, José Javier; Jiménez Sierra, Lucía
  • Publication
    Trends in prevalence and the effects on hospital outcomes of dementia in patients hospitalized with acute COPD exacerbation
    (Elsevier, 2023) de Miguel Díez, Javier; López de Andrés, Ana; Jiménez García, Rodrigo; Hernández Barrera, Valentín; Carabantes Alarcón, David; Zamorano León, José Javier; Omaña Palanco, Ricardo; Gonzalez Barcala, Francisco; Cuadrado Corrales, Natividad
    Aims: To assess changes in prevalence and the effects on hospital outcomes of dementia among patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AE-COPD); and to evaluate sexdifferences, as well as the impact of COVID-19 pandemic in this relationship. Methods: We used a nationwide discharge database to select patients admitted with AE-COPD in Spain from 2011 to 2020. We identified those with any type of dementia, vascular dementia (VaD) or Alzheimer’s disease (AD). Results: We identified 658,429 hospitalizations with AE-COPD (4.45% had any type of dementia, 0.79% VaD and 1.57% AD). The presence of any type of dementia remained stable from 2011 to 2015, and increased significantly between 2016 and 2020. For VaD, the time trend showed no change until 2020, when a significant increment was found. The probability of AD decreased significantly overtime. The in-hospital mortality (IHM) among patients with any type of dementia remained stable overtime until 2020, when it increased significantly. Older age, higher comorbidity, COVID-19, and use of mechanical ventilation were variables associated to IHM. Women had lower risk of dying in the hospital than men in all subgroups. Conclusions: After a previous period of stability, the prevalence of any type of dementia increased over the last 5 years of the study, although we identified different trends depending on the specific cause of dementia. The IHM remained stable overtime until 2020, when it increased, probably related to the COVID-19 pandemic. It is remarkable the protective effect of female sex for IHM.