0000000000050030
AUTHOR
Antonio Fernandez
Clinical Inertia in Poorly Controlled Elderly Hypertensive Patients: A Cross-Sectional Study in Spanish Physicians to Ascertain Reasons for Not Intensifying Treatment
Clinical inertia, the failure of physicians to initiate or intensify therapy when indicated, is a major problem in the management of hypertension and may be more prevalent in elderly patients. Overcoming clinical inertia requires understanding its causes and evaluating certain factors, particularly those related to physicians.The objective of our study was to determine the rate of clinical inertia and the physician-reported reasons for it.An observational, cross-sectional, multi-center study was carried out in a primary care setting. We included 512 physicians, with a consecutive sampling of 1,499 hypertensive patients with clinical inertia.Clinical inertia was defined when physicians did n…
Impact of Acute Hemoglobin Falls in Heart Failure Patients: A Population Study
Aims: This study assessed the impact of acute hemoglobin (Hb) falls in heart failure (HF) patients. Methods: HF patients with repeated Hb values over time were included. Falls in Hb greater than 30% were considered to represent an acute episode of anemia and the risk of hospitalization and all-cause mortality after the first episode was assessed. Results: In total, 45,437 HF patients (54.9% female, mean age 74.3 years) during a follow-up average of 2.9 years were analyzed. A total of 2892 (6.4%) patients had one episode of Hb falls, 139 (0.3%) had more than one episode, and 342 (0.8%) had concomitant acute kidney injury (AKI). Acute heart failure occurred in 4673 (10.3%) patients, represent…
Mortality and cardiovascular disease burden of uncontrolled diabetes in a registry-based cohort: the ESCARVAL-risk study
Background: Despite the epidemiological evidence about the relationship between diabetes, mortality and cardiovascular disease, information about the population impact of uncontrolled diabetes is scarce. We aimed to estimate the attributable risk associated with HbA1c levels for all-cause mortality and cardiovascular hospitalization.Methods: Prospective study of subjects with diabetes mellitus using electronic health records from the universal public health system in the Valencian Community, Spain 2008–2012. We included 19,140 men and women aged 30 years or older with diabetes who underwent routine health examinations in primary care.Results: A total of 11,003 (57%) patients had uncontrolle…
MOF-Stabilized Perfluorinated Palladium Cages Catalyze the Additive-Free Aerobic Oxidation of Aliphatic Alcohols to Acids
Extremely high electrophilic metal complexes, composed by a metal cation and very electron poor σ-donor ancillary ligands, are expected to be privileged catalysts for oxidation reactions in organic chemistry. However, their low lifetime prevents any use in catalysis. Here we show the synthesis of fluorinated pyridine-Pd coordinate cages within the channels of an anionic tridimensional metal-organic framework (MOF), and their use as efficient metal catalysts for the aerobic oxidation of aliphatic alcohols to carboxylic acids without any additive. Mechanistic studies strongly support that the MOF-stabilized coordination cage with perfluorinated ligands unleashes the full electrophilic potenti…
Supervised Analysis for Phenotype Identification: The Case of Heart Failure Ejection Fraction Class
Artificial Intelligence is creating a paradigm shift in health care, with phenotyping patients through clustering techniques being one of the areas of interest. Objective: To develop a predictive model to classify heart failure (HF) patients according to their left ventricular ejection fraction (LVEF), by using available data from Electronic Health Records (EHR). Subjects and methods: 2854 subjects over 25 years old with a diagnosis of HF and LVEF, measured by echocardiography, were selected to develop an algorithm to predict patients with reduced EF using supervised analysis. The performance of the developed algorithm was tested in heart failure patients from Primary Care. To select the mo…
Formation of an interlocked double-chain from an organic-inorganic [2]rotaxane.
Here we show that a structure containing a polymeric interlocking daisy chain is obtained from the reaction of an inorganic–organic [2]rotaxane [HB{CrIII7NiII(μ-F)8(O2CtBu)16}], where B is an organic thread terminated with a bi-pyridyl unit, with an oxo-centered metal carboxylate triangle [FeIII2CoII(μ3-O)(O2CtBu)6(HO2CtBu)3].
Self-assembly of catalytically-active supramolecular coordination compounds within metal-organic frameworks
[EN] Supramolecular coordination compounds (SCCs) represent the power of coordination chemistry methodologies to self-assemble discrete architectures with targeted properties. SCCs are generally synthesized in solution, with isolated fully coordinated metal atoms as structural nodes, thus severely limited as metal-based catalysts. Metal-organic frameworks (MOFs) show unique features to act as chemical nanoreactors for the in situ synthesis and stabilization of otherwise not accessible functional species. Here, we present the self-assembly of Pd-II SCCs within the confined space of a pre-formed MOF (SCCs@MOF) and its post-assembly metalation to give a Pd-II-Au-III supra molecular assembly, c…
Rationale and methods of the cardiometabolic valencian study (escarval-risk) for validation of risk scales in mediterranean patients with hypertension, diabetes or dyslipidemia
Abstract Background The Escarval-Risk study aims to validate cardiovascular risk scales in patients with hypertension, diabetes or dyslipidemia living in the Valencia Community, a European Mediterranean region, based on data from an electronic health recording system comparing predicted events with observed during 5 years follow-up study. Methods/Design A cohort prospective 5 years follow-up study has been designed including 25000 patients with hypertension, diabetes and/or dyslipidemia attended in usual clinical practice. All information is registered in a unique electronic health recording system (ABUCASIS) that is the usual way to register clinical practice in the Valencian Health System…
Real-World Data of Anticoagulant Treatment in Non-valvular Atrial Fibrillation
AimsTo assess the impact of anticoagulant treatment on risk for stroke and all-cause mortality of patients with atrial fibrillation using real-world data (RWD).MethodsPatients with prevalent or incident atrial fibrillation were selected throughout a study period of 5 years. Stroke, transitory ischemic attack, hemorrhagic stroke, and all-cause mortality were identified in the claims of the electronic health records (EHRs). Subjects were classified according to the anticoagulant treatment in four groups: untreated, vitamin K antagonists (VKAs), New Oral Anticoagulants (NOACs), and antiplatelet (AP). Risk of events and protection with anticoagulant therapy were calculated by Cox proportional h…
A [13]rotaxane assembled via a palladium molecular capsule
Molecules that are the size of small proteins are difficult to make. The most frequently examined route is via self-assembly, and one particular approach involves molecular nanocapsules, where ligands are designed that will enforce the formation of specific polyhedra of metals within the core of the structure. Here we show that this approach can be combined with mechanically interlocking molecules to produce nanocapsules that are decorated on their exterior. This could be a general route to very large molecules, and is exemplified here by the synthesis and structural characterization of a [13]rotaxane, containing 150 metal centres. Small angle X-ray scattering combined with atomistic molecu…
The influence of hemoglobin A1c levels on cardiovascular events and all-cause mortality in people with diabetes over 70 years of age. A prospective study
Abstract Aim Glycated hemoglobin A1c (HbA1c) is a reliable risk factor of cardiovascular diseases in diabetic patients, but information about this relationship in elderly patients is scarce. The aim of this study is to analyze, the relationship between HbA1c levels and the risk of mayor adverse cardiovascular events (MACE) in patients with diabetes over 70 years. Methods Prospective study of subjects with diabetes using electronic health records from the universal public health system in the Valencian Community, Spain, 2008–2012. We included men and women aged ≥ 70 years with diabetes who underwent routine health examinations in primary care. Primary endpoint was the incidence of MACE: all-…
Acute kidney injury in heart failure: a population study
Abstract Aims The objective of the present study is to assess the prognostic value of acute kidney injury (AKI) in the evolution of patients with heart failure (HF) using real‐world data. Methods and results Patients with a diagnosis of HF and with serial measurements of renal function collected throughout the study period were included. Estimated glomerular filtration rate (GFR) was calculated with the CKD‐EPI (Chronic Kidney Disease Epidemiology Collaboration). AKI was defined when a sudden drop in creatinine with posterior recovery was recorded. According to the Risk, Injury, Failure, Loss, and End‐Stage Renal Disease (RIFLE) scale, AKI severity was graded in three categories: risk [1.5‐…
CCDC 1892911: Experimental Crystal Structure Determination
Related Article: Rosa Adam, Marta Mon, Rossella Greco, Lucas H. G. Kalinke, Alejandro Vidal-Moya, Antonio Fernandez, Richard E. P. Winpenny, Antonio Dom��nech-Carb��, Antonio Leyva-P��rez, Donatella Armentano, Emilio Pardo, Jes��s Ferrando-Soria|2019|J.Am.Chem.Soc.|141|10350|doi:10.1021/jacs.9b03914
CCDC 1892914: Experimental Crystal Structure Determination
Related Article: Rosa Adam, Marta Mon, Rossella Greco, Lucas H. G. Kalinke, Alejandro Vidal-Moya, Antonio Fernandez, Richard E. P. Winpenny, Antonio Dom��nech-Carb��, Antonio Leyva-P��rez, Donatella Armentano, Emilio Pardo, Jes��s Ferrando-Soria|2019|J.Am.Chem.Soc.|141|10350|doi:10.1021/jacs.9b03914
CCDC 2107391: Experimental Crystal Structure Determination
Related Article: Rossella Greco, Estefania Tiburcio-Fortes, Antonio Fernandez, Carlo Marini, Alejandro Vidal-Moya, Judit Oliver-Meseguer, Donatella Armentano, Emilio Pardo, Jesús Ferrando-Soria, Antonio Leyva-Pérez|2022|Chem.-Eur.J.|28||doi:10.1002/chem.202103781
CCDC 1572780: Experimental Crystal Structure Determination
Related Article: Jesús Ferrando-Soria, Antonio Fernandez, Iñigo J. Vitorica-Yrezabal, Deepak Asthana, Christopher A. Muryn, Floriana Tuna, Grigore A. Timco, Richard E. P. Winpenny|2019|Chem.Commun.|55|2960|doi:10.1039/C8CC09339C
CCDC 1860091: Experimental Crystal Structure Determination
Related Article: Jesus Ferrando-Soria, Antonio Fernandez, Deepak Asthana, Selina Nawaz, Iñigo J. Vitorica-Yrezabal, George F. S. Whitehead, Christopher A. Muryn, Floriana Tuna, Grigore A. Timco, Neil D. Burton, Richard E. P. Winpenny |2019|Nat.Commun.|10|3720|doi:10.1038/s41467-019-11635-6
CCDC 1572781: Experimental Crystal Structure Determination
Related Article: Jesús Ferrando-Soria, Antonio Fernandez, Iñigo J. Vitorica-Yrezabal, Deepak Asthana, Christopher A. Muryn, Floriana Tuna, Grigore A. Timco, Richard E. P. Winpenny|2019|Chem.Commun.|55|2960|doi:10.1039/C8CC09339C
CCDC 1892912: Experimental Crystal Structure Determination
Related Article: Rosa Adam, Marta Mon, Rossella Greco, Lucas H. G. Kalinke, Alejandro Vidal-Moya, Antonio Fernandez, Richard E. P. Winpenny, Antonio Dom��nech-Carb��, Antonio Leyva-P��rez, Donatella Armentano, Emilio Pardo, Jes��s Ferrando-Soria|2019|J.Am.Chem.Soc.|141|10350|doi:10.1021/jacs.9b03914