Publications by authors named "Antonia Socias"

8 Publications

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Cardiac arrest following unsuspected self-poisoning with doxylamine.

Ther Drug Monit 2022 Jan 11. Epub 2022 Jan 11.

Clinical Toxicology Unit, Clinical Analysis Department. Hospital Universitari Son Llàtzer. Research Institute of Health Sciences (IdISBa). Palma de Mallorca, Spain. Intensive Care Department. Hospital Universitari Son Llàtzer. Research Institute of Health Sciences (IdISBa). Palma de Mallorca, Spain. Intensive Care Department. Hospital Universitari Son Llàtzer. Research Institute of Health Sciences (IdISBa). Palma de Mallorca, Spain. Intensive Care Department. Hospital Universitari Son Llàtzer. Research Institute of Health Sciences (IdISBa). Palma de Mallorca, Spain. Cardiology Department. Hospital Universitari Son Llàtzer. Department of Medicine, Faculty of Medicine, University of the Balearic Islands. Research Institute of Health Sciences (IdISBa). Palma de Mallorca, Spain. Institute of Legal Medicine of the Balearic Islands. Ministry of Justice. Department of Medicine, Faculty of Medicine, University of the Balearic Islands. Palma de Mallorca, Spain. Institute of Legal Medicine of the Balearic Islands. Ministry of Justice. Department of Medicine, Faculty of Medicine, University of the Balearic Islands. Palma de Mallorca, Spain.

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http://dx.doi.org/10.1097/FTD.0000000000000960DOI Listing
January 2022

Colorimetric Detection of Sepsis-Derived Hyperdegranulation with Plasmonic Nanosensors.

ACS Sens 2021 Dec 18;6(12):4443-4450. Epub 2021 Nov 18.

Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain.

Hyperdegranulation of neutrophilic granulocytes is a common finding in sepsis that directly contributes to the heightened immune response leading to organ dysfunction. Currently, cell degranulation is detected by flow cytometry, which requires large infrastructure that is not always available at the point of care. Here, we propose a plasmonic assay for detecting the degranulation status of septic cells colorimetrically. It is based on triggering the aggregation of gold nanoparticles with cationic granule proteins. Cells from septic patients contain fewer granules and therefore release less cationic proteins than healthy cells. This results in red-colored assays than can be easily detected by eye. The assay can selectively detect cationic granule proteins even in the presence of an excess of unrelated proteins, which is key to detect degranulation with high specificity. Coupling this signal generation mechanism with a magnetic purification step enabled the identification of septic cells with the same performance as flow cytometry. This makes the proposed method a promising alternative for diagnosing sepsis in decentralized healthcare schemes.
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http://dx.doi.org/10.1021/acssensors.1c01884DOI Listing
December 2021

Optimized detection of lung IL-6 enzymatic liquefaction of low respiratory tract samples: application for managing ventilated patients.

Analyst 2021 Oct 25;146(21):6537-6546. Epub 2021 Oct 25.

Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.

Lung IL-6 is a promising biomarker for predicting respiratory failure during pulmonary infections. This biomarker is found in respiratory samples which need to be liquefied prior to analysis. Traditional liquefying methods use reducing agents such as dithiothreitol (DTT). However, DTT impairs immunodetection and does not liquefy highly viscous samples. We propose an enzymatic method that liquefies samples by means of generating O bubbles with endogenous catalase. Low respiratory tract specimens from 48 mechanically ventilated patients (38 with SARS-CoV-2 infection) were treated with DTT or with the enzymatic method. We used turbidimetry to compare the liquefaction degree and IL-6 was quantified with ELISA. Finally, we used AUC-ROC, time-to-event and principal component analysis to evaluate the association between respiratory compromise or local inflammation and IL-6 determined with both methods. Enzymatically treated samples were better liquefied than those reduced by DTT, which resulted in higher ELISA signals. Lung IL-6 levels obtained with the enzymatic procedure were negatively correlated with the oxygenation index (PaO/FiO) and the time of mechanical ventilation. The proposed enzymatic liquefaction method improves the sensitivity for lung IL-6 detection in respiratory samples, which increases its predictive power as a biomarker for evaluating respiratory compliance.
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http://dx.doi.org/10.1039/d1an00763gDOI Listing
October 2021

Nanoparticle transfer biosensors for the non-invasive detection of SARS-CoV-2 antigens trapped in surgical face masks.

Sens Actuators B Chem 2021 Oct 24;345:130347. Epub 2021 Jun 24.

Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Spain.

Detecting SARS-CoV-2 antigens in respiratory tract samples has become a widespread method for screening new SARS-CoV-2 infections. This requires a nasopharyngeal swab performed by a trained healthcare worker, which puts strain on saturated healthcare services. In this manuscript we describe a new approach for non-invasive COVID-19 diagnosis. It consists of using mobile biosensors for detecting viral antigens trapped in surgical face masks worn by patients. The biosensors are made of filter paper containing a nanoparticle reservoir. The nanoparticles transfer from the biosensor to the mask on contact, where they generate colorimetric signals that are quantified with a smartphone app. Sample collection requires wearing a surgical mask for 30 min, and the total assay time is shorter than 10 min. When tested in a cohort of 27 patients with mild or no symptoms, an area under the receiving operating curve (AUROC) of 0.99 was obtained (96.2 % sensitivity and 100 % specificity). Serial measurements revealed a high sensitivity and specificity when masks were worn up to 6 days after diagnosis. Surgical face masks are inexpensive and widely available, which makes this approach easy to implement anywhere. The excellent sensitivity, even when tested with asymptomatic patient samples, along with the mobile detection scheme and non-invasive sampling procedure, makes this biosensor design ideal for mass screening.
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http://dx.doi.org/10.1016/j.snb.2021.130347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225299PMC
October 2021

Low Albumin Levels Are Associated with Poorer Outcomes in a Case Series of COVID-19 Patients in Spain: A Retrospective Cohort Study.

Microorganisms 2020 Jul 24;8(8). Epub 2020 Jul 24.

Vascular and Metabolic Pathologies Group, Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.

There is limited information available describing the clinical and epidemiological features of Spanish patients requiring hospitalization for coronavirus disease 2019 (COVID-19). In this observational study, we aimed to describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior to hospitalization. Forty-eight patients (27 non-ICU and 21 ICU) with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were analyzed (mean age, 66 years, [range, 33-88 years]; 67% males). There were no differences in age or sex among groups. Initial symptoms included fever (100%), coughing (85%), dyspnea (76%), diarrhea (42%) and asthenia (21%). ICU patients had a higher prevalence of dyspnea compared to non-ICU patients (95% vs. 61%, = 0.022). ICU-patients had lymphopenia as well as hypoalbuminemia. Lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU ( < 0.001). Lower albumin levels were associated with poor prognosis measured as longer hospital length (r = -0.472, < 0.001) and mortality (r = -0.424, = 0.003). As of 28 April 2020, 10 patients (8 ICU and 2 non-ICU) have died (21% mortality), and while 100% of the non-ICU patients have been discharged, 33% of the ICU patients still remained hospitalized (5 in ICU and 2 had been transferred to ward). Critically ill patients with COVID-19 present lymphopenia, hypoalbuminemia and high levels of inflammation.
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http://dx.doi.org/10.3390/microorganisms8081106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463882PMC
July 2020

Computerised sepsis protocol management. Description of an early warning system.

Enferm Infecc Microbiol Clin (Engl Ed) 2018 Feb 10;36(2):84-90. Epub 2017 Jan 10.

Unidad Multidisciplinar de Sepsis, Hospital Son Llàtzer, Palma de Mallorca, España.

Introduction: New strategies need to be developed for the early recognition and rapid response for the management of sepsis. To achieve this purpose, the Multidisciplinary Sepsis Team (MST) developed the Computerised Sepsis Protocol Management (PIMIS). The aim of this study was to evaluate the convenience of using PIMIS, as well as the activity of the MST.

Methods: An analysis was performed on the data collected from solicited MST consultations (direct activation of PIMIS by attending physician or telephone request) and unsolicited ones (by referral from the microbiology laboratory or an automatic referral via the hospital vital signs recording software [SIDCV]), as well as the hospital department, source of infection, treatment recommendation, and acceptance of this.

Results: Of the 1,581 first consultations, 65.1% were solicited consultations (84.1% activation of PIMIS and 15.9% by telephone). The majority of unsolicited consultations were generated by the microbiology laboratory (95.2%), and 4.8% from the SIDCV. Referral from solicited consultations were generated sooner (5.63days vs 8.47days; P<.001) and came from clinical specialties rather than from the surgical ward (73.0% vs 39.1%; P<.001). A recommendation was made for antimicrobial prescription change in 32% of first consultations. The treating physician accepted 78.1% of recommendations.

Conclusions: The high rate of solicited consultations and acceptance of recommended prescription changes suggest that a MST is seen as a helpful resource, and that PIMIS software is perceived to be useful and convenient to use, as it is the main source of referral.
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http://dx.doi.org/10.1016/j.eimc.2016.11.011DOI Listing
February 2018

[Nosocomial spread of linezolid-resistant Staphylococcus hominis in two hospitals in Majorca].

Enferm Infecc Microbiol Clin 2011 May 23;29(5):339-44. Epub 2011 Mar 23.

Servicio de Microbiología, Hospital Universitari Son Espases, Palma de Mallorca, España.

Objective: Since March 2008, several linezolid and teicoplanin-resistant Staphylococcus hominis (S. hominis) isolates have been recovered from patients admitted to the two major hospitals on the island of Majorca, Spain. For this reason, a study was conducted to determine the molecular epidemiology of these isolates and the mechanism of linezolid resistance.

Methods: The molecular epidemiology study was performed by pulsed-field gel electrophoresis (PFGE) analysis, after digestion with ApaI. Linezolid resistance mechanisms were evaluated by PCR amplification of a fragment of the domain V of the 23S rRNA gene (followed by sequencing) and cfr gene.

Results: From March 2008 to February 2009, 15 linezolid and teicoplanin-resistant S. hominis isolates were recovered from 14 patients. All of them, except one, were hospitalised in the intensive care units of either of the two institutions. Isolates were obtained mainly from blood cultures (9). The majority of infected patients (12 of 15 infectious episodes, 80.0%) had received courses of linezolid prior to detection of the resistant isolate. PFGE analysis revealed the presence of a unique clone among linezolid resistant S. hominis isolates. The G2576T mutation was detected in all the linezolid resistant strains. None of the resistant isolates showed a positive PCR for the cfr gene. All of the isolates were also resistant to penicillin, oxacillin, trimethoprim-sulfamethoxazole, ciprofloxacin, levofloxacin, and tobramicin; whereas all of them were susceptible to erythromycin, tetracycline, gentamicin, and daptomycin. The MIC of vancomycin was 4μg/ml for all the strains.

Conclusions: The detection of linezolid resistant Staphylococci highlights the need to rationalise the use of linezolid, and maintain an active surveillance of its resistance to preserve the clinical usefulness of this antimicrobial.
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http://dx.doi.org/10.1016/j.eimc.2011.02.001DOI Listing
May 2011

The ventilator-associated pneumonia PIRO score: a tool for predicting ICU mortality and health-care resources use in ventilator-associated pneumonia.

Chest 2008 Dec 8;134(6):1208-1216. Epub 2008 Sep 8.

Critical Care Department, Joan XXIII University Hospital, University Rovira & Virgili, Institut Pere Virgili, CIBER Enfermedades Respiratorias, Tarragona, Spain; Critical Care Department, Joan XXIII University Hospital, University Rovira & Virgili, Institut Pere Virgili, CIBER Enfermedades Respiratorias, Tarragona, Spain. Electronic address:

Background: No score is available to assess severity and stratify mortality risk in ventilator-associated pneumonia (VAP). Our objective was to develop a severity assessment tool for VAP patients.

Methods: A prospective, observational, cohort study was performed including 441 patients with VAP in three multidisciplinary ICUs. Multivariate logistic regression was performed to identify variables independently associated with ICU mortality. Results were converted into a four-variable score based on the PIRO (predisposition, insult, response, organ dysfunction) concept for ICU mortality risk stratification in VAP patients.

Results: Comorbidities (COPD, immunocompromise, heart failure, cirrhosis, or chronic renal failure); bacteremia; systolic BP < 90 mm Hg; and ARDS. A simple, four-variable VAP PIRO score was obtained at VAP onset. Mortality varied significantly according to VAP PIRO score (p < 0.001). On the basis of observed mortality for each VAP PIRO score, patients were stratified into three levels of risk: (1) mild, 0 to 1 points; (2) high, 2 points; (3) very high, 3 to 4 points. VAP PIRO score was associated with higher risk of death in Cox regression analysis in the high-risk group (hazard ratio, 2.14; 95% confidence interval [CI], 1.19 to 3.86) and the very-high-risk group (hazard ratio, 4.63; 95% confidence interval, 2.68 to 7.99). Moreover, medical resource use after VAP diagnosis was higher in high-risk and very-high-risk levels compared to patients at mild risk, evaluated using length of ICU stay (mean +/- SD, 22.0 +/- 10.6 d vs 18.7 +/- 12.8 d, p < 0.05) and duration of mechanical ventilation (18.3 +/- 10.1 d vs 15.1 +/- 11.5 d, p < 0.05).

Conclusions: VAP PIRO score is a simple, practical clinical tool for predicting ICU mortality and health-care resources use that is likely to assist clinicians in determining VAP severity.
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http://dx.doi.org/10.1378/chest.08-1106DOI Listing
December 2008
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