Paloma Oliver

Hospital Universitario La Paz

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Antonio Buño Soto

Hospital La Paz Institute for Health Research

Pilar Fernández‐Calle

Hospital Universitario La Paz

Rubén Gómez Rioja

Sociedad Española de Medicina Interna

María José Alcaide

Hospital General Universitario de Elche

José Manuel Iturzaeta

Hospital Universitario La Paz

Maria José Alcaide Martín

Louisiana State University Health Sciences Center Shreveport

Yale Tung‐Chen

Hospital Universitario La Paz

Blanca Fabre-Estremera

Hospital Universitario La Paz

Estéfani Martínez-Chávez

Hospital Universitario La Paz

Alberto M. Borobia

Hospital Universitario La Paz

Cooperative Institutions

Hospital Universitario La Paz

371

Instituto de Salud Carlos III

246

Universidad Autónoma de Madrid

186

Centro de Investigación Biomédica en Red

175

Hospital La Paz Institute for Health Research

109

Universidad de Sevilla

Instituto de Biomedicina de Sevilla

Hospital Universitario Virgen Macarena

Centre for Biomedical Network Research on Rare Diseases

Hospital General Universitario Gregorio Marañón

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Ifcc Professional Scientific Exchange Programme (PSEP) Report: CYP1A2 And CYP3A4 Gene Polymorphisms.

PubMed (2005)

Paloma Oliver

Differences in DNA sequences occur naturally in a population. A point in the human genome that can exist as two different versions (alleles) is known as polymorphism. Single nucleotide substitutions, insertions and deletions of nucleotides and repetitive sequences (microsatellites) are all examples of polymorphisms. There are upwards of 1,000,000 such SNPs (Single Nucleotide Polymorphisms) in the genome and they are responsible for the unique characteristics of every individual, from hair colour to disease predisposition.Numerous SNPs have been described in CYPs isoenzymes. For instance, within CYP2D6 we can find CYP2D6*1B (3828G>A) (1) or CYP2D6*3A (2549A>del) (2).

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Revisión de valores críticos obtenidos en gasometrías realizadas en el lugar de asistencia al paciente

Revista del Laboratorio Clínico (2009)

Cosmin Boteanu Antonio Buño Soto Paloma Oliver Maria José Alcaide Martín Pilar Fernández‐Calle

10.1016/j.labcli.2009.02.001

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Citations (1)

Los errores en las pruebas de cabecera pueden resultar en falsos niveles de potasio

Advances in Laboratory Medicine / Avances en Medicina de Laboratorio (2022)

Antonio Buño Soto Paloma Oliver

Resumen Las pruebas de cabecera (POCT, por sus siglas en inglés) permiten disponer de los resultados en un corto espacio de tiempo, facilitando la toma rápida de decisiones médicas. Sus resultados deben ser fiables, y su calidad no debe verse comprometida durante el proceso. Las gasometrías son una de las pruebas POCT más utilizadas en los servicios de urgencias y cuidados intensivos. Se suele utilizar sangre entera como muestra, debiendo tener en cuenta el riesgo de hemólisis. Sin embargo, los analizadores empleados para las gasometrías POCT no detectan la presencia de hemólisis en la muestra y, debido a las características de la misma, tampoco se puede identificar la hemólisis a simple vista. La hemólisis puede alterar el resultado de parámetros como el potasio, mostrando resultados anormalmente elevados o concentraciones normales, enmascarando niveles que, en realidad, son bajos (hipopotasemia). La hiperpotasemia está asociada a un mayor riesgo de sufrir arritmia potencialmente fatal, y requiere de una actuación médica urgente. La hemólisis es la causa más frecuente de pseudohiperpotasemia (hiperpotasemia espuria) o pseudonormopotasemia, lo que puede llevar a un diagnóstico erróneo y a la consiguiente toma de decisiones clínicas inadecuadas. En el presente artículo, realizamos una revisión completa de los posibles factores que pueden hacer que una prueba POCT informe un resultado falso de concentraciones elevadas de potasio en sangre. Los programas de POCT adecuadamente supervisados y organizados por el laboratorio clínico pueden contribuir a prevenir errores y reducir su impacto en el manejo del paciente.

10.1515/almed-2022-0015

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Meta-analysis of genome-wide association studies for cancer therapy-related cardiovascular dysfunction and functional mapping highlight an intergenic region close to TP63

Scientific Reports (2024)

Laura Martínez-Campelo Alejandro Blanco‐Verea Teresa López‐Fernández Amparo Martínez‐Monzonís Antonio Buño Soto

Cancer therapy-related cardiac dysfunction (CTRCD), which commonly includes left ventricular dysfunction and heart failure, is the main adverse effect of anticancer therapy. In recent years several candidate genes studies and genome-wide association studies have identified common genetic variants associated with CTRCD, but evidence remains limited and few genetic variants are robust. A genome-wide meta-analysis of CTRCD was performed with 852 oncology patients receiving cancer therapy. DNA samples were genotyped and imputed to perform a GWAS meta-analysis for case-control (N = 852 (380 cases and 472 controls) and extreme phenotypes (N = 618 (78 cases and 472 controls) looking for genetic variants that predispose to CTRCD. The results were validated in a replicate cohort of 1,191 oncology patients (245 cases and 946 controls). Functional mapping of the replicated loci was then performed. The meta-analysis showed 9 and 17 loci suggestively associated (P-value < 1 × 10

Genome-wide Association Study

Genetic Association

10.1038/s41598-024-69064-5

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Clinical, operational and economic outcomes of point-of-care blood gas analysis in COPD patients

Clinical Biochemistry (2015)

Paloma Oliver Antonio Buño Soto Rodolfo Álvarez-Sala Pilar Fernández‐Calle María José Alcaide

Pulmonology

Oxygen therapy

Gas analyzer

Point-of-Care Testing

Arterial blood

Blood gas analysis

10.1016/j.clinbiochem.2014.12.020

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Citations (9)

Mucocutaneous Findings in 666 Patients with COVID-19. Prevalence in a Field Hospital in Spain

SSRN Electronic Journal (2020)

A. Nuño‐González Pilar Martinez-Carrillo K. Magaletsky María Dolores Martín Ríos Cristina Herranz Mañas

Mucocutaneous zone

2019-20 coronavirus outbreak

10.2139/ssrn.3608077

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Detection of bacterial DNA in sterile serum and ascitic fluid from patients with cirrhosis. Preliminary data

Journal of Hepatology (2001)

José M. Such Rubén Francés Cristina Parrilla Muñoz Juan Antonio Casellas Sonia Pascual

Ascitic fluid

10.1016/s0168-8278(01)81131-4

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Real-world use of key performance indicators for point-of-Care Testing network accredited by ISO 22870

Practical Laboratory Medicine (2020)

Paloma Oliver Pilar Fernández‐Calle Roberto Mora Jorge Díaz–Garzón Daniel Prieto

We aimed to evaluate the results of key performance indicators (KPIs) for a period of over three years, as well as their effectiveness as an improvement tool, to provide information about Point-of-Care Testing (POCT) management system performance and quality assurance.KPIs regarding the global POCT process, extra-analytical phase, quality assurance and staff training and competency were evaluated for blood gases, HbA1c, sweat test and non-connected and connected glucose in an ISO 22870 accredited network. We established the definition of every KPI and its corresponding target. The results of KPIs from all clinical settings were appraised every month during the study period, taking corrective actions when necessary.Annual global results were generally acceptable. However, some clinical areas displayed deviations in specific months. The monitoring of these KPIs allowed us to detect the deviations immediately and identify their causes. These included errors in patient identification, consumables, strips, reagents, analyzers, calibration, internal and external quality control, sample management, connectivity, and operator identification strategy, among others.The evaluation of these KPIs over time has shown their appropriateness. This set of quality indicators could be a useful tool for laboratory medicine leading POCT networks for better and safer patient care.

Performance indicator

Point-of-Care Testing

Consumables

Identification

Sample (material)

10.1016/j.plabm.2020.e00188

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The influence of undetected hemolysis on POCT potassium results in the emergency department

Clinical Chemistry and Laboratory Medicine (CCLM) (2024)

Andrei N. Tintu Antonio Buño Soto Viviane Van Hoof Suzanne Bench Anthony Malpass

Abstract Objectives This study aimed to evaluate discrepancies in potassium measurements between point-of-care testing (POCT) and central laboratory (CL) methods, focusing on the impact of hemolysis on these measurements and its impact in the clinical practice in the emergency department (ED). Methods A retrospective analysis was conducted using data from three European university hospitals: Technische Universitat München (Germany), Hospital Universitario La Paz (Spain), and Erasmus University Medical Center (The Netherlands). The study compared POCT potassium measurements in EDs with CL measurements. Data normalization was performed in categories for potassium levels (kalemia) and hemolysis. The severity of discrepancies between POCT and CL potassium measurements was assessed using the reference change value (RCV). Results The study identified significant discrepancies in potassium between POCT and CL methods. In comparing POCT normo- and mild hypokalemia against CL results, differences of −4.20 % and +4.88 % were noted respectively. The largest variance in the CL was a +4.14 % difference in the mild hyperkalemia category. Additionally, the RCV was calculated to quantify the severity of discrepancies between paired potassium measurements from POCT and CL methods. The overall hemolysis characteristics, as defined by the hemolysis gradient, showed considerable variation between the testing sites, significantly affecting the reliability of potassium measurements in POCT. Conclusions The study highlighted the challenges in achieving consistent potassium measurement results between POCT and CL methods, particularly in the presence of hemolysis. It emphasised the need for integrated hemolysis detection systems in future blood gas analysis devices to minimise discrepancies and ensure accurate POCT results.

Point-of-Care Testing

10.1515/cclm-2024-0202

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Impact of COVID-19 pandemic on HbA_1c management and results in pediatric and adult outpatients with diabetes

Advances in Laboratory Medicine / Avances en Medicina de Laboratorio (2023)

Paloma Oliver Marina Pellicer Daniel Prieto Jorge Díaz–Garzón Roberto Mora

Diabetes mellitus intensify the risks and complications related to COVID-19 infection. A major effect of the pandemic has been a drastic reduction of in-person visits. The aim of this study was to evaluate the impact of the COVID-19 pandemic on HbA1c management and results among pediatric and adult outpatients with diabetes, considering the laboratory and point-of-care testing (POCT) HbA1c measurements.Observational retrospective study including patients from pediatric and adult diabetes units was conducted. HbA1c results obtained in the laboratory and POCT over 3 years (2019-2021) were collected from the laboratory information system.After the lockdown, the number of HbA1c plummeted. Children returned soon to routine clinical practice. The number of HbA1c increased gradually in adults, especially in POCT. Globally, HbA1c results were lower in children compared with adults (p<0.001). HbA1c values in children (p<0.001) and adults (p=0.002) decreased between pre-pandemic and post-pandemic periods, though lower than the HbA1c reference change value. The percentage of HbA1c results above 8% remained stable during the study period.Continuous glucose monitoring and a telemedicine have been crucial, even allowing for improvements in HbA1c results. During the lockdown, patients with better metabolic control were managed in the laboratory whereas patients with poorer control or a severe clinical situation were attended in diabetes units by POCT. Adults returned to pre-pandemic management slowly because they were more susceptible to morbidity and mortality due to COVID-19. Coordination among all health professionals has been essential to offering the best management, especially in difficult scenarios such as the COVID-19 pandemic.

Pandemic

Diabetes management

Point-of-Care Testing

Metabolic control analysis

10.1515/almed-2022-0098

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Citations (3)