javier lópez | Universidad Veracruzana (original) (raw)
Papers by javier lópez
European heart journal, 2007
Aims There is no agreement in the best cutoff time to distinguish between early-and late-onset pr... more Aims There is no agreement in the best cutoff time to distinguish between early-and late-onset prosthetic valve endocarditis (PVE). Our objectives are to define early-onset PVE according to the microbiological spectrum and to analyse the profile and short-term prognosis of this entity.
The American journal of medicine, 2007
The prognosis of patients with left-sided endocarditis remains poor despite the progress of surgi... more The prognosis of patients with left-sided endocarditis remains poor despite the progress of surgical techniques. Identification of high-risk patients within the first days after admission to the hospital would permit a more aggressive therapeutic approach. METHODS: We designed a prospective multicenter study to find out the clinical, microbiologic, and echocardiographic characteristics available within 72 hours of admission that might define the profile of high-risk patients. Of 444 episodes, 317 left-sided endocarditis cases were included and 76 variables were assessed. Events were surgery in the active phase of the disease and in-hospital death. A stepwise logistic regression analysis was undertaken to determine variables predictive of events.
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2009
Revista española de cardiología, 2010
In many cardiovascular and infectious diseases, there are clinical and prognostic differences bet... more In many cardiovascular and infectious diseases, there are clinical and prognostic differences between men and women. The aim of this study was to compare the presentation of left-sided infective endocarditis in the two sexes. A total of 621 episodes of left-sided infective endocarditis (395 in men, 226 in women) were studied. The comparative analysis considered epidemiological, clinical, microbiological, echocardiographic and prognostic variables. Despite marked epidemiological, echocardiographic and microbiological differences between men and women, clinical characteristics, treatment approaches and outcomes (in-hospital mortality: 28% in men and 35% in women; P=.1) were similar in our patient series.
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2006
We evaluated the occurrence of severe infections in 192 consecutive adult recipients of volunteer... more We evaluated the occurrence of severe infections in 192 consecutive adult recipients of volunteer unrelated donor allogeneic hematopoietic stem cell transplants, with a detailed analysis of severe infections after receipt of cord blood transplants (CBTs; n ؍ 48) or bone marrow transplants (BMTs)/peripheral blood stem cell transplants (PBSCTs; n ؍ 144). At a 3-year median follow-up, CBT recipients had a higher risk of developing any severe infection (85% versus 69% in BMT/PBSCT recipients, P < .01). CBT recipients had a higher incidence of severe bacterial infections before day ؉100, but at 3 years the risks of these and other infections were similar in the CBT and BMT/PBSCT groups. In addition, the 100-day and 3-year incidences of infection-related mortality (IRM) did not differ between groups (P ؍ .2 and .5, respectively). In multivariate analysis, the most significant risk factor for IRM in all 192 patients was monocytopenia (.2 ؋ 10 9 /L). In CBT recipients, only neutropenia (.2 ؋ 10 9 /L) on day ؉30 and low nucleated cell dose infusion (<2 ؋ 10 7 /kg) showed a trend for increased IRM (P ؍ .05 in both cases). Stem cell source had no effect on day ؉100 or 3-year nonrelapse mortality (NRM), cytomegalovirus infection, cytomegalovirus disease (7% versus 6%), or overall survival (36% versus 39%, respectively). The number of mismatches in HLA (A, B, and DRB1) had no effect on any outcome in CBT recipients. In contrast, in the BMT/PBSCT group, the presence of any mismatch by low or high-resolution HLA typing (A, B, C, and DRB1) increased NRM and decreased overall survival (P < .01). IRM was the primary or secondary cause of death in 61% and 59% of CBT and BMT/PBSCT recipients who died, respectively. Our results confirm the relevance of severe infectious complications as source of severe morbidity and NRM after volunteer unrelated donor hematopoietic stem cell transplantation in adults, but suggest that CBT recipients have a similar risk of dying from an infection if an accurate selection of a cord blood unit is done. ) .05 for BMT vs CBT and PBSCT Follow-up (mo) in survivors, median (range) 48 (31-95) 53 (21-95) 38 (16-62) .05 for BMT and CBT vs PBSCT 3-Year NRM, % cumulative incidence (95% CI) 48 (23-59) 42 (33-51) 38 (12-51) .3 3-year OS, % probability (95% CI) 36 (26-44) 40 (31-49) 38 (24-52) .7 GVHD and hematopoietic recovery GVHD, n (% cumulative incidence) Grades 2-4/3-4 aGVHD 35 (45)/14 (18) 68 (41)/27 (22) 12 (40)/8 (29) >.1/.1 Extensive cGVHD, n (% cumulative incidence) 6 (9) 23 (16) 4 (15) .1 Hematologic recovery, ؋ 10 9 /L, median (range) Day to stable neutrophil engraftment (>0.5)# 22 (13-52) 19 (10-31) 16 (11-23) Detailed below § Patients with <.5 neutrophils at day ؉30 4 (8) 1 (1) 0 Day to platelets >20# 67 (10-230) 21 (5-138) 12 (9-38) Day to monocytes >0.2 27 (13-66) 19 (10-366) 17 (10-23) Day to lymphocytes >0.2 41 (12-69) 23 (4-399) 17 (7-41) Day to lymphocytes >0.5 49 (26-147) 36 (8-269) 24 (8-51)
CCNC IEEE Consumer Communications and Networking Conference, 2006
Computer, 2000
ABSTRACT Despite successive attempts to protect critical infrastructures against incidents and ma... more ABSTRACT Despite successive attempts to protect critical infrastructures against incidents and malicious threats by using traditional situational awareness solutions, the complex and critical nature of these infrastructures makes this adaptation difficult. For this reason, experts are reconsidering the topic of Wide-Area Situational Awareness (WASA) to provide monitoring of performance at all times from anywhere while ensuring dynamic prevention and response services. Given the novelty of this new research field, a WASA methodological framework together with a set of requirements for awareness construction are presented in this paper in order to help in the development and commissioning of future WASA defense solutions.
Computer, 2000
In the Internet of Things vision, every physical object has a virtual component that can produce ... more In the Internet of Things vision, every physical object has a virtual component that can produce and consume services. Such extreme interconnection will bring unprecedented convenience and economy, but it will also require novel approaches to ensure its safe and ethical use.
Abstract: Virtual Private Network (VPN) solutions mainly focus on security aspects. However, when... more Abstract: Virtual Private Network (VPN) solutions mainly focus on security aspects. However, when security is considered the unique problem, some collateral ones arise. VPN users suffer from restrictions in their access to the network. They are not free to use traditional Internet services such as electronic mail exchange and audio/video conference with non-VPN users, and to access Web and Ftp servers external to the organization. In this paper we present a new solution, located at the TCP/IP transport layer and oriented to UDP ...
Nuevas tendencias en gestión de redes, Novática, Dec 1, 2008
En el momento que se introduce en el mercado nuevas tecnologías basadas en entornos distribuidos ... more En el momento que se introduce en el mercado nuevas tecnologías basadas en entornos distribuidos comienzan a surgir en paralelo nuevos problemas de seguridad en los sistemas SCADA (Supervisory Control and Data Acquisition), los cuales monitorizan y gestionan otras infraestructuras de gran complejidad y escala. Un fallo o una interrupción en uno de sus componentes podría suponer un impacto negativo sobre la funcionalidad de otras infraestructuras, por lo que se hace necesario realizar frecuentes análisis de seguridad para así mantener actualizado el conocimiento y proveer recomendaciones y/o soluciones para mitigar o evitar futuras ocurrencias, garantizando una gestión de red fiable y siempre disponible.
International Journal of Mineral Processing, 2011
European heart journal, 2007
Aims Surgery in patients with infective endocarditis (IE) can be elective (upon completion of ant... more Aims Surgery in patients with infective endocarditis (IE) can be elective (upon completion of antibiotic treatment) or urgent (before antibiotic treatment has ended) when the clinical course is unfavourable. However, urgent surgery for left-sided endocarditis is associated with high mortality. The aims of this study were to describe the profile of patients with left-sided endocarditis who underwent urgent surgery and to analyse the factors that predicted mortality. Methods and results Among 508 consecutive episodes of IE, 391 were left-sided and 89 required urgent surgery. The main reasons for urgent surgery were heart failure that did not respond to medication (72%) and persistent infection despite appropriate antibiotic treatment (31%). Thirty-two patients (36%) died during their hospital stay. Univariate analysis identified renal failure, septic shock, Gram-negative bacteria, persistent infection, and surgery for persistent infection as factors associated with mortality. Multivariate analysis confirmed only persistent infection and renal insufficiency as factors independently associated with a poor prognosis. Conclusion Patients with IE who need urgent surgery have a poor clinical course. Heart failure, the main cause of urgent surgery, was not associated with higher mortality. However, persistent infection and renal failure were factors associated with higher post-surgical mortality.
Revista española de cardiología (English ed.), 2012
European heart journal, 2007
Aims There is no agreement in the best cutoff time to distinguish between early-and late-onset pr... more Aims There is no agreement in the best cutoff time to distinguish between early-and late-onset prosthetic valve endocarditis (PVE). Our objectives are to define early-onset PVE according to the microbiological spectrum and to analyse the profile and short-term prognosis of this entity.
The American journal of medicine, 2007
The prognosis of patients with left-sided endocarditis remains poor despite the progress of surgi... more The prognosis of patients with left-sided endocarditis remains poor despite the progress of surgical techniques. Identification of high-risk patients within the first days after admission to the hospital would permit a more aggressive therapeutic approach. METHODS: We designed a prospective multicenter study to find out the clinical, microbiologic, and echocardiographic characteristics available within 72 hours of admission that might define the profile of high-risk patients. Of 444 episodes, 317 left-sided endocarditis cases were included and 76 variables were assessed. Events were surgery in the active phase of the disease and in-hospital death. A stepwise logistic regression analysis was undertaken to determine variables predictive of events.
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2009
Revista española de cardiología, 2010
In many cardiovascular and infectious diseases, there are clinical and prognostic differences bet... more In many cardiovascular and infectious diseases, there are clinical and prognostic differences between men and women. The aim of this study was to compare the presentation of left-sided infective endocarditis in the two sexes. A total of 621 episodes of left-sided infective endocarditis (395 in men, 226 in women) were studied. The comparative analysis considered epidemiological, clinical, microbiological, echocardiographic and prognostic variables. Despite marked epidemiological, echocardiographic and microbiological differences between men and women, clinical characteristics, treatment approaches and outcomes (in-hospital mortality: 28% in men and 35% in women; P=.1) were similar in our patient series.
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2006
We evaluated the occurrence of severe infections in 192 consecutive adult recipients of volunteer... more We evaluated the occurrence of severe infections in 192 consecutive adult recipients of volunteer unrelated donor allogeneic hematopoietic stem cell transplants, with a detailed analysis of severe infections after receipt of cord blood transplants (CBTs; n ؍ 48) or bone marrow transplants (BMTs)/peripheral blood stem cell transplants (PBSCTs; n ؍ 144). At a 3-year median follow-up, CBT recipients had a higher risk of developing any severe infection (85% versus 69% in BMT/PBSCT recipients, P < .01). CBT recipients had a higher incidence of severe bacterial infections before day ؉100, but at 3 years the risks of these and other infections were similar in the CBT and BMT/PBSCT groups. In addition, the 100-day and 3-year incidences of infection-related mortality (IRM) did not differ between groups (P ؍ .2 and .5, respectively). In multivariate analysis, the most significant risk factor for IRM in all 192 patients was monocytopenia (.2 ؋ 10 9 /L). In CBT recipients, only neutropenia (.2 ؋ 10 9 /L) on day ؉30 and low nucleated cell dose infusion (<2 ؋ 10 7 /kg) showed a trend for increased IRM (P ؍ .05 in both cases). Stem cell source had no effect on day ؉100 or 3-year nonrelapse mortality (NRM), cytomegalovirus infection, cytomegalovirus disease (7% versus 6%), or overall survival (36% versus 39%, respectively). The number of mismatches in HLA (A, B, and DRB1) had no effect on any outcome in CBT recipients. In contrast, in the BMT/PBSCT group, the presence of any mismatch by low or high-resolution HLA typing (A, B, C, and DRB1) increased NRM and decreased overall survival (P < .01). IRM was the primary or secondary cause of death in 61% and 59% of CBT and BMT/PBSCT recipients who died, respectively. Our results confirm the relevance of severe infectious complications as source of severe morbidity and NRM after volunteer unrelated donor hematopoietic stem cell transplantation in adults, but suggest that CBT recipients have a similar risk of dying from an infection if an accurate selection of a cord blood unit is done. ) .05 for BMT vs CBT and PBSCT Follow-up (mo) in survivors, median (range) 48 (31-95) 53 (21-95) 38 (16-62) .05 for BMT and CBT vs PBSCT 3-Year NRM, % cumulative incidence (95% CI) 48 (23-59) 42 (33-51) 38 (12-51) .3 3-year OS, % probability (95% CI) 36 (26-44) 40 (31-49) 38 (24-52) .7 GVHD and hematopoietic recovery GVHD, n (% cumulative incidence) Grades 2-4/3-4 aGVHD 35 (45)/14 (18) 68 (41)/27 (22) 12 (40)/8 (29) >.1/.1 Extensive cGVHD, n (% cumulative incidence) 6 (9) 23 (16) 4 (15) .1 Hematologic recovery, ؋ 10 9 /L, median (range) Day to stable neutrophil engraftment (>0.5)# 22 (13-52) 19 (10-31) 16 (11-23) Detailed below § Patients with <.5 neutrophils at day ؉30 4 (8) 1 (1) 0 Day to platelets >20# 67 (10-230) 21 (5-138) 12 (9-38) Day to monocytes >0.2 27 (13-66) 19 (10-366) 17 (10-23) Day to lymphocytes >0.2 41 (12-69) 23 (4-399) 17 (7-41) Day to lymphocytes >0.5 49 (26-147) 36 (8-269) 24 (8-51)
CCNC IEEE Consumer Communications and Networking Conference, 2006
Computer, 2000
ABSTRACT Despite successive attempts to protect critical infrastructures against incidents and ma... more ABSTRACT Despite successive attempts to protect critical infrastructures against incidents and malicious threats by using traditional situational awareness solutions, the complex and critical nature of these infrastructures makes this adaptation difficult. For this reason, experts are reconsidering the topic of Wide-Area Situational Awareness (WASA) to provide monitoring of performance at all times from anywhere while ensuring dynamic prevention and response services. Given the novelty of this new research field, a WASA methodological framework together with a set of requirements for awareness construction are presented in this paper in order to help in the development and commissioning of future WASA defense solutions.
Computer, 2000
In the Internet of Things vision, every physical object has a virtual component that can produce ... more In the Internet of Things vision, every physical object has a virtual component that can produce and consume services. Such extreme interconnection will bring unprecedented convenience and economy, but it will also require novel approaches to ensure its safe and ethical use.
Abstract: Virtual Private Network (VPN) solutions mainly focus on security aspects. However, when... more Abstract: Virtual Private Network (VPN) solutions mainly focus on security aspects. However, when security is considered the unique problem, some collateral ones arise. VPN users suffer from restrictions in their access to the network. They are not free to use traditional Internet services such as electronic mail exchange and audio/video conference with non-VPN users, and to access Web and Ftp servers external to the organization. In this paper we present a new solution, located at the TCP/IP transport layer and oriented to UDP ...
Nuevas tendencias en gestión de redes, Novática, Dec 1, 2008
En el momento que se introduce en el mercado nuevas tecnologías basadas en entornos distribuidos ... more En el momento que se introduce en el mercado nuevas tecnologías basadas en entornos distribuidos comienzan a surgir en paralelo nuevos problemas de seguridad en los sistemas SCADA (Supervisory Control and Data Acquisition), los cuales monitorizan y gestionan otras infraestructuras de gran complejidad y escala. Un fallo o una interrupción en uno de sus componentes podría suponer un impacto negativo sobre la funcionalidad de otras infraestructuras, por lo que se hace necesario realizar frecuentes análisis de seguridad para así mantener actualizado el conocimiento y proveer recomendaciones y/o soluciones para mitigar o evitar futuras ocurrencias, garantizando una gestión de red fiable y siempre disponible.
International Journal of Mineral Processing, 2011
European heart journal, 2007
Aims Surgery in patients with infective endocarditis (IE) can be elective (upon completion of ant... more Aims Surgery in patients with infective endocarditis (IE) can be elective (upon completion of antibiotic treatment) or urgent (before antibiotic treatment has ended) when the clinical course is unfavourable. However, urgent surgery for left-sided endocarditis is associated with high mortality. The aims of this study were to describe the profile of patients with left-sided endocarditis who underwent urgent surgery and to analyse the factors that predicted mortality. Methods and results Among 508 consecutive episodes of IE, 391 were left-sided and 89 required urgent surgery. The main reasons for urgent surgery were heart failure that did not respond to medication (72%) and persistent infection despite appropriate antibiotic treatment (31%). Thirty-two patients (36%) died during their hospital stay. Univariate analysis identified renal failure, septic shock, Gram-negative bacteria, persistent infection, and surgery for persistent infection as factors associated with mortality. Multivariate analysis confirmed only persistent infection and renal insufficiency as factors independently associated with a poor prognosis. Conclusion Patients with IE who need urgent surgery have a poor clinical course. Heart failure, the main cause of urgent surgery, was not associated with higher mortality. However, persistent infection and renal failure were factors associated with higher post-surgical mortality.
Revista española de cardiología (English ed.), 2012