Josep Ribas
University of Barcelona
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Featured researches published by Josep Ribas.
AIDS Research and Human Retroviruses | 2008
M.T. Martín; E. Del Cacho; C Codina; Montserrat Tuset; E. De Lazzari; Josep Mallolas; Miró Jm; Jm Gatell; Josep Ribas
The relationship between adherence, antiretroviral regimen, and viral load (VL) suppression was assessed through a 1 year prospective follow-up study among 1142 HIV-infected patient. Patients on antiretroviral therapy who attended to the pharmacy during a 6-month period were considered eligible. Those included in the final analysis were patients who had been taking the same antiretroviral therapy for > or =6 months since their inclusion. The cohort included patients taking first line therapy (n = 243) and antiretroviral-experienced patients (n = 899). Naive patients who were included had to have reached undetectable VL at enrollment. Antiretroviral-experienced patients with detectable VL determinations in the previous 6 months were excluded. Adherence was measured by means of announced pill counts and dispensation pharmacy records. Of patients, 58% were taking NNRTI, 31.4% boosted PI, and 10.6% unboosted PI-based regimens. Overall, the relative risk of virologic failure was 9.0 (95% CI 4.0-20.1) in patients with adherence 80-89.9%, 45.6 (95% CI 19.9-104.5) with adherence 70-79.9%, and 77.3 (95% CI 34.2-174.9) with adherence <70%, compared with adherence of > or =90%. The risk of virologic failure in patients with adherence <90% taking unboosted PI was 2.5 times higher than the group taking boosted PI (95% CI 1.2-5.3). There were no statistical differences in patients taking boosted PI and those who were taking NNRTI. Less than 95% of adherence is associated with high virologic success. For patients taking NNRTI- or boosted PI-based regimens with adherence rates of 80%, the failure rate is <10%. These data do not affect the goal of achieving the highest level of adherence possible.
Medicina Clinica | 2002
María Teresa Martín; Carles Codina; Montserrat Tuset; Xavier Carné; Santiago Nogué; Josep Ribas
Fundamento Mediante este estudio se ha pretendido: a) identificar y caracterizar los problemasrelacionados con la medicacion (reacciones adversas, fracasos terapeuticos relacionados con ladosis e intoxicaciones) que provocan ingresos en el Hospital Clinic de Barcelona, a traves delservicio de urgencias; b) conocer que tipo de medicamentos se ve implicado con mas frecuencia;c) identificar los factores que predisponen al ingreso hospitalario por problemas relacionadoscon la medicacion, y d) evaluar cuantos de estos ingresos se podrian haber evitado. Pacientes y metodo El estudio ha sido de caracter prospectivo y se ha realizado durante los mesescomprendidos entre agosto y noviembre de 1999 y entre enero y mayo de 2000. Duranteestos periodos se han obtenido un total de 1.800 ingresos correspondientes a 1.663 pacientes. Resultados El numero de ingresos debidos a problemas relacionados con la medicacion, incluyendolos casos definitivos, probables y posibles, ha sido de 215 (11,9%). De estos casos, 108(50,2%) han correspondido a efectos adversos, 100 (46,5%) a fracasos terapeuticos relacionadoscon la dosis (fundamentalmente mal cumplimiento) y siete (3,3%) a intoxicaciones. Si seexcluyen los casos posibles para conseguir una relacion causal mejor definida, el numero deproblemas relacionados con la medicacion como causa de ingreso ha sido de 139 (7,7%).Siguiendo los criterios de Schumock y Thornton modificados, un 68,4% de los ingresos debidosa problemas relacionados con la medicacion se ha considerado evitable. La mayoria de losingresos evitables son debidos al mal cumplimiento, seguidos de ausencia de profilaxis y monitorizaciono seguimiento inapropiado. Conclusiones El numero de ingresos debidos a problemas relacionados con la medicacion eselevado y en muchos casos se podrian haber evitado.
Enfermedades Infecciosas Y Microbiologia Clinica | 2002
C Codina; Mireia Martínez; Montserrat Tuset; Elena del Cacho; María Teresa Martín; José M. Miró; Josep Mallolas; Elisa de Lazzari; Felipe García; Esteban Martínez; José M. Gatell; Josep Ribas
Introduccion El calculo de la adherencia al tratamiento antirretroviral constituye un dato de gran utilidad en el seguimiento de los pacientes con infeccion por virus de la inmunodeficiencia humana (VIH). Se han propuesto varios metodos para calcular la adherencia, pero cada uno de ellos presenta ciertas dificultades de aplicacion. Pacientes y metodos Se han evaluado, de forma prospectiva, tres metodos para el calculo de la adherencia: el recuento de la medicacion sobrante (RMS), la entrevista estructurada (EN) y el registro de dispensacion de medicacion desde el servicio de farmacia (DM). Se ha considerado el RMS como metodo patron y se ha evaluado la sensibilidad y la especificidad de los otros dos metodos con respecto a este. Resultados Los tres metodos se han podido aplicar a 69 casos. De estos, el porcentaje de pacientes que ha tomado el 95% o mas de las dosis prescritas ha sido del 72,5% (RMS), el 85,5% (EN) y el 81,2% (DM). Si se considera el RMS como el metodo patron, la concordancia con DM ha sido del 75,1% y con EN del 73,2%. La sensibilidad de DM y EN ha sido del 52,6 y 42,1%, respectivamente. Los pacientes con una adherencia _ 90% (RMS) presentaron una probabilidad de alcanzar una buena respuesta virologica 1,29 veces mayor (intervalo de confianza [IC] del 95%: 1,04-1,62; p _ 0,0138). Conclusion Aunque la concordancia entre los metodos es aceptable, DM y EN sobrestiman la adherencia respecto a RMS. Debido a que no se dispone de un metodo ideal para medir la adherencia es importante combinar varios metodos para realizar una medicion lo mas aproximada posible a los datos reales.
Infection Control and Hospital Epidemiology | 1999
Carles Codina; Antoni Trilla; Nuria Riera; Montserrat Tuset; Xavier Carné; Josep Ribas; Asenjo Ma
A questionnaire survey was sent to a random sample of the Spanish network of National Health System public acute-care hospitals. Of responding institutions (representing 25% of Spanish hospital beds), nearly 75% had active surveillance programs for the prevention and control of surgical-site infections (SSIs), but only 20% performed postdischarge surveillance. Overall, perioperative antibiotic prophylaxis (PAP) was used in 84% of all surgical procedures. For 77% of procedures, there were written guidelines for the choice and use of PAP. Cefazolin was the most commonly used antibiotic (38%). Duration of PAP was shorter than 24 hours in 75% of procedures, and only a single dose was given in 52% of procedures. PAP was commonly used in breast (52%) and inguinal hernia repair (69%) procedures, as well as in laparoscopic abdominal surgery (86%). In summary, the use of PAP in Spanish hospitals is adequate, but improvements can be made in the frequency of prolonged PAP and in the use of broad-spectrum antibiotics. Surveillance systems for SSI, including postdischarge follow-up, also should be improved.
Medicina Clinica | 2006
Laura Gratacós; Montse Tuset; Carles Codina; José M. Miró; Josep Mallolas; Núria Miserachs; Maria Teresa Martín-Conde; Elena del Cacho; Elisa de Lazzari; Josep Ribas; Josep M. Gatell
BACKGROUND AND OBJECTIVE: Different combinations of antiretroviral drugs are used as initial HIV therapy but comparative studies between them are not frequent. The objectives of this study are to determine the median duration of different therapy combinations in naive patients between 1998-2000 and the main reasons for changing or stopping this first antiretroviral therapy (ARVT). PATIENTS AND METHOD: This study included a total of 518 naive patients who began antiretroviral therapy patients from 1998-2000. Using a Kaplan-Meier analysis the median duration of different combinations was determined. In addition, the main reasons for changing or stopping this first treatment were analysed. RESULTS: First ARVT median duration was 427 days (IQR: 114-890). 47% of patients stopped their first therapy due to adverse effects, 6% voluntarily withdrew from it, in 9% of patients the therapy was not effective and 15% of them were lost of follow up. Only 9% of them continued with the same ARVT at the end of the study but if we add 7% of treatment simplifications we can consider 16% of first ARVT successful. CONCLUSIONS: A median duration of 427 days, similar to other studies, is shorter than we would prefer for HIV, a condition that requires continuous treatment. On the other hand, the study corroborates that secondary effects are the principal problem associated with ARVT.
Therapeutic Drug Monitoring | 2006
Dolors Soy; Ester López; Josep Ribas
Abstract: The goal of this study was to build a population pharmacokinetic (PK) model to characterize the population PK parameters in our hospitalized patients. Teicoplanin serum concentrations from clinical routine were used. Antibiotic dose history and blood collection times were recorded and analyzed with NONMEM-V. Demographic and biologic data creatinine clearance (CLcr), weight (WT), and albumin (Alb) were tested for inclusion as covariates in the basic model. Intraindividual and residual variability were modeled. One hundred seven sparse samples (mainly trough levels), from 79 patients, were included. A 2-compartment PK model characterized by clearance (CL), central compartment volume of distribution (Vc), intercompartment clearance, and steady-state volume of distribution (VSS) with first-order elimination adequately described the data. CLcr and WT significantly influenced teicoplanin CL (CL = 0.57[0.15]*(1+0.0048[0.39]*(CLcr − averageCLcr)*WT) L/h). VSS was not affected by any covariate (VSS = 50.2[0.13]L). A negative trend between Alb and individual VSS estimates was observed without statistical significance. In a new data set, bias and precision resulted in mean values of −3.24% and 9.42%, respectively. In conclusion, CLcr and WT are significant covariates on teicoplanin CL. Results from predictive accuracy and precision show the usefulness of this model for implementation in a therapeutic drug monitoring program in the near future.
Clinical Chemistry and Laboratory Medicine | 2011
Laura Guerrero; Ma Jesús Pinazo; Elizabeth Posada; Joaquim Gascón; Josep Ribas; Dolors Soy
Abstract Background: Chagas disease is endemic in Latin America, affecting 16–18 million people with more than 100 million exposed to risk of infection. Its etiological agent is Trypanosoma cruzi. To date, benznidazole is the only treatment of Chagas disease available in Europe. Methods: A high-performance reversed-phase isocratic liquid chromatographic method for benznidazole analysis in human plasma is described. The mobile phase consists of 60% ultrafiltered water and 40% acetonitrile. Samples were precipitated with trichloroacetic acid (0.3 M) (1/1, v/v). The injection volume was 100 μL. Benzocaine was used as internal standard. Results: The assay was linear over a benznidazole concentration range of 1.6–100 μg/mL. The method showed good agreement of results (n=15): inaccuracy (5.6%), intra- and inter-day variability (1.1% and 3.9%, respectively), recovery (94.9%), limit of detection (0.8 μg/mL), lower limit of quantitation (1.6 μg/mL) and acceptable stability over 24 h in the auto-sampler. Only 25 samples (58%) showed values within the therapeutic range. Three samples were subtherapeutic and 15 were in the toxic range. Conclusions: The method offers a fast and simple approach to determining benznidazole in human plasma which could be of use in pharmacokinetic and safety studies.
Pharmacy World & Science | 2002
N. Creus; J. Mateu; J. Massó; Carles Codina; Josep Ribas
DMSO is a dipolar, aprotic, hygroscopic solvent for which a large number of pharmacologic properties have been claimed. Topical DMSO is considered an effective and safe antidote to be used with topical cooling after extravasations of vesicant drugs. A case of toxicity after its use as an antidote is described. Furthermore, the increasing importance of DMSO pharmacology, as its use in haematologic patients is spreading, is reviewed.
Pharmacy World & Science | 1992
N. Corominas; J. M. Mañé; C. Codina; M. A. Paz; Josep Ribas
In this report we describe a case of a nonatopic patient who developed an anaphylactoid reaction immediately after receiving intravenous hydrocortisone. The patient recovered after reanimation techniques and intravenous administration of atropine, epinefrine and plasma expanders. Although allergic reactions to corticosteroids appear to be rare there are a few case reports in the literature. This case is presented to draw the attention of clinicians to the occasional hazard of intravenous corticosteroid preparations, specially hydrocortisone.
Enfermedades Infecciosas Y Microbiologia Clinica | 2006
Ester López; Dolors Soy; M.ª Teresa Miana; Carles Codina; Josep Ribas
Son numerosos los trabajos de investigacion que se han publicado acerca de la administracion de antibioticos betalactamicos en infusion continua. Los resultados obtenidos indican que podria tratarse de una estrategia terapeutica de gran utilidad en el tratamiento de la infeccion nosocomial, las agudizaciones de las infecciones pulmonares de pacientes con fibrosis quistica y el tratamiento de la neutropenia febril. Desde el punto de vista farmacodinamico, los antibioticos betalactamicos tienen un patron de actividad dependiente del tiempo y es el tiempo durante el cual la concentracion de antibiotico libre supera la concentracion inhibitoria minima del microorganismo responsable de la infeccion, el indice farmacocinetico/farmacodinamico que mejor se correlaciona con la eficacia clinica. La administracion de betalactamicos en infusion continua logra maximizar el citado indice, y ademas algunos estudios indican que podria resultar tambien ventajosa en terminos economicos.Numerous studies on continuous intravenous infusion of betalactam antibiotics have indicated that this could be a useful strategy for treating nosocomial infections as well as exacerbations of pulmonary infections in patients with cystic fibrosis and episodes of febrile neutropenia. From the pharmacodynamic viewpoint, betalactam antibiotics have a time-dependent behavior. Thus, the pharmacokinetic/pharmacodynamic index that best correlates with therapeutic efficacy appears to be the time during which free antibiotic concentrations remain above the minimum inhibitory concentration (MIC) of the infecting microorganism. Continuous infusion of betalactams successfully optimizes this pharmacokinetic/ pharmacodynamic index. Furthermore, some studies have shown that this therapeutic strategy may be favorable economically.