Person:
Fernández Pérez, Cristina

First Name

Cristina

Last Name

Fernández Pérez

URI

https://hdl.handle.net/20.500.14352/77390

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Enfermería, Fisioterapia y Podología

Department

Enfermería

Area

Enfermería

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Now showing 1 - 10 of 21

Measuring intraocular pressure after intrastromal corneal ring segment implantation with rebound tonometry and Goldmann applanation tonometry
(Cornea, 2015) Arribas Pardo, Paula; Méndez Hernández, Carmen D.; Cuiña Sardiña, Ricardo; Fernández Pérez, Cristina
Purpose: The aim of this study was to compare intraocular pressure (IOP) measurements in patients with ectatic corneas after intrastromal corneal ring segment (ICRS) implantation using the Rebound tonometers (RBTs) Icare and Icare Pro, compared with Goldmann applanation tonometry (GAT) and to assess the influence of central corneal thickness (CCT), corneal curvature (CC), and corneal astigmatism (CA) on IOP. Methods: This prospective cross-sectional study consecutively included 60 eyes of 60 patients with corneal ectasia having ICRS for at least 6 months from January 2011 to December 2013. All subjects underwent GAT, Icare, and Icare Pro IOP measurements in a random order, and CCT, CC, and CA evaluation using a Pentacam. The Bland–Altman method and multivariate regression analysis logistic method were used to assess intertonometer agreement and the influence of corneal variables on IOP measurements. Results: Icare significantly underestimated IOP compared with GAT [GAT - Icare 1.2 ± 3.0 mm Hg, P = 0.002 (95% confidence interval, 0.5–2.0)], whereas Icare Pro showed no statistical differences compared with GAT [GAT - Icare Pro 0.1 ± 3.1 mm Hg, P = 0.853 (95% confidence interval, -0.7 to 0.9)]. Both RBTs presented good concordance with GAT (intraclass coefficient correlation > 0.6). All tonometer measurements were influenced by CCT values and age (P < 0.05); the number of ICRS implanted did not influenced IOP measurement with any of the 3 tonometers. Conclusions: Both RBTs could be an alternative to GAT in patients with corneal ectasia and ICRS; however, Icare Pro shows greater accuracy.
Risk score for cardiac surgery in active left-sided infective endocarditis
(Risk score for cardiac surgery in active left-sided infective endocarditis, 2017) Olmos, Carmen; Maroto, Luis; Maroto Castellanos, Luis Carlos; Fernández Pérez, Cristina; Vivas Balcones, Luis David; San Román, José Alberto
Estudio que calcula una escala de riesgo de mortalidad hospitalaria de los pacientes con endocarditis infecciosa a través de la valoración de una cohorte de 1.299 pacientes. A través de las variables edad, situación hemodinámica, insuficiencia renal, microorganismo responsable, complicaciones perianulares o sepsis se puede predecir la probabilidad de muerte hospitalaria ante un paciente ingresado con endocarditis infecciosa. Objective To develop and validate a calculator to predict the risk of in-hospital mortality in patients with active infective endocarditis (IE) undergoing cardiac surgery. Methods Thousand two hundred and ninety-nine consecutive patients with IE were prospectively recruited (1996-2014) and retrospectively analysed. Left-sided patients who underwent cardiac surgery (n=671) form our study population and were randomised into development (n=424) and validation (n=247) samples. Variables statistically significant to predict in-mortality were integrated in a multivariable prediction model, the Risk-Endocarditis Score (RISK-E). The predictive performance of the score and four existing surgical scores (European System for Cardiac Operative Risk Evaluation (EuroSCORE) I and II), Prosthesis, Age ≥70, Large Intracardiac Destruction, Staphylococcus, Urgent Surgery, Sex (Female) (PALSUSE), EuroSCORE ≥10) and Society of Thoracic Surgeons's Infective endocarditis score (STS-IE)) were assessed and compared in our cohort. Finally, an external validation of the RISK-E in a separate population was done. Results Variables included in the final model were age, prosthetic infection, periannular complications, Staphylococcus aureus or fungi infection, acute renal failure, septic shock, cardiogenic shock and thrombocytopaenia. Area under the receiver operating characteristic curve in the validation sample was 0.82 (95% CI 0.75 to 0.88). The accuracy of the other surgical scores when compared with the RISK-E was inferior (p=0.010). Our score also obtained a good predictive performance, area under the curve 0.76 (95% CI 0.64 to 0.88), in the external validation. Conclusions IE-specific factors (microorganisms, periannular complications and sepsis) beside classical variables in heart surgery (age, haemodynamic condition and renal failure) independently predicted perioperative mortality in IE. The RISK-E had better ability to predict surgical mortality in patients with IE when compared with other surgical scores.
Impact of Heart Failure on In-Hospital Outcomes after Surgical Femoral Neck Fracture Treatment
(Journal of Clinical Medicine, 2021) Marco Martínez, Javier; Bernal Sobrino, José Luis; Fernández Pérez, Cristina; Elola Somoza, Francisco Javier; Azaña Gómez, Javier; García Klepizg, José Luis; Andrès, Emmanuel; Zapatero Gaviria, Antonio; Barba Martín, Raquel; Marco Martínez, Fernando; Canora Lebrato, Jesus; Lorenzo Villalba, Noel; Méndez Bailón, Manuel
Background: Femoral neck fracture (FNF) is a common condition with a rising incidence, partly due to aging of the population. It is recommended that FNF should be treated at the earliest opportunity, during daytime hours, including weekends. However, early surgery shortens the available time for preoperative medical examination. Cardiac evaluation is critical for good surgical outcomes as most of these patients are older and frail with other comorbid conditions, such as heart failure. The aim of this study was to determine the impact of heart failure on in-hospital outcomes after surgical femoral neck fracture treatment. Methods: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2007–2015. We included patients older than 64 years treated for reduction and internal fixation of FNF. Demographic characteristics of patients, as well as administrative variables, related to patient’s diseases and procedures performed during the episode were evaluated. Results: A total of 234,159 episodes with FNF reduction and internal fixation were identified from Spanish National Health System hospitals during the study period; 986 (0.42%) episodes were excluded, resulting in a final study population of 233,173 episodes. Mean age was 83.7 (±7) years and 179,949 (77.2%) were women (p < 0.001). In the sample, 13,417 (5.8%) episodes had a main or secondary diagnosis of heart failure (HF) (p < 0.001). HF patients had a mean age of 86.1 (±6.3) years, significantly older than the rest (p < 0.001). All the major complications studied showed a higher incidence in patients with HF (p < 0.001). Unadjusted in-hospital mortality was 4.1%, which was significantly higher in patients with HF (18.2%) compared to those without HF (3.3%) (p < 0.001). The average length of stay (LOS) was 11.9 (±9.1) and was also significantly higher in the group with HF (16.5 ± 13.1 vs. 11.6 ± 8.7; p < 0.001). Conclusions: Patients with HF undergoing FNF surgery have longer length of stay and higher rates of both major complications and mortality than those without HF. Although their average length of stay has decreased in the last few years, their mortality rate has remained unchanged.
Letter in response to article in journal of infection: “High SARS-CoV-2 antibody prevalence among healthcare workers exposed to COVID-19 patients”
(Journal of infection, 2020) Arriola Villalobos, Pedro; Fernández Pérez, Cristina; Ariño Gutiérrez, Mayte; Fernández Vigo, José Ignacio; Benito Pascual, Blanca; Cabello Clotet, Noemí; Mayol Martínez, Julio; Gegúndez Fernández, José Antonio; Díaz Valle, David; Benítez del Castillo, José Manuel; García Feijoo, Julián
Procalcitonina es superior a recuento linfocitario, índice neutrófilo/linfocito y proteína C reactiva para la predicción de mortalidad a 30 días de pacientes con COVID-19 en el servicio de urgencias
(Emergencias, 2021) López Ayala, Pedro; Alcaraz Serna, Ana; Valls Carbó, Adrián; Torrejón Martínez, María José; López Picado, Amanda; Martínez Valero, Carmen; Miranda, Juande D.; Cozar López, Gabriel; Suárez Cadenas, María del Mar; Jerez Fernández, Pablo; Angós, Beatriz; Rodríguez Adrada, Esther; Cardassay, Eduardo; Toro, Enrique del; Cuadrado Cenzual, María Ángeles; Díaz Del Arco, Cristina; Chaparro, David; Montalvo Moraleda, María Teresa; Espejo Paeres, Carolina; García Briñón, Miguel Ángel; Hernández Martín-Romo, Víctor; Ortega, Luis; Fernández Pérez, Cristina; Martínez Novillo, Mercedes; González Armengol, Juan Jorge; González del Castillo, Juan; Mueller, Christian E.; Martín Sánchez, Francisco Javier
Introducción. Existen múltiples variables demográficas y clínicas predictivas demortalidadenpacientes con COVID-19. Sin embargo, hay menos información sobre el valor pronóstico de los biomarcadores inflamatorios. Métodos. Estudio de cohorte retrospectivo. Se incluyeron de forma consecutiva todos los pacientes con COVID-19, confirmado por laboratorio, atendidos en un servicio de urgencias hospitalario (SUH) y con valor basal de los siguientes biomarcadores: recuento linfocitario, índice neutrófilo/linfocito (INL), proteína C reactiva (PCR) y procalcitonina (PCT). La relación entre los biomarcadores y la mortalidad total a 30 días se analizó mediante una regresión de Cox y gráficos de dosis-respuesta. Resultados. Se incluyeron 896 pacientes, 151 (17%) fallecieron en los primeros30 días. La mediana de edad fue de 63 años (51-78) y 494 (55%) eran hombres. El valor de INL, PCR y PCT fue mayor, mientras que el recuento linfocitario fue menor, en los pacientes que fallecieron respecto a los que sobrevivieron (p < 0,001). La PCT fue superior al recuento linfocitario, INL y PCR en la predicción de mortalidad a 30 días (ABC 0,79 [IC 95%: 0,75-0,83] vs 0,70 [IC 95%: 0,65-0,74], p<0,001; 0,74 [IC 95%: 0,69-0,78], p=0,03; y 0,72 [IC 95%: 0,68-0,76], p<0,001). Los puntos de decisión de PCT propuestos, 0,06 ng/l para exclusión y 0,72 ng/l para inclusión de muerte a 30 días, podrían facilitar la toma de decisiones en urgencias. Hubo 357 pacientes (40%) con valores de PCT en estas categorías. El análisis multivariable mostró una mayor asociación con la mortalidad para PCT que en los otros biomarcadores estudiados. Conclusión. PCT es el biomarcador con mejor capacidad para predecir mortalidad a 30 días por cualquier causa en pacientes con COVID-19 valorados en un SUH.
Hepatosplenic and renal embolisms in infective endocarditis
(Revista Espanola de Cardiologia, 2004) Luaces Méndez, María; Vilacosta, Isidre; Sarriá, Cristina; Fernández Pérez, Cristina; San Román, José; Sanmartín, Juan; López, Javier; Rodríguez, Enrique
Introduction and objectives: Among the complications of infective endocarditis, systemic embolisms are an ominous prognostic sign. The aim of the present study was to compare the demographic, clinical, microbiologic and echocardiographic features of episodes of endocarditis accompanied and unaccompanied by embolisms in the spleen, kidney or liver. We also assessed the prognostic impact of these embolisms. Material and method: Prospective, multicenter clinical cohort study. We analyzed 338 consecutive episodes of left-sided infective endocarditis in 308 patients. Episodes were classified in two groups: group I, episodes with hepatosplenic or renal embolisms (n=34); group II, episodes without embolisms (n=304). Results: There were 41 embolisms in 34 episodes (10%). Of these, 34 were located in the spleen, 5 in the kidney and 2 in the liver. Some forms of clinical presentation predominated in group I, e.g., abdominal pain, splenomegaly, cutaneous stigmata, hematuria, embolisms in other locations, and septic shock. Staphylococcus aureus and enterococci were more commonly isolated in group I. Detection of vegetations (by transesophageal echocardiography) was more frequent in group I, and they were larger than vegetations in group II. Hepatosplenic and renal embolisms were not independently associated with the need for cardiac surgery or death. Conclusions: Hepatosplenic and renal embolisms occur in 10% of left-sided episodes of infective endocarditis. The clinical presentation of these episodes has characteristic features. Vegetations are larger than in episodes without these embolism. Hepatosplenic and renal embolisms do not increase neither the need of cardiac surgery nor the risk of death.
Effects of Implantable Collamer Lens V4c Placement on Iridocorneal Angle Measurements by Fourier-Domain Optical Coherence Tomography
(American Journal of Ophthalmology, 2016) Fernández-Vigo, José Ignacio; Macarro Merino, Ana; Fernández-Vigo Escribano, Cristina; Fernández-Vigo, José Ángel; Martínez De La Casa Fernández-Borrella, José María; Fernández Pérez, Cristina; García Feijoo, Julián
Purpose To assess by Fourier-domain optical coherence tomography (FDOCT) changes produced in iridocorneal angle measurements in patients undergoing Visian Implantable Collamer Lens (ICL) V4c (STAAR Surgical AG) placement. Design Prospective interventional case series. Methods In 50 eyes of 25 myopic subjects consecutively scheduled for ICL implant, FDOCT (RTVue; Optovue Inc) iridocorneal angle measurements were made before and 1 and 3 months after surgery. Trabecular-iris angle (TIA) and angle opening distance 500 μm anterior to the scleral spur (AOD500) were compared among the quadrants nasal, temporal, and inferior, and correlations with ocular variables including lens vault were examined. Results Preoperative TIA was 48.7 ± 8.7, 48.2 ± 8.7, and 48.7 ± 9.3 degrees for the nasal, temporal, and inferior quadrants, with no differences (P= 1.000). Following ICL implant, corresponding values fell to 31.2 ± 11.5, 30.0 ± 10.7, and 29.7 ± 8.1 degrees at 1 month postsurgery, indicating angle narrowing of 34%-42%, and to 30.6 ± 12.3, 30.1 ± 11.9, and 29.8 ± 12.3 degrees, respectively, at 3 months postsurgery. Angle measurements failed to vary between 1 month and 3 months postsurgery (P= .481). In 8 eyes, iridotrabecular contact attributable to surgery was observed. One month after surgery, vault measurements correlated with TIA (R = -.309;P= .048). Six variables were identified as predictors of TIA at 1 month postsurgery (R2= .907). Conclusions Although considerable angle narrowing was detected 1 month after ICL V4c implant, this narrowing remained stable at 3 months postsurgery. Factors predictive of TIA could serve to identify suitable candidates for ICL placement.
Agreement and clinical comparison between a new swept-source optical coherence tomography-based optical biometer and an optical low-coherence reflectometry biometer
(Eye, 2017) Arriola Villalobos, Pedro; Almendral Gómez, Jaime; Garzón Jiménez, Nuria; Ruiz Medrano, Jorge; Fernández Pérez, Cristina; Martínez De La Casa Fernández-Borrella, José María; Díaz Valle, David
Purpose To compare measurements taken using a swept-source optical coherence tomography-based optical biometer (IOLmaster 700) and an optical low-coherence reflectometry biometer (Lenstar 900), and to determine the clinical impacts of differences in their measurements on intraocular lens (IOL) power predictions. Methods Eighty eyes of 80 patients scheduled to undergo cataract surgery were examined with both biometers. The measurements made using each device were axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW), and pupil diameter (PD). Holladay 2 and SRK/T formulas were used to calculate IOL power. Differences in measurement between the two biometers were determined using the paired t-test. Agreement was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. Results Mean patient age was 76.3±6.8 years (range 59-89). Using the Lenstar, AL and PD could not be measured in 12.5 and 5.25% of eyes, respectively, while IOLMaster 700 took all measurements in all eyes. The variables CCT, AQD, LT, and MK varied significantly between the two biometers. According to ICCs, correlation between measurements made with both devices was excellent except for WTW and PD. Using the SRK/T formula, IOL power prediction based on the data from the two devices were statistically different, but differences were not clinically significant. Conclusions No clinically relevant differences were detected between the biometers in terms of their measurements and IOL power predictions. Using the IOLMaster 700, it was easier to obtain biometric measurements in eyes with less transparent ocular media or longer AL.
Fourier domain optical coherence tomography to assess the iridocorneal angle and correlation study in a large Caucasian population
(BMC Ophthalmology, 2016) Fernández Vigo, José Ignacio; García Feijoo, Julián; Martínez De La Casa Fernández-Borrella, José María; García Bella, Javier; Arriola Villalobos, Pedro; Fernández Pérez, Cristina; Fernández Vigo, José Ángel
Background: Recently, novel anatomic parameters that can be measured by optical coherence tomography (OCT), have been identified as a more objective and accurate method of defining the iridocorneal angle. The aim of the present study is to measure the iridocorneal angle by Fourier domain (FD) OCT and to identify correlations between angle measurements and subject factors in a large healthy Caucasian population. Methods: A cross sectional study was performed in 989 left eyes of 989 healthy subjects. The iridocorneal angle measurements: trabecular-iris angle (TIA), angle opening distance (AOD500) and trabecular-iris space area (TISA500) 500 μm from the scleral spur, were made using the FD-OCT RTVue®. Iris thickness was also measured. Correlations were examined between angle measurements and demographic and ocular factors. The main determinants of angle width were identified by multivariate linear regression. Results: TIA could be measured in 94 % of the eyes, and AOD500 and TISA500 in 92 %. The means recorded were TIA 35.8 ± 12.2 degrees (range 1.5 to 76.1), AOD500 542.6 ± 285.4 μm (range 15 to 1755), and TISA500 0.195 ± 0.104 mm2 (range 0.02 to 0.62). The correlation between the temporal and nasal quadrant was R = 0.902 for TIA. The reproducibility of measurements was excellent (intraclass correlation coefficient >0.947). Mean angle width measurements were smaller in women (p = 0.02). Correlation was detected between angle means and anterior chamber volume (ACV; R = 0.848), anterior chamber depth (ACD; R = 0.818), spherical error (R = -0.619) and age (R = -0.487), while no correlation was observed with Intraocular pressure (R = -0.052). ACV emerged as the main determinant of TIA (R2 = 0.705; p < 0.001). Conclusions: In this Caucasian population, strong correlation was detected between FD-OCT anterior angle measurements and ACV, ACD, spherical refractive error and sex, emerging the ACV as the main determinant of TIA.
Glaukos iStent inject® Trabecular Micro-Bypass Implantation Associated with Cataract Surgery in Patients with Coexisting Cataract and Open-Angle Glaucoma or Ocular Hypertension: A Long-Term Study
(Journal of Ophthalmology, 2016) Arriola Villalobos, Pedro; Martínez De La Casa Fernández-Borrella, José María; Díaz Valle, David; Morales Fernández, Laura; Fernández Pérez, Cristina; García Feijoo, Julián
Purpose. To evaluate the long-term efficacy and safety of the iStent inject device (Glaukos Corporation, Laguna Hills, CA) combined with phacoemulsification in patients with coexistent cataract and open-angle glaucoma or ocular hypertension (OHT). Methods. A prospective, uncontrolled, nonrandomized, interventional case series study was conducted in patients with both mild or moderate open-angle glaucoma or OHT and cataract. Patients underwent cataract surgery along with the implant of two iStent inject devices. Outcome measures were intraocular pressure (IOP), topical hypotensive medications required, and best-corrected visual acuity (BCVA). Results. 20 patients were enrolled. Mean follow-up was months. Mean baseline IOP was mmHg with medication and mmHg after washout. Mean end-follow-up IOP was mmHg, representing an IOP decrease of 36.92%, mmHg (), from baseline washout IOP. The mean number of medications was significantly reduced from to (). 45% of patients were medication-free by the end of follow-up. Mean BCVA improved significantly from to (). No complications of surgery were observed. Conclusion. The iStent inject device combined with cataract surgery served to significantly reduce both IOP and medication use in the long term in patients with coexistent open-angle glaucoma or ocular hypertension (OHT) and cataract.